Brian Lenzkes realized years ago there was a serious problem with his medical career. He just wasn't quite sure what to do about it.
It was the day after Thanksgiving in 2017 when he penned the words to an article he never published.
"My career in medicine is kind of like running on a treadmill that is just a little too fast for me," he wrote. "I can keep up for now, but I know I can't keep up this pace forever."
Dr. Lenzkes received a BS in Biology from UC Irvine before attending the Keck School of Medicine at USC. After graduating in 1999, he started his residency program at Scripps Mercy Hospital in San Diego, and extended his residency for an extra year to serve as Chief Resident. In 2004, he started his private practice career at Internal Medicine Associates, the longest established and most respected Internal Medicine group in San Diego.
So what could be so wrong with the career of a man who has been voted one of the "Top Doctors" in San Diego for 11 years, and is highly regarded by both his patients and his peers in the medical community?
Like a growing number of doctors, Dr. Lenzkes felt trapped in a what can only be described as a broken system. He was able to articulate the problem--if only he were able to envision a solution.
"Many of us feel this way on a daily basis," the article draft continued. "We are overwhelmed by the constant barrage of text messages, e-mails, family/work obligations, social stressors, sleep deprivation, and limited free time. In the medical community, we feel like Sisyphus trying to push that massive boulder uphill for all of eternity."
In the more than two years that have passed since Dr. Lenzkes wrote those words, many things in the medical community remain unchanged. Some things continue to get worse. Physician burnout is at an all-time high. Suicide rates for doctors are more than double that of the general population.
"Our profession continues to see a constant influx of sick patients we are unable to cure," he said. "The status quo is to throw pills at them and tell them to shape up. We grow frustrated as patients fail to improve. We become cynical."
But over the past couple of years, something has changed within Dr. Lenzkes, and he's realized he's no longer willing to stand by as patients grow sicker and sicker. The change started with a video he watched in early 2017 featuring Jason Fung, a Canadian nephrologist who is also a world-leading expert on intermittent fasting and low carb, especially for treating people with type 2 diabetes.
"That video changed my life," said Dr. Lenzkes, who has gone on to become a leader in the low carb community, and has added therapeutic carb restriction, the ketogenic diet, and fasting to his medical toolbox. Lenzkes adapted a low-carb diet and lost more than 50 pounds, and soon began helping patients lose weight through the implementation of "evidence based" lifestyle changes.
For the past year and a half, Dr. Lenzkes has co-hosted the popular Low Carb MD podcast with Dr. Tro Kalayjian, a board certified Obesity Medicine and Internal Medicine doctor based in New York, along with Dr. Fung and Megan Ramos. Low Carb MD podcast episodes have been downloaded nearly 1.4 million times.
"It recently dawned on me that I'm reaching tens of thousands of people every month through my podcast, but I’m often unable to truly reach people in my own practice. The last three patients of mine who developed diabetes, I predicted it six months before it happened. Diabetes is a preventable and reversible illness, and it's heartbreaking. We have the skills needed to avoid this disease."
Last month Dr. Lenzkes attended the Low Carb USA Boca Conference, where he delivered a presentation entitled "Deprescribing: Ending the Prescription Cascade." At the conference, he realized there were no shortage of people interested in his message, but he just needed to find a better way to reach them.
It was in Boca that he met Dr. Kristin Baier, MD, a family medicine doctor advocating for therapeutic carbohydrate restriction, who he learned was interested in moving to San Diego.
In a tweet published last Wednesday, Dr. Lenzkes announced "I am going DPC with an awesome partner Kristin Baier starting 7/1 in San Diego!!! We can keep people healthy with a clear conscience now. All we need are patients, a building, website, logo, etc...and tons of antacid!"
Dr. Lenzkes and Dr. Baier plan to open their new practice, Low Carb MD San Diego Direct Primary Care & Metabolic Health, on the campus of San Diego Christian College this July. They plan to cap their practice at a total of 400 patients per doctor, to allow the doctors to spend the time needed to develop more rewarding and effective doctor-patient relationships than can be achieved in the traditional system.
“People ask me how I can go from a practice where I had more than 3,000 patients and reduce that number to just 400. You can’t spend adequate time with the patient in a system where patients have to take a number, and only get 10 minutes with their doctor. This move will be like upgrading from an overcrowded Boeing 747 to a Learjet.”
