Using ketosis to lose weight and improve your health – Podcast #109

Dr. Justin Marchegiani and Evan Brand dive into an in-depth discussion about nutritional ketosis and what benefits you can reap from it. This is a podcast episode where you’ll get valuable information about a Ketogenic-Paleo diet, what to eat (and when!) to get the best results.

ketosisLearn why insulin needs to be kept low and the ketones high. Find out how you can keep your diet in check and avoid wasting money when you’re taking exogenous ketones. Discover why carbohydrates are better consumed during night time.

In this episode, topics include:

03:38   What is Ketosis? Who is it for?

08:35   Kinds of ketones

09:50   Ketone supplements

17:36   Using ketones beneficially

28:45   Ketoacidosis vs ketosis

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Dr. Justin Marchegiani:  Evan, it’s Dr. J! It’s a Monday. How’re we doin’?

Evan Brand:  Hey, I’m doin’ great. What’s up with you?

Dr. Justin Marchegiani:  Hey, it’s good that you survived the weekend.

Evan Brand:  Yeah, it was extremely exciting weekend with the baby—getting a lot of trouble with the baby.

Dr. Justin Marchegiani:  Nice. What’d you guys do?

Evan Brand:  Just hanging out at the park, hanging out outside.

Dr. Justin Marchegiani:  Nice. That’s awesome.

Evan Brand:  You get—you get stopped by a lot of people when you have a baby.

Dr. Justin Marchegiani:  Oh, I know. I just a got a dog a month or two ago and I just—I’ve never realized how many people are dog lovers, but man, we get so much attention when we have our dog. It’s crazy.

Evan Brand:  Yeah, if you were single. That would be the easiest way.

Dr. Justin Marchegiani:  I told my wife that. I said, if I ever—like if something ever happened where I can go back in time—if I were to do it all over again. I would’ve got a dog like right off the bat, like just a really cute, small dog but it’s all good. I’m happy where I’m at.

Evan Brand:  Yup, cool.

Dr. Justin Marchegiani:  But I wanted to say, we were talking pre-show there that I got a crown today and I go see a holistic dentist in Austin. Her name is Dr Joan Sefcik. I’m gonna actually have her on the podcast real soon. We’re gonna talk about root canals, cavities, crowns, all those things, but I had an issue with my tooth where I needed a crown. About 16 years ago I split my tooth in half when I was really young, just eating a whole bunch of sugar, eating a whole bunch of gluten. Hadn’t really got the message back then about health. Split my tooth but I was actually able to keep it together with some cement, and obviously changed my diet and never had anything like that happened with my tooth again, but I had those—the long-term consequence of that tooth being unstable so we put a crown on it and we actually did some testing, too, to figure out what the best material was and we actually—I think we ended on a cubic zirconia. So right now I have an acrylic crown that’s a temporary one and we got a cubic zirconia one coming in. We had it muscle tested and we called the lab. We—we chose the top 3 materials that test the best based on blood chemistry and then we muscle tested the top 3 and I tested great for all of them which was great, and then the doc said, “Well, you know, this is the one I have the best success with, and because you tested great with all three, we’re gonna go with this one.”

Evan Brand:  So I’m sure people wanna know with holistic dentistry, that’s all cash no insurance for that?

Dr. Justin Marchegiani:  A little bit. I mean, we have some dental but I—you know, I paid that I think out of pocket. I think it ended up costing me like a thousand bucks for the crown–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And if I didn’t have insurance, it would have cost me $1500. Something like that.

Evan Brand:  Oh, okay. So insurance kinda works for holistic dentistry.

Dr. Justin Marchegiani:  A little bit. I mean, the thing is what’s holistic is the material we’re using, right? We’re not using the standard-based crap. I think it’s nickel a lot of times–

Evan Brand:  Yeah, it’s horrible.

Dr. Justin Marchegiani:  Which can screw up with, you know, the conduction of nerves in the body. So that’s the big thing and also she used a lot of ozones as she go in there. She’d use ozone and get in there, like a lot of essential oils. So it was really targeted to kill a lot of the bacteria and crap that could be in there even though she—I actually asked her, she said it was great, which is good. It’s testament to you know, good, clean—clean eating. So we’re gonna have her on the show real soon to talk more about healthy teeth and oral hygiene, so that that’ll be fun.

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  So I’m doin’ pretty good. Not bad. I get to go get my cubic zirconia tooth. My wife was texting me, it’s like, “Is that gonna look like one of those fake diamonds?”

Evan Brand:  Is it?

Dr. Justin Marchegiani:  In your mouth? No, I don’t think so. I asked. It’s gonna look, you know, it’s gonna look cosmetically in sync with my other teeth. So it’ll be alright.

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  Yeah. So we talked about doing something on ketosis. I’ve had Jimmy Moore on the podcast. I’ve spoken on Livin’ La Vida Low Carb Cruise. We did a podcast a few months ago on Keto OS which is a synthetic ketone supplements and look forward to digging in a little bit more on ketosis.

Evan Brand:  Yeah, there’s a lot of benefits. Ketosis in my opinion is not for everyone at every point in their life. It has a lot of incredible benefits for weight loss but if you have adrenal issues in my experience, some people feel worse. Maybe there is that adjustment period but I find that if people are just they’re afraid of carbs, they can tank out even more. What’s—what’s your experience with adrenal issues and—and ketosis?

Dr. Justin Marchegiani:  So I think ketosis is phenomenal for most people that are out there, especially if you’re dealing with metabolic syndrome, meaning there’s a level of insulin resistance and you’re body is having a difficult time tapping into fat for fuel, ketosis is phenomenal because what you’re doing is imagine fat is like this big branch and we’re trying to throw that branch into the wood chipper and then out of that wood chipper comes these things called ketones, and these ketones can be used by different tissue in the body and the thing is, glucose actually burns dirty. Right? It’s like a diesel fuel. You kinda sm—it’s smells. It’s stinky. If you ever drive by in a diesel car, at least the older ones. But ketones they burn really clean and when I say burn really clean, you don’t get a lot of reactive oxygen species or free radicals afterwards. So it burns really clean like that and also you don’t get the effects of glycation, which is basically all the proteins or tissue in your body gets sugar-coated and that creates basically a m—a magnet for free radicals. So we like ketones because of the stability they give people, right? With sugar, we get this up and down reactive hypoglycemic effect with a lot of people that are doing refined sugar or just higher glycemic foods, meaning they get into your bloodstream really fast. We don’t quite get that with ketones. So the big issue is most people who have metabolic syndrome, big waist, high blood pressure, lots of inflammation, lots of insulin and blood sugar, they can’t get the sugar into their cells and utilize it for fuel optimally. So they can’t—their cells are—are very resistant so they start—one, they get reliant on sugar to burn but two, their cells don’t wanna take it in a lot and actually burn it so they get very tired and a lot of that that gets put in gets stored as fat. So it’s a double edged sword. They’re tired. They don’t wanna exercise. They get cravings. They create more sugar and then when your insulin levels are high, it basically blocks fat from being burned so you’re primarily burning sugar but you can’t get a lot of it to the cells so you’re tired.

Evan Brand:  Right. I’ve heard recently which I’ve read. I can’t remember what I was reading. There’s this kind of—there’s kind of a myth that’s perpetuated where people who are only a fat burner or only a sugar burner and that’s not the case. It seems that most people have the ability to do both and if you wanted to survive in primal times then you would have, you better have that ability to be able to burn glucose or ketones to survive. But I think the goal of that is you just wanna be primarily a fat burner, not primarily a sugar burner which is what would you say, 90% of the population is probably primarily glucose—glucose driven?

Dr. Justin Marchegiani:  Yeah, I would say at least 75%, and we talk in generalities, right? We’re talking like, “Hey, you know, you’re primarily burning sugar for fuel or primarily burning fat for fuel.” That’s—that’s the thing that we’re kinda get across there and most people, you know, when we talk about calorie partitioning, their partitioning, right? You know, imagine you got a police officer and his siphoning people through, “Go that way. Go that way.” You got all these calories that are going through and the police officer is saying, “Hey, go this way into the fat cell. Get stored as fat and a small amount will actually get burned. So we’re not shunting those calories. “Hey, go to the mitochondria. Get burned. Create energy.” While you’re creating energy, you’re building muscle because you’re doing something that’s creating resistance in the body which builds muscle, whether it’s the piezoelectric effect and you’re building calcium into the bone or whether you’re putting muscle into the muscle belly. So we wanna essentially use that you know, traffic policer officer or that you know, flight tower attendant that’s telling the planes which direction to go. We want tell those calories, “Hey, go to the mitochondria. Get burned versus get stored in the fat cell.” And one the biggest ways we can do that especially with people that have this insulin resistance metabolic syndrome is getting into ketones by cutting carbs.

Evan Brand:  Yup, so–

Dr. Justin Marchegiani:  Typically down to 20-30g is a great starting point for most people. Go ahead.

Evan Brand:  Now, the people actually need to count? I mean, I’m probably in ketosis now at this point because I haven’t had much today. I had some—I had a bison burger and also I had some bison—or no, what did I have for breakfast? Had some kinda meat and—and I can feel that. I know because you can feel your breath start to stink a little bit more. That’s how you know. That’s like the first sign of ketosis or one of the first signs.

Dr. Justin Marchegiani:  Well, yeah, you get the acetone but I mean, if you’re only at like .5 mmol, I mean that’s not a ton. So maybe your breath gets a little bit fruity, that’s the acetone. So there’s 3 kinds of ketone. There’s acetone. There’s beta-hydroxybutyrate and there’s acetate. So like if you look at the breath meters. The breath meters are really measuring the acetone in the breath and then the blood is measuring the beta-hydroxybutyrate–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  In the blood.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Right? And then some will actually measure the ketones in the urine, not that efficient because if you’re burning ketones, well, that means if you’re burning them they may not end up in the urine, right? So if you get someone who’s in ketosis, they’re spitting out a whole bunch of ketones but they’re burning them up efficiently they may not pee a lot out. Does that make sense?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So early on you get a lot of people that are in ketosis but they’re body’s not efficient at burning those ketones so those ketones go in the urine to start.

Evan Brand:  Well, let’s–

Dr. Justin Marchegiani:  But then later on as they get more efficient, you won’t see them in the urine. That’s why I got my ketone meter right here. I use the Abbott Precision Xtra or Precision Xtra and it’s—I got blood sugar on there as well as ketone strips, too.

