Ask The Low-Carb Experts podcast

46: Dr. Jacob Egbert | Functional Fitness Medicine

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AIR DATE: September 19, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "Functional Fitness Medicine" One of the major flaws in the way traditional medicine is practiced these days is this over-obsession on treating symptoms and lab panels rather than getting to the heart of what is causing chronic disease in the first place. Rather than seeking out preventative modalities that include nutrition, fitness and lifestyle changes, many doctors are opting for pharmaceutical and surgical answers first without ever giving a second thought to alternative treatment options. Thankfully, there are an ever-growing number of medical professionals who are bucking that system by zeroing in on what just plain works for their patients. That's exactly what this week's guest expert has done and the lives of his patients are being changed on a daily basis as a result. He is a Utah-based Physical Medicine and Rehabilitation specialist named  and the . Dr. Egbert has seen firsthand how debilitating physical weakness is for most people and is committed to improving their functional fitness level to coincide with a rock-solid Paleo nutritional plan. That's what we'll address in Episode 46 of "Ask The Low-Carb Experts" taking YOUR questions on the topic "Functional Fitness Medicine." SUGAR-FREE, LOW-CARB PEANUT BUTTER CUPSNOTICE OF DISCLOSURE: INTRODUCING THE PALEO TREAT NOGRAINOLA:NOTICE OF DISCLOSURE:  Here are a few of the questions we addressed in this podcast: ANN ASKS: I have been following a high-fat, moderate protein, low-carb diet for the past 5 months. It has been life-changing for me to say the least and I have lost 40 pounds with no exercise. But now I would like to become stronger and more flexible but unfortunately can't afford to join a gym. Do you have some suggestions to help me accomplish this goal in my home? JAMIE FROM AUSTRALIA ASKS: A medical term we don't hear enough about is “sarcopenia,” that is the loss of skeletal muscle mass and strength. This is typically attributed to aging, but a lack of physical activity, dieting and illness are the primary forces behind why it happens. Of course our skeletal muscles are the body's sink for glucose and are important for metabolic health. So here’s my question: What is the best way for a doctor to monitor muscle mass and strength changes? Why don't they pay any attention to muscle status? Is there a role for a certified personal trainer in the health care system to monitor strength as a simple predictor of muscle health? Is there a process or prescription/referral pad for a doctor to prescribe exercise or refer a patient to a certified trainer?

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    52: Jill Ciciarelli | All Things Fermented (Fermentation 101)

    1:01:36

    AIR DATE: October 31, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "All Things Fermented (Fermentation 101)"  With the increased interest and popularity of the Paleo lifestyle in recent years, so many people with chronic health and weight issues are discovering the power of an ancestral nutrition and fitness program. But many of these Paleo newbies are neglecting a key aspect of Paleo that is critical in light of all the emerging science we are seeing on having a robust and healthy gut microbiota. This is something holistic health coach  has noticed as well and is seeking to educate others about the vital importance of fermenting food for health. Our modern-day culture makes the idea of fermented foods seem strange (ever tried to ferment a Dorito or Twinkie?), but this is something that has been done by traditional cultures around the world for centuries to add more flavor and abundant nutrition to the foods being consumed. Jill's August 2013 book release  shares all the basics of fermenting, finding foods locally in your area to ferment, and to begin perhaps for the first time in your life to add in this aspect of the Paleo lifestyle that has been missing. That's what we will take on this week in Episode 52 of "Ask The Low-Carb Experts" with the timely and very relevant topic of "All Things Fermented (Fermentation 101)." JOIN YOUR LOW-CARB FRIENDS ON THE 2014 LOW-CARB CRUISENOTICE OF DISCLOSURE: TENDERGRASS FARMS GRASS-FED/PASTURED MEATSNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: BOB ASKS: Is there any way to improve the Vitamin K2 content of fermented vegetables? I know natto has the highest amount of Vitamin K2, but I would like to maximize it in the veggies that I personally ferment, such as cabbage, peppers and more. Do I need to use a specific starter culture to make this happen or is there some other way to do it naturally? JANE ASKS: Is there a sure-fire way of getting my cucumber pickles, when fermented, to remain crisp? I'm a moderately experienced fermenter and have tried making pickles three times. Unfortunately, they come out so soft I just had to throw them away. Adding grape leaves to the batch hasn’t helped a bit. What am I doing wrong? FREDA ASKS: Can you address the controversy over bacteria from open fermentation using ball jars vs. PickleIt Jars that are completely anaerobic. The PickleIt Jar supporters suggest that the bacteria created in open fermentation creates bacteria that is not good for the gut and can actually be detrimental. What say you? LENI ASKS: How is the probiotic content of sauerkraut (and other fermented foods) affected by heating? What is the temperature range that supports the survival of probiotics? DEB ASKS: It it possible to make a "milk kombucha" as opposed to milk kefir? Is there enough sugar in milk to feed a SCOBY (Symbiotic Colony Of Bacteria and Beast)? If so, then does the milk need to be pasteurized to avoid bugs battling bugs? I’ve heard you're not supposed to use raw honey for the same reason. ANNE FROM AUSTRALIA ASKS: I was wondering if you can tell me about the Vitamin K2 content of fermented foods, especially kefir? JOANNA ASKS: I’m wondering about the amount of Vitamin K2 in non-dairy fermented foods. Grass-fed cheese has been my go-to source for K2, but I’ve realized that I really have to limit dairy in order to lose weight and I suspect that dairy is an inflammatory food for me. Do non-dairy fermented foods provide a rich enough source of K2 so that I won’t have to supplement? And what quantity of fermented foods per day do you think would be necessary? TAMMY ASKS: Is it possible to safely ferment using only a mason jar? And what about using a layer of olive oil to seal it? I tried to do a quick ferment of pickles over a week recently and apart from being too salty, the olive oil layer turned green and really weird-looking after refrigeration. It makes me nervous to try using that method again. LOUISE FROM NEW ZEALAND: The Inuit eat fermented fish. How do you ferment fish and is there a way to do it safely? What does fermented fish taste like? HARRY ASKS: I know salami is fermented and I enjoy this aspect of it. But is commercially-made salami beneficial or are you best to make your own? MECHELLE ASKS: A group of us get together regularly to make some fermented foods. Most recently, we juiced pears and made hard pear cider using the apple cider recipe from Jill's beautiful book. We invited our entire neighborhood over to drink it, and it was such a yummy hit! Thanks Jill! I’m curious, do you know of any research looking at the blood sugar impact of fermented foods? And are fermented beverages more likely to raise blood sugar than fermented foods? JULIA ASKS: Do you have any favorite brands of fermented foods, especially kombucha, that you recommend? Or is pretty much anything in the refrigerated section of a health food store probably a good bet? Are any of the non-refrigerated fermented foods on store shelves any good? SAM ASKS: I love the taste of kombucha, and my neighbor has SCOBY for me to start making my own. To be honest, I still feel confused about kombucha because of noted integrated health and wellness expert Dr. Andrew Weil's stance. Here’s what he has to say about it: “I am...concerned about the possibility of contamination in home-brewed kombucha. Some batches contain aspergillus, a toxin-producing fungus. This would be a significant risk for individuals with compromised immune systems, such as those with AIDS or in chemotherapy for cancer.” He also notes that he knows of “no health benefits to be gained by drinking kombucha tea.” This is the same man who makes his own sauerkraut and regularly talks about the health benefits and delicious taste of fermented foods! What are your comments about Dr. Weil's concerns?
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    51: Dr. David Perlmutter | Grain Brain & Ketones

