This transcript is brought to you thanks to the hard work of Jeanne Wagner.

Do you think people with weight to lose need to consider calories if they are experiencing a long plateau when eating a ketogenic diet? It’s that dreaded word, isn’t it? Calories.

Calories. You know what? The answer is, maybe, maybe they do. There’s a whole long list of things that we can consider when somebody is experiencing a weight plateau and yeah, calories is one of them. So for example, if you are just taking in too much energy from fat or from protein or even from carbohydrate or alcohol, if you’re just taking in too much energy and pushing through those hunger and satiety signals, because you’re eating for all the raisins or whatever it may be, then definitely reducing calories and trying to tune back into those hunger and satiety signals might be a strategy. So that’s often why people will use something like intermittent fasting. You know, they’ll spend that period, whether it be three months or six months or whatever it is, or shorter to get themselves fat adapted. And then they start to notice that the appetite goes down, and so they’re like, okay, well now I’m ready to do something else. 

And maybe the weight has plateaued. So then something like intermittent fasting where calories are being either spontaneously or purposely reduced by reducing meal frequency or reducing the eating window, can certainly be effective. But I guess as well, there’s so many other things to consider. It’s very easy just to default to the whole calories in, calories out thing. But you know, a lot of people, again, they try the calories in, calories out thing and it doesn’t work. So if it’s not working, well what else can we consider? And there’s a few little things that I look at in particular when it comes to weight loss resistance or weight plateaus. And one of them is iron levels. So if somebody is low in iron and it’s usually iron stores. So on the blood test, it’s called Ferritin, that’s your iron stores.

So if we’re low in iron, well that means we’re basically low in energy. So we need iron to transport oxygen around our body. And that’s how we produce energy. So if you’re trying to lose weight, you’re basically trying to get your body to expend energy to burn its stored energy. So it’s like a double whammy trying to get rid of energy from the body, but you don’t have enough iron to carry oxygen around the blood sufficiently. So the body is going to be like, well, hang on a second. We’re not getting rid of this precious energy that we have and we’re not gonna waste any energy burning fat because we don’t have enough iron. And it’s not like the body is consciously making that decision. It just can’t do it. And there’s the other theory as well where if the body is low in something like iron or one of those essential vitamins or minerals, it releases a bit of a low level stress response, which increases insulin resistance, which helps the body hold onto stored fat because any type of stress, it’s kind of like the body thinks it’s in a famine or in some sort of danger mode. So it’s not going to comfortably release any stored energy. 

So iron is a big one, massive one. And that’s something I think people should check specially, women of childbearing age or people with gut problems. So if you’ve got any sort of gut issues like inflammatory bowel disease or IBS or something where your ability to absorb nutrients is hindered iron is usually one of those things that’s not absorbed very well in those sorts of people. And then other things too, so it could be magnesium, a inadequate intake of magnesium is very strongly linked to insulin resistance. So you could have the perfect diet in terms of your carbohydrate macros, carbohydrate, fat, protein macros, sorry. And you may even be eating low calorie or you may even be in a calorie deficit and you’re still not losing weight. And so magnesium is a huge one because if you’re deficient in magnesium, essentially what that means is that the insulin signaling becomes less efficient.

So you become insulin resistant and then being insulin resistant actually makes you more deficient in magnesium because you use up more magnesium to make more insulin that you need. And so it’s actually like a vicious cycle, whereas your body is making you more and more deficient in magnesium when you’ve really need magnesium to get out of there and maybe restart weight loss or something like that. And magnesium deficiency is common. I know, I mean, when I was going through my dietetics practice, I remember learning about magnesium and they just said to us, Oh, you don’t have to worry about this one because no one’s deficient in magnesium. And I was like…

I thought it was more a case of everyone pretty much.

I was like, whoa, whoa, whoa. So we just don’t worry about it? Like no one’s deficient? Have you surveyed me? You don’t know what I ate. You don’t know if I’m deficient. Like how do you know? And I was just like, that’s not right. And so I actually delved into it a bit deeper and what they were trying to say, in their defense, was that so many foods contain magnesium. It’s abundant in our food supply that it’s not likely someone’s going to under eat it. So like, you know, it’s not like as obvious. Whereas if you stop eating meat, you’re probably going to be deficient. And I, and there’s, you know, cause a lot of food groups have it. But I thought that was, you know, that’s still not enough to then be like, okay, well everybody’s going to be safe from a deficiency because what we know about magnesium is that we all have a different magnesium bucket that we’ve got to fill up. 

And if you’re under a lot of stress, for example, which most of us are in this modern world, or you’re going through a very stressful period of work, or you’re doing a lot of fasting, which is a stress or whatever it may be, your magnesium bucket actually gets bigger. So now you’ve got to fill up a larger magnesium bucket so that you don’t have a deficiency. So trying to fill up a huge magnesium bucket -let’s say you’re really stressed at work, you’re also doing this fasting thing. Or maybe you’re doing a low calorie diet, they’re all stresses on the body and maybe you’re not sleeping well. Maybe you’re taking lots of medications- you’ve got this massive magnesium bucket and you just can’t, you can’t fill it. You can’t fill it up. So you become deficient. And that’s maybe where supplementation could be useful.

Because isn’t part of the argument, you mentioned that their argument was, that it’s really easy to get magnesium from foods. But I thought that that was one of the arguments actually that foods have less than less magnesium in them, so it is more difficult actually to get enough magnesium from the foods. Even if you’re eating a diet that is allegedly rich in magnesium.

Agreed. So the soils are becoming more and more deplete in magnesium. So we don’t even really know how much magnesium is in the food were eating, you know, from the vegetables and the seeds and all of that. You know, if a food is fortified with magnesium, which a lot of those packaged bread and cereal products are fortified with magnesium, well that’s kind of a supplement really. If it’s being fortified, it’s not in the food naturally. If you’re doing that, then yeah, you might be able to argue that you’re getting in enough magnesium. 

But, you know, a lot of people particularly in this space aren’t eating those fortified breads and cereals and that’s when I think short term periods of supplementation can be warranted. So for this particular person who is trying to figure out why they are in this weight plateau, you’d go through those different types of things as well. So a lot of it is micro nutrient based, trying to figure out if somebody’s got a deficiency in one of these major micronutrients and if they do well, can we use short term supplementation, to help boost up the levels. And then once they are able to get things going again and we’ve seen adequacy in those micronutrients, then we can try and keep that there with food. So yeah, there’s, Oh my God, there’s so many others. Like I’m just thinking of more that I come into my head a well.

It can be difficult to test magnesium can’t it though. I seem to remember reading that the blood test to see if your levels of magnesium isn’t particularly accurate. Is it sometimes a case of sort of guessing what the problem might be in? I mean something like taking magnesium supplements is unlikely to do you any harm, is it? You just end up, you can tell if you’ve had too much because things tend to move through your system a little bit too quickly to put it a bit lightly.

Yeah, no, you’re right. So, a lot of the blood tests for vitamins and minerals are just completely inaccurate. Sodium magnesium is one of them. The blood tests for serum B12 is highly inaccurate and the reason the blood tests and the magnesium is inaccurate is because magnesium is stored in our bones. So it’s not really frolicking around our blood stream anyway. So it’s more used in the acute care setting where they’re trying to work out, um, people’s electrolyte balance and whether or not they need to give them supplementation to keep them alive and things like that. So that’s why the magnesium always appears on your blood test, but it’s actually not useful in determining whether or not you’ve got a deficiency. 

The way I do it is by one trying to predict how large someone’s magnesium bucket is. So do they have higher requirements and if they have insulin resistance, if they’re taking multiple medications, if they’re under a lot of stress, if they’ve got anxiety, things like that, then I just make the assumption that they’ve got higher requirements for magnesium and then you can supplement based on that assumption alone and then just sort of track symptoms and see if things improve. But also the other thing is as well is that you can calculate people’s magnesium so you can sit down and you can go, well, what are they eating? How much of my magnesium are they eating and match it with your prediction for increased requirements. 

But then the other factor that comes in, which is how this conversation all started, is that people are usually trying to lose weight as well. So if you’re trying to lose weight on top of an increased requirements for vitamins and minerals, sometimes you actually can’t eat enough food. Even if you’re eating all these magnesium rich foods, you can never get to that point where you’re going to meet your requirements because you’re also trying to lose weight and you’re trying to keep your food intake low. You don’t want to overeat. So that’s the other thing. 

You know, sometimes when you sit down and you put together, well this is what you’d have to eat in the day to meet your magnesium requirements. Someone’s magnesium requirements are really high. They’re just like, I can’t eat all that. Like if I eat all they have, I’m gonna gain weight and they might be right. So that’s another thing that needs to be factored in. But there are some blood tests which are good. So you know, vitamin D is usually a pretty good correlator of your vitamin D levels and your vitamin D status, and also some other good ones. Iron is good.

The iron tests are reliable aren’t they?

Yeah. But like for the minerals, they’re all pretty basic. They’re not really going to tell you much about your actual diet. Another good one that I’ll share is that I think a really good blood test to request from your doctor is something called homocysteine. Have you heard of it?

I have. I couldn’t talk about it. I’ve definitely heard of it. So I’m fascinated. I know the word.

Yeah. Well, I mean, I didn’t learn about this at uni or anything either, and I don’t think a lot of people know about it, what it is or what it does, but I learned about it through my own sort of health journey as well, and then I dived into the research. So basically it’s a protein and it will build up in your blood if you have a deficiency in either folate, which is vitamin B nine or vitamin B12. So if you just got a blood test for vitamin B9 and they looked at serum B9, a lot of the times your blood has a lot of this serum B9 floating around a lot of B12 floating around and your doctor goes, oh, that’s good, you’ve got no deficiency. But those two vitamins need to be activated to actually be used by yourself. 

So they can be floating around the blood and high amounts. But the question of whether or not your body is actually using those B vitamins can be answered by testing homocysteine. So if you test your homocysteine and your levels are elevated, you can assume that you’ve got a deficiency in either vitamin B9 or vitamin B12 or both. And you just sort of play around with that until you get the homocysteine levels down. So I think that’s a really good one because that definitely happened to me. 

I you know, when I went through my kind of stage where I was doing a lot of restrictive eating, I ended up with nerve damage in my hands and my feet and they, all, the doctors tested me for vitamin B 12 because vitamin B 12 is linked with peripheral neuropathy, which is nerve damage in the hand of feet. And My B12, my serum B12 always came back high, you know, it was, it was always, Yup, you’re fine. It’s got to be something else. They called it idiopathic peripheral neuropathy. And you know, seven years passed before I finally found out that the B12 blood tests really just does not correlate to your B12 stores. And my body had a problem in activating B12. So even though it was in the blood, my body couldn’t get it into the cell. 

And so I had to supplement with an activated form of B12 to help my body get that sort of B12 into the cell. And boy, I wish I knew about that seven years ago because maybe the nerve damage is permanent, and maybe that’s something I’m going to have to live with. And if I can prevent other people from having any permanent damage from a B12 deficiency or a folate deficiency, I’m going to spread that message. So homocysteine, get it tested.

That sounds like it’s potentially wrapped up with the problems that some people have with the MTHFR gene. Yeah, it sounds like it could be linked.

There’s a lot of different genes which are gonna affect your ability to activate B vitamins and other vitamins and minerals and so on. But yeah, so essentially when I say activation, that actually means methylation and the MTHFR gene mutation that you’re talking about, there’s a few different types, but one of the more well researched ones means that if you’ve got the mutation, then you have a reduced ability to methylate things in the body. So turning things on or turning things off like for example, being able to activate a B vitamin to get it into the cell, your body can’t do that very well. And you know there’s a lot of people walking around with these genetic mutations who have absolutely no problems.

And just because you have a genetic mutation doesn’t necessarily mean that you’re going to develop these medical problems from it. Everybody’s different. It’s kind of how it gets expressed in your body. I know with that particular mutation, a lot of people end up with miscarriages and problems with fertility because we know that folate, vitamin B9 is essential to grow in your human and to be fertile. And so if you’re not activating vitamin B9 and you’re not able to actually get that into your cells and tissues, then yeah, there could be problems with fertility and there could be problems with having a healthy baby, which is awful to think about and awful to think that there’s a lot of people that may have this mutation and may have those issues but don’t know it and don’t know how to actually test whether or not they are deficient in B12. I mean B9 or B12. So you can get tested for the mutation pretty easily and you just ask your doctor to throw on a test for MTHFR and they can just do it with your regular blood test and if you want to know about it, you can know about it.

I mean really the way you sort of manage that mutation is, is by checking on homocysteine anyway. So you know, it’s more linked to those deficiencies in B12 and B9 so if you’re looking at your homocysteine and keeping that am in a good range, then it doesn’t really matter whether you have the mutation or not kind of thing, but a lot of people like to delve into their health more. I would put a, a big beware sticker on that though because it is a little bit scary if you type in or if you Google the MTHFR genetic mutation… I don’t know, have you googled it?

Yeah, a whole slew.

Oh yeah. It’s like all the worst things, you know, just pop up like cancer, depression, stroke, miscarriage, nerve damage, Alzheimer’s. It’s like everything that you want to not get in life is what you’re now learning you’re at greater risk of. And so, you know, it was really scary finding out that I had that and I’m a health professional who’s able to look through the literature and kind of just cycle through it and figure out what I need to do. But there’s a lot of people that that would just completely overwhelm them and be far too much and maybe they don’t even need to worry about it. That’s the thing. It’s going to be a different outcome for different people depending on your lifestyle, you may have absolutely no problem whatsoever with the mutation or it could be something that’s crucial in your health journey to find out about.

Yeah, that’s the thing. I think it can totally be overwhelming, but it can also be that missing link for something like for example, when I interviewed Carrie Brown and when she discovered that there was this problem, it was suddenly, you know, light bulbs going on everywhere and gave her a way to treat and reverse, you know, her bipolar disorder along with eating Keto. It just, it suddenly, it’s a relief to somebody like that because they find out one of these root causes and the problems and it gives them a path for treatment. But yes, I can totally see the other way. If you’re not looking for something, if you’re not looking to try and fix a problem and you suddenly find out that potentially you’re vulnerable to a whole myriad of things, that could be very scary. So I suppose it depends what angle you’re coming at.

Yeah, that’s a good way of looking at it. And I’ll just quickly finish up by saying what you just said there about knowing she had the mutation and that knowledge and that management strategy in combination with the ketogenic diet is important actually because she may, let’s say as an example, never knew she had the mutation but when and changed her diet and she could still ended up improving her health with the same outcomes. It’s obviously going to depend, this is completely, I actually didn’t listen to the interview I don’t know her, but you don’t have to know you’ve got it. You can still just make the best decisions for your health and keep going on how you usually, you know, doing your, health goals and then working towards them, fixing your diet, whatever it is and you can still be fine. You don’t always have to know you have it. And so the ketogenic diet, the way it can help with the MTHFR mutation is by reducing or eliminating your intake of folic acid. Did she discuss this?

Not so much. It was more, she, well she found a big improvement just with the Ketogenic Diet and that really helped with her bipolar. But then it didn’t take her quite far enough. And by discovering that she had this gene mutation, that’s when she started supplementing with methylated B vitamins and noticed a huge improvement after doing it.

Yeah, that’s awesome. And so where that first benefit could have come in, obviously there’s all those mechanisms with the ketones that would be good for brain signaling and all of that. But as well if you go on a Ketogenic Diet you’re essentially getting rid of a lot of products containing wheat, and wheat is fortified, at least in Australia. Most countries is fortified with folic acid, which is the synthetic form of folate, which is actually really not good for somebody with an MTHFR mutation because you can’t process it. So you can’t activate that folic acid and turn it into the folate you actually need. It’s a synthetic form, which they say is very bioavailable. They say all folic acid, you can absorb it really well all as well, but you can ‘t actually then go and activate that if you’ve got this genetic mutation.

So having folic acid or a lot of folic acid can sometimes make your symptoms worse. So step one could be getting rid of the excess folic acid and then as Carrie has shared step two might then have to be going supplementing with those vitamins that you’ve been missing out on. And certainly that was the same with me. So I cut out my folic acid and had some benefit, not very noticeable with my nerve health. And then learning about this mutation and what it does with the activation of the vitamins just opened this whole new door for me cause I was at the point of my investigation of my nerve damage where I was kind of ready to give up. I was saying this is the last person I’m going to see about this and then I’m just never going to talk about it again. I’m just going to deal with the pain. But now it’s like I’ve got this, this hope again. So it is, yeah, it’s, it’s cool. But it is overwhelming.

Yeah.

So people out there, you know, if you’re going to test for genetics, take your genetic tests to somebody who knows how to deal with it and talk to you about it in a way that is applicable to you.

Yes. Real and practical solutions rather than being overwhelming. I think it’s fascinating how we start. I always wince when someone talks about calorie counting and and should I lower my calories? I get this reflex and I think straight away to start with, you started talking about energy intake and I think I prefer to to think of calories as energy intake. And yes, it might be necessary to literally reduce how much you’re eating, but I think it just goes to show and you’ve highlighted with potentially things that you need to supplement. I mean, and there are a whole load of other things that you could be looking at like stress and sleep and all kinds of things. But I think what’s so interesting is that we tend to jump straight to that conclusion because it’s been rammed into our brains that you’ve got to keep your calories down if you want to lose weight, but actually there’s a whole load of other things that you should be looking at first, and they all revolve around improving your health and well-being and actually it could be those that you need to look at probably are those that you need to look at rather than jumping straight on with cutting calories.

Exactly right. You said it. It was a really great question because it’s funny how we started with calories and then ended up with genetics. Sorry, just goes to show you know, there’s so many different things and I think it’s not a pretty answer when you can’t give a yes or no answer to that, you know, it’s not pretty, but it’s the truth.

Yeah. Just like you were saying in the interview, people generally, we all like a yes or no answer, but it’s just more complicated than that, isn’t it? That sort of, you know, it depends. Well maybe, but the other thing is what’s a plateau? You can get people saying they’re on a plateau they haven’t lost weight and you find out it’s just been a week. Well that’s certainly not what I think of as plateau. I mean I would go for months at a time without losing weight. Again, it’s just a natural part of the process, isn’t it? Just leveling out every now and then?

Yes. Super good point. I think that was my top tip on your last podcast. On our first interview. It was my top tip. I remember saying, you know, weight plateaus are a good thing or can be a good thing because yeah, we don’t just lose a kilo a week until we reach our goal. That’s not how our body works. We’re not machines. So having that period where you’ve lost some weight and then stabilizing so your whole energy homeostasis can reset and actually, you know, get that new set point and not work against you the whole time. Then can allow you to safely lose some more weight or more effectively lose weight, and keep it off.

Yeah, exactly, yeah.

Yeah. Instead of your body always wanting to revert back to the start weight, it will revert back to where it’s last got that homeostasis. If you do ever sort of revert, that’s because people are so afraid of putting all the weight back on and well, yeah, maybe if you lose it all at once by drastic measures, maybe you will put it back on. But if you do it slowly and gradually with those, you know, stepwise reductions and stabilizations in between, then you’re probably not going to put it back on.

Yes. I always think of it as your body just taking a bit of a breather. This whole losing weight business, it’s, you know, it takes quite a lot of work. It takes quite a lot out of the body. I just want to rest and sit where I am for the time being, but I love what you were saying about it’s a good way of just slowly bringing your set point down over time rather than your body wanting to go back up. But we do panic. I think if we’re someone who’s been overweight for a long period of time and we’re used to either gaining or losing weight, that’s what it’s always been. It’s been the cycle of one or the other and we lump maintaining a loss in with gaining because it’s not a loss. We shouldn’t, it’s a perfect place to be in just holding your weight.

MMM. You could argue the same for like HBA1C for example. If your HBA1C is 6.4 and then you get it tested, three years later and it’s still 6.4 I would be patting you on the back saying great, you’re doing something right. You know, cause it’s not progressively going up. Okay. But if we want to get it down, what can we do? And yeah, people are too quick to just find the negative in things and we need to look at outcomes not as like just good or bad. You know? We need to think of them more of sort of just like a continuum, like a scale.

Absolutely.

So, oh my gosh, we’ve almost recorded another podcast here.

Yeah I know! I was just going to say thank you so much. This is all first bonus content package and what a bonus content it is. Thank you so much Jessica, for taking that extra time.

That’s all right. I think I was about to say something else and then I was like, you know what? I think my brains fried now. It’s my bed time, so…

I’ve been draining, I’ve been sucking the life out of your brain, and this is you. You recorded another podcast earlier as well, so you must be completely frazzled.

No, it’s fine. I loved it and I think this is fantastic to everyone who’s a patron of a Keto Woman. I think that’s great. So I, I’m happy to give this long interview at 11:30 at night.

Oh my goodness. Well, thank you so much. We’re going to switch off now and I’m going to let you get some sleep.

All right. Good night. Thank you so much for having me.

This transcript is brought to you thanks to the hard work of April Ihly.

Welcome back Annette, to another ask Dr Boz where we will get to the ask Dr Boz question from the get go. 

Absolutely. I’m so happy to be back. Thanks for having me back. We will tackle questions. We will not tangent onto a Dr Boz-Daisy duo. 

Well don’t make promises you can’t keep because I’m sure we will end up going off on tangents, but we’ll try and keep on track at least to start with. 

Perfect. 

Okay. Shuffling my papers. So this is back to April where we started last time with the story of getting some help for her mum who has early onset Alzheimer’s and that was a really good development and that’s happening now. She’s getting them and by all accounts it’s a good thing and it’s helping. But April’s questions, she has a few. “Can a small fatty umbilical hernia self-repair on Keto. I feel like mine has improved since I started.”

Okay, let’s talk about umbilical hernia. So again, a hernia is an opening or a defect in the lining of a space in your body. So we’ll use the word inguinal hernias. And those are mostly associated with males. You can have an inguinal hernia as a female, but it’s much more rare and you can have an umbilical hernia. The inguinal hernia is the space where the testes actually left the abdominal cavity and go into the the genitals during birth. And if that lining gets too much pressure, it will pop open a connection between the scrotum and the abdominal wall. And I use that as an example to explain what happens with umbilical hernia because it’s much easier for people to visualize these two spaces having a connection. 

When it comes to umbilical hernia, you’re supposed to have a seal all the way around the inside of your abdomen. When you were in your mother’s womb, you were getting your nutrients and food through this vein and artery combination through your belly button. That cord got sealed and was supposed to completely adhese and scar off any opening. But if your tummy got big, if you have a weight problem, and you can even see this in little babies, if they have those cute little full tummies. If the scarring didn’t happen at the time of birth, you’ll see that the edge never could find its partner to seal. In their umbilical hernias, we worry only if the tissue comes through that opening and get stuck. So it’s actually safer to have a large umbilical hernia as opposed to a small one. A small one, if the tissue kind of pops through this little tear or this lack of adhesing, of sealing, and then the tissue on the other side gets kind of irritated and happens to swell too big to pull back into the tummy, that’s when you have a problem. 

I’m a big proponent of the less surgeries you have in life, the better you’ve done. So when I look at the need for an umbilical hernia, if you’re a swimsuit model, we can help you. If your hernia is stuck, it’s super painful, like it’s going to cause gangrene and die, it’s going to be an emergency, so it’s not like, oh, it’s a little tender. Nope, it got stuck as the tissue left the abdomen and got stuck on the other side of that opening. So when we look at can an umbilical hernia improve or repair, let’s just unpack that a little bit further. As the mass inside your abdomen gets less with the weight loss associated with the Ketogenic Diet, you’ll see that the pressure pushing through that little opening is now much less and the hernia will kind of retract back into the abdomen.

Will the scar ever seal shut? 

No. That time it’s torn. There’s nothing stimulating it to connect back together. But is it an emergency? Should you have to go under the anesthesia to get your umbilical hernia repaired? For your brain’s sake, I would say no way. I mean, every time, especially a patient with high inflammation, so if you’ve had an overweight tummy enough to cause an umbilical hernia, if you’ve been struggling with high insulin states of Metabolic Syndrome or God forbid, full diabetes, your brain doesn’t need any help with destroying or putting stress on those brain cells. Anesthesia, every time we do it, you have a cognitive hit. I don’t care what age you are, but if you’re inflamed, if you have high inflammation in your system, the cognitive hit is higher. So I would not sacrifice brain cells to repair an umbilical hernia unless your whole income comes from being a swimsuit model and you need that little bulge to not be there. That’s how I would answer that question. 

So yes, basically, yes, it’s not ever going to repair, but it’s going to get significantly better. 

Right. Good answer. Way To summarize what I just rambled on about. 

Okay. Another problem she has, although by all accounts from her update, it has got better. But I think this is an interesting one and this is a question I see from other people, so I do think it would be interesting to address it. When I fast, I feel great and the longest was 40 hours. The problem is that I feel awful when I start eating again. I’ve been slowly incorporating foods back in after a fast that no matter how slow or what foods I try, I always feel horrible for days. It’s only when I start eating again and not while I’m fasting. I want and need to fast, but I’m developing a fear of eating again afterwards. What might be causing this? And I know from my own experience, I don’t have as much of a problem as that, but certainly when I start eating again, I how should we put this politely? Have to run to the bathroom? And that always happens with me always when I start eating again and it’s something I know that’s going to happen, so obviously I plan for it, but this, I can see how this going on would just become a self fulfilling prophecy, if nothing else. But I have heard many other people saying the same thing. The fast is great. It’s when they start eating again that they have problems. 

There’s a few things, I’ve seen this multiple times as well, and here’s the advice I give folks. First of all, I would start with, as you look at a GI system that’s been shut down, which is what happens during fasting, it really slows down the movement, the gas, all of the secretions are much slower. You’re going to restart it when you start eating again. And the first wave usually does end up with an urge to go to the bathroom. One of the better ways to do that is to make sure that that first bit of food is high salt and warmth. So I recommend leading that first moment of breaking a fast with warm, salty broth. That nutrients is great, the salt is great, it tastes really good. And that kind of leading syndrome of there’s a lot of bone broth that does really does get absorbed before it ever gets to that large intestine. 

So you can see, even though the wave of peristalsis starts to send the wave down the gut, it’s much less if they lead with that. Second of all, you can talk to many of the people who’ve had gastric surgery for weight loss that they will have, I wouldn’t call it a full dumping syndrome where it’s a lot of diarrhea, but I would call it like a high like reflexive trigger for their peristalsis when they start to eat again. And I haven’t seen anybody successfully train out of that. So you’ve cut the nerves when you did that surgery and there’s a part in there that’s going to have this high almost reflex. And when you start eating, when you’re eating all the time, the reflex gets worn out and it’s not, you don’t have the diarrhea, but when you’ve had a pause and then you restart it, the wave goes from top to bottom and they end up at the toilet. 

That may fit to some people, but that, uh, is not uncommon. The third thing that I’ve seen that’s really important when thinking about what do you do to break a fast is consider whether or not what you’re eating is something you’re allergic to. And specifically, I point out lectins, I didn’t even know what lectins were before before the ketogenic diet, but you know, from bell peppers to peanuts to even jalapenos have some lectins in them. If what you’re eating are these wonderful ketogenic foods, but they are high in lectins, I have been amazed at how many of my patients when they cut out lectins, and really they did carnivore for about a month, so almost no vegetables, no peanuts, said my diarrhea went away. And so what I’ve reverse engineered is to say it is essentially an intolerance for lectins. And many of my celiac patients or gluten intolerance, even if they’re not full celiac, really have an insensitivity to when they consume a lectin, they get very loose stools and they get more of a spasm in their gut and they do a beautiful kind of movement and absorption process. 

And then the fourth one is what I do, which is when I’m done fasting, I feel the need to celebrate. So I will eat too much. And even though I’ve gotten a lot better at it, it probably took me like 50 times fasting to say you do not deserve a celebration. It is not that big of a deal. You are going to be fine. So the amount of food at first, try not to celebrate after a fast. And again, this is a goal, so keep working towards it. But if you celebrate with fasting, by eating a large volume of food, you’re going to pay the price. Your gut is just not goingto handle that as well. 

Yeah. Interestingly, I find it a good way to reset my satiety signals a bit, actually. I’m the opposite. I can’t eat much. The first meal I have is always a lot smaller than I would normally have, so I go the other way. But yeah, I know for some people the temptation is to eat all the things. 

If you’ve ever done one that’s been like four or five days, that’s the ones where I really mess it up and like I’ve only done that a few times. Usually I do a 48 hour, maybe a 72 hour, but 36, 48 are much more normal in my life and I’ve don’t have as much celebration. But boy, the times where I’ve pushed it, you’d think it was like a wedding or something.

It’s funny how our brains have to compensate. Yes. Okay. This is the big one, really. This is the main one. “I’ve around 200 pounds to lose. I’ve had some great non-scale victories, but Ihave lost no weight at all.” That’s got to be really frustrating, right? If you’ve got all this weight to lose when you’re over a certain size, that’s the assumption that you think that the weight is gonna drop off fairly quickly. At least to start with. “I’m not in it just for the weight loss and while my inflammation is down, it’s still really bad. I’m under 20 grams of carbs a day, at least 95% of the time and always under 30. I know I need to be patient and stay the course, but what are some potential reasons why I’m not losing the swelling and inflammation?” And I’m going to go on with along update now. 

That was her original question. I’ve pulled these questions from a list we had way back when we did the first ask Dr Boz and so I got an update from April to see where she’s at now. “My main question is why are my blood sugars still so high and why am I not losing the inflammation and weight, although that’s not my entire focus, after being Keto for so long?” Because of course she’s now, she’s been doing it for quite awhile. “I’m 46, menopausal and have severe sleep apnea and use a CPAP machine every night. I average about seven hours a night during the week on the weekends I often end up sleeping 10 or 12 hours to make up for what I’ve missed during the week. I don’t set an alarm. I just naturally sleep longer. I know I need more sleep during the week, but I always wake up around seven hours. 

There’s been a lot of stress in my family over the last two years. There hasn’t really been a break between incidents. My dad passed away three days before Christmas in 2016 from stage four renal failure, liver failure and diabetes. His heart gave out. My mom had not yet been diagnosed with Alzheimer’s but could barely take care of herself, so my sisters and I took that on. It was a huge source of contention for awhilewhile we figured out how to move forward. In the meantime, one of the family members was getting more and more toxic and dealing with them became an unavoidable nightmare. I’ve done what I can to remove them from my life, but they keep dragging out things that I have to be involved in, so I’m not completely free from that obligation. Mum was recently moved into a care facility. It’s a good one, but there are still stresses in dealing with that. 

Work isn’t really stressful, but there are times when it is. I’m also switching careers, so I’m dealing with learning a completely new career while still doing my current job. I started Keto in April, 2017 or what I thought was Keto. I think it was more low carb than Keto. I was told eat low carb and low fat because I had a lot of fat on my body. I started real Keto in June, 2018 after finding and devouring all the 2 Keto Dudes episodes. I had a relapse over the holidays. I was depressed because I had hardly lost any inflammation. My blood sugars were still ridiculously high and of course I hadn’t lost a single pound. I recommitted in January this year and purchased a ketone glucose meter to start tracking. I attempted fasting but my body didn’t respond well after the fast when I started eating again. Eventually I got over that and was able to fast without too many side effects. 

I tried to get the optimal Dr Boz ratio, but even after fasting for 69 hours, I was still way off. I went mostly carnivore in February. Still couldn’t hit the ratio. Ketonesrarely went over 0.5, they were at 0.1 or 0.2 most of the time and blood sugar still in the high one nineties regardless of how long I fasted or what I ate or the time of day. Recently I started an experiment. I eat only beef, usually ground beef or steak, butter, salt and water. I got a host of labs done beforehand, fasted. Waiting for the results to come in. My insulin a couple of weeks ago was 19.2 which is in range, thankfully. I plan to do labs periodically to compare. So far this seems to be helping as I’ve lost eight pounds in 12 days and my GKI is slowly improving.” She believes that cortisol is to blame, at least in part for her constantly high blood sugars. 

“I get a 40 to 50 point spike in the morning around two hours after I wake up and take my first reading. The result is the same whether I’m just driving to work or laying around the house relaxing.” She does tend to eat late in the evenings, but she’s tied to that because of her work schedule, sometimes doesn’t eat before 9:00 PM. She knows this is detrimental, but she doesn’t believe it’s the only cause, but she is trying to make changes so that she can eat a bit earlier. So that’s a long update, but quite a bit of information in there that I thought might be useful. 

Right. I took notes, so I was trying to keep track of what my thought processes were. So you can tell she’s watched some of the videos on my channel because she knows about checking those blood sugars with the blood ketones. She’s clearly making ketones, which is powerful to just reassure this is a better metabolism than she’s been at. And then to know that there’s a 200 pound excess mass on her body. To hear the words, I have sugars in the one nineties after multiple hours of fasting and when I checked my blood tests and I only had an insulin of 19 as I was fasted, which is in this normal range, I would actually tell her that she has undiagnosed diabetes. So whether she knows that or not, I don’t know if that’s part of the journey. I didn’t hear that in her presentation. But when your body has diabetes, it has, the efficiency for processing the glucose is broken, which is what causes the brain to deteriorate, the heart to deteriorate and the scramble inside the body to find a place for glucose. That when you have a blood sugar of 190 and your body’s only producing that lower amount of insulin, that is a mismatch. The insulin should have been higher in her case. You’ll say, but doc, the range of say, you know, if you can get it below five, you’re doing great, so 19 isn’t awful. Like those are with normal blood sugars. You should have produced more insulin to put away that sugar to get it out of the bloodstream, because that sugar is what is inflaming your system. It is what it is aging your blood vessels in your brain. So when I look at what would I do in a case like this, I would look at an A1c. 

I bet you it’s, she’s not making enough insulin anymore. Her cells for producing insulin have either fatigued or just cannot produce enough insulin for the mass of her body. So what do you do? She’s doing a lot of things right, like to reset and to encourage her, is her metabolism really is the key to fixing this. Running her body’s metabolism on a fat-based platform as opposed to a glucose based platform, she’s heading there. Looking at weight loss in a diabetic, it’s difficult. That is almost the taboo. We say you can’t lose weight. You’re a diabetic. Now, that’s not true. But it’s so hard when they do not understand their own glucose ketone ratios, that without monitoring that you will be so frustrated. You will think I’m doing everything right. I’m doing all the rules correctly. I can’t fix the problem. I can’t lose weight. I don’t know if you’ve watched any of the videos I’ve done, but there’s a type one diabetic that I followed on my show and again, so she doesn’t make any insulin and she comes with an average sugar around 300 at the beginning of this journey. 

Now her sugars are around 100, 110, but if she fasts, which she’s done the last couple of months now, it’s the only time she’s been able to lose weight and she’s like, why is it that when I fast, I can do that? Number one, we cut her insulin in half because we don’t want her blood sugar to drop too low. But number two, the ability when you lower insulin, especially if you’ve been given the same dose everyday, everyday, boom, you drop it down, you now give permission for those fat cells to open up and release their stored energy. You’ll say, well, you know, why can, you know, what is it about producing a ketone that has to do with insulin? The state your insulin is at is goingto be pretty stable. Yes, it goes up and down when you eat, but the average number is going to be plus or minus 10 and your pancreas will keep that level at that certain range until a sudden drop in food or a rise in energy demands happen. 

When the sugars change, the insulin can change and that drop in insulin allows your fat cells to provide the ketones, to provide the source of, you’re trying to lose weight, the weight comes from emptying a fat cell. You cannot empty a fat cell when the insulin stayed the same. You have to drop the insulin. So in a type one diabetic, we dropped the insulin during her fast and she’s able to lose weight. Well, doc why don’t you just drop her insulin the whole time? Because her sugars would be too high. It’s a very difficult thing to navigate to help her with the weight loss and then keep lowering the insulin steadily over time to match what her glucoses are. In a case like what you’ve described, the first thing I would start with is, there’s a drug called metformin and it’s out there. 

If you’ve been in the Keto world awhile, you’ll hear that it’s gonna have some impact on mTOR and cancer prevention and longevity, but it’s a diabetic medication. That’s what it was first put on the market for and it’s not insulin, but it does improve the efficiency of taking sugar from the blood and putting it inside the cells. So in a case like this where she’s doing all these things right, I would augment her body’s ability to do that with a prescription of metformin. I sometimes use that in people who say, I just want to help the sugars be better controlled. And even if they make plenty of insulin and they’re not, metformin, it doesn’t hurt you, doesn’t lower your blood sugars too much. It just gets them from the bloodstream inside a cell easier. And that’s really where she’s struggling. 

The next thing I would consider is really getting her a continuous glucose monitor for a two week experiment because it would be very powerful to see what is the range of her sugars. And if the sugars are all hanging out between 150 and 200 or 150 and 250, you’ve got to get on board with an internal medicine or primary care family practice doctor to address the lowering of the sugars with added insulin. And that’s gonna sound like the enemy at first. But trust me, you gotto control the sugars in order for the inflammation to be better. If she was trying to avoid that, avoid being an insulin dependent, and this would be a type two diabetic even though it’s from fatigue of insulin production that we’re kind of stuck with here. We look at matching her cortisol. I mean that is incredible amount of stress. 

Her stress level is powerfully overriding the production of releasing glycogen, releasing sugar from storage. So that’s part of where all of this sugar stuff has come from. So what I would say is she knows what I’m going to say cause she said, I already tried this. I know I’m doing this wrong. So especially women over 40 and I do this because I get a ton of messages from them saying, Dr Boz, I’m at a stall, I can’t lose weight. And you know that woman over 40 I’ll say, allright, you see what time the sun comes up, you have eight hours to eat. And it’s because that sun comes up and your brain sends a signal to release cortisol, which tells the liver, give me some of that stored sugar called glycogen. And your sugars go up and the energy in your body rises while you’re asleep and that’s what wakes you up in the morning. 

You will have a churn of extra cortisol for the next six to seven hours after that. So we say sunrise plus eight hours is your eating window. Even if you say, but I don’t eat in the morning, I fast. I’m like, yeah, but you didn’t tell your brain and your liver that, you didn’t tell the sun that. And so keeping the calories low during that time is a great way to burn those sugars. Have black coffee, continue to fast during that time, but set the timer to say, I need your big meal to be before that eight hours is up. What she needs, she’s like, well I can’t do that with my work. I’m like, get a doctor’s note. Find a way that you’re not eating after that. Because what’s happening is even if she’s eating the most ketogenic meal, she is still producing cortisol every time she eats. 

And like, what? Like she’s in a high stress state so she is churning another wave of cortisol by eating, you know like, okay, so I need only one wave a day. We can’t stop the sun from coming up. So that’s goingto be the one wave of cortisol we use and as that wave takes its time and goes up and down by the end of that eight hours. That’s why I like them eating in the middle of the afternoon, that two to three o’clock when they’re stuck with a stall, I need them to eat. I need them to have high fat. I need them to eat to satiety. They’re fully satiated and then I need them to have none after that. That is difficult. It is a social time to eat. It is a very challenging goal. So to wake up tomorrow and ask her to do this is kind of unlikely, but if we say, all right girl, wegotto back it off the edge. 

You’re going to start with, thereis no food after seven o’clock at night. Even if you work the night shift, I need you to respect that. You gotto find a way to get the food in before seven o’clock. If you don’t, find a way to fast until the next morning. My husband teases me because I tell him when he wants to eat late at night, honey, your clock will reset and he uses this against me whenever I want to do that late at night, your clock will reset, but it will. If you can push through that wave of hunger after that seven o’clock hour and once you’ve mastered seven o’clock, then we’re going to back you to six o’clock and we’re going to keep going back until you can get your eating to be within the eight hours after sunrise and you will reverse the problem. 

You will start using energy as fat cells. You see it already in the times where you’ve successfully fasted and I would contend that that has been your lifesaver. I mean that by you’re not, I mean to have the body mass that, that you’ve struggled with and then to see that your sugars have been in the 190 long enough that we have some sort of insulin production fatigue, like the insulin is not meeting the demands of your body. It says the algorithm is advanced. We are at the later stages of a diabetic journey. We can help with Metformin, but nothing will be as powerful as her honing in the hours that she eats. Fasting is one of those way`s she can do that, but putting the food to match the sun is going to be super important. 

Yeah. As you’re speaking, I’m trying to think of a practical way that she’s going to be able to do this. She obviously has this problem. I think she finishes work maybe around seven. This is why by the time she’s got home, yeah, and even prepared something quickly, it’s difficult, but I’m thinking so, okay, so what is the solution here? Obviously weekends, no problem. Can follow a plan at the weekends where you’re saying, so really all her food needs to be in before, what, three, four o’clock in the afternoon? 

That would be amazing. But again, if you start her there, that could be too heavy of a goal. 

Yeah, absolutely. And I get what you’re saying about moving it back. All I’m thinking is that during the week that’s not goingto be possible, even from that 7:00 PM. But what I’m thinking is maybe, especially if she could incorporate some fasting days during the week, that obviously completely solves the problem, but also potentially being open to maybe going for the breakfast and lunch option. I think it might be difficult to have much of a meal at work, so maybe the big meal being the breakfast. I don’t know, I mean it’s a real massive change isn’t it? It’s a big jump to go from one thing to the other, but maybe.

Here’s a couple things I’ve done, because I’ve actually had this same scenario in my clinic where I’ve said, all right, let’s fail upwards. Let’s improve upwards. 

I’m thinking of that push back. I’m sort of sitting in her position saying, well, I don’t get home, I don’t leave work until seven how am I supposed to eat my meals before seven you know, what can I do? 

So, right. Yeah. Planning and having that break at work to eat your meal at work those are great ideas and they could work, but it is a different approach. What I would contend was if she gets to 7:00 PM and she just cannot imagine not eating, I would encourage her to do exogenous ketones. I would make a shake of ice and ketones and sip on that. It is fuel. It will enhance her metabolism. It is not sugar that goes in with, I mean she’s got plenty of sugar happening. That’s the problem actually. She’s got really high sugars. So when we fail upwards, if we add ketones to her situation and say, okay, we want you not eating anything at all, but if you’re goingto put something in, we’re going to add something that over the next couple of days you will have a stronger metabolism because you put more ketones in to burn for your metabolic health than you wouldhave had, had you, I mean, even if she wouldhave fasted, her ketones will still be at a lower level until she gets that metabolism rising. So when I say fail upwards, it’s not perfect. I would love a whole script and put her into like a, you know, calculate what she should do and follow the rules specifically. But when the enemy is us, you say, allright, what could she do that would feel good to her? And you know, those exogenous ketones, mix them with a little cream if she needs to have, you know, some fat with it. If it happens to be MCT, it’s even better. So now she’s got two ways her body’s adding ketones. It’s going to be the energy or the fuel she needs and it will become this mindset that says, if I want to eat, I have to do that before seven o’clock. 

Or the only option I have left on the table is to add ketones without food. And that has worked amazing. Like I have two people. I’m thinking in mind that it did improve. It took about three weeks for them to say I figured it out, but I only figured it out because I did it with that messy version where I couldn’t not eat, I wasn’t strong enough to fast, but I put in ketones and by about the fifth day they start thinking in a different way. They start strategizing and the next choice was better and the next choice was better. Now they don’t do those exogenous ketones at all, but for bridging that, it really did help her. The two I’m thinking about saying, oh look at that. You got home from work, you did not carb crave. You did not even like ketoglutton, you know like they’re, everything I eat is Keto, doc.And like I know, but you’re putting in so much mass, I can’t get to tap into the stored fat cells that you’re trying to lose for weight. And if you want to do that, we have to shift the metabolism. So fail upwards and that will shift it. 

Yes, because ultimately like you’re saying, if you’re goingto ride that cortisol wave and eat while you can, and if the only time you can eat at home and have that meal is breakfast, ultimately that’s going to be your goal is fasting and breakfast during the week with meals into the afternoon at the weekends. But you’re right, it’s just that massive jump. But if you can bridge that gap and then get to a place where you’re doing something that works, even if you thought it couldn’t work into your schedule, but if it’s goingto get you where you want to go. You know, this is a big problem that she’s got to solve, isn’t it? 

And it’s not uncommon. 

There’s only so many ways to do it. 

It’s a great question because she’s doing everything right. She’s invested to understand her own body chemistry and she can see that there’s a problem. She has sugars in the 190 range. That’s diabetes. There is a break in metabolism. If I could get a reign on this, if she could get the numbers down, if I could get her to fast for a month, okay then we’d be fine, but that doesn’t fit life. Look at all the stress she’s had. Look at the lack of sleep. You know her support system is obviously good enough to do as much as she’s doing. So asking her to be the perfect results. That’s ridiculous. There’s no chance for longterm success by saying, oh honey, if you just fast for the next 40 days, you’re going to be fine. 

She can stay off of insulin longterm, if we can shift her metabolism to a higher ketone base and essentially what she’s going to be doing is we want her using the calories stored in those fat cells so it will become a lower calorie ketogenic diet is what will, because she’s already keto adapted. As long as we can keep the ketones burning, the size of her meals will get smaller and those are conscious choices, but also subconscious because she feels good. That does play a part. I don’t usually talk about a calorie restricted ketogenic diet unless I’m talking with seizure patients, cancer patients, or in a situation like this where I really need a metabolic boost in her system to keep her off of injectable insulin. So pushing to bridge that eat during the cortisol phase and once you kind of find the rhythm that you’re now eating in that eight hours after sunrise, that’s when we would talk about now we want your meal sizes to be smaller. And the reason why is I need to tap into the calories you’ve stored as fat. That’s how get the weight loss gone. That’s how your insulin needs will be less when your body mass is less. It’s a three step process here. 

Well, hopefully she can see a way through this and start seeing a change because I really feel for her. I’ve seen how hard she works and as you’ve seen, you know, she’s a smart cookie. She’s worked out a lot of these things for herself. She knows where the issues are and she works really, really hard at it, you know, and is prepared to be very restrictive in what she eats to work really hard to do the work with the tracking and all sorts of things. And it’s just must be so, so frustrating. I really do feel for her. 

Well, I do hope she’s got a support system of people encouraging her because that, I mean, had she not taken on Keto in the last chapter, she wouldhave been in an ICU somewhere with a completely failed pancreas. So she needs to know that the choices she made to make this shift have been life altering even though she can’t see the disaster that would’ve happened. I’m certain of it. 

That’s very true actually. Yes. That’s a very good perspective, is to actually see what feels like such small steps forward as actually really massive leaps. 

From where it shouldhave been, right, where she was headed. 

