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Keto Chat Episode 134: Cross-fitter Finds her Keto Groove to Lose 35 lbs

 

Interviewee Bio:

Rita Ott PSC Bio

I live in Corcoran, MN (a northwest suburb in Minneapolis) with my husband Leo, and chocolate lab Molly where I work for General Mills.

As much as I hate to admit it, struggling with weight has been part of my life since high school. Over the years I have tried many different types of diets. Some were successful, but the positive results were always short term.

When I moved to Minnesota in 2006, I was finally able to figure out how to make fitness a regular part of my life. For the last 3 years, I have been attending a CrossFit gym and absolutely love it! But even after many years of regular exercise, I still couldn’t resolve all of my issues with weight. At the start of 2020, I decided I finally wanted to figure out the weight issue.

I was turning 50 in December and wanted to finally solve this by then. I tried Keto on my own and quickly lost about 15 pounds. But then I hit a wall and it seemed like nothing I tried work. I was 2 months away from my birthday and nowhere near my goal. I started looking for a coach and found Keto Carole. Her program was easy to follow and filled in all the gaps I was missing. So far, I have lost 32 pounds and over35 inches. I am also sleeping better and no longer wake up every night with leg cramps. All this time I thought they were a result of my CrossFit classes! I still have a long way to go, but know I am well on my way to reaching my ultimate goal of mental freedom from worrying about my weight.

I look forward to supporting others in their Keto journey.

Transcript:

Carole Freeman:

Well, hello everyone. Thanks for joining us today on this episode of Keto Chat. Today, I’m here to interview Rita. Welcome Rita.

Rita Ott:

Thank you. I’m glad to be here.

Carole Freeman:

Excellent. Just going to be sharing her keto journey with us, with working with me and hopefully being inspiration to at least one person out there. So Rita, can you just give us a little intro of yourself, tell us who you are, where you live.

Rita Ott:

Sure. So my name is Rita Ott. I live in Corcoran, Minnesota, which is a small rural suburb of Minneapolis. Have been here since 2009 and have really enjoyed it. We’re out in the country a little bit and have a couple acres and really enjoy our space of where we’re at and what we have. So I’m married. My husband’s Leo. We have a chocolate lab, Molly. We don’t have any kids, but we’re doing just good. I’ve got a several nieces that take up some of my time when I get to visit them back in Kansas, where I’m originally from.

Carole Freeman:

All right. Excellent. Welcome. A chocolate lab. That’s my mom’s favorite dog.

Rita Ott:

Oh, they’re wonderful.

Carole Freeman:

Yeah. Well let’s go back to before you even knew who I was. What kind of struggles, what were the things, the challenges that you were having as far as your weight and your health that were basically first thing you think about waking up in the morning and take us back a little bit on that journey.

Rita Ott:

So as I think back, I would say probably going all the way back to high school, I think I have always struggled with my weight. So it’s kind of always been a constant, there in my life, and I would say probably 10 years ago, roughly when I moved to Minneapolis, I figured out the exercise piece and I started exercising on a regular basis, which I had never done, but it still didn’t… That really didn’t impact my weight. I mean, I felt better, but I still wasn’t losing weight. And then last year I decided at the beginning of the year, because December of 2020 was my 50th birthday, at the beginning of the year, I’m like, “Okay, this is my year. By the time I turn 50, I’m going to have this figured out.”

Rita Ott:

So I started keto on my own and quickly, on my own, I lost 15 pounds. And then I just stayed there for six, seven months, and just couldn’t figure it out, and it was frustrating. I couldn’t figure out. It didn’t matter what I… What I tried, it didn’t seem to work. So it was getting closer and closer to that birthday and I’m like, “I got to figure something out.” So I’ve had that before with coaches, whether it be on fitness or on financial, and I’m like, “Okay, let me see what I can find.” So one day I just decided and I started searching on the internet and found Carole and decided I’m going to go for it and give it a try. I’m so glad that I did.

Carole Freeman:

Excellent. Excellent. So it sounds like the struggles you were having had you searching out a coach to get you better results then were just like, “Okay, I lost a little weight. I have a glimpse of keto could be this amazing thing, but why is it not working for me like I see it working for everyone else?” Is that kind of…

Rita Ott:

That’s it, yeah. I couldn’t figure out the nuances of it. And then of course then the frustration sets in and then it’s like, “Well why am I even bothering because it’s not working, but yet I know that’s what I want to do.” I was reaching to that point where I’m like, “I’ll just give up,” and I didn’t want to do that.

Carole Freeman:

Excellent. So what was it then, we have our first consultation where we kind of talk about, is it going to be a good fit? What was it that clicked for you that made you decide, “Yeah, I think this is what I need.” Do you remember what that was, or…

Rita Ott:

One, I think it was just your energy and you’re so positive and you’re like, “Absolutely. I know your story. I know I can help you.” And even then it seemed like it was going to be easy, and not easy in that it’s an easy journey, but easy that the process seemed easy. And then I think as I started to learn more, I think what I like about it, there’s a process and there’s rules and guidelines, but yet there’s freedom within those rules and guidelines too, and that you’re not, “Well, here’s your 30 day meal plan. You have to follow it exactly to the T.” Because that was stressful to me, when you would look at that. So being able to have that freedom and to, “Here’s my guidelines, and if I can just stay within those guidelines and make adjustments in there, what works for me,” that felt freeing to me.

Rita Ott:

Just the whole program, there’s just those little tidbits that I was missing that filled in the blanks to make it easier for me to be successful. I think the other thing that’s surprising, I thought I was doing good and I was eating all these vegetables, but I didn’t… I knew, I mean, I’m a food scientist, so I know vegetables have carbs, but I didn’t realize how many carbs I was getting based on the amount of vegetables I was eating. So I thought I was doing the right thing, but it wasn’t working, obviously.

Carole Freeman:

Yeah, that’s a big challenge people have is that in past diets we’re always told vegetables are a free food, so they don’t really register that we’ll have to like eat a smaller portion of vegetables. That seems a little crazy for a lot of people to wrap their head around. And I talked to so many people, they’re like, “I’m not eating any carbs at all.” And then it’s like, “Oh, but they’re having maybe like 80 grams of carbs a day, but they feel like it’s none.”

Rita Ott:

That was surprising to me.

Carole Freeman:

And I’m glad too that you see that freedom within the structure too, because that’s my goal is to help everyone find a way of doing this that fits their unique personality, their likes and tastes, their lifestyle, their goals and things like that too. So I’m glad that you got that, that it’s easy within the structure and also you have freedom.

Rita Ott:

Right. And I think that makes it easier and that allows you to have ownership. And like you said, it’s not somebody telling you have to do ABC, which sometimes that can be hard. Naturally you want to deviate from that some.

Carole Freeman:

Excellent. So you completed our fast track program and then you stayed on in our crew, which is the membership after that. And also you’ve graduated the point where you’re supporting others as a peer support coach now, which I love. So share with us, what have your results been over this journey? We’ve been together maybe four or five-

Rita Ott:

Almost five months. Yeah, almost almost five months. The time’s gone by so fast. It’s been great. The best part, I’ve lost 36 pounds. It’s been a few weeks since I’ve measured, but at that time I’ve lost a little over 35 inches. Which is just huge. So that’s great. But then I think the other surprising thing for me is the other little subtle things of just how I feel I’m sleeping through the night. I don’t wake up with leg cramps like what I used to. I always thought that was because I was going to the gym, and I just said, “Oh well, that’s part of it.” I don’t have that anymore. Which is just amazing and awesome. So it’s all those little things of how you just feel good. I feel I have so much energy. The last month, there’s been probably every week, probably at least two days a week, I’ve gone and done like two workouts in a day. And I don’t struggle with energy of being able to do that. And I’m not hungry. It seems to be working and it makes me feel good, so I enjoy that.

Carole Freeman:

I love that like. So much energy that you’re like, “Oh, let’s just go for a second workout today.”

Rita Ott:

Yeah. Let’s go for it. Earlier this week I was going to do that and I didn’t feel it, so I’m like, “I’m just going to do the one.” So that’s nice where you are able to learn to listen to your body of what you want and what you can do and what might not work today, but can work tomorrow.

Carole Freeman:

Wonderful. So here’s where things take a turn. We’ve been talking about the positives in all this now. So let’s take an imaginary journey that where would you be now had you not found me?

Rita Ott:

Oh, wow. I don’t know. I don’t know if I would have just given up or if I would have to struggle but I think back, every day was like… It was just this inner battle of I know I wanted to be good and I want to try and do the right thing and eat right, but then it doesn’t matter, so who cares, so I’m just going to go have something that I know I shouldn’t. And it was just that constant mental drain of that that internal discussion every day of trying to figure out what are you going to fix for a meal. That’s all gone. I don’t know where I’d be. I don’t know if I would have… I would have continued to exercise, but I feel like I’d probably just be stuck in the same place, and then probably just from emotional and mental I probably would probably be in a worse spot than where I was. That would be my guess.

Carole Freeman:

Well thankfully that’s not where you’re at.

Rita Ott:

And the thing now is I feel like for the first time… I still have quite a ways to go on my journey and more weight I want to lose, but this is the first time I can see that in the future and that I have confidence and belief that I’m going to get there. I don’t know how long it’s going to take, but I have that confidence and belief now that I will… I now know what I need to do to get there and sustain it. I don’t know that I’ve had that before, because I’ve been like everybody else. I’ve tried tons of different diets and have lost weight’ and then you gain it back and gain more than what you lost, which is always frustrating. But this is the first time I think, I’m like, “Wow, I know I’ve got this.” That’s exciting.

Carole Freeman:

I love that. That was going to be my next question is what do you see on the horizon for yourself? So you’re already synced up with what you’re going. What other side benefits, other things that you didn’t expect to get better? Maybe the influence you’ve had on other people in your lives or your family? The ripples of healthiness that have changed around you too.

Rita Ott:

Oh wow, that’s a good question. My husband is starting. He’s been slow to take this on, but he’s trying and we’re going to get there, so I’m excited about that and that possibility of him giving this a try. I know my family has been excited for me, my friends. They’re just super excited, and if anything, they give me more motivation now than ever. And not that I would, but they’re not going to let me fall off. They’re just so supportive and excited. I’m really excited since I’ve been working from home since March of last year, so I haven’t seen very many people. So some people have commented, like when they see you on a Zoom call or a Teams call, but I’m excited at one day to when I can go back into the office and see everybody and see everybody’s comments and thoughts. So that’s probably the biggest thing.

Rita Ott:

And then it’s just… I guess it’s fun going out. The biggest thing I was looking forward to is just to… I just want to be able to live life and not think about weight. So I’m on that path and I think about it less and less than where I was. So that’s enjoyable too. It’s just that you don’t have that mental heaviness day in and day out. That was one of my whys and what I was looking for, and I feel like I’m definitely seeing the benefits of that and I know that’s only going to continue. So I’m sure that makes me a better person to be around too.

Carole Freeman:

I love that. That’s so great. Just overall quality of life, confidence, just the freedom of no longer being this heavy lead blanket of constantly consuming your thoughts, your worries and stuff like that too. Yay. I’m so excited and happy for you and congrats on all your success and excited for the future. We’re going to be hanging out for a while longer in the future too.

Rita Ott:

Yep. And I think that’s… I have to admit, I was excited when I joined, but I was also a little bit concerned or skeptical, I’m like, “Okay, what’s this going to be like? And what’s the support level?” And I have to say I was pleasantly surprised. Because sometimes you do that and you’re like, “Here’s the information. Here’s what you need to go do. Okay, now go do it.” So I was a little bit worried. I’m like, “Oh, is that what’s going to happen?” There’s so much support through this whole program as long as you take advantage of it. I think that’s huge as well. One you can learn from others, you can see their successes and see what they’re doing. You can learn tips and tricks to help you out. Things that you didn’t even think of.

Rita Ott:

To me, it just keeps you motivated and going. Like I said, I’ve been so pleasantly surprised to have all the support from everybody and directly from you, Carole, we’re on this journey. That’s one of my tips to people is I probably didn’t take advantage of that early enough. I joined the coaching calls, but I waited to reach out with questions until later because I just didn’t know if that was appropriate or if I could do that. So that’s probably been a great surprise and a great benefit as well.

Carole Freeman:

Oh, I love that. I know sometimes people feel conscientious about asking a question, but everything there, and I’m so glad that you feel so supported because I’ve really crafted this in a way that trying to cradle you in support at every turn so you feel like a safety bubble around you that you’re always there and everybody’s cheering you on, but also there for support and tips and tricks, like you said too. So wonderful. Well Rita, any last comments or anything else you’d like to share? Anything else you were hoping I would ask about?

Rita Ott:

No, I don’t think so. I’ve just had such a great experience. I hope I can help others in the future. Another thing that I’ve really enjoyed is that… I did a diet several years ago where I lost quite a bit of weight, but at that one part of it, they’re like, “You need to stop exercising,” because all of that and hormones and exercising it just really makes it more difficult in some ways was their recommendation. And you know what, it worked, I lost weight, but I’ve been able to continue to exercising and do stuff and I haven’t… I’m having to rebuild up some strength, and with losing weight, I’ve lost some of the strength on lifting weights that I had, but I’m not too far off. So that’s also been something that I’ve enjoyed that I’ve been able to continue to do that throughout. And that I didn’t have to cut back or give that up as well. So I think that’s huge too.

Carole Freeman:

Yeah, wonderful. Because I know you’re a big-

Rita Ott:

CrossFit. Yeah, I love it.

Carole Freeman:

I know, because a lot of times people say like, “Oh, you can’t do keto and do CrossFit,” but you’re doing it twice a day now.

Rita Ott:

On some of them, yeah.

Carole Freeman:

Well excellent, Rita. Thank you so much for sharing your story. I know you’re going to touch at least one person and probably lots of people, they’re going to identify with something about your story, that’s going to hit them where they’re going to say, “Oh my gosh, that’s like me, and if Rita can do it, so can I.” So thank you so much for sharing that and inspiring others to get on this healthy journey and get that freedom from constantly worrying about how to lose that weight and just move into a place of feeling amazing and the best decades of your life are ahead of you, so that’s great. Well, thanks everyone for watching. If you’ve enjoyed this, if you’re inspired by Rita’s story, comment below and share with us, what was it that moved you, that you can identify with there? Give us a thumbs up, subscribe to hear more of these success stories too. So thanks for watching and we’ll see you soon. Bye.

Rita Ott:

Okay, thanks. Bye.

 

Keto Chat Episode 133: Should I Worry about my Cholesterol on Keto?

 

Interviewee Bio: 

I’m a senior software engineer and entrepreneur.

I began a Low Carb, High Fat diet in April 2015 and have since learned everything I could about it with special emphasis on cholesterol given my lipid numbers spiked substantially after going on the diet. As an engineer, I spotted a pattern in the lipid system that’s very similar to distributed objects in networks.

I’ve since learned quite a bit on the subject both through research and experimentation which has revealed some very powerful data. With this new general theory, I’ve shifted around my cholesterol substantially without any drugs or special supplements of any kind.
https://cholesterolcode.com/
Twitter: @DaveKeto

___________________________________________________________________________________________

Transcript:

Carole Freeman:

Well, hey you guys. We made it. We’re live here broadcasting into our Keto lifestyle crew. And you may be watching us later as well too on YouTube and Facebook. So thank you so much for joining us. I am so excited to be here today with Dave Feldman who is a personal friend, but also an amazing, amazing guy. I call him a cholesterol investigator. He calls himself a senior software engineer and entrepreneur. So welcome Dave. Thank you so much for being here.

Dave Feldman:

Thank you for having me Carole.

Carole Freeman:

I miss … Every time I get to do one of these interviews now in these current times, I miss you guys even more because we can’t see each other in real life. But it’s good to see you virtually. I met you Dave, what is it, going on, five, six years ago at the very first Low Carb USA conference.

Dave Feldman:

Yes.

Carole Freeman:

And my first … I remember you before you even met me because I, at lunch time the first day of Low Carb USA, I’m sitting by myself outside. Would grab lunch at some like randomly. You were at a table next to me. We’d grab lunch at some grocery store or something like that, and you’re sitting at a table with a bunch of guys. And I can overhear you talking about like, “You guys, I think I figured out this weird thing with cholesterol,” and you started sharing the things you’d find out at that point. So that’s my first memory of you. And then we later connected and got to know each other better from then.

Carole Freeman:

Some people watching this may like totally know who Dave is and are huge fans, or on one side of the controversy or not. But let’s just take it back for those people who are like, “Who the heck is Dave? Why should I care who Dave is?” Let’s take it back and just tell us how you got so interested in this cholesterol thing.

Dave Feldman:

Well, mainly it’s because mine jumped through the roof after I went on a ketogenic diet. I started in about April of 2015, and about seven months later I get my blood work back, and like so many others I was like, “Oh, I’m expecting it’s going to be better than I’ve ever had,” because I’d been feeling great, I was setting personal records with my running. It’s just I had every confidence in the world that it was going to be fantastic. I thought there was a chance my cholesterol might go up a little bit, so I was prepared for that, but it had skyrocketed. It had gone up, I think, over 100 milligrams per deciliter.

Dave Feldman:

So here I am. I’m looking at an LDL of like 230, 240, something like that, and I’m flipping out. And after that, I became obsessed about this science that revolves around cholesterol, and really, the overall topic itself of lipids which are just these insoluble elements that your body makes use of that it needs this system to move it around in your body.

Dave Feldman:

And what’s funny about that is, this system in many ways is one I’m kind of familiar with in software. It’s a network. And that’s how I ended up getting so interested in it. I started seeing patterns that I thought were familiar, and then I started doing a number of self experiments which I’m sure you’re very familiar with now where I found I could manipulate the numbers very substantially because basically, and this is kind of my elevator pitch, I posit that our cholesterol levels in somebody metabolically healthy especially are kind of ride sharing with our fat-based energy. So if you’re powered a lot more by fat, it will almost certainly have an impact on your lipids, particularly your cholesterol levels.

Carole Freeman:

Ah. So those of you that are watching right now, I can see that we have some people watching live. So go ahead and just chime in, in the comments, so we know you’re here. Just share with us where you’re watching us from, and feel free to pop questions in for Dave. He’s here to answer questions, but also, if there aren’t questions where I’ve got plenty of questions for him too. So let us know that you’re here and what are your top questions about cholesterol in general.

Carole Freeman:

Let’s go back to like what’s old school, what doctors think of what is cholesterol, and then we can then compare that to what you’ve discovered and over the years.

Dave Feldman:

Well, of course, I believed like so many others before I got into this that cholesterol was just kind of this liquid that’s just traveling through your bloodstream and globbing onto the edges, because I grew up with the same thing I’m sure you’ve seen many times over which is these pipe analogies. You’re seeing glunk like going down and then getting stuck in the pipes, and that’s how you end up with these stenosis that you would see in the arteries.

Dave Feldman:

And over time I found out no, no, it’s actually extremely sophisticated in that your body makes these proteins, lipid carrying proteins which you’ll hear of as lipoproteins, and they’re carriers. They’re carriers for these lipids, and they actually are being made by your body all the time to move them around because really these lipids, they don’t hang out in your bloodstream unescorted. They’re constantly being escorted by these lipoproteins, these boats as I like to refer to them.

Dave Feldman:

And that’s actually one major misconception, is for example, you’ll hear something like LDL cholesterol and you’ll think it’s a kind of type of cholesterol. It’s really only one type of cholesterol. There’s really only one cholesterol molecule. But LDL is really the kind of boat that you find that cholesterol in, HDL cholesterol, the so-called good cholesterol. By HDL cholesterol what they really mean is the cholesterol found in HDL particles. But that’s also another carrier protein.

Dave Feldman:

So these boats, they’re being made constantly up. I’ll share a fun fact with you. How many LDL particles do you think you have in your body right now? Just guess a number out of nowhere.

Carole Freeman:

Oh, me personally, gosh, I don’t even know. This is fun because I’m like, “No, we never talked about this in school. We never learned this.” So I don’t know. I’m going to guess 400.

Dave Feldman:

Nope. You have about a million trillion.

Carole Freeman:

Oh, okay.

Dave Feldman:

So do your best to imagine a trillion, and then imagine a million trillions, right? It’s basically a one … It’s called a quintillion. It’s a one with 18 zeros behind it.

Carole Freeman:

Okay.

Dave Feldman:

So to give you-

Carole Freeman:

We’ve got one a person from California. Hello Facebook person from California. Welcome. Please share. Pop in your questions about cholesterol. Okay. So a number that’s so big we can’t even imagine it. Okay, got it.

Dave Feldman:

But I can give you an analogy, something else that’s measured in quintillions. It’s estimated there’s 7.5 quintillion grains of sand on every beach and desert all around the world.

Carole Freeman:

Okay.

Dave Feldman:

So if you counted every single grain of sand all around the world, it would come to that amount. And that’s about how much your body turns over every two weeks.

Carole Freeman:

Wow. Wow. Okay.

Dave Feldman:

It’s making those and turning them over constantly.

Carole Freeman:

And so we’ve become obsessed with a tiny little number. So the difference between somebody who’s say 90 LDL versus 400 LDL, we’ve associated that with bad things versus I don’t even know what decimal point that would be as far as actual change compared to how much is actually there.

Dave Feldman:

Well, actually, and then I’ll take it to the next step which is for all those boats that are in your system, you might be like, “Wow, that is so many proteins. I mean my bloodstream must just be packed full of them.” Actually I’ve calculated the surface area for what would be. So for example, an LDL particle is around 2.3 nanometers, which isn’t going to mean anything to you. But you can take it as what the fraction of the total blood volume is. So in an adult male there’d be like five liters of blood. So the total amount of that blood volume that’s taken up with these boats if you were to just put them all together is around 1 10,000 to around 1 5,000, somewhere in that range. So about maybe 2% of 1% to give you a sense of it. It’s hardly, it’s … Oh, go ahead.

Carole Freeman:

Oh, I was going to say so the old analogy of cholesterol clogging your arteries is definitely not what’s going on. Like there’s not so much of it in there that it’s just backing up and causing this sludge mess. That’s not what’s happening.

Dave Feldman:

Well, I’m not going to make a true/false answer to that because of course I am going to state plainly. I don’t know if cholesterol causes heart disease indirectly. For example, ApoB containing lipoproteins to just get a little bit technical are participants in atherosclerosis. The bigger question you’re really reaching for is, is atherosclerosis the buildup of plaque in the arteries, is it mediated mostly by your cholesterol levels?

Carole Freeman:

Well, I would more-

Dave Feldman:

That’s the question we have.

Carole Freeman:

Well, and I was more looking at like people visually who haven’t studied biochemistry. They actually have been conditioned. The analogy is like, no, it’s just like this big glob that get stuck in there, so it’s a mass problem, like the …

Dave Feldman:

Yeah, and that’s what I’m getting to, is that original analogy I brought up earlier definitely doesn’t hold, and that it’s not just this goop that’s kind of wandering around and finding its way into your arteries as described. It’s certainly much more complicated than that.

Carole Freeman:

Yes. And we’ll get there. So our Facebook viewer, I’m wondering this … I think this might be Penny, but I don’t know for sure, that hoping will talk about convincing her doc who’s only considering that you need to follow a plant-based diet and then follow up to that was doesn’t believe in any new science. So should we go there now? Should we work our way there?

Dave Feldman:

Yeah. I think, and this is where it gets interesting, because the energy model that I really since you met me was kind of the beginnings of the energy model. And what I mean by the energy model is it’s this sort of larger take, if you will, that I have. And I have a, for anybody following, they can go to cholesterolcode.com/model and there’s a poster. And the poster kind of walks you through these different elements that I’m talking about. So it might make it a little bit easier if you go and visit that.

Dave Feldman:

But the model suggests that indeed, if you’re metabolically healthy, it’s more likely than not, particularly if you’re lean, particularly if you’re like normal weight or even leaner and very low carb that you’ll be trafficking more of these boats, and therefore it’ll be a higher likelihood that your cholesterol levels will be high, not just your LDL but also your HDL. And typically your triglyceride levels are low, and that’s what I call the triad, is those three together, high LDL, high HDL, low triglycerides. And that’s common for somebody on a low-carb diet who is metabolically healthy, normal size to lean. That’s a common response.

Dave Feldman:

Now, this may be surprising if you’ve started out as really overweight and you’ve now gotten to a weight for which you still have a little bit to go. A lot of times those folks will either see a drop in their LDL cholesterol or a slight increase, or that it remains roughly the same. This too actually fits the energy model which I’m not going to go into yet.

Dave Feldman:

But I do want to get into the plant-based scenario where if you are low-fat high-carb, well then, you’re trafficking glucose more in your bloodstream, not fatty acids. If you’re trafficking glucose, you don’t need a carrier. Glucose is water soluble, so it fits right into your bloodstream, can move around just fine. And because of that in the same exact scenario, I would say, I would predict that it’s more likely your cholesterol levels will go down. And that’s why I could see how from a distance it looks like that’s just the most obvious decision to make if you’re wanting to bring down your cholesterol levels.

Dave Feldman:

And, for what it’s worth, if somebody were to come to me and they said, “Look, the only thing I care about is reducing my total and LDL cholesterol levels,” I would say, “Well, yeah, yeah, I mean consider going low-fat high-carb because that will succeed in dropping that down if that’s where you want to take it.”

Carole Freeman:

Well, and even when I was in school all those years ago, I remember our biochem class where our professor explained the mechanism where when insulin was higher, that was a driver of creating cholesterol in the body. And I had a light bulb moment even at that time, long before I’d even started following keto, that like, “Oh, wait a minute. So high-fat diet doesn’t cause like directly this cholesterol to go up automatically? It’s insulin which is high-carb diet is going to cause insulin to be higher and that is going to cause cholesterol be higher.” And I’m like raising my hand. They’re like, “Well yes, but,” and then the recommendations were follow a mixed diet, moderation, never mind the science that we just learned. Let’s go back to lowish fat and don’t try to restrict carbohydrates.

Dave Feldman:

Yeah. Certainly I feel very differently on that in the general view. Again, speaking just as far as being metabolically healthy, insulin typically brings up expression of your LDL receptors, it activates something known as lipoprotein lipase. Lipoprotein lipase is the enzyme that will take triglycerides off and in particular for your adipocytes which are your fat cells. So if you’re consuming a lot of carbs and you reach a point of maxing out your carb storage known as glycogen, then it’s time to store it. That’s why oftentimes you’ll see triglycerides go up in people who are consuming a lot. Whether they’re low-carb or low-fat, if you’re consuming a lot, your body wants to store it because that’s how we ancestrally survived to make it through the famines and so forth.

Dave Feldman:

So that takes insulin. Well, if you’re low, if you’re basically on a diet that results in lower relative insulin, then odds are you’re actually doing the opposite. You’re taking more of the fat out of your adipocytes and out of your fat cells, and you probably need to circulate it more depending on how low your total fat mass is. You may have to circulate it more in a global sense as opposed to in a local sense. That by the way is why the energy model kind of makes sense for when you are of a higher weight. You have more fat mass to muscle mass, and therefore, there’s more, if you will, local availability of those fat cells. You know what I mean? Hopefully that kind of unpacks that a little bit.

Carole Freeman:

So this is Penny that’s questioning here. She’s watching us live. She’s got, yeah, LDL and HDL are high but our triglycerides are low, so that classic high good cholesterol, low triglycerides, but the LDL is the wild card. Let’s start with can you just kind of in a easy for people … That’s one of the things I love about your presentations, is you’re always able to create these analogies that make it easy for people to understand when they don’t even have any science background or nerdy biochem background or anything like that. Can you help people understand? So what is LDL? What is HDL? And then what is triglyceride because people get those numbers on their lab reports and then they just rely on their doctor to be able to interpret those?

Dave Feldman:

Yes. I do have kind of a new analogy I’m going by that’s probably going to make it into our paper. You hear a lot about ApoB. ApoB is short for Apo lipo protein B, but you hear about it as very relevant because it’s on that LDL boat. So ApoB is that protein that carries it around.

Dave Feldman:

Well, you make ApoB in your liver and it’s constantly making these boats that are loaded up with triglycerides and fat soluble vitamins, basically all these lipids your body needs. So that boat, it starts really big, bloated with these things that your tissues need. And its job is to start big and to get small. And there’s really only one way it gets small, which is that it gets its cargo taken off of it. And not to get into the biochemistry of it, but its hull, the outer part of its hull are made of things that are also part lipid and part water soluble, but they have to shed. These are phospholipids. They have to shed as they get smaller. You don’t make things get smaller at these sizes without parts of it being shed. And here’s where it gets interesting.

Dave Feldman:

Correspondingly with ApoB there’s this ApoA1 which is really the species of HDL. And HDL is supposed to start small and get big. And that’s why we see an association with more HDL cholesterol having lower and lower cardiovascular disease, because that usually means HDL particles are being successful. Those boats are successfully getting their cargo. And we won’t get into the where the cargo comes and goes and so on and so forth, but we will say this much. On a constant basis what you want to be seeing in your bloodstream is you want to see those ApoB like VLDL and LDL succeed at dropping off their cargo, and you want to see the HDL succeed at picking it up. And the way that’s happening is at the port.

Dave Feldman:

So where’s the port? The port is any cell that needs it. Whether or not it’s muscle cells or your heart cells or your adipose cells, what’s happening is that the big boats are coming along, they’re dropping off their cargo, the ApoBs, they’re getting smaller and smaller, and at the same time those constituent pieces that are coming off of it are going on to the HDL boats that are getting bigger and bigger. And that’s why two years ago, two, gosh, it’s almost three years ago, I realized that actually so much important information comes from just those three markers together, those simple markers.

Dave Feldman:

Forget about NMRs and forget about a lot of these other things that, granted, I’m very interested in. You know I get a lot of blood tests Carole. Ridiculous amount. But a basic lipid panel actually tells you quite a lot right there with that triad, because when you’re seeing that your LDL cholesterol is high but you’re also seeing your HDL cholesterol is high and your triglycerides are low, to me it’s very suggestive that you have a very functional, very active low-carb lipid system. And it seems to be succeeding because your triglycerides are low.

Dave Feldman:

No doubt Carole, you and I have seen people who go on a ketogenic diet. They have high LDL but they don’t have what I just described. Instead, they have low HDL and high triglycerides. And I often hear from other people who are critics of my work that I’m just fine with high LDL in a ketogenic context. It’s not the case. I don’t care who you are or what diet you’re on. If you have low HDL and high triglycerides, that says to me that there’s a failure of moving that cargo across right. And that in a nutshell is why I started pursuing three years ago in particular this triad, and I even put out a challenge. You may have heard of it, the low-carb cholesterol challenge.

Carole Freeman:

Yes. I’ve been meaning. I can’t wait to ask you about how that went because I often cite that to my clients who they come back and their HDL is high, their triglycerides are in optical range, and then the doctor’s like, “Your cholesterol is through the roof,” and maybe they have like a 200 LDL or something like that. So I often would cite that Twitter challenge that you put out. So would you just reset like what that is for people that you did? And I don’t know the outcome, so I can’t wait to hear the outcome.

Dave Feldman:

Yeah. So I started about, again, it’ll be three years ago this February, February 13th. And what it was is I basically, I just made this image that said, hey, send me the best study that you have that shows those people with high LDL will have higher cardiovascular disease when likewise matched with high HDL and low triglycerides. It’s just very straightforward.

Dave Feldman:

And I said best because I thought I would get flooded. I was fairly new into my research and I thought that there would just be a fire hose of different studies, so I just wanted to see the best ones. And it was just sort of generally ignored, which I was surprised by because I was reaching out in a friendly way to a lot of the bigwigs that were out there, and there were a couple doctors who said, “Hey, I’ve got a study that meets your your challenge.”

Dave Feldman:

And then we went through it. It didn’t actually meet the challenge. But I remained encouraging. I was like, “Okay, this one doesn’t meet it if you look at this criteria. But let’s see if we can get.” And then six months later to the day I said, “You know what? I’m going to put a finder’s fee behind it.” And so I’d put a-

Carole Freeman:

You wanted. You wanted to find the truth. You wanted to see if this information was out.

Dave Feldman:

I do. Yeah. I do. And I really should emphasize this. Like I don’t, I’m not a scientist at a lab where I have access to, or nor am I researcher who has access to all of this data. But I’ve been seeking this data for a long time, particularly these three together. Because I, again, I think that if the LDL hypothesis of it being independently causal towards heart disease is not modulated hardly at all by other risk factors, then it should be fairly straightforward. You should see people with very high LDL, like you just mentioned. People let’s say at 200 LDL, they should have definitely above average cardiovascular disease.

Dave Feldman:

So six months later after I started that, I then put this finder’s fee of like $300. So if anybody could find a study that meets this criteria, and I laid it all out. And I didn’t even want high cardiovascular disease. I said just above average. If you have something that’s just like just above average cardiovascular disease for high LDL when likewise matched with a stratification of high HDL and triglycerides, then I have the reward. And the stratification by the way was like an HDL of 50 and above and triglycerides of 100 and below. And I know Carole, you and I both see people all the time that are way higher each day on way lower triglycerides.

Dave Feldman:

But that said, it’s not been met yet, and I actually brought up to a thousand I want to say six months after that, and it just, it’s been lingering there. I’ve never actually dispersed anything because it’s just, it’s not been met. And like I said at first it got ignored, then it started getting ridiculed, and then it started getting like pushback and so forth. I was like, again, this is me wanting to fund the debunking of this, you know what I mean? Help me disprove my hypothesis in this regard, at least the foundation of how this may associate back to risk.

Carole Freeman:

So originally when did you make the request that’s now a challenge? I missed how many years ago is that now or a year or …

Dave Feldman:

Be three years this February 13th.

Carole Freeman:

Okay. So this, and for those of you that aren’t Twitter people, I got to tell you, like Twitter is the place where people are going to be like, “Oh, I’m going to prove this person wrong, and here’s my proof, here’s the science, here’s the research article.” It’s not just where people argue about things. They actually, there’s a lot of people on there that are backing it with real research articles.

Carole Freeman:

So this means that in three years with a thousand dollar bounty not one person has been able to produce one research article, one study that’s ever been done that shows that if your HDL is in a good range, healthy range, your triglycerides are also in a healthy range, that the LDL number matters one bit. There’s no correlation between heart disease … cardiovascular disease, the broader term for that.

Carole Freeman:

I rest comfortably with that. But I also encourage my clients to make their own informed decisions about how they interpret those numbers. But again, so in three years nobody’s been able to produce even one piece of research that shows that that’s of concern. That says a lot to people.

Dave Feldman:

Well. No, hold on though. I will add a few things. So one, we do have two studies, and the two that I cite frequently that have stratified for it and that do show an association with lower cardiovascular disease. One with I think ischemic heart disease, and I forget what the other one is. But they both, they show near very close to about the same as the optimal levels but with low LDL. But, I’m sure critics, and they have, point out that there’s a slightly higher association with those that have the higher LDL. And I’ll 100% acknowledge that. That’s why I want even bigger data, because both of those studies, I think one was with 4,000 participants, one was with like around 5,000, something along those lines.

Dave Feldman:

So it’s still very compelling in that I can correctly say that every study I’ve looked at, and there’s these two. Technically there’s a third one, the third one, and I try not to talk about statins was on the 4S trial where they also stratified out and found that those people with low HDL and high triglycerides in the placebo group saw the worst outcomes when they did not have the intervention of the statin that was being examined in that study. But that those who didn’t, who were in the placebo group but who had high HDL, low triglycerides. Actually I don’t think it was. I think it was like moderate HDL and moderate triglycerides compared to what our standards are saw virtually no benefit. So technically there’s really three studies per se that stratify out this triad.

Dave Feldman:

Now, I again, I try to be a good scientist. I want to say, “Look, we don’t know what we don’t know,” and that’s why kind of helps me segue into I’m doing this study. This study has been kind of consuming my life, especially in the last year, and that we’re getting a whole bunch of individuals that have this triad at very heightened levels, which is a phenotype I like to call lean mass hyper responders. And we want to get a hundred of them enrolled and followed for one year where we’re going to get CT angiograms at the beginning and at the end of the year to compare with each of these individuals.

Dave Feldman:

But given the existing lipid hypothesis right this moment at enrollment, if we have some amount of time that they’ve already been a lean mass hyper responder to qualify and we will, there should already in that first tranche of data be substantial atherosclerosis. There should already be given how high their LDL levels already are, that should already be obvious, that should already be evident in the initial scans. And again, I want to be a good scientist. I don’t know what I don’t know. We’ll see when we get there.

Dave Feldman:

But I will say that I am at a minimum a little surprised that we’ve had, like certainly I’ve come to know some lean mass hyper responders with extraordinarily high levels of LDL who I’ve told them, “Your levels are comparable to somebody who has a genetic disease known as familial hypercholesterolemia.” Here are the things that they typically see such as tendon xanthomas or of course they may develop an angina at a fairly quick pace. We’ve already seen this with unfortunately small children who had that genetic disease. And that’s part of what’s convinced modern science that it’s LDL that’s doing it, not the genetics.

Dave Feldman:

I may have a different opinion, but again, I think that there’s more to the story at least, I guess you could say. And that’s why I want to find out and that’s why I tell them, that’s why I stay close with these people at the super high levels of LDL as the mass hyper responders to see if they develop these. Now, anecdotally speaking, I’ve not seen a lot that substantiated it, but I can’t say that it’s entirely conclusive that anybody who’s ever become lean mass hyper responders of no concern at all. It’s just, it’s certainly not matching the pattern at a population level that I would definitely expect for people with LDL levels that high, that they compare to those who have familial hypercholesterolemia or FH as they tend to call it.

Carole Freeman:

Oh, the more we talk, the more questions pop into my head. Oh gosh. Well, yeah. Oh, gosh, where do we want to go next? Let’s see. Those of you watching too, like what questions do you have about cholesterol for Dave? Your personal journey or other cholesterol questions too.

Carole Freeman:

Let’s see. So just to clarify then. The three-ish studies that have come up, what did you find as far as like did it meet … So you said two of them met your criteria as far as like optimal levels of HDL? Say again what those showed.

Dave Feldman:

Yeah. So one is the Jefferson study which I believe it separated them out into three groupings. And that one did have relatively high HDL in the smallest tertile, which I want to say was 57 and above I think.

Carole Freeman:

Okay.

Dave Feldman:

I’d have to double check on the triglycerides, but I think it’s something under 100. And then what they did was they stratified them out into these … Really they stratified below 170 LDL and above 170 LDL, which is part of why I liked it, was because 170 is already just about 20 off from the guidelines at the top level. So right now, if you came to your doctor with an LDL of 190, odds are they might diagnose you on the spot as having FH, as having this genetic disease, because how else could you have an LDL that’s high?

Dave Feldman:

I’ve been doing my darndest to stay in contact with the NLA and to emphasize that no, there does seem to be … This is certainly central to my research, this other LDL level that seems to be diet induced. Spence coined the phrase, and I like it, diet induced hypercholesterolemia. And unfortunately it’s not well recognized yet. I wish it would be, because my concern is that I think that there’s a lot of people who are going on a low-carb diet. Their doctor says they have FH, and then makes decisions that are life-long therapy related based on the assumption that they have FH.

Dave Feldman:

And I think it’s not a safe assumption, because if it’s concerning to the doctor and patient, they’re going to take steps to change that medically. They should at least know that dietarily you can change that, getting back to the energy model. You can if you want to take on marginally more carbs and even still be low-carb, but have to take on at least enough that your body needs less reason to traffic the fatty acids. So anyway. That’s kind of the challenge.

Carole Freeman:

And so that study then did show that the over 170 had a slightly increased correlation with cardiovascular events?

Dave Feldman:

Yes. I almost … I’m able to, yeah, I guess I am able to screen share on here, right?

Carole Freeman:

Yeah.

Dave Feldman:

I kind of want to kind of just pull this up real quick because I think I know how I can get to it quickly. Because when I say that it’s an increase, I want to say it’s like less than a percent change.

Carole Freeman:

And that also … Last time I saw you speak, you were talking about all-cause mortality as well as being even more important, right? So a lot of people hyper focusing on cardiovascular. But if you die from something else with a lower number, is that, and your increase of dying of something else is much higher than your risk of dying of cardiovascular, which is more important to you.

Dave Feldman:

Yeah. You’re really teeing me up here because it’s absolutely the case, that I put enormous … Here’s a running joke I’m sure you’ve heard me say many variations of which is what’s one activity I can all but guarantee will reduce your chance of dying of cardiovascular disease by 99%. It’s rock climbing without safety equipment. Another one is playing in the traffic. Another one is skydiving without a parachute. All of these things, you could correctly say they will reduce your chance of dying of cardiovascular disease. Obviously it’s hyperbole. What I’m trying to illustrate is that no, it’s not good enough to look at a single endpoint. You need to be able to see all the endpoints. You need to be able to see and really the ultimate endpoint is all of them together as all-cause mortality.

Dave Feldman:

Now, there’s already existing studies long before I got into this that show that actually high LDL is associated with longevity, is associated with lower all-cause mortality. And there’s additional nuance and context to it. But, as you know, once I finally got a hold of a large data set which was NHANES, I didn’t even bother with cardiovascular disease. I shot straight to all-cause mortality. I was like I want to see how the triad performs in all-cause mortality.

Dave Feldman:

And in the NHANES data, if you extract out, if you exclude those people who are on statin therapy and so forth so you could help to confirm there’s no confounders, it’s actually quite impressive. High LDL, high HDL, and low triglycerides appears to be the best combination you can have of all of those markers, that again, even when comparing high LDL versus low LDL with the same amount of high triglyceride, or sorry, high HDL and low triglycerides, then actually the higher LDL performs better. And granted, this is associational data, can’t emphasize that enough. It’s not necessarily causal, but that’s also part of how the whole model works is.

Dave Feldman:

And Carole, this is kind of the part that I never seem to be good about getting across to people, which is that the existing science, existing literature thinks of these boats, these lipoproteins as the cause of a problem, that they’re the source of the issue.

Dave Feldman:

Now, I do think you can have high LDL cholesterol and high LDL particles and it be for a bad reason. And I think the typical tip-off is the opposite of this triad, is having the low HDL, the high triglycerides. This even has a name in literature called atherogenic dyslipidemia. But I believe that this profile that appears, this low HDL, this high triglycerides, it’s not because the HDL is not doing enough of its job and it’s its own independent cause, and the high triglycerides being these triglyceride rich lipoproteins are independently the cause therefore of atherosclerosis. I would argue, as an engineer, this is kind of like looking at a network and trying to pick out which packets are the worst because you think the packets are the problem. I would say isn’t it possible though that it’s actually that which results in the characters of those packets?

Dave Feldman:

Sorry. That was a little bit geeky because you guys probably know what packets are, but-

Carole Freeman:

There may be an engineer watching here somewhere, so.

Dave Feldman:

Yeah. My point is I think it’s the profile, it’s what the lipid patterns are telling you about the state of the individual, and then it’s like you’re wanting to shoot the messenger. Now, this isn’t to say that it isn’t possible that both are true, that there could be some form of the lipid hypothesis that is in fact true. It’s just that an easy way for us to test that was to go and look at healthy populations with the triad. It’s the easiest possible way to test it.

Dave Feldman:

And that’s why I wanted to get a hold of NHANES. That’s why I like to get a hold of these other data sets, especially if they have longitudinal data, because I posit it and I still do to this day that the triad is going to show generally much more positive results, especially at a population level. And that’s why we’re doing this study. We’ll see. We’ll see with even those people at the highest levels of LDL.

Carole Freeman:

Were you the one that came up with the ambulance analogy where is it, if you look at accidents on a freeway and you look at the number of ambulances responding to car accidents and are you going to blame the car accidents on the number of ambulances there or are you going to blame it on actual accidents?

Dave Feldman:

I’m sure because I think that analogy was used in other contexts so I doubt I’m the one who originated it, but it’s definitely a way for you to recognize cause and effect relationships. So whenever you read a headline on some paper that says such and such linked to such and such, usually it means it’s associated. And an association is important because a basic example that was provided that I still like to this day is they find that people with red cards get pulled over more often. Oh, that must mean if you get a red car, you’re going to get pulled over more often. Is it though? Or is it possible the people who are attracted to buying red cars are already the kinds of people who like to drive cars fast?

Dave Feldman:

Well, science is supposed to be adamant about reducing the likelihood of other things that could confound that. So before you can say A causes B, you have to rule out two other things. You have to rule out how much B can cause A, and you have to rule out other things that can cause both, a C or a D or an E or an F, et cetera. So I think, and I can be wrong, that a large amount of what is the problem of atherosclerosis, this buildup of plaque in the arteries, can result in higher LDL levels as in the case of some genetic abnormalities but also in the case of being highly inflamed. I think you can get this atherogenic dyslipidemic profile, and I think that that can move up your LDL levels, but it will probably do it alongside higher triglycerides and a lower HDL.

Dave Feldman:

Again, this is just my hypothesis, but that’s what I think the data is telling us because in every turn that I’ve been able to find, the triad is associating not just with lower cardiovascular disease in general but with greater longevity, which is like less dying overall. At low levels of LDL you have a higher association for example with cancer. That’s not to say that low LDL causes cancer. But we can’t necessarily rule it out either. That’s why we, again, we just need to follow these individuals more to actually get clinical data to know. Bottom line is, let’s stop testing sick populations to come up with our conclusions. We need to test more healthy populations. That’s for sure.

Carole Freeman:

I’m keeping an eye on time. I know you got to get out of here in about less than 10 minutes, so we’ll make sure we wrap this up for you. I know you said you’ve got … You’ve always got an experiment going on. So can you share us like what you’re personally working on right now?

Dave Feldman:

Yeah. No, no, I started Thursday, did I? Or Friday. No, sorry, I started Friday, and today is the third day. For five days I’m eating my “baseline” diet. There’s a diet that I decided on a while ago because it works for traveling and so forth, but it needed to be very fixed, so that when I had a washout period, I could always check what that blood work was at the end of the washout against other washout periods to know what differences there were. That diet is not going to sound super exciting. It’s just cheese, hard-boiled eggs, and all beef hot dogs. And the reason that was selected was because I can actually get it in probably any place around the United States, and because I travel a lot, or at least I used to before COVID, I knew I could get those products just about anywhere of that particular brand. So I could be confident that it was portable.

Dave Feldman:

Well, I have a multivitamin as well and I also supplement salt tablets. Now, I’m going to have that for five days, and I’m going to eat exactly the same meal at 9 a.m, 2 p.m, and 7 p.m, and that’s what the normal baseline diet is. But starting Wednesday, I will get my blood work in the morning to confirm against that baseline, and for the next five days I will be compressing it to where I’ll be eating at 4 p.m, 5:30 p.m, at 7 p.m.

Carole Freeman:

Oh, an intermittent fasting test.

Dave Feldman:

Exactly.

Carole Freeman:

Okay.

Dave Feldman:

And what I like about it is I’m going a step further. It’s kind of a big pain in the tuchus, but I’m also getting … Six times a day I’m getting both ketones and glucose and lipids. Once when I wake up, once at 7 a.m, once at 9 a.m, just before I eat, once at 2 p.m just before I eat, once at 7 p.m just before I eat, and then finally at 10 p.m before I go to sleep. And I suspect that’s going to yield some pretty good data. So far it already has, and that part I can’t share, but-

Carole Freeman:

Okay-

Dave Feldman:

… it’s pretty fascinating to see the patterns. But I’m interested to see what they look like when I start heading into the intermittent fasting phase. We’ll see.

Carole Freeman:

Okay. Cool. Very cool. And then the research that … the bigger scale research that you’re doing. Is that still in recruitment phase? Can people sign up for that or is that, where’s the stage of that?

Dave Feldman:

We haven’t started recruitment. We’re in the process of drafting the protocol that we then send to the IRB committee.

Carole Freeman:

Okay.

Dave Feldman:

We hope to be submitting that soon. Naturally my partners would get annoyed if I didn’t mention. You can help us out by going to citizensciencefoundation.org. And if you do, know that we’re actually a bonafide 501c3 public charity. So your donation could be tax exempt. Please, see your tax preparer, but typically it is. But yeah, Citizen Science. I mean, we raised the money on this from private individuals because I got tired of trying to go the public route. But I think it’s absolutely crazy to me that these lipidologists in this very field that I’m swimming in, aren’t absolutely over the moon trying to study the same exact thing. It’s just such a big deal in my opinion, but whatever.

Carole Freeman:

Yeah.

Dave Feldman:

Obviously I’m biased.

Carole Freeman:

Like Penny’s doc that’s like, “I don’t want to look at new science. We’ve already got this figured out. So why should I even try to look into it even more?” Well, just in wrapping this up, thank you so much Dave for being here. Just in wrapping this up, any closing thoughts, anything else you wanted to mention real quick before we wrap this up?

Dave Feldman:

Yeah. One, if you see just 1% of 1% of my research, you should at least know that your lipid levels are typically very malleable. I really do feel like if there’s any one thing people should take whether they believe in low-carb or not, it’s that they shouldn’t make life-long medical decisions from a single lipid test, especially if it seems to be something that changed due to diet. So that would be one thing. Two, please be sure you’re fully fasted when you get your blood tests. I know that that’s a change that they’ve made over the last five or 10 years or something like that. But if you are on a low-carb diet and you are powered by fat, you’re almost certainly going to have high triglycerides, even though we just talked about it, if you have a a test that’s not 14 to … or sorry, 12 to 14 hours water only fast. Try to fast for at least that amount of time.

Carole Freeman:

I didn’t even know that they’d made that change in lab recommendations until like I think it was just a few months ago I saw the protocol change. I was like, “What?” So apparently they’re telling people that you don’t have to be fasted for your test now. But it’s like, how? There’s so many things that you absolutely need to be fasted to interpret because we haven’t interpreted information of people who’ve just eaten. So all of a sudden we’re throwing that in the mix? I was just like, “What is this world coming to?” Yeah, nonsense.

Dave Feldman:

Well, and unfortunately a lot of doctors spring in on their patients. Like the patient comes for a visit and they’re like, “Oh, well while you’re here, we’ll just go and get your blood work.” Well, if you just had a big fatty meal three hours ago, you literally installed triglycerides into your bloodstream because that’s, again, just as I was talking about, those are the boats that are dropping it off for you. So my two cents is just be very cautious with that. Make sure you try to get a fasted test, just because it’s the number one thing that comes to our groups.

Carole Freeman:

And water water only for 12 hours, right?

Dave Feldman:

Yes. Try not to consume anything else if you can.

Carole Freeman:

Fasting also includes liquid calories that you drink. I remember looking at people’s labs for so much at Microsoft, and one dude came in and his triglycerides were super high and I was just like, “Oh my gosh, what’s going on? Are you fasted?” “Oh absolutely. Well, I just had coffee this morning.” And I was like, “Okay, so anything in that coffee?” “Oh yeah. I just had a white chocolate mocha at Starbucks, a venti, 400 grams of sugar in it.” I was like, “Okay, so just so you know, I know you didn’t eat any food, but that’s actually still this.”

Carole Freeman:

We’ve got one quick little question that popped in here last minute. Well, how do I get my doctor on board with this information? Any quick suggestions for that Dave?

Dave Feldman:

Don’t underestimate your own ability to bring new information to your doctor. There really are a lot of doctors who, I mean, most of them push back, but there are definitely a number of them that now follow this work, particularly if you’re not the first keto patient, you don’t know if you are, who’s brought this to their attention. Feel free to send them our way to Cholesterol Code. We put special emphasis on responding to doctors who are not low-carb doctors to, and again, in the politest way, try to bring them as much information and dialogue as possible to help answer their questions.

Carole Freeman:

Yeah. And all else fails, there’s new doctors that you can consult with that may be open to this information too. I know you got to run. Dave is so great at actually following very strict protocols. For all of you out there that are saying like, “I’m so bored with my keto foods,” like did you hear what he’s eating for five days? Hot dogs, cheese, and hard-boiled eggs for five days straight, so.

Dave Feldman:

Not for the first time.

Carole Freeman:

Stop complaining about being bored with your keto diet. Anyways. Dave, thank you so much for being here. It’s so great to see you. I miss seeing everybody in person, miss you so much, and thanks for sharing all this. Well, contact information is going to be, all the links that he’s mentioned and all that will be in the notes section here. So reach out to Dave and thanks everyone for watching.

 

Keto Chat Episode 135: Why Your Keto Diet Could Trigger Oxalate Detox

Interviewee Bio:

With over 30 years in the health and wellness field, Sally K. Norton is a consultant, writer, educator, and speaker who specializes in helping people overcome pain and fatigue by avoiding or limiting plant foods that contain a natural chemical called oxalate.

For over 30 years, she struggled with her own seemingly unanswerable health puzzle: “Why would a person who knows how to build health have so many health difficulties that she cannot overcome?” When she finally discovered the cause and the path out of misery, she committed to teaching and reaching out to others stuck in a similar frustrating situation.

Sally holds a nutrition degree from Cornell University and a Master’s of Public Health degree from the University of North Carolina at Chapel Hill. She worked in the field of Integrative Medicine at UNC Medical School as Project Manager of an NIH-Funded project for expanding medical education to include more awareness of holistic and alternative healing arts.

Sally has published popular articles in academic and popular journals and appeared In numerous interviews (including with Dr. Joseph Mercola) discussing the widespread but little-known harmful effects of oxalates in our food.

Sally has published a cookbook of low-oxalate recipes available on her website, sallyknorton.com. Her book explaining the dire health effects of eating too much oxalate and how to overcome them will be published in 2021.
Mini-CV (see full resume for more details): Bachelor of Science from Nutrition Science Cornell University, Ithaca NY. Master of Public Health from the University of North Carolina at Chapel Hill CV available upon request.

See video of my presentation to the Ancestral Health Society (9/2017), as well as links to my podcast appearances and interviews here: https://sallyknorton.com/interviews-talks/

A brief 3-minute video with clips of me at various speaking engagements is available here:
https://sallyknorton.com/celebrating-life/

SOCIAL MEDIA
Again, podcast interviews are mostly linked to the website: https://sallyknorton.com/interviews-talks/.
YouTube Playlists: https://bit.ly/3gssKg0

The Bottom line Health picked up my article, “Lost Seasonality and Overconsumption of Plants: Risking Oxalate Toxicity” with this item, published August 15, 2018: “The Toxin Hiding in Superfoods”
https://bottomlineinc.com/health/diet-nutrition/oxalate-toxin-in-superfoods

The journal What Doctors Don’t Tell You published an article in February 2020 about oxalates by Cate Montana that includes a lot of great information about oxalates: https://www.wddty.com/magazine/2020/february/how-i-beat-my-back-and-joint-pain.html

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Transcript:

Carole Freeman:

Hey, welcome everyone to another episode of Keto Chat. I’m your host, Carole Freeman, and today oh my gosh, we were chit-chatting, because I’m here with my good friend, Sally Norton, Sally K. Norton. And so, I’m excited.

Carole Freeman:

We’re going to get a little… We’ll try to be official here because we’re trying to catch up. We haven’t been able to see each other in a while. So, Sally K. Norton is the… I’m just going to say you’re like the current world’s expert in oxalate toxicity. I’m going to just crown you that designation right now. That’s in my mind. So, we’re going to talk all about oxalates, what they are, how they accumulate in our body, how some of the things we’ve been told are the most healthy for us, actually probably aren’t the most healthiest, and wherever else this journey takes us, but welcome, Sally.

Sally K. Norton:

Thank you, Carole. It’s fun to be with you, and whoever else is with us today.

Carole Freeman:

Yes. Excellent, excellent. Yeah. So, as you’re watching, go ahead and put some comments in there, and questions. I’ll chime back in a few times here to reset, and invite people to to ask questions of you, too. So Sally, I’ve done an interview with you in the past, but people may not have watched that one. So, let’s start with some background. How did you get into this oxalate territory? How did that path happen for you?

