I wanted to share a recent story about my experience with the Carnivore Diet and Low Insulin Lifestyle. Maybe it’s because I just finished watching Netflix’s Apple Cider Vinegar, but sharing my health experience feels strange: very health-influencer-esque. There is some mention of weight and weight loss and some mention of body image and my relationship with food, but that’s not really what the story is about: it’s about insulin. I know I’ve shared things of this nature before, and sometimes, weaving stories can add some humanity to what might otherwise be a cold and clinical onslaught of health information.
So, if you find the idea of reading about me intriguing or even entertaining, read on. As usual, remember that this is my experience and can’t be extrapolated to everyone. Let’s talk in a clinical setting if you read something that resonates with your experience and want to learn how it might fit your health history and goals.
Last summer, something shifted in my health. Maybe it’s the same thing that happens to most women around this age (late 30s), i.e., the catch-all explanation-replacement for “it’s just stress”-perimenopause. Maybe there was a shift in how I was taking care of myself, although it felt like I was staying on top of everything. I walked a lot, went outside, and ate fruits, vegetables, and protein. But something still felt off.
And the thing that felt “off” was what so many patients often complain about. I felt… well, I had gained some weight, and not just physical weight. I felt mentally and spiritually heavy. The weight seemed to pile on out of nowhere. I shun the scale and rarely weigh myself, but one day, I did. The jump in number was so big in such a short time that my judgey scale asked if I was the same person who had weighed in 3 months before. Wow. Nice…
The heaviness wasn’t without its causes. That Spring, I finished my Masters of Counselling Psychology–a long, almost three-year slog. Shortly after, my 15-year-old dog, Coco, stopped eating for four days. He was diagnosed with protein-losing enteropathy and put on a daily dose of liquid prednisone, a steroid. Coco has been with me from the start of all this, when I first filled out applications to attend naturopathic college. He slept beside me during late nights of studying. He came with me to my exams. The sleepless nights, the decision-making, weighing the responsibility of senior pet ownership–when to intervene medically, when to decide to end his suffering, of course, the sheer financial cost– was a lot to grapple with and went on for months. It’s still going on, to be frank.
That summer, my Nonna passed away a few weeks before her 97th birthday.
I wondered if it was grief, or stress, or even steroids getting on my skin, but I felt puffy. I was tired. I felt sluggish and less stress resilient. I was still active but doing more sedentary activities: reading and learning guitar.
Weight and digestive issues have been a struggle my entire life. The “healing journey” has led me on some valid paths: exploring food sensitivities and gluten-free living, nutritional support through supplements and nutrient-dense foods, meditation and mindfulness, adrenal support and herbal medicine, and prioritizing rest and mental health.
But, regarding nutrition, I felt I was doing everything I could. I didn’t want to go down the road of caloric restriction. I didn’t want to deprive my body or fight its process. Sometimes, weight is protection. Sometimes, we need a warm, heavy blanket. Sometimes, we need to slow down.
So, I did. Of course, I was tempted by thoughts of how to solve the weight gain by dieting, as so many of us have been programmed to do. I even recorded a podcast about retraining myself to value and preserve my muscle mass rather than trying to become smaller. I accepted this new shape and focused on the tasks: my work, hanging out in nature, surfing, and healing my gut.
My gut health was terrible, although I was managing it based on all the research I had sifted through on my way to creating a gut health course. I added in more fibre and fermented foods. This worked for a time but didn’t solve the problem entirely. For most of last year, my irritable bowel syndrome was wrecking havoc. I was highly distended, often in pain.
I had brain fog and physical sluggishness. I felt stuck in a parasympathetic state. So, I sat on the couch, enjoying slow mornings, reveling in the absence of deadlines. I read books. I went for long walks. That summer, I swam in lakes and went to the Atlantic ocean.
While trying to be patient with my body, I constantly felt that I wasn’t tapping into the energy from my food. I would eat a full day’s worth of food and some stews, legumes, rice, smoothie, and salads and still feel hungry. I was constantly thinking about food. I tried to honour this by just eating more whole foods. I believe the body asks for what i needs, if we’re willing to listen. So I tried my best to listen.
Around Christmas, I was at a cafe with my boyfriend. He was eating a sandwich. Ever since naturopthic college, I have diligently avoided gluten. But I was already feeling sluggish and bloated. I was already tired. And here was a delicious, bready baguette. A delightful sandwich with soft carbs, mayo, cheese, and meat, just inviting me to sink my teeth into it. What good was avoiding gluten doing me at this moment? I avoided gluten to feel energized, healthy and light. I already wasn’t feeling that way, so eff it, how could things get worse?
I took a bite. It was divine. I let myself eat gluten for the next month. Glorious, glorious bread! I felt like my life was straight out of the pages of Eat Pray Love as I gorged on all the pasta and pastries I wanted. I chilled at Christmas parties, eating brie, bread, cakes and pies. I had all the dessert. There were no limits anymore. And, in a way, that food freedom did heal my soul. It was like a vacation from all rules and guidelines. We need this from time to time.
But, if I was barely staying afloat before then, adding in the gluten and sugar made me slip below the surface. I was insanely bloated. My weight soared. I felt sore, stiff, and clumsy. I had significant brain fog. My ankles and face were comically puffy. While I didn’t regret a second of it, after my foray into the world of gluten, I decided it was time for a reset.
After much consideration, a light switch clicked on, and I decided it was time to try the Carnivore Diet.
The premise of the Carnivore Diet is that it’s the ultimate elimination diet. It’s ketogenic, or zero carb, and contains no FODMAPS (fibre), grains, or other allergenic foods. It gives the gut a chance to reset.
While we often hear about how good fibre is for us, the truth is that some research shows that eliminating fibre can heal constipation. Emptying the gut and consuming a low-reside diet, in other words, all the components of the diet are digested and absorbed early on in the digestive tract, can give the colon a break. Further, burning ketones can heal the gut as the primary ketone, betahydroxybutryrate, is food for gut cells (we often hear about butyrate in the context of eating fibre).
Advocates of Carnivore talk about appetite control, abundant energy, healthy digestion, clear skin and effortless ease in maintaining a healthy body weight. I wanted this. I also wanted to feel more connected to my body and its energy processes. I wanted agency over my food cravings. I felt my appetite was out of control and my body needed something it wasn’t getting or couldn’t access.
Within the first 24 hours of Carnivore, my brain fog lifted. After the first week, I dropped 12 lbs . It felt like emerging from the fog into sunshine, and tossing off a heavy cloak.
I felt fully nourished for the first time in a long time. I ate a lot of fat, meat, eggs and even dairy. I felt energized. My appetite calmed down. I woke up in the morning, and instead of rushing something down my throat, I made myself a coffee and felt hunger slowly creep in.
I would prepare a big breakfast of meat and eggs that would hold me until the mid-afternoon. The food noise died down. My brain felt supercharged- I could think again. Even after long hours of talking to patients or working at the computer, I felt my brain could keep going and going and going. I no longer got that white noise static electricity that I associated with oxidative stress caused by overworking my neurons.
My mental health was better than it had ever been. I felt calm, persistent brain energy and agency over my thoughts. I felt emotionally stable and resilient. Nothing seemed to phase me. I felt strong.
I felt great. My original intention was to do the diet for a couple of weeks, but after the first week, I thought, I can do this forever! This is my diet, it’s my way of eating, something about it felt right. It was also the dead of winter. What would I be surviving on if I were in the wild right now? No fruits and vegetables were around; the ground was covered in snow. I would be hunting and killing animals and surviving on their meat. This way of eating felt aligned with the season, and I believe it was what my body needed at the time.
My brain and body thrived on the ketones. I had no cravings. Even on my birthday, I just wanted a nice ribeye steak. I couldn’t care less about cake, potatoes, or any other exciting comfort foods we look forward to on birthdays.
It was hard to sustain the diet on vacation. When I went to Ecuador in late February, I decided to let go of Carnivore and eat what was available. Because of the sun, surf, walking and relaxed vibe, I felt good in Ecuador, but my body felt far from magical. I dealt with chronic gut issues, miserable period cramps and a three-day migraine throughout my time there. On the plane ride back, I was ready to restart Carnivore and found it relatively easy to jump right back in the following day.
I hesitated to talk about my experience on Carnivore even three months into the experience. I felt great. My body felt like an efficient engine, burning fuel cleanly. However, the food was all…well, brown. And salty. And I often felt dehydrated. Also, after the initial drop in weight, I had stalled.
Grocery shopping was a strange experience. It felt surreal to be surrounded by all this… food. Stuff that wasn’t a part of my day at all. It wasn’t the snacks or chips or candy or even the carbs that tempted me. It was the rainbow of fruits and vegetables that greeted me every time I wheeled my cart into the store.
The fruits were shiny and colourful, advertising their sweet, hydrating juices and vitamins. Glycogen, or stored carbs in our muscles and liver, hold water in our bodies. On a low-carb diet, we often burn through our glycogen stores. If there was one thing I craved on Carnivore, it was the sweet hydration of juice.
One day, I was browsing Instagram and saw a comment on a popular account about glucose regulation. The account features a biochemist/influencer who shows a series of continuous glucose monitor graphs and discusses the glucose response to food. Her methods feature tips like “add fat to your carbs to lower your glucose spike.” This post highlighted how adding fat to starches (like hummus, which adds fats like olive oil and tahini to starchy chickpeas) can reduce the height of a glucose spike, helping to regulate blood sugar.
This is something I often coach my patients on, as blood sugar regulation is the key to mood stability, mental health, cognitive energy, and adrenal function, among so many other things. Interesting how I was kind of wrong about that.
The comment that caught my eye was written by a PhD who pointed out that while adding fat and carbs together can lower a glucose spike, it does not change the height and area under the curve of the insulin spike. Adding fat to starches might make the insulin response to food larger, even if it’s curbing and controlling the rise in glucose. It hit me then. We’ve been focusing on the wrong thing. I assumed glucose and insulin were like two twins on a tandem bike. One rises, and the other one joins in. Seesaw, yin and yang. But I started connecting the dots from the cases of patients I’ve seen, my experience, and third-year biochemistry. Yeesh, it’s all about insulin.
I remembered something else, too: the Insulin Index.
88-90% of humans are insulin resistant. We can’t access our fat stores or the energy from our food because we have chronically high insulin levels and unresponsive cells. Insulin’s main job (or maybe its most famous job) is to help drive glucose into shelves. You consume starch, glucose explodes onto the scene, and insulin puts it all away for you. It stores the sugar as glycogen and fat, and your body burns those later for energy.
Naturally, whatever causes a rise in blood glucose will also cause a rise in blood insulin. But sometimes, glucose isn’t rising on a continuous glucose monitor because insulin has already lept onto the scene to bring sugar down. Further, some foods, like whey protein and milk, don’t spike glucose much but will have a (significant) impact on insulin levels.
The commenter, Dr. Ali Chappell, PhD, described herself as an insulin researcher. Her research involves examining the effects of a low-insulin spiking diet on PCOS (an insulin-resistant hormonal condition that affects about 10% of women). The Low Insulin lifestyle was tested on various women who reliably lost 19 lbs in two months without counting, eating as much fruit, non-starchy vegetables, nuts and seeds and animal protein as they wanted. When I discovered Dr. Ali Chappell, I had just been hired to do a course on Insulin Resistance, which involved researching the manifestations and solutions to keeping ourselves metabolically healthy.
While a low-carb or Ketogenic diet like the carnivore diet can certainly heal metabolic dysfunction, it didn’t feel right to recommend this lifestyle to patients. It wasn’t for the faint of heart, for starters, and something in my soul was starting to miss fruit and vegetables. As part of my course research, I began to dive deeper into the low-insulin lifestyle.
Some bells started to ring for me. At the same time, my good friend was struggling on Carnivore because, while she felt great, she was breastfeeding, and the diet was affecting her milk supply. I shared with her what I learned about the Low Insulin Lifestyle. She started on the diet and, within a few days, told me her cravings and hunger were diminished. She was dropping her weight-loss-resistant belly fat like a stone.
After she had been on it for a week, I followed. I was ready to add more colour to my life. I removed the whey protein and dairy I had been eating, thinking it was fine and not realizing it was impacting my insulin. I added more fruits, vegetables, nuts, and seeds. I had dark chocolate again!
The variety was lovely. My gut was ready for fibre again, particularly the soft, gooey, juicy fibres from fruit. It felt good to fill my stomach with bulk. And it felt terrific to eat so many colours and textures of food.
Weight loss that had stalled for months after that initial drop on Carnivore kicked up again. My appetite chilled out, and I felt nourished again. I realized this eating pattern had been something I stumbled on from time to time: my trip to Brazil in 2020, my first forays with Paleo, even following the guidance of a microbiome test I did in 2021. However, none of these experiences involved intentionally targeting insulin. I would often eat starches like sweet potatoes or rice. I sometimes cut out fruit, with its fructose, which has a minimal impact on insulin.
This finally clicked things into place for me. It helped create a framework to encase my intuition around food and what humans should eat.
I was consuming whole, natural foods our ancestors would have consumed. Unprocessed plants and animals. Lots of healthy fats. Lots of sugar from fruit. Phytochemicals from colourful plants. Protein and nourishing fat from meat, eggs and some yogurt or cheese. I ate berries and burgers. Salads, broccoli and asparagus. I had sausages with organic tomato sauce. So many bacon and eggs breakfasts. I had nuts and seeds and pumpkin seed butter. I had dark chocolate and bananas. Pistachios. Shawarma meat and salad (hold the rice). It was easy to make decisions and figure out what to eat.
Looking back, I think glucose intolerance has plagued my whole life. It has affected my body and my relationship with food. It led to years of binge eating that only stopped if I ate more consistently. Protein helped immensely.
When things started to feel off, I consulted with a family doctor. I ordered some bloodwork through her and did some myself. My fasting insulin levels and insulin sensitivity (HOMA-IR) value were normal. However, when we eat foods spike insulin, it can cause a post-prandial (i.e., post-meal) rise in insulin that can stay elevated all day, as we go from one meal to the next. It can spike hunger and cravings, causing us to eat and continue to boost insulin. While hyperinsulinemia can lead to insulin resistance, I don’t think my body was there quite yet. I was raising my insulin levels, blocking my body’s access to energy stores and driving the hunger, inflammation and heaviness I was feeling.
Insulin sensitivity and glucose tolerance tend to shift as our hormones change through our late 30s and 40s. As estrogen and progesterone levels change, insulin levels increase, and we become more insulin resistant. This explained that shift I felt. The old patterns of diet and exercise I was engaging in weren’t working either. I needed to be more intentional with the way I was eating and exercising.
I started adding in more resistance training, scheduling in weights and high intensity interval training two to three times a week in addition to my yoga, swimming, and walks. The carbs from fruit helped fuel my muscles. I felt myself shift out of that parasympathetic shutdown state. I watched my nervous system enjoy more flexibility.
In a few weeks, I will start filming my course on insulin resistance. Then, it will go to editing. I’ll let you know when it’s time for it to be released. The course has been a gift. It allowed me the space and time to dive deep into the research and start putting various bits and pieces together. Metabolic dysfunction is the great health crisis of our age. I’m becoming more and more convinced that it drives so many of the common concerns we see in natural medicine practices: SIBO and candida overgrowth, adrenal fatigue, estrogen dominance, and chronic inflammation. There is a whole budding field of mental health called “metabolic psychiatry” that examines the role that insulin resistance has on mood and brain health.
Until proven otherwise, if a patient is dealing with high insulin, we must address this as a potential root cause that ties together all their concerns.
The medical establishment often overlooks insulin resistance, as the primary focus is on diabetes, which represents a later stage on the disease continuum. Decades of dietary advice have also set us up for metabolic inflexibility and an overabundance of dietary glucose that overworks insulin and blocks our ability to use energy for brain and body health.
The good news is that I believe the solution is simple. Eat a diet that leaves insulin alone: animal protein, nuts and seeds, fruits, non-starchy vegetables and healthy fats. Leave aside the starches (grains, legumes, root vegetables) and sugar. Add in some higher intensity training and work your muscles. With this approach, we have the start of a full-blown health revolution on our hands.
Stay tuned for more podcasts and courses on this topic in the coming months!
I am excited to introduce a new podcast episode (I know it’s been a while). I’ve been deep in the weeds of research about insulin resistance for a course I’m working on (for a health education platform that I’m very excited to tell you more about in the coming months).
I came across Dr. Ali Chappell, PhD, when researching my course. She helped hit home for me this idea that we’ve been focusing too much on blood sugar when the real focus for better metabolic health, body composition (i.e., weight management), energy and mood needs to be on INSULIN.
For years, I’ve been telling patients to “put clothes on their carbs” by adding fat and protein to higher-carb meals to regulate blood sugar. I’ve also recommended whey protein for protein powders. I didn’t realize this was the wrong approach for supporting metabolic health when someone is dealing with insulin resistance (as many of us are).
While these foods and practices DO regulate blood sugar, they don’t minimize the root of blood sugar and insulin resistance issues, which is insulin spikes.
You might have heard of the “glycemic index,” which tells us how much a food spikes blood sugar. Well, there is also something called the “insulin index.” Dr. Ali Chappell, PhD, decided to look more deeply into this concept when developing a lifestyle to treat her PCOS, an insulin resistance hormone condition, and the number one cause of infertility in women.
She found genuinely remarkable results in herself and decided to turn to science to test her theory.
In this podcast, we discuss her research done on women with insulin resistance and PCOS. These women got incredible results, losing an average of 19 lbs and reducing their fasting insulin levels by 50% in 2 months—eating all the nuts, fruit, vegetables, fat, and animal proteins they wanted. In this study, the women counted no calories, carbs, protein, or macros. They just avoided foods that spike insulin. It’s very simple.
This research has been repeated three times, and a randomized control trial is set to be published soon. In this trial, the lifestyle was tested against conventional medical advice for PCOS and insulin resistance (eat less, exercise more, and take medication).
We talk about the science of insulin resistance and how food impacts insulin, why we need to start focusing on insulin as a medical community, and how to take back your life, manage your appetite, and stop cravings—all the good things—so you can live with lower inflammation, better mood, and better energy.
We might have discussed this lifestyle plan if you’ve seen me in the past few weeks.
This podcast is a must-listen if you’re struggling with
Abdominal weight gain and difficulty losing weight
low energy
hunger and cravings
considering Ozempic or other GLP-1 medications
PCOS and other insulin-resistance conditions
Have seen high insulin, high blood sugar, or high cholesterol on your bloodwork
have hypertension, insomnia, energy crashes throughout the day, irritability
inflammatory conditions (anything that ends in “itis”)
a family history of Alzheimer’s and dementia
a family history of cardiovascular disease
…and so on and so on- everyone can benefit as 90% of us are insulin resistant, and I’m becoming more and more convinced that conditions like “adrenal fatigue” or menopausal weight gain are due to elevated insulin levels affecting our bodies’ ability to get energy and burn fat.
I’m so excited that Dr. Ali agreed to speak with me and that she was so generous with her time and information.
Speaker1: [0:02] So welcome, Dr. Ali Chappell. Thank you for meeting with me.
Speaker0: [0:06] Thank you for having me.
Speaker1: [0:07] Yeah, and how I found you, just for the audience to know, is I was on a very popular Instagram account about glucose regulation. We may not mention the name, and that shows a lot of continuous glucose monitoring. And one of the things that it highlighted was if you combine, like if you eat if you combine chickpeas with fat, you get less of a glucose spike. And I was drawn, my attention was drawn to your comment. And you had a very thorough, very interesting comment about how, I know, partly why that glucose spike is reduced is because when you combine starches and fats together, you get this big insulin spike, which is lowering your glucose. And it, you know, as a naturopathic doctor, you know, I think, you know, we pay a lot of attention to insulin resistance, we pay a lot of attention to blood sugar, glucose, metabolic health, but there’s something about how the medical community and even natural health doctors tend to frame everything about glucose, you know, and this is a very popular Instagram account. Everyone loves it. It’s like all about how to lower your glucose. And we forget that it’s actually insulin that we’re trying to regulate. And so then I started following you, you know, read your book, read your research. And so I’m really excited to have you on.
Speaker0: [1:25] It’s my favorite topic.
Speaker1: [1:26] Yeah.
Speaker0: [1:27] I, Sometimes I get a little frustrated when I scroll through Instagram because it is this very glucose-centric, but that’s not just Instagram, that’s the medical community as well. So I think we’re turning a page and I think we’re moving in the right direction from a medical perspective, but we’re not there yet completely.
Speaker1: [1:47] Yeah, like we’re hearing the word insulin mentioned more, but it’s still all about glucose. And so maybe we can start by you explaining a little bit about, you know, blood sugar, insulin resistance and insulin, you know, and I mean, I told you in the email and in our communication that my audience knows, they have a bit of a background about insulin resistance, but it’s always helpful to hear it again. And also for newcomers that are just joining, it would be helpful for them to hear a bit of an explanation.
Speaker0: [2:14] Yeah. Well, maybe I’ll start with how did I even get into this, right?
Speaker0: [2:19] And where did Um, you know, I have PCOS. I started having symptoms at 14, just a lot of weight gain and acne. And at 21, uh, and I had one period a year. Um, and at 21, I was studying to be a dietitian, never heard of PCOS. I went to the on-campus clinic and a women’s health nurse practitioner diagnosed me and basically said, well, you need to lose weight, which every dietitian loves to hear.
Speaker0: [2:46] And that, you know, I need to watch my weight. And, you know, here’s a brochure and a pat on the back and here’s some of my pentacle pills. And that was, that was it. And I was like, how does my diet and my ovaries have anything to do with each other? Like I literally am about to graduate with a bachelor’s in nutrition. I’ve never heard of PCOS. So that really where I started researching this and was like, it has all to do with insulin resistance. And at that point, the only thing I knew about insulin was, you give it to diabetics to lower their blood sugar. That was all I knew. So it was understanding really how insulin is the driving factor of PCOS. So then I thought, okay, well, what raises your insulin levels? And that really led me down this journey of, well, okay, so there are certain foods that raise insulin, even if they don’t raise blood glucose. And what does that mean? And what are those foods? And that is really what started this journey. So, you know, I incorporated this kind of what low insulin diet, although I just don’t like the word diet. It’s kind of a four-letter letter word, especially because I struggled with binge eating for so long because of PCOS and because I couldn’t lose weight. So I called it a low insulin lifestyle.
Speaker0: [3:52] And that really started the journey. It worked, you know, it was amazing results for myself, you know, with acne and, you know, helping me lose weight. And so that’s when my PhD advisor was like, well, why don’t you just do a study
Speaker0: [4:05] and see if it works for other people? And so, you know, I was very lucky. I got grant from the Laura W. Bush Institute for Women’s Health Research, you know, a prestigious research scholar grant for $25,000, which allowed me to kind of start the study. And that really, the results were, you know, better than I could have expected. I was working with a reproductive endocrinologist, and she was sending only all of her patients. And so that really led down this journey. So now we’ve been, we’ve done three studies now, a randomized control trial. And So here’s what that is kind of what’s launched this whole low insulin lifestyle and all the data to support it. But, you know, I think when you start with understanding that over the past several decades, more than that, probably.
Speaker0: [4:52] Medical establishment focuses on glucose, and they don’t really care about how you lower glucose. They just want glucose within a normal range. And so that has led to the development of many, many drugs, pharmaceutical drugs, that stimulate the pancreas to make more insulin, right, in an effort to lower blood glucose. And once that patient’s glucose is in the normal range, they get a glurine check, and they’re off on their way, and they’re healthy.
Speaker0: [5:19] But the problem with that is that so many people, their pancreas is just overworking so hard to keep that blood glucose in the normal range that there’s a class of medications I’m sure you’re familiar with called sulfonylureas, and they stimulate the pancreas to make insulin. And yes, the glucose levels normalize, but the long-term side effects of these medications are pancreatic cancer and worsened insulin resistance. Because when you’re raising insulin levels in the blood, you’re going to have worse health outcomes. And so we’re now beginning to realize that it wasn’t ever the glucose that was the problem. It’s always been the insulin.
Speaker0: [5:58] And so I try to explain it as, imagine you hire somebody to fix your foundation of your home. And they come in and all they do is patch the cracks in the wall, right? And they fix the cracks. So you don’t see the foundation, you know, the cracks anymore. And you’re like, they’re like, all right, it’s fixed. And you’re like, did you really fix it or did you just fix the symptom? Because that’s the problem. Glucose imbalance is a symptom of an insulin problem. And so I think now, finally, we’re starting to really turn the page and say, well, you know, if I’m not measuring insulin, then how do you really have the full picture of what’s going on in the background to make that blood sugar go well? Does that make sense?
Speaker1: [6:42] Yeah. Yes, definitely. Yeah, it’s infuriating, as you said. I mean, people will have all the symptoms, which I’m sure we’ll talk about, of high insulin, insulin resistance, but their blood sugar will be normal, even ideal. Their HbA1c will be ideal. And then it’s like, okay. So often what I have to do when people bring in blood work if we’re not ordering it ourselves is like kind of look peripherally at the signs and symptoms like, oh, you have high triglycerides, you have low HDL. Oh, you’ve noticed weight gain, you’re not sleeping. So it’s looking at kind of all around it when we could just directly measure insulin. It’s not very expensive.
