Written by Christopher Kelly
Oct. 9, 2014
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Chris: Hello and welcome to the Nourish Balance Thrive podcast. I'm Christopher Kelly and I'm joined today by Rachel Albert. Rachel has been a natural food chef, freelance food and health writer, cooking instructor and nutrition educator for more than 25 years. She's an award-winning cookbook author, thriver and survivor of a stage four metastatic breast cancer and advocate for the ketogenic diet for cancer.
Hi, Rachel. Thanks for coming on.
Rachel: Well, I'm so glad to be with you and your listeners and just an honor.
Chris: Thank you. Tell me, how long have you been following a ketogenic diet and what prompted you to start it?
Rachel: Well, I've been doing it for nine months now and what prompted me was finding out that the cancer that I thought I had beat was back and it had metastasized to my brain.
Chris: Oh, wow. And how did you find out that you had brain tumor? How many did you have? Are they gone now?
Rachel: They're gone now. I had two, a primary and then a very small one and the way I found out was actually my oncologist was doing some year end tests and he ordered a mammogram, an ultrasound and then the radiologist was sure she saw something on the films that hadn't been there six months or a year. And then my oncologist at the time was going to order a CT scan and I asked him why he wasn't going to do a PET CT so that we'd have more information.
So he put in the order. He said he normally wouldn't do it, but for me he would. So once I had that the same week the next morning I got three urgent calls from his office and they wanted to get me in immediately for a brain scan, so brain MRI. So I was shocked. That's how I found out.
Chris: And when was your first cancer diagnosis?
Rachel: The first one was September of 2011 and at that time I had two-biopsy confirmed tumors and two suspected tumors that were later confirmed on PET scan.
Chris: And what was your diet like at that time? Had you made any connection between diet and what might be going on with your health at that time?
Rachel: Well, I was already into paleo diet. I'd actually been into Whole Foods produce dominated diet for more than 25 years. So I was into paleo and I would vacillate between 100% adherence to maybe one to three times a week sometimes having something that had a little bit of gluten free grain or dark chocolate or occasionally some legumes.
So it wasn't like huge strays from the diet, but I taught cooking classes and some of my students ate grains or beans and you know. So sometimes I would have servings of those, but it wasn't any kind of binge and I did eat a huge amount of like I said fibrous veggies, leafy greens, protective things, but I really think that other factors really put me at risk for developing cancer.
Chris: What do you think these factors were?
Rachel: Well, one of them I think was that I had more than 25 years of varying degrees of insomnia at the time of diagnosis that I hadn't been able to resolve. And I had a huge amount of financial and emotional stress. I stayed in a very unhappy, very unhealthy marriage for about 17 years and there's a lot of research linking stress to the development of cancer and other degenerative diseases.
So I really think those are the things that disabled my immune system and prevented my body from stopping the growth of the cancer cells that our bodies just make automatically.
Chris: And so were you using the paleo diet in your cooking classes for all that time? When did you find out about it? How long have you known?
Rachel: Good question. So some of my classes were very paleo, some of my classes I cooked that I kind of food, but I didn't use the term. And even in classes where I did serve some let's say quinoa or brown rice or something it was still good with healthy proteins and lots of veggies and some fruits. And I actually got into paleo diet in the late 1990s before it was even popular.
Chris: Oh, my goodness. Yes, that is a long time before I'd ever heard of it.
Rachel: Yeah. And that was after years of trying vegetarian and vegan diets, trying to make them work for years and not having success and then I got into paleo diet and then there were brief forays back into eating grains and beans when my former husband would apply pressure when he would go back to eating that way and eventually I just said, "I don't care what kind of pressure he tries to apply. I'm not going to go back to eating that way."
Chris: Okay. And then how did you find out about the ketogenic diet for cancer?
Rachel: Oh, that's a really great question. So I had actually read a little bit about it. One of the nutritionist involved in the paleo movement had sent me some PDFs after the first diagnosis and those were about ketogenic diet for brain tumors.
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And then when I had my second diagnosis, the recurrence, a girlfriend of mine who I had known for probably 20 years she emailed me and she was urging me to get on the ketogenic diet for cancer right away. And she was already doing the diet and so a week after I had the information that I had brain tumors I got on the ketogenic diet.
Chris: So when you say the ketogenic diet for cancer is that something specific? It's different from maybe the ketogenic diet that I'm eating?
Rachel: Yes, absolutely. So ketogenic diet for athletes is more liberal with the carbohydrates and sometimes with the protein as well. With what's called a restricted ketogenic diet for cancer, the calories are usually restricted initially at least 10 to 20% and overtime someone might like me I had to supplement with more oil, more good fats.
But the other thing that's different is protein is usually restricted to a lower amount. So it's just enough for cellular repair and maintenance and the carbohydrates are usually kept much lower and typically recommendations are 12-20 grams of net carbs a day. So you have to be really strict about watching everything and checking medications and electrolyte supplements and all kinds of things to make sure you're not getting unsuspecting carbohydrates.