    1:17:19

    AIR DATE: October 24, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "Grain Brain & Ketones" LISTEN LIVE TONIGHT AT 7PM ET by calling (712) 432-0900 and use the access code 848908. The biggest breakthrough health book of 2013 contains a simple, yet profound message--the carbohydrates we are eating in our diet are directly leading us down the inevitable pathway to dementia, Alzheimer's disease and other neurodegenerative brain health ailments. It's the #1 New York Times bestselling book  (read ) by a Naples, FL-based neurologist named  (listen to Jimmy's interview with him in ). Dr. Perlmutter identifies in his book the key role that ketone bodies play in various aspects of our health, especially brain health. And that some of the most common foods consumed in our diet--namely whole grains, sugar, starch and other culprit carbohydrates--are the very things that are robbing our bodies of adequate ketone production to thrive as our bodies were intended. That's what we'll be addressing in Episode 51 of "Ask The Low-Carb Experts" this week when we take on the topic "Grain Brain & Ketones." REGISTER FOR SEAN CROXTON'S "REAL FOOD CON"NOTICE OF DISCLOSURE: TRY WATER THE WAY PALEO MAN ENJOYED ITNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: LENI ASKS: What is the impact of a ketogenic diet on bone health? There’s a lot of information on the web that seems to indicate that a ketogenic diet creates an acid environment that leeches calcium and other minerals from the bones. Is this true? ADAM ASKS: What has been your response to the emerging idea that saturated fat is the root cause of Alzheimer’s disease? And I’m curious about what would bring on Alzheimer’s faster: a high-carb, high fat diet or a high-carb, low-fat diet? MARY ASKS: After reading Dr. Perlmutter's eye-opening book where he mentions fasting blood sugar levels are closely associated with cognitive function. Would that be the best thing for me to track or would it be more useful to track post-prandial blood sugar and/or blood ketone levels? REBECCA ASKS: If a person already has moderate to severe Alzheimer's or signs of dementia, is it too late to reverse the damage by eating low-carb, high fat? Can there be any reversal in symptoms? LINDA ASKS: In 1997, I underwent surgery for a benign, but fairly large brain tumor. The dietitian put me on the Food Pyramid diet and I ate that way until I read Dr. William Davis’ Wheat Belly in 2011. We don’t touch wheat and gluten anymore and happily eat low-carb. I wonder what effect grains have on the development of brain tumors. As a 63-year old, is it too late for me to achieve optimal brain health after a lifetime of eating grains? SANDRA ASKS: Should my husband be worried that his cholesterol has risen from 208 to 267? He eats what I eat—a low-carb, moderate protein, high-fat diet. His doctor will undoubtedly want to put him on a statin and my hubby is kinda freaking out about all of this. Any words of comfort you can give us? LISA ASKS: I loved Grain Brain and have already implemented many of your suggestions. I've heard it argued by people in the low-carb and Paleo community that it's the processed foods doing most of the metabolic damage to our health in modern society. However, the unifying factor in many of the world’s traditional cultures is that they're all eating real, whole foods. But Dr. Perlmutter seems to be saying that even real, whole food carbohydrate-based foods like fruits and tubers are poison. Does this apply to everyone, or just those who are metabolically challenged in some way? I think many will find it hard to swallow the "all carbs are poison for everyone" theory when there seem to be so many people eating real-food carbs while maintaining excellent health. HILARY ASKS: If carbs are so bad for our health, then how do people like Michael Phelps and Dr. Oz perform so well for so long eating pasta, pitas and pancakes? And why don't football players drink olive oil and eat sticks of butter on the sidelines rather than a solution of sugar and electrolytes? MARGARET ASKS: When I hit my early 40’s I started having occasional memory issues—it’s both annoying and embarrassing. I've been eating low-carb, high-fat with no grains or sugars and copious amounts of coconut oil for the past two years. I am an avid exerciser and at a normal weight, but I’m still insulin resistant. While my memory hasn’t gotten any worse, it hasn’t gotten any better either. Can I ever hope to see improvement if I continue with what I’m doing or are there other things I can do to help with this? KIM ASKS: I am a 53-year old female who has been on a ketogenic diet for about a year. I am reading your book and now know that many of my problems are a direct result of inflammation. I have lost 90 pounds so far, but I still have a lot of belly fat and inflammation. My low-carb friendly doctor recommends that I stay on a 1,000-calorie-a-day fat fast for a while to see what impact that will have. What effect will all this have on my brain? And what can I do about my belly fat and inflammation since I now know it shrinks the brain? WENDY ASKS: Can you explain why switching from a grain-brain to a ketone-brain is so important in light of menopause? All the books about this subject say to eat soy and flax, load up on the carbs, exercise them off doing cardio exercise, and somehow avoid stress—yeah right! Obviously these people have never had hot flashes! When I started eating ketogenic after reading a book by your fellow neurologist Dr. Larry McCleary called The Brain Trust Program, I noticed my hot flashes disappeared for a while, but then they came back. Why aren't medical professionals from various fields willing to offer any meaningful enlightenment on this issue? Is this something that neurologists like yourself will need to lead the charge on? DELILAH ASKS: For an 80+ year old woman already showing signs of dementia, how helpful will a ketogenic protocol be at this point? Is there any expectation of improvements and/or reversals in neurodegeneration at this point? TRISH ASKS: I inherited the ApoE 4 genotype from a relative who developed dementia at an early age. In light of this, is a low-carb, high-fat diet the best one for me to be consuming to support my brain health? Or should I consider cutting back on my intake of dietary fat as has been recommended for ApoE 4’s? MEREDITH ASKS: I'm confused about your statement in your book and on “The Dr. Oz Show” that it's okay to eat certain grains such as rice. What is it about the non-gluten grains on your "eat in moderation list" that makes them acceptable? Thanks for clarifying. Loved your book! ERIC ASKS: Are you aware of any animal or human studies on the effect of ketogenic diets on Alzheimer’s disease? AMBERLY ASKS: When I have been pregnant, my doctors have told me that being in a ketogenic state is not healthy for a developing fetus, specifically for their brain development. What research is there to support or refute this position? If ketones are good for an adult's brain, why wouldn't they be good for a growing baby's brain? DAVID ASKS: I've been reading your book and talking to my sister about it. She made the point that it wasn’t until grains were introduced into the human diet that there were great intellectual and artistic advances in our civilization. She can't think of one non-grain based population that has produced any great philosophers, artists, etc. She argues that a grain-based diet is what fueled all the great intellectual achievements in human history and thus will do the same for her. How do I respond to this assertion? DAMON ASKS: I have struggled for a long time trying to increase my blood ketone levels to an adequate level and it has never happened while eating ~200g fat, ~60g protein, and less than 30g carbs daily for that past six weeks. Is it possible to do so much damage from consuming carbohydrates in the past that becoming ketogenic is now impossible? KURT ASKS: I've eaten mostly the SAD diet for the 54 years I’ve been alive. I probably already have a huge backlog of AGE's to now overcome. At my age, can a ketogenic diet reverse and even repair the damage that’s been done from a lifetime of high-carb eating? ANN ASKS: If I remove gluten and grains from my diet at 50 years old, am I able to prevent the onset of Alzheimer’s disease? Or has the proverbial damage already been done?
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    50: Dr. Bill Lagakos | All Things Calories (Calories 201)