Evan Brand:  Yeah, I’ve done the breath. It was by Ketonix.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I’ve done their breath one. That one was pretty good. I find that I had like a low level of ketones all of the time. Let’s clear something up though. When people hear about ketones, they’ve likely been in the grocery store or Walgreen’s or somewhere and they’ve seen the raspberry ketones as a weight loss supplement. They became very popular over the last probably 5 years. First off, raspberry ketones, they’re not even derived from raspberries when you see those. Most of the time when I’ve looked at the ingredients, a lot of times there’s synthetic chemicals in there. There’s artificial colors, sometimes artificial sweeteners in these raspberry ketones. So I do not recommend them. I don’t actually know enough about what’s actually in there to know what’s actually going to happen but generally just looking at some of the ingredient list on ketones, it—it’s garbage.

Dr. Justin Marchegiani:  Yeah, raspberry ketones aren’t necessarily ketones. I mean, if you look at what’s in there, there are these phenolic compounds that aren’t your typical beta-hydroxybutyrate whether it’s calcium or sodium beta-hydroxybutyrate salts. Like if you look at a lot of the ketone products, there’s Keto OS. There’s another one, a Keto Sport I think, and they’re using the beta-hydroxybutyrate salts, calcium or sodium. Those are like the gold standard. Now you can use precursors, right? Kinda like how we use maybe pregnenolone for adrenal support precursors. You can use precursors like medium chain triglycerides which are gonna be primarily C8 and C10. Like the, you know, the brain—the brain ketones are more C8, right? Octanoic acid or I think that’s maybe caprylic, there’s two names. I like the octanoic because it’s more descriptive. The oct–, octo–, octagon, that’s 8—8 carbons. So typically we’ll do ketones that are C8 and C10 because you get the brain effects of ketones but you also get the metabolic effects. So like typically in the morning after I have either a good clean collagen shake or some eggs and I do my butter coffee with high quality MCT oil. I’ll get my ketones up within an hour or 2 to—to .5, .6 mmol and I feel great.

Evan Brand:  Do you measure that?

Dr. Justin Marchegiani:  I measure it, yeah. Now the thing is with the Ketonix, it’s more qualitative. So like that number like let’s say you’re—you’re a different color or light on that variant. That light that you hit one day, you may hit it the next day but your number may have been different if you were measuring it in mmol of ketones. So it’s a good indicator to—to say if you’re in ketosis. It’s not a good quantitative indicator of what exactly were you.

Evan Brand:  Yeah, the other brand that I’ve seen before. I’m looking—trying to find the ingredients right now is Kegenix. So I’m trying to see what’s in here. It’s $200 for a 4-week supply.

Dr. Justin Marchegiani:  Yeah, they’re kind of expensive. My biggest thing off the bat is number one, get your diet dialed in. So you talked about carbs. So the first thing is as a macro percentage of nutrients is you wanna get your fat up. Most people screw up in ketosis because they go too high in protein. They’re eating like you know, 30-40% protein. It’s hard to do that much in protein unless you do two things wrong. Number one, you eat lots of lean meat and number two, you do excessive protein powders. So those are the 2 things. Now you can get away, going higher on protein if you’re doing a lot of resistance training, alright? But if you’re not doing a whole bunch of resistance training, you want your macros up around 60-70% fat as a pretty good starting point. So what I recommend is just throw your foods into a MyFitnessPal and if you’re using a Paleo template, so that means you’re gonna be getting most of your meats from animal products. Your carbohydrates, you’re gonna choose obviously more from a non-starchy vegetable sources. A really easy thing is you’ll typically be good around 20-30g and you can just throw in your carbohydrates, a cup of broccoli, a cup of spinach, a cup of kale, maybe you’re doing some asparagus, maybe you do another salad for dinner or lunch. Throw all the vegetables that you do in there, you’re probably find that you sit around 30g of carbohydrate once you factor out the—the fiber, 20-30 is pretty good unless you’re doing a ton of juicing or ton of veggies. You’ll probably be around 20-30 net carbs. That’s a pretty good place to be. So that’s a good starting point and then from there, depending on whether you wanna stay in ketosis—I like to—to keep myself around 40-70 carbs a day and I keep—I get my ketones up to .5 and I feel phenomenal–

Evan Brand:  So you’re—you’re–

Dr. Justin Marchegiani:  At around .5.

Evan Brand:  So you’re basically in some level of ketosis most days.

Dr. Justin Marchegiani:  Absolutely. Absolutely. And then like if you listen to guys like Jimmy Moore, Jimmy is around 1, maybe—maybe 1-2. And again, you don’t have to worry about ketoacidosis until you get to about 20. Ketacidosis is potentially what could happen to diabetics type 1 primarily and/or alcoholics that have cirrhosis, with that—they have messed up livers. Essentially ketoacidosis is when your insulin levels are high and your blood sugar’s high. Okay, that typically hard to do because when the insulin goes high, blood sugar goes low.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Alright, so insulin’s high. Blood sugar’s high in the bloodstream but what’s happening is we can’t get the—we can’t get the—the calories or the blood sugar into the cell so the cell’s starving and what happens is the body is trying to generate energy so it spits out a whole bunch of ketones.

Evan Brand:  Yeah, so–

Dr. Justin Marchegiani:  Does that make sense?

Evan Brand:  Yeah, so I was looking at the ingredients here. Basically what this is, it is the beta-hydroxybutyric acid, that’s literally what’s your supplement— supplementing with. That along with some medium train—medium chain triglycerides and then leucine, lysine and isoleucine. That’s it. And then erythritol, some Stevia, some color, things like that. So you’re literally just taking—you’re taking ketones. That’s what it is, right? The—the beta-hydroxybutyric is one type of ketone?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Is that right?

Dr. Justin Marchegiani:  Correct. I wanna go back and correct myself. I misspoke. So regarding the ketoacidosis, it’s the insulin is low. Insulin’s low.

Evan Brand:  So you can’t deal with the blood sugar.

Dr. Justin Marchegiani:  Blood sugar is high so you can’t get it–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Remember insulin’s the lock or the key that goes into the lock. The—the keyhole is receptor site, whether it’s a GLUT4 key which is that’s allowing sugar into the muscle or whether it’s on the liver and an—various different GLUTs. So imagine the GLUT’s the lock and insulin’s the key. So you can’t use the key to get into the cell. So what happens is all the sugar accumulates in the bloodstream because insulin’s low. So everything I said before is correct except it’s because of low insulin. Think, right? Type 1 diabetics have an issue with low levels of insulin because their—their islets cells in their pancreas, the beta cells have been destroyed by autoimmune attack. So they can’t get that sugar in there, so the body’s freaking out. It’s saying, “Where the heck am I gonna get energy?” So it starts ramping out a whole bunch of ketones. Ketones have an acidic ash to it or an acidic foundation to it so it shifts the pH because of instead of being a nutritional ketosis at .5 mmol or 1 or maybe 2, they are 20-10 x higher and that shifts the pH down. When the pH goes down, they can go into a diabetic coma.

Evan Brand:  Wow. Yeah, I—you said that quickly otherwise, I probably would have caught that. That makes a lot more sense. So insulin’s low, sugar’s high. That’s when you don’t wanna do it and like the supplement says that you cannot use it with type 1 diabetics for that reason.

Dr. Justin Marchegiani:  And I—exactly. And I was listening to a lecture just yesterday talking on the topic and he did the same thing I just did and I—I got his bad habit from it. He said the exact thing I said the first time.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I got the bad habit by osmosis, but we corrected it here. So think low insulin, high sugar, the cells are starving.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  The body freaks out and it tries to go and generate a whole bunch of ketones but shifts the pH. Now how do we use ketones beneficially? So we can use exogenous precursors like we mentioned, okay? Obviously the diet’s gonna be foundational. Now for some people, there’s a couple of ways of doing it. You can live in ketosis. That can be great for some people. If you have cancer, lot of great studies especially over at Boston College, Dr Veech, NIH guy. He went to school—he studied under Dr Hans Krebs, I mean the guy invented the Kreb cycle, alright? He discovered it, which is how the body generates you know, energy via NA—NADH and FADH redox—redox reactions which then generate ATP in the—in the Kreb cycle as well as the electron transport chain, but this is how our body generates energy and this guy studied with this doctor that created or discovered this stuff. So moral of the story is this is another way the body can generate energy and ketones are really important part of the Kreb cycle and they are really important part of starving out cancer cells. So cancer’s primarily—primary fuel if you look at Otto—Otto Warburg or Otto Van Warburg, a German scientist in the 30s and 40s who got 2 Nobel prizes discovering this physiology around cancer cell metabolism and he found that cancer cells primarily survive on glucose and if you can starve the cancer cells of that metabolic fuel—remember it burns dirty—if we can use ketones, we can essentially starve that type of cell.

Evan Brand:  Yeah, so—I mean, basically you and I both touch in to ketosis. Now I do do some sweet potatoes and things in the evening so I likely pull myself out of that so this is something that this is gonna depend on the person but you can touch in to ketosis—you do some carbs, don’t you? Do you do sweet potatoes with dinners?

Dr. Justin Marchegiani:  I cycle in and out. I cycle in and out. Typically at dinners, I’ll do after a dinner as a treat. I’ll do a handful of berries and maybe some cream.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Or I’ll do some high quality, 90% dark chocolate that’s you know, organic and you know, obviously gluten-free. So it depends. Like this week I did buy some sweet potatoes so at one night, I’ll have that. I mean, you get different diets out there like a cyclical ketogenic diet.

Evan Brand:  Right.

Dr. Justin Marchegiani:  There’s also Jason Seib’s stick on the AltShift Diet, which is I think a 3 days—I think it’s a 5-day low carb, 3-day high carb kinda stick as well. So there’s different things out there where you can cycle in and out and those I think tend to be really good for most people. If you’re more metabolically damaged, ketones, ketosis at that 20-30 induction phase can be pretty good. It depends. Some people I see if they’re in ketosis long-term will start to develop some of those hypothyroid symptoms, losing hair, hair loss, outer third eyebrow, cold hands, cold feet, mood stuff.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And then would just add in just a little bit carbs, small amount, and they’re doing better, so–

Evan Brand:  That’s what I had to do.

Dr. Justin Marchegiani:  Yeah, so some people–

Evan Brand:  I crashed.

