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Amy Berger, MS, CNS, is a U.S. Air Force veteran and Certified Nutrition Specialist who specializes in using low-carbohydrate and ketogenic nutrition to help people reclaim their vitality through eating delicious foods, and showing them that getting and staying well doesn’t require starvation, deprivation, or living at the gym. Her motto is, “Real people need real food!” She blogs at www.tuitnutrition.com, where she writes about a wide range of health and nutrition-related topics, such as insulin, metabolism, weight loss, thyroid function, and more. She is the author of The Alzheimer’s Antidote: Using a Low-Carb, High-Fat Diet to Fight Alzheimer’s Disease, Memory Loss, and Cognitive Decline.

Transcript:

Carole:                  Everyone, welcome to another episode. Today we’re going to be talking about how to start keto the easy way with Amy Berger, so stay tuned. Hey, welcome everyone to another episode of keto chat. Today I’ve got special guest, Amy Berger. Amy, welcome.

Amy:                     Hey, Carole, how’s it going?

Carole:                  Great. Loving the gray weather, you’re favorite.

Amy:                     My favorite, yes, nobody else’s.

Carole:                  Hey, tell everybody for those people living under a rock that don’t know who you are can you give a little intro?

Amy:                     Sure. I, like you, am a keto and low-carb friendly nutritionist. I’m probably best known for writing though. I write a blog at my website which is TuitNutrition.com, and I’m the author of a book about Alzheimer’s disease, which they now call Type 3 diabetes. My book is called “The Alzheimer’s Antidote.” It’s about using a ketogenic diet as a nutritional strategy. I’m not allowed to use the word treatment because we’re not doctors. A nutritional intervention for Alzheimer’s, and totally just rocked my world recently you know Mark Sisson from Mark’s Daily Apple listed my blog as I think one of the top keto blogs or whatever he called it. I was like, what?

Carole:                  Yay.

Amy:                     I’ve been following Mark Sisson for I don’t know how many years, 10 years, 15 years, and never saw that coming. I mean, here I am reading his blog 10 years ago, and now he’s reading mine. Anyway, I don’t know what more people want to know. I mean, the 30 second version of how I got into low-carb is that I used to be heavier. I didn’t have any major health problems that I know of because I was still relatively young. I found low-carb the Atkins diet when I was in my late 20s and I didn’t really have any health issues, but I was overweight. I was overweight despite running two marathons, and doing tons of exercise, and eating what I thought was a good diet all those healthy whole grains with my light margarine, and my skim milk on my cereal. No matter how hard I worked, and no matter what I did I couldn’t lose weight until I tried low-carb. Now it’s probably like you, or like most of us who get into this the more I learn and the more I research about the way this diet works, and how it works at this point weight loss is the least impressive thing this does in my opinion. It’s like, hey, you could get off your Type 2 diabetes meds. You could get off your blood pressure meds. You get off your antacids, all this stuff. Oh, and you might also lose a couple of pounds along the way.

Carole:                  Yeah, fantastic. Congrats on getting your blog mentioned on Mark Sisson’s blog. Your approach is just extremely thorough, extremely wordy, but also very approachable and very practical for everyone, so that’s why you have such a following.

Amy:                     Mark Sisson even said he only wrote a little snippet about my blog, but he said, “Her posts are really long, but worth reading.” I think I am known for really long posts, but I try to make them funny and fun to read, and for people that don’t want to read I started a YouTube channel recently so they can just watch videos instead.

Carole:                  Excellent. Yeah, I mean, you’re an excellent researcher, and you pick apart myths, and all that kind of stuff. Good work.

Amy:                     Thank you.

Carole:                  Today it’s really common that people are struggling with how to figure how to do keto because there’s a lot of complicated approaches out there so we’re here to talk about how to start keto the easy way. How do you want to start off this? I know you’ve got a lot to say about this.

Amy:                     I have a lot I have too much to say. I would start off by saying that I don’t envy the people that are new to this now because when I was new to this circa 1999, 2000-ish there was one Internet forum. Facebook did not exist. Reddit did not exist. Instagram, Twitter did not exist when I was new to this. There was two or three books. There was the Atkins book. There was “Protein Power,” and there was maybe one or two other low-carb type books. There was a lot less information at that time, but because there was less information there was less misinformation. There was less nonsense garbage that you had to sift through. There was just here’s how to do it. Here’s what to eat, here’s what not to eat, go do it. There wasn’t 800 different people with their own opinions on it.

Amy:                     I think it’s great that low-carb and keto have become so popular, but because they’re so popular there’s so much stuff. There’s an avalanche of information out there. I got to tell you if I was new now I probably wouldn’t start it at all because I’d just feel like that’s too much. I can’t even figure this out forget it. I’m not even going to try, or I would probably be like half the people that write to me and probably write to you also, help, oh, my God. I don’t know what I’m doing, or I’ve been doing keto for six months I’m not getting results. I don’t even know where I would start. It’s insane what’s going on now.

Amy:                     The way to start keto easy is to stop eating sugar and starch, period. That is literally the most important, most effective thing you can do. That’s what’s going to get you the majority of the results. Everything else might matter, it might not, it might be relevant to you personally, it might not be, but the place to start is basically an Atkins style induction, or a keto first phase whatever you want to call it. Very, very little sugar and starch in your diet. You don’t have to weigh stuff. You don’t have to test your blood. You don’t have to wear a ring to track your sleep. Just eat foods that are really low in carbs.

Carole:                  Yes, yeah, and more of a Ted Naiman style. Dr. Ted Naiman approach is steak and eggs and vegetables. It’s an easier way of just thinking about categories of foods. Eat real meat. Eat veggies that grow above the ground. That is the easiest way to get started. I’m thinking about all the different things that make it complicated, right? We can dive into all the different reasons why it’s so complicated, or why people are making it complicated, but sticking with simple real foods is the first step.

Amy:                     Yeah, but I do think it also matters why somebody is doing keto, right? Because depending on why you’re eating this way, and what you’re trying to accomplish it might matter how you get started. If somebody is doing this just to lose body fat that’s one thing. If somebody is doing it as a therapy for epilepsy that’s different. If somebody is using it for migraines, or some other health issue it could be a little different. I think the main place to start is still that basic real food that you actually have to cook that doesn’t come in a packet. Well, that’s almost getting too far a field because there are some packaged foods that are totally fine, but cooking most of your own meat, poultry, seafood, eggs, dairy, non-starchy vegetables that’s the place to start. Honestly, some people won’t even need anymore than that. That’s going to get some people pretty much where they want to go. Other people are going to have to fiddle with things.

