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Keto Health Care

Join Carole as she chats with Physician Assistant, Maria Shesiuk, as she shares her keto journey to health, how she first heard of Carole and how she influenced her, and how she now used keto with her patients.

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Transcript provided by Descript

Carole Freeman: Are we ready to do this, Maria? Hey, everyone we’re live.

Do you wonder how a low carb diet can help with chronic disease?

Are you curious how a low carb diet impacts athletic performance? Ooh, easy for me to say.

Do you wish there were more keto, friendly healthcare providers out there?

This episode is for you stick around and learn how physician’s assistant Maria Shesiuk discovered a low carb diet for herself, how it impacted her health and eating habits and how she now uses it clinically with her patients.

Welcome everyone to keto chat live. I’m your host Carole Freeman masters in nutrition and clinical health psychology.

I’m also a board certified ketogenic nutrition specialist. I specialize in helping women 40 plus follow a keto diet for sustainable way. Got to plug the medical disclaimer here. The show has meant for educational and entertainment purposes only. It is not meant for medical advice nor intended to diagnose, prevent, treat, or cure anything at all.

Except for maybe boredom or curiosity. If you have questions or concerns related to your specific medical condition, please seek out your qualified healthcare professional. Welcome Maria to the show. So glad that you’re here. Everyone who is watching. Go ahead and give us a comment, share where you’re joining us from and help me welcome our guest.

Maria is a physician’s assistant personal trainer, yoga instructor, and Maria received a BS in psychology from Wayne state university in 2000 2010 and a master’s of science in physician’s assistant studies from . CCBC PA program in 2012 with hospital-based experience in medical coverage of multiple surgical specialties.

She is an N a S M certified personal trainer and a yoga Alliance, certified yoga teacher, and a competitive Olympic weightlifter. So ha that’s a mouthful. Welcome Maria to the show.

keto health care

Join Carole as she chats with Physician Assistant, Maria Shesiuk

Maria Shesiuk: Thank you so much. I sound really impressive on paper.

Carole Freeman: You are impressive in person too.

Maria Shesiuk: Thank you so much for having me on Carole. Like we discussed before I have been following you for quite some time. And the lectures, one of the presentations that you gave in salt lake city really changed how I think about. Food and diet in general. And it really, it helped me and in turn to help my patients.

I really appreciate all the work that you’re doing. I think it’s really awesome and incredible.

Carole Freeman: Oh likewise, I can’t wait to get to know you even deeper on today’s show too, and share with you. I wanted to share, so you sent me the bio I just read, but you also sent me a specialized clinical interest and a personal statement, which I’m really impressed with.

And I want to share that with everyone first, before we go into some more questions for you. Let me do a little more reading and mix up some letters while I’m doing that. Maria is specialized clinical interest at IHP, which is the clinic that you work at them. So many, right? Maria focuses on functional evaluation prevention and treatment of patients with chronic medical conditions, with a particular interest in addressing them with low carbohydrate ketogenic and animal-based diets.

She also sees patients who are seeking to optimize physical and cognitive performance, her professional. Personal experience has taught her the importance of physical fitness, mindfulness practices, and self realization in alleviating symptoms of most elements, and then personal statement. I hope to help you heal by training the mind and body as one.

My desire is not to simply treat symptoms and manage illness, but to help you maximize your levels of energy and vitality so that you can truly enjoy life. We have many powerful tools to help people help help the body heal itself with an open mind and a large dose of curiosity. I’ve used nutrition, herbs, and movement practices to heal myself and to help others do the same.

I love this last line. I view you that’s her patients. I view you as the practitioner and myself as the facilitator in healing. I felt really important. I wanted to share that because it’s such a different approach than probably most people are used to with their healthcare provider. So powerful.

I got tingles all over from it. How did you get interested in healthcare in the first place?

Maria Shesiuk: It was a long and winding road. I I was working in many different degrees because I kept wandering in college. I didn’t really quite know what I wanted to do. I had an interest in art.

I had an interest in physics. I had an interest in science. I was all over the place, just constantly switching majors. And also there was also concerned about what am I going to do? Majors w what will my life look like? If I learned how to draw really well, there were a lot of uncertainties, because I, I come from a very modest family were immigrants and we never had a lot of money and I wanted to have both job satisfaction and a decent income and be of some service to society.

I wondered a lot. And also I was very sick in my twenties actually started late in high school in 11th grade. I became very ill and it continues continued through my twenties. Part of my switching majors was due to just not feeling well, mentally, spiritually, and physically.

I actually met a PA who experienced the same wandering path. And she’s the one that told me about the profession, because I didn’t know, I didn’t even know what a PA is until she told me about it. And she told me a little bit of a her story and she really inspired me to pursue this profession and I don’t remember her name so I can reach out to her and say, Hey, thanks.

And by the way, do you have any idea of the ripple effect that you had from having that really honest discussion with me? Because she didn’t have to, she was actually providing care to me at the time and she did not have to disclose any of that information. I often think about her when I talked to my patients and I do probably share more than most providers are willing to do because I think that it can have that ripple effect.

I experienced that. The interested in the profession I, at that time I was con got settled on getting a psychology degree and I actually wanted to become a clinical psychologist. But then she made me change my mind and I decided to pursue this path instead. So that’s that’s it in a nutshell, that’s how I got here, but the road to functional medicine, which is the field that I’m working in now was also very anti.