Dr. Justin Marchegiani:  Do better so I’m not dogmatic at all. There are people out there that do great on that diet and because they’re not clinically oriented, meaning they’re not working with patients that we are, they—they just think well, because they did good on it, the other person out there that’s having a bad response or not as good response must not be doing it wrong.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I’m sorry, must not be doing it right.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Because they’re doing it wrong essentially. So we always just make sure the fat macros are up, the protein macros aren’t too high, and then just make sure the carbs are there and that’s a pretty good sign off the bat and then we can always measure it. Get to a .5 to 1. 1 is pretty good. Cut off. So we can customize it and then we can figure out. Okay, you’re at ketosis. You’ve been there for 2-3 weeks. You’re stabilized now. Okay, you’re already at a healthy weight. You’re feeling good. Your markers look good. Let’s just taper up some of those carbohydrates a little bit, just a little bit. And this is where it’s cool that you can play around with these exogenous ketones, the beta-hydroxybutyrate salts like the calcium and the sodium. This is great to try. Be careful though. Don’t make the mistake of adding these synthetic ketones and eating a whole bunch of sugar. The body is programmed when insulin goes up, typically ketones never should be there, right? Because think about it, right? Insulin has to be low for ketones to be high. Because if high insulin’s present, the body will block fatty acid synthesis. What are fatty acids? That’s the tree branch going into the tree chopper. Out comes the ketones, right? So we wanna keep insulin low so if we eat a whole bunch of sugar, take some exogenous ketones, insulin’s high, guess where those ketones are going, you know?

Evan Brand:  Well, hopefully it’s gonna help go into the mitochondria.

Dr. Justin Marchegiani:  Well, if insulin’s high and sugar’s high, you’ll actually pee it out. So if you use exogenous ketones, you wanna keep the insulin low still.

Evan Brand:  So if you—so if you’re eating high sugar or you’re eating high carb and then you take ketones, you’re saying waste of money.

Dr. Justin Marchegiani:  Waste of money. And again a lot of the marketings out there because frankly, a lot of these ketone companies, they don’t care if you do it right or wrong.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Because they’re getting—they’re getting paid either way.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  Not saying that’s bad. There’s education that comes into play. So if you’re using exogenous ketones which I think can be great from a performance, neurological standpoint especially if you have issues with Alzheimer’s, things like that. That can be phenomenal because then if you have the right diet in place and then you add some ketones, it’s like bada-bing! You’re there. You know, we call it therapeutic ketone therapy. You know?

Evan Brand:  So basically, don’t waste your money. If you’re gonna do this thing then get the diet straightened out always but then get the—get the cyclical Ketogenic Diet or experiment with that first before you buy ketones.

Dr. Justin Marchegiani:  Experiment.

Evan Brand:  That—that’s expensive. That’s $200 and that’s a—a way to waste it.

Dr. Justin Marchegiani:  And you may not have to be you know, full out ketosis. You know, I sit around .5 to 1 and that feels pretty good. I think just spit out some ketones.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Get to a pretty good place. See if you can test it. Get down to .5 or 1. See how you feel. Stabilize and then taper in some carbs. You know, start off with a little bit of lower sugar, lower fructose fruit, and handful of berries. It’s a pretty good place and then you can always try adding in a little bit of safe starch, sweet potatoes, squash, yams, plantains. Do it at night. Because your body doesn’t need the extra sugar during the day because cortisol’s already there, mobilizing and conducting sugar out of the—out of the glycogen, out of the muscle tissue, or out of the liver. So the glucose is already going where it needs to go because of the high cortisol. Do your carbs at night where that cortisol isn’t as present.

Evan Brand:  This is fun.

Dr. Justin Marchegiani:  Yeah, you having a good time here?

Evan Brand:  Yeah, this is fun.

Dr. Justin Marchegiani:  Awesome.

Evan Brand:  Well, just because you know, there—there’s so many different ways to go about this and there’s never—I—I think when people download these episodes, they think there’s gonna be like a single and that’ll be all answer, and that’s never going to exist especially for this ketosis discussion here.

Dr. Justin Marchegiani:  Plus we’re clinicians, so if it were that easy, you know, every patient would be a home run, right?

Evan Brand:  Yeah, exactly.

Dr. Justin Marchegiani:  So we have to put on our clinician cap, you know, so to speak. And we look at the diet, we customize it. So if you’re an endomorph, right? Larger, bigger, you know, wider hips, bigger belly, you know, those type of things, you put on fat easier–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it’s harder for you to burn, then you know, you’re gonna really benefit by starting out with a Ketogenic Diet and then customizing and then stack your carbs. When it’s time to stacking your carbs, stack your carbs on at night.

Evan Brand:  Here’s another thing I wanted to mention though, too, that we haven’t brought up yet. And you and I talked about Kalish’s talk I think a few weeks ago together, where if someone has a bigger waist and they have this excess body fat. Even if they go into a ketogenic approach, they may not lose weight because of those toxins that are stored in the fat cells could still disrupt the metabolism, right?

Dr. Justin Marchegiani:  Yeah, so the fat cells are a toxic reservoir for toxins essentially. A lot of our toxins go into the fat cell. They’re–

Evan Brand: So what do we do then if—if you’re going, you’re trying to go super low carb and yet you still just maintain your heavy weight, you cannot burn fat?

Dr. Justin Marchegiani:  Well, that’s where seeing a good functional medicine practitioner helps so we’d look at organic acids. We would look at how you’re detoxifying via pyroglutamate and sulfate and a lot of these organic acids that look at phase 1 and phase 2 liver detoxification. Phase 1 is taking fat-soluble toxins, right? It’s already there. They’re lipid-soluble. I mean, they’re in the fat cell. We’re liberating them and turning them into water-soluble toxins primarily via B vitamins, antioxidants, and then we facilitate the transfer of these water-soluble toxins out the urine, out the stool, out the breath or skin, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And we do that with sulfur amino acids, right? We’re supporting methylation and—N-acetylation, hydroxylation ,right? Glucuronidation, glutathione, all of these pathways that are shooting it out. So phase 1 is more B vitamin and antioxidant induced. Phase 2 is more sulfur amino acid induced. And then also some people because amino acids make carnitine, carnitine’s a really important compounds that shuttles fat into the mitochondria. It’s literally called the carnitine shuttle. You can Google it. It’s shuttling fat in the mitochondria to be burned so some people will see low carnitine. We’ll see some mitochondrial defects and then we’ll see some detox issues. So that can be something that we–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Incorporate into someone’s metabolic functional medicine program to help enhance it. So we get the diet dialed in non-dogmatically. Again, if you’re overweight, default to a Ketogenic Diet. That’s pretty safe. A Ketogenic Diet on a Paleo template. Right? Atkins create the—or Atkins made that ketogenic term famous except he used a lot of crappy foods, you know, didn’t differentiate with soy protein, added aspartame and artificial sweeteners. Didn’t care about grass-fed or chemicals or pesticides or Roundup so he kinda stumbled on it by accident–

Evan Brand:  Right.

Dr. Justin Marchegiani:  Because he was just looking at it from a sugar and carbohydrate standpoint. He didn’t look at it from the qualitative standpoint of phytonutrients and pesticides and chemicals and—and inflammatory foods and excitotoxins like MSG and aspartame. So we know more. So we kinda add like a—a Ketogenic-Paleo template on to it and then we have tools like the Precision Xtra by Abbott and get it on—I think get it on eBay and buy the strips on eBay. There’s a company out of Australia. You can get a much cheaper—they’re expensive. They’re like $1 or $2 a strip but if you buy them here, they’re like $2 to $3. So you can get them like 50% off. I bought like 100 strips and I just test my ketones a couple times a week to see where I’m at and I pretty much know where I’m at based on what I eat because I’ve tested so many meals. I see a pattern.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So if I’m eating like good, clean eggs or a good clean collagen shake with some good fats, MCT and butter in the morning, I’m sitting around .5.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And I feel pretty damn good with that.

Evan Brand:  Yup, so I know we’re running out of the time but some of the benefits you can expect—I notice mental clarity goes up if I’m pushing towards ketogenic. Weight loss can happen which I don’t need to lose any weight but I am less hungry. I’m able to go little bit longer between meals. I don’t feel like I’m crashing like I was when I was doing more starch. There’s a few benefits for me. Did you wanna say anything on that part?

Dr. Justin Marchegiani:  I think you touched upon it really well. I think a lot of people will hear this especially if they’re medically oriented. People get confused between ketoacidosis and ketosis. So I already kind of touched upon the people that ketoacidosis happens to and typically you’re looking at over 20 mmol/L is gonna be what happens in ketoacidosis and ketosis, you’re gonna you know, .5, 1, that’s totally fine. Now there’s nutritional ketosis which is what we’re focusing on, right? We’re doing it by nutritionally eating an adequate amount of calories because you can go on ketosis by starving and fasting.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Right? Because you still drive down your insulin levels because there’s no calories. If there’s no calories, remember insulin’s the door that opens up the cell for the calories to go in. Whether it opens up the mitochondria or the muscle or the fat cell, that’s dependent upon how much insulin is coming in. But you can lower insulin by just going low calorie. So you can be in ketosis via starvation, too. The difference is we’re doing it nutritionally, meaning we’re actually eating foods. They’re real whole foods and we’re getting enough calories so you’re body’s not gonna be eating away lean tissue.

Evan Brand:  Yes.

Dr. Justin Marchegiani:  Most people confuse it and they think, “Oh, you’re gonna be ripping up your body. You’re destroying your muscle.” It’s like—well, my body’s not stupid. It rather burn the nutrients that are in it versus taking away lean tissue, right?

Evan Brand:  Yeah, so—so don’t starve. This is not starvation–

Dr. Justin Marchegiani:  They’re confusing the physiology.

Evan Brand:  Yeah, totally.

Dr. Justin Marchegiani:  They’re confusing it and that happens all the time.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it drives me nuts so people need to really understand ketoacidosis and nutritional ketosis, and they need to understand ketosis vs fasting vs ketosis vs adequate calories and also ketosis at the acidotic level because of cirrhosis or type 1 diabetes.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Well, I think that’s pretty good there. If you would have sum it up, what’s the take home, Evan?

Evan Brand:  Well, take home. Try it out. Make sure you’re eating enough food. It’s easy to undereat if you’re basically cutting out, not almost, not an entire food group but essentially, so make sure you are getting enough good fats, enough good proteins, your coconut oils, your avocados, your avocado oils, your good meats, your good veggies. You know, your leafy greens are excellent. Stay away from the chemicals. If you start to crash, if you notice your outer one-third eyebrows going away, if you notice hair loss, if you feel like you’re a little bit more sluggish, you feel like hands and feet are getting cold like you alluded to, get some tests run. You can get some blood panels run for thyroid. You could get your adrenals tested to see if you’re just tanked out. Maybe you can’t go super ketogenic. Maybe that puts an extra stress on the body and you’re—you’re just not ready for that right now. So make sure your adrenals are healthy. Make sure your gut’s healthy and I think you’re gonna be—you’re gonna be on your way to—to weight loss if that’s a goal which is why many people go to—to ketogenic approaches.

