How a Modified Keto Diet Can Help You Lose Weight and Keep It Off

February 2019
Volume 25    |   Issue 2

If you pay any attention to diet trends, you’ve probably heard of the ketogenic diet. Proponents of the “keto” diet like that this high-fat diet actually helps them lose weight. But you may be wondering what this diet really entails and whether it’s actually healthy.

I’m sure you know that fats are high in calories. And the conventional way to lose weight is to cut back on your calorie consumption. This led to the low-fat craze we saw a few decades ago. Now, predictably, the pendulum is swinging back the other way. The keto diet is all about fat. So how does it help with weight loss?

When I say “all about fat,” I mean that almost literally. This diet is 70-80% fat, 20-25% protein, and only 5-10% carbohydrate. There are a few reasons that it helps followers lose weight. One is that fat is very satisfying. So even though it’s high in calories, it can help you consume fewer calories overall.

However, the main reason the ketogenic diet works is that it forces the body into a metabolic state called ketosis. To reach ketosis, you have to use up all your stored carbohydrates. Once your carb stores are gone, your body will begin burning fat instead. Reaching this state can be good for you. But you have to be very careful with your carb consumption once you get there. Any extra carbs can switch your default away from burning fat again.

Because of these requirements, adherents to this diet have to stay away from most processed foods. Flours and sugars are a no-go. Even most fruit is out due to its natural sugar content. At the end of the day, fruits are a carb.

We’ve talked a lot about the dangers of processed sugars. But the sugar packaged up in fruit does have fiber and antioxidants to go with it. I think that for most people, it’s fine in moderation. Having said this, I have many patients who have thrived on the keto diet. But most of my patients give it a spin and in the end return to the Mediterranean diet. Why? What most people report is that it’s just too difficult to delete an entire food group, such as carbs, and integrate into the world successfully. But don’t tell this to the mothers of some of my epileptic young patients. The keto diet was first developed to help treat children who were experiencing seizures and had not seen success with medication. This diet is indeed remarkable for most young children experiencing seizures.

So, when it comes to diet, I’m generally a fan of the Mediterranean diet. This dietary pattern allows fruit and vegetables of course. It also emphasizes high-quality protein and even small amounts of alcohol in moderation. Most Mediterranean cultures are getting the majority of their protein from fish, beans, and legumes, rather than red meat. And there’s a good bit of fat in the diet as well, particularly from olive oil.

Like the keto diet, the Mediterranean diet doesn’t have much room for refined sugars or flours or other processed foods. In general, I think it’s a healthy way to eat. But because it’s so flexible, it can be easy for followers to go overboard on the carbs. People can tend to home in on the fruits, red wine, and whole grains when they should be filling more of their plates with vegetables, olive oil, and fish.

That’s why I’ve begun tweaking my recommendations and asking patients to consider what I’m calling the “Keto-Med” diet. I think eating this way combines the best of both worlds. It encourages high-quality fat consumption but also allows for good complex carbs, primarily from vegetables and in small amounts. The keto diet often leads people to eat too much unhealthy fat just to meet their energy needs. But eating the right amount of fat from healthy sources can help keep you from going overboard on the complex carbs.

Researchers are starting to take note of this dietary pattern. Let me tell you what their studies have found so far.

Researchers have always been particularly interested in investigating dietary changes in people who are obese. I’m sure you know there are connections between obesity and a number of diseases. Losing weight can help people keep their blood sugar and blood pressure under control and decrease risk of cardiovascular disease and diabetes. So the keto diet could help them. But it can be hard to follow.

Researchers in Spain designed a diet they called the “Spanish Ketogenic Mediterranean Diet” (SKMD) to test with 31 obese participants. They asked the participants to focus on fish as their primary protein source. People in Spain eat a lot of fish – thus the “Spanish” designation.

For carbohydrates, the participants mainly ate green vegetables and salads. But they were allowed 200-400 ml of red wine every day. Their principal source of fat was virgin olive oil, a keystone of the Mediterranean diet. And they had a lot of it – at least 30 ml (2 tablespoons) per day.

