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8 Reasons You Can't Lose Fat #DocMuscles #KetonianKing DocMuscles.com

Eight Reasons You Can’t Lose Fat

Inability to lose weight is the most common reason people see me. It’s often a combination of small things that they are unaware of that is keeping the spare tire inflated around the waist.  I’ve listed the eight most common reasons you can’t lose fat that are seen in my office.

You Eat Too Many Carbohydrates

About 85% of the people that walk through my office doors have some degree of insulin resistance. This means that they produce 2-20 times the normal amount of insulin in response to ANY form of starch or carbohydrate. Insulin is the hormone responsible for letting glucose into the cell to be used as fuel. More importantly, it is the hormone responsible for dