Showing posts with label Low carb. Show all posts
Showing posts with label Low carb. Show all posts

Friday, March 21, 2014

REDEFINING WHY!

Hi Everyone,

Bear with me on this one. This is my over-tired (due to new baby care) attempt at soul searching & sincere self-examination. There is a lot more to the story, but I’m trying to stay on point with main things that have either directly or indirectly affected my body composition over the years.

I was always a lean & athletic guy. Growing up in a farming area, we ate pretty well (farm fresh side of beef, pig & chickens in the deep freeze, free range chicken eggs, fresh dairy, etc...) and throughout high school I did competitive Rowing, Karate, Kick boxing, Volleyball and of course all the pick up games of roller hockey, ice hockey, street hockey, football and soccer that my cousin & I could arrange! I pretty much trained all year long for rowing (dryland training) including tons of running, ergometers & weights (light circuits & heavy weights also). Therefore, I was doing a huge volume of work at this point in my life. I was 145 lbs until my senior year in high school and when I left for University I was 155 lbs.

This trend continued to University where I found competitive coed cheerleading (awesome sport for those of you who don’t know about it) & I practiced Japanese Jiu Jitsu & Capoeira. Of course, I learned some weight training from more senior guys on the Cheerleading team & started banging on those. Hitting the heavier weights, I bulked up to 175 lbs and remained here for the next decade and a half.

By the time I went to Montreal for my professional degree, I was still around 170 lbs and with some dietary manipulation & body weight training courtesy of Matt Furey (combat conditioning), I leaned down to 8% body fat. Then I started hitting the weights again, and seeing as how I was studying Human Nutrition & Dietetics I started experimenting with different strategies to add mass, as I had always been a “hard gainer”. Unfortunately, the techniques mostly involved eating higher carbohydrate, lower fat diet as a backbone, and using protein & mass gain shakes and things after my heavy weight workouts, so all of that combined with being over 30 years old at that time all lead me to increase my weight up to about 185 lbs and of course my body fat went up as well (to around 17%).

When I got into my Masters degree in Montreal, I was able to workout with and join the Cheerleading squad there, however, the team was mostly women & there were only 2 of us dudes (actually as I write that I realize, it wasn’t all that bad ;-) . It was great fun & actually with my heavier frame (190 lbs at this point) I was able to do some more advanced stunting that had escaped me at 175 lbs. My tumbling suffered a lot though. At one point at 175 lbs, I was able to do a roundoff, back handspring, back tuck fairly routinely and the same sequence with a back layout in place of the tuck with a bit more effort. However, at 190 lbs, this was much more difficult to do. I essentially, had to relearn the moves at my new heavier weight. In the end, I was able to do standing back handspring, back tucks routinely, but it did take a fair amount of effort and I’m sure my technique was sucking quite profoundly.

Next, my funding ran out for my Masters and I returned home to find work as a Registered Dietitian. I was able to find a one year mat leave for the first year, and of course had to live at home. During this time, I was able to get down to 180 lbs by participating in the Body for life challenge. I also started working in Hamilton at an Obesity clinic one day per week.

At the conclusion of that one year contract, I obtained a permanent position as a Registered Dietitian in Hamilton at a Mental Health Facility, and am still there now. In addition to completing my Masters, I was able to propose and initiate a PhD through my same University supervisor located at this hospital, but unfortunately, due to changes in drug purchasing contracts (move to generics) the funding was pulled by the drug company that had originally committed, and so I am pursuing my PhD in a topic similar but more complex & advanced of my Masters.

I should mention that during all of the above times my free time got less and less as my responsibilities increased. Additionally, I realize now in retrospect that my WHY for pretty much the bulk of my physical activity/working out thing was actually extrinsic, all about the ladies (attracting my dream girl), so to speak. I was a young guy & I loved women & wanted to meet as many as possible so I could finally meet the one.