Sally K. Norton:

The Oxalate Outpost. It’s like, “Boy it’s lonely over here.”

Carole Freeman:

Yeah, the pioneering oxalate days.

Sally K. Norton:

Yeah. I have been in the nutrition sphere forever. I think it was probably 1977 when I decided to get into nutrition, as a kid. And in school, I went to Cornell for Nutrition, they talked about oxalate barely. I mean, I came away from school realizing oxalate captures calcium, and so does tea, and a lot of other things, oxalate is a kidney stone thing, and that’s about all I knew.

Sally K. Norton:

And then I went back later on, when I realized how profoundly it had affected my health. That’s what sucked me into going, “Oh, you’re a big ignoramus, Sally. You really don’t have an education in this, even though you’ve been in integrative medicine, and grant writing, and public health, and nutrition forever. You don’t know anything.”

Sally K. Norton:

And that, being in the field of nutrition, you think you know stuff, and so you’re kind of a jerk. Because you really… The more you know, oftentimes, the less you’re free to hear new information. And that’s really the problem we’re all in right now with oxalate. We have been so misinformed, and this topic has been so overlooked, that when you bring it up, people immediately have this negative reaction to it. Because it actually flies in the face of a lot of the garbage that we’re hearing online, and the general sphere of nutrition has been moving towards, “Oh, any amounts of any old plants, in huge piles is going to be great for you. It doesn’t matter if it’s a plant, and it’s not covered in canola oil, and trans fats, you’re cool.” This, “Have all you want, and the more you have, the better.”

Sally K. Norton:

It turns out, no, that is not true. And oxalate really taught me that very seriously. I was a big kind of vegetable over doer. I always had to have a nice big salad, plus three side dishes that were vegetables, plus something that was called the main dish. I’ve been way over doing the vegetables, and the plant foods for a long time, and I paid a terrible price for that. I mean, I started having problems as a kid, and never connected it to my love of home cooking, and rhubarb crisp from the backyard, and liking peanut butter, or anything like that.

Sally K. Norton:

And now I realize that wow, we’re not being careful curating what we eat. We have such kind of vague, and crude ideas about foods, that we don’t realize when we’re eating a toxin, and when we’re eating something that’s metabolically appropriate for us, in terms of something you eat chronically, over and over again.

Sally K. Norton:

Our daily staples, so many of them are now these foods that are full of these plant toxins, and oxalate is a plant toxin that has a lot more profound effects down at the cellular level, screwing up your immune system, and your mitochondria, and your connective tissues, and your vascular system, and then ultimately taking those of us who keep abusing them, we end up with some form of sets of autoimmune diseases, connective tissues falling apart, fibrotic problems, organs start being taken out, you can even have vision problems, and lots of arthritis, and joint problems and osteoporosis, and skin problems, digestive problems, neurological, and mood problems.

Sally K. Norton:

So, when you’re messing up your cells at the mitochondrial level, day in, and day out, you’re taking in a poison that plants produce for their own reasons, and for their own self defense, day in and day out, it starts to add up to something that can get quite serious.

Carole Freeman:

So, let’s do the record scratch part right here, because I know there’s going to be a ton of people watching this, that like, “Plants are toxic? Plants, toxins? How can plants be bad for us? We’re supposed to eat 47 servings of fruits and vegetables a day.” So, let’s start there with this basic concept, because this is really really hard for most people to wrap their brain around, that plants could ever be bad for us.

Sally K. Norton:

Yeah.

Carole Freeman:

We’re all being told right now, we’re evil, we’re trying to kill the planet if we don’t move towards a high plant based diet. So, let’s cover this topic a little bit, of the plant toxins.

Sally K. Norton:

Boy, I would love to spend the next hour talking about that issue, too.

Carole Freeman:

Yeah.

Sally K. Norton:

Yeah, so okay, so if you’re a plant, you’re planted in the ground. Now, some plants are clever enough to have thorns, but even the thorny rose still gets picked. And some of the self defensive plants are more obvious like that. So, I put one on my Facebook Live, because some herbalist had a beautiful picture of a leaf that had like two inch barbs on the leaves themselves.

Sally K. Norton:

Now, you don’t usually see things quite that sizable, and plants are often defending themselves from funguses, and tiny insects, and aphids, and small animals that are eating them, and they put in there, actually, plants designed the first arrow of warfare. Okay? So a lot of plants will produce these bundles in their cells, of basically sets of toothpicks with double pointed needles, that are very fine, in bundles like hundreds of them, in these [inaudible 00:07:22], and they’re really designed to be puncturing the cells of things that break up their cells. So, when you damage, or chew on a leaf, you can be releasing these needles, and they’re in the fluids of the plant.

Sally K. Norton:

And we see that in plants we know are toxic, and if you think about plants, when you go to the plant store, and you go buy plants, almost none of them are edible. Or if your kid ran outside, and ate the berries off your front bushes, would you be okay with that? No, because they might be yew berries that would kill them. Or even chocolate, you give chocolate to the dog, and the theobromine in the chocolate can kill your dog, depending on your dog, and the situation, whether you’re running to the vet and spending $200 to have

the stomach pumped, or what. If the dog got on the counter with your chocolate chip cookies, that could be expensive.

Sally K. Norton:

And that’s because plants are full of many thousands of chemicals, for their own purposes, and some of those purposes include self defense. So plants, the only reason they’re still here, and haven’t been herbivored into oblivion, is because they’re toxic. So, it limits how much a cow will eat, which ones the cows will eat, which ones the insects will eat. And it turns out that’s why Swiss chard, and spinach looks so lovely in the garden, because the insects don’t want to eat it, because it’s so loaded with oxalate. If you eat enough Swiss chard, and spinach as an insect, then eventually you’ll be dead, or you’ll figure out there’s got to be something better to eat.

Sally K. Norton:

And so, we have cultivated certain plants since we left the old hunting days, when we ran around and shot big animals, and then had giant parties, because we had a ton of meat because we were eating initially, wooly mammoth, and stuff like that. Did that for a long, long, long, long time, hundreds and hundreds of centuries, we were doing stuff like that. And then we got real clever, and started being able to collect seeds, and start to select for certain properties, and start training plants to produce more, and more of the parts that we figured out how to make them edible.

Sally K. Norton:

But to make them edible, we had to learn things like soaking, and fermentation, and grinding, and all kinds of things you have to do to make them safe to eat. A lot of which has been forgotten now, including by those of us with degrees in nutrition. Like I didn’t realize that if you don’t hyper cook your beans, you really should soak them for like three days, and then pressure cook them with high heat. If you don’t do that, you allow the lectin proteins to survive, and they start destroying your gut.

Sally K. Norton:

Gluten is an example of a lectin protein, very hard on the gut. And these proteins can move around, and attach to your nervous system, and do a lot of problems, and there’s a book about the lectin problem by Steven Gundry. But he’s missing the other piece of it. Well, hello, plants have many toxins, lectins are not the only ones.

Sally K. Norton:

And oxalate turns out to be kind of the ringleader. I mean, this is the real pimp of all the toxins. Oxalate pretty much helps make everybody be toxic. More than the other way around. But, the more different chemical toxicity techniques a plant can have, the better chance it has of getting you, and keeping you away. And trying to train you, “Hey, I am not here for your dining pleasure. I’m here to give you oxygen to breathe. Isn’t that good enough? Okay? That’s a service to all of you mammals, and animals. I’m here, in the plant kingdom, so you can breathe. You want more from me?”

Sally K. Norton:

I think it’s like the plant kingdom is over us. We have tried to make plants edible, so we have developed like the cabbage family, which is two thirds of your produce department. It comes from some old mustard plant, and we’ve turned that into a arugula, and watercress, and cabbage, and collards, and broccoli, and cauliflower, and you name. Like huge… Rutabaga, turnip, there’s just a bunch of them. They’re all the cabbage family. But that was human intervention, creating those foods, because if you go out in the woods, and you get like really wild plants, they’re not too tasty. They’re not too nutritious, and they’re going to give you stomachache, if not worse.

Carole Freeman:

And they’re like little tiny, tiny doses of them. If anybody’s ever gone hiking in the wild, and like the berries you can eat, they’re tiny little things, and you can’t pick a gallon of them.

Sally K. Norton:

Yeah, you’d spend days getting a bucket full.

Carole Freeman:

Yeah.

Sally K. Norton:

Yeah. And that’s the other thing. We’ve had the mono crop these plants that we’ve invented, in order to get enough of them in one place, in order to concentrate them into enough calories. We have a big brain that requires a lot of calories, and despite that, we still get fat. But we need calories, and plants, it’s very hard to extract the calories from plants, partially because these chemicals will interfere with the enzymes that let you digest food, which is one reason when you go on a plant based diet, it’s easy to lose weight, because you’re no longer extracting the proteins, and the calories that you need from the food, because the polyphenols and so on are interfering with your digestive enzymes.

Sally K. Norton:

It’s really a de-nurturing kind of process, where too many plants can kind of like suck nutrients out of you in a way, and that’s what oxalates are doing, too. They’re binding with chemicals, or with minerals rather, oxalic acid is a tiny little chemical that is a chelator, and chelating meaning it sticks to minerals, and minerals sticks to it, and that’s why oxalic acid, which is the base chemical of oxalate, which is just the oxalic acid, plus the mineral. Often it’s calcium oxalate, but the soluble form is a potassium oxalate, or a sodium oxalate.

Sally K. Norton:

And potassium oxalate is a cleaner, or oxalic acid is a cleaner, because it grabs minerals. So, you can take the rust stains out of your concrete deck with oxalic acid. You can bleach wood, and fabric with oxalic acid. You can strip the rust off an old radiator with oxalic acid. You can strip varnishes, and paints with it. It’s quite corrosive, because of this strong [inaudible 00:14:13] affiliation with positive charges.

Sally K. Norton:

So yeah, if you can clean your deck, and your radiator, imagine how it’s cleaning you out of your calcium, and your magnesium, and your iron, and so on. And that’s what it does over time. You end up with osteopenia, and osteoporosis, and problems with nutrient deficiency. It’s not just the minerals, too, we lose magnesium and calcium, and other nutritive minerals, from too much of this soluble form of oxalate, which is the form of it that gets into our bloodstream, and starts cleaning our clocks.

Sally K. Norton:

But, then it starts forming… When it takes the calcium out of your blood rather than just out of your food, that little chemical called calcium oxalate can start binding with other chemical oxalate molecules, and become crystals. And that’s a big problem, because you get these nano crystals, and micro crystals forming in your body, the ones, like you ate the crystals from the dieffenbachia plant, but they can start forming in your bones, and tendons, and tissues, and joints, and kidneys.

Sally K. Norton:

And eventually they start clumping together in some people, in their kidneys, and they get kidney stones. And those are aggregates of small crystals sticking to each other. And this happens in people who aren’t producing enough anti-clumping proteins, and citrates. Their bodies might be a little too acidic, and they might have a genetic tendency to be a little bit sluggish, in producing these many anti-clumping proteins.

Sally K. Norton:

So, some people, 12%, 15% of people are inherently vulnerable to oxalates becoming kidney stones. But the rest of us produce a lot of anti-clumping proteins, and we don’t get the kidney stones, even when we eat a lot of oxalate. So, that’s confusing to the researchers, or used to be for a while. They used to think, “Well, it doesn’t matter. Some people eat a lot of oxalate, and they don’t get stones, and other people eat a lot of oxalate, and they do get stones. So therefore, it can’t be the oxalate.”

Carole Freeman:

Yeah.

Sally K. Norton:

Well, it’s the oxalate interacting with whatever your genetic vulnerabilities are, your nutritional vulnerabilities, your metabolic vulnerabilities are. If you’re born, you know deficient in a B vitamin or something, that’s a type of vulnerability. And the combination of eating a lot of toxins, and being nutrient depleted, or under resourced with nutrients, sets up the kinds of vulnerabilities that you have, and sets up your genetic expression.

Sally K. Norton:

And one of the things that oxalate will do, is turn on the genes that can transform a muscle cell into a bone cell. So that’s how you get oxalate turning your arteries into calcified arteries, because you change the genetic expression, you turn the muscle cells around

those arteries into bone producing cells, and if too much of that’s going on, you get calcified.

Sally K. Norton:

And so, you can get calcifications all through the body. You can get fibromyalgia, calcified damaged muscle fibers. And interestingly enough, one of the things that turns that on, is the proteins your kidneys and other cells make when there’s too much oxalate in the body. So, you turn on the production of these anti-clumping proteins, which I do beautifully. I never will get kidney stones, because I have been eating oxalate like crazy, and peeing it out like crazy.

Sally K. Norton:

You can see it often in cloudy urine. When you’re really high in oxalate, you’ll get these cloudy urine episodes. And that’s often the crystals that you’re peeing out. Which everyone pees out crystals of oxalate at some point almost every day. Every day of your life, you’re peeing out millions of little bits of oxalate, but when you’re really doing it a lot, you can start seeing cloudy urine. So, anyway, this can go on, but I’m producing something called osteopontin, which is one of these anti-clumping molecules, that helps to turn on that calcification process, and helps to create fibromyalgia.

Carole Freeman:

Okay.

Sally K. Norton:

And so, in fibromyalgia, there’s an example of an autoimmune disease that goes along with migraines, or pain, or digestive problems, and fatigue. Well, also these crystals are getting set up in your tissues, which tells the immune system you’ve got particles and enemies hanging around that have got to go. So the immune system either tries to wall them off, tries to eat them, and that doesn’t work. And so, then these neutrophils expel their DNA, and so on, and the dead DNA wraps around the crystals, and it’s a way of hiding that crystal, so that the other tissues nearby don’t get damaged, and don’t get that genetic change.

Sally K. Norton:

It helps protect you from getting calcifications, but you end up getting these things called granulomas, and you get into these sarcoidoma kind of diseases. If you’re doing this, too much of this having to deal with crystals in your tissues, you’re asking your immune system to manage a mess. And these nanoparticles, and crystalline particles is pollution starting to contaminate your bones, or your joints, or your tendons, or wherever your particular tendencies are. And they get hung up in tissues that have inflammation already, or have infection. So, that might be someone’s jaw, or someone’s sinuses, or somebody’s whatever. And then those same places that have inflammation, start getting crystal deposits from oxalate, become really prone to chronic inflammation, and infection.

Sally K. Norton:

So there’s this kind of vicious cycle, where you’ve got an unhappy immune system that’s turned on all the time, and yet you’ve got chronic, either like yeast, or moles, or sinus, or candida, and various problems. It makes no sense, you never respond well to the treatments, because the fundamental problem is that your immune cells, and your fundamental resources of your nutrients, and your cell energy, is going to this defense, and trying to manage this mess.

Sally K. Norton:

And it’s starting to suck the life out of your cells, and you get a problem with low functioning mitochondria, that are prone to inflammation, because they’re so stressed, with too much toxicity, and this kind of depletion of the B vitamins, and the minerals. And minerals are so critical to mitochondria because they’re cofactors on enzymes that allow you to create your ATP, which is what’s running the show. If you don’t have ATP, you’re tired, and so is the cell, and then they’ve got inflammation, and disease.

Carole Freeman:

So, let’s cover… So people right now might be wondering, like, “Okay, so what are the common culprits of… Are all vegetables bad? Do we need to cut them all out? What are the most common offenders of the Oxalate Outpost, as we’re calling it?”

Sally K. Norton:

Yeah, out here in the outpost. Yeah. The feedbag that we’re sucking down, that’s delivering these lovelies, includes our favorite greens, spinach, Swiss chard, and beet greens, and also sorrel, which people don’t eat very much of. And then the Mesclun lettuce mixes the have a lot of little baby beet greens, and baby Swiss chard because they’re cute and red, and the baby spinaches.

Sally K. Norton:

So, the mixed salad greens have less oxalate, because it’s watered down with some romaine, and some nice peaceful greens, because the lettuces are low. Most of the other greens are low. The cabbage family vegetables are generally pretty low. The really bad ones, it’s like four of them. That’s it. Spinach, Swiss chard, beet greens, and sorrel.

Sally K. Norton:

And then of course, things that contain those, which are lots of things these days. I mean, spinach is put in everything. You can buy spinach pasta, spinach this, spinach that. Spinach chocolate bars is probably the latest innovation. I haven’t seen it yet.

Carole Freeman:

Double whammy.

Sally K. Norton:

But it’s everywhere. And in chocolate Of course, chocolate is full of toxins, including a lot of oxalate, and it’s pretty bioavailable oxalate. It only takes about an ounce and a half of chocolate to be causing enough oxalate to get into your bloodstream that you get a spike in

levels in the bloodstream, that helps promote this tendency for oxalate to get stuck in your tissues.

Sally K. Norton:

That’s a trigger of accumulation, just an ounce and a half of chocolate. And some people are thinking, “Oh.” And now on keto, people go to sugar free, and the darker the chocolate, the less diluted it is with sugar and milk, the more oxalate, because it’s in the cocoa, right? It’s not the butterfat, or the cocoa butter. It’s in the cocoa fraction. And so, the more you concentrate that, in like 100%, zero sugar keto chocolate, you’re just supercharging the oxalates.

Sally K. Norton:

And unfortunately, in keto world, the other big problem is the almond flour, and using nuts left and right, because they’re low carb. Of course, they’ve got a lot of omega sixes, they’ve got a lot of other toxins, they can go rancid. They can be full of aflatoxins. These are after effects, but inside them, they have arsenic, and heavy metals. And just again, because this is the seed of the plant. The plant is toxic, and where is it going to put its protective toxins, if it isn’t in the seed?

Sally K. Norton:

So the outside of a lot of seeds have oxalate crystals, and many other chemicals there, that help protect the seed, help keep it dormant, and then also help it in its transition from dormancy, into being a green something or other. Becoming a little sprout, a little baby tree, or baby whatever, that transition period requires a certain chemistry, and oxalate helps to do that. Oxalate holds on to that calcium for the seed, and then oxalate will break off, and you can use the calcium to run enzymes, to build a little sprout.

Sally K. Norton:

So, there’s a lot going on chemically. I mean, it’s a miracle that a tree nut or a seed can hang around for five or six years, and then suddenly it gets a nice rainy spring, and it knows, “This is my time to become the next tree.” And it’s doing it with so much cleverness, plants are brilliant. But we’re not so brilliant to make seeds our major thing on the plate, and make that a daily staple, and become a squirrel, instead of a human. That’s getting us into trouble.

Carole Freeman:

Another one that is, I think a pitfall, is the chia seeds, right? Like a lot of people think, “Oh, I’m going to make this chia seed pudding.” I was experimenting with that my early days, until I met you, and then I was like, “Nope, nope, I don’t need chia seeds anymore in my life. Those are cute plant things, but not food.”

Sally K. Norton:

Cute plant things, not food. Really, we’re not really good at eating seeds. I mean even birds who have the beaks, and so on, designed to kind of peel seeds, and get rid of some of the harder parts to digest, they have a special crop for grinding them. We have teeth, they have

the crop. But they also pee out, and poop out a lot of oxalate crystals, the birds do. And their metabolism may be even better at that than ours is, because they’ve been eating seeds for a long time. Our idea of seeds as human food is a pretty new concept. We don’t realize that, but we really were not hanging out in trees, waiting for the nuts to ripen before we ate dinner. No, we were not doing that.

Carole Freeman:

Well, and I even explain to my clients the absurdity of just how hard it is to even get one nut out in nature. If you had to go and pick a walnut, and clean the crap off the outside, and crack the shell, and pick that one nut out of there, and it tastes okay. It doesn’t taste amazing, like it’s roasted, and salted, and soaked in sugar we can buy at Costco in five gallon buckets. But, the amount of work it takes, you would maybe eat one or two, but you wouldn’t eat a handful even.

Sally K. Norton:

Yeah.

Carole Freeman:

You wouldn’t eat a pound of it, that’s already roasted. And so, usually when people do that experiment, they’re like, “Oh, you’re right, you’re right. We wouldn’t eat very many if we were having to harvest them ourselves.”

Sally K. Norton:

No, and it’s so much work. I mean, this is almost Christmas, like a week from now is Christmas, right? So, when I was a kid… My mom’s family was German by descent, and so there’s a thing that Santa does, he does the orange in the toe of the stocking, and then he throws in a handful of nuts that are… They’re the whole nut in the thing.

Sally K. Norton:

And Santa, for five kids in the house, could buy one two pound pack of whole nuts, and that was enough for the entire family, because when we’re all hanging around with our nutcracker, passing around the nut pick, and the nutcrackers, and going, “Hey, mom, can you get this nut out of here? I’ve just been working at this for 10 minutes, could you help me?” It’s a project to get the nuts out. And Brazil nuts, a lot of them went in the garbage because their shell is so hard, you need like a massive rock on a bigger rock. It just is impractical at the dining room table.

Carole Freeman:

Same thing at my grandparents’ house. I remember, they wouldn’t put them in the stocking. But I remember, you go over and the coffee table had the big bowl of non shelled nuts, and the nutcracker, and the pick, and all that, and was like, maybe for a fun little project as a little kid, because I’m bored by the adults talking, I would try to crack one open, and pick it out. But it was just like, “That wasn’t worth all that work.” And it didn’t even taste that good. So, they just would sit there.

Sally K. Norton:

Sit there and get stale. Yeah. And human beings, for a long time, even before we were really great hunters, if some other animal took down some animal for dinner, we would go scavenge the rest of it. That’s a lot easier than cracking open and nut, and you’ve got a fire going anyway to stay warm, so sticking the leftover leg of whatever poor animal that other animal was eating in the fire, just was really easy, and practical, satisfying, nutritious, and made a lot of sense. And so, our metabolism is more set up for that than hanging around, and waiting for the nuts to fall out of the tree, or figuring out how to process them. That’s technology that’s allowed this to happen, and technology is taking us into places that is too far afield from what’s really supporting long term health.

Carole Freeman:

Yeah, and we’ve gone through this period of, well, fat is bad, and salt is bad, and meat is going to kill us, we’ve been told all these wrong things. And so, the only thing left to eat were fruits and vegetables. And so, the American way is if some is good, more must be better. And so, then we’ve created all these ways of trying to choke down really highly concentrated forms of plants, aka oxalates, and plant tox toxins. So if some spinach is good, let’s make a smoothie of it, and take five pounds of spinach, and drink it down. Or, if almonds are better than white flour, let’s puree it, and put it into a flour, or almond butter, and then eat two cups of that a day.

Carole Freeman:

So, we’ve come into a time where people are starting to have a lot of these symptoms of this, and they don’t really know what it is. And I want to acknowledge what you said about how there are genetic differences. So, some people may be able to eat this stuff, and not really notice any differences, but other people are going to have a lot of symptoms.

Carole Freeman:

And I want to talk to you next about… So I’ve noticed this in my own clients, is some of them that likely are genetically predisposed to this, is that as they clean up their diet, as they They transition to keto, they’re actually eating much healthier foods, and in better process for their body. They start to have these flare ups, they have these oxalate symptoms, and I’ve referred them to you when I see kind of the picture.

Carole Freeman:

Basically, if they don’t feel better within a few weeks of doing keto, and they’re starting to have flare ups of pain, and things like that in different areas, I’ve recognized like, “Okay, I’m going to send them to Sally, because I think this is what’s going on.” And so for example, the ones that I’ve noticed is, maybe they’re having joint pain flare up, which typically gets better on keto, or they’re going to have just random body aches, and pains that they don’t really know what’s going on.

Carole Freeman:

Another one more recently was a lady would have… She tried to do keto on her own, had the same issue, and then when she started with me, the same thing, she had a pancreatic flare up. And so, her doctor told her it was, “The fat is bad for you, you need to stop that.”

But I was like, “I think this is just a sign of oxalate toxicity detox.” So, long explanation of, can you talk about how it is, why is it that we start to clean our diet up, we may get some of these detox symptoms of oxalates?

Sally K. Norton:

Yeah, so this is so important. This is the heart of the matter, and why I’m doing the work I’m doing. A, you made the point of, you could go toward a healthy diet that could be higher in oxy, because you’re doing more spinach, or more almond bread, or something like that. And it’s great you’re not doing Coca-Cola, and sugar drinks, and all those blue cupcakes, and Pop Tarts, and garbage that people literally try to live on, and become this big addictive problem.

Sally K. Norton:

So yeah, great. Move over to some whole foods. But sometimes you go to whole foods, and you go into high oxalate foods, and it can make you feel worse. But, even if you went to a low oxalate diet, if you’re suddenly now getting nourished, you’re getting the energy you need, and you’re not adding more oxalate, it doesn’t take long for your body to go, “Oh, this is my chance to clean house and get stuff out of here.”

Sally K. Norton:

And unfortunately, if you have grown up on high oxalate foods, which by the way includes potatoes, that’s potato chips, baked potatoes, potato soup, french fries. And now, I mean, for the last 10 or 20 years, people have been going out to eat at lunchtime, or dinner, many days of the week, and your side dish of choice is either fries, or chips, or baked. We’re eating potatoes way a lot.

Sally K. Norton:

It really is… We invented them like in the 1950s with the commercial potato chips, and the commercial french fries, and now we think they’re food, just like the idea that pizza is food. We’ve been doing it long enough people actually think that’s food. That was meant to be a treat, or dessert, or a snack between meals, not a meal. Because of course you combine high fat, and white flour, and that’s not a good idea.

Sally K. Norton:

So yeah, the problem is, if you’ve been around on this planet eating peanut butter, potatoes, any chocolate, basic stuff, chances are, you’ve got this oxalate accumulation somewhere. It could be your teeth, your sinuses, your bones, your joints, your thyroid gland. Something like 85% of us have oxalate crystals in our thyroid gland by the time we’re 50 years old. That means everybody, right? We’re all filling up with oxalate.

Sally K. Norton:

when you stop eating this stuff, if you got enough nutrition, and energy, and B vitamins, your body will start trying to remove that. Well that is also an immune system event. So, the immune system has to come along, and try to get this stuff out of there, and then it’s

got to break it down from, I mentioned before that the body will try to sort of mask it, and hide it. It wraps it up and dead DNA, and dead cells, and just makes it quiescent, and quiet.

Sally K. Norton:

So you could have no symptoms whatsoever, and be filling up with oxalate crystals. We see this in the genetic form of this disease. Okay, so someone can have an oxalate production problem in their liver, where they’re producing way too much from a genetic defect. Very rare disease, very rare. But, you probably could have subtle versions of this. And we know if you’re deficient in B1, and B6, especially B6, the chances of you over producing oxalate, because it’s also a metabolic byproduct, which is why you’re always going to pee out oxalates.

Sally K. Norton:

But it also tells us the body knows something about oxalate, and how to deal with it. Except, in today’s world, where we’re eating it every meal, that’s just not done. We didn’t used to be able to have a high oxalate food year round. We used to have fruits, and nuts at a certain time of year. Literally, nuts was December, maybe to Easter, and that was the end of it, and you at least had summer off from the nuts, and so on.

Sally K. Norton:

But now, Costco is making sure you get bucket loads of whatever you want, anytime of year. I noticed in a store, yesterday was it? Or the day before? Raspberries, and strawberries in December. Okay. Human beings didn’t do that. As you mentioned, you’re out in the woods, you get a few little berries you can fit in the palm of your hand, because it happened to be June. Not now.

Sally K. Norton:

So, there’s all these things, we’ve been living now for 30 years in a world with interstate highways, refrigerated trucks, year round produce, 24 hour grocery stores, we’ve been eating too much peanut butter and potatoes, plus these healthy things. So, your body is loaded with it. And now, when you change your diet, and you stop eating… Let’s say, you really want to do a low toxicity diet, and low oxalate diet, you stop the spinach smoothies, you switch from keto bread, to maybe cheese, or meat or something more human oriented food, and then your body goes, “Okay, okay.”