Chris: That's incredibly low. I don't actually measure anymore, but I'm guessing even just eating leafy vegetables I must be getting more than 15 grams a day, right?
Rachel: Yeah. You're probably getting I would guess that you're probably around 30 -- 25 to 30 or 40 depending on what volume you eat and what vegetables.
Chris: That's a lot. Like every plate is like a mountain of it, so yeah. And then what are the potential benefits? Why would you want to do this?
Rachel: Okay. Well, for someone dealing with cancer there are some really fantastic benefits. One is that ketogenic diet reduces the production of damaging free radicals. It has an anti-inflammatory effect. It can repair damaged neurons and cell membranes. It can starve cancer cells.
There's also some evidence that it can make chemo and radiation more effective and that it stimulates a process called autophagy where the body recycles old and damaged cells, remodels them and gets rid of cellular debris. And it can also stimulate some cellular regeneration and tissue repair.
Beyond that, it gives you the benefits of fasting which has been shown to be very effective for cancer and a lot of other treatments without having to starve yourself and so many other benefits, improve cognitive function, better moods because it favors the production of GABA, the feel good neurotransmitter.
So there are just so many benefits to it for someone dealing with cancer, but also anyone who has any kind of health condition that they're trying to work with. Some conditions are contraindicated. So anyone listening should talk to their doctor before going on a ketogenic diet just to make sure it wouldn't interact with any medications or that they don't have a genetic abnormality that would make a ketogenic diet dangerous for them.
Chris: And what were some of the immediate benefits you experienced?
Rachel: Well, one of the first was that even though I was on very high dose steroids once I found out about the brain tumor literally that day. I didn't have the ravenous appetite and I didn't gain weight, not an ounce. In fact, I lost weight. And I didn't -- I just I never got puffy, whereas the year before, earlier that year when I'd been going through chemo I've been on hefty amount of steroids taking only once every three weeks three days in a row.
And now I was on it every day and much higher amount and back then initially I had gained 12 pounds earlier in the year on the steroids and here I was on a very high dose and I didn't gain any weight which was great. I didn't have the weird moon face or anything like that.
Chris: Do you understand why that would be? It's kind of not entirely clear to me.
Rachel: Yeah. The reason is that steroids, corticosteroids raise glucose and insulin levels and that depresses ketone production. So that along with the amount of stress, high amount of stress, the seteroids I was on was raising my glucose and insulin levels, but it wasn't causing the insulin resistance and weight gain that I had experienced previously with steroids.
Chris: And did you see that in blood glucose numbers? Were they elevated or were they normal and all?
Rachel: What was interesting was they were elevated for me. So my typical baseline glucose when I went in for lab work before chemo and other test was usually in the 80s first in the morning were 80s or low 90s even if I'd eaten breakfast. After I got on the ketogenic diet my numbers were typically high 80s, 90s, 100, sometimes 115.
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So it wasn't high for the typical person. It was within range or close to an average range, but it was high for me and that actually hindered my ability to get into deep ketosis and stay in deep ketosis for a while unless I fasted or did a lot of MCT oil.
Chris: And then did you go cold turkey or did you transition into it slowly?
Rachel: Well, I would say it's a little bit of both. I had actually spent the previous six months gradually lowering my carb intake after I had listened to the Grain Brain audio. And I was resistant to just making that final leap. You know I love my vegetables and fruits and couldn't imagine having to restrict them.
But as soon as I found out I had the brain tumors I changed overnight and at that point I probably went from an average of 50 to 80 grams of carbs a day down to about 15, sometimes 20 give or take a little bit.
Chris: And did you still have difficulty getting into ketosis?
Rachel: I did because of the steroids and I was on the high dose steroids for two months. What would really help me get my ketone levels up and my glucose down is if I did a 24-48 hour water fast or if I did a water fast and then had a quarter cup of MCT oil per day. Then I could get really great numbers.
So I kept tracking them and even though I wasn't in the ideal range for ketones I knew I was still getting benefits. I could just feel mentally, physically that I was getting a lot of benefits. So I just figured eventually when I got off the steroids and my body adjusted that my numbers would come into the range.
Chris: I think the numbers can be important, but really the way that you feel is the most important point. But what were those numbers when you were struggling?
Rachel: When I was struggling sometimes my ketones were .5, .9 sometimes I would get them to like 1.5. But I really wanted to get into deep ketosis and have them in the 2.8, 3.0 maybe even 4. So when I fasted or did fasting with MCT oil I could get it to be like 2.5 or even a little bit higher like 2.7 or something. And so I still struggled with the glucose levels for a while and as you might know steroids create a lot of stress.
So I was totally wired on the steroids and not able to sleep. So my sleep problems even got worse on the steroids. So I think that also made it hard to get my glucose levels down and my ketone levels up.