Carole Freeman: Let’s just next clarify what is a physician’s assistant?

Maria Shesiuk: So Carole it’s actually physician assistant. Okay. Assistant. It’s a pretty, a lot of people make that mistake or assumption, whatever you want to call it. We’re not really assistance. We work alongside physicians. So I, there’s no I don’t belong to a physicians per se.

And we do have quite a bit of independence when making clinical decisions in the way we work with physicians is they, the supervisory role is not that he is looking out over my shoulder every minute. Tell me what to do is just it’s more of we should probably be called physician associates rather than assistants, but that’s how the profession was born.

The name

Carole Freeman: what’s the difference between physician assistant then and a full fledged physician maybe that will help?

Maria Shesiuk: Our training is very different. Physicians go through medical school and residency and by the way nurse practitioners go through, I think they also have a residency and they are able to practice completely independently of a physician assistants go through PA school, which is, it’s a different way to learn medicine.

We do have clinical rotations, but we do not do residencies. It’s like we have a little bit more freedom to change specialties because we don’t have to do a residency all over again. So there’s a lot of freedom in this profession.

Carole Freeman: All right. Then tell us more about functional medicine.

I’m a big fan of that and It makes such a huge difference in people’s lives. And a lot of times, some of my clients are like why would I have a doctor already? Why would I need to see a functional medicine doctor? Can you share a little bit about, how that kind of health care is very different me of the benefits of why somebody may choose that?

Maria Shesiuk: Functional medicine is often times called a root cause medicine approach. But somebody in conventional medicine might disagree and say we’re looking for root causes too, but. It’s hard to defend, differentiate it by just saying it’s a root cause approach. Then I feel like if functional medicine, like we, we focus a lot on lifestyle modifications, a lot on like diet, gut health things like, perhaps like stealth infections that are often, overlooked in conventional medicine.

When a patient comes to me, I’m not thinking just in terms of relieving their symptoms, although we do that. But then on top of relieving their symptoms, I’m thinking, okay, what is the underlying cause here? And we go very deep when it comes to the underlying cause. In conventional medicine, maybe if a diabetic comes to clinic there is some discussion about diet, there’s a tremendous amount of focus on.

Medications. We might try, herbal supplements first and really focus on diet. That’s where for me, the low carb diet is, a huge benefit, right? Like how else you reduce blood sugar, rice, carbs or sugar. I want a low carb diet. I encourage, diabetic patients to do that.

And I think patients come to us with that expectation. They’re already prepared to make those changes. There’s a lot from the gut lots and lots of focus on the gut.

Carole Freeman: One of the ways I think of it differently is, like you said, in your statement of thinking of the whole person, whereas conventional medicine looks at each part as a separate thing, and you need a specialist to do the liver, the bones the eyes, the brain whereas functional medicine looks at the person as a whole and all the different aspects that go into health rather than just what medication or surgery can resolve the symptom.

I think another big difference that’s typical as well, that surprises people is how much time they get to spend with you. And do you know, your appointments are 30 or 60 minutes long,

Maria Shesiuk: the first initial appointment is usually an hour long. The followups just, it depends on what the needs of the patients is.

It could be 15 minutes, it could be 30 minutes, 40 minutes, but there are definitely much longer.

Carole Freeman: Yeah. Yeah. And what, when’s the last time you got more than five minutes with your doctor?

Maria Shesiuk: We really think in terms of systems, but that’s not to say that we don’t utilize specialties, specialists.

Sometimes we do need to send people out to a specialist yeah. And we’re also an integrative practice. That means not only do we use a functional approach, but we use other therapies as well. Like we have an energy healer here at the practice. We used to have an acupuncturist and a massage therapist, but that kind of fell apart because of COVID we’re hoping to bring some of those people back.

At some point I used to teach yoga and the practice as well, but I’m not doing that right now. And we

Carole Freeman: Where are you located again?

Maria Shesiuk: This is an Ellicott city Maryland. Near, near Baltimore, very close to Baltimore.

I actually live in both.

Carole Freeman: Tell anyone, in Maryland, you can go see Maria and at her clinic, there’s a, we’re covering each quarter and every state one by one here on the show. You’d said that you’d heard a talk that I did that, which actually you referred me a client and I reached out to interview cause I’m like, who is this person that knows me?

And I don’t know her. And you shared that you heard a talk that I did it at salt lake city, which would have been, I think it was 2019

Maria Shesiuk: 2018, maybe 19.

Carole Freeman: Yeah. How you must’ve heard about low carb before you heard the conference? Tell me more about what led you there.

Maria Shesiuk: I think it might’ve been part of the I don’t know.

I have, I used to listen to so many low carb conferences and lectures on YouTube that I can’t even tell you how I found you. But I started low carb in 2015. Okay. And it’s, I just think it’s a funny story. I had this book that I purchased, it was it’s called why we get fat by Gary Tobbs and this book sat on my shelf probably for a couple of years.

Carole Freeman: And without words, I can’t point at it. It’s right there.

Maria Shesiuk: I should have it in my office and it was sitting on my shelf and I was cleaning, cleaning up my clearing out my space and looking at all of the books and trying to figure out what I’m going to keep and what I’m going to donate, because I didn’t have a ton of high quality books that I was going to read again.