    55:48

    AIR DATE: October 17, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "All Things Calories (Calories 201)"  The concept of calories is one of the most controversial and highly misunderstood concepts in the discussion of nutrition and healthy living. Most conventional health experts put forth the notion that weight and health management simply comes down to basic math--eat less calories in your diet and burn off more calories. In their world, it's all about food quantity. But for many of us in the low-carb and Paleo community, choosing food quality is so much more important as a means for controlling the hormonal and metabolic impact of those calories over how much of that food we are consuming. This is a concept that this week's guest expert knows a thing or two about. He is nutritional biochemist  (listen to Jimmy's interview with him in ) and the author of a book entitled . He'll took on the topic "All Things Calories (Calories 201)" in this fabulous podcast. You might recall we had  for a Calories 101 discussion. Listen in as we dig a little deeper into this topic to clear up any lingering misconceptions you may have about the subject of calories. REGISTER FOR SEAN CROXTON'S "REAL FOOD CON"NOTICE OF DISCLOSURE: THE ALL-NEW WHITE CHOCOLATE RASPBERRY QUEST BAR:NOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: KAREN ASKS: What role do hormones play when it comes to the amount of calories consumed as it relates to weight loss? GERARD ASKS: What does Dr. Lagakos think of Lyle McDonald's energy balance formula? Does it line up with his findings about calories? DEBRA ASKS: I just don't trust calories anymore. All I need from them is to do their job. How did the whole calories in/calories out concept gain such a stranglehold on our culture? Aren't our bodies so much more complex than energy consumed and energy expended? AMY ASKS: Does Dr. Lagakos think the average person would be better off if we'd never heard the word "calorie" as it applies to food? I'm saddened when I think of all the human potential and creativity that are lost as a direct result of the obsessive behavior of calorie counting, watching the calorie meters on cardio equipment at gyms, and the complex math equation people think they need to perform in order to "balance their calories." That’s just way too much wasted brain power and emotional energy spent on a numbers games rather than focusing on nourishing our bodies the same way our healthy, lean, robust ancestors did for generations before anyone had ever heard of a calorie. JAMES ASKS: There have been isocaloric studies conducted where the major difference was the macronutrient composition, but the outcomes tend to differ regarding fat loss and lean body mass retention. Then why do the "experts" still insist that 400 calories of a rib-eye steak is no different from 400 calories of Pop-Tarts? Does Dr. Lagakos think we will ever reach a scientific consensus that embraces the notion that calories from fat, protein, and carbohydrates have different biochemical effects and can't possibly be lumped together based on their calories? KARL ASKS: I understand what the strict definition of a calorie is and that is refers to turning potential energy into kinetic energy. But I also know that our bodies don't utilize calories, but rather ATP. So given a basic understanding of how ATP is generated in the mitochondria, I don't see how to equate calories with the generation of ATP. Could you explain how the body utilizes energy? HELEN ASKS: Is there any scientific evidence supporting the timing of when the calories are consumed. For example, if someone eats 2500 calories per day, does it matter if those calories are spread out over 4-5 meals or if they are all consumed in 1-2 large meals as part of an intermittent fasting protocol? GARY ASKS: There is a common belief in our culture that states when you don't eat enough calories your body will go into "starvation mode" and accumulate stored body fat. Is there any science behind this, and if so, what exactly is going on inside the body to make this happen? Speaking of common beliefs on calories, doesn’t the idea that all calories are the same actually violate Newton’s Second Law of Thermodynamics? KURT ASKS: For years on the SAD diet I weighed 210 and regularly exercised by jogging, biking and lifting weights. Since going 90% Paleo/primal and wheat-free (but not ketogenic) 8 months ago I’ve lost 21 pounds and feel great. I exercise the same as always but I’ve plateaued at this weight for 4 months now. As near as I can tell, at 10% less weight, I seem to need 30% fewer calories than I did on the SAD diet. Have I become more efficient at using calories or are the calories I’m now eating somehow more efficient? This has been driving me nuts lately because I’d like to lose another 15 pounds without losing muscle. I look forward to your insights. CHRISTA ASKS: I have a question about calorie consumption during pregnancy. The current advice is to eat about 300 more calories per day while pregnant. I want to support my baby's growth and am eating the most nutrient dense foods I can find. But I also don't want to gain an unhealthy amount of weight in the process. Do you have any thoughts on how a woman can determine the proper amount of calories that should be consumed when pregnant?
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    49: Dr. Donald 'Rock' Schnell | All Things Aging (Aging 101)