Dr. Justin Marchegiani:  So who should do this? Cancer patients, Alzheimer’s patients, anyone with metabolic syndrome, right? Waist size 35 or bigger for a woman, 40 for a man. Blood pressure, you know, in the 140s or up. Any bit of inflammation, chronic pain, any of those symptoms. A good therapeutic trial of a Ketogenic Diet, Paleo style, Paleo template is a great starting point and again if you enjoyed this show and you’re applying the information and loving it, sharing is caring. Also give us a 5-star review. We appreciate it and click below this screen and you can help us out.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Evan, it’s been real, brother.

Evan Brand:  You, too. Take good care.

Dr. Justin Marchegiani:  You, too. Bye!

Evan Brand:  See ya! Bye!

Keto Clarity with Jimmy Moore Podcast #14

In this podcast, Dr. Justin interviewed Jimmy Moore co-author of Keto Clarity who phenomenally lost 180 pounds through low carb dieting and progressed towards attaining nutritional ketosis.

Jimmy emphasized the importance of consuming high amounts of saturated and monounsaturated fats to satiety, moderating the protein intake along with the low carb to be in a state of ketosis.

He also explained that there is no set ratio or measurement that would work for everyone but people need to find their own personal carb tolerance and protein threshold levels to make it work.

Discover the different tests to measuring ketone levels and which is the most accurate to know if one is in ketosis.

 

In this episode we cover:

10:00   Top 5 Foods that induce ketosis

18:47   Dairy sensitivity can cause insulinogenic response

23:47   Importance of insulin levels in ketosis

25:42   Keto Adaptation

33:47   Ketoacidosis

38:03   Testings for Nutritional Ketosis

45:10   Atkins Diet vs. Ketogenic Diet


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Dr. Justin Marchegiani:  Hi, this is Dr. Justin Marchegiani and we are back with Beyond Wellness Radio.  Again, Baris Harvey will not be here today but I will be joined by Jimmy Moore.  And again, Jimmy Moore I do not think really needs an introduction.  He has got the biggest Low Carbohydrate blog on the internet.  He also has a couple of new books out.    One book last year was Cholesterol Clarity and he teamed up again with Dr. Eric Westman to write Keto Clarity.  Jimmy welcome to the show. 

Jimmy Moore:  Hey, Justin.  What is going on, man?

Dr. Justin Marchegiani:  Not too much.  I am really excited to get some more information about ketones and ketosis.  There are a lot of myths out there.

Jimmy Moore:  Yes.

Dr. Justin Marchegiani:  And I have a lot of my patients that are, you know, they are using Ketostix or ketosis as a way of losing weight.  There are also many other health benefits that come from being in ketosis.  It almost sounds like it is too good to be true.   

Jimmy Moore:  Laughs

Dr. Justin Marchegiani:  I will put the ball in your court.  There are so many benefits out there.  Why don’t you tell us about a couple of them and why they seem so good to be true?

Jimmy Moore:  You know it is funny because people they look for a miracle pill.  They are looking for all the right health that comes in a pill.  Let me just give you a stark shake back into reality people, there is no such thing as health in a pill.  Health comes from nutrition and the right nutrition.  And unfortunately we have been given the wrong nutrition for far too long and people think healthy means, “Oh, that’s low fat.  That’s low calorie.  That’s exercising on the treadmill for hours a day on and on and on.  And yet what we are trying to communicate with Keto Clarity is hey, there is a new way to look at things from kind of a low carb high fat perspective.  And the high fat is kind of a new concept for a lot of people, Justin.  They were like, “With a minute!  I understand low carb but what is with this high fat thing?”  So when you cut carbs and you are trying to be ketogenic which in a nut shell basically, ketogenic means you are trying to be a fat burner not a sugar burner.  99% of the world’s population right now is burning sugar for fuel.  But if you want to optimize your health and get these benefits from the ketones that we are about to tell you, you really got to shift your carbs down to your personal tolerance level, moderate your protein intake and we can talk about that in a second.  And then eat more fat probably than you ever thought about eating in your life.  When I refer to fat, I am talking about saturated and monounsaturated fats primarily.  Of course, the omega 3 fats thrown in there as well.            

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  But when I am talking about vegetable oils, do not drink the vegetable oils.  I know that is what they tell you, it is the healthy oils but they are not healthy.  They are cause inflammation which we talked about in Cholesterol Clarity.  But you asked about the health benefits that come from being in ketosis.  And one of the biggest ones and this is a big sign that your diet is the right one is you have natural appetite control.  You do not have hunger pangs two hours after having that oatmeal with margarine on top with berries and a glass of orange juice for breakfast.  Why are you hungy two hours later if that is a satiating, well-nutrient dense meal for you?  Why are you hungry?  Hunger is one of the first signs you are missing something in your diet- either macro or micronutrient wise.  So that is a big one, Justin.  The mental clarity that I get from having ketones, I mean, I can tell when I am out of ketosis because I will start getting that kind of brain fog.  You know you see those cartoons with the little lightning bolt and a cloud over their head?  You know, people they walk around that is how they feel and yet it is almost like haahh…

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  The skies open up and the sun shines out you know.  And ketones provide that.  Why does that happen?  Well, your brain, 25% of the fat in your body is in that brain.  They call us a fat head for a reason.

Dr. Justin Marchegiani:   Uh-hmm.

Jimmy Moore:  We are fat heads and if we are not feeding it fat which in turn turns to ketones then you are not feeding it what it wants and it will just scream at you, “Please feed me more fat.”  You know, I often wonder sometimes these low fat vegans that are out there that are very militant and have anger issues and they are always really mad at everything, I wonder is it a lack of fat in their diet?  And that is not a criticism of them.  I am honestly wondering is their behavior because they are not consuming enough fats. 

Dr. Justin Marchegiani:   That’s a really good point.

Jimmy Moore:  I mean I could go on and on.  Stabilized blood sugar happens. Your insulin sensitivity is restored when you are in ketosis.  Inflammation levels are down.  All of these things contribute to optimized health and that is what we are hopefully all striving for.

Dr. Justin Marchegiani:  That is great.  I think it was a movie in the 80’s or the 90’s with Meryl Streep called “Do No Harm” and were not they talking about a ketogenic diet in that movie in helping to cure epilepsy?

Jimmy Moore:  Yes, we actually provide a link to it in the book itself, in “Keto Clarity”.  It is called, “First Do No Harm” and you can actually watch it for free on YouTube.  So if you go to youtube.com type in First Do No Harm Meryl Streep you will be able to find that and it is the whole movie.  My wife Christine and I actually watched that just a few months back.  But yes it was all about probably what the ketogenic diet is most famous for.  No, it is not Dr. Atkins’ weight loss diet.    

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  It is actually most famous for being one of the longest running,  well-studied ways to control epileptic seizures.  And I will tell you what, Justin, I thought I ate pretty hard core ketogenic, this diet is pretty darn hard core. (Laughs)

Dr. Justin Marchegiani:  (Laughs)

Jimmy Moore:  I was looking at it in preparation for this book and it is a 4:1 ratio of fat to the combined carbohydrate and protein.  So the fat intake for example could be like 80% of the diet and then the other 20% is the combined protein and carbohydrate.  So these kids that have epilepsy they are showing dramatic improvements eating this way.  It is not a cure all for everybody that has epilepsy that has seizures.  But it sure does work in a whole lot of people that definitely makes it worth giving it a go if you have a child especially with epilepsy.  I mean you sit there in the movie; it was funny when they started feeding the kid, who was a wonderful actor by the way and did not have epilepsy but you would believe that he did with all the seizures.

Dr. Justin Marchegiani:  Laughs

Jimmy Moore:  The way he dramatically interpreted those it was awesome.  But he had bacon and eggs you know for breakfast with lots of fat on top and it was like, “Hey, that is like my breakfast!”  (Laughs)

Dr. Justin Marchegiani:  Oh, wow!  Now imagine with these diets from what I understand back in the 20’s the Mayo Clinic was using ketogenic diets for epilepsy and they were having I think an 80% cure rate which is unreal.

Jimmy Moore:  Yes.

Dr. Justin Marchegiani:  And it is just like cream and eggs and full fat meats like rib eye.  What would the typical diet be like for these kids with epilepsy?

Jimmy Moore:  Well, and let me be very clear.  They actually have made “The Ketogenic Diet”, they differentiate that from like an Atkins.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:   Describing itself as ketogenic because they want people to know this is therapeutic for seizure control.  And even now there are researchers out there, Dr. Eric Kossoff most famous at Johns Hopkins University who is using this and they are calling it a modified Atkins Diet.  Basically a much more ketogenic inducing diet which we are going to talk about here in a second why Atkins may not be ketogenic inducing.

Dr. Justin Marchegiani:  Uh-hmmm.

Jimmy Moore:  But what you want to do is produce those ketones.  They measure off exact measurements of fat, exact measurements of carbohydrate and exact measurements of protein because they do not want these kids to not get those therapeutic benefits.  That is one thing we tried to do in Keto Clarity is say: Okay, if you want to know what that right formula is for you, here is how you figure it out.  There is no macronutrient ratio that is magical that is going to work for everybody.  You are not going to sit here and say, “Oh yes, 80% of your diet is fat.  15% of your diet as protein and 5% of your diet as carbohydrate and you will magically be in ketosis.” 

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  Well, not everybody needs to do necessarily that ratio.  And that does that even bring into the equation calories and it also neglects that some people are little more sensitive to carbohydrates and proteins that others.  And so there is no magic pill.  You kind of have to figure it out.  No magic formula.  You have to figure it out for yourself what is right for you to get into ketosis.  And we help you do that in Keto Clarity.

Dr. Justin Marchegiani:  That is great.  And what would you say that the top five biggest whole foods sources are for inducing ketosis?

Jimmy Moore:  Laughs

Dr. Justin Marchegiani:  And I understand that is a loaded question because if you are eating a whole bunch of carbohydrate with it…

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  It does not matter what you eat but just based on your experience.

Jimmy Moore:  Well, let us assume that you have dialed in your carbs to your tolerance level which for me personally, Justin is about 30 grams.

Dr. Justin Marchegiani:  30.