Speaker0: [7:18] It’s not, but you know, there’s some problems with that. So historically it was using what are called immunoassays, which are We’re not always very consistent, but now we’re using mass spectometry, which is very consistent, very accurate. So a lot of the providers and the things, why the reason that measuring insulin isn’t in standard practice guidelines is because they say that the results are not necessarily always accurate, and so they don’t want to test that. That’s not true anymore, right? We have devices that can measure hormones in urine using your phone. And you’re telling it, we can measure insulin accurately in the blood.
Speaker0: [7:58] The second problem is that we haven’t developed standard normal ranges. Okay, so if you go and get your insulin tested today, whether it’s through Quest or wherever, all of them are going to have a different range of normal and they’re all wildly inaccurate. So they’ll say that anything between 3 and 30 micro units per milliliter are normal. Like anything over eight is considered to be too high. And some even say even above six is too high, but eight is as a more well accepted, you know, they’ve been, they’ve done some studies looking at this and over eight really is where you, it sets you up for, you know, problems. So for somebody, I’ve had plenty of people say, well, I have all these symptoms, but I’m not insulin resistant. And I’ll say, well, did you get your insulin tested? And they said, yeah, it was 22. I’m like, well, that’s three times higher than it needs to be, you know, but we don’t have the standard normal ranges. So until we have mass awareness that testing insulin is important, normal ranges so that people actually know what is and is not considered a problem, then I think we just, and also just the general education of the healthcare community that measuring insulin is the other part of the conversation and even a bigger and more important part than just glucose um because otherwise people are just walking into a house and you know assessing the foundation by whether or not there’s cracks in the walls and that’s just not how you do it.
Speaker1: [9:27] Yeah and i think too um knowing how to treat it right because a lot of people and and also for the canadians eight uh is about 42 or 50 in the standard units so people looking at their blood ever being like that.
Speaker1: [9:45] But still, you know, the ranges in the SI units go up to 300. And I have seen people over that range, but not commonly. But often people will have a HOMA IR value that is abnormal. So it’s a little bit more nuanced and helpful, which is a calculation with fasting glucose, fasting insulin. But another part is just knowing how to treat it because people are told like, well, you’re already eating well, very general term, and moving. So let’s just watch and wait until you have type 2 diabetes, and then we’ll give you drugs for it, basically.
Speaker0: [10:22] That’s absolutely what’s happening. And that’s where really the issue is. And what I’m trying to do is that the standard nutrition recommendations don’t really work for insulin resistance, because they’re not focused on minimizing insulin spikes. So I’d always like to use this like an orange with thumbtacks. I don’t know if you saw that post on my profile.
Speaker1: [10:49] Yeah, that was good.
Speaker0: [10:50] Yeah, I thought I.
Speaker1: [10:50] Was stealing your idea from my course I’m doing. It’s a great vision.
Speaker0: [10:54] The more education gets out there, the better. So, you know, I kind of show this orange with these thumbtacks. And I say, well, this is a cell. And these thumbtacks are your insulin receptors. And when you eat foods that spike insulin, and I’m gonna say insulin, not glucose, although sometimes they’re together and sometimes they’re not, but we’ll talk about that later, is that when you eat foods that cause these insulin spikes.
Speaker0: [11:16] Those receptors become overwhelmed with all the insulin in circulation, and they start basically saying, whoa, whoa, whoa, I’m overwhelmed. I’m going to start removing these receptors from my surface. And when that happens, there are fewer receptors where insulin can bind and pull glucose in because the only way they get glucose out of the blood is to have insulin bind to a receptor and it pulls the glucose into the cell. Well, if you have less receptors, then you have less ability to get glucose from the blood.
Speaker0: [11:45] Well, pancreas then says, hey, wait, there’s too much sugar in the blood. We can’t have all this sugar in the blood. So it sends out more insulin. And that kind of starts this vicious cycle. So now you’ve got the pancreas compensating for these reduced number of receptors, which then makes more receptors disappear. And here you are eating every two hours foods that are causing more insulin spikes. And it really causes this huge vicious cycle because more insulin in the blood means more of the food you’re eating is going to be stored as fat as compared to used. And it also means your metabolism is going to slow because your brain says, whoa, my cells are starving. We don’t get enough glucose. I don’t know where my next meal is coming. I’m going to slow everything down so that we don’t have to start burning muscle for energy. And that’s when you go take naps. And that’s when you have chronic fatigue. So all of it really starts with what you’re eating and whether it’s spiking your insulin, because that is the stimulus that gets the snowball rolling.
Speaker0: [12:50] And then, you know, at that point, the problem that most people find is that they will have all these symptoms. And like you said, their glucose will be normal because your pancreas is still able to secrete enough insulin. It just… It just can’t get the job done. It can keep the blood glucose level stable for long enough, but eventually it starts to get out of hand. I think of like the I Love Lucy episode. I’m dating myself. But, you know, when they’re in the chocolate factory and they’re like, oh, this is okay. Like, we’re good. And then the machine like starts going and they’re like, whoa, whoa, whoa, I can’t keep up to date. But that’s basically like your blood sugar, essentially, where it starts to
Speaker0: [13:32] get too out of control and they no longer can get it managed. The pancreas can’t manage it. So I hope that I like to give these visuals so that we understand like what’s happening below the surface.
Speaker1: [13:42] Yeah, I often use the like beach ball. It’s like, OK, your beach ball, you’re pushing it down. But the more buoyant it is, the harder you have to push. So the amount of insulin is telling us how hard are basically is your pancreas working to keep your blood sugar where it is. So your HbA1c is, let’s say, 5 percent or your fasting glucose is 5. These are the Canadian units, which is normal, which is ideal. But there’s two people with the same blood sugar. One may have really high insulin pressing down on that fasting glucose and someone else may have low insulin. So their cells are a lot more sensitive. And so it’s like only when you can no longer suppress it, then you start to see rises in blood sugar. And then you start to, you know, have your doctor call you in to say, hey, you’ve pre-diabetes, you know.
Speaker0: [14:29] Yes. I think that’s the other thing. I wish that the diabetes community would come up with different terms for the different types of type 2 diabetes, right? Because if you’re just measuring a glucose, well, you don’t know if that person’s making so much insulin, it’s just not working very well. Or if their pancreas is, I call it a lazy pancreas, if you saw in my book, right? Or they have a lazy pancreas. So, you know, I think there’s quite a bit of people now talking about these very thin people who say, I’ve always struggled to gain weight. I’ve never been able, I’ve never had to struggle with my weight, but now I’m pre-diabetic. What’s going on? Well, and that also is kind of, and I talked about how you can’t look at other people and say, well, look, they, you know, Asian people eat all this rice and they’re very skinny. And how can they get away with it? It must be good for you. Oh, they have a definite, a very different metabolism. They can’t make enough insulin, right? They’re not going to gain weight no matter what they do. So, you know, it’s just, it’s like we need a type A, a type 2A and a type 2B.
Speaker1: [15:29] Yeah, that’s true. Yeah, it should be called different things ultimately because it’s, yeah. I mean, one of the things I was seeing in practice, not so often, but my type 2 diabetic patients were being prescribed insulin, which is wild, right? Because you’re getting more of the thing that’s driving the disease process is very short-term, short-sighted thinking based on a paradigm that’s not, the whole paradigm is shifted off of what’s actually true, which is weird. Because it’s not that hard to just shift it to more accurate, which is what you’re doing.
Speaker0: [16:04] And even if you have, let’s say you have a lazy pancreas, right? You can’t make enough insulin to keep up with the food that you’re eating. Giving them a medication like a sulfonylurea to just force that poor little overworked, you know, pancreas to make even more insulin is like kicking a dog while it’s down. Like it can’t keep up. And now you’re going to force it to make more. And all that’s doing is going to lead to beta cell failure. And then they are going to have to take insulin because their pancreas is going to be so worn out, it can’t function anymore. And that does happen to the other group too, right? I mean, eventually their pancreas is like, I’m retiring. I’m done. I’ve been overworked for so many years. I’m just not, I’m just, I’m just done. And then they then become. So I wish that we could get to a point where diabetes management is insulin management and not glucose management. But there’s just a lot of education that would have to be done, I think.
Speaker1: [16:58] Yeah. And I think, you know, you were coming at it from your own experience, which is having PCOS, which for anyone listening, if you don’t know, polycystic ovarian syndrome, which is a condition of insulin resistance. But it’s often not framed that way or treated that way. I mean, one of the therapies is metformin, which is a diabetes drug. But, you know, people are also prescribed, like, testosterone blockers and anti-androgens and birth control to regulate the period, which, you know.
Speaker1: [17:31] But, yeah, and I think, yeah, a lot of conditions that are not being flagged as being insulin-resistant conditions, you know, and again, this is kind of more of that same problem. And how insulin resistance can affect you know aside from sort of diabetes it has all of these other symptoms in the body potentially Alzheimer’s weight gain and these changes in in menopause and perimenopause that can increase insulin levels that can contribute to all these symptoms that people notice like I’m having difficulty sleeping you know I’m irritable my I’m noticing all this weight gain and I haven’t changed my diet or I haven’t changed my exercise and all these really frustrating symptoms that people are just left to deal with on their own. And they’re told to exercise and diet more, which is difficult because as you mentioned, you’re fatigued, you have all these cravings, your blood sugar’s cycling, your insulin is spiking and it’s making you starving and tired. And so, yeah, we’re sort of missing a huge opportunity to treat people.
Speaker0: [18:38] You know, if, first of all, insulin resistance affects 89% of U.S. Adults, but just as many, you know, abroad as well, as well as children, you know, insulin resistance really starts in the womb.
Speaker0: [18:52] So before a mom even gets pregnant, they’ve done studies where they can take
Speaker0: [18:56] insulin in a mom before she even conceives. And it will predict whether her female child would have early puberty because when they have too much insulin over the course of pregnancy, and pregnancy is a natural state of insulin resistance because insulin resistance helps you store fat and it helps you grow. And so insulin resistance is super important in pregnancy. But if you already had too high before you even got pregnant, then you’re even higher. And that leads to the baby to have genetic changes that leads them to over-secrete insulin. And your breast milk, because milk has insulin in it, it’s what helps cause insulin resistance in a newborn baby because insulin resistance is important in newborn babies because what are they doing? They’re growing and they’re storing fat. So that breast milk is helping do that because their pancreas isn’t advanced or mature enough to make enough insulin, so they’re getting their insulin from the breast milk, which happens from cow’s milk too. We can talk about that later.
Speaker0: [19:58] So, you know, they’ve even looked at moms who have high insulin levels. Their breast milk has higher insulin levels, which means that baby’s getting more insulin from the mom. And that leads them to this spiral. So when we look at all these intervention programs for young kids who are overweight and obese, the intervention is like almost too late by that point. The intervention needs to start in the reproductive age women to get them as healthy as possible before they even have a baby.
Speaker0: [20:24] But you know I say all that to say you know.
Speaker0: [20:28] There could be nothing more important than insulin management because, like you said, especially menopause is the same thing. It’s this very, I wouldn’t say natural phase of insulin resistance, but it is. I mean, when estrogen drops, insulin rises, and they start having all these symptoms, including cardiovascular disease. That’s why heart disease risk increases after menopause.
Speaker0: [20:49] And it’s definitely something that we’re missing, for sure.
Speaker1: [20:53] Mm-hmm. Yeah, I also in my course talk a lot about these sort of vicious cycles of inflammation driving insulin resistance and vice versa. And then you mentioned like muscle breakdown in order to get glucose levels normalized, which, you know, reduces some of our insulin sensitizing capacity because we have less muscle. And so there’s all these, you know, stress and how that affects our blood sugar and how that affects our insulin. And so we’re kind of caught in these like snowballs and, you know, which also resists kind of very basic treatment recommendations like, oh, just eat less, exercise more. Eat less, exercise more. Yeah, exactly.
Speaker0: [21:33] So, you know, that kind of goes back to this journey and what I just realized and what I understood about what foods really spike insulin. And so I think, you know, I can get wrapped up in how bad insulin is and what it causes and all these things. And people are sometimes like, OK, I get it. But like, what do I do? So, you know, the thing about insulin is that first, what we’ve been teaching for nutrition perspective, you know, all through my dietetic education and everything was more whole grains, more beans, less meat, more low-fat dairy. I think that’s been pretty much the advice that we’ve been given. And the problem with that is that, you know, when you look at whole grains and beans and sweet potatoes, they’re all starches, right? And starch is the only carbohydrate source that is pure glucose. Now, of course, those foods give you protein and fiber and vitamins and minerals, right? But they also give you lots of starch. I mean, a third of a cup of quinoa is 36 grams of starch. That’s a lot of starch. Well, the problem with that is because starch is essentially just made up of pure glucose. Pure glucose chains, that’s what starch is. So when you eat that and you break all those glucose molecules up, all that is doing is causing a huge insulin spike. So when people say, well, we should be able to have some starch, it’s not that this is a never thing.
Speaker0: [23:00] It’s like telling somebody with a peanut allergy that they should be eating peanuts because they’re healthy for them. When you’re insulin resistant, it means you’re glucose intolerant. That is essentially the medical term to our glucose intolerant. That’s why we give them glucose tolerance tests. And if you fail that, which most people do, it means you’re glucose intolerant. So the last thing you want to be doing is eating sources of pure glucose, right? That’s not going to really help you towards your goal. So when you think about carbohydrates, it’s not about limiting your total carbohydrates or having to count them. It’s simply getting them for foods that are lower in glucose, which are non-starchy vegetables and whole raw fruit versus starches. And the other thing is that, yes, those foods give you fiber and protein and vitamins and minerals, but you can get all of those same vitamins, minerals, protein, fiber in more insulin friendly options. So that’s one component that’s kind of against conventional nutrition recommendations that’s part of a low-insulin lifestyle is limit the starches as much as you can. Eat as many carbs as you want just from fruits and veggies. The second is around dairy.
Speaker0: [24:13] So remember, breast milk, the purpose of breast milk is to provide insulin and insulin growth factor. Insulin growth factor is this very, very potent growth hormone.
Speaker0: [24:24] In infancy, it’s so important. It’s what helps babies double their length and triple their weight in the first year. It’s the most rapid time of growth. I mean, just look at the clothing sizes. Anybody who has a head of baby sees that these babies are growing. But adults, or really even after infancy, were not growing really. that much. The next time that IGF-1 or insulin growth factor levels increases, again, is during puberty when we’re growing. You don’t want, you know, insulin growth factor, IGF, you don’t want IGF levels to be high throughout the lifespan because IGF-1 is the strongest predictor of cancer risk because cancer at its most basic is an overgrowth of cells, right? And so that’s just a growth hormone that’s telling your cells to grow. So milk provides both insulin and insulin growth factor. And cow’s milk provides even more than human milk because look at how much a cow has to grow. So from a milk perspective, milk is very, very insulin spiking because you’re essentially just drinking insulin. Okay. Now, the second component of dairy that’s very insulin spiking are the proteins in milk. So the proteins in milk are whey and casein. They have a very unique amino acid profile. They’re the most concentrated sources of branch chain amino acids, which are essential. You need them to build muscle.
Speaker0: [25:46] You don’t need to overdo them because overdoing branch chain amino acids causes excessive insulin secretion. And there’s tons of research looking at branch chain amino acids and type 2 diabetes. So, you know, that really begs this question of, well, we have whey protein in everything. I mean, when one walks down the-
Speaker1: [26:04] So popular you know protein cereal it
Speaker0: [26:07] Is in everything and the reason it’s in everything is because it’s a waste product from the dairy industry to make one pound of cheese it makes nine pounds of whey waste and they didn’t know what to do with it all so in the 70s and 80s somebody was like oh let’s powder this and dry it and we’ll aggressively market it to the fitness industry and you know it’ll be a high protein we’ll market it as protein and put it in everything because it’s a waste product and it’s they couldn’t they’re not allowed from the environmental protection agency if that still exists um they’re not allowed to pour it down the rivers because it killed all the fish because it causes algae bloom so they literally didn’t have anything to do with it um and so they started marketing it to people and it’s now a multi-billion dollar industry so now you look at, anything and everything. And it has whey protein in it, not because it’s healthy, but because it’s very abundant, if you can imagine.
Speaker1: [27:06] I’m so guilty of recommending it. And there’s also this conflicting, I think you made a good point about how it’s not like people get confused and they get wrapped up in emotional. And so for anyone listening, it’s not about like foods being, it’s not about like quinoa being bad. It’s about what your underlying health concerns and health goals are and whether it’s appropriate like glucose you’re not glucose tolerant just like someone who can’t consume peanuts they’re not peanut allergy but it’s some right and so when we hear of like branch chain amino acids and whey protein stimulating protein muscle synthesis it’s like okay that is appropriate for that context maybe but if we look at the context of someone who’s insulin resistant you don’t need to be spiking your insulin and this could be working gains too and this is what I was on a keto diet which we’ll probably talk about and I was like why am I not really getting that great results while I was mixing my whey protein into some yogurt high fat yogurt natural yogurt and I was like when I read your stuff I was like oh okay that’s why I’m starving after I have this
Speaker0: [28:18] Well, and let’s go back to, because I do get a lot of criticism when I make posts about whey protein from the bodybuilding community, because let’s talk about why is it effective for stimulating muscle growth?
Speaker0: [28:30] Because it spikes insulin and it spikes insulin growth factor. And those are growth hormones. I mean, they’re not that different than anabolic steroids. An anabolic steroid means growth hormone. And insulin and IGF-1, especially IGF-1, is a growth hormone. So if you’re eating things, I mean, there are some bodybuilders who are just injecting IGF-1. Like that’s now part of the doping, the doping, like where the Olympic Association is now measuring blood levels of IGF-1 to determine whether people are doping. That’s how strong of a growth hormone it is.
Speaker0: [29:06] For somebody who’s like taking a walk around the block and then coming home
Speaker0: [29:09] for a whey protein shake is not only counterproductive, but possibly worsening. And so that’s the thing is you’re going to the grocery store and you’re buying these protein pancakes thinking, well, there must be better than regular pancakes. And actually they’re worse because it’s the same processed flour, but now you have processed flour with whey protein in it. And that manufacturer of those protein pancakes paid nothing for that whey protein because it was just a waste product. And they’re charging you more for it because you think it’s healthier because it says high protein. I mean, it’s just, and even then, even if you’re not buying the protein pancakes, it’s in everything. I love Birch Bender’s pancake mix, the keto pancake mix. Well, they recently reformulated their recipe to add whey protein in it, but it’s not high protein. It’s not a high protein food. They added whey protein as an additive for who knows what. So it’s just, it’s literally in everything. And it’s like, why would, you know, to think about it, even in one cup of milk, right, if you just get a cup of milk.
Speaker0: [30:12] 20% of the protein in a cup of milk comes from what? Only 20%, which is probably biologically being like, well, we want these babies to grow, but like, let’s keep it kind of regulated, right? Let’s not make the whole thing just this huge insulin spike. But yet now we’re concentrating it and adding multiple scoops to a propotein shake and having way more branched chain amino acids and insulin spike than nature ever intended. And it’s scary. So, you know, that’s kind of the whole thing about dairy. But I’m not dairy free. Because, and I’ll, sorry, you had a question.
Speaker1: [30:52] No, no, no, go ahead. No, I think, well, yeah, go ahead.
Speaker0: [30:55] Yeah. I’m not dairy free. You would think, well, obviously she doesn’t eat dairy. No, because fermented dairy, when you think about Greek yogurt and cheese, to make Greek yogurt and cheese, you have to remove all the way. Okay. That’s why they’re, that’s why Greek yogurt is very thick compared to other types of yogurt. Skier is very thick compared to other, like regular Yoplait yogurt or whatever at the store. It’s kind of runny. That’s because it still has a lot of whey in it. Same thing with cottage cheese. It has a lot of whey in it because whey is liquid. But Greek yogurt and cheese, the way to make those is to completely remove the whey. So you’re just left with casein. Now, casein still raises insulin and insulin growth factor, but when you ferment those, the bacteria changes those branched-chain amino acids to branched-chain ketoacids. It changes the actual structure of those branched-chain amino acids, which lowers that insulin response. So when you look at these studies that look at dairy and health, they all will say, well, yogurt’s still good for you and people see a benefit because you have the probiotics from the fermentation, but you also have fundamentally changed the insulin component, the insulin spiking component of that casein. So you have a much more insulin friendly product. So I still, so it’s Greek yogurt and I recommend full fat because if you take out the fat, what are you concentrating? The protein.
Speaker1: [32:23] And the sugar.
Speaker0: [32:24] Protein is, yeah. So you want the fat in there because you don’t want so many dairy proteins. You know, dairy proteins, their biological purpose is to stimulate insulin. So I still recommend that if they’re going to, you know, for a low insulin lifestyle, we recommend getting rid of all dairy except full fat Greek yogurt and aged cheese.
Speaker1: [32:44] Yeah, which is great because it still gives you, like you said, there’s a lot of studies where it’s like, you know, yogurt can reduce belly fat, so it can be confusing for people when they hear. But I was going to say when you were talking about whey protein and the insulinemic effects, if you are monitoring your glucose with a continuous glucose monitor, adding whey protein would probably lower your glucose. Yeah.
Speaker0: [33:11] Yeah. And so that’s another thing. It’s so funny. I get, I get these people that are like, you don’t know what you’re talking about. I wear a continuous glucose monitor and it doesn’t spike my glucose. I’m like, I didn’t say it spiked glucose. Whey has no glucose in it. It’s not going to affect your glucose. It’s going to drive insulin. But you know, one of the things that protein also does naturally is it also, this might be too sciencey and we don’t even have to get into But.
Speaker0: [33:37] You know, you have glucagon also, right? So you have insulin and glucagon. And when glucagon rises, it releases glucose from the liver. And so they’ll say, oh, well, it increases glucagon, which makes people more full for longer. And that’s all true. But the reason it stimulates glucagon is because if it doesn’t, a person’s going to be hypoglycemic. It has to have that glucagon release the glucose into the bloodstream so that it doesn’t overcompensate and drive the blood sugar down too low. Does that make sense? So you have a net neutral of glucose because you’re releasing more glucose into the bloodstream from the liver, but you’re also blocking, you know, pushing glucose down lower because you’re trying to drive it into those cells. That’s why it’s great for muscle building but you don’t whey protein after a workout yes you need insulin to drive muscle growth and get those amino acids into the cells to build um but that’s like whey protein is like starting a fire and throwing gasoline on it like you can start a fire without gasoline yeah it may be faster with gasoline but you’re going to cause potentially a lot more.
Speaker0: [34:44] Problems than you intended by doing that. So yeah, definitely if people want to have a protein powder, I recommend foods with a much more balanced amino acid profile like egg white protein is great. My husband loves J-Rob. We’re not affiliated. That just seems to be a really good one. J-Rob egg white protein is good. Bone broth protein powder is also a good one or if they’re plant-based um, hep C protein is, uh, is a good one as well.
Speaker1: [35:14] Okay. Yeah. Thank you. That’s good. What about pea proteins? People ask me this all the time. So often they’ll remove the starch, although peas would naturally have starch, but do you know about the branch amino acid?
Speaker0: [35:26] Well, they are not going to have many. They are, they do have some, so they are like a complete protein, although that’s not even necessary. Like you don’t have to have every single protein source have to be a complete protein every time. As long as you’re eating a variety of protein foods, you’re going to get all you need. So when people say, well, bone broth protein is not a complete protein, you’re going to be fine. But with pea protein and brown rice protein, yes, they do remove the starch. So from an insulin spiking perspective, it’s better. It’s okay. It’s just that they’re very processed, right? They go through a very extensive processing to remove all that starch so that you can get that concentrated protein. Whereas hemp seed protein is just hemp seeds, Right now, it does top taste like the inside of a lawnmower, so you better like that earthy taste.
Speaker1: [36:19] It’s pretty rough, but you can doctor it up and make it taste pretty good.
Speaker0: [36:23] Or you can just sprinkle hemp seeds into your smoothie and they don’t have a taste at all. But the same thing with like now they’re coming out with these new protein powders like almond protein powder and pumpkin seed protein powder. They’re just processed to remove all the extra fat which you should be getting anyways because fat is good for us but it concentrates the protein because everybody is so obsessed with getting more protein getting more protein but i’d like to challenge that a lot of that came from the marketing of the whey protein powder industry um that’s interesting to make people think they needed 200 grams of protein a day yeah.
Speaker1: [37:02] I mean well and also and i’m definitely guilty of pushing the protein thing. But when people have high insulin, like generally just high fasting insulin, I mean, you’re already kind of set up to technically build muscle.
Speaker0: [37:17] Yeah.
Speaker1: [37:18] That’s a big complaint.