    1:18:30

    AIR DATE: October 10, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "All Things Aging (Aging 101)" Father Time has a sneaky way of catching up to us all at some point, doesn't he? But what if you could hold off the effects of aging for many more years than you think simply by making some basic shifts in your diet, fitness, supplements and lifestyle choices. That's the heartbeat of the work of this week's guest expert named  (check him out on  and ). He is an anti-aging specialist and co-author with  of the book . Dr. Rock was once a staunch vegan advocate and noticed how it greatly accelerated his aging which is what motivates him to help people over 40 discover the easy and intuitive methods for increasing vitality, sexuality, and youthfulness through whole food nutrition, convenience exercise and correcting micronutrient deficiencies. That's what we'll address in Episode 49 of "Ask The Low-Carb Experts" taking on the topic "All Things Aging (Aging 101)." TENDERGRASS FARMS GRASS-FED/PASTURED MEATS:NOTICE OF DISCLOSURE: GET JIMMY'S BESTSELLING NEW CHOLESTEROL BOOK:Get a FREE CHAPTER by visiting  Here are some of the questions we address in this episode: HILARY ASKS: I'm 48 years old and menopausal. I've had lupus-like symptoms ever since I was a kid and my health has been improved beyond my wildest dreams by avoiding wheat, plus adding in healthy fats and a pile of supplements that I cycle into my routine when I feel I need them. I'm curious about DHEA and I'm trying the NOW brand of 7-Keto DHEA. Every once in a while when I feel like I need an anabolic boost, I sprinkle around 5-10 mg into my Bulletproof coffee. It really is helping my tendons, muscle tone, mood and energy. Do you think this protocol I am doing is helping me fight aging? Is this the best form of DHEA for reducing the masculinizing effect? JAMIE ASKS: We often hear insulin referred to as the “fat-storage hormone” but is it accurate to also call it the aging hormone? Do some medications accelerate aging? And are there any anti-aging supplements? JENNY ASKS: I am 41 years old and not in peri-menopause yet. I’d like to retain my present feelings of vibrant youth and know that fertility is a marker of being young and full of health. What do you think of using bio-identical hormones to continue to menstruate through and after menopause? How exactly does doing something like this work? ERIK ASKS: Would Dr. Schnell consider using exogenous testosterone as we get older to stave off the effects from aging? If so, then does he have a preference regarding the modes of administering it? MARK ASKS: Is mimicking the internal chemical environment of a young body the best way to defy aging? If so, then how do "turn off" late-acting deleterious or lethal genes? ANN ASKS: How do refined carbohydrates affect the skin as we age? Is this a direct reflection of what is happening in our organs long before it reaches the surface? KATHIE ASKS: Which vitamins are most beneficial in warding off the effects of aging in conjunction with my low-carb, high-fat lifestyle? LIZ ASKS: I work outdoors in a place where we have sun all year round. What are the best ways to keep my skin from prematurely aging? I use sunscreen (which I know has terrible ingredients in it) and cover up as much as possible. Many people I’ve seen who have worked outdoors doing what I do look 30 years older than they really are. I don't want to end up like that! KURT ASKS: I’m 54 years old and enjoy running, biking and weight lifting. There is conflicting advice between doing steady cardio vs. intense interval training. What do you feel works best for men as they begin aging after 50? NICK ASKS: Is eating low-carb to limit insulin and moderating protein down to limit MToR the best way to slow aging and increase longevity?
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    48: James Clear | All Things Intermittent Fasting (IF 101)

    1:13:22

    AIR DATE: October 3, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "All Things Intermittent Fasting (IF 101)" Just mention the word "fasting" to the man on the street and the reaction you'll get from most of them would probably fall somewhere between completely scoffing at the idea to the sheer terror at the realization of going without food for more than a few hours. This concept of fasting even on an intermittent basis, as has become popularized in the Paleo community in recent years, is certainly a highly controversial and misunderstood strategy that could very well be the last piece of the puzzle in optimizing your weight and health issues. Is intermittent fasting (aka IF) the right way to go for everyone, especially for women who seem to have more difficulty with this? Is there anyone who absolutely shouldn't IF or even those who must do it for therapeutic purposes? And how long and how often should these fasting periods be done to get the most benefit out of them? These are just some of the questions we're going to explore further with a nutritional habits expert named  (listen to Jimmy's "Livin' La Vida Low-Carb Show" podcast with him in ) in Episode 48 of "Ask The Low-Carb Experts" where we'll take YOUR questions on "All Things Intermittent Fasting (IF 101)." Here's your chance to speak directly with the expert to ask YOUR questions. Start getting me your questions on this topic NOW by e-mailing them to  no later than 3PM ET this Thursday. You can also ask your question LIVE on my show by calling (712) 432-0900 or Skype the show for FREE by calling the username freeconferencing.7124320900. Whether you call or Skype, be sure to use the access code 848908. Listen LIVE and  if you like what you hear. This is golden opportunity to interact with the best nutritional health experts in the world, so don't be bashful. We look forward to sharing this brand new episode of "Ask The Low-Carb Experts" with you later this week. SUGAR-FREE, LOW-CARB PEANUT BUTTER CUPSNOTICE OF DISCLOSURE: LOW-CARB PASTABILITIES FROM QUEST NUTRITIONNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: RENEE ASKS: I have long heard that women in general don't have great results from intermittent fasting. I'm wondering whether you agree with this, why it happens, and if this applies to post-menopausal women? I am a post-menopausal female and naturally IF more days than not. What effect does IF have on women's and men's hormones? KARL ASKS: I have been doing Intermittent Fasting for the past few weeks eating meals between 12-8pm. Do you have any suggestions about how I can make sure I get enough food in my body during that 8-hour window? I feel like I’m eating way too few calories. I do have a cup of coffee with about two teaspoons of heavy cream in the mornings. Does that coffee and/or cream make any difference in the effects of an intermittent fast? Should I add a tablespoon of coconut oil or MCT oil to make it better? Or should I be going that entire 16 hours without any calories consumed to technically do an IF? JENNY ASKS: I've been eating low-carb, high-fat for 3 months now and incorporated a 24-hour fast, two days a week for the last month. I also try to mini-fast for 17 hours between my meals everyday. When does the timer begin for fasting: as soon as I put my fork down or about 3 hours later when I've digested my last meal? One issue I am having is that I want to take my vitamins everyday, especially on fasting days, but I can't keep them down on an empty stomach. Is there any type of food that I can eat to stay in a fasted state but is substantial enough to let me take my vitamins? I tried almond butter and was able to keep the pills down but it was not the best option for me. Would a pure fast be even more beneficial than a multivitamin? DAMON ASKS: Assuming proper caloric load and macronutrient breakdown compliance, what could be the reasons for not getting results as far as fat loss goes when engaging in regular periods of intermittent fasting? Are there any disadvantages to doing resistance training in a fasted state in the morning if you don’t eat until later in the day? DEB ASKS: I’m a 48-year old woman and changed my exercise to mainly weight-training and short bouts of high intensity interval training with lots of walking, but was eating low-calorie/low-carb/Paleo for part of the time and doing IF for most of that time frame. I check my muscle progress by doing hydrostatic weighing and I was told I’m losing muscle because I train in a fasted state. Does the kind of exercise matter when doing it fasted? What should I be doing and what should I avoid if I exercise in a fasted state? JASON ASKS: How important is it to eat as soon as possible after a fasted workout? I enjoy my post-workout fat/protein shake but I could just as easily go without it as I am rarely hungry after a workout. Am I harming recovery and/or muscle growth if I just wait until lunch to eat after my morning workout? Is there a known physiological benefit to forcing a 24 hour fast? What are the health reasons to do periodic fasts during the week? JANIE ASKS: I skip breakfast just about every single day as I'm just not hungry in the mornings. Sometimes I'll have decaffeinated coffee with a tablespoon of heavy cream but I wonder if that officially breaks my fast. I see people in the Paleo community having multiple tablespoons of fat in their coffee yet they say that they are still fasting! I am pretty sure a 900-calorie cup of coffee is NOT fasting, right? Is there a calorie level that I can consume in my coffee that keeps my intermittent fasting going? GEZ ASKS: I’m a 44-year old man and have lost 70 pounds following a low-carb, moderate protein, high-fat diet. Intermittent fasting 16-18 hours daily and high intensity eccentric exercise for 30 minutes once a week helped me shed the final 14 pounds. My question is I’m finding it difficult to lose the remaining fat around my waist and lower back. Should I change the length of my intermittent fast to longer periods of time between meals? I’ve also considered adding in a high-carb day once a week in the vein of Keifer’s Carb Nite Solution ketogenic cycling system. Any thoughts? MICKEY ASKS: I have been fasting quite regularly and eat one meal in the evening around 1500-2000 calories a day. I don't really get hungry at all during the day. My concern is whether or not I am prone to losing too much muscle mass doing this? Is it possible to overdo it when you are fasting?
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    47: Dr. William Curtis | Nutrition-Based Diabetic Therapy