I picked up this book, I’m like, what’s this? And I started flipping through it and I must’ve flipped to the right page because I start reading this book somewhere in the middle of it. And it just really grabbed me like some something I was reading in there. I couldn’t put it down. I finished it within a couple of days.

And after reading that book, it’s all these light bulbs started going off. And prior to reading it I had all sorts of health issues that I was managing, but very poorly. And I had severe cystic acne, depression, anxiety, insomnia just endless GI problem. I actually went through two rounds of Accutane that probably even contributed to my GI problems even more.

And I just, I tried being a vegan and a vegetarian and I tried this and that and the other and nothing was really helping me. I decided to give low carb a try and it wasn’t just low carb. I wanted to try ketogenic diet. I’ve really focused on staying ketogenic, not just little card because there’s certainly a difference.

Within about two weeks of doing not a very good ketogenic diet because I didn’t know what the hell was doing. My skin completely cleared up. Then a couple of weeks did for me what two rounds of Accutane could not do. And it was so shocking to me that I actually thought I was pregnant.

I couldn’t put two and two together. I didn’t realize that dog. Can make such a big change. I kept taking pregnancy tests, thinking I must be pregnant because I’ve never had clear skin since I was maybe 10 years old. And, but then it dawned on me that the only thing that really changed was my diet. I started researching, I would just Google acne and ketogenic diet and there it was.

It turns out that could have been an option for me, but the physicians that I kept going to never offered it to me, they never said, Hey, like not even ketogenic, like maybe cut out sugar, cut out, grains, breads, pastas. Me of this might resolve, you would think that a dermatology office at a very prestigious university would know these things would know this information would offer that to me.

And let me decide. If I want to do the keto route, or if I want to do the Accutane route, but they made it sound like Accutane was the only way to go. That’s when my eyes started to open real wide. And I realized what a powerful tool diet truly is. Then of course, I started sleeping better, my energy shot through the roof.

I was no longer bloated, although that’s, that did come back because I was, I started eating way too many vegetables. I got on the vegetable craze and I, I had to get away from that. That’s how I started, but the low carb journey for me took on many different variations, but yeah, that was like, that was the start.

And I was almost I was almost addicted to listening to all of these low carb lectures because I just couldn’t get enough. Just the amount of information that physicians and PhDs and nutritionist just give away for free was just incredible. It was like, I felt like I was getting a PhD without going to school.

Carole Freeman: Oh, so true. You shared a little bit that when you heard my talk, it really changed your approach and then your approach with your clients. I’m really curious to hear how that

Maria Shesiuk: impacted you. Yeah. I know in that particular lecture, I know that you talked about the raccoons, right? The raccoons that if you feed them, they’re going to keep coming back and you were talking about sugar cravings and I don’t know why that was.

Like such earth shattering news to me that eat, if you want the cravings to go away, you actually have to stop eating that food and constantly feeding the raccoons. I continue to use that with my patients, but also you talk a lot about not I’m flipping through recipes all the time.

Like letting that food be some kind of I guess food porn is the only way I can put. And also you, you talk a lot about the behaviors, the behavior changes in order to make low-carb work. And keeping it simple and eating real food.

All of those things helped me stay on track. And then, I pass it onto my patients because it’s so easy to turn a ketogenic diet into yet another sort of junky, low carb thing.

Carole Freeman: Yeah, probably all the symptoms that you got rid of can, could come back. If you went the process food, pseudo fiber products are out there.

Maria Shesiuk: And there’s so much of that junk out there.

Carole Freeman: Yeah. Oh, I’m so glad. I it’s so touching to me to know that. Cause sometimes it feels like I’m speaking into a void of anybody realize how important this is. I’m as passionate about the psychology of this as the nutrition aspect of it.

And I’ve seen. I don’t know how to measure the hours of which I’ve studied more, but all throughout school I was learning about, from Stephan Guyenet is a very big influence on me as well as Kathleen Des Maisons, she did work. She had a PhD in addictive nutrition. That was a book I found long time ago and just really opening my eyes to I love learning about, what is it that causes cravings and how do we get rid of them in instead of just managing them and what are the things that influence appetite too?

Stephan Guyenet that’s his wheelhouse is all the different aspects that come into play of what triggers us to overeat. What I teach is really paramount and FA foundational to like, how do we actually regulate our appetite? We’re not just constantly feeling. Hungry and regaining the weight.

And it is, it’s a battle. It’s a constant, lifelong journey in this world that we live in that we’re, every other day, there’s another, probably 10, 10 foods, a day of new keto foods that are coming out. And, it keeps me busy with my clients asking what about this thing?

I saw this at Costco the other day. I said let’s look at the ingredients and see what you think. And yeah. I’m so glad that resonates with you. And it does make a difference. I’ve been doing this, I just celebrated my seven year anniversary of following this myself. We started the same year.

And it, it working with everyone that I have, it makes a huge difference in quality of life. And the sustainability of it is as long as they continue to address those things. Thank you. Thank you. Let’s see. Another question is, okay, so you had amazing results and like a lot of people really dramatic results in a very short period of time.

What was it then that kept you on the path and continue.

Maria Shesiuk: I didn’t want to go back to what I came from that was just too terrifying, that constant misery I can’t believe how long I functioned sort of function because not really in, in that state of like brain fog and chronic fatigue, and, I still managed to run marathons in that state.