Chris: And were you sure that -- I know that say the [0:12:56] [Indiscernible] guide suggest that 0.5 to 3.0 is the beneficial range and certainly I've never been up as high as some of the numbers you just mentioned then, but if you've seen specific events and information that suggest that the deeper the level of ketosis is beneficial for cancer?
Rachel: Absolutely. There are two ketogenic diet e-books for people with cancer and they recommended going higher and also when I listened to Thomas Seyfried's audios about his interviews and lectures online. And that gave me the information that it would be better to get and stay in deep ketosis rather than be just under one or between one and two.
So it took a while to get my numbers to get into a better range, but like I said I knew I was getting benefit and I had also listened to some lectures online that said it's not as important your specific ketone level as the relative drop. So if you look at where you started from and then what you've achieved in the process of getting into ketosis sometimes it's actually more important the change from baseline rather than you have this absolute number.
Chris: Okay. And then do you still use intermittent fasting with the ketogenic diet?
Rachel: I do. Sometimes when I'm looking at my numbers and I might see, "Oh, it's .9 or oh, it's .5 this morning." Then I might say, "Okay, I'm going to fast until lunch or I'm going to fast all day," or typically I'll do between skipping one meal and skipping three meals and then I'll just do either just water and maybe some Bulletproof decaf or I will do MCT oils and you know or just give my body a rest just 24 hours of just water before I eat again.
Chris: So I'm sure that a number of people who are listening are thinking, "Well, this must require a level of self-discipline that most don't have." But do you think being in ketosis affects your ability to go into intermittent fasting?
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Rachel: Oh, absolutely. It makes it so much easier. I had actually done some intermittent fasting during the last four months of chemo earlier in 2013. And a friend of mine had actually advised that after my initial diagnosis and she had told me that she had gone for two years no sugars, no starches, no grains. Just none of that and that she did a very modified fasting the day before chemo and then the day she fasted and then just ate lightly later in the day.
And I remember thinking that sounded so extreme and I just I didn't think it was necessary. But I actually did that the last four months of chemo and I actually found it made a huge difference. I was less tired from the chemo. I had fewer digestive side effects and it really made a difference. And actually during the six months before I got on the ketogenic diet I was typically skipping breakfast and doing Bulletproof coffee or just doing water until lunch time.
So it wasn't a huge switch to do the intermittent fasting. The diet does require a lot of focus and commitment, but I would say if your life is on the line or it's taking meds for the rest of your life or losing it then I would say anyone can develop that motivation and focus and commitment if they have a will, a really strong will.
Chris: Yeah. I agree. Yeah, there's a level of motivation I probably don't understand. And then how did your doctors respond to hearing that you're following a ketogenic diet?
Rachel: Oh, that's a great question. My naturopath was actually very pleased. He's a naturopathic oncologist and he knew a little bit about ketogenic diets and he actually was very pleased when I was doing the fasting before chemo because he was familiar with the work of this Dr. Valter Longo who had great results fasting mice and then some humans before chemo.
And my oncologist and my radiation oncologist they were openly supportive. If they were skeptical they didn't really say much about that and they approved of what I was doing and they were glad that I was working with my naturopath who they both had good relationships with. So they knew that he was helping monitor it and that I was testing my glucose and ketone levels.
Chris: So what would the advice have been then had you not done this research for yourself? What would they have told you to eat?
Rachel: They actually would have probably just said if I was losing weight, which I was when I got on the ketogenic diet, but they would have just said, eat plenty of food to keep your weight on. And cancer doctors and dietetic oncologist they typically know very little about nutrition and whatever they know about nutrition it's certainly not whole foods nutrition and I haven't met any of them who were telling people to avoid sugar, reduce or eliminate starches, avoid alcohol, juices, things like that.
So it's going to be a little bit of time before doctors really catch on, but I have heard of some doctors and other alternative practitioners who are promoting a low carb or ketogenic diet for cancer.
Chris: Okay. And did you combine the diet with conventional treatments and which treatments did you use and what were the results?
Rachel: Well, I did about a month after I had gotten the diagnosis and gotten on the ketogenic diet I went through a week of what's called CyberKnife and Gamma Knife. And those are pinpoint laser directed beams of light that are directed at the tumors and it's like surgery, but without any incisions. So I had five days of that treatment for the primary tumor and then I had one day where I had two treatments and then I also received a treatment to the back of my head to the little spot that had shown up on the scan.
So I did that and I actually sailed through that fairly well. I mean I had a really, really bad headache on one day on a scale of one to 10 it was probably an 11. But one of my girlfriends said, "Well, why don't you just take some Advil?" and I was like, "Oh, great idea," because that wasn't something I typically do and that helped and then I had a few other days where I had to take some Advil.
But I was able to keep working. I just did a little lighter work load the week of the radiation and the week after. And then three months later when I had a brain MRI the primary tumor was reduced to a quarter of its size and the tiny spot at the back of my head was gone. And then I started on an immunotherapy drug, HER2 medication that was oral. So it's in a pill.