Carole:                  Yeah, good point. We didn’t clarify how to get started for keto for different reasons, you’re right. If somebody’s got a therapeutic application for I would say Alzheimer’s, epilepsy, brain cancer they’re probably going to need that complicated approach where they’re going to want to work with a trained specialist that works in those areas, but even for them starting out by just cutting out sugars and refined starches is going to go a really long way at helping their body be a lot healthier.

Amy:                     Yeah, that’s still where you’re going to start anyway.

Carole:                  Another reason it gets really complicated is that there is this pervasive myth out there that you’ve got to follow certain percentages of macronutrients. Macronutrients are carbs, fats and proteins for people that don’t know. There’s probably 50 or 100 different macro calculators out there. I’ve got my own viewpoint on why this myth came out that you’ve got to follow these percentages, but that is one of the biggest reasons why people are so confused is they think a keto diet has to do with percentages.

Amy:                     Yes. I wish this macro thing would just die. I just wish it would die. I think I did a video and I even called it there’s no such thing as keto macros. These macros, these percentages and ratios came from the origins of the ketogenic diet as a treatment for epilepsy. Some of those kids really needed a freakishly high amount of fat compared to total combined protein and carb. They call it a three to one, or four to one ratio meaning three or four times as much fat to combined protein and carbs. Some people did not have remission of seizures until they got there. Some people don’t even have to do keto for epilepsy. They can do gluten-free, casein-free. They can do modified Atkins.

Amy:                     The point is these ratios really don’t matter when you’re using this for weight loss, when you’re using it for diabetes, when you’re using it for gout, or cardiovascular disease, or any other reason that people use this. It just gets people into trouble, and the beauty like I said when I was new the beauty of this is that there was only one thing you had to watch out for and that was total carbohydrate that you were putting into your mouth. As long as your carbs were really, really low there was no limit on protein. There was no limit on fat, but there was no limit on fat with the understanding that people weren’t going out of their way to load extra fat onto their food. You could eat a fatty steak. You could eat a fatty pork chop. You could eat cheese, and put cream in your coffee, but we weren’t just drinking liquid fat all the time. We weren’t loading fat up to make some kind of magical ratio or percentage.

Amy:                     The protein Atkins induction I keep saying Atkins because somewhere along the way the Atkins diet got this weird bad reputation even though it’s arguably the simplest and most effective way to do this for any type of metabolic issue, metabolic syndrome, insulin resistance, obesity, that stuff. The Atkins induction phase which is the strictest, but the most effective and easiest way to do this except for straight up fasting just not eating, period, was unlimited in protein. You could eat as much because it’s zero carb, right? As many eggs as you wanted. As much fish, chicken, beef, pork, whatever, but, again, I think Dr. Atkins probably wrote that just like with the fat with the understanding that you’re going to stop eating when you’re full. Unless you’re Shawn Baker you’re not going to eat six pounds of rib eye steak. It was unlimited with the sense that you’re a normal human that’s not going to intentionally eat 12,000 calories a day for no reason.

Carole:                  Yeah, yeah. Let’s go back to that percentage thing again because people right now their head is a little spinning like what? This isn’t I don’t have 70% fat or 90% fat?

Amy:                     Yeah. Thanks for reminding me because the main point that we can get across is what makes the ketogenic diet work is the absence of carbohydrate not the presence of tons and tons of fat. I write about Atkins all the time. I talk about it all the time. What switches you over from having a carb based metabolism and being a sugar burner to being a fat burner is the missing carbohydrate. When you’re not eating a lot of carbohydrate your body finds an alternate fuel, and the alternate fuel it uses is fat. Here’s the deal. If this diet worked by ratios and percentages you could eat 10 bagels, and as long as you put enough butter and cream cheese on them to make it 70% fat, or to make that ratio line up with whatever your stupid macro calculator told you, you would be in ketosis, you’d be losing weight, you’d be burning fat. We all know that’s not how it works because it’s not the presence of the butter and cream cheese that puts you into a ketogenic state it’s the absence of the bagels. You know what I mean?

Carole:                  Yes.

Amy:                     Truly, people need to understand that you don’t have to add fat to make your food more ketogenic. Nails on a chalkboard. What you have to do is keep the carbs really, really low. Some people have to keep them lower than others. Some people have to stay at 20 to 30 grams total per day. Some can eat 100 grams and still lose weight. That’s an individual thing. These ratios have just got to go. It’s probably one of the most common things I hear from people, and probably you too. They write to me I’m doing keto. Why isn’t it working? I’m eating 80% fat. I’m like, stop right there. You just answered your own question.

Carole:                  Well, yeah, and they say, well, I’m not losing weight so I’m pretty sure it’s ’cause I’m eating too much protein, and I’m having trouble getting enough fat in. This is the most pervasive paradigm that’s out there is that you got to keep protein low, and you got to keep the fat up, and you got to drink certain brand names of high-fat coffee, and that’s what’s going to help you lose weight.

Amy:                     Yeah. Well, hopefully, you can’t hear there’s a car. Okay, it just stopped. There was a car alarm going off outside my apartment.

Carole:                  That was the subliminal red flag.

Amy:                     Don’t be afraid of protein. Yeah, that’s a huge thing. People have become afraid of protein, so when they’re hungry instead of eating an extra hard boiled egg, or another piece of chicken or fish they’ll have a fat bomb, or oil, or something when they would have been better off eating the solid piece of protein. I don’t know if you want to get into that now with the protein thing, but people are afraid of protein because they’ve heard two different things, right? One, too much protein turns into sugar, or too much protein will kick you out of ketosis. That is a misunderstanding of the biochemistry and the physiology that is behind those processes. Amino acids from protein can be converted into glucose they can, but that doesn’t happen just because you eat a huge chicken breast, or just because you eat two steaks. It happens when it needs to happen.