The researchers didn’t restrict the participants’ calories at all. They could eat as much as they wanted within these parameters. The participants followed this diet for 12 weeks.

Even though the participants could eat a lot of food, by the end of the study, they’d lost quite a bit of weight. In fact, they dropped from an average of 238 pounds down to about 208. That’s quite a difference in 12 weeks!

Their other numbers improved as well. Systolic blood pressure dropped from 125.71 mmHg to 109.05 mmHg. Diastolic blood pressure went from 84.52 mmHg to 75.24 mmHg. Total cholesterol went from 208.24 mg/dl down to 186.62 mg/dl, with LDL dropping from 114.52 mg/dl to 105.95 mg/dl but beneficial HDL cholesterol actually increasing from 50.10 mg/dl to 54.57 mg/dl. Blood glucose levels improved from 109.81 mg/dl to 93.33 mg/dl as well.

The researchers concluded that the SKMD is both safe and effective. These improvements in weight and diabetes and cardiovascular disease risk factors are likely to have significant effects on the participants’ long-term health, especially if they continue to follow this dietary pattern.

I think there are a few reasons this diet produced such great results. One is that the fat came mostly from olive oil. Many researchers think that olive oil is a key ingredient in the benefits of the Mediterranean diet. And a 2014 meta-analysis confirmed that a relationship exists between consuming olive oil and a lower risk of stroke, heart disease, and overall mortality. I think getting the majority of your fat from olive oil rather than a variety of saturated fat sources is a good strategy.

Fish can play a key role as well. In conjunction with olive oil, fatty fish can contribute to a diet that’s predominately fat without veering into unhealthy territory.

It is important to note that it isn’t always wise to follow a ketogenic diet permanently. For one, it’s challenging from a logistical standpoint to stay in ketosis permanently. And ketosis is essentially a starvation state. Once you begin eating carbs again, your body may overreact and begin to store excess fat. This can lead to yo-yo dieting. However, for some people it’s a perfect fit. I have several patients who have been on Keto for four years. They’re very strict with it. And they feel brilliant, look great, and are not turning back. It really depends on the individual. All of these patients lost more than 40 pounds. One lost 65 pounds. And they fear they will go backward if they change. But for most people, the Keto-Med is much easier to follow and, in the end, overall healthier for the majority of people.

Following the Keto-Med diet can help with this. In fact, when researchers asked participants to briefly follow a ketogenic diet for two periods and follow the Mediterranean diet in the interim, they were quite successful. They kept weight off long-term and improved their overall health.

I think that in the long run, it’s best to be just outside ketosis. A good range to shoot for is 55-65% fat, 22-30% protein, and 7-10% carbs. You can also get 5-10% of your calories from red wine if you choose.

Of course, the foods you choose to hit these ratios are as important as the ratios themselves. Your protein sources should supply a good bit of fat too. Think fatty fish, eggs, and cheese. You can also choose some leaner meats occasionally. But steer clear of red meat, as the Mediterranean diet recommends, unless it’s grass-fed beef, venison, bison, and the like. These red meats have much better fat content than corn-fed beef.

Get the rest of your fat from plant-based sources like coconut and olive oils. Avocados are a good choice, too.

For your carbs, you can eat a lot of vegetables for your caloric buck. Fill your plate with plenty of leafy greens and non-starchy vegetables first. But the occasional piece of fruit or starchy sweet potato is fine, too. These foods supply plenty of benefits. You just want to stay away from a lot of sugar and flour, especially processed grains.

You can adjust the ratios as needed if you want to try to hit ketosis. But don’t stay there. As I mentioned, being in ketosis long-term can have some negative consequences. And most people find it difficult to maintain.

When people stop the keto diet, they often find that much of the weight they lost comes right back on. That’s because people tend to add too many carbs back in too quickly. When coming out of ketosis, if you want to avoid weight gain, it’s important to add very small amounts of carbohydrates slowly. And following the Keto-Med diet will help you avoid this pitfall.