Speaker0: [37:19] Yeah.
Speaker1: [37:20] People are like, I easily put on muscle. I just can’t lose weight. It’s like, well, okay, then you don’t need whey maybe.
Speaker0: [37:27] No, you definitely don’t need whey. I hope that I don’t ever sound like I don’t think protein is important. Protein is absolutely important. I do not track protein at all. I did track one day just to see like, what do I get? I’m curious, you know, and I had about 95 grams of protein and that’s like from peanut butter. I love shelled, I love shelled edamame and like, you know, for lunch, I eat a pound of frozen vegetables that I put in a pan and I cook it in some avocado oil and I throw shelled edamame, like a half cup of shelled edamame and I sprinkle some grated Parmesan cheese and some toasted a pecan and it’s like this big and I will eat the whole bowl. And it’s like 30 plus grams of protein just for that. You don’t really need to track it as long as you’re being mindful that every meal you’re having fruits and veggies, you’re having something protein and you’re having some fat, you’re going to be fine. I think this idea of these excessive protein goals came from the fact that the only way you can meet that goal is by using protein powder, which then plays into the industry, you know?
Speaker1: [38:33] Yeah, I mean, we’ll get into this, but I think I was going through one of the studies where it showed sort of the macronutrient results because they had people do diet diaries. You had people do diet diaries a couple times during the two months. And yeah, they were eating about 90 grams a day, which is a lot of people struggle to get that much. And I wonder if maybe there’s something about kind of removing the food noise by having like, OK, here’s the foods that you’re eating. And, you know, a huge chunk of that is protein foods. Um maybe there’s something about how starch kind of changes our appetite or or our satiety so we’re not really interested in protein but yeah it’s interesting that we’re kind of falling into it you know
Speaker0: [39:13] They i mean these were patients who were you know very overweight they their average fasting insulin was 31 now remember it needs to be eight so their average fasting is eight or less Their average
Speaker0: [39:26] fasting insulin was 31 and their A1C was 5.2 or 5.3, like totally normal. If they went to the doctor, the doctor would be like, you’re healthy as a horse. I don’t know why you’re having all these symptoms, you know, come back when you’re in bed. Right. That’s basically what they’d be told. And behind the scenes, their insulin is three or four times higher than it needs to be. And we basically said, okay, well, you’re going to follow this plan. You’re going to eat as much as you want, whenever you want. at these foods that don’t spike insulin. Non-starchy vegetables, whole fruits, you know, lean proteins. We didn’t even stress the lean on the protein, but we were like, just trim visible fat. By no means do you need to eat egg whites. Like eat the eggs. Make sure you’re getting lots of healthy fats. I even was encouraging them. I was like, I want you to eat a whole medium avocado every day. Like I want you to make that a goal.
Speaker0: [40:19] And that was it, right? And then we told them, you’re gonna, first eight weeks, we want you to not eat anything on this list of insulin spiking foods. Also, you can have either Greek yogurt or cheese, but only one serving a day. And you could have red wine. If you want to, because it’s a sustainability, am I saying red wine is a health food? No, but… It is part of like just having something that’s sustainable that you can have as a treat and they could have an ounce of dark chocolate. And, you know, what’s really important is we didn’t allow them to exercise. And not the exercise is, of course, important. And we recommend exercise for a clinical research study. You have to make sure that the results they’re seeing are from the diet changes and not that exercise. So they couldn’t exercise. And that was it. You know, and two months later, they lost 19 pounds. They had a 50 percent reduction in insulin. They had a 50-plus percent reduction in HOMA-IR. They had a 35% drop in triglycerides. I mean, two months. Their testosterone levels went down by 25% because they had PCOS. I mean, it was crazy. The results and those results have been extended to all of the studies that we’ve done. And what was great was that they did these diaries. And so for whoever’s listening who hasn’t read the studies, their average calorie intake was just around 1,400 or 1,500 a day. I mean, again, not counting calories, eating whatever they wanted, their carb intake.
Speaker1: [41:42] As many nuts as you want.
Speaker0: [41:43] As many nuts, as much fruit, whatever they want.
Speaker1: [41:46] Red meat.
Speaker0: [41:46] Red meat.
Speaker1: [41:47] Yeah.
Speaker0: [41:49] And one girl told me, she’s like, I ate an entire pack of bacon. I know I wasn’t supposed to do that, but I kind of like just binged on a pack of bacon.
Speaker0: [41:58] I’m not saying bacon’s healthy. You should not eat bacon. It was uncured bacon, thankfully. But because their body is able to burn that fat, it wasn’t just circulating in the blood causing triglycerides, right? And so their fat intake was very high, right? I think they had 70-plus grams of fat, which coming from avocados, the actual breakdown was it was largely monounsaturated. It was coming from nuts and avocados and oils and whatnot. So, you know, that’s the thing. It’s when people get their appetite hormones more regular or regulated, they just don’t feel as hungry. I mean, that is one of the most common in the very first place. Testimonials that people tell me is when I make an, when I take an insulin first approach, not glucose, not calories, not protein. When I take an insulin first approach and insulin levels lower, your appetite hormones regulate. And they’re like, I’m just not hungry. Like I can’t believe that I have no cravings for anything. Like I’m just content and satisfied. It’s like, because your body can access your stored body fat now. And it doesn’t need to force you to eat all the time because prior it was like okay you have a lot of fat in here but like I can’t use it so I need you to keep eating because that’s the only thing I can use for energy, and now it can tap into that fat stores and so it’s like oh I’m good I don’t you can eat if you want but like I’m good yeah that’s essentially what your brain is saying.
Speaker1: [43:22] Yeah I remember reading that thing in the 1400 I was like wow because you’re eating ad libina which means just whatever you want like you can eat as much of all those allowed foods I mean there’s restrictions for the dairy in terms of portions but nothing else has portion restrictions and so people are kind of naturally settling into 1400 calories which i wonder if i mean on a diet diary day i probably wouldn’t eat my pound of bacon so it might oh no not be she didn’t report
Speaker0: [43:49] That that was not on the diet.
Speaker1: [43:50] I think that’s probably maybe like i’d be on my best behavior so that might be a little i don’t know if you agree it might be like lower than what they were eating um but they were the weight loss And I know it’s not all about weight loss, but I think it’s so difficult to lose weight when you’re insulin resistant. And a lot of like ketogenic diets and kind of zone diets, I’ve been looking at a lot of research for a course that I’m producing on insulin resistance. And 19 pounds in two months is like amazing. With no exercise. With no exercise. And no counting, no tracking, no restriction. They’re not restricting. I mean, they’re taking out certain foods. So maybe there’s an element of, you know, psychological restrictions like that. But you’re not hungry is the point, you know.
Speaker0: [44:37] And did you read our second study was really, you know, not to get too sciencey, but I think it really helps explain this concept is that, you know, we had patients get under this machine and it basically just measures oxygen and how much you breathe in and out. And it tells you whether you’re burning fat or carbs. I know science is cool. So it tells you whether you’re burning fat or carbs. Well, you know, these patients were coming in after not eating for 12 hours and they were coming in and they were burning almost no fat. Like even after fasting for all night long, their body still had so much insulin in their system that they couldn’t burn their fat. And then after that, we gave them this very high shake, high fat shake. It was just basically an insure that I added 70 grams of fat to butter melted.
Speaker1: [45:22] And also, they’re probably suffering 12 hours of no eating and they weren’t burning fat.
Speaker0: [45:28] Well, it was just that they hadn’t eaten since 7 p.m. the night before. They came in the morning. They, you know, we took them there at rest to see how much were they burning, how much fat were they actually burning after not eating for 12 hours, which most people should be only burning fat, right? You’re not, you haven’t eaten in a while. Like, you should be getting your energy from fast stores. None. They drink this high fat shake. Basically shows they stored all that fat from the shake and just burned the little bit of sugar that was in the Ensure. And that was it. All right. After eight weeks, they come in to do it again, burning almost all fat because now their insulin has dropped after the eight weeks of following this approach. They’re burning almost all fat. They drink the high fat shake, burn almost, you know, their fat burning from that after five hours was significantly higher than before. And it just shows while you go tell a patient with insulin resistance that the only way that they’re going to reverse insulin resistance is to lose weight and eat less and exercise more and come back, you know, and they’re like, I can’t even burn fat when I’m eating nothing. And it’s true. Like I lived to that. That’s why I was a binge eater. Like I would eat nothing because I was like, nothing else works. I’ll just stop eating. And then you eventually get to a point where you eat everything and then you just have this terrible cycle. But, and it’s, it’s so validating. I mean, that study was just so validating to the people who are like, I am doing everything and nothing is working.
Speaker0: [46:56] Um and then you know like just for the randomized control trial i’ll just say it was a it was an independent study right because with research like you have to have an independent group that can replicate your findings because that’s just that’s just important like i can’t run all the studies and be like this is so great somebody else has to do the same thing and see what they find um and they did they did a randomized control so half the patients just did general nutrition they They followed the NIH nutrition guidelines, which was more whole grains and beans and more low-fat dairy, and eat less and exercise more, and they got put on metformin.
Speaker1: [47:32] So they also had exercise and they had metformin.
Speaker0: [47:35] And exercise. And the other group just followed our plan with no exercise. And this was during COVID. So, I mean, this study started January of 2020. So you’ve got a lot of cortisol going along. You’ve got all these things happening. People stuck at home. And the group that followed our plan lost an average of 17 pounds. During COVID.
Speaker1: [47:58] When everyone gained the COVID-19.
Speaker0: [47:59] When everybody gained the weight. So they had, on average, it was between 12 and 17 pounds. And the group on the metformin and eat less and exercise more was, they gained a third of a pound. And their insulin levels went up. So it was just, yeah. So it really just is continuing to validate this. We’re missing the wrong biomarker, right? Insulin is really the only thing that matters and we’re just ignoring it. And it’s frustrating.
Speaker1: [48:26] I think, too, in that study, if I remember correctly, the control group, so like the high grains group, was also in a calorie deficit. Like they were told to eat 500 calories less. So they were supposed to be losing a pound per week kind of thing. And then they were exercising.
Speaker0: [48:43] Like everybody else. Yeah. They tried it because they were just standard nutrition advice, that control group. So the group that did the study was a group of reproductive endocrinologists. And they basically said, we just treated them like every other patient we treat. We have a brochure it talks about, you know, it’s just based on like the NIH nutrition information, eat less and exercise more. And if their fasting insulin was too high, which was pretty much everyone, we gave them metformin. And that was like just the standard of care. Like that’s what every other patient, except for most patients go to fertility clinics. We’re not getting their insulin tested because most fertility specialists don’t even understand that that’s the reason why these patients aren’t getting pregnant. And so, yeah, they just submitted the paper for publication. And so hopefully we’ll have that data published soon. But it was really great to have a completely independent group replicated. That study independently.
Speaker1: [49:39] Yeah, so how many studies are there in total? There’s three, I believe.
Speaker0: [49:44] So the three actual prospective clinical studies, one of those was a case series because out of the 24 patients in the original study, about 10 of them, not everybody was trying to get pregnant, first of all. Some of these patients were just trying to lose weight or improve their symptoms. But 10 of the patients, even though they, you know, were infertile, they had issues with pregnant, were getting pregnant. They were seeing a fertility specialist, which should say a lot. They got pregnant very quickly. And we had some, we had probably four or five patients who had to drop out of the study because they got pregnant in the two-month study. And they actually, so the fertility specialist wrote that up as a case series to said, you know, they talked about each patient. It was like, this patient has been infertile for this time. They’d done these different things and essentially showed that the average time to conception in these patients was 86 days after starting this lifestyle change. 86 days.
Speaker1: [50:42] That’s the average. So it had sooner. Yeah.
Speaker0: [50:45] And it blows my mind. You know, I have a friend, a couple of friends who have PCOS. And they, one of them had five miscarriages in like an 18-month period. And her doctor would refuse to test her insulin. And he said, your A1C is normal. You don’t need to test your insulin. Like, refused.
Speaker0: [51:06] And, I mean, it just blows my mind. It just blows my mind.
Speaker1: [51:09] Yeah, I think in your, there’s a lecture that you have on YouTube where you talk about how high insulin can increase the risk of miscarriage and pregnancy complications. So it’s not even just about getting pregnant. It’s also what the high insulin does to the health. Yeah.
Speaker0: [51:24] And that’s not even just PCOS. I mean, you know, that’s there was this really awesome study out of Columbia University, this group that their fertility division and their maternal fetal medicine department that was that does a lot of research on miscarriage. And this was published in Fertility and Sterility, which is, you know, the biggest fertility journal. And what they did is they said, okay, we’ve been testing glucose and A1C standard when somebody comes in with recurrent miscarriage, which means they’ve had at least two miscarriages within account, two repetitive miscarriages. And so they were like, but we’re testing their glucose and their A1C and it’s normal and it’s not necessarily associated with a higher risk of miscarriage. So what they did is they took some of these, they had patients who miscarried, and they took some of these early placenta cells, okay, and they put them in a petri dish, and they exposed them to either high levels of glucose or high levels of insulin.
Speaker0: [52:26] And what they found was that high glucose levels did absolutely nothing to those early placental cells. Nothing. High levels of insulin was as toxic to the developing placenta as chemotherapy drugs. And yet somebody comes in with recurrent miscarriage, and we don’t even test insulin. We only test glucose. And so that group alone, I mean, they’re a huge fertility center in back Columbia. And they were like, we’re missing the boat. In our clinic, we’re going to start testing insulin in every person. So it’s just, there are people that are out there talking about it,
Speaker0: [52:59] but it just hasn’t made it fully there.
Speaker1: [53:04] Yeah, it’s like it needs to kind of just, like, it’s like a Venn diagram. We’re not quite focusing in properly on what we should be. Yeah, and so back to the results. I mean, amazing. Like, people are getting pregnant. They’re losing consistently. Like, it’s not, I mean, I have a friend who’s started your program. Um, she’s on like day five and she’s like giving me a daily update. She’s like, I was so hungry. Now she’s like, I’m not hungry anymore. I feel amazing. I’ve lost just like half a pound, like almost a pound a day. It’s wild. She’s just like dropping. It’s just coming off. Your body’s like
Speaker0: [53:40] Can actually access that stored fat and do what it’s supposed to do, which is. Burn it for energy.
Speaker1: [53:47] And this is her like trying carnivore and keto just before and it wasn’t really working. And she was like, she’s trying to breastfeed. It wasn’t, you know, so this is like she’s like mind blown. And so she was telling me to ask you certain things. But, you know, I was when I was kind of selling her the protocol, I was like, no, she’s legit. She’s like, she’s repeated these results. It’s not just, you know, a one time study where people lost a bunch of weight. Like this is it’s a consistent result. where people are losing 17 to 19 pounds in two months by following this plan, you know, so you don’t have like a super loser in your group or something like that that’s doing the results.
Speaker1: [54:24] So it’s pretty miraculous. Like it really is amazing. Yeah.
Speaker0: [54:29] Well, so, you know, I don’t know if I don’t share it too much on my page yet, but I am working with the FDA. So I don’t know if you’re aware of that. So I’ve been working with the FDA for the last year. I’ve met with them five times. I have my next meeting with them in a week and a half because I’m trying to get my this app. So I’m launching an app. So it will officially be launched on May 19th. It is in the app stores right now. Do not. We’re still working on the back end, but we have to make it to get it in the app store and then we’re working on it. So I haven’t told anybody it’s there. It’s it’s there. It’s not really functioning yet. So we are officially launching it on May 19th. But one of the things that we’re trying to or that I’m trying to do is get FDA cleared as a what is called a software as a medical device. People have heard of software as a service, whatever. So now the FDA regulates this type of medical device, which is a software. So apps are considered software as a medical device. So, you know, there’s a few that are approved for diabetes, some that are approved for depression. So this would be the very first approved for insulin resistance or PCOS.
Speaker0: [55:34] But, you know, I have to do this big study. right? You have to do a big, study, uh, to support that clearance. Um, and I have an entire independent group, a different independent group. So, um, I’m very, very proud to say that my, the PI or the person who’s basically the ringleader of this study is, um, Dr. Timothy Garvey. He’s the director of obesity research at, um, University of Alabama, Birmingham, which is a huge research center. Um, he’s an, you know, internationally known endocrinologist. So he is taking the study and like, I have a dermatologist dermatologist, a clinical dermatologist at University of Texas. I have an obstetric neurologist who’s doing all of like the mood evaluation changes after using this. She’s at Baylor. I have another dietitian, PhD dietitian who’s out in California. So, I mean, it’s truly independent, right? Like I can’t have anything to do with it. And so, and they’re basically where they’re having patients use our app. So, they’ll use the app for eight weeks, follow the guidance. It has recipes and meal plans and all the things. And after eight weeks, we test their blood before and after and submit it to the FDA for approval. So we’re hoping to have that next year, which would really just be, you know.
Speaker0: [56:50] Amazing for patients and amazing to like really have this become like the standard treatment for insulin resistance is an insulin first approach.
Speaker1: [57:02] Yeah like to just have your doctor be able to give you that advice it’ll actually work so it’s motivating you feel a lot better you’re not as hungry um you’re even your taste buds change because you’re like you’re you’re interacting with whole foods that aren’t spiking your insulin so your like cravings and your appetite are all regulated and oriented towards what the food that you’re getting as opposed to like random you know you’re not ending up at the bottom of a bag of potato chips because you’re like blood
Speaker0: [57:30] Sugars drain i need more glucose and i can’t get it and i need to eat this.
Speaker1: [57:34] Yeah and
Speaker0: [57:36] So that’s why you know i don’t necessarily i don’t necessarily condemn the use of the glp1 drugs because GLP-1 is an important appetite hormone. And tons of data, research has shown that when people have high insulin levels, they have lower GLP-1 because insulin is a master hormone. It affects everything, including your appetite hormone. So when insulin is off, your appetite is really unregulated. And the GLP-1 drugs are kind of just like bypassing that whole system just to like flood the body with GLP-1 so that you don’t feel as hungry, which is fine. But the thing is is that if you were just to focus on this you would increase naturally levels the glp1 because insulin is suppressing that you know so um that’s where i’m like you can you could do that that drug but you have to realize like you’re not fixing the problem and the problem’s going to come back the appetite problem the weight problem is going to come back until you fix the underlying hormonal problem cause of why you are hungry all the time in the first place you know Yeah.
Speaker1: [58:40] Yeah, because, I mean, the problem, I think, it’s a common criticism with those drugs is that it can be a really important tool. I mean, some people have a lot of weight to lose, you know, it’s causing a lot of problems. But if you’re just having less Doritos, like it’s just about appetite suppression, and you’re not shifting your dietary patterns, and you’re not kind of using it as an opportunity to learn and to change things, then you’re either stuck on them forever, getting nutrient deficient and losing muscle mass, or you’re just going to gain the weight back. So you have to kind of change things. So it’s why not try the diet first, the exercise first, and then use them as a tool if you have like 300 pounds to lose or something.
Speaker1: [59:22] You know, if you have a lot of weight to lose, maybe they could be helpful. But yeah. That’s what Dr.
Speaker0: [59:26] Gardy wants to do, right? He’s like, after we do this study, you know, if you would be interested in sponsoring another study to look at patients on GLP-1 drugs who also follow this plan, right? Because taking a GLP-1 drug actually stimulates insulin secretion. And so if you’re eating foods causing even more insulin secretion and you’re in a calorie deficit because you’re not eating as much, you’re just eating less of insulin spiking foods, you’re actually losing muscle because it goes back to the body not being able to burn fat. And so it needs to make up that calorie deficit somewhere and it’s going to pull from your muscle. So that’s really why you’re seeing a lot of muscle mass on these drugs. And so when you, he was like, if we could pair something like this with the GLP-1 drugs, then while you’re getting your own appetite hormones more regulated, you have this. And then when you come off of it, you don’t see such a huge shift in making, you know, wanting to go back to eating all the time because now you’ve fixed the underlying cause. That is how those GLP-1 drugs should be used. But they’re not being used because they’re not giving the right information. They’re not giving the right education. And they’re sending them home telling them to eat more whole grains and beans and low-fat dairy and then they’re just in this cycle of bad. And so if we could come out with that data, I think it would be, you know, life-changing, I think.
Speaker1: [1:00:46] That’d be really interesting. Yeah, it’d be interesting to see, like, what people actually, I’m wondering if there’s data on, like, what do people end up eating when they’re on a GLP-1? Like, what are their macronutrient spreads? Because people tend to lose appetite for, like, high-fiber foods, protein foods. Like, you don’t want satiating foods. You want just kind of easy to absorb, easy to digest. You’re nauseous. So you’re probably going to go for more starchy foods i would assume but
Speaker0: [1:01:12] Well except for now everything it’s like well you need to be a you need to be making eating more protein so you don’t lose so much muscle mass it’s like the reason they’re thought the reason they’re losing muscle mass is not because they’re not drinking whey protein shakes like in fact that might worsen it so it’s it’s that message and so now you’ve got all these food companies that are going about to come out with tons of protein rich snacks because they’re trying to attack they’re trying to attach themselves to the people who are taking these drugs who are trying to eat more protein and those snacks are just the same processed crap with now processed way back i saw that that there’s like very like.
Speaker1: [1:01:57] Big food is trying to design foods that kind of override the natural appetite suppression so that you still stay addicted so it’s like a whole hot mess
Speaker0: [1:02:07] I don’t know if it’s that or they’re just trying to appeal to this new customer who’s like well i’m not really hungry but i have to get my protein in so i’m gonna eat this protein snickers and it’s gonna be better for me so it’s just, and it’s sad and it’s scary and you know that’s that’s where we’re going because everything you scroll on instagram one time and all it talks about is if you don’t get 50 grams of protein for breakfast and you can just kiss your biceps goodbye. And it’s like, hmm.
Speaker1: [1:02:37] Yeah. But maybe, yeah.
Speaker0: [1:02:39] I’m not saying protein is important. I’m saying you don’t need 50 grams.
Speaker1: [1:02:44] Yeah. Like if you’re, yeah, regulating your insulin levels, are you just, are you going to be better at using and maintaining your muscle mass and burning fat instead of burning your muscle, you know, the protein from your muscle to make glucose?
Speaker0: [1:02:58] Yes.
Speaker1: [1:03:00] Like those people, those sugar burners in your, in the study that you referenced were probably just breaking down their muscle mass.
Speaker0: [1:03:06] Yeah they’re breaking down like shake yes the amino acids that they because you know when you eat protein it your body breaks it down into the amino acids and then it uses those whatever it needs right whatever amino acid it needs to build whatever that is whether it’s hair because there’s like you know whatever amino acids they need at the time for those things so that’s like an amino acid pool which is why every single food you eat doesn’t have to be a complete protein because it’s just getting broken down into these bricks right and they’re just pulling the bricks as they need them. But that’s what’s happening is that those sugar burners were essentially just burning yesterday’s excess protein that he didn’t need, which because a lot of times we’re eating more protein than we actually need. Not everybody. Some people are not. But now I feel like people are.
Speaker0: [1:03:51] Putting a scoop of whey protein into their Greek yogurt, which is like a lot of protein in one sitting. And it’s just breaking that down into those bricks that they can then use for energy if they can’t get enough body fat. So that’s basically what they were doing because you can break amino acids down into like essentially glucose and just burn that. So metabolism is very complex, right? It can definitely overwhelm people.
Speaker0: [1:04:16] But I think at the end of the day, if it if it seems excessive it probably is um and if it seems too good to be true it probably is like going back to the instagram account on glucose regulation you know if you are adding there’s this idea of food combining of if you add if you’re going to eat carbs you need to make sure you add fat or proteins to it and it will make sure that your glucose doesn’t rise too fast and sure, there are all kinds of beautiful CGM reports that will support this message that as long as you add butter to your bread, then it will be okay because your glucose doesn’t rise. But what that’s doing is when you have a lot of fat and a lot of glucose in the bloodstream at one time, it actually, the fat, I remember my biochemistry teacher in college said, When you have too much fatty acids and too much glucose in the bloodstream at one time, what that does is it’s like throwing gum in a lock. Those fatty acids block the insulin from working. So then the pancreas does what?
Speaker0: [1:05:28] Sends out even more, right? So you have this huge insulin spike happening in the background, which is driving that blood glucose down. So what you see on your CGM is adding butter to my bread stopped that glucose spike. That’s so great. But what you don’t know in the background is the insulin bomb that happened to keep that glucose level normal. And that’s what the problem is. So, yeah.
Speaker0: [1:05:52] It’s unfortunate because I think now 5 million people think that as long as they add peanut butter to their ice cream or their, you know, whatever, that it’s like better. Again, I’m going to do that. It’s more nuanced than that.
Speaker1: [1:06:07] Yeah, like I, this is why yours have blew my mind because I, I was sort of recommend, I mean, there is a separate benefit to regulating blood sugar, obviously, but it, it, the story is more holistic. Think it makes more sense in the context of insulin because insulin is damaging. So it’s like not about regulating blood sugar at the expense of insulin spikes. It’s, but you know, so I would recommend to people, okay, you’re addicted to donuts and you’re going to get a donut nut to put some peanut butter on it to regulate it. And there’s a bit of like maybe delayed gastric emptying or delayed release of glucose. But when I saw your comment, I was like, yeah, I knew this from biochemistry, but for some reason didn’t put it together.