Dr. Lenzkes plans to continue to spread the word about low carb through the podcast, and he is also looking forward to helping to educate doctors about ways they can be more effective, while avoiding the stress and helplessness that nearly devastated his own career.
SIGN-UP LIST FOR PROSPECTIVE PATIENTS - If you are interested in signing up to receive information on how you can become a patient, sign-up here. Patient list will be capped at 400 patients per doctor.
In the video below, Dr. Lenzkes details the many things that factored into his decision. This is a must-watch for any doctor experiencing physician burnout, or disillusioned with the current state of the medical profession. Emotional, educational, and timely...WATCH & SHARE!
This is a crazy story, but it's making more sense every day. Dr. Kristin Baier and I talk about the Direct Primary Care clinic we're opening together in July. We're calling it Low Carb MD San Diego Direct Primary Care & Metabolic Health. Please share this with anyone you think it might benefit.
A new study shows how sports leagues like the NFL fan the childhood obesity epidemic.By Julia Belluz@email@example.com
There’s a reason sports heroes like Michael Jordan have been appearing on cereal boxes for decades. Food and beverage companies have learned that spending billions of dollars on marketing targeted at kids as young as 2 can sway the food choices they make for a lifetime. Yet we have become numb to this advertising because it’s all around us — and it’s a major and often ignored driver of the obesity epidemic.
New research in the journal Pediatrics reveals the precise role America’s beloved sports leagues play in this marketing blitz. The first study to quantify food marketing to children through professional sports organizations in the US, it casts these leagues in a new light: as key peddlers of junk food to children.
The paper, led by researchers at New York University, focused on sports sponsorships — or the money food and non-alcoholic beverage companies pay teams to use their logos, brands, and products in sports venues and advertisements. The researchers found that major sports leagues like the NFL and NBA have millions of young viewers (about 412 million under the age of 17 per year, to be exact). And that food and non-alcoholic beverage companies — including McDonald’s, PepsiCo, Mars, Kraft Heinz, and Kellogg — were the second-largest category of sponsors to these leagues, after only the auto industry.
The food sponsorships are ubiquitous — appearing in the names of playing fields and the socks players wear on those fields (see photos above and below). What’s more, the vast majority of the snacks and drinks featured through these sponsorships is overwhelmingly unhealthy.
The takeaway is this: The millions of kids who follow sports leagues are being saturated with messages about junk food, from Doritos to Skittles to soda. “[Children] see these pro athletes at the pinnacle of physical fitness — then cut to a commercial and see sponsorship for chips and sugary drinks,” said Marie Bragg, assistant professor of population health at NYU School of Medicine and the study’s lead author, in a statement. “At [best], it’s an ironic paradox. At worst, it could lead kids to think these products are healthier than they are.”
The junk food saturation is especially pervasive for football fans. Of the 10 leagues most watched by youth, the NFL carried the most food and beverage sponsorships, followed by the NHL and Little League, the researchers found.
“There is overwhelming evidence that kids eat more when they see food ads compared to when they see non-food ads,” Bragg added. “[Our] study shows us, in addition to the more generic food ads that young people are seeing on TV, they are also getting a heavy dose of these ads through sports sponsorships. And the association with sports may be especially problematic — it fuses this healthy activity with this really unhealthy message.”
76 percent of the foods shown through sports sponsorships were unhealthy
The rate of obesity in children and adolescents has risen tenfold globally in the past 40 years. Of the 20 largest countries in the world, the US had the highest rate of childhood obesity, at 13 percent. One of the well-appreciated contributors to childhood obesity globally is food marketing.
A 2006 report by the Institute of Medicine reviewed dozens of studies on the impact of food marketing to kids and determined there’s a link between the rise in childhood obesity and the ubiquity of junk food ads targeted at young people, as I’ve reported with Eliza Barclay.
In 2014, according to the UConn Rudd Center for Food Policy and Obesity, food companies spent $1.28 billion on snack food ads — and nearly 60 percent of that advertising promoted sweet and savory snacks, while just 11 percent promoted fruit and nut snacks. This problem has been growing worse over the years. According to Rudd, ads for snacks increased 15 percent, even between 2010 and 2014:
The global sports sponsorship business is even larger. In 2015, the new study found, sports sponsorships totaled $57.5 billion worldwide. To find out how food and drink companies were investing this money, the researchers compiled a list of all the sponsors of the 10 most-watched sports organizations among children and youth, and identified all the products shown in sponsorship ads. They then rated the products for their healthfulness, using the Nutrient Profile Index, a scoring system used in the UK and Australia that evaluates foods’ nutrition value.