Jimmy Moore:  And then dial in your protein.  If you are real sensitive to carbs guess what?  Newsflash!!  You are also going to be sensitive to protein because there is this long G word that we talked about in the book called gluconeogenesis.  Basically that is where you have excess protein and it gets converted into sugar by the liver.  And so people do not realize that they have always heard, “Oh ketogenic diet, high protein low carb.  No it is not.  It is high fats, moderate in protein and low in carb.  So let us get right into the fats then because if you got your carbs dialed in, 30 grams there for me and your protein moderated down and for me protein is around 80 to 100 grams a day which translates to about 6 ounces of like a steak or something like that.  

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  Four eggs and 3 ounces of meat or something like that and then the rest is fat.  So that is going to be the magical part of getting into ketosis.  So what are those fats that you can consume?  Dude, I so love grass-fed butter.  I mean.

Dr. Justin Marchegiani:  (Laughs) Yes.

Jimmy Moore:  I am like infamous at these Paleo conferences and on the low carb cruise.  I bring my own Kerrygold Butter and I am literally eating a little bit of butter in every bite of food that I have.  And people kind of look at you when you do that but for me that is the way I know I have to eat to get all those benefits we just talked about and we list a whole slew of benefits on page 37 when people get the book.  So grass-fed butter number one.  You said five.

Dr. Justin Marchegiani:  Yes, top five.

Jimmy Moore:  Coconut oil is another fabulous, fabulous fat.  It is 90% saturated fat.  You know people freak out about saturated fat.  We do a whole chapter on fat and why you got to get over your fat phobia.  You know, if people are worried about raising their LDL cholesterol and total cholesterol and getting heart disease and clogging your arteries and all that please go read my last book, “Cholesterol Clarity” because we put that one hopefully to rest.  So now that we are talking about high fat diets you should not be freaked out about that.  So coconut oil, number two. 

Dr. Justin Marchegiani:  Got it.

Jimmy Moore:  Full fat meats.  People forget chicken breast is not a health food, people.  I am sorry.  It is just not especially if it is from the T company.  (Laughs)

Dr. Justin Marchegiani:  Yes. 

Jimmy Moore:  The Tyson Company does not care about your health.  All they care about is their bottom line profits.  And it sickens me that the number one meat sold in America is chicken breast.  Let us stop buying those stupid things because they are only giving you way too much protein kicking in that gluconeogenesis that we were talking about.  It is not healthy.  So you want to try to pick the fattier cuts of meat.  In fact, go to your butcher, you know, or go to your local farm.  If you are going to get some meat get a good grass-fed meat but ask for the extra fat that comes with it.  Because they usually trim it off.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  Thinking people do not want that.  They might even sell that to you at a dirt cheap price. 

Dr. Justin Marchegiani:  Oh, yes.

Jimmy Moore:  You want that fat.  And on that note number four, pork lard is really incredible as well.  If you are not cooking with butter or coconut oil try lard.  And again, it is that whole imagery of you know we have heard lard butt you know kind of as a slur.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  Well, I am sorry.  Lard does not give you a butt. (Laughs)  It really does not.  If you are keeping your carbs limited and you are trying to be ketotic, lard is probably one of the healthiest things that you could consume.  Then if I have to do one more food to induce ketosis, the thing that helps me a lot and it is only because I can tolerate it is full fat dairy. 

Dr. Justin Marchegiani:  Hmmm.

Jimmy Moore:  So things like cream, full fat cheeses.  Please stay away from American cheese that is not cheese.  I do not care how low in carbs it is.  It is not cheese.  Neither is Velveeta, please stay away from that plastic crap.

Dr. Justin Marchegiani:  Yes, absolutely.

Jimmy Moore:  And get real whole food cheese.  Real raw sources of dairy if you can.  I know here in South Carolina where I live you can get raw dairy and it is legal here in this state.  I think its 10 states that it is legal in still.  So find the best quality sources of bull fat.  Greek yogurt is really amazing.

Dr. Justin Marchegiani:  Hmm.

Jimmy Moore:  So anything that is going to have like, you know I turn to the nutritional label on the back, Justin and I will look first at the fat.  I want to see is it like big time double digit fat.  Okay good.  Then I immediately go down to the protein and if the protein is like half the number of the fat okay that is not too bad.  I prefer it to be like a fourth of the fat.  And that is optimal.  And then of course, carbohydrates in whatever that product is need to be pretty darn low as well.  So that is my five and I am sticking to them.

Dr. Justin Marchegiani:  I love it.  And a couple of follow-ups right off the bat, what are your takes, I think you mentioned grass-fed meat, correct?

Jimmy Moore:  I did.

Dr. Justin Marchegiani:  Do you have any favorite steaks like Delmonico, Ribeyes, New York?  Do you have any steak faves in there?

Jimmy Moore:  Yes. The kind that does not go “moo” anymore.  I do not really care.  (Laughs)  You know, really any of them that have a nice marble.  I am a sucker for you know a really good filet mignon when it is done well.

Dr. Justin Marchegiani:  Oh yes.

Jimmy Moore:  And then instead of steak sauce… People like, “Oh, what do you eat with your steak if you do not have sugar because A1 has sugar in it?”  Well, guess what?  The best steak sauce I found is garlic butter.

Dr. Justin Marchegiani:  Laughs.

Jimmy Moore:  I tell you what man, you put garlic butter on top of a steak you know and then maybe a little sour cream too, “oohh!”

Dr. Justin Marchegiani:  Oh, my gosh!

Jimmy Moore:  It’s so luscious.  It’s so good.

Dr. Justin Marchegiani:  I was at a steakhouse here in Austin just the other day and I was having a steak, ribeye and I asked the lady for a side of butter.  And I was putting the butter on the steak and I just had a little small thing of broccoli and everyone was looking at me like I had ten heads.  I am like, “No, this is good.  This is good.”

Jimmy Moore:  (Laughs) I tell a story in Keto Clarity.  When I go out to eat I look at the server and I said, “Do you have real butter?”  So once I ascertain that they have real butter which you have to know what that means.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  And I will say, “Okay, bring me more butter than you ever brought any human being in your life.”

Dr. Justin Marchegiani:  Laughs

Jimmy Moore:  And you know they think I am joking but my wife, Christine says, “He is not kidding.”  (Laughs)  So I have got as little as two pats at a restaurant to actually your hometown of Austin Texas holds the record the 24 Diner.  I went to Paleo FX a couple of years ago in the 24 Diner that poor server brought me sixteen pats of butter.

Dr. Justin Marchegiani:  Oh my gosh.

Jimmy Moore:  I ate every single one of them with my breakfast that I had that day.  You know, I could see him over there in the corner.  They were like all huddled up looking at, “He just ate number eight!  He just ate the eighth one!”

Dr. Justin Marchegiani:  Laughs

Jimmy Moore:  And it was like a sport watching me eat butter.  Yes it looks weird but I know that is what I need to do to get those benefits that come from nutritional ketosis.  Now, does everybody need to eat that much butter?  Probably not. 

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  I just know for me, if I eat that way and that was the only meal had all day that I was able to go through the whole conference at Paleo FX and not be hungry and you know fully engaged, fully energetic all those time.  Did not feel like that orange juice and oatmeal story that I gave earlier that I had to eat two hours later.  You know, that is what I know it takes to keep me satiated as the ketones that do that.

Dr. Justin Marchegiani:  And again, I imagine you put out there one caveat will be you do not want to have a lot of sugar if you are going to be eating all that fat.  You want to make sure it is fat.    

Jimmy Moore:  Exactly. 

Dr. Justin Marchegiani:  Without all the extra carbs.

Jimmy Moore:  Yes, dialed in your carb tolerance level and it is definitely not going to include sugar. 

Dr. Justin Marchegiani:  Those are great points there.   I know Gary Taubes has mentioned this.  I think a couple of other low carb docs have mentioned this, too; that dairy with some people can be insulin producing.  What are your thoughts on that some people being dairy sensitive and creating more of an insulinogenic response?

Jimmy Moore:  Yes, I believe it can happen.  My own wife, Christine actually has had to give up a lot of the dairy she used to eat.  Because I get away with a lot of dairy.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  I can consume it and it does not seem to be problematic for me in terms of fasting insulin levels.  But for her, her fasting insulin levels start to getting up there a little bit.  We could not figure it out because she was in ketosis and she was eating low carb and doing all the things that she needs to do and yet she still was seeing this fasting insulin levels go up.  So we have switched over from putting like heavy cream in her latte in the morning to now using coconut milk in her latte.

Dr. Justin Marchegiani:  Ahh…

Jimmy Moore:  So you make little changes here and there and then you just kind of figure that out for yourself.  Again it is part of that testing process.  Try no dairy and see how you feel and then maybe introduce it back in.  Some of these elimination diets are really good.  The Whole30 from Dallas and Melissa Hartwig is really fabulous.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:   “It Starts With Food”, their overwhelming New York Times bestselling book, check that out because it really does help you identify what it is that you are sensitive to.  So figure that out.  Maybe dairy is good for you maybe it is not.  So that is kind of the difference between Paleo and Primal.  Paleo is no dairy.  Primal is kind of into the high fat dairy.  I label what I do to kind of a Primaleo Ketogenic.

Dr. Justin Marchegiani:  (Laughs)  I love it.  I love it.  That is great.  So what is your take on Bulletproof Coffee?  Have you tried adding butter and MCT oil to your coffee as a way of inducing more ketones in the blood stream?

Jimmy Moore:  I have interviewed the man himself, Doctor… He would kill me if I call him doctor. 

Dr. Justin Marchegiani:  Dave Asprey.

Jimmy Moore:  Dave Asprey from the Bulletproof Executive who came up with that.  And I remembered when I interviewed him for the first time I told him I said, “Dude, I hate coffee.  It is the most disgusting thing in the world to me.”  And he was like, “Oh, but you will love my coffee.”  And so he sends me some of his coffee and I go buy this fancy coffee machine and I do the blender and all the stuff with MCT oil and all that.  And I drink it and I spit it out because it’s the most disgusting thing.  So I am the wrong person to ask about Bulletproof Coffee.

Dr. Justin Marchegiani:  Got it.

Jimmy Moore:  Because I hate coffee.

Dr. Justin Marchegiani:  In general.  Got it.