Amy:                     The thing is triglycerides three pieces of fat, three fatty acids tied to this molecule of glycerol, which is how our bodies store fat, or how fat comes in food when you break that apart to burn it the glycerol portion that’s left over can be converted to glucose. Two glycerol’s can make a glucose, but you don’t hear anybody worried about that when they’re drinking a 500 calorie fatty coffee. You don’t hear anyone say, well, too much glycerol turns into sugar because it doesn’t. It turns into glucose when the body needs to make glucose. I know we’re so terrified of glucose and keto, but glucose is not the problem. Too much glucose all the time is the problem. The body needs glucose. We might not necessarily need it for energy all the time, but we actually need it. There are structural molecules in the body that contain glucose. There are certain cells in the body that can’t burn fat or ketones. They have to burn glucose.

Amy:                     Glucose by itself is not bad. Just like insulin by itself is not bad. Water is great. Oxygen is great. You can also die from too much of those. It’s just a misunderstanding that has gotten out of control. This is something that wasn’t a part of low-carb when I was new. Nobody was afraid of protein, but not to muddy the waters too much there are some people who seem to be really sensitive to protein. I can’t tell you who they are. Sometimes, it’s people that are very, very severely Type 2 diabetic, and when they’re new to this they might be better off having moderate protein higher fat and as they get healthier gradually shift those ratios. That’s something to remember, too. People get so scared to change something. If something was working for six months, well, now it stopped working. Well, don’t keep doing that. If you’ve lost 50 pounds, or you’re off six medications you’re literally not the same person you were, so maybe you do need to change your diet a little bit at that point.

Carole:                  Yeah, yeah. Dr. Ben Bikman was it last year that spoke at Low Carb Denver about that research showed exactly what you were saying that most people in the context of a low-carb ketogenic diet don’t have to worry about protein at all, however, people with some forms of diabetes, Type 2 diabetes, or advanced even severe diabetes. There isn’t such a thing, or I mean there’s not a diagnosis of that, but they tend to be a little more sensitive to protein. However, they don’t need to eat a low-protein diet.

Amy:                     There’s two issues come up there. One is people might be afraid of protein, or think it turns into sugar because people with Type 1 diabetes do need to account for protein when they dose their insulin because the protein affects insulin, it affects blood glucose, but not because the protein you just consumed 30 minutes later has turned into sugar. It takes longer than that to even digest. The glucose is coming from your own liver in response to protein the liver will actually send out some glucose. It’s supposed to do that. Healthy bodies do that. Type 1 diabetes bodies do that. In Type 1 diabetes they don’t have the insulin to counteract that little bit of glucose that normal bit of glucose that’s supposed to be there. Someone like you or I, Ben Bikman is exactly right. Eating higher protein in the context of a low-carb diet is really different than eating more protein in the context of a higher carb diet.

Amy:                     Then the other thing you were saying some people might be better off with the more moderate protein diet, but they don’t have to go low. If you follow Ted Naiman we might have to explain to people the protein leverage hypothesis, but I think most people at least in the U.S. anyway are consuming too little protein, so what we consider a high-protein diet is probably actually a normal protein diet. You know what I mean? Well, maybe not like you and me, but most people in general, especially, women are not eating anywhere near enough protein so they could increase significantly, and I still wouldn’t call that a high-protein diet. I would call that now we’re adequate. Now we’re just getting enough.

Carole:                  Yes, yeah. There’s a lot of [inaudible 00:20:26] a lot of nutrients. Most protein dense foods actually are the most nutrient-dense foods despite what we’ve been told about fruits and vegetables being high in protein also have the most nutrients in them.

Amy:                     Yeah, if you think of a piece of red meat, or even pork is very high in B vitamins and minerals, seafood, especially. I think Ted is right on the money. There’s a guy out of New Zealand a friend of mine named Jamie Scott who also talks about protein leverage a lot as well. I think they’re right on the money. We’re actually so accustomed to low-protein diets that when we increase protein we think it’s high, but it’s not. That’s more normal. Just like with carb we’re not on low-carb diets. We’re on normal carb diets. Everyone else is on this freakishly high, insanely high-carb diet, right?

Carole:                  Yes, yes, that’s so true, right, because we’ve been told for 50 years that fat is bad, meat causes cancer, so the only thing that’s left to eat is carbs. We’ve gone through 40 years of having a pure carb breakfast, and a mild amount of protein at lunch, and then a mild amount of protein at dinner as well, so that puts us under a protein allotment because we’re only eating protein at two meals a day, and no protein for snacks.

Amy:                     Right.

Carole:                  I’m coming up with the list as we’re talking here about some tips about how to start keto the easy way. One of the things we said already is real food. Keep it simple, real food, meat and veg, okay? Keeping carbs as low as possible. No sugar or starch cut that all out. I’m going to add another one that I think is really important is don’t drink your calories. Don’t drink high-fat beverages. Don’t drink your calories. This goes along with that myth we were talking about how percentages don’t matter. People fall into this thing of I can’t get enough fat in my mouth so I better drink all these high-fat beverages.

Amy:                     Even though I have so much fat on my behind.

Carole:                  Yeah.

Amy:                     I mean, not to be rude or anything, but I hear this all the time. The literal word for word phrase that I hear so many times is I’m having a hard time hitting my fat macro. I’m like why are you trying to hit a fat macro? So when people come to me so often my first question is if it’s just their initial email and I have no idea who they are, or what they’re trying to do. What are you trying to accomplish? Why are you interested in keto? Then my other question because most of the people who come to me are already doing it. They’re already eating this way, but they’re not getting the results they want. I rarely get people that are new, but once in a while I do. So when I get someone that’s already been doing it, and they’re not happy with how things are going then my next question is where are you getting information from? Where have you gotten your guidance from? Did you read a book? Do you watch somebody’s YouTube, whatever? So it’s interesting to see where people get this stuff from.

