Written by Christopher Kelly
Aug. 4, 2014
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Christopher: Hello and welcome to the Nourish Balance Thrive podcast. Today, I'm joined by author, blogger, ketosis expert Jimmy Moore. Thanks for coming on, Jimmy.
Jimmy: Hey, Christopher. Thanks for having me.
Christopher: Thank you. Now, I'm going to resist the temptation to ask you to tell your story because it is an amazing story, but it's also the reason you started writing. So if anyone would like to know more about how Jimmy was able to permanently lose 180 pounds whilst feeling great and getting off prescription meds for high cholesterol, high blood pressure and breathing problems, then I encourage you to head over to his site Livinlavidalowcarb.com.
Am I right in thinking that now? Is that your weight losses now, 180 pounds? Is that correct?
Jimmy: Yeah, I lost 180 pounds in 2004. People think you just magically stay there once you've lost weight, and I've been on this journey now for over a decade. I've had my ups and downs. I'm currently at a weight that still has 150 of those pounds off of me.
Christopher: Excellent, but I think it's definitely fair to say that you are a big ketosis expert. I think of you as being a champion of this diet. I'm not sure that many people really knew that much about it before you came on the scene.
Jimmy: Yeah, I'm trying to be. I think the "K" word, as it's often referred to in hushed tones out there in health circles, it's like, "Okay, we can talk about low-fat. We can talk about vegan. We can talk about -- okay, we'll let them talk about cutting sugar and that -- yeah, but don't bring up the 'K' word."
That always perplexed me, Christopher, because the "K" word has so many great health benefits. It seems like all we've ever heard are the negative implications associated with ketosis. So "Keto Clarity" is my credence to all those great health benefits that you and I know that a ketogenic diet can provide people.
Christopher: Excellent, yes. So before we jump in any further, I think it'd be very useful if you could define what ketosis is. What is a ketogenic diet?
Jimmy: Yeah, great question, and we hit that one head-on in Chapter One: "What is ketosis and why do you want it?" So ketosis, to bring it down to the brass tacks, the bare knuckles, in layman's terms, what it means is shifting your body to burning fat.
Now, people are like, "Well, doesn't that happen when you lose weight? You're burning fat?" Yeah, you're burning fat, but you're also burning whatever you're fueling yourself with. So most people walking around out there, probably 99% of the world's population are what's considered sugar burners or glucose burners, so they're using carbohydrates as their main source of energy.
We often hear from dieticians. They say, "Oh, you have to eat carbohydrates because that's your energy source," and while that's true of your sugar burner, there is an alternative perspective, and that's where ketogenic diets come into play and where you're trying to get into this state of ketosis. So you're shifting from being a sugar burner, mostly glucose, to now being a fatty acid and ketone burner.
And how do you do that? Well, there's a three-legged stool that I like for people to think about. A lot of people think, "Well, just cut your carbs and that's ketogenic." Uh-uh. If it was that easy, everybody could do it and would be enjoying the benefits of it.
So really, there are three things. The first thing is keeping your carbohydrates to your personal tolerance level, and we talk about in the book how you do that. You've got to figure out what your tolerance level is through a glucometer.
A really cool one, Christopher, is looking at your triglycerides on your cholesterol panel. If they're under a hundred, you're doing great in binding your carb tolerance, but if they're over a hundred, you might want to back off on the carbs. Then once they're under a hundred, you found that perfect level of tolerance. So that's the first part.
The second part is moderating down your protein intake. People are like, "Well, wait a minute. I thought a low-carb diet was a high-protein diet." Well, really, it never has been. It's always been a moderate-protein diet. It's a high-fat diet, which we'll talk about here in a second, but moderating down protein is so critical. A lot of people don't realize this but protein gets converted into glucose through the liver because of this long "G" word we talk about in the book. It's called "gluconeogenesis."
Now, don't let that "G" word scare you. All it means is making glucose sugar out of the excess protein that you're consuming. So if you're eating chicken breast and you think, "That's pretty healthy, right?" Well, not if your goal is to get into ketosis because excess protein is producing excess glucose, and that glucose is going to kill all the ketones that you would want to build, so moderating down that protein with the low carbs.
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So we talk about in the book finding your protein threshold. So you've got a carb tolerance level and a protein threshold level. Incidentally, my carb tolerance is right at 30 grams. I can eat about 30 grams of carbs, total carbs. I don't count the net carbs. That's a scam. Please run far away from the net carbs and -- what were they called? "Effective carb." I've heard all kinds of marketing terms, but total carbohydrates is what I'm talking about here. So 30 grams of that, about 80 to 100 grams of protein -- it depends on -- if I'm exercising that day, I'll probably do a little more protein, but for the most part between 80 to 100 grams.
Then the third leg in that stool is dietary fat, and this is the one that freaks people out. They're like, "What do you mean I eat more fat? Doesn't that clog your arteries and lead to heart disease or raise your cholesterol?" So we address that in my last book "Cholesterol Clarity" so please go check out that book if you're concerned about that, but once you understand and have a purpose in mind that you want to get into ketosis, you probably have to start eating more fat than you ever have thought about in your life.
For me personally, it's probably, Christopher, about 80% to 85% of my nutritional intake is from dietary fat, and when I say fat, I'm not talking about vegetable oils. I'm talking about real, food-based saturated -- which is like coconut oil, butter, full-fat meats and cheeses, cream, those kinds of things, and then monounsaturated fats, things like avocados, avocado oil, macadamia nut oil, olive oil, those kinds of things. So that's what it takes to get into ketosis and when you do that, you will shift from being that sugar burner into a state of ketosis which makes you a fat-burning machine.