Right. Okay, so this is another one that’s in the ballpark of where we’ve been talking and I know is something that you’re really passionate about and that’s brain injuries. This is from Sarah. Sounds like they’ve been a bit unlucky in their family. “I have so enjoyed your episodes with Dr Boz. With her experience with brain injury, it would be helpful for me and my family if she could address concussions and how Keto helps them to heal. I have had at least two in my life. My son had a serious concussion a few years ago when he was 16 and now my daughter also. She has just turned 16. They are both soccer players. I watched the brains of addiction video you posted. Thank you. Does a concussion leave defects in the brain such as the ones in the pictures you showed? Does Keto help heal these holes over time?” 

I love this question. I do this workshop called Brains of Addiction: From Trauma to Repair. And the foundation of that format is an 8 to 10 hour course, which sounds like a lot, but people are so hungry for this exact question. And it may at first sound like I’m goingto talk a lot about addiction, but I really spend time talking about the traumatic injuries to our brain and what we know about healing them. There are many parallels to addiction, but her kids at 16 and 16 having concussions, she is near and dear to my heart for, for being passionate about, how I think of the job as moms is, it’s my job to develop your brain to the highest level and make sure you’re not in my basement at 30. And I think of that as what is the, what are the foundational rules for brains and repairing them, as you guide your teenagers through these injuries. 

Because when they have a concussion, there is very good evidence you can see on those videos that I’ve talked about, that the brain no longer conducts messages through the sections that are swollen or concussed and as long as that swelling repairs and completely goes away, you can see that brain awaken. But if you want the biggest enemy for a concussed brain, there are two that are so common in our teenagers today. Number one, they have an unstable bedtime and it’s too late. They are pushing their brains to be awake too late. They are stimulating their brains with screens for at least two hours before going to bed, and the depth of sleep needed to repair the brain, specifically making something called BDNF, brain-derived neurotrophic factor. That protein is what repairs our brains. And if you’re not getting that good teenage 10 hours of sleep, especially after an injury, you are inhibiting the brain’s ability to repair.

Because they’re forced to get up early as well, aren’tthey? I’ve heard people talking about this, we should really be starting teenagers at school much later. 

I would actually say that it, shifting that to an earlier bedtime is just as easy for our society to do and actually probably plays forward in the neural programming better than starting their school day later. I say this as a mom of teenagers where it would be perfectly easy for me to have them start later, but I’m saying I want their brains to play forward with the best neuro programming and that really does say getting their head to bed earlier, showing them the respect needed for repair of a brain. But the other major enemy out there is sugar. And when watching a teenager’s brain go up and down in sugar production, unbelievable how damaging that is for a scar that’s already swollen in their brain. 

In that brains of addiction video, you’ll see a picture of a diabetic and that diabetic hasn’t, doesn’t have an alcohol problem, they don’t have a drug problem, they haven’t had concussions, that is simply from their diabetes. And it is the swelling that happens in their brain and stops the conduction of messages going through because of the repeated swelling from high blood sugars. So to get that concussed brain to repair, pushing their brain to use ketones over glucose, very important. Number two, bedtimesof the whole family. If you want a teenager to do something, telling them to do it without doing it yourself, good luck. So now you have 16 year old brain injured teenagers who are going to be moody and irritable because that’s the journey they’re in. But I would contend that their moodiness and irritability grow worse every time you stop the maturation or the maturing process of their brain, which happens with a concussion. 

But it also happens when they have poor sleep, when they have excessive sugars go up and down. My youngest son is a wrestler and between him or his buddies, whenever they have concussed brains, I’ve had consults in the homes of his friends saying, all right family, I know this is hard, but all screens need to be off by seven o’clock at night. If you have something you need to watch, you can put it off till tomorrow. No screens in the bedroom. Everybody’s phone goes in the basket at seven o’clock. 

Wow. That is hard. 

What is powerful though is, and some of them did the Ketogenic Diet. Others supplemented the ketones to get the family onboard and then has actually graduated to a very sustainable ketogenic lifestyle for that family. But it wasn’t easy at the beginning. And that commitment to say, when you see the suffering that happens longterm with concussions, it’s powerful how many brains don’t return to normal because they aren’t given the six months time to repair. So you say, well, how long do you have to do this? If it’s a teenager, it’s a six month process of getting that inflammation out and allowing their brain to return back to the normal growth pattern and for heaven’s sakes, don’t let them get another head injury in the meantime, so that can mean a limited amount of the sport activity until they graduate. I can’t emphasize enough how powerful it is when the families choose to engage in those treatment programs versus not. In that first couple chapters of my book, I talk about these brains of kids who had seizures and then years later, you know they get put on the ketogenic diet because they’re the misfits. They didn’t fit the treatment protocol, they didn’t respond to the prescription medications, and we have a couple of autopsies from these seizure kids that are now in their seventies or eighties and they’re at autopsy. Their brains are beautiful. 

That’s not how it’s supposed to be. That environment of low inflammation, specifically fed by a high fat diet is a powerful repair process for the human brain. Getting those kids to journey onto that type of eating, they have temptations at every turn. It can be really difficult. So showing them the process and the progress by sharing some of the stories from that book or looking at some of those youtube videos, that’s how these moms motivated their kids to get on board. Because what they were saying was ridiculous and no, no way. But just looking, saying, hey, you’ve got a brain that had this injury. If we want it to repair, here’s the rules. We need really good sleep and the sugars have to be low. You can’t be carving up day after day after day. It’s gotta be a Ketogenic Diet. Very good question, though, because I get that a lot. 

So there is hope then. 

Yes. 

You know when you’ve seen these scary videos with all these pictures of holes, what you’re saying is that you can heal them.

Absolutely. And I think that’s the part that when people say, why would the average person look at a doctor Boz ratio or what, you know, getting that glucose and dividingmy ketones, why would you look at these numbers? That sounds kind of geeky. I give them affirmation that says, no, you have a really important repairing process that’s happening every day in your brain. And some of the injuries we don’t know about, they’ve led to chronic depression because the scar never healed from that injury long ago. Andyousay, well doc, it’s been 30 years. Can I do anything about it? Like yeah, stay in Ketosis for three to six months as an adult and watch what happens. And you’re like, what? No cheat days. I’m like, no, no cheat, that we’re repairing a brain here. And again, if I, if I have that as the leading conversation with somebody who going into the ketogenic diet, I can often lose them. It sounds impossible, but once people have been keto adapted and they really feel the positives and the energy and the focus and the improvement they have with a Keto diet, and then they say, are you saying that if I do a really good job of this for three to six months, that my old brain injuries have a chance of healing? And I’m saying yes, but it has to be a steady chemistry environment for them to repair. And that wins the conversation. 

Right. And it all starts becoming more feasible and doable, doesn’t it? When you start feeling better. You know a lot of people start Keto and they think they could never eat this way for the rest of their lives, but they actually start doing it and realize how delicious it is. And yeah, this could be a lifestyle. This is not just a diet. And I feel great to boot. 

And if you ever didn’t remember that, you felt great, itt’s that first time where you binged saying, I have done a great job for several months and then they have, you know, carb up and you’re like, oh, I’m heavy, I’m swollen. I can’t get my ring off. I just feel my joints hurt again. It didn’t take long for all that to come back and then suddenly you say, well, it wasn’t that bad of a list of foods. Actually they were pretty good. So if you’re saying that I could journey in that direction and feel that good, now you have other reasons why they stay the course and they hop on the bandwagon quicker and yeah.

Well that’s why people tend to stay. I find a lot of people start from a weight loss perspective and might see it as short term, but they start to feel so good and that’s what keeps them, that’s why they stay the course, is for the health benefits. 

Absolutely. And that is a real improvement in the conversations that even were happening at the time where I was first writing this book where I couldn’t hardly find anybody to sit still and say, no, no, no, this is my plan for a life. Is that safe? And now you hear all the evidence of improved telomere length and improved longevity and brain function and you know, repair. You know, you look at the of national sports physicians that attend these metabolic health summits or conferences because they want to enhance the repair process of their athletes on the team. That’s the difference between and win or lose, is how quickly they can repair and nothing beats the anti-inflammatory state of a ketogenic athlete. You can hardly find a national athletic league, from my standpoint, that doesn’t at least talk about the ketogenic diet being part of a good option for their athletes. 

Right. I mean you could call it, that could be another name for keto couldn’t it? Anti inflammatory diet. 

Yes, andin fact my husband does not like theword ketone. He thinks it’s too sciency and so when I was writing writing the book, he’s like, you’ve got to come up with a better name than Keto. It just sounds like chemistry. And I’m like, it’s because it is honey. 

That’s not a bad thing. 

So one of my options was, well I can call it the anti-inflammatory diet, but that’s just so many syllables over and over again, I don’t think it works. So I agree with you. 

This is a question from Shelly and is about tinnitus. It’s short and sweet. “Do you have any experience of healing tinnitus with Keto?” I can instantly tell that she hasn’t read my book because I put together a list of things that surprised me when I had implemented the Ketogenic Diet in my internal medicine practice and done it for other reasons, but I had the first two patients that came back and said, you know that ringing in my ears that I’ve had forever and ever and you gave me these meds and we tried this and that and nothing really worked? I was afraid to tell you because I thought it would come back, but it really is gone. And that really landed in their journey about three months into the real journey. And I say that importantly. At first they were a little bit Keto, meaning they’d checked a couple of urine Keto strips and they had turned pink and then they fell off the wagon and then they went back on and then they carb cycled where they did good job during the week but had a bunch of beer on the weekend and then something, in each of their stories it was different, something pushed them to say, all right, I just need you to give me three months of not screwing this up. You can do this. It’s better than anything else we have. And if this doesn’t work, we can take you to surgery. So they manned up, girled up, whatever, and did it. 

And they took their doctor Boz ratio, meaning they’dcheck their sugars and their ketones and really monitored that they were in ketosis and it wasn’t that great of a ratio. They had a Dr Boz ratio of like under 120, so not terrifically wonderful. Just pretty good. And it was constant. 

I was going to say, it’s that consistency thing that you were talking about before, just being in Ketosis for a block of time. 

Right. And you know, it’s, it’s that same thing. What would you pay to take away that buzzing in your ear? And it’s haunting. I mean I have spent hours and tons of time just trying to crack the puzzle of why it happened and what, and really, I have come back to after years of, you know, struggling with this, is they have kind of an arthritis, if you would, in their ear. 

I was goingto ask you, isn’t it one of those things, is it difficult to pin down exactly what it is, what causes it? 

Right. So you’re conducting a sound when it’s not supposed to conduct. So I always tease my kids which substance conducts sound the best? Air, water or a solid? And sometimes they’ll get it right. Sometimes they won’t. And I said it’s a solid and if you put your ear on the railroad tracks and you could hear the train coming. You remember how they used to do this and that? Okay. Put your ear on the railroad tracks. Is the train coming? You could hear it on the rail long before you could ever hear it in the airwaves. You look at telephone wires. I mean they conduct sound. So you look at your ear and the same thing happens. 

It’s got a fluid that sound conducts through and that’s inside the inner ear conducting the sound, moving that energy into a nerve that gives you a sound that your brain knows what it is. If you now crystallize that or it gets a hardening, now the sound conducts quicker and faster at the slightest movement. That’s why sometimes you can say doc it seems to be my pulse. Like, yeah, the movement of that blood creates a vibration and sound is a vibration. So I need you to stop conducting that sound. I need you to block that out. But they can’t. It’s signaling too high from their baseline. So to undo that means the swelling in the other parts of the ear need to reduce. So you need to remove the water and remove the inflammation from the inner ear. Well, you can’t unless you’ve got the whole body’s anti-inflammatory, or removal of inflammation happening. 

And in some people they get lucky enough where if there is some crystallized or hardening or calcification that’s happened in the inner ear, the swelling now isn’t surrounding that crystal. And so the solid crystallized compartments don’t touch anything else and that’s when the sound stopped. It’s super sciency and kind of gets into a microscopic level. But I hope you can imagine like as soon as there’s nothing conducting the sound, as soon as you separate the water from the crystal, you have no more ringing in the years. Well that is, that’s a advanced level of your removal of inflammation. It’s on the inner part of your ear. So we had to keep them in Ketosis for several weeks in a row. I didn’t do it for that reason. We were doing ketosis three months for other reasons and they came in on their own saying, guess what? And like no way. And then then I’ve had a few other patients do the protocol. They have to stay in that zone, they have to stay in ketosis. And then of course, like anybody, a couple of them fell back off. The swelling came back. Boom. 

I was just gonna say, I bet it comes back full force.

Oh yeah. You look at those kids who had the seizures and they stayed on the ketogenic diet because every time they weren’t on a ketogenic diet, they had a seizure. It was forced compliance. And so when people say, oh, shucks, like if I go off, I have my ringing in my ears back. I instantly compare it to that. I’m like, this is nothing compared to a seizure. You can do this. And it gets a little easier. Besides, if they get their autophagy, there is a chance that they can recycle those crystals, recycle that arthritis. And I don’t over promise that, but I’ve been very impressed with, the longer they’re lean with ketosis, the less orthopedic surgeries I am referring for. 

Oh, that’s really interesting. You start to worry that you’re gonna sound a bit like a broken record though, don’t you? Because it’s like any kind of condition somebody mentions Keto, but seriously, if any condition is an inflammation disorder, it’s going to help isn’t it? 

Yes. I look at my clinic and think what would it not help? Because it does, it sounds like a panacea. You’re over promising, this is never goingto work. And you’re like, no, no, really. You just have to link it to inflammation for the science to be broken down. And the longer I do this, the more I see. Yup. That has an inflammatory component as well. From brain health to heart health to arthritis. Yep. Inflammation is in all of them. And it speckles not just an internal medicine clinic, pretty much every clinic for primary care. That’s why you see more physicians saying, alright, teach me how to get my patients wrapped around this. And the more we can educate them, the better the outcomes have turned out. So I highly encourage the woman who wrote that in to go check that chapter out in my book. I do write about that story of the patients in that book because it was shocking to me. Like who knew? 

Yeah. Wasn’t something you were expecting. I forget which speaker it was. It might have been Dr Westman, at the conference at Denver. And he was talking about all these different parts of medicine and how not necessarily Keto specifically, but changing sort of health and lifestyle certainly in that direction should be a primary care, because it impacts all these different branches. 

He is one of my heroes, Dr Westman. He is internal medicine as well. So he has this kind of sorting of how he thinks about problems that matches the way I think about problems. And if you talk about beacons and leaders in my world, he is one of my favorites. So I just would say any lecture where he’s been talking about sorting of improving the health of your body, check it out on youtube because I’m gonna bet it matches what we just talked about here. 

You absolutely have to get to the conference at Denver. I thought of you while I was there. It was just, it was amazing. It’s the first time I’ve been to a conference like that that’s so full on turnover of speaker after speaker after speaker. You know, hard and fast, sort of half an hour presentations and I thought, wow, my brain is just going to shut down because it’s going to be overload and I’m just gonna have to zone out by about two o’clock cause they start really early as well. 

Yes, we internists. Any physicians, you have rounds, and early, absolutely. 

So the day kicks off really early and also the clocks wound back. So it ended up being like ridiculously early on the Sunday. I was actually fine with it because of the jet lag. So I was fine being up early but I really thought it would be just too much. You know, for someone like you, you’d love it. But actually it was fine. They really got the pace of thelectures going well. So it just, it was so stimulating and interesting. I could see you there really, really enjoying it. So you must, you must go next year. 

I’m looking forward to the next year. I truly have been in hiding waiting for this decision from the medical board saying I just, I don’t want to have any reason to take any media or take any attention. And so hiding was safest, but I was envious of, and waiting for the lecturers to come out on YouTube so I could watch them myself and have not been disappointed. Very, very powerful presentations and conference. 

Absolutely. I really enjoyed it. It was fantastic. I guess you’re going to be all the conferences next year then?

I’d like to be, yes. I told my husband I’m going to become a Keto junkie starting now. 

There are worse things. Well, thank you so much. We still have some questions, but they’re going to have to wait for another episode, but I will keep them here and I will try and get you back soon to go through the rest of them. 

Well, Daisy, I just want to say thank you so much for having me on your podcast. I really find the format of the discussions and just the tone of how you connect with people very attractive. So thanks for including me on your list and I look forward to more episodes. 

Well, thank you for coming back and I look forward, too. Thank you Annette. 

You betcha.

This transcript is brought to you thanks to the hard work of Dawn Michelle.

You’ve spoken a bit before about how Will cooks up all these tasty things. And I’d forgotten actually when you mentioned just now that last year at Ketofest it was just those samples that you were bringing that you hadn’t set up the company at that point. I’d completely forgotten that. I was thinking in my head that you already had it then, but how did you come to that? Was that part of the supportive process, him experimenting with making foods for you to have, is that how it all started?

Absolutely. I feel like some people would take the carnivore, purist approach and they’re like, well, I can be the healthiest by eating just meat and vegetables. And so, I’m not going to risk anything. Perhaps I’m a little bit of a risk taker in that sense because I know that I have a sweet tooth and I used to have a pretty serious food addiction that I let run my life. So, I don’t want to ever go back there. But, if I can have tasty things that I can enjoy and let my sensual pleasures, you know, really, indulgent without going nuts and getting back into food addiction, then doesn’t that enrich my life? 

Do I need to be a purist in aesthetic and deny myself pleasures for no reason? I don’t think I do. So there are some healthy ways that I found to add tasty things back into my life besides not saying that the meat and vegetables is not tasty, but I really like a good Keto ice cream if I can enjoy a good Keto ice cream without messing up my health. So, for instance, Halo Top, you’ve tried it, right?

I have never tried Halo Top, actually. The only ice cream that I’ve tried in the states is Rebel ice cream at Ketofest last year. I’ve never tried Halo Top. I gather it’s got some not-so-great ingredients in it.

It does have some not-so-great ingredients in it. Now, the founder of Halo top was actually a Redditor, participant on the Keto sub-Reddit. So, I felt like I personally chatted with him on there. So, I did try it back in 2016 and sure, some of the ingredients were sketchy and the ice cream wasn’t a hundred percent great. Now I understand it wasn’t like a ton of sugar, a little bit of sugar, but it wasn’t awesome. 

And so, there were some things that, I was curious about, sweeteners that I felt did not have any sort of negative health impact. Actually, this was a problem because as a part of diabetes and monitoring my blood glucose. I could see that a lot of the supposedly okay sweeteners out there that weren’t counting as sugar, were actually terrible for me. These people are lying. Sorbitol, maltitol, mannitol, isomaltitol, isomalto-oligosaccharides, all these things listed under the sugar alcohols category. Most of them, I could see spike my blood glucose. Erythritol was okay, erythritol was fine.

That seems to be one of the universally accepted by most people not to give them digestive issues and things like that as a one that’s available to most people. Most people seem to get on okay with erythritol, don’t they?

Yeah. Yeah. I think erythritol is okay, and the taste is pretty good. I mean, it’s not exactly sugar and it doesn’t cook like sugar.

No. That’s the problem with it. And a lot of people don’t like the cooling effect it has on everything. I find that in some things you make, you don’t get that cooling effect. And I actually don’t mind it that much, but I know that’s a complaint that a lot of people have with it.

Well, it’s okay.

Exactly, it’s okay.

And then sucralose, Splenda, aspartame, saccharin, all these chemicals, I researched them, and you know, there’s nothing saying that they literally cause cancer. Okay, there is a little bit, but not much. But there are plenty of research showing that aspartame is linked to migraines. Sucralose and saccharin are linked to leaky gut, intestinal irritable bowel disease. If you use them on a regular basis, then your chances of developing these conditions seem to go up, or at least, there’s lots of research showing that they’re linked. And then even petri dish research showing that they do cause the epithelial lining cells to develop gaps, which is literally leaky gut disease. So, I don’t want any part of those. I mean occasionally a little bit, whatever, it’s not going to kill you, but still not healthy.

That’s the thing. It comes down to what you just said is the regular use thing, isn’t it?

Yeah. I think no one’s going to die from having the occasional bit, but regular use, daily use, definitely have been shown in some research. Not a lot of research, but some research to be problematic. And then I’m not really a big fan of the taste of stevia.

No, me neither.

I like monkfruit. Have you tried that?

I haven’t. I’ve never tried it. No, it’s not something I can get here.

Oh dear. Well, I like monk fruit. It’s not exactly the taste of sugar, but it has a nice kind of clean sweetness to it, which, I find pleasant. It’s not a sugar, you can’t cook with it.

That’s often the problem isn’t it? You actually, for most things you’re making, unless you’re sweetening something like coffee, for example, you need that bulk. You need the actual mass of sugar, in inverted commas, in whatever you’re making. That plays a part every bit as much as the sweet flavor does, doesn’t it?

Well, in fact, I mentioned that I was corresponding with the Halo Top founder, Justin Wolverton, on Reddit and I was asking him, why do you put sugar in your Keto ice cream? It seems to defeat the purpose, right? He’s like, well, originally, I started with a very Keto purist sort of a recipe. And he’s driving around with his little sample pints to different places and trying to find a place that would manufacturer the ice cream for him. And the problem was that his mix would freeze in the lines, which I think as you know, like you try making a Keto ice cream with erythritol or swerve or what have you, and you put it in the freezer, and it freezes solid as a rock. You know, if you have any leftovers after you’ve made your batch. Sugar alcohols freeze solid. And he said the property of sugar that is essential for the ice cream is that it lowers the freezing point so that it stays soft in the lines of the manufacturing equipment but also then in the freezer. So, you don’t want to have to have a pint of ice cream that you pull out of the freezer and have to sit on the counter for 20 minutes.

Although, I have to say this is one of my slight bugbears with people who go on about ice cream freezing solid, which I have to say it is a thing with erythritol. It freezes really solid. But, you can take it out and leave it in the fridge for half an hour and then by the time you come to eat, it softened up a bit. But, people talk about this being completely scoopable from the freezer. Well, my favorite ice cream has always been Haagen-Dazs. That was my Achilles heel. That was the ice cream that I always used to have. Now, that is not scoopable straight out of the freezer. I’m not sure freezer is on a low, or shall we say high, I suppose setting. It comes out solid. You watch the adverts for Haagen-Dazs and even on a lot of the containers they recommend you have to take out and you have to leave it sitting on the counter for five to 10 minutes before it becomes that sort of perfect scoopable texture. So you know, it isn’t just a Keto ice cream thing. Although I have to say that I’ve been making a vanilla chocolate chip ice cream with allulose. You’ll be pleased to hear it was the very allulose you brought to Denver for me.

Excellent.

And, I have to say, you’re absolutely right. It is perfectly scoopable straight out the freezer and it’s very delicious. I have been enjoying it every day since ice cream season.

I think that now that I’ve gotten into the business, there’s just a number of properties of sugar and also allulose that I’ve come to appreciate. Lower freezing point, crystallizing, are just the tip of the iceberg really. Providing that crystalline structure, for instance. We’re trying to make fudge. The consistency of fudge is hugely important. Well, forget trying to do that with erythritol. It’ll come out in sort of icy shards.

It crystallizes, doesn’t it?

It does. And you know, you’re not going to do it with sucralose. That would be disgusting. Or stevia or anything like that. But if we can crack allulose fudge. We’re going to trial a couple of things at Ketofest this summer. We have actually started making a nut bars using allulose caramel. And allulose caramel, wow, it’s so good. And it provides this nice kind of stickiness that, makes these nut bars just delightful. I haven’t quite figured out how to package them to be honest. But, right now we’re just using craft paper bags and a little parchment paper and I’m distributing them at our local farmer’s market and people are just mad for them.

That sounds delicious. How did you end up at allulose? You started saying there was this progression of different sweeteners that you tried. How did you end up at allulose because it wasn’t, and it’s become a bit more known now, but presumably, I mean, when you first stumbled across it, you must’ve almost stumbled across it? How did you find out about it in the first place?

It’s sort of my hobby to, become on top of the literature of, sweeteners and their health impacts because I wanted to know for sure. Because I used to drink sweetened diet sodas, instead of water all the time. Diet Coke, Fresca all these different things. And I wanted to know what health impact they had. And a lot of people said, you know, if you follow the science that there is no problem, really. Its people who say these chemicals are bad for you, they’re just chemo-phobes but there’s no solid science behind it. I’m like, well, you know, I’m not sure. 

I tried it actually a couple of years ago, I went on a sweetener moratorium for two weeks. I am dropping all the sweeteners out of my life, zero everything, just coffee, black coffee, water, tea. But nothing that has any sweeteners. And I was checking my blood glucose the whole time and it had a huge impact. I didn’t realize, I mean, not huge, maybe five to 10 points on my baseline blood glucose. And it dropped. And I lost weight. So clearly these sweeteners were having impact on me and I didn’t realize it. Even though they’re supposedly zero calorie and supposedly safe.

It’s not all about the calories though. That’s where it comes down to, isn’t it? Or even sometimes the immediate impact on blood sugar, it just goes to show that all these other things that they can potentially have this ripple effect that could end up causing you to gain weight or not lose weight or whatever it is. That’s the issue you’re dealing with.

Absolutely. There’s a lot of other issues and it’s not just blood glucose or insulin. Also, they talk about cephalic phase insulin response. Well, if something just tastes sweet or you’re thinking about something sweet, you’re going to get that cephalic phase insulin response, for sure.

The other thing I find is that it stimulates appetite too.

Absolutely. After I did this two-week sweetener moratorium, I talked about it on my Facebook page and some of my friends were like, you know, that’s very curious. And I’m like, how about you all, do two more weeks with me and I’ll go two weeks more. Once I got past the first 10 days, the first 10 days were rough. I was super addicted. Daisy, I was like struggling. I was thinking, oh God, I really want MiO in my water, or I really want Diet Coke. And I was biting my nails. I was gritting my teeth, but it got easier. And after those first two weeks, I was like, I’ll go another two weeks. 

So, I got a bunch of friends to try it as well, and they were also type two diabetics. So, they gave it a go and two of them couldn’t do it. They dropped out right away. They were like, no, I love my Diet Coke, can’t give it up. One of them dropped out after three days because she got dehydrated. She realized that without the stimulus of the sweetness driving her to drink, she wasn’t drinking, and she got dehydrated and her electrolytes are messed up. So, she had to go back to it. So it wasn’t that she was addicted, but it was more of an electro-chemical imbalance that her body had just become adjusted to, I guess. And then the rest of them stuck through the whole two weeks. And what they found, about half of them found, that it did drop their baseline blood glucose by 5-10 points. And half of them found that it had no impact except to deprive their life of the pleasure of diet soda drinks. So, they went right back to it. 

So, I think it’s very individual. I think some people are going to see a reaction if they cut the sweeteners out. But I think it depends on the sweetener too. So, I started doing more research back to allulose. I’m like, well, obviously there’s more to the sweetener thing than I thought. And I started learning about all the different kinds of sweeteners and high intensity sweeteners versus bulk sweeteners, sugar alcohols, different sugars. And, I did find this new sweetener, well not new, allulose. Allulose is a rare sugar. It’s been around. It occurs in nature and so they’ve been doing research on it for decades and interestingly in 2015, they figured out a way to produce it commercially using an enzymatic process. So now it’s similar to erythritol. Erythritol is produced from cornstarch. They take cornstarch and they do a series of chemical reactions and you get erythritol.

Sometimes it comes from birch bark as well. Is that right?

If you buy it commercially, do you honestly think that there are giant factories out there stripping birch trees of their bark?

I don’t think there are giant factories, no. I have noticed that the occasional product does say it comes from birch as opposed to the usual. The usual is cornstarch, isn’t it?

Yes. I don’t know if anybody is actually out there stripping birch trees of bark, Daisy.

No, I mean it kind of seems a bit of a laborious and not very helpful for the birch trees.

Cornstarch I think is where 99% of the stuff comes from. And I don’t know about the other 1%.

There are some very naked birch trees somewhere. That’s the 1%.

The erythritol birch orchards in southern France I hear are beautiful this time of year. So allulose is found naturally in figs and jackfruit and raisins, maple syrup. And I suppose, prior to this discovery, the way they made it was by squeezing figs or jackfruit and then refining from there. But now they have discovered a way to make it from corn syrup. So, using corn syrup in a series of fermentations and refining and whatnot. So now it’s commercially available and the research on it, unlike the research on sucralose, the research on sucralose is all about does it really cause intestinal bowel disease, or does it just make the symptoms worse if you already had it? It’s all bad, there’s nothing good. 

But the research on allulose is crazy good. We’ll see it being used in a much larger way over the population. Maybe some people will end up having negative reactions. But right now, the research is on people and also dogs, rats, tapeworms, planaria. The research is 100% positive. It increases insulin sensitivity. It decreases postprandial blood glucose response. It helps people lose weight. It helps people with their hepatic fatty liver deposits. It seems to be a health boon in almost every way. It increases GLP-1 secretion, one of the talks at low-carb Denver got into the incretin hormones. And so GLP-1 secretion is good, it’s sort of a counter hormone to insulin. The important thing is it tastes just like sugar. I mean almost, its 70% as sweet as sugar. But the chemical properties that it has in terms of crystallization and freezing point and bulk and various other, mouthfeel and and aftertaste are very similar to sugar. The fact that it’s less sweet is a problem.

I actually quite like the fact that it’s not as sweet as sugar. So this ice cream recipe that I been playing around with over the last few days is actually just an adaptation of a Mary Berry recipe. I’ve made a few tweaks, but I’ve pretty well just subbed out the sugar for allulose at the same amount. So that has effectively made it 70% as sweet. It’s not as sweet as the original recipe. And actually, less so because I changed some of the quantity ratios so effectively it was even less than that. But that I think is a good thing for most people, especially people who’ve been on Keto for a little while. Their sensitivity to sweet increases quite a lot. 

So actually, having something that’s a bit less sweet, 70% is quite a nice sort of drop in sweetness. Isn’t it? I think anyway that’s what I find. I find the problem with quite a lot of Keto products, especially things like cookies. I found the ones I’ve tasted anyway are so ridiculously sweet. They’re too, too sweet. You want to drop that sweetness down because when things are too sweet, you can’t actually taste the flavors of the ice cream or the cookie or whatever it is you’re eating. Can you?

Yeah, I agree. I feel like I’ve just had a mouthful of sugar alcohol and that’s pretty good. Yeah, it’s interesting. I’ve been doing a lot of direct sales every weekend. I’m going to the local farmer’s market with Will and we’re giving away samples and trying different recipes and seeing how people like things. And these are people that are farmer’s market patrons, so most of them are not Keto, although I’ve been very happy to meet some Keto people there that are just delighted to meet other Keto people. We could do the secret Keto handshake. And they buy lots of my stuff and they love it, which is great. But just the general populace, I pitch this as healthy, all natural, mostly organic, vegan and soy free, dairy free, gluten free, etc. So, it appeals to a lot of the general populous there that go to the farmer’s market and they are not used to having something that’s natural and sugar free. And so, when I say that they’re a little suspicious, they’re like, so is this going to tastes like crap?

Yeah. Cause that’s the usual payoff, isn’t it? That’s what usually happens. It ticks all these boxes. It’s really good for you, it’s good for the environment, it’s good for all this, but it tastes like pants.

And that’s what they expect, to taste like pants. And then their eyes light up like, oh, this is really good. Is it really, is it really sugar free? There’s gotta be sugar in it. I’m like, no, it’s really sugar-free. So, it’s great having that feedback. I’ll ask them for like their critique, would you change anything? Well actually, I really liked it. It’s not as sweet as I was expecting. I was expecting it to be really sweet, but it’s not, and I really like that. So, I think even the average American consumer, at least the people that attend the farmer’s market are wanting things that assault their taste buds at a lower intensity.

That’s true actually. I think, yeah, a lot of it is just a case of that’s what’s available. I have a friend I cook for quite a lot. One of the things he really likes about the desserts that I make, that they are less sweet. It’s something he always comments on. He said, you know, I really enjoy the things you make because they’re not overly sweet. I can taste the chocolate, I can taste the coconut, I can taste, the flavors that are in it. And he really likes and comments on the fact that it’s not as sweet as something he’d buy it Tesco’s or whatever. So, I think you’re right. I think actually that most people wouldn’t complain about things being less sweet in general.

I think the only problem with allulose from my perspective, well it’s expensive. But also, people do have, depending on their gut biome and the amount of allulose they eat, some people do seem to have, I’ve experienced this myself, just literally explode. Something you mentioned, erythritol is pretty well tolerated. Some people have a reaction to erythritol.

I think that’s true, actually. And I think if you haven’t had any for a while and you go back to it, that happened to me with the first batch of ice cream that I made. I hadn’t really had any sweetener like that for a while. And I don’t know whether it was that or whether it was something else I ate, but I didn’t feel at all well. Actually, I was sick, and I wasn’t well at all, but have been fine with it since. 

I’m the kind of person that will push through it when it comes to ice cream, I’m going to test it the next day. I’m not going to believe that that ice cream made me out. I’m gonna try it out the next day. If maybe I’m ill three days in a row after eating the ice cream, then I might decide to drop it, but when it comes to ice cream, I’m going to keep pushing through and it’s been fine since you’ll be, you’ll be pleased to know. In fact, I had it for breakfast this morning. That’s the only problem with me when I make things like that, and I can’t make them too often because I do tend to overeat them a little bit. But yes, I can certainly attest it that it works very well in ice cream, incredibly well actually, at least in the recipe that I made.

Excellent. I’m really looking forward to Carrie Brown coming out with allulose ice cream recipes. I know she’s been experimenting.

Yes, she’s right on the brink of, I don’t know what it’s going to be. I don’t know whether it’s going to be a general adaptation that you can use in all her existing recipes or whether it’ll be a whole new bunch of recipes where it’s different for each flavor. I’m not sure yet, but apparently, yes, she’s right on the brink of, of having perfected. I know when she first tried just subbing the allulose for the xylitol in it, it didn’t work. She said it tasted okay. It was the texture. She said it was kind of crumbly, an odd sort of texture. And you know what a perfectionist is. So, she’s not going to put it out there until it’s right. But I know she’s been working very hard on it because a lot of people don’t like using xylitol. So, she’s been working very hard on allulose alternatives.

Yay! I can’t wait. Will makes allulose ice cream for us and he has sometimes really just hit the money, where it tastes to me just as good as Haagen Dazs. But his flavors are vanilla or chocolate. And, Carrie’s are Baskin Robbins, Haagen Dazs and Ben and Jerry’s, all one excellent chef woman.

Incredible range of flavors. I’m very simple with mine as well. I usually start with vanilla, but I did put some chocolate chips in. It’s very delicious. I will send you the recipe when I’ve perfected it. I will share it with everyone. Like I say, it’s not really my recipe at all. It’s Mary Berry’s recipe that I have Ketofied, but it is delicious, and it absolutely stands up to Haagen Dazs, and as Haagen Dazs connoisseur, I think that tells you something. We need to know where to find you and all your delicious candy. And presumably, I know you send your candy out mail order, presumably these other products that you’ve teased us with are not at that stage yet by the sounds of it.

I invite everybody to hit me up on Facebook either, be my personal Facebook buddy or our company Facebook page is Moons Grove Farms. We’re also on Instagram and I have a website, it’s moonsgrovefarms.com. We’re on Amazon, Etsy, and that’s it. Well no, there are a few stores that are stocking us, but nothing nationwide yet, although I have dreams.

What is only been a year, less than a year.

Much less than a year because after Ketofest I got my butt in gear and started putting the company together. But wow, there’s a lot of work involved, and it took me awhile to get everything all in order. I don’t know if we have time for a story about Amazon.

Well I was just gonna ask you actually, because I know you had some hideous problems with Amazon, didn’t you?

I did. Now 50% of all online commerce goes through Amazon. So, I knew that if I’m going to sell anything online, we gotta be on Amazon.

Yeah. You’ve got to be in bed with them, really haven’t you if you want your products out there on a big scale.

So, I went through all the proper steps. I got FDA approval for my products. We have a commercial kitchen, we have packaging and nutrition facts labels and professional photographs, the whole thing. An Amazon representative helped me set up and everything was good. We flipped the switch, we started selling. The first couple of days people love this stuff. We’re getting five-star reviews. And then my account’s been suspended, and it was right before Thanksgiving. I’m like, but there’s people that need my candy for their Christmas presents and stuff.

That is the worst possible quarter, isn’t it? That’s the quarter that everyone goes on about. That’s when you make all your money.

So, they say. And my Amazon representative is like, well, I don’t see what’s wrong. I’m sure it will be resolved really quickly. I’m like, okay, I love Amazon. You guys are the best. You will fix it. Okay. So, a few days go by and I get no notice. Well, we’ve permanently suspended your account because of extra high cancellation rates. I’m like, I haven’t had any cancellations. So how could it be an extra high cancellation rate because my cancellation rate is zero. And the sales rep said oh, they must’ve made a mistake. I’m sure they’ll clear up. 

Another week goes by and nothing. And then he said I’ll talk to my boss. And the boss tried talking to the boss, the other department that did the suspensions and the boss was like, I don’t know, they won’t return my email. So, they went back and forth another couple of weeks and now it’s Christmas. Well, this is all messed up. And then the guy he’s like, well, I’m sorry, I don’t know what to say. So, I hired a lawyer. In fact, I read a story. It was in the New York Times about how Amazon was doing wrong to sellers, which still continues, and how sellers have had to resort to different means to try and get Amazon to treat them right. And one of the people in the story was a lawyer in Atlanta who has fought with Amazon on a number of occasions. So, I contacted him, and he took me on and he happened to have a direct connection to Jeff Bezos. So, he wrote Jeff Bezos, and it took a few weeks to get a response, and we never got a direct response from Jeff B. But I got a call from the Amazon suspension department. They are like, hi, Jeff Bezos asked us to look into your case and you’re un-suspended. Good luck selling on Amazon. So, I don’t know what I did wrong, if anything.

So, no explanation and it took that kind of wrangling to get switched back on.

Yup. About three months and a lawyer and Jeff Bezos’s personal intervention.

And you miss that fourth quarter of sales.

Totally. So, I don’t know. But I’m happy to be on Amazon, so, thank you Jeff, I guess.

Thumbs up to Jeff.

It gave me a very deep appreciation of today’s economy. They got the power.

Absolutely. Yeah. That is the problem, isn’t it? There’s nothing much you can do when computer says no. So, you’re going to be at Ketofest with your candy. Well, I suppose it would be difficult. It won’t be like the local farmer’s market. You won’t be able to bring fudge.

No, you’re wrong about that. I’ve been talking with, our Ketofest organizers and, the local health department and there won’t be a problem. I am definitely bringing some new products to Ketofest. Hopefully we will have the fudge recipe down. We have a fudge recipe down. It’s just not shelf-stable. It has to be refrigerated. It’s amazingly good. You don’t have to worry about eating too much of it because it’s so rich, you have like a little square.

That sounds like a challenge. Your candied ginger, what is that supposed to be? Two servings.?

Three actually.

Well a bag easily is just one serving for me, and I can easily do two bags. You’re talking to a little bit of a greedy piggy when it comes to things like that. So, I’m not sure one little square with fudge with suffice for me.

By the way, we’ve changed how we are making the ginger and the orange, number of the peels actually, in response to getting some more experience making it and selling it. So, I think it’s much better now. And if you tasted the ginger or the orange before, I’d be really curious to get your reaction this year because I think it is loads better. Will says he is ashamed.

I think there was a difference in some that you very kindly sent me home with a huge amount of candied ginger, which I won’t embarrass myself by telling you how quick that can seem to go, but there was a difference. Some of them were a lot sort of thicker cut and juicier, I think that’s what you were saying. It’s moved more towards that. Yeah, definitely brilliant.

And they also seem to be hotter.

Which is not a problem for me. I was speaking to Karen Ogilvie and I don’t think she can eat more than one or two pieces, they’re too hot inside now. Love it. I tell you what does really temper it, what I’ve discovered if you eat, I’m just showing myself out now to be such an absolute pig. But if you eat the candied ginger, and I love it hot, I don’t mind that it absolutely sets my mouth on fire. The hotter, the better as far as I’m concerned. But if you eat it with super dark chocolate, the chocolate tempers the heat. I don’t know why there’s some kind of synergy between the two that it takes the heat out of it.

Nice. I gotta try that.

I can’t explain why it tastes very good. I mean, chocolate covered candied ginger is just delicious anyway, but for some reason it takes the heat out.

We’re working on that.

Yeah, I remember you saying that.

We’re working on incorporating the dark chocolate covered orange rinds and ginger.

Very delicious.

So, I figured out we’re going to change the packaging on the ginger. We’re going to call it nuclear ginger and put skull and crossbones and flames. So, people really understand we’re serious. This is spicy ginger.

And a lot of people like that. They like the challenge as well, don’t they, or eating hot? And funnily enough, I’m actually not the kind of person who likes, I like a bit of heat in a curry say, but I don’t like the super-hot curries. If it’s too hot for me, I can’t taste it. But when it comes to your ginger, I just love the heat in it.

I made a small child cry at the farmer’s market. We were giving out samples and the mom tastes it. She was like, oh, this is really good. She gives a sample to her kid. The kid starts crying. Oh God.

I hope you didn’t video that one.

I’m like, I’m so sorry. The four-year-old won’t come back and buy any candy from me anyways. So that’s fine. And I laugh about it now, but yeah, we’re gonna re-label that nuclear ginger. And the lime, if we continue making the lime, we’re going to call it lime jerky because we can’t make those lime peels soft and chewy. There’s just no way. We’ve tried different things. It just doesn’t work. So, it’s hard jerky-like candied lime peels. I don’t know. Some people may love the flavor. So, when I proposed that we stop making it, they’re like, “No!”. But a lot of people aren’t expecting it to be so tough and it’s really, super hard. So, I don’t know. But the nut bars are incredible, and I can’t wait to bring them to Ketofest and let people sample them there.

Oh, I cannot wait to sample them. I shall let everyone know what they taste like.

Excellent. It’ll take a while for me to wrap up and get FDA approval and do the nutrition facts labels and the packaging and get them on the website, but I’m happy to be able to take them to Ketofest and distribute them in person.

Yeah. Well something for us, Ketofesters to look forward to.

Among other things. I can’t wait. Bacon bar!

All the things.

All the things.

Yeah. Hog roast. The plaza square on the Saturday is just going to be full of all sorts of delicious things to eat.

And demos. I’m actually doing a cooking demo with Karen Ogilvie.

You are? And what have you finalized on? You’re doing muffins, aren’t you?

We’re doing muffins. Actually cupcakes. I’m not sure of the technical difference between muffins and cupcakes.

I’m not sure, icing maybe.

Icing, that’s it. So, we have muffins where we’re going to be including diced candied orange peels from Moon’s Grove Farms. Of course, if people want to make it without that, that’s fine. But then we have this lovely dark chocolate allulose fudge icing that we’re going to be swirling on top of those things. And also, we’re still tinkering with the recipe for either a sour cream lemon or sour cream lime cake with a cream cheese icing on top. Frosting, buttercream, cream cheese, something like that. Anyway, we’re playing with it right now. When I say we, I mean Will is playing with the recipe right now. And we are really excited, Karen and I, to do this cooking demo. It is going to be a lot of fun. Karen and I are actually, in theory, starting a podcast. We keep trying to make time for it. It’d be Keto book bookclub and if we can get that launched before Ketofest, I will be thrilled to, pleased as punch to hope that people have a chance to listen to it. I think a Keto book club is something whose time has come.

I do, I’m very excited about it. We’ve been talking about it, haven’t we behind the scenes for a while. You told me about it quite a while ago. And yes, I think it will be a great format. Like you say, it’s not something that’s out there already. It would be a great new podcast I think for the Keto universe.

I’m excited about it. And now that Karen’s schedule is freed up a little bit, with her son not being in school, she has less errands and running around and PTA business to do, so we’re gonna hit it pretty hard, in theory.

Perfect. I can’t wait for that. That sounds like you’ve laid down the gauntlet there. That will be nice to be telling everyone at Ketofest that it’s launching.

That’s right, Karen. Karen and I are both psyched and we both have busy lives so it’s hard to fit it in. I have no idea how you do it, Daisy. You are a super woman.

I was just going to say, yeah, obviously I know what it’s like in it seems like a huge challenge and it is very daunting when you’re starting because there’s so much to organize to launch it in the first place. That’s the thing. And there’s this other element that holds you back a little bit because you know that once you’ve started, you’ve got that commitment. If you’re doing a weekly podcast, as soon as you put the first one out, that means you’ve got to be putting one out every single week. And yes, it is a big commitment. I mean now that I do every part of it myself, I’ve worked out that each episode takes a minimum of a day and a half, probably closer to two days really, to produce the hours episode that you listened to, and all the things that go with it. So, all the social media and the show notes, everything that goes into producing and promoting that episode. Yeah, and it’s the best part of two days’ work. You’re taking on quite a lot. I mean it’s good when there are two of you, obviously you can share the load a bit and as everyone knows by now, I think, I’m a bit of a bit of a perfectionist nut job when it comes to editing. So, it probably does take me a lot longer than it does for other people.

Maybe. I’ve certainly heard some podcasts out there that clearly have not had professional editing of any sort. So, maybe a certain amount of sloppiness is acceptable.

It’s finding the balance. Yes. It’s that whole don’t let perfection be the enemy of good thing. It’s the finding the balance between the two. And I’m getting there, I’m getting to the point where I’ll leave in a lot more of the things that I used to just get so super-involved in taking out.

I don’t think I’ve ever heard bad sound on your podcast, at least to the extent that like I’ve been like irritated by it or anything.

I should hope not. I had good training. I was brought up in the Carl Franklin and Brandon Wen school of podcast editing, so very good training. Absolutely.

Very cool. I’m just delighted if we can get this podcast launched and I say if, because both Karen and I do lead busy lives and have obviously other irons in the fire. I think that terrific fun and I love reading books about Keto, as does Karen. So why not help other people?

And as does the community, I think. It will be very needed. I not sure if needed is the right word. Do we ever need anything? I think it’s a podcast that people will be very interested in and will also enjoy being involved in as well. That’s the thing with the book club, isn’t it? That the listeners can become involved in it and be part of it.

And we can have discussions about what does this part mean? Did you try this recipe from this Keto book? Is this Keto author insane? That kind of thing. It’ll be fun.

I think it’s a fantastic idea. And you know, good for the authors as well. It works in all different angles, isn’t it? Promoting their books to the community, getting feedback from the community. Everyone wins. Can’t wait for the Keto book club podcast.

Yeah. I’m psyched. Did you hear that, Karen? Let’s do it.

She’s gonna love you for this.

We’re going to have a great time together, Karen and I.

You are, absolutely. Obviously, I do my podcast on my own, but I do like the dual presenter podcasts. It’s interesting. Obviously, they have their guests on, but it’s interesting seeing that synergy between between the two hosts and often that’s entertaining in itself.