Amy:                     I will say in terms of starting simply I would say that there may come a time when somebody does need to keep track of food because it’s very possible that they’re eating a lot more fat than they realize, or less protein than they realize whatever it is. There is a time and a place for keeping track, but I think when somebody’s brand new for the first three weeks or so just keep the carbs really, really low. Get your body adjusted. Make the transition. Don’t worry about the weight loss. Don’t worry about anything else. Worry about getting used to eating this way. Worry about getting used to figuring out what the heck you’re going to have for lunch when you can’t have your sandwiches anymore, and you can’t have your pasta, and you can’t have your wraps and your burritos. Figure that out. Get used to this. Stock your fridge. Stock your freezer. Make a crap ton of food in advance. Cook a ton in advance because when stuff is ready to go then when you’re hungry you can grab a hard boiled egg, or you can slice off a cold piece of steak. Get used to eating stuff cold. You’re not a two-year-old. You don’t need everything to be hot. It’s okay to eat cold leftovers I do it all the time. Grab something right out of the fridge. If we want to make this as easy as possible you have to prepare your environment so that it’s as easy as possible. When people are new that is not the time to worry about, okay, we’ll have this many grams of this, and this many grams of that, and only eat twice a day. When you’re brand new is not the time to worry about anything except keeping your carbs low.

Carole:                  Yes, I love that. Prepare that’s one of my things I always recommend to start out with is that the easier it is to just grab stuff out of your fridge the more successful you’re going to be which means go so far as to buy pre-sliced cheese, pre-sliced meat, hard boiled eggs that are already hard boiled. Stock your fridge with all those foods so that it’s so easy to just grab something. Truthfully, if you’re eating those foods you don’t need to worry about grams of protein, fats, or anything like that. All of those things are already perfect keto foods by themselves.

Amy:                     Exactly, it works itself out.

Carole:                  We’ve talked about don’t fear protein, all right. When in doubt go for protein. Any of those protein foods that we just talked about are perfect. I’ll also add another one. Go ahead.

Amy:                     I was just going to say if somebody has the money to buy all organic and grass-fed, and fancy-schmancy food do it. If you don’t it’s totally fine to go to the regular store, and get your regular beef. You can do lunch meat is okay. Just don’t get honey baked ham or brown sugar turkey. Get roast beef, get pastrami, get something that really is very, very low sugar, but that stuff is fine. If that’s going to make it easier for you. Again, what makes this diet work is the lack of carbs not the organic, not the free range, not the Fairtrade. I’ve worked on small farms. I am 100% in favor of that stuff. That stuff is really, really expensive. I can’t afford that stuff half the time. Nobody should feel guilty or feel ashamed, or feel like this diet isn’t going to work for them if they’re just going to literally Walmart and getting a tube of ground beef, getting celery, whatever. When we say about these protein foods it’s okay to buy regular salami from a store, pepperoni, cheese, it’s all good.

Carole:                  Absolutely. Oh, I love that you brought up that point, too, because so many people get stuck on, well, I can’t afford all this it’s too expensive.

Amy:                     I can’t afford it either.

Carole:                  The keto version, the high-fat versions of most cuts of meat at the grocery store are the ones that are usually on sale and they’re the cheapest. You can get chicken drumsticks and thighs with the skin on for 99 cents a pound a lot of the time. 90% of the health benefits of eating this way come from just keeping carbs low. If some day you want to go for investing in the organic versions of that you might get a 2% or 5% more health benefit, but you’re going to get 90% of the health benefits just getting the carbs and sugar out of your diet.

Amy:                     Exactly. Let’s maybe if we can just for a second talk about why because you and I have been harping on that point. The reason keto does what it does whether it means getting body fat off, bringing your blood sugar down, bringing the insulin down, lowering your blood pressure, clearing up your skin, getting rid of the joint pain, PCOS, restoring fertility most of that comes because you’re not eating carbs your blood sugar is much lower, and it’s not just lower it’s steady. It’s not doing this up and down all day. Your insulin is a lot lower. It’s also not going crazy up and down all day. We have these small little blips like we’re supposed to just a little bit, but that is what’s responsible for the majority of the health of fats of this diet. It comes from lowering the blood sugar and insulin, so you just want to eat with keeping in mind what’s this going to do to my blood sugar? What’s it going to do to my insulin? Then you have your answer as to what you should eat.

Carole:                  Yeah, and so many people get stuck on, well, we’ve been told for so long to eat lots of fruits and vegetables get the antioxidants from them, but it turns out our body has a fantastic, very powerful antioxidant system that when we’re keeping carbs low, and insulin is at a healthy normal level our body’s antioxidant system is way more powerful than any supplements, or any fruits or vegetables that we could eat.

Amy:                     Yeah, I mean, if people watching or listening know Dr. Georgia Ede. Her website is Diagnosis:Diet.com. You’ve probably met her. I’ve met her a couple of times. She’s great. She writes about this all the time that these fruits and vegetables are not necessarily deserving of the health halo that we give them. If you’re not sensitive to some of the compounds in the plants they’re fine, right? People have been doing Atkins since the ’70s eating spinach, eating broccoli, and they’re doing great, but there are some people that seem to be sensitive to certain things that are in plants who do better on a low-plant diet, or almost no plants, but this antioxidant thing we take it for granted how could vegetables and fruits not be good for us? They’re so colorful. Eat a wide variety of colors. They’re purple, they’re red. They have anthocyanins, they have sulforaphane, they have betacarotene. They have all these compounds that give them those colors. Produce is beautiful, it is, it’s gorgeous to look at, but oddly enough I think a lot of the antioxidants that are in those plants are used for the plant. It’s not for the human.

Amy:                     I don’t know that it survives the digestive process. After all that acid, after all that alkaline do we actually absorb those things intact, and they have the same effect in the body as we would expect them to. I don’t think they do like you say. The most powerful antioxidant in the human body are produced in the human body. Actually, some of them they’re amino acids, they’re peptides like glutathione, but I do think certain compounds can have what I would call a pharmacological effect. I don’t know if you’re familiar with Linus Pauling from back, I think, it was the ’50s the megadoses of Vitamin C, and it was a medicine, but you’re not going to get that effect from drinking a glass of orange juice. That’s an infusion of mega, mega doses of Vitamin C. It can do the same thing with other compounds, or what happens in a petri dish of cultured mouse cells that you add concentrated broccoli seed extract to for the sulforaphane is not necessarily what happens to you or me when we eat a bowl of broccoli.

Amy:                     Again, I’m not saying plants are bad for you. There’s some keto nutritionists would argue that. Eat plants if you want to. The bottom line is there’s almost nothing that you can get from plants that you can’t get from animals. I think vegetables can be a perfectly wonderful part of this way of eating, but if you go a day or two, or a week or two, and all you’re eating is meat and cheese that’s probably okay too. You’re not going to get scurvy in two weeks of not eating bell peppers, or some low-carb food that has Vitamin C in it.