Seventy-six percent of the foods shown through sponsorships — such as Snickers bars, Doritos chips, and chocolate and Frosted Flake cereals — were deemed unhealthy (or, more specifically, “energy-dense, nutrient-poor products”). More than half of the beverages being marketed were sugar-sweetened — most commonly, full-calorie soda, followed by diet soda and sports drinks. In contrast, ads for plain water were only featured six times among the 273 advertisements in the sample the researchers examined.
The US is lagging in the global crackdown on food marketing to kids
Food companies invest money in ads targeted at kids because they work, said Scott Kahan, director of the National Center for Weight and Wellness and a faculty member at both Johns Hopkins and George Washington University, who was not involved in the study.
“There are data showing that when kids see a given food that is branded with a character or a superhero or a sports hero, they eat more of it than they would if it didn’t have branding or marketing, and they say it tastes better,” Kahan added. “[Marketing] strongly impacts kids’ assessment of food, kids’ desire for food, and ultimately creates potentially lifelong preferences for given foods and given brands.”
This is why groups like the World Health Organization have long suggested stricter regulations on food ads targeted at kids. And it’s why many countries, from Chile to Ireland to Norway, have followed those recommendations, cracking down on food companies’ abilities to reach kids through bans and restrictions on advertising and marketing.
American lawmakers have moved more slowly on this front. In 2010, the Healthy, Hunger-Free Kids Act mandated that schools stop marketing and selling the fat-, sugar-, and salt-laden snacks — the sugary beverages, the candy — in cafeterias and vending machines, and that they replace those offerings with lower-calorie and more nutritious alternatives like fruit cups and granola bars.
“But other than the limits on junk food sales in marketing in schools as a result of [the act],”Margo Wootan, a longtime nutrition advocate and director of nutrition policy at the Center for Science in the Public Interest, told me, “we as a country have been relying on companies to do the right thing and self-regulate to address this important issue of food marketing to kids.”
In 2011, an Obama administration effort to pass voluntary guidelines that would have curtailed the food industry’s ability to peddle to kids failed in the face of fierce food industry opposition. And there’s no sign of an imminent crackdown now, either. The Trump administration has said childhood obesity is not a priority. It’s also repeatedly signaled a desire to back off from the issue, including relaxing school lunch regulations that were targeted at making the food in schools more nutritious.
Sports junk food ads create unhealthy associations
It may seem ironic that sports are now synonymous with junk foods, but Bragg views it as part of the food industry’s campaign to change how we view their products (even though the preponderance of evidence suggests what you eat matters much more than how much you exercise when it comes to weight).
Food companies have for decades put out messages — and sponsored science — suggesting that it’s okay to eat junk food as long as you burn it off with exercise. Ads during sports games reinforce that misleading message.
“Sport sponsorship is useful to the food industry, not just in the context of direct marketing but also to help thwart legislative efforts to rein them in as tying themselves to healthy behaviors,” said obesity doctor Yoni Freedhoff, “and pointing to their sponsorship of youth sports directly, allows them to make a case that without their dollars, youth sports would not survive.”
Interestingly, many big food companies — including PepsiCo, Coca-Cola, and Kraft Heinz — have signed on to a voluntary pledge through the Council of Better Business Bureaus to reduce unhealthy marketing to kids under 12 via media with an audience of at least 35 percent children. “But when they sponsor organizations like these, and there are 412 million kids watching each year, this allows them to circumvent the spirit of the pledge,” Bragg said.
“While people are sitting watching sports, they are being bombarded by foods that are going to undermine their health, and that just doesn’t seem right,” Wootan added. The CSPI and the authors of the new study would like to see sports organizations, whose audience include so many young people, adopt policies promising to avoid marketing junk food to children.
Bragg pointed out that there was a time when professional athletes would endorse smoking — a practice that died when consumers and policymakers got fired up enough to stop it. “As a society, we have to wake up and think about the message we are sending to kids, and adults, about what it means to be physically fit and healthy,” she added. “And sending these unhealthy diet messages is not the right way to reverse the obesity epidemic.”
By Nina Teicholz
The process for the 2020-25 U.S Dietary Guidelines for Americans (DGA) got off to a strong start this week, when the U.S. Department of Agriculture (USDA) solicited public comments about a list of key issues for the guidelines to review. This was the first time that the USDA or the U.S Department of Health and Human Services (HHS), the two agencies tasked with developing the Guidelines, took this unusual step.