Well, I think Karen and I have different perspectives on things. So, we can inform and engage each other and hopefully our listeners.

Absolutely, can’t wait. So, we’re at that point in the show where I ask you to leave us with a top tip.

Okay, my top tip is if you have not tried intermittent fasting, try it. Trying to get more in touch with my body’s signals for when I’m actually hungry and when I actually want to eat has been an incredible change in my health and my approach to food. Divorcing myself from eating because it was expected and there’s food available. It’s time to listen to my body and say, I think that I don’t need to eat because I’m not actually hungry, and then not doing it. It has been so empowering. So, if somebody is looking to take their Keto practice to the next level, they should try it. It is almost as hard as just starting Keto in the first place, to take control. Not really change how much food I eat, but just listening to my body about when I eat it and saying this is what hunger is, this is just emotional, I want something in my mouth. It has been a real game changer for me.

Yes, I do think it does really help dial in those signals. I found the same. I’m definitely a bit of a grazer, especially when I’m at home and I know the difference, because I can be out gardening on a job all afternoon and I don’t feel the need to be eating all the time, yet when I’m at home and the fridge is there and just, oh, I’m hungry. But I’m not hungry, I know I’m not hungry, I know it’s just I want to pick, because I know there’s some cheese in the fridge or there’s some ice cream in the freezer or whatever it is. Yes, to actually go for period of time without food and to really get properly hungry. It does really help I think if you’re one of these people that struggles with head hunger versus real hunger.

You know what it is for me? I realized eating something feels vaguely productive. Like I have done something, I’ve accumulated resources for my body. So, at a kind of emotional intuitive level, it lowers my stress level a little bit because I have packed on some more resources. So, I’m not going to starve. Nothing to do with physical hunger, just emotional satisfaction because I’m not going to starve today and it has to do with maybe food insecurity or something, but it doesn’t have anything to do with physical hunger. So being able to tell myself I’m going to direct that need to do something productive into a different thing that is also satisfying. Maybe doing a little house cleaning, maybe, buying something on Amazon, doing some gardening that also satisfies that.

It’s weird how you have so much time on your hands when you don’t eat as well, don’t you? I mean, I found that a bit when I was doing my carnivore experiment. How much more time there was, and I can remember when a friend came out to eat, he obviously wasn’t eating carnivore, so I had to prepare some vegetables and things for him and it was like, blimey, this all takes so much time. My rack of lamb ribs or something, it was just a case of taking it out of the fridge, putting it in the oven, taking it out the oven, eating it. The extras that I had to do for him. But obviously it’s a whole new level when you’re fasting, you’re not eating at all. And I know that whenever I do fast, I’m not very good. I need to get a fasting routine. It’s those days when you’re not eating, it’s like, oh, this extra time on your hands when usually you’re either preparing, cooking or sitting down and eating that food. It actually takes up quite a chunk of your day, doesn’t it?

Yeah, absolutely. Or I’ll be out on a business trip with colleagues who obviously are not Keto or fasting. And it’s a good third of the day that’s spent sitting, eating, getting food, going into a restaurant, whatever it is. Even more than a third of the day. And if I say, you know, guys, I have to make up an excuse, so it doesn’t sound weird but I’m not eating with you. I’m just going to go back to my hotel room and get some work done. That gives me back so much time and I need it. Because I’ve got a lot going on in my life, Daisy. Woo. So, it works out pretty well.

Yeah. Busy women just as you were saying, you’re just going to try adding a podcast to that. Good luck finding the time.

Better time management. Of course, I cannot neglect my partners or my family or the garden or the pets or anything. So, it’s a matter of priorities.

Yeah, I have the advantage there. I just have my dogs and cats really. I don’t have to think about entertaining other humans. Now I do keep forgetting to ask people, so I will just throw it in at the end here. What your Keto looks like on an average day when you’re not fasting, obviously.

Definitely. Black coffee or sometimes with a little bit of heavy whipping cream. And about the coffee, I’m serious about coffee. I’m nuts about it. We have our own home roasting machine. We import beans from either Costa Rica or Tanzania. We got some lovely Tanzanian peaberry right now. So, we roast our own beans, grind them. We have an espresso machine.

Because the roasting is important, isn’t it? Sort of the temperature of the roasting and how long you roast it all really affects the flavor, doesn’t it?

Absolutely. So, you have different roasting profiles that change the temperature of the roast throughout the roast cycles. Fresh roasted is totally different than stuff that was roasted a week ago. If you’re buying stuff in the stores in little bags, it might’ve been roasted a month ago and wow, that’s very different. So, the fresh roasted beans changed my life. I’m fully caffeinated now, Daisy.

So, when you say its worlds apart flavor-wise, but what is that difference?

Well, it actually changes if you have coffee that’s been roasted within the past 24 hours. The notes of the coffee are more floral, more bright, has this dimension to it that goes away. A lot of the essential oils evaporate within that first 24 hours. A lot of out-gassing so, it’s less acidic after 24 hours. It’s different. The chemical composition is different.

So just like wine then really, it’s the difference between having a Beaujolais Nouveau to having something that’s been aged for however long.

That’s it. Exactly. And some people will say, some Beaujolais are too young, or they don’t have that depth of character. So, it’s not always the case that fresh roasted is better. It’s different and sometimes I really love it, but sometimes letting the roast sit for at least 24 hours to out-gas and mature a little bit. Then that first 24 hours to a week period. I think that’s where you have the richest flavor and then maybe after a week a lot more of the oils have started to either mature or evaporate a little bit. So, the flavor is less intense. 

Anyway, that’s how my day starts. Cup of fresh roasted coffee and water, tea. I have 20 different kinds of herbal teas that I love. I don’t do soft drinks with any of those nasty sweeteners. We have seltzer often; I love seltzer or other kinds of naturally sweetened things. Not naturally sweetened, naturally flavored, like little bits of lemon juice or lime juice or whatnot. And then food wise, a little left over from last night maybe for lunch if I feel like it. Or we have chickens, so eggs are pretty common for a meal, either hard-boiled or scrambled. Or I’ll make a quick frittata. 

And then dinner, Will has usually cooked some large piece of meat that we’ll slice. He just roasted a smoked brisket, nice chunk of beef brisket on hickory wood, also a rack of ribs. So, he’ll come up with something and sometimes he gets super creative and comes up with some crazy dish. He did Indian butter chicken last night with cauliflower rice and a salad and a Keto coleslaw sweetened with allulose. But some days it’s just burger, patty of ground beef with cheese and bacon, then the salad. And honestly that’s the best.

It sounds pretty handy having a live-in chef.

It really is. I highly recommend it.

So, I mean overall, as we mentioned earlier. Fairly simple really, it sounds like you’re a two meal a day as well, that that seems to be the most common pattern. I think two meals a day.

Generally. Yes. Sometimes one, sometimes none, but generally two.

And so, when you fast, do you have a regular fasting routine? You talk about intermittent fasting and for how long do you fast?

Generally, I will do food-less Mondays. Where I just hate Mondays. So, I don’t want to sully Mondays by doing anything pleasant like eating. I just want to have full, pure hatred for Mondays. So, that’s it. No food Mondays and then, generally I’ll eat, either breakfast or lunch, but not both. And then dinner. That’s it. Nothing fancy.

One of the things that is quite often leveled against fasting is that, you know, I’ve heard the argument that people just make up for it. They compensate on the days they’re eating and eat twice as much. But I found the absolute opposite actually the day after. If I fast, I tend to fast for either 24 or 36 hours. And certainly at least the first meal I have is probably half the normal size. I tend to find that I eat less on the day after I’ve fasted, not more.

I think that it kind of re-calibrates my appetite and stomach to not eating. And so, you can’t really just go right back in and have a huge meal. I’ve done five-day fasts on a number of occasions. I think for health purposes it’s great to really get that deep into autophagy. So, I think maybe once a quarter to do that, but not for weight loss purposes. Because I did find that, after five days of fasting that in the weeks afterwards that I did have a heightened appetite. So, I don’t think those longer fasts, for me anyway, helped me lose weight. But a short fast, food-less Mondays, skipping breakfast or even skipping breakfast and lunch sometimes. That doesn’t seem to move the dial for me one way or the other, it just helps. I think it keeps my system more insulin sensitive to do it occasionally. Sort of like exercising, which I should do more of. I have a treadmill desk. I work from home; I use the treadmill desk every day. And I love it. I highly recommend it. That’s my other top tip. Intermittent fasting and get a treadmill desk if you work from home.

I’ve never heard of treadmill desks. I’ve heard of standing desks, but I have not heard of treadmill desks.

Standing desks actually don’t do that much good for you because you’re just standing still. You’re just standing. I mean, it’s maybe a little better than sitting, but maybe not. Because you’re still just standing there, still. It’s not natural. It’s not natural for people to be sitting or standing in a still position for long periods of time every day. Walking is natural. So, I have a treadmill and I have a hutch that goes over the treadmill and my laptop sits on top of the hutch. I don’t do super concentrating work there. So, if I’m working on software and coding or writing, no, I have to sit down cause you need to concentrate. But for surfing, answering email, doing Facebook, the treadmill desk is perfect.

Interesting. I’m going to be imagining whenever I read one of your Facebook posts, while she was watching this, she was walking on her treadmill desk.

Very frequently.

Well, it’s been wonderful catching up with you and finding out a bit more about you. Thank you very much for sharing your time with me.

Oh, I thank you for sharing your time. It’s delightful, you’re one of my heroes and, I’ve just been squeeing inside this whole time. I love what you do, Daisy.

Thank you very much. And I look forward to that hug at Ketofest.

Me Too. Me Too.

See you soon.

See you soon.

This transcript is brought to you thanks to the hard work of Dawn Michelle.

Welcome Jennifer to the Keto Woman podcast. How are you doing today?

Oh my God, I’m so excited. Just happy to be here. I love talking with you and I’m thrilled to be a guest.

And we’ve actually met a few times in person, so it’s nice to see you again.

It’s great to see you. I just wish I could give you a big hug.

Yes, we like hugs. Well it won’t be long. Because we will both be at Ketofest, won’t we?

Yay! I’m so excited about that, too.

Yeah, I know, me too. I suppose it is a ways away, it must be about six weeks away. But I know it’s going to come around really quickly.

I’d say seven, not that I’m watching the clock, but much to do, lots to prepare.

And exciting for me to be in America again. It’s become a bit of a regular thing for me these days. Having not been to America at all until last year, was the first time I’d ever set foot stateside. Yes. Becoming a bit regular now.

Your first Ketofest last year?

Yes. That was my first trip to the US of A.

Oh wow. Well, I’m very happy that it was a good experience. And, I was so psyched to meet you last year and then to be on your show this year. Oh my God. Yay.

We’ve been talking about it for a while, haven’t we? So, it’s nice to finally have you here sharing the web waves with me.

It’s been quite a year, actually, almost a full year since then. Thinking about everything that’s happened in my life and, just the world in general. It’s been crazy times.

Lots of changes. A lot has gone on in this year. So, on that subject, tell me a bit about you.

I am 48, I have two partners and I’ve started a low carb candy company, which, I founded actually after Ketofest last year. I was passing out some samples of my partner’s candy. He makes candied citrus peels and orange rinds and ginger and stuff. And I was passing out samples, last year to see what people thought. And everybody’s like, oh, that’s really good. So, I started a candy company and also of course I’ve been Keto for quite some time, about four and a half years now. I was a type two diabetic back in 2014. I got my diagnosis and it was really bad. I had a 12.1 A1c and started to have kidney disease. My eyes were messed up, you know, all the complications. I spent like a year trying to find, just trying different things, drugs, trying to eat a little better, but, you know, I didn’t know. Finally, I had a big wake-up call that it wasn’t working, I hit the Internet real hard found Keto and, saved my life.

How did you find Keto? Literally a Google search with your symptoms? How did you come across it?

Oh, actually, I went on Reddit. I was a Redditor and the diabetes sub-Reddit there is not entirely friendly to Keto and they’re mainly type one diabetes oriented. And they’re not strictly about Keto. But from there, some people are like, you should try Keto. And then the Keto sub-Reddit was all like, this is going to do it. You’ve got to do it. And they were right. In fact, I almost died. So I was very hesitant and fearful about trying Keto because the fear that you read on the Internet, so I went to my doctor at the time and I said, well you want me to keep increasing my dosage of these different medications? Do you want me to go on Lipitor? You have me taking Amerol and Glipizide and you say diabetes is a progressive disease on, I don’t want to see it progress anymore.

So I was thinking about trying this Keto diet. “Well, some people say it works, some people say it doesn’t. I don’t know. Yeah, if you try it, that’s all right.” So, he didn’t push it. He didn’t say it was good. He didn’t say it was bad. And so, I went, and I tried it and I was on all those medications. What do you think happened? Well, the first day that I cut out all the carbs and then the next morning I took the standard dosages of all those medications almost passed out. I think I did pass out briefly and when I could get to a blood sugar meter, it read 24. I had chills and I had to crawl, and I finally got to the phone and I talked to the doctor’s office and they’re like, oh yeah, that can be a complication. Just keep some candy on you. And you know, if you start to feel queasy like that just eat candy, it’s a problem with the Keto diet. Okay. I don’t think that’s the problem. I think the problem is with the medication. Well, if you want to cut back, you could go back to like maybe, you know, a half dose and see how that goes. Like how about a zero dose? So, I fired that doctor.

I mean, it’s crazy, isn’t it? That’s why people really need to get their doctor on-board. And the doctors need to be on-board in the first place or at least open to it because this is a great illustration of what can happen if you are on medication. You know, it actually shows just how effective this change of diet is that the medication ends up then having that such a dramatic response that it sends your blood sugar through the floor, you know, that’s actually a good validation of Keto, isn’t it? However, it could lead to potentially deadly consequences. So that’s why it’s so important to be able to work with your doctor. But to be able to do that, they have to have at least some kind of understanding, which you know, it sounded like originally when you spoke to your doctor that they did because they said they knew about it. They said Keto can help. It helps for some; it doesn’t help for others. So, I think you would be justified in thinking that they were okay with it and would have given you the guidance that you might need. If you had needed to be aware that this might be a problem when you started, that the medication was going to bring your blood sugar right down, it’d be something that you could have looked out for and managed and all the rest of it. Crazy.

I thought I was doing all the right things, consult your doctor, you know. And I did. And, it turned out that he wasn’t helpful at all, but I didn’t know that, he sounded helpful. I feel like a lot of people accept their doctors as authorities. They just do whatever the doctor says. They trust them and they don’t question, and that’s how I used to be. That ripped the scales from my eyes. And I found a doctor who views himself as my partner, and my health coach. He is an MD, but when he says something, he expects, and I do go research it and then decide for myself, if that makes sense. And take action on it or propose an alternate course of action, which I’ve done. And then he’ll research, and he’ll say whether he thinks that makes sense. So I’m not saying I have an MD or I’m an expert in stuff, but I’m an expert in my own health.

And I think that’s how it should be. And I think that’s more and more. That’s what seems to come back from pretty well everyone I speak to is this sense of empowerment and confidence that Keto low carb gives them, they get this understanding of how their body works because even if they just read the most basic of the science that goes with it, it all starts to make sense how their body’s working and they get it and they start to understand why they had the problems they had and how easy it can be to fix it or at least help whatever the issues are that they have. And that gives you a real sense of confidence to be able to then go to your doctor and let you say you’re not speaking to them as an equal. You’re not saying you have the qualifications they do, but you’re speaking to them on that kind of level where you’re the expert of you and you’re an intelligent person and you’re willing to put in the work. And when you do find the right person, and my doctor’s very similar, you get that kind of relationship where you work together. Rather than they’re just, like you said before, they’re just this authority figure that expects you to just do whatever they say.

The high priest of medicine, you walk in and it gives you three hail Mary’s and sends you home with a prescription for Ritalin or whatever. My current doctor, I love him and he’s a good guy and he loves me, you know, not in any sort of inappropriate way. But anyway, I’ll talk with him about Keto and diabetes and continuous glucose monitors and fasting all these health practices that have changed my life. And, he promotes them to his other patients, but he says that I am one of the few patients that actually does it and he feels like I’ve talked to him about how angry I am at the medical establishment for not effectively communicating to people that these practices are not just some sort of woowoo alternative with no health implications, but these are very powerful and that I feel like I might have wasted or suffered for years of my life that I didn’t have to because I didn’t know. And he said that as much as he has preached these practices to his other patients, very few of them actually adopt it.

Right. Interesting.

So, it’s kind of wasted time and then most of them are just there for a pill anyway.

Yes. That’s always going to be the problem, isn’t it? That, not everyone, I think you kind of have to be that certain kind of person, and it’s the kind of person that we tend to find in the Keto community, is that they’re sort of slightly rebellious, prepared to push back, interested in the science, interested in doing their own research, not bothered about going out there alone if needs be. Putting themselves first and leading the way.

Another problem here in the US is the way that medical billing is done. My doctor does not get paid for time he spends giving nutritional coaching. The insurance company will reimburse him for diagnostic codes, for prescribing, for performing procedures. And for a visit, he gets five minutes reimbursement and if he spends longer than that, he’s not getting paid by the insurance company, you know? He has to support the whole office with all the people that do the medical billing and the paperwork managing and appointments and stuff like that. So, if he’s wasting time talking to patients who aren’t going to actually take his advice, that hurts his whole practice.

Yes. Exactly. I remember Shawn Baker talking about the problem that he had with the hospital that he worked for and that was the same problem. He was wanting to give some nutritional advice and coaching and setting up weekly sort of drop in center type advice to give to patients who were coming in for these operations. The goal was for them not to have the operation in the first place. And, of course the hospital, the finance department freaked out at this and that’s where everything started to go wrong for a time. It’s sad isn’t it? That money basically is coming before health. And I know you talk about that the system in America and it’s different in the UK. But the frustration, I think a lot of us feel is that this way of eating could potentially save the health system. It can certainly save the NHS, which, you know, probably the biggest amount of money that flows out is to deal with type two diabetes or the associated problems that come with that. You start reversing all that, you suddenly freed up all this money to do all these other things. I mean, it just seems so obvious yet. Nope.

Completely obvious. And I’m living it and I’m trying to be an example and not horribly preachy to all my friends and family, but to inspire. It kills me that their doctors are not advocating for this. My whole family has obesity genes and diabetes genes and you can see it in action. Unfortunately, with my older relatives who are, you know, not all of them have diabetes, but a lot of them. And a lot of them are taking the approach that they can eat whatever they want and then just inject insulin to cover for it. Or, take a handful of pills, good to go, right? And they have more pills and more complications. We know how that goes, but the doctor isn’t pushing them. So, I don’t know if their doctor did push them. But they all say to me, “Oh, Jennifer, I admire what you’re doing. It’s inspirational. I wish I could do that.” Like you could, you could do that. You know, you say that, but you could.

It does seem nuts doesn’t it when you’ve got, so on one hand, you have this disease that’s progressive and there’s this path that you can take with it. On the other hand, and the choice is yours, there’s this different diet and lifestyle that you could adopt that could reverse your condition. It’s your choice. Which one are you going to take? This one involves medication, eat what you like, but it’s going to be progressive, which means it’s gonna keep getting worse. You’re going to have to keep taking more medication, and so on and so forth. Or, it’s going to be a bit more work. It’s going to be difficult to adjust to, but we can reverse it. Which one? It seems amazing that people still choose the progressive option.

It’s incredible. And then when they talk about, the things that they would have to give up, I’m like, but I know there are Keto options that would do that thing for you. You know, you have pasta. Awesome. Let me introduce you to zoodles or shirataki or these oat fiber konjac noodles that I love? Or instead of using pasta, imagine you had your sauce and sausage on a bed of Broccoli. Yum. Right? Okay. The rice, try cauliflower rice. There’s candy. I got a candy company. You don’t have to miss candy. And they’re like, well, maybe if I had your partner Will to cook for me. And I have to admit, having my partner Will to cook for me is pretty awesome. But now there’s so many companies out there providing even pre-packaged cauliflower pizza in the frozen pizza section or whatnot. You know, you don’t have to cook it all from scratch. Although I don’t think it’s that hard, I don’t do all my cooking either, so I might be kind of privileged there.

I do think it’s something that it’s a skill that is useful to have, but only basic cooking skills. Keeping it simple I think is the mainstay for everybody. Even people like me who like cooking and experimenting for the most part, I keep it simple because it’s just easier that way.

Any dinner that’s steak and a salad, is a good dinner for me.

Exactly. What’s not to like? Let’s go back a bit. I’d be interested to find out what led you to that place where you had your wakeup call with the 12.1 A1c? How did you get there? You’ve already mentioned that there’s genetic history there.

If you saw a picture of my family, you would see me, my brother, my mom, my dad, everybody. We all have the same build, what we call in Yiddish, zaftig. Do you know what that is? Puffy, to say the least. I believe that our genetic heritage, you know, is we’re perfectly well suited to living in the ghettos and surviving on nothing but cabbage and, and maybe, a Borscht for months at a time. I think we’re all very well adapted to a fasting for instance, but we’re not well adapted to living in plenty. So all of us, I wouldn’t say that we struggle with our weight because that would imply that we struggle. And for most of my life I was perfectly happy being a rotund Rubenesque. I was jolly and around 200-220 pounds. I don’t know what that is and your weird kilogram units, but larger than is healthy for me. And I was fine with that as long as I was healthy. I would go to the doctor and have my lipids and he’d say you should lose weight. But it wasn’t like I had any problems, so I ignored him. I like food.

But then I did start to have some problems with my vision where my vision was not a sharp is it should’ve been. And I went in for a checkup and he’s like, oh yeah, so your blood sugar is 320. I’m like, is that bad? And he’s like, yeah, you have diabetes. I’m like, are you sure? He’s like, I’m sure. You don’t need to retest? No, I don’t need to retest. So that began the year of trying to treat diabetes with drugs. And then just kept adding on and on and on. And then there was this one day where I had this series of unfortunate events. I was at an amusement park with my family. And there all of us were, the Kleiman genes all on parade. They had a new roller coaster. And I don’t know if you’ve been to an amusement park here where they have the safety harnesses and the fancy rides and the cages and restraints and stuff, but you have to be of a certain body size in order to fit within these safety harnesses.

That’s right, you have to, I can always remember, I’m not a fan of most of these rides that I can remember that from as a child with things I wanted to go on this, and minimum height requirement isn’t there? But then there’s also a maximum size, I guess.

Well, the newer rides because they are pushing the limits and so they have like special elaborate harnesses with different straps and cushioning and stuff. So, they actually have a test seat that you can try on to see if you will fit before you spend an hour waiting in line to go on the ride. And so, we walk up to the newest ride and it has, you know, your test seat. My dad looks at it and he doesn’t even try. My mom, no. My brother tries it and he just barely makes it. I try it and I just barely make it. So, we wait an hour to get on the ride and I get up there and it took three of the park attendants to force the harness closed over me and squish my fat into place. And that was so humiliating, and I could just see them kinda staring at me in contempt. I mean I’m probably imagining some of it, but I don’t think all of it. And you know, the other people on the ride, you know, they had to wait for these people to, to shove the harness in place over my guts. Well that was all pretty terrible and I don’t think I enjoyed the ride either.

Well, you’re not very likely to after that style, to be honest. It’s not going to happen.

No, not at all. Oh, there it was terrible. And then afterwards I had heard that my aunt who suffers from diabetes had an incident that morning where she lives alone, and she had fallen, and she was also very obese at the time. She couldn’t get up and she had to call the paramedics to come and it took a squad of six young men to get her to her feet. And I’m like, wow, so this is my genetics, this is my future. If I don’t do something, I’m going to be living alone and calling 911 to help me get to my feet until I die an early death of complications of various diseases. So, I had to do something. And wow, I’m so lucky I found Keto because, you know, one of the things we’ve talked about now is that people need not to be their own doctor, but at least be responsible for their own health. But it’s so hard because saying I reject the authority of the doctor. That’s a great first step. But then there are so many charlatans and so many different alternative health paths. And not to say that all of them are bad or all of them are good, but to be able to judge which is the right path now that you’re taking responsibility, now that I was taking responsibility for myself.

It is not an easy thing to say, this is real, this works. And this is a bunch of, woo-woo, it has marketing cache, and so it’s popular because it has an emotional appeal or whatever, but it doesn’t actually help. So, I, have a lot of scientific training. I was studying to be a PhD in mathematics and math education. And so, I had some training in reading research papers and evaluating both qualitative and quantitative research. I was able to find a lot of research backing the Keto diet, which helped me, but I can’t imagine that the average person trying to decide what’s the right health practice for them. They don’t have those resources. They’re probably just asking their friends, are going on the Internet and Googling and finding all kinds of other answers, which may or may not actually help. So, it’s difficult.

It’s tricky isn’t it? Because on one hand, especially with the recent dramatic rise in popularity of Keto, there is so much out there on the Internet and it’s all completely free. That’s one of the things I like about Keto is that it is accessible to everyone for free. You know, I mean, it hasn’t cost me anything to learn how to eat this way and I know it can do. And I know there are multiple businesses building up around it now and around the popularity of it. Businesses like yours that we’re going to talk about in a minute that are selling products to eat. There are coaching programs like the one I endorse, Kim Howerton and Carrie Brown’s program, which is fantastic. And there are all these things that you can pay money to learn about Keto if you want to, but you can also access it all for free. And that’s what I like about it is universally accessible for absolutely anyone completely for free. But there’s also the other side of that there is so much information out there, it can be really confusing to figure out which is the best path for you.

You know, Daisy, I think we kind of live in a very happy bubble actually because I think I’ve met people who have approached Keto from a less informed and less free, point of view. But where they got introduced to Keto through, for instance, Pruvit marketers or through their chiropractor who has a bunch of products, various powders and MCT oils and exogenous ketones. From that approach, it’s not a free diet, but to this approach, it’s more of a sort of a magical process of taking different potions that will make you better. And you know, the marketing hype around these things is intense.

Yes, that’s a very good point actually. And I kind of had completely forgotten about that because it’s, it’s so much something that I stay away from. I forget what a big industry it is, and of course it really does appeal to those people, that group of people that you were talking about before where your doctor was saying, he wished all his patients who Keto would have worked for, would adopt it. But it is those kinds of people who like to take a pill that are already susceptible to the exogenous ketone marketers.

One extreme or the other. You get the pill from your doctor. The people that will not venture out from their doctor’s protection and they are just going to take the pill and they don’t want to consider anything else because the doctor hasn’t said to do it. And then there’s the people who have thrown the shackles of the doctor off. But they are not scientific in their approach. So the first, and the most bloviated marketing claims out there, they’re like, well, this stuff, this is amazing, and it says, and it has these endorsements by these beautiful looking people, and, it costs a lot of money, so it’s gotta be good. Those people, you know, it’s hard to kind of separate out the facts from the fiction when you have to start evaluating these health claims that they’ve been caught in. I went to the Nourished Festival for gluten-free products, which our candy is gluten-free. And while I was there, there were several other, Keto people at this conference, including the Pruvit booth, and the Pruvit marketers. They were very enthusiastic about their product and they sounded very sincere about it. And, I hope that if they are listening that they’re not going to be offended, but their product is just completely unnecessary unless you happen to be a high-performance athlete. I don’t know. I don’t think so. I mean, obviously most high-performance athletes don’t take exaggerates ketones. So, I don’t think it’s a necessary product even for them, but certainly not for people who are just trying to lose weight.

Well, in actual fact, it goes the other way. That can actually be counterproductive if you’re trying to lose weight.

Oh, I was talking with someone actually literally yesterday about this. She said she was doing a little fast because she wanted to get her body back in a higher state of operation and she was measuring her ketones and she was 36 hours into the fast. So, she said, I took some exotic as ketones to really boost my ketones and really get deeper into the fast. I’m like, okay, you just actually completely tanked your fast because your body was producing the ketones and that means your body was taking its stored fat reserves and converting it to energy, and now you just took a whole shot of extra energy. And so, your body’s like, wow, well I got extra energy, I don’t need to produce any more ketones.

It’s actually, you just fed me, thanks, fast over.

She’s like, oh, actually that makes a ton of sense. But the Pruvit people aren’t going to say that. Sorry, Pruvit people. All right now they hate me. That’s just the mechanics of it. And you know, I understand the average consumer is not going to get deep into the science and so they’re just going to believe marketing claims.

That’s right. And it is, when you look at the science behind it and you start. I have a very logical brain and I have to understand how something works before I can buy into it. And when you start picking these claims apart is when you start realizing there’s something dodgy going on. And it’s not to say that there aren’t potential really useful applications for exogenous ketones. I’ve recommended them to my uncle, for example, who has early onset Alzheimer’s, perfect candidate for exogenous ketones in my opinion. And there are others. But if weight loss is your goal, stay away from them. Save your money, spend it on steak and bacon.

The interesting thing about the marketing and health auras and taking an emotional approach to health. I think it is the intuitive way that most of us operate and some of us are more rational. I’m not saying rational is better, but because rational can get trapped too. We can make things over-complicated and we can get stuck trying to evaluate different courses of action and fail to take any action. Sometimes we have to rely on our feelings. But often our feelings will lead us to the flashy over marketed solutions that seem emotionally appealing but are not the right ones.

Difficult balance to try and figure out. Tell me about, you obviously adopted this way of eating and for some people and I’m not sure how I would cope in that situation. I live on my own so I can do what I want in my house and have what foods I like in the house and all the rest of it. I’m not sure if I could cope if I lived with someone who was a carb eater. I’m not sure how I’d deal with that. I know people find a way, but you are quite lucky, I think. You managed to get your team on-board and they found their own benefits from it. Is that right?

Well, not right away. My partner Will, did start cooking Keto for me right away because he was very supportive and is very supportive. But my partner Gloria, she, while being emotionally supportive, she loved her carbs and it was actually a big sacrifice for Will. He was cooking Keto for me, but he was still having carbs himself. And he was going through a phase at the time where he was perfecting his artisan bread skills. And let me tell you, I think he caused my diabetes. I’m sorry, Will. Will, you, there? You caused my diabetes. He just would pull this perfectly amazing loaf of sourdough out of the oven and offer me a hot slice of this crusty, amazing smelling bread with butter. Oh, just thinking about it. I mean, there is no Keto equivalent, unfortunately.

That’s impossible to resist, isn’t it? I do understand that. That’s where I was saying, if I had that in front of me, I’m not sure how I’d cope.

And oh, he’s making these pretzels and bagels and he was just really getting into it. Fortunately, he stopped making those and he would still make fried potatoes or whatnot for him and Gloria. But I could resist those, under the threat of looming death. Death is a great motivator and, avoiding death. Once it became apparent to me that eating carbs and paying attention to my blood sugar, it was very apparent. You know, even the supposedly to heart-healthy oatmeal that my first doctor had advocated would spike my blood sugar and there it would be up the 200-300 range again.

It’s a very good way actually, isn’t it? Bringing things like that home. It’s one of the reasons why I say that it is useful to get a meter just to do that, to test different foods cause I’ve done the same thing. I had the exact same result with oatmeal. I used to love the steel cut oats. You know, these are super healthy, and I used to eat all the time. I can remember having a conversation with my sister who also used to like having oatmeal for breakfast and she used to say, the thing is, you know you have this thing that’s supposed to be really good for you and is supposed to be really filling, but I just tend to feel sleepy and I’m really hungry mid-morning after having it. Of course, now we know exactly why that is, it’s because of the massive spike and then slumping in blood sugar.

I’ve been surprised by a number of foods, and butternut squash. I made some soup with it and as soon as I tasted it, it tasted so sweet. So, I thought, right, I’m going to test my blood sugar response to this. And it went even higher than oatmeal. So that’s where it’s just really worth testing different things, especially if they are your favorite things. And then you have this black and white data in front of you. You can’t argue with that. You can’t argue and potentially play down how you felt, which is really easy to do when it’s balanced with something that you’re really craving. You can really play down those other things. But when you’ve got that data, black and white in front of you, that’s shown you exactly what’s happened to your blood sugar and you combine that with how you feel and then it makes it a little bit easier to balance those scales in the right direction I think.

Absolutely, having that feedback loop is the only way I think that people learn to change their behavior. You know, just somebody telling you, oh, you shouldn’t do that. Well, okay, yeah, probably they’re right. But, being able to experiment and do something and see the results of that, is so powerful. So, I’ve been wearing a continuous glucose monitor (CGM).

I would love to try out those.

For about a year and a half now, ever since they became available for type two diabetics. Not that I take any drugs or anything. So, my doctor’s like, well, you know, if you want it, I’ll prescribe it for ya. Cause he’s my health partner. But he’s like, I don’t know why you need it. You know, it’s not going to tell you any information. Like you need drugs, cause you don’t. I’m like, it’s going to tell me stuff. And it really has. It’s fascinating to see how different foods react. And even though I’ve pretty much cured my insulin resistance at this point, and I have experimented by having a carb meal or a piece of chocolate made with real sugar. I can see it spike and then I can see it go down again. And that makes me so happy to see because wow, you know, back when I was still fighting the insulin resistance, I would go up and it would stay up.

That’s the problem, isn’t it? Has anything surprised you? So, you’ve obviously had this data for a long period of time. Have there been things in there that you would never have expected to either spike it high or maybe drop it low, and not even necessarily food? I know some people react to things like coffee. Or have you seen maybe things like stress or sleep impacting it? I mean that’s where it must be so fascinating. Just having that continuous, being able to monitor it all the time. You can see the results of so many different things.

It’s really has provided a level of insight into my metabolism that I had zero insight, or a very tiny insight into before. One thing that I can say that is hugely important to understand is that when you’re using a little blood glucose meter where you do the finger prick, you are getting one readout, one tiny piece of information. And compare it to a continuous glucose monitor. It’s like you’re looking into a room, a dark room, completely dark room and you flick the light switch for a second compared to just turning the light on.

Yeah. So much you can miss.

Huge. So, when people say like, Oh, I’m going to test my reaction to coffee. I’m going to take a read out before and a read out after. My experience with the continuous glucose monitor, it tells me that a hundred percent, those two readings are basically meaningless because there’s a natural fluctuation. There’s other stuff going on depending on the time of day, your circadian rhythm, heat, stress, sleep, other foods you might’ve eaten in the past 12 or even 36 hours. And just your general state of health too. So, depending on your body’s general state. Like I can see where my body is in a general, like kind of unstressed, very relaxed, healthy state for a couple of weeks at a time. And then I can see my baseline blood glucose is in the 80s. But then I can absolutely see where maybe my sleep isn’t as good because I’ve been traveling, or work stress is going on. And then my baseline glucose is going to be 90s or even up around 100. And my reaction to foods is different. No, somebody can’t just do like, I’m going to see how I react to coffee and take two readings. That’s not going to tell you anything. Or people say, I tested my reaction to this sweetener allulose and I did this thing and I took two readings and now I know it spiked me 15 points. That’s just noise. For one thing, those little, readers have a variation of 10 to 15 points anyway. Even if you took two readings in quick succession using the same finger, even the same drop of blood, you get variation and then to think that you’re going to learn something.

Yeah, you can still learn something. I mean, I know whenever I test foods, I do the baseline before I start and then I’ll do three afterwards. I tend to do one at 30 minutes, one at 60 and one at 90 or two hours, I think I do. It’s going to tell you something. It’s going to show you that general trajectory. But, but yes, what I’m fascinated about is to see all those nuances and particularly the impact of things like stress and sleep because everyone always looks directly at the food. It’s a common thing, isn’t it? When people are stalled, when they’re having problems with losing weight and it’s always about the food and they can be saying things like, I’m doing everything right and I don’t understand why am I not losing weight or why have I gained weight this week? And, and it’s only when you look at all the other things that really can have a dramatic effect. So it’s interesting that you say that you have seen that, you have seen the impact that it has on your blood sugar so that we can then infer from that that it’s going to have an impact on say, weight loss, if that was what you were tracking from something like stress or lack of sleep.

I think so. I think it’s the causal chain based on all the science that I understand is you’ll have generally raised cortisol levels and that increases your insulin resistance and your general insulin levels, which will lock the fat within your fat cells so you’ll feel less energetic overall and not burn as much energy and have less access to your fat stores and, you know, the whole cascade. So, I think it is clear that stress and lack of sleep has a huge impact.

So is there anything that surprised you during the time you’ve been monitoring? Is there anything that you wouldn’t have expected to impact the way it has that you’ve seen pop up on those charts?

One thing I would say is that if you are exposed to heat at all, don’t take blood sugar readings and expect to get something meaningful, Because if you get in a hot bath or a sauna or something like that, your blood sugar is going to shoot up like 50-60 points. I think it’s universal. I’ve read that, everyone has this response, but nobody knows about it. So, you go sunbathing or something like that, your body gets hot, it’s gonna release blood glucose, and then once you get cool again drops right back. But to see the magnitude of these swings, you wouldn’t expect it. Also exercise. Exercise is very, very interesting. If you just think like, well I’m going to exercise and so my muscles are going to burn glucose and my glucose is going to drop. Yeah. Not really. Yes, in the total energy sense because you obviously are burning energy and so the energy has to come from somewhere, but your body also responds to stress by releasing glycogen, so your muscles have more energy to burn and it’s always a moving target.

So, your body’s going to release depending on the, the stimuli you get like a really intense lifting session. I go out there and I’m really giving it my all, my body’s going to respond by releasing a ton of glycogen, blood glucose, so I have that energy. Because it’s like, well, you’re doing something seriously intense, I’m going to give you a ton of energy. So, you’ll actually see on the CGM a spike. And then because generally lifting is not a sustained exercise, then you know, maybe you don’t burn that right off. So, you see the spike and it’s not exactly a a crash right away, but a sustained exercise that is intense. Like, sometimes I’ll hit the treadmill as hard as I can and then I kind of oscillate. So, I’m releasing, burning, releasing, burning. And these swings are pretty large until you see it.

And I think once everybody has CGMs accessible to them, like as part of the Apple Watch or fitbit or something like that, I think people are going to be responding to these by maybe structuring their workouts so that they, you know, that you can have a glycogen workout. Where your aim is to exhaust your glycogen. Or maybe you don’t want to exhaust your glycogen because you’re prepping for a race the next day or something like that. But you’ll be able to finely tune what you’re doing with your body and see how your body’s responding to the stress.

Wow. That’s fascinating. It makes me want to try it. I’d be looking at it, I’d be like testing everything. I did see what impact it had.

Definitely.

Oh yes, that spike was such and such.

I also wear an Oura ring. So, I can measure how my sleep, you know, it gives you sleep scores and stress level scores and stuff like that. So, I can also see and correlate. And it absolutely does correlate with what I see on the CGM in terms of general stress levels.

Ah, interesting. So, another thing I’d like to see, but then I’d also probably be a little bit dismayed by the results I’m going to sleep with. My sleep is less than perfect.

Well, it gives you the tools to measure, you know, how your sleep is, and then you try different things to experiment to improve your sleep.

That’s true. Actually. And that goes back to what we were saying before. It’s hard to deny what’s going on if you’ve got the data in front of you.

Exactly. It’s important to measure. Measure, and then respond.

This transcript is brought to you thanks to the hard work of Cheryl Meyers.

Welcome Jackie to the Ketowoman podcast. How are you doing today?

I’m very well Daisy. Thank you for having me. It’s a real pleasure.

It was lovely to meet you in person. You are another one of the lovely ladies I’ve met at the PHC conference the other weekend. It was great, wasn’t it?

It was great. Although, as I don’t know if you remember, my son had called me in the middle of the night to take him to the hospital and so I was a bit sleep deprived and kept dozing off, but I really enjoyed it.

Oh gosh. Yes. I remember now. I’d forgotten that you had great dramas, didn’t you? Really bad timing.

Yeah, I was. So looking forward to the conference, you know, had been booked it about six months before now, five months before and I was really looking forward to it. So that night, sitting in, sitting in the hospital is that they go, these things happen.

They do often in opportune moments. What was your best bit, what was your favorite takeaway from the conference?

I loved Dr Robert Lustig. I thought Zoë Harcombe’s was really good. And really interesting considering that she isn’t Keto, but how she was saying that you don’t have to have carbohydrates. I thought they were all very good. I was even really impressed with the president of the Royal College of GPs and that looking forward to how AI is going to interact with our health and how we deal with things going forward.

Absolutely. I must admit, when I, when I was looking at the lineup, I was thinking that his presentation might be a bit dry, but actually like you say it was really great, wasn’t he? He was. He was very entertaining. I really enjoyed his presentation.

Definitely and I think it definitely got me thinking about how AI is going to interface with our lives. We already see it a little bit with Alexa, but that’s taken it even a step further and how people might start recognizing issues before they even get to a major level.

I must admit, I’m very tentative about allowing an Alexa into my house. I don’t have one. Although I did, did have a very entertaining interlude at my sister’s house. My brother in law had been online and he’d found out these different things you can do and you can ask Alexa to fart and she has this whole catalog of farts and we were being Brits and liking toilet humor, we were very much entertained, to the point of yes, tears of laughter. So if anyone’s got an Alexa, ask her to show you an array of her farts. It very entertaining.

I have to try that later.

It’s very funny if you find that kind of thing funny, which obviously I do and my family does too, so yes, that was very amusing. Let’s get onto the matter at hand, which is you. So Jackie, tell me a bit about you.

I’ve done various things throughout my life, jumping from one thing to another. I’ve never really stuck with things very much and I was thinking that I’ve always considered myself quite healthy, but it’s only in the last year that I realized that I probably wasn’t as healthy as I thought I was. I’ve always been overweight from probably nine or 10 years old. I felt overweight. Now when I look back at the photos, I just think you look lovely. What was wrong with that? But obviously compared to some of my peers, I was overweight and my dad was overweight. My granddad used to have the nickname Cannon because he was so overweight. And I just grew up with that belief and I took after my dad, so I took after his side of the family.

So I grew up with the belief that I was going to be fat and of course that translates into being fat anyway. Then when I was 17, I had a, they didn’t know what was going on–it had been going on for years and I’d been in and out of hospital, not hospital, but the doctors trying to find out what it was. And they thought I had something wrong with my kidneys. And when they did a scan, they then thought I was pregnant and I was only 17. So they took me into the hospital–where I’d never even met the gynecologist– came in and operated on me and afterwards found out I had a tumor the size of a football.

Wow.

And they removed one and a half ovaries and my appendix at the same time. Now at that time I was nearly 18 I was still in hospital on my 18th birthday. I didn’t understand the consequences of what was going on. It was only later when I was in my thirties when I got married and my dad stood up to give a speech that I realized the impact it had on the whole family at that time, but I was completely oblivious. Now I realize that that operation in itself probably led to the ongoing weight gain that I experienced in my late teens and early twenties. Then around, I was probably about 27 at the time, I was living in Majorca. I had just, what a one off to start with was a headache. Like I’ve never known before. I ended up in bed for five days and someone had to look after me cause I was living on my own at the time and from then on I started to get migraines very regularly and paracetamol wouldn’t do anything. I was on really strong pills for my headache and I was taking those pills. They reckoned you should take one or two a month. And I was taking on average nine a month.

Wow.

Probably getting headaches every other day and I couldn’t function without the pills. I was just, and when I took the pills, it would knock me out for a couple of hours. I had to just go and lay down. I couldn’t do anything because the side effects were so bad. Then I got married in my thirties and couldn’t have kids–not realizing at the time that I’d lost one and a half ovaries. So it’s not surprising really. After two rounds of IVF, um, managed to conceive twins who are now 16 and just doing their GCSEs. Over the last, well up until 2017 and for the few years before that I’d been in a situation which was quite stressful and I was often working at night, usually once a week. But there was a period of time before that when I was doing quite a lot of night shifts and they work 12 hour night shifts.

It was in my own business, but for staffing reasons, I had to step in and I didn’t realize at the time how that was influencing me. So from February 2016 to May 2017, I put on something like 23 pounds over the year. So my weight had gone up really quickly, but I hadn’t really noticed it because you just don’t do you. And it was at that time that I was listening to a podcast that recommended a book and the book was Gretchen Rubin’s “Better Than Before”. And in the book, Gretchen Rubin said about another book, which was Gary Taubes, “Why We Get Fat”. I was listening to the book on Audible. So the following month when my credit came up, I thought I wasn’t in the mood for dieting. I’d tried lots of times before, all through my teens, and I’d got to the point where diets don’t work. I was also telling myself, I know what to do. You have to eat less and move more.

Of course. That’s what we’re told, isn’t it, by pretty well everyone.

Yeah, absolutely. I just figured that I wasn’t any good at it and I was a failure and I would go to bed every night and I would say to myself, tomorrow’s going to be different.

Why is that? I find I’m exactly the same. I have this massive boost of motivation in the evenings and it tends to manifest well with all sorts of things, but it’s that those lists of things you’ve got to do, and I often walk around my house, looking at all the jobs that need doing and think, yes, I do that and I’ll do that. Why is it you have that real peak of motivation before you go to bed, but when you wake up the next day, somehow, it’s all disappeared.

Is it because you’ve had, you feel like you’re such a failure during the day because you haven’t done what you said you’re going to do. And so you go to bed thinking “Tomorrow’s going to be different.”

I don’t know, but it really seems to be a pattern. I wonder if something that popped into my mind then was perhaps it’s that you can think like this because you’re not going to do anything about it right now. And there’s some kind of, because you know you’re going to sleep, that there’s some kind of cutoff. I don’t know, but it’s weird. It’s just when you said that, it just immediately resonated with me because it’s something I do so, so often.

And I did that for a long, long time. And particularly around diet and food and just telling myself I was going to eat less. I was going to move more. And then I’d wake up the next day and nothing had changed. I think that leads you to a place of feeling like a failure and like it’s all your fault and you’re useless. And even at that time, I knew wheat was addictive. I’d read, “Wheat Belly” by William Davis. And so I knew wheat was addictive. I knew the effect it was having on my brain, but I just couldn’t stop eating it. I’d seem to be eating more and more as time was going on. And I know now that stress was an influence as well.

Yes. I just wanted to pick up on that actually–just going back a little bit, when you mentioned about that it was a very stressful period of your life, but also the fact that you were having to do night shifts and you had that period of quite rapid weight gain. And do you put that down to one or either or both of those things with hindsight?

I think what I’ve learned on my Keto journey is that it probably did have a huge influence, both the stress and the working at night was most probably influencing my insulin levels. Now when I was working at night, I was taking my own supper with me, which was usually something like roast chicken and a salad and my own homemade dressing. And once I eaten that I didn’t eat for the rest of the night. So it wasn’t as if I was snacking all night. So I was keeping up fairly good food times, but my whole circadian rhythm was probably just thrown out of balance. And it would take me a few days to get over it and then it would be back to Sunday again. I’m back doing the night shift again and then we’d start the week again. And that went on for well over a year, maybe longer that I was doing that.