    1:26:49

    AIR DATE: September 26, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "Nutrition-Based Diabetic Therapy" According to , 26 million Americans currently have diabetes (mostly Type 2) with a whopping 79 million more who are what's known as prediabetic where they are insulin impaired to the degree that if nothing changes they will become a full-blown diabetic in the coming years. The sad reality of these statistics is they are getting worse, not better, with an additional 2 million+ new cases of diabetes being added annually. What's going on here to explain the explosion in the rates of Type 2 diabetes and even the more rare Type 1? That's precisely what we cover in this podcast featuring a former ER physician and family doctor from Corpus Christi, Texas named  who has become passionate about how healthcare must shift the way they treat patients away from disease management and more towards wellness and prevention care. His clinical experience has shown him firsthand that health does not come from the medicine bottle for the vast majority of patients but from the very foods they are putting in their mouths as well as fitness and lifestyle changes. When it comes to the subject of diabetes, that statement is magnified many times over with the need for the right kind of nutrition and lifestyle treatment modalities as the FIRST line of defense in an overall wellness plan. Dr. Curtis doesn't believe we should be convincing everyone they are sick and in need of a prescription medication to get better again. He contends that a whole foods-based, low-carb lifestyle that he teaches through his  will provide diabetic patients with REAL encouragement and invaluable information to help them defeat this chronic health issue. That's the topic we'll take on directly in Episode 47 of "Ask The Low-Carb Experts" taking YOUR questions on "Nutrition-Based Diabetic Therapy." LOWER YOUR BLOOD SUGAR LEVELS NATURALLY:USE PROMO CODE "THANKYOU" FOR 10% OFFNOTICE OF DISCLOSURE: LOW-CARB CHOCOLATE CHIP COOKIE DOUGH QUEST BARSNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: ANDREW ASKS: It may just be a semantic argument, but I am wondering why the typical medical establishment position is that Type 2 diabetes is incurable. Conventional wisdom says that once you have a consistently elevated fasting blood glucose level, the “diabetic” label seems to stick for life. My doctor bestowed me with that distinction although he never even once checked my A1c, which I later discovered was low. But now my medical records show me as having Type 2 diabetes although I’ve never taken a single drug to treat it. This is such a scarlet letter on my health history that I’m wondering if I am plagued with this label for the rest of my life. What is the difference between "reversed" and "cured" in the context of diabetes? And is the term "managed" the best label one can hope for in the context of our current medical nomenclature? DEB ASKS: I am a 48-year old female who has eaten low-ish carb for the last year and a half (~75-130g per day) and my fasting blood glucose was always nice and low (100 units per day) who adopt a low-carb lifestyle? Do you see problems in this type of patient particularly in achieving the blood sugar lowering you’d hope for and do you attribute that to glucagon dysfunction and hepatic insulin resistance? What other factors should be considered when low-carb just isn’t enough on its own?
  • Ask The Low-Carb Experts podcast

    46: Dr. Jacob Egbert | Functional Fitness Medicine

    44:51

    AIR DATE: September 19, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "Functional Fitness Medicine" One of the major flaws in the way traditional medicine is practiced these days is this over-obsession on treating symptoms and lab panels rather than getting to the heart of what is causing chronic disease in the first place. Rather than seeking out preventative modalities that include nutrition, fitness and lifestyle changes, many doctors are opting for pharmaceutical and surgical answers first without ever giving a second thought to alternative treatment options. Thankfully, there are an ever-growing number of medical professionals who are bucking that system by zeroing in on what just plain works for their patients. That's exactly what this week's guest expert has done and the lives of his patients are being changed on a daily basis as a result. He is a Utah-based Physical Medicine and Rehabilitation specialist named  and the . Dr. Egbert has seen firsthand how debilitating physical weakness is for most people and is committed to improving their functional fitness level to coincide with a rock-solid Paleo nutritional plan. That's what we'll address in Episode 46 of "Ask The Low-Carb Experts" taking YOUR questions on the topic "Functional Fitness Medicine." SUGAR-FREE, LOW-CARB PEANUT BUTTER CUPSNOTICE OF DISCLOSURE: INTRODUCING THE PALEO TREAT NOGRAINOLA:NOTICE OF DISCLOSURE:  Here are a few of the questions we addressed in this podcast: ANN ASKS: I have been following a high-fat, moderate protein, low-carb diet for the past 5 months. It has been life-changing for me to say the least and I have lost 40 pounds with no exercise. But now I would like to become stronger and more flexible but unfortunately can't afford to join a gym. Do you have some suggestions to help me accomplish this goal in my home? JAMIE FROM AUSTRALIA ASKS: A medical term we don't hear enough about is “sarcopenia,” that is the loss of skeletal muscle mass and strength. This is typically attributed to aging, but a lack of physical activity, dieting and illness are the primary forces behind why it happens. Of course our skeletal muscles are the body's sink for glucose and are important for metabolic health. So here’s my question: What is the best way for a doctor to monitor muscle mass and strength changes? Why don't they pay any attention to muscle status? Is there a role for a certified personal trainer in the health care system to monitor strength as a simple predictor of muscle health? Is there a process or prescription/referral pad for a doctor to prescribe exercise or refer a patient to a certified trainer?
  • Ask The Low-Carb Experts podcast