Sally K. Norton:

The body is reading what’s coming in your stomach, what’s coming in your bloodstream. And it’ll say, “Oh, okay, we’re going to clean out the kidneys.” The kidneys will clean out, sometimes people, it takes a while. But then they’ll get arthritis, or something like that, or they start getting headaches on and off, or on and off sleep problems, or restless legs, or tooth pain, all kinds of stuff, because oxalate, of course can affect your digestion, your basic metabolic health, but it can get into any tissue.

Sally K. Norton:

And when the immune system has to come into that tissue, and drill out these crystals, it’s like getting surgery, but no anesthetic. So, it’s got to get in there, and do micro surgeries in your teeth, or jaw, or sinuses, or shoulder, or hips, or tendons, or spine, and that’s not going to be pleasant, because it’s turning on inflammation, and it’s the body’s response to the toxicity, and the work that it has to do to get it out that turns on the symptoms, because that inflammation has these collateral effects, that harms nerves, and connective tissue, and causes some fibrotic recovery.

Sally K. Norton:

And if you’re healthy, and you’re not adding more of these toxins, eventually the body will clean up the scar tissue, and clean up the fibroids, and repair the bones if you know what you’re doing. but the process of getting there can be very unpleasant, and quite toxic, because you’ve got to take them from the big crystals that are now in your shoulder joint, down into ions, which are the really toxic form, and run that back through your bloodstream, and inflame your bloodstream in the process, and get it back out through your kidneys, which is stressing your kidneys.

Sally K. Norton:

So, you can actually create kidney stones when your body starts flushing out the oxalates. You stop eating oxalate, and then you get your kidney stones. I’ve seen that in a few people, because now the body in a somewhat disorganized way sometimes, is sort of puking out oxalates, at a level that it’s toxic, or more toxic than your two spinach smoothies every day. It might be like the equivalent of three or four. And actually, if you were to eat like six or seven spinach smoothies, you literally could kill yourself.

Carole Freeman:

Wow. Wow.

Sally K. Norton:

Yeah, it is possible to die from oxalate poisoning.

Carole Freeman:

Well, just like we recognize that in dogs, if they eat too much chocolate, they could die. But we don’t recognize the fact that that same compound is toxic to humans, we’re just a little bit better at detoxing it. So we could also die from excessive chocolate ingestion as well. It would take quite a bit, but the same thing, these other plant toxins truly are toxic.

Sally K. Norton:

Yeah. I was really fascinated, I ran into articles in the literature, because I’m constantly doing research, really since I discovered this for myself in 2013. I had my head in the medical literature ever since, and I’ve been reading thousands of articles, and I’d spent a long time reading about lectins, and other plant toxins just in general, just to kind of understand the whole landscape of this.

Sally K. Norton:

I was surprised to see that chocolate, a pregnant woman eating chocolate, can create diseases for her unborn babies, including future testicular cancer in the boys, and malformed penises, and stuff, which is very common now, actually to have the urethra in the penis not be quite right, and little infants need surgery. And this comes from poisons like the plastics, in all the food, and the plastics in general, and things like theobromine in chocolate, is quite toxic to fetuses, and I don’t think pregnant women get warned, “Hey, you should not be picking out on chocolate while you’re pregnant.”

Carole Freeman:

Yeah, no sushi, or brie cheese, but go ahead and have all the Reese’s Peanut Butter Cups you want, huh?

Sally K. Norton:

Yeah, yeah. Truly our nutrition advice is not good. We have a lot to get it together. Unfortunately, there’s some very strong certainty about, “Oh vegetables are great for you.” In every department, whether it’s mainstream medicine, whether it’s the DASH diet, or the keto diet, or the whatever. Everybody thinks you need to do more and more vegetables, and if you don’t distinguish the difference between romaine lettuce and spinach, that’s a very dangerous piece of advice. It’s just too crude, and not really… We just haven’t wanted to notice the plant toxins. It just hasn’t been cool in our minds and culture, so both at the science level, and then the interpretation level, and then now in the cultural level, there’s been a long pressure to promote plants as noble, and moral for 200 years. There’s been a long, long history of this.

Carole Freeman:

Oh, yeah, it goes back at least… What’s that movie about Dr. Kellogg, and his sanitarium that he started? I think it’s Matthew Broderick that’s in that one, have you seen that?

Sally K. Norton:

I have not seen that movie, but I have read all this stuff from way before the Kellogg era, and he picked it up from Ellen White, and her husband who founded the Seventh Day Adventist church. He was a Seventh Day Adventist, and as a 12 year old boy, he was helping to lay the type for the books they were writing.

Sally K. Norton:

And Ellen White was very productive as a writer, she wrote, and wrote, and wrote, and wrote and she taught people all kinds of fabulously weird ideas. And he learned as a 12 year old that it’s very nasty to touch your genitals, or anyone else’s, and that you will go to hell if you do that. So, any self pleasuring, or self touching will send you to hell.

Sally K. Norton:

So, he remained celibate from what I understand and and did not have sex with his wife. They adopted all their children, so that they could all go to heaven. And he spawned off the… He had this… The sanitarium, and the Kellogg sanitarium in Battle Creek, Michigan, the Battle Creek Sanitarium became the Kellogg’s Company that is brother spun off the

cornflakes. They were developing cornflakes, and these high bran, or actually it was initially very refined grains, because they felt like the infirm people, sick people had to have simple carbs, and simple, highly processed things. So, they developed the cornflakes, which were really popular with the guests at the sanitarium, and became this big product.

Sally K. Norton:

But the sanitarium grew and grew. He attracted presidents, and the fancy people. And so, he was a very fancy [inaudible 00:42:07], he made a lot of money. And he used students, nursing students, and medical students who could come work there for free, because they were interns. So he could make it a very profitable thing, and with that profit, he formed a nursing school, a medical school, and all these spin off things. And one of his nursing students founded the American Dietetics Association. She was also a very rabid, religious, Seventh Day Adventist vegetarian, and that was who founded the American Dietetics Association. So, [inaudible 00:42:37] the birth of nutrition, it came out of this moneyed, affluent elites telling everybody that you should eat garbage food, and that’s better for you, because it’ll keep you from going to hell.

Carole Freeman:

Yeah. Well, it hasn’t worked yet. So…

Sally K. Norton:

Yeah, but see, the moral tinge on this is-

Carole Freeman:

Yeah.

Sally K. Norton:

The religious moral tinge, that somehow eating meat gives you carnal desires, and if you eat meat, you’ll masturbate, and then you’ll go to hell.

Carole Freeman:

Yeah.

Sally K. Norton:

So you better not eat meat, was kind of the underlying theory of that. And we’re doing the modern version of that, if you eat meat, you’ll send the planet to hell, and we’ll all burn up.

Carole Freeman:

Yeah, yep.

Sally K. Norton:

But that’s not true.

Carole Freeman:

I know. Yeah. We’ve turned the ship around in some ways about nutrition, but then it’s like, “No, no, it’s going too far the wrong way, too.” We’ve got to keep doing these course corrections, and we’ve got a lot of work to do about… It’s so confusing, right? People are so confused about like, “Okay, so if too many plants are bad, what’s the option?”

Carole Freeman:

So a little bit, it’s for some people, and I want to talk now about, because we might have made some people a little bit worried, like, “Okay, wait, so if I clean up my diet, I might have these horrible aches and pains in my body? Should I just keep eating the Pop Tarts?” Is there hope for those people to be able to detox, and get to the other side, and feel better?

Sally K. Norton:

Well, hopefully most people, when they get their nutrition straight, and they are getting the B vitamins, and they’re not eating a lot of high oxalate foods, and plant toxins, and kind of overdoing the all the bran, and all that stuff, their bodies pretty much… Then that’s when their arthritis finally clears up, or their weird eye problem, or their… They always thought they were prone to something or other, and that usually clears up.

Sally K. Norton:

So I think most people have a pretty easy time of it, where suddenly their carpal tunnel, or their aches and pains, or their somewhat restless nights, mostly get better, but there’ll still be a background process of your body cleaning out, and when it’s doing that work, it will add inflammation, and you’ll get little flare ups of minor hip pain, or even a couple… It’s kind of like gout. So people with gout, and gout is… There’s an oxalate gout. I mean, people think of gout as uric acid, but gout is this gouty arthritis that usually is periodic, and it lasts a few weeks, and then your immune system turns off.

Sally K. Norton:

And there’s like five versions of gout, but everyone’s kind of forgotten about oxalate gout, and the other non uric acid gouts. But again, what happens there, is somebody will get these periodic flare ups for two weeks, where some body part is so dysfunctionally painful and swollen, they can barely use it, and they need a crutch or something, and then it resolves on its own, because the immune system is trying to clean out something, and then it realizes, “This isn’t working.”

Sally K. Norton:

And then it sends out these enzymes, it breaks up the cytokines, and the things that have been promoting this inflammation, it just shuts it all down, and then you’re fine again. So, you get this with oxalates, where it’ll turn on on a crystal, and try for a while, and then it might stop. But, some of us who really grew up on not only the peanut butter, but also the rhubarb, rhubarb is one of these really high oxalate foods, worse than spinach. We’re pretty toxic with it, and we get into this oxalate clearing illness, and it’s about a 10 year or something process, for your body to remove all these oxalates.

Sally K. Norton:

So, you can go through several difficult years, but hopefully most people don’t. But the fact that we are suffering so badly, those of us who are very sick with oxalate, we should be a warning to you guys, “Hey, don’t become us.” Why would you wait until the symptoms break through? All disease is silent until it’s not, including the genetic form of this disease.

Sally K. Norton:

A lot of people have no symptoms for a very long time, and then all of a sudden, they give birth, or have some little trauma, some infection, something that turns the immune system on, because of stress, or mast cell activation, or something. Because this is a mast cell disease, you get high histamine problems, you get all this kind of stuff. It’s all immune activating, the oxalate, ultimately what it’s doing is it’s screwing up your repair processes, and screwing up your immune system, until you end up with all that crazy stuff that leads pretty much anywhere it can go, in some of us. You don’t want to wait until you have symptoms to worry about oxalate. We should consider high oxalate foods as fundamentally inedible. They certainly shouldn’t be a daily food.

Carole Freeman:

Oh, man. So, I just had, as you’re talking about that, too, and I’m like, “Oh my gosh, is this symptom?” I don’t think I asked you about this before, but on my initial six months of keto, I would notice that about every 10 pounds, I would have like some kind of a skin eruption, and that’s what I’ve seen, is that people kind of have their… Their body has their go to detox area. Some people end up with…

Sally K. Norton:

Diarrhea, or something.

Carole Freeman:

Yeah, diarrhea, or some people have kidney pain, or maybe they’ll have, like you said, the joint pain, or something like that, or headache or something. For me, it was skin eruptions, so I’d have large, not quite cystic acne, but large, almost a boil like thing on my face coming out, on my inner thighs, like on my back as well, about every 10 pounds. And now I’m like, “Huh, was that what that was? My body was releasing, like, ‘Here’s a little pocket of stuff we’re trying to get out of the body.'”

Sally K. Norton:

Yes.

Carole Freeman:

“Here you go, get rid of it.”

Sally K. Norton:

No doubt. And we see this a lot with the oxalate, and you’re exactly right. I mean, there is these sort of types. Some people will dump a lot of oxalate through their skin, and they’ll get these boils, these little boils everywhere. And some people literally, each one is pushing out a crystal, and they can tell it’s crystals coming out.

Sally K. Norton:

Other people, it’s their eyes, and their eyes are watering like crazy, which is a way of removing this particulate pollution that’s in the eye area, with the tears, mucus, high mucus will do that. The crystalline urine, or the kidney problems, or the diarrhea, those are different departments in the body that’s getting really good, an area where the body is good at pushing it out. The skin eruptions is really quite brilliant, because then you don’t have to dissolve the crystals down, you can just push them out, which is saving your kidneys from having to pee them out. So that’s pretty cool.

Carole Freeman:

Yeah.

Sally K. Norton:

Some of us just get like a heat rash early on, when we first start this diet.

Carole Freeman:

Oh, yeah, the keto rash, this mysterious keto rash that flares up, yeah.

Sally K. Norton:

That is very much an oxalate rash. That’s the immune system going, “Whoa, found something here.” Something’s triggering, turning on immune system. And we see that very, very common when you first start a low oxalate diet, if you’ve been eating these high oxalate foods, and this, immune activation is one reason we want you to go slow, not go from two spinach smoothies to none.

Sally K. Norton:

You want to kind of find a way to come down, down to half a spinach smoothie pretty quickly, but stick around with that for a few weeks, and then work your way down. Because if you go all the way really low, if you figure out… The cool part is there’s enough oxalate hanging around, you can accidentally keep some around for a while. Which is helpful, because it’s really when you get super low with it, where the body goes, “Oh, okay, time to clean house.” And we don’t want to clean house.

Sally K. Norton:

So, there’s this place, where a lot of people are in what I call the danger zone, eating too much nuts, and spinach, and you’ve got to get out of the danger zone, and come down into some more moderate zone, but not all the way down to the clearing area, where you’re eating so little, the body starts clearing, we don’t want to start that right away. You want to build up your nutritional well being, your metabolic well being, and get that in place. And eventually, you can go down to a really low oxalate diet, like a carnivore diet, is the ultimate zero carb diet.

Sally K. Norton:

But a lot of us who are sick with oxalate, we have the enzymes that produce glucose are damaged, because the minerals aren’t there, because the oxalate are holding them. So, a lot

of us, we can only do really super low carb for like four or five days, and then we need a little perk up, we need some carbs. And you can get your metabolic flexibility going, you can wear out your muscle glycogen, and liver glycogen, that’s a good thing to do.

Sally K. Norton:

But, having some carbs, and getting a little shot of insulin can be therapeutic, and helpful. In fact, the research suggests that staying ultra zero low sugar is bad for oxalates. It increases your internal production of oxalates. So, keto is great, but you don’t need to make a religion out of it, and do it 24 seven. If you need a pile of rice on Fridays, once a week, that’s fine, you’re listening to your body, that’s probably going to help you sleep better, and so on.

Sally K. Norton:

So, it’s important that you know about things like oxalate, and know a little bit about these mechanisms behind the scenes, so that you can interpret what’s going on with your own body, and make some smart decisions. The tricky thing with the carb control is that we’re so addicted to carbs. There’s some people in the early days, the least little bit of carbs, and they’re off to the races again. They’re like [inaudible 00:51:56] for sugar all over again, and it’s a real battle.

Sally K. Norton:

It took me three years to get off sugar when I first tried to do it, about 18, 20 years ago, because I had been a vegetarian, and I was so… Vegetarian diet has to fundamentally be a high carb diet. I mean, it’s very hard to eat a low carb, vegetarian diet. And so, a lot of us who tried that, ended up being sugar nightmares, and sugar addicted badly.

Sally K. Norton:

But that came out of the low fat advice. I mean, you were saying, we went through this era. We went through the 35 years of being told we should be low fat, and that’s promoted all this metabolic derangement. That’s why we have all these problems with sugar addiction, and obesity, and diabetes, because that’s not quite right. And if you need to do a low fat diet, it almost has to be a vegetarian, low fat diet. If you need to do a meat based diet, it needs to be a high fat diet. You can’t do a low… I mean, there lots of issues with nutrition, again, so it’s all confusing, but I think we’re on the way to figuring this thing out. Honestly, I think we’re on the edge of having a much better breakthrough, if we can get over the profiteering that’s going on behind the scenes, that’s promoting the wrong information.

Carole Freeman:

Yeah, there’s a lot of political stuff there, for sure. So, yeah. Let’s see. So, gosh, we’ve covered so much great stuff. I would just love to kind of wrap this up, and just kind of talking about the evolution of your diet, with going from low oxalates, low carb, I know, and then you’re currently primarily meat based. Is that still true, or?

Sally K. Norton:

Yeah, it is still true. It is still true. I think I cooked… Today I threw some pork roast in the oven last night, so I think I now have about eight pounds of cooked pork. I also have a rib roast waiting for me, and I have one on order for next week. Yeah, so I eat a very meat heavy diet. True enough. I really think it’s helping me rebuild my spine, my spine has been completely messed up from the oxalates, and it’s really bringing me back. So, I’m quite pro meat.

Carole Freeman:

And we didn’t cover this, but animal based things are virtually oxalate free?

Sally K. Norton:

Yeah, yeah, just consider them zero. Consider them zero, because the little bit of traces they have don’t really matter.

Carole Freeman:

Yeah.

Sally K. Norton:

Yeah, so that’s a really interesting thing. The folks who are doing this all meat diet, which is just considered bizarre by mainstream people, are the ones who are discovering this oxalate thing, because a subset of them, I wish we knew the numbers, like is it 20%? Is it 15%? Some subset of them get into big trouble pretty fast with oxalate clearing, and they’ve got crystals popping out, and they’ve got weird symptoms, and they’re having panic attacks, and just all kinds of stuff.

Sally K. Norton:

Because behind there, there was this oxalate toxicity disease, that you don’t notice until you get off the stuff. So, a really good test of whether you have an oxalate problem for real, is to go on a low oxalate diet, or get there in a smart way, don’t just jump off what I call the high diving board.

Sally K. Norton:

Instead of jumping off the high diving board of spinach smoothies, keto bread, and dark chocolate every day, start cutting those out, and then gradually learn how to get on the low diving board, and jump into the pool of low oxalates from a little elevation. That’s the time to go down. So, but yeah, the carnivore world has done a great job of going, “Hmm, oxalates are a thing.” So, it’s a big conversation there, in the carnivore world.

Carole Freeman:

Yeah, because it’s… I know the people that follow that way of eating, they just feel better. And most of them have tried low carb, and or keto, as an interim, and they’ve gotten carnivore curious, and done a trail of it, and most of the ones I’ve heard speak, say that, “I just felt better, so I went back to my low carb-ish ways after my carnivore trial, and I didn’t feel as good. So, I just keep doing what feels best for me.” It may not be right for everybody. And as you pointed out, it isn’t something you probably should just start from vegetarian

green smoothies and go 100% carnivore, that may not work very well. But, for some people, they find it does help them feel the best possible.

Sally K. Norton:

And see, what I think the biggest innovation that I noticed is that once you go low oxalate, your body will tell you what you can eat, what you can’t eat. Your ability to know what’s working for you is much better. Beforehand, when you’re eating a high oxalate diet, you cannot tell that these things are harming you, and you cannot tell that you would do better without them, until you’re really totally without them, in a good, thorough kind of obvious way where you’re conscious of what’s going on, and you’ll be able to see better, and observe.

Sally K. Norton:

I mean, it’s so confusing your body to be so toxic, that it really can’t tell you in the short run, “Hey, that sweet potato just really hurt my stomach.” It just can’t even tell you. But once you go carnivore, and you’ve cleaned out the plant toxins in general, and you start adding them back in, you will get some messages that will be hard to ignore.

Sally K. Norton:

So, I mean, to me, that’s the best use of that carnivore diet, is to use it as an elimination diet, and get there gradually, do it consciously, because you’re changing your microbiome over, you’re changing so much when you do that. It’s not good to traumatize your body, and jump from one idea to the next. You need to have a plan to do things consciously, and gradually, when you make these dietary changes. Otherwise, you’re just going to hurt yourself more. So, take a deep breath and learn more and before you jump.

Carole Freeman:

All right. Well, I think it’s almost time to wrap this up. Any last parting words? Anything else you were hoping I would ask you about this time, Sally?

Sally K. Norton:

You and I could chat forever about all kinds of things. I think, unfortunately, the nutrition world has gotten very politicized, and people are very hung up on their school, or belonging to a club, and I’m not a club person. I don’t belong to any group, any label. I’ve just been studying oxalate like crazy, and trying to let people know this is a possibility. If you have health issues, and you can’t figure it out, your doctor says you’re crazy, the things that you go try to do to help you maybe help for a week or two, and then you realize it’s not working.

Sally K. Norton:

So, you’ve been to every chiropractor, and every acupuncturist, and every this and that, and it’s not really working for you, then you need to be studying what’s on my website. Really, if it’s nothing’s working, oxalate, the chances are that it’s oxalates I would put a 90% guarantee on that. So, come to my website, learn about oxalates. There’s free stuff there.

I’ve got free information on Facebook, and Instagram, and I’ve got an inexpensive PDF book that teaches you about the low oxalate diet, and gives you, I don’t know 180 recipes.

Sally K. Norton:

It has mostly low carb, there’s like two or three rice recipes, and the rest is all low carb. Eggs are relegated to a small chapter, and it’s very allergy aware, it’s gluten free. It’s all the stuff, so if you feel like you have to thread this needle, you can’t eat gluten, you can’t eat beans, you can’t eat this, you can’t eat that, everything’s bothering you, my cookbook can help you with that, because I’m like that, basically, so I figured out I cook around all that mess.

Carole Freeman:

Is there a book in the works, Sally?

Sally K. Norton:

There is. I’m working on my manuscript. I’m hoping to get it into Random House in early January, and then we’ll be fluffing it up, and doing all the polishing, and deciding for sure what images, and getting it all set up. So, by this time next year, there will definitely be a book out there.

Carole Freeman:

Yay.

Sally K. Norton:

And I’m really hoping that everybody will make a point of getting a couple of them, and sharing the message, because this needs a bigger… It needs all of us to kind of share this information, because a lot of us are unnecessarily hurting our children, giving baby smoothies, and keto bread, and very popular people online are showing how you could make gluten free almond whatever, and give it to your one year old child. I think that’s [crosstalk 01:00:47].

Carole Freeman:

Yeah, yeah. Excellent. All right. Well visit-

Sally K. Norton:

Thank you, Carole, it’s so fun to be with you.

Carole Freeman:

You too. I’ll put links to Sally’s website below, and her PDF, and cookbook, we’ll put that all in the notes below. So, thank you all for watching. Just to recap, oh my gosh, I can’t even recap everything we’ve talked about. Plant toxins, why more plants are not necessarily better, and probably worse for your health than you think. All the myriad conditions that could be related, or signs of oxalate toxicity.

Carole Freeman:

We talked about how, when you clean up your diet, you may experience worse symptoms, and some of the most common foods on keto, and otherwise, that are really high in oxalates, less of those initially is probably better for you, and then transitioning towards those, and how to know… You gave a very short synopsis of how to know if you may be suffering from oxalate toxicity.

Carole Freeman:

If you’ve got all these random symptoms, you’ve seen every practitioner you can see, and they can’t figure out what’s going on, it may be oxalate toxicity. So, thank you again for being here, Sally. It’s always a pleasure. Thanks, everyone for watching. If you’ve enjoyed this, give us a thumbs up. Subscribe, hit the bell for all the notifications, for future episodes, and thanks for watching everyone. Bye.

Sally K. Norton:

Bye.

Keto Chat Episode 132: 4 Steps to Overcome Sugar Addiction with Bitten Jonsson

Interviewee Bio :

Biography and Resume

Bitten (Britt-Mari) Jonsson
DOB November 28, 1952
Address below.
+ 46 70-643 73 73 Cell
bitten.jonsson@bittensaddiction.com
www.bittensaddiction.com
Facebook: BittensWay
Twitter: Bittenjonsson
LinkedIn: Bitten Jonsson

Bitten Jonsson, R.N., Addiction Specialist, SUGAR/ADDIS-Certified, is a forerunner in this field in Sweden, an international lecturer, and has frequently been seen on TV and Radio in Sweden, Norway, and Finland. Bitten is trained in the USA and has developed a special treatment method, involving Integrated Functional Medicine and Orthomolecular Medicine together with American Addiction Medicine, Twelve-step based programs, and Traditional Medicine. Bitten has written 3 books about sugar addiction: “Sockerbomben I din hjärna ” (The Sugar bomb in your brain ) her first book, was published in 2004 and revised in 2010 and 2016. The Sugar-Free Cookbook, published in 2006, and updated in 2018. The books have all been very well received and one version is also published in Norway, Denmark, Finland, and Germany. She has also further developed SUGAR , the evaluation instrument for sugar/food addiction. Bitten Jonsson was a member of the National Association of Addiction Treatment Providers (NAATP) in the USA and NAADAC, USA ( www.naadac.org) for many years, and has been on the Board of Directors of the Food Addiction Institute (FAI), USA www.foodaddictioninstitute.org, since 2010.

2007 – to date
CEO at Bittens Addiction Corp. Developing new methods for teaching, lecturing, and coaching professionals, tutoring, and treating addiction, especially sugar/flour/food addiction.

The hands-on developer of policies and procedures for sugar addiction treatment and professional training.

Board of Director role, in charge of working to influence WHO’s group for developing ICD 10 (11), (International Classification of Diseases) to include food addiction as a diagnosis, Bitten is working alongside a team in the USA, within the FAI, that works on achieving the same for DSM5.

Developed SUGAR®, a mapping instrument based on ADDIS to evaluate if a client has a pathological use of sugar/flour/food, together with Dahl & Dahl. Reference: Börje Dahl Ph + 46 70 600 84 96 , www.addis.se

On the expert panel for Diet Doctor www.dietdoctor.com answering questions about sugar addiction since 2013.
Reference: Dr Andreas Eenfeldt ph. +46 70 973 39 50

A faculty member of INFACT, Iceland. Reference: Esther Helga Gudmundsdottir, Ph + 354 699 2676

Developing guidelines for sugar addiction treatment, teaching a one-year training for professionals since 2012. Reference: Dr. Jen Unwin.

Managing several groups on Facebook, two support groups for sugar addicts, and two for professionals in order to spread the message.

Started a program for further training for sugar addiction professionals. 2019

2008 – 2010 Responsible for developing and teaching a new curriculum for Addiction
Counsellors at Forsa College, Hudiksvall, Consulting.
Reference; Annica Strandberg-Schmidt ph +46 73 052 70 67

2006-2007 Participating in a Research program “ Neurological Background of Eating Disorders with special regards to Sugar Addiction. Jarmila Hallman (prof. of Psychiatry) and Lars Oreland (prof. of Pharmacology at Uppsala University, in cooperation with Charlotte Erlanson-Albertsson (prof.in Physiol. Chem.) University of Lund, Sweden.
Reference: Jarmila Hallman MD, Ph.D., Professor, P +46 18-611 5205
On the board for the Nurses Association for Private Care, VIAM, for 4 years.
2005- During 2004-05 a member of The Nurses Association as an expert in Addiction Treatment, in order to write a new policy. Published in 2005.
2005- RN Addiction Specialist, Halsans Rus, Consulting.

1999 -2005 CEO/ Founder of Bitten Jonsson Center Corp., Treatment facility in Hudiksvall.
Registered with the National Board of Health and Welfare.

1993- Trained by Terence T. Gorski, CEO Cenaps Corp, USA in the USA. Relapse prevention, relapse treatment. Developed a unique relapse program for sugar addiction from his training modules. Reference: Tresa Watson, tresa@cenaps.com

1995-99 Started Hälsans Rus, open clinic in Addiction Treatment
1995 Started Friskhuset in Hudiksvall. An Integrated Functional Clinic. Chairman of the Board from March 2006.
Reference: Eva Bovin.Founder P +46 70 840 09 95

1990-95 Certified in ADDIS, www.addis.se diagnostic tool. Reference: Börje Dahl, www.dahlanddahl.se

1990-96 Executive Director at Provita Noor. 30-bed facility in Uppsala.
1990-97 Developmental Director at Provita Inc.
1990-98 Training at the Lutheran General Hospital and with Terence Gorski in Chicago

1990-1995 Responsible for developing and training staff for an addiction clinic at Hudiksvall Hospital.
Teaching Criminal Justice staff and developing a Drugfree Jail in Hudiksvall.
1987 Shasta options, Opencare alcohol and drug treatment in Redding, Calif.

1986-87 Student at Shasta College, Redding California.

1984-85 ”Department Head Nurse” at Trinity General Hospital i Weaverville, California.

1985 Capistrano by The Sea, California USA September, treatment for alcoholism.

1982–88 Registered Nurse in California, USA.

1978-82 Clinical Supervisor, Karolinska Hospital, Stockholm

More references upon request.