Speaker1: [1:06:49] And it may speak to, to give myself some compassion and credit, it may speak to just how we’re so not focused on insulin, even in holistic space.
Speaker0: [1:06:58] Like you said, there is an aspect of managing glucose. That’s true. But if you are managing the insulin, then it’s working well. It’s working, it’s doing what it needs to do. And you don’t really need to focus on the glucose. So I have a lot of people say, well, if I have commented to that post or sent me direct messages, they’re like, well, so does that mean that I should just, well, what if I want to eat gummy bears? Like, is it worse to add almonds to my gummy bears or just eat the gummy bears by themselves? And I said, well, this is the actually, what you need to realize is that, you know, if you want it, if you want to eat Oreos, do it infrequently and enjoy them. And if you want to dip them in peanut butter, do it because it’s delicious but don’t lie to yourself that the peanut butter has somehow made the oreos better for you because it didn’t and it actually was probably worse but it’s it’s more about enjoying the foods you want to eat and enjoying them and not feeling like you have to add something to it to make it better because then you’re then you’re mentally thinking well oh i can just i’ll eat you know whatever i’ll eat the bread because i’ll just put the butter on it and it will cancel it out that is just human nature and that is what people do because their cgm tells them that that’s better and that’s just not the case and so it’s it’s not necessarily that that eating it by itself is good by any means but i don’t think anybody needed to tell you that eating gummy bears wasn’t good for you right i’m trying to tell you that yeah adding almonds doesn’t make them better yeah.
Speaker1: [1:08:27] It’s like just let them serve their purpose which is
Speaker0: [1:08:30] Just serve their purpose enjoy them enjoy them and try make them as infrequently as possible because life is meant to be lived, enjoy the things occasionally, but, adding protein and fat. And like you said, with the delayed gastric emptying, my challenge to that is ideally what you want is you want insulin to be released after a meal, help bring your blood and then you want it to come down, right? And you want it to be low so that between meals, you’re pulling fat from your body fat. And then it goes up again after a meal and then it comes down. And then after dinner and while you’re sleeping, it’s low. I mean, that’s really the idea, ideal. You want it to go up and then back down, up and then back down quickly.
Speaker0: [1:09:09] When you are adding protein to gummy bears now you’re adding like you know some cheese to gummy bears or something what that’s doing it is delayed delaying that gastric emptying but it’s not, it’s not getting rid of the glucose you’re still going to absorb all the glucose from those gummy bears but now you’re just doing it over time well what does that mean that means glucose levels are higher in the system for longer and insulin levels are higher in the system for longer right versus just having it go up and then come back down i’m not saying you should just eat the gummy bears you shouldn’t eat gummy bears but if you do just do it because you like it and try to do it as least less frequently as possible but if otherwise if you’re just eating fruits and vegetables and nuts and seeds and proteins and all of that then you would eat your insulin would come up moderately do what it needs to do and then come back down versus you know eating a biscuit with eggs on it. Like, okay, it’s not going to have a huge glucose spike, but now you’re just going to have glucose higher for longer as it slowly enters the bloodstream. Does that make sense? Yeah, it does. And then really at the end of the day, there is no way that you’re going to slice it, cut it or whatever. Starch is going to lead to higher glucose and there’s nothing you’re going to add to it that is going to make it better. So if you have to have it, enjoy it. Don’t lie to yourself that doing something has made it better for you. Just move on and try to do better at the next meal. That’s my advice.
Speaker1: [1:10:31] Drink water. Yeah. And also, if you’re healing insulin resistance in the background, you’re able to kind of come down again, right? You’re dealing with this cause.
Speaker1: [1:10:40] So maybe you’ve better tolerance for those random spikes and you eat your Oreos and you get done.
Speaker0: [1:10:46] And your liver is better able to clear that insulin from the blood. So like one of the studies that that influencer likes to use a lot is a study that shows, well, if you add protein and fat to starch and sugar, it leads to lower glucose levels. Well, yes, but in the exact same study, it talks about how insulin levels rose 52%, in the same period, right? And part of that was because it increased insulin secretion, and part of that was in decreased insulin clearance. Because when you add the fat and the protein to your fat and the starch, the body’s like, well, I can’t get rid of this glucose or this insulin. I have to have this insulin here because something has to get rid of this glucose. So that’s why it increases insulin secretion and prevents the liver from actually getting rid of excess insulin from the blood. So you just have more insulin, right? More insulin means less less blood sugar. So, you know, if you read the article, it says that very, very blatantly. Like, I think it was on like the sixth line. It was like, it increases insulin secretion and decreases insulin clearance. And it’s like, you’re.
Speaker1: [1:11:50] Yeah, but you’re an insulin researcher. So you’re like, you see it right away, but everyone else is like, that’s great. Higher insulin is what we want, right? That’s, that’s what we do with our job.
Speaker0: [1:11:59] Exactly. I commented on her post like a year ago, or this person’s post like over a year ago. And I said something to that effect. I was like, you can’t manage a glucose and just ignore the insulin. And I think she has some moderators. And one of her moderators said, she’s not an insulin expert. She’s a glucose expert. And I was like.
Speaker1: [1:12:17] Like, okay.
Speaker0: [1:12:18] Okay, I have to walk away.
Speaker1: [1:12:20] I know everyone knows exactly what we’re talking about. I mean, there’s no reason to not say the name, but it’s funny too, because the approach isn’t, like, clinically, when I’m working with people, it’s not an easier approach necessarily. Like, you know, I actually had one patient I’m just thinking of who, you know, we got blood work back, she’s insulin resistant, I started educating her on what that means. And she’s like, you’re not going to make me follow the, you know, this influencer stuff, are you? Where it’s like, you know, fiber before your meal, which is maybe not a horrible advice. And like adding, it’s like, you’re not going to make me follow that, are you? But when I’m recommending the low insulin lifestyle, which I have been doing, actually, a lot of people are like happy to receive it. Like it’s, there’s something very validating about understanding the symptoms. And the diet is very manageable for people, like kind of psychologically. You can eat what you want. It’s logical. It makes sense. It’s not like like low FODMAP diets. There’s certain fruits and vegetables that people don’t categorize that you’re allowed and you’re not allowed. At this one, it’s you’re allowed all the fruit you want, all the non-starchy vegetables, all the animal protein, your six ounces of Greek yogurt or an ounce of cheese, all the fat you want and avoid sugar. And then you have like it’s a very little it’s a small blur that I send people.
Speaker0: [1:13:36] Yeah, it’s a small little thing. And there’s always, you know, you have allulus and monk fruit and all these other things. So you can still have those. I cook with almond flour all the time. I mean, I make almost, I have tons of stuff with almond flour. I mean, I make Cheez-Its. Like I just mix almond flour and egg and some cheddar cheese and I roll it out and I air fry them. And it’s like, you know, so I, there are so many, and that’s part of, you know, what will be on the app is just hundreds of recipes, like things like this to really help. And I’m, I’m not doing a plug, but I’m just saying I am coming out. A guidebook, because I feel like the original book is very silency, but in a layman’s perspective. And if we need to stop, we can. I mean, I’m good. But… Is this guidebook that’s like, if, okay, you know, this is a lot of science. I like to know, and it’s important to know, but I want to know, like, how do I really incorporate this? And some people want something tangible. So in the next month or so, I’m launching a guidebook, which is like, it really still goes into the details of the studies and the data and the science, but with more pictures, less words, more, you know, recipes, meal plans, how to eat at restaurants, what to do in the holidays, how to build a grocery list, how to read a nutrition label. Like, I mean, just kind of like this more reference guide that’s more tangible for people who don’t want to use an app. You know, they can have a book, be very colorful. They can set it in their kitchen and like reference whenever they want. So that’s, I think will help be helpful too.
Speaker1: [1:14:59] It’s so good. Yeah. It’s your Instagram account is great too. You have lots of good recipes. Like, but I think, I think one thing we might’ve missed is why is fruit allowed? Because I think people might be wondering that. I don’t know. Okay.
Speaker0: [1:15:11] So fruit is part glucose and part fructose. Now, fructose gets a very bad reputation for good reason. Too much fructose overwhelms the liver, leads to fatty liver, which is like high fructose corn syrup. So fructose in large amounts, really bad. Actually, just a history lesson. One of the reasons why they came out with high fructose corn syrup, aside from it just being very cheap and very sweet, was because it had less glucose. They thought it would be better for diabetics. Because it wouldn’t lead to the same glucose response. Does that make sense?
Speaker1: [1:15:43] Yeah. They didn’t realize that. We’ll throw this in. It’ll be great.
Speaker0: [1:15:47] What could go wrong? It’ll be so healthy. And then they were like, oh, this was a problem. They don’t care. They still add it to everything. But we know that excess fructose is a problem. Now, whole fruit.
Speaker0: [1:15:58] Well, sorry. The good thing about fructose in its naturally occurring form amounts is that it requires zero insulin release for metabolism. So fructose does not elicit any insulin relief. So that’s, again, why they thought, oh, high fructose corn syrup would be great, but no. So the amount of fructose in a whole raw fruit is not going to overwhelm your liver, right? You have that fiber. It is going to slow that digestion. So you’re getting a slow trickle of the fructose instead of just, you know, a soda. So because it’s part fructose and because fructose does not elicit any insulin response, fructose as a whole has a lower insulin response. Now, fruit still has glucose and you still might see something on your CGM or something, but it’s still going to be far less than, you know, having a whole apple as compared to a third of a cup of quinoa is very different, right? And so the amount of glucose in a whole apple is maybe 10 grand. It’s like 6 grams of fructose, about 10 grams of glucose, whereas 36 grams in a third of a cup of quinoa. So it’s really just thinking about that perspective is that fruit doesn’t have that huge insulin response because it’s part fructose.
Speaker0: [1:17:22] And I always like to tell people, too, agave nectar.
Speaker0: [1:17:27] Is worse than high fructose corn syrup. Agave nectar is 90% fructose. High fructose corn syrup is only 55% fructose. So you’re drinking straight fructose when you’re having agave nectar. So I just try to tell people just because it’s natural sugar doesn’t necessarily mean that it’s better.
Speaker1: [1:17:47] Yeah, that’s a good point. Yeah. And I think one thing that you stress is that there’s no limits on fruit. So people are eating as much food as they want, which when I hear that, I’m like, Dr. Allie, I don’t think you know me. Like maybe you’ve done research, but maybe you haven’t met people like me. Like I could eat a lot of fruit if you’re just going to let me go. But it looks like people were eating about 90 grams of carbs, which is fairly low carb. And your desire, yeah, kind of.
Speaker0: [1:18:14] Your desire goes down. You’re like, I eat fruit every day, but I probably eat like, I don’t know like two pieces of fruit maybe like sometimes one sometimes two sometimes more but again it’s one of those things where you’re just full you’re eating a lot of fiber you’re eating a lot of fat and protein and you just like fruit is great but you’re just not as hungry and you’re definitely not as hungry for carbs so it’s just one of those where you still eat them but it’s not one of those like I want to eat you know this whole bowl of fruit you just have your your taste buds and your appetite changes.
Speaker1: [1:18:48] Yeah, this is so good. What have you seen beyond two months? I don’t know if you’ve tracked people or worked with people or just in personal experience. How long does it typically take for people to get their insulin into the normal range? It looked like people’s HbA1c was all normalized after two months.
Speaker0: [1:19:06] It was normal to begin with. Yeah.
Speaker1: [1:19:10] Sorry, their HOMA-IR. HOMA-IR was what I wanted to say.
Speaker0: [1:19:12] Yeah, yeah. So we haven’t done any studies beyond eight weeks. Okay. Right. Just from financially, right? The longer the study it is, the more money. And even the new study, it’s called the Lilac study, the Lilly App clinical study. The Lilac study is also eight weeks. Because from research, it’s hard to like do these. Now, after the eight weeks, we will give the participants the ability to say, would you be interested in continuing to follow this? and, you know, continuing to even just report patient-reported outcomes, like how their acne has changed. There’s some of these very validated, like, PCOS quality of life surveys that we’ll administer once a month just to continue to keep that data, have them self-report their weight once a month. You know, so I’m excited about doing more research. You know, part of the revenue from our company as a whole will go to continuing to provide more funding for research because I want to do all kinds of, you know, research. But.
Speaker0: [1:20:13] Beyond what after you know eight weeks like I have quite a few Instagram influencers like one girl I think she’s lost she went from like 190 and now she’s 135 she’s pregnant right now so but she’s she’s been following me for over a year a year and a half um and then a personal friend or a family friend of mine she was four foot 11 and 190 and she’s now 135 and she’s that’s been two and a half years and she’s been like just steady at 135 and she she had a stroke like 10 years ago and her doctor now took her off all of her meds because her her blood levels of everything are normal so it is sustainable because it teaches you to think about food in a different way you’re not thinking about of calories and i need to eat more i need to exercise to burn off something it’s it’s thinking of it you know in a different way and i i’ve plenty of people that are like i’ve lost so much weight i’ve gotten around i got rid of all of my fat clothes because i have no concern that i’m ever going to keep it off like i i have no no issue um or others will say i’ll go on vacation and like i’ll do whatever i want but it’s okay because i come home and i get right back on it and the water weight that i’ve gained is off in a week you know and i’m back right back to my normal so it’s like you can still enjoy your life um and have those moments where you can just.
Speaker0: [1:21:35] Eat what you want as long as you know what your default is. You’re going to come home and you’re going to get back on your default and you’re going to give your pancreas a break from the damage you just did. I don’t want to say damage. From the enjoyment that you’ve had and then you’re going to go back and you’re going to give your pancreas a break. So I have what’s called a bounce back blueprint that I put in the it’s like, you’re going to wake up you’re going to drink a bunch of water or you’re going to go for a long walk. Like how to get back into all right I’m going to get back into mine.
Speaker1: [1:22:04] That’s good. Yeah, it’s good from kind of like, like a binge eating perspective, right? It’s like, okay, like, no all or nothing thinking, just get back on it. And, and, you know, you’re not, I think you’ve talked about the keto diet. And this is because you’re eating carbs, and you’re just getting your carbs from fruit and vegetables. You’re not like, going on vacation, getting out of ketosis, then having a switch back in going through that whole metabolic process,
Speaker0: [1:22:29] Like you’re just a few weeks.
Speaker1: [1:22:30] Yeah, you’re just okay, I’ll just I’m just probably going to eat a lot of bananas the first day until everything regulates and then and then my appetite will settle and I’m not having to like metabolically switch in that way that, you know, can cause side effects for people or this idea of like, you’re either in it or out of it.
Speaker0: [1:22:50] Because ketosis is I mean keto basically lowers insulin that’s what it’s that’s what it’s doing it’s just doing it in a very aggressive way and when your insulin lowers that that low and you don’t have any glucose that you’re eating your body has no choice but to switch over and burn only fat which is what is releasing those ketones and what your body is using but, That that leads to that keto flu, because until your insulin level is lower enough to where you can burn that body fat, your brain is like, I don’t have anything here. Like, I don’t have enough glucose. I don’t have enough fat to eat to use because your insulin is too high. You really have to wait until you get to that switch where you can lower insulin and you can start burning all that body fat. But here is this more of a middle ground because your insulin levels are lowering, but you still have some glucose that you’re eating from the fruits and the vegetables. So it’s more of like what’s called metabolically flexible you’re you’re you’re able to burn glucose when you need to and then your insulin levels fall and then you can burn some body fat and then you eat again and you can burn some glucose and then you can burn some body fat you’re just your body is and that’s a term like that’s an actual term metabolic flexibility that you are flexible and that you can burn whatever it is that you need um most people can’t do that right most people can’t burn body fat can’t burn fat for energy um and then keto it’s just a very aggressive way of lowering insulin and wanting to just never have a glucose well you don’t really have to do that right like you can there is a middle ground yeah.
Speaker1: [1:24:17] Which is yeah which is so refreshing to see and like you know it’s well received like people love it like oh i can have as much fruit okay because we’re told often that fruit is bad and everything is confusing you know
Speaker0: [1:24:30] Because it’s glucose right they think oh if carbs are bad carbs are bad like think of it more of like how it’s affecting your metabolism, right? And how you’re, and people think of metabolism as just like how many calories you burn every day. No, no. Metabolism means how you use the food that you eat for energy or store it as fat. And if you’re eating foods that are constantly forcing insulin release, then you’re storing it as fat. You know, that’s just what’s happening. So, and eating big breakfast to boost your metabolism, that’s, eat when you want if you’re not a breakfast person don’t eat breakfast right like this is getting rid of every single food rule there is one rule if it spikes your insulin you should avoid it as much as you can if it doesn’t spike your insulin eat it whenever you want you know that is there is one rule you know and that really it makes people feel refreshed like the amount of, brain space that I don’t spend on food because I just and you know for 10 plus years the amount I mean the amount of time I spent worried about food and calories and carbs and working out and protein and everything else like it’s just like free up your brain for other things in life that bring you joy you know that’s really the most important thing.
Speaker1: [1:25:52] Yeah I can relate to that so much you know and even the being a sugar burner like being metabolically inflexible when I first learned about it I was like yeah that’s me every two hours I need to eat and it feels like you’re not you know especially if you’re if you are a calorie like I was a calorie tracker for a while and I’d be like how am I burnt like if this has 500 calories why am I hungry you know based on this whole calories in calories out all the biochemistry that you learn like I should be full for i don’t know longer than two hours i’m not burning 500 calories sitting here and studying um and so when i learned about that i was like oh yeah i’m not accessing the fat from my food or my body i’m just running on sugar it’s like a bat like a car with a race car engine or something i’m like burning all the gas out and having to refuel constantly and it’s mad
Speaker0: [1:26:40] And this is nine out of ten i think it’s like four out of ten kids they did a study you could test the insulin levels of a five-year-old right now. And it will tell you whether they’re going to be overweight, have type early diabetes, a five-year-old. And they did finger pricks at school for like thousands of kids. And they measured them. They followed them over the course of like, I think, 10 years or so. And they said the number one strongest predictor of early, you know, adolescent obesity was elevated fasting insulin at age five. And it’s so sad. It is. There’s so much to be done. And I will say, people are going to be like, well, why are people not talking about this? Why are doctors not talking about this? Why are you measuring it? I can tell you in one very simple way. Because the only time that clinical guidelines actually change is when somebody foots the bill. And it’s usually Big Pharma. So when Big Pharma came out with cholesterol-lowering drugs, they had the teams that worked with the clinical societies. They worked with the insurance companies. They worked on developing the standard ranges because they had a solution to a problem that they needed to make sure that everybody understood the problem so they would buy the solution.
Speaker1: [1:28:02] Mm-hmm.
Speaker0: [1:28:03] And unfortunately, there is no drug in development for lowering insulin levels. And so because of that, there is nobody footing the bill for increasing access to this information, to making sure that we have standard ranges, to make sure the insurance companies are reimbursing for this. I mean, it is, it takes deep pockets to do that. And the only people who have pockets deep enough are big pharma. And there’s no drug on the horizon to lower insulin. And that is the reason. Because they have huge field forces to go out and educate every single doctor about you need to measure this and why. And look at our data. And this is so important. And look at the outcomes for people who lower than, there’s nobody doing that.
Speaker1: [1:28:40] Yeah. It was a whole task force around fat, cholesterol. It was like decades of people all getting together and deciding on these guidelines. And, you know, and that I’m just thinking about the kid with high insulin who, you know, let’s say the parents are like, OK, we’re going to put some effort in and we’re going to look at your diet and we’re going to follow the guidelines. We’re going to put, you know, pay attention to labels and we’re going to probably be eating our six.
Speaker0: [1:29:05] We’re going to eat whole grain.
Speaker1: [1:29:09] Yeah. Which, you know, so it’s like we take our effort, our best intentions and then we’re we’re not applying the right interventions. And people give up you
Speaker0: [1:29:19] Know yes and then they’re like but whole grains are good for you i’m not saying that they don’t have nutrition that doesn’t mean they’re good for somebody with glucose intolerance which is essentially almost everyone so you know yeah they think that they have the best intentions they go to the store they buy the whole grain goldfish instead of the regular goldfish and they buy the protein special K because it has more protein and low calories and they mix it with the low fat skin milk. And literally every single one of those choices could not put more insulin into the system. I mean, it is literally flooding it. And it’s like, Oh, there’s another dietitian influencer on, on Instagram. And she basically was like, if your kid is struggling and you should, if they want to have KFC and they want to eat the biscuits, you just need to make sure that you give them the chicken leg with the biscuit because the chicken leg gives you the protein and the fat. And so that’ll offset the biscuit. I mean, this is a dietitian. She has hundreds of thousands of followers and it’s just maddening. It’s maddening and so and i feel like nobody can win for losing because they’re just they’re like i’m following all this advice and my kid’s getting worse or you know and it’s just yeah.
Speaker1: [1:30:38] I really feel like it doesn’t work or i’m broken work or yeah
Speaker0: [1:30:41] I made a i made a post recently that we go to conferences we go to the big conflict the big fertility conference and whatnot and i i have i’ve had many doctors tell me fertility specialists tell me i don’t send my pso my pcos patients to dieticians anymore because they come back worse than they started because that they get told eat more whole grains and beans and low-fat dairy and they come back and they’re heavier than they started yeah i.
Speaker1: [1:31:03] Have a patient i’m thinking with prediabetes who’s already on like maxo and the metformin dose and her dietician is like okay when your blood sugar drops because you’re on metformin and you’re not diabetic so your blood sugar is going too low and it’s but you know metformin is lower in blood sugar it is lung insulin a little bit but not enough and uh it’s like just have a candy. Take candies with you and have candies to bring your blood sugar up. I put a diabetic patient.
Speaker0: [1:31:28] It’s just granola bar. Like, oh my God.
Speaker1: [1:31:31] Terrible. So it’s just, and even she was like, this isn’t working. I feel like trash. Like, I’m not going to go anymore.
Speaker0: [1:31:38] Dietitians do not understand insulin resistance. It’s not taught in school. I mean, I graduated in from my bachelor’s in 2009. So that was a long time ago. And I was really hopeful that they’d at least caught up with the data. But I have another follower who’s currently getting her bachelor’s in nutrition. She’s like, The only thing I’ve learned about insulin is that you give it to diabetics to lower their blood sugar and that’s it. Like they do not learn about this. So if everything looks like a hammer, if all you have is a hammer and everything looks like a nail, everyone’s getting the same advice. Yeah.
Speaker1: [1:32:10] Terrible. It’s flashy.
Speaker0: [1:32:12] You can tell I’m very passionate about this.
Speaker1: [1:32:14] This is so good. This is so informative. I think people are really going to love this. My last question is, you know, about men. So I know your research is PCOS. We’re talking more broadly about insulin resistance. I think what’s really beautiful about your research is that it’s done on women because so much is not done on women at all. And so conventional advice like intermittent fasting, cold therapy, all this stuff that’s so great and influencers are recommending may not be great for women who have different hormones, different considerations.
Speaker1: [1:32:42] But this is like these are results done on women. And everybody who’s done a diet with their male partner knows like he loses like 50 pounds, I lose one, you know? Yeah. But my friend wanted to know if if this applies to men, which I think the answer is obvious. But yeah.
Speaker0: [1:32:59] I mean, it applies to everyone. Right. Kids, pregnant women, men, everything. Because for men, you know, one of the bigger issues is around the age 35, they start to have a reduction in testosterone. Right. Let’s call it menopause. They start to have a reduction in testosterone just naturally, which coincides with an increase in insulin. So a lot of times they’ll see that they’re having Dabod, which may not be anything to do with what they are changed in their eating or exercise. But when you have higher insulin, you start to gain weight and a large part of that goes to your stomach.
Speaker0: [1:33:31] And more so, that’s even more problematic with that is that when you have more fat tissue, That fat tissue has an enzyme called aromatase. And what happens is testosterone gets converted to estrogen into that fat tissue. So now not only do you have this natural decline in testosterone, but now whatever testosterone is left and being pumped out is getting turned into estrogen, right? So you have a, that’s what’s causing men to have low testosterone. And the only therapy we’re giving is to do testosterone injections or testosterone replacement therapy, but you’re not getting to the real reason why they have the low testosterone in the first place.
Speaker0: [1:34:13] That’s one of the problems, but that also leads to erectile dysfunction because now you have more chronic inflammation, which inflames, you know, all of your vascular system, but also, you know, having lower testosterone. So all of that kind of compounds to lead to erectile dysfunction, which is one of the earliest symptoms of insulin resistance in men. People, I had no idea. A third of men experience erectile dysfunction. That is a very early sign of problems. Before they have anything wrong with their labs, before anything happens, if they’re experiencing erectile dysfunction at an early age, it’s not just psychological. There is definitely something wrong going on. So that’s something I would say if you’re having a husband that’s experiencing that, they need to probably go get a workup. But, you know, the other thing is like sperm, high insulin and that chronic inflammation leads to changes in the sperm. So, you know, if you’re trying to get pregnant, you need to be following it. But so does he. He needs to have the healthiest sperm he can have. And that starts with, lowering insulin, making sure there’s not enough testosterone, making sure there’s not chronic inflammation. So I shared earlier, my husband, he’s part Hispanic. His dad died of a massive heart attack at the age of 41.