Jimmy Moore:  With that said, anybody that wants to get more fat in their diet that does like coffee, definitely I can see Bulletproof Coffee being a great way to do that.  Now, I know there has been some criticisms about Bulletproof Coffee, its excessive calories and what about the fat.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  And it is going to cause dyslipidemia and all these kind of stuff that has been put out there.  You know, to me if your goal is ketosis, basically Bulletproof Coffee is all fat.  There is no protein and no carbs in it at all.  It is all fat.  What is the harm in kind of getting ketosis jumpstarted in the morning with a cup of Joe that has a lot of fat in it?  I see no downside if you like coffee.  Again, that caveat.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  I do not.  You know, I would much rather just eat the butter straight up.

Dr. Justin Marchegiani:  (Laughs)  I love it.

Jimmy Moore:  You know this stick of butter just take it and just gnaw on it.

Dr. Justin Marchegiani:  I love it.  Yes, I personally see coffee and vegetables as basically put on this earth to be…

Jimmy Moore:  Conduits for the butter.

Dr. Justin Marchegiani:  Yes, to conduits of the butter to get it down.  I just love it.  It just gets it in there.

Jimmy Moore:  (Laughs)  That is right.

Dr. Justin Marchegiani:  Very cool.  And what I am really waiting for, I am waiting for a blood sugar meter to test ketones and insulin together.  

Jimmy Moore:  You know, you are living in my dream world because that is what I am looking for.  You know I think what is going to happen, Justin?  We will see it in a medical device attached to a smart phone eventually.  I think someday that is where it is going to move.  I do not think there will be a device per se that will do all that.  But trust me I as a quantified sulfur N=1 or I would love to have a fasting insulin test at home.  A ketone, blood sugar all in one with the same blood drop that would be awesome.

Dr. Justin Marchegiani:  Oh, that would be amazing.   

Jimmy Moore:  Laughs

Dr. Justin Marchegiani:  Because I see so many people with okay blood sugar, you know.

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  But again we look at their insulin levels on a glucose intolerance, their insulin is so high to get their blood sugar down there in that safe level.  So if you did not have the insulin there they will fall under the radar.  So many people I feel like without the insulin they could escape underneath the radar.  

Jimmy Moore:  Yes, indeed and thank you for bringing that up because I think people think, “Well, my blood sugar is normal according to what my doctor said.  Anything under 100 is normal but 99 blood sugar but your fasting insulin is say 14.  That is not real good.   You need to kind of figure out why is the fasting insulin so high and you would not know that unless you test it.

Dr. Justin Marchegiani:  Love it.  And how important is having the right insulin level to being in ketosis?  How important is that?

Jimmy Moore:  You know I often put out there that blood sugar that is elevated is the quickest way to kill your ketones.  And the same goes for insulin.  Insulin levels that are up means ketone levels will be down.  You really have to control the blood sugar and the insulin which incidentally, Justin… (Laughs) It just so happens that when you put your body into a ketogenic state guess what happens to blood sugar and guess what happens to insulin levels?  (Whistles)

Dr. Justin Marchegiani:  They all normalize.

Jimmy Moore:  They go down. They normalize, that is right.  And even better than normalize because when your ketone levels go up something interesting happens to your blood sugar levels.  I am not sure what happens to the insulin but blood sugar levels will be correlated going down the higher your blood ketone levels go up.  So one time I had, the highest reading I ever got on the blood ketone meter 6.7 mmol/L which is really high.  But at the same time my blood sugar level was 62 and I was completely cognizant.  There were no signs of like hypoglycemia.  But people would see a 62 blood sugar, I have even been in the 50s before completely aware but because the ketones were higher they were stepping into the place of where the blood sugar would be in the blood stream and totally normal.  So we kind of have to shift our paradigm of what we see as normal.  You know most doctors say, “Well, anything kind of under a hundred is a good blood sugar.” 

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  Well, if you are in nutritional ketosis and you got a 99 or 100 blood sugar, guess what?  You probably are not in nutritional ketosis because that is almost impossible to have simultaneously high blood sugar levels and higher blood ketone levels. 

Dr. Justin Marchegiani:  Good point.  Now can you talk about the process of getting into ketosis?  Now this is known as Keto adaptation.

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  And I heard it takes about one to two weeks.  I have seen it in myself and my patients.  Talked about that and I find this one to two-week time frame depending on the individual can really make it so someone does not get into that ketosis state because they just cannot take the cravings and such.

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  Can you talk more about that and tricks to get in there better and faster?  

Jimmy Moore:  Sure.  Well, that’s a lot of questions you threw at me there.  So, you know, basically the one to two weeks, I would say, if you already generally eat a low carb diet, within one to two weeks you probably should be there.  If you are coming from the SAD diet where you are eating a lot of carbs it may take upwards to four to six weeks.  I am sorry to be the bearer of bad news but it does take time for the body to make that shift from being a sugar burner into a carb burner.  You know, I think about 410 pounds Jimmy Moore back in 2004 who just came off of drinking 16 cans of coca cola a day.

Dr. Justin Marchegiani:  Gosh!

Jimmy Moore:  Two boxes of Little Devil snack cakes a day.

Dr. Justin Marchegiani:  (Whistles)

Jimmy Moore:  Big plates of pasta.  I mean I was a carboholic, Justin.

Dr. Justin Marchegiani:  Wow!

Jimmy Moore:  Probably 1500 grams of carbohydrates a day I was consuming.

Dr. Justin Marchegiani:  Wow!

Jimmy Moore:  And that Jimmy Moore would not have gotten Keto adapted in one to two weeks.  (Laughs)  He probably would have been at least one to two months before he got there.  But we can all get there.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  And you asked how.  So there is kind of a three-legged stool as to how you can get there.  In the book, we actually created this acronym that hopefully will be some of the people can like print out and put up on their refrigerator.  But the acronym is KETO.  K stands for Keep carbs low.  And low is going to be relative.  You got to figure out what your carb tolerance level is first.  And once you get the carb tolerance level and we will show you how to do that with the blood sugar monitor.  Triglyceride is kind of a good tell-tale sign. If you got trigs on your cholesterol panel that are over 100, guess what that means?  You are probably eating a few too many carbs for your carb tolerance levels.  So back off on the carbs and that trigs number will go back below a hundred which you are better of metabolically that way anyway. 

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  The E in KETO stands for eat more fat. We kind of talked about this already.  The saturated and monounsaturated fats.  Avocados are great monounsaturated fats.  Of course, saturated fat we have already talked about all these foods earlier.  T is for test ketones often and this is one that we can kind of expand upon here in a minute if you want to.  But basically there are three different ways you can test now.  Traditionally, it has been the urine test.  The gold standard right now is kind of the blood ketone test.  That is that 6.7 that I was just telling you about.  And then there is an emerging technology that is coming with breath ketone meters and we can talk about that in a second.    

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  But the last letter in the KETO in the acronym O – overdoing protein is bad.  So you want to moderate down that protein to your personal threshold level and again you kind of have to test to see.  And we show you how to do that in the book.  So the three-legged stool is control your carbs to your tolerance.  Moderate your protein to your personal threshold level.  Eat fat to satiety mostly saturated and monounsaturated fats.  You do those three things and then test for those ketones and you are going to be gold.

Dr. Justin Marchegiani:  Great points.  I know a lot of people that are kind of against the low carb ketogenic type of eating.  One of the biggest things they talk about is constipation.  I know there has been some new research out there regarding resistance starch in the blogosphere talking about these low carb eating plans.

Jimmy Moore:  Yes.

Dr. Justin Marchegiani:  We decrease certain bacteria in our gut especially the E. rectale and roseburia bacteria.  And again these bacteria they produce butyrate which is the same fat that we have been eating anyway which is quite interesting.    

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  So can you talk about resistance starch and is it possible to include resistance starch in your eating plan and still be low carb and ketogenic?

Jimmy Moore:  Let me address the constipation thing first because when you said that I thought about my interview.  I had a very famous interview with the vegan doctor Dr. John McDougall.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  And I remember at one point in the conversation he was very belligerent by the way.

Dr. Justin Marchegiani:  He was.

Jimmy Moore:  If you want to go have some fun go Google John McDougall and Jimmy Moore and you will find that interview.  But yes, he said, “So how’s the constipation?”  And I said, “I am not having constipation.”  “Oh, well Dr. Atkins himself said that you are having constipation.”  And I am like I drink plenty of water and eat enough vegetables that I do not have an issue with constipation.  So it is kind of funny.

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  But that is kind of put out there as a kind of a meme if, “Well, do not eat low carb or you are going to get constipated.”  I have never had that problem if you just drink enough.  So you asked about resistance starch. 

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  We do address this in the book, surprisingly.

Dr. Justin Marchegiani:  Oh, great!

Jimmy Moore:  Because it is an unknown right now.  Nobody has really done any controlled randomized clinical trials of this yet.  So we just do not know.  I think it is another one of those things of test and see if you feel like you want to try it and see.  I know my wife, Christine actually wants to test resistance starch.  She stays pretty ketogenic all the time but she is interested in maybe trying to optimize the microbiota in the inner gut and see what this would do.  So I am very curious about it and I am urging other people.  I actually had on The Livin La Vida Low-Carb Show, my podcast; I had Richard Nikoley and some other people, my friend Tom Naughton from the Fat Head movie.  You know, they are communicating, hey this is working for some people and it is helping to restore that gut health.  Give it a go.  If you are having issues in your health that maybe the Ketogenic diet is not helping by itself maybe this is something else.  And the interesting thing about resistant starch is ketosis and resistance starch are not necessarily mutually exclusive.  You can be both.  And not necessarily everybody but I think a good chunk of people could indeed become ketogenic using resistant starch because the resistance starch actually turns into the fat that would turn into ketones in the body.   

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  So I am not anti-resistance starch.  I personally have not done it simply because I am doing okay with what I am doing now staying in ketosis all the time nutritionally without it.

Dr. Justin Marchegiani:  It ain’t broke don’t fix it, right?

Jimmy Moore:  Exactly.

Dr. Justin Marchegiani:  Love it, love it.  And myself I do well on ketogenic diet. But I do some cross fit, I do some high intensity movements so I find doing a cyclical ketogenic diet where I kind of in it for a couple of days and then come out.  What is your take on cyclical ketogenic diets?

Jimmy Moore:  Yes, again, that I think is one of those things you will just have to kind of figure out what works for you.  And Justin, you certainly figured that out that that is a good approach for you.  I do not personally cycle carbs.  I know John Kiefer one of my experts in the book; you know he is a big fan of kind of doing this back-loading of carbohydrates after a workout.

Dr. Justin Marchegiani:  Carb nite.