Christopher: Excellent. That sounds like a very desirable thing. It certainly -- for myself, there were huge benefits. So I was one of those people that was a sugar burner, and just the world is a darker place when you're burning sugar all day long. It really is.
Jimmy: Yeah, go ahead.
Christopher: Sorry. I was going to ask you -- so it's easy to find your glucose tolerance using a glucometer, but what about protein? I mean, I've seen it in myself that it can raise blood glucose, but how are you finding -- it's a question I get asked all the time -- how are you finding the appropriate amount of protein?
Jimmy: Yeah. In Chapter Six, we actually help you determine your personal protein threshold level and it's going to be very similar to your carbohydrate level. You want to make sure you're not over-consuming. So if you got your carbohydrates down to a really good level and you're still seeing elevated blood sugar levels or you're seeing lack of ketone production, it's probably a good idea to start experimenting.
So when I started experimenting with this myself, I think I started off like 120 grams of protein thinking that that would be good, and then I slowly worked it down to 110, 100. Finally, when I hit 80 was when I started seeing those therapeutic levels of ketones on the blood ketone meter that I thought would be necessary.
Now, there's a lot of debate out there. Many have guessed that if you have 1 to 1 1/2 grams per kilo of body weight that that's the right amount. Dr. Ron Rosedale who is one of the experts in my book says that he wants people who want to be in ketosis to consume one gram of protein per kilogram of ideal body weight and then subtract 10%, and that's their formula for figuring it out.
I've actually interviewed a guy on "Ask the Low-Carb Experts," one of my podcasts. He's a protein expert, Dr. Donald Layman, and he suggested that you should limit your protein intake to no more than 30 grams per meal. So those are all good tips.
The problem is, Christopher, there is no one perfect formula that works for everybody. As we say throughout Keto Clarity, you have to test and figure it out for yourself.
Christopher: Yeah, absolutely. It's surprising actually how little protein you actually need, and then -- I mean, I'm sure it's different. I'm not a strength-based athlete. I'm a cyclist so it's much like a time trial, the type of events that I do, mountain bike racing.
It's really surprising. I'm probably about the same as you. I'm a little bit lighter but certainly 80, 90 grams of protein is absolutely plenty for me. Then if I eat more than that, I get into this gluconeogenesis trap that we talked about.
Jimmy: And what's interesting is your body can recycle and reuse a lot of the protein it has in its muscles, bones and tissues. One of the statistics we provided in the book, up to 300 grams of the protein in your body can be recycled every single day. So people think, "Oh, I need to eat protein." Okay, maybe you need to eat a certain amount of protein but it's not the gobs and gobs that we've been told to consume, which is funny now that we have these products out there on the shelf like Cheerios Protein. Have you seen this nonsense on the --
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Christopher: Yeah, I've seen that.
Jimmy: They're putting protein, and ostensibly a really horrible kind of protein, in these products trying to draw into this whole idea that protein is good. Well, don't get me wrong. Protein is an essential amino acid for a reason, but it doesn't mean you need to just stuff yourself with them. Get the right amount of protein with the appropriate amount of carbs for you and then eat fat to satiety, and that's nirvana to get into ketosis.
Christopher: Yeah, and then I should also mention actually that I've seen stress really affects this whole amount of protein that you need, and you talked about protein recycling already and we can actually --
We've been running this test. It's a urine test called the Genova Diagnostics Organix Profile. It's an organic acid urine test and we see elevated sulfur on these tests in people that are stressed out. So their body has entered into this catabolic physiology where they're actually breaking down their own lean muscle mass for use in this gluconeogenesis process. They're actually, "Let's just get the heck out of here. Let's get out of the jaws of this tiger and survive the day and worry about producing something useful like hormones or neurotransmitters or muscle tissue tomorrow."
But of course, in today's modern society, the stress, it never goes away. So it's definitely something you have to watch out for too, I think, when you're worried about gluconeogenesis.
Jimmy: Right.
Christopher: We have lots of different types of people that come to us for doing lab tests to try and figure out their problems, and usually they're just looking for that last 10% or 15%. Nearly all of them know about high-fat diets or ketosis or actually trying to achieve ketosis as a goal. But I wonder, for those people, they obviously know something, what they're likely to get from your book. So I just wanted to run through --
So really common is a post-menopausal woman that's been eating on an Atkins-style diet forever, right? She had amazing results initially with the Atkins diet maybe ten, 20 years ago or something, and now she's hit a plateau and isn't really losing weight anymore. And quite often, when you get someone like that to measure the blood ketones, they're quite unspectacular, like maybe just borderline, nought point five, nought point four, something like that. So what would that type of person have to learn from the book?
Jimmy: Well, hopefully they learn the mistakes that they're making. I was making a lot of those mistakes. I started eating low-carb, Atkins-style low-carb in January 2004 and I started experiencing weight regain and some other issues with little quality of health issues. Sleep became hindered.
So what I've discovered was -- you know what? That protein issue is probably the big one, Christopher, because there are people out there, "Well, a chicken breast is completely low in carbs, almost devoid of all carbs, and it's got protein so it must be good, right?"
So what happens is people are having a green salad and they're putting these chicken breasts on top, and maybe some olive oil dressing or something. That's not a lot of fat, and so what's happening is their body is taking in these carbohydrates from the green leafies, which is totally fine, and is taking in the fat from the olive-oil-based dressing and that's totally fine, but it's getting an overabundance of the protein. So what we just talked about a second ago, gluconeogenesis kicks in and that's why the ketone levels are low.
I would say if that client probably cut their protein level down -- I don't know how many grams they're eating now, but let's just assume they're eating a chicken breast -- instead of having a chicken breast, have a fatty cut of beef instead. Shift over to those better fatty meats rather than the lean meats and I would not be surprised to see those blood ketone levels go up in very short order.