Hmm. Interesting. So often people assume that it’s all to do with the food or you know, at least the majority of the change that they think they need to make is the food, it’s what everyone goes to first and it’s what throws a lot of people, I think, when they’re saying, but I’m doing everything right. I’m following all the rules–yet I’m not losing weight or I’m gaining weight. And they don’t look at all the other things that are going on that can actually have a massive, massive impact.

Yeah, agreed. And it’s taken me until probably earlier this year to recognize that it’s not just about what I’m eating. It’s other things as well.

I’ve taken you off track a little bit. So going back, you started to discover some interesting books via podcasts. Let’s go back to that and what you started learning from. If I could have a pound for every time someone mentions Gary Taubes, I’d be a rich woman. It has to be, I think the most cited book on this podcast that people talk about. That was really the turning point for them.

Yeah, and I think it was just that understanding of calories in, calories out don’t matter. Fat is not the thing that we have to be scared of. We want to be avoiding carbohydrates as much as possible and the vegetable oils and just going back before that, when I was listening to the Gretchen Rubin book, I was telling myself, oh, I can’t do this. I’ll be useless. I’m no good. I can’t keep anything up. But I still went ahead and bought the book. So obviously part of me, although I didn’t want to diet, part of me was thinking I’ll listen to it and see what I think. It just all made so much sense. Previously I’d been thinking about the best way to go would be to have a vegetarian diet, but I wasn’t–I had tried that in the past, but it wasn’t very good because I love my meat too much and I was thinking I needed to get back to that.

And then this book was sort of talking to me in the sense of, you can eat meat and you can have butter. I love butter. The things I absolutely adored. My favorite foods, which is bread, potatoes and pasta are the ones that I shouldn’t be eating. So I just thought I’m going to cut that out. And I didn’t read anything more or do anything else other than read that book. And I cut out potatoes, pasta, bread or wheat, biscuits, cakes. I just cut that straight out. And I said to my husband, because he does all the cooking, I said, I don’t want potatoes anymore. Can you replace my potatoes with another green vegetable or another vegetable? I didn’t even say green vegetable. And for the next six months that’s what I did. But I didn’t realize I was eating loads of peas, loads of meat and loads of corn, um, corn on the cob over that following six months. And I still managed to lose probably about a stone, maybe just after just over a stone–17 pounds, I think in that six months until I felt ready to investigate a bit more and I bought Jimmy Moore’s book, “Keto Clarity.” Then I started to understand more about the ketogenic diet, so I started to make some changes to what I was eating, so I cut out the peas and cut out the corn and replaced those with green leafy vegetables. That’s when I started to see a change and I started to incorporate some intermittent fasting by, the first thing I did was not eat after my dinner, although I didn’t do it very often since I’d been on the low carb. I’d started to eat cheese at about 11 o’clock at night or something like that, so I cut that out.

I’m a late night snacker, too. I’m a devil for that.

Well, I never used to be, but then I started doing it because I could. I can eat cheese, so I’ll eat it. From January last year, January ’18, I cut out anything after my supper and went through to the morning. Then I found that eating in the morning wasn’t sitting well with me and I didn’t feel great eating and I was eating quite a lot eggs and bacon as Jimmy Moore recommends and avocado and sour cream and I was feeling quite yucky so I just cut that out completely as well and went through till lunchtime. And that’s my day to day regimen is to have my supper and then nothing till lunch. I do do some network meetings where they, it’s a breakfast meeting and they have breakfast and it’s really hard sitting there watching other people eat. So I quite often will have some egg and bacon but most days I don’t have breakfast.

From there I started listening to Jimmy Moore’s podcasts, from there I’ve found other podcasts, and I’ve been listening to lots of them all the time really and making different changes. So back in January I tried carnivore and did that for a couple of weeks but was really missing vegetables. I was even craving, which I’m never usually bothers me. I was even craving fruit at that time. So I only did it for two weeks cause I thought I can’t do this long term. And then when we were at the PHC conference the other week, I met a lady called Christina who said two weeks is not really enough and you need to give it a bit longer. So I thought, okay, I can try that again. So now I’m doing a sort of lighter version of carnivore where I’m just eating meat and fish and butter, 85% chocolate and occasionally some nuts. And most evenings I will put some nut butter on my chocolate. But other than that I’m sticking to carnivore and eggs. Of course.

Yes. I suppose you’d more call it just that, you know, really just the real drilling down on the carbs I guess. Um, I think quite a lot of us sort of jump to carnivore when we’re thinking of that because it’s, I don’t know about you, but it’s this, like you just, you just kind of need a name for something. But what you’re really saying is just that you’re really drilling down those carbs as low as you can comfortably go. But still including some things in your diet that keep you happy doing that.

Yes, definitely isn’t no carbs at all. I’ve still been having some olives as well, occasionally.

That’s an interesting thing that came to mind when you were speaking earlier and I’d be interested in your perspective on this and whether you agree. It’s going back to when you were talking about listening to the Gary Taubes book and before that talking about how you just felt a failure a lot of the time because you couldn’t do what you thought you were supposed to be doing, whether it be eating vegetarian diet and/or the whole eat less, move more like we’re all told and instead of automatically assuming that what we’re being told is wrong, we feel that we’re failing at it. And I wonder if there’s part of us in there and it’s, it’s thinking about the Gretchen Rubin’s tendencies and I, I don’t know what tendency you are, but I’m a rebel tendency and I’ve always felt this sort of inner part of me rebelling and fighting against what I’m being told I’m supposed to be doing. 

And I wonder if there’s a part of us, because we’re intelligent humans, we’re intelligent women. We shouldn’t blame ourselves first and foremost and assume that we’re the failure. We should be thinking, well perhaps it’s what we’re being told. And I wonder whether so many of us have this massive light bulb moment when we read something like Gary Taubes who is saying, and the phrase that is often picked out in these kind of books is when they say, “It’s not your fault, you’re not doing anything wrong.” It’s what you’ve been told and this system that you’re trying to squeeze yourself into, that’s never gonna work for you. And I wonder if, if that’s why it really resonates so much with us where when you were saying, and I’ve heard so many other people saying, it all suddenly made sense, you know, because there’s the science that goes with it and everything suddenly makes sense. It’s logical. Whereas before, I wonder if there is a part of us inside, although it’s not shouting loud enough, that was saying, you know, hold on a minute, none of this makes sense. Why are you doing it? And so sort of pushed against it. I don’t know. I don’t know how you feel about that, but I think maybe that’s part of the issue that I used to have.

It might be part of it and I was always, I sort of flip between rebel and obliger.

Right. That’s definitely a flip one extreme to the other.

Yeah, and in all these psychometric testing, I never fit in one box neatly. I’m always a bit of something, a bit of one and a bit of another.

Oh, absolutely. And I think she really just talks about your dominant tendency doesn’t she? We’re all made up of different parts, but she certainly found that most people tend to fall predominantly in one, one tendency with overlaps of other ones.

I sort of flip between both of them and just going back further, I never bought into the low fat products. I would have full fat yogurt, I wasn’t a great yogurt eater anyway, but you know, whatever there could be low fat of, I would always have the full fat version and I would always have butter. I’ve never had margarine–if you go to what we used to say was a cafe, I would say no butter because I knew it was margarine and I’d rather have no butter than margarine. But even that over time we’ve become so brainwashed into what the government are telling us, not so much school when I was at school, but just everybody, especially the young people growing up now, they still have an influence on us as to what we should and shouldn’t be eating and how we should be moving so much more. And I think with Gary Taubes’s book, I think that the one thing that really stuck out with me was even if you exercise an hour a day, every day, every year, you have to do even more just to maintain your weight where it was. So it’s not definitely isn’t about calories in and calories out because you have to increase that exercise year on year to just maintain where you are. I think that was very prominent. 

And I think at the time I was also still scared of the fat issue, of eating the fat. I love the idea of it, and maybe the reason it resonates so much with us is because that’s our natural way of eating. We would have come through thousands or millions of years of eating meat and eating fat and it’s only in the last 40 years that we’ve stopped doing that as much. But maybe that is our natural tendency and that’s why it feels so right to do this. And so at that point when I had sort of been doing the low carb thing for about three or four weeks, maybe, probably three weeks, and I was on holiday with my friends in Spain and my friend is a nurse and she said she was doing the low carb and that they’re now recommending it to diabetics as a way of controlling their diabetes. And I was asking her, but is it safe? Is it okay? It didn’t feel it still, there was still that part of me, that brainwashed part of me that felt it wasn’t okay to do low carb. And I am so glad that I had that conversation with her because I think if I had an, I might have just gone back to eating carbs and gone back to that belief that we need so many carbs that we have to have carbs. So I’m so grateful to my friend for, you know, just reiterating that. And, and I think at that point it was still hard, but it was easier and easier to eat the fat and leave out the carbs.

So remind me, you’ve been Keto low carb for, for how long now? Getting on for that must be getting on for a couple of years?

It’s two years now. It was the end of May. I did the low carb with the peas and the corn version for about six months. And then in January ’18 was when I started to dial it down. And really, you know, I ordered my ketone meter, started to check my ketones and it still took me a good few months to get those ketones up to more than 0.5 or 0.4. It took quite a lot of work and a lot of dialing down and a lot of titrating. I’ve always been a big eater. I used to worry, if I’d go out, I used to worry that they wouldn’t be enough food and that I might be hungry and I used to eat loads. It took time for me to recognize, even just tell myself if I’m hungry later I can eat more, and I had to keep doing that and saying it’s okay. You don’t just have to have your one meal. If you’re hungry later you can eat more. And that was really a massive thing for me because I was so used to eating my lunch and my dinner. I never used to snack a lot between meals–I used to eat loads and it took me a long time to sort of dial down the portions to be satisfied without overeating.

Yes. It’s interesting isn’t it? What you’re used to. I was exactly the same before I had weight loss surgery and I would say, I’m a good few years out of weight loss surgery now and I can eat, I would say the amount that an average person eats, but I used to eat a huge amount and it’s funny when you keep saying things that sort of send these bells off in my head thinking, Gosh, yes, I used to do that too. And it was, there was that kind of panic wasn’t there, that panic of thinking that there might not be enough food, that you weren’t going to feel satisfied and that you were going to need more and I wonder how much that’s actually relating to food and whether it’s some kind of other emotional need or something because logically it doesn’t really make much sense does it? We get to do that, especially as you were saying with you starting to do some intermittent fasting and what I always find that is most interesting when you do do that, you really get to see what real hunger is. The difference between that real stomach growling, ravenous hunger and then when you do eat you don’t find that you can eat that much before you’re satisfied and it’s, I just find it interesting, the whole concept of hunger.

I don’t think I ever really got hungry before. I don’t think I allowed myself to get hungry. And even now I still will tend to have my lunch around lunchtime and my supper at suppertime probably irrespective of whether I’m hungry or not.

Creatures of habit aren’t we?

Part of it is habit and part of it is the social aspect. So lunch I will mostly have with my mum, so it’s a time for me to be with her so she’s not on her own and then in the evening it’s with the boys and we will tend to watch something on TV and that’s become part of the social network of how I eat. But outside of those times I don’t usually eat. I might have a little little bit of chocolate after my lunch. I might have occasionally a few nuts if I want to in the afternoon. Sometimes I’m just craving something to eat. But for the most part, I will just have my lunch and my supper.

Yes. I think a lot of people seem to fall into the two meal a day category, don’t they? I would say, oh, I know it’s a bit of a generalization here, but most people I know who are Keto tend to fall into that group. The two meal a day.

Yeah. I don’t know. It’s easy. I do do the occasional–I’ll go through from one suppertime to another. I do do on a Thursday night, I go to taekwondo, so I will probably go from the Wednesday night through to the Friday lunchtime. Do you know what I love is the freedom to not worry about food. To know that if I don’t eat all day to day, I will be fine.

Yeah. You’re not going to pass out.

I’m not going to pass out. I’m not gonna get a headache. I’m not going to get the jitters. Which would have happened beforehand. If I went past lunchtime, I would end up with the jitters and I would have a headache and a migraine and it’d probably last for a few days. I always made sure I ate, but now I always walk around with things in my bag. I’ve always got two or three bags of one ounce of nuts and I was generally got a bar of 85% chocolate and I know that if I’m really hungry I can eat that and I can still go all day without touching it. Even though it’s there and it’s beside me and I’ve got it with me, I don’t actually need it. I think that brings so much freedom to the way you live now. Way I live now.

You mentioned that it’s just reminded me about when you were talking about the migraines that you had and there are two questions, really, one that would you attribute to your change of diet, which you attribute the easing of the migraines to that, but also what did you notice? What were the big changes you noticed? Obviously when you went from how you were eating before and you went through that period where you lowered your carbs but you weren’t keto and you mentioned how you lost weight, but then when you went to keto and you started measuring your ketones and, and so on and so forth. But what kind of changes did you notice from transitioning between those stages? Because I know I too had a period where I was quite sort of, well, moderate to low carb I guess. And there were definitely improvements from a weight loss point of view, but it wasn’t until I dialed down to keto levels that I started seeing changes to things like my migraines and depression and things like that. So I’d just be interested to hear from you what the changes were that you noticed with those different periods.

Just going back to the migraines, they had been changing over the years. So, from when I was pregnant, I still had them through my pregnancy, but afterwards they eased a bit and they weren’t as bad as they used to be. And then with time, that has got even better. And I, I even got to the point where I would stop taking the sumatriptan pills I was taking.

Oh, is that what you were taking? When you mentioned the tablets that you were only supposed to take a few a month and you were taking them a lot more? Is that what you were referring to?

Yeah.

Oh, well you would be horrified then that the point I got to, and this is where I realized something had to change, where my migraines so bad and that’s what I took as well. There’s a whole group aren’t there called triptans, which they use to treat migraines and it’s to do with, changes the flow of blood doesn’t it? I can never remember whether it opens up or constricts the blood flow, but it does one or the other and that’s supposed to be how it works.

I think it’s constrict, yeah.

I can never remember. In my worst months I was getting migraines half of every month, so I was taking, that’s probably about 15 tablets a month. That’s what I was taking. And I got to the point where, and I’m sure you’re probably familiar with the whole concept of rebound headaches and migraines and that you actually start getting headaches or migraines because of the tablets that you’re taking. And so it just becomes this vicious cycle. And I can remember reading a really interesting book about it and they said, at some point you have to break that. And the only way you can break that cycle is to stop taking the medication. And that’s why I did.

And somebody years and years ago said to me, she had migraines and she said she stopped taking the pills, but it just seemed inconceivable to me to stop taking them.

Yeah. Because how can you function with the migraine?

Exactly. Once I came out of the pregnancy, and so even before I went low carb, I probably had a couple of years where I did, for the most part, I did stop taking them. And if I had a headache, I would just grit my teeth through it. And it would often be three days where I felt lousy and nine times out of 10 I would not take a pill, but then I would have the occasional one, which would make me very sick in my stomach. And at that point I would need to take the pills. So I was down from nine or 10 a month to maybe one or two a year.

Wow. Big change.

Once I went low carb, that sort of continued. But when I started keto, I started to actually get more migraines than I had been previously. But I haven’t had one for ages now. And I’m wondering if now sitting here right this minute, thinking back, maybe it was the electrolytes, because now when I feel a headache or any sign of a headache coming, I will go and eat some salt or make myself a drink of water with salt and low salt in. And so I’ve managed to keep it at bay. So maybe in those early days when I was getting migraines, maybe it was an electrolyte imbalance.

Quite possibly. It’s with that transition phase, isn’t it? When your body’s adjusting to the new fuel, I guess, is literally what it is–everything goes a little bit sideways, as far as things like that go, especially if you’re vulnerable to headaches. I found the same thing when when I was doing my carnivore challenge that I was getting at a lot of headaches. I got a tremor in my eye and as soon as I started taking magnesium, that really helped actually. So similar thing. What changes did you start to see then when you were fully into keto and were in ketosis that you no doubt saw on your ketone meter. What changes for the better did you notice, if any?

So I think the main thing was, which completely astounds me, even now, probably around April last year, I decided to exercise–

Of your own volition?

Of my own volition. Somebody in a group that I belonged to was mentioning about Joe Wicks, the body coach. So I started doing his absolute beginner video. I’d put it on, and I’d do that about three times a week. And then in June last year, two people said to me in the space of about 10 days that they were doing the Couch to 5k, I don’t know, you did it as well. And I thought, well I might give that a go. So I did and I couldn’t get to the 5k but I could run eventually for the 30 minutes.

Oh, well done. Did you actually get to week nine? I’m a shocker. I got to week eight, which you believe before I stopped and I haven’t taken it back up again. Um, but did you actually get to the end of the program then?

I did and I got to the end of the program and I kept it going.

Wow.

Until October. So then back in August I thought I might go back to taekwondo. I’d done it a little bit beforehand, but hadn’t done it about three years. So I went back to taekwondo. Then in October, while sparring, I damaged my toe, my big toe, and the nurse had said to me, don’t do anything. So then I stopped running and I didn’t do anything for about five weeks. And then I started the couch to 5k again and thought, right, this time I’m going to try and go faster, faster, but I wasn’t doing very well. And then back in January, I started again on week one again, I thought, right, I’m going to start again. And now I do it and I’ve done about three park runs so far, but I’ve done it with the couch to 5k. So I do my walking bit and the running bit in the walking and the running bit. But since then I’ve just been running and I’ve been extending my mileage. So I’m up to about 2.4 miles that I can run without stopping. But very slowly. And then recently this week, I’ve just thought, well, I don’t have to just run for 2.4 miles. If I’ve only got 10 minutes, I could just run for 10 minutes. And so that’s what I’ve been doing as well. And just giving myself a bit less of a hard time, but trying to do something a bit more regularly.

Mm. Yeah, I was going to ask you actually if you had a a park run near you, you know when you talk about going to a taekwondo class, it just struck me that you might be the kind of person that likes to go and do an organized type of exercise, if you like. And especially doing it with other people. I know a lot of people really get a lot out of park run.

I think I’m doing it to push myself. I don’t think I need to go. We’ve got quite a long drive so, and we live on the top of a hill with no pavements and cars going past very quickly. So running on the road is not really advisable. So I tend to just run up and down the drive. So getting to the park makes it just a bit different and it’s also pushing me to aim for that three mile or 5k goal really. So I’ve been pushing myself a bit harder and I think other changes, well I just, I don’t know about you but I just feel, I tell people I feel amazing. I feel like I’ve never ever felt before in my life. And somebody said to me a little while ago, you probably just don’t remember what you did feel like when you were younger. But actually I do because leading up to that operation when I was 17 I’d been ill for years before that. I felt something hard in my stomach and my mom said go to the doctor and I didn’t like doctors so I wouldn’t go. And it had been going on for years and I used to come home from school in the middle of the day because they’d send me home because I was in so much pain in my side. It was usually around my period time. And what they reckoned afterwards was at the time of my period, everything would, the tumor would push on some of my vein, um, yeah, probably veins and arteries and all sorts of things in roundabout about my kidney area and that was causing all the pain. So I never felt great. I always was, always felt overweight and I never felt great. And then afterwards I was probably going through a hormonal change. This probably similar to menopause, if not, not exactly, but you can sort of imagine that having all your ovaries ripped out, and Gary Taubes does mention in the book about rats where they take out their ovaries and how the body totally changes. So I never felt great, but I never felt that bad that I thought there was anything wrong. It just became, this is me, this is who I am, and I’m a person that can’t follow through. I’m a person that can’t do things, you know, I’m not consistent. I can’t keep up new habits. And since going keto, and particularly in this last six or eight months, I’ve come to recognize that that wasn’t true. What it was was what I was eating or how I was living. Probably eating was stopping me from being the person I am today because I feel different.

It’s lovely to hear when people say they feel amazing. I mean, you know, what more could you ask really?

And I’m still not great because I still get a tired slump in the afternoon and I haven’t quite worked out why that is. But other than that, I’ve been able to introduce new habits. Previously I was having problems with my gums and I would have to go to the hygienist every three months and more recently she said, I don’t need to see you for six months because I’ve started flossing and brushing with the interdental brushes, which I would never have managed to be consistent in keeping that up previously. And I think that as well as avoiding all the sugars and the carbs has helped my dental health.

There’s interesting, right when you mentioned about having that afternoon slump because obviously you’ve experimented a lot with your diet. So I mean it strikes me that it’s not what you’re eating that’s impacting that. Something that jumped to mind was, and I can’t for the life of me remember which one of the Rangan Chatterjee podcasts it was, because there’s been a few that I’ve listened to recently that have had a lot of overlap with sleep and with circadian rhythms and things like that. So I can’t remember exactly which one it was, but one of them was talking about how we have transitioned, evolved over time as a human race, but also how we evolve from birth and as we grow up between different patterns of sleeping and they were talking about, I think do they call it the bi-phasic? That sounds logical because that’s too, but this sleeping in either sleeping in two blocks of time when it was quite normal–and babies and very young children do this, but we also used to do it apparently quite a lot, however many years ago–where we’d sleep for a block of time and then actually have a period of time in the middle of the night where we might get up and talk to each other or whatever and then go back to sleep.

Interesting enough, I did that for a few months when I worked on a kibbutz and because of the way we socialized in the hours we worked, we started very early. I slept in two blocks of four and actually felt very good on that, but the point I was going to make to you that might be worth trying, I don’t know if it would fit into your lifestyle and it might have been, thinking about it, it might’ve been the Matthew Walker podcast. He has his book about sleep and the importance of it and the different patterns and they talk about as long as you have the whole period that you need to have all the different phases of sleep, which for most people is 90 minutes so you get that entire sleep cycle. He was saying a lot of people benefit greatly from having a nap or sleep during the day.

It’s quite important that you have it before, I think the cutoff point was about 3:00 PM or you’ll struggle getting to sleep and that will cause problems, but a lot of people really benefit from having a sleep cycle length nap in the afternoon and I remember my grandmother, it was always absolutely part of her routine and she set her alarm after lunch. She had her nap and then you know away she went for the rest of the day. I just wondered if it’s worth experimenting with something like that. Maybe your body is telling you that you need that rest at a certain point in the afternoon.

It could be. It also relates with the Spanish siesta time as well. What I’ve found that I’ve been doing is I’ve been going to pick my boys up from school and getting, aiming to get there about 10 minutes early and then I just sleep for about 10 minutes in the car. And that 10 minutes makes a big difference to the rest of the day for me.

Interesting.

What I’ve been doing is trying to get my circadian rhythms in balance by going out in the daylight as early as possible without any glasses or contact lenses and then going to bed a bit earlier at night. Also, I’ve been wearing blue blocking glasses, not all the time in the evening when I’m watching the TV, but definitely when I’m in bed reading my Kindle and if I get up in the night, I quite often put those on. So I’ve really been focusing on my sleep hygiene as well and trying to dial that down. But that’s been a recent thing over the last three or four months I’ve been working on.

And you mentioned to me you’ve been playing around with the “Miracle Morning” concept of getting up early, is that right?

Yes.

It’s another book that I’ve read and had great, great promises to myself at night that I would do. And weirdly enough, actually the week it took to read, I would read it as I was going to bed and I was actually waking up at six o’clock in the morning. It was most bizarre, not that I did anything with it. This is um, you’ll see this is a bit of a recurring pattern with me, but by all accounts you have actually been putting it into practice.

I have, you gave me that recommendation a couple of months ago and I had it on my wishlist on Audible. So I downloaded it on Monday, listened to all the way through and then listened to all the way through again, this time bookmarking certain areas of the book. And so I think Wednesday morning was my first day. Now I normally get up at six o’clock in the morning. So I got up at five to five and I was the 10 minutes of everything, which for the listeners are Silence–so meditating for 10 minutes, Affirmations for 10 minutes, Visualization for 10 minutes–I’m not very good at visualizing things that are not yet, but I’m working on it. And the E is exercise, the R, he says SAVERS–the R is reading and the S is scribing or journaling. So I have been doing that. Over the weekend, I was up late on Friday night and Saturday night, so I didn’t get up early, but I still had time to take that hour and a bit of time to do that. So I have done it for six whole days now.

Wow. And what are you feeling about it?

I’m feeling–I think it’s adding to my confidence and my confidence has been growing over the last 18 months. It’s been adding to my confidence of I can install new habits. I don’t know how long this is going to last because I’m sort of person that would do it for a couple of weeks and then stop. But something feels different inside this time. Something feels like I might actually do this and carry on with it. I bought another book, by Emily Fletcher called “Stress Less, Accomplish More”, which I’ve been reading this week and it just, it’s given me more of an outline of how to meditate and giving a bit of a leeway around meditation. So I’ve quite enjoyed that book. Today was the first day that I’ve put her session into my miracle morning. So we’re going to see how that goes. I have to report back to you on that.

Yes, you absolutely will, okay. I find this with a few people, I might recommend something. They actually go out and do it–other than me who reads the book and doesn’t do it. So I will be, I will be fascinated. I love this recurring theme of a building of confidence and it’s something I really feel strongly about that keto seems to have this empowering this, this gives people, their sense of empowerment. It seems to happen over and over again that people gain confidence because they suddenly start figuring out, I guess, how their body works, why their body works the way it does, start gaining control of food maybe where they’ve thought they haven’t had any control of it before. It just seems to be an overriding thing that comes up again and again, particularly with women. I feel that just a sense of empowerment and confidence.

I think before, I felt I was controlled by food, that food had some sort of power over me. Whereas now I know that I’m in control and I can choose to eat something and I can choose not to eat something. I can choose to eat off of what we would consider a ketogenic diet or I can choose not to. That control is very, not only liberating, it gives you back your power. But also I think that the carbohydrates, particularly the wheat, affects our brain to the point where we don’t feel like we can do anything. And that then influences out over our whole lives. And we then quite often you were talking about depression, I think was I depressed? I don’t know. But I was very lethargic and couldn’t be bothered. And I think that freedom from that also allows you to do other things and feel good about other things. And like for me, as I said, it’s like I’ve never felt before in my life. So it’s just amazing.

Another thing that seems to happen with a lot of people, we get rather evangelical about it and want to want to spread the word. We, we are running out of time here a bit, but I would really like to hear about your plans for that because I know you have several things in the offing where you’ve, I believe you’ve already started with some things. You have some YouTube videos, and whatnot, don’t you? But you have some plans for, for spreading the word and helping other people. Tell us a bit about that.

Back in April last year, I started a website and a YouTube channel and I was just doing a weekly update of what was going on for me and that was taking up quite a lot of time as well as doing everything else I was doing. So I did leave that go a little bit to the wayside and I was very evangelical about it and I was telling everybody whether they would listen or not. It was just, Ah, you’ve got to do this. I’ve managed to dial that back down and try and bite my tongue a bit, and not say too much, too often, but sometimes it comes out. But I was having a conversation and I’ve met Louise Reynolds a couple of times for coffee since she’s working in the UK and she’s only up the road from me. It was just a comment that she made and I thought, actually, this is something I really want to do. I think people talk about their passion and living life on purpose. And I never knew what that was before, but this really feels like it’s the right thing for me to do. I already have a Facebook group and I am going to be doing some coaching and I have been, I have started coaching a couple of people recently, so I’m going to be doing some coaching and I’m going to be starting my own podcast, British podcast and all things coming up in the future.

Fantastic. And what’s it going to be called? Because I rather liked it.

Oh, you did? Okay. It’s called Fabulously Keto.

I love that. It makes me think of AbFab, which all ties into the whole Brit thing, doesn’t it?

Yes. And Louise actually did actually mention to me AbFab, but the domain had already gone—AbFab Keto had already gone, so I stuck with Fabulously Keto. So I think for me, I’m aiming this at over forties because I look on Facebook groups, on Keto Facebook groups, and I see lots of, particularly women losing lots of weight very quickly, but men as well. And that hasn’t been the case for me. And it’s been a very slow process. I’m probably down to about 53 pounds I’ve lost so far, but it’s been very slow and very plodding. And I think that’s because once you either start to go into your menopause or you’re in it or you come out the other side, things in your body are working very differently. And even though it might not be exactly the same for men, I think the older the body gets than it does have a different effect on your body. So fabulously Keto is aimed at the over forties. And it’s not that I must have this weight loss and I must have it by next week, but it’s about an understanding that we’re here and it’s about health.

And I think that is really key. And I heard a great quote the other week that says we have two lives and our second life begins when we realize we only have one.

I like that.

And I thought, yeah, and I think I’ve got to that point a couple of years ago where I am now on a completely different trajectory. So that my first half century or just over was on one trajectory and my second half century is going to be on a different trajectory and I want to get to that point where I get to, I decided about 10 years ago, I wanted to get to 107. Well, I want to get to 107 now being able to do the things that I’m doing at 55 and not be sat in a chair in a home waiting for my sons to come and visit me, who probably won’t want to do that.

Wow.

I want to be able to enjoy them and see their kids grow up.

I love that. I’m going to repeat that. I think for the end quote–that ties in very well. Talking of quotes and tips, we’ve come to that point in the show where we’d like to hear from you what would be your top tip?

I listen to your top tips and I always said that my top tip would be your why. And for me it started out about weight loss but very quickly became about health. And I know so many people have said that over the time. And I think it is really important because that’s the thing that keeps you on track and keeps you choosing and making the right choices. And as I said, my why is now to get to 107 and be able to do that with great health and maybe even still be running and to see my kids grow up because I’m 40 years older than they are and I want to see them grow up and I want to see them have children of their own. I just want to add in another little tip that I think has been a key for me. And that is I don’t feel like I’m on diet. I feel like this is the way I eat and this is the way I choose to eat. But if I choose not to eat this way, then that’s fine. But it’s a choice and it’s not something I just throw all caution to the wind and say I’m not doing this anymore. So I will sometimes choose to have something which is non-keto and it might be a whole meal, it might be a holiday, it might be a whole day. But I know and I set in my mind that is my time span. So it might be the meal, it might be the day, it might be two weeks and I will then choose to get back on to the way of life because I’m not on diet and I haven’t fallen off. It’s been a choice. And I think I always say to my kids, you have to do well at school so that you can have a choice of what you do. And that’s what I feel like I’ve got now is I’ve got choice. And I would say to anybody, don’t think about being on the wagon or off the wagon. It’s about choosing to eat the way you want to eat and choosing not to at certain times.

Yes, I love that perspective. It changes it doesn’t it from this thing that you’re shackled by something that you’re restricted by that has these constraints and boundaries to just flipping that on its head and it being your choice. So automatically all those, all those boundaries just disappear because it’s your choice. You have complete freedom in what you do.

Yeah, and last year when I was on holiday, my choice was I’m going to eat bread and I’m going to have chips if I want to. And in reality when the bread came up at the dinner table, if it didn’t look that good, I would just say to myself, do I want to eat off plan for this bread that doesn’t look that great? And the answer would be no. So I wouldn’t have it. And if the chips look like they come out of a packet, then I wouldn’t have them because it’s then choosing is this worth eating off plan for? And quite often the answer is no. And so you end up sticking to the plan anyway.

Yeah, that’s right. That’s, that’s one of my rules actually. I think it’s one of the things that is, I’m going to go out there and say impossible to ketofy and that is chips or French fries for our American cousins. We’re not talking about crisps, which is what we call chips. Your chips are our crisps and our chips are your French fries. But yes, it’s something that I just don’t think that you can get that hit with keto, but my rule is I will not have them in the house, but if I’m out at a restaurant and it’s on the menu choice that I want or I feel like having them, I see them going out to another table and they look like amazing chips, then it is something that I will have in that context, in that situation. And I’m the same as you. I’m very picky. So if they, if they don’t look like they’re very nice, well then, I’m not going to bother. If they look like real knockout chips then I’ll have them. But what is interesting to me is that I won’t eat them all. So they will come and I’ll have some and I’ll enjoy them and I’ll probably leave at least two-thirds of what ends up on my plate, which I never would have done before. So I do think there are some, uh, I called it a rule, didn’t I? But like you say, let’s use your perspective. It’s a decision. It’s a decision for me that, that I make in a certain context and it works. It might not work for somebody else, but it works for me.

Mm. And I’ve had you say you’re an abstainer. Well, I’ve worked out, I’m a moderator so I can have something occasionally and then straight away get back to it. I don’t have that. I must eat the whole–even beforehand, if I had a bar of chocolate, I would eat one or two squares. I’d be quite okay with that. I wouldn’t have to eat the whole lot. I give myself a little bit of flexibility, but the rest of the time I’m so strict with myself that I can have that leeway if I need to.

Yes. And there is a scale because I am definitely an abstainer, but I can set up these rules for myself. If I had potatoes in my house, I would not be able to moderate them. No way. But I can selectively have them sometimes when I’m out at a restaurant. So it’s interesting isn’t it? How in certain conditions I can be a moderator, but there’s a very narrow window of when that works. Overall, I’m an abstainer, but I do think keto or whichever of eating that you find works really well for you can empower you to make some of those decisions and have them work well for you.

Yeah, definitely find liberation there.

Well, wonderful, fabulous. I should say. Seems fitting to use while I’m talking to you. It has been truly fabulous talking to you today and it was fabulous also to meet you in person and enjoy the conference with you. I think it’s, it’s always nice to share something like that with somebody else, isn’t it?

Yeah, it was really good. It was really good to meet you because I felt like I’ve known you for a long time, but you probably not the same because I get to hear you every week and you don’t get to hear me every week.

You’ve got me in your ear holes every week. What it’s going to be the other way around soon and I shall get to hear you and your podcast. I very much look forward to that.

Okay. I think it will be launching in September.

Fantastic. Well, what we’ll do is we’ll update the show notes and I’ll put out something on social media to remind people so that they can find you when it comes out. I wish you all the best with that. Good luck.

Thank you very much. Thank you for having me.

And I have to ask you, are those peacocks in the background that I keep hearing?

Yes. Sorry about that. They are peacocks.

First of all, I thought it might be a cat and then I thought, oh no, that’s a peacock, isn’t it?

Yes.

They’re yours presumably, are they?

No, they just arrived and they sometimes visit our house and sometimes they’re next door. I think at the moment they’re next door somewhere, but this is their screeching time of year.

Oh, it’s a particular type of year, isn’t it? They don’t do it all year?

No. It seems to be now around the springtime and then the rest of the year they’re fairly quiet.

Well, that’s merciful because they are rather noisy, aren’t they? Beautiful birds.

And they do it at night and early in the morning.

Oh goodness me. What a joy. Not! Well, thank you very much, Jackie. It’s been a great pleasure.

Thank you Daisy. It’s been lovely talking to you.

This transcript is brought to you thanks to the hard work of Trish Roberts.

Welcome Siobhan and Dave to the Keto Woman podcast. How are you doing today?

Great. Thank you for having us.

Very excited and happy.

And how are you feeling about the conference? We’re nearly at an end and I’m starting to feel a bit deflated. Getting a bit sad about leaving everyone. What have been your best bits?

Oh my goodness. For me it was getting a chance to see…. I’ve really been impressed with the advancement on, especially the cardiology front. Brett Scher and Nadir Ali are cardiologists that are really breaking ground and addressing a lot of these tough topics head on. And I’m really glad to see that. I really enjoyed Paul Mason’s presentation as well. And again, I’m kind of biased, but I feel like it’s a very critical question that a lot of people have. In many respects sort of the one key question because as far as being concerned in terms of mortality in the ketogenic diet… I mean, people aren’t worried about keto rash or cramps in their legs as much as they are of, if they’re going to die of heart disease. And so I’m glad there was a lot of focus here on it and they were really good talks.

Yeah. One thing I’ve been really excited about this time was just the level of excitement and hope. Not only in Low Carb Denver, but also CarnivoryCon. There’s a lot of developing stuff, a lot of people talking about just getting healthier. One thing in particular that I enjoy is just the level of excitement from the doctors because one thing that Brett has talked about in the past is doctor burnout, where they’re trying and they’re trying and they’re trying, and it’s the same for the patients. Like nothing they’re doing is working, and it just hits them hard. And to see care providers and doctors and coaches and stuff, just happy and excited to be able to help people is just exciting.

I’ve been speaking to quite a few Type 1’s, and they were really excited about that presentation yesterday as well with Nadia Ali and Brett Scher. They really seemed to get a lot from that.

Well Type 1 is especially challenging because I feel like the science is so strong for a ketogenic diet with Type 1s. There could be a case – and I believe somebody was doing a fairly good job of this – I think it was Sarah Hallberg who was saying, there are these three different ways to address diabetes and that she was speaking more to diabetes Type 2. For Type 1… I try not to be a specific diet advocate, but in particular for Type 1, it’s kind of comparable to epilepsy in that you really should find a way to manage bringing down total carbohydrates because of how much you know. You know how much insulin you’re going to need to manage it, and your body has an enormous challenge in trying to regulate it. And so for me that’s not as close of a call.

Yeah. Especially because lately more and more we’re finding type ones that are transitioning into Type 2s. Like their dietary management is just so poor that they’re becoming insulin resistant, which is just complication on top of complication, and it has to be really difficult for them.

So you two are both known for doing crazy experiments. What have you been up to lately?

Gosh, where to begin? I guess if I were to say what the last set of experiments are, they were to do carnivore. And one thing I didn’t get a chance to talk about in the presentations, but I feel like it’s kind of a little more appropriate for a podcast….for all of the kinds of experiments I’ve done and for the controversy they’ve garnered, nothing came close to my mentioning I was going to do a carnivore experiment. I got a whole lot of people both jumping in on the positive and negative side. It had enormous attention and this I found to be pretty odd because my ketogenic diet, I’m normally having close to 75 to 80% animal based products.

So getting all the way to 100% I thought would be, to use the euphemism, a nothing burger. Probably it would feel like keto to me. Probably no one would care. I couldn’t have been more wrong about that. Not only was there a lot of pushback on the outside, but I was thinking, gosh, I hope there really is going to be good data given there’s not…given how much I’m having to put up with to make this happen. And sure enough, I found that if I went on carnivore I did in fact see a lot of effects that really kind of blew me away. As you know, a lot of the data I just go and get it myself. That’s the value of N of one, is when you’re the N, you get to find out how much things people have been telling you really pan out.

And in the case of carnivore, I really can’t say there were a number of symptoms. I would say both advantages and symptoms that turned out to be worthy of mentioning. A lot of them most of your followers probably already know. My appetite was much more satiated and in fact I just thought less about food. I didn’t think about planning for food and so forth. And that was very liberating. A little less time in the bathroom…make of that which you will. I really found that I enjoyed meat a lot more specifically when meat was my main target; which was good. That said…

You think it would potentially be the opposite..that you get bored with it?

As I was about to say, that said, I haven’t done a really long-term carnivore experiment, but in both that first one I did and in a second one that I did just recently, I do get bored of food choices. But it seems as if it’s in the process of subsiding before it is, that I end up ending the experiment. So it could very well be that if I were doing carnivore for say, three months, that I would actually find, oh, okay, I’m really getting into animal products only. It’s working out for me.

Yeah. And that’s actually exactly what I found. I’ve been doing carnivore for almost a year and a half I think – since October 2017 – and I definitely found… I thought I would get bored going in, but it was the exact opposite. My excitement for food went from absolutely zero to just excited about every single meal. Happy while eating. Satisfied after the ambiguity and appetite I was experiencing with keto went away. It’s absolutely clear when I’m hungry and when I’m not. And after all this time, am I bored? No, absolutely not. It’s more enjoyment than I’ve ever experienced from food. Ever.

I actually want to prod you into what really should be the experiment you should talk about because it is one of your most recent experiments and it relates to carnivore. It’s your raw week.

Yeah, so I’ve been having a…I think it’s a pre-existing issue with low folate, and I think it’s pre-existing because even in my Standard American Diet days, I was having symptoms of numbness and tingling in my fingers. And actually right before I started keto, I had a numbness and tingling in my toe that was not going away. And that was actually a big motivator for keto because like in my head it was like diabetes or something. But obviously that wasn’t it. I was also experiencing shortness of breath, even just like sitting and doing nothing like we’re doing right now, it would just be like breathing normally, but feeling like there’s just not enough oxygen. And eventually I got tested, B12 and folate, and folate was like rock bottom, like 2.8. Normally low carbers I see like levels of 10. So clearly that’s pretty abnormal, especially because there’s research indicating that with low carb diets folate goes up, even with the same intake. Amber discussed at CarnivoryCon that this relates to gut bacteria and things like that.

And I decided to try supplementing for a while. So I did that while I was out of the country for three months and the symptoms did subside, but I wanted to see if I could find some other way to fix the issue. And I was like, hey, if you cook meat, you lose water content and folate is a water soluble vitamin, so if I just don’t cook it, maybe I’ll get more folate that way. It was just a random thought. So I decided to do a full week of raw meat only, and I was doing that while at Amber’s house before the conference. So it was like raw chuck roast, raw beef heart. Not really any organs then, except for the heart, because I didn’t want that to confound. I just recently got my labs back and my folate was 18. Granted, that could be still coming down from the supplementation even though I’d stopped it several weeks before that.

But this is definitely something I want to look at further because if that’s all I need to do to fix it…

Can you tell them what the reference range is?

So the reference range I think is like under 3 is a clinical deficiency, and then up to, I think it’s like above 28. Just say it’s above 28 and you’re out of range.

And your prior tests?

My prior test was 2.8, and then 3.1 for another one, and then it went out of range when I was supplementing. And now it’s 18. So it’s very interesting. And while I was eating raw, I experienced something very similar at the beginning of carnivore, where when eating pork I was getting like this feeling of just absolute happiness and excitement while eating…like a borderline euphoria. And that eventually faded over time. And that’s why I was eating pork so much. It’s actually something I’m kind of known for on social media.

Pork and cream cheese.

Pork and cream cheese was my go to. But I was getting the same feeling with raw meat and in my head it’s like, maybe there’s something in here I need. It’s not very scientific, but it’s something I want to pay attention to because it’s not ignorable for sure.

Well, it’s using your first and most important meter. Because I can never say this enough times, for as much as we like to experiment and measure methodically, the one meter you should never lose touch with is, how you feel. Never. And I think that if you’re feeling good around the clock…and I always put it that way, as in 24/7 you’re just generally feeling good. Not having rushes. Not having feeling good briefly, and then having a crash. But if you’re feeling good around the clock, that’s very valuable information and you want to be very mindful of what you’re doing and how this came about.

And presumably you’ve seen an improvement in those things.

Yeah, like the symptoms haven’t come back. Nothing. No tingling or shortness of breath. I’ve been running all over the place and been fine. And so it’s definitely something I want to continue. Although I do have another experiment coming up that will be not as fun. I want to dig a little deeper into lipoprotein(a) because I did some fasting, and then high calorie, and then baseline diet, high calorie, and it seemed to be tracking with fat intake. So I want to explore that a little bit more. Probably as soon as I get back home. And that’ll be with a high carb, low fat diet.

Yuck.

I agree. Especially because… I mean to be honest I don’t like plants that much regardless of what they are. It’s just soul sucking to eat them. But I really, really want the data.

That’s going to be a real shock to your system surely, after all this time.

Yeah. I want to give it a good length of time just to make sure there’s not any transition, so it’ll probably be multiple weeks paying very close attention to how I feel. Because when I was following the Standard American Diet, I had depression and it was pretty bad. So that is one thing that I’m concerned about, and I’ll have my parents on standby, like warning them ahead of time, watch out for anything. Please let me know if I’m acting weird and I’ll just stop because that’s not anything I’m messing around with.

And as we would advise to anybody else considering N of 1s, you always want to be prepared to cancel an experiment if it’s not working.

Absolutely. There is nothing shameful in that. Absolutely nothing. You have to take care of yourself first and foremost.

And on that note, while I was doing the white bread and processed meat experiment, which was also a high carb, low fat diet, and my continuous glucose monitor was just constantly showing me the alps, if you will. I was very irritable. It was probably one of the most difficult times that I’ve had as far as maintaining control of my emotion. And Siobhan would joke toward the end – though not entirely joking.

I was not joking.

That she might have to take time off soon if I was going to continue the experiment too much longer. So if I’m experiencing the same thing on the other side, I’ll let you know.

Yeah, I would appreciate that.

It’s a challenge though because in approaching an experiment like this, you do want to do your best to keep your own biases in check. So I intend to every time I do an experiment, even if I’m going out of keto, to try to experiment with something like this, I try to maintain the best outlook for what the experiment could be, and not let anything trip me up. And I will say, there are experiments where I’ve had carbs and not fat, and it did not have a negative impact on my mood. This last one was one of them. And of course, I’m going to be hoping the same for you as well.

Yeah. And one thing I’m going to do to try and mitigate that…because the problem with lipoprotein(a) is it’s an acute phase reactant, meaning if there’s inflammation it goes higher. So I’m actually trying to go out of my way to avoid that. And one of the ways I’ll be doing that is going with the whole food based approach. So it’ll be a very simple sweet potato, lean meat type of thing. And I’m hoping that’ll help mitigate part of the mood issue, because I think part of that was largely due to insulin resistance and things like that. So hopefully that’ll help and I can coast through easy and just be bored, and that’ll be the worst of it.

And do you think the kind of carbs you had in this experiment where you were feeling irritable, played a part?

Oh yes. Michael Eades did a really great presentation not too long from that, to really emphasize, how a food is processed can matter for how it impacts your system. And he was going into not just your insulin, but also a number of other factors. I certainly have speculated on for some time when I like to call speed of entry…how fast things that you’re consuming, food stuffs that you’re consuming, can get into the vascular system. And particularly we’ve found a lot of ways through refinement that I speculate, can kind of trick our enterocytes to some degree. As I say over and over again, we’ve had a lot of practice as a species with protein, fat and very fibrous carbs. This is sort of a brand new paradigm where we’ve actually found ways to get, say, glucose inside of our bloodstream within minutes.

That just wasn’t really that possible before, not at these scales, right? And given that, it doesn’t surprise me that I’ve now done – in one year’s time – I’ve now done four different experiments that had to do with carbohydrates. First one being the skittles experiment from last year. Then I did the weight gain experiment where as the standard American diet. Then I did the white bread and processed meat experiment. And then a very recent one was the added dextrose experiment. All four of them have character to themselves in both how I was feeling about it. What I saw for the difference in my continuous glucose monitor and aftermaths.

And ironically of all of those experiments, the shortest of them was the added dextrose experiment. It was only four days long. It was a total of 75 grams of dextrose added to each meal. So a total of 225 per day. It was the highest my glucometer had ever gone. And afterwards I had cravings like I had never had post any other experiment. I actually really wanted sweets. So I had a whole bunch of keto junk food, but I kept trying to figure out a way to just get my head space out of it. It wasn’t until I went into the second version of the carnivore experiment that I was really able to reset. These things really weigh on me as to how much other people may be dealing with the same things. And I do believe, again, it’s not just carbs, it’s the nature of those particular things that I was eating.