Näsviken October 28th, 2020

___________________________________________________________________________________________

Transcript:

Carole Freeman:

Hey, welcome everyone to another episode of Keto Chat. I am your host, Carole Freeman, a board-certified keto nutrition specialist. You guys, I’m so excited today for my guest. I discovered her, I’d never heard of her before, I was listening to a podcast, Dr. Tro’s podcast, and she was talking about a topic that I love so much, and it’s so integral into being successful if you’re going to follow any kind of a dietary change long-term. And so please help me welcome Bitten Jonsson, all the way from the middle of Sweden. She’s a registered nurse, addiction specialist, SUGAR/ADDIS certified, is a forerunner in this field in Sweden, international lecturer and has frequently been seen on TV and radio in Sweden, Norway and Finland.

Carole Freeman:

Bitten is trained in the USA and has developed a special treatment method involving integrated functional medicine and orthomolecular medicine together with American addiction medicine, 12-step based programs and traditional medicine. She’s written three books about sugar addiction, The Sugar Bomb in your Brain was her first book, and the Sugar Free Cookbook in 2006 and updated in 2018. And so please welcome, everybody clap for, Bitten Jonsson.

Bitten Jonsson:

Thank you, Carole. I’m very happy to spend some time with you. I have studied your website.

Carole Freeman:

Oh, wonderful.

Bitten Jonsson:

A huge interest with your journey. Wow. So happy to see you so healthy.

Carole Freeman:

Me too.

Bitten Jonsson:

After what happened to you, that’s amazing.

Carole Freeman:

Yeah, me too.

Bitten Jonsson:

You’ve done a lot of hard work. I know what it takes to really heal like that. It’s not something you do sitting in a chair and doing nothing.

Carole Freeman:

Yes, yes it was a lot of-

Bitten Jonsson:

Action. It’s action.

Carole Freeman:

It was a lot of Googling and searching and pleading with people to help. So yes. Thank you so much.

Bitten Jonsson:

And eating and moving and all kinds of things.

Carole Freeman:

Yeah. Yeah.

Bitten Jonsson:

I know.

Carole Freeman:

So take me back to the beginning. How did you get interested in this topic of addiction and sugar addiction? And tell me your path.

Bitten Jonsson:

Well, that’s a long one, but I’m going to be short. I started stealing sugar cubes when I was four. That’s how it started. I was a very happy-go-lucky kid. I grew up in a big family in the country, ate really good food, but absolutely loved sugar. My favorite drug was chocolate and ice cream all the time. I could die for that.

Bitten Jonsson:

So anyway, as a teenager, we started dieting, which is deadly dangerous to do. I mean, talk about gaining weight. So we started all kinds of crazy diets. And then starting nursing school, I always wanted to be a nurse when I was young, or a veterinarian, or a astronomer. Astronomer, not astrology. Astronomer or a pilot, all kinds of stuff. But anyway, I ended up being a nurse, started drinking, smoking in nursing school, just to lose weight, to curb appetite. That’s why it started. Nothing else. And then drinking. So when I was 19 was my first time tasting alcohol and I loved it, loved it, loved it.

Bitten Jonsson:

So let’s speed forward, and I’m an alcoholic, working as a nurse in US, married to an American, and totally trying to hide it, as we do, feeling of shame and all that. But my husband, he was a really nice guy. I owe him this forever. He slammed me into a treatment center in California in 1985. So that’s when I got sober, in September ’85. And I was shocked, totally shocked that alcoholism was a brain illness and that it had to do with reward center and dopamine and neurotransmitters.

Bitten Jonsson:

In Sweden, it was a psychosocial, blah, blah, blah, you drank because you were lonely or didn’t have a job or blah, blah, blah, there was a cost to it. And they said to me, “It’s a primary illness,” and I was freaking out. But at that point, I started to study addiction medicine, neuroscience, and I’ve been in love with that topic for ever since.

Bitten Jonsson:

So that’s what I do. I teach addiction. I don’t treat clients, I teach them. Because I mean, if you teach somebody what addiction is all about you take away the stigma. You understand that you didn’t cause this, you’re not a weak, bad person. You have a brain in there. And you know what I like to say? People say that, “Well, is it genetic? Is there something wrong in my brain?” I tell them, “No, it’s the opposite. You have a very sensitive brain. I’m thinking a space nerd, nobody would ever think that the telescope out in space that can see galaxies, that’s a very sensitive instrument, right? Would anyone think that’s bad? That sensitivity. So that’s what I mean.

Bitten Jonsson:

And that sensitivity is like having this Ferrari or this space telescope and not knowing what to do with it. So that’s what I mean, addiction is an illness that you need to understand on a very deep level. That’s what you can get out of it. So I got sober, then, but at that time, 1985, I must say, I knew nothing about nutrition. But I don’t feel ashamed because nobody taught me. It was not in nursing school. Nobody knew anything about nutrition.

Bitten Jonsson:

So we ate whatever we wanted. One day I could eat bacon because I liked salt, the other day I could eat only chocolate, and then I smoked and drank a lot of coffee, but I didn’t drink. So I was okay, right? Then I was listening to an American that’s an expert on relapse prevention and I was doing that in my line of working with alcoholics, drug addicts, and so forth, so I should help the clients, right? And he told me that, “If you keep drinking a lot of coffee, eating bad food, smoking, you have a high risk of relapsing in alcohol and drug addiction.”

Bitten Jonsson:

I said, “What? How come? How is that going together?” That’s how little I knew in 1992, [inaudible 00:06:44] sensitive brain. But that made me wake up. So of course I went home from that lecture, quit smoking, cut down on coffee and I thought, “Well, I don’t have to do anything about my food because I don’t like McDonald’s.” To me, junk food was only McDonald’s. It was not chocolate, ice cream, you know.

Bitten Jonsson:

Anyway, that ended up with me gaining a lot of weight, and I think most of all, I know now, I didn’t know then, was the volatile blood sugar you get from [inaudible 00:07:17] you know. So my energy level was either on top speed or crashing bottom, and my mood swings was the same. Either I was really hunky-dory or I was very upset, very tired, very cranky. So it was up and down, and I wanted to sleep all the time. I almost drove myself into a car crash because I almost fell asleep twice in front of the wheel, even though I slept 14 hours a night.

Bitten Jonsson:

The tiredness, the moodiness, those were much worse than the weight gain. So anyway, I had the incredible fortune to work with an American woman at that time. Here in Sweden. I moved back to Sweden by then. So she was training in addiction medicine and how to do addiction treatment. So I said to her, “But Joan, how in the whole world is it that I can quit alcohol, quit smoking, cut down on coffee, but I can’t quit chocolate and ice cream? Because I tried, I promise you, I tried for nine months to really stop that, but I couldn’t.”

Bitten Jonsson:

She looked at me and she said, “Well, you might be a food addict.” And I got freaked out. “Food addict? You can’t be a food addict.” I said, “I never, never binge on boiled cod or cucumbers or anything in that way.” Because at that time, 1993, we didn’t know about sugar, flour and processed food. We didn’t understand that connection. So we had a horrible food plan in the beginning, you know? We thought we took away sugar, but we didn’t. We had grains and we had low fat and all kinds of things. So it was really hard to stay drug free, as I call it.

Bitten Jonsson:

But you know, I kept fighting. I kept learning more and more, and started to learn about nutrition. And then diet doctor Andreas Eenfeldt, and Annika Dahlqvist, another doctor, came along in 2005 and talked about low carb. And I had been sniffing around at Atkins, but I didn’t have the knowledge. I didn’t really understand why it was to work.

Bitten Jonsson:

So anyway, we started with low carb. That’s how it started in 2005. And we saw a remarkable difference in craving, less craving in clients. We started seeing they started to heal much better and it was easier to stick to that food plan, and so forth. By that time I’d been running a treatment center in Sweden for five years, and we saw results. But it was very hard to run a treatment center because the National Board of Health didn’t accept the diagnosis sugar addiction. So we had a hard time getting clients. Or I shouldn’t say that. We had a tremendous amount of clients wanted to come to us, but we couldn’t get paid by the national health system. So that was sad.

Bitten Jonsson:

But really, 1994, I started my food group, support group, and ’96 I started what I call my four-day intensive or one-week intensive, where people came and I taught them what addiction was and how to eat, and relapse prevention, and blah, blah, blah. So I’ve been working with thousands of clients with sugar addiction. And as being a nurse I know how important it is that you don’t guess what kind of problem a client has. If you step into my door and I think, “Well, I guess you have a problem with your knee,” or, “I guess,” you know, “I guess,” no, no. You want to know what’s going on.

Bitten Jonsson:

I knew that there were diagnostic tools for alcohol and drug use by that time. Many by the American called Norman Hoffman, called SUDs in the US, and that was brought to Sweden, and that’s what ADDIS is. ADDIS is Alcohol and Drug Diagnostic Instrument. We already

had that based on the international diagnostic criteria for addiction, which is ICD-10, or 11 now, and DSM-5. So I thought, “Well, why not do it for food? For sugar, flour, processed food?” So I did. I started to work on that quite some years ago. Started teaching people 2013, I think.

Bitten Jonsson:

So today, we have that tool where we can really assess somebody. Today, we can know if you have a harmful use or if you have an addiction, or eating disorder, or addiction. Because I think you know that if somebody had an eating disorder, what they try to teach you is to eat in moderation. And to tell an addict to eat in moderation, that’s the white unicorn, as my colleague David Wolfe used to say. It’s a myth. You can’t do it.

Carole Freeman:

It’s so true. That’s what they taught me in school, was-

Bitten Jonsson:

I know, I know.

Carole Freeman:

… if you restrict any food choices, that’s what makes people obsess about it. So you need to help them moderate their intake. And that works really well for people that don’t have that biochemistry of being [crosstalk 00:12:45]

Bitten Jonsson:

Yeah. People with harmful use.

Carole Freeman:

Yeah.

Bitten Jonsson:

People who harmful use can do that.

Carole Freeman:

We have a viewer here that’s got a question. So, Umay says, “I’m 21, not overweight.”

Bitten Jonsson:

Yeah. Hi, Umay. Not overweight. Oh, I used to say that sugar addiction comes in many shapes. People can be really, really emaciated, really skinny, and normal weight, and overweight. So it does not have with weight to do, because it’s a problem in your brain. One thing we see with people that are underweight or normal weight that they have visceral fat. They can have a lot of fat around inner organs, which is very dangerous too. So I mean, it’s not less dangerous. And you know how people say to somebody, “Oh, you can eat anything, you’re so skinny.”

Carole Freeman:

Yes.

Bitten Jonsson:

Another thing we know today, the problem is that you and I, Carole, we could eat one apple each, the same big apple or a smaller apple, exactly. And then we would measure our insulin, not our blood sugar, insulin, and if we do that, we could see that one of us could have 10 times more insulin response than the other one. From the same food. So we are also biochemically unique. So you know, one way to know if you are not overweight, but think you have a problem with sugar, you risk other health illnesses. Other consequences, you know? You could be depressed. You could get volatile blood sugar. You could be insulin-resistant. You can get all of the consequences but not being overweight. So that’s why it’s important to know if you’re addicted.

Carole Freeman:

What would you recommend for this person, then? I could point out a couple of bad symptoms or effects that they have that they don’t realize that they have, but the person is saying that everything’s normal, it’s fine. What would you advise this person? Not advice, because you can’t give advice here, but what would you suggest for somebody that feels like, “I’m not overweight so how can it be bad for me?”

Bitten Jonsson:

Yeah. Right. Well I would first of all go to my website bittensaddiction.com and take the screening instrument that’s on there. Six simple questions called UNCOPE. And if you have two or more yes, you do have a problem. But it will not measure the severity. So if you think that you want to look further into if it might be a problem, because you might not feel consequences now, but later on in life you can have very bad consequences. And that’s something we see with sugar. It doesn’t kill you right away. It takes a long time to really destroy your body.

Bitten Jonsson:

So that’s important to know, because our body’s not made to eat sugar, sweeteners, flours, processed food. Our body should eat biologically-appropriate food. And I used to joke and say, when people say, “What should I eat? What should I eat?” “Eat only things that have one ingredients.” You know? In a piece of meat it’s only meat. Fish, fish. Egg, egg. That type of thing. In a veggie, just a veggie. Then you’re on the safe side.

Bitten Jonsson:

But then of course, you need a coach or somebody to help you make a food plan and to develop the fuel mix, which is what I like to say. The fuel mix. The combination of protein, fat and veggies.

Carole Freeman:

Nice. Well, and then I’ll just add, too, that while Umay, do you know how to pronounce that? Okay. That while she’s saying there’s no bad effects or symptoms, but the fact that

she’s identifying as a sugar addict means that she is having the symptom of constant craving and obsession, and probably spends a lot of time every single day trying to obtain more sugar and making sure she gets enough sugar. So there is a negative effect or symptom that people have, even if they aren’t noticing any physical-

Bitten Jonsson:

And also, the body wants to have homeostasis. So the body tries to compensate. And you 21, a young person’s body and brain can balance this hassle for quite some time. But when the consequences come, they come big time. Then you’re suddenly into the depression, no energy, you might start to gain weight. Everything is going to play out very bad for you.

Carole Freeman:

And probably headaches, and people [crosstalk 00:17:37] in my brain.

Bitten Jonsson:

Yes, yes. Tired, mood swings, you name it. Yes.

Carole Freeman:

All right. All right, so there’s your website. People can go there for a quiz. Well, continue on. So I would love, next, if you’d just explain… So you mentioned that alcoholism, sugar addiction, food addiction, is a brain illness.

Bitten Jonsson:

Yes.

Carole Freeman:

For those of you watching who want a bit of information, explain that, right? Because like you said, most people think it’s somebody’s sad or they’re lonely, or they just need to have better coping skills with life to not care about alcohol or sugar or anything like that. Can you share a little bit more about-

Bitten Jonsson:

That’s the explanation people have to keep drinking, using, eating. But you know, the problem is that when we start doing this really deep, deep questionnaire, the sugar assessment, we see that the first symptoms of addiction usually come around age four to five. I used to say it’s simple. Don’t put the wagon in front of the horse. Basically you see it when you hear people, that what they thought was depression was low energy due to the sugar. So when they get on the right fuel it makes the energy come back, and there is no depression. All kinds of consequences they have will disappear on the right food plan. So the food caused the addiction.

Bitten Jonsson:

And then, sugar is the gateway drug. Sugar rebuilds the reward center, and you increase the tolerance, and you increase the tolerance. That’s the way the brain and the body works. So you need much more, after a while, to get the same kick, effect, or numb, whatever

feeling you want to obtain from it. And that’s another interesting thing when you study neuroscience. If you ask people, “What do you want the food or the drug to do for you?” And some people will say, like I used to say, I wanted chocolate and ice cream to make me alert. I want to be speeded. Woo hoo. I wanted alcohol to make me speeded.

Bitten Jonsson:

But actually, it’s not speed. Alcohol is a sedative. So my body and my brain reacted with speed on that drug. Do you see what I mean? Other people want to be calm, relaxed, and they use alcohol. Same drug, two different effects. That’s another interesting thing you need to know about neuroscience, neurotransmitter and the reward center, that it can react in different ways. But what I’ve found is that people who like flour, the bread, pasta, all that, they like to be tired, slow down, calm. They like the calmness. And people that go for pure sugar, they want the speed. And I was that way.

Carole Freeman:

Oh, that’s interesting. Yeah. That’s interesting. I never thought about that. That’s really…

Bitten Jonsson:

Look at that. Start looking at that. At least in the beginning. Once your reward center have upregulated and downregulated the neurotransmitters, you usually use both because you’re tired from one drug, so you need to speed with another one, and then you feel stressed by the one you speeded with so you need to take another one to calm down. So this all starts in the reward center, in those pathways with dopamine and all kinds of neurotransmitters. So it’s the reward center where this process starts.

Bitten Jonsson:

Then, of course, it also affects our reptilian brain because that’s the survival brain. And if you think about it, the instinct to eat comes from the reptilian brain. It’s more like an instinct. It’s not a conscious thought up in the neocortex. So people think that they are very conscious and that they make a decision themselves, and I say, no, no. You’re run by a monster in your brain that is driving you, and that’s why you have loss of control, because you say, “Okay, I don’t want to gain weight,” but you keep eating. So you do the opposite. So you have lost control. And that’s actually what addiction is all about. The losing of the control.

Bitten Jonsson:

So actually, your brain have different parts. If you think about your brain, the most primitive part is the reptilian brain, and then you have the reward center. They are both very geared into survival. Survival. So they are ready-wired when you’re born. But then anything you do, eat, and that’s something that is very fascinating too, people don’t understand what kind of building parts they need for their brain. I tell you, you can’t go to the hardware store to buy stuff for your brain. It’s food, and it is keto food. That’s exactly what it is all about, okay? That’s how you heal.

Bitten Jonsson:

So when we talk about biochemical repair, the most important thing is the food, the food, the food. I mean, it comes to one to 10 is the food, and then you can add, I like to talk about breathing, I like to talk about sleep, I like to talk about physical activity, and then you can also use supplements. But there is no quick fix, and you know that. I saw that on your story.

Bitten Jonsson:

But anyway, other parts of the brain is the prefrontal cortex where your personality is, where you make logical reasoning, and you have the limbic system with all your feelings, and you have the neocortex with all the higher functions. They all cooperate all the time. But when a drug hijacks your reward center, and your reptilian brain, you become a little red dog monster, is what we call it, the red dog, you know? That is in there craving, making you do things you don’t want to do.

Bitten Jonsson:

When the activity is, as I say to my clients, it’s like you have this beautiful mansion with all the rooms. There is wiring for electricity drawn to all the rooms, but if you pump the big chandelier in the hallway, there’s not enough electricity to go to your limbic system, your neocortex, and your prefrontal cortex. You see what I mean? So your light starts to dwindle. You become drug-oriented. Your life is about eating the drug, the food drug, trying to recuperate from eating the food drug, feeling miserable that you ate it, thinking about how you can avoid it, another diet or some quick fix, or whatever, and then you eat it again, even if you didn’t want to. So you are in a vicious circle where there is very little light going out to all those other functions, all the rooms in that beautiful mansion.

Bitten Jonsson:

So what we need to do is take away the drug. Start healing. Neurons that fire together wire together. And I call it brain bypass. All the pathways that you created in your drug life, you have to create new ones. That’s why you can’t think yourself into recovery. You can’t talk yourself into recovery. You cannot read yourself into recovery, but you can act. It’s action. You need to get your butt off the chair and do things. It’s action. All about action.

Bitten Jonsson:

And then, my clients say to me, “No, I don’t want to do that, because it’s boring.” And I say, “I don’t care, do it anyway. Do it anyway.” Because you know, once you start doing little baby steps, and doing it and doing it, it’s going to be fun. You need a new pathway, then it’s going to be fun. So I mean, the brain, so many things that you could learn about the brain and the connections and how it works, and nourishment, and neurotransmitters and all of that. But that was more of a broad picture what’s going on. So the illness is in the reward center, but it fills the whole brain, and your stomach. Your body. Everything.

Carole Freeman:

Yeah. Well, and it speaks to-

Bitten Jonsson:

[inaudible 00:26:35] primary illness brain.

Carole Freeman:

Yeah. Well, it speaks so much to, you know, I’m mostly working with women because they’re very good dieters. They diet a lot, but they always say, “Well, that diet worked really well because I lost the weight, but something happened, I don’t know what happened and then I just fell off the wagon and I just started eating the way I ate before, and now I’ve gained the weight back.” So, it really is the food addiction part of the brain that’s never being addressed. That’s the part-

Bitten Jonsson:

You know what we call that? It’s addiction memory circuit, or euphoric recall. The thing is, it’s an irreversible thing in your reward center. Once an addict, always an addict. So that’s the problem that nobody teaches you about your addicted brain and teach you what to do and not to do. You can never have one bite. But nobody want to think that of their favorite food, their favorite drug. “What’s the meaning of life if I can’t eat chocolate?” And that kind of thing.

Bitten Jonsson:

So you need to be coached to grieve that, to find other things that are fun in life. And also I think one of the most important thing is never ever think forever. It’s only for today. It’s only for today. Everybody can think in the morning, “Only for today I’m going to stick to my food plan.” 24 hours. That’s it. Tomorrow you can make a new commitment. But don’t think about the rest of your life today.

Bitten Jonsson:

And also, you need to be aware that somebody need to teach you relapse prevention. What is a risk situation? How do you deal with a risk situation? What is warning signs? What is your warning signs? Your specific warning signs? I love to teach clients that, so they are aware of that. That here are my warning signs. And if you and I will hang together, and you were an addict, I’m sure that your risk situation wouldn’t be the same as mine.

Carole Freeman:

Right, right.

Bitten Jonsson:

I would have a different risk situation that I react to, and you would have different. So I need to deal with mine and you with yours. And also, the reason a support group is so important is that somebody’s always ahead of you. Okay? So let’s say that you were ahead of me and I will have a risk situation tomorrow. I call you and say, “Carole, tomorrow I’m going to do whatever, this and that, and that’s a risk situation. I might get craving. I don’t know. How’s it going to work? It might be a lot of food there. I don’t want to see it.” And then I ask you, “Have you done that?” And you said, “Sure.” “What did you do? What did you do?”

Bitten Jonsson:

You have a lot of people to call and ask them, “How did you do it?” “Well, I brought my food with me,” or, “I went out, ate in a different place,” or, “I took care of it.” And then there’s something else that is very important to understand. We have something called euphoric recall. So anything that happens to us, I mean, sad things, good things, fun things, our brain, that part of our reward center, can suddenly say, “Ooh, wouldn’t it be good with chocolate now?” “Oh, you’ve been so good today, Bitten, you could have some chocolate.” Because that is the physical euphoric recall. I didn’t cause it. My brain caused it. A part of my brain caused that.

Bitten Jonsson:

So, we need to learn how to deal with that, to tell that little red dog monster, as I call it, “Hey, calm down. You know what? Sure. That’s a good idea. But you know what? We’re not going to do it today.” That red dog is street smart but not intelligent. So I can say to it, “We’re not going to do it today.” So it goes in the basket and say, “Okay, I’ll wait till tomorrow.” If that happens tomorrow I say the same thing. “Well, okay, not today.”

Bitten Jonsson:

And then in a couple of days that craving is gone. You feel much better. You’re in balance again, and so forth. So it’s very important to learn, of all addictions out there, of all the outlets of addictions, I think that sugar addiction is the worst in the way of craving due to the fact that we are exposed to that drug very early in life. Baby babies. Very early. So the pathway is very strong for the particular addiction.

Bitten Jonsson:

Not only that, you tell me. Can you go anywhere in society today and not see the drug? So we are constant exposed to our drug. I mean, cocaine addict is not having cocaine at the gas station, grocery store, wherever they go, they are not and in little pots and filled with cocaine, you know?

Carole Freeman:

Yeah. Right.

Bitten Jonsson:

It’s everywhere. Smell. And we are more sensitive to cue-induced cravings than other addicts. The smell of things. Bread, chocolate, whatever you have, food. So that hits our brain much harder. It causes craving. We need to be aware of that and we need to learn how to do craving management. We used to say, one bite is too much, and 1,000 is never enough. Does it make sense?

Carole Freeman:

Absolutely. Yeah. Let’s talk to the people out there right now that might be a little in denial, that, “Well, no, I just need something sweet to get rid of my cravings. That’s how I cope.” For the people I’m working with, I’m appealing to out there, following a keto diet that they feel like, “No, I need the keto desserts and the sweets and all this kind of stuff, because the cravings get too intense if I don’t have those things.” What would you say about that?

Bitten Jonsson:

I would say that first of all look over your food plan. Is the fuel mix wrong? Do you need to increase the fat or do you need to increase the protein or where do you need to increase something, you know? You need to be very aware of that. Are there other factors you need to look at? Salt, minerals, fluid? Are you drinking enough? Are you moving? How’s your sleep? I would just shoot a lot of questions at them first of them.

Bitten Jonsson:

And then, I would say that the absolutely most stupid thing you can do if you’re a sugar addict is to eat keto bread and keto desserts, because those are substitutes, and substitute will never work on an addict. So if you take one bite, you’re waking the monster up. If you have been a heroinist, you can’t take a little bit heroin on a Saturday. That’s going to start the illness all over. I mean, it’s going to just go downhill ever since.

Carole Freeman:

Well, yeah.

Bitten Jonsson:

You need to be aware. You need to accept that you’re an addict. You can cry and be mad at that, that life threw you that curve ball, but you know, if you accept it you need to act in that manner. You need to learn about it. Lots of knowledge. You need to hang with other addicts, you know? “How did you do it?” And then you have to share. You have to share your problems so that people can mirror you and tell you what to do. Not by saying, “You do this,” by saying, “This is how I did this when that happened. Try that, try that, try that.”

Carole Freeman:

Yes, yeah. And I advise my clients that the brain can’t tell the difference between the keto version and the real version, right? When it sees a keto pizza, it thinks a pizza, it doesn’t know-

Bitten Jonsson:

Of course.

Carole Freeman:

… “That’s a keto version. That’s not the same.”

Bitten Jonsson:

No, no, no. No, no, no. No, no. And also, we have to understand that people of different trigger foods, some people trigger on seeing pizza. I was never a flour addict. Bread, pizza, pasta, not interesting. Chocolate, ice cream. Chocolate, ice cream. That was my drug. So of course I don’t eat the keto substitute, but that wouldn’t trigger me, as something chocolatey, ice creamy. That would trigger me. So I stay away from that, you know? And I wouldn’t try that substitute, because I know how dangerous it would be for me. It would wake up the monster, and I don’t want to have that monster waking up because it steals energy from me. I want to live life to the fullest.

Carole Freeman:

Yeah. Yeah. That’s the truth, the freedom. Instead of coping with cravings by feeding them, you actually get rid of them, or reduce them, minimize them, so that you do have the freedom that you’re no longer obsessed and compulsively eating.

Bitten Jonsson:

Yeah. Well, if you go on a craving and eat something for the craving, it’s going to increase, I promise you.

Carole Freeman:

Yep. Yes, yes, yes. So true. So what are some basic steps of moving towards addiction recovery? What do you recommend with your clients?

Bitten Jonsson:

Yeah. If you have a hard time accepting that you might have the illness and you’re in and out of diets, and you’re always crashing and getting back up, and you’re tired of being sick and tired, I would certainly advise you to go to my website. There is a PDF with trained professionals, and look for one that you contact to do a sugar assessment. That is an in-depth assessment, I promise you. It is two to three hours really working with a professional to get your whole life laid in front of you in chronological order. And that will help you to see how this has affected you, and also give you a lot of tools in what you need to do next.

Bitten Jonsson:

Because, I mean, if we look at the steps, it’s easy. You need to detox. There’s no other way around it. Oh, you did the Swedish version.

Carole Freeman:

Well, the website, well, you can pick translate-

Bitten Jonsson:

Oh, yeah. Okay. Yeah.

Carole Freeman:

… into English, but the URL still is in-

Bitten Jonsson:

Oh, okay. Good. Good.

Carole Freeman:

Let’s see, up here we can do… Yeah. People can’t click on it from here, so I’ll just leave it as.. We’ll put back up… Here, that’s easier for people to copy down.

Bitten Jonsson:

Yeah. Okay. And then they go to For Patients, and Help, Getting Help. And then you have a PDF there. And then you need help to detox. I have been doing this for 27 years and thousands of clients. I think that cold turkey is the best, but you need to know what you do between the meals. Then it is, in the beginning, three meals it is. It is glutamine powder and coconut oil between meals as curbing cravings. Salt shots. I mean, there are tricks you can do to ease that period.

Bitten Jonsson:

And what keto world call keto flu we call withdrawal. So that’s exactly the same symptoms, right? And there are ways to work on that. You can’t take it all away and be hunky-dory in two days, I promise you. But after three weeks you will have a different level of energy, outlook on life. You will feel much better. The first three weeks might be the toughest. And you need a lot of support. I would advise you to ask a professional for help. They have done this so many times. They know exactly what to do and what kind of tools you need.

Bitten Jonsson:

And then, one of my favorite, favorite de-stressing tools is… I’m going to try something on you. Can I do it just on you, Carole?