Simultaneously, if they're having blood sugar issues, which I'll assume if their blood ketones are low, they probably are having some blood sugar issues, that will normalize as well. So that's a huge mistake that's oftentimes made. Another one that's made is not eating enough calories.
So again, we live in this fat-phobic society that tells us, "Well, if low carb is good, low carb/low fat must be better." Uh-uh. You've got to eat that fat, and one of the big reasons you've got to eat the fat is it gets your calories to an adequate level. You don't want your body to be screaming at you that it's hungry and it's hungry for fat.
So that's a big mistake that happens as well and I'd say to your client like that, "Definitely make sure you're consuming adequate enough calories." We've had this hammered, "Lower your fat. Lower your calories. If you want to be healthy, you've got to do this thing," and we've got to transition in our minds -- and hopefully that's what they would learn in Keto Clarity -- transition in your minds there's a new way of looking at these things.
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Christopher: Excellent, yeah. So another sort of person that commonly comes to me is someone like me in my old work, an engineer that's maybe noticing a little bit of creeping weight gain despite the fact that -- maybe they work for a big tech company and that tech company has a fantastic gym on site. They're using it every day but they're still noticing creeping weight gain.
And then difficulty concentrating; if you're an engineer, a programmer or pretty much anyone that spends any time looking at a computer screen, concentration can become difficult, really hard. The browser tabs are the worst invention ever for trying to concentrate. I'm just wondering, do you think then ketosis might be beneficial to someone like that and they'll be able to learn how to do this from the book?
Jimmy: I have often told people that if there were no weight loss benefits to a ketogenic diet -- which there are for a lot of people -- in fact, the only thing -- it's not the magic pill for weight loss so don't get me wrong. If you get into ketosis, I'm not saying that the weight will magically just pour off and you'll have no trouble with your weight. That's really not the point.
If I didn't get any of those kinds of benefits from this and all I got was the brain health improvement benefits from ketosis, I would do it for that reason alone, Christopher, and that's one of the things we really harp on throughout the book is this is not really about weight loss. While that is one of the great benefits of it, the greater benefits are your brain will finally be optimally fueled.
And I know you've experienced this, being out there on the cycle. Yeah, you get this sustained energy, but the mental clarity that comes -- you're talking about those engineers sitting in those jobs -- I mean, you want to have a sharp brain when you're going through all that development process.
So ketones are probably one of the best -- better than any drug we could ever give anybody. These ketones step in because -- people don't realize this but 25% of all the fat in your body, you want to know where it is? It's right up there in that noggin of yours. They call us a "fathead" for a reason and that fat is there for a reason. So if we're not feeding it fat, which is what you're doing on the ketogenic diet, then you're depriving your brain of these basic building blocks for having the best memory, the best mood, the best clarity -- all pun intended -- of mind. All of these things improve.
So if I was somebody that was working in an industry where I needed to have a sharp brain -- I really wish our government people would start eating ketogenic because we need them to have some sharp brains. Unfortunately, they don't. So doing that is what helps improve brain health, and we're talking about all the neurodegenerative diseases that are brought on by a high-sugar diet, a high-carb diet, things like Alzheimer's disease, dementia, Parkinson's disease. All these things are improved when you go on a ketogenic diet.
Christopher: Okay, and then what about -- obviously, our main, our forte, our niche is athletes. They doctor we're partnered with, she's a pro mountain biker -- so am I -- and we're really convinced. But what would I have to learn from Keto Clarity if I've already read the Volek and Phinney book, which I consider to be the definitive text even though it's very short? It's really a complement to the art and science of low-carbohydrate living. So what's changed? Obviously, those books are not brand new anymore. What would I learn as an athlete from your book?
Jimmy: Yeah. I mean, there's a lot of the emerging science that's looking at exercise performance with a ketogenic diet. Unfortunately, most of the book that we talk about, like all these diseases and stuff -- and it's so funny; right smack dab in the middle of all these evidence that we're presenting for diseases, we say, "Exercise performance, okay. It's not a disease we get..."
But we're actually seeing more and more science, and you're right, Volek and Phinney have led the way on this one. In fact, it was Steve Phinney himself, this is how he got involved in ketogenic diets was back in the early '80s, he published a landmark study in the journal "Metabolism." He looked at five elite cyclists.
Originally, that study was only supposed to go about a week long, and after a week, of course, all the cyclists declined in their performance. It was just horrible and he said, "Well, hmm, let's go ahead and go at least another week to see what happens." So they went another week and of course you know what happened. They became keto-adaptive. So once keto-adaptive, their performance returned and they even got better.
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Ben Greenfield who is a triathlete is one of the experts in my book, and we talk all about all these great benefits for athletes. Another expert in there, John Kiefer, he says for athletes it's the only method available for losing body fat while maintaining and increasing your performance, and that's the key. If you want to lean out, you want to increase that exercise performance, you really have to look for ways to do that and ketosis does that for you, and what they'll get out of this is how to get there.
A lot of athletes are still in that mentality of, "Well, I need to carb up." Well, maybe you don't need to carb up, and we show you in the book step by step. If you want to really try ketosis and be serious about it, here's what you do. Here's how you get there.
Christopher: Excellent. That's exactly what I'm looking for. And then I have lots of women. It seems like new moms are really well-educated and they know about this stuff, but it seems like maybe a risky intervention when you just compare it with conventional wisdom. People always ask me about breastfeeding. The fact that my wife Judy is breastfeeding on a ketogenic diet, it doesn't really give that [0:21:34] [Indiscernible]. I mean, that's no evidence at all, right? You've got to conduct your own experiment.