When I started my permanent position as an RD in Hamilton, I met my (to be) wife at my orientation. We connected at a deep level immediately & she was the sexiest, most intelligent, kindest women I had ever met in my life (still is actually)! I proposed a little over 1 year after we met & we were married one year later. Interestingly, we found our dream home in a beautiful location, the unfortunate part was that it was a 1 hour drive from work. I commuted 2 hours/ day x 5 days / week for 5 years and during this time my weight skyrocketed to 225 lbs with obviously a huge shift in my body comp to fat mass (around 25%) with a waist circumference of 39.5” :-(. We were blessed as well with our first daughter during this time, and since, we’ve been blessed again. The massive increase in my body weight (& fatness) was obviously due to my decreased physical activity. Interestingly, I was actually working out pretty hard regularly for 2.5 years of our 5 with the 1 hour commute including rediscovering Japanese Jiu Jitsu (until our first daughter was born, then sleep went bye bye) but my weight still remained at best around 210 lbs. Honestly, I knew that my commute was killing me. Thankfully, my health was fine, no issues of note, but I knew that I was on the roadway to Diaobesity! My wife and I decided to move closer to work (decreased commute=more family time) & her family (greater support for our kids & connectedness with their cousins). We were expecting our second child while we listed our home (with countless open houses) & while we were searching for our new home. It was challenging & time consuming since we lived about an hour from where we were searching & we were both working full time. Additionally, I had to prepare for my PhD oral comprehensive exam right after we were slated to move into our new home. Additionally, we planned for a significant renovation on our new home once we moved in & had to start purchasing items & reviewing options after work in the months leading up to the move. Bottom line, we were living fast & hard, with very little time to dedicate to exercise/fitness. The only saving grace was that we walked daily together each evening as a family. Of course, this became harder as the Canadian Winter set in. 

Now, all things considered, my experiences started to make me question all the strategies I had learned & had been taught in school. I started to hit the research & I mean individual blogs, books, etc… Then I verified what I was seeing by perusing various scientific studies using similar principles. Shockingly, at least to me, I started to discover that most of the info that I was finding on “unreliable” (at least we’d been told in school) sites were actually validated by clinical research, and that we had never been taught any of these principles. This was my discovery of the Paleo/Primal/low carb lifestyle. This fascinated me, and it definitely made logical sense. Unlike, fad diets though that can often make some logical sense on the surface, this seemed to have no downside. It baffled me why we never learned anything about this during my clinical nutrition classes & also why not one of my colleagues seemed to even know what I was talking about when I mentioned it to them. Anyway, I plowed through all the podcasts (Robb Wolf first, then Jimmy Moore, Abel James, Mark Sisson etc…) & blogs (Mark Sisson, Robb Wolf, etc…) & then books including but not limited to The Paleo Solution, The Primal Blueprint, The Paleo Diet, The Paleo Answer, and The New Evolution Diet. Not to mention countless Paleo/Primal guides. 

Anyway, we are now living closer to work (20 min drive each way), the initial renovations are done, we had our second daughter & she is now about 6 weeks old and I have about 4 more months off from my PhD (paternity leave). This year, I even started attending 2 cross fit classes per week at a local box, but that was put on hold when our second daughter was born (less sleep & more to do around our new home). At this point, my wife & daughters’ happiness are far more important to me than my body composition. And then, suddenly, all at once, I realize why I’m not chomping at the bit to get back into the gym/workout/exercise whatever you want to call it. This had always been my way throughout my graduate degree, what the heck gives? 

All of this is basically a cliff/coles notes (depending on where you are from) version of my weight & body comp history as it pertains to significant life events. Interestingly, there’s a critical message hidden throughout the story. Did you figure it out? It’s painfully obvious, once you see it.

At every point in my life when I was working out super hard & absolutely committed I had a compelling WHY, to attract the woman of my dreams! So once I found her, married her & we started having children, that WHY was achieved and no longer drove me. I became more focused on surviving our new hectic schedule including a then 2 hour commute, helping care for my wife & our child, as well as maintaining my job, business, studies & our home. Now that the commute has been reduced, that’s one less thing, but with a newborn in the house & a 2 year old, my WHY shifts to include helping with the care of the entire expanded family & maintaining and doing some smaller renovations to our new home. I think about working out, my wife and I discuss how to fit everything in, and at long last my wife’s agreed to come aboard the S.S. Paleo/Primal and eventually we will convert our 2 year old as well. Our hope is that once we introduce solids to our second daughter she won’t even know what a grain product is. So, in that way I was able to integrate my primary WHY for caring for my family to include a healthy diet that will help me lean out. However, the exercise thing bothers me, because I know I’m not a lazy person. So why am I not leaping back to the gym to whip myself back in shape? The short answer is that in my current life with the new set of circumstances (married to the woman of my dreams, 2 beautiful children, working full time, pursuing PhD, Blogging & starting online business), I have not taken the time to update/re-define my WHY.