Carole Freeman:

Sure.

Bitten Jonsson:

To show what this is all about, what I mean. Short. You look straight forward. Don’t move your head. Don’t move your head, only your eyes. And okay, start. Look up. Look down. Look to your right. Look to your left. Look up. Look down. Look to your left. Look to your right. And look up. And look down. How many good breaths did you take?

Carole Freeman:

I noticed at least one but I wasn’t focused on the breathing.

Bitten Jonsson:

This is a very good test to do, because most people say, “None.”

Carole Freeman:

Oh.

Bitten Jonsson:

Because they forget to breathe because they were so focused on doing what I told them, so they hold their breath. And this is something we do many, many times during the day. This is called stress apnea. And you open your computer, and 30 mails come bouncing in, boom. Telephone goes high wired. Kids are screaming. Noise at the office. I mean, there are so many stressful things in your life. You’re rushing around. You hold your breath, and that is very, very bad for your body. That increases craving tremendously and it puts the body on hold.

Bitten Jonsson:

There is a lot to read about this on the site consciousbreathing.com. So I learned about this many years ago, and I tape my mouth every night because many of us snore a little bit, or sleep with open mouth. And nose breathing is the natural way to breathe, and it’s the healthiest way. And also that is very good to think about now when we have the COVID, that you breathe through your nose. If your nose is stuffed, it is because you’re mouth breathing too much. So you can read a lot on the site consciousbreathing.

Bitten Jonsson:

So first the food, and then the breathing. There is something called the sleep tape, or you can take surgical tape from the pharmacy, and tape. I kiss my dog goodnight and then I tape. And if I fall asleep not taping I’m much more tired the day before. And more tired is the biggest warning signal that wants us to start eating, right?

Bitten Jonsson:

And then I use my favorite tool, the Relaxator. It’s breathing resistant. There’s a membrane in here. So if I were stressed, or when I drive the car, or when I’m in front of the computer, when I watch TV, I train my diaphragm with this. I get a much better breathing and a much better oxygen and carbon dioxide exchange in my body, which increases fat metabolism and curbs craving. There is a book written about this, about the science behind breathing, this exercise and the nose breathing and the taping. So that’s another thing I do. I love my little pacifier.

Bitten Jonsson:

Okay. So I use that. You can use it 10 minutes in the morning, 10 minutes at night and whenever you want during the day. Out walking or whatever. Forget about people looking at you. They’re just jealous.

Carole Freeman:

Well, if you put it under your mask, these days, nobody will even see it.

Bitten Jonsson:

That’s right. That’s right. Exactly or a visor. Okay. Yeah. But anyway, so food, one, breathing, two, sleep. How to sleep, and get your sleep hygiene as I call it in Swedish, I don’t know if you have a word in English, about to work on your sleep, to improve your sleep, is incredibly important. Your body needs rest. It needs to recalibrate. It needs to resynchronize everything in your brain and your body. It’s very important to get your sleep in.

Bitten Jonsson:

Everything you do start with baby steps. Tweak it a little bit. Baby, baby steps. Very important. And of course, physical activity. I say to somebody that is very overweight, the word exercise makes them puke, “I understand that. The reason is because your body doesn’t have any energy on a cellular level. You’re tired to your bone because of this eating.” So I tell them, “Forget about exercise.” And they look at me, “Oh, you mean I don’t

have to exercise?” “Well,” I tell them, “You can’t exercise away any obesity or overweight anyway. You need to do that with the food. But for one thing, if you had a car where the fuel tank were broken, would you try to run it?” And they say, “No.”

Bitten Jonsson:

So we need to fix the fuel mix. And this I can really see in clients. When you’ve worked on the food for three weeks, they start feeling energy and wanting to move. So if all they are do the first days of this is take a walk around your living room, do that. And then do the living room, the bathroom and the kitchen. What I’m trying to say is, start slow and increase. Don’t feel that, “Oh, my God, tomorrow I’m going to start eating really good and I’m going to run and I’m going to go to the gym.” I mean, that’s how people do it and crash after four days. They are in bed and they think, “I never want to do that again.”

Bitten Jonsson:

So I want them to really do that, and have somebody supporting you, somebody that calls and said, “Carole, did you walk around the living room twice? I love it. You’re good.” That type of thing. And that makes people feel really good about themselves, and not have these high, high goals, because it doesn’t work when you’re an addict. Addicts can’t have big visions and big goals. They need to get through the next 24 hours, and then feel good.

Bitten Jonsson:

And then my favorite, favorite de-stress spiritual changer is the gratitude list. No matter how shitty your day was, excuse my French with that word, that’s a Swede, how bad it was, when you go to bed, think about or write down three things that you can be grateful for that day. Did you go outside on the porch and breathe air? Maybe that was your little exercise. Did you have good food that day? Were you kind to somebody? Was somebody kind to you? It can be anything. Did you really hug your pet for oxytocin? So important. Whatever. But it can be very small things. But I think if you do that for 90 days, you’re going to have a different outlook on life, I promise you. Do the gratitude list for 90 days and build on that.

Carole Freeman:

I love it. So based on what you’ve shared with me here today, I’m going to recap.

Bitten Jonsson:

Sure.

Carole Freeman:

There is four steps to sugar addiction recover, where number one is you need education. You need to understand that you are an addict, you need to come to terms with that, and you need to understand how that all happens in your brain. Number two is you need support, both from a trained professional, and group support, other people that have been through the process. Number three is you need to change your food. Cold turkey is best. Not only do you need to eliminate the addictive foods but you need to eat the right fuel mixture, and nourish your body and eat healthy, one-ingredient foods.

Carole Freeman:

Number four is the category of self-care, and you’ve covered a lot of those things. Stress management, relaxation, breathing, sleep hygiene, movement, even if it’s not to the degree of exercise, and also gratitude exercises too.

Bitten Jonsson:

Yes, yes, yes.

Carole Freeman:

That’s simple. It’s simple. There’s the process. There’s just four steps you have to do.

Bitten Jonsson:

It should be very simple, otherwise, you know, you won’t do it. And if you fall down after Day Three, get back up and talk to somebody about it. Nobody is doing this perfect ever. You can fall down a year later, and relapse is not failure. You are not a failure. It’s not something that you should stay stuck there, just because you fell down, you can’t get back up. Get help. Ask for help. Have somebody talk you through it and see, what could I have done different? Is there something I should take away that I’m doing? Is there something I should add? That’s all it is. It’s just a lecture. Relapse is lectures.

Carole Freeman:

Yes. Excellent. Well, in wrapping this up, is there anything else that you were hoping I would ask you about or that you want to share with people watching?

Bitten Jonsson:

Well, all I want to say is, if you sit out there and you feel this is your problem, please, please be in touch with us. We have been there, many of us. We have been there ourself. We know how to get out of the jungle. We guide you. We do that with love. Please contact us. We are many today that can help you.

Carole Freeman:

Yes. You’re not alone in this world of addictive substances at every turn. Yeah.

Bitten Jonsson:

No. Not at all.

Carole Freeman:

Well, excellent. Thank you so much. This has been such a pleasure. I’m sure that you and I could talk for three days straight and never run out of topics to cover, so I appreciate you taking the time.

Bitten Jonsson:

Yeah. I loved it.

Carole Freeman:

It’s a big one that’s really missing out there, right? Because we’ve got the diet specialists and the nutrition people, and the healthy food, and then we’ve got the psychology people, and there are so few of us that bring those together, and they’re essential if we’re going to solve this obesity, and chronic disease, and all those things that people are suffering from, from their missed diagnosis of sugar and food addiction too. So I believe that that’s really at the core of why we’re struggling with all these chronic diseases and overweight, it’s because we’re eating these foods that are addictive-

Bitten Jonsson:

Very.

Carole Freeman:

… and in denial that they are, and everyone else is telling us that we should be able to moderate the portion of it, and it must be something wrong with us that we can’t just eat less of that. So I really appreciate you being here and getting the word out.

Bitten Jonsson:

I appreciate you asking me. Thank you very much. It was wonderful to hang with you for a while and get to know more about you.

Carole Freeman:

Yeah.

Bitten Jonsson:

I read your website. I love that.

Carole Freeman:

Oh, wonderful. Thank you so much. We have a few people still watching, any last-minute questions for Bitten before we wrap this up? Pop them in now. Any questions about sugar addiction, food addiction, recovery from any of that. We’ll hang out for just one or two more minutes. There’s a little, tiny bit of a lag, so if they want to pop a question in there, we’ll do that real quick. So all right.

Bitten Jonsson:

Otherwise, email me.

Carole Freeman:

Yeah. I’ll put her website up here one more time, too. So all right, thank you all for watching. If you enjoyed this on the YouTube, give us a thumbs-up, subscribe, hit the bell for all the notifications too. Always working on bringing you the best of the best people to help you live a healthy keto lifestyle. So thank you again, Bitten, for being here-

Bitten Jonsson:

Thank you.

Carole Freeman:

… and we’ll see you later, everyone. Bye for now.

Bitten Jonsson:

Bye.

Get a FREE 7-day Fast & Easy Keto Meal Plan: https://ketocarole.com/free-7-day-meal-plan/

Keto Chat Episode 131: Denver’s Diet Doctor Shares Biggest Mistake People Make when going Low Carb

Interviewee Bio :

Dr. Jeffry N. Gerber, MD, FAAFP is a board-certified family physician and owner of South Suburban Family Medicine in Littleton, Colorado, where he is known as “Denver’s Diet Doctor”. He has been providing personalized healthcare to the local community since 1993 and continues that tradition with an emphasis on longevity, wellness, and prevention.

___________________________________________________________________________________________

Transcript:

Carole Freeman:

Hello, and welcome, everyone. We’re live here in the keto chat crew or keto chat group, keto lifestyle crew, keto chat episode, all that stuff. Anyways, I’m Carole Freeman. It says it on the screen. You should know that. And today, our very special guest is Dr. Jeffry Gerber, all the way from Denver, Colorado. Welcome.

Dr. Jeffry Gerber:

Hi, Carole, and everyone listening.

Carole Freeman:

Those of you that don’t know, Dr. Gerber is co-author of Eat Rich Live Long, one of my top… Really, this is my favorite keto book and I recommend it non-stop. He’s also Denver’s Diet Doctor. And so, welcome, Dr. Gerber.

Dr. Jeffry Gerber:

Yeah. Thanks again, Carole. We’re just doing this in between patients today. I still see patients and enjoy it, after 30 years, still going strong.

Carole Freeman:

Oh my gosh, that’s excellent. So, how long have you been doing low-carb yourself, and then how long with your patients?

Dr. Jeffry Gerber:

Yeah. It goes back about 20 years. And we were traditionally trained as a family doctor, not really getting much nutrition advice. But I honestly grew up in a family that we had weight issues, health issues, and as a result became interested in diet and nutrition. And about 20 years back I was challenged to lose 40 pounds. There were other family members, and we approached low-carb.

Dr. Jeffry Gerber:

And I had lost weight without much difficulty. And I had other patients who had success. And back then, I was a little skeptical thinking that their hearts were going to explode from changing their diet in this way. But lo and behold, we followed metabolic markers. And for myself and for my patients, the metabolic markers actually went in the right direction.

Dr. Jeffry Gerber:

And we’ve been sharing our knowledge with patients, with other healthcare professionals through the book. We also run medical nutrition conferences for healthcare professionals and the general public. So, it’s been a joy.

Carole Freeman:

Oh, I love that you shared, that you went into it really skeptical. That’s probably the biggest challenge a lot of my clients have, is that their doctor hates keto. Their doctor thinks it’s going to kill them. Their doctor thinks that they should go plant-based. So, I know we’ve

got a couple people watching too. So, if anybody has any questions for Dr. Gerber, please ask them. But I know that my clients, that’s one of the things that they were most looking forward to coming on or having you on, was that, how do I approach my doctor when they’re not a fan of low-carb or they haven’t experienced it? What are some tips that you have about how somebody might go about, like working with their doctor when they’re not experienced with low-carb or keto?

Dr. Jeffry Gerber:

Well, firstly, the low-carb approach is really in part in the guidelines. In fact, the American Diabetes Association recognizes low-carb diets as a valid approach to patients that are type two diabetics. So, that’s information for you right there. The heart associations do recognize that sugar is a problem in terms of cardiovascular disease and excess of carbohydrate intake.

Dr. Jeffry Gerber:

So firstly, there’s lots of evidence that has been mounting over the decades that continue to support the low-carb approach. And there’s probably a hundred papers now that support the low-carb approach.

Dr. Jeffry Gerber:

And the other aspect that you can share with healthcare professionals is that, we try to look for common themes that other healthcare professionals can accept. And so of late, we’d like to call it a low-carb Mediterranean diet, because everyone seems to think that a Mediterranean diet is a healthy approach. Although, it’s really ill-defined, but it gets your foot in the door.

Dr. Jeffry Gerber:

And to us, what does that mean? It’s really a Mediterranean diet, a whole food diet that is low-carb. So, that really defines a meat and vegetable based diet. So, it’s a variety of meats, chicken, fish, pork, red meat. It can be shellfish. It can be lean cuts. It can be fatty cuts, and healthy, natural fats, which include olive oil, avocado oil, which are the mono and saturated fats, but also the saturated fats, including butter, coconut oil, and yes, animal fat. And so, we add healthy salads, non starchy vegetables. And that really defines a low-carb Mediterranean diet. So, these are some of the things that we share with our patients, that they can take back to their healthcare professionals.

Carole Freeman:

Oh, I love that. That’s a foot in the door, a low-carb Mediterranean diet. That should get some more acceptance then. All right. So, let’s talk a little bit about your book right now. So seriously, like this is my number one favorite keto book that I recommend.

Carole Freeman:

So, and the reason I really like this is because, I always tell people it’s in three sections. So, the first part is, let’s understand how we got to fear fat in the first place. And it’s a very easy to understand, first through the book for anybody, even if you don’t have any medical

background. The second, third, goes in deeper. And then of course, you’ve got to throw in some recipes because every keto book has to have some recipes in there.

Carole Freeman:

And one of the things that is great about this is that this is a fit for everybody, because it doesn’t say everyone needs to be keto. It actually has recommendations for how to tell what level of carbohydrates may be best for you. Can you talk a little bit more about how do you look at that, and what do you recommend as far as how do people know how extreme of carb restriction they should be looking at?

Dr. Jeffry Gerber:

Well, Carole, I’m so glad you are taking it in that direction. I’ll talk about that in a minute, because it’s really critical. But yes, I co-authored the book with Ivor Cummins, and he’s a chemical engineer that uses his problem solving skills to address health-related issues. And I was more of a consultant to Ivor. He wrote the book. But all of the clinical and the practical information comes from the things that we do with our patients in the office. And Ivor talks more about the technical aspects.

Dr. Jeffry Gerber:

And the book is really for everyone. And as you said, it’s simply written and there’s a lot of practical information in there. But then you can take the deeper dive in the third section, in particular, if you have an interest in looking more into cardiovascular disease, the heart calcium score, which we think is a wonderful test to assess risk, rather than just looking at cholesterol profiles. You can dive into diabetes and a more nuanced information is in there.

Dr. Jeffry Gerber:

But most important in the practical section, as you alluded to, is that the low-carb, high fat ketogenic diet is not for everyone. And it depends where you are in the insulin spectrum. And a lot of people in the low-carb community, just assume if you’re not at your ideal body weight, that you have some degree of insulin resistance or you’re pre-diabetic, or diabetic, on this one side.

Dr. Jeffry Gerber:

But we have patients in particular women, it discriminates, unfortunately, that they’re not at their ideal body weight. And then you measure the metabolic markers and they seem to be metabolically healthy, as far as we can tell, in terms of looking at insulin resistance, pre-diabetes, inflammatory markers, lipid ratios. There may be some other subtle things going on with those particular patients, but we call them the insulin sensitive ones.

Dr. Jeffry Gerber:

And so, you can put these patients, these individuals on a low-carb, high-fat diet, and yes, it will control appetite rapidly, and they may lose a few pounds. But often they get frustrated because they hit a plateau or the weight starts to come back up.

Dr. Jeffry Gerber:

And so, the point I’d like to make is with both of these groups, the insulin sensitive and the insulin resistant, the goal is to find a macro nutrient mix that controls appetite, so you’re not as hungry and you eat less. And so, it turns out with the insulin resistant patients, the low-carb, high fat diet really does the trick because it regulates blood sugar and it controls appetite. But on these insulin sensitive individuals the way to control appetite, the macronutrients vary a little bit.

Dr. Jeffry Gerber:

And so, we tell everybody down the road that the goal is to fill with fat. So, you don’t want to gorge with fat. You want to fill with fat, maybe eat a little bit more protein. And on these insulin sensitive individuals, a little more carb might be fine. So, actually a little potato, a little fruit, for insulin sensitive individuals.

Dr. Jeffry Gerber:

And the point there is that, I’m saying that the calories and the quantity of the food at the end of the day, it does matter. But you have to understand, and this is really important, that we’re not telling people to eat less and exercise more. It’s not about calories in, calories out. This isn’t an approach where it’s mindful living. And we’re trying to find an approach to diet and lifestyle that controls appetite and living healthy, getting proper sleep, eating less frequently if you’re not hungry. So, mindful living rather than depriving yourself. But at the end of the day, the hormones matter and the calories, and the quantity of the food, all matters. So, you have to bring it all together.

Dr. Jeffry Gerber:

Now, one more point, Carole. And sorry for going on. For the insulin sensitive individuals, we refer to this diet, which again is low-carb Mediterranean. It’s a version of a protein sparing modified fast. And really, that’s been around for a long time. But again, you’re just backing off on fat calories a little bit. It’s still a higher in fat diet. And you’re increasing protein, and perhaps increasing carb for these insulin sensitive individuals. And so, that hopefully describes the difference.

Carole Freeman:

That’s nice. And I just love that you’re looking at individual bio-individuality, there’s no one size fits all diet that everyone should be on and fixes everything. So, you’re actually looking at these people as a whole human, and a lot of different factors as to what actually is going to be a sustainable lifestyle for them. That’s great.

Carole Freeman:

Okay. Pennie, is the one that I was thinking of. So, she says that her doctor is, she just recently changed physicians and he is not on board with keto. He’s concerned about her cholesterol. Pennie, can you tell more. And also, caveat here, Dr. Gerber cannot give specific medical advice to anyone here, because unless he’s your doctor. So, we’ll talk in generalities. But high HDL and a high LDL, Pennie, what’s your… High LDL, I know is not even that high though for her.

Dr. Jeffry Gerber:

Yeah. I think I understand the question. I love how it pops up on screen. It’s beautiful how you have that formatted.

Carole Freeman:

StreamYard is the app we’re using to stream. Yeah.

Dr. Jeffry Gerber:

Yeah. So, penny, this is very typical when you go on a low-carb, high-fat ketogenic diet, that we see the LDL go up and the HDL go up. And typically, triglycerides go down. Now, the ratio, I don’t know if you’re talking about the triglyceride to HDL ratio. Generally, we like that to be under two. So, if that’s what you’re talking about, that looks really favorable.

Dr. Jeffry Gerber:

And so, traditionally doctors are focused on looking at LDL as the singular measure of health. And again, it’s unfortunate over a half a century that has been the focus on health, therefore the dietary recommendation to do everything to lower LDL cholesterol, such as a low fat, low calorie diet. And this is where we’re trying to teach healthcare professionals to take off the blinders, and to understand that the LDL cholesterol is just one parameter.

Dr. Jeffry Gerber:

And when we say we’re looking at metabolic health, we’re looking at inflammatory markers, we’re looking for insulin resistance. And we also measure the heart calcium score, which is direct visualization of the disease process. It’s a CAT scan of the heart, uses a tiny bit of radiation, and you can see calcium or plaque in the arteries itself. And it gives you some historical data as to what’s going on.

Dr. Jeffry Gerber:

Now, if you’ve recently changed your diet, your LDL went up well, or you can track it with metabolic markers. They tell you what’s going on at the present time. But you can also do serial calcium scores down the road. But getting back to the specifics on this, so we see the cholesterol going up in a healthy way, where… Go ahead.

Carole Freeman:

Let me show you. So, here’s her numbers. This what her doctor thinks is high LDL. So, I’m laughing to myself here that her LDL is only 124.

Dr. Jeffry Gerber:

Yeah. So, they want to see LDL under a hundred, but even by mainstream standards, I think most would pass on that. Especially when you look, you have a very high HDL, you have a very low triglyceride. So, I don’t really know what the fuss would be there.

Carole Freeman:

Yeah. Do you think that sometimes it’s just, even when markers look really good, people in general and physicians have a bias, they just think, well, it’s healthy, so it could be better. Do you think that maybe?

Dr. Jeffry Gerber:

Yeah, or they have a bias that low-carb is unhealthy.

Carole Freeman:

Right, right, right. That’s what I meant. Yeah, sorry.

Dr. Jeffry Gerber:

Yeah. They have a bias that low-carb is unhealthy. And yeah, there is a bias there. And so, this is where we tell the patients to say, “I’m doing a low-carb Mediterranean diet and look at my numbers, they look real, pretty, they look good.” So, it might be her LDL went up a little bit.

Dr. Jeffry Gerber:

But so the point is though, Dave Feldman through the Cholesterol Code has done a lot of research on these LDL hyper responders. And he wants to actually do more research with these particular patients. But what we see is that a diabetic, for instance, that goes on a low-carb, high fat diet. And I don’t know if Pennie, was diabetic or pre-diabetic. But all the metabolic markers improve, triglycerides go down, HDL goes up, inflammatory markers improve, insulin gets better. We do two hour glucose tolerance tests by the way, where we measure glucose and insulin. A1C is improved. And the only number that goes up is the LDL cholesterol. And again, that’s just one metabolic marker of health. And so, from our perspective, we see a patient like that doing everything right, and they’re losing weight. So, this is the conundrum, and this is where we’re trying to help our healthcare professionals and our patients to understand what’s going on.

Carole Freeman:

Pennie has lost what? Over 200 pounds, I think so. And she’s maintaining her weight loss for a long time.

Dr. Jeffry Gerber:

Yeah. That is great. That’s great way to go.

Carole Freeman:

She’s worked very hard in following a low-carb ketogenic lifestyle. She has through trial and error, she has found that she does feel a lot better doing a higher protein, lower fattish approach. So, that’s something that we found for her that she just feels the best too.

Dr. Jeffry Gerber:

Was she diabetic by any chance? Pre-Diabetic? You don’t know.

Carole Freeman:

She’s lost over 300 pounds. Here we go. Correction, she’s lost over 300 pounds.

Dr. Jeffry Gerber:

Pennie, that’s tremendous.

Carole Freeman:

Yeah. Pennie, I don’t know if before we were working together, were you ever diabetic or pre-diabetic? Let us know there. So, she’s had tremendous [inaudible 00:18:04].

Dr. Jeffry Gerber:

What I might say is, how the diet looks now is different than when Pennie started. And so, naturally, if you lose weight, there’s less of you and you’re just not hungry, and you don’t eat as much, or you eat less frequently. So, it’s just a natural progression. But if you haven’t reached a goal or you’re hitting the plateau, then you have to think about the things that we were discussing earlier, that you just want to eat enough fat to fill, and so forth.

Carole Freeman:

Yeah. Not diabetic. So, she’s [crosstalk 00:18:45]. Yeah.

Dr. Jeffry Gerber:

Yeah. So, this is an example of someone that was not necessarily full-blown diabetic, maybe not even measured for pre-diabetes or insulin resistance, but did have success. An if we query Pennie, she would probably say that she’s doing a lot of the things that I’ve been talking about, anyway.

Carole Freeman:

Yes. I know she is. Yes.

Dr. Jeffry Gerber:

Yeah. That’s your plant, Carole.

Carole Freeman:

My plant, yeah. Oh no, well, the people that we’ll be watching live are going to be my current clients.

Dr. Jeffry Gerber:

Excellent.

Carole Freeman:

So, when we put this out on the YouTubes later, we could have, who knows how many people watching there. So yeah, we get the special as a bonus for my clients, they get to watch live, and then we’ll share it out more for other people too. So, all right.

Carole Freeman:

So Pennie, other questions you’ve got for Dr. Gerber. So, perhaps talking with your doctor about following a low-carb Mediterranean diet may make them feel a little more comfortable. But I also know from talking to Pennie, yesterday, that her doctor just in

general thinks that plant-based is best. And so, I don’t know that even saying a low-carb Mediterranean would make her doctor happy right now. But yeah, she’s saying that the low-carb Mediterranean, I think that may make him feel a little more comfortable.

Dr. Jeffry Gerber:

Yeah. So, you can also approach it from a low-carb vegetarian approach. Plant-based it really just the new term, perhaps it’s more palatable rather than saying vegetarian. But I think you have to ease your way into it. And we don’t want the people to be at the doctor’s throat with this extreme dietary approach because it really isn’t.

Carole Freeman:

Mm-hmm (affirmative). Right, right. The preconceived notions of what a low-carb diet is for a lot of people, it can be plant-based, if you’re eating a certain percentage. And also, that’s such a nebulous term. Right? So, plant-based, what percentage of your diet or calories need to come from plants for you to be plant-based?

Dr. Jeffry Gerber:

Right. Exactly.

Carole Freeman:

So, let’s go back to, when you did your own experiment, you saw the results and that started to influence the work that you were doing with your patients at your clinic. Can you share some of your favorites stories of transformation of people you’ve worked with over the years?

Dr. Jeffry Gerber:

Sure. And it varies across the board, that we have patients that will lose 20 pounds, a hundred pounds, 200 pounds. And I have a database. Although it’s important to understand, I don’t have a research type of setting in my office. It’s just simply clinical. But we try to keep it a database.

Dr. Jeffry Gerber:

And one patient, this reminds me early on, he’s been a patient for probably 25 years. And he’s diabetic and overweight, when we first met him. And he didn’t have a heart attack, but he was having, I think it was anginal symptoms. And then he ended up going to the cardiologist. And whether or not you agree that the patient got stents with non-MI disease, that there’s some controversy about stents in patients that just have stable angina or unstable angina. Well, he got a stent and he was fine. But we also noted that he was a diabetic. And we ended up early on placing him on a low-carb diet. And I think he had lost like 50 or 60 pounds. And we got his diet under control without medication. And he’s still a patient of ours for 25 years. And knock on wood, he hasn’t had any cardiovascular events.

Dr. Jeffry Gerber:

And we see these stories over and over again. And we see a lot of patients that come in precisely with this concern about going on a low-carb diet and then their LDL cholesterol

went up. And is this placing them at risk or not? And so, we have these discussions with our patients each and every day.

Carole Freeman:

Yeah. And like you said earlier, you’re looking at the whole picture and all their metabolic markers, and making that decision individually with each person.

Dr. Jeffry Gerber:

Yeah, absolutely. And the beauty of what we do is that we really blend traditional medicine with the nutritional approach. And we talk about medication. If a patient can comply with lifestyle modification, we get them off medication. If they can’t comply and they’re having a really hard time, well, then we say, okay, well, there’s medication. So, we have that discussion as well. But we certainly prefer getting people off medication and addressing healthy lifestyle and diet.

Carole Freeman:

Pennie, has got another question. Pennie, I’m going to ask for a little more details here. But she’s asking how does support fit into your practice and experience. So, if you’re talking about like, I’m going support or what type of support?

Dr. Jeffry Gerber:

I get the question. So, Pennie, what we’d like to do is empower our patients and to be their personal health coach for them to bring about change. And what’s interesting with our medical practice, we work in the context of health insurance. So, we’re dealing with health and nutrition, and comorbidities. So, in a sense, we’re not a weight loss clinic, where we have nutritionists that you meet with once a week. We’re actually the nutritionists.

Dr. Jeffry Gerber:

It’s actually somewhat unfortunate within the health insurance model, we can’t even get paid to have nutritionists in our office. The criteria for nutritionists to be paid by commercial health insurance is they have to have end stage renal disease, end stage heart failure, before they’ll even consider reimbursing a nutritionist. It’s an end game type of approach. It’s terrible. So, we’re the nutritionist. And my staff are somewhat trained, so we’re always available to help answer questions. And we see patients back on a regular basis. We have support group once a month, although because of the pandemic we’ve put that on hold.