But do people really want to be conducting an experiment whilst breastfeeding? What are your thoughts? Is it safe for a breastfeeding mom and could she learn how to do that safety from your book?
Jimmy: It's always amazing to me that people are scared of the nutritional approach and yet they'll take a prescription medicine and not even think about it. "Oh, that's from a doctor so that has to be good for me." Uh-uh! That's more poisonous than anything you could ever do nutritionally with real food, which is what we're talking about with the ketogenic diet.
To answer your question, one of my experts in Keto Clarity -- and I had 22 total experts plus my co-author Dr. Eric Westman and myself, so 24 total that know what we're talking about when we're talking ketosis, and one of them is a woman named Dr. Mary Newport. She specializes in baby care and she says, "Did you know that within 12 hours of being born" -- and Christopher, you may not know this, but within 12 hours of being born, a baby is already mildly ketotic. That's how they're sustaining energy. So if ketosis was such a dangerous thing for your baby, why is the body -- why did God make that happen where ketones would be in this baby's body at such a crucial part of their life? The early hours of their life, it's there.
So there's not been a whole lot of research unfortunately about this subject so that is what freaks people out, but again we're talking about nutrition here, not a drug. So embrace the nutrition. Realize it's real food. Realize that this process is completely normal. This is not some abnormal state. This is the way the body back in our Paleolithic times -- during times of deprivation, they would have had to sustain themselves on ketones. So those ladies, they didn't worry about, "Oh, should I breastfeed my baby and all I have to eat is eggs and meat? Can I really do that?" Yes, you can.
Christopher: Yeah, absolutely. I think you're right. Yeah, I'll be interested to see. So a good way to measure ketones -- am I right in thinking this? -- there's a new breath analyzer out. I heard another podcast, an engineer talking about this. I wonder how hard you have to blow into one of those devices. I'm just wondering how young a child could be before they could use a device like that to measure ketones.
Jimmy: It definitely would not be for a baby. It needs to be somebody that could really blow because you've got to blow a steady stream for about 15 seconds. I hope you're referring to the Ketonix brand.
Christopher: I think I am, yeah.
Jimmy: Yeah. That's the only one that's commercially available currently. By the way, the ketone body that it's measuring is called acetone, and that acetone correlates very well in the scientific literature with what's called beta-hydroxybutyrate. That's the blood ketone. We do a whole chapter on blood, urine, and breath ketones, but the technology with breath ketones is probably the most exciting part of this whole ketogenic story right now.
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Ketonix is out there right now. There's another company called Invoy Technologies out of Arizona that is currently developing an FDA-approved device that would measure for breath ketones. I'm actually a part of a study with that device. I haven't actually seen the device. They won't let me see it until FDA approves it, but that's really exciting. Then there's some Japanese researchers that have an iPhone app and a little apparatus that can connect to your phone that you can blow right into your smartphone and get a reading there.
So I predict, Christopher, in Keto Clarity that by the year 2016, we'll probably be seeing some of these breath ketone meters available for purchase on store shelves.
Christopher: That's awesome. Yes, the Ketonix meter is available on Amazon now. I know because I just bought one. It's not going to be delivered as fast as you might be used to with some things in Amazon but --
Jimmy: So there's two versions, by the way. If you get the standard version, it's for somebody that's really never done ketosis before and it basically shows lower levels of ketosis. So it changes four total colors. The red color is the biggest and on that standard one, it's right around the same as 1.0 millimolar on a blood ketone meter, which is pretty good for people starting off. But if you want to get a little hardcore, if you're Christopher Kelly and Jimmy Moore, you might want to try -- and I hope you got this one --
Christopher: Yeah, I did. I jumpstarted with the Sport.
Jimmy: -- got the Ketonix Sport. So it measures for higher levels of ketosis and you have to be pretty heavy-duty in ketosis to make that one change to yellow or red.
Christopher: Right, yeah. Exactly. And then, say, the last scenario that I had is for the endurance athletes, there are very clear advantages of the ketogenic diet, but if I'm a strength person -- so we're working with an Olympic swimmer, Roland Schoeman, who just won silver at the Commonwealth Games. He tried this. He actually talked to Professor Tim Noakes and tried the high-fat diet. It didn't really work for him, and do you think that will be true of anyone looking to put on lean muscle mass? Can I still be a strength athlete on a high-fat diet?
Jimmy: I think this is one of those things you're going to have to test and see. During my experiment with nutritional ketosis back in 2012/2013, I actually did a DXA scan right in the midst of doing this and then purposely lifted in a fasted state, in a ketogenic state eating a diet of 85/12/3 fat/protein/carbohydrate just to see could I put on muscle at the same time as being ketogenic and have all the strength and all that?
In two months after starting that, in just this little short period of time, I did another DXA scan and lo and behold! I put on six pounds of muscle on my body. I was able to burn about 16 pounds of body fat for a net -- it was right around ten pounds lost on the scale but it was six pounds of weight gain from muscle and 16 pounds of body fat loss.
You often hear, "Well, you can't both burn body fat and build lean muscle mass at the same time." Yeah, you can. I showed you could do it. But for this elite level of body builders, what I hear you saying, perhaps cycling in and out of carbs might be a beneficial thing for them. I'm not a big fan of that personally for me, but of course, I'm not a bodybuilder either.
So I think it's one of those things you have to tinker around with but I think on non-training days, being ketogenic is probably a great idea, and on training days maybe half of a sweet potato post-workout to give you that little bit of an insulin bump to build muscle. I'm all about helping people find what works for them, and sometimes what works for one person isn't going to work for another. So give it a go and see what happens.
Christopher: Yeah, I think that's a great idea. And then I wanted to talk to you a bit about some of the commonly held beliefs and drawbacks of ketogenic diets.
Jimmy: Bring it.