Carole:                  Yeah. Excellent.

Amy:                     How many minds do you think we’re blowing with this? I don’t know maybe people that watch the videos might already know this stuff, but we’re saying everything I thought is wrong.

Carole:                  Yeah, I probably say that every day a couple times is probably 90% of the information we were told the last 50 years about nutrition is just backwards and wrong.

Amy:                     You know what the thing is though just so the people watching don’t feel left out I feel this way too. Every time I learn something new it’s like, oh. Being in the low-carb, keto world you and I are already like, okay, I already know most of what we were taught was garbage, but even now what we’re learning from the carnivore movement, or learning from Georgia Ede, or learning from Ted with protein or whatever, it’s going even beyond what we knew. I’m going to lose all my clients now, but sometimes I’m like I don’t know what the hell I’m doing anymore because I learn something new every day.

Carole:                  No, and even the times I’ve been doing this personally almost four years. In the beginning I was like, well, don’t get too much protein. Now I never told people it turned into sugar, but I talked about the insulin response and it was listening to Dr. Bikman’s presentation where I was like, oh, my gosh, okay, we don’t need to worry about protein like we thought we did even though we can explain all the mechanisms of how it interferes with ketosis and things like that. In the context of low-carb diet a lot of these biochemical processes that we learned in school don’t follow the same pathways that we learned there are differences. Along the lines of something else that we were led astray of is salt. That’s another one that I’m going to include. How to start keto the easy way is make sure you’re getting adequate salt when you start out and all the time.

Amy:                     We’re touching all the third rails in this video. It’s funny you should say this because actually I already recorded a video on salt. I’m probably going to publish it tonight or tomorrow.

Carole:                  Okay. We’ll link to it here.

Amy:                     Yeah, thanks. When you say adequate salt it’s like the protein thing. Adequate salt on a ketogenic diet is a lot more salt than most people are used to, and especially more than most people think is safe like, oh, all that salt can’t possibly be good. Most people are not sodium sensitive with blood pressure meaning they could eat a lot of salt, a lot of sodium, and their blood pressure doesn’t move. There are some people. There’s a small subset of people who do have higher blood pressure from salt, so if you know you’re one of those people watch out for too much salt, but on keto you really do need a lot more salt than usual, so there’s really no harm in using it because keto changes the way the kidneys hold onto minerals in sodium, potassium, magnesium, not just the sodium. I want to plug. We’ll plug for James DiNicolantonio’s book. He’s this researcher that wrote a book called “The Salt Fix.”

Amy:                     Oh, she probably has it. You’re going for it. It is brilliant. I highly recommend this book. Your mind will be blown because you can eat so much more salt that you thought. I think it’s probably just like the protein insulin thing so much of the research that has led to some of the guidelines that we have was done in people eating diets with 50% to 60% carbohydrate, and it might not apply to somebody eating 10% carb, or even 15% or 20% carb because it is so much lower let alone 5% or 0% carb. The information what does salt do in a person who’s already hyperinsulinemic and hyperglycemic versus in somebody who isn’t. I think that’s why we keep learning so many new things. So much of what we think we know is based on people eating a lot of carbohydrate and it just might not hold for people who aren’t.

Carole:                  Yeah. I start with what Volek and Phinney recommended in “The Art and Science of Low Carb Living” starting with the minimum of an extra teaspoon of salt per day. My clients will say, “In addition to what’s in your food?” Actually, you’ve got to measure it out because a lot of people are like, oh, I salt my food plenty. I get plenty of salt, and you’re lucky to get in two grams total if you’re doing that too. Again, it doesn’t matter you don’t need to buy fancy salt. Any kind of salt is fine for this. You don’t need special [inaudible 00:36:44] Sherpa collected salt, or anything like that.

Amy:                     No. Thank you for saying that because I make that exact point in my video. What you need is the sodium, and you can get sodium from any salt. If you like fancy smoked Himalayan gray, whatever, Celtic, use it, but what you need is the sodium, and that’s in any salt that you will find.

Carole:                  Yeah, yeah, great.

Amy:                     Yeah, it’s just, man, the salt thing.

Carole:                  Yeah, yeah. I think is it Phinney that was talking about how the populations that are getting six grams per day are associated with the best health outcomes, too, which is triple the current recommendation in the United States that we need to stay under.

Amy:                     Yeah, it’s a little crazy, and if I remember right I don’t mean to confuse the issue here, or make it more complicated, but I think that’s grams of sodium, not even grams of salt.

Carole:                  Right, right, right.

Amy:                     So you pick a salt that’s half, it’s sodium chloride it’s only half sodium. It’s half chloride. We need the chloride, too, but we need the sodium more. You think, wow, that’s a lot of sodium. Yeah, it’s even more salt because the salt is only half so it’s a shit ton, pardon my language, of salt.

Carole:                  Yes.

Amy:                     I think I just made Carole’s YouTube channel adult only. Now we have to put the language warning.

Carole:                  Oh, great.

Amy:                     No, I think it was just the one little word we’re fine.

Carole:                  Yeah, okay, so lots of salt. Don’t be afraid of salt. I’ll just add in, too, if you try to do too much salt in one time your body is very good at regulating that. You’ll get rid of it very quickly if you do too much of one dose, so spread that out throughout the day. Don’t try to do one teaspoon all at one time, or you’ll just have a good time in the bathroom the rest of the day. Let’s see, another one I recommend to get the best results to start keto the easiest way is going to be to avoid nuts and seeds to start with. That’s because most people overeat them. Nuts and seeds in nature are really, really hard to get to. They’re very nutrient-dense and nuts and seeds are actually pretty high in carbohydrates as well. A handful of nuts and seeds might be your entire day’s worth of carbohydrates for some people, too. I recommend staying away from them in the very beginning because most people have a really hard time with moderating their intake of those.

Amy:                     I can agree with that. I don’t normally tell people that, but I’m clear they are so easy to overdo. If you really truly can limit yourself to that one ounce serving than have it, but if you think you’re having an ounce and you’re having half the bag not that I know anything about that personally. Yeah, they’re a very easy trigger food. They’re extremely concentrated sources of fat because they’re just very high in fat, and they do, the carbs can add up, especially, if you’re doing something like cashews much higher in carbs. Macadamia nuts are very, very, very low in carbs. Pecans and walnuts are okay, but they’re super, super high in fat, which is fine for keto, but it’s just easy to overdo, so I think that’s probably not bad advice to avoid nuts and seeds at first.