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And then I also started on oral chemo and they actually wanted me on those earlier in the year, but there had been some crazy mix-ups with the new insurance in the new year so it actually took three months before I got those medications. But even so I was doing remarkably well and one of the things my radiation oncologist waited to tell me until that good news on the scan was that in the month between the diagnosis of the primary brain tumor and that radiation the tumor had almost doubled in size and I was so glad he hadn't told me then. It was just it wouldn't have done anything for my mood and my morale. So he waited until the right time to tell me.
Chris: Wow. That's amazing. And then are you still in treatment for cancer?
Rachel: I am. So three months after the first follow-up MRI after the one tumor was gone and the other was reduced then three months later I actually had another scan and it showed my brain was completely clear. And so all we had to worry about at that point or not worry about, but focus on was the tiny blueberry size spot in my right breast.
So I'm still on oral chemo right now and I'm still on this HER2 medication and they're both medications that cross the blood brain barrier. And here's an interesting thing. When I asked the radiation oncologist how long he thought that tumor would have been growing to get to the size it was at diagnosis he said a year or two or a year and a half.
So that means it was actually growing while I was going through chemo, but the meds I was on at that time didn't cross the blood brain barrier so they couldn't have prevented it.
Chris: And then how often do you monitor your glucose and ketone levels?
Rachel: Typically what I do is I will test my glucose two to four times a day with the glucose ketone monitor and check my ketones with also the finger prick method with the monitor not every day for that. I would say some days it's once or twice and maybe that's a few times a week that I will use that I'll test my ketones that way. But a couple of weeks ago I started using the Ketonix device to test the breath levels.
Now, it's not the same. They're not testing the same ketone. Whether you're testing your blood or your breath or initially your urine they all test different types of ketones, but it still gives me more information and it's a lot cheaper than testing my ketones everyday which I have been sometimes, but it's two dollars a test strip.
Chris: Where do you get them for two dollars? I've not seen them that cheap.
Rachel: Okay. Well, I use the Nova Max glucose ketone monitor and the test strips are much cheaper either from Amazon or from Nova Max than if you're using the Precision Xtra. When I check --
Chris: Yeah, I think I have both of those monitors.
Rachel: Yeah. It's amazing how much less expensive it is for the one I'm using, for the Nova Max.
Chris: And then what if you found the comparisons. I also have the Ketonix as well. Have you found the comparisons between the blood? So in blood we're talking about beta-hydroxybutyrate and then the Ketonix we're talking about acetyl acetone in breath isn't it? It's slightly different, but have you found that they line up?
Rachel: Well, it's kind of interesting. I'm still trying to kind of get a feel for that, but it's interesting. Sometimes the Ketonix device will show moderate ketone levels and my blood ketones will be on the fairly low side. It's kind of interesting. So --
Chris: So you say fairly low. What numbers are you talking about for beta-hydroxybutyrate?
Rachel: Well, for beta-hydroxybutyrate so let's say I might find that in my blood it's .9 or one, 1.5 and it varies with the Ketonix. Like they don't actually match up exactly and the guy who made the device sent a few technical emails.
Chris: It's incredibly helpful, isn't it? I asked a question and he sent back so much information and he clearly typed it all out. It wasn't just boilerplate you know. It's amazing.
Rachel: Yeah. And so it doesn't exactly correlate, but what's fascinating with my Ketonix device is that I like how the flashes so it tells you what color and that tells you whether it's trace or small amount or moderate or high level of ketones. And what I don't know if you know and this is something that the guy who made it told me is that when you see the flashes. Do you know how many flashes you have with whatever color shows up?
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Chris: Yeah. So the most I've ever seen is nine green and then usually it's more like first thing in the morning it's going to be like three and then during the day it's normally about five.
Rachel: Yeah. So I have sometimes I have green, sometimes it's yellow which is higher and the most I've gotten is nine yellow and once or twice I've gotten it slightly into the red which is a higher ketone level. So I really like tinkering with the stuff and tracking numbers and I really see myself coaching other people who want to do the diet for not just cancer, but epilepsy, diabetes, PCOS, chronic migraine.
So I figure the more I learn about these different tracking devices and the more I can see what my glucose relative to ketones are the more I'll be able to help other people who might be struggling when they first get on the diet or if they're on medications.
Chris: Okay. Yeah. I'm wondering where is your blood glucose at during this because I've noticed when I first tried to get into ketosis my blood glucose didn't go that low. And at that time I was measuring beta-hydroxybutyrate in blood and not really seeing much more than between one and two minimal. But over the last few weeks in particular I've noticed that my blood glucose has dropped a lot and now I'm consistently waking up in the low 80s maybe even in the 70s. I've seen that a lot during the day.
Rachel: Yeah. I would say when I wake up in the morning I get excited if it's like below 80 or below 90. So sometimes it's in the kind of mid to high 70s, 80s. Sometimes when I get up in the morning it might be 100 or 101. And part of that can be overnight your body can be breaking down some protein through gluconeogenesis to fuel your brain when you're sleeping.