Yeah, I agree. I was about to bring that up. We do see anecdotally that some people who are consuming liquid fats habitually – not just bulletproof coffee, but I’ve also seen an example of bone broth with butter melted into it – they can sometimes come back with really weird lab results, or weight stalls, or weight gains, and for the lab results it tends to be high triglycerides and it’s like I’m following really strict keto, but my triglycerides are really high. I don’t know what’s going on. And it’s on our list for people who have high triglycerides on low carb, are you consuming liquid fats? And I think it’s the same issue. It’s the speed of entry that’s the problem.

Yeah, there’s definitely something in that. I mean it makes sense logically as well, doesn’t it?

Well, I mean I think the best way to think of it is we’re having a conversation all the time. Our digestive tract is having a conversation that’s spoken in hormones, spoken through signals through the vagas nerve. These are practiced over 2.5 million years, right? And for Homo sapiens, we’re talking what, 200,000 years, I want to say. This is very long. It’s very common. There are all sorts of refinement that’s happened for how that system works, and now we’re throwing that all up in the air entirely. And so the signalling things like your leptin response, probably the dosage that was actually in your vascular system at the point where that was getting activated was so much smaller than it is on the Standard American Diet. So, so much more is inside, and that’s why people could have cycles where it’s not just a hypoglycemic but also hyperglycemic. I doubt any of our ancestors were dealing with this.

Yeah. And I just want to clarify that I don’t think this is a problem for everyone, but I definitely do think it is a potential problem because while I was losing weight, I was drinking the bulletproof coffee. And so it’s not everyone for sure, but I do think it’s important for people to realize that if they’re having issues, it’s something to think about because it can just be helpful to know what could be contributing to potential problems and then they can kind of figure it out and go from there.

And let me just add, I think one of the worst excuses to be having liquid or refined forms of fat is that you’re trying to “fill your macros”. Oftentimes people are trying to hit a percentage that they’ve heard is the keto percentage. I’m happy for family and friends to get into things like keto treats in the beginning to get into things like bulletproof coffee if they find that it satiates them away from carbohydrates to some extent. But I actually get a little bit frustrated with them if I feel like they could have a coffee that isn’t bulletproof and it’s not something that they necessarily need to have and they feel that they need to add it in order to hit their fat macros for the day. If you’re trying to add energy for the purpose of meeting these macros, I highly discourage it.

I agree. And people finding ways to add things like MCT oil just because they’ve heard they should be adding it. But for what reason?  It always comes down to these real whole unprocessed foods and if you stick to those in majority, it’s very difficult to go wrong, isn’t it?

Well, I do want to nitpick a little because I actually do take issue to the whole process debate, because there are plenty of processed foods that we eat that are perfectly healthy.

That’s very true. Bacon…

Cheese and salami and stuff like that. I think what I would like people to focus on is the metabolic effect of what we’re eating and the better we can understand that process, the better we know… I don’t react well to this. I react well to this. I can have bulletproof coffee be perfectly fine. Everything looks good. I feel good. I’m full from that. And then some people have the complete opposite reaction. And so I think that’s what I try and focus on is the effect of what we’re eating. Because what else would you care about in the end?

It gets back to whether you have a problem or not.

Yeah, exactly.

If you’re having fat shakes and fat bombs and you’re still running record marathons and so forth, then you probably aren’t listening to this part of the advice anyway, right? And I’m not going to tell that person, oh, you’re wrecking your life. If you’re happy 24/7 – getting back to that first meter – and you don’t seem to have any issues with your personal goals. You know, your weight’s at the right weight and you don’t have any stalling. You don’t have any disease states that’s arising. Whatever you’re doing is probably good. Probably is. That said, if you want my top list of suspects. If you find that your weight’s stalled. If you find that you’re not feeling good, I start with how fast are you getting food into your body? Because that is stored energy ultimately and your own hormonal system to be able to turn on those regulators like leptin to be able to tell you you’re done, that’s got to happen soon enough for you to then limit the amount of food that you’re eating.

Yeah, and I think this would actually apply to carnivore as well because I’ve noticed that people seem to sometimes think that because I follow a carnivorous diet, I’m recommending it to other people. And sometimes I think if there’s evidence behind something they’re experiencing, and carnivore could potentially help based off of anecdotal data that we have, I’ll mention it, but a lot of the time I don’t. And I think that’s because if you can eat plants and be happy and feel healthy and feel energetic and great – why would I tell you to do anything else? That’s just silly. Obviously you can try it and see if you feel even better, but then if you do that and find, whatever, I miss my vegetables then go eat them.

And you mentioned you were getting quite a lot of pushback and extreme reactions to carnivore experiments. Was it along those lines or something different?

Yeah, so some people even within the keto community, some big wigs for that matter. Some would say that it’s unsustainable environmentally. Some would say that actually there’s still a number of issues with nutritional completion. Certainly there are a lot who are concerned, even eating nose to tail, that you don’t get enough nutrients. All of these things, again, me being an N of 1, I like to go get my own data. I like to go see for myself. I know that I am going to be getting very wide spectrum testing and so I’ll have a fairly good idea of what I feel like the data’s going to look like, even if it’s just in the short term. And that I’m going to find more meaningful than what anybody tells me, truly. Because a lot of times, even what I’m telling myself turns out to be wrong, the blood work is the most important.

Oatmeal was an interesting topic in your CarnivoryCon presentation.

Yeah. So that presentation focused a lot on an area that I’d been excited to explore because I was considering – and truly I still am considering – I would like to do a plant based diet for around four to six weeks because I feel like that would give it the best shot. And if I went for that period of time, I need to figure out what diet I could eat that I would feel was nutritionally complete enough. And, believe it or not, I landed on Michael Greger’s Daily Dozen which I was showing in my presentation. It actually came pretty close to hitting all the stuff that I wanted to hit. But amino acids was pretty tough. And even with all of the different samples that I had put together, I found that oatmeal was really the primary source of the amino acids I was looking for. So then it was like, okay, well maybe I can just pump up oatmeal in particular, and then I found that it needed to be at least a pound and a half dry. So a pound and a half dry, which means…

I’d struggle with that. Just eating it consistently.

Yeah, so before adding water….Right, it’s like its so much oatmeal. And where I was going with that whole talk was that, amino acid composition – like if we were to take each of us and enzymatically break us apart to where we just have this bucket of the mixed amino acids, there’s around 23 of them associated with the human body. Well we’re pretty close to the other animals who are making a lot of the same proteins from the same amino acids, that I was basically pointing out that amino acids are kind of like the toner for our proteins that proportionality speaking, it makes sense why it is that those would end up being comparable to each other.

Whereas if you go to the plant kingdom, how surprised could you be that there’d be some amino acids that would be highly lacking while others were way over the top, right? And that’s what I found is that sure enough, while I was checking out, just trying carnivore, a nine ounce ribeye steak covered all my amino acids. A nine ounce chicken breast covered all my amino acids. Salmon, all my amino acids. It was crazy. And the other food compilation I put together – there was a dozen – really took about a pound and three quarters and didn’t quite get me there either.

To lower the tone of it…it’s no surprise that there’s a difference in toilet activity really. When you come down to it, the more nutrient dense it gets for your needs, the less waste there’s going to be. Whereas if you got to bulk it up with pounds and pounds of carbs…

Yeah, to be sure I’m going to… I have two very good vegan friends who I spoke of in the conference. What they would want to say is, well, okay, sure; but how much environmentally did it take to make that cow or to make that chicken and so forth. These are all, I think, valid things to bring up as long as it’s within that sphere. I think you’ve got to still separate though the two. You’ve got to talk about the topic of nutrition and it should stand on its own for nutrition. I lauded those people in the vegan movement who are trying to move towards more nutrition completion because I think it’s something that we should all be striving for. Again, if I had a vegan friend, just like Siobhan was saying, if they’re all into plants for that matter and they’re meeting their nutritional needs, why would I tell him to do anything differently if they’re happy?

I think you mentioned this in the presentation. The point is if you’re going to do it that way and I’m the same. If you want to do it that way, that’s fine. It takes a lot more work and effort, and being methodical about it, and working out exactly what you need to eat, and the variety of what you need to eat, to get those things you need. Whereas it’s a lot easier just to throw a steak in the pan.

It’s actually a really massive gap. Again, I really want to be even handed about it, but I would just love if there was a lazy nutritionally complete vegan diet that’s whole foods plant based. Because I really think I would have already been doing it by now. I would’ve just started acclimating to whatever that was, but I wasn’t able to find a way to reach the vitamins, the minerals and the amino acid completiveness that I was seeking. And I didn’t even need it to be perfect. I just needed to be close enough to where I could say I did a good shot at doing a plant based diet and here’s what it looked like. Not that I was going to change any minds in either sides of the movement, but because I want really good information. I wanted to see, hey, what does Dave Feldman look like on a nutritionally complete plant based diet?

And as I told my wife, I think I could pull it off if I just had a vegan cook in the house. And by the way, I’m not totally ruling that out. If it eventually gets to the point where I can rope somebody in to make all my vegan meals to be able to make it to that level, then I would do it. But as far as like me planning it, cooking it on my own, no. Yes, it’s just, its way easier to throw a ribeye steak onto the grill. I don’t have to do that much more past that point. It’s kind of daunting.

Yeah. I can actually back that up because I first heard Amber discuss carnivore at that first Ketofest where I met Dave actually. And after that I started… I was already working a full time job and then pretty much all of my free time after work was studying, helping Dave, talking to Dave, figuring out all this stuff, and so anywhere I could cut out time that I didn’t need to be spending, I was doing that. And that’s a large reason of why I started carnivore in the first place because it’s like, picking these vegetables of what I want to eat and cooking them and preparing them and chopping them, while I could just throw, you know, mostly pork on a baking sheet, stick it in the oven, heat up some cream cheese and eat it, and then be done in like 15 minutes. It’s just no comparison. And understandably though other people do enjoy cooking. Like my dad enjoys cooking. I’m not one of those people.

Nor me.

Not even close.

No, I must admit, I’m not overly tempted by vegan, but I can remember when I interviewed Carrie Diulus, and she made it sound really interesting and tasty. But the effort that goes into it, and for me in France, just the lack of availability of ingredients, if I was to do vegan keto, it would be so boring.

I know. If I could make things that were three ingredients and as fewer steps as possible, that’s what I want.

Now, Carrie if you’re listening, if you cook for me and Dave, we will come over, have a little vegan keto retreat, get blood work all together.

100%.

It’d be fun.

Carrie Diulus, by the way, is one of my favorite people in the keto movement. And she actually has a tough job because she is vegan – vegan keto – so she’s kind of straddling two worlds that are at battle with each other. And God bless her, she’s doing such good work, and not just for Type 1 diabetics – she’s Type 1 diabetic – but also for those people who are emerging who want to do a vegan diet, that’s ketogenic.

Absolutely. I have utmost respect for her approach and what interested me was that she landed there through self-experimentation via carnivore actually, and found that vegan keto was how her body felt the best.

Yes. And I think that’s a valuable lesson to take away. Because once again, if you’re really good scientist, you’ve got to keep from falling into your own biases. And so I would hope that if I had a family member that was in the same spot and I had them trying carnivore as the multiple removal diet, and they were still having problems, so we could figure out if they were the next Carrie Diulus, and move them over to vegan. Because whatever works is what we want to hope you can find, but part of that is remaining open minded the whole time.

Yeah. I just want people to be happy and healthy and that’s all I really care about.

What about coffee?

Coffee’s a fun topic for us. First of all, I should just say that it’s been annoying to me only from a studying aspect, as in it kind of came on to my radar really, and I want to say maybe a year and a half ago, but very loosely. And one of the experiments that haunted us a bit – actually, you weren’t as involved at that time, but you did know her, was a gal by the name of Brenda Zorn who I’m sure you know well. She had gone on a steak only diet before carnivore was even as big as it is now. And there was a lot of battling and a lot of internet rancor about it. But while she was on it, one month later she got her blood work, and her triglycerides are sky high. They were 500 and she didn’t have those kinds of triglycerides before being on keto.

Well, I tried to reassure her that probably it was temporary. Because at those levels, if you’re metabolically healthy, you can probably correct them quickly – that’s a lot of what this research shows. But sure enough it ended up tapering down. The only other thing she was having than steaks, was coffee. And ironically I asked her if at the beginning of the experiment if she could actually go without the coffee for lack of confounders, and she said there was just no way. And then brought up lots of euphemisms of things that would happen to me if I tried to make her. So that was the very first time it kind of came onto the radar. And the reason I started asking on occasion whenever somebody would come with high trigs and it didn’t make sense. And by it didn’t make sense is, we do expect people who when they go on a low carb or a carnivore diet, that typically triglycerides will be low in HDL will be high. Triglycerides being low, like say under a hundred would be ideal, but at least under 120 or 130, and HDL being high, typically 50 or above.

Now when triglycerides end up being above 150, but HDL is also high, let’s say 50, 60, 70. That’s curious. And we have two suspects when that happens. The most common one is they didn’t actually do a fully fasted blood test. We recommend that that you fast for 12 hours or more, preferably 12 to 14 hours is the nice spot we would like you to be in. Water only. No coffee. Now if they’ve done that – if in fact they definitely fasted for that period – our next question is do you drink coffee? And if they drink coffee, then our next suspect is that it could be a coffee sensitivity which we have seen with a number of carnivores. Not the majority of them. Don’t throw anything at your iPod right now, but a fraction of them do appear to have high triglycerides. We had somebody – Sean Brennan – who actually did a very extensive N of 1, showcasing this with himself that looks very compelling.

He was trying different types of coffee while intermittently having no coffee and when he had no coffee, his triglycerides were low. When he had coffee his triglycerides are high. Whether it was filtered or not, French press or even decaf.

So it’s the coffee itself. It’s not the caffeine.

That’s what we think. I mean to be sure it’s an N of 1 – as always, we like to get reproduction by other people who may have this coffee sensitivity to see what it looks like. And to be fair, our original No of 1 ended up coming back, ended up doing a very extensive experiment and it didn’t work the second time around.

So Brenda actually did a… I believe it was a six week experiment where she did a baseline test just eating her normal diet, coffee included. Then she included coffee for two weeks. So steak only, coffee, normal amount of exercise, not within a couple of days leading into the test, but otherwise. And then she did no coffee and we didn’t see the same triglyceride increase. But CarnivoryCon gave me some additional ideas because they were talking about phytotoxin – toxins found in plants and I’m wondering maybe it has something to do with gut permeability. I don’t think we really have any idea at this point. It’s definitely interesting though and definitely would like to see more people trying it out if they’re curious. If they suspect it, it’s pretty easy to test. Usually what people end up doing is they just subtract coffee for two weeks, go water only, and then retest and then they’ll come back and see it dropped from like 296 to under 100.

It’s really a remarkably high number of people that we see correct their surprisingly high triglycerides by either making sure that they’re at least 12 hours water only fasted, and/or eliminating coffee for like say 7 to 10 days. We usually like to say 10 days if possible. And that suggests there may be some phenomenon here. I do, by the way, have some new ideas I have to talk to you about, particularly since I’ve kind of come to realize a couple of other things since Michael Eades talk that may be relevant.

Hmmm…mysterious.

Yeah, we’ll talk.

They’re looking at each other secretively. I would hazard a guess though that if you found you got some pushback from carnivore, the pushback you’re likely to get from suggesting people give up coffee, it’s going to go off the charts.

You have no idea. I always feel like I have to hold my hands up in defence as any objects are going to be flown my way. You know what’s fascinating to me, is coffee I feel like is one of those quiet addictions. People don’t realize just how addicted they are until you’re even just suggesting that they go without it. And then there’s almost like a visceral reaction people get. This is the worst part…anecdotally speaking, the people who seem to have the coffee sensitivity anecdotally seem to be the ones who are the most attached to coffee.

I can see the logic in that though.

Yeah. It does make me wonder if you look a little deeper, one of the fascinating things you find out about is it’s an adenosine aggravator. But that typically is talked about as far as the brain goes, not so much as to what would be happening in the vascular system. Which is why I kind of assumed it wasn’t really that big of a deal. There really hasn’t been a lot of presentations and some work sent my way that has me like… I feel like I could spend a week just on looking at how coffee affects the human body. It turns out there’s really a lot of things it can impact. So all of these things have me quite curious.

Yeah, and to note, I don’t have this reaction, and Dave has asked me before…would you be willing to go without coffee? And I was like, yeah, sure, whatever.

But you’ll do anything it seems.

But she doesn’t have a coffee sensitivity, that’s her point.

I would be thrilled if I did because then I could just test it, test it, test it, test it, test it, test it, over and over and over until I could figure out what it was.

Then probably give it up.

Neither Dave nor I have figured it out. And it’s worth mentioning we don’t know if there’s an increased risk from this rise in triglycerides – we just don’t have the data on it. And so really I think it’s up to the individual, but it is worth noting, I’ve never actually seen a case of something that increases fasting triglycerides that is anything that you want to have around.

But what’s good for the goose is good for the gander. We don’t want to make the statement that we know for sure that this could be problematic. All things considered, I just say I don’t feel comfortable with it.

Yeah, and that’s kind of what we go with. People have to decide for themselves if they’re comfortable with it or not. And it’s just part of being honest here.

I’m interested in the behavioral side of it. After talking to Amber about how much liquid I intake, and I know a lot of that is just habit. I’ll have a coffee and then I’ll go make another coffee, and another coffee, and then my tea for the rest of the time. And I’ve been interested in doing a carnivore experiment again – really strict meat, eggs, salt. That’s it. But extending that out to just water – meat, eggs, salt, water – just to see…because having tried it before, the more restrictive you get with the food – as you’ve noticed – your appetite goes down and cravings go down, and all that stuff. I’m just interested to see…I don’t dislike water at all, but I don’t think I’ll have the same behavioral issues as I do with coffee and tea. I think I’ll only drink it when I need to – when I’m thirsty.

I definitely do still drink water out of habit, but I also drink other things. And I actually have tried to go water only before, but the first time I did end up successfully quitting diet soda, which is fantastic for me.

Same here.

Not because I have seen any hard evidence on any harm, but I didn’t like the feeling of being addicted to it. But going water only the first time resulted in really severe carb cravings, which I’ve never actually had before. And it got so severe, I was like texting Dave, like nearly in tears, like what do I do? And his response was to go have a cup of coffee if it’s that bad.

And it changed it, right?

Yeah, immediately after I had that cup of coffee, the carb cravings were gone and it wasn’t even like, oh, a carrot. It was like I was at the store and it was like, they sell donuts, you should buy like five donuts and just binge eat all of them. It’s like, what the heck is going on? So it’s very clear that coffee does have an effect on me and I don’t know what it is. It wasn’t that I was under eating, I was eating more than normal just to try and keep this stuff at bay. And then I actually tried again recently because I had heard on the Carnivore Cast – if you’ve ever listened to it – Amber had been talking about how she had had withdrawal symptoms and she supplemented with L-Tyrosine, which is a type of amino acid. I was like, all right, I’ll try this again, I’ll see if I can induce the cravings again and then do a clean break where I add the coffee back in, and then try a break again with adding the L-Tyrosine, and see if I can get rid of it.

I stopped after three days but only because it was making me really hungry, and I was also simultaneously trying to work on my presentation for CarnivoryCon and I was like, I’m not doing this right now, I just don’t have the head space for eating more than I usually do as well as trying to work on this presentation. So I’ll definitely come back to that. It’s not at the top of my priority list, but mostly just because I have like six other experiments I have ahead of that.

But I do actually want to express this. This is another observation of patterns that I certainly see a lot. It seems people are chronic soda drinkers are typically not the big coffee drinkers, and vice versa. A lot of people I know would say, oh yeah, you know what? I only drink water Dave. I mean, except for coffee. But it’s almost like a throwaway line. And this is where I find the visceral reaction that I do. And I’m like, oh, well why don’t you try just doing water only and cutting out the coffee, and then sit up straight. There’s an alarmed look as though, oh no, no, no, I can’t. Okay, well then you know, you haven’t quite hit water only, and it’s okay, you still have an attraction to coffee. It’s almost as intensive as what my prior sweetened drink attraction was.

I was a chronic soda drinker my whole life. Truly tried – this isn’t hyperbole – probably six times in the last five years to really give up soda. And that includes after I went keto and I was having diet soda. My cravings for sweetened solids went down, but my cravings for sweetened drinks didn’t. And I kept wondering how much of that was truly habit. Sure enough, while it could be a podcast of its own, and I’m sure Siobhan’s tired of hearing me talk about it, but it’s an area of great fascination for me. I finally figured out what I need to do in order to accomplish going to water only. So now every beverage I have is water. Full stop. Since May 1st of last year. So I’ll probably come up to a year pretty soon actually.

Yeah. And this is actually something I’ve talked about a lot with Dave because I had the same exact experience of trying to quit soda, trying to quit soda, trying to quit diet soda after I went keto, and it was like nothing would work. It was like this horrible addiction and I really didn’t like it. And so he went water only and I was like, okay, maybe that’ll work for me. And even though I didn’t keep the coffee out and stick with water only permanently, it did work to quit the diet soda, which I consider a huge win. And the funny thing for me is I don’t have the same addiction reaction to coffee. I don’t have the same addiction reaction to sparkling water or whatever.

So I’m mostly okay with keeping those in for the short term. And it’s just fascinating how different the response is because if I go to a coffee shop and it turns out they’re closed, it’s like, yeah, whatever, I’ll just go do something else. But with the diet soda, it was like this visceral disappointment at not being able to have it, and then the anticipation, and then the satisfaction. And then shortly after that, the anticipation again.

Panic if there aren’t enough left in the fridge and it’s a Sunday and you can’t buy anymore.

Yeah. I really would love to figure out what that is because I don’t think it’s necessarily the sweetener. I don’t think it’s necessarily the carbonation.

There’s some kind of a fix effect.

Yeah, definitely.

There’s some kind of a key satisfaction that does seem to be quantitative in nature. During the time…people also knew me before I started the water only challenge, that I would obsess about the subject a lot and really break it down. I even got to the point where I would kind of break it out into what the phases of joy were. So, for example, at the point where I knew I was going to go get one, I had a reward effect just in knowing that I was going to go get one. And that oftentimes felt like the biggest effect of all. That now the plan was in place, I would say, be walking across the street to the grocery store and, oh, it was just going to taste so good. And that had a euphoria all on its own before me even having one sip of it. And then as I drank it, I oftentimes wouldn’t drink it all at once, like chug it. It would be kind of a nursing it, sipping it slowly, et cetera.

And then there was sort of an aftermath. An aftermath that seemed for me to last about two hours. Around two hours of almost as if I was still sipping on it. But it’s a fresh memory of joy and therefore there was this kind of euphoria in the aftermath. And that to me was something that I found to be so fascinating because here you are, you’re having an experience that you could say stretches out over two and a half, three hours from this one drink. From this one 20 ounce bottle.

I’ve always found with that, but with other sweet things. I remember it with ice cream – was that anticipation and that climb, that mounting up to the top. That actually when I started eating it, I realized I was back on the way down. That high point was actually before it even went in my mouth I found.

I think that happens a lot of times especially with things you’ve determined that you’re going to cheat. Like if you were going to break a commitment. The excitement of breaking the commitment is almost greater than when you’re breaking the commitment. Like you’re almost in the process of eating this food. You’re like, you know, I didn’t really need to eat this even though this is off my diet, and I decided to do this, right? But I try to bring this up for people to kind of realize it. If right now I were attempting you with a donut, and you really didn’t want the donut, and I was like, this is great donut. Telling you we’re all going to have one, and you really felt like you wanted to have one, and then you went, all right. And at that point you committed to going ahead and cheating. You’re like, you sure you’re going to…

And in that moment you’re getting excited about it, and then I go, no I was just kidding, I’m not going to let you have that donut, I’m going to be mindful. I’m going to be careful. You would actually feel this kind of frustration and resentment towards it, as opposed to relief that I just now prevented you from breaking your commitment. That’s what’s so fascinating to me is I think that a lot of that initial joy is relief from indecision. You were being tempted with something that you weren’t so committed to that you could ignore it, and you were sitting there teetering for so long that it took that moment where you said, okay, I’m going to go ahead and commit to this direction – it’s just the easier one – that you actually felt a release.

Is that part of what you were saying…you said the only thing that worked – with repeatedly trying to give up the soda, and then the diet soda – was the only thing that worked…just going to water only.

Yes. So I will unpack this for a second just because you’re curious. Basically every time I tried to quit I had that which I would replace it with. So either I had say sparkling ice, which was another kind of sweetened drink or sweetened tea that I’d sweetened with stevia or just club soda. I’d rationalize, okay, well you know, its sparkling fizzy water, so I’ll still feel somewhat entertained. But there was a problem with every single time I did this; my head space was still applying the attempt to go seek this out. To seek out these other replacement beverages. And therefore, even if I was drinking more water, it didn’t change that the water was disappointing because I could have been having the club soda. And so then I would still be…we’d be going to different restaurants and I would care whether or not they could serve a club soda or not.

And let’s say I go there and I said, could I get club soda? And no, we don’t actually have club soda, would you just like water? And I’d like, yeah. But I’d be disappointed. So what I needed to do was I needed to find a way to remove beverages as a source of joy. Only when I could do that could I remove them as a source of disappointment. So that sounds almost too easy to accomplish. But that’s exactly what happens. And I like to use smoking as an analogy. You don’t smoke, right?

I used to.

Oh, you used to smoke. Okay. So when you’d gone a long period of time without smoking, it’s not so much that you would think, oh, this inhale is a wasted inhale. I could be inhaling smoke, right? But on some very tiny level…actually kind of is, because you had a bodily function that you now apply to the source of joy, right? Well, if you think about it, drinking is a bodily function that’s being applied to a source of joy because we now have drinks that make it entertaining. I needed to change my drinking to be just like my breathing. So if it’s not a source of joy, it’s not a source of disappointment. It just is.

Yeah. And I wanted to make a point because the big problem with me is it would result in this cycle. For me, eating is a huge source of joy and excitement and pleasure and it’s all good. But after I’ve eaten, that’s it. I’m not hungry anymore. It stops there. It doesn’t turn into this cycle of eating and excitement like what I had before. And it was actually a rule that I had very early on into keto which is, if something was resulting…if I ate something immediately after eating that thing, if I just wanted more of it, it was out. Immediately. Not allowed in my diet. And so that included fruit of any kind, even low carb, berries, nuts and stuff like that. And it’s just because if something is hijacking my appetite like that, or my mind like that, I didn’t want it anywhere near me. Like I think you’ve mentioned before, there are moderators and abstainers. I’m a hardcore abstainer. If I can’t moderate, you don’t deserve to be anywhere near me. And so the diet soda was definitely the hardest of those. But really satisfying.

In my opinion, there are very few actual moderators. I think most people in order to truly quit something, need to completely cut it out. And to Siobhan’s point, I’ve actually given this advice before myself in that, if I find I will eat something – not that I can eat something or even that I desire to eat something, but that I will – then that is something I need to be mindful of. What is it that activates me to go ahead and eat something when I’m not hungry? So by the same token, I would say the same thing with beverages. What gets you to drink something when you’re not thirsty? Because a lot of the soda I was drinking, I wasn’t drinking when I was thirsty.

Exactly it. That’s what I was thinking. That was my instinctive feeling that just taking it down to water; I would only drink it when I actually needed it

And that was always the pitch to myself long before I was into keto and nutrition or any of that, going all the way back to my twenties I kept thinking, if there’s one habit that I could feel confident was a net health gain, I’m pretty sure that it would be to just drink water only. That anything I’d be drinking that wasn’t water was probably worse for me on balance. Even if it was a “vitamin water”. Probably anything that I could get from a beverage, I’d be better served getting from food. So if I could just flip a switch…and I had actually said this to Siobhan before I pulled this off…if I could flip a switch and just drink only water, that’s what I’d like to do. And so I’m so happy to have found that actually it’s easier than it’s ever been. Each month it actually gets easier than the month before. It’s like, great, now I don’t even think about it.

And it’s so fascinating because this seems to be – this type of cyclical reaction to things seems to be – very individual because I’ve heard people having the same struggle with dairy, and I was like, hey, maybe that’s me. I’ll quit dairy for a month and see. But even before that I would have cheese in the fridge for like a month, and I just wouldn’t touch it except for an occasional meal. And then after that I was like, I don’t want any more of this. And I did go a whole month without dairy and I was like, this is nothing. I don’t even care. Even after that I didn’t really go back to eating that much dairy. So, for me that’s a non-issue, but then for other people they’re like, I can’t have cheese in the house. I can’t have it anywhere near me because I’ll just eat it even if I’m not hungry.

And I really wonder, is this a different physiological reaction to the food? Is it a psychological reaction to the food. Is it both? I’m really curious what drives that? Because it does seem to be pretty individual.

It comes back a lot to addiction I think. Abstaining, moderating and just those emotional reactions to food or drinks. What’s next on the cards for experiments? Siobhan, you mentioned high carb, low fat.

Sweet potato and lean meat. Not Looking forward to it, but hopefully the data is good. I have a whole ton I want to do after that. Pork with L-Carnitine because I’ve seen a drop in Lipoprotein(a) with beef. And then maybe some more fasting experiments. I want to get a cardio check, which is a home cholesterol meter and do some fasting with day to day or even hour by hour readings. Just lots of fun stuff.

And how long have you got to torture yourself with the high carb?

I think probably two or three weeks just to give it a fair amount.

I look forward to watching that one. What about you Dave?

Well, so there are two experiments. One that’s the top secret experiment that Siobhan knows about, but I think it’s less likely it’ll be in the very near future. There’s one that I would like to do that I may be able to pull off even within a week or two, of total time of the experiment – which is I’d like to do my baseline and then the intervention be the addition of insoluble fiber. So I’d like to see what that would do with my blood work. Obviously there’s lots of speculation on that. But all of that said, I’m very reluctantly coming to grips with the fact that I am human, and that apparently I may need to de-emphasize my experimenting for a little while because there are some larger responsibilities that are coming onto the scientific front with some bigger players. And I guess I could…this may be the first podcast I mention this…I may have a book coming out in the near future.

How exciting.

Yes. My hope is it will be sometime late summer, or the fall. We’ll see because me being me, I’m sure I’ll be obsessively editing it a lot.

I know all about obsessive editing.

And I better be one of the first ones to get a signed copy.

Oh, I think you’ve got an in.

So perhaps you could leave us with a top tip.

I think for mine, it would be to pay really close attention to yourself. You know, if something is changing your behavior in a way that you’re uncomfortable with, it might be something to think about. And unfortunately that does include coffee for some people, not everyone, but also food habits. People, just try and pay attention to yourself and see what sort of impact things in your life are having, because you never know what sort of impact removing it could have. How about you Dave?

I’m going to extend my invitation that I gave at the talk today, which is that I really want anybody listening who likes the work we’re doing to consider being one more contributor. Don’t underestimate your contribution to also be a citizen scientist, because as I said in the room, every one of us is. Every one of us are conducting an N of 1 experiment and we actually are pretty interested in how the outcome of that experiment goes. Well you may learn something quite valuable that can help you out, but why not go ahead and help out everybody else as well.

Good point. And where do we need to go to do that?

Cholesterolcode.com is of course the site we manage and we put up a lot of our materials there. We do also invite people to come to the Cholesterol Code Facebook group -a lot of people are networking there. And of course for those who are Lean Mass Hyper Responder – having LDL of 200 or more; HDL of 80 or more; Triglycerides of 70 or less or thereabouts – may want to strongly consider a special Facebook group we have for Lean Mass Hyper Responders.

Fantastic. Thank you very much for sharing your time with me. It’s been a great pleasure, especially to do it with you here in the same room, face to face, and to have shared this wonderful conference with you both. As well as CarnivoryCon of course, which was amazing, wasn’t it?

Yes, it was. Thank you for having us.

Yeah, wonderful. Thank you.

Thank you.

This transcript is brought to you thanks to the hard work of Cheryl Meyers.

Welcome Bec to the Keto Woman podcast. How are you doing today?

I’m doing really well. Thank you Daisy. Thanks for having me.

Loving the conference?

It’s awesome. I’m learning so, so much, my brain is full.

Mine too. It’s, it feels like there’s a little bit of space there left to maybe squeeze some more knowledge in, but I was just saying earlier before we started, I sometimes feel have this sort of limit to how much you can stuff in, in a limited period of time. But you made the comment and I think that’s absolutely true that they’ve got a really nice pace with different presentations going on that that just stops you having that overload effect.

I agree. I think that they’ve balanced the high level public health content with the getting down into the weeds with the technical stuff really well. So you can come through a technical presentation and just have a little bit of a break and zoom out and take on something that’s a bit more big picture. I really like the way they’ve balanced that.

Yeah, me too. So tell us a bit about you.

I am 35 years old. I’ve had Type 1 diabetes since I was 17. I’ve been eating low carb for about 17 and a half years. So seven or eight months post diagnosis, I switched to a low carb diet and have been Keto since about 2012 when I started experimenting with a Ketogenic approach for endurance exercise. I’m also the CEO and one of the founders of the Type 1 diabetes family center in Perth, in Western Australia. And that’s a facility and service of which I’m immensely proud. 

We’re now supporting more than a thousand people impacted by Type 1 diabetes in our state. And we very much have an holistic and food first approach to diabetes management encompassing not only nutrition, certainly, but insulin therapy, being versed up on all the tools, the technical tools and devices that you can use to manage diabetes, but also mental wellness, peer support and very much that wraparound social support element that I think is needed for a life well lived with a chronic disease like diabetes.

I think it’s really important to take that holistic approach.

Absolutely. And I think that we’ve had a very medical model of care for Type 1 diabetes that’s really focused on insulin therapy and insulin delivery devices. And I feel that zooming out and looking at all the different pillars of good diabetes care and good health and nutrition, exercise, mental support, and indeed family support. That’s why we called ourselves the Type 1 diabetes family center as far as I’m concerned, Type 1 diabetes is a team sport. Every person in a family is impacted by a diagnosis, and every person needs to be knowledgeable, compassionate to the person living with diabetes but also to themselves because it is a long journey and it can go on a lot of different directions and the family center is there to help people through that.

And it’s great this working together with the patient and their family, which is really important, but with the medical care they’re getting. I was talking to Belinda Lennerz earlier and she was saying that there’s often this mismatch between the patient and the practitioner they’re working with and that they’re quite often feeling really alone because they’re going out on a bit of a limb getting involved in this way of eating and then not feeling supported. So it’s really nice to hear that there are more practices at least embracing this approach even if they can’t necessarily promote it, but it sounds like you’re able to take it more to that level to actually promote it and suggested as a way of eating and a lifestyle to adopt that’s really going to help manage the lifestyle for the Type 1 diabetic in question.

Yes, we are, we believe that a low carbohydrate approach should be on the table as one of the first line therapies in relation to Type 1 diabetes management. Obviously it’s always going to be adjunct to good insulin therapy. However, we’re not afraid to talk about it. We feel that it is not that controversial. It’s just eating real food. And it is certainly central to our approach to care. If patients want to come in and talk about it, then we’ll have the conversation because at the family center, we believe that people with Type 1 should be supported to transition to or maintain a low carbohydrate approach with solid dietetic support. They need to be meeting their micronutrients, they need to be meeting their energy requirements. And I think that not everybody does it well alone. And if we’re able to provide them that clinical support, then that’s what we’re here to do.

We are not necessarily leading with it. We lead with the holistic approach that I think the patient-centered approach is really what we’re about, in that when patients come into the family center, the first question they’re asked is what are your goals? And we really work with those because if somebody comes in and, HbA1c isn’t their goal and it’s not their focus, but perhaps weight management or exercise or managing hypos is, then we’ve got to go in building a relationship on what they need, rather than necessarily going away and say, well HbA1c is the marker of good diabetes management. That doesn’t necessarily serve them. So, that’s what we do.

And what are the most common concerns that people have when they come to you? The primary concerns, the things that are impacting their lives in the most negative way that they’re trying to fix or find strategies to help, you know. What are the most common problems that people are asking for help?

In relation to diet and Type 1 diabetes or more generally?

I suppose generally, because you take that holistic approach in just managing their Type 1 diabetes. What are the biggest issues that they have that really impact living a quote/ unquote normal life?

Before we opened the family center, we ran a whole series of focus groups asking parents of kids with Type 1 and adolescents and young people with Type 1 what they needed. And the theme that came through most strongly was connection. They said to us, we feel isolated. We feel alone. We feel unsupported and underserved by not only the medical community but by the community at large. People don’t understand our disease. It’s invisible, which is in some ways a blessing and in some ways a curse, because the general community doesn’t see it, doesn’t understand it. And the power of connection is transformative. And that’s why we have very much led with a peer support approach. 

We’ve set up online communities that are thriving with parents of kids with Type 1 and now adults, and they’re running through closed Facebook groups. And as you’re known as someone participating in the social media world in relation to Keto and this way of eating, it’s just a live dynamic community. And so we’ve set those up. We have hundreds of engagements every day through our online communities and we also have a lot of face to face connection and events. So that’s how we have tried to build a community in Western Australia, our own people with Type 1, because we want to make sure that people don’t have to live that lonely road, and that they, they can feel connected. And I think the value of connection is not only in the sense of not feeling isolated and alone, it’s also the information exchange that happens when you’re part of a bigger community, the hive brain that you can tap into of hundreds of people that have experienced what you’re experiencing and can offer insight and advice and knowledge. I think there’s huge value in that as well.

That’s a really big difference, isn’t it? I can remember when I had my first weight loss surgery and I was just completely isolated and just couldn’t do it, wasn’t getting good information from the bariatric team and there was just nowhere to access the information until I started finding online groups, you know, and that surgery didn’t go well, but when I had the revision surgery, I had access to all these online groups and the difference was incredible. Being able to make contact with people who are going through, have been through the same thing. It’s just worlds apart from dealing with the theory of it from someone who hasn’t experienced it. It’s just so much more reassuring to be able to, to talk to your peers in that situation isn’t it?

It absolutely is and we’ve made that central to the philosophy at the family center in that nearly every member of our team is personally impacted by Type 1 so it goes all the way through to the people. I truly believe that people with Type 1 diabetes should be working in diabetes organizations because there is that sense of, again, connection. You can drop your shoulders when you walk into the family center because everybody there gets it and that ocean deep compassion, that’s the stuff. That’s the stuff that changes the trajectory of people’s Type 1 diabetes management that helps them come to terms with it, to make peace with it because they see others who are living with it and working well with it. And I think that’s what we aim to create.

I’d be really interested to hear more about your personal experience about when you got your diagnosis. What led up to that? What led up to you know, you obviously realized that something was going wrong, there was a problem, but I’d just be interested to hear more about that.

It was interesting. It came off the back of it very, very stressful year. I had finished my final year exams and I was the goody two shoes over achiever at high school who was the captain of everything. And I had, I believe that maybe that lead in of that sort of eight to 12 months of high stress in my final year at school, was possibly one of the triggers of my diabetes diagnosis, which was in April the following year. So I got a really unwell over a series of, you know, short months and lost a lot of weight. I think I lost 12, 14 kilos over a couple of months. Started—the thirst is just indescribable, and I remember I would wake up through the night and probably I drank the worst thing I possibly could have drank. I still couldn’t, I couldn’t even go near a glass of it today. And that was apple and guava juice. I went through liters of the stuff! And indeed I remember being at a wedding, and that night I was so thirsty, I drank five carafes of lemonade. I mean, and I, I remember the fellow I was with thinking, what is wrong with this girl? 

And I was just making my sugar level higher and higher and higher and getting thirstier and thirstier. I had every symptom in the book, blurry vision, sores that wouldn’t heal, leg cramps—and finally my mom dragged me to the doctor. I had, she had made several appointments for me, which I had canceled cause I hate going to the doctor. And I went to see my GP who did a finger stick. And, actually no, he did a blood draw and I got a phone call the next day and I’ll never forget his voice. He said, ‘Rebecca, you have diabetes.’ And it was his very final sentence. And my heart sank. I didn’t really know what that meant, but I knew it was bad. And he basically said, get to the hospital asap. And I went there and I was diagnosed and it was just this whirlwind of three or four days. I was admitted. I was given my first insulin injection, which made me feel instantly better, which was wonderful. 

But then I was given the education and I will never forget again, they gave an brought in an orange and a needle and they made me practice learning how to inject with the orange because it’s the same sort of texture as flesh, apparently. So I injected a number of times and then they gave me a fresh needle and said, okay, now it’s your turn. And that was it. That was the start of five to seven injections of insulin every day. I think on calculation I’ve probably had around 45,000 injections in my life. It was the start of eight to 10 blood glucose finger pricks every day. And it was the beginning of the counting, the endless counting of carbohydrates, fats and proteins, plugging that into complex insulin to carbohydrate ratios, which change in my body four to five times a day. The string theory that you have to do to manage insulin dose calculations. And I guess the beginning of that fear, which lasted in a very intense way for the first eight months, of administering a hormone that is so powerful, it will kill me if I get the dose wrong in what back then was in really quite large amounts and had me afraid to take a walk around the block.

That’s incredible.

Or to go to sleep or any of those things that are normal life we should be able to do without thinking. And that was the beginning of my journey towards finding a solution.

Yeah. So what advice were you given when it comes to diet?

Eat according to the Australian guide to healthy eating, which was, you know, 8 to 12 serves of starchy vegetables and grain based carbohydrates every day. Limit fat, lots of fruit and I did, I dutifully did that for the first eight months. It was cereal and toast for breakfast. I had sandwiches for lunch, I had fruit for snacks. I had pasta for dinner and every meal, my blood glucose surged high and then crushed low because insulin is a woefully blunt tool. Synthetic insulin in any case, it is not even close to the sensitivity of a physiological insulin response. So I was trying to deal with these tsunamis of glucose charging into my system with, you know, great big wads of exogenously delivered artificial insulin and a lot of guesswork.

That’s what strikes me—that the calculations are just fraught with danger because they can only be guesstimates at best.

They are. And I think that we’re given this advice as people with Type 1 that here is this thing called the insulin to carbohydrate ratio. And if you count your carbs accurately and you weigh them and you’d do the ratio, then your dose is going to be good. And I really genuinely think that many members of the medical profession believe that works. It’s not sound science, it’s much more art than it is science because there are so many factors that influence not only the carbohydrates and the rate at which they’re absorbed into our system, but also how fast insulin is absorbed. I know from years of practice that if I put my needle in my stomach it’s going to work a lot faster than if I put it into my arm. And if I put it into my bum, it’s going to work in a different way altogether. 

And so even just the basic where you put your needle in is going to impact how fast the insulin works. And then there are myriad other factors around absorption of tissues at the site, you know, how active you’ve been. I think wonderful Adam Brown has isolated 42 factors that impact blood glucose and a lot of them are food and obviously insulin related. But it is, it is just such a complex beast, and the advice that you’re given that here’s the formula, go forth and conquer. It just falls flat. And yet I think so many people, it raises this false hope that “We’ve got, we’ve got a tool, we have a formula,” and it just doesn’t work like that.

There are just variables at every level, every turn. But yet you’re being told that this is quite an accurate linear equation that you should be able to master. So if things aren’t going quite right, which I imagine is probably the norm or certainly not going right all the time, the logical conclusion of that is well, I must be doing it wrong.

Absolutely. And there, I think the feeling of I am a failure is a very familiar feeling for people with Type 1, because you know, we’re set up to hope and believe that with the formulas and with the counting, you know, we’ve got this control over diabetes and that doesn’t work. And then when we go in to see practitioners around it who aren’t compassionate to the daily experience of living with Type 1, it can feel like you’re a naughty kid being dragged in front of the principal. You know, they’re there. I remember going in to see my endocrinologist and he would flip through my diet, my book, you know, there’s apps for this stuff now, but I used to write down all blood sugar levels and, and I might have fantastic control for weeks, but then he’d flipped back and he’d point to the hypo that I had on the 7th of April, which is months before, and he said, what happened here? And the whole appointment many times would be zero in on something that went wrong and reverse engineering that. And so there is never a sense—well there wasn’t in my experience—it wasn’t a sense of congratulating me or celebrating me for the things I did right. It was more around, okay, how do we hone in on the risks and that and the stuff that I didn’t do right. 

And I think the hard thing about Type 1 is that it’s all on me. All of those calculations, all of the discipline around food, around exercise, around managing those myriad factors, it’s all on me to manage. There’s no other thing I can blame. And so when it goes wrong, it does feel like my fault. And that can be a really hard thing to deal with. And learning more recently around self-compassion, and building that resilience and, and compassionate self-talk and behavior has been a really important piece for me and a relatively new thing. But we have to be compassionate to ourselves because there’s a lot of management that goes into diabetes at any given moment. 25% of my brain space is taken up with calculations.

Got to allow some room for other things. What triggered, led you to start looking for something else? A different way of managing all this?

There wasn’t a particular incident. I just woke up one morning and said, I can’t live like this, I’ve had enough. I there has to be another way. And I think I went, it wasn’t Google then, I went online and found the Dr. Bernstein “Diabetes Solution.” I wish I could remember the search terms that I plugged in to find that, but I saved up, I was working in a video store as a student at the time and I was earning $11 an hour and I had to save up, I think it was about $68 to buy this book and pay for the shipping. And it took weeks to come from America. There was no Amazon or Book Depository then. And I read it, I devoured it and it made so much sense in indeed I had already been restricting carbohydrate in the lead in to getting this book because I just couldn’t cope with the high, the feeling of my high blood sugar. And then reading that was very much validation. 

So I took those high level principles I felt much more confident about it and implemented them into my life. And almost immediately everything changed. My insulin dose has dropped by 75%, and they still remain very, very low. So my error margins dropped significantly because I wasn’t, dosing myself with industrial doses of insulin anymore. My hypos became mild instead of completely brain frying, you know, shaking, sweating, terrifying things. And everything became so much easier. My roller coaster blood glucose levels smoothed out and I have maintained that way of eating, with a few blips, admittedly, for the last 17 and a half years and maintained A1Cs in the low fives and high fours. I think my highest A1C ever was 6.6 for the majority of that time. It has completely changed my trajectory, with this disease and my ability to live a rich and full and active life with it.

Yeah, and I can just sense that switch from despair and I just can’t do this anymore to one of hope and potential of happiness and normality.

Absolutely. And people say, Oh wow, but isn’t eating low carb hard? I think it might take a bit of discipline. I find it extremely easy now, and a bit of creativity in the kitchen.