Carole:                  That’s one place to look if you’re struggling and not losing weight on keto is maybe try cutting the nuts and seeds out.

Amy:                     Yeah.

Carole:                  Let’s see, so just a recap. We’ve got a list of about eight things here. Eight rules to follow to start off with keto.

Amy:                     I feel bad because starting keto is supposed to be easy. If eight things make it easy, one thing to make it easy keep your carbs really, really, really low.

Carole:                  Okay. There we go if you come out one thing. For us as nutritionists it’s really easy to understand what has carbs in it. For some people they are clueless about that, so that may mean you need to just track your food. You need to look things up to figure out what has carbohydrates in it because a lot of people are really surprised. I met a former, or not former, a friend of mine that said something about like, well, bagels those are protein foods, right? Because they come in that Starbucks protein box so bagels are a protein source. We take it for granted that we know what has carbs in it, so for some people if you don’t know what carbohydrates are and even for some people that think they do know it might be necessary to look things up and track that just to make sure you are keeping it low, so that’s the simplest thing keep the carbohydrates low.

Amy:                     Yeah, and really stick to the protein and fat food. Like I said the Atkins induction was unlimited, meat, poultry, seafood, eggs because you don’t have to count carbs when you know you’re eating foods that are zero carbohydrate. It’s not necessarily a plug for the carnivore diet, but it’s a plug for making the vast majority of your food intake foods that are zero carb because then you don’t have to count.

Carole:                  Yeah. Okay, we’re boiling this down to the simplest things possible. Eat meat, fish, seafood, poultry, eggs, and cheese.

Amy:                     Cheese, but, unfortunate, cheese is very similar to nuts it’s very easy to overdo. I think for somebody that wants something fatty and yummy I think cheese is a better choice than nuts because it tends to have more protein at least it has. It’s still higher in fact than it is in protein, but it has more protein than nuts do. If you’re going to eat that much fat at least get some protein along for the ride.

Carole:                  Right, right. Yeah, and if people are just eating cheese they get satiated. If you’re just eating a block of cheese maybe one day you’re going to overeat it, but then the next day you’ll be like I’m ready for something different.

Amy:                     Yeah, I’m over the cheese because it is easy to overdo, but you probably wouldn’t do that every day.

Carole:                  Yeah, yeah. All right, well, okay, so we boiled it down to the simplest, the very easiest way to get started on keto is just real simple food. I think people one of the other reasons it gets complicated, though, is a lot of times we’re used to convenience foods, packaged, boxed, protein bars, diet drinks, and things like that, so people they think that’s what a diet is so then they’re looking for the equivalent of that the keto version of that. I think that’s part of where people make it too complicated.

Amy:                     Yeah. There are packaged foods that are fine, but you have to be a label detective. You have to read the label because it’s going to say low-carb or sugar free, or keto, and it’s like, oh, this thing is actually loaded with carbs. You shouldn’t be afraid to buy a package of salami, but read the label. Read the label more so for the numbers the total grams of carbs per serving. Look at the ingredients, too. See if there’s sugar, see if there’s corn syrup, but there’s a lot of things that actually contain sugar or cornstarch, or something like that, but the total carbs are still really, really low. For example, most bacon is cured with sugar or brown sugar, but the amount remaining in the final product is negligible, or it’s one gram per two or three slices of bacon.

Amy:                     If sugar is in the ingredient it’s not necessarily off limits. It’s really about the total amount of carbs. I think another way to keep this simple Dr. Eric Westman is all about total carbs. If anyone comes to him … If people don’t know who that is Dr. Westman is one of the most famous low-carb doctors. He learned from Dr. Atkins. He’s been doing this longer than almost anybody whose still around. When anyone struggles to lose weight in his clinic he’s always like, go back to 20 grams total carbs, not net because net then you start eating all those bars and shakes and packaged products where it’s maybe 25 grams of total carbs, but only two or three net so people are like, oh, it’s only two or three carbs. Some people are more sensitive than others to the fillers and the sugar alcohols, and stuff.

Amy:                     If somebody is struggling that’s definitely one place to go is go to total carbs if you were doing net. If you’re brand new you might as well not even bother with net just go by the total. That makes it easier because you don’t have to figure out the fiber, you don’t have to figure out sugar alcohols, just look at the total. You almost have to stick to real food that way because there’s not going to be any maltitol in it. There’s not going to be any corn fiber in it. You know what I mean? It’s just going to be cucumbers or steak, or whatever.

Carole:                  Right. Total carbs under 20 grams there we go.

Amy:                     That’s supper, supper strict. Most people can probably lose weight at 30 or 40 if we’re doing total. 40 grams net carbs is a lot of carbs. 40 total is still pretty low, but if somebody’s already there, and the weight isn’t budging then you got to really tighten things up.

Carole:                  Well, if we’re just talking about the easiest way, I mean, the lower your carb intake the faster you’re going to get to ketosis, so it’s not going to hurt anyone to go 20 total, and you’re going to cover 90% of the population to get into ketosis.

Amy:                     That’s actually why Dr. Westman starts everybody out at 20 total because he knows just about everybody is going to begin ketosis at 20 grams total or less. They won’t have to count anything. They won’t have to measure their ketones. They won’t have to do anything. He gives them a list of foods. If it’s not on the list you are not allowed to eat it, period. If you stick to the list and stick to the amounts he knows you’re going to be in ketosis. I think he does it for that exact reason because it’s the easiest. It’s going to work for everybody. Once somebody’s been doing that for a while they can play around. Hey, maybe they can do okay at 40 or 50, but maybe they can’t, but he knows everybody is going to be successful right out of the gate at 20 or less.

Carole:                  Yeah, that’s what I have my clients do as well, it’s easier.

Amy:                     To be honest I wasn’t because I wanted to be like, well, see what you can get away with, and it’s not working. I have to be real now and tell people, listen, you can’t play around. Sorry, you do it or you don’t.