The announcement is good news, because it signals that the USDA and HHS are committed to increasing transparency in the Guidelines’ process, which in 2015 became a political battle field, riddled by activist agendas and corporate interests. It’s also good news because on the USDA’s list of topics for review are saturated fats and “low-carbohydrate diets,” both of which The Nutrition Coalition has identified as areas where DGA recommendations are not in line with current scientific thinking.
In taking this step, the Administration is clearly heeding the call of the National Academies of Sciences, Engineering and Medicine (NASEM), whose September 2017 report found that the DGA process lacks scientific rigor, falls short of meeting best practices for scientific reviews, needs greater transparency, and altogether “needs to be redesigned….to be trustworthy.”
Ensuring that the Guidelines are based on rigorous, up-to-date science is essential so that the nation has a fighting chance to stem the epidemics of nutrition-related diseases that now plague us, including obesity, type 2 diabetes, heart disease, hypertension, and fatty liver disease.
Since the DGA were first issued in 1980, the food pyramid–and now the MyPlate icon–have been used to direct the federal government’s nutrition programs, such as the School Lunch Program, feeding programs for the elderly, and military rations, as well as nutrition information provided to patients, school children, and consumers. However, the guidelines have often issued nutrition advice based on weak or flawed evidence, resulting in significant mistakes, such as a 35-year cap on cholesterol, which was dropped in 2015, and several decades of advice to eat a “low-fat” diet, language that has slowly disappeared from the DGA over the last decade.
With this announcement, USDA and HHS implied there are other topics where recommendations could be out of sync with current nutrition science. Saturated fats have clearly been the subject of much rethinking in recent years, and the DGA’s three “Dietary Patterns,” have been criticized for being nutritionally insufficient, in addition to remaining a one-size-fits-all diet.
USDA and HHS are also seeking public feedback on nutrition for infants, proper nutrition for those over 65, and the role of beverages and sugars in the diet for adults.
In a departure from tradition, Brandon Lipps, who serves as both administrator of USDA’s Food and Nutrition Service and acting deputy undersecretary of food, nutrition and consumer services, said the guidelines – for the first time ever – “would not review the entire body of evidence,” and that “we do think that there are a number of issues that haven’t changed significantly over time.”
We agree: it certainly makes sense to set priorities and focus on areas where the science has been updated.
A month-long public comment period is set to start February 28. You can comment here.
Learn how to submit a comment by reading our guide here.Here are the two topics that rise to the top for The Nutrition Coalition:
Adam busts some dietary myths wide open. Turns out fat isn't the only thing that makes you, well, fat.
CollegeHumor with truTV.
Source - Low Carb USA
Editor: Yassine came all the way from Belgium to attend our San Diego event in August 2017 and submitted this story about his daughter to us afterwards about how they are using a Low Carb Diet For Type 1 Diabetes. We felt we had to share it with you.
On August 19th 2016, our 11-year-old daughter was diagnosed with type 1 diabetes. The care team at the hospital did a phenomenal job at nursing her back to health and training us in the main aspects of diabetes management, namely diet and insulin regimen.
One week later we were back home and implementing the diet we were taught, structured around specific amounts of carbs for each meal and snack and corresponding insulin doses. We were using 4 daily injections of a fast-acting insulin (NovoRapid, similar to NovoLog, typically 22 units per day) and slow acting insulin (Lantus, typically 11 units at bed time).
During our training at the hospital the educators were very clear that the long-term complications of diabetes (retinopathy, nephropathy, micro and macro-vascular disease, etc.) were due to high blood sugars (>160mg/dL, aka “hyperglycemia”, or “hypers”) inflicting progressive damage to specific cells over years of poor glycemic control.
Low blood sugars (<60mg/dL, aka “hypoglycemia” or “hypos”), in comparison, can create significant discomfort (dizziness, sweating, trembling, etc.) but our care team explained that they were not dangerous per se (unless a severe hypo happens while the diabetic is driving for example).
We were also taught that the key health metric used to track glycemic control was glycated hemoglobin (aka “HbA1c”). It is a good estimation of the average blood sugar levels over approximately the last 3 months. Healthy non-diabetic people typically have A1c values between 4.5 and 5.5%. diabetics are typically higher than 6.5%. Most diabetes care official guidelines try to keep patients’ HbA1c levels below 7.5% for kids and 7% for adults.