And what I find is if I have a fat-rich snack that's very low on carbs before bed then sometimes I'll find I have lower glucose levels in the morning. So it can vary depending on what time I ate dinner, how much exercise I had the previous day and then throughout the day it can change quite a bit too. I might wake up and find my ketones are .9 and my glucose is 100 or 101.
And then I can adjust certain things with maybe doing more MCT oil or really skipping the vegetables at a meal or eating much less of them and then later in the day I can see my glucose level drop into the low 90s or 80s or sometimes in the high 70s. So it's really variable and there are a lot of factors that can affect that. I think part of the issue now is that I'm on a two week on one week off cycle with the oral chemo.
So when I'm on the chemo regimen, chemo cycle I've got a lot more oxidation going on internally and then depending on whether I get up and exercise first in the morning and whether or not I take some kind of coconut oil or MCT oil before I exercise. That can affect my numbers in the morning too.
Chris: Okay. What type of MCT oil do you use out of interest?
Rachel: You know I've tried several brands. I've used the Now brand several times and I actually I have a brand right now that's was from Pilgrim's Pride or something. I think it's Pilgrim's Pride and they had a special buy one -- it was buy one get two free or buy two get one free. So I've been experimenting with different brands and I really don't know how much difference there is from one to the other. So I wondered if you've seen a difference from one brand to another.
Chris: No. Not that I've measured. I couldn't say to you I've measured, but I definitely notice the Bulletproof Brain Octane is definitely stronger. I find that you need less of it to get that effect where you're seeing like a .5 maybe minimal increase in.
Rachel: Oh, interesting. And I've had people say that you need to be careful taking it in the evening let's say before bed because it might make you too stimulated. But I'll have to try that brand because I want to try different brands and see if I notice anything different and one of my friends has that brand and she thinks it's really amazing. So maybe I wouldn't need to take as much of it I switch to that.
Chris: Yeah, it's fabulously expensive. I can't remember. I think it's close to $40 a bottle or something.
Rachel: Is that the 32 ounce?
Chris: Yes, it's the big one.
Rachel: Okay, good.
Chris: So what's been the hardest thing for you about ketogenic diet?
Rachel: I would say one of the hardest was having to restrain myself with vegetables. I was used to eating ten to 15 USDA servings of produce a day before paleo and even after I got into paleo diet. So definitely having to eat smaller portions of even the fibrous vegetables and I thought I would really miss the sweet potatoes and the fruit a lot and sometimes I see them or I'll cook them for a client during a class, but I'm just not attached to them.
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So biggest thing is just having to be more conscientious about how many carbs I'm eating and about also having to eat smaller portions of protein. So that's an interesting thing because most people assume low carb means high protein, but it's actually protein adequate if it's well-designed and you're dealing with a metabolic condition like I am.
And so I do have to eat smaller portions of that, but it's not a big drawback. I mean for me I just I feel great. I look great. I can be physically active and I'm just grateful that I'm healing so well and continuing to exceed my doctor's expectations.
Chris: That's fantastic. And do you think that's absolutely required for a ketogenic diet for cancer then, restriction of those vegetables because I found that it wasn't required. Like initially I thought I would have to really limit those vegetables, but now I'm finding not so much and my wife's a food scientist and she's just produced a short book. It's fifteen pages and there are lots of pictures of the type of food that we eat.
And I think it's probably what you were doing before you switched to the ketogenic diet, so tons and tons of vegetables. Julia goes to the farmer's market three times a week and every plate is just heaped full of leaves and broccoli and things like that.
And it doesn't interfere. We're both still in ketosis. It's fine. Is that just as long as you get the numbers then you can eat those foods or is it something specific to cancer?
Rachel: Well, the two people whose e-books I have on the ketogenic diet for cancer they definitely recommend like 12 to 15 grams of carbs a day or 20 and the woman that I had some coaching sessions with, Miriam Kalamian. She actually said and I said, "I really am used to eating big servings of kale and collards and mustard greens and broccoli." And so she said that this was a couple of months into the diet or few months into the diet.
She said, "You know I don't think that's a problem." Because I told her sometimes I'm eating a little bit more than that, but it's super nutritious green leafy and fibrous orange and yellow vegetables. So she didn't think that was a problem because there are so many cancer protective benefits with the cruciferous and other vegetables.
But what I noticed is that if I want to get my glucose level lower and my ketone levels higher I do have to restrict a bit more than someone who's not dealing with what I am. But I figure once I'm off the oral chemo that I'll probably be able to eat more of the fibrous veggies and have maintain better glucose and ketone levels.
So it's kind of a tradeoff because obviously there's a lot of benefit to eating those leafy greens and garlic and what not. But so sometimes I'll go a little higher on those portions and just figure, "You know what, the worst thing is that I'm eating a bigger serving of broccoli or cauliflower or something. That's not so bad because I'm doing a great job in all respects with everything else I'm doing."