I mean, think about it. At this point, I haven’t returned to working out yet, because in my mind right now, I want to spend my time with my wife & daughters, building my online business & of course (feel I have to) work since we’re currently limited to only my income. So what I need to do is layout my new WHY given my new set of life circumstances. I think it’s key to remember that a WHY that drove us phenomenally for decades might be completely powerless once circumstances change (i.e. Pursuing the woman of my dreams & then me finding her & marrying her). But as Tony Robbins says in his audio programs, I have been caught up living day to day and forgot to design my life (I’m paraphrasing, but you get the gist).

Anyway, the take away message is that for any change, lifestyle or otherwise, we need to have a clearly defined WHY, or we are doomed to not achieve our goal!

I will redefine my WHY related to exercise in my life & post it next week to show the process that I used, in case anyone wants to do it also. If you are in a similar boat, I suggest you do this too!

Together, as a community, there’s nothing that we can’t overcome!

Have a great weekend!


Dan T

Monday, December 23, 2013

SMART Goal Setting Review

Tis the season for Setting Goals!

Do NOT sell yourself short! You can achieve what you set out to achieve, just be sure to create the right road map (i.e. behaviors to reach the goal).

Be sure to check out my YouTube channel coming in 2014!

www.dietitiandant.com -click on the Video tab.

Sincerely,

Dietitian Dan T

SMART GOAL SETTING

In the spirit of the Holidays, please enjoy my segment on how to set SMART goals.  Adopting this effective strategy should help to optimize your chances of successfully setting and reaching a goal rather than the business as usual New Year’s Resolutions, as you will see.  ENJOY!

Every New Years we do it...  Take a look at our lives and decided to change… something! January has the highest number of people starting lifestyle change plans, etc… However, it also has the highest percentage of these individuals who drop out, or quit!  Therefore, we examine how to set goals in a way that maximizes our chances of following through! 

SMART Acronym:
1)     Specific – Must answer the six “W” questions:
a.    Who – is involved?
b.    What – do I want to accomplish?
c.    Where – Identify a location.
d.    When – Establish a time frame.
e.    Which – Identify requirements and constraints.
f.    Why – Specific reasons, purpose or benefits of accomplishing the goal.
Example: SMART Goal regarding health = Do cardio training for 45 minutes 3 days / wk and resistance training for 45 minutes 3 days/wk at XYZ fitness club VS. Get in shape.

2)     Measurable – Concrete criteria for measuring progress towards the attainment of each goal you set & regularly scheduled progress checks.

3)     Attainable – You begin to figure out ways to achieve your goals.  Develop attitudes, abilities and the skills to reach them.  This “development” occurs only when you see goal achievement as possible for you.  Stair steps/Stage wise – over time what was once inconceivable to you becomes well within your achievement.

4)     Realistic – A goal must represent an objective toward which you are both WILLING and ABLE to work.  TEST of Realistic = DO you BELIEVE that the goal is attainable?

5)     Timely – A goal should be grounded with a time frame.  This increases your sense of urgency and can help you tap more of your resources to achieve the goal.

Other tips for Lifestyle Change Goals: 

A) Include adhering to your lifestyle habits as an outcome (i.e. I will consume 8 servings of fruits and vegetables per day; or 5 vegetables and 3 fruits per day; or I will do 3 cardio and 3 resistance training workouts this week (for 30 – 45 min each)).  This is critical, because change in measured parameters may take some time, but this way you know & are recognizing if you are on track behaviorally or not.
B) Research your desired outcomes and be sure to discuss them with a health professional who can help you set a realistic target and timeframe, as well as help you overcome obstacles and use effective, proven strategies.
C) Share your goals with peers who can support you and hold you accountable to your standards.
References:

1) Adapted from: Psycho-education.  2006.  Dr. I. Patelis-Siotis, McMaster University, Hamilton, Ontario.
2) Wikipedia entry on SMART/ER - http://en.wikipedia.org/wiki/SMART_criteria.