Speaker0: [1:35:28] And he was about 200 pounds when we started dating. He’s 5’11”. And he has now, I mean, that’s been 10 years, 10, 12 years since we started dating. And he is, he’s at 175 and has stayed at 175 like completely and he’s not perfect I told I told you that he doesn’t realize you can eat a pint of ice cream in more than in different settings like he just eats the whole thing so he’s not perfect but he is very very you know if he goes up a little bit he stays strict for like a few weeks and he’s back down and it’s just you know very even keel And I will say, you know, we, there was a study in 1966. So back in 1966, where they said fasting insulin is the strongest predictor of heart disease, strongest predictor of heart disease in the Lancet in 1966. So he went to his cardiologist like two months ago, because I told him, I was like, you know what? I don’t care that you look healthy. You obviously have genetic history. You need to go and start getting work up with your cardiologist. He’s 38. And uh, he went and he asked his doctor his cardiologist to test his insulin levels and she literally said I don’t think you can test insulin Wow And he was like, yeah, I know you can test insulin. She goes, I don’t know how to do that I’m gonna have to go talk to my colleagues.
Speaker1: [1:36:50] In 1966, so right before the low-fat cholesterol kind of paradigm.
Speaker0: [1:36:55] Everything. We have known for decades on decades that insulin is a problem, and yet here we are in 2025, and we’re not measuring it. And their excuse is that, well, the assays aren’t predictable. Then develop a better assay. That’s not the answer. It’s just like, oh, well, we can’t measure it.
Speaker1: [1:37:15] What? I mean, there’s developments for type 1 diabetes, So they must have figured out how, I mean, we can isolate insulin. We can make the peptide. We can inject it in people. We have long act, we have all kinds of insulin.
Speaker0: [1:37:27] We know how to do it. You can pee on a pregnancy test and it will measure a certain small hormone in your blood in a few seconds. And you’re saying we can’t develop assays for insulin? I mean, it’s mind-blowing. But I think personally, it’s probably a little bit of a conspiracy because if we start managing the insulin, then how are we going to treat the cancer? And who’s going to make money on treating the cancer? and the Alzheimer’s and the diabetes and the weight loss.
Speaker1: [1:37:51] Yeah, like all of our health issues go away.
Speaker0: [1:37:53] The testosterone replacements. I mean, all of the health care would go away. Yeah.
Speaker1: [1:37:58] Everybody’s talking about this idea of metabolic health, metabolic disease, and this is exactly what you’re working with. And I was just listening to Andrew Huberman. I know we’re almost at our time, but he’s talking about, he’s like, you know, a lot of my friends follow this really great diet, and he was describing your diet. I don’t think he knew about your diet. Hopefully he will one day. But he was like, yeah, lots of fruits and vegetables and proteins. From animals and they feel great and everything’s great and their cravings are managed and so we all intuitively know that’s the way to eat eat plants and animals
Speaker0: [1:38:26] Less processed nuts and seeds and like things that are just yeah normally available like people don’t realize as how the amount i think i used ai because i said okay imagine that all of human evolution was one year how long have we been eating starches and dairy? And if you were to do that, what would your guess be? If all of human evolution was compacted into one year, how long do you think we have actually as a species been eating starch or dairy?
Speaker1: [1:39:03] It’s, I mean, I have a little bit of knowledge. In like the 12-hour clock, it’s like the last second or something like that. So I imagine it’d be like the last month.
Speaker0: [1:39:14] Two and a half seconds. Yeah. Oh, wow. We have been eating starches and dairy for two and a half seconds and so when people are like we’ve been eating bread from the beginning of history i’m like no no no no and.
Speaker1: [1:39:28] It was different bread and we had different we had different like
Speaker0: [1:39:31] A different bread and we also didn’t eat bread we ate bread when we became societies and we didn’t want to have to look for our next food and that makes sense and that’s great we built societies but we also work we we exercised a lot more we were just active right like we were going out and bothering that around that.
Speaker1: [1:39:49] Time we had like bad bone structure like things changed not you know all of these diseases ran rampant and
Speaker0: [1:39:56] Right like we there is nothing that’s naturally available to us that spikes insulin fruits people are like oh well like you know the fruits today are so big they’re not the same well, Have you ever seen a fruit tree that’s like heavy with fruit? If you were like a hunter-gatherer or like an ancient person and you just happened upon this fruit tree, you might sit there and eat three or four apples. Like who cares if an apple today is this big when you just would eat, several of them you know like that’s and they’re like oh well they’re sweeter i’m like no no no i spent two two weeks in the amazon when i was 18 and that fruit is unadulterated and is sweeter than i’ve ever tasted in a grocery store so it’s not because it’s sweeter it doesn’t matter that it’s bigger fruit has always been very available i live in the coast the orange trees here get so full of oranges that the branches touch the ground i mean fruit would have always been available to us vegetables would have always been available to us like my parents are drowning in pecans we live in texas i mean the amount of pecans and they have six countries at their house like these are foods that would have just been available to us you know and it’s like, going and gathering enough oats to make your morning bowl of oatmeal that you cooked in the microwave for 90 seconds and added milk and honey to.
Speaker1: [1:41:18] You don’t you don’t know how to do that like you know how to pick an apple you can theoretically imagine how you kill an animal, but how you make oats, even what an oat looks like when it’s growing, nobody knows, right?
Speaker0: [1:41:30] No, and it would have just been wild oats, right? Like you would have had to go forever to find enough oats to like put in your bowl and then somehow make it, I mean, steel cut oats take forever to cook and just, it wouldn’t have been part of our life. And now people think nothing of a bowl of granola and skim milk, which is just oats and sugar and milk or a bowl of oatmeal with, milk and honey in it and they’re like oh it’s oatmeal it’s like um it’s so much more than oatmeal it’s a bowl of glucose you know and it’s hard for people to get their head wrapped but hopefully with the this conversation they understand
Speaker0: [1:42:08] a little bit more behind what’s going on yeah.
Speaker1: [1:42:11] I think minds will be blown so really one why i wanted to talk to you i wanted to be like listen to this conversation to patients who are like what like you know but um dr ali any last thoughts? Any last words? Thank you so much.
Speaker0: [1:42:23] No, I think that, you know, I think we covered everything and more. People might need to watch this on 2X to get this.
Speaker1: [1:42:31] Yeah, watch it a couple times. I might have another episode kind of going over the signs with PowerPoints to kind of like reinforce what we talked about. But yeah, this is really great.
Speaker0: [1:42:41] Yeah, I think the free webinar, right? That free webinar I have on YouTube, I think it really helps also just, you know, put some perspective i have a free guide on my website with kind of all the foods that you can eat freely of um and then yeah so and i have i have the app coming out i’ll have tons of free education um it’ll have a subscription because that’s just you know part of the world we live in but if you want to access some of the tools and resources but a lot of the education will be free so perfect i’ll.
Speaker1: [1:43:08] Link to everything in the show notes for people to check you out and to follow you so your website and your instagram um is that the best place people can find you kind of website Yeah,
Speaker0: [1:43:16] I think I’m not very active on any other social platform. I can only handle one. But Instagram is where I’m at. Yeah, where I do the most.
Speaker1: [1:43:25] Thank you so much. This has been so great.
Speaker0: [1:43:27] Thank you for having me. Love it.
I’ve struggled with body image as much as the next woman. In certain influencer, nutrition and health circles I find “skinny” is confused for “healthy”. When we talk about health and wellness, people assume we mean “thinness”, or weight loss. And I want to confess something: I hate treating weight loss. I love love love when people notice positive side effects from their treatment plans: they’re sleeping better, more relaxed, have better skin and yes, have even noticed some weight loss, but when weight loss is our primary goal, something we’re aiming for at all costs, (and this is the key point) beyond the weight OUR BODY WANTS to be for health, then I’m often stumped. My goal is to support the healing process of the body, and to do no harm. Fat, while vilified in our society, is not a 4-letter word. (I also mean that literally… it’s… a 3-letter word). Our bodies love fat. Fat is stored energy. It’s your cushy bank account—resources saved for a rainy day. It’s mental, emotional, and physical protection. Our cushioning protects us against falls. It’s a storage reserve for reproductive needs (growing a baby’s brain and breast-feeding). It’s the rubber insulation of the electrical wiring of our nervous system and brain. It’s brain mass. It’s a layer of warmth. Stress, famine, lack of sleep, inflammation, and hormonal resistance, are some common signals that tell the body to store and maintain fat. Our bodies also have a set point range at which they feel most comfortable—and this set point, unfortunately for our Instagram followers, may be higher than society tells us it should be. I have found in my practice that if we treat the underlying causes of fat gain: the inflammation, poor sleep, chronic stress, insulin resistance, etc., we might notice weight loss as a happy side effect of improved metabolic functioning. Sometimes our bodies have experienced mental, emotional, physical or metabolic trauma and need to hold onto their protective layer a little while longer. Maybe your body thinks you need a little softness… I created a course: Intuitive + Mindful Eating, body image, metabolic health, hormones and more.
So, if another diet “failed”, trust me, that’s normal. It’s not your fault. Diets don’t work. In fact, in the long run they do the OPPOSITE of what their supposed to do: improve our metabolic health. Instead they DAMAGE our metabolic health, through cyclical restriction (which often leads to binging and weight gain). And this leads to guilt, shame, and a poor relationship with our body image and food. The solution is to work with your body where it’s at. – Understand how your metabolism works, and learn about your Set Point Weight. – Listen to your cravings and hunger cues and use them as tools for communicating with your body to heal your metabolism – Make peace with your body size through developing Body Neutrality (easier to achieve than body positivity for a lot of people) and becoming more “embodied”–feeling at home in your body vs. trying to change it. – Recognizing that you can feel at peace with your body where it’s at right now: and that losing weight (if it means working against your metabolism) won’t make you healthy. And it won’t make you happy. – Making peace with food through Intuitive and Mindful Eating. – Practicing gentle nutrition that honours hunger cues and cravings and keeps you fuelled throughout the day. – Self-compassion – Understanding how hormones play a role in body size and metabolism and how to nurture them to feel your best. I cover all of this in more in my course You Weigh Less on the Moon. Because it’s true, you do!
Yes. Have you heard of something called “self-objectification”? It is the effect of moving through the world imagining how your body looks to others: perhaps checking yourself out in the mirror, adjusting clothing, taking selfies–the awareness of your body moving through space and the impact your “image” has on others. As if part of your consciousness is outside of yourself, looking in. Self-objectification is so so common. We all do it. Does my hair look ok? Can you take another picture? I wish my thighs were more toned. Do this ____make my ____ look _____? Remember when you were a kid and you just went to the beach? Or, maybe take a page out of Teddy’s book, in the first photo. She doesn’t care about her beach body. She just wants to be on the beach, running, free. Self-objectification prevents us from being present, from enjoying life. It blocks creativity and flow state. The remedy? Embodiment. Presence. Body neutrality (the art of worrying about other things—how you look is truly probably the least interesting thing about you!) Mindfulness. How does my body feel? What can my body do? Am I hungry? What food do I love to eat? Am I thirsty? What would I like to drink? How does the sun or water FEEL on my skin? How does the sand feel between my toes? Can I taste the air on my tongue? Do my muscles feel tense or relaxed? Am I breathing from my belly or my chest? Do I want to move or rest? And so on. No matter what, though, the beach is ready for you. I created a course to introduce you to these topics and more. It’s called you Weigh Less on the Moon.
I review my adventurous year of living on the Low Carb High Fat Ketogenic Diet.
I’ve always had a sweet tooth.
I remember binging on Halloween candy as a kid, stuffing one tiny chocolate bar after another into my mouth, as fast as my little fingers could unwrap them, trapped in some kind of sugar-filled trance.
“Never get between Talia and her food!” My family would joke when my blood sugar would crash between meals and I’d rage towards the fridge for a snack to keep me sane.
I remember digging into the little bags of cheese popcorn reserved for school lunches, finishing off one after another and then hiding the wrappers in their big Costco box so that it would look like it was still full, the way rebellious teens top up empty vodka bottles with water.
I can gain weight with the drop of a hat (but also put on muscle fairly easily), and it takes concentrated effort and dedication to take it off.
After a period of temporary stress and bagel-related weight gain, I decided to embark on a bit of experimentation. Work was getting busy and I wanted to supply my brain with constant energy without having to take snack breaks every few hours. Also enticed by anecdotes of shattered weight loss plateaus, I decided to “go Keto”.
I like experimenting with diet. Like many health-conscious people, finding the right nutrition regime for me has been a process. In my teens I started controlling portions and switching out white breads for whole grain rye and Jolly Ranchers for carrot sticks. In my early 20’s, I was vegetarian. I tried being vegan for a while before deciding it was a disaster for my health when I began to experience nutrient deficiencies, weight gain, and hormonal issues.
Later on, I followed my naturopathic school classmates to a modified Paleo diet (keeping in some gluten-free grains and legumes), then moved to a more traditional Paleo diet (taking out the grains and legumes), before going back to the modified version (which is probably the best eating style for me—more on that later).
For the most part, my diet is comprised of whole foods, with lots of vegetables, but in the Fall of 2016, when this all began, I was in a pretty Standard North American place when it came to food intake. At the time I was suffering from IBS, some issues related to subclinical PCOS, and fatigue. I was also starting to see some signs of impaired glucose control.I wasn’t feeling good and I was in need of a kind of reset of sorts.
I was interested in seeing how relying on ketone bodies for fuel would help my body, mental performance, and improve my blood glucose control and symptoms. I have a family history of type II diabetes and I wanted to do what I could to prevent insulin resistance and metabolic syndrome. Drastic times call for drastic measures, I thought.
Ergo, The Ketogenic Diet.
About the Diet:
The Classic Ketogenic Diet was first developed in the 1920’s to treat children with medication-resistant epilepsy.
When our brains are starved of glucose, their preferred fuel source (our brains use up 60% of the body’s glucose), the liver creates ketone bodies from stored or dietary fat that the brain can use as a substitute source of energy.
One of these ketone bodies, beta-hydroxybutyrate, is thought to be a particularly therapeutic molecule for the brain, conveying anti-convulsive benefits, thereby helping to reduce the incidence of seizures in children who don’t respond to medication.
However, the original Ketogenic diet is more extreme than the general health and weight loss-aimed diet we see described in recipe books these days. The Classic Ketogenic diet consists of about 90% of calories coming from fat. In order to achieve that, followers need to severely restrict their protein intake, and virtually eliminate all dietary sources of carbohydrate, which drastically limits their nutrition choices.
Since, the benefits of beta-hydroxybutyrate are being studied for other neurological disorders, such as Parkinson’s disease, dementia, migraine headaches and narcolepsy. It’s being looked at as a potential treatment for mental health conditions, like autism and depression, and metabolic disorders such as type II diabetes, and even to increase the efficacy of chemotherapy and radiation treatments in cancer. Other studies are looking at its role in improving cognitive function in mice and humans.
Some research shows that beta-hydroxybutyrate can expand lifespan by interacting with genes that slow aging. It is also shown to confer anti-inflammatory and antioxidant benefits.
In the 1970’s, Dr. Atkins responded to the high-carbohydrate, low-fat dogma of the nutrition world at the time, by bringing a modified Ketogenic diet into vogue. Restricting all forms of carbohydrates and encouraging a consumption of the still-vilified high-fat foods like bacon, eggs and cheese, Atkins affirmed that people could lose weight by eating fat, as long as they restricted carbohydrates at the same time.
The modern version of the Ketogenic Diet is slightly more health-conscious, promoting a higher intake of vegetables. The current diet restricts carbohydrates to under 20 to 50 grams per day, and encourages a high fat intake and a moderate protein intake, in order to encourage the body to turn to fat as its primary source of fuel. The current version of “Keto” is less strict than it’s initial epilepsy-treating incarnation, with anywhere from 60-85% of its calories coming from fat.
My Version of Keto:
I started the whole journey by tracking my food intake (using My Fitness Pal). My aim was to consume 20 grams of net carbs, or less, per day to push my body into using fat-turned-to-ketone bodies as a its primary fuel source.
Net carbs are calculated by subtracting dietary fibre from total grams of carbohydrates. For example, 1 cup of raw broccoli contains 6 grams of carbs. 2.5 of those are fibre. Therefore, the net carbs in broccoli are 3.5, which would count towards my net carb goal of 20 grams per day.
This isn’t easy. Take a look at any package of food you regularly consume. 1 cup of cooked oatmeal contains 23 grams of net carbs: 3 grams over my entire daily allotment. Therefore all high-carb foods like grains, legumes, starchy nuts, all fruits, and some starchier vegetables, were off limits.
Many people opt to test their blood, breath or urine for ketone bodies to determine whether or not their bodies are in ketosis. I dabbled in this, using the urinalysis strips in my clinic to test for urinary ketones. However, even though I was sticking to the diet, the strips would mostly turn up negative for ketones.
There are a few reasons why ketone strips may not be a reliable marker for ketosis. Firstly, the don’t test for beta-hydroxybutyrate, which is the main ketone body utilized by the brain, but acetoacetate, another ketone body produced in the liver.
Secondly, urinalysis strips only test for urine ketone spillover. They don’t necessarily reflect blood levels, and they won’t pick up the ketones that are being utilized as fuel by the body. If cells are absorbing all the ketones the liver produces, urine testing may not be positive.
The most accurate, albeit more expensive, method for testing ketone bodies is through a skin-prick test that analyzes blood levels of beta-hydroxybutyrate.
While I knew that the urine strips weren’t highly accurate, not having my state of ketosis validated was discouraging. I was often left in doubt over whether things were “working”. I wondered if there was some other mechanism going on. Was my body finding carbohydrates from someplace else? Did I have Small Intestinal Bacteria Overgrowth that was digesting my fibre and allowing me to absorb it somehow? Were my blood ketones being used up somewhere else (by the yeast in my gut, for instance)?
I did have signs of being in ketosis that I could watch for, however. When I avoid carbs, or fast for a few days, I start to develop a metallic taste on the tip of my tongue. It’s not a common sign of ketosis, a more common sign is a “nail polish” or “paint thinner” taste in the back of the throat, but still a symptom that some people report.
Keto Flu:
During the first few days of switching to Low Carb High Fat, I had to white knuckle through a phase realistically termed the “Keto or Low Carb Flu”. This horrible phenomenon is thought to be a result of the body switching from burning glucose as its primary fuel source to adapting to ketone body production. There is often a painful adjustment period for brains that have to learn how to rely on ketones for their main fuel source after a lifetime of glucose abundance.
It was nasty. I felt intense hunger and sugar cravings, nausea, dizziness, and weakness—it truly was a “flu”.
I knew that I had spent most, if not all, of my life as a sugar burner. Before Keto, I would crave food even just two hours after a full meal. I would often feel “hangry”: dizzy and shaky in between meals, and irritable if made to wait for food for too long. I had been existing between carb-dense meals, experiencing insanity-inducing reactive hypoglycemia between my regular sugar fixes.
The more I read about others’ experiences, the more I was assured that the keto flu symptoms were actually a sign of my body healing. I was becoming adapted to other fuel sources, which was a good thing, I thought.
So, I muscled through and followed the online advice: I consumed more fat to provide more fuel to my brain, including medium chain triglyceride (MCT) oil, which is quickly absorbed by the lymphatic system and turned into ketones by the liver, and I consumed electrolytes, which are more rapidly excreted from the bodies of low carb dieters.
For some people, Keto flu can last for days, for others it lasts weeks. For me, the Keto flu thankfully only lasted two days, after which my body began to adjust and my cravings for sugar went down. I began to feel more energy, which felt encouraging.
Daily Meal Plan:
For breakfast, I would typically eat a high-fat smoothie containing coconut milk yogurt, gelatin, and avocado, and topped with pumpkin seeds and cacao. Sometimes I’d make fat bombs or homemade unsweetened chocolate.
I’d have my second meal of the day in the mid-afternoon, around 2 to 3 pm, for which I’d consume a few cups of cruciferous vegetables, like broccoli or cabbage, with a fatty cut of meat like ground beef, chicken thighs, or salmon, all topped with liberal amounts of fat from coconut, olives, avocados, or grass-fed ghee. I made a lot of batch-cooked grain-free curries and stews.
If I had a third meal or snack in the day, it would be another serving of fat: a handful of macadamia nuts or a hunk of creamed coconut.
Eating this way made me feel like Obama and his grey suits—I didn’t have to plan my meals too carefully. All I had to do was eat fat. My food was so calorie dense and my blood sugar so stable that I didn’t need to eat often. This meant that I didn’t need to worry about bringing food with me everywhere I went; one meal could satiate me for half the day. Hunger was never an emergency situation, as it had been in the past. Hunger would come on very slowly, and it would never be “hanger”; my already low blood sugar had nowhere to dip to. If I needed more food, I could always wait until I got home to eat.
More Benefits:
Within a few days, my PCOS- related cystic acne cleared. I also felt slimmer as some water retention deflated. This felt good. Our body stores carbohydrate in the form of glycogen in the liver and muscles. Glycogen stores retain water.
When glycogen stores are used up, a rapid 5 or more pound drop in weight can occur. This is the “water weight” that people talk about losing when they first begin some kind of nutrition plan.
It’s also common to notice a drop in water weight from a decrease in inflammation, when embarking on a new eating plan. I know that I am sensitive to certain carbs and dairy and, because those things were out of my diet overall (although Keto can certainly include high-fat dairy products for those who can tolerate them), the water retention caused by chronic inflammation seemed to clear.
Although it seems to attract people primarily for its hip-slimming potential, the Ketogenic diet probably does not cause weight loss in and of itself. Instead, the diet encourages a passive reduction in calories by stabilizing blood sugar and insulin levels, while promoting the intake of highly satiating foods containing protein and fat. Ketone bodies also have appetite-suppressing effects. Therefore, it’s probably a calorie deficit that causes the weight loss, rather than any specific biochemistry in the diet itself.
I didn’t lose much more weight than the water weight. However, my mood was brighter. I would wake up in the morning looking forward to the day, which often doesn’t happen in the winter. I felt more sustained energy throughout the day, and really enjoyed the decreased appetite, which led to more productivity.
I felt fine consuming two meals a day, able to get through hours of back-to-back patient visits without needing a snack or a break. It was actually incredible to need so few meals; it was like becoming another person, one no longer ruled by sugar cravings. I was like a camel, switching to stored fuel when the fat from my last meal had run out, and the transition was seamless. There was no wall to hit, and no hypoglcyemic crash to be seen.
I also noticed less bloating and digestive issues, probably from the lack of fermentation in my gut and the reduction in foods that tend to aggravate IBS, like certain vegetables, fruit, and legumes.
However, all was not roses on the Keto diet. While the first few months were dreamy, the longer I stayed on it the more I started to notice changes in my body that indicated the honeymoon period I was enjoying wasn’t going to last.
The Microbiome:
The research is in: human beings probably need 10 servings of fruits and vegetables a day (roughly 5 cups), or 800 g, a day to get the most heart disease, stroke and cancer-preventing benefits that diet can afford us. The International Journal of Epidemiology concluded that, if the correlations found in their February 2017 study were causal, almost 8 million lives might have been saved in 2013 if everyone in the world had simply consumed their fruits and veggies.
It’s one thing all diets, even the faddy ones, agree on—from the Paleo Peeps, to Plant-Based Hippies, to Raw Macrobiotic Sun Worshippers, to Whole Foods Michael Pollen Omnivores, to the dejected nagged-at husband pushing brusselsprouts around on his plate—fruit and vegetables are good for you. You should eat them. If you’re a typical North American, you should probably eat more than you’re eating. The health value of everything else we eat seems to be up for debate: red meat, saturated fat, soy, bread, coffee. The benefits of eating enough fruits and vegetables, however? There’s no contest.
It’s hard to pick one way in which fruits and vegetables are so health protective. It could be because of their high concentrations of micronutrients, reducing the risk of common nutrient deficiencies, like magnesium and vitamin C. It could be because, if you’re filling your body with a kilogram of fruits and vegetables a day, you probably aren’t scarfing down an entire medium-sized pizza and supersized orange pop as well—there just isn’t room. It could also be the antioxidants they contain that protect cells against free radical damage, protecting DNA. Or perhaps its the fermentable fibres present in fruits and vegetables that feed our invaluable microbiome.
The problem with keeping net carbs under 20 grams a day was that I needed to restrict my fruit and vegetable intake. I was eating no fruit at all, and staying away from the starchier veggies, like carrots and beets. I still stuck to my beloved leafy greens and crucifates, but even eating 2 to 3 cups of those guys a day would push me to the upper limits of my carbohydrate intake, which meant I couldn’t eat them as liberally as I had been.
