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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/

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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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