Carole:                  Yeah, well, okay. I think we figured it out the easiest way keep your carbs low. Eat real food. Avoid net carbs that’s going to avoid those foods that really are going to be not really truly keto anyways. Anything else that you want to add to this? Here’s one. I have two more ideas that people always get confused about, too. What about water? Shouldn’t I be drinking a gallon of water a day?

Amy:                     I did a video recently on water. I said this radical crazy thing. Drink when you are thirsty. What? It’s okay. I really don’t agree with what’s often said where if you’re thirsty it’s too late. If you’re thirsty that means you’re dehydrated. No, I think thirst is your body’s signal that it’s time for some water. We never say that with hunger. If you’re hungry you’re already starving it’s too late.

Carole:                  I love that you said that. I so agree. I say the same thing, too. Well, yeah, if you’re hungry it’s too late. You should eat before you get hungry because you don’t want to get hungry.

Amy:                     Eat all the time so that you never get hungry. I see these people walking around literally carrying a gallon jug of water. If you think we’re very into ancestral stuff and what happened in human evolution and this keto movement. Do you think that Grok or Mr. Caveman was walking around with his water bottle? No, they got water where they could when they could. I think there is a small kernel of truth for the fact that some people will eat when they’re actually thirsty, so they might be eating mistaking hunger for thirst, or thirst for hunger, whatever. I do think, honestly, sometimes I get lazy about water, and I feel better physically, mentally I feel better when I’m hydrated, but I don’t guzzle water all day long. I honestly think you should just drink when you’re thirsty.

Amy:                     Drinking more water is not going to make you lose weight faster. That’s a total myth. I mean, how many of us tried that for 20 years and it didn’t work, but I think Amber O’Hearn who’s well-known in the carnivore movement said something really interesting on a podcast the other … Well, not the other day. I listened the other day it’s an older show, but she brought up a really interesting point, and that was that she thinks some of the increased need for sodium on keto is because so many are drinking more water basically flushing it all out. People shouldn’t skimp on water. Don’t be afraid to drink water, but there’s no need to just guzzle water for the sake of guzzling water. It doesn’t make keto work any better or any faster. You might actually do yourself harm by diluting all those minerals.

Carole:                  Yeah. When I went through my nutrition training it became very obvious, oh, well, humans need water, but the water that’s in food counts toward our water need.

Amy:                     Yes, thank you.

Carole:                  Most food is 80% water. I think that’s part of why when we’re thirsty a lot of people eat because the body knows there’s water in food, and that will meet our water need.

Amy:                     That’s a really good point. I mean, it’s especially true of things like look at cucumbers, or celery, or lettuce it’s 98% water.

Carole:                  Yeah. Well, even cooked chicken breast has water in it. I don’t know I’m going to blame it on personal trainers sometime that didn’t take a nutrition class that then because the water needs this much water that means you have to drink that much pure water. I still want to figure out somewhere along the line somebody thought more is better so a gallon of water. There’s still people out there that their goal is to drink a gallon of water a day, and it’s not even healthy.

Amy:                     Yeah, it’s too much, but there’s a fine line because I think there probably are some people that are dehydrated, and they don’t feel well. I know on keto we were talking about salt, I think, the salt and water balance is even more important if you’re working out whether you’re an endurance athlete or you’re a body builder or something and you sweat a lot you probably do need more water, but you need a lot more salt, too, to replace what you lose.

Carole:                  Absolutely. In “The Salt Fix” book, Dr. DiNicolantonio actually has some recommendations about how to dose salt for working out and even so specific as what temperature you’re in. Also, yeah, I’m glad you mentioned the athletes and things like that because especially it seems for body builders or somebody whose lifting weights they have an exponentially higher amount of sodium that they need. It’s probably likely because of the muscle contraction and the building of all that requires a lot more sodium. My son has recently started getting into body building and he finds he needs about six to eight grams, or maybe even 10 grams of sodium a day to not feel lightheaded and dizzy. Another friend of mine, Mike Berta, who does the Ketogains bootcamps he said he found that when he was doing those actively he needed 10 grams of sodium per day to feel normal and healthy.

Amy:                     Wow.

Carole:                  Yeah.

Amy:                     I think Dave Feldman eats about that much and he’s not a body builder. I think he just says that’s where he feels best. Yeah, that’s a lot of salt. I think just so people are aware some stuff that could happen if you’re not getting enough sodium on keto, or you’re getting too much water in relation to the sodium you’re getting is headaches, fatigue, just feeling sluggish, feeling blah. If you are an exerciser or you work out losing power and strength not having the same oomph that you normally have at the gym, but headaches, dizziness, and lightheadedness are the biggies if you’re not getting enough salt or sodium.

Carole:                  And constipation and muscle cramping I’ll add, too. Those are common ones as well that are symptoms of not enough sodium.

Amy:                     I think that’s magnesium, too, the muscle cramps, but sodium will do that as well.

Carole:                  Yeah. Anything else? I was going to add as well, too, people wonder about how much exercise do I need to lose weight? Should I be exercising? Then it’s interesting, too, there’s some local diet programs that say they’re a ketogenic diet, but then they tell people that they can’t exercise because that burns muscle somehow, and I’m like where did they get this information that they tell people that they’re not allowed to exercise because they’re going to lose all their muscle mass if they exercise on a low-calorie keto diet?

Amy:                     If you look at the Ketogains stuff, yeah, they’re losing a lot of muscle aren’t they? And for people that don’t know Ketogains we are being sarcastic. Those guys are like they’re building muscle like crazy. Exercise is such a contentious issue. Personally, coming from an exercise background and I’m not a body builder, I’m not a professional athlete, I’m just someone who worked out a ton because I thought it would help me lose weight. Exercise does not make you lose weight, and I learned the hard way, the very, very hard long way. I mean, I wish it did because look at all that wasted time. I think it’s really important for health. I think it’s important for mobility and for strength. For me, it’s a mental health tool more than anything. I feel better. I tend to lean toward depression and melancholy, and all this bad stuff, and I feel better not just acutely I feel better when I’m actually exercising, but in general all throughout the day when I’m exercising regularly I feel better emotionally and mentally.

Amy:                     The fact is you do not have to have exercise to lose body fat. If you want to build muscle, so you can lose body fat, but you’re not going to have a six pack. If you don’t have a six pack you have to develop those muscles if you want to be toned the phrase that all the women use. If you want those womanly shapely like if you want Michelle Obama arms you have to have the muscle so you can lose weight, but if you lose the fat and there’s no muscle there you’re just going to be a smaller version of what you look like now. You have to build the muscle if you want muscle to be revealed when the fat comes away.