Dr. Jeffry Gerber:

So, I think it’s very important question that you’re asking. And so, really empowering our patients to make change is important, and it’s something we do each and every day with them.

Carole Freeman:

So, I wonder if the insurance nutrition reimbursement must be state by state. Because I know back in Washington, the nutritionist there could get quite a bit of reimbursement.

But also, I think a lot of that was influenced because there was a lot of Microsoft employees there, and they had pretty significant, they could get like 12 appointments a year with a nutritionist for weight loss or various things. So, maybe in different states, that varies, is that why?

Dr. Jeffry Gerber:

Well, we deal with co-morbidities and that’s how we work with health insurance. And they do recognize obesity codes. And so, they’re included when we deal with patients. Traditionally, the health insurance, again, to their fault, were very skiddish about reimbursing for anything related to obesity. It’s absolutely ludicrous. But for us over our career, we’ve really worked it in, and have created a model for what we believe is the correct delivery of primary care and primary prevention in this way. Yeah.

Carole Freeman:

Pennie loves your personal empowerment term. I’m sure that that’s not common for a lot of medical clinics. So, that’s great.

Dr. Jeffry Gerber:

Nice [crosstalk 00:28:12].

Carole Freeman:

So, what are some of the first steps? So, let’s imagine you’ve got somebody coming to your clinic for the first time, and they’ve never embarked on a low-carb approach. What are some of your initial recommendations of how they can get started?

Dr. Jeffry Gerber:

Yeah. Well, the evaluation is we do a physical history and we look at their dietary approach, their medical problems, medications they’re on or not on. And then we will do basic metabolic markers. And as I get older and crotchety, I have decided that simple is best. And we can get so much information by doing a standard lipid profile, glucose and hemoglobin A1C in a urine in our office. And we have equipment, we get the results in 10 minutes. [crosstalk 00:29:06].

Dr. Jeffry Gerber:

Yeah. And that tells you so much about metabolic health right there. But we take it one step further. We’ll do general blood work that we’ll send out to the lab. But we’ll also include an insulin, a C-peptide, which is a pro insulin measurement. We’ll do CRP sed rate.

Dr. Jeffry Gerber:

And then in certain individuals that we do suspect insulin resistance, we’ll bring them back for the second visit and do the two hour glucose tolerance test with a two hour insulin. And so, the two hour insulin is rather interesting. We see patients that all the numbers I just mentioned are, can be pretty normal, including a fasting insulin and your A1C, and your glucose may not even be that high. But then the two hour insulin, if it’s over 40 micro units, that definitely confirms that you have an insulin problem.

Dr. Jeffry Gerber:

And we’ve seen patients, they’ve set records where we’ve seen the two hour insulin over 500, over 600. And other patients’ stories, very surprising that you look back at their fasting blood work, and you don’t see a whole lot going on.

Dr. Jeffry Gerber:

And what’s interesting is that insulin measurement, the endocrinologists that we sometimes refer patients to, where the patient has seen an endocrinologist is taken back, “Why are you as the family doctor measuring insulin?” Well, we read our book. That’s why we measure insulin.

Dr. Jeffry Gerber:

So, at the second visit, then we see the patient back and we go over the results. We might do a heart calcium scan. And we individualize a dietary and lifestyle approach at that point.

Carole Freeman:

Oh, so that’s really cool. I recommend that people get a fasting insulin. But you’re going a step further with the two hour glucose and insulin tolerance test, because you’re going to see the insulin dysfunction even before it shows up in that fasting insulin. So, that’s really great that you’re able to do that, because that would be another one that [inaudible 00:31:20] clients ask their doctor. The doctor be like, “Why do you need that?”

Dr. Jeffry Gerber:

So, this comes from the work of Dr. Joseph Kraft, who Ivor and I had a chance to meet when he was at the tender age of 95. And he’s since passed, but he actually devoted his career to the insulin assay. And what he really demonstrated is that you can identify an insulin problem, 20 years before the diagnosis of diabetes by simply doing the insulin assay. And so, we’ve learned from that, and we’ve been doing that for years.

Carole Freeman:

Oh, I love that. Now, I want to come out and see you out there. So, I know that people that have been following low-carb ketogenic diet for a while, they don’t do very well on the two hour glucose test. Right? Because they’re not really tolerant anymore. But will their insulin be normal?

Dr. Jeffry Gerber:

Yeah. So, that’s a great question, Carole. So, we really reserve doing the glucose tolerance test in patients that are low-carb naive.

Carole Freeman:

Okay.

Dr. Jeffry Gerber:

Because once you’re on a low-carb diet, there’s something called physiologic insulin resistance that can skew the results. Now, we see a lot of data geeks and biohackers that come into our office, and they’re on a low-carb diet. And they insist on doing a two hour glucose with insulin. And so, what we do with those patients is we say, “Okay, I understand you’re data geek. So, what we’re going to do is have you load up with carbohydrates. You have to eat 150 grams a day for maybe seven to 10 days. And then we bring you back. And then we do the glucose tolerance test. And that’ll give us more of a baseline result.” But it’s really an important test to do in patients that are low-carb naive.

Carole Freeman:

Okay. What do you see is one of the biggest mistakes of people trying to adopt a low-carb lifestyle?

Dr. Jeffry Gerber:

I mentioned it before, I think the biggest mistake is this idea that you can just gorge on fat, that calories don’t matter. And over the years, that frustrates me. And so, the message is clear that eat enough fat to fill. If you’re not hungry, eat less frequently. Again, you shouldn’t force, intermittent fasting is what we’re referring to. So, yeah, that’s kind of the main theme. And you have success, if you’ve paid attention to that.

Carole Freeman:

Yeah. I love that message is starting to come out more and more that, maybe three, four years ago, that was the theme was like, you got to get your fat in. You got to have all these fat bombs. You got to drink fatty coffee. And it turns out that may actually not be very healthy either, as well as not being necessary or good for results too.

Dr. Jeffry Gerber:

Carole, I’ve learned a lot along the way.

Carole Freeman:

I think we all have. Yeah. Well, and I don’t know if you saw this or not, but a friend of mine was on a podcast interview, Mike Berta, where he’d already lost quite a bit of weight on low-carb. He was in maintenance mode. He lost about 80 pounds. And when you look at him, you’d think like, “Oh, this guy had never had a weight problem his whole life.” And so, then he tried the 90% fat ketogenic approach for his N-of-1 experiment just to see what happened. So, he’s a patient of Dr. Ted Naiman. And he shared this openly. So, he went in and got his blood drawn after he did this 90% fat ketogenic experiment. And his triglycerides were 1500. And Dr. Naiman said, “Abort, abort, this experiment.”

Carole Freeman:

And so, I’m thinking and wondering why, when we try to apply this medical therapeutic diet that was applied to little kids with epilepsy a hundred years ago at 90% fat, like perhaps that extreme level of high-fat, especially when applied to people that are just trying to get metabolically healthy, may actually be part of why we can see in literature that there are some complications of a really high fat ketogenic diet.

Dr. Jeffry Gerber:

Well, that’s actually unusual. So, we have patients that have familial hypercholesterolemia, they have lipid disorders. And that can include very high triglyceride. And it’s interesting, you put them on a high-fat diet, it seems to be kind of counterintuitive or a paradox. But we do see the triglycerides come down.

Carole Freeman:

Yeah.

Dr. Jeffry Gerber:

And that’s just really unusual. And so, what we see is that the high fat, low-carb helps to push the fat energy into the cells where it’s needed for energy rather to have it stuck or circulating in the blood vessel, where you can measure the high triglyceride. So, I’d like to hear a little bit more about that patient. And hopefully, the triglycerides came down, whatever the intervention was.

Carole Freeman:

Well, they were. And his moderate fat, high-fat ketogenic lifestyle that he lost the weight with, his triglycerides did come down to normal. It was when he was at a lean body mass that he tried this 90% fat experiment that that’s when the triglycerides bumped way up. So, it might’ve been that extra fat trafficking at that level for him, it showed that that was not the way to continue his lifestyle for a 90% fat [inaudible 00:37:42].

Dr. Jeffry Gerber:

Good for him it came down. But it just reminds me of this aspect that what we’re trying to do for weight issues is to mobilize stored fat. So, we want to mobilize the stored fat, where the energy is predominantly stored, and get that out of the fat cells. And so, it’s a balance between the dietary fat coming in and the fat that stored. And so, if you lower down the dietary fat, then you tap into the fat stores in a sense, and then the energy becomes available.

Dr. Jeffry Gerber:

But if you’re diabetic, this energy here in the fat stores is trapped because of high insulin levels. And that’s where you can eat a lot of high-fat initially. And again, it seems like a paradox, but that high-fat diet mobilizes the fat stores. And then, you see the fat energy it gets released, it gets distributed throughout the body, stored in the lipoprotein. But then eventually the insulin resistance gets better. And then you have to back down the dietary fat long-term.

Carole Freeman:

I’ve got one more question for you about the prevalence of people that look lean and healthy but actually have metabolic, I guess, well, maybe it could be metabolic syndrome. They’re just don’t have the obesity. But like pre-diabetes. So, I have a lot of my ladies that, “Oh, my husband, he can eat whatever he wants and he never gains an ounce.” But I always caution them that those people are the ones that are at danger of developing undiagnosed

diabetes. So, and I know a lot of these people fly under the radar because their doctor is not checking them for diabetes because they look lean. But in your clinical experience, do you have a sense of what percentage of those people that look lean, that can eat whatever they want, they eat a lot of junk and sugar all day long, that actually are at risk of developing complications or metabolic dysfunction?

Dr. Jeffry Gerber:

Sure. Well, I would say in general, two thirds of the population have some degree of metabolic syndrome, whether they’re at their ideal body weight or are not at their ideal body weight. And so, you’re referring to patients that are TOFI, so they’re thin on the outside, fat on the inside. We have an expression for that. And we typically see a large Asian population that fit into that category. And we see that each and every day. And you think they’re healthy, and then you measure their metabolic markers, and they are pre-diabetic or overtly diabetic. And so, because of what we do, we screen for this, and very early on, we can say, “Hey, there’s an issue.” And again, we can pick up the problem sometimes 20 years ahead. So, it’s important to screen for these individuals that are thin on the outside, fat on the inside, meaning that they’re metabolically unhealthy.

Carole Freeman:

Yeah. Yeah. That’s great. Well, let’s wrap this up now. Anything else that you were hoping I would ask about or that important information that you’d like to get out there to the world as we continue to work on changing the health of this planet?

Dr. Jeffry Gerber:

Yeah. Well, we still enjoy family medicine. We’re in the trenches and hope to continue doing that for a while. And also, spreading the message with our patients, with healthcare professionals and in the writings. And we had to put a hold on our conference for 2021, because there’s so much uncertainty because of the pandemic. But we keep our fingers crossed that we can have an in-person conference in 2022. As you know, you’ve attended our conferences, and it’s just much more rewarding to do it in-person.

Carole Freeman:

Yeah. Oh, I miss it so much. That’s the last time I saw you, was in, right before things got bad this year. So, and you’re right, the online conferences are just nothing like the in-person experience of getting to meet everybody and connect with other people that are following this low-carb Mediterranean lifestyle. So, well, thank you so much for taking the time, Dr. Gerber. We appreciate all that you’ve shared and for being here. And thank you for taking the time to be here for us.

Dr. Jeffry Gerber:

All the best, Carole, and also to your clients. Stay healthy.

Carole Freeman:

Excellent. How can people follow you? What’s your website they can connect with you?

Dr. Jeffry Gerber:

So, two websites, Denver’s Diet Doctor, or Low Carb Conferences.

Carole Freeman:

Excellent. Excellent. And we’ll have those linked in the show notes below too. So, thank you so much. Thanks for everybody for watching. That’s all for now. We’ll see you next time. Bye.

 

Get a FREE 7-day Fast & Easy Keto Meal Plan: https://ketocarole.com/free-7-day-meal-plan/

Keto Chat Episode 130: How To End Your Carb Confusion About Keto Diet

Interviewee Bio and Links:

Book: End Your Carb Confusion

Eric’s Bio:
Eric C. Westman, MD, MHS, is an Associate Professor of Medicine at Duke University. He is Board Certified in Obesity Medicine and Internal Medicine and founded
the Duke Keto Medicine Clinic in 2006 after eight years of clinical research regarding low-carbohydrate ketogenic diets. He is Past President and Master Fellow of the Obesity
Medicine Association and Fellow of the Obesity Society. He is an editor of the textbook Obesity: Evaluation & Treatment Essentials and co-author of the books Cholesterol Clarity, Keto Clarity, and
the New York Times bestseller, The New Atkins for a New You. He is cofounder of ADAPT Your Life, an education and product company based on low-carbohydrate concepts.

Eric’s Links:
Website: http://drwestmanonline.com/
YouTube: ADAPT Your Life – https://www.youtube.com/channel/UCni9TCw0YPwTdu7BYF3j0Eg
Twitter: @drericwestman – https://twitter.com/drericwestman
IG: @ecwestman

Amy’s Bio:

Amy Berger, MS, CNS, is a U.S. Air Force veteran and Certified Nutrition Specialist who specializes in helping people do “Keto Without the Crazy.”™ She has a master’s degree in human nutrition and writes about a wide range of health and nutrition-related topics, such as insulin, metabolism, weight loss, diabetes, thyroid function, and more. She has presented internationally on these issues and is the author of The Alzheimer’s Antidote and The Stall Slayer: Seven Roadblocks to Keto Fat Loss and What to Do About Them.

Amy’s Links:

Blog: http://www.tuitnutrition.com/

YouTube: Tuit Nutrition – https://www.youtube.com/channel/UCmDz-SYYhoerycynsCm7L8g/videos
Twitter: @Tuit Nutrition – https://twitter.com/TuitNutrition

IG: @TuitNutrition – https://www.instagram.com/tuitnutrition/

___________________________________________________________________________________________

Transcript:

Carole Freeman:

All right. Welcome everyone to this episode of Keto Chat, I’m here with wonderful people, Amy Berger, Dr. Eric Westman, welcome everyone. They’re here to talk about their brand new book that’s coming out End Your Carb Confusion. If you guys have been living under a rock, and you don’t know who these two people are, let me just read their bio for you. Oh, oops. Let’s see. I had that pulled up and then I closed that out. Bear with me a moment here. Okay. Dr. Eric Westman is an associate professor of medicine at Duke University, he’s board certified in obesity medicine and internal medicine, and founded the Duke Keto Medicine Clinic in 2006, after eight years of clinical research regarding low-carbohydrate ketogenic diets. He is a past president and master fellow of the Obesity Medicine Association, and fellow of the Obesity Society. He is editor of the textbook Obesity: Evaluation and Treatment Essentials, And he’s co-authored the books, Cholesterol Clarity, Keto Clarity, and New York Times bestseller, The New Atkins for a New You.

Carole Freeman:

He’s co-founder of Adapt Your Life, an educational product company based on low-carb concepts. You guys know who he is now, don’t you? Welcome Dr. Westman.

Dr. Eric Westman:

Well, thank you. After seeing your name for so long, Keto Caroline changed the name of her clinic to the Keto Medicine Clinic.

Carole Freeman:

Oh, great, great. Well, I’ll send you the bill for the 10% on Keto royalty [inaudible 00:01:48]. I own that name, right? No. So I’m glad you’re here. And then Amy Berger is a U.S. Air Force veteran and certified nutrition specialist, who specializes in helping people do keto without the crazy trademark, she has a master’s degree in human nutrition, and… I don’t know why I put quotes on trademark. Anyways, TM. Master’s degree in human nutrition and writes about a wide range of health and nutrition related topics, such as insulin, metabolism, weight loss, diabetes, thyroid function and more. She has presented internationally on these issues and is author of the Alzheimer’s Antidote, and The Stall Slayer: Seven Roadblocks to Keto Fat Loss, and What to Do About Them. Welcome Amy Berger.

Amy Berger:

Thank you. I’m more impressed that Dr. Westman is a master fellow of the Obese [inaudible 00:02:36]. Is there a special handshake? That’s very [crosstalk 00:02:41].

Dr. Eric Westman:

[inaudible 00:02:41].

Amy Berger:

I’m not a Master Fellow of anything, I just write a book.

Dr. Eric Westman:

It’s a secret.

Carole Freeman:

That’s tripped me up a little bit too. I was like, “Oh, I haven’t seen that designation, the master fellow.” So I imagine you have a sword or something they give you for that, right?

Dr. Eric Westman:s

No, it just means you’re old.

Carole Freeman:

Well welcome, thank you all for reaching out. I was so excited to hear you guys have this new book coming out. So, let’s start out with, how’d this book even come to be?

Dr. Eric Westman:

Sure. Well, gosh, how many years have we crossed paths girl? The cruises, the low carb meetings.

Carole Freeman:

Probably about four or five now-

Dr. Eric Westman:

For five, yeah.

Carole Freeman:

… [inaudible 00:03:25] first Low Cab USA was. Which was four or five [inaudible 00:03:32] around there.

Dr. Eric Westman:

Well, I’ve gotten to know a lot about keto diets, used them in the clinic with people who have all sorts of diseases, and it’s very, very therapeutic. It’s very effective. But I’ve come to the realization that not everyone’s going to do it, including my brother and my kids. So the thought occurred to me and to my partners with Adapt Your Life, that why don’t we bring the knowledge that we’ve learned about carbs to people who wouldn’t do keto, who wouldn’t even think about it? Give up an apple or something. Yes, you can have an apple and still achieve a lot of the benefits that you get by cutting carbs, and because there’s so much confusion, I find that my clinic day is basically trying to get rid of all of the misconceptions about what keto means.

Dr. Eric Westman:

So when I learned about Amy Berger and her Alzheimer’s Antidote book and the clear writing, she’s a professional writer, and also that she had a keto without the crazy mentality of trying to make things simple, it was natural. So I asked her to help me operationalize the idea of telling people about what we know about sugar and carbs, and that not everyone needs that. If your metabolism is suitable, you don’t have to do keto, which might surprise you.

Carole Freeman:

Yeah. Yeah. Anything to add Amy?

Amy Berger:

Yeah. In my thinking this book, like Dr. Westman was saying, we’ve all three of us have been at this keto thing and low carb thing for a number of years, Dr. Westman, more than you or I Carol. And we’ve seen it evolve from something that was pretty simple, just don’t eat a whole lot of carbohydrate and you’re like 90% of the way to where you want to go. That’s the main thing you have to do. And over the last few years, it’s become so complicated So confused by all of this extra stuff that wasn’t really part of the core message, was just eat very little carbohydrate. Everything else is detail. Maybe it matters, maybe it doesn’t, but the place to start is just cutting your carbs way back.

Amy Berger:

And that signal has been lost in all of the noise. So this book really, I think quiets all that noise, gives you the main message, and just takes… I mean, the best way for me to say it is, this is the book I would want if I was new to all of this now. Because the fact that this way of eating has become so popular is so great, because there’s so much more information about it than there ever was, but then there’s also a lot of misinformation and a lot of stuff that’s really high-level and complicated, that you don’t even need to understand at all, to do the main thing and be successful. And Dr. Westman is being too modest.

Amy Berger:

The real story of how this actually evolved, is he originally wanted to write a book that was a 30 page, like a pamphlet that you could pick up at an airport, before COVID when people actually went on airplanes, that you could pick up at an airport bookstore, read on the flight, and by the time you landed, you could actually be ready to start keto. Like this little thing with just, “Here’s what you need to do.” And the publisher was like, “Nobody’s going to buy a 30-page book. Can we do this with something more?” So we fleshed it out with a lot more stuff, but-

Dr. Eric Westman:

Well, I think it’ll have a broader appeal than the, “Here, just do keto.” For example, I have a brother who his life has been full of carbs, but he was the one who was naturally active and played basketball in high school, and in college, while I was studying books. So there are individual differences that we hope to bring the knowledge of what we’ve learned about low carb and keto to the other people that need it and wouldn’t consider, or maybe they would consider if they knew how easy it was to do keto. And in my clinic I have medical students and residents, and recently the first patient I saw was one of the students. She came in and the patient said, “This is too easy.” And I said, “Well, what do you mean?” “Because I’m not hungry, I don’t have to think about what to eat.” And also some people are going to be surprised at how simple it really is.

Amy Berger:

Yeah.

Carole Freeman:

Oh yeah. That’s so true. I get that… My clients, “Here’s what you do step by step.” And they’re like, “This is so much easier than what I was trying before.” Everybody’s got to make it so complicated out there. You don’t need all the macro calculators, you don’t… I got an early copy of your book, and there’s not one mention of macros in there, no calculators or percentages or anything crazy like that. So [crosstalk 00:08:36].

Dr. Eric Westman:

I think there is a mention in macro and we say, “Don’t do it.”

Amy Berger:

Yeah. We think don’t worry about math. But I think Dr. Westman is right. It’s not just a keto book and I think that’s where this is new to our space, so to speak. Honestly as much as all three of us, we make our careers out of this way of eating, but it would be frankly wrong, downright incorrect of us to say that “Cantaloupe is poisoning you.” Or, “Sweet potatoes are killing you.” When there’s billions of healthy people around the world that eat these foods and they’re thin, they’re healthy, they age with their faculties intact. So our book helps people find, “What is the carb level that’s right for me?” Because the truth is, a lot of people do need keto. There’s a lot of people with type 2 diabetes, and PCOS, and hypoglycemia and all of these conditions that respond really well to keto.

Amy Berger:

And then there’s people who don’t need to be quite so strict, and then we all know plenty of people too, that may be at one point were very sick or very, very overweight, and did keto for a while, corrected all the issues, and now what? Should they eat strict keto for the whole rest of their life, or do they maybe now have a little more flexibility? So that’s where this book… Because I think in the keto world, unintentionally, we do people a disservice by making them really scared of foods that might be perfectly okay for them. Not 400 grams of carbs a day, but maybe you can have a peach from the farmer’s market in the middle of summer, and it won’t actually kill you.

Carole Freeman:

I think Amy, you have a phrase and I don’t know which food it is, but you say something about, “Eating sweet potato’s never made anybody overweight,” Or, “That’s not the problem.”

Amy Berger:

Yeah. Nobody got diabetes from eating too much broccoli.

Carole Freeman:

Exactly, right? Well, you guys hinted on that, so let’s just go there now. So who is this book for? Who should read this book?

Dr. Eric Westman:

Well, we want it really to be for the general public. Just someone who’s interested in improving their health by addressing nutrition, and that’s the main thing. We have a sound modulators or an amplifier with different dials, but we explain that the nutrition dial is what you got to really work on first. The other things usually come around on their own, but it’s also good for a keto crowd who might be at a stall, who might not understand the original… If you are in this world, it’s more like the original Atkins Induction or Protein Power, which is how we all learned this 20 years ago, So it’s a reminder, a refresher for people who are already in the world. And we don’t do the food quality really, that piece will say, “Don’t worry too much about it, it’s great if you can.” And then, “Don’t over-consume fats and oils.” which are still problems I see today in people who are in this world, but not getting the results they want.

Dr. Eric Westman:

You might even send it to a relative who you might want to help influence, who thinks keto’s crazy, and this is not a, “You must do keto.” Kind of book. It helps you figure out what would probably work.

Amy Berger:

I think to anyone watching this after, we’re recording on Saturday, November 7th, I think we are getting a tiny bit of the noise. There’s some celebrating in Dr. Westman’s neighborhood. I think he lives on a [crosstalk 00:12:15]. I think we’ve had some car honking. Anyway. No, I agree. The book is for-

Dr. Eric Westman:

I think they’re celebrating the book.

Carole Freeman:

Yes.

Amy Berger:

[inaudible 00:12:23]. I mean, the book is for everybody, but I think it’s for… There’s so many different audiences that I think would benefit from it, but the two that jump out to me the most are people who… It’s well known at this point that keto, or even just low-carb is really good for weight loss, and also even for type 2 diabetes. People are starting to know that this is the best way to go. But what about all the people that have these weird unexplained health problems, and they don’t know why, because every time they get their blood sugar checked at the doctor it’s normal, and your A1C is normal. “Well, we don’t know what’s wrong with you, you’re not diabetic, see you in six months.” And all three of us talk about this all the time.

Amy Berger:

What’s going on with insulin when your blood sugar is normal? So we have a whole chapter on insulin and how that chronically high insulin explains things like hypertension and gout and PCOS, and even migraines and all of these other things, even when your “traditional blood work” looks normal. And then the other group of people I think is like Dr. Westman was talking about, somebody that knows they have health issues, but they’re never going to do keto. They’re just like, “I’m not ever going to do that crazy keto thing.” They could read this and learn like, “Oh, I don’t have to go to that extreme level.” So many of these people will get much, much better just cutting carbs to some extent. Now, they might get even better if they would go all the way, but if they’re not going to, maybe they could come off their insulin and come off two medications, and maybe they’re just still taking Metformin. Or maybe they get 80% of the way to where they want to go, and they’re perfectly happy there.

Amy Berger:

And should we leave those people behind? Should we say, “Well, you still want to eat fruit, so you might as well just be sick and we’re going to leave you, we don’t care.” No, “What can we do to get you in a good direction?” And then Dr. Westman was saying, he wasn’t really clear on what he meant by the food quality, but there’s all this talk about, “Your food has to be organic, and it has to be grass-fed, and you can’t have the soybean oil in your salad dressing.” And those are again these peripheral issues that are not the biochemical way by which this way of eating actually works inside you. Carole I’m sure your fans probably know your history.

Amy Berger:

Not everyone can afford to go to the hoity-toity co-op and pay $20 a pound for steak. Should we leave you behind? Should those people be left to just, “Well, sorry you can’t afford grass-fed beef. I guess you just have to go blind from diabetes.” No, you can eat discount chain food. You can go to the fast food drive through and you can get burger patties, and you’ll do great, as long as you just keep the carbs low.

Dr. Eric Westman:

And I’ve learned this from many of my patients who are from all walks of life in Durham, North Carolina. Some eat from fast food and restaurants entirely, some go to the fancy grocery stores and cook their own meals, but we had to come up with the essence of what would work in all of these different places. And we share that information just as clearly as we can.

Carole Freeman:

Oh, it’s so true. You guys know my backstories. When I first started this, I was so disabled, I was getting my food at the food bank. And if we get the message out that you don’t have to have really expensive food, you can actually do it on any budget, even if you have no budget, there’s a way of making this work and you get, I don’t know, 98% of the benefits just making that change in eating any quality of food that you can afford. It’s very important message to get out there, I love that. And also I love that this whole book is about being more inclusive. Like, “Let’s bring along everyone, no matter where they’re at.” Because our diet mentality is it wants to be black or white like, “You’re all in, or you’re binging on junk food.”

Carole Freeman:

And I love that this book is about, “Let’s meet people where they’re at, and there is an approach that can fit that just improving your diet in general, is going to get you a lot of benefits, So you don’t have to be black and white. You don’t have to be all or nothing to get a lot of the benefits.”

Amy Berger:

I think, you mentioned something about, the all in, or you’re either 20 grams of carbs a day or fewer, or your face first in a tub of ice cream or something, but something that our book includes too that I think is missing from the keto world is that there’s a lot of books on food addiction and sugar addiction, and then there’s books on keto, there’s nothing that really incorporates both, until now.

Amy Berger:

Our book doesn’t talk a ton about it, but we do have sections on food addiction, sugar addiction. “Okay. Ideally, this is the diet you follow. What happens in that moment when you have that day where… or just want a damn doughnut.” What do you do? Well, if you have the doughnut, okay, get right back on plan immediately after, no big deal, move on. Or, maybe instead of the doughnut, we have a food list, for example, a cinnamon roll flavored protein bar is not really part of the food list. But if you’re in that situation, and you can barely hang on, we would prefer that you have a cinnamon roll or a birthday cake-flavored protein bar, rather than a pint of regular ice cream. There’s a spectrum of how can we indulge and go to get over that hump with the least metabolic damage?