It takes some discipline to start with.

Yeah, I agree. It takes, you know, build your knowledge base, get committed, be disciplined around navigating your food choices and you know, get creative. Although it’s getting easier and easier now. It wasn’t easy then because they were no low carb conversations happening. I was very much out in the wild. But it is something that we can do and we can thrive with. And you’re absolutely right. Once you have that foundation and that base laid around the confidence and the skills to eat low carb and navigate food, then it becomes so much easier and life does feel more hopeful.

I was at a party last night, Pamela Zorn had laid out a wonderful array of food and we were just laughing, you know, joking saying this, this way of eating is so onerous. There were two or three different kinds of crackers, there was a delicious smoked salmon dip. She’d made cultured butter, cultured truffle butter, poppers, prime rib, smoked chicken.

Where was my invitation?

Is so hard. How can anyone think eating that is onerous in any way? Yes, the transition is difficult because apart from anything else, you know, most people are just fighting that carb addiction. But once you’re through that and you can just revel in so many things that we’ve been told for so long are bad because they’re full of fat, but they’re delicious.

Yes, yes.

But you’re a swimmer, a competitive swimmer.

That’s right.

Tell us about that and how that all the implications of that with the Type 1.

I love swimming. I’ve been swimming since I was a kid. And I’ll dial back a little bit into sort of transitioning across into Keto because it has been, I had to take a long hiatus from swimming until I really got Keto right, because for various reasons there were difficulties, technical difficulties around testing my blood glucose in the water. But also the transition across to Keto in 2012 was around endurance exercise. Generally. I was doing long distance mountain bike racing at that point and triathlon and the conversation around ketogenic diets and becoming fat adapted sort of came across my radar with Steve Phinney and Jeff Volek’s book, “The Art and Science of Low Carbohydrate Performance.” And that really changed my thinking around how I could become a better endurance athlete by becoming completely fat adapted.

At that point I’d probably been low carb, and eating above the Keto threshold. When I read that book, I dropped my carbohydrate considerably and change my macronutrient ratio and found myself racing around mountain bike courses with a big smile on my face and endless energy. And that really helped me feel safe and confident to come back to swimming because I felt having watched my blood glucose stay completely stable while I raced and trained on land, I felt confident that I could get back in the water. And at that point, because I was not able to test my blood, I could still trust that it was going to stay stable. So that was really the push that I needed and certainly wanted to be able to get back into swimming. And I have since gone on and done the Rottnest channel swim twice now, which is a 20 kilometer swim to an island off Perth.

We’ve got a few big plans to do a double crossing next year. So that would be a pretty major achievement that I’d really love to tackle. But we do a huge amount of training, so squad sessions, sessions in the river, sessions in the ocean every week in the lead up to these races. And yeah, fueling it with a ketogenic approach. It’s quite remarkable when I see my swimming friends who are taking on carbohydrates every 20 minutes while we’re training and gel shots and we’re having to drop drink bottles with PowerAde right up and down the beach when we do our long sets and they all remark, you know, how do you do this without any fuel? And I think I’ve got enough fuel in my left bum cheek to swim to Madagascar and it feels wonderful and very freeing to not only be able to feel like I have an endless source of slow burn energy, not have to eat because—eating while swimming, I don’t know if you’ve ever tried it. It’s not an easy thing to do—

I can’t imagine it would be, no.

—when you’ve got a salty tongue and you’re tried to ingest something while you’re treading water because you’re not allowed to hang onto a boat that’s against the race rules. It’s, it’s not a fun thing, you know? And I’ve got mates that ate peanut butter sandwiches and all sorts of ridiculous things out there and they’re great. I’d rather just keep swimming, thanks. But also finally to trust that I can, my blood glucose is going to say stable. That’s the holy grail of exercise formulas for someone with Type 1. So it’s something that ketogenic diet has very much enabled me to do and, and to do well, which I’m really happy about.

I can still remember my mum used to drum into me that I wasn’t allowed to swim until at least an hour after I’d eaten. So I think I’d constantly have that voice in my head. Well, you can’t possibly eat and be swimming at the same time.

You’d have to take a little rest, a siesta floating on your back. I don’t actually understand.

I don’t know where that has come from either. But it was just something that was this really strict rule.

Yeah, I’ve heard that too as a kid. So I don’t know about that.

Presumably then you must have seen quite a difference with the practicalities of how you were organizing that your swim before and after Keto. It sounds like you’re not having to take on any fuel at all, you know, in the competition swimming or do you have to take on some?

I could very easily do it completely fasted. I guess the only reason why I need or I would refuel during a long race is if I get a bit hungry or to lift my spirit. Because if you’re face down in murky green water for hours and hours on end with no one to talk to you and just inside your own head, sometimes it’s nice to take a break and having something nice to eat is, or take on board is just something to do. I think the other reason why I might take some nutrition in is to keep me warm and that does actually really help. Yeah, there’s no real need for it. I can run on ketones and feel like I’ve got perfectly stable energy levels throughout long swims.

But you did need it before, pre-keto?

Pre-keto, I was doing a little bit of swimming, but I think that at that point I had a lot less knowledge and the skills weren’t there in relation to how I manage diabetes and I wasn’t doing particularly well, which made me sort of avoid swimming to a certain extent, the testing regimen was a lot more onerous. Now I wear a Freestyle Libre, which is the little sensor I can put the receiver in a waterproof phone bag and just scan myself in the water so I’m totally self-sufficient. Then I’d have to stop and dry my fingers and get warm and test my blood and it was just fairly onerous to do. So I think that combination of the technology and the ketogenic approach is really just allowed me to do swimming with the freedom that I want to do it with without having to constantly think about or be anxious about blood sugar levels and how I’m going to test them next.

I remember Richard Morris telling me about the practicalities. You have to have the insulin you potentially need floating out there, accessible for you to use when you need it?

Yes. So, when I race, I have a paddler, a support paddler and he would have my hydration, nutrition, insulin or preprepped, my glucose monitor in the Libre. And when we stop to do a blood sugar test, he will throw me Libre. I can’t touch the boat. I’ve got to tread water, scan. If I made insulin, he’s got the pens, he has to throw that to me. It’s got a float on it so that it doesn’t sink because I can’t even be passed something because that would be a disqualification. I have practiced treading water and injecting insulin. It’s not as difficult as you might think with a pen in particular. And yeah. So all of those transitions have to be practiced before race day to make sure that we’re doing it right. I’m not going to be disqualified and I can do all the diabetes management tasks that I need to do.

What’s the distance? How long are you talking about with these races and the time that it takes?

We would do 10 kilometer swims regularly on the weekends and the distance for the race, this recent one’s 19.7 kilometers. So what’s that? About 12 and a half miles, I think. The first time I did it was horrific. It took nearly 10 hours. I got stuck in a horrible current and I swam over the same rock for about two hours, at one point I think it was soul destroying.

I was going to say, that sounds like the ultimate in frustration.

It was awful and I was seasick and I didn’t know that I got seasick until about 10 k’s in, when I started being sick and my heart just sank because I thought, oh my gosh, I’ve got a long way to go. If the only thing that’s going to fix me at this point, because I can’t keep anything down, is being on land and I have 10 kilometers to swim. So that took me six hours, that last 10 k’s of that race because of the current issue. And because I had to stop every 15 minutes to puke. But if not for keto at that point, if I had of been a carb dependent athlete and I needed to have nutrition going in every 15 or 20 minutes, that would have been my swim over, you know—and I trained for six months for this race. 

But the fact that I didn’t have to take anything on board as I was being sick, that was something that I was thinking far out, I’m so glad that I’ve adapted to this approach because I just don’t need to have the fuel. It’s awful vomiting, but I can get through that. The second time I did it, which was last week, it took me seven hours. So I took three hours off my PB, which I’m really happy with. You don’t do that every day. And it was a brilliant swim, I had a great time. I had a tiny little bit too much long acting insulin on board, which I started to really wear in the last couple of hours of the race. So I did need to take some glucose on to counteract that. But again, first 14 k’s was a breeze. I had half a YoPRO yogurt, which was three grams of carbs just so that I could take some medication on board at the 10 k mark and more sea sickness tablets. And that was all I would have needed if not for that tiny little bit too much insulin. So I felt a lot better through that race.

So you’re out there apart from your support team, you’re out there on your own. Multiple people are racing but yeah. So all on your own

Yeah, the Rottnest Channel Swim is an iconic event in WA [Western Australia], they have about two and a half thousand participants, not all solos. There’s about 300 odd solos that attempt to do it each year and the rest of doing it in duos and teams. So it’s a busy race. It thins out a bit in the middle, but very congested at the start and the finish, I don’t think I would swim to Rottnest just on my own. I like the safety in numbers concept as you may know, WA is also the shark attack capital of the world at the moment. So I think that I’m, I’m happy to be in the mix there, but it’s a lovely swim. You can see the bottom the whole way. And it really is a stunning environment.

You’ve mentioned a few times how things were when you were first diagnosed and the technical advances in things that are available to you to help you manage and monitor this. Perhaps you could just share a little bit about the change that you’ve seen over the years that you’ve been dealing with this.

When I was first diagnosed, it was obviously a blood glucose monitor. That’s the only technology that was out then. And I used that for many years. Indeed, I still do when I had to take breaks from the Libre or CGM. And obviously that’s evolved to continuous glucose monitoring and the Libre Flash glucose monitoring devices. I think both of them have been absolute game changers in Type 1 diabetes care. Unfortunately they’re not as affordable as they need to be for the Type 1 community. And that’s something that they’re suddenly changing to a certain extent in Australia. They are now federally subsidized for people under 21 and fingers crossed that they subsidize them for adults as well. But the visibility of blood glucose levels is something that when we work with people at the family center, the lights go on when they see the blood glucose surge that happens after they eat carbohydrate.

It’s instant. When I was diagnosed, and indeed even now, the advice, I still hear that people are told this, I was actively discouraged from testing my glucose after meals. I was told test before, so before breakfast, eat your breakfast and then don’t test again until before lunch. And of course in the meantime, my blood glucose would have gone up to 15, 17, 20—and it would come back down very nicely into range and I might be 5.6 before lunch, but meanwhile I spent three hours with my blood sugar level out of range.

What was the reasoning for that then? It doesn’t seem to make any sense—you would’ve thought you’d need to know what was going on in-between?

Well, the rationale would be it’s going to happen anyway. And if you know about it, you want to correct it with more insulin and if you correct it with more insulin and you end up in a hypo because there’s going to land in the safe range, it be all right.

That is obviously that linear equation, again, that doesn’t exist…

Well it just disregarded the three hours after every meal that I would spend outside of range. And if I didn’t know about it then I couldn’t even act on it. And at that point, the only, apart from reducing carbohydrate, I could change the time I took my insulin, take it a little earlier. So it married up with the carbohydrate curve perhaps as a mitigating strategy. But I wasn’t even given access to that information. And it took me becoming an overzealous blood glucose tester to the point where I had to have letters written by my doctor to the National Diabetes Services Scheme, justifying why I needed so many blood glucose test strips because people thought, I think they thought I was selling them on the black market or something. Because I was doing 20 tests a day cause I just needed to understand.

So CGM—now people, it’s visible. You know, we’ve got 288 glucose readings a day and it’s just sensational information. And I think that people really have the tools now to be able to act on that and change their management strategies to adapt their food and their insulin therapy due to better manage diabetes. That’s glucose monitoring technology. Obviously the insulin pumps have come a long way. I don’t use one, but I see their benefits particularly in children. Kids need that flexibility I think around being able to manage insulin and basal rates according to their very sporadic levels of activity. I think as adults we can be a little bit more structured about activity choices. Whereas kids, I think, you know, type Type 1 diabetes already feels like a straightjacket if they can run and play when they feel like running and playing and we can just drop their basal rates, I think that’s fantastic. 

The other thing I think the benefit is micro bolusing. The pumps give the ability to bolus and indeed run basal rates at much more sensitively fine-tuned doses than you can get with a syringe or a pen. There are real benefits to the pump. That said, there are also the downside. Wearable technology has mechanical issues, you know, pump fat failures, bubbles in the line. All the things that happen that come along with pumps that people need to think about as does CGM. It’s very intrusive if you’ve got a phone or a device alarming at you all the time, especially if you’re trying to run really tight thresholds, you will hear alarms often. It will interrupt your day and your sleep and your thinking. And that’s one of the pieces that I think that we don’t do very well in Type 1 diabetes care is prepare people for the psychological burden of the wearable devices. The very active wearing a piece of space junk our kids call it on our bodies and getting the questions and the curiosity from the community at large and have to explain diabetes over and over again. That can become a real drag. So there’s light and shade around technology, and I think we have to be really careful in the way we talk about it because in our diabetes community pumps are almost incentivized. I hear this thing of when we get to the pump, like when we graduate to a pump,

Yeah, this is the goal for everybody.

Yeah. And a pump is just a glorified insulin delivery device. You know, it might be snazzy, but it isn’t going to change the fact that you’re still making all the decisions. We do have closed loop technology that is just starting to be released, which was really exciting. So that means a continuous glucose monitor is talking to the pump and automatically adjusting basal rates. The person still has to think, they still have to do meal announcements in exercise announcements. So they’re actively managing those variables.

Yet the tendency is to think that it’s all just going to be automated and they can, the worry goes away because the responsibility is taken on by these interacting machines that are just going to manage it all for them.

Indeed. And that plays out both in the community at large, where people, every time there’s a big news article, Oh closed loop technology, somebody rings me up and goes, they’ve got an artificial pancreas now—your problems are all solved. And you know, that’s absolutely not the case. And then within the Type 1 community, when we see the research plays out, when you put people on pumps, their A1Cs in the first 12 months often going up because they themselves think, ah, I’m on a pump now, it’s all automated. And so, and that’s a bit of a hard reality when they realize, Whoa, actually I still have to do the inputs. I choose not to use a pump primarily because there are no pumps that are waterproof. So that’s a little bit of a struggle for me. But also because I’ve found a really great regimen with the insulins that I use and I feel like if it ain’t broke, don’t fix it.

Interestingly, I have a retro thing going on with the insulin that I use. So when I was first diagnosed, there wasn’t any rapid acting insulin. I was put onto regular human insulin, which is now considered so old school, you know, pharmacies don’t stock it. When I asked my GP for it, he looked at me like I had grown a second head. You know, why do you want this old insulin, over the years, over the time I progressed to the newer analog insulins for a period of time there. But I’ve since come back to using R, the regular insulin, in the last few years because it’s remarkable in how the time action profile and the peak of R insulin marries up with a protein glucose spike that I get. So protein spikes my glucose after four to five hours and that is exactly the time when R peaks. So, it’s really interesting that you know, we can actually look to the older insulin technology and find it useful in this new way of eating.

That is interesting. I found it interesting as well what Jake Kushner was saying about how potentially these automated systems with the insulin pump, how it potentially could work particularly well if you were eating low carb because you had, the blood glucose ranges were moving in a much tighter band.

Yes. And the increases are not as sharp. So if you’re eating a mostly protein and fat based diet, you’ll have sort of these mild peaks and that’s something that the pump can keep up with so that the pump can actually automatically adjust a basal rate rather than requiring a big bolus of insulin in order to keep up with that protein and fat curve. And I think that, I mean that is really the ultimate hands-off diabetes management. I mean, you’re not actually having to actively put meal announcements or food announcements into that pump, which is almost, I mean, I hate to say the word cure, but it’s certainly lightens that mental burden, which is one of the hardest things to bear with diabetes.

Yeah. So it feels like, instead of having to do that micromanaging throughout the day, if you more macro manage, pun intended, I guess, with your overall diet. And look at focusing on that. But that’s not having to look at the details all the time. I can see that being quite freeing. Obviously you’ve still got to carry on paying attention, but you’re managing it with more broad brush strokes and maybe this technology and equipment could take care of those finer details.

Absolutely.

It can free you up a little bit more for day to day living.

That’s the ultimate application for the closed loop system. And indeed are you familiar with the We Are Not Waiting movement?

No.

The We Are Not Waiting movement created a technology initially called Nightscout. It’s open source. It’s created by citizen scientists, mums and dads and people with Type 1 diabetes around kitchen tables around the world where they hacked continuous glucose monitors and firstly worked out a way to bounce the information to phones for remote monitoring. Awesome. Especially for parents. The next step has been the development of the open artificial pancreas system and the loop system. So these are again hacked systems where people are essentially running the closed loop type technology and have been for a number of years now well before the companies have released it. I have a friend at home, Kyle Masterman, who is a sensational athlete, low carber and he’s running an open APS and he has messaged me a number of times and says, I haven’t given myself a bolus all week.

And the system is just running in the background and managing things for him, and it’s giving him these micro boluses of insulin as he eats a big protein meal, you see the insulin start to catch up and his blood sugar level is insanely good. The thing I think the system hasn’t quite adapted to, is exercise yet, and that’s the next piece. But the idea that the food variable and the insulin variable can run in the background. That is awesome.

Yeah, I think that sending the same way when we haven’t spoken too much on that, but the tendency is just to look at food. But it sounds like looking at your activity level is hugely important.

I’ve worked out over years of experimentation than any exercise that spikes my heart rate over about one 80 beats per minute is going to raise my blood sugar level. So I actually need to take insulin in order to do high intensity interval training or spin class or anything where I’m going to do sprints. That’s so counterintuitive. I need insulin to exercise. Hang on a minute. The other thing that causes my blood sugar level to go up is glycolytic exercise, like lifting. Then the opposite effect happens if I’m doing longer, slower endurance stuff. If I’ve got the formula in my basal insulin dose right, and keeping in mind that I inject that, you know, I’ve got, I’m committed for 16 to 18 hours of a certain activity level once I do that. So sometimes it’s seven o’clock in the morning, I take a certain dose and I do a different activity than I anticipated in the evening. And sometimes you can get that wrong, but if I’ve got my basal conditions right, then my blood sugar level with endurance exercise normally stay stable.

If I’ve got it wrong, sometimes it will drop off a little. So that seems to play out as a general assumption for most people with Type 1. High intensity—blood glucose spike, low intensity—blood glucose is stable or drop. And bringing that into play is really important. , because when you’re dosing insulin, you’re not only dosing on what you’re about to eat, you’re also thinking how much activity have I done in the last three to 24 hours and how much activity do I anticipate doing probably in the next three to eight hours. And so as you say, you’re bringing in another set of variables, the duration, the time, and the intensity of activity or another few variables if you want to really drill down into it that you have to consider.

It sounds like you have to be super organized and good at planning.

Absolutely. I think that’s something that diabetes has taught me. It’s not my strong suit, but amongst a whole lot of other lessons, being a good planner. And I think almost to the extent where that too for a while it took over my life about planning and routine and I would become very anxious if my routine was interrupted and started to try and build a little bit more, I guess being able to be a little bit more relaxed about changes to the plan has been again, a more recent project.

Well, I could go on talking to you for hours. We’re being ushered and nagged by—interesting enough, the room needs to be set up for an exercise and movement session. I like to round off the podcast with a top tip, which can be anything you like, but I think maybe it would be nice to give your top advice for somebody who’s just been diagnosed with Type 1.

Connect with community. Clinicians took me some of the way—the community took me the rest of the way. If you have access through online groups or face to face support, other people who are walking a mile in your shoes, the information exchange, the support and understanding that you will get is the key to not only understanding diabetes well, but making peace with diabetes. And I feel that that community is transformative. It’s absolutely essential.

Well, thank you so much. It’s been a great pleasure for me and really interesting. I’ve been fortunate enough to be able to interview a few of you who have Type 1 or involved with Type 1 and it’s been very interesting and an education for me and hopefully will be for the listeners as well. So thank you so much. It’s been a great pleasure.

Thanks for taking an interest in people with Type 1. It’s important to us and thank you to all your listeners for being interested also.

This transcript is brought to you thanks to the hard work of Michelle Richter.

Welcome to a very special edition of Keto women podcast. I have here with me today not one guest but three. Ash.

(Ashlee) Hi

Tracey and Jody, welcome to the keto women podcast. How are you all doing today?

(Tracey) Very well. Thank you.

(Dr Jody) Wonderful to be here. Nice to meet you.

(Ashlee) I’m feeling awesome.

And Ash is my youngest ever extraordinary woman on the podcast. So, we’re here really to talk mostly about you. So let’s hear from you, tell me a bit about you, your story.

(Ashlee) Well my name is Ashlee. I am a type one diabetic and I have been for two and a half years. I am eating keto, which is low carb. We started a bit before I was diagnosed except it wasn’t completely keto. A few meals we had every now and then were keto, but we really started doing the real low carb one month after I was diagnosed.

And you enjoy eating this way?

(Ashlee) Yes, because we can have alternatives for different foods and meals and yeah,

I just had a squizz at the contents of your fridge and you got quite a few tasty looking things in there.

(Ashlee) Yes, they are very yummy. 

So let’s hear a bit from Mum and just elaborate a bit on the story and you know how it all came about. Must have been very worrying for you, the diagnosis and the treatment and what’s been happening.

Well Ash was diagnosed on the 25th of August, 2016. She was sick leading up to it. She actually was sick. She had chicken pox about maybe two months before that. Um, she seemed to have got better from that, and then a couple of weeks before that she was sort of just was a bit lethargic, not feeling very well. So, I packed the kids up and went up to Queensland, which is nice and sunny and I thought we’ve just got to get away from this cold winter. We went away, everything was fine.

When we came back I started to notice little differences and I thought they were girly hormones cos we just cry over something or we’d do something. Never in my wildest dreams would I have thought that this was signs of type one diabetes. But looking back now, there were signs, it came to a couple of days, It was about a Thursday. She had um, a year seven orientation. She was fine, she was happy, she was great. By Saturday morning she was starting to not feel great and I thought we’ve just had a big week, have a sleep. She slept all day again Sunday. By Monday she was, “Mum, I’m not really well” and I thought  something’s not right here. Like you’re never really this sick. So I booked a doctor’s appointment for Wednesday cause that’s all I could get in. Never thinking we should rush this.

By Tuesday afternoon she wasn’t crash hot. She wasn’t really talking to me. I’d have to say her name very clearly like “Ashlee“, and she’d wake up and she’d look at me and fortunate enough, my husband is in army reserves. He came home that night on the Wednesday night, thank goodness. And we would just sort of sitting, chatting in bed about what he’d been up to and she got up to go to the bathroom and she missed the bathroom because this is a sign of, ‘cos you drink so much water when you’re in the state of being diagnosed with type one. And she missed the bathroom ‘cos she was unaware, also too ‘cos her bloods were probably sky high. 

By Thursday morning when we woke up, her breathing was odd. I cannot explain to you what it was like to listen to her breathing. Um, her eyes were rolling in the back of her head when I was speaking to her. So, my first thoughts were going through like, she’s got meningococcal meningitis, diabetes, just never, we didn’t know anyone with diabetes. Um, I had never come across, we don’t even have type two diagnosed at that stage in our family. We rushed her up to the GP because we’d had that appointment, thank goodness that I made. However, he had no idea what he was looking at when we got there. And he said, “I think you need to go to the hospital.” And I said, “Well, if you don’t know, we need to go find somebody that does”. Annd off we went to the hospital driving.

I kept saying her name to her as we were in the car ‘cos I was so scared because she’s sort of passing in and out. Um, we got to the hospital and it was just very thankful that the nurse behind the counter knew what she was looking at and she goes, is she a diabetic? And I went, I don’t know. She yelled out she needed a glucometer and it came quickly. She pricked her and the next minute there was a bed. Ashlee’s thrown on a bed and she’s being rushed up the whole way. Pete’s grabbed the other two kids. Lucky he’s like six foot five and he’s got these kids under his arm and we’re just running after Ashlee, and I was sitting in this room with about 12, nine to 12 doctors and nurses.

She had tubes coming out of everywhere. Machines were beeping and buzzing tests were going on and I had no idea what was happening, people going she’s a diabetic, and I went, what does that mean? The only thing I knew about diabetes was amputation of limbs. So of course. So then I started panicking and then after that she got much better cause we had insulin and things like that. And, and then I had a dietician come around and talk to me about the fact that I’m, now that Ashley has insulin and we know this beautiful thing that she was hiding from us. “She has diabetes and now she’s got it, she’s got insulin, everything’s gonna be fine because she can eat whatever she wants, she can even have Mcdonald’s”.

Oh, okay. And I stood there and thought, this is odd, Mcdonald’s? She’s the sickest child I have but now you’re telling me I can have Mcdonald’s. So, things like juice, jelly beans, chips, all this carbohydrate foods started coming home because, well, one, I was told I needed it. And so you’re very, uh, you’re taught so much about Hypos, um, hypoglycemia events that you stress out about the thought of saying the word. So, I had, you know, massive jars of jelly beans ready for these horrible events. Children doing meltdowns on the floor because well if Ashlee gets one, we want one. And I, I was losing my mind because here is a mother trying to give nutrition to my children, having a type one diabetic and needing apparently needing these foods.

So eventually, after a horrible event where Ashlee’s glucose levels just dropped one night, I decided I needed to go on a, I needed to go back to my roots, which was food. And we started low carb, which was really good. Um, we were doing really well until her HBA1 C’s started going up and I thought, well, this is what, what’s, what’s going on here? What am I doing wrong? I’ve changed the food. Then I worked out after elimination and things that we don’t actually know what insulin is. What is insulin? What does it do in the body? What does she need it for? And so many times I’ve been bullied by endocrinologists, laughed at by doctors, nurses, because why bother teaching me? I’m just a mom. You should just listen and do as you’re told. I’m not that kind of person. This is my baby here. I need to know what’s going on.

For months and up to a year. I had no help, nothing until my wonderful dad, bless him, he watches all his, I call them his Keto gods, but he has these beautiful people that he watches and he’s learnt so much for himself. He watched an episode with Mike Mutzel who runs high intensity health and it was on this wonderful type one diabetic specialist that he met, I think in his father’s town, and  He did an interview with her, my dad, myself, and Ashlee because dad had come down for Christmas. We sat on the couch and we just think I had tears and I think my eyes almost popped out of my head and Ashlee just sat there and she goes, “I want to talk to her”. And I went, “Okay, let’s make this happen”.

I got straight on my phone, I booked in an appointment, a 20 minute get to know you session. And from then on, it’s just been onwards and upwards because I met this fantastic, beautiful women Dr Jody, who’s just taught me, I mean, our first session was on the importance of Basal Insulin. My knees went weak. I just, I’m sitting there, I’m looking at my husband, I’m going, Oh my God, Oh my God, we’re talking about insulin. I need to know this. And I was there with my pen and paper like I was, you know, ready to go into university. I’m studying and I, I still remember our first session together. It just gave me so much hope, but someone was teaching me, someone was finally teaching me what my daughter was diagnosed, and I had this feeling of I can actually be her Mum again for a whole year, I felt completely lost that I couldn’t be her Mum, but she was given to me. How can that be? How can I be given this beautiful child who’s now going through this horrible thing, but I can’t be a Mum. So that’s where we are and we’ve now 18 months or almost 18 months, and we’re just, we’re all thriving. I’m a Mum of four children now to a type one diabetic to the other three and we’re just, we’re bopping along. She’s got an HBA1C now 5.4. And I’m really proud of her. She’s amazing.

Well that’s fantastic. There was something I just wanted to ask you about, just to go back a little bit, when you said going back to your roots and the food and that’s what you know about and the low carb so this is something that you’d been involved with before, you know, how did you know to go to that? What led you there?

When I was about 13/14, I became anorexic. I was obsessed with food and wanting to be really healthy. I was into sport and I went down a very dark path with food, um, more so it was just, I wasn’t eating enough. And after I was diagnosed, my father said to me, that’s it, you’re not swimming. And that was my life. Swimming was my absolute life. And I thought, well, I’ve got to get myself better. How am I gonna get better? I’ve got to work out a relationship here with food. So, I turned those horrible thoughts into a passion and that’s where I’ve just myself have been learning what fuels me, what fuels my body. And I’ve done that for years and years and years. When I was 18 I was in a very stressful household. My mother was very stressful. Um, I ended up getting sinus infection after a sinus infection and I then started researching and looking into natural medicine things.

And so I combined my love of food and natural medicine and I’ve just sort of always criss-crossed those paths on my own. Just reading. I mean YouTube is an absolute blessing. I love listening to podcasts, watching YouTube videos because I can learn on my own accord. But six months before Ashley was diagnosed, my father started watching sugar videos, things about sugar and then he put two and two together and you know, oh my goodness, carbs are sugar. And we, so we sat down together and worked out some recipes. I love to cook. I’ve always loved to cook since I was about seven, the kitchen and I were just best mates. And so, he called me and said, “Let’s work out some recipes”. So, I started dabbling into what low carb foods was, what it meant, meals. And so  I thought this is great, I can incorporate it into our family. And so, I started learning about low carb through more of a metabolic syndrome type two diabetic approach.

But I just knew that night when I was really upset and I knew I went back to my roots, I knew I needed to go back to food because food has always been that really important part of me, I’ve always understood that.

Yeah, really interesting. And so, to go now to the woman who, it sounds like, has had a major influence on your life. And I can see now listening to you talking about the way you like to learn and really drive your own knowledge and how that influences your life and I can see how it really appealed to you to, to reach out to somebody like this. And I think we’re going to have to have you back on a podcast, a separate podcast just of your own to hear your story ‘cos I bet that’s going to be an interesting one. But for now, to just talk about your involvement with this family and the different things that go on it at a lot of people. And we’re here at the conference and it’s type two diabetes predominantly that that gets talked about and type one gets sort of left in the corner a little bit, although coming much more up to the forefront. You know, I’ve been talking about it with people like Jess Turton, there’s a lot more, research and an understanding about it in the low carb community isn’t there? So, perhaps we could hear from you now then Jody.

Absolutely. So, I’ll just say my name again. My name is Dr Jody Stanislaw and I was diagnosed with diabetes in 1980 so almost 40 years, which is surreal cause I don’t even feel 40,  and I knew the only diabetic I knew was at summer camp because there was no internet, there was no, I mean there was no connection with any other type ones. So, um, it can be very lonely. And once I became a teen, I started asking my doctor a lot of more challenging questions and I’ll never forget the day that when I asked my doctor about blood sugar level with exercise, he just patted me on the knee and said, oh, it’s too difficult for me to explain it to you, you would never understand. And I’m quite certain that he actually didn’t know the answer.

And that’s what I’ve realised is that the majority, hands down of family practice docs or just general medicine docs absolutely are not skilled to truly give a type one the care they need. But the sad thing is, is I’ve also found that many endocrinologists who are supposed to be the experts and diabetes, um, many endocrinologists are also not adequately trained. And I just truly think that the training is not out there. I mean, I’ve been asked, you know, what textbook for type one did you use in med school and I was like, oh, there’s, there’s not a textbook. Everything I’ve learned is really from my own experimentation.

There are a few other type one medical professionals that have written books and they’re just catered not to med schools, they’re catered to patients. So, all of us type ones, we have that bond, where as soon as, even if I see, you know, somebody wearing an insulin pump or a CGM in public, suddenly I’m like, Hey, hey, hey, you know. So, there’s this a really deep bond. And I, um, I learned so many incredible valuable things about how to get better blood sugar level just from my own experimentation over 20, 30 years that I, I went to med school and I also am a very adventurous person. So, I didn’t want to be in a classic, you know, standard hospital job. So, I created an online virtual practice. I have patients in 10 countries and all over the U.S. and I’m so lucky that Tracey and Ashlee found my video. It’s truly a miracle. I mean, I was a little teary when you were telling the story because this is my job to help change lives and help improve lives. And it’s so needed. And we, you know, after a year of being on Skype together, we just met face to face today for the first time ever.

That must’ve been quite an incredible experience. I mean, I met you two. Ash and Tracey, and you are so excited Ash, weren’t you, waiting, waiting to meet this woman. I remember seeing you in your face and you just, you just kept looking, looking at the door, looking at the door. She come yet, is she here, is she here? Uh, yeah. It must’ve, it must’ve been quite something to all get together. I’ve experienced that. We’re talking to people online, but the actual, when you, when you get to meet them, when they’re there in front of you, it’s something else, isn’t it? 

Yeah, very special. So, I feel very fortunate that I get to help people like Tracey and Ashlee and my big passion now is to really help millions or I don’t know how many type ones are online. There’s, I mean there’s only, they say maybe 10 million in the U S or I’m, I mean in the world in the U S it’s anywhere from one to 2 million. Sometimes I hear 3 million, but people don’t really know. The reality is hands down, the education for type one is very poor and standard conventional recommendation is eat as many carbs as you want and take more insulin and this is devastating.

This is absolutely, it creates such poor health for the children it’s very dangerous because they have to give such high doses of insulin that then you can’t necessarily know exactly how much and when you need the insulin, you’re always guessing when you give a shot and if you give too much insulin you can go into a coma and die, you know, and then the high blood sugar levels are creating blindness, heart disease, kidney failure, strokes, gangrene, Alzheimer’s Moodiness. If a child’s blood sugar level is high, they have recognised that you can be excused from taking an exam because the brain doesn’t work. So here they are saying eat as many things as you want and take as much insulin as you want. But the reality is they’re at risk for dying from a low and slow death from highs.

Now I understand why they say that though because before that it was an incredibly strict diet. I weighed and measured every bite of food I ate my entire childhood and so eating disorders are much higher risk of eating disorders when you have type one and so they are justification for why they say, oh, you want to eat like all the rest of the kids is to avoid that. But it’s still, you know, it’s just the pendulum has swung from strict to nothing and neither extreme is good.

Perhaps you could explain exactly how it works and how the whole system works with dealing about your food intake and judging how much insulin you need to inject and when and how the whole system works.

Well, I normally work with people for three months to answer that question, but the conventional doctors will say, count your carbs and for every one unit or for every approximately 15 grams of carb you eat, you need one unit and 99% of type ones, that’s the full education that they get. So, if you eat 30 carbs, you need two units, 45 carbs, three units, like that. That’s it. But the reality is you also need a background dose of insulin.

That’s the first thing that I worked with Tracey with on day one, because your liver is actually putting glucose into your body all day long. So you actually need, I did a seven day water fast once and I still had to take insulin because you absolutely have to have insulin to be alive and your liver is actually feeding your glucose. Insulin, I like to say is the pickup truck for glucose, once you eat, the glucose is absorbed into your bloodstream and then insulin is needed to pick up that glucose and feed it to yourselves, right? So without insulin, the glucose stays in the bloodstream, which is not good, and your cells starve, which is not good.

The first thing I work with patients is just figure out their baseline need, which is to counteract the livers glucose. So we haven’t even talked about dosing for food yet. You have to figure out that first. Then we’re going to look at, there’s many aspects to how to dose a meal. Carbohydrate is one of them, but if you’re going to have a banana versus black beans, it could be the same amount of carbs, but you’re going to have to change the timing, right? Because what’s a banana gonna do? Immediate Spike. A black bean, not immediate spike. So you have to think about glycaemic index.

Then if you’re just eating protein, protein itself actually can raise blood sugar. So many patients think they can just have, you know, all this protein and they don’t have to worry about it. They have one little piece of bread and they think, oh, I only need one unit because I only had 15 grams from the bread, but protein actually can turn into glucose, so I have to teach patients how to dose for protein, which is very different than dosing for Carb, and then actually fat can have an effect on glucose as well. So that is just food.

The size of your meal also is dependent on your dose because the timing, right? You could have this many carbs, but if you have this huge holiday meal, it’s going to be digesting for hours, so you’re going to have to spread out your dose over hours, right? So that’s just food. Stress raises blood sugar, getting sick raises blood sugar, hormonal swings  raise blood sugar. Then there’s just life. Insulin can go bad, it can get too hot and then people are dosing. Then they go high and they don’t know why. Well, your insulin was in the sun, right? Absorption when people dose a really big amount, if they’re eating a lot of carbs, absorption from day to day can vary, especially the bigger dose of insulin you given any one time, the less consistent the absorption.

So these are all the fine tuning details that I teach patients that truly I don’t see, yeah, it’s life changing because all we’re told is dose one unit for 15 grams of carb. And if you go, low eat sugar,

It sounds mind-blowingly complicated. I have to say, I’m feeling overwhelmed and stressed as listening to the thought of, you know, the thought process I’m going through and I’m just, you know, with everything you’re saying, I can just see potential issues with all of it. You know, I talk to people about not completely trusting labels and they’re you know, they’re always going to be an average of the contents. I always cite the packs of Bacon that I buy, you know, and it lists how much protein and how much fat is in there. Well that’s an average. I always pick the ones that’s got a load of fat on it and leave the ones that are really lean. But you can’t tell me, the macros are the same. The macros that are written on the nutritional information on that pack well they can’t possibly be the same. And uh, you know, and that’s the same for everything, isn’t it? So you know, what size is your banana? And it can vary, an apple can be different sweetnesses, and when it’s off season, I mean..

Exactly. 

So presumably it’s only going to be a sort of a guesstimate at best.

Every time and this exactly is where low carb comes in. So the biggest driver of high blood sugar is carbs. So you can see this whole array of conditions and variables that we have to manage every day that if you just reduce your carbs, your job’s going to be a lot easier. It’s still a lot of work and I still go up and down, but my life is so much easier. If I’m going to have a chicken salad, I’m like probably need a unit. I might need another unit later. If I have pasta and bread, I’m like, Oh Gosh, do I need 10 units now? And then I wonder if though, what if they all hit at once and then I go low. So, but then if what if I go high later, well then, if I have a high carb meal, I will only have it at lunch because there’s so many variables for hours after you eat carbs that you have to be on your toes to manage. Are you going to go low, are you going to go high? If you go low you have to eat more sugar. If you go high, you need more insulin. Dinner is always, if there’s ever, I allow myself treats every now and then and I try to always have him at lunch because I don’t have to worry. But yeah, low carb, it just makes sense. And this is not conventional medicine.

Well that’s the thing, logically to me it absolutely makes sense. Just thinking about those highs and lows, that anything you eat is going to cause a rise of some kind instead of having those, you know, nice rolling hills, you know, you have these huge great mountains spikes that and I can see how very difficult it would be to treat those because as we were just saying is it’s really difficult to get the right dose and whenever you go up high you’re gonna come down really low. So, so tricky. Logically it just seems the perfect way to eat.

Diabetes camps, summer camps for kids. They completely embrace, eat whatever you want. I’ve been to diabetes. I mean I’m on staff diabetes camps cause it’s, it is such a huge life changer but unfortunately now I have to kind of, you know hesitate before I recommend them because all my families are low carb. Right. And then they send their kid to diabetes camp and they serve them every carb you can imagine.

I was going to say with the, the swings, the blood swings, they, it’s not only, you know what like for a parent having to watch those blood swings and correct them and change them and do it, it also does mentally challenge and physically challenge your body. Ashlee if going into lows, t’s so draining, it’s exhausting. And even the highs, the body goes into stress mode as you’ve taught us. After you go into like once you pass blood glucose level 10 the body starts going into this mode where it’s going to pee out the calories because it wants to get rid of that sugar that’s now in the system. That sends, the body doing things that it’s got to, quick, we’ve got to get rid of this, we’ve got to get rid of this.

And those highs and lows, those swings, it’s not just the bloods that you worry about, it’s mentally too because they, you know, she feels low, she can’t go and play, she can’t, and then when she’s high, she’s still can’t go play. She can’t go swimming, she can’t concentrate and she gets frustrated with herself. So it really upsets me when I see these bloods because I know from a mum side of things what those little children are going through or anybody with type one, watching them go from a high to a low to a high..

And that is the majority of type ones. That’s how they live their life. 

Very tricky. And what about you Ash? How have you adjusted to this complete life change and it must have been a massively steep learning curve. 

(Ashlee) Mm yeah sort of.

Sounds like you’re the kind of person that really just takes it in your stride. 

(Ashlee) I kind of just go with the flow, you know.

Yeah, she’s got a good Mumma, helps her out. 

(Ashlee) Yes. Mum does a lot of work. She tells me when to do insulin and how much I need most of the time at school and whenever I’m home alone or something like that, I normally do it myself. But whenever Mum is near me or around me, she will tell me what to do. 

That’s so great. 

So specifically what was your involvement with these guys? Just educating them a better way to be doing it.

Exactly. Yeah, so I work virtually, so anybody listening they can find me at website and sign up for a free call. In the free call I assess are we a good fit? And then, um, I do series of Skype or phone calls. So I do a minimum of three hours with patients. So that could be three one hour calls or six 30 minute calls. I think we did six one hour calls or something like.

Yeah, we did fortnightly one hour sessions.

One hour every two weeks. Yeah. I always encourage people to really invest in a minimum of three months of working with me because in the past I would give as much as I could in an hour and nothing, it was too overwhelming. Nobody, then we’d have our second appointment and it’s like I just said everything again in appointment number two. So, I’ve actually changed it to 30 minute calls for majority of people now and I spread them out over three months. There’s so much to digest.

And you need to adapt and practice what you’ve learned, then come back and probably reinforcing those lessons, but then gradually learning new things as you go.

Absolutely. And, as a holistic physician, I am not only interested in how their blood sugar level is doing and that they totally understand insulin. I want to know how you’re feeling and you know, how are your bowel movements and what supplements are you on and what are you eating? And are you exercising? I mean, I truly, I’m a holistic physician, which means I want to take care of the whole of you.

I became the kind of physician I was wished I found, which I still have never found. I want somebody that takes care of all of me and asks me how I’m doing. Maybe have an appointment where we don’t even talk about blood sugars. We just talk about, oh my gosh, this is a lot. It’s overwhelming. I know. You know, and it’s so beautiful that I have type one because I have that immediate bond with my patients. There’s a lot to work on. 

That’s what I loved about Jody so much is that she could connect with me, talk to me about everything, but she also could connect with Ashlee, which is something I can’t do. There’s this little small part. I’ll never, I’m not a type one diabetic, and it was so nice to have someone that I trusted to be able to be there for my daughter. And the best thing, I still remember clearly, I think it was about session three we were cold, which is not cold to doctor Jody because she’s has snow, we don’t in Canberra, so were all rugged up in our blankets and Ash was just sort of sitting there and the last 15 minutes of our session, it was all about, Jody just brought it into Ashlee, “How are you feeling? How’s school?” We were talking about some stress levels at school. It wasn’t really anything to do with diabetes, but Jody made it all about Ash, which was just perfect because that’s what it needs to be.

I mean I need to learn. I really do. I’m the mum. But Jody remembers that Ashlee’s the one with type one. Ashlee is the one dealing with this day in, day out, you know I can go and have a shower and forget about it for five, 10 minutes. These two can’t. It’s always there and that was what was really special for me is that Ashlee has someone she can turn to that I trust that can help her with any stage of her life.

Sounds like a really important resource you offer. 

Thank you. 

We were talking a little bit before we started recording. Can we talk about that then? This new Facebook group and the potential that has to reach so many more people.

Right. 

Cause obviously you deal with people as you’ve explained, working one on one, but the power of the Internet is often to be able to extend that reach massively. So perhaps you could tell us a bit about that ‘cos it sounds really exciting.

I’m very excited and it is, I’m so passionate about helping people really, you know, have the transition and the transformation that Ashlee and Tracey have in just a year or two. I’ve had patients that have had this transformation as well, but they had diabetes for 40 years and it took them 40 years to find me. So, year after year of just hearing how much my work has changed lives, I was like, I need to reach the masses. So I’ve spent actually the last two years recording videos and making handouts, and then I had to re-record all the videos and then I made some new handouts and I’ve put my heart and soul into these online courses and they’re actually available now on my website.

Which is?

It’s Dr Jody ND [drjodynd.com] – so that’s d r j o d y n as in naturopathic and then d as in doctor. There is a membership tab there. All the courses are there. I have a course on getting off the blood sugar roller coaster, what to eat and how to dose mastering your blood sugar level with exercise, how to stay positive and avoid burnout because that’s a whole other topic when it’s just like too much and people give up. The three essentials of lowering your a1c, I do group calls. Um, I also have an annual retreat in Sun Valley, Idaho.

But yeah, the Facebook thing is going to be launching in I think it’s March 14th, which is like in a week and it’s basically a monthly subscription for $20 a month and you get access to all of my courses. There’s two live calls a month and I do a weekly live video and I can’t give you details to where to go because the page doesn’t exist yet. But if you go to my website.

Presumably yeah, though there will be updates on your website. 

Yeah. Well if you just go Jody A Stanislaw on Facebook, that’s my Facebook page and then drjodynd.com is my website, so you can definitely find me in those two places already.

And then presumably with this Facebook group you’re going to be building a community. 

Yes

That’s the beauty of it, I mean that’s what I love about coming to conferences like this is the community and making that connection and obviously you’re going to be there to help and teach people, but there’ll be that comradery and the community where the people can help each other as well. 

Exactly and I’m sure Ash and Trace feel like, I mean I feel like I’ve already known them for a year ‘cos I have known them for a year. Although we just physically met today, it certainly doesn’t feel like we just met today. You know, that’s the beauty of the Internet. And so that would be my goal. My goal is to have a thousand people in that membership program within the next three months and then 2000 and I mean given the millions of type ones. My goal is that it’s that easy.

A million by the end of the year. 

Yeah, that’s it, right. 

That’s your challenge! 

Right? I’ll take it. I dream big so,

Well, it’s been really wonderful talking to you three, my first ever four-way podcast 

Okay. 

And my youngest ever extraordinary woman

14. I don’t think we ever said her age.

(Ashlee) Yeah, I’m 14. I was born December 31st, 2004

I’m a December baby too. Well I traditionally wrap up the podcast with a top tip. So as I’ve got three of you, maybe I can get three top tips. Who wants to go first? So a tip for the listeners, it can be anything you like. 

If you know anybody with type one please have them reach out to me

As a parent of a type one, don’t be afraid to keep asking questions and keep learning. Just because you’re a parent, just because you may not be a doctor or a specialist, that doesn’t mean that you can’t learn.

Tracey, you know more than most endocrinologists now

As a teenager and a type one, what would your top tip be? Think of it this way. What would your top tip be to fellow teens who had just had a similar diagnosis?

(Ashlee) Try Low carb. Low carb is the best. It’s healthy, that one. And also ,for type one diabetics, it’s easier to manage bloods.

So yeah, just like we were saying earlier, it actually just makes your life easier.

It makes sense.

And it tastes so good.

It’s much easier for Ashlee when she’s at school because she’s by herself. She’s dealing with things, you know, going in and out of class. She doesn’t have to add up these copious amounts of carbs. She just actually, most of the time at school, she just, what we call like sugar surfing. She just eats morning tea and lunch and then she just watches her CGM. I mean with, thank God for CGM’s.