Getting enough vegetables and (any) fruits on the keto diet is hard, if not impossible. This can impact our ability to get the micronutrients we need, but also enough fermentable fibres from vegetables like garlic, onions, yams, Jerusalem artichokes, and legumes, which provide food for our microbiome.
Feeding our gut bugs is important. They benefit us in numerous ways, from digesting out food, to calming inflammation, to fuelling gut cells by producing a short-chain fatty acid called butyrate. They help our immune systems function optimally. They produce neurotransmitters for our brains to work. They balance our stress responses and our circadian rhythms.
Jeff Leach, at the Human Microbiome Project speculates that the lack of dietary fibre in most low-carb diets may impact the health of the microbiome in negative ways by depriving the gut bacteria of their preferred food sources, as well as altering the acidity of the colon and intestines. He cites this article, in which obese subjects on a high-protein and low-carb diet had lower levels of butyrate in their bodies and intestines, likely due to decreased diversity in their guts.
There are, however, some studies that suggest that a Ketogenic diet can improve the microbiome in children with epilepsy, and autism, and some speculation by the researchers that that may be how the diets treat these conditions. However, since these studies are not done in “healthy” children, with an already healthy microbiota, it’s hard to extrapolate the findings to the healthy adult population.
Then there’s the fact that most studies that look at high fat diets and their impact on the microbiome are mostly done in rats. Of course, rats aren’t humans, despite there being relative genetic similarities. In these animal studies, researchers refer to “a high fat diet” when in fact they mean a high fat, high sugar diet. The sources of fat in these “high fat” mouse diets are often corn, margarine, or soy oil, which we know are highly inflammatory and offer few if any health benefits.
In other words, many studies on “high fat” diets are not looking at a relatively balanced Ketogenic diet that consists of vegetables, proteins, and healthy sources of fats from avocados, coconut, fish, olives, nuts and seeds and grass-fed meats.
Context is important as well. Is it the high fat diet that causes a reduction in gut diversity or the absence of fibre? This one mouse study showed that simply providing the mice with fibre in addition to their high fat diets decreased their risk of obesity.
I felt that my gut initially improved in the first few months on Keto: the diet was low in foods that aggravate me: namely refined carbs, sugar, gluten and dairy, as well as some of the fermentable fibres that can aggravate IBS. However, it never fully healed. After a few months, I started to notice the symptoms of bloating and digestive irregularities coming back.
Candida, a yeast that resides in the gut and can overgrow in the intestines in some people, especially the immunocompromised, causing symptoms of fatigue, IBS, and weight gain, among a variety of other symptoms, can survive on ketone bodies. Yeasts have mitochondria of their own. Some species of gut bacteria can consume protein, bile salts and even fats.
Contrary to what many claim, a Ketogenic diet doesn’t necessarily “starve out” the bad gut bugs. Combined with the lack of fibre to feed the beneficial gut bacteria and promote more bacterial diversity, a prolonged Ketogenic diet may be a recipe for gut dysbiosis.
Hormones:
Throughout my year spent in ketosis, I definitely noticed an improvement in my insulin signalling and glucose control, especially in the first few months. Looking at my blood work in March, after about a year of the Ketogenic diet (and then having been off it for a few months), my fasting insulin was very low and fasting blood glucose levels were in the low-optimal range. HOMA-IR, a calculation that is used as a marker of insulin resistance, was also low, indicating good insulin sensitivity.
I personally believe that this means that my risk for getting metabolic syndrome or type II diabetes is low, as long as I maintain this level of insulin sensitivity by watching the glycemic load of my diet and my stress levels.
The metabolic flexibility awarded to me from my year in ketosis also proved to be invaluable. Now, I no longer fear fasting and I can survive on other fuel sources besides sugar. My brain knows how to tap into stored and dietary fat more efficiently, and use those for energy. Even when not following any sort of low-carb diet, I noticed that I could survive between meals while travelling in Southeast Asia for two months, whereas normally I would have had to exist on unhealthy, sugary snacks.
However, after a few months on the diet, I began to notice a decline in my menstrual health. My cycles began to get longer, and soon I started missing periods. I noticed more hair falling out in the shower and more cystic acne developing on my chin. When I ran my blood estrogen and progesterone levels, I was surprised to see that their levels were very low.
We know that insulin, while often vilified as a “fat storage” hormone is actually responsible for storing everything, including nutrients. It also correlates with estrogen levels and the conversion of T4, one of our thyroid hormones, to its active friend, T3, which runs our metabolism. Insulin builds muscle, bone and brain cells. Very low insulin levels, in my case, were contributing to amenorrhea and a disruption in my sex hormones.
This wasn’t good.
While not quite the same as Intermittent Fasting (IF), Keto is often grouped into the same category because of its similar impact on blood glucose and insulin. The difference is that Intermittent Fasting induces ketosis through periodic food restriction, as opposed to carb restriction. Keto and IF often go hand in hand, however. The reduced hunger and high-nutrient density of the foods eaten on a Ketogenic diet often lend well to practicing intermittent fasting. It did in my case—I was only eating two main meals a day.
I always found it interesting, however, that most proponents of intermittent fasting are men. The male body appears to thrive in the fasted state, getting a boost of growth hormone and norepinephrine, both of which provide men with energy, motivation, and an improved sense of well-being.
This hormonal change may be a remnant of our ancestral hunter-gatherer days where it would be an advantage to feel motivated and energized to go out and hunt during periods of food scarcity.
I don’t think female bodies experience exactly the same effect. Some preliminary animal research tends to suggest that as well.
A few rat studies indicate that fasting may impair female insulin sensitivity, and induce amenorrhea, or missed periods. Female bodies rely on a consistent influx of calories and carbohydrates to stimulate insulin, which plays a role in stimulating thyroid hormones and estrogen, to continue to ovulate. Another study showed that fasting tended to “masculinize” female rats, lowering their female hormones, and increasing their levels of androgens, the male sex hormones, like testosterone.
Of course, these studies were done on fasted rats, which cannot be fully translated to the effects of Intermittent Fasting and Ketogenic diets on women. However, some of these findings did validate my experience, which certainly wasn’t being validated in the podcasts and blog posts I was exposed to, largely written and followed by men.
I did experience positive hormonal effects: the increased insulin sensitivity and lowered blood glucose. However, I was not happy about my irregular cycles and estrogen deficiency.
Therefore, I decided to increase my carbohydrate intake, returning to a more moderate Paleo diet that consists of some fruit, starchier vegetables and legumes. After a few months, my periods returned to normal, my skin cleared up, my hair stopped falling out, and my thyroid hormones, estrogen and progesterone levels all returned to their optimal ranges.
I have still have low fasting insulin levels, suggesting that the Ketogenic diet did help to reset my insulin sensitivity and that this effect may be lasting.
Metabolic Health:
After a year of doing the Ketogenic diet, and then a few months of returning to a moderate-carb paleo diet, I tested my cholesterol levels and inflammatory markers. My HDL cholesterol (the “good” cholesterol, to put it very simply) was high, my triglycerides (a risk factor for heart disease) were very low, and my LDL cholesterol (the “bad” cholesterol that statin drugs target) was also low. My inflammatory markers: C-Reactive Protein (CRP) and erythrocyte sedimentation rate (ESR), were also low.
While it is typically the monounsaturated fats, like olive oils and avocados, that are associated with increased levels of the heart-protective HDL cholesterol, even saturated fats from coconut oil can raise HDL. LDL is often lowered by these healthy monounsaturated fats, however saturated fats, even healthy ones, can raise LDL in certain individuals.
All else being equal, higher levels of LDL may not be as big of a problem as we think. Especially in the context of low risk factors, like low inflammation, absence of smoking and a healthy body weight. What’s more, the triglycerides and cholesterol/HDL ratio may be more important factors for determining heart disease risk. Further, assessing LDL particle size may also provide those concerned about their LDL levels with more information concerning their cardiovascular health. That being said, it is important to be aware that some of the fats present in a Ketogenic diet have the potential to raise blood levels of LDL in certain susceptible individuals, and that not everyone’s blood lipid results will look like mine.
Triglyceride levels are associated with liver function, and generally reflect dietary sugar, fructose and refined carbohydrate intake, rather than fat intake. Reducing refined dietary carbohydrates like white grains, flours and sugars is a good strategy for reducing triglyceride levels and reducing heart disease risk.
Some individuals can experience elevated levels of inflammation on a Ketogenic diet, depending on the quality of foods consumed. A Ketogenic diet low in fibre that fails to feed the microbiome; high in foods that a person may have an individualized sensitivity to (such as dairy, eggs, nuts or soy); or high in inflammatory fats like trans fats, and industrial oils like canola and corn oil, may all contribute to increased inflammation.
That being said, certain ketone bodies like beta-hydroxybutyrate may have anti-inflammatory properties. Many of the fats consumed in a mindful, whole foods Ketogenic diet, such as olives, avocados, seeds, salmon, and coconut, are also anti-inflammatory.
I found my blood markers a good indicator of the power of a high-fat, low-carb diet to, at least in my case, improve HDL cholesterol and lower triglycerides, fasting insulin and fasting glucose levels. Whether I needed an entire year in ketosis, or whether I even needed to actually enter ketosis to receive these benefits, isn’t clear. Perhaps I could have gotten the same results by moderately lowering my carb intake while increasing my dietary intake of healthy fats.
Modified Ketogenic Diets:
While I do think I benefitted from entering into ketosis, I would not necessarily recommend a Ketogenic diet to patients unless to achieve some sort of therapeutic goal, such as improved insulin resistance, or for adjunct cancer care, to reduce inflammation, or to improve severe depression, migraines, or narcolepsy.
However, there may be a benefit to cyclical Ketogenic diets for memory and cognition, and increased life span in mice. Cyclical Ketogenic diets involve entering ketosis on alternate weeks. On the other weeks, participants return to a normal, whole foods diet that contains higher amounts of carbohydrates. In this case, individuals gets the benefits of beta-hydroxybutyrate production and increased metabolic flexibility on their weeks on, while also being able to eat a high amount of fermentable carbs and fibres on their weeks off, essentially getting the best of both worlds.
Adding medium chain triglycerides to food may also confer health benefits, similar to being on a Ketogenic diet. One study showed that adding MCT oil to a high-carb breakfast (pasta), reduced appetite in men. This is likely because, after burning through the glucose in the pasta, the men’s brains were able to access the ketone bodies that were made readily available by burning the MCT oil. This kept their brains fuelled and their bodies satiated for longer.
The men eating pasta and MCT oil in the study had a ketone blood level of 0.3, which is similar to that obtained from a diet that derives 10% of its calories from carbohydrates, which is an essentially a very low-carb, if not Ketogenic, diet. This may indicate that simply adding MCT oil to a moderate to low-carbohydrate diet, may confer some of the benefits of having a slightly higher rate of circulating ketone bodies without having to follow a strict diet. Again, following this strategy, you can get the best of both worlds: consume a diet high in fibre, while also getting a steady flow of ketone bodies to the brain.
Other interesting areas of research are the use of supplemental, or exogenous, ketones for therapeutic use, however the area is new and not something I currently recommend in my practice (although this may change when more research begins to emerge and better supplements enter the market).
My Plan Moving Forward?
I’m happy that I gave the Ketogenic diet a try, but now I’m back to my more modified Paleo diet, aimed at promoting gut health, optimizing my micronutrient intake, regulating hormones, and supporting my energy levels. I now consume berries and apples, legumes, starchier vegetables and lean proteins more often and aim to get 10 servings of fruits and vegetables a day, with 8 to 9 of servings coming from vegetables, as opposed to fruit.
I currently start my day with a smoothie with berries, an avocado, spinach and protein powder. For lunch I have some sort of protein, fat, and tons of veggies. I eat more often than when I was in ketosis: about 3 meals a day with a vegetable and fat as a snack, or no snack at all in between, depending on my schedule.
My total daily carbohydrate intake falls around 100 grams a day with a net carb intake between 50 to 70 grams a day, depending on the fibre content of the vegetables, seeds, and legumes I’ve eaten that day. I try to get upwards of 30 grams of dietary fibre per day.
I avoid all sugar, including sweeter fruits like tropical fruits, and dried fruits, like dates. I especially stay away from refined sugars, even “natural” coconut sugars and agave. I avoid processed carbohydrates and flours. I mostly avoid grains, except when travelling or visiting someone’s house, getting my carbs from starchy vegetables and tubers, legumes and berries. I continue to avoid dairy (which I’m sensitive to), gluten, and processed industrial oils like canola, corn, and soy oil.
Right now, rather than focussing on macronutrient ratios, I’m directing my food intake towards obtaining the Recommended Daily Allowances of the micronutrients that run all of our cellular reactions, and the fibres that feed a healthy gut microbiota. I use an app called Cronometer to track this.
I definitely eat more fat than before, adding MCT oil to my morning smoothie, especially on days when I need to stay full and focused for longer. I also aim to do at least 12 hours of fasting a day, trying to get in 16-18 hour fasts where I can, ending dinner at 4pm, for example. I no longer do regular long bouts of Intermittent Fasting, particularly not when I’m feeling stressed and burnt out.
Would I Recommend the Ketogenic Diet to Patients?
One of the main tenants of Naturopathic Medicine is “Do no harm”. While it may seem like making diet and lifestyle recommendations are relatively benign therapies, I believe that they do have the potential to do physical and psychological harm, particularly if they are strict recommendations.
Following a strict diet may have health benefits, but it also may isolate us from friends and family, frustrate us and restrict our intake of certain nutrients, like fibre, vitamins and minerals. This is one of the reasons I do not ever advocate a Vegan diet, although if patients are following one already, I believe in guiding them to optimize their nutrient intake.
Furthermore, at least in my personal experience, the cure was stronger than the disease. I probably didn’t need to do the Ketogenic diet for so long; this was evidenced by the hormonal imbalances that I began to experience towards the end of my year on the diet.
However, particularly for patients who are suffering from metabolic syndrome, type II diabetes and insulin resistance or PCOS, there may be some powerful benefits to entering ketosis in order to dramatically reverse metabolic dysfunction. In this case, a modified regime combining Intermittent Fasting and cyclical Ketogenic diets could be beneficial.
Of course, it all depends on where patients are at in their nutrition journeys. Sometimes I meet patients who require, and respond well to, more heroic lifestyle interventions. Other times I meet patients relying on several sugary treats a day to get them through. In these cases, simply tweaking their diet in small ways, using baby steps may also have powerful disease-risk-reversing effects.
In the past I used to suffer from “hanger”, feeling hungry and irritable if going more than a few hours without food. Now my body is adapted to fasting, going prolonged periods without food—and I feel all-the better for it.
When I was a kid, no one ever had to convince me to finish my dinner. Perpetually “hangry” (hungry and angry), I was the Tasmanian devil of snacking, vacuuming up whatever food substances crossed my path, leaving wrappers and crumbs in my wake. “Never get between Talia and her food,” my brother facetiously coined when, like a voracious bull, I would bully my way into the kitchen to fix myself an emergent after-school snack. From the moment I was born, it seems, going more than two hours without eating was a physical impossibility. “I’m sick with hunger,” I would complain whenever my blood sugar levels dipped.
Now I sit here writing this article, in my adult incarnation, comfortably having abstained from eating for more than 14 hours. Whereas before I couldn’t go more than 2 hours without some kind of sugary snack, my body is now adapted to thriving during prolonged periods without food—and I feel all-the better for it.
“Eat a snack every 2-3 hours to keep blood sugar stable and lose weight,” dieticians and nutritionists often advise . However, as we dig into the disease prevention, anti-aging and weight management research, we learn that there may be benefits to going without food for prolonged periods.
We humans spent much of our evolutionary history hunting and gathering with extended periods of food scarcity. Our bodies adapted to survive through, and perhaps even thrive and depend on, periodic fasts. We now live in a society that enjoys food abundance: with 24-hour convenience stores and fast food restaurants at our disposal, we rarely go hungry. This recent lifestyle change may contribute to the increase in the diseases of excess that afflict modern bodies.
Ancient healing systems like Ayurvedic medicine and Traditional Chinese Medicine have long recognized the benefits of fasting for purifying and healing the body. Today, a body of research is accumulating that suggests that fasting may help treat diseases like multiple sclerosis and cancer, reduce the risk of chronic metabolic diseases, such as diabetes, battle dementia and cardiovascular disease, and reverse the effects of aging, helping us live longer.
What Happens During Fasting:
Human physiology fluctuates between two modes: the fasted and the fed state. After eating, a hormone called insulin rises in response to the intake of dietary carbohydrates and, to a lesser extent, protein. Insulin allows glucose to enter cells where it can be used for energy. Insulin encourages the storage of body fat and glycogen—a molecule stored in the muscles and liver that can be broken down quickly for energy. Insulin is an anabolic hormone that promotes tissue building and growth.
Our bodies are in the fed state, or postprandial state, for up to 4 hours following a meal, when blood sugar and insulin levels rise and the body begins to store food energy. 4-6 hours after eating, our bodies enter the post-absorptive state. Insulin and blood sugar levels fall, and blood sugar is maintained through the breakdown of liver and muscle glycogen. At the 10-12 hour mark post-meal, the body enters the fasting state. At this stage, glycogen stores have been depleted and blood glucose is maintained through a process called gluconeogenesis: glucose is created from fat, lactate and protein. In the fasting state, the body taps into fat stores to create ketone bodies, which are used for fuel.
Approximately 24-48 hours after a meal, the body enters a state called autophagy (or self-eating). The body breaks down old, damaged cells into their proteins and reuses them to build new cells or for fuel, through gluconeogenesis. Autophagy has gained the attention of researchers who recognize its benefits for managing inflammation, slowing the effects of aging, and treating various chronic diseases, such as autoimmune disease and cancer—more on this later!
Fasting to Treat Cancer:
Valter Longo, PhD, at the Longevity Institute at the University of Southern California, examined the effects of 2 to 4-day fasts on patients with cancer who were undergoing chemotherapy. The study found that several days of fasting improved the efficacy of chemotherapy, while reducing its side effects, protecting healthy, non-cancerous cells. Healthy cells responded to the periods of food restriction by shutting down, protecting them from the toxicity of the chemotherapy. Cancer cells don’t have such a response, leaving them susceptible to the chemotherapy. “Cancer cells are dumb cells,” says Dr. Longo.
The fasting period not only improved the effects of cancer treatments, it stimulated the regeneration of the immune system through the creation of progenitor stem cells. Fasting cleared out damaged immune cells and cancer cells through autophagy and new cells were regenerated upon re-feeding. Dr. Longo and his team found that up to 40% of the immune system is rebuilt in mice after a fasting and re-feeding cycle.
Fasting Mimicking Diets:
Recognizing the difficulty in going 3 days without food, Dr. Longo developed a 5-day “Fasting Mimicking Diet” that allows for the consumption of about 700-1000 calories per day in the form of small snacks. The Fasting Mimicking Diet is low enough in calories, protein and carbohydrates to mimic the physiological conditions and benefits of fasting like autophagy, ketone body production, beneficial stress response, and cancer cell starvation.
Mice given the Fasting Mimicking Diet (FMD) lost 30% of their body weight through the breakdown of body fat and clearing away of old, damaged cells. When the mice were re-fed, their blood, brain and bone cells were rebuilt. The mice who underwent the Fasting Mimicking Diet had rejuvenated immune systems, decreased incidences of cancer, reduced body fat, improved cognitive performance, decreased inflammation, and increased lifespans.
Fasting to Treat Autoimmunity:
Research in mice showed promising results in using the Fasting Mimicking Diet to treat multiple sclerosis, a debilitating autoimmune condition that attacks the nervous system. When following the diet, immune cells that were attacking the brain and spinal cord were destroyed. Upon re-feeding, new progenitor stem cells were created that repopulated the immune systems of the affected mice, and aided in repairing the damage to the brain and spinal cord. The Fasting Mimicking Diet resulted in a 20% reduction in autoimmunity in mice with multiple sclerosis.
A study that examines the effects of the Fasting Mimicking Diet on humans with Crohn’s Disease, an autoimmune disease the affects the digestive system, are currently underway.
Fasting to Reverse Aging:
Autophagy, the process of removed and recycling old and damaged cells, is a new area of research for reversing the effects of aging. Autophagy alleviates the body burden of senescent cells that have stopped dividing but are still robbing the body of essential nutrients and energy.
When cells become senescent, they release inflammatory mediators, which can damage neighbouring cells and cause inflammation and disease. Cellular senescence is thought to be one of the primary mechanisms by which we age. As we age, more cells become senescent, causing age-related inflammation. A study found that inflammation is the primary factor that drives the aging process, damaging DNA and contributing to various diseases, such as cardiovascular disease, diabetes, arthritis, cancer, and autoimmunity.
The process of fasting and re-feeding stimulates the production of new, healthy progenitor stem cells in the immune system. Mice and human volunteers who underwent cycles of the Fasting Mimicking Diet had decreased numbers of myeloid cells, the inflammatory immune cells that become more numerous as we age, and increased numbers of cytotoxic T cells, which protect the body against viruses and cancer.
Fasting promotes longevity through its inhibition of Insulin-like Growth Factor -1 (IGF-1), a growth factor that promotes cellular growth, and prevents the death of senescent cells. Growth factors are important for growing babies and children, developing fetuses, boosting muscle, and growing new brain cells. However, growth factors like IGF-1 are negatively associated with longevity because of their potential to stimulate the growth of cancer and prevent autophagy. Mice whose growth factor-dependent genes were removed, or “knocked out”, lived 40-50% longer and suffered from less diseases as they aged. IGF-1 is stimulated by protein and carbohydrate intake; it is elevated in the fed state and inhibited when fasting.
Healthy humans who underwent cycles of the Fasting Mimicking Diet had lower risk factors that were associated with cardiovascular disease and diabetes, such as lowered blood pressure, reduced CRP (a marker of inflammation in the blood), and reduced fasting blood glucose levels. These markers remained improved even after the subjects returned to a normal diet, which indicates that fasting may help reduce the risk of chronic diseases, such as diabetes and heart disease, promoting health longevity and increased lifespan.
Fasting for Energy and Resilience to Stress:
Hormesis is the process in which the body’s response to a stressor like the slightly toxic flavonoids in plants, intense exercise, or extreme temperatures, benefits the body as a whole. Hormesis is one of the reasons that exercise and green leafy vegetables are so good for us; they impose minor stressors on the body, boosting its healing properties, and improving resilience.
Fasting, in addition to other positive stressors, up-regulates a stress-response gene called FOX03. When FOX03 is activated, it produces proteins that reduce inflammation, increase anti-oxidant production, repair DNA, and increase cellular energy production through the creation of new mitochondria. Humans with a more active version of the FOX03 gene have an almost 300% chance of living to be over 100 years old.
Fasting also promotes a process called mitophagy. Similar to autophagy, mitophagy involves removing and recycling damaged mitochondria that are no longer able to effectively produce energy. Through activation of the FOX03 gene, more mitochondria are created to replace the old, improving energy production. The creation of new mitochondria only occurs in response to exercise, extreme temperatures, and periods of fasting.
Fasting for Weight Loss:
It doesn’t take a researcher to figure out an obvious truth about fasting: when you don’t eat, you lose weight. Dr. Jason Fung, MD, a Toronto-based nephrologist, prescribes fasting to his obese and diabetic patients. In his book, The Obesity Code, Dr. Fung discusses how the old paradigm of restricting calories for weight loss—eating 1500 calories a day while burning 2000, for example—is out-dated and ineffective for keeping weight off longterm. Dr. Fung argues that fat storage and breakdown are not the result of a simple calories in minus calories out equation, but the performance of a hormonal orchestra conducted by insulin. Insulin stores fat and glycogen, while inhibiting the release of fat breakdown. The body only begins to tap into its glycogen and fat stores when insulin drops during the post-absorptive and fasting phases after a meal. Once it depletes its glycogen stores, the body burns fat as its main source of fuel as long as insulin levels remain low.
According to Dr. Fung, fasting is superior to caloric restriction diets because it keeps insulin levels low for long enough to allow the body to deplete its glycogen stores and tap into fat. Fasting also releases surges of growth hormone, which prevents muscle loss, and norepinephrine, which boosts energy and feelings of well-being. Unlike caloric restriction diets, studies have shown that metabolism increases during and after fasting, preventing weight regain. Dr. Fung argues that fasting can spare muscle, boost metabolism, increase energy, and increase feelings of well-being, making it an effective tool for lasting weight loss.
Ways to Fast:
While the health benefits may be numerous, fasting isn’t easy. The first time I tried a prolonged fast, all I could think about was food. Food was everywhere and the people around me seemed to be eating all the time. My body, accustomed to being constantly fed, wasn’t too happy with the sudden metabolic switch I was demanding from it. Many of our metabolisms have been trained to run on dietary carbohydrate and glycogen as their primary fuel sources, making the first few hours to days of fasting a challenge. However, there are many ways to ease into the practice of fasting. You can obtain Dr. Valter Longo’s Fasting Mimicking Diet kit from a healthcare provider through ProLon, or practice small intermittent fasts, such as Time-Restricted Feeding.