And I think the reason I loved running so much is because running relieved a lot of the agitation that I had all the time I’m going to help running, helped me sleep, running, help my anxiety. Running was good in a way, because it helped me manage these symptoms, but, I’m not sure that it’s healthy to run marathons all the time just to maintain some kind of level of health.

What kept me coming back is that is the amazing results. And I didn’t want that misery anymore. But I still, I still made a lot of mistakes and I wasn’t a hundred percent. All the following years I was constantly tweaking and learning new information on doing some of the mistakes that I was making on a ketogenic diet.

Like one of which was I restricted my protein. And then I learned that duh, I’m an athlete. Why am I restricting my protein? I was so obsessed with staying in ketosis that I was afraid to eat protein. That’s not good for an athlete. That’s not good for anybody really.

Then I changed that behavior. I started eating more protein. I noticed that, all these green smoothies I was drinking and all of the salad I was eating just kept me almost as bloated as the grains did. Then I had to change that around a. And eventually I actually stumbled upon some carnivores in the community and went a little bit more down the carnivore road path.

And I’m not a strict carnivore, however, I’m definitely, I call myself carnivore ish. I, I eat a lot of animal foods, mostly animal foods with a little bit of plants. And I am pretty low carb, but probably not ketogenic at this point.

That’s my kind of story of where I started and where I am now.

But what I have to say, what the ketogenic diet did for me is it seems to have balanced out all my hormones, cure them. I left him was totally out of whack. I’m sure my insulin was probably sky high from all the carbs I was eating for the running and stuff. And it seems to have. Completely downregulated my cravings.

Now if I eat something a little bit, carby like there is a stopping point. I don’t feel like I want to keep eating and eating this stuff. Just a little bit of something like a half, an orange or a grapefruit satisfied, satisfies, whatever glucose that I’m craving and I don’t have to keep going.

Carole Freeman: Yeah that’s I like that you’re sharing that too, because I found from my clients is that there’s a wide spectrum of how metabolically unhealthy people are. Me people like you that have a very strong athletic background and worked significantly overweight. You have a lot more metabolic flexibility.

You’ve got to that point that your body’s pretty healthy. And as long as you’re sticking. Real whole foods. I’m sure that you have a lot more leeway, but you’re also able to make the choice of eating the foods that make you feel the best instead of being stuck in cravings and food obsession,

Maria Shesiuk: Right.

Yeah. For example, today was an incredibly busy day and I didn’t even have time to make lunch. I didn’t have any breakfast food because I haven’t been grocery shopping. It’s just, this week has been a little bit of a disaster. I had some coffee this morning and like I’ve been seeing patients all day and I didn’t have to eat.

I did not have to eat until two, 3:00 PM. I wasn’t even hungry. And to me that is a sign of metabolic health because my body, like I don’t get, I don’t crash. My body just reverts to burning fat for fuel. My brain is working and I don’t have to eat. Then in the afternoon I had some sardines it’s not exciting.

Whatever it’s protein, it’s fat. When I come home, I might have something a little bit more exciting than that. That’s like another thing that is a gift of the low carb lifestyle is that I don’t have these constant food cravings and addiction. Like I can eat something that maybe isn’t very exciting or, it’s not going to give me a dopamine rush.

Because I look at food as fuel instead of entertainment.

And that really came from the low carb diet from this lifestyle, from everything that I’ve learned is understanding the food is fuel first. Maybe occasionally it can be entertainment, but not every day. All the time.

Carole Freeman: Yeah. Oh, that’s so true.

We live in a world where people think they need to have dessert six times a day.

Maria Shesiuk: They get a lot of this I don’t like to eat that or don’t like to eat this. And it’s it’s okay to occasionally eat something. You don’t like very much to fuel your body properly.

Carole Freeman: Yeah. If food is your only entertainment, it’s really time to look at living a more balanced life.

A healthy, energetic, spiritual well-rounded person has more interests and things that they can turn to for entertainment.

Maria Shesiuk: Yeah. But I remember what it was like to have food as entertainment. I remember that feeling and it’s such a horrible trap to be in, to shift focus and to find other hobbies and find other things.

It doesn’t work that it’s not an overnight change. It actually takes practice. Every day I would wake up and, and practice doing those things. Eat a breakfast that’s that is full of fat and protein. Don’t get these crazy cravings and then work on finding something in my life that brings me so much joy that I stopped thinking about food.

Yeah. I’ll do things. But again, like if I didn’t stumble on the low carb diet, then I wouldn’t be doing all of that work.

Carole Freeman: How did you find that low-carb diet impacted your athletic performance? You’re a yoga instructor and Olympic weightlifter tell us how that impacted your physical things you like to do.

Maria Shesiuk: The Olympic weightlifting came a little bit later. That was two and a half years ago, actually. Prior to that, I was a long distance runner. Like I said, I did marathons and just long distance running in general, just for fun, basically. And I’m a yoga practitioner I’ve been practicing for about 10 years, a little bit less than the last two and a half years, just because of the Olympic weightlifting take up, takes up a lot of time.

For running, I basically, I didn’t need to refuel period. The only thing I had was it’s so fun because no goo and no bunking no, and no consequences of eating goo because it can never, my stomach couldn’t handle that. Yeah, I could run forever pretty much. Because even, I think even when you’re really lean, you have enough body fat to probably run a hundred miles, I’m, I wasn’t a sprinter.