With all the various diets out there, it can be hard to know what to choose. The good news is that in many cases, it’s possible to combine the best of them. The Keto-Med diet does just that.

If tracking your ratios of fats, protein, and carbs sounds overwhelming to you, that’s okay. You can stick with the basic guidelines of the Mediterranean diet. Just don’t go overboard on the carbs. If your diet emphasizes vegetables, some fruit, limited amounts of high-quality animal protein, beans, legumes, and mostly plant-based fats, chances are you’re going to be okay.

While I call this a “diet,” it’s important to think of this more as a lifestyle. Don’t worry about your weight as much as you concern yourself with the quality of the food you eat. Doing so will not only help you lose weight, but it will also help you live a very healthy life.

This “Healthy” Sweetener Isn’t So Healthy

Pretty much everyone agrees that sugar isn’t good for our health. But pretty much everyone enjoys the way it tastes too. So we’re always seeking that elusive ingredient that will make food taste sweet without making us too unhealthy.

Some people thought Splenda was the answer. But it has a lot of downsides. I’ve written plenty about them before. But if you check out those articles in the archives, you’ll see that one of the alternatives recommended was agave nectar.

Agave nectar comes from a plant. That’s usually a good place to start when you’re looking for healthy foods. And agave nectar is low on the glycemic index (GI). That also tends to be a good sign. And some animal studies have found that mice fed agave nectar fare better than mice fed sucrose. They don’t gain as much weight, and their insulin and blood sugar levels stay lower.

But it turns out there’s more to the story. The reason agave nectar is low on the GI is that there’s very little glucose in it. Glucose is typically the culprit when blood sugar or insulin spikes. But just because there’s no glucose doesn’t mean there’s no sugar.

Agave nectar sounds very natural. But it’s actually highly processed. And it definitely contains sugar. To create it, manufacturers first extract sugary sap from the agave plant. This alone isn’t so bad. The sap still contains a good bit of fiber in the form of fructans. These help your metabolism and insulin levels stay stable.

But the next step in the manufacturing process is where the trouble comes in. Manufacturers then heat the sap to form a syrup. This process destroys any health benefits in the sap and converts the fructans to fructose – a form of sugar.

You may recognize fructose as the kind of sugar we find in fruit. But again, when you eat fruit, you get plenty of fiber packaged with the fructose. Fructose is also the sugar form in high fructose corn syrup (HFCS). And you know that isn’t good for you.

Over the years, I’ve found that many of my patients struggle with fructose. And unfortunately, that includes agave nectar. Table sugar and even HFCS are about 50% fructose (the other half is glucose). Agave nectar, by contrast, is about 85% fructose.

It turns out that all this fructose is hard on the liver. All of your cells can use glucose for fuel. But the liver is the only place the body can break down fructose. So if you get a major influx, the liver has trouble keeping up.

When the liver can’t metabolize fructose quickly enough, it starts turning the fructose into fat. And this fat increases your blood triglyceride level. It may even contribute to fatty liver disease.

Because the liver turns fructose into fat, fructose doesn’t seem to increase blood sugar levels in the short term. That’s a big reason we thought agave was a better option. But over time, this fat is also harmful. And fructose can eventually contribute to insulin resistance if you consume a lot of it. That in turn will increase your risk of metabolic syndrome and type-2 diabetes. It also increases your LDL cholesterol levels.

Not all of the news about agave is bad. Agave contains inulin, which is now being associated with a functional prebiotic. So, while agave isn’t as good as we originally thought, it’s better than Splenda and the other synthetic chemical sweeteners.

I do still think stevia is a good option. And the bottom line is that we need to train our palates not to expect so much sweetness. Sugar in any form is something to use sparingly. And of course, you can choose whole fruit to satisfy a craving for something sweet. The fiber in fruit helps the body process the fructose easily and helps keep you from overeating.

I don’t think you need to avoid agave nectar completely the way you should shun Splenda and other artificial sweeteners. But you should consider it a treat, just like you do other forms of sugar. And you probably don’t need to use it as a substitute for other natural forms of sugar unless you truly prefer the taste.