Time-Restricted Feeding:
A researcher at the Salk Institute in Califoronia, Dr. Sachin Panda, PhD, found that restricting eating time had amazing health benefits in mice. Mice were fed an unhealthy diet of lard and sugar. The mice, as you might expect, had shorter lifespans and a variety of health problems: diabetes, obesity, and heart disease. However—and this part is miraculous—when Dr. Panda and his team restricted the time the mice were fed the exact same crappy diet to 12 hours (instead of allowing them to eat whenever they wanted), none of the negative health benefits occurred; the Time-Restricted Fed mice were 70% leaner, lived longer and were free from diabetes or heart disease.
Further investigation revealed that restricting feeding time to 8-12 hours a day, resulted in mice that had less body fat, improved muscle mass, decreased inflammation, increased cardiovascular function, increased mitochondrial function, higher levels of ketone body production, increased cellular repair processes and anti-oxidant production, and increased aerobic endurance. It was when the mice ate, not what they ate, that conferred these health benefits.
North Americans, on average, eat on a 15-hour clock. We seem to eat constantly, stopping only to sleep. To study the effect of Time-Restricted Feeding on humans, Dr. Panda had human participants restrict their food intake to 12 hours a day; if the volunteers had their first sip of coffee at 7 am, they were told to cease all food intake by 7pm. After the completion of the 16-week study, the volunteers lost 3-5% of their body fat without making a conscious change to their diets. The participants reported sleeping better and feeling more energized in the morning. They noted that their overall calorie consumption decreased by about 20% without effort.
Research into Time-Restricted Feeding indicates that allotting at least 12 hours a day to fasting boosts the body’s repair mechanisms, improves digestive function and motility, provides time for the body to switch to ketone body production (which tends to happen 10-12 hours after a meal), improves blood sugar control, regulates appetite, and enhances stress resilience. Taking a break from eating allows the body to invest its energy into repair, rather than digestion. The best part about Dr. Sachin Panda’s research is its simplicity; to obtain all of the benefits, simply avoid after-dinner snacks!
Intermittent Fasting:
Similar to Time-Restricted Feeding, Intermittent Fasting plays with the ratio of fasted to fed hours. Proponents of Intermittent Fasting refrain from eating from 12 to 23 hours within a 24-hour period. A common ratio of fasted to fed time is 16 to 8 hours: fasting for 16 hours a day and eating within an 8-hour window. For example, if breakfast is at 8am, then those following a 16:8 intermittent fast stop eating by 4pm in the afternoon.
Alternate Daily Fasting or the 5:2 Diet:
Studies with mice and human subjects found that alternating daily food intake, or following a 23:1 fast (having just one meal a day) every second day, was effective for weight loss. The protocol is beautifully simple: every second day either fast completely or indulge in only one meal. While people tend to eat more on their “fed” days, they don’t seem to make up the calories that are lost on the fasting days, resulting in an overall reduction in calories and weight loss.
Water Fasts:
It’s estimated that we need to fast for at least 36 hours to get the autophagy benefits, which makes water fasting a powerful therapeutic and anti-aging practice. Water fasting is simple: withstand extended periods, usually 3 to 5 days, but often longer, only consuming water.
The longest recorded water fast was 382 days, performed in 1973 by a 27-year old male who weighed 456 lbs. During the months he fasted, the 27-year old consumed only water and a multivitamin and, according to the study published on him, experienced “no ill-effects”. While water fasts can have amazing therapeutic benefits, it is advised that they be medically supervised.
Ketogenic Diets:
Ketogenic diets are high-fat diets that restrict carbohydrates and limit protein, and can mimic the low-insulin conditions of fasting. Because carbohydrates and protein are restricted, the body is forced to turn dietary fat into ketone bodies, which it can use for energy.
Ketone bodies, especially beta-hydroxybutyrate, produced from either dietary or body fat, have important therapeutic uses. They provide more energy for the brain than glucose, which can have benefits for memory, mood, concentration and cognitive performance. Ketogenic diets have been recommended for treatment-resistant epilepsy, and diseases associated with cognitive decline like Alzeimer’s and Parkinson’s. More recently ketogenic diets have been recommended for mental health conditions, such as depression and anxiety.
Ketone bodies also help cells resist oxidative stress, preventing cellular damage, which makes ketogenic diets of interest to cancer researchers because or their ability to starve cancer cells of protein and carbohydrates, while fuelling healthy cells.
Ketogenic diets can deliver many of the benefits of fasting because of the low-insulin, low growth factor conditions they induce. When a person becomes “keto-adapted”, able to burn ketone bodies efficiently for fuel, the transition to fasting is easy. For this reason, ketogenic diets and fasting often go hand-in-hand.
Cautions:
While fasting can deliver many health benefits, it can impose a temporary stress on the body for those who haven’t adapted to ketosis or prolonged periods without food. Therefore, it’s important to fast under the supervision of a medical professional, especially if deciding to embark on an extended fast.
Before deciding to fast, the individual’s energy levels and vitality, health status, hormone regulation (those who are taking insulin should practice extreme caution when fasting), age, health history, and health goals, should all be considered. A woman of fertility age will have different health goals than a 72-year old woman with type II diabetes. The former may want to preserve body fat and promote fertility and ovulation, while the latter may want to reduce her insulin and growth factor levels, and lose weight in order to promote health longevity.
Fasting may not be appropriate for everyone. For example, those who are underweight, pregnant, breastfeeding or suffering from an eating disorder should not fast. Fasting in women of reproductive age has the potential to produce hormonal imbalances such as hypothalamic amenorrhea (irregular or absent menstrual cycle). Fasting can exacerbate or cause dysregulation in stress hormones, particularly cortisol, known as “adrenal fatigue”, and potentially effect thyroid function, as a result of the body’s starvation response. Fasting while under the pressure of chronic mental and emotional stress is probably not a good idea. Working with a professional and listening to your body are key elements to doing fasting right.
However, when used correctly, it can be a simple, free, powerful therapeutic tool for healing the body, treating chronic disease, and promoting longevity.
Polycystic Ovarian Syndrome, or PCOS, is the most common hormonal imbalance in women of reproductive age and can result in weight gain, infertility, acne, irregular cycles and unwanted hair growth. I talk about a naturopathic and functional approach to managing symptoms of PCOS and restoring hormone balance.
Hello, everybody. My name is Dr. Talia Marcheggiani. I’m recording to you guys from my clinic in Bloor West Village. It’s called Bloor West Wellness Clinic. And today I want to talk to you guys about one of my favourite conditions to treat when it comes to naturopathic medicine. And this condition is called Polycystic Ovarian Syndrome. And this is an endocrine, or hormonal condition, and it affects about 10% of women. It’s the most common cause of hormonal imbalance in women of menstruating age. And it’s a syndrome, so it’s not a disease. There’s a different constellation of symptoms that arise with it and this could be one of the causes of infertility in a lot of women. And because the symptom pictures are so diverse, it’s really hard for a lot of women to be suspected for a diagnosis of PCOS, or polycystic ovarian syndrome.
So, PCOS, the hallmark, the diagnostic criteria, based on the Rotterdam Criteria, is having either two of these three symptoms: anovulation or oligomenorrhea, which means having periods that are irregular. So, either having more than one period per month or missed cycles and long cycles of 6 weeks or more. The average female menstrual cycle is about 26-34 days, so having periods outside of that “normal” range could indicate one of the symptoms of PCOS. The other one is something called “hirsutism”, which is caused by high androgens, or male sex hormones, like testosterone or DHEA. And some of the symptoms of that are acne, so hormonal acne, those pustular, cystic acne that happens around the chin and jaw-line, or the chest and back. And “hirsutism”, which is the male-pattern hair growth, which is great, if you’re a woman, to have, which is the hair on the mustache and chin. So, you kind of sport a Frida Kahlo mustache and probably have to deal with that on the regular. Similarly, having hair loss on the scalp, is another sign. So, when you think of men, men will typically experience male-pattern hair loss, and hair-growth in the facial area.
And the third symptoms is the presence of cysts on the ovaries, which is diagnosed or sighted with a transvaginal ultrasound. There’s a scope placed through the vagina and an ultrasound is done to see if there are cysts on the ovaries.
It can also be diagnosed with lab work, so that’s not using the Rotterdam criteria, but there are two hormones that the brain makes that control the ovaries and these are called FSH, or follicle-stimulating hormone, and LH, lutenizing hormone. The brain makes the hormones and they tell the ovaries when to ovulate and the ovaries also make LH, lutenizing hormone after they’ve ovulated, or after the corpus luteum forms, after ovulation should happen, so whether the egg is fertilized or not, the corpus luteum will form.
And so PCOS is probable when you order labs and find that, so the FSH and LH should be almost the same, they should be at a 1:1 ratio and PCOS suspect when the LH to FSH ratio is 2:1 or higher. So you have either 2 or more times the LH than you have FSH. And this is because in PCOS, the ovaries will secrete a lot more LH and that is one of the reasons why they hypothesize that there are high androgens, because the LH can stimulate more androgen release.
So, there’s a “skinny PCOS”, so these are women with those symptoms that don’t experience obesity or metabolic syndrome, and then there’s the metabolic syndrome type of PCOS and in these patients there’s an insulin-resistance present, or a glucose-intolerance. And so these women will frequently experience hypoglycaemic crashes. They’ll also probably be on the obese side and really struggle to keep weight off and they’ll experience the low energy, the cravings for carbs. They’ll experience the hunger that comes two hours after a meal, despite having eaten an adequate amount of fat and protein, and this is really problematic for them because they’re set up for diabetes and for cardiovascular disease down the line. And then they’re also experiencing symptoms of obesity and they’re not super happy with how they look.
And we’re not exactly sure what causes PCOS in women. There’s evidence for it being heritable, so genetically passed on. There’s evidence for it being caused by insulin-dysregulation, and perhaps the ovaries are not responding properly to insulin. What insulin does, is it helps us take in fuel or glucose into our cells and, just like all the cells in our body, the ovaries require insulin to absorb glucose so that they can function properly. And so one of the theories of PCOS is that the ovaries are resisting insulin and the insulin is signalling them to grow, but they’re growing in the absence of proper fuel, or proper glucose as fuel and so they’re creating these follicles, or cysts.
And so, absence of periods, or irregular periods; male-pattern hair growth; obesity; infertility and then the presence of those cysts on the ovaries are all symptoms of PCOS. So, when we’re trying to get a diagnosis, we’ll send patients in for a transvaginal ultrasound. We’ll also look at their fasting blood glucose and fasting insulin. We’ll look at their progesterone and estrogen, because oftentimes these women are suffering from estrogen-dominance: there’s low progesterone and high estrogen in relation to the levels of progesterone. We’ll look at their FSH and their LH, and I’ll also check out their thyroid because oftentimes the symptoms of hypothyroidism and PCOS are overlapping and so I want to find out if there’s a thyroid pathology happening in the background.
So, one of the main reasons that women will come in with PCOS is because they’re trying to get pregnant, or they want to preserve their fertility in the future. They might come in for acne issues or the hair growth, or just to sort out their periods, but the main reason that they come in is fertility. And 40% of women with PCOS do experience infertility or fertility challenges. So this is a big issue for them.
And the reason I love treating PCOS in my practice is I find that, and this is sort of perhaps not technical or scientific, but I find that the personality of women with PCOS tends to be more phlegmatic, so they’re usually more agreeable, and happier and patients that really want to do good work and so it’s really enjoyable to work with them. But also, the reason I love treating patients with PCOS is because there are so many effective strategies that naturopathic medicine offers and I don’t see an equal amount of strategies in the conventional system.
And I’ll talk a little bit about some of the conventional therapies of PCOS. So, what happens is, in conventional therapy, is they kind of look at the symptoms in the syndrome spectrum and they kind of try to deal with each symptom individually. So they look at irregular periods and they’ll prescribe a birth control pill. So, like, “ok, we’ll just over-ride your own hormonal production and we’ll control your periods and get you cycling regularly”, which obviously doesn’t treat the underlying hormonal imbalance, because you’re just placing exogenous, fake hormones on top of the picture.
Or they’ll say, “ok, there’s blood-sugar dysregulation, so I’m going to prescribe a diabetic medication called ‘metformin’, which will help resensitize your cells to insulin”, which again is not the best strategy, although there’s some evidence to support that this helps. But, we’re not again treating the underlying issue of insulin resistance and metformin is pretty toxic to oocytes, or ovarian cells, so when you’re treating infertility you’re not setting the body up for healthy ovulation and producing a healthy baby. So, ehh, metformin.
And then we have, they’ll treat the high androgen symptoms, the hirsutism symptoms, the hyperandrogenism, by prescribing spironolactone, or Yas or Yasmin birth control pills, that block androgens. And, again, not the best strategy because it’s not treating the underlying cause, and there’s some evidence that Yas and Yasmin are one of the oral contraceptive pills that set you up for a higher risk of blood clots compared to other pills. So, women who are taking these are slightly higher than normal, compared to other birth control pills, risk of pulmonary embolism, deep vein thromboses, and those kind of blood clotting issues, which could be fatal. So, that’s an issue, right? And, again, not treating the underlying cause.
So there’s not that many great therapies and they’re not holistic. They’re not looking at the whole picture, they’re kind of reactionary and they’re just treating the symptoms. And then in terms of fertility, so women will undergo IVF treatments or they’ll be prescribed ovulation drugs like Clomid, which increase estrogen and get your body ovulating, kind of forcing ovulation to happen and again can be an issue because these women with PCOS are having sometimes an estrogen dominance picture, so their estrogen is high in relation to their low progesterone and so adding more estrogen-promoting drugs like clomid could just make life a mental and emotional disaster for these women while they still have the drug in their bodies. That could happen to a lot of women, but, again, not the best. It could achieve the end goal of getting pregnant, by increasing your chances, but we’re not looking at what’s going on.
And so, what happens, if when I first see a patient with PCOS, we’ll run the labs, or I’ll get the labs that their family doctor has run, if that was done recently, and we’ll take a look at their symptoms, so I’ll ask them how their periods are, and if they get PMS symptoms, and how often their periods come. And I’ll get them to track their periods, so I can see are they happening regularly, and they’re just very far apart? Or are they all over the place? We’ll look at their FSH and their LH, to see if they have that classic high LH to FSH ratio, and we’ll look at their insulin and fasting blood glucose and their testosterone. And I’ll ask them about symptoms, like acne and hair growth and we’ll talk about weight loss and if they’re getting those hypoglycaemic or insulin resistance symptoms. And we’ll talk about mood and emotions and digestion as well, which I talk about with all my patients, and energy and things like that, because we want to get a holistic picture and we want to —the reason is when I’m treating people I’m treating from the premise that it’s possible to be healthy and we can influence our health and the more I examine healthcare, and the healthcare model that is conventional, the more I doubt that that’s the premise that they’re standing on. Right? They’re kind of looking at making symptoms manageable, or maybe achieving outcomes or end goals, or preventing death and things like that, but they’re not coming at health conditions from a place of: “this person can influence the situation that they’re in through targeting and trying to understand the root cause of what’s going on, and then treating that.” So that’s where I’m coming at it. I’m looking at the whole picture, and I’m trying to understand this person’s unique hormonal imbalance and what the symptoms are that manifest from that.
Then it comes to choosing a treatment plan, so there’s lot of treatment that have a robust amount of evidence surrounding them and so you frequently hear people say that naturopathic medicine, or functional medicine, of these natural forms of medicine have no evidence and they’re pseudoscientific, well there’s tons of evidence for increasing fertility and improving PCOS using natural remedies, like nutriceutical remedies and herbal remedies.
So, first of all we have something called inositol. Inositol acts like a sugar in the body and what it does is it re-sensitizes the ovaries to insulin and serves as a fuel for the ovaries. And inositol doesn’t have much of a taste, it doesn’t have any side effects. It actually has some positive effects in helping with bipolar disorder and psychosis and those kind of mental health disorders, so if those are comorbid, then it’s great. If you have PCOS and you have bipolar, then inositol is a great choice. And with inositol, there’s some studies that show that in 3 months of supplementing with inositol periods have become regular, hyperandrogenism symptoms have gone down, so the acne and hair growth, and women had a 1 in 2 chance of getting pregnant. And then another 3 months of that, and their chances went up. So, inositol on its own is pretty powerful.
Another nutriceutical is N-acetyl cysteine, so NAC, which helps the liver clear out hormones and rebalance hormones and another great remedy for PCOS. We’re not exactly sure how it works, but there’s some theories about it rebalancing hormones, and perhaps through it’s antioxidant activity, because NAC creates an antioxidant, the main antioxidant in the body called “glutathione”. So, probably through its antioxidant activity, it’s helping the mitochondria, those fuel-houses for the cell, work better.
Another thing, when it comes to PCOS are some herbal remedies. So there’s an herb called vitex that helps establish a healthy hormonal estrogen and progesterone balance and that could be appropriate for some women. And there’s some studies using white peony and licorice that can help lower those hyperandrogenism symptoms. And then there are some herbs like saw palmetto that can help balance those high androgens as well, as they bind up testosterone and DHEA in the blood, so they increase something called sex hormone binding globulin (SHBG) and that can help clear out excess testosterone.
So those are just a few of these herbal and nutriceutical remedies that can be helpful in PCOS and I might prescribe some B-complex or some magnesium depending on how the adrenal glands are functioning and how hormones are cycling. And another thing we really like to do is tackle PCOS with diet and improve that blood-sugar balance if some of those insulin resistant symptoms or metabolic syndrome symptoms are there. And there’s a great study that shows that front-loading, so really increasing the calories that women are eating in the morning, having moderate calories at lunch and then having a lower or lighter dinner, kind of a snack for dinner, is really helpful in promoting fertility, lowering those androgens, resensitizing the ovaries and the other cells in their bodies to insulin and thereby resetting the hormonal stage. Really cool that this study just by changing your diet, although not the easiest change, is helpful for balancing hormones and you’re not doing something toxic, like the birth control pill or metformin, or something like that.
Also, a paleolithic diet, so changing the glycemic index of your diet by choosing fruits and vegetables that are lower on the glycemic index, so those leafy greens and adding fat and protein to every meal. It’s difficult as a vegetarian to shift hormones for the better and so I often recommend a more paleolithic diet to women, however, vegetarians, it is possible to increase your protein, it just takes a little bit more of conscious effort. And the reason that paleo diet is helpful is because it is lower glycemic index and has those higher fruits and vegetables with their antioxidant properties, but it also promotes the healthy fats and having an adequate intake of lean protein, such as your chicken, fish, lean beef, or eggs and even some dairy products depending on how someone tolerates that. And the last thing I’m going to talk about—this is just sort of a PCOS overview—the last thing I’m going to talk about is, with my patients I always work on self-care and stress relief because we know that the stress hormone cortisol can really mess up the other hormones in our body. It can contribute to insulin or worsen insulin resistance. It can worse that estrogen-dominance picture, it can prevent us from making enough progesterone because the progesterone and the cortisol pathway follows the same pathway and so that could be problematic if we need more progesterone but we’re using all of the resources to make it on making cortisol to deal with our stressful lifestyle. And a big part of managing PCOS, I find, is just getting cortisol under control and that might include increasing self-care, getting into things like yoga or meditation or doing some shin-rin yoku, like in the other video where I talk about Japanese Forest Bathing, so spending time in nature. That could be walking in the woods, or gardening, even watering a plant or hanging out with a pet or animal. Doing these things that feel nurturing and feel supportive to the mind and the emotions and help us face the daily stressors that we face with more resilience are all great strategies for managing hormonal health.
So, if you have any questions, just send me an email at connect@taliand.com or you can check out my website at taliand.com and my blog for other articles on hormonal balance, such as estrogen dominance, choosing an oral contraceptive pill, if you need one, and another article that I wrote about PCOS.
My mother tells a story about my childhood where she is standing in the kitchen, preparing dinner. I stand below her, tugging at her shirt, and begging for food.
“I’m hungry”, I say, according to her recollection of that moment and many others like it; she says that as a child I was always preoccupied with food. My constant yearning for something munch got to the point where every time she tried to cook dinner, I’d follow her to the kitchen, like a hungry dog, and persistently beg for food. I was insatiable, she claims. But, as an adult looking back I wonder, insatiable for what?
I remember that moment, but from the third person perspective. So I wonder if it’s as past events sometimes go, where the telling of a memory from an outsider’s perspective serves to reshape it in the imagination. I can feel the emotions, however, watching my 4-year old form tugging on my mother’s clothing, her body towering over me, her face far away. She stands at the stove. I remember feeling full of… what was that yearning? Was it for food? Was it hunger for physical sustenance or nutrition from some other source? I wonder if the constant, nagging hunger was an articulation, in 4-year old vocabulary, of the need for something else: attention, affection or reprieve from boredom. I remember being told at one point that my favourite show was on and felt some of the anxiety of missing what I was lacking dissipate: a clue.
As a child, adults occupy the gateway to food. As adults, the gateways take on another form. Perhaps it is anxiety about body shape or the guilt of knowing that eating too much of a certain kind of thing isn’t nutritious. Perhaps the barrier to sustenance is financial. However, when I stand now in the kitchen, bent over the fridge, arm slung over the open door, contemplating a snack, I know that I am making a choice. And, for myself, as for many others, it’s not always clear whether the call to eat is hunger and physiologically based.
In the west, we have an abundance problem. More and more adults are reaching obese proportions. Metabolic diseases of excess like diabetes and cardiovascular disease are increasing and more and more women are experiencing the hormonal dysregulation that can come from carrying more body fat.
While I don’t recommend aspiring to the emaciated standard that we see plastered on magazines, Pinterest ads or runways, I do think that, for many people, balancing energy intake with energy output could be beneficial for optimal health and hormonal signalling. Body fat is metabolically active. It also stores toxins and alters that way our body metabolizes and responds to hormones, insulin being just one example, estrogen being another. Therefore, conditions like PCOS, infertility, diabetes, PMS and dysmenorrhea, or certain inflammatory conditions might benefit from a certain amount of weight loss.
An addition here: this post is not about body-shame or even necessarily about weight loss per se. It’s about overcoming emotional eating patterns that might even derive from the same disordered patterns that manifest in anorexia or bulimia. The goal of this post is to bring more awareness to how we operate within the complex relationships many of have with food and with our own bodies.
There are many reasons why we eat and physiological hunger is only one of them. Tangled up in the cognitive understanding of “hunger” is a desire for pleasure, a desire to experiment, to taste, to experience a food, to share with family and friends, to enjoy life. There are also deeply emotional reasons for wanting food: to nurture oneself, as reward, to combat boredom and to smother one’s emotions like anxiety, depression, ennui, yearning for something else— we often eat to avoid feeling.
Health issues aside, I believe that Emotional Eating (as it’s so-called) is problematic because it dampens our experience of living. By stuffing down our emotions by stuffing our faces we prevent ourselves from feeling emotions that it might be beneficial for us to feel in order to move through live in ways that are more self-aware, mature, self-developed and meaningful. While some emotional reasons to eat might be legitimate (acknowledging your beloved grandmother’s hard work by having a few bites of her handmade gnocchi, for instance), many of the reasons we eat linger below the surface of our conscious mind, resulting in us suffering from the consequences of psychological mechanisms that we are unaware of. I believe in making choices from a place of conscious awareness, rather than a place of subconscious suffering.
In heading directly into the reasons I am tempted to emotionally eat, I’ve learned quite a lot about myself. I’ve ended up eating less, as I’ve become more aware of the non-hunger-related reasons that I reach for a snack, but that doesn’t have to be the end goal for everyone. I believe that just understanding ourselves through uncovering and analyzing the emotions that influence our everyday behaviours can have life-changing effects; it allows us to know ourselves better.
As I work through the process of understanding why I overeat, I’ve realized there are a few steps to address. I believe that there are layers to the reasons we enact unconscious behaviours and first, it is important to untangle the physiological from the emotional reasons for eating, understand what real hunger feels like, address the “logical” reasons for overeating and then, when ready, head straight into the emotions that might cause overeating to occur
Distinguishing between physiological hunger and emotional hunger:
The first step, of course, is to distinguish between physiological/physical hunger—the body’s cry for food, calories and nourishment—and emotional hunger. Typically, physiological hunger comes on slowly. It starts with a slow burn of the stomach, growling, a feeling of slight gnawing. It grows as the hours pass. For some it might feel like a drop in blood sugar (more on this later): feeling lower energy, dizzy and perhaps irritable. Physiological hunger occurs hours after the last meal, provided the last meal was sufficient. Usually, if one drinks water at this time, the physiological hunger subsides and then returns. Essentially, eating a meal or snack will result in the hunger vanishing and returning again still hours later.