Perhaps sprinters could use a little bit more glucose because it’s a highly glycolytic sport, but long distance running requires no sugar. Like you can just run on fat. Once I got fat adapted, running just became so easy, I just need a water and salt and then yoga. Yoga is not a glycolytic it’s not like I’m not gonna call a sport activity.

It’s not a glycolytic activity. You don’t need any carbs for yoga whatsoever. What I found was in my yoga practice, once I switched to low carb my focus improved. It was easier to get into that meditative state. My mind wasn’t constantly all over the place. I was way more focused and I could hold poses for a really long time, which I couldn’t actually do when I was very carved up.

And I didn’t have any cramping. I would go to these hot classes and not suffer any cramps or exhaustion or feeling like I’m going to pass out. But the in Olympic weightlifting, it’s been an interesting journey. For that, I should probably tell you for the past two and a half years, I’ve been experimenting, adding some carbs and then taking carbs away and adding some carbs.

And really, I haven’t, I can’t say that carbs have done anything magical for me in Olympic weightlifting. Sometimes if I’m training for a solid three hours and once it gets to the second half of my training session, I find that I’m getting a little bit slow. I’ll have a tablespoon of honey. Really that’s 25 grams of sugar.

But I’m still lifting for another hour and a half. By the time I’m done, there’s nothing left. I’ve tried that approach and that seems to work a little bit, but I don’t even always do that sometimes. I’m fine. Going through entire training session with that about anything. I can train that hard for three hours in a fasted state.

And that once again, that’s only because I spent so many years in this fat adapted state.

Carole Freeman: Yeah. Oh, this is great. It’s the typical story, Maria, where. Oh, boring. Everything got better. Everything’s better.

Everything got better. I just, I’m having flashbacks of when I interviewed Dr. Ted Naimin the first time. I’m originally a Seattleite and interviewed him many years ago and asked him, what do you see gets better for people when they go low carb? And he says, everything, everything you can measure gets better.

Maria Shesiuk: I actually, I listened to that interview and I’m a huge fan of his of him. He he’s very protein centric. When I started eating more protein about three years ago when I went more down carnivores ish route I. Started feeling stronger. And I had even less cravings then.

Like I, the under eating of protein I was screwing myself for a number of years doing that. I really appreciated the information that he has provided in the low-carb space about, the importance of paying attention to protein. There’s also Don layman. I don’t know if you’re familiar with his work.

He is a researcher, a protein researcher who talks a lot about equality of protein, the amount that we need that I’ve listened to quite a few interviews with him as well.

Carole Freeman: Ooh, fun. A new person for me to rabbit hole on. I hadn’t heard of him. That’s one of the changes I’ve made over my journey as well.

And this is episode 47 of my show and my last episode, 46, I did my second. keto anniversary show and talked about the things that are different than the beginning. And the same thing for me in the beginning, we all thought we had to keep protein, adequate not too high. And that’s a big shift that I’ve made myself.

And then also with all of my clients and you’re right, it makes a big difference of reducing cravings overall better hair, skin and nails. A lot of my ladies would, as they were losing weight would lose a lot of hair. I did it as well. And now when I recommend a much higher protein intake for them, they don’t have that issue of the hair falling out anymore.

Maria Shesiuk: Yep. Acids are the building blocks of life, we probably getting enough.

Carole Freeman: Yeah. And another big influence of mine is Peter Attia. And he’s been talking recently about how little protein, like when he sees middle-aged women coming in, that’s the number one issue they have is they don’t eat enough protein.

It is. Interesting how much work it is to, to gradually. I usually stair-step my ladies into higher protein. I trick them and start them on 80 grams. And then I want them like a hundred usually or more. And first they’re like, it’s so much protein and I’m like, just wait. But once they get there, once they get used to having that much, they actually prefer that they feel better.

They choose, they crave the protein more than they do other things too.

Maria Shesiuk: Yeah, it is a hard change because protein, especially animal protein it’s not very exciting to eat, it doesn’t give you that dopamine rush. It’s boring. Yeah, it’s hard to make that change and also.

Like I’ve noticed in my patients, the patients that have been eating low protein most of their life, and maybe like a heart higher carbohydrate diet, they seem to have some enzyme deficiencies. They have a really hard time adjusting the proteins. They have to slowly help them build up to a better level of protein.

Carole Freeman: And. Yeah, they have, they need the amino acids from the protein to make the enzymes to digest the protein.

Maria Shesiuk: Yeah. Yeah, but I hear the story all the time. One of, one of the questions they asked, I just, I asked my patients, I tell them, give me your typical day of eating and, it’s like over and over again, I hear I have a hard boiled egg and a piece of toast and, fruit or my personal favorite steel cut oats with fruit and honey.

Yeah. I’m like where’s the protein, oh, I eat peanut butter, stuff like that.

Carole Freeman: Or a green smoothie with yogurt.

Maria Shesiuk: Or the protein powders, the endless protein powders.

I don’t know, in a way those are the easy patients because you make a few small changes and they’re like a million times better. Yeah. Yeah.

Yeah. How do you use low carb or ketogenic diets clean.

And like a million different way.

keto health care | KCL47

Carole as she chats with Physician Assistant, Maria Shesiuk, as she shares her keto journey to health.