Thursday, August 8, 2013

Macronutrient Partitioning



Today, I want to chat briefly about the concept of Macronutrient Partitioning.  This refers to the breakdown (percentages of total calorie intakes) of carbohydrates, proteins and fats that we eat.  This is a general overview of the topic.  If you want more details, I would suggest that you check out this blog post on Robb Wolf's site and consider this ebook, which is very well researched and describes the topic in quite easy and practical terms, it's called carb backloading.

Why consider this? Simple. If how much we ate was the only driving force, then circulating hormone levels would not need to be considered.  This is NOT the case, and as you will see, macronutrient composition can alter hormonal circulatio, which then can determine how the macronutrients are utilized in the body.
All macronutrients are necessary for overall health, optimal performance and maximal longevity!  Here we look quickly at the role of each macronutrient in the body.


1)    Carbohydrate.  This category of nutrient is primarily used for energy.  Interestingly, the body has the ability to create carbohydrates given the right substrates and it can adapt to ketone bodies as fuel as well. This category includes mainly fibre, starch and sugar.  Fibre is primarily indigestible although some has been shown to be broken down by bacteria in the colon to release fatty acids for fuel.  Sugar is the simplest form of carbohydrate energy and is quickly absorbed and enters the blood as glucose.  Table sugar is actually sucrose which is a 50/50 blend of glucose bound to fructose molecule.  Fructose is preferentially stored in the liver and has been shown to lead to central adiposity.  The structure of glucose is shown to the right and is a primary fuel source for anaerobic activity (think high intensity glycolytic activities) via glycolysis and Kreb’s cycle and the electron transport chain one molecule of glucose directly creates a net of 2 ATP (energy molecules).  Glucose is blood sugar and entry of this into the blood stream stimulates secretion of insulin by the pancreas to regulate the circulating levels of this in the blood (CITE).  Most food labeling requires sugar be listed because of its rapid effect on blood sugar (and insulin) levels, however, a large amount of starch, although not as rapid-acting can definitely raise blood sugar (and insulin) for longer periods of time, which can change structure of adipose tissue to become more efficient at storing fat (vs. burning it).



2)      Protein.  These are essential nutrients for the body, as they are building blocks of every tissue and are also used for energy sources.  Certain amino acids are essential as humans cannot synthesize them; all others can be made from the essential ones or by breaking down ingested proteins.  Conditional amino acids are not usually necessary except during times of stress, illness and specific inborn errors of metabolism.  By far the best biological availability and quality of proteins are found from animal sources.  Vegetarian options can suffice but are less than optimal.  Branched chain amino acids can be broken down into Acetyl-CoA and Succinyl CoA and enter Kreb’s cycle to produce energy as the body requires.


3)      Fat (Lipid).  This group includes fats, waxes, sterols, fat-soluble vitamins (A,D,E,K), mono-, di- and tri-glycerides, phospholipids and others.  Their main roles include energy storage, signaling and structural components of cell membranes.  Fats provide the richest source of energy for aerobic respiration, in which two carbon units of fatty acids are released and enter Kreb’s cycle and subsequently the electron transport chain to create energy (i.e. palmitate (C16:0) oxidation results in 106 ATP (13.25 ATP per 2-carbon chain)).




We need to understand the effects of each macronutrient profile on hormone secretion and subsequently on body composition.

A)     High carbohydrate, low fat: This is the USDA, HC norm and given today’s sources of carbohydrates (i.e. highly refined) has been associated with increases in insulin (to the point that the body can become resistant insulin resistant) and increased body fat particularly around the abdominal area (i.e. surrounding the visceral organs).  This is the most dangerous form of obesity and is directly associated with metabolic syndrome.

Elevated insulin:
-          Promotes fat storage and stops fat burning.
-          Promotes protein synthesis and decreases protein hydrolysis.
-          Therefore, it promotes growth of both fat & muscle tissue.
-          Can cross the blood brain barrier and when dysregulated it has been implicated in neurodegenerative diseases (i.e. Alzheimers) and psychiatric disorders (i.e. Schizophrenia).

B)      High fat, low carbohydrate: This is a ketogenic diet.  It can take up to 4 weeks for the body to adapt to ketone bodies as a primary fuel source.  This directly oxidizes and burns stored body fat.  Circulating insulin levels are low and therefore the body is shifted into fat burning mode away from fat storing mode.  Many different tweaks have been shown to improve fat burning ability and further hamper fat storing expression (i.e. exercise type & volume, timing and amount of carbohydrate intake, amount and type of protein intake, etc…). 