Christopher: Yeah. So I'll be honest with you. I see it batted about in this Paleo community all the time and I've seen none of it in our testing. So we've done lots of saliva testing on people and it's a 4-point cortisol test, and I nearly almost see -- I can literally count on the fingers of one hand out of a hundred tests how many people I've seen with high cortisol, and yet nearly everybody that we're talking to is eating high-fat diet, but people say that ketogenic --
When I say say, I have actually seen a study. I think it was people suffering from arthritis that were put on a ketogenic diet like an autoimmune disease and it mildly elevated cortisol. So have you seen any research? Do you think that's the true statement, that ketosis is stressful or elevates cortisol in some way?
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Jimmy: They'd certainly say that, don't they? So the cortisol question, the hypothyroid is -- the adrenal fatigue, I've heard all these negative stigmas. In Keto Clarity, I ask all the practitioners, every single one of them, "Do you see this in clinical practice with your patients?" because if this such a widespread, commonly believed -- things are happening because of the ketogenic diet, surely it's showing up in clinical practice. But guess what, Christopher? No, it's not. Not one single one said that this is something they normally see in their clinic.
One of my experts, Nora Gedgaudas, actually took on this whole cortisol issue. One of her quotes was, "Chronic lack of sleep leading to circadian rhythm imbalances and/or chronic levels of significant stress will drive up those cortisol levels in a way that can make getting into a state of ketosis essentially impossible." So I would push back on these people that say ketosis increases the stress levels and the cortisol levels because if that was happening, guess what would happen to the ketones? They would go away because the stress will undo all the good that you've done in your diet.
So no, I am probably one of the least stressed people you'll meet. I just don't get stressed and I'm probably more ketogenic than most people you'll meet as well. I call foul on this one. It just doesn't make any sense at all.
Christopher: It's certainly not been what we've seen with testing either, and I think there's a danger there sometimes when a paper gets out there. It just gets communicated. That information or that statement gets communicated as a true fact to many people very quickly, whereas the [0:32:03] [Indiscernible] experiments that people would do where they find that statement to be false, that happens very slowly and that information gets disseminated very slowly, and so this statement persists.
Jimmy: And a lot of times you get the echo chamber going on. So one person writes something about that on their blog and then somebody says, "Well, did you hear that ketogenic diets do this? Oh, wow! Did you hear..." So it just takes on a life of its own.
Unfortunately, that's what's happened with the cortisol one, the hypothyroidism one. I've seen one about "leads to dry eyes and dry mucus" and all this kind of stuff and it's, "Really? That's the best we've got?" Unfortunately, what's really sad about all this, Christopher, is it's turning some people off from trying a ketogenic diet who very well need to be on a ketogenic diet.
Christopher: Well, that was the next thing I was going to ask you specifically about was the thyroid's connection. I think technically what's going on here is if you lower insulin to a point, insulin does other things other than just store glucose. My understanding is that it is required to do some of the conversion of thyroid hormones. It's possible to be in a hypothyroid state if you stay ketogenic for too long, but again this is another one of those things where I've tracked this stuff coming from a fairly poor digestive health background. I was hypothyroid. My thyroid function has improved, but do you know -- did any of your experts have anything to say about this specifically? Was there any --
Jimmy: Oh, yeah. This is one I slammed them right between the eyeballs with because I was like, "I'm tired of hearing this," and it's a lot from the Paleo community throwing out there like we were just referring to -- one person says this and then it gets the echo chamber.
All the studies that the people that support this idea have cited, all of them, yes, they were ketogenic or at least low-carb, but every single one of them was also hypocaloric. So we're talking about a low-calorie perspective here and if you're eating a truly well-formulated low-carb, ketogenic diet that's moderated in protein and high in fat, it's going to give you plenty of calories -- and you're listening to your satiety signals -- it's going to give you plenty of calories to ward off these thyroid issues.
Now, I'm not saying thyroid issues don't manifest themselves in people who go on a ketogenic diet, but one of my experts actually said, "You know what? Part of that is probably people who start a ketogenic diet were already pretty well on their way to hypothyroidism anyway and it just happened to be that when they went ketogenic, those symptoms started to manifest themselves."
So do we blame the diet? I don't think so. I mean, I think if that person came in that way, then that's the same, but make sure you're eating adequate calories when you're doing a ketogenic diet, and the way you do that is you eat more fat.
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Here's another point I think is too important not to share. Perhaps the people that are doing these tests and we see normal ranges, perhaps those are normal ranges for people that are sugar burners. Maybe a ketogenic dieter has lower levels of what would be considered normal because, like you said, insulin plays a role in that conversion. Maybe you don't need to have the thyroid work as hard as you would if you were a sugar burner.
Christopher: That's an interesting idea.
Jimmy: Yeah.
Christopher: And then I think there's often a case of mistaken causality here. People make this large intervention into their life like changing their diet in a radical way and then something good or bad happens which may or may not be related to the intervention they've made, and then, of course, the first thing they do is attribute it. I always make the joke that I broke my wrist after I started eating a ketogenic diet, right? So that changes --
Jimmy: So obviously, a ketogenic diet leads to broken wrists.
Christopher: Yeah, exactly. Yes, it's just stupid. Then I see the same thing with -- resistant starch is my favorite one at the moment. You see people add this thing into their diet and then something happens and they're like, "Well, it must be the resistant starch. This is the best thing..." Never mind the other 17 variables that you also change at the same time.
So the other thing that I saw, actually, specifically in the blurb for your book was that a ketogenic diet could be used for treating non-alcoholic fatty liver disease, but there's also some rodent studies that show that it actually causes non-alcoholic fatty liver disease. So I wondered whether you knew anything about that.