All the complications of diabetes are associated with high A1c level. According to the studies on diabetic cohorts, higher risks of serious complications appear for A1c higher than 5.5%
(data from DCCT (1996) (1), Stratton et al. (2000) (2), Khaw et al. (2004) (3), Feinman et al. (2015) (4)).
Dependence of risk for myocardial infarction and microvascular end points on hemoglobin A1c. Data adjusted for age at diagnosis of diabetes, sex, ethnic group, smoking, presence of albuminuria, systolic blood pressure, high- and low-density lipoprotein cholesterol, and triglycerides. UKPDS
The absolute risk of sustained retinopathy progression (hazard rate per 100 patient-years) in the combined treatment groups as a function of the updated mean HbA1c during follow-up in the DCCT estimated from a Poisson regression model with 95% confidence band. C: rate vs. values of HbA1C 58%. D: cumulative incidence (probability) over 9 years of treatment vs. HbA1c
This was very surprising to us. If the odds of extremely serious complications started from A1c levels higher than 5.5%, why would the objective be to be at 7%? Why not shoot for normal blood sugar levels for diabetics?
The answer we were given was that it was very hard to control blood sugars in general, and that it was not realistic to aim for normal blood sugars and A1c levels, so if we were below 7%, we were already “reducing” the risk for long term complications. The curves above represent instantaneous (C) or 9-year cumulative risk levels (D). My daughter will hopefully live way beyond 9 more years, and over her full expected lifetime, the cumulative risk corresponding to a 7% A1C is dramatically higher than that of an A1C of 5.5%. Conclusion: @ 7% A1C, we are definitely NOT reducing the risk for long term complications to an acceptable level, only normal A1C levels (as in healthy non-diabetic subjects) would do.
We thought that we should investigate ways that we can improve glycemic control and test the hypothesis from our diabetes care team that it is “impossible to have normal blood sugars” in our daughter’s case.
We are lucky to be able to use a continuous blood glucose monitor (Abbot’s Freestyle Libre), which provides us with a continuous curve of blood glucose measurements throughout the day (technically, the sensor captures sugar concentration in the skin interstitial tissue and extrapolates blood sugar, but in our case, the estimate we get from that are very close to a 20-minute time-shifted curve of actual blood glucose as measured by a standard finger-prick glucometer method). Here is how a day of our daughter’s blood glucose levels looked like on the recommended diet and insulin regimen (on a good day…).
After each meal (containing typically 30-70g of carbs), blood glucose would go up, then the insulin we had injected 5 to 15 minutes before the meal would kick in and bring it back down. These significant variations are due to the recommended high carb diet. We were taught to count the carbs and inject a corresponding dose of fast-acting insulin.
We found it extremely hard to reduce or remove the variations in the curve above. We experimented by slightly changing the insulin doses, the timing of the injections with respect to meal times, etc. But we learnt that the speed at which carbs impact blood sugar depends on many things (what you eat with the carbs, in what order, etc.). The absorption speed of injected insulin is also variable. Bottom line, we found that, in perfect agreement with what we were told at the hospital, we could not maintain a low variation of the blood sugar curve, at least with the recommended diet.
So, to recap, in order to avoid long term diabetic complications, we want to maintain low A1c levels. To do so, we need to maintain low average blood sugars. Since the curve varies significantly due to high carb meals, low average blood sugars mean very frequent hypos. Although we understand hypos are not serious issues per se, they have a significant impact on our daughter’s daily life, including relatively severe discomfort multiple times a day that affect her classroom focus and overall morale.
In other words, as long as the blood sugar curves have such levels of variance, we have to choose between the 2 undesirable outcomes of higher either A1c (long term risks) or many hypos (short term issue).
We therefore started thinking about how we could lower the variance of the glycaemia curve. Given that dietary carbs have by far the highest impact on blood sugar levels, we started considering lower carb diets and, accordingly, lower fast-acting insulin doses.
When we lowered the number of carbs per day from 160-200g per day to 35-40g a day, the results were spectacular (right hand curve is for low carb).
Switching to a low carb diet was a very effective way to normalize our daughter’s blood sugars.