Therefore, it would seem that for optimal health, performance and longevity we would be best served by doing the following.

1)      Protein:
a.       Aim for around 1 g/ lbs of your ideal body weight daily
b.      Choose the best sources (animal vs. vegetable; grass fed vs. grain fed; consider fats included with protein) 

2)      Fats:
a.       Aim for 2 g/day of omega-3 (DHA + EPA combined).
b.      Not more than 8 g omega-6 per day.
c.       Get adequate monounsaturated fats (olive, avocado, hazelnut and macadamia nut and oils).
d.      Saturated fats (animal sources + coconut oil).  When carbohydrates are lower, these can be your primary fat sources.  These are the most stable for cooking and least oxidizable.

3)      Carbohydrates:
a.       Keep your total intake to around 100-150 g per day (depending on your body composition goal).
b.      Eliminate sugar and refined grains (i.e. all grains are refined).
c.       Consume your main carbohydrate loads post workout (especially strength training) up to 4 hours after and focus on starchy vegetable carbohydrates primarily. 
Citations

Monday, July 8, 2013

Are Low Carb Diets the Devil?


Hi everyone,

A quick disclaimer to go with my post.  I hope you find the information useful!
 
Remember, I do not know your case at all.  Be sure to discuss this with your doctor or a health care provider who does know your case well, before attempting.  I am providing you with information to better understand a nutrition protocol and how it might be useful to you, but am in no way suggesting you do it.  As such, I am not responsible if you do try this unsupervised and bugger yourself up.  Use your common sense, and discuss this with someone who can help you do it safely.

As a registered dietitian, we are often taught that Atkins was a loon & that low carb diets are the bane of health & longevity. Well, after delving into the research & examining this topic for myself, and also experimenting with this practice personally (n=1 experiment) I can say, that they are definitely NOT the devil & they might actually possess some incredible therapeutic benefit!  Read below & draw your own conclusions.


What is Ketosis
State of elevated levels of ketone bodies throughout the body (including the blood).  These are formed by ketogenesis when liver glycogen stores are depleted. Two major ketone bodies used for energy are acetoacetate and β-hydroxybutyrate.  Both are readily used by most of the tissues of the body except the heart & one portion of the brain.  Interestingly, humans have evolved a method of creating glucose from broken down proteins (certain amino acids).  While semantic debate rages on about why we evolved this capability, the fact is we have it and as a result, we really don't need much direct carbohydrate intake to live healthfully!  The only caveat I will add now is that if you have to perform physically demanding and performance dependent activities on a regular basis, then you will need to add more carbohydrates (complex, safe starches are excellent for this) in the 3-4 hours post activity.

Common Concerns:

As a health professional, the most common concerns that I've read about, heard or even stated as fact myself (incorrectly, I might add) are here:

1)      Ketosis is harmful – The fact is if glucose cannot be broken down (i.e. insufficient insulin levels) then the body metabolizes fat, which will increase blood ketone levels leading to ketosis.  The ketoacidosis situation arises when these ketone bodies continue to elevate due to the complete lack of insulin and the fact that sugar is being consumed and remaining unused in the blood stream.  This leads to high levels of ketone bodies and high levels of blood glucose concomitantly, which decreases the pH of the blood (increases acidity) leading to metabolic acidosis in which enzymes, tissues and organs can fail leading to coma and subsequently death.  Obviously, that is something that we would all like to avoid like.  However, it’s critical we understand that an otherwise healthy person who is making insulin readily can undertake a well-designed low carbohydrate diet safely.  They will be in ketosis, which can be extremely beneficial.

2)      High Protein diets and kidney failure – it’s believed that higher protein consumption increases risk of kidney damage.  This has been disproven by several well-designed long term studies. The only caution I would mention is that people suffering from failing kidney function already or those at high risk for kidney failure (i.e. long term poorly controlled diabetes) or gout might require limited protein intakes.  Otherwise, there is no known upper safe limit for protein intake.

3)      Cognitive burnout - My Brain & nerves needs sugar as a fuel – This is true, to an extent. Parts of the brain can burn only sugar as fuel, however, the body can create sugar via gluconeogenesis (in the liver) from proteins, which is one of the reasons why protein intakes are elevated in low carbohydrate diets.  Furthermore, the only studies that I've seen linking low carb intake to poor cognitive performance vs. high carb intake were in subjects that were NOT fat-adapted.  In other words they did not undergo the 2-4 week adaptation/detox phase in which their body decreases carb burning pathways & upregulated fat burning ones, making us efficient at fat burning.  Anyone, detoxing would not perform well on cognitive test.