Carole Freeman: Everything gets better.

Maria Shesiuk: Didn’t, we already conclude that.

We have, we certainly have plenty of patients with metabolic issues and elevated A1C is, my blood sugar. We have a lot of patients with chronic pain issues inflammation low carbohydrate diets, certainly reduce inflammation. It’s just it never ceases to amaze me how, patients go on a low carb diet for a while and they’re like, oh, I forgot to tell you that this back problem I had, I don’t have it anymore.

Carole Freeman: I’ve found that my people that had to go to the chiropractors a lot before, so sorry, chiropractors, but they’re just like, oh, I haven’t had to go in 30 days or a month or two. Oh yeah, my back feels great.

Maria Shesiuk: They’re having that same realization that I did when I realized that it was in fact, the ketogenic diet that cleared up my skin, not a surprise pregnancy.

Is that, oh, it can

do that. Yeah. Yeah. Have you heard this one as well? Maria. Cause this is one of the most I haven’t seen, and there’s no, I don’t, as far as I know, there’s no research on this as well, but a lot of my ladies, everyone who has ever experienced urinary and. That goes away as well.

And it’s one of those things as a mother, we’re told like, oh, that’s just part of pregnancy. You get torn up down there, get used to it. And one time on a group call, somebody shared that. And they’re like, this is a weird thing. Is anybody else note it? And everybody on the call was like, oh yeah, me too.

Somebody would say oh, it’s just less weight on there, but it goes away much faster than the amount of weight that you’d think that would have to be taken away from you. No pressure on the bladder. Somehow it just makes all the

muscles work better. It makes the muscles work better. And think about this, they could have a cystitis, right?

An inflamed gallbladder will not feel better. What am I saying? An inflamed bladder. And if you put them on a low carb diet, the inflammation is reduced. They don’t have that urgency. They don’t have the spasm anymore. It makes sense. I can’t say that personally have had clients where patients with that particular issue, but it makes sense when you think about the physiology of at all.

Yeah, absolutely. We also utilize it and I say low carb because, sometimes it’s ketogenic, sometimes it’s just low carb. We have, we offer mistletoe therapy here in the office and I don’t know if you’re familiar with mistletoe, but it is a like a supportive therapy for patients with cancer.

We do get patients coming here for various therapies that have cancer and we’re trying to add something to their conventional therapies. Oftentimes they do go on ketogenic diets to starve the cancer. That’s another application and I feel so, so honored fortunate that I can help.

Get, guide them through it. Like I have I’ve had two or three cancer patients that I’ve worked with remission, nutrition, which is it’s a service for ketogenic diets for cancer. But in addition to that, they have me as a resource, so they don’t have to go to that service every time they can just come to me and say, what do you think about this?

What do you think about that? When I can guide them through that. And I think that’s

Really cool.

Carole Freeman: Do you

Maria Shesiuk: with memory problems dementia, right? Yeah. Yeah. We’ve had that too. That’s a little bit more difficult because the memory problems, the dementia itself can make following ketogenic diet very difficult.

Carole Freeman: Yeah, once so many powerful applications of it. What kind of reception do you get from your your patients when you talk about this?

Maria Shesiuk: Oh, it’s all over the place. If I’m talking about low carb and that’s the term I’m using, then most patients are fine with it. They’re at least open-minded about it.

If I start going more towards a carnivorous diet, like a carnivore diet, not even calling it a carnivore, like a meat-based diet, they’re like, oh, wait a minute. It doesn’t meet cause cancer and, on and on. I get a lot of skepticism.

Carole Freeman: There’s all these terms. We have to come up with a light plant diet.

Maybe they’d accept that a little bit more a reduced plant diet versus a meat centric diet,

Maria Shesiuk: right? Yeah. Plant, animal-based. Yeah. Yeah, so the reception is all over the place and the word is getting out into the public sphere. People are a little bit more open-minded and certainly people that come here are very open-minded about all sorts of alternative therapies.

Carole Freeman: Do you do any work with like CGMs

Maria Shesiuk: Yes. Okay. CGMs are still very expensive. The one that I’ve been recommending, I probably shouldn’t be name-dropping. They’re expensive. I think that unless you were actually a diabetic or a type one diabetic insurance companies, don’t always cover them.

It has to be the right patient, basically patient with disposable income.

Carole Freeman: Mentioned it maybe they’ll sponsor the show

Maria Shesiuk: is the one that, yeah. But there, I can’t even afford it. I wanted to do it, but I don’t have that kind of cash. But yeah, I think it’s an incredible device.

It’s very useful. Because you do get immediate feedback on how you respond to certain foods instead of guessing, or having to prick your finger and the blood sugar meters are not very accurate. I remember that when I used to prick myself for for ketones and blood sugar, it was all over the place and I tried multiple eaters and I love the idea of using a CGM.

Carole Freeman: And you do the same. You do the stick a couple of times. The ten points. Yeah. Yeah.

Maria Shesiuk: And I think to myself, how did diabetics deal with this? Cause they can overdo the insulin. Yeah.

Carole Freeman: When those people that can afford the CGM, how do you recommend they try it out?

Maria Shesiuk: I usually recommend three months. I think three months is a really good timeframe.