    45: John Kiefer & Dr. Rocky Patel | Cyclical Ketogenic Diets For Health And Performance

    1:30:16

    AIR DATE: September 12, 2013 at 7PM ETFEATURED EXPERT:  & FEATURED TOPIC: "Cyclical Ketogenic Diets For Health And Performance" At the recent 2013  in Atlanta, Georgia last month, Jimmy Moore was the moderator of a fantastic panel of experts addressing the topic "Ketogenic Diets & Exercise Performance" featuring a star-studded line-up of Paleo fitness studs that included Robb Wolf, Mark Sisson, Ben Greenfield and Jamie Scott. The general consensus by most of these top names regarding the future use of the ketogenic approach for exercise and general health is the idea of regularly cycling in and out of ketosis to experience the maximum benefits. This is something that our expert guests this week know just a thing or two about. They are an exercise scientist, nutrition expert, and the author of The Carb-Nite Solution as well as  named  and a board-certified family physician from Gilbert, Arizona named . These two knowledgeable men were here in Episode 45 of "Ask The Low-Carb Experts" addressing the issue "Cyclical Ketogenic Diets For Health And Performance." TENDERGRASS FARMS GRASS-FED/PASTURED MEATS:NOTICE OF DISCLOSURE: THE WHITE CHOCOLATE RASPBERRY QUEST BAR:NOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: PEGGY ASKS: I see no reason why I should "cycle" in and out of ketosis. That seems a bit ridiculous to me, actually, when my performance is so fabulous remaining in ketosis virtually all the time. It's been truly miraculous for me. What added benefits will I get from going out of ketosis on occasion rather than simply staying in a constant state of ketosis for my exercise performance? ALAN ASKS: Dr. Peter Attia on his “Eating Academy” web site (http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-i) says that research shows "someone in nutritional ketosis – even if eating zero carbohydrates – still has about 50-70% of a normal glycogen level, as demonstrated by muscle biopsies in such subjects." I have been on a ketogenic diet myself since May 2013. And as a recreational athlete, I like to do long endurance runs of 13+ miles at a time. Sometimes my runs are great, but other times the performance is poor and I bonk near the end. It feels like I have depleted my muscle glycogen stores at this point. What strategies would you recommend that I do to boost the muscle glycogen prior to going on a long run while on a ketogenic diet? ADAM ASKS: Is there such a thing as bulking up on a ketogenic diet? If you can’t bulk up in the traditional sense, then can you at least build muscle or see body recomp changes using a ketogenic approach? JERIS ASKS: I do a lot of Bikram Yoga and I've been on a low-carb, high fat ketogenic diet for several months. I noticed at first I was getting that ammonia smell and bonking near the end of the 90 minutes. I tried loading up on different carbs and experimented with this on several occasions. A bunch a fruit right before, sweet potatoes the night before--nothing worked. Finally, I heard Ben Greenfield talking about MCT oil and I was already putting that in my coffee in the morning. So I tried putting it in my water for the yoga and amazingly I could do the whole class with no carbs and without bonking or getting the ammonia smell. Maybe I just wasn't getting enough calories of any kind or I was eating too much protein. My question is this: Is it okay to use MCT oil daily in order to stay in ketosis? I guess cycling in and out would mean back-loading with a sweet potato or some other "safe starch" once or twice a week. I'm not doing that right now, I'm just eating a bunch of veggies and a little bit of berries for carbs, so I THINK I'm staying in ketosis. If you stay in ketosis, then won't you become fat adapted more quickly? DENNIS ASKS: If someone is engaging in a 24-hour intermittent fast a couple of times a week, then should they break the fast with starches? LINDA ASKS: I am a 50-year old female runner who has been running for nearly three decades. I’ve always eaten carbs and low-fat protein 5-6 meals a day up until a year and a half ago when I started to lower the carbs and up the fat. I am at a healthy weight, but found that adding the fat made me feel so much better. I’ve been eating mostly Paleo with a little bit of dairy. I’ve really enjoyed listening to the ketogenic success stories of athletes like Ben Greenfield, Vinnie Tortorich, and of course Jeff Volek and Dr. Steve Phinney. My question is how is this working for the ladies? Even all the male podcasters have female co-hosts that seem to whisper in the background that they need more carbs, especially when they race or train at high intensity. I will admit, when I posted to Ben about how many carbs to eat when training for a half marathon, he said at least 100g on high volume days and scale back on rest days. I know eating for leanness and eating for performance are two different goals, but I would like to hear more about low-carb performance for women, especially at you get older. DAMON ASKS: If someone ate a cyclical ketogenic diet but never got blood ketone levels to a significant level, then it seems to me that they would be in no man’s land where they have no ketones for energy but are also carbohydrate depleted. How can someone with this issue of low ketones and depleted carbohydrate stores figure out how to increase ketones to improve their health and performance? LAWRENCE ASKS: Keifer says that staying on a ketogenic diet for too long can lower your testosterone levels. But low-carb researchers like Dr. Steve Phinney and Dr. Jeff Volek never mention this as a long-term problem for people in a constant state of nutritional ketosis. On what basis does Keifer make this claim? JASON ASKS: Is a cyclical carb strategy REALLY necessary for everyone or is it more dependent on the specific kind of activity you are engaging in? I stay in a constant state of ketosis and run 20 hour/week as well as hit the gym twice weekly. I never feel low on energy and actually feel great pretty much all the time. In fact I do NOT like the feeling I get when I am kicked out of ketosis. In light of this, is there some unknown performance reason why I should be cycling in carbohydrates into my diet? And if I do decide to add in some carbohydrates, how do you determine the correct quantity so you don’t prevent keto-adaptation from taking place? MINDY ASKS: I’m a 47-year old female who weighs ~175 pounds and I want to lose body fat. I’ve been on a Paleo/low-carb plan for about 3 years and I swing kettle bells a few times a week for exercise. I am currently attempting to do my own version of Kiefer’s CarbNite plan with a very low-carb, higher fat program for six days followed by a smaller carby snack, carby dinner, and ice cream on day 7. I’ve had blowout CarbNites before and then end up spending the next 6 days just losing what I gained from that event which is why I'm scaling back on them. Also, I initially did your high protein protocol and started gaining weight. I have found that much lower protein and higher fat just works and feels better for me. What, if anything, would you advise I change about the way I’m implementing a cyclical ketogenic diet? DAMON ASKS: What is the maximum amount of time that you suggest being low-carb before beginning to cycle in and out of ketosis? Other than diabetes, are there any other conditions that may prevent someone from getting into ketogenesis if they are eating low-carb, high-fat? MARK ASKS: What is the relationship between ketogenic cycling frequency, the amount of workload during exercise, and lowering body fat percentage if your goal is continual fat loss? GREG ASKS: Does Kiefer or Dr. Patel promote using tools like blood glucometers or blood ketone meters along with the carb back loading protocol? I am particularly interested in the context of someone like myself who is around 15% body fat while doing heavy lifts like back squats, deadlifts, bench presses, and military presses a few times per week. Is there a particularly good way someone could use these meters to optimize and individualize things like carbohydrate intake post workout? PAUL ASKS: On The CarbNite Solution, is it possible to kick start things by lowering your protein intake down to the bare minimum needs perhaps around 30-40g a day? If so, is this something you’d do for 6 of the seven days or just a few of them? DEBBY ASKS: I'm currently using the CarbNite Solution protocol and an avid baker using coconut oil and coconut milk predominantly in my baking. I live a primal/Paleo lifestyle and limit my carbs to rice, sweet potatoes, and other real food starchy carb sources. I have heard that combining MCT oil with carbs, like sweet potatoes, raises insulin levels. If this is true, then would using coconut oil with other clean carbs such as the ones I listed above do the same? And if so, is there a limit to how much coconut oil to consume with our carbohydrate on a CarbNite plan? JULIE ASKS: I am a 34-year old female currently following the CarbNite Solution program. I had gestational diabetes with both of my kids 2 and 3 years ago. At my heaviest weight I was 260 pounds and my fasting blood sugar level was about 104. I gradually reduced carbs and finally discover CarbNite Solution that helped me get down to 185 pounds with an 84 fasting blood sugar in the morning and 5.4 A1c level. However, my blood sugar sometimes goes up to 97-104 on other mornings. Is this something to be concerned with? Should I consume less carbs on my CarbNite until my readings return to normal the next morning? Or am I just overthinking this? JOS ASKS: I'm a 34-year old female and just started weight training about almost a year ago. I am 5’5” and weigh 110-112 pounds with about 19% body fat. My goal is to increase muscles while minimizing fat gain. My current workout program mainly focuses on basic lifts such as a glute bridge, squats, deadlift, push and pull. I've been on CarbNite Solution for almost a year and have lost a good amount fat and gained a bit more muscle. I used to be that skinny fat Asian girl. Recently I've just started to increase my training intensity by going a bit heavier in weights. I heard that once you increase the workout intensity that we need to increase our carb re-feeds during the week, as opposed only having it once a week. What do you consider “working out with intensity” and why can't we just increase the amount of carbs in our once a week carb re-feed CarbNite instead of eating more carbs during the week? Or do you think I should start switching to your other protocol, Carb Back Loading?
  • Ask The Low-Carb Experts podcast