Jimmy Moore:  Yes, and the carb nite solution.  You know it is one of those things and I sound like a broken record but it is a key thing to how Keto Clarity is.  You got to figure out what works for you.  And I cannot tell you what your macronutrient ratio is.  I cannot tell you if resistance starch is good for you.  I cannot tell you if cycling the carbs every couple of days like Justin does is going to work for you.  You just got to kind of tinker around.  There is no shame in trying something and it does not work.  You just go back to what does work.

Dr. Justin Marchegiani:  Right, right.  Exactly.  There are a couple of myths out there I hear all the time with dieticians.  When the word ketosis gets brought up it is like a switch goes off in that person’s head may just think ketoacidosis.  Can we talk about the difference, Jimmy?   

Jimmy Moore:  They go bat crap crazy, don’t they?   (Laughs)

Dr. Justin Marchegiani:  Oh, my gosh!  It is just insane.

Jimmy Moore:  This is my favorite question.  So thank you for asking this one.  And it was so important, Justin that we not only address it one time in the book.  I think we addressed it about six or seven times at least in the book.  We just want to remind you in case you missed it the first six times, we are going to tell you again.

Dr. Justin Marchegiani:  Okay.

Jimmy Moore:  So the difference between nutritional ketosis which is kind of what we are talking about in Keto Clarity and diabetic ketoacidosis could not be more night and day.  And unfortunately, the problem that comes into play it is kind of like the problem with fat.  Fat makes you fat.  Fat clogs your artery, you know.  There’s kind of this negative connotation with fat even though fat is not the enemy.  The same goes with ketosis and ketoacidosis.  They sound similar.  But here is the deal.  Diabetic ketoacidosis can only happen in people with type 1 diabetes or those type 2 diabetic that are truly insulin dependent they have lost all beta cell functioning, cannot make insulin at all.  If you live on this planet and you can at least make a little bit of insulin it is impossible for you to have diabetic ketoacidosis.  I cannot emphasize that enough.  People that have some insulin ability there is no way you can get diabetic ketoacidosis.  But it does not happen as a result of consuming a low carb high fat diet.  Diabetic ketoacidosis happens from eating too many carbs and not putting insulin in your body to handle those carbs.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  So your blood sugar in that type 1 diabetic and the insulin dependent type 2 diabetics your blood sugar goes up and up and up in excess of 240 and the body, and that person then starts kind of freaking out and it is like, “Oh we need energy.  We do not have any energy.” Even though there’s plenty of energy with the blood sugar.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  We need energy so it starts creating ketone bodies at the same time that blood sugar is going up.  So diabetic ketoacidosis is, the hallmark of it is very high blood sugar in excess of 240, very extremely high levels of blood ketones.  Now I told you the highest I have ever gotten is 6.7, right?  

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  I did that one time.  It is usually way down like two or three at the very highest now.  What we are talking about diabetic ketoacidosis is closer to 20mmol/L.  So even at my highest I was still about less than a third of what would be considered diabetic ketoacidosis levels of ketones.  But remember, my blood sugar at that time was 62.  Diabetic ketoacidosis is well in excess of 240.  So nutritionally, if you are eating a low carb, moderated protein, high fat diet you should never, ever, ever, ever, ever… Did I say ever?  Ever get diabetic ketoacidosis because the hallmark of nutritional ketosis is moderately high levels of ketones but a simultaneously lowering of that blood sugar like what we talked about a while ago.  

Dr. Justin Marchegiani:  And I liked how you are putting that meme out there nutritional ketosis.  Because that needs to be there because we can go to a ketosis through starvation, right?

Jimmy Moore:  Right.

Dr. Justin Marchegiani:  So it talks about really having a good diet behind it that is ideally nutrient dense as well that is allowing that ketosis to facilitate itself, correct?

Jimmy Moore:  That is right.

Dr. Justin Marchegiani:  Great.  And then regarding the ketones, you mentioned the 6.0, the mmol/L type of standard deviation there.  If we are talking about Ketostix that I think are mg/dL, what number would you see on there to indicate ketoacidosis?

Jimmy Moore:  You know I am not sure because that is kind of what their purpose is or was when they first came out.  I would think it would be anything that would be on that darker purple and I do not have the number.  But I think it would be like well, well in excess of that 160 that is on the urine ketone sticks.  You kind of threw me for a loop there when you threw the ketoacidosis in there. (Laughs)

Dr. Justin Marchegiani:  Got it.

Jimmy Moore:  But we have not talked about the different tests.  Would you like to cover the various ways of testing for nutritional ketosis?

Dr. Justin Marchegiani:  Love to, that is a great segue.

Jimmy Moore:  Yes, so there are three different types of ketone bodies in the body.  And the one that everybody knows about is the one that you just talked about and that is acetoacetate.  That is the ketone body that is in the urine.  And so you usually pee on the stick that you are just talking about.  And you get anywhere from starts at beige with no ketones, from pink to purple and even darker than that.  And people get all excited when it turns really dark, “Whoa, I am in deep, deep ketosis!”

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  You know, and if you are just starting off, those are probably okay.  You know, you can buy a bottle of 50 of those for like $15 at your drugstore.  So really kind of a good way early on to kind of reassure yourself that okay I am on the right track.  I am producing, I am at least spilling ketones into my urine.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  But the problem that comes into play, Justin is once you become keto adapted.  So after that one to two week period for the people that are already probably eat pretty low carb, or that four to six week period or maybe four to six months for that Jimmy Moore who was eating 1500 grams of carbs. (Laughs)   You know, the period of adaptation you might lose your urine ketones.  Now does that mean you have done something wrong?  No, it means you have done something very right. 

Dr. Justin Marchegiani:  Hmmm.

Jimmy Moore:  But unfortunately, people that are peeing on the urine sticks are saying, “What the heck, I am eating low carb, I am feeling great.  I feel like I am in ketosis but I am not showing any on the acetoacetate measuring sticks anymore.  What is going on?”  Well, here is what is going on.  The acetoacetate becomes converted into beta hydroxybutyrate which is the active ketone in the blood.  So that is why measuring for blood ketones is probably going to be the best way to know where you stand in nutritional ketosis.  So the blood ketone meters, there are two of them out there.  One is called Nova Max Plus.  It is okay but there are some discrepancies when you are in the lower levels of ketosis.  It just gives you a low.  It does not really give you an actual number.  So that does not help people.  The one that I promote to people is called Precision Xtra.  And it is about $15 or $20 for the device itself.  Where they get you, Justin, is the strips. (Laughs)

Dr. Justin Marchegiani:  Got it.

Jimmy Moore:  In America, those strips can cost upwards of $3 to $5 a piece.  Now I was testing day and night for a year and sometimes every hour on the hour in some of those days.  That is expensive if you are getting them from America.  So Canadian pharmacies have them for about $2 a piece.  I got a friend that lives in Australia and he is like, “Hi Mike, you can get those for 70 cents here.”  And I am going, “Ah, can you hook up, too?”

Dr. Justin Marchegiani:  That is great.  So Precision Xtra and Nova Max.  Those are the big ones.

Jimmy Moore:  Those are the two and I would not recommend the Nova Max at all because of just the discrepancies in the lower levels of ketosis.  You do not want to be discouraged when you start this.  You want to have every, I guess, reinforcement of what you are doing.  And if the meter is saying they are telling you low when you could be let us say a 0.8 or a 0.9 which would be in ketosis and it is saying low, that could discourage you.

Dr. Justin Marchegiani:  Ahh.

Jimmy Moore:  And so one thing we have not said, the range on the blood ketone monitor, 0.5 is kind of the very, very low end of nutritional ketosis.  So that is kind of where it starts.  And then the benefits according to Jeff Volek and Steve Phinney, two great researchers in this realm, go all the way to 3.0 mmol/L and once you hit 3.0 in the blood ketone meter there is really no added benefit to being higher than that.  So blood ketones are a great way to measure. Now again, the cost issue with testing is the big problem.  So that is why I am really excited and we shared about this in the book of the emerging technology with the third ketone body.  This is the last one that is in the body.  It is called acetone.  And that is in the breath.  And some people like well if acetoacetate disappears in the urine does not acetone disappear in the breath once you become keto adapted?  The answer is no.  There have been two really good studies that have correlated beta hydroxybutyrate levels in the blood with acetone levels in the breath.  They correlate pretty well and I actually have a breath ketone meter.  There is one right now that is commercially available. It is called Ketonix.  And basically it is a USB device that you plug in and you blow into it for 15 seconds and then it gives you a color change.  You can kind of see your level of ketosis.  Now there are a bunch more on the way.  There is one now in Arizona right now being developed by a company called Invoy Technologies.  I was actually a study participant with them because they wanted people that were already in ketosis and could show ketones on the meter.  I can do that.  (Laughs)      

Dr. Justin Marchegiani:  Laughs

Jimmy Moore:  So I blew into a bunch of bags for them but I have not seen the actual meter.  I know they are trying to get FDA approval right now so that is kind of what we are waiting on.  Once they get the FDA approval I would be able to see the meter itself.  I am not sure but it will have a digital reader.  I am not sure anything about it other than it is coming. (Laughs)

Dr. Justin Marchegiani:  Nice.

Jimmy Moore:  So hopefully by this fall that will be out.  And I know Japanese researchers are currently working on an iPhone app that would enable you to blow into it and see your acetone levels.  And I am not sure when that will be developed but I predicted in Keto Clarity that by the year 2016 we will be seeing some kind of a breath ketone meter available commercially in stores.

Dr. Justin Marchegiani:  That is great.  And if you are to just buy one right now, what would you recommend?  If there’s more then just get one monitoring system.

Jimmy Moore:  Just one monitoring system?

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  If you want accuracy you got to get the Precision Xtra.  The blood ketone meter.  That is going to be the best way to be absolutely accurate.  I love my Ketonix and I did not tell you the price that Ketonix meter is only $100.

Dr. Justin Marchegiani:  Hmm.

Jimmy Moore:  It is a guy in Sweden that developed it.  He has epilepsy, speaking of epilepsy.  He has epilepsy and he is trying to control his seizures with a ketogenic diet.  So he needed a way.  He thought urine ketones strips were too messy and not accurate and then the blood ketone was too painful pricking yourself.  So if you freak out about pricking your finger maybe the Ketonix is a way to at least give you a yes-no answer whether you are in ketosis or not.

Dr. Justin Marchegiani:  Got it.  Got it.  So quick review for all of our listeners: What Jimmy said there, first method is using the acetoacetate where we are testing it in the urine.  The second is we are doing the beta hydroxybutyrate in the blood and then the acetone in the breath.  So those are the three main methods there.  Anything I missed Jimmy?