Carole Freeman: Is that something that you find that is a helpful tool in getting people to convert to low carb? Like they can see I’ve seen this in some friends of mine online that they aren’t keto. But they’ve got the CGM and they’re like, oh my gosh, these foods, I don’t want to eat that anymore. Cause I had no idea what it was doing inside my body. Do you find that it helps people that are a little hesitant to go low carb?

Maria Shesiuk: Definitely. But I can’t say that my patients are the patients that agree to these things are not really super hesitant to begin with already on the path. But it’s just a great learning.

Carole Freeman: Yeah. More of a bio-hacker type of person.

Maria Shesiuk: That’s exactly right. Yeah.

Carole Freeman: Yeah. I think they’re great for, especially once you get to that point where you’re metabolically healthy and determining which foods work for you, which ones don’t and then what quantity of those another thing that comes up too is just how stress affects your blood sugar too.

One of my ladies that was finding out every time I go into this meeting at work, my blood sugar goes up 30 points, just thinking about going into it.

Maria Shesiuk: Yeah. That’s very interesting. Yeah. And I wonder about like my coffee consumption. I am a bit of a caffeine addict. How much my blood sugar is affected by.

I guess I’ll never find out because I can’t afford the CGM.

Carole Freeman: Come on Nutrisense, send Maria and a sample one. Maybe those there’ll be a I don’t want lower quality ones, but you know how there’s all the different companies now that put out like the glucose monitors and the ketone meters.

I get contacted all the time by Hey, you want to try this one out? And I’m thinking like, they’re probably not very accurate. Why would I want to waste my time on that? But maybe someday we’ll have some more affordable CGM monitors on the market. Yeah. I just think that for any style of eating a CGM is going to be pretty powerful.

Maria Shesiuk: 100%.

Carole Freeman: When you figure out what foods work for you in general,

Maria Shesiuk: 100%. Yeah, absolutely.

Carole Freeman: Yep. What is your current diet look like? You gave us some examples. Do you want to share, a typical day of, I guess you told us today but like maybe. Typical day of,

Maria Shesiuk: There’s a typical day of what I’m at home and there’s a typical day of when I’m at work.

I have been recently starting my mornings with actually raw eggs. I found that I digest, I tolerate raw eggs, much better than cooked eggs. I haven’t found the explanation for this phenomenon yet. I get my eggs from a local farm

Carole Freeman: are you doing, can I just this is a little area that I’ve studied a lot on.

Are you only doing the yolk?

Maria Shesiuk: No, I’m doing the yolk and the whites.

Carole Freeman: The white has a compound in there. Avidin, do you know about that and how it binds with biotin?

Maria Shesiuk: Yes, but I also talked to another nutritionist and he said that if you’re eating the yolk and the white together, and you have other sources of biotin, that it shouldn’t be.

Carole Freeman: I well, so I would challenge that because the avidin has a binding capacity for more biotin than in the yolk, of a typical egg, and it will bind with other biotin in your body. And over time it can start to cause a biotin deficiency. Yeah. This is why a cook, but cooking the white inactivates it but also maybe just toss out the white and just do the yolk part.

Maria Shesiuk: I need the protein. More yolks. Yeah, I just, the thought of throwing food out makes me sick to my stomach. I’m just so I can’t.

Carole Freeman: Yeah, maybe it’s so separate them and cook the yolk just a little bit. This is something I’ve I researched a lot. I used to teach nutrition classes too.

It’s it’s something I find is not really well known. Like for awhile there was people recommending. You put raw eggs in coffee. And that also it’s just not enough heat on the white inactivate that avidin that’s in there.

Maria Shesiuk: It’s really easy for me.

We actually have a LabCorp in the building, so it will be really easy for me to order a biotin test and take a look. Yeah, and then that was a concern of mine, but it’s like, there’s this back and forth on this issue. I’m like, all right, let me just do this for a while and see what happens.

Carole Freeman: Continue on raw….

Maria Shesiuk: What’s interesting. If I cook the eight eggs, I feel really sick. I just feel like I ate too much, but if I drink and this brings up an excellent point. This is why drinking your calories. When you’re trying to lose weight is a really bad idea. I’m not trying to lose weight.

I’m actually trying to maintain my weight because it’s so hard to maintain my muscle mass on my weight, doing what I’m doing in the Olympic weightlifting. That’s why I started drinking the eggs and I find that it doesn’t make me feel very full and I feel good. Like I just, I feel I’m not hungry, but I’m not stuffed.

And I’m getting this tremendous amount of super high quality nutrients and protein and fat soluble vitamins. That’s been my favorite breakfast recently. Sometimes I make a little smoothie with eggs and heavy cream. I know that sounds gross, but sorry.

Carole Freeman: I’ve had it taste amazing. It’s like eggnog, right?

Maria Shesiuk: It pretty much. Yeah. You add a little Stevia to, it tastes like eggnog, lunch. Sometimes they eat lunch sometimes I don’t. If I’m at work I’ll keep it simple and just either bring some leftover it’s a hamburger or brought worse, whatever we grilled the night before. And I love pickles.

I can’t live without my pickles. Pickles with everything. And then dinner is usually whatever we remember to defrost out of the freezer, buy whole animal. We buy a whole pig and a whole cow from a farm. And whatever’s at the top is what we pull out and defrost and it’s there on the grill. And then as far as like the plants go in and by the way so I do try to split up my protein intake throughout the day.