Amy Berger:

Ideally, you would have a piece of pepperoni instead, but you’re not going to do that. You wanted the sweet. How can we have the least metabolic damage, so to speak. And I don’t know a better way to say that, but we’re being realistic. It’s like Dr. Westman says. The holidays are coming up, if you want to enjoy on Thanksgiving or Christmas or Hanukkah or whatever… I’m going to steal your line missy, your thunder, Dr. Westman.

Dr. Eric Westman:

It’s okay.

Amy Berger:

He says, “Don’t let a holiday become a holiweek, or a holimonth.” Nobody became obese and diabetic from having one piece of pumpkin pie. The problem is that we eat like it’s Thanksgiving 365 days a year, that’s the problem. Not the once in a while slice of pizza.

Carole Freeman:

Mm-hmm (affirmative).

Dr. Eric Westman:

It’s okay, I stole that from another doctor. We all share good lines like that.

Amy Berger:

Because I say it all the time, but I always give you credit?

Dr. Eric Westman:

Well, I got it from Alan Rader who-

Amy Berger:

And it’s actually in here. This is our book, everyone it’s actually in here.

Carole Freeman:

Ooh.

Amy Berger:

[inaudible 00:19:28] in here.

Dr. Eric Westman:

Very cool.

Carole Freeman:

That’s great. So you can cite your source now too, [inaudible 00:19:34]. And those of you that are watching this, if you’re watching the replay, #replay, let us know you’re watching the replay, but if you’re somebody who is ready to end your carb-confusion, if you’re in that place where you’re really feeling like, “Yeah, I’m really confused about how many carbs, should I be at zero, or should I be at 400?” So say yes in the comment section, let us know that you are ready to end your carb-confusion. But let’s talk about it. So your first section of the book is how we got here. Can we talk about that, because it’s been so long now that we’ve been told that fat’s bad for us, salt’s bad for us, we should eat six times a day. People forgot that there was something before that. So how do we get to this point now, where most of us are going to do better with having some level of carbohydrate restriction?

Dr. Eric Westman:

Yeah. So how do you boil down the Good Calories, Bad Calories, book by Gary Taubes and My Big Fat Diet by Nina Teicholz-

Carole Freeman:

Yeah, yeah. That one right there.

Dr. Eric Westman:

But basically it was the focus on avoiding fats, and fat in the food causes fat in the arteries, and fat will raise your cholesterol, and the cholesterol causes heart disease, and all of that is fading away, it’s dying a political death, which means we we don’t talk about it and nobody comes out and says we were wrong. So that’s really the false demonization of fat and cholesterol, is how we got here, and the free access to sugar, “Oh, it must be fine. If it doesn’t have the cholesterol, Skittles are these candies they’ve pure sugar, but they’re good for the heart.” No, no, no, no. So that shift is called a paradigm shift though, and it takes time. In fact, it takes maybe half a generation of people who are taught a certain way, and now are no longer are in practice.

Dr. Eric Westman:

And the younger people grow up familiar with the idea that sugar is bad, and that the sugar and insulin connection, and that the [inaudible 00:21:48] feeling bad, the rollercoaster of sugar and insulin is something that’s very real. And you can actually help people by understanding that, we tried to communicate it just as quickly as we could. And I just have to say, we don’t have a reference. We don’t have one reference, meaning a scientific citation. We did that on purpose. This is solid science. Who wants to look up, it’s a distraction when you’re reading. So that was on purpose that we… Did you notice we didn’t have any scientific reference?

Carole Freeman:

I didn’t notice that, no.

Dr. Eric Westman:

Good. Excellent. It’s the way we want it.

Amy Berger:

I’m a little nervous. I’m like, “We’re going to take a lot of criticism because of that.” But I think anytime you write anything about anything, you’re going to take criticism, but then I had to remind myself, nothing that we say is controversial. We don’t need to back anything up because like we were saying before, we don’t even demonize carbohydrate. We don’t say that bread is bad for you. “What is your medical situation? Maybe you can have bread and it’s fine.” But was a little odd to write a book and not… Especially as a nutritionist and not a doctor, I’m so used to feeling like I have to back up everything I say. Like, “Well, this study says…” That’s a little interesting.

Carole Freeman:

Now I’m going to go back and re-look again and notice that there is not that, but your knowledge is-

Dr. Eric Westman:

[inaudible 00:23:24]

Carole Freeman:

… based on lots of solid research, which is the point that Dr. Westman [crosstalk 00:23:27].

Dr. Eric Westman:

A lot of people will write a diet book and there’s not solid science, and they find these references that really have no relation to what they’re talking about. It’s like if there’re all these references they’re protesting. There’s that saying that we think they protest it’s too much. Say there are all these studies… Well, anyway, the solid science says that once you get to a certain place, you don’t have to be, “Oh, well, let’s see, there’s a paper. There’s a paper.” The diet world, as long as there’s one person against it, the news media will find them, and then suddenly there’s controversy. So this is not really controversial anymore.

Carole Freeman:

I think everyone in your neighborhood is honking in support of ending the carb confusion.

Dr. Eric Westman:

It must be.

Amy Berger:

I live just a few miles from him and there’s nothing where I live, thank goodness, because I can’t take the noise, but it’s [crosstalk 00:24:29] where I live.

Dr. Eric Westman:

I’m sorry about that. [crosstalk 00:24:33]

Amy Berger:

I was just flipping through this and I was reminded that, something else that I like about our book is, again keto is so known for weight loss, but our book really, even the cover has nothing about weight, the subtitle and the title say nothing about weight, it says optimal health. And at the end of each chapter, there’s a real-life success story of a person that we know that ate this way and reversed all kinds of health issues, and many of them do talk about weight, but it’s weight and PCOS or migraines or binge eating or fatty liver, or all kinds of other things.

Amy Berger:

And we do have two or three stories from people that were athletic, or lean their whole life, but discovered that, “I’m an athlete and I’m not overweight. Oh my God, I have pre-diabetes. How did that happen?” So I think that’s nice too, we emphasize that weight is only one aspect of what happens when your metabolism is wonky.

Carole Freeman:

Yeah. I love that you guys talk about insulin, because it’s good to see, back when we could still go to conferences and things like that, that people are starting to talk about insulin as the driver for a lot of chronic illness and disease. I enjoyed Dr. Ben Bikman’s book that just came out in 2020 as well, which is Why We Get Sick, talk to all about insulin, but you guys did addressed that as well. So can you talk just briefly about, how insulin is the primary driver? Why when people lose weight, these other things get better too?

Dr. Eric Westman:

Yeah. It’s so old that you can’t get study funded just to look at insulin. It’s so important, again, it’s not controversial. The problem is most doctors don’t measure insulin. So we’re left with measuring glucose, that’s the sugars and stuff. The blood sugar or glucose up, insulin goes up to keep the blood sugar down, but insulin tells your body to make fat, store fat, and is also pro-inflammatory. So another side of doing a low-carb diet is the anti-inflammatory effects that you get by lowering the insulin levels. And we don’t go deep dive into it, don’t worry, it’s not too technical, but it’s important to mention that, and as many people are pointing out, including Ben Bikman, the full picture can’t just be seen by measuring the blood glucose. You really need the blood glucose and the blood insulin. And back in the old days, you would actually give some sugar, and check the blood glucose and the insulin over a three or four-hour period, to see how your body responds to the blood sugar. Very few doctors do that anymore, and I don’t do that because it’s not going to change what I do.

Dr. Eric Westman:

But if you really wanted more information about glucose and insulin, you’d do more extensive testing, but it’s important to know that it’s not just about the blood sugar or blood glucose.

Carole Freeman:

And I’ve had my clients almost fighting with their doctor, “Just please let me get my insulin tested.” They don’t even know what to do with it too. But actually it was my last interview with Amy that she told me about directlabs.com, so now I’ve been able to help them, empower them to be able to just order their own labs. And interestingly, my clients were saying, “This is cheaper than my copay through my insurance to get this done.”

Amy Berger:

It’s cheap. Last time I checked, it was $34 for a fasting insulin from [crosstalk 00:28:21]

Carole Freeman:

$26 west of the country.

Amy Berger:

Oh, yeah. Unfortunately I think if you’re in New York, New Jersey and maybe Rhode Island, there’s a couple of states where it’s not legal to order your own stuff, but most of them it can be done.

Carole Freeman:

Thank you for that [crosstalk 00:28:44]

Amy Berger:

I send people there all the time for the… I always talk about thyroid panels. A lot of doctors don’t want to do the full thyroid panel. There it’s worth every penny and it’s not really that expensive.

Dr. Eric Westman:

So the insulin story is really just getting out here, Dr. Bikman’s book is going to help a lot. And it’s just not in the current way of thinking of most doctors, even internists, even endocrinologists. So you may have to take matters into your own hands with $50, $35, $20, and check some of these on your own. And fortunately, we explained a little bit about, we don’t get into those levels and all that detail, but just the general knowledge that you want to keep the insulin as low as possible. Now that is getting more traction in the deep research world, like if you study mice and all that. It’s known as a fasting mimicking diet, actually where you don’t eat much for a while and your insulin goes way down, you get all those benefits, and that happens on a keto low-carb diet too.

Dr. Eric Westman:

It’s a fasting type of diet, so you get the benefits of fasting, the fat burning and metabolism, while you’re still eating food. But that’s a hard thing to… “Oh no, that’s fasting.” No, fasting is fat burning. And that happens when you’re actually eating protein and very low amount of carbs. So, if you hear fasting has this benefit and that benefit, you’re actually getting that benefit on a keto diet.

Carole Freeman:

Yeah. That reminds me of a fun question, I get this all the time is, what can I eat or drink and still be fasting?

Amy Berger:

What can I eat while I’m fasting?

Carole Freeman:

Yeah.

Amy Berger:

What can I do to be awake while I’m sleeping?

Dr. Eric Westman:

Another common questions is [crosstalk 00:30:51].

Amy Berger:

Are you awake or you’re sleeping? Are you eating or are you fasting? No, it’s a fair question though, and I don’t think we address that in the book. Because we have an FAQ, and we do address, is fast required? And of course the answer is no, but it depends on how you define fasting. If you’re just skipping a meal or eating only once or twice a day because you’re only hungry once or twice a day, to me that’s not fasting, that’s just eating normally because you eat when you’re hungry and when you’re not hungry, but you don’t eat just because, “Oh, it’s breakfast time I should eat.” But the whole goal of fasting, from a metabolic point of view, I’m not talking about a serious medical issue that may be somebody is using fasting, medically supervised, but just metabolically speaking, in my opinion, the main point of fasting is to get your blood sugar down and keep it nice and low, or get your insulin down, keep it nice and low.

Amy Berger:

And like Dr. Westman was saying, if you do keto the right way, that happens on keto anyway. But with that in mind, you can drink coffee, and in my opinion, you can drink coffee and still consider yourself fasting, even if you’re putting a little splash of cream or… Even if some people want to push a meal an extra two or three hours later, rather than eat at their normal mealtime or whatever, I do think you can eat half an ounce of walnuts, or an ounce of macadamia nuts, something that is basically zero-carb and close to zero-protein, something that’s almost pure fat, because I’ve done this.

Amy Berger:

For psychological reasons, if I want to fast for a day or two, just to see if I can do it, I will do that, and I’ll consider myself still in a fasting state, because metabolically speaking, an ounce or half an ounce of walnuts or macadamia nuts is going to do nothing to your blood sugar and insulin, and to me, that’s what you want to do with fasting. You want to stay in that state and that kind of stuff is not going to push you out, I don’t think. So, coffee, tea, water…

Dr. Eric Westman:

So the problem comes in in the practical reality that some people can’t limit themselves to that much.

Amy Berger:

Of course, yeah.

Dr. Eric Westman:

Of course, these are people who come to my clinics so that if you have a difficult time moderating any of these things, then the easiest teaching is to say, “Don’t have it.” But then it becomes too depriving. I can see why a lot of people say, “No, you can’t.” But then it keeps people away from it, and then we try to teach, “Well, it’s the metabolic state that you’re in, a little bit won’t interfere with that.” “But when I have the little bit of cream, it turns into a lot of bits of cream.” “Well then, okay, you can’t have that.”

Amy Berger:

Well I say, “You have to know yourself.”

Dr. Eric Westman:

Those are the trigger food concepts. It’s interesting that nuts and cream and oils and even pork rinds in my area, these puffed up big skins become trigger foods and people can’t stop, and you just have to be aware that that’s pretty much a universal thing. We all have our trigger foods and buttons that you just got to stay away from those things for a while.

Amy Berger:

I myself recently, a little personal confession here, I had to move… I don’t know if you’ve ever heard of this concept of green light, yellow light and red light foods. Green light food is something you have no problem with, you can eat it, it’s fun. Red light food is a food that you know is a trigger food. Like some people [inaudible 00:34:30] peanut butter or something like, “I can’t have just one spoonful, I’m going to have a whole jar.” So that’s a red light food for you. Pork rinds for me, used to be a green light food, now, they were a red light food and there was no passing through yellow because my serving is the bag. Whether that’s the little snack size bag or the family size bag, my serving is the bag. So now my serving is zero, there’s no pork rinds ever.

Dr. Eric Westman:

So, someone reads the book, we actually have three specific phases or categories or whatever [inaudible 00:35:08], we call it phase one, phase two and phase three. So I think, of all of the things I have, this is unique in that all of the books we’ve read, and because we’ve been positioned in the keto world, we’re not afraid of saying, “Yeah, you can do keto forever, here are the things you need to watch out for, and yeah, you can have some carbs forever.”

Dr. Eric Westman:

So what we’re trying to do is help with the practical reality of what carbs you can eat, what carb levels, but also the day-to-day things we’ve learned from working with people with keto, and these practical things often are the little devil’s in the details they say. And often as you coach someone, you get to know what they’re having, you get a sense for, “Okay, certain domain of this is a pasta, bread sort of thing.” Have you heard of chaffles? That chaffle is the greatest bread substitute or substitution. It came on the keto world maybe 18, 20 months ago or so. I was interviewing for Woman’s World, they did an article on the cheese and egg waffle. You’ve never had a chaffle Carole?

Carole Freeman:

Oh no, I have. It’s just that you got me interviewed for Woman’s World for chaffles is just funny to me. It’s amazing because it’s like cheese and eggs make a waffle, when you see the mixture together, you’re like, “That’s not going to be…” And it’s like, “Oh my gosh, how’s that happened? It’s magic in the little waffle iron.” So I love that you guys you’re looking at individual carb tolerance from two different ways. So one is a metabolic place, where you have a different carb tolerance, depending on where you are metabolically and that can change over your lifetime, but as Amy’s been talking about, and Dr. Westman too, that there’s also the psychological, knowing yourself, right? The red light, yellow light, green light foods, there may be some foods that just don’t work for you personally, even though other carbs may work for you too.

Carole Freeman:

So I love that you’re addressing that. It’s not that, here’s the one-size-fits-all diet for every single person, here’s the food you’re going to eat and here’s the foods you’re not going to eat, and there you go.

Amy Berger:

Right. And even the keto foods, like we were just saying, there’s a reason not… A Dr. Westman’s famous page four diet, that’s what our phase one is an endocrine confusion. There’s a reason nuts and seeds aren’t allowed, and it’s not that they’re not suitable for keto, they are. It’s just that it’s like the number one most common trigger food or binge food, I always joke you get that bag from Trader Joe’s and you sit down on the couch and before you know it, half the bag’s gone, “How did that happen? Oh my God.” If you are the rare person that can have the one ounce of almonds and put the bag away, have the almonds. And same thing with cheese, cheese is limited for the same reason. Cheese, it’s perfectly fine for low-carb or keto, it’s just so easy to overdo. So it’s not just the high-carb foods that we have to watch out for, you just have to know, for you… And because there are people that can have one little square of cheese and put the block away. So you have to know where you fall on that spectrum.

Dr. Eric Westman:

Yeah.

Carole Freeman:

I remember Dr. Westman in Austin, Texas, and this probably was about three years ago, I’m going to guess. After the conference you were talking about the things that people crave, and clinically that you’ve noticed when somebody says, “I crave bread.” And then when you question them, “Well, what are you eating?” Do you want to share a little bit about your…

Dr. Eric Westman:

You want me to give away all my secrets? Is that it?

Carole Freeman:

Yep.

Dr. Eric Westman:

Well, ask me if I crave fruit.

Carole Freeman:

Do you crave fruit Dr. Westman?

Dr. Eric Westman:

No, I don’t eat fruit. “Oh.” And of course there’s that initial, “You don’t eat fruit?” “Well, no, I’ve done this 20 years. It doesn’t tug at me anymore.” But then, Amy, do you crave cigarettes?

Amy Berger:

I don’t smoke.

Dr. Eric Westman:

No, because you don’t smoke. That’s right. So when someone comes in and says, I ask, “Are you having hunger?” “Yes.” “Oh, well, what are you craving?” “Oh, bread.” I know they’re eating bread. Because you don’t crave it if you don’t eat it. At first I don’t really… I’m always supportive, that’s a big part of what we do. I have to say the book is written, thank you, Amy, in a way that’s very supportive. And if anything, we bend over backwards to help solve this problem, which is really a difficult one for so many people. So if you’re craving something, it means you’re having it.

Carole Freeman:

Yes. Or you’ve recently had it.

Dr. Eric Westman:

Yeah, you’ve recently had it.

Carole Freeman:

I love that. In other part of the book… well, I’ll get to that in a second, but you’ve got a questionnaire in there that helps you find your carb threshold. Because like you said, you’ve got the three different phases that are different carb recommendations for those phases, the questionnaire that you have in your book, how did that come to be? can you share a little bit of some of the highlights of how somebody would know maybe where they fall?

Dr. Eric Westman:

So the big theme here is trying to keep things simple. So we don’t go into, what’s your blood test level and all that. We have it into categories of syndromes or symptoms, so that you can take this simple checklist, and you’ll see how many are in each column, and then that puts you into one of three categories in terms of carb tolerance, or how many carbs you should have to begin with, and it works pretty well. So we’ve studied low-glycemic diets, we’ve studied actually higher carb, low-fat diets, and we studied keto diets and people sort out into these three different categories. And we tried to make it easy with, if you have a medical thing like diabetes, high blood pressure, PCOS, polycystic ovary syndrome, you fall into the, you probably should do keto, the therapeutic level of carb restriction or low-carb diets.

Dr. Eric Westman:

But if you’re like my brother who only had 20 pounds to lose, and he’s never had a problem with weight, and he’s 60, then he falls into phase three where he could eat more carbs and could still get the benefit of avoiding sugar in a big way, which is a theme of the book.

Carole Freeman:

We’ve got a question from Robin, she’s up in Canada and wondering, when is the book going to be available in general, and is that different than when it will be available in Canada? And the book, Robin, the book is called, End Your Carb Confusion. There we go.

Amy Berger:

End Your Carb Confusion. We have friends in Canada that have already ordered it. So you might be able to find it on Amazon in Canada already.

Carole Freeman:

Okay.

Dr. Eric Westman:

And the release-

Amy Berger:

I find this interesting. Please do consider pre-ordering because our publisher tells us that all the pre-orders count toward the first week sales, and those initial sales are critical to potentially hitting some kind of best seller list or something, but it’s called, End Your Carb Confusion.

Dr. Eric Westman:

Release date is December 15.

Amy Berger:

Yes, totally love that part, thank you.

Dr. Eric Westman:

But that’s when it’ll be mailed if you pre-order it, right?

Amy Berger:

Yeah. The release date, at least in the U.S. is December 15th, I’m not sure if it’s the same in Canada, but it’s available for pre-order in Canada right now. And that checklist Dr. Weston was talking about, let’s not lie to people, most people will be pointed toward the keto level at least to start with, but then there’s a whole section on how to gradually transition, if it’s appropriate for you and when it’s appropriate, “How do I start incorporating more of those carbs?” And even the highest level, our level three, is I think 150 grams of carbs a day, which sounds like a lot to those of us that do very, very low-carbo keto, but 150 grams of carbs, it’s lower than most people are eating. But let’s say a big potato is maybe 50 grams, a big potato.

Amy Berger:

That’s still gives you 100 grams of carbs to play with. 100 grams of carbs buys you a lot of eggplant and zucchini and blueberries, and even, shhh, a little bit of rice, or a little bit of beans. At that level when you’re active and healthy and lean, but it’s still carbohydrate controlled, we would say. You can’t go to town on every sugar and starch in site. So the mindset is always on your carbohydrate tolerance, but that higher level is more generous, and you’ll find on that checklist, it just depends on what your health issues are, that where you should start. And [crosstalk 00:44:48], we make a point of saying that even if you’re filling out the checklist and it says, “Hey, guess what? You could start at level three, you don’t need to go that low-carb.” We encourage everyone to start at the keto level, because all three of us know that when you are actually in ketosis, you might feel and experience things that you don’t get with more carbs, even if you’re healthy and you’re fit and lean.

Amy Berger:

Some people just find they have sharper thinking, their mood is better, acid reflux. So even if you have a higher carb tolerance, we want you to start at the low level, just to see what happens, and you might have little weird things, that you don’t even realize you have till they’re gone. Like, “Hey, wait. My knee doesn’t hurt anymore. My knee usually hurts when it’s going to rain.” Or like, “Hey, I haven’t had a headache in three weeks.” Whatever it is that’s… So it’s helpful to start at the low level, but you don’t have to if you don’t want to.

Carole Freeman:

Wonderful. There’s tons to love about the book, but the last thing I love about the book is appendix A, which is all about how to actually get medical care of people, doctors, nurses, practitioners in general, that are supportive of lowering carbs, the big category of lower carb and/or keto. So I love that you have that section in there. Actually, the last interview I did was with Dr. Jeffrey Gerber, and I talked to him about that, because that’s an ongoing thing with a lot of my clients is, “My doctor thinks keto is going to kill me, how do I find somebody, how do I get the right care?” So I love that you have that in there. Do we both speak about how to help people find support for their choice of doing a keto low-carb approach?

Dr. Eric Westman:

Yeah, and it’s important to know the barriers for safe use, so this is therapeutic and I take people off drugs. I take them off 10 drugs over time, I might have to reduce a drug on the first day, So it’s not that the diet is bad and harmful, it’s these drugs can become too harmful. So we make a strong, urge you, if you have medical problems to get advice, and we don’t just say, “Just find your doctor.” We have now lists of places and the growing number of doctors who are keto-friendly, it’s called. But the important thing is, if your doctor’s not supportive, it’s like they just haven’t kept up with the research and literature, and we’re working hard to teach as many people as we can, but it’s a slow process.

Amy Berger:

But I will say, it’s really encouraging that I know Dr. Westman’s clinic is here in Durham, North Carolina, but you’ve had people come from overseas. Doctors from other countries come to visit your clinic to learn what you do. That’s encouraging that this is happening, but probably unfortunately more people from overseas than even from the U.S., but I know people flock to your clinic to learn about this. So it’s more and more doctors and nurse practitioners, or other sort of allied health professionals are coming to it, but it’s still small, but it is growing.

Dr. Eric Westman:

Well, that was another reason for the book is the inordinate waiting time to come to see a doctor like me in the clinic, and then that means you don’t have access to the information, if you have to wait to see me in the clinic and get my handouts. So, we’re trying to treat just as many people, inform as many people as we can, and that is one reason for the book to eliminate confusion, get the information to more people, and to keep things simple.

Carole Freeman:

I don’t know if you’ve heard him say it or not, but here’s Dr. Gerber’s fun little phrase that he recommends that, if your doctor freaks out about keto, just say you’re doing a low carb Mediterranean diet and usually go, “Oh, that sounds wonderful.”

Dr. Eric Westman:

Well, that’s healthy.

Amy Berger:

And no wonder, I’ve told my clients just say that you cut out sugar and refined carbs. No medical professional can argue with that. You don’t have to say, “I’m pouring MCT oil into my coffee and I’m eating rhubarb with…” You don’t have to say that part. Don’t [inaudible 00:49:27] part out loud, as they say. Just say, “I’m just eating better. I’m eating whole real food.” And who’s going to argue with that?

Carole Freeman:

Right, because there’s the preconceived notion of what keto looks like, but then you actually like a plate of food. The meal plans, suggestions, ideas that you have in the book are all like, “If you saw that plated.” And you’re like, “That just looks like a healthy plate of food. It doesn’t look like some crazy diet.”

Amy Berger:

Right.

Dr. Eric Westman:

I remember some years ago I was giving him my first research poster, I won’t say how many years it was, but there was a young researcher with the same data, and same doing the keto diet study, and I said, “Aren’t you worried about the diet?” And he looked at me and he said, “Doc, it’s just food, I’m not going to hurt anybody.” I was like, “Wow, that’s brilliant.” Because we come in with all of these false prejudices, really, and I’ve heard the same criticisms for 20 years now that haven’t been… They’re unfounded criticisms.

Carole Freeman:

Yeah, I’ve had the same thing where, mom-clients of mine, they’re like, “Ooh, my kid really likes this food. Is it safe for them to eat it too?” I said, “Meat and vegetables? Is that okay for a kid to eat?” And they’re like, “Oh, well, when you put it that way.”

Amy Berger:

This is why I like… We all know Ken Berry. Ken Berry calls it the proper human diet. “Is it safe for my kid?” “Can my child eat the proper human diet?” Or my husband’s in the military. “Can the troops eat the proper human diet?” When you frame it like that, well what… And you know what kills me? No pun intended. No one asks, “Is it safe for my child to eat a bowl of sugary cereal with a glass of liquid sugar, orange juice, and then a fat-free bran muffin.” Which is nothing but sugar. Nobody asks, is that safe, but, “Is it’s safe for my child to eat a chicken pie with roasted broccoli?”

Carole Freeman:

That’s a [inaudible 00:51:33].

Amy Berger:

How did we get to this point?

Carole Freeman:

Oh, it’s a crazy world that we’re in. Oh my gosh, this has been so much fun, I love having you guys and chatting, and I miss seeing you guys in-person too. But just in wrapping this up, what last points that you want to make about the book or keto in general, or optimal health or anything? Throw something at me.

Dr. Eric Westman:

It’s really exciting to see the keto take off and help so many people, and we actually have another venue, it’s Adapt Your Life Academy, which is the first masterclass we’re doing, is a keto made simple masterclass with videos that I did, and if you want a deeper dive into how we got here, and learn about the grassroots movement, we’re going to roll that out in just a few weeks, in November. So we have different ways of teaching this, and that’s really my goal, is to get this information to as many people as possible in different ways.

Carole Freeman:

Excellent. [crosstalk 00:52:44]

Amy Berger:

For me I would just say, I think one of the biggest selling points of the book is that it’s written in plain English. You’re not going to need the book, and then also a dictionary side-by-side. This is very easy to understand, you don’t need a PhD to get through, it’s very plain language. I tried to make it that way anyway, that I think it’s plain language.

Dr. Eric Westman:

We did.

Amy Berger:

[crosstalk 00:53:13] we think, yeah.

Carole Freeman:

One of your many talents, Amy, is writing in a way that’s very engaging and makes you want to just keep turning pages.

Amy Berger:

Thank you.

Carole Freeman:

Well, thank you both for being here, Amy Berger, Dr. Eric Westman, thank you so much for taking the time, I’m so excited. Congrats on your new book coming out, and just adding to your list of amazing, wonderful things, information you put out there in the world and helping change the health of this world. We’ve got the ship going in the wrong direction the last 60 years, and we’ve got to turn it around 180 degrees, so it takes time. So I’m glad you’re out there doing the hard work.

Amy Berger:

Well, thank you very much Carole-

Dr. Eric Westman:

Thank you Carole.

Amy Berger:

… Always good to see you.

Carole Freeman:

Yeah. All right. Well, thanks everyone for watching. If you’ve enjoyed this, subscribe, give us a thumbs up. Give us a comment of your takeaway during this interview. So thanks for watching everyone, we’ll see you next time, bye.

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