    44: Dr. Paul Ralston | Low-Carb Diets & Spinal Pain

    54:27

    AIR DATE: September 5, 2013 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: "Low-Carb Diets & Spinal Pain" Have you ever suffered from back pain in your life? If you're like most people, the answer is an emphatic YES! Spinal pain is the #1 cause of disability worldwide and lower back pain is the #2 cause of missed days at work (behind sunny days!). What's at the root cause of all of this chronic pain that people are dealing with? And what can a low-carb and/or Paleo nutrition and lifestyle plan do to help alleviate the aches associated with our backs? That's what a Milwaukee, WI-based chiropractor named  will be exploring with us in this week's show. Dr. Ralston presented a lecture entitled  at the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month and he is a big fan of CrossFit, Paleo and low-carb diets. In other words, he knows just a thing or two on this subject we've got for you in Episode 43 of "Ask The Low-Carb Experts" addressing the issue "Low-Carb Diets & Spinal Pain." LOWER YOUR BLOOD SUGAR LEVELS NATURALLY:Use "THANKYOU" coupon code to get 10% off!NOTICE OF DISCLOSURE: LOW-CARB PASTABILITIES FROM QUEST NUTRITIONNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: MARGIEANNE FROM NEW ZEALAND ASKS:I’m a 75-year old woman and have had Bells Palsy since February 2012. I am working hard to stay in a state of nutritional ketosis. Recently I twisted my back while re-learning to ride a bike again. My chiropractor is doing wonders so I have great hope of feeling better than I did before the accident. I think I'm doing okay with my diet except I seem to be stuck about 44 pounds heavier than I’d like. I have about 30g of coconut oil daily and 10-15 mL of cod liver fish oil. Since I'm not losing weight, I've been tweaking things until I find what works again, including setting for myself a goal of getting in 10,000 steps/day several times a week. Is there anything else I can do to optimize my health based on what you’ve heard from my story? KIM ASKS:I suffer from a lot of back pain mostly due to spinal fusion, scoliosis, degenerative discs, and fibromyalgia. The pain has gotten a lot better since I started eating low-carb. Why does low-carb help with back pain? I know I would have less back pain if I could lose some belly fat, but low-carb alone is not getting rid of it. I currently take oxycodone for the pain and wondered if taking pain medications interferes with weight loss. Do you have any natural remedies that can help me with my persistent back pain? J.D. ASKS:I used to get severe pain in my lower back whenever I ran. Over the years, it began showing up when I walked, too. Among my many pre-low-carb attempts to fix my health, I tried a calisthenics routine for a few months that involved back extensions and that improved things considerably extending the distance I could walk. When I started eating low-carb, it had progressed to the point that I couldn't walk more than half-a-mile without pain. In fact, two weeks after starting low-carb, it was gone, entirely, and has never come back again! I spent the day at the State Fair, last weekend, walking for more than ten hours, carrying a backpack, and I had soreness in my joints, and in my shoulders and back, and was generally worn out--but I never experienced that back pain. And here's the thing: it disappeared over the space of two weeks, during which I did no exercise and lost about five pounds. So what changed? I have to think that the problem involved fuel partitioning. My hypothesis is that because I was severely insulin resistant, and thus hyperinsulinemic, when I walked the muscles in my back were mostly burning carbs, and that the pain I felt was just ordinary lactic acid build-up. After I went low-carb and got my insulin levels under control, I regained the ability to burn fat. Of course, I may be entirely off-base, but whatever happened, it couldn't have been a response to weight loss or exercise, because it happened before any significant amount of either had occurred. Does Dr. Ralston have any thoughts about my situation?
  • Ask The Low-Carb Experts podcast