Emotional hunger, however, is different. It starts with an upper body desire to eat. It might be triggered by commercials, social situations, or certain strong emotions. There might be cognitive reasons to eat (“I might be hungry later” or, “Oh! We’re passing by that taco place I like!”) that are not directly guided by the physical desire for sustenance. Emotional eating is often felt in the mouth, rather than the stomach. It might be brought on by the desire to taste or experience the food, rather than to fill oneself. The cravings might be specific, or for a certain food-source, such as cookies (this is not a hard and fast rule, however). Emotional hunger does not vanish from drinking water. Emotional hunger comes on suddenly, and is often not relieved by eating the prescribed amount of food (having a full meal); oftentimes we finish lunch only to find ourselves unable to get the cookies at the downstairs coffee shop out of our heads.
2. Settling hormonal reasons for overeating: serotonin, insulin, cortisol:
Not all physiological hunger, however, is experienced as the slow, gnawing, slightly burning, grumbling stomach sensation described above. Sometimes we experience the need to eat because our blood sugar has crashed, or our neurological needs for serotonin have gone up. We might eat because stress hormones have caused blood sugar to spike and then crash. We might also experience certain cravings for food because our physiological needs for macronutrients; like carbs, fat or protein; or micronutrients, like sodium or magnesium, have not been met.
Therefore, it becomes essential to address the hormonal imbalances and nutritional deficiencies that might be causing us to overeat. Oftentimes, getting off the blood sugar rollercoaster is the first step. This often involves a combination of substituting sugar and refined flours for whole grains, increasing fats and protein, and, of course, avoiding eating carbohydrate or sugar-rich foods on their own. It often involves having a protein-rich breakfast. I tend to address this step first whenever my patients come in and express feeling “hangry”: irritable and angry between mealtimes.
Often drops in brain-levels of serotonin cause us to crave carbohydrate-rich foods. This is very common for women experiencing PMS. In this case, balancing hormones, and perhaps supplementing with amino acids like l-glutamine, tryptophan and 5-HTP, can go a long way.
One of the questions I ask my patients who crave a snack at 2-3 pm (a mere 2-3 hours after their lunchtime meal), assuming their lunch contained adequate nutrients, is “Do you crave, sugar, caffeine, salt or a combination of the above?” Cravings for sugar or salt at this time might indicate a drop in cortisol and give us a clue, combined with the presence of other symptoms, that this person is in a state of chronic stress, burnout or adrenal fatigue. In this case, it is essential to support the adrenal glands with herbs, nutrients, rest, and consuming adequate protein during the afternoon crash.
Finally, when it comes to cravings for foods like chocolate, meat or nuts, or even specific vegetables (when living in South America I would experience over-whelming cravings for broccoli, funnily enough), I find it important to identify any nutrient deficiencies. It is common to experience a deficiency in something like magnesium, iron, selenium, zinc, and the fat-soluble vitamins A, D, E and K; and our bodies will do their best to beg us for the specific foods they’ve come to learn contain these nutrients. Either consciously eating more of these foods (like brazil nuts in order to obtain more selenium), preferably in their healthiest form (such as dark chocolate, as opposed to milk chocolate, to obtain magnesium), or directly supplementing (in the case of severe deficiency), often results in the cravings diminishing.
3. The Hunger Scale and food diaries:
One of the first things I have patients do is understand the Hunger Scale. There are a variety of these scales on the internet that help us cognitively understand the stages the body goes through on its quest to ask for food and it’s attempt to communicate fullness. Being able to point to certain levels of hunger and fullness and pinpoint those physiological feelings on the Hunger Scale allows us to further flush out the subtleties between a physical or emotional desire for food.
Food diaries, I find, can help bring more awareness to one’s daily habits. Oftentimes, keeping a food diary for a few weeks is enough for some patients to drop their unwanted eating behaviours altogether. Other times, it can help us detect food sensitivities and unhealthier eating patterns or food choices. It also helps me, as a practitioner, work off of a map that illustrates a patient’s diet and lifestyle routines in order to avoid imposing my own ideas in way that may not be sustainable or workable for that particular individual.
A word about diet diaries, however: when recording food for the purpose of uncovering emotional eating behaviours, I often stress that it is important to record every single food. Sometimes people will avoid writing in their diary after a binge, or outlining each food eating when they feel that they’ve lost control, writing instead “junk food”. Guilt can keep us from fully confronting certain behaviours we’d rather not have acted out. However, I want to emphasize that the diary is not a confession. It’s not, nor should it be, an account of perfect eating or evidence that we have healed. Keeping a diet diary is simply a tool to slow down our actions and examine them. It’s a means of finding out how things are, not immediately changing them into what we’d like them to be. This is an important reminder. The best place to start any investigation into being is from a place of curiosity. Remember that the point of this exercise is to observe and record, not necessarily to change, not yet; it is very difficult or even, I would argue, impossible to completely eradicate a behaviour if the reasons for engaging in that behaviour escape our conscious awareness.
Therefore, recording food allows us to begin to poke at the fortress that contains the subconscious mind. We start to slow down and uncouple the thoughts and emotions from the actions that they precede and, in doing so, develop some insights into how we work. It can also help to start jotting down other relevant points that might intersect with what was eaten. These pieces of information might include time of day, where you were, what thoughts were popping into your head, and how you felt before and after eating the food. As we observe, more information begins to enter our conscious experience, allowing us to better understand ourselves.
4. Pealing back the layers: Understanding the “practical” and logical reasons for overeating:
One of the things that I have noticed, through my own work with addressing emotional eating, is that there are often layers to the “reasons” one might overeat. Some of the first layers I encountered were cognitive, or seemingly “logical” reasons. For example, I noticed that before eating without hunger I might justify it by thinking “I need to finish the rest of these, I don’t want them to go to waste”, or “I’ll finish these in order to clean out the container”, or “I should eat something now so I won’t be hungry later”, or “I didn’t eat enough (insert type of food) today so I’ll just eat something now, for my health”, or “If I don’t have some (blank) at so and so’s house, she’ll be offended”.
When looking more closely into these justifications, I found them to be flawed. However, they were logical enough for me to eat for reasons other than to satisfy a legitimate, physiological yearning for nutrients. It’s interesting to see how the mind often tries to trick us into certain behaviours and how we comply with its logic without argument.
5. Addressing the practical reasons: Planning:
In order to address the first layer of rationale for eating when not hungry, I decided to do the following: I would plan my next meal and either have it ready in the fridge, or pack it with me to go, and then I would wait all day until I was hungry enough to eat it. I would repeatedly ask myself, every time I thought of reaching for my portions, “Am I hungry now?” And would answer that question with, “Is there a rumbling in my stomach? No? Then it’s not time to eat.”
I found it would often be a several hours later before my body would genuinely ask for the food. I also found that eating satisfied the physical hunger often much sooner than it took me to finish the food. I realized how I often eat much more food and much more often, than I genuinely need.
However, holding off eating until physical hunger arises takes a conscious effort that is often unsustainable. Few of us can move through our busy lives constantly asking ourselves how hungry we are and when, and then have food at the ready to satisfy that hunger with appropriate, healthy choices. Therefore, I used this practice as a mere stepping stone to move through the deeper layers of emotional eating. By addressing the rational and logical reasons for overeating, I was able to get in touch with the deeper, emotional (and, arguably, real) reasons for which I was eating without hunger.
6. Pealing back the layers: Understanding the deeper, emotional reasons for overeating:
For a while I would wake up, make myself a coffee, and then wait until I felt hungry. Sometimes the feeling would arise in a few minutes, sometimes it would take hours. Depending on what I’d eaten the previous day and what my activity levels were, I would often not get hungry until well into the afternoon. However, the thoughts of eating something would frequently persist. And when the thoughts came up, whereas before they would be satisfied by me having something to eat, I now resisted them. When I resisted the thoughts, their associated emotions would strengthen. I then decided to journal before reaching for food, especially when I wasn’t sure if I was actually hungry or not.
Journalling can help us pull up, process and make sense of some of our emotions. I would write about what I might be feeling—what I might be asking for that wasn’t food. Through doing this, emotional reasons for hunger began to surface. The more I held off eating, the stronger and more clear the emotions became. It was a deeply uncomfortable process. This is why we emotionally eat—removing the emotions is often far more pleasant than dealing with them.
Emotions that surfaced were anxiety, ennui, boredom, loneliness and sometimes even anger. However, boredom and a listless, almost nihilistic, sense of ennui were among the two most common emotions I realized that eating medicated for me. For me, eating was entertainment. It broke up the monotony of the day and gave my senses something to experience. It gave my body something to do: chewing, tasting and digestion. Not eating made that sense of boredom grow stronger.
7. Addressing the emotional reasons: Nurturing and preventing:
Knowing more about the root emotional causes for overeating allowed me to work more closely with the source of my behaviour. I find that the closer we get to the source, to the roots, the more effective we are at removing the weeds, or behaviours, from our lives. I knew now that if I didn’t want to overeat, I would have to prevent myself from getting bored. I would have to have checklists of things to do. I would stay active and engaged in life: in my work, my friendships, and the other non-food-related things that brought meaning to my life.
During this time, I did more yoga and meditated. I journaled and wrote. I also meditated on boredom. I traced it back to where I might have felt it in my life before and noticed themes of boredom in my childhood. I realized that the child tugging on her mother’s shirt and asking when dinner was ready was probably a child who needed something to do, a child who was bored.
8. Pealing back the layers further: Working directly with core emotions:
Going even further, we can begin to peal back the layers of the emotional reasons for overeating in order to avoid replacing one “addiction” with another—such as replacing overeating with over-busying oneself, distraction or overworking. I began to find other emotions that ran deeper than mere boredom. I also realized that whenever I had felt boredom in the past, there was a threshold, often filled with discomfort, that I would eventually surpass. Once surpassing this threshold, a well of creativity, or a plethora of interesting insights, would spring forth. I remember as a child I would create stories, or lie on my bed and stare that the ceiling of my bedroom, contemplating the nature of the universe. These beautiful moments had been made possible by boredom and my courage to not distract myself from it.
Working with a therapist, or doing some deep inner work, we can access the core beliefs and emotions that might cause these emotional reasons for overeating to exist. Oftentimes we encounter core beliefs whose effects spill out into other areas of our lives, preventing us from living fully and consciously. Working through these beliefs can be deeply satisfying and help us experience transformational self-growth.
9. Setbacks: Understanding Change Theory:
Finally, engaging in this process of self-discovery doesn’t follow the same pattern in every person. Some people may find that their reasons for overeating are dissolved as soon as they start recording the foods they eat (this is surprisingly common). Others might find that years of working with a therapist have resulted in a mere dent in their ability to eat in response to hunger and to stop unwanted eating behaviours. In most everyone progress is not linear.
Change Theory and the Stages of Change schema depicts the alteration of behaviours as cyclical, rather than linear. As we move through the stages, we enter a cycle of pre-contemplation, contemplation, planning, action and maintenance. Sometimes we fall out of the cycle and relapse. Many people working with behavioural changes and addictions prefer to rename relapse “prolapse”, claiming that prolapse is a necessary stage for continuing the cycle of change and that much is to be learned from failing at something. It is through observing how the world produces unexpected results, and then attempting to understand the unexpected while trying again, where learning takes place. We don’t really learn if we don’t fail.
Sometimes addictive behaviours, emotional eating included, worsen at a time when someone is on the verge of making a massive breakthrough. Sometimes poking at a new layer of the source of unwanted behaviour accompanies an exacerbation in the practice of that behaviour. Having curiosity and self-compassion throughout the process is essential. Savouring the increased self-awareness that comes with any effort to effect change in one’s life is part of the enjoyment of the experience.
I have some amazing news—my patient is better. Whereas only a few short months ago, he was plagued by inexplicable weight gain, debilitating fatigue, depressed mood—convincing him he must be suffering from clinical depression—a sore throat and an inability to regulate his temperature, now he feels normal. A few months ago, his lab results indicated a serious and spiralling case of autoimmune thyroid disease. Now the lab results shows markers that are completely within the normal limits. My patient got to where he is now naturally—he did not take a single medication. His body was unleashing an aggressive attack against his thyroid gland under a year ago. Now, his thyroid is healthy, happy and working normally. My patient is back to work, exercising, traveling, feeling happy, fulfilled and creative. He is no longer suffering.
The Thyroid Gland
The thyroid gland is an important organ. Shaped like a butterfly and located right below the Adam’s Apple on the front of the neck, it has a variety of essential, life-sustaining tasks. The thyroid is responsible for maintaining our body’s metabolic function. It keeps our cells busy, and allows us to convert our food and fat energy into important metabolic functions. It regulates our hormones, cardiovascular system, skin and hair health, contributes to mood, regulates body temperature, balances estrogen and progesterone in females, thereby contributing to healthy fertility, and helps with the functioning of the immune system.
However, as important as the thyroid gland is, it’s also the body’s “canary in the coal mine”, susceptible to the smallest changes in our health status. Physical, mental and emotional stress can contribute to declines in healthy thyroid functioning, as can exposure to environmental toxins, inflammation and deficiencies in important nutrients such as iron, zinc, selenium and iodine. Because of the thyroid’s senstivities, however, we can use impending thyroid symptoms as signs of overall body imbalance. Therefore, treating thyroid symptoms at their root is important for restoring our bodies to mental, emotional and physical health.
Hypothyroidism Symptoms
Most commonly, when the health of the thyroid gland is affected, it’s functions decline, causing hypothyroidism, or under-active thyroid. Hypothyroidism of any cause is the most common thyroid condition and is very common in the general population, affecting about 4-8% of North Americans. The symptoms range from mildly upsetting to debilitating and can show up in a variety of the body’s organ systems. They include feelings of puffiness, especially of the face, caused by water retention; fatigue; dry skin and hair; hair loss; constipation and slow digestion; mental depression and low mood; acne; mental sluggishness, brain fog and poor memory and concentration; menstrual irregularities, heavy or scanty menstrual flow; infertility; cold hands and feet; orange-tinted skin; and, of course, weight gain that is unexplained by changes to diet and activity levels.
Bloating, yeast overgrowth and dysbiosis can occur from hypothyroidism when the core body temperature drops below 37 degrees Celsius. A cooler body temperature due to under-active thyroid can upset the intestinal flora and cause an overgrowth in harmful bacteria and yeast, causing further fatigue, weight gain, depression and digestive symptoms.
Diagnosis and Lab Testing
In the standard medical model, thyroid conditions are screened by testing a hormone called TSH, or Thyroid Stimulating Hormone. TSH is not a thyroid hormone, but a hormone produced by the brain that signals the thyroid to work. Through measuring TSH, doctors can tell indirectly how hard the thyroid is working. Is TSH is high, it can indicate a sluggish thyroid, since it is requiring more stimulation from the brain. Lower TSH levels may indicate that the thyroid is working fine. So, the higher the TSH levels, the more sluggish the thyroid. However, the reference ranges for TSH are from 0.3 to 5 U/ml, which indicates a wide range of possible thyroid states. A TSH under 5 will not be flagged by a medical doctor as being hypothyroid, even though symptoms may be present!
More progressive clinicians start to become concerned about thyroid function when symptoms are present and TSH is above 2.5 U/ml. Therefore, many patients with under-active thyroid and upsetting thyroid symptoms may be told by their doctors that everything is fine, delaying treatment and invalidating their decision to seek help.
When TSH is off, doctors then test the thyroid hormones T4 and T3. (There is also T1, T2 and calcitonin). The thyroid makes the hormones T3 (20%) and T4 (80%) but the active hormone that allows the thyroid to exert it’s effects on the body is T3. T4 must be converted to T3 by the body. Problems of conversion of T4 to T3 can be caused by stress and inflammation. It may be helpful for your doctor to test for reverse T3, a hormone that is created from T4 if the body is in a state of imbalance.
To detect if hypothyroidism is caused by autoimmune disease, also known as Hashimoto’s Thyroiditis, doctors will test for antibodies that attack the thyroid, anti-TPO and anti-thyroglobulin. An imbalance in the immune system and inflammation in the body, often caused by stress, can cause the body’s own immune system to attack the thyroid gland, preventing it from working properly.
Treat the Patient, Not the Disease
Naturopathic and functional medicine aims to use lab testing to detect patterns that are playing out below the surface of the body. We connect signs and symptoms and labs, not to diagnose a disease but to look at patterns of imbalance that are playing out in our patients’ bodies before disease sets in. This allows us to intervene before things are too late and healing becomes more difficult.
The Cause of Hypothyroidism
Gluten: There are numerous studies that link thyroid issues to celiac disease or non-celiac gluten sensitivity. In one study of 100 patients, hypothyroid symptoms were reversed after following a completely gluten-free diet for 6 months.
Goitrogens: Soy, raw cruciferous vegetables (kale, broccoli, cauliflower, spinach, etc.), nightshades (tomatoes, potatoes eggplant, etc.) and coffee can act as “goitrogens”, suppressing the thyroid. Lightly cooking leafy greens, avoiding soy, especially processed, GMO soy, coffee and nightshades is helpful for avoiding the thyroid-suppressive effects of these foods.
Leaky gut: Food sensitivities, bacterial imbalance, antibiotic use, stress, excess alcohol and caffeine and intestinal infections can disrupt the barrier between the intestine and the rest of the body. Termed “intestinal permeability” or “leaky gut” this condition is getting increasing attention for being the root cause of inflammatory and autoimmune conditions. Identifying food sensitivities through an IgG blood test or trial-and-error and then healing the gut for 3-6 months is essential for getting thyroid health on track.
Dysbiosis: There is a close correlation between thyroid health and the health of the gut bacteria. Every human has 4-5 lbs of essential, life-giving bacteria living in their intestinal track. These bacteria help us break down food, help train our immune system and product hormones like thyroid hormone and serotonin, the happy hormone. It is estimated that 20% of thyroid hormones are produced by gut bacteria. Therefore a disruption in gut bacteria can wipe out the body’s ability to regulate the thyroid and metabolism effectively.
Environmental toxins: Toxic estrogens, heavy metals and other environmental toxins can suppress thyroid function. The thyroid gland is a sponge that is susceptible to whatever toxic burden the body is under and therefore, thyroid issues may be the first sign that the body is under toxic stress. 2-3 yearly detoxes are recommended to improve liver health, decrease the toxic burden and support a healthy thyroid. Detoxes are best done by eating a clean, grain-free diet and detoxifying the home by reducing exposure to pesticides, radiation, tobacco smoke, excessive alcohol, mercury from fish and silver fillings, bromide, fluoride and chloride (from swimming pools), which can decrease the body’s ability to absorb iodide.
Stress: Stress can suppress thyroid function by preventing the conversion of T4 to T3, the active form of thyroid hormone. During stress, T4 becomes something called “reverse T3”. Both cortisol and thyroid hormones require the amino acid tyrosine for their production. Therefore, during times of the stress, when the demands on the body for making cortisol are higher, not as many resources may be used to produce thyroid hormones and hypothyroid symptoms may result. Ensuring proper cortisol function and decreasing stress is important for recovering from thyroid symptoms.
Nutrient deficiency: Thyroid hormones are made of tyrosine and iodine. A deficiency in protein and iodine may result in an inability of the body to make thyroid hormone. Selenium is also important for converting T4 to T3. Zinc and iron are also important for proper thyroid functions and, in modern day society, these deficiencies are very common.
Inflammation: Using high omega-3 fatty acids EPA and DHA from fish, rhemannia and turmeric can help bring down systemic inflammation and decrease autoimmunity, thereby working to treat autoimmune Hashimoto’s thyroiditis and restoring thyroid function.
A Word On Medication
Synthroid is a synthetic version of the thyroid hormone T4. When prescribed, it can replace the need for the thyroid to act and help the body get back into balance. However, since T4 must be converted to T3 in order to become active, simply adding Synthroid may not be enough to eradicate thyroid symptoms if there is a problem converting T4 to T3, such as selenium deficiency, dysbiosis, inflammation or stress. Furthermore, when the cause of hypothyroidism is autoimmune, this means that there are antibodies attacking the thyroid, not that there is something wrong with the thyroid itself. Without addressing the underlying autoimmunity and inflammation, patients will only need to eventually continue to increase their Synthroid dosage as the ability of the thyroid to function gradually decreases.
For more information on how to address thyroid symptoms naturally, contact me for a free 15-minute consultation.
I’m tucking away at the cake again because the people who’ve invited me for dinner have dessert. Dessert: the gluten-y, sugar-y, dough-y sweetness of relief from deprivation, the dopamine and serotonin rush when the food smashes against my lips, teeth and tongue and gets swallowed, in massive globs, into my stomach. The desire for more smashes maddeningly around my skull. Getting the next fix is all I can think about. I reach for another slice when no one is looking. I guess some people call this binging, a complete loss of control around “forbidden” foods. All I care about is devouring another bite, and feeling the euphoric blood sugar rush that flushes me with giddiness and good feelings before the shame sets in.
One I’ve begun to indulge, however, the voice demanding more exits stage left and is replaced with a little gremlin who fills my head with sneering and loathsome disparagement. It doesn’t speak in whole sentences, but rather in snippets, sentence fragments and hateful keywords. Sugarrr…. it hisses, gluten, bloating… FAT! Ugly, worthless…No control, no willpower, useless… failure…FAT! Not that the cake contains fat, but fat is what I will become when I allow the cake to become a part of me, the little evil voice suggests. Sometimes I can temporarily drown out his voice by eating more cake, which only makes him louder once all the cake is gone or my stomach groans with fullness.
I’ve come to realize that this cycle can be set off with feelings of boredom, anxiety and, most of all, hunger. A low-calorie diet, detox or a period of controlled eating leaves me susceptible to these binge lapses. It’s taken me the better part of 30 years to figure that out. However, stress can also send me to the pantry, digging out whatever sugary treats I can find. And so the cycle of loss of control followed by self-loathing begins.
The next day, or even within the next few hours, I feel fat.
Fat feels a certain way to me. It feels physical: puffy, bloated and sick. Most of all, it feels like I’ve done something wrong, that I am wrong. It brings with it feelings of lethargy and heaviness, not the light, perkiness I associate with health and femininity. I feel gross, unworthy of good things: attention, love, affection. I feel like I’ve failed. I feel like I’ve lost control of myself. For, if I can’t even control when I shove in my mouth, how can I have power over anything else in life?
However, a person can’t really feel fat. I mean, especially not after only a day of overeating.
And besides, fat is not a feeling.
Perhaps fat was a stand-in feeling for other difficult emotions my childhood brain couldn’t fully comprehend. Like the time I wrote in my diary, at the age of 8 years old, That’s it, I’m fat, I’m going on a diet. From now on, I’m only eating sandwiches. Funny and touching, but also sad, I wonder what 8-year-old me was really feeling when she claimed to feel “fat”. Perhaps she felt helpless, out of control, different from the herd and hopeless about fitting in.
If I pause to peer below the surface of “fat”, I find other words or cognitive connections that underlie it. When I feel “fat” I also feel out of control, worthless, lonely, like a failure. I sometimes feel sad and anxious. Sometimes I simply feel full, like I’ve fed myself, and as I’ve often heard repeated, “It’s important to leave a meal feeling a little bit hungry”, the feeling of being fed can induce feelings of guilt.
Everywhere we look, the media equates “healthy” with thin, glistening bodies. Fitness models with amenorrheic abs, bounce back and forth on splayed legs in front of a full make-up, costume, lighting and camera team to simulate the image of running through a field. “Losing weight” equals “getting fit” equals “being healthy”. As a society we’ve failed to ask ourselves what “health” might mean and instead deliver the whole concept over to impossible standards of beauty, making “health” as unachievable as the stringy bodies that represent it. While I intellectually know that this isn’t the case, that health comes in all sizes—and may actually hover around “plus” sizes, in actual fact—restriction has been imprinted in my brain as a sign of healthy self-control.
But, maybe the definition of health needs to come from digging within and asking the question What does health mean to you? Perhaps the body knows more than the marketing media does about what it needs for health. Maybe, just sometimes, it needs cake to be healthy. Maybe even the act of overindulgence is healthy sometimes.
Perhaps if I give my body enough of the healthy food and fuel it needs, it won’t go crazy the next time it sees cake. When we try to murder ourselves by holding our breath to stop our breathing, we pass out. The body deems us too irresponsible to control the precious task of breathing and so it turns the lights out on conscious breath control. Our very own physiology doesn’t trust our conscious thought if we abuse it. So, when I force my body to survive and thrive on restrictions, self-hate and negative talk, perhaps it induces a binge. Maybe I binge to survive. Or maybe my body loves cake as much as I do.
Instead of feeling like a failure, because I didn’t win the fight against my body, perhaps I should respectfully hand it back the reins and tell it, with my conscious mind, “I trust you, I respect you, I’ll listen to you more carefully from now on.”
And, like Marie Antoinette once granted her people, I can grant my body permission, and let it eat cake.
For breakfast, I would typically eat a high-fat smoothie containing coconut milk yogurt, gelatin, and avocado, and topped with pumpkin seeds and cacao. Sometimes I’d make fat bombs or homemade unsweetened chocolate.