4)      High fat diets and high cholesterol – It’s still (erroneously) believed that a high fat diet leads to cholesterol elevation.  This has been disproven by several well-designed studies and it has been established that refined dietary carbohydrate is far more likely to lead to metabolic syndrome and dysregulations in cholesterol that significantly increase risk for heart attack or stroke.  Furthermore, overt blood cholesterol values are less meaningful than once believed.  More telling tests including LDL-particle size, which unfortunately is not routinely available, is one of the best to determine cardiovascular risk vs. LDL number.

5)    Low carb diets will increase risk for Cancers due to low fruit & vegetable intake – It’s (erroneously) believed that high animal protein, high fat diets increase risk for cancer.  There are two active hypotheses.  The first is that animal protein causes cancer.  This comes from studies that showed an association between animal protein intake and cancers, however, on further examination, the data analysis is suspect. For example, whenever pizza (with peperoni) was consumed all the calories were counted as animal protein and including lunch and cured meats as animal protein sources would definitely skewed results, especially in light of the huge body of evidence linking sodium nitrates and the like to stomach & bowel cancers (strongly).  The second hypothesis implicates lack of vegetable matter in this; however, it is carbohydrates that are being restricted, not vegetable matter.  Whenever I am counseling someone on a ketogenic protocol, I recommend that people consume low carb vegetables with every meal and use fruit sparingly.  In the end, clients consuming a low carb paleo diet often consume more plant matter compared with the usual North American diet.  In fact, dietary carbohydrate especially from refined grains, sugars, etc... and excess fat mass have been implicated in causation of many cancers.  Even more research, has demonstrated a treatment enhancing effect by using a ketogenic diet.  Specifically, the theory is that a tumor uses glucose as its primary fuel source, and is unable to utilize ketone bodies, whereas humans can adapt to ketone bodies.  There are many studies showing that a ketogenic diet during cancer treatment helps to eliminate tumors faster and more effectively than traditional treatments alone, likely because it starves the tumor.  Specifically, most of the research on ketogenic diets improving cancer outcomes have examined endothelial derived cancers (i.e. bowel and breast, etc...).

What are the Benefits of a Low Carbohydrate diet?
1)      Decreased hunger - more insulin stability and presence of ketone bodies both act to increase satiety.
2)      Long-duration fuel supply - decreased dependency on quick burning sugars allows for longer lasting, more stable energy levels.
3)      Decreased exposure to highly toxic refined grains & other processed foods - the processing used in preparations of grain products, juices & sugars, etc... act to increase our exposure to many chemicals the effects of which in the long term are unknown.
4)      Reduction of over-stimulation to the brain (i.e. with seizure disorders, depression, bipolar disorder and schizophrenia) - this has been examined for years in children with epilepsy, but more recent studies have found success in subjects with other brain disorders. This is likely due to reduction of readily available, fast burning sugar, so the brain is better able to regulate the use of energy even in hyperactive firing areas.

Okay, I would like to give this a try, how the hell do I do it?

How do I achieve Ketosis?
In order to enter into ketosis, the average person needs to consume < 100 g of total carbohydrates per day.  Metabolic individuality might mean that some will enter ketosis slightly above or below that, but that seems to be a reasonable goal amount for carb intake to be below for ketosis.  This is carbohydrates from all sources, but I strongly suggest eliminating highly refined carbohydrates (I.e. sugars) and grain products (especially wheat), and possibly even dairy for at least 60 days to see how you look, feel and perform (depending on your specific individual goal) and then reintroduce as tolerated, if desired.  This could provide many further benefits in addition to ketosis.  This means that your only sources of carbohdyrates for those 60 days will be low carb vegetables, starchy vegetables and limited whole fruits.  Many of you might recognize this as a low carb paleo diet.