Why Women Are More Likely to Suffer From a Stroke — And How to Prevent Them

Did you know that 55,000 more women than men suffer a stroke every year? In fact, strokes are the third-leading cause of death in women in the U.S. Despite their prevalence, we still have a ways to go in understanding what makes women so vulnerable, especially when compared with men.

Researchers at Brigham and Women's Hospital have been investigating women's risk factors. After evaluating a number of factors, particularly those related to women's hormones, the researchers identified a few key risk factors. These include being less than 10 years old at menarche, being less than 45 years old at menopause, having low levels of the hormone dehydroepiandrosterone (DHEAS), taking oral estrogen or combined oral contraceptives, and having a history of pregnancy complications like gestational diabetes, pre-eclampsia, or hypertension.

These factors are common, and many more women will have these risk factors than will actually experience a stroke. However, women should be aware that these factors increase their stroke risk. So if you have any of these risk factors, it's important to take steps to improve your cardiovascular health.

If you have any of these risk factors, here's how you can protect yourself:

First the obvious: If you are still smoking — quit. If you're seriously overweight and it's interfering with your ability to be active, ideally you will shed some pounds. If your doctor has told you that you have prehypertension — lower your blood pressure using Advanced Blood Pressure Formula (800-791-3395) so things don't escalate.

Next, try to add fish oil to your diet either by eating fish two to three times per week or taking a supplement. This will help to keep your blood less sticky and flowing more easily which will help reduce your risk of having a stroke. If you currently exercise only a couple of times per week, try to walk 20 minutes on the days you're doing nothing.

If your blood sugar is on the high end of normal, tighten the reins on your diet. Try less sugary foods, especially in the evening. If you crave sweets, try eating berries or half of an organic apple.

And lastly, if you feel very fatigued with seemingly no apparent reason and occasionally feel what seems like a rapid heartbeat, dizziness, shortness of breath and/or excessive sweating - go see your doctor today. You could have atrial fibrillation. If you do, this should be addressed, as it significantly increases your risk for stroke.

Stacie L. Demel, Steven Kittner, Sylvia H. Ley, Mollie McDermott, Kathryn M. Rexrode. Stroke Risk Factors Unique to Women. Stroke, 2018; STROKEAHA.117.018415 DOI: 10.1161/STROKEAHA.117.018415.

Nutrition Detective

Eating Less of This Protein Can Help You Live Longer

Do you want to know if you’re likely to live past 100? Becoming a centenarian is a goal many health-minded people pursue. Knowing if you’re on track to reach it can help you with your retirement planning. It can also motivate you to keep leading a healthy lifestyle.

Of course, no one can predict with total certainty how long you’ll live. But researchers are getting better and better at estimating this key number. That’s because we now have a better understanding of what causes aging in the first place.
One such driver of aging is a protein called galectin-3. Galectin-3 contributes to ongoing inflammatory conditions. And as you know, inflammation leads to aging. It plays a role in many diseases.

High galectin-3 levels are present with many horrible conditions. These include metastatic cancer, heart disease, organ failure, and immune dysregulation. Measuring galectin-3 levels helps doctors know if these deadly diseases are progressing.
In particular, this protein helps cancer cells stick together. The inflammation it creates contributes to heart disease and tissue damage. It can help build the blood vessels that feed tumors. It even contributes to skin diseases like atopic dermatitis.

One large study of over 8,000 people focused on galectin-3 levels. The researchers wanted to see if there was a connection between this protein and overall mortality. And there certainly was. In general, they found that elevated levels of galectin-3 triples overall mortality.

Other researchers wanted to know if the opposite was true. Can low galectin-3 levels predict overall health and long life?

Researchers from Spain decided to find out. They gathered two groups of people. One group served as the controls. They were healthy “younger” people. They ranged in age from 70 to 80. The other group, which the researchers dubbed the “dodgers,” were 100 and older. They were also healthy – they had “dodged” typical chronic age-related diseases.