Using large doses of carbs and insulin makes any tiny variation in absorption rates or timing result in a hyper or a hypo. Using lower doses of carbs and insulin mean the unavoidable variations in timings and absorption rates result in tiny peaks or valleys instead. Smaller inputs lead to smaller errors from unavoidable mistakes. As the peaks and variance become much smaller, it becomes possible to have a normal average blood sugar levels without the crippling hypos she used to undergo. She has been on this diet for a couple of months now, her blood sugars typically vary between 60 and 130mg/dL in the day with averages between 80 and 90, her A1c 3 months after diagnosis was 5.2%, the hypos went from more than 10 to less than 3 per week and the hypers went from 2 per week to 0. This outcome is actually consistent with the rare academic studies we have been able to dig up on the use of lower carb diets for type 1 diabetics (Nielsen et al. (2005) (5)). We were by the way surprised to find so few studies on this topic. The sample sizes are quite low and the long term impacts poorly known as few studies go beyond a couple of years.
We wondered how our daughter would take to a low carb diet. I guess we are lucky that she does not have a sweet tooth. We compiled a list of recipes from websites like dietdoctor.com or ditchthecarbs.com. We created weekly meal and snack plans from these recipes. Then we tested them and asked our daughter for rate each recipe. To this day we keep testing new recipes and replacing the ones she does not approve of. Giving her control of the meal plan is our way of making her part of it and making sure we are not subjecting her to meals she does not like. She says she is reassured by her blood sugar curves and likes her meals so far. We do no hesitate to make exceptions (e.g. birthday parties, when she asks for sushi, etc.), we just give her the corresponding dose of fast-acting insulin. We are also experimenting with many low carb sweetened recipes so she does not feel deprived of cakes, sweets and deserts. The online resources for this are abundant and the recipes fairly easy to follow.
This low carb approach to stabilize blood sugars is still an exception among diabetics. Very few doctors recommend this diet for multiple reasons, most of which are still unclear to us. The 27 co-authors of Feinman et al. (2015) are strongly advocating for the use of low carb diets for diabetics, claiming that the available evidence for the upsides is compelling enough while that of the alleged risks is not. Davis & Runyan’s book (6),and Dr. Bernstein’s (7) Diabetes Solution are 2 very useful sources on this topic.
At the same time, most doctors, including our original endocrinologist, do not recommend low carb diets. They mention many long-term risks (growth, liver metabolism, oxidative stress, microvascular issues, etc.). The problem is, we have found many research papers tying all these problems to high blood sugars, not low carb diets. The pattern we have seen is that most situations where we see these problems also involve high A1c levels, which normal blood sugars specifically help avoiding.
The bottom line is: we are in charge of our daughter’s health, and to the best of our knowledge a low carb diet tackles the biggest long term risk for her health. We are perfectly happy changing our mind and diet if
The Facebook group Type1grit was a tremendous help during this whole process. It is a extremely active and helpful community of type 1 diabetics and their parents following the low carb diet described in Dr. Bernstein’s diabetes solution book. The members are very supportive and combine a wide variety of expertise areas and experience levels. I have still to ask a question in that group’s page that was not followed within hours, sometimes minutes, by a useful and supportive reply. This community is wonderful and an invaluable help in the emotional rollercoaster following the diagnosis.
Now let’s take a look at some of the common warnings we got from different doctors or dietitians about low carb diets:
1. You mean you eat more Fats?Reducing carbs means increasing at least one of the other two macronutrients. We follow the protein guidelines for her age and weight (and appetite). The main change in her diet is a significant increase in the quantity and variety of vegetables, as well as a significant increase in protein (about 2g/kg/day, she weighs about 40kg) and natural fats (1.5g/kg/day – by “natural” we mean no prepared industrial dishes, trans-fats, etc., but the fats naturally present in meats, fish, dairy products, etc.). We have naturally looked into the recent literature on dietary fat, focusing on RCTs and systematic meta- analyses, and our conclusion is that dietary fat (especially saturated fat) is not convincingly associated with heart disease (see Harcombe et al. (2016) (8), Santos et al. (2012) (9), Kuipers et al. (2011) (10), among others). We are aware this is complex and extensively researched, that different types of fats play different roles, that long term studies tend to be observational cohort ones while RCTs testing for causality tend to be relatively short term (less than 2 years). That being said, we have found no compelling evidence to discourage us from using a low carb diet to stabilize blood sugars. Gary Taubes’s book, Good Calories, Bad Calories (2007), proposes an in depth literature review on this topic and helped us tremendously in navigating this research field.