Why is Ketosis safe for most of us?
Human evolved over millions of years before agriculture (only about 10,000 years old) with a cyclical pattern of eating, often famines followed by feasts, etc… Furthermore, there was only a brief time relative to today that fruits & vegetables would have been plentiful (i.e. late spring/summer & fall).  This means that over-winter and even into spring there would have been limited amounts of carbohydrates available at all.  We had to adapt to a long lasting fuel source to allow us to survive over winter.  This is likely why fat evolved and metabolically why we can adapt to ketone bodies as a fuel.
Interestingly, even today there are many documented cases of human societies today that exist in a long-term ketogenic state. After a 2 to 4 week period of adaptation, human physical endurance is not affected by ketosis, according to studies - meaning that we do not necessarily need a high carbohydrate intake in order to replace depleted glycogen stores for exercise. This makes the argument more compelling that; in fact, we are designed to thrive at certain levels of ketosis.

Remember it’s a total lifestyle that’s critical.  So in addition to the diet alterations, be sure to get the rest of your lifestyle in order.
  1. Get adequate and the best quality sleep you can nightly;
  2. Activity: Be sure to do some (lower intensity) exercise every day and then twice per week add in lifting heavier things (i.e. weights, bands, body weight), and once per week move as fast as you can (i.e. wind sprints).
Great sources for more information on activity for health, performance & longevity are Robb Wolf's site & Mark Sisson's site.  They also have some great info on primal/paleo eating as well.
So here's the protocol, I'm doing & that I have recommended that I see clients get the most out of.

Nutrition Strategies for a Ketogenic Diet 
  1. Decrease your total carbohydrate intake to less than 100 g daily. 
  2. Avoid highly refined carbohydrates (i.e. sugar and refined flours) because these will spike insulin and that will stop fat burning & stimulate fat storage.
  3. Exclude all grain products (especially wheat) for at least 60 days.
  4. Consume adequate vegetable matter.
  5. Limit yourself to less than 2 fruit servings per day.
  6. Avoid fruit or vegetable juices.
  7. Consume at least half your plate of low carb vegetables at each meal on average.  This provides at least 6 servings of highly nutrient dense vegetable matter per day.
  8. Include safe starches: potatoes (especially sweet potatoes, and other starchy tubers – these will provide carbohydrates to be readily converted into glucose by the body, but also come very complex starches that can be utilized by healthy gut flora (i.e. pre-biotics).
  9. Consume adequate protein.
  10. Depending on your individual needs, you will need differing levels of protein – usually 35% of total calories are good.
  11. Choose either grass fed, humanely raised animals or if you use conventionally raised then be sure to consume high omega 3 animals at least 3-4 times per week (i.e. oily fish).
  12. Don’t fear FAT!  You will be consuming around 50% of your calories from fat.  This is the most energy dense nutrient source, but it also has many health benefits.  In a ketogenic adapted person, this becomes your main fuel supply.
  13. Choose mostly anti-inflammatory fats – specifically foods high in omega-3 fats (animal sources like oily fish, pastured meats, cream & butter) and monounsaturated fats (like pastured meats, cream & butter, olives, avocadoes and their oils) and also saturated fats (pastured animal fats and coconuts and their milk (full-fat) and oil).  These are all highly anti-inflammatory.
  14. Use nuts sparingly due to high omega 6 fats.  Macadamia and Hazel nuts (philberts) have lower omega 6 content vs. monounsaturated fats.
  15. Adequate hydration – You will need to consume adequate water per day to ensure that you allow for adequate removal of byproducts associated with protein breakdown & ketosis.  Although some guidelines suggest 3-5 L per day, the best indicator is that your urine color (see chart below)



So I hope that you find that information useful and now you can bring that information with you to your health care provider.  Remember, I do not know your case at all, be sure to discuss this with your doctor or a health care provider who does know your case well, before attempting.  I am providing you with information to better understand a nutrition protocol and how it might be useful to you, but am in no way suggesting you do it.  As such, I am not responsible if you do try this unsupervised and develop issues as a result.  Use your common sense, and discuss this with someone who can help you do it safely.

If you do decide to talk to someone and move forward, remember that it is critical to keep a journal about how you are looking, feeling & performing each day to be able to see and record the changes that are happening in your life.  This way you'll know if this approach is moving you towards your goal or not.


Till next time.

Dietitian Dan T

Citations
http://www.ncbi.nlm.nih.gov/pubmed/12047499
http://www.ncbi.nlm.nih.gov/pubmed/19245705
http://www.appforhealth.com/wp-content/uploads/2011/07/Urine-chart.jpg