Amy:                     I think it’s important to build those muscles, but I know some of the keto doctors who have patients in wheelchairs, who have patients that can’t exercise that are disabled, or they’re paraplegic or something and keto still works for them so exercise is not essential. I know that’s crazy. Believe me I hate even hearing myself say that. I want it to be essential because I have even more of an incentive to do it, but the fact is it’s not. I mean, the diet I couldn’t put a percentage on it, but it’s probably 90% diet. I think exercise does seem to be really helpful for insulin sensitivity for giving glucose somewhere to go. The more muscle you build the higher your carb tolerance is going to be for the most part, right? Because the muscle is just going to be able to deal with it.

Amy:                     The sad fact is, or maybe it’s a happy fact for some people you don’t actually have to exercise to lose weight. That’s great news because if anyone watching us is let’s say you’re 400 pounds or 500 pounds it’s not really a great idea for you to go running. Lose a bunch of weight first. Get some of the strain of your joints. Maybe you could do water aerobics, you could walk. I’m not saying don’t become active, but there’s some movements that are not really going to be that wise for you to do until you’ve gotten some weight off. The larger you are like the heavier your starting weight the more quickly and easily the weight comes off. There’s a Dr. Tro Kalayjian whose lost over 150 pounds on keto. He started out all he was doing was slow walking on the treadmill probably barely burning anything. There’s a lot of people who start out morbidly obese who don’t add exercise in until they’ve already lost a substantial amount of weight. Again, I’m not telling people not to exercise, but that is not what makes this way of eating work.

Carole:                  I couldn’t agree more. I tell people that exercise has plenty of health benefits, but it’s not part of the equation that’s necessary for weight loss.

Amy:                     Yeah.

Carole:                  Yeah. Well, I think this is great. I hope that people really learn a lot from this. I hope that a lot of people have some smoke coming out their ears, and their head is spinning a little bit like what do you mean? Shaking up the paradigm. I mean, there was a lot of great that came out of my education, but I think one of the most valuable things I learned was to always stay open. Stay learning there’s a lot of stuff we don’t know. We’ve got a lot of great researchers out there that they’re continuing to learn and dive into all this information. Yeah, anything else that you think we missed or want to add?

Amy:                     Not really, but just to tell people don’t be afraid to try something different whatever that means. Increasing protein, decreasing protein, trying this other type of food, doing this other thing. You don’t need anyone’s permission, right? How many times do you see online can I do so and so? Is it okay if I eat? I don’t know, try it. You’re a grown adult. You don’t have to ask me for permission. You don’t have to get a signed contract from somebody. I don’t want to say anything dangerous here, but there’s very little that you can do to your body with food or a change in your sleep or your exercise that’s going to kill you over the course of three weeks. You could try something, hey, I want to try eating that, or I want to try cutting that out, or sleeping this. Do it. You’ll know if it’s working or not. We’re not dealing with medication. We’re not dealing with surgery. There’s not a whole lot that you can do to yourself that is going to cause irreparable harm in the short term. Does that make sense?

Carole:                  Yeah, I think so. I also think, though, that people get overwhelmed with all the possible things that they could change especially if they’re in Facebook groups where they say here’s where I am at, and then they get 100 different replies about what they should change. I would just recommend pick one thing. Try that one thing for a week. Stick with it for a while then that will be enough time to let you know if that’s helping or not. If you do one thing for one meal, and you change the next meal you do this that’s going to be really hard to figure out whether that’s working or not. Yeah, there’s a lot of things you could change. Pick one thing try it for a week see what happens.

Amy:                     Yeah. I got to say I’m terrible at that I’m the worse. Dave Feldman would kill me. I’m the worst scientist because I never change one thing I change six things and it’s like, well, great, now what? Then if I feel better it’s working I have to keep doing all of that because I don’t know which thing was responsible for it. Oh, God.

Carole:                  Well, and if all else fails get some help reach out to one of us if you need some high-level support.

Amy:                     Set you straight, yeah.

Carole:                  How to start keto the easy way. Cut out the carbs. Eat real food, meat, fish, poultry, some cheese. That’s what we came up with, right?

Amy:                     Yes. Some cheese if you like it. If you don’t like it you don’t have to eat cheese.

Carole:                  Oh, yes.

Amy:                     Send it to me send your extra cheese to me I’ll eat it.

Carole:                  Oh, yeah, the final point is that there is no magic keto food. There is no food that you have to eat that’s keto that if you don’t like it, right? Every day there’s somebody that’s like I don’t baking can I still do keto? I don’t like dairy can I still do keto?

Amy:                     I don’t like avocados.

Carole:                  Yeah, okay, that’s another one.

Amy:                     I don’t like avocado. I don’t eat them. You don’t have to use MCT oil. You don’t have to use coconut oil. You don’t have to make anything with almond flour it’s not required.

Carole:                  Yeah. Keto is about what you’re not eating not what you are eating.

Amy:                     100%, yes.

Carole:                  All right. Okay. Hopefully, you guys learned a lot. Hopefully, you have a lot of questions as well so comment below with your aha, your takeaway from this, or more questions for us. If you enjoyed us, too, give us a thumbs up, and subscribe. Hit the subscribe button, and then if you want to get notified of new episodes hit the bell as well because that’s going to give you the notification for that. Amy, thank you so much for being here. We’re going to link Amy’s stuff down there. We’ve got a couple of videos we mentioned as well so we’ll put all those in the comments below. Thank you for being here.

Amy:                     Yeah, no problem, and I’ll see you in Salt Lake City. I don’t know if this is going to be published before or after that, but Carole and I are both speaking. I don’t know if it’s called low-carb or Keto Salt Lake.

Carole:                  It’s Keto Salt Lake.

Amy:                     Yeah.

Carole:                  Yeah, yeah, we’ll try to get this out before then, and this will live on forever on the air web, so check out the latest keto conferences coming up. Yeah, thank you everyone for watching. It’s been so much fun. Thanks, Amy, for being here.

Amy:                     Yeah, yeah, see you soon.

Carole:                  Bye.

Amy:                     Bye.

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