Continuous Glucose Monitor

She just watches her glucose monitor and she just doses accordingly as she needs to throughout the day and it makes her life. She can just be a teenager and bop along as her bloods are bopping along.

Well. Fantastic. Thank you all very much. It’s been a great pleasure and wonderful to be sat here with you all, not just across the computer screen which is what I usually do so, thank you very much. 

Thank you. 

(Ashlee) Thank you.

Thank you.

This transcript is brought to you thanks to the hard work of Trish Roberts.

Welcome Jennifer to the Keto Woman podcast. How are you doing today?

I’m doing really great, Daisy. I’m so happy to be here talking to you today.

Oh, it’s nice to be talking to you too. Why don’t you tell us a bit about yourself and your journey?

I think I had a fairly regular childhood. I kind of like to start with that. I was a fairly…I’m using quotation marks, although you can’t see that…normal weight up until I was about six years old. I have a picture from when I was in kindergarten and I looked like I was at a…again, quotation marks…normal weight. And then after that I started getting a little bit chunkier. I like to say I was a chubby child, an overweight teenager that grew into an obese adult. And just as I went from high school, I was overweight. I wasn’t terribly overweight, but I was probably about 15 or 20 pounds overweight. And when you’re a teenager you really… it could be a hundred pounds. It feels the same even though it really isn’t. Since I got older and I had the full-time job and started having the children and you’re just kind of gradually gaining weight over time.

I ended up being about 300 pounds and that was just before the birth of my last child. I was 300 pounds. And even after I had my baby, I still only lost about 30 pounds. So I was about 270 pounds. I’m only five foot two. So, I felt that I looked pretty awful and I wasn’t feeling very healthy and I had looked into weight loss surgery because I felt like I had tried everything and just really gotten nowhere. At the time, here where I live in Ontario, Canada, they did not offer any kind of weight loss surgery, that wasn’t paid for by the government and otherwise you had to pay for it out of pocket. And it probably runs like $10,000 or $15,000. If you qualified, you could go and have it done in the United States and they would pay for it. But again, it was a huge process and I was a bit worried about going to another country to have surgery. So after a couple of years they did end up offering surgery here. They really made a very big program into it and quite a process because they recognized that short term it was less expensive for the government to pay for a surgery, than for me to develop diabetes and heart disease and have to have acute care somewhere along the road.

Where were you with all that? Did you have, you know, any health issues, apart from the obesity obviously, but usually there are other things that go with it or was it actually just like I had… really, I actually was fairly healthy from a metabolic and blood work point of view, but it was the practicalities of it that I found very difficult. And I wanted to ask you just going back a little bit, how you found both your pregnancy and then the stresses and strains of dealing with a young child when you were that size. Because, snap, as far as the weight was concerned, that was the weight I was. I’m a little bit taller than you and I know how limiting it was for me and how hard work it made, everything. So I can only imagine how it must have been for you with a baby.

When I was at 300 pounds towards the end of my pregnancy, it was quite awful. I was swollen everywhere. I could barely stand. I could barely walk. I had to leave work about two months early just because there’s no way I could cope. And then after I had the baby, I was still fairly limited in what I could do because I had no strength. But I bounced back pretty quickly, because up until then I’d been a fairly healthy person. I hadn’t had any major health issues other than being overweight. And I think that’s where a lot of people are, that they don’t have a lot of issues and people are almost fatter younger because of the obesity epidemic. I think when I was in my twenties and thirties there really wasn’t that many obese people and now…or at least it didn’t seem like it anyways…and now it’s much more common to see people in their twenties and thirties that are morbidly obese.

And so I think that having a lot of healthy, overweight people – and that it’s a good idea from a government perspective to try and get a handle on costs – to look at trying to help these people that are otherwise healthy before they start developing other issues. And I think I was very lucky that way, that I hadn’t developed any blood pressure or diabetes or heart disease or anything like that. I think I was quite lucky that way. But otherwise, I’d always been fairly healthy. I was strong. I went to the gym quite a lot. I had a physically demanding job, so that way it was, it worked out well for me that, going into the surgery, that was my only issue, was being obese.

So as far as the process went, because it sounds a bit like a similar process to here in France and I know in the UK…I’m not so familiar with the States, but again, I should imagine somewhat similar. It’s a process in differing lengths that you have to go through and you have to tick certain boxes to be eligible for that surgery. Unless of course you’re paying out of pocket and then you can do what you like. But if you’re reliant on some assistance from the government, there’s this process that you have to go through. Did you have any issues with ticking all the boxes or did it just purely come down to you’re a certain weight and so that automatically puts you through? Which was pretty well the case for me actually…I went in and he had his sort of dial that he worked out my BMI and he said, right, this is the surgery for you. And it was literally just because you’re overweight.

That was pretty much the situation for me as well. Here in Ontario, they have what they call a bariatric registry. So you go to your family doctor, you tell them you’re interested in having this surgery, they refer you to this bariatric registry, which then refers you to whatever the closest hospital is in your area that does the surgery, their clinic contacts you, and then you start a series of appointments. You see a social worker. You see a nurse. You see a nutritionist. You see a resident. You meet the surgeon. And this is usually over the course of several months. You have to have an ECG. You have a gastroscopy. You have an abdominal ultrasound so you go through all of this preparation work. Oh, you may or may not have a sleep study to see if you have undiagnosed sleep apnea. You answer a lot of questionnaires. You do blood work.

So it’s quite a process because they want to make sure that you’re relatively healthy going into it. Yes, you do have to have a certain amount of weight on you. From my experience and from what I’ve heard from other people, they go by the BMI, which isn’t the greatest indicator, but that’s generally what their guidelines are and have other co-morbidities. So I mean there’s always the potential to develop diabetes and obviously high blood pressure, heart issues when you’re carrying excess weight. So you’ve pretty much got those co-morbidities down to begin with if you’re morbidly obese. So the process can take anywhere from about nine months to a year to get through all of this.

It’s a lengthy barrage of tests isn’t it? I had the same here put together a dossier of various appointments.

Yes, that’s right. Yeah. I do wish though that in hindsight, I wish that they had done a little bit more emphasis on the social work, mental, emotional aspect of it because I think that that would have been a really big indicator going forward, how I would have managed after the surgery. I don’t know that I ever would’ve been able to manage losing weight without the surgery, but I think that I could have maximized my abilities afterwards if I knew a little bit more about myself as a person and why I had gained the weight to begin with. Because I don’t think people just gain weight in a void. Most people gain weight for a reason. And if I’d been able to understand that going in, I think I would have done much better after. As it was, I struggled for several years with losing weight.

I lost probably about 70 lbs right off the bat, which was great. It put me under 200 pounds, but then I kind of yo-yoed with about 20 pounds here and there, kind of getting down to about 175 at one point. And then I was up to about 220, so I kind of yo-yoed back and forth. And then I had sort of settled around 200 and I just wasn’t able to lose any more. And then I had actually gone back to the bariatric clinic to ask for a revision. I had the vertical sleeve gastrectomy, which is a surgery where they basically leave your digestive system intact. They just cut away the bottom part of your stomach, which is the biggest part. Your stomach is shaped like a banana – essentially how they leave it. And I had gone and asked if I could have a revision to a surgery called a bypass – they do a lot of moving things around and making your stomach into teeny tiny pouch about the size of a golf ball or a tennis ball. And it’s so that you cannot absorb a lot of your nutrients that you’re taking in and that’s how you lose weight.

Yeah, because they bypass part of the digestive tract…part of the intestine is bypassed. That’s literally how it gets its name, isn’t it?

That’s right. Yeah.

You’re not absorbing everything. Just to go back a little bit, two questions. By the sounds of it, they offer different operations. So presumably when you went in, were you given any kind of choice with the operation you had, or were you told the operation that they thought was appropriate for you? What was that initial choice of operation process? If there was any.

What they do here is they generally do the bypass as kind of the gold standard, because that’s the surgery that they really have the most studies on, and long-term data to understand that it’s the one that’s the most successful for most people. The other surgery, the vertical sleeve gastrectomy, is being done a little bit less. It’s a little less invasive and takes a little less time and there are a little less complications with it. And that was the surgery that I was interested in, but understanding that they would probably want to do the bypass, I actually wrote a letter to my surgeon asking him about getting the sleeve. Because I have migraines and I have to be able to take Ibuprofen, and when you have the bypass they discourage you from taking Ibuprofen because long-term use of Ibuprofen, you have the potential to develop ulcers.

And when you’ve got a bypass, getting an ulcer is a bad thing. Especially if you get it in the portion of the stomach that’s been, effectively, sutured off or stitched off. So if I got an ulcer in that spot, they would never be able to see it on an endoscopy if they were checking to see what was going on. Why was I having all of this pain? So that’s why they discourage using Ibuprofen. But with my migraines, that’s the only thing that I could take that was effective for me. I tried with other medications. I couldn’t find anything really that worked as well as Ibuprofen. So I asked him if I could have the sleeve just so I could be able to manage my migraines and he was agreeable to that. And that’s why I got the sleeve. I think they’re doing the sleeve a little bit more now than what they used to.

Maybe because they find that people are having good results with it, or that there’s less complications. I’m not really sure, but it seems to be about half and half – the people that I am in contact with that have had surgery. Some of the people are getting bypass and some are getting sleeve. So it seems to depend on the surgeon when they get in there. Sometimes if the person’s had other surgeries before, they have a lot of adhesions and scarring and things like that, so they prefer to do the sleeve as opposed to doing the bypass, which is a little bit more intensive.

And what advice were you given? Well globally, but for what you should be eating post-op?

The nutritionist at the bariatric clinic that I go to, they advocate a moderate diet in all food groups. Now Canada has this wonderful Canada’s food guide and they advocate a certain number of servings of this and a certain number of servings of that. And that’s kind of what they have to go by because they are a government funded clinic. So they kind of have to follow whatever the government guidelines are, which at this time advocate eating from all the food groups. So they want you to have a certain number of calories. They know right after surgery, you’re not going to be able to eat much. So they advocate getting your protein in, but as the weeks go on, you’re supposed to increase your diet and have a certain amount of carbohydrates, a certain number of fats, a certain amount of protein, protein first always, but they’re still advocating that you should be able to eat moderately from all food groups. And that was difficult for me. So, I just did not get on well after the surgery. I lost a bit. I mean, you’re going to, because for the first few weeks you really just can’t eat, so you’re going to lose weight. So I lost about 70 pounds fairly quickly. But after that, I really struggled because I just could not maintain that moderate diet that the clinic was advocating.

So from a macros point of view, you would see if you were to look at a graph, say, that the protein percentage would be probably the highest macro to start with because of the quantity you can eat. So because of the “protein first” mantra, you’re having to take up most of the available space – most of what you physically can eat in a day. If you’re going to eat your protein first, you’re going to quite often find that there’s not much else you can eat after that. And is this something they were really strict about enforcing because I know it’s something that I came across a lot that they hammered home that all things in moderation – actually from the get go I was given in hospital…bearing in mind, I was in hospital for quite a long time. They had me in for eight days in total.

I nearly went rather bland. Most of that was post-op. I was actually only on liquids. I think they had me fasted properly for the first day post-op and then I was on liquid for a day. But then straight after that, I was actually on pureed or minced up foods. They actually had me ahead of the schedule that I’ve seen in other places. You know, other places are on liquids say, for two weeks afterwards. But the point I’m making here about the macros is that I was given the balanced macros, if you like, so I would have this minced up spoonful of meat, and minced up spoonful of vegetables, and minced up spoonful of mashed potato, or pasta, or whatever it was. They would insist on me eating regular meals. So I was having something like six small meals a day and as those alternate meals between what you think of as the standard meals, were like something like a yogurt or something. It was usually a dairy based sugar – of course, it had in it – snacks in between. It felt like they were feeding me constantly. I just didn’t want the food. But, my point is I certainly didn’t have that protein first. The whole “protein first” mantra I got actually, was from information online in forums and in Facebook groups and things. But were they quite forceful with you about doing that? Was that the message you were getting from your nutrition team?

Yes, absolutely. It was protein first. They were very, very hard and fast that you had to have your protein first.

So even if you could eat nothing else, if all you could eat was your minimum requirement of protein, then that was all you ate in a day.

Yeah, because right after you have the surgery, they give you what our group calls the Bible. So it’s a handbook of what you’re supposed to do, what you’re not supposed to do, and guidelines for each week and suggestions for food. So week one you would be having your protein shakes kind of thing. Now they’ve changed a bit since I had the surgery, they are pushing people along faster. I guess they’ve found that people are recovering from the surgery faster and so can start eating more. I think it’s actually better the way that I did it because I think I did like two weeks of shakes. Then I did like two weeks of full fluids, and then a week of soft foods or puree. And then moving onwards. But yes, protein was absolutely first, but then they would have your carbohydrates. So they would have cream of whatever, soups, cream of mushroom soup. They would want you to have protein, so like your shake. And then if you needed to have chicken or something you would like blend it in a blender and add broth to it, or whatever.

But then they still wanted you to have your other foods, your other carbohydrates, and cream of chicken soups, and oatmeal, cream of wheat, soft cereals like that. And then moving on, when you’re getting to real food – things like Melba toast was okay, and chili. Going to one of the fast food places here that serves a good chili seems to be on everybody’s, the first thing I’m going to do when I get to that week, I’m going to go to this fast food place and get their chili, seems to be quite the thing. And as long as you don’t get the bun, I guess its okay. Not that I think that it’s okay, but I think that they really need to sort of look at those guidelines again to weed out some of these things like Melba toast, which for me was a major trigger food. I can’t just eat one Melba toast but I guess some people can and that’s good for them, if you can eat in moderation. But if I think if I had known a bit more that I couldn’t stop at one Melba toast and looked at it from a different perspective, I think I would have done much better.

I would actually argue that the majority of people who end up having weight loss surgery and actually probably the majority of people who end up morbidly obese have an issue with moderation.

Absolutely.

Because otherwise where would be the problem? And well, more so a problem with moderation with certain foods because we all know when we eat the right way for us having to moderate becomes less of an issue. It’s certain foods that we have trouble with when it comes to control and moderation, and I think it’s going back to what you were saying about going through that process of tests and interviews and appointments with the lead up to surgery; there should be much more emphasis on finding out how and why the person in question that’s on the receiving end of having to have all these tests, got that way in the first place.

That’s right.

And then if you decide that surgery is the right course of action, then tailoring the program afterwards. The two things really that are going to have the most influence as far as that goes, is tailoring their diet to address that, but then also tailoring if it is part of it, the emotional issues that go with it, and the habits that have been formed over years, and why those habits are there.

I think that’s absolutely right, but I think the issue from the bariatric clinic or even the health care system in general, is that it’s going to cost a lot more money than doing the surgery and turning people loose. Because if you want to be completely honest, and people always say I’m an emotional eater and what they really mean to say, but they don’t want to say it out loud is, is I’m a food addict. I’m a carbohydrate addict. Because saying that you’re an addict is a negative thing that people don’t want to admit to. Saying I’m an emotional eater sounds much better, but it’s the same thing. If you’re an addict, it’s because you have this compulsion to do something that you know is going to have a negative outcome. So if I go and I’m upset, I’ve had a fight with my husband and I go to the refrigerator and I get a quart of Haagen-Dazs and I know I’m going to feel like crap afterwards, but I eat it anyways.

That’s an addiction. It’s no different than as if I took a beer or I smoked some crack or whatever. It’s exactly the same, but it’s harder I think to admit to because somebody that doesn’t think that – oh, I would never do anything like that. I’m not an alcoholic. I’m not a meth addict – are going to have to cop to, I’m an addict. And it’s a lot easier to say, oh, I’m an emotional eater, than I’m an addict. But sometimes you have to get a little bit hard with it. You have to look at the truth. And the truth is, is that you cannot control your eating. And even after you’ve had the surgery, you cannot control your eating because they’re not doing surgery on your brain. They’re doing surgery on your stomach. And at some point, even if I’ve had the surgery, my brain is still going to say to me, ooh, I want carbohydrates and therefore I’m going to eat carbohydrates.

It doesn’t make a difference whether I’ve had surgery or not. I think some people need to have surgery. I needed to have surgery. Even if I had done keto I don’t know that I still wouldn’t have been able to stop eating carbohydrates. I don’t know. I don’t know for sure, but I think that definitely there’s a place for surgery, but at the same time people regain weight all the time with these surgeries. All the time because they don’t get that chance to overcome that carbohydrate addiction because they are being told that you should be able to eat moderately.

Yes, I absolutely agree with that and I think it’s the biggest failing of the system and I think just like with any other trap that people fall into, it’s the same almost as something like Weight Watchers or any kind of plan that somebody adheres to and has some success with weight loss, and then something goes wrong and they regain. What they’re told is it’s not the program’s fault. There’s no problem with the program. The problem is with you. You’ve messed up. You failed. You failed to adhere to it. That’s where the problem lies. But that is the biggest flaw that I see of weight loss surgery because basically the message that I see coming across is, we are going to impose on you an enforced restrictive eating plan – that’s basically what it is – we’re going to make you, because we’re going to adjust your body so that it is physically impossible for you to eat more than a certain amount.

So it’s like you going on your calorie controlled diet, going to Weight Watchers, going to whatever. It’s a bit unfair that I always mention Weight Watchers, but I forget the names of all the others. Use Weight Watchers as a global term for all these diet programs. But the problem is, if you could stick to that kind of program, if they were sustainable, then there wouldn’t be a problem and the exact same thing happens with weight loss surgery. This is the problem I see coming from people who’ve had it, who all of a sudden think this is amazing. I can suddenly eat in moderation. Problem solved. I can do exactly what people have been telling me to do all these years. I can do exactly what my surgery team are telling me what to do.

It’s fine. It’s easy. This is going to work. This is going to be me for the rest of my life. I can still eat cake. I can still eat ice cream when I want it. Everything’s wonderful. Except it’s not, is it? That wears off. It might take longer than one of these programs that you’ve gone to that involves you using just your willpower and sticking to it. You know, think of this as someone’s enforcing that willpower on you, but it does not last. Apart from an absolute tiny, tiny minority, it doesn’t last. And so if you don’t address those problems, if you don’t address and change your way of eating, you’re going quote unquote, fail. But it’s not you who’s failing. Again, just like with so many people who’ve been on this podcast who’ve had that lightning bolt moment when they’ve read someone like Gary Taubes who says, it’s not your fault.

Well it’s the same, except these people are going back. These people are working on another level because they’re going back just like you did, and we’ll come back to that, with me going off on this tangent, but you going back – and they ended up going back – and having revision surgery. So they have a second surgery. And I’m one of those people. The problem with my first one was it was the band, which is just a nightmare surgery that fortunately is happening less and less now. But a lot of people have the sleeve and then go on to have a bypass, or DS – a Duodenal Switch. Of course, that’s how it started the sleeve, wasn’t it? It was the first stage process for the DS surgery. And sadly I think a lot of surgeons still actually do have that attitude. And I have heard people whose surgeons have said to them, we’re going to give you the sleeve, but the chances are you’re going to be back in a couple of years for revision surgery either to the DS or bypass. That I think is criminal.

That’s right, yes. When I first got onto the idea about addiction, which was I think a couple of years ago, I thought everybody that had had ever had to have weight loss surgery was a food addict. And then after sort of seeing some more people in my Facebook group, or with my weight loss surgery Facebook group, and there are a lot of people that, they have their surgery and they are able to eat moderately, and they are able to lose weight, and God love them, I wish I was one of them. And after thinking about what my perspective was on food addiction, and then when I got into keto as well, I came to the conclusion that there’s a lot of people that they’re using food to smother their feelings, they’re emotional eaters. At some point or another they worked through whatever it was.

Maybe they had problems with their husband or their wife, or whatever. They worked through it, but they’re stuck in that addictive carb cycle, and they can’t break free of that carb cycle. They have the surgery which breaks them free of the carb cycle, and then they’re able to eat moderately. They go on their merry way, they lose weight with the surgery and they’re good to go. And then the rest of us, I think either we’re still dealing with the emotional issues – we’ve just kind of never worked through them completely or we’re just too stuck in that carb cycle. Because they do say that carbohydrates are as addictive as any kind of opioid and maybe we are just kind of stuck in that’s the way that we’re going to be forever. Whether we’ve got still got some underlying emotional issues or not. And yes, people will regain and then they try and go back or a second surgery, which I did.

I went to see if I could get another surgery because I was stuck. I wasn’t losing weight. I went back to the bariatric clinic. I asked them about getting a revision. At that time though – they go by the BMI – they said, no, your BMI is too low, we won’t do another surgery. I was pretty upset by that afterwards. In hindsight, I’m glad that I didn’t, and I’m glad that I’m addressing the other issues because maybe I wouldn’t have got to that place where I needed to see that there’s other things going on. This is why I can’t lose weight. So I’m glad in hindsight that I didn’t get the other surgery. But I think from the get go they sort of need to look a little bit deeper into why people are needing the surgery to begin with.

And doing a second surgery – when somebody comes back to them – that’s when they really need to say, okay, you had one surgery, you’re not making it work, what’s going on? Don’t just automatically sign them up for another surgery. Maybe some people will need it. People that are 500 pounds – here anyways in Ontario – they will do the sleeve as the first step. It’s planned to do the DS when they’ve lost like about a hundred pounds. When it’s a little bit safer for them to be under the anesthetic for the longer period of time that it would take to do that surgery. So sometimes it’s a plan to step surgery, but other times people are getting it because their weight loss is stalled. And I think that that’s when they need to do a little bit more intensive digging into why aren’t you losing weight?

Like let’s look outside of the box. Let’s look at what you’re eating. But then it kind of goes back to – a lot of people have talked about this – the current healthcare systems don’t want to admit that they were wrong about the carbohydrates. That it’s not an essential part of your meal plan – there’s no such thing as essential carbohydrates – but they don’t want to admit that because that goes against everything that they’ve been saying for the last what, 50 years or so. And that’s not what our government supports, so we’re kind of stuck.

Sometimes it is the case obviously, that people do need to go back for the second phase of the operation. That happens, especially for people who started off at a much higher weight. But yes, that’s exactly why they started doing the sleeve because they found that a lot of people were having so much success with it. It’s that first stage of a two stage operation, and they weren’t needing to go onto the second stage when they started using it a lot more. But, yes I think you’re right. I think at that point when someone goes back for a revision, or goes back to say that they’re regaining weight, and why they’re regaining weight, there shouldn’t be that assumption that they’ve done something wrong and the way to fix it is another operation. Just to go back to the whole moderation thing.

I think there are echoes with this. It’s not just with people who’ve had weight loss surgery that these principles apply. I think there are lots of people who start doing keto who it’s almost like that magic switch that is switched by having the weight loss surgery. Suddenly you can do everything in moderation. Suddenly your hunger and satiety signals start working perfectly. And you hear lots of people saying this. Richard Morris is a really good example. When you hear him talking about how back in the carbie days, he could eat vast quantities, but now he is doing keto, once he’s full, that’s it. He stops eating. He doesn’t have cravings. All is hunky dory. But there are some of us, if we still have these addiction issues that they’re not completely fixed by keto. Just like they’re not completely fixed with weight loss surgery, and although those signals they tune back up much better, we still have to combat those other issues that are going on.

Oh, I absolutely agree with you on that. They really need to start looking a little bit more at what’s going on in your mental and emotional state rather than just, what are you eating and why aren’t you eating hundred grams of carbohydrates, and thinking that that’s the answer. Because it’s not. But I mean counseling is intensive. Not everybody wants to do it. They don’t want to dive into those kinds of issues, but they would rather go and have another surgery and think that’s going to fix them. I do have a lot of people say; I’m so hungry all the time. And I’ll say, if you stop eating carbohydrates, I promise you, you will stop being hungry.

And then I tell them the story – Dr Fung likes to use this, and I’ve heard Megan Ramos say it on podcasts before – they use this wood analogy where carbohydrates are your fast burning wood and fats are your hardwood that takes longer to burn. So if you’re going to go out, and you’ve got your fireplace and you want something to burn in it, and you’ve got all this lovely hardwood that you’ve been stocking, and instead you throw in an old dining room chair that’s made out of softwood that burns in 15 seconds. And in 15 seconds you need more wood for the fire. Well, that’s kind of your body. Your carbohydrates burn off instantly and you need more carbohydrates. So that’s why you’re always hungry. Your body is just screaming out for carbs.

But if you give it fat – you give it that nice hardwood that takes longer to burn – then you don’t feel hungry. So that’s the kind of the analogy that I use – and that’s Megan’s analogy, not mine, I never take credit for that – because I think it’s something that people will understand – that if you give your body something that’s going to take longer to burn, and if you listen to your body…that’s key too, is you have to listen and understand why am I hungry? Well I’m hungry because maybe I haven’t eaten in 18 hours, or maybe it’s because what I had an hour ago, like I had a bowl of pasta, has already burned off. So if you just kind of eat nice fats and protein, and not have any carbohydrates, you’re not going to be hungry. At least your body’s not going to be hungry, and maybe your head’s still going to be hungry, and that’s a whole other story that we’re talking about as well.

Well that’s the problem, isn’t it? It’s this interference that goes on between your body and your brain. It’s the interference that goes on between that’s the problem. You mentioned before about how it often comes down to potentially a cost, but I would have thought that the extra cost of tailoring the program a bit more, tailoring it nutritionally and adding on counseling, is a lot cheaper than revision surgery. I think maybe part of the problem is having to admit that the nutrition advice they’re giving is not correct, and having to change that; and they can’t go back on that.

That’s right. Especially with us being government funded, they can’t go and say, oh no, we don’t want you to eat carbohydrates when our Canada’s food guide – the latest one that just came out – is almost entirely plant based. And I mean it’s nothing but carbohydrates. So they can’t now suddenly turn around and say, no you can’t eat carbohydrates. And not only that, but the numbers of people that are going through this program are just unbelievable. The number of people that they’re trying to get through and have the surgery… it’s taking months and months, not just because it’s so time intensive with the appointments, but because there’s so many people that they’re trying to get through the system. The clinic is running at full speed all the time and the wait lists are phenomenal. It takes months just to get that first phone call, to start with the orientation and learning more about the program, and then getting in through the appointments.

If you try and even call the clinic if you’ve got a question, it takes a long time for them to get back to you. And after the surgery you’re supposed to go in for one week check-up. Well, sometimes you don’t get in for two weeks. Or your one month check-up will be two months later. Or your six months check-up might be a year and a half later just because they’re overwhelmed with the number of people that want to have the surgery. So unfortunately stuff like that just falls by the wayside for sheer numbers.

Absolutely. And it’s definitely a sign of the times to see how long the waiting lists are. So you went back to ask for the revision surgery and they denied that. So how did it come about then that you started looking at changing the way you were eating. How did you find out about keto? What led you down that path?

I was actually at my local public library and I happened to see Dr Fung’s book, “The Complete Guide to Fasting”, which I picked up and I started reading. I was fascinated and it was one of those lightning bolt moments where I realized, wow, it’s not my fault. I am not able to lose weight because of this whole carbohydrate insulin cycle. And what really impressed me about the book in particular was that it didn’t seem like your common diet book. Every chapter had references to studies and medical journals. And I felt, well, this is somebody I can trust that knows what they’re talking about. So after I read that, his co-author on that book was Jimmy Moore. And so I went on the internet and I was looking at Jimmy Moore, and I happened to see that he had all of these podcasts, and he had these books.

So I started listening to Jimmy Moore. And then I think from Jimmy Moore, then I found the 2 Keto Dudes. So I listened to them. And then from the 2 Keto Dudes, they had the episode that you were on, and Liz, I think, talking about weight loss surgery.

Louise and Donna, yeah.

So then that’s how I got listening to you as well. So it was sort of a chain reaction that I started with Dr Fung’s book, and I started listening to all of these podcasts, and I heard about Nina Teicholz and Gary Taubes, and I got their books and I read them. So I think at this point I’ve probably listened to hundreds, if not thousands, of hours of podcasts, and watched all of these videos and read all of these books. Immediately though, after I read The Complete Guide To Fasting, I started to go low carb.

Of course, I did this completely backwards. I don’t even think I had been doing it for a couple of weeks and I thought, oh, I’m going to do a fast. Let me do a fast. So I actually did a six day fast, which probably not even fat adapted at that point. I actually managed and I wasn’t hungry. And things that I noticed – of course I did lose weight right off the bat because you’re losing all of that water weight, not eating carbohydrates -was not being hungry was fantastic. It was just unbelievable to me that I could go so many hours without eating. Whereas before, and with the bariatric clinic, and what is kind of common, nutrition guidelines, you’re supposed to eat every three to four hours, which I probably was doing. But I wasn’t hungry and that I didn’t need sugar. Like if I was going to go and have coffee before, I had to have all of this cream and sugar in it.

And tea. I could not drink tea without sugar. So when people were talking about bulletproof coffee or putting heavy whipping cream in coffee, and I started that and I didn’t eat sugar. And that was like a revelation to me. It really was. That I did not need sugar in my coffee or my tea, which kind of sounds strange, but it just seemed so unreal that I did not need sugar and I did not need sweets. I did not need to eat dessert. I just lost all of those sugar cravings, which, you know; it was just such a relief not to have those sugar cravings. And I did lose weight. I lost about 20 pounds fairly quickly. So that was great. Unfortunately I did end up regressing and it was because I had not addressed some of those emotional things that were going on in my life, and I had a lot of stress.

I did end up gaining the 20 pounds back because I was really kind of stupid. And I thought to myself, and I remember this very clearly thinking, okay, you’re going to have stress. You’re going to want to eat. So why not go for it. Which in hindsight sounds really dumb. I should have really just tried to work through it a little bit better. But I did end up gaining the 20 pounds back, and at the beginning of the year I really recommitted back to being more strict with my keto, and I have lost almost half of that. I’ve lost 10 pounds. So that’s been great. But more importantly, I feel so much better. When I was kind of letting myself go with the stress eating, I felt like crap all the time. And I knew that I felt like crap, but I was stuck already in that – it doesn’t take long to get stuck back in that carb cycle where, even though you know you’re going to feel horrible, you still keep eating it.

I think it really kind of took me hitting the bottom of that barrel. I just feel so awful. I’m waking up every morning with a headache. I have no energy. I need to get back to doing this. And instead, I think when I had been doing my keto before; I was really trying to still eat the 20 grams of carbs. And now I’m probably closer to zero. I’m really eating more meats and dairy and eggs and very little actual carbohydrates in the way of vegetables. And I find that that works so much better for me. I am hardly hungry. There are days where I really have to push myself to eat so that my metabolism doesn’t bottom out.

Do you still employ some intermittent fasting? Because that always seems the sensible thing that, if you have days when you don’t feel like eating, instead of not eating very much is to actually harness that opportunity, and say, okay well I’m going to have a day when I don’t eat anything.

I do, I really do. Or I will have like one meal a day and trying to go along with, what is your limit of fasting? Because you’ll see some people will say nothing at all, like just water or black coffee or with a splash of whipping cream if you want, but like no substantial calories. And some people will say, oh if you have less than 500 calories, that should still be okay. I don’t know. I think the jury’s kind of still out on all of that. And then you’re kind of getting into when does autophagy kick in, and all of that.

I always go back to what Terri Lance says. I’ve seen her talk about it on quite a few posts when people ask that same question, you know, what counts as a fast, and is this a fast, and is that a fast? And the important question that she says you need to ask; is what are your goals? So if your goals are weight loss, then having a few of those things that have some calorific value aren’t necessarily a problem. If your goal is more the autophagy side, then you need to potentially be a bit stricter about what you’re having. And you know, it’s only water or maybe some coffee and things like that. So it’s really important just to figure out what your goals are, but also of what you’re capable of, what you’re happy with and, and what you feel good with. And there’s often a difference between what you do when you start out.

Megan Ramos talks about training wheels, doesn’t she? That there might be some things, like you might need a little splash of heavy whipping cream in your coffee, or some broth, or things like that. If they’re going to get you through while you’re getting used to fasting – because I think everyone agrees that its consistency is what is a good thing – is to get into that routine of fasting. Now if when you start doing that, you need a few of those things to get you through – to get you into that habit, to get that habit formed, and what you can probably find is that those things get dropped off as you get more used to doing it. It all comes down to the individual and what works for you and what your goals are, I think.

I think that’s right and you have to definitely find what works for you, and if you just want a couple of eggs and a couple of slices of bacon, then that’s good. I don’t think you need to worry too much about it. With having the weight loss surgery, I can’t eat like…I would like to have one meal a day where I ate 1200 or 1600 calories, but I physically can’t without making myself sick. So I do tend to eat twice a day, like once in the morning and once in the evening. And it’s hard though, when you’re not hungry to make those calories count because you have to balance – again, eating enough so that you’re keeping your metabolism going. Or not eating anything, so you’re keeping your metabolism going. You don’t want to consistently eat only 600 or 700 calories, and then your metabolism slows down to account for the fact that you’re not eating enough. It’s kind of a tricky spot just to find the right combination that works for you for whatever your goals are. It depends f your goal is weight loss, or if your goal is metabolic healing, or if your goal is autophagy.

Absolutely. Just going back to what you said right at the beginning, about your choice of surgery and part of what drove you to ask for the sleeve as opposed to bypass, was the fact that you suffer from migraines. Well, I’ve certainly seen a big improvement in my migraines, so I was wondering if you’ve seen a positive change in yours?

Oh absolutely. And there’s been times where I’ve almost kicked myself because I think that weight loss was definitely a part of that. I think a lot of my migraines were hormonal in nature, so getting older sort of took care of that. But if it was even just from a pure weight loss standpoint, sometimes I’ve kicked myself, like I said, I could have had the other surgery, the bypass, and maybe been more successful with it, and still not had the migraines. So it’s been kind of a catch 22 you know, like you can maybe have the surgery that you’ll lose weight faster and you still won’t have migraines, but you’re kind of taking a chance. Maybe you’ll still have the migraines and then you won’t be able to take the medication that you need for the migraines. But yes, definitely I did see an improvement almost right away that I didn’t need to take any medications for my migraines. So you don’t know what you don’t know, right?

That’s interesting then that you found an improvement just with the surgery. Interestingly enough, I did see a period of about three months when I first had the sleeve where I didn’t have problems with my migraines and I thought it was potentially just down to the operation. With hindsight actually I think it was probably because I was in ketosis without knowing it at the time. The combination of what I was eating and how much I was eating. Although I wasn’t eating ketogenically, I think just by the fact of how little I was eating probably got me down, if not in ketosis, down closer to that state, and that is what was helping. Because it only lasted for those few months and then they came back again. And it was only a couple of years later…I did start doing low carb fairly soon after that…or a moderate carb I should say, because it wasn’t low enough to impact significant change. But it was only when I dropped it down to a ketogenic level that I started seeing real success with my migraines. That’s why I was interested in knowing the difference with you, whether they improved straight away or whether it wasn’t until you switched to fasting and keto that you saw that improvement.

That’s interesting because now that you’re saying that, I’m just thinking back to the fall when I was stress eating and eating a lot more carbohydrates, and I did notice that I did have a couple of migraines where I don’t think I’ve had like a really bad migraine in a couple of years. So that’s interesting that you say that it’s probably been a combination of the weight loss and being in ketosis that has really taken care of the migraines. For anybody that suffers from migraines, you know how horrible they are.

We have kind of addressed that question. I think it’s something that we probably not only get asked by other people, but we ask ourselves. And that is, if you’d known about keto and fasting before you went for the surgery, would you still have done it?

I think if I’m really honest with myself, would I have lost weight without the surgery? If I’m really honest, I’m going to say no. because in the period leading up to the surgery, because it does take quite a while, I said to myself, I’m going to do my utmost best to lose weight and I could not shift a pound. Even if I had known about keto, would I have been able to stick to it. There’s a certain element of willpower to any change. Not just changing what you’re eating, but committing to any kind of change in your life. There’s a certain amount of willpower because instinctively I think most people don’t like change because it can be a lot of hard work and I don’t think I could have stuck to it.

I don’t know if it would have been thinking well, surgery is on the horizon, I’ve got that to fall back on. Or I just didn’t have the willpower. Or I was just too stuck into that carb addiction cycle. I don’t know. But honestly, I’ve thought about it a lot since I kind of discovered keto and when those 20 pounds dropped off last year – fairly quickly – I was really like, I wish I’d known about this before I had my surgery. But then I really thought about it and no, I really don’t think I could’ve done it. Now to kind of qualify that. If I’d had some coaching or some counseling along with the keto, then maybe. If I’d had a bit more insight into what was going on with me, maybe then. Maybe then I would have been able to do keto and lost the weight and not had the surgery.

But just by itself, it’s a nice thought. It’s a nice thought to think that you can do it. And I’m using air quotes – normally – because you’ll hear people say that, oh, why don’t you just lose weight the normal way without having surgery? I mean, it’s nice to think that you wouldn’t have to go to the lengths of having surgery to lose weight because losing weight seems like something…it sounds like it should be simple, but of course it’s not. We know it’s not. But I think it’s probably the perception of a lot of people that don’t have weight problems, that’s what they think. Weight loss is simple. I can lose five pounds tomorrow if I wanted to. But of course it’s not that easy. And if I could have done keto and lost the weight, that would have been fantastic. I really don’t think I could have, if I’m honest.

It’s a very interesting question, isn’t it? I’m not sure either. I think part of the problem certainly for me was all that interference I spoke about before – those habits of food addiction, the depression. The habits I had of eating carbs to not only numb the pain of depression, but also that would get me into this eat, sleep cycle, so that basically I just didn’t have to be awake more than I had to be because it was just not very pleasant to be awake. So I don’t know if the benefits of keto would have been able to kick in quick enough and to be strong enough to get all that interference down to a low enough level for me to be able to do it long enough to really start affecting that change. I really don’t know. And I think that’s what weight loss surgery did for me is, it forced me into that position for a certain period of time.

And I do know that if I hadn’t have found keto, I would probably be heading back towards where I was to start with. So I do know how important it has been for me, but I struggle with it. I struggle with that, and I struggle with…and I don’t know how you feel about this, both coming from yourself, but potentially from what other people have either said directly to you or about people who have weight loss surgery in general; and that is you’ve cheated. You haven’t done this the hard way like we have. You’ve taken the easy way out and you cheated. How do you feel about that? Because I bet you’ve come across that.

I haven’t. To be honest, I haven’t personally ever had anybody say that. I’m in a Facebook group for the people that have had surgery at the same hospital that I had, the same clinic, and a lot of people have said that they’ve had people that to them, and it’s really one of those things that I just kind of have to take it with a grain of salt. I tell people that’s how you should take it. Because you can’t know what it’s like to be a morbidly obese person unless you’ve walked a mile in their shoes any more than I could know what it’s like to be a person of another race, or another sexuality. Until you’ve walked a mile in that person’s shoes, you just can’t judge. And they come from a position of not being informed, not having the understanding. And it’s easy to say, oh, just let it go, because they don’t know.

But ultimately, that’s what you’ve got to do. Unless you want to try and educate the person and say, you know, this is what my life was like when I was morbidly obese and I could not for the life of me control my eating. But I don’t think you need to get that personal with a random person unless you really want to. I think people just don’t understand. You can’t. You really can’t understand. It would be like asking an alcoholic; why don’t you just stop drinking or somebody that’s addicted to any other substance. Why don’t you just stop? Or people that smoke? Why don’t you just stop smoking? I don’t smoke. I’ve never smoked a day in my life. And even I wouldn’t say that to a smoker. Why don’t you just stop? Because I know it’s not that easy. It’s not easy when you’re stuck into that behavior that’s so addictive and so compelling and so compulsive, that you’ve got no control over it.

And it’s all the same. It doesn’t matter whether its food or tobacco or alcohol, it’s just the same difficulty to stop. And I think actually food is harder, because I don’t have to smoke a cigarette. I don’t have to drink an alcoholic drink, but I do have to eat and there’s not the same level of compassion I think, for people that are obese as there are for people that smoke or people that drink. People don’t say to an alcoholic…they don’t push people. If I’ve identified myself as an alcoholic, nobody’s going to push me to have a drink or nobody’s going to push me to have a cigarette. If I tell people I just stopped smoking, nobody’s going to do that.

But people will push you to eat, you know, just have an ice cream. It’s not going to hurt you. One’s not going to hurt you. But it’s funny, if I was a vegan; people aren’t going to push me to have a burger. So I don’t know why people that if I identify myself, oh, I don’t eat carbohydrates or I’m a low carb…why would people push me to eat, or have a piece of bread, or, oh, you can have a bun with your burger. It’s kind of an interesting comparison I think, that people don’t have the same compassion for things around food and obesity. It’s interesting.

It certainly is. And complicated. And like you say, it’s not something you can ever really understand until you’ve been in that specific position yourself. And then even then you’re going to have different thoughts about it and a different reaction. So you said that your day to day keto these days is looking pretty like carnivore by the sounds of it?

It’s pretty close. Actually there are days where I am a full on carnivore. My son, he actually started doing keto not too long ago. He’s 17 and he just kind of wanted to drop a few pounds. So he was interested in doing keto. When I’m making supper, he still has some vege, and the other day I just popped a piece of broccoli in my mouth and I thought, wow, when was the last time I actually ate a vegetable? And I couldn’t really remember. Because I’ll have bacon, I’ll have eggs, I’ll have whatever meat that we’re having for dinner. I don’t usually have the vege that I’m serving with it. I have dairy. I’m terrible with cheese. I love cheese. I’m kind of glad I’m not there in France with you because I would never lose weight. I’d be eating all the cheese. Every once in a while I’ll go and buy like a really good piece of cheese and it’s like gone in a day. I just love cheese.

I think that’s the best way to do it actually. Well, it depends. And that’s where the whole addiction thing comes in. If you can…and I can do this with cheese. If I was to do it with sugar type foods…if I indulged, it would be a slippery slope, and it would just turn into a full on binge. But then there are these foods that sort of start getting closer into that addiction circle, if you like, but they’re close enough to the edge that they’re the kind of things that I can indulge in every now and then. So like you, I will buy a couple of bits of cheese and have a cheese board or something, and then I would just accept the fact that I’m going to pick at them and I’m going to indulge them and they’re going to be gone in a couple of days. But that’s okay.

It’s a great keto food. It’s very low carb – sometimes even zero with some of the cheeses I choose – and so it’s not going to do a huge amount of damage. I feel indulged. It’s not going to start some slippery slope where I turn into a cheese monster for two weeks. So it’s interesting isn’t it? There are different categories for these foods that we do find addictive that they can’t necessarily be of our daily lives, but they can be an every now and then food without causing too much damage.

I think you’re right. It’s just knowing yourself. Like am I going to be able to have a piece of cheese and maybe I eat it for a day or two and then I don’t have any for another couple of weeks or whatever. Or, am I going to go back the next day and buy another block of cheese. So it’s just knowing yourself. It’s having that self-assessment, okay, I finished this block of cheese, am I going to go get another? Nah, I’m good. I’ll be good for a couple of weeks and maybe I’ll see another block of cheese…something different in the store a couple of weeks from now and then I’ll do the same thing. So it’s just kind of doing that self-assessment piece and self-analysis, if you want to call it that, and just knowing yourself and knowing what you’re going to do with yourself.

But generally I think I kind of am a little bit more carnivore than completely keto. Kind of coining the keto carnivore phrase that’s going around where you’re just making sure that your fat macros are still on the higher side than the protein. I don’t really overly track, but I do try to eat the fattier cuts of meat. Or if I’m making something lean like a chicken breast, then I’m cooking it with some butter and maybe adding some cheese on it or something like that. I feel great.

I never cook chicken breasts, I just don’t eat chicken. But I’ve never particularly like it. I have always been someone who likes the full fat versions of things. I’ve never bought low fat mayonnaise or anything like that. And it’s the same with meat. I’ve always liked the fatty cuts. I’ve always liked the dark meat on a chicken. I’ve always loved the chicken skin. I’ve always loved the fatty bits of bacon, the fat on lamb. I’ve always loved that. So keto is just heaven. I don’t have an issue with that at all. I know some people don’t like that visible fat on meat, but I love it.

I do enjoy the dark meat on the chicken, or the turkey, or whatever. The issue is actually budgetary because I don’t know where you are, but the dark meat…if I was going to go buy a chicken thigh it’s actually more expensive than a chicken breast. And I don’t know how that works exactly.

Oh, isn’t that interesting? No, it’s the opposite here. The cheapest chicken I can buy is a kilogram tub is what I tend to buy from Lidl of chicken thighs – that is the cheapest form. So I lucked out on that. Drumsticks are more expensive for some reason. But chicken breast is the more expensive. So I have it the right way round.

I tend to buy in bulk and then portion things out and put them into freezer bags. So if I go to a market that they do their own butchering and they’ll have like big bags of giant chicken breasts, and I can buy a big bag of those when they’re on sale, and those will do for like a couple of week’s worth of meals. And to buy like the chicken thighs, I wouldn’t even get half as much.

Wow, interesting.

So when you’re watching your budget you just have to go with what you’ve got. So I’ll just try and make it a little bit more fatty by cooking it in butter or cooking it in bacon fat, because I’ve always got lots of bacon fat. Or putting some cheese on it and I find that that’s fine for me.

I don’t want anything else. I was cutting up some melon for my kids the other day…I popped a couple pieces of melon. Now before, I would have eaten like the whole thing, but I was quite happy just having one or two really nice cold juicy pieces of melon. I found that I was a little worried, because afterwards I was like, do I feel that sugar craving? And…I’m okay, I’m okay. But even that. There’s a lot of sugar in melon, but it could have spiked that sugar craving, so I feel that its better just not to even go there. If I’m going to have vegetables like broccoli, they’re not sweet, so you’re not going to have that sugar craving.

So it’s just better really not to go there in whatever way that you’re eating. If you know you’re going to be triggered by something, just don’t even go there. Like with the weight loss surgery we were talking about earlier, in the second or third week, they said that you can eat Melba toast. Well you can. Do you want to? Should you if that’s going to be a trigger food for you. If before surgery you could eat a sleeve of crackers…that used to be one of my things…I could eat a whole sleeve of crackers with cheese whiz or peanut butter. Then maybe crackers isn’t a good idea for me. Even if you want me to eat moderately, sort of pairing up the idea of what caused you to gain weight in the first place, and now that you’ve had weight loss surgery, sort of incorporating what you know about yourself and making that model work for you for maximizing your weight loss. So if carbie foods are a trigger, then you’d better not eat them. Not until maybe you’ve lost a lot of weight and you feel comfortable that you could eat them without being triggered to overeat.