So I kind of go back and forth between the little larger servings of vegetables and smaller and some days I just say, "You know what, I'm going to have this big salad and I'm not going to measure out or count how much bell pepper or how much tomato. I'll figure it's a big salad. It's fibrous and I've got plenty of good fat there and my body will deal with it."
Chris: It's interesting the way that your idea of reward has been altered. Do you see what I mean? Like for some people they need something much more rewarding than a salad in order to have a rewarding experience, but --
Rachel: I know. I was like broccoli. I mean I love, love vegetables. I make cauliflower rice and cauliflower mashed potatoes and I'm used to eating a heaping cup of cooked kale or broccoli or what not. So it is kind of a treat to have a bigger serving of vegetables or sometimes I'll have a little bit more nuts than is ideal or have a little serving of some berries and just make sure I have plenty of fat with it.
And particularly on a day that I work out harder I'll be much hungrier and I'll eat more fat, but sometimes I'll be a little bit more liberal with the protein on those days that I'm working out because I definitely want to build muscle and I've lost a lot of weight on the diet. So again there are some flexibility, but you do have to be fairly precise if you're dealing with a condition like I am.
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Chris: And do you include dairy products at all?
Rachel: Not very much. I use some ghee, some pastured butter. Once in a while I'll have a little sprinkle of goat cheese, sheep milk feta or something like that on a salad or an omelet. But it's recommended that people who are dealing with cancer reduce or typically avoid dairy protein because of the certain amino acids in there that can fuel cancer and also because of the growth factors that are naturally present in milk fat and milk protein that can potentially stimulate certain pathways that can fuel the cancer.
Chris: Okay. So what's your main source of fat then if no dairy?
Rachel: Well, I do a little bit of dairy. So I don't avoid it completely, but typically because I do some butter. But my main fat is coconut oil, avocados, olives, olive oil, avocado oil. I do a fair amount of macadamia nuts. They're my favorite and so it's those oils, those fats especially avocado.
I tend toward an either an avocado a day or at least every other day. It's a great source of potassium too which helps since I'm not eating the quantity of vegetables I used to eat.
Chris: Just hearing you say this stuff like an avocado a day. I mean I guess my calorific requirements are probably significantly higher. I'm sure I'm an awful lot heavier and I'm doing these three hour bike rides every day and yeah an avocado a day, I could easily eat an avocado every meal.
Rachel: Oh and you could -- when I eat an avocado typically I'll sit down and just the whole avocado is what I eat at that meal, but and I'll have some other fat added. But definitely you have greater calorie needs so maybe you need three avocados a day. But at least I like to aim for one avocado a day just because it's super nutritious and it's also a great source of some good antioxidants.
Chris: Yeah. We're lucky to have them and they become a little bit difficult to find in California right now, but I never even tasted one before I came to the US. I didn't really know what they were. So and it's weird because that's such a staple in our diet now.
Rachel: Oh, my gosh. And if you were in Arizona it's amazing. Avocados are so prolific here most of the year and I recently found these really big ones and I'm kind of fascinated with the different kinds of avocados and just the big one is like, "Oh, that's good. Now, that's a meal sized avocado."
Chris: That's great. And then was it the vegetables that you initially missed the most?
Rachel: Well, I would say sweet potatoes because I used to eat a lot of sweet potatoes and what most people call yams. I used winter squash a lot. I was used to eating apples and pears and melons and berries and things like that. So but it wasn't like seriously missing. I mean in the beginning I would sometimes allow myself half a cup or a cup of berries when I was initially getting into the diet.
But I just I really looked at it as you know what I'm just I'm not going to buy them for myself. I'll cook them for clients or in classes if I need to. But it really wasn't, it was more having to cut back on the volume of vegetables that was the issue because I was fine with just replacing one kind of vegetable with another.
Chris: Yeah. I was the same actually. I used to -- I was eating a paleo diet, but still it was a very high carbohydrate diet. And so I used to pre-roast sweet potatoes and the reload on glycogen every time I got back from a ride and it was like a job. Like I feel like I have more time now you know like just even though it's pretty simple to roast sweet potatoes.
But the mountain of them I was eating was incredible and it shocks me to think I'm still performing the same amount of exercise and yet the volume, just the volume of that carbohydrate is gone and I don't really think about it anymore. It's like it was such a big part of my life and now just the thought doesn't even cross my mind really. It's just once you're in a new routine it becomes so much easier.
Rachel: Oh, absolutely and that's actually a great point. I spent a lot of time with food prep with paleo diet because of the quantity and variety of vegetables I ate and then had to cook more protein than I do now and so I actually am saving time. I spend less time in the kitchen. My food preparation is so much shorter and eating a meal takes so much less time because it's just so much simpler.
Okay, got my protein, got some good fat and then and a lot of fat since that makes up about 80 something percent of my calories. And then a little bit of fibrous veggies. So it definitely simplifies cooking. So that's another bonus.