2. It may work, but it is not sustainable!It is working for us for now, and our daughter loves the recipes. We understand that this might change dramatically as she grows up, hits teen age rebellious years, etc., but in the meantime we will have gained as many years as we can with normal blood sugars and we will have trained ourselves and her to makes delicious low carb meals. We allow exceptions (friend’s birthday cakes for example) and our daughter is in full control of the meal plan.
3. It is not possible to control blood sugars!We are aware that blood sugar can be influenced by a myriad of factors (diet, exercise, weather, hormones, puberty, infection, etc.). We have already observed wild variations during an infection (a cold) and expect significant ones during puberty etc. We understand there are many factors we do not control, we just want to fix the one we do control.
4. It will interfere with her growth!This was a surprise to us, as we could not find out why sufficient protein, sufficient energy (from fat) and a wide variety of healthy vegetables would impair growth. We have found a few articles (Bonfig et al. (2012) (11)) about growth curves for type 1 diabetics and they show an association between high A1c and stunted growth. Our low carb diet allows us precisely to keep A1c low, so we are still looking for evidence. We are checking regularly her height and weight. 5 months from diagnosis, she is still tracking nicely with her pre-diabetes growth curves (75th percentile for height and 50th for weight), time will tell us if she is drifting away from them.
We are still looking for all the evidence we can find to help us understand the risks we may be increasing, but so far we have found nothing compelling to lead us to change what we are doing.
Both my wife and I are engineers and profound believers in science. We usually follow to the letter the doctor’s recommendations. In this specific case, we are for now convinced that the nutrition research does not support the alleged evils of a properly formulated low carb diet. We are actively in search of evidence either way and are fully ready to change our approach in the face of compelling evidence. We are not certain of our approach, especially in the face of so much push back from most doctors, but in our honest opinion the available evidence is not consistent with this pushback, and the alternative would be to submit our daughter to higher A1c levels, and there is ample compelling evidence that that is not a favorable outcome.
[Make sure you get to one the LowCarbUSA® events and see people who are changing lives and meet others whose loves have been changed forever!]
It's the simple things that often can make a huge difference in our life.
That's why I always encourage my patients to take small steps in the right direction when doing a low carb based diet. And this post is all about taking another productive step on your Keto nutrition program.
Drink more water!
Not only does it improve your skin, prevents headaches, and other benefits. It also promotes weight loss.
The recommended amount is eight glasses of water per day. But if you exercise, your water intake should be more. The difficult part is being able to drink anything close to that amount.
Usually we drink when we are thirsty which is not the best indicator.
Here are a few tips to help you stay hydrated:
4 Simple Ways to Drink More Water
Here are four ideas that you can use to help you drink more water:
1. START YOUR MORNING BY DRINKING A GLASS OF WATER
Make this part of your daily routine. Keep some water nearby so that it's the first thing you see when you get up and drink as part of your getting ready routine in the morning. It's easy to do and a great way to start your day!
2. BRING A WATER BOTTLE
It's a simple thing to do but it works! If you make a habit of carrying a water bottle with you, you'll find yourself drinking more water.
Choose a water bottle and keep it on your desk in easy reach. There are so many different version, you can get one that fits your personality. There are some stainless steel versions that insulate throughout the day.
You'll start sipping from it during the day, almost without noticing. And you'll see exactly how much water you've been drinking.
3. SET A REMINDER ON YOUR PHONE OR CALENDAR APP
Take advantage of your smartphone (make technology work for you):
If you are sitting for most of the day, then these reminders are also great for reminding you to take a walk to the water fountain or outside the office.
Eventually drinking water at these times will become a habit (if you stick to the same schedule each day). And then you won't need any reminders.
4. MIX UP YOUR FLAVORS
One reason why we don't drink enough water, we find the flavor boring.
It's especially hard if you used to drink a lot of strongly flavored sodas before starting a low carb diet.
Want to try giving your tastebuds something a little more interesting? Try adding some berries to your water.
Try adding 2 slices of lemon, 5 blueberries and 3 raspberries
Another is adding 3 lime slices, 5 blueberries, 3 raspberries, and 1 blackberry.
Don't forget to get organic berries whenever you can. Give yourself the best and you will feel the best!