And that’s the power of the Internet, I think. Because that’s certainly what I was able to tap into. Interestingly enough one of the things that was also on my meal plans was to have these…I’m trying to think what they call it here…but it basically looks like slices of mini toasts as your Melba toast type thing; that I used to have with cream cheese on. And that was something that was recommended as a snack, and it was one of the things that sent up a red flag for me is: why can I eat more than they’re saying I should have, and I’m still hungry, but then it’s just inducing these cravings that I want to keep going back. I want to go back and have some more half an hour later, and more half an hour later. And I could just be, just like you, I could just be on and on and on at that all day.

And that was one of the first things that got me thinking, hold on, something’s not right here. And that’s when I started tapping into things online and hearing about the experiences of other people and starting to question the wisdom of what I was being told by the surgical team. So sometimes we do have to go against what we’re being told to figure out what’s going to work for us. And I know a lot of people don’t necessarily want to do that, especially if it crosses paths with having to accept that they’ve got addictive type tendencies. It’s possibly a lot easier to just say, well, my team knows better, I’m going to do what they say and then deal with the problems when they arise. It’s been fascinating talking to you today and, and throwing around this topic of weight loss surgery. It’s not something that I’ve talked about with somebody else on this podcast in more depth and I’ve been looking forward to discussing this topic with you. I know there are a lot of people out there who are about to go through it or who’ve gone through it and run into problems.

And it is something that is sometimes shunned a bit in the community and people feel like they need to keep it a bit secret. But I definitely feel that keto is something that works very well as a way of eating after you’ve had surgery. It certainly has for me.

I think I have to agree with you on that. And I think I have heard in the United States there’s more bariatric clinics that are recommending the keto diet, which I find is fantastic. And I know amongst the people on my weight loss surgery Facebook group, there’s so many people that are discussing regaining and they’ve come to me and asked me about keto, and I’ve pointed them in the right direction. And that’s when I’ve heard people say, I’m so hungry all the time; even with the surgery, I am just hungry. And I’ve said, well, this has been my experience with keto, especially when I stopped the carbs; I know that I’m not hungry. And if that’s your challenge, then this is going to work for you I think. And I really hope that it does work for them. I think that a few people have already seen some good results with it. And I hope they continue on that.

And I just put myself out there and I’ve had numerous discussions with people saying, you know, our clinic says that we shouldn’t do fad diets. I try not to get into that whole argument about is it a fad diet? To me it’s a way of eating. It’s not a diet; it’s a way of eating it. Just as being a vegan is not a diet, it’s a way of eating. So is keto or low carb, or whatever, or being a carnivore, it’s a way of eating. Often too, when talking about keto, people will say it’s not sustainable. And it’s absolutely sustainable.

And people will say, I will miss this, I will miss that. And I want to say, tell me whatever it is you think you’ll miss and I will tell you a keto alternative. Because there’s so many people out there, so many people doing blogs and websites. Everybody’s developing all of these recipes that you can replace anything – crackers or breads or ice cream – there is a low carb version of it. So you’re not missing out on anything. You want on a birthday cake? You can have a low carb birthday cake. I don’t think you’re going to eat it every day, but you can have it. It’s there. You’re probably just going to find you’re not going to want to eat.

Sometimes I think there’s a fear around low carb as well. And I feel a little bit that the bariatric clinic – ours in particular – pushes that a little bit…that you still have to eat carbs; that low carb is bad. And so I don’t know if that’s the perception that anybody else has ever had with their weight loss surgery clinics? You know, being low carb is a bad thing. But I think that they still do get that. So I’ll get some argument, oh we’re not supposed to do low carb. Low carb is bad. And you try and challenge them. Why? Why is it bad? Tell me what’s your evidence? Where’s your science? And that’s the thing I absolutely love about keto, is that everybody is super knowledgeable about it. You go on to any of these websites – Diet Doctor, the Ketogenic Forum, the 2 Keto Dudes, and yourself – you all have all of this information at your fingertips. And people that do fad diets, they don’t know anything. They couldn’t answer a why question if their life depended on it. But I could ask anybody that’s serious about keto why something, and they’ll know. And if they don’t know, they’ll go and find out why. And they’ll tell you why and that’s the way I am too.

If somebody asks me a question, why this, why that? I’m pretty sure I know the answer at this point and if I don’t I can probably find out. And the second piece that I really like about keto is the self-assessment. Everybody’s very much into doing these N=1 experiments to see what works for you and what doesn’t work. Nobody is saying you have to eat this or you have to eat that. It’s like, well try this and see how it works. It might not work. You might not feel better, or maybe you will, and if that doesn’t work, then try something else. There’s no cookie cutter, one size fits all diet, the way that the weight loss clinic surgeons and dietitians would have you believe. You have to find what works for you because we’re all different. We all have different metabolisms, and all different body structures. We’re all different. You need to look outside the box. You need to experiment. So that’s what I really like about keto. Nobody is so stuck in the mud…it’s all written in stone…you have to do it this way.

Yes, exactly. I think that’s right. That’s what I was saying before about the biggest flaw I see about it is, them trying to put us all in one box, and that’s never going to work. It’s been great talking to you today. Perhaps you could round us off with a top tip.

I was thinking about that and there’s like so many things that I think would work so well, but kind of going off off…I saw one of your other interviewees was saying…they we’re talking about making a plan, and having goals, and I think that’s when you…how does the saying go? Failure to plan is a plan to fail. So if you can have a goal in mind. Somebody in the group had their action plan, and sleep was their goal. So if sleep is your goal, for example, make it measurable. So if sleep is your goal…I want to improve my sleep – that’s kind of nebulous. So how am I going to determine if I have reached that goal? If you make something measurable, and you make yourself accountable to that, I think you’ll do better. So first just using sleep for an example, I can improve my sleep when I have three hours of deep sleep according to my Fitbit or whatever. You know, or one of those nice Oura rings that people have been getting.

Then I would know my sleep will have improved. Make it measurable. Don’t have these up in the air goals or objectives. I want to lose weight is a great goal, but it’s kind of nebulous. Drill down a little bit. Like what is it that you’re really after? And make it measurable and make it attainable, and really look at what steps…like for sleep, maybe painting your room a different color or putting room darkening blinds…like there’s a lot of different things that you could do for your goals if you make it very specific. It’s much easier to research and see how you can attain that goal.

And then with that, to make it time specific – time that you’re going to work on reaching this goal. Like if you’re going to work on it for a month, then the really important piece, I don’t think people do…talking about self-awareness and self-assessment. Do that evaluation…okay, has this improved? Have I reached my goal? If I haven’t reached my goal, then what do I need to do to reach that goal? How have I not reached it? Have I completely failed? I think that person with the action boards that she hadn’t been looking at it for months probably because it wasn’t specific enough. It was too vague. It was too, you know, like unattainable. There was no timeline. So if you set yourself up something you can succeed at, you need to sort of plan it. We have your plan, you have your objective, you have your action steps, you have your evaluation. But if you make things very specific, I think it makes it easier to succeed at it.

Yes, especially if they’re nice little bite size steps that are attainable, and like you say, you can then re-evaluate when you’ve got to that point and change up that plan if you haven’t managed to achieve the goal, you set out, re-evaluate, and work out why it was difficult in this instance to get to it, and change it, and reset it, and then work towards that next step and so on. I think that’s a very good point, is taking it away from these sort of vague sweeping statements and drilling down into something really specific. It’s more actionable, isn’t it? When it’s specific?

Yeah. I think when you make things very specific, they do become much more actionable and much more attainable. One other guest said about keeping it simple, silly. So if it’s something simple, something actionable, something attainable; I think you’ll be much more successful in the long run. And doing that self-assessment piece, the self-evaluation. And don’t be afraid of it. People fail at things and you need just to learn from your mistakes. And don’t swim around in it. If you’ve had a failure, that’s okay. You can still pick yourself up and move on. Just don’t get bogged down by failure. Everybody fails at something. You just got to learn from them and move on. Get back on that horse.

Absolutely. And then it’s not a failure, is it, if you’ve learnt from it. I think you’re right. I think getting specific about something forces you to really look at it and set those goals. Because it’s very different, isn’t it? Saying I want to lose weight, to saying I want to get into that pair of jeans that’s the next size down. And being specific about your goal makes you actually figure out and work out what is a realistic target, and what is a realistic timeframe for that. So yes, I like it.

Well thank you very much for talking to me today. It’s been a pleasure.

Thanks so much for having me on Daisy. I’ve really loved this. It’s been fantastic.

Welcome Kim and Carrie to the Keto woman podcast. How are you doing today?

[Kim] Doing good.

[Carrie] I’m doing awesome.

It’s nice to be back together again even though it is only remotely.

It is, but you know what, Denver will keep me going for a few months. We had a fantastic time in Denver, the three of us all hanging out and being ridiculous and eating great Keto food and just, you know, chewing the cud and catching up and it was awesome. And that’s going to keep me going for a little while longer at least.

I think you two are going to be getting together a bit sooner, aren’t you? Are you both going to Salt Lake?

Yeah, we’ll be in Utah.

We are off to Low Carb Utah at the end of April. So we will uh, we’ll drink a toast to you. Daisy.

Thank you. With the wonderful Keto Chow people – I’m very jealous. I’m sure it’s going to be good; it’s a great looking lineup.

We shall miss you.

So I thought it would be really nice to have a go-to Beginners Episode that we can send anyone to who just wants to know all the basics of how to start Keto. But before we do that, perhaps you could just tell us a bit about yourselves in case people don’t know who you are. Kim?

Okay. Hi, I’m Kim Howerton and I am a Keto coach. I teach people the where’s, why’s and how’s of Keto. I also love food, so I do recipes and cookbooks. But my primary kind of mission in the world is bringing some ease and comfort and joy into people’s lives by making Keto less complicated because I myself can overcomplicate everything. And so I know that instinct and I want to help other people not indulge that instinct too much.

Carrie, what about you?

I am Carrie Brown and I am first and foremost a recipe developer, which means that I publish recipes for free on my blog. And then I also create cookbooks to serve the Keto and Low-Carb community. The other thing that I have a passion about, apart from showing people that Keto can be more delicious than any food they’ve ever eaten before, is how incredibly powerful Keto can be for helping people with mental health issues. I myself spent most of my life struggling with bipolar two disorder, but I have completely eradicated all my symptoms and the need for any pharmaceutical medications through use of a Keto diet and a few supplements. So those are the two things that I’m passionate about and that’s what I do to help people on their Keto journeys.

And of course your, well you have a few podcasts on the go, but you’re a regular Dude.

Yes, I am cohost on the 2 Keto Dudes podcast, which is a weekly podcast that I do with the wonderful Carl Franklin who has healed his type 2 diabetes following a ketogenic diet. I also podcast every month, the first Monday in the month with Aarn Farmer from the My Sugar Free Journey podcast. And in that one we focus on all the cooking things. So that’s a podcast where if you want to know what the best thickener is, or the best Keto sweetener or how to do cooking things, that’s the podcast for you.

And she is a featured player on the upcoming podcast that I’m producing, which is called Keto Life Support.

And I’m very excited about that because that too is going to be a lot about food and Kim and I love, love, love our food.

We do. The first episode we recorded was kind of a hoot because I don’t know that there are two people in the world that have spent an hour happier to discuss a spice. So yeah.

Which spice was it?

To be fair, it was several. There were several, but you know, there was a section in which we were just overjoyed about…

Cardamom

…the simplest. Yours was cardamom, but mine was the simple amazingness of onion salt.

Interesting. Interesting choice. So while you’ve mentioned that, just tell us a little bit more, give us a bit more of a tease about the new podcast.

So the new podcast is actually, um, my idea behind it was that I just find so many people out there in the world don’t have as much support as they want when they start Keto. So maybe their spouse isn’t into it, maybe their kids aren’t into it. Maybe everyone thinks they’re weird and their doctor told them they’re going to get lupus. You know, there’s kind of a pretty negative world sometimes and not all of us have enough soft places to go. 

And so the idea behind the podcast was – if you need some Keto besties, I have some to lend you. There’s going to be me, Carrie, who you’ve met today. Um, there’s going to be a little-known man named Ken Berry.

Who’s that? No, I’ve never heard of him!

You’ve never heard of him right? Yeah. Um, and Neisha Salas Berry, who is awesome as well. And so the four of us kind of are rotating through talking about, you know, medical thoughts, uh, food thoughts, lifestyle thoughts, how do we do this, how do we support? 

And then there’s also going to be a community right alongside it, a Facebook community so that, um, you get as much support as you need on your journey and you feel you’re just so you’re not alone. You’re not alone here.

That sounds fantastic. I’m wondering maybe if we should give a little bit of a tease, Carrie.

I Dunno. What do you think?

Release the tease? Well why not?

Go for it.

Why not? We haven’t completely decided on the name yet, so we, we won’t drop that yet, but we’re going to start a podcast too aren’t we?

We are!

I’m shocked! What’s happening? I usually know everything.

Yeah, somehow… How did we manage to spend all that time together in Denver and it never came up in conversation.

Because we thought we were dying of the plague.

Oh that’s right. Two of three of us. Two thirds of us were dying of the plague. So

You two were very poorly. I feel very, very fortunate that I managed to escape the plague.

I don’t know. We caught it. We were out.

Bad, bad.

I’d like to offer a suggestion as to why we kind of didn’t talk to Kim or most other people we know about it because it’s not really going to be Keto heavy.

That’s true.

What you mean you have other interests? That’s nuts! What’s wrong with you?

We started talking a while back. I think I was, and I was trying to remember last night who suggested it first. I think I might have originally thrown the idea of doing another sort of food podcasty type thing.

I think, as I recall, it came out of some person on YouTube that was criticizing a Keto Woman podcast that we did and we dared to talk about something other than Keto.

Yeah, that’s certainly where it developed.

This person kind of got upset and we like, well we, we do have other like brainwaves, we have other thoughts that involve things other than Keto and, and we actually have a lot to say about life and the universe and everything and, and… but apparently we can’t talk about it on the Keto Woman podcast. 

But a lot of other people were very interested in what we had to say. So I think that’s where the idea came from that then like let’s just do a separate one about all the other things we have to say and just make it completely separate from all the Keto things we do.

Yes, exactly. So it’s separate but linked. So our thoughts were to do a much shorter form podcast but talking about, potentially the ideas we’re throwing around are, putting out two a week – one which is talking about a motivational or inspirational quote that we’ve come across that we really like and the other one was that sort of slightly old fashioned Agony Aunt type thing where somebody has an issue and I’m sure we all see it all the time in our Facebook groups when someone says, “Oh this happened and I don’t really know what to do about it.” So we’re hoping that people will send us those in and we can offer our suggestions.

What’s it called?

We don’t know yet.

We don’t know yet! My idea that I threw out there was “Afternoon Tea with Daisy and Carrie” because I just quite like, it’s sort of having a bit of a chinwag and the whole afternoon tea thing with the both of us being Brits. So that’s an idea. But we haven’t…

A cuppa

…we haven’t fully decided. A cuppa even.

“A Cuppa with Daisy and Carrie”

Yes, maybe.

I speak Brit.

You do speak Brit, you’ve told me that before cause you used to have British nannies. Is that right?

I did. I know what a boot is and a bonnet and things like that!

We have all these different words. Some of them are funny. Some of them can get you into really deep water.

Yes, especially when you’re angry and drunk or something.

I can’t remember which one I used the other day and Carrie wrote underneath for translation for Carl what it meant in American. It means very different than, I can’t remember what it was, but had a very different meaning.

Yes

Okay. So let’s get on to the topic for today.

We could do this for like three or four hours. So we might need to get onto the topic.

We’ve sort of lapsed into just…

What we do!

What we do, yes. 

Thank you very much to the KKBs for giving me a list of suggestions to structure this podcast around. I thought it would be nice just to sort of flesh out, I suppose a series of tips, top tips of what to do, how to get started, what to avoid, what to do, what not to do, all the rest of it. 

So I guess I will just kick off and we’ll go from there. The first one is about measurements and journaling. I always add journaling because I think it’s important. So it’s about the measurements that it’s really useful to take before you start and then all about what might be useful to measure and journal as you go along.

I think this kind of grows out of the number one thing when you talk to somebody who’s really gone into the deep end of Keto and you’ll say, “You know, what do you wish that you’d done before you started?” And they are all like, “Get your baseline numbers”, ” Take before pictures”, “Measure things”. Um, even get, you know, like a full blood panel – if not before your journey, like as soon as you can – because it’s really super interesting later on in your journey to have something to compare to. That being said, if that’s out of people’s budget or you know, lifestyle, you know, a simple picture in a mirror in clothes that show your body the way it is. Um, this will be the opposite of the way many of us like to take photos, which would be in clothes that make it look better than it looks.

Exactly. It’s not for public consumption.

You’re not showing it to anybody.

Just for you.

Absolutely. And to get some measurements – all you need is a tape measure – is really helpful for sort of a starting place to have those things for posterity. 

In terms of other types of tracking, are you asking about like journaling your food and things like that?

Well. So for example, I think yes, when, when you’re starting, and that’s exactly me when you said that – I did take beginning measurements. What I didn’t do so much was set like a monthly date or something to do those. And I wish I had, when I see people like Siobhan Huggins, for example, has a wonderful collage of, I think it’s probably just her face, but she sort of took the same picture every month and it’s so good to see that. And I wish I’d done that. 

But yeah, I think taking your basic weight, measurements, photographs and doing that, say once a month. But the other things that I think are useful to journal about: what’s your sleep like? what’s your mood like? your stress? what exercise do you feel able to do? And then you see, you start pulling out the non scale victories as you go, which are really important and more important than weight, which is what people often focus too much on.

So I think conceptually you’re talking about kind of two separate concepts. 

One of them is keeping track of metrics, right? So, I’m going to have a set schedule that I’m going to track my photos, my weight, my measurements, and on this date, every month I do this. It’s my routine. And with that I can use it to motivate me or to see what’s happening when, because often we only pay attention to one metric. We pay attention to what the scale says. But we didn’t notice that we are down three pants sizes. We only cared that the weight didn’t move, you know, the scale numbered and it moves. So I think having multiple measures to track and not doing it too often, you know, once a month is plenty I think is very important. 

And then there’s a second concept, which is the day to day. So, there are different approaches and I think Carrie and I have very different approaches on this specific topic, but what do you track? What data do you want? Are you a person that needs data? Is a question. So what that would look like is keeping track every day of what are you eating? Maybe potentially using some type of an app to track what we call macros. Keeping track of your exercise, keeping track of how you feel, the less technical aspects, right? The emotion, the mood. I’m cranky today, I’m tired today. So like tracking sort of your experience on a day to day basis is sort of a secondary part and for me that was really essential because I kind of look at my Keto journey as a bit of an experiment, right? 

We’re our own experiment and when I have data I can use that to reflect how my experiment is going and I can see the effects right from that first category, what are the effects? Oh look this month I gained weight or I lost weight or my right bicep grew, like what’s going on? And then I can compare that to the day to day tracking and see did something change or is something different. Maybe there’s something I need to evaluate here.

Exactly it’s the only way really you’re going to spot patterns because you forget so quickly and the only way you can really spot is, oh hold on. I remember feeling a bit like I feel today, which is rubbish, two weeks ago. What happened? And if you can actually go back in your diary and look at that and, oh this happened on that day and this day so maybe x, y or z is a potential problem that I need to consider going forward.

Right. But I think Carrie has a different perspective, which I think is important for people to know about.

Absolutely.

And I think the main reason that the way we track or don’t track and the things we do, Kim, is so very different is that I came to Keto for very different reasons. So I did not come to Keto for weight loss. I’ve always kind of just magically hovered around the ideal weight for my height. So weight loss has never really been a thing for me. I came to Keto specifically for mental health and, in my case, that was Bipolar 2 disorder. And so, for me, a lot of the things that Kim mentioned is not, I’m not gonna weigh myself, I’m not going to measure myself cause those are not metrics that I’m interested in changing. 

But what I do wish I’d done a better job of. So whatever your reasons for doing Keto, one thing I would encourage you to make note of, and actually write it down somewhere is your non scale victories or, if you’re doing it for weight loss, your scale victories. Because people ask me now we know what changes have you seen on Keto? And I’m like, they become normal. So no skin tags, right? I no longer have any skin tags, but I actually have to remember that. 

It would be super cool now to just have this laundry list of all the things that I no longer have to deal with. And I didn’t do that. And I wish I had. And I think that would have helped me as I’d have gone along to, you know, we all get those days where it’s just like, oh why am I doing this? I’m, you know, and so to be able to get out a written list and go, oh, that’s why, because I’d forgotten that I used to have skin tags because our brains are very forgetful, so, oh yeah, I forgot that I no longer have psoriasis. I forgot that I no longer have skin tags. I forgot that I no longer need to use deodorant because I have no body odor. Because those things just become a normal part of life when you’re on Keto. And so it’s easy to forget that they were irritations that you had to deal with. 

So I do wish I had done a better job of keeping a record of that as I went and I think that would have helped me in those times where we all, you know, struggle. Just being able to pull that list out and go, oh yeah, that’s why I’m doing this would have been super helpful.

It’s really true that you forget the excitement, isn’t it? See, I only have to see someone post a picture of their belt done up on an airplane and to go back and experience what that felt like. I was really naughty actually, and I never asked for a belt extender. I just always used to hide the fact that I couldn’t do it up with it draped cardigan or something over the top of it. So I never went through that. But when somebody is super, super excited and posts a picture of said belt done up, I remember that feeling and you’re right, we should have some kind of reminder that we can really remember the excitement for those things. And those are the things I think that make more difference than losing a certain amount of weight.

I mean, we don’t wear our weight. We don’t have a sign on our head with our weight. We live a life, we have experiences, it’s how we, how fit we are within those experiences, right? How well they work for us and we work for them. Those are the real changes. Not you know, what some magical number is, but I think Carrie brings up a good point, which is not everyone gets into Keto for weight loss or not only for weight loss. And so what you track really depends very much on what you’re looking to shift

And at the start, so for the first three months, I did pee on sticks and I did track how dark purple my pee sticks were every day.

You’re peetones?

My peetones. But again that was not something you really need to do if you’re doing Keto for weight loss. For someone who was having a mental health issue, keeping ketones super high can be super important. So I was just doing that just to make sure that when I got started that the things I was eating were translating into producing large amounts of ketones, which was the goal for us because we were trying to heal my brain. And I did that for three months and then I got confident with what it takes to keep me at a certain level of ketones and then I stopped. 

The other thing that I find incredibly useful is my Oura ring. So I do have an Oura ring but you can use other things to track sleep. I find tracking my sleep and my activity is incredibly useful. So that is something I track, although I don’t track a lot of the other things that Keto people do.

Assuming we are going to do some tracking. We mentioned Siobhan earlier, so I think in her honor we will just list a few things that would be a good idea if you’re going to get that baseline blood testing lab work done. And I do think, if you have any kind of sneaking suspicion that you have issues with any of your health markers in that way, it’s so useful to do. Obviously I appreciate that, you know, it might be a budget issue but if you can at all, it’s very useful isn’t it, to just have that baseline panel?

Absolutely.

So what things should we test? What’s the bare minimum that’s going to be really useful to have to start with that we can compare say a year later or something?

I think if we’re looking at metabolic markers, there are a couple that are super important. The first would be, and these are ones that aren’t, so there are ones that your doctor will probably like smile and nod about testing, like a CBC (a complete blood panel), you know, that’s a good idea to get. If you have any thyroid issues, you’ll also want to get a complete thyroid panel. Now most doctors, or if you suspect I should say you might not know you have a thyroid issue, but it’s possible. If you have any of the kind of fatigue, brain fog, unexplained weight issues, I would suggest getting a complete thyroid panel. And so often doctors will only test one thyroid test – the TSH, but there are I think seven. And if you go to stopthethyroidmadness.com (it’s a website) they list all seven of the tests.

Yeah, and it’s brilliant. That’s what I did. I was diagnosed with underactive thyroid. I had that diagnosis for 20 years before I investigated and it was that website and that’s when I got my free T3 in particular tested but other things as well and changed my treatment from that point.

Yeah, absolutely. There’s, you know, there’s thyroid is many hormones and well, I mean it’s a thyroid hormone, but it’s many interactions within that system. You know, T4 has to convert to T3. If it doesn’t convert you have this problem. Your TSH could be normal, it could be low, it could be high but, unless you’re looking at the full panel, sometimes you’re going to miss things.

In conjunction with symptoms. That’s the other thing. It’s one of those slightly tricky ones isn’t it, that you can’t diagnose simply by the numbers?

No

Any good doctor will use the symptoms as well.

Right? We are sadly, or maybe not sadly, but we are not like data input/output machines, we’re complex systems, which means that, you know, maybe if this one hormone is a little bit low, but this other one over here is a little bit high and they’re compensating… you know, so it’s not really clear cut and nothing can be looked at in a vacuum. But I would say your complete blood panel, your full thyroid panel, you definitely want to get your A1c. Now some doctors will just test your glucose, your fasting glucose. However, a lot of things can be hidden in there and they won’t test your A1c. Now there are some, none of these tests are standalone. You have to look at them together. But, for most people, A1c is a great way to look at what your average glucose looks like. In addition to that, I would say you want to get your fasting insulin, which hardly any doctors test. So you have to ask for this.

Yeah. And that’s why it’s important to get, you get the fasting glucose and the fasting insulin done at the same time. You can actually do things with that. [See HOMA-IR calculators like this one ]

Yeah, absolutely. And then the second test, which is sort of a way to backup what you see through your fasting insulin is your C-peptide (the letter “c” – peptide) because that is going to tell you how much insulin your body is producing over the day. And so your fasting insulin tells you your baseline insulin that day, but there’s some noise in there, but then when you look at also your C-peptide, you’ll get those two in conjunction. You get an idea of what your insulin is doing and those specifically (the last two I mentioned) are ones doctors generally don’t look into, but it’s super important because it can tell you years in advance of your body completely breaking down into metabolic failure what might be going on and it is a lot easier to stop the train wreck than to fix the train that is off the tracks.

And, again, I’ve got Siobhan sitting on my shoulder.

I didn’t even mention cholesterol numbers, so we’re going to go there now.

Well we’re going to have to have a basic lipid panel I think.

Yeah, yeah, absolutely. I was taking a breather!

HDL, LDL and trigs have got to be (triglycerides) have got to be a basic panel that are really useful to have aren’t they?

Yeah, absolutely.

You were talking about, we were having this conversation I think when we were at Denver, you were talking about CRP as well and how useful that can be.

CRP is an interesting test and I really do suggest you get a baseline on it. There are two versions. Get the one that’s called high sensitivity or hs-CRP. It stands for C-reactive protein. What does that tell you? Well, some people will say it’s a heart marker. It’s not. It can be, but what it actually is is a generalized inflammation marker, and I think any of us who pay attention in the news these days know that inflammation is a big hot topic for a very good reason. Inflammation is sort of like, it can be very useful, but it can also be a bit of a wrecking ball within your system. 

Now, if you need to tear down a building, you need a wrecking ball, so if you’re sick, if you have some real dysfunction, if you broke a bone, you need your inflammation to go up because you need that inflammation to do what it’s supposed to do. However, when we have rather than acute inflammation, we have chronic inflammation which is ongoing high levels of inflammation that’s causing a lot of issues and a lot of metabolic damage, interactive damage. 

And so getting your high sensitivity CRP as a baseline can be fabulous because when most people go Keto that inflammation goes way down due to a couple of reasons. One is the removal of inflammatory foods and then secondarily beta hydroxybutyrate which is a ketone body has in and of itself anti inflammatory properties.

That’s an interesting one. I would like to get that done and again, Siobhan, she was really excited to get her CAC done (Coronary Artery Calcium) to get that score. Now that’s one of the slightly spendy tests, you’ve got to be quite geeky and have a bit of money to spare, but certainly a very useful test to get done.

Right. I would say that they tend to recommend you get your CAC at a certain age within this, you know, Siobhan’s younger, she got her CAC done. There’s a bit of discussion around if it’s worthwhile below a certain age just because you need a certain amount of age to show this kind of damage. But ,in the US at least, you can get the CAC done for around $99 and if coronary issues are of concern for you, say they run in your family or you know, you just know that you have a lot of risk factors for those things, you know, it’s certainly not a bad thing to do.

And the other one that can cost a fair bit of money, but it’s one that a lot of people wish they had done to start with is a DEXA scan.

Absolutely. I 100% totally completely wish that everyone had a DEXA scan to start their Keto journey. What often ends up happening, so if you don’t know what a DEXA scan is, it’s essentially like an x-ray of, that’s not the technical explanation, but it gives you an image of your body and breaks down what is fat, what is muscle, what is bone? And so one, it can kind of tell you how your bones are doing – so it’s important for like osteoporosis kind of issues – but, mainly in Keto, what we like is the body fat percentage. 

And one of the things that I have noticed is a lot of people don’t get a DEXA scan to start with and then they get a DEXA scan like six months into Keto and then they have a nervous breakdown because they’re like, “I have lost 50 pounds and I am 50% body fat. How is that even possible and what’s happening?”. Because they didn’t realize that before they started Keto – OK, I will say no one thinks they’re over 50% body fat and that is wrong – they were like 75% body fat before they started and were in some denial. So I mean, DEXAs can be a little bit of a rude awakening, but you know, you will be so glad you have that starting point.

Yes, it’s another one I would have. I would have liked to have that but you can’t go back.

It can also be very helpful in figuring out your macros.

Ah, yes, very true and we will go onto that in just one second. There were a couple that I would add I think especially for women, probably all women, and probably everyone to be honest, but especially if you’ve got any inkling that you might have a problem with iron deficiency is to get an iron panel because I think that affects a lot of people and where you’re at as far as iron goes and all the things that concerned with it, ferritin and how it gets transported around your system, and different percentages, all that stuff, can have a real impact actually on everything else. So sometimes these things, if you find out there’s an issue and if you target that and fix that, it’s the same with thyroid, isn’t it? It can have such a massive effect on everything else.

The other thing I, and I do come from a bit of a different perspective just because my journey has been so different because it wasn’t for weight loss, but for me, one of the things that was super helpful because I have a lot or I did have a lot of food allergies or food sensitivities caused by leaky gut and there’s an enormous number of people who have leaky gut but have no idea and they’re not used to correlating their symptoms with what they ate. I found it incredibly useful to keep a list, not how much I ate because again I wasn’t doing this for weight loss, but a list of what I ate and then I was linking that up. 

I mean, I discovered for myself that I was allergic to eggs because I noticed that on the days I ate eggs, about two hours after I ate them, all the skin on my feet fell off, which is weird, but true. Had I not been noting that down like I ate eggs, I ate cheese, hazelnuts, I ate whatever. It’s almost impossible to keep that all in your head and make those connections about what weird symptom could be connected to what food. If you don’t keep track of that because it might be that at some point if you’re not getting the results that you think you should be on Keto, or that you think everyone else is getting, it might be that your body’s like massively inflamed because you’re actually sensitive to eggs but you keep eating them because you didn’t know it was eggs and you take eggs out and voila, everything magically gets back on track. 

So that’s why I mentioned it because there’s some foods that can cause a whole lot of issue with anything working right just because you have a sensitivity to them. If you don’t know that, then you’re not going to eliminate it. A lot of people find that they have a problem with dairy. If you’re not keeping track of your symptoms and what you ate the day before or the hour before or four days before, it’s very hard to notice, as Daisy said earlier, those patterns. You can’t correlate them if you don’t write them down. So I would also advocate tracking what you eat, even if you’re not doing it for weight loss, because you can see patterns between what you eat and how your body responds that could be super important in your overall health.

And I think to be honest, you both know, I’m not a massive fan of tracking for myself, just mainly because I’m lazy and I can’t be bothered! However, I did at the beginning and I do whenever I think there might be a problem. So I think it’s something that I would recommend to anyone who’s starting – that they do track, at least for a given time, especially if they’re not aware of how much is in different foods. You get people who are really surprised of, “Boy, I didn’t realize how many carbs were in this food or that food!” and you make assumptions and by tracking for a while you start getting to terms with what’s in what. And, and I know Kim, you’re much more of a fan of tracking food and macros so maybe, I know those are, they’re linked, but they’re kind of two different things. Perhaps we could just talk a little bit about the importance of the two.

I also want to go, just take one step back – there were a few tests I didn’t mention and so maybe what we can do is I’ll give Daisy a list and we can put them in the show notes cause that might be a little bit easier about the baseline tests. 

CMP (complete metabolic panel)

CBC (complete blood panel)

Standard Lipid Panel

HbA1C

C-peptide

Fasting insulin

Basic Thyroid (if no symptoms)

Full Thyroid (if have symptoms)

Ulta Lab has a lot of great test packages. Another direct to consumer is Direct Labs.

There are additional tests, but that depends on symptoms. 

Okay, so in terms of tracking, I definitely am a bigger fan of tracking. Now, what I always tell people is know thyself, right? If you are someone who you say, “Kim, if you make me track, I’m not even gonna go Keto. I’m not, I’m just not going to do it!” then don’t do it. I’m not the boss of you! I just tell people what tends to work and not work. Now, if you are not tracking and you’re not seeing the results you want, then I would come back to you and say, how do you know what to change? Because you don’t have any data. If what you’re doing is working, work it, do it, keep going, go, go you! And, for some people, that works and they do awesome and they’re fine and life is fabulous.

Now, if you are not experiencing the everything you ever hoped it would be about Keto, maybe you’re not losing the kind of weight you want, if weight loss is important. As Carrie mentioned, for her, gut health and mental health were crucial. And so she really pinpointed a lot of that could be tracked in terms of keeping track of ingredients she was using and or level of ketosis. 

And so what needle you’re trying to move will dictate what specifically you’re tracking, but the more data you have, the more ability you have to make those adjustments. Also, though I would like to say don’t drive yourself insane! There are boundaries here. Some people just love tracking everything and so you have to find your happy spot. But I certainly recommend tracking your macros. 

Now that is with a caveat. Macros are only so-so accurate packages are only so-so accurate. I don’t know how fat that steak was versus this steak, that cow may have been more sedentary, this cow ate more grass. And so there is just some shrug, OK, you know, kind of so-soness you have to accept. However, I will talk to people who aren’t tracking and say, you know, “How many grams of fat do you think you’re eating in a day?” And there’ll be like, “I don’t know, 60, 70?” and then we track and it’s like 240. You know, that you can definitely use to evaluate some choices you might be making because we are just (I was gonna use a bad word!) we are terrible at estimating things sometimes that we don’t actually keep track of.

The other thing I wanted to reiterate (and you mentioned it just now Kim, but maybe I’m coming from a bit of a different angle) is you, do you. I think it’s, when you’re starting Keto, it’s incredibly, there’s like, the whole world is like shouting different ways to do it and it’s very easy to get sucked into, particularly on social media, looking at someone else’s results and copying their macros. Or you know, uh, well she doesn’t eat dairy, so therefore I don’t eat dairy or she eats loads of nuts and she’s losing weight, so I’m going to eat loads of nuts. 

You have to find what works for you. And I think it’s really important to understand that you are an individual right at the get go so that you can kind of try and stop yourself getting sucked into this comparing yourself with everybody else because everything for you will be different. I mean the general parameters are going to be the same but, within that, you’re going to find that it takes you longer to reach your goals if you’re focused on looking at someone else’s results and mimicking what they do and expecting that to work for you.

And so how important are macros? Macros, macros, macros gets thrown about all over the place. Anyone’s only got to mention Keto and macros. So, you know, what are they? And do we really need them?

I think yes and no. So, macros (for people that don’t know) macro is short for macronutrients and, when people use the term macros in Keto, they’re often talking about, you know, what is the layout of how much of these three macronutrients you eat. The three macronutrients are fat, protein, and carbohydrates. I do go over macros with people. I do think macros are important. 

However, if you think you can plug your height and your weight into some calculator online and it tells you that you should eat 19 grams of carbohydrates, 72 grams of protein and 137 grams of fat, or you’re going to fail! It can’t know that! Your experience matters. 

But macros are often a good place to start, but I would rather people have a slightly more nuanced understanding of macros. What are they for? So protein is a building block. We eat protein to rebuild our bodies. They get torn down on a daily basis. We need to rebuild them. It’s useful for building. It is a structural element. It is not primarily an energy source, not primarily, notice I use the word primarily, that is not its primary job. Carbohydrates and fat are primarily energy sources, but on a ketogenic diet we’re limiting carbohydrates so then fat becomes our energy source. 

Therefore, how much carbs, protein and fat we’re eating is very dependent upon our body’s energy needs. And so I would say: one, macros are very important, two, not in the way most people use them, three, you have to actually understand what is happening in your body to properly know how to calculate your macros.

So they’re useful in a place to start. I think so so many of these things is you, you need a place to start, you have to start somewhere and you have to start with something and you have to start with some kind of guideline of how much of each of those macronutrients to eat but, like you say, there are so many nuances involved but you gotta start somewhere.

Absolutely. Macros are a starting place. Experience is what tells you how to tweak from there.

It’s also good to know at this point that you decide are your macros when you start, is going to change because, as you heal and as you lose weight (if that’s one of your goals), your requirements (what your body needs) is going to change. So what you start out with is not written in blood. You will have to reevaluate that every, I don’t know, three months, six months or if you plateau, if you stop getting the results, if things stop changing, then you will need to change your macros to match the new you. 

And so you’ll have to go through that process repeatedly as you go along. But I think it’s good to know that now because I think a lot of people think, okay, this is what I’m going to eat forever and in, in my experience, looking at the thousands of people that I’ve interacted with, that’s just not true. You actually, you will progress and your macros will change and your needs will change as you go along on your Keto journey.

And the types of foods you eat will change, though I think the way that you start is not necessarily the way you continue. Maybe you start Keto very dairy heavy and that’s totally working for you and you’re doing awesome and things are going great, and then at some point something has shifted and suddenly it seems like your body doesn’t like dairy anymore and you have to respond to that. 

I think one of the tough things that people don’t always love about Keto when some people love it, there’s like two camps, there’s always you know, two camps, but there are the people who are like, “Just tell me what to do and I’ll do it and I want success and I don’t want to think about it.” And then there’s the other group which is like, “Life is an experiment and I’m always tinkering.” I would say the first group will probably struggle with much more frustration than the second because Keto is an adventure. 

It is always interesting and it is not one size fits all so, if you’re looking for somebody else to tell you what your body will do based on the information they’re giving you, they’re guessing. Now they may have a very educated guess. I do a lot of guessing. But then you do checking, guessing and checking. And if you’re not doing the checking part you might be very sad.

And I think from the most basic point of view, whether you’re really into tracking or not, the one macro that everyone needs to focus on is carbohydrates and simply limiting them below a certain level.

Yeah.

That’s another question. Well there are two things because you see macros expressed as percentages, which I don’t think works very well, I think it’s better to look at grams. So you hear that magic number of keeping below 20 grams of carbs per day. And again, that that is different for everybody but that’s a kind of a general rule that’s going to work for everyone isn’t it? But the other thing that gets asked a lot, and I know you get this question a lot is net carbs or total carbs, which should I be going for?

I am firmly in team total!

I know!

I’m firmly on team total for some reasons. One of which is actually something you just mentioned, right? Which is some of us have a higher carb tolerance and some of us have a lower carb tolerance, but we tend to recommend, and I tend to recommend, the lowest common denominator, right? Which is 20 works for almost everybody, so let’s go with 20 right? 

In terms of if you just need a number for grams of carbs and you’re not going to test what specifically is your range for where you stay in Ketosis? Some people can get away with more carbs and, just as an analogy, some people can get away with net carbs. But I don’t go by, I don’t suggest what some people can get away with. Like I don’t suggest not wearing your seatbelt because you may not get in a car accident. I suggest doing the thing that I find most effective for most people and that is counting total.

There are a couple of reasons. One, it’s less complicated. Two, some people are affected by fiber, depending on the type of fiber. And the other thing is that food manufacturers are getting very, very sneaky.

Um, really sneaky.

And so there are a lot of foods on the market that will tell you it’s 2 net carbs but you, it’s all you ate today and your ketones went from 1.5 to 0.2. Now I’m going to say that that’s either net carbs is BS or they’re lying to you with some creative math. And so I just find if you count total carbs, you avoid that whole mess because you’re like, “No, I don’t eat Quest bars because the total carbs are far too high.” I do have some tolerance for people looking into certain types of sweeteners, like maybe you’re like, “No, you know, my body doesn’t seem to have a negative impact from erythritol so I’m going to subtract those carbs are not count those carbs in my carb count.” 

I also have tolerance. If you say, “You know what, when I eat a lot of vegetables, my ketones are great and I don’t have any issues, so I’m going to count net carbs on leafy green veggies” and I’m like, “If that works for you, great.” But I certainly would not suggest net carbs on any package products with a lot of fiber because there are metabolically active fibers that they pretend aren’t.

Yes, exactly. People can get freaked out and I think that is often with a packaged goods isn’t it? They’re like, “What? Someone recommended this and it’s millions of total carbs.” And it’s because it’s got the sugar alcohols and everything in it. That’s another thing that’s interesting that is a debate that goes on and I certainly know that I’ve changed my opinion on it as I go and that’s how many of the Keto treats types of foods and the carb substitute types of foods to include in what you’re doing. 

And, as I say, I do think it changes as you go on. When I started Keto I wanted to play around with all those kinds of recipes and make the perfect Keto bread and cookies and all the things and that can be really good to see you through that hump. I’ve come to the place now where I hardly eat those kind of things because I find that they tend to bring out cravings and things for those types of foods and I tend to overeat and so on. But have you got a go-to or is it completely flexible about whether to go there with those kinds of foods when you start?

I think this is so, so personality based. It really is knowing yourself, you know, people will talk about – apparently I’m very binary! – there are two groups. There are the people that will say don’t feed the beast, right? If you feed the cravings, they’ll just follow you around. Like don’t, don’t treat him like a stray dog. And then there are other people that say, “You know, when I have the Keto brownie, I don’t eat a regular brownie. That is a win for me and I’m going to call that a win and be good with that.” I think it depends and people tend to know. Like last year at Christmas time I was like no more sweets for awhile. Like I was just done with them and I, you know, I had a month of just kind of meat and a little bit of veg and that was great and then you know, at some point in the future, I might say, “You know, I’m kind of feel like making some Keto something or other” and I’ll do it.

My list of products that I will buy that are Keto treats is exceedingly short because, if it has ingredients that require I have some type of a lab in my house to make, I don’t want to eat them from the lab, from the, you know, the purchased product either. And I’m not trying to like say like science is bad. I’m not, I’m not saying that, I’m just saying I know how certain foods work and if I don’t understand what the food is because it’s been changed so much biochemically, I can’t trust it anymore.

Good point. What about you Carrie? You’re into all things to do with cooking. What’s your view on this for somebody who’s starting?

For package products – and I’m always going to err on the side of how it tastes – Kim’s here to give us the science about why you shouldn’t eat it and I’m just here to say…

Plus they do taste like complete crap as well!

They do. And because I’m less focused on weight loss and I know how to keep myself in my brain happy range, I will try or I’ll have a bite of all of them. And I can tell you that 95% of packaged products don’t even get on the bottom rung of the scale of tasty in my little world. So I would always suggest, for different reasons to Kim, but I would always suggest that learning how to cook some things, simple things, and using real whole foods is always going to be a million times better than any packaged products you can buy. 

There’s a few exceptions to that rule, but honestly, if you look at the recipes that Kim and I create, it doesn’t take you to have a degree in the culinary arts. It does not take a ton of time. It does not take a lot of fancy equipment or expertise. We’re really focused on helping you become brilliant in the kitchen in a way that you probably never thought possible, but in very simply and easily and quickly, being able to create delicious Keto meals that are better than anything you’ve been eating for your life so far and are light years better than any packaged product you can buy?

Yes, I must admit what I’ve found with, and I’ve got to sample a few more of these products, the ones that are the nicest are the ones that are quite close to home cooked foods.

Right.

It’s the ones that have quite a short shelf life and they are basically home-baked Keto foods that might have a bit of preservative or some kind of thing in there to extend their shelf life a bit, but they’re basically pretty much what you could do at home and they’re the nicest ones that I found.

I think whey is a problem in my experience a lot of people find whey products very difficult to lose weight on. And a lot, I would say the majority of products out there that are kind of like a baked thing or a bar or something that’s cooked, they’re going to have whey in there. So I won’t even look at products that have whey in them.

Yes, I feel that it’s a bit problematic. I know you do too as well, don’t you Kim?

Yeah, I mean I think there is a time and a place potentially for use of things like whey protein isolate in terms of are you a bodybuilder person who’s looking for a specific type of an effect? Biochemically and what it, but I don’t use it as a filler ingredient in baked goods. It’s a targeted type of isolated protein that you may or may not think is useful within a certain context. But I see a lot of people using it as a, you know like a “free flour” in a baked good because, “well it doesn’t have any carbs!” But it does have other effects and I just simply find from experience people don’t do as well when they include it for the most part. 

Now the poison is sometimes in the dose, right? Like I once saw a creamer that had what was probably an infinitesimal amount of it. That would be different say than you know, making a whey protein shake. So you know, I also want people to use common sense. But most of these packaged products: one, they don’t taste good, two, they aren’t great for you, three, I think there’s just some sort of like mental pathway that they awaken about junk food eating. It’s just bad layered on, not good, layered on sort of meh. I don’t think that’s a good layer cake. There are recipes you can make that are super easy and there are a few products that are tasty in my opinion and not so bad. So stick to that short list and or cook a little bit is probably the better way to go about things.

However, when you’re starting out, if grabbing one of these products is what’s going to keep you going, do that! Because we would rather you stay on of much of you on the Keto train as you can when you’re starting out than completely go and buy a box of Little Debbies and chow down on those.

Absolutely. I think a very important thing that we have stolen from the 12 step community is “Progress, not Perfection”. I think if you’re like, if I’m not perfect, screw it all. I’m having the Little Debbies. You might want to just reevaluate your mindset and make the best choices you can today and you can make better choices tomorrow.

But if you’re caught out, if you’re in a situation where you didn’t plan well or the day went sideways and you find yourself out and you have a Quest bar in your bag, eat the Quest bar rather than drive through McDonald’s and get a Big Mac and fries is all I’m saying.

Exactly. There are always those choices in the moment to make aren’t there? And I think what we’re talking about underlying this, and it’s an important thing to deal with are cravings. Cravings you’re getting for those old, carby foods, that’s when you’ve been doing it for a while, but it might just be those carby foods that you gave up yesterday.

Well it looks like we’re going to have way too much information for just one show, so we’re going to break it here and come back with part two next week.

Yay part two!

Yay.

Thank you very much.