The researchers tested the participants’ blood for galectin-3. And they found that galectin-3 was indeed a helpful biomarker for healthy aging. In fact, the “dodgers” had lower levels than the “young” crowd!

Clearly, low galectin-3 levels can mean good things for your longevity. So you certainly want to keep it under control.

There are several ways to do this. One of my favorites is modified citrus pectin (MCP). I like a product called PectaSol that contains MCP. MCP helps block the activity of galectin-3 to protect your body. In fact, it’s recently been highlighted as the top choice of 40 naturopathic oncology providers in treating thoracic cancers. These include lung and esophageal cancers. I’ve written extensively before about PectaSol. So you can check the archives online if you’d like to learn more about this option.

Another solution is immune-boosting mushrooms. Several types of mushrooms can help reduce inflammation and down-regulate galectin-3. You can find these mushrooms in Integrative Digestive Formula. Improving your digestion will also help your body produce fewer toxic metabolites that contribute to aging.

Finally, you can try Advanced Adaptogen Complex. You don’t want to make it to 100 only to be exhausted all the time. This formula will help you reach that milestone by reducing the effects of galectin-3. And it will also help boost your energy and stamina as you get there. It will assist you in carrying on with all the activities you love that have made life worth living for 100 years!

There will always be things in life that are outside of our control. But by controlling what we can in our health, we’ll help set ourselves up for success – years and years of it! (You can order all three of the products mentioned here by calling 800-791-3395.)


Q: I’m 62 years old and I’m still experiencing hot flashes. I went through menopause at age 48, so I've had hot flashes for 14 years. I’ve visited with my gynecologist and she’s loathe to prescribe me hormone therapy because of the history of breast cancer in my family. HELP! Is there anything I can do besides constantly fanning myself and disrobing? – Alana, Fort Lauderdale, FL

Dear Alana,

You’re not alone in your frustration. A lot of women haven’t found a solution to their hot flashes. Fortunately, there are a few natural, non-hormonal options:

(1) Homeopathic Lachesis – Most women who experience hot flashes through the night or upon falling asleep or when they first wake up do especially well with this homeopath. If you experience hot flashes all day, this is still worth a try for a small investment of around $10. This remedy is the most popular homeopathic remedy to give relief to those with menopausal hot flashes.

(2) Black Cohosh – Black Cohosh is very helpful in balancing female hormone imbalances. In a 2010 scientific review, the efficacy of black cohosh reducing night sweats and hot flashes had a 26% reduction.

(3) Wild Yam – You can take Wild Yam internally or topically. It’s most effective when a woman is low in progesterone. If you visit with your gynecologist, she can test you to determine a level of estrogen, progesterone, testosterone, and DHEAS. All of these hormones contribute to a smooth menopausal experience. If it turns out that you’re low in progesterone, you may want to try a topical progesterone, such as Emerita Pro-Test Natural Balancing Cream (Amazon) or an internal supplement, preferably a capsule.

Q. My doctor recently told me that I have high blood pressure. WOW! Was I surprised! Well, I've been eating even better than I had been and exercising more, but it doesn't seem like it's touching my blood pressure. My doctor said that I am technically “pre-hypertensive” and that I could try for one month to do things naturally. Do you recommend anything that I might try? – Stephanie, Rapid City, SD

Dear Stephanie,

In addition to CircO2, which works great for lowering blood pressure, there are a couple of things you might want
to try.

(1) Hibiscus & Chinese Salvia (Dan Shen) – Both of these herbs alone and together are remarkably effective for both pre-hypertension and hypertension. Advanced Bionutritionals has a very effective formula that contains both of these herbs. We have had many customers send us endorsement letters thrilled with the results. You can also purchase these herbs and make a tea if you prefer that.

(2) Ameal Peptide – Ameal Peptide was first discovered over the course of 40 years of continuous research. One of its key features is blood pressure lowering and the ability to improve cardiovascular functions. It has an inhibitory effect against angiotensin converting enzyme (ACE). It works on blood vessels by inhibiting enzymes that cause blood pressure to increase.

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