Looking for an easy quick, low carb, Keto friendly idea for lunch or dinner? Try this ridiculously easy Cauliflower Mac n Cheese receipe:
• 3/4 cup fresh (or frozen) cauliflower florets
• 1 ounce cheddar cheese, shredded
• 1 tablespoon heavy cream
1. In small microwavable dish with lid, microwave cauliflower covered for about a minute.
2. Remove from microwave and chop into small pieces.
3. Microwave for another 50 seconds or so, then add shredded cheese.
4. Microwave for another 10 seconds or so.
5. Stir melted cheese in, then stir in heavy cream until sauce forms. 6. Enjoy!
Makes 1 serving
INGREDIENTS INSTRUCTIONS Makes 1 servings Nutrition per serving: 191 calories, 14.9g fat,
I wanted show you the top 5 Keto mistakes I have seen or experienced while on this program. Hopefully this will help in your keto health and wellness endeavors and make the transition smoother into ketosis.
One way to track the ratio of your diet to stay in the 75%-80% fats, 10%-15% protein and 5% carbs is to check out https://cronometer.com . This is a great site where you can log all your foods during the day and set your preferred ratios so you can see where you are at in realtime. There is also an app for your phone!
When done correctly the ketogenic diet can be a lifesaver and help you mentally and physically so give it a try and email us at firstname.lastname@example.org if you have any questions.
Also, download the free 'Real Food Chart' to see what types of foods you should be eating and which ones to avoid.
You can do this!
Free Nutrition Expo 2018 is less than 20 days away! For more information and to reserve your space, please go to my website - http://www.lowcarbmd.com/upcoming-events.html
In the workshop we will discuss the low carb/Ketogenic diet and benefits such as:
Come and listen from the standpoint of a physician. I will answer any and all questions to get you to be the BEST YOU.
If you haven't already, get a copy your free nutrition guidebook . The role of poor dietary advice has been ignored for too long. Specifically, the“low fat” and “lower cholesterol” message have had unintended disastrous health consequences. Now you can have a role in reversing obesity and Type II Diabetes and help others.
Source: Harvard Health Publishing - Harvard Medical School - Marcelo Campos, MD
Recently, many of my patients have been asking about a ketogenic diet. Is it safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
What is a Ketogenic diet?
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.
Are there benefits of a Ketogenic diet?
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
What’s the bottom line?
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
There are many studies done on Intermittent Fasting and the health benefits that can come from it if done correctly.
Intermittent Fasting (IF) is currently a major health and fitness trend. People are using it as a way to help lose weight and improve overall health. We’re going to explain what it is, go over the benefits and risks, and walk you through how to safely incorporate it into your life, if it’s something you want to try.
What is Intermittent Fasting (IF)?
Intermittent Fasting more accurately describes an “eating pattern” than a “diet.” With IF, you cycle between periods of fasting and eating. It doesn’t dictate what to eat; it dictates when to eat.
Is it safe to do?
You’ve probably heard that to keep your metabolism chugging along, you should eat every 3-4 hours. But going through periods of fasting is actually more “natural” than eating every few hours. That’s because our ancestors (the hunter-gatherer ones) didn’t have the convenience of 24/7 access to food. They didn’t have restaurants, grocery stores, or refrigerators. They sometimes had to go extended periods of time without food due to availability. Fasting is also a part of religions. In other words, humans are physically able to function without food for extended periods of time.
What are the most popular methods?
By limiting the hours you eat, the idea is that you’ll consume fewer calories and lose weight. Intermittent Fasting only works as a weight loss method if you don’t compensate by eating too many calories during the eating periods. It’s also critical that you eat healthy foods when you do eat. Binging on junk food after hours of fasting won’t do your health any good.
What are the benefits?
While weight loss is the most highly touted one, research shows IF offers many other health benefits.
Are there any risks to IF?
For some people, Intermittent Fasting may not be beneficial, and could even be harmful. Consult your doctor prior to fasting if you:
What can I drink during fasts?
Water, coffee, tea, and other non-caloric beverages are fine. Coffee can help suppress appetite so is popular during fasts. Avoid adding sugar to your coffee. A little bit of milk, cream, or heavy cream is okay.
Can I take supplements during fasts?
It’s not only okay to take supplements, it could help you feel better. Exogenous ketones are an example of a supplement that can help during Intermittent Fasting. Here’s how they can help:
Any last words of advice?
Keep in mind that Intermittent Fasting is just one of many methods that can help you lose weight and lead a healthier life. But always remember that eating real (unprocessed) foods, staying hydrated, exercising regularly, and getting adequate sleep are the most important factors for health and wellness.
We will cover this topic in more detail at our upcoming Low Carb Nutrition Expo on January 14, 2018.
Visit our link for more information and to RSVP - click here
You can do this!