Jimmy: Yeah, it makes me glad I'm not a mouse, and mouse study -- I'm sorry, I had to say that -- in Chapter 16 of Keto Clarity, at the very beginning, before we get into -- well, we have really strong evidence -- 4, 17 we have the good evidence and 18 we have the emerging evidence, but 16, at the very beginning we help people understand how to read research studies.
My co-author, Dr. Eric Westman, he actually is a researcher. He's been doing research for well over a decade now. So when research papers come out, the media goes all crazy over all research papers, treats them exactly the same whether they're mouse studies, whether they're epidemiological studies where they're just looking at data from a whole bunch of old studies and making new data out of it. Very few of them are randomized, controlled clinical trials and that's the gold standard. That's really the only one that we can really say anything of substance about.
So with non-alcoholic fatty liver disease, yeah, you probably are going to have some mouse studies that will show that there's something wrong with eating low-carb, high-fat. But there are equal studies that are out there of actual people that have been put on a ketogenic diet. One of them, September 2006, ten volunteers lost fat in their liver after following a low-carb diet for ten days.
Another study in February 2007 that incidentally Dr. Westman was a part of put five patients with non-alcoholic fatty liver disease, all put on a low-carb, high-fat ketogenic diet for six months. The four people who followed all the instructions exactly showed significant weight loss and improved and completely resolved their fatty liver. So I say take your mouse study that says it causes it and I'll raise you my human studies that say I see reversal happening.
Christopher: Right. Yeah, I think it's just one of those things where it shows how careful you have to be with the research.
Jimmy: Yes, exactly, and we help you do that in Keto Clarity. We give you all the little things to look for, what makes for a good study, what makes for a cruddy study -- oh, that rhymes, "cruddy study," I need to use that again -- and how you as a consumer of all this have to stop reading the health headlines and start looking into the studies themselves. When you do that, you'll find that nutritional research has got a whole lot of corruption in it.
Christopher: Yeah, I see, yes. So I had a wonderful example the other day, actually. My uncle is a professor of pharmacology and he sent me this paper and it was a meta-study of several other studies that looked at probiotics for lowering blood pressure. So they just did some statistical manipulation and they showed this tiny, tiny decrease in blood pressure from administrating probiotics, and then I think the gain only came if there were lots and lots of different varieties, which sort of makes sense, too.
[0:40:00]
But then when you looked at the amount that the blood pressure had actually decreased, this was not significant from a physiological standpoint. This was just like noise. The reduction in blood pressure was so small, and yet still, technically the statement is true that probiotics lower blood pressure, which might be desirable for a lot of people out there.
When you look at that like that, if someone is looking at the research, you would just write it off in an instant. But then, sure enough, two days later I get an email from ConsumerLabs and there's the headline "Probiotics Lower Blood Pressure," and of course, from that point to all eternity it becomes a statement as true fact, which is really dangerous.
Jimmy: Yeah, and that's the state we live in with scientific research, which is why we included that in Keto Clarity because we wanted people to not be confused, to know what the real deal is on this research and then to make appropriate changes from there.
Christopher: And then what did you find out about this idea of physiological insulin resistance, which has never really made much sense to me? I just can't understand it at all. So the idea being is that somehow, in the absence of insulin, you downregulate your sensitivity to it somehow. Then you start to see elevated fasted morning glucose as one symptom and people say, "Oh, you're becoming physiologically insulin-resistant." Do you know anything about that?
Jimmy: Yeah. I mean, it's been out there for a little while, this whole idea of the physiological insulin resistance. I say give it time. I think people that are experiencing that, it's not something that if you stay in a steady state of ketosis remains.
I had elevated blood sugar levels when I first started this and was not fully keto-adapted, and then I started producing ketones and getting the therapeutic benefits from that. It took about three or four months before those morning fasted blood glucose levels of 99, 104, that kind of thing, suddenly became 81, 78, 84, 72. I mean, you'll see a normalization over time when you stay in ketosis, but yeah, some people for some reason -- and we don't quite know the mechanism as to why that happens but for some reason, that morning reading is a bit elevated.
Christopher: I think for me, I discovered that what would elevate it is the excess protein at dinner. If you're going to eat too much protein any time of the day, it would probably be at dinner. It seems like the digestion and assimilation and conversion to glucose takes a little bit longer with protein and so that I would see the elevation in the morning rather than -- with half a sweet potato, I'd see the elevation within 30 minutes even so, so you -- that's one thing. But yeah, this idea of physiological insulin resistance is strange.
But then, the other thing I thought about was -- and you already mentioned this to an extent -- the dry eyes and mucin production just seems a bit weird to me as well. Can you tell me, do you know anything about this, that people end up with dry eyes if they stay in ketosis for too long?
Jimmy: Yeah, this whole idea came from a gentleman by the name of Paul Jaminet. He wrote a book called the "Perfect Health Diet."
Christopher: Which is a great book.
Jimmy: Yeah, really fantastic book. But yeah, we address this one, and no offense to Paul but I thought it needed to be addressed because, I mean, I've been ketogenic for a little while now. I've never had dry eyes, dry mucus. Sorry, my snot works just fine, thank you. So mucus production can happen very normally on a very low-carb diet. Our bodies can make enough glucose because of the gluconeogenesis and unless there's some underlying metabolic issue regarding proteins, amino acids, this really isn't an issue.
One of my experts in the book was Nora Gedgaudas. She notes a study that was published in the June 2006 issue of The Journal of Nutrition, and that study found that impaired production of mucin, the molecules that make up the mucus, has more to do with amino acid imbalances than some kind of a carbohydrate deficiency, which is what Jaminet claims is the reason for the mucus being an issue. So she says try consuming bone broth and pasture-raised gelatin to restore the amino acid imbalances, and don't necessarily think you have a starch deficiency that needs to be filled.