[0:40:05]
Chris: And then what's one of your favorite foods now?
Rachel: Oh, what are my favorites? Well, besides those zero less than one gram of carb, Shirataki noodles. I really like those and I do some amazing things with those and I'll actually have some recipes in my new book and when I launched my new blog.
What other favorite food, well, I mean butter is pretty amazing. Let's see, favorite food. Well, I would say avocados is right up there and pork rinds, fried pork rinds. But I get the ones that are free of canola oil, free of GMOs and whatnot. So those are really fun kind of crunchy dipper or crouton alternative. So those are kind of fun thing that I had never eaten in my life, but now they're in there as a treat or a little grab and go kind of munchy thing if I need it.
Chris: I love those too. We get them from U.S. Wellness Meats, but they're fabulously expensive. Again, it's another one of those sorts of treats that you buy from the internet, but yeah they're great.
Rachel: Yeah.
Chris: And what foods did you think you were going to miss the most?
Rachel: Well, I thought I would miss the sweet potatoes the most and the fruits, but I adjusted and sometimes I really want something sweet and I do occasionally make some dessert sweet with stevia or stevia with a very small amount of sugar alcohol. But I don't use those a lot, but I do make them from time to time and then I stash whatever I'm not going to eat in the freezer or I give it away.
And I actually am working on a new cookbook and so I'm testing different recipes and really have been since right after, shortly after my diagnosis because that was like that was right before Christmas when I got my diagnosis last year. And so I'm making some treats that people will be able to use over the holidays and it'll make it a lot easier for people who are following this lifestyle since it's not just a diet. It's really a lifestyle as you know.
I want to make it easy for them. So when birthdays and anniversaries and holidays come around they won't feel like they're deprived and they probably won't feel like abandoning the diet to eat those treats if they have some healthier lower carb treats.
So that's one of my motivations for making some of those treats and coming up with really great recipes. And so far my friends even friends and neighbors even if they don't eat like this they love the things I've been making especially the treats.
Chris: That sounds really good. I can only imagine. So what do you typically eat for breakfast?
Rachel: Okay. Well, for example this morning I stir-fried some broccoli, tiny bit of onions, celery, ginger and added a couple of scrambled eggs I'd whisked with some herbs and spices and then I added some of these little Shirataki rice grains. So it looks like rice, but it's made from a yam. It's native to Japan and it's rich in something called glucomannan.
It's less than a gram of carbs per serving and it has a lot of anti-inflammatory benefits and they have noodles. They have little rice grains. So that was my breakfast with plenty of fat in there. Sometimes I'll just have two or three hard boiled eggs with some homemade mayo and maybe some raw bell pepper or steamed or blanched cauliflower or broccoli or mixed vegetables. It kind of varies. Sometimes it's even just leftover salad with a little bit of meat and homemade vinaigrette.
Chris: Is there a particular -- I've only just found out. I didn't even know what Shirataki was. Is there a particular brand? Where do you get that from?
Rachel: Well, you can get them from Amazon. Whole Foods market has them as well. I've tried three brands so far. So one of them was called Miracle Noodles, the other was called No Oodles and there's another one that just came out called Skinny Noodles that I'm testing out and planning to write about on my blog.
And so I like all three brands and there's actually a special way to prepare them so that they actually get drier and they can soak up whatever fat or sauce you add to them.
Chris: Well, yeah, I'll look out for that. And then and so walk me through the rest of the day. What's lunch and dinner like?
Rachel: Well, lunch typically it's a salad with some chicken, fish or meat and salad dressing or it might be steamed or blanched veggies with homemade mayo and some kind of protein. Kind of vary, but typically I'll have at one meal a day I'll have a green salad. At one meal I'll have steamed or blanched or stir fried cruciferous vegetables with maybe some onions or mushrooms or celery or bell pepper thrown in or a couple of those with garlic or ginger.
[0:45:14]
And then typically at one meal I might have either the Shirataki noodles or I'll make zughetti so zucchini spaghetti with the spiralizer or something else that's maybe it's grilled asparagus or some other vegetables and I eat red meat fairly often and then fish. Probably fish maybe three or four times a week and then fair amount of chicken and sometimes I eat goat or buffalo. So I like variety with the meats.
Chris: That sounds pretty good. Like I thought I mean when you said about restricting the vegetables I thought you were going to be one of those ketogenic dieters that eat one rib eye steak with some butter on it or something like that you know.
Rachel: No. I mean I've seen that in books and I just can't imagine not eating the vegetables. They've just been such an integral part of my diet for so many years. So it might be half a cup or a cup of fibrous veggies at a meal. If I go out to eat I might have a salad and some asparagus or broccoli or something. So I don't worry about it. I figure it's fibrous. It's good stuff.
So occasionally I'll have a little bigger vegetable serving, but I'm not into the no vegetables. You know occasionally I might skip vegetables at a meal like at AHS I had scrambled eggs or scrambled eggs and bacon and I would put butter on top of the eggs. So I actually had some amazing glucose and ketone readings when I was at AHS and probably because I had some meals like some just breakfast really some breakfast without any vegetables.