    43: Jimmy Moore & Dr. Eric Westman | Cholesterol Clarity Q&A

    1:08:21

    AIR DATE: August 29, 2013 at 7PM ETFEATURED EXPERTS: FEATURED TOPIC: "Cholesterol Clarity Q&A"   With the much-anticipated release of the book  by Jimmy Moore and Dr. Eric Westman, both of the coauthors joined us on "Ask The Low-Carb Experts" this week for a Q&A session answering listener questions about this critically important new book about the subject of cholesterol. This book was written to fill a major void in the marketplace of an easy-to-understand manual on cholesterol, why it's not the evil substance we've been led to believe, what really matters the most on your cholesterol panel, and which levels are optimal if you are going to pay attention to cholesterol. Here's your exclusive chance to hear directly from both Jimmy and Dr. Westman answering listener questions about the book. That's what we've got for you in Episode 43 of "Ask The Low-Carb Experts" in this Cholesterol Clarity Q&A. Get (or download the ) from Amazon.com: SUGAR-FREE, LOW-CARB PEANUT BUTTER CUPSNOTICE OF DISCLOSURE:  Here are some of the questions we address in this episode: ROXANNE ASKS:I have read and enjoyed books by both of you and am very much looking forward to reading Cholesterol Clarity! I am a 53-year old diabetic female who had heart bypass surgery 6 months ago. There is a history of cardiovascular issues on both sides of my family. I've read that statins can have some rather serious side effects. What, if anything, can you say to me and my doctor to convince us that it would be safe for me to stop taking the 10mg Lipitor I am now taking? JAMES ASKS:So what's the deal with plant sterols? I see it for sale as a supplement to "lower your cholesterol" and I see people taking it. Is there any benefit to it? What about the harm in taking it? I follow a low-carb, high-fat lifestyle, so I get plenty of dietary cholesterol from animals. TRAVIS ASKS:I have a one word question: Eggs. I eat at least three eggs a day everyday for breakfast along with some cheese and bacon. I feel this kind of large low-carb breakfast really gets me through the day. However, I can't find any consensus about eggs. Are they good, good in moderation, bad long-term, or will eating 21 eggs a week kill me? KEVIN ASKS:I've read that higher serum cholesterol could be a clue that something else is going on in the body—for example, tissue damage that needs repair, or a decreased ability for cholesterol to be delivered into cells. Could you please talk about the role of LDL in particular, and what an increased level might indicate about other health factors? KEN ASKS:The homeostatic model for serum cholesterol appears to be well worked out for a standard high-carb diet. Do you think that the correct model is substantially different for a ketogenic low-carb, high-fat diet, and that this might be the reason for the large number of "hypercholesterolemic" responses on this diet? Might the small intestine, instead of liver, be the dominant source of endogenous cholesterol on this diet? DENNIS ASKS:My question is about the effect of fructose, sugar alcohols, and alcoholic beverages on your triglycerides. Would the fact my triglycerides are crazy high at 260 while everything else is fine mean that I should limit these things in my diet? JULIE ASKS:I have been diagnosed with a number of health issues including diverticulitis and Type 2 diabetes. Since then, I have been doing Paleo and cut out all gluten, sugar and high carb foods in my diet. I discovered that going ketogenic was right for me. Before I went keto, I had blood work run with the following results: Total cholesterol — 265HDL — 64LDL — 176Triglycerides — 158A1c — 5.8 The next time I had blood work done was 6 months later. I asked for a VAP test and, although my doc doesn't understand how to read this test, she ordered it for me on my insistence. I moved towards a higher-fat diet and lost 40 pounds over that time since my last cholesterol panel. Here are the numbers: Total cholesterol — 313 (my doctor was pushing statins)HDL — 108LDL — 187Triglycerides — 77 To tell you the truth, my doctor had no idea how to interpret the more advanced numbers on my VAP test and I don't understand it either. I didn't accept the idea that I needed to go on a statin drug but I am greatly concerned with this very high 300+ total cholesterol level. So how do I interpret these cholesterol tests and what should I be doing differently in my diet to work on any weakness in these results? What exactly should I be looking for to track my progress? MARYANN ASKS:The only guidelines I repeatedly see for the ApoE genotype 3/4 and 4/4 people are this: exercise, avoid smoking, abstain from alcohol and cut your saturated fat intake. Do you agree with these recommendations, especially the mandate to cut down on saturated fat? If so, how do you advise you patients who are eating low-carb, high-fat to reconcile this mandate to basically limit or avoid saturated fat with all that we know about the life-saving benefits of eating this way? What do people with this ApoE genotype gain by avoiding saturated fat? PATHOLOGIST DR. SMALL:I’m 59 years old and went low-carb about a year ago and my HDL rose from 50 to 77 and my triglycerides dropped from 92 down to 38. My cardiologist was stunned and asked me how I got such an outstanding triglycerides/HDL ratio with an outstanding CRP level of .4 and an carotid artery scan that show I have the arteries of an 18-year old. But he was not impressed with my LDL being above 130, my ApoB rising to 102, and my LDL-P coming in at 1500. How do you prioritize the favorable readings against the somewhat unfavorable ones? Do Heart Calcium Scores from a CT scan really tell the tale of where you stand with actual disease taking place in your coronary arteries? HOLLI ASKS:I'm wondering how I can raise my LDL cholesterol levels since they seem to be too low. I haven't tested recently, but my previous test showed my total cholesterol is 142, HDL is 78, LDL is 71, and triglycerides are 50. I've been working on correcting a leaky gut and eating a Paleo/GAPS diet for the past year. My energy is very low, I’m always tired and my hormone levels are all on the low end of normal. I'm wondering if my too-low cholesterol could be part of the problem and if so, what can I do to raise it? I am not taking any cholesterol-lowering medications. DAVE ASKS:I went to my doctor and he says I am in the "dangerously high LDL range" and I should stop eating my low-carb high-fat diet and reduce my egg consumption to no more than 3 per week. My last lab results were the following: Total cholesterol – 254LDL – 186HDL – 52Triglycerides – 82Blood glucose – 79 Over the last three years, my triglycerides have decreased, HDL increased, LDL increased, blood sugar decreased and weight decreased. I used to take a statin drug, but I will never take it again. I realize I probably shouldn’t worry about it, but my doctor went crazy about my numbers. Is the increase in my LDL cholesterol something I can choose to ignore or should I modify my diet to reverse the upward trend? JW ASKS:Is it possible that the rise in either total cholesterol or LDL-P that some people report while on a ketogenic diet is due to the fat leaving the adipose tissue as they lose weight? Are there any studies that show if it persists or goes away once weight stabilizes? And if your HDL is higher than your triglycerides while your fasting blood glucose level is under 100, do you care what total cholesterol or LDL-P is assuming there is no familial hypercholesterolemia?

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