Like for example, I might not have a formal lunch, but I will have a can of tuna, which is like 40 grams of protein, or I’ll have a can of sardines something easy and quick to get in that extra protein. And then for dinner, I might have two or three burgers with cheese, with some pickles in a glass of milk.

Sometimes we grill bratwurst. We have lots of pork because we buy the whole animal. Ground pork with a little bit of vegetables just for flavor. My, my meals are very most people would say they’re boring, right? Because it’s just cook some meat with some salt and maybe a little vegetable here and there.

It’s just really simple.

Carole Freeman: It’s such an ancestral way of eating though. And for most of human existence, we ate very simply and we were much healthier,

Maria Shesiuk: The vegetable, now, like my, I’m growing cucumbers, so my cucumbers are gonna start coming up soon. But do you love cucumber?

The cucumber pickle thing, I have an obsession with cucumbers and pickles. I do like olives. I love so I have some arugula growing. I might load up on that. During the growing season and eat a little bit less of that in the winter time. Very simple. And like my salad dressing is really high quality olive oil and red wine vinegar.

That’s it. That’s all, it doesn’t need to be more than that. Yeah. Yeah.

If I really, if it really wants something sweet, I might have a little cup of yogurt with a few blueberries and like a teaspoon of honey and maybe some pecans. Like my go tos are occasional pecans, occasional blueberries.

Carole Freeman: What’s your favorite brand of olive oil?

Maria Shesiuk: This is almost embarrassing Kirkland brand. Extra-virgin. Organic extra-virgin olive oil. Oh. Because it tastes great. I think it won some awards for purity in the past, and that’s good to know. That’s why I started buying it in the first place.

Okay. And it’s, it has the bitterness and like that peppery taste of really high quality olive oil. Oh yeah. And it’s inexpensive.

Carole Freeman: I personally, I like to order Bariani, which they press their own and you’re right. When you get that real olive oil, it is so different than what most fake olive oil,

Maria Shesiuk: Most olive oils are really soybean oil.

Carole Freeman: You know that. Yeah.

Yeah. I assumed it was canola, which I don’t know if is any better or not, but

Maria Shesiuk: probably just as bad,

Carole Freeman: oh,

Maria Shesiuk: canola making process.

Carole Freeman: I have not, I can only, I remember. Google is going through like a chart of the 7,500 steps and all that kind of stuff.

Maria Shesiuk: Look up the videos on YouTube.

Oh, pretty disturbing.

Carole Freeman: I can only imagine. Yeah. Yeah. Was there anything else you were hoping I would ask about or anything else you want to share before we wrap this up?

Maria Shesiuk: I’m sure as soon as we’re done, I’m going to think of a million things that I should have said, but that’s how it goes.

I really appreciate you reaching out and doing this. And I’m so glad that we connected and now I have yet another resource for my patients. Oh, this is really great.

Carole Freeman: Now people can work with you in person. Did you figure out whether you can do any virtual consults or anything? We really can’t.

Maria Shesiuk: The first visit has to be in person, but the follow-up visits can be virtual.

Carole Freeman: Okay. If you can make your way to Maryland and go see Maria in person, then she could be your healthcare provider. But tell anyone that, that lives in Maryland or nearby there. If we need to spread the word about people that are doing the good work out there and helping people actually change their health for the better.

And let’s see. Next week’s episode is going to be the secrets of ending emotional eating. I’m relaunching my I have a program called the pathway to end emotional eating. It is a hundred percent of the psychology it’s based on a DBT dialectical behavioral therapy. And by popular demand, I’ve had a bunch of people reaching out and saying Hey, I kinda need something else here.

Next week’s episode is going to be all about information about. Why we emotional eat what it is? Why are, why we have feelings in the first place? Oh my gosh, they’re so annoying. Why do we even have to have feelings how we learn to use food, to cope with that, and the other ways that we do, and then how to begin to unravel that habit that we have and begin to address our true needs so that we can have healthy relationship with our emotions.

That’s going to be next week’s episode. So come back. Thank you again, Maria, for being here, if you’re out there also, how can they get in touch with you? Is there a website for your clinic?

Maria Shesiuk: Yeah, so it’s IntegrativeHealthPractices.org.

Carole Freeman: Check out Maria’s work and consult with her.

Maria Shesiuk: I also have an Instagram account. If anybody is interested in following me where I occasionally post what I eat and what I’m doing athletically

I go by Meeeaaty Maria.

This is funny. It’s Meeeaaty Maria and Keto Carole.

Carole Freeman: Okay. Oh my gosh. I love that Meeeaaty Maria. Okay.

Three E’s two A’s Meeeaaty Maria on Instagram.

How fun this has been. So fun.

Thank you so much, Maria, for being here and sharing the work that you do, your transformation, inspiring other people to do the same. Go check out her. On Instagram. And if you live in the Maryland area or you can get yourself out to Maryland, go check out IntegrativeHealthPractices.Org.

If you’re a struggling on keto and maybe you’re struggling with emotional eating come back next week, but also check out my website, KetoCarole.com.

And if you enjoyed the show, tell a friend, cause remember if you help us grow the show, we’ll help you shrink. And thanks again, Maria, for being here. Thank you. All the viewers and listeners, and we’ll see you next week. Thank you.

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