Christopher: It comes back to this idea that I changed this one thing, which was to start a ketogenic diet, and then I noticed something bad happens. Therefore, it must be the ketogenic diet.
Jimmy: It must be the very low carb, right.
Christopher: Yeah, but it certainly doesn't make sense. I mean, it goes back to that gluconeogenesis thing. My understanding is that gluconeogenesis is driven by the need for glucose, and so if you have this process that goes on within your body that needs glucose, then you will produce it unless something is wrong. It doesn't really work like that.
[0:45:07]
But it does raise another question. My understanding of the scientific method is that you can never prove something right. You can only prove it wrong. So you have this idea, say, mucin production requires you to eat starch. Then someone comes along and says, "Well, I'm not eating any starch and I don't have dry eyes or a dry mouth," and that, for me, then proves that idea wrong. I'm just wondering how many times do you have to prove something wrong before you throw the idea out? It's strange, isn't it?
Jimmy: Yeah, you need to prove it in science for some people. Unfortunately, those studies, there's no will to do those studies. So that's part of the issue is -- and vegans are notorious for doing this -- "Well, show me the science where it says whatever."
Unfortunately, the best science is what you find about yourself in an n=1 test. So that's why I say, "Yeah, it's cool to see the studies that come out, but at the end of the day, what do they mean to you?" They don't really mean anything to you until you test them and see how you respond.
Christopher: Yeah, absolutely. So that's almost true, isn't it? Even when you ever see a study and it's a double-blinded crossover trial, you still don't know. Unless you are a part of the trial, you still don't know how that affects you. So yeah, it's kind of a dicey one.
I wanted to end by -- most people, when they said -- they're like, "Right, I'm sold on this. This is a really good idea. I want to do it," they then ask the question, "What the heck do I eat?" Could you run through a day of what you would eat or someone that you -- you think that's a good choice for food throughout the course of the day?
Jimmy: Yeah. So when you start ketogenic diet, it's going to be challenging some paradigms you probably believed your whole life. We've often heard breakfast is the most important meal of the day, right?
Christopher: Yeah.
Jimmy: So I agree with that. I just don't agree that it has to be at 7:00 in the morning, because you look at the word "breakfast," what does it stand for? It stands for "break the fast." So when you break the fast, the fast could be broken at 2:00 in the afternoon.
So this whole idea of eating breakfast, snack, lunch, snack, dinner, snack, midnight snack, we've been conditioned in our culture -- and dieticians push it -- "You need to eat every few hours to keep the metabolism revved up," and I'm going, "Yeah, you eat every few hours and you keep your blood sugar raised and your insulin raised." Your body never gets a chance to really do what it's designed to do, and one of the sure-fire ways that you're not feeding it well is you're hungry within a couple of hours after eating. If you're hungry just within three, four, five hours after your last meal, you're probably not eating very well in your diet.
So one of the things we talk about is bumping up the fat in your diet, and I'm getting to my meals here in a second but I thought this was a good -- I had to lay the groundwork for this because people will hear, "You only eat one or two meals a day? What's up with that?" So what's up with that is I'm able to consume foods that will satisfy me in a ketogenic diet. That's one of the hallmarks is you lose the hunger, you get great appetite control, you don't get those ravenous cravings that you want to bite somebody's head off if you don't eat something right away. I used to be one of those people, by the way.
So for example, a great meal is -- let's say you wake up in the morning. You ate at 5:00 in the evening the night before. You wake up in the morning, "Okay, I'm not hungry yet." So you continue the fast, and then you find around 1:00 or 2:00, "Okay, I could eat."
So you go and pull out a pan in the kitchen, you throw some butter into the pan, and you could cook some eggs, for example. So throw four eggs in there and add some cheese on top of that, add some sour cream on top of that, add a whole avocado on the side of that, maybe some bacon or sausage on the side. You see it's a pretty sizable meal but that's by design, because think about this, Christopher. If that's the only meal you eat in the whole day, guess what? That's all the calories you're consuming in that day.
So for someone like me, I can eat a meal like that. It could upwards of 2,100 calories in one meal, and guess what? That's all I eat all day. So I'm able to spontaneously, after eating a meal like that at 1:00 or 2:00 in a given day, I'm able to definitely go the rest of that day without eating, an overnight fast, and then I wake up in the morning and I assess, "Am I hungry this morning? No? All right. Well, let's see how long it is until I start feeling a feeling of hunger," and gee, lo and behold! It's about 1:00 or 2:00 in the afternoon the next day.
[0:50:06]
So I just went 24 hours between meals, and that period of intermittent fasting is going to help my ketone levels as well. I'm completely satisfied. I've got all the alertness, all the energy. People are worried, "Well, if I don't eat, do I lose energy?" The way you lose your energy is you're not eating enough in the meals that you do eat or you're fueling your body with something that's dragging you down vis-à-vis carbohydrates, too much protein, not enough fat. All those things contribute.
So we provide sample recipes, food shopping lists, and a three-week/21-day kick-start keto guide in the back for meal plans. So the first week, we're not quite that hardcore on you in the first week. That's Jimmy Moore hardcore. We get there in Week Three. But Week One, we give you three meals and some snacks and they say, "Okay, try to get into ketosis." Then Week Two, we do two meals a day and a snack, "Try to do that and get into ketosis," and then by Week Three we're like, "Okay, time to go hardcore. We're going to give you one meal in a day."
Now, obviously if you get hungry, please eat something, but that means you didn't eat enough fat in your previous meal. Fat really is the key in all this that enables you to spontaneously intermittent fast and that's going to help you drive more ketones and get all the benefits that you want out of nutritional ketosis.
Christopher: And then do you not worry about not enough vegetables? When you get the fat so high, do you not worry about that? because we've looked at this closely and it seems like the vegetables in particular have a lot of vitamins and minerals and antioxidants and fiber and other goodies that really you're not going to get from any kind of fat that I know.
Jimmy: Well, you can get it from organ meats, and so adding in liver -- one of my experts was Dr. Terry Wahls, the great doctor who was able to overcome her MS with a ketogenic, paleo-ish style diet. She said, "Yeah, if you're sensitive to carbohydrates and you can't have a whole lot of vegetables..." You can still have some vegetables. It's definitely a great conduit for butter, by the way. So eat it with the butter, but to answer your question, you can get some really fantastic micronutrition if you eat the whole animal.
So make sure you add in -- liver is a really great one that needs to be added in if you're concerned about that micronutrient deficiency, but really all kinds of parts of the animal have so much nutrition in them. Don't neglect, don't think that the only way you get vitamins is from your vegetables and fruits. Fruit is nature's candy, by the way, so you want to try to avoid that unless you're not real sensitive to carbs.
So again, figure it out for yourself. If you have a higher carb tolerance level and you can have 50, 60, 70 grams of carbs and still be ketogenic, then by all means eat up on the vegetables. But if you're real sensitive, somebody like me -- 30 grams a day is not a lot -- I have to be careful, and so I limit my vegetables. That's where somebody like me probably needs to be eating more organ meats. You get the same vitamins and micronutrition from there.
Christopher: And then do you worry about what's going on with gut microbiomes? So the flora, do you think maybe you could starve that off somewhat by eating -- there's nothing to feed the bacteria effectively?
Jimmy: Yeah, there's definitely a mean mouth there about this and we address this. We have a "Frequently Asked Questions" chapter right in the middle of Keto Clarity, and one of the questions that we ask is, "What happens to my gut microbiota when I eat a ketogenic diet?" This is another one of those things that's put out there that, "Well, if you eat ketogenic, you're going to totally take away all the good microbiome." Okay, great.
We're not seeing that. That's just not happening in published studies. In fact, we cite one study that came out this year in January in the journal "Nature," found that ketogenic dieting actually increased the microbes of the genus Bacteroides and decreased Firmicutes. This is probably of clinical relevance for many reasons in obesity and other parts of metabolism. Reducing inflammation, this is happening as well.
Dr. William Davis was another one of our experts and he talked about if you're really, really worried about this -- we're not talking about great levels of carbohydrates that we're adding -- he recommends, if you want to do this, no more than 15 grams of carbs in a six-hour window. It could be something as small as half of a sweet potato, an unripened banana or plantain, or even something like a Quest Bar, any of those things can feed the gut flora. So if that's something you're concerned about, it does seem like there are ways to stay in ketosis and yet provide those gut flora the fibers that they need.
[0:55:08]
Christopher: Yeah. So I should clarify, the type of vegetables I'm talking about are the ones that grow above ground, so the leafy stuff that's a really good vehicle for more fat, and I think maybe less so than some of the more starchy plants. They should be able to an extent feed the microbiome, right?
Jimmy: They should, yeah, anything with fiber in it or that would have those indigestible fibers in it. It doesn't have to be starch-based, that's for sure.
Christopher: Right, yeah. I mean, I know for certain that it's doing something, or at least -- before, when I had overgrowths of bacteria, like when I eat vegetables I get more bloated because you would just obviously be feeding those things and they would blow up like a balloon. So definitely, it's doing something. I think some people said that when you cook it too much, then there's nothing really left for the bacteria, but I know that not to be true.
But do you not worry then about constipation? I mean, you need fiber to give bulk to the stool, right? And when you stop eating any of it, there's really nothing left. Do you not find that to be a problem?
Jimmy: I had a very famous podcast interview on the Livin' La Vida Low Carb Show with the vegan advocate named Dr. John McDougall. That was one of his questions to me. "How is your constipation, Mr. Moore?" I said, "I don't have constipation." "Well, every ketogenic dieter has constipation." I'm like, "I don't know about 'every,' but no, that is not an issue."
If you are drinking adequate amounts of fluids and having the right -- those vegetables we were just talking about, all of those things can ward off constipation. I've never seen that as an issue so long as you are hydrating yourself.
Christopher: Excellent. Well, this has been fantastic. I'm really looking forward to the book. I never actually read the title so I should clarify that now. It's "Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet" which I'm really looking forward to. So when is the publish date?
Jimmy: It's coming out August 5th, which is Tuesday, and it's coming in hardback, Kindle ebook, and I also read -- because I'm a podcaster, people know my voice -- I read the audiobook. So it'll be an Audible audiobook as well.
Christopher: That's awesome. So you're not going to tease us then with a hardback version first to make everybody wait?
Jimmy: Yeah, we did that with my last book "Cholesterol Clarity" and people are like, "Where's the audiobook?" I'm like, "What? What audiobook are you talking about?" "You've got to read it!" I'm like, "I've never done anything like that before." But it was a lot of fun.
Christopher: Excellent. Well, thank you so much for coming on today. This has been great. It's like to clear all this stuff up. I get asked these questions all the time. I have a lot of knowledge but it's all quite shallow. I don't really go into depth on one particular thing in quite the way that you've done with this book, obviously. So to have someone on this -- I mean, obviously, you -- and then you probably have an incredibly broad knowledge too because you've worked with so many experts to produce this book, right? I'm sure there's lots of things that one expert won't know because they're just not looking at that stuff. So yeah, an amazing resource. Thank you so much for coming on today.
Jimmy: Thank you, Christopher.
Christopher: Okay. Cheers then, Jimmy.
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