But you know typically I'm just so used to eating vegetables, breakfast, lunch and dinner that I don't skip them. But occasionally I will just in the interest of getting my numbers into a better range.
Chris: Okay. And then what do you like most about eating ketogenically?
Rachel: I would say reduced prep. I don't have to buy as many vegetables as I used to because my refrigerator used to be so packed. Sometimes it was hard to get it closed. It was like a packing U-Haul. I'd have to move things around so that groceries for me and my cooking classes would fit.
So I don't have to buy as much produce or meat. I don't have to cook as much and then I like being able to go for longer periods of time without eating and to more easily skip a meal if I need to.
Chris: Yeah. So you have enjoyed some of those benefits too as well. Yeah. So since you teach cooking classes I'm curious, have you been leading them with this way of eating?
Rachel: Well, it's interesting you ask. I actually did a presentation to a group of people for our Phoenix Paleo Primal meet up on Sunday and I did talk quite a bit about the ketogenic diet. And then I had a cooking class on Monday night and we talked a little bit about it. And I'm actually planning to do some ketogenic cooking classes and presentations to teach people more about the benefits and how to get started.
But in general a lot of the places I teach I will be kind of under the radar paleo. Like there won't be any grains or beans or legumes on the menu and I don't use that term Paleo, but I'll just show them how to make outrageously delicious food that just happens to be free of grains and dairy or minimal on the dairy. So it really depends on the venue I'm in, but I definitely plan to use that term more and like I said create a whole blog around the ketogenic diet for healing and recipes and resources.
Chris: So if I can't attend -- I'm sad that I can't attend those classes in Arizona, but you're writing about the stuff too.
Rachel: Yes, absolutely and if I had a wealthy benefactor I would be working on my cookbook five days a week, but since I don't yet I work on it when I can and definitely making some progress. And so I've got several book ideas in the works and the cookbook will be first.
Chris: I think that's going to be really important. There are not really much of them. Is there anything you could recommend at all that's out there on the market at the moment?
Rachel: Okay. So there are two ketogenic e-books for cancer. One of them by Ellen Davis and one of them by Miriam Kalamian and there's a woman in the UK who has a two-week meal plan that can help people transition into the ketogenic diet. And I like her book. It definitely has more meals that are meatless than I would typically do. But she's got a lot of great suggestions and some good recipes. Her name is Patricia Daly.
[0:50:10]
I also really like Jimmy Moore's new book Keto Clarity and I flagged probably a dozen recipes in there that I want to try. So there are some good things there, but overall it's I think if you look for paleo or paleo low carb recipes online you can get some ideas and if you're good at modifying recipes like I am you can look at recipes and say, "Ah, I'm going to switch that out for that and replace that and make it fit the keto diet."
Chris: And do you see this as a short term thing or are you going to keep doing this even if you didn't have to? Would you keep eating this way?
Rachel: You know I would. I see it as a lifestyle. I see it as more of a lifestyle for me more of a long term thing and what I imagine is that overtime I'll be able to add more vegetables and more and maybe even have berries and some other fruits in a larger amount. But I see this as a really important lifestyle because the cancer I had was stage IV. It was very high risk and I don't see myself taking some of the meds they want me to take indefinitely that long.
I plan to at a certain point with medical supervision wean off some of the drugs that they would normally have people on longer term. So I think the diet is very protective and I imagine that once I'm off some of these meds I'll be able to stay in ketosis with a slightly higher carb limit particularly with exercise and more exercise that I want to be adding in over time.
Chris: Right. And then how can people find you, learn more about your work and your recipes, the blog? Whereabouts is that?
Rachel: If they go to thehealthycookingcoach.com, that's my blog, they can find recipes, book reviews, product reviews. I do monthly giveaways of different paleo and primal books and products there. And then I also have a Facebook page, The Healthy Cooking Coach and YouTube. I don't do a lot with YouTube. I do more with my blog and I have a monthly newsletter and then Facebook. So if they go to my blog they can also subscribe to the newsletter and to updates for my blog. You can also find me on Twitter.
Chris: Wonderful. Well, thank you so much for coming on today. It's a truly inspiring story and I wish you all the best. It's incredible the amount of motivation and determination and discipline that you have is quite extraordinary and I'm really looking forward to seeing the cookbook and reading more of your recipes. So yeah, thank you very much.
Rachel: Sure. And I'll put you on my list for review copies of the cookbook when it's ready.
Chris: Ooh. Yeah, Julie will love that. She's the mastermind when it comes to cooking certainly. She does all the hard work. It's easy for me to say, "Oh." Really she's doing all of it. I just have to do the eating part which most people can do.
Rachel: Yeah, that's easy, right?
Chris: Yeah. Okay. Well, thank you so much.
Rachel: All right. Thanks for having me.
Chris: Yes. Bye.
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