Jimmy Moore:  No that is it, spot on.

Dr. Justin Marchegiani:  Great, great.  So talk about the difference between Atkins and the Ketogenic Diet that you recommending here?  How are they different?

Jimmy Moore:  Yes, I am most famous for being a big success story on the Atkins Diet back in 2004.  Lost 180 pounds on it.  I love Dr. Atkins.  I think what he did for nutrition is still under appreciated in the world today.  I think he is going to get a posthumous Nobel Prize one of these days, at least he should.

Dr. Justin Marchegiani:  Hope so.

Jimmy Moore:  Because he put on the map this idea of limiting carbohydrates and eating more fat.  And so what is the different between that that he promoted and a ketogenic diet?  Well, you can do an Atkins style diet and not be ketogenic.  And that is kind of surprising to a lot of people because sometimes Justin you will hear people say, “Oh the low carb ketogenic diet.”  And then my question to those people that describe a diet that way is, “So how are you measuring for ketones?”  And they are like, “What do you mean?  Low carb is ketogenic.”  I am like, “No, it is not.”  Low carb is one aspect of what it takes to get into ketosis but it is not the only aspect as we have been talking about moderating the protein and eating more fat.  You really have to be skilled at kind of using the technologies we were just talking about to really know if you are in ketosis or not.  So the problem with the Atkins Diet is it is not necessarily ketogenic.  And you know Dr. Atkins would put the emphasis on carbohydrate restriction but then he would say eat protein and fat to satiety.  So he threw the protein in there and I think that was a mistake for people that are trying to get into ketosis.  Now some people can reach ketosis and get those ketone levels on that blood meter or the breath meter that we were just talking about.  You know they can get it eating an Atkins diet but it is because their tolerance level for the protein and the threshold of the protein is probably higher.  But if you got that real sensitivity to carbs and protein like I do…  

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  You know, maybe Atkins is not enough.  And you need to go full out ketogenic.  I would say the best way to describe it is it is fattier- the Ketogenic Diet.  You really have that up the bat probably a lot more than what Dr. Atkins even promoted in his book.  And I know he got raked over the coals for his high fat diet, high protein diet, you know.  But he really kind of started this whole look into the therapeutic use of ketosis in health and that is kind of the heartbeat of what we are trying to do in Keto Clarity.

Dr. Justin Marchegiani:  Ah, great points.  Great points on there.  Wow!  Excuse me, my head is spinning right now with all the information.  I learned a lot of new things already here.  So what would you say is your biggest three criticisms are regarding the Ketogenic Diet?

Jimmy Moore:  (Laughs)  So you know, I know there are criticisms from all angles and that is what is kind of funny about this.  I dibble dabble in the low carb and Paleo communities and one of the interesting ones from the Paleo community is, “Oh, very low carb ketogenic diet is going to induce hypothyroidism.”  Which is kind of always been funny to me.  People like Chris Kresser and Paul Jaminet, you know they are doing great work and I have great respect for what they are doing.  But quite frankly they are putting out that information.

Dr. Justin Marchegiani:  Right.

Jimmy Moore:  And it is not fair to the ketogenic diet to have that label, that scarlet letter so to speak that it induces hypothyroidism because I get emails all the time and people are like, “You know, I tried that ketosis that you talked about unfortunately it is going to give me hypothyroidism because Chris Kresser and Paul Jaminet say it will.”  I am going, “Ugh, please.”  The problem that comes into play here is this, Justin.  They are predicating that conclusion on some studies that yes they were low carb ketogenic diets but guess what else they were?  They were hypocaloric.

Dr. Justin Marchegiani:  Ahh…

Jimmy Moore:  In other words, low calorie diets and you know you are the thyroid expert.  You know about this stuff.  You got to eat adequate calories or the thyroid starts doing stuff.   

Dr. Justin Marchegiani:  Absolutely.  Absolutely.

Jimmy Moore:  And so that is a big one.  That is a huge criticism that is unfounded.  And anybody just thinking about doing a ketogenic diet and you are worried about your thyroid I would say give it a go but make sure you are eating plenty of calories.  And guess how you can get more calories?  Eat more fat!

Dr. Justin Marchegiani:  Absolutely.

Jimmy Moore:  That is the easiest way to get more calories and if you do that you will be able to be just fine with your thyroid.  I have never had any issues at least outwardly.  No symptoms that I have any kind of thyroid issues and I eat 30 grams of carbs a day.

Dr. Justin Marchegiani:  Have you done any thyroid testing on yourself at all?

Jimmy Moore:  I have and we actually addressed this point in the book as well.  My levels of different things are a bit lower.  But maybe the people who have the higher levels of thyroid and this is your territory so you correct me if I am wrong.

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  Higher levels of various thyroid things on their panel perhaps those are the ones that are high and the people that are on a ketogenic diet are the normal ones.

Dr. Justin Marchegiani:  Hmm… hmmm.  Interesting points there.  And I know that the amount of carbs that you need in ketosis will vary depending on your activity level.  I have heard Ben Greenfield talk about having up to 200 carbs a day and he is doing Ironman type of activities and still being in ketosis.  So can you talk about where too much exercise ketosis may not be the best thing but also some people may need more carbs and still be able to stay in ketosis while exercising more.  Can you touch more on those issues?  

Jimmy Moore:  Yes, rock on Ben Greenfield.  He was one of my experts in Keto Clarity and he is exactly right.  When you are able to use those strategically in competition and in exercise performance and you are able to still burn fat for fuel, eating that many carbs, he is a well-oiled machine when it comes to this. Again it goes back to the individual.  You got to figure out if that works for you and what your goal is.  Your goal is exercise performance, you know in your training you are able to be fat adapted and keto adapted and then on race day up the carbs a bit.  And you are able to do well and be fully fat adapted, go for it.  There is definitely nothing wrong with that and it is going to be a tinkering around process.  There is no perfect formula for this is what everybody should do for whatever the activity is.  You just got to figure it out and it is going to be different from person to person. 

Dr. Justin Marchegiani:  That is great.  That is great.  I want to wrap up here and one last question so people can get a sense of what a day in a life of Jimmy Moore is like.  Can you walk us through what you would eat on a typical day in breakfast, lunch and dinner?

Jimmy Moore:  The important thing is there is no such thing as a typical day.

Dr. Justin Marchegiani:  Laughs

Jimmy Moore:  Because you know we live in a society where we eat breakfast – snack, lunch – snack, dinner – snack, midnight snack.  We are like grazing all day long.  I have not eaten that way in years.  I do not even remember the last time that I had more than a couple of meals in one day.  Typically, it is one to two meals a day.  And we often hear breakfast is the most important meal of the day.  I could not agree more except I do not agree it has to be in the morning.

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  Because look at the word breakfast, what does it mean?  Break the fast, right?

Dr. Justin Marchegiani:  Yes.

Jimmy Moore:  So if you are fasting overnight which everybody is when their sleeping unless you are sleep-eating somehow.  You are going to wake up in the morning and if you are not hungy why would you eat?  Why would you eat if you are not hungry in the morning?  So break the fast when you get hungry.  And that could be 1 o’clock in the afternoon.   And so breakfast is the most important meal of the day but it is only when you break that fast and that could be midday.  So I probably could eat somewhere around midday at like 1 or 2 o’clock and I can have eggs cooked in butter.  I like to throw some sour cream on top of that with some cheese and cold avocado on the side.  Maybe some bacon, yes it’s very fat.  Bacon or sausage and then sometimes I will get even some more butter and take a little bite of butter with each bite of food.  And then that meal will hold me upwards to 12, 16 sometimes as much as the 24 hours until the next day.  So that is an example of something that I will have on a typical day.

Dr. Justin Marchegiani:  That is great.  And what is your favorite ketogenic dessert that won’t throw you out?

Jimmy Moore:  (Laughs) The ketogenic dessert that would not throw me out of ketosis does not exist.   

Dr. Justin Marchegiani:  Hmm.

Jimmy Moore:  Because for me I am so sensitive to carbohydrates that I have to be extremely careful.  I guess if I have to choose a “dessert” it would be dark chocolate and cream cheese.

Dr. Justin Marchegiani:  Hmm, that sounds great.

Jimmy Moore:  So, 85% dark chocolate and you put some cream cheese on it.  Give a little more fat.  Dark chocolate actually is really, really high in fat if you ever look at a true dark chocolate.  And I am not talking Hershey’s Special you people that is not dark chocolate.  There is a brand I like called Taza brand.

Dr. Justin Marchegiani:  Uh-hmm.

Jimmy Moore:  It is really nice, they put little cacao nibs in the chocolate, it is so good.  But it gives you that chocolaty flavor, really rich, deep chocolaty flavor, you know.  And then you add the extra cream cheese it’s a little bit of a creaminess almost like a pie consistency.  So that is, I guess, a ketogenic dessert.  But try to stay away from sweet things especially if you still have the carb cravings and you are not able to control your blood sugar that well yet.  Let us get that under control first before you start worrying about low carb ketogenic desserts. 

Dr. Justin Marchegiani:  That makes a lot of sense.  Excellent.  Well, his name is Jimmy Moore.  He has a new book coming out next week August 5, called Keto Clarity.  Jimmy can you tell us more where my listeners can find out more information about you and all of your podcasts and blogs and such?

Jimmy Moore:  Sure and thank you for having me on your show.  Yes, it is actually going to be in hardback, a Kindle e-book and the audible audio book.  When I did “Cholesterol Clarity” last year, Justin people were like, “Where is the audio book?”  And I am like, “What do you mean an audio book?”  

Dr. Justin Marchegiani:  (Laughs)

Jimmy Moore:  They are like, “You got to have an audio book.”  I am like, “Okay.”  And then they are like, “You’ve got to read it.”  “What? I have never done that before.”  (Laughs)  So being a podcaster that people know my voice.  I have done well over a thousand episodes of my podcasts combined.  I guess people want to hear my voice.   So we did Keto Clarity in audio book as well.  So all three of those will be available, ketoclarity.com is the website if you want to learn more information about it.  We have sample chapters and things like that in there. How do you find me?  You can go to livinlavidalowcarb.com and if that is too much to remember you can just type in Jimmy Moore in a Google search and I think I am the whole first page.  Everything on that first page is all my stuff.

Dr. Justin Marchegiani:  That is great.  Awesome.  Thank you so much Jimmy.

Jimmy Moore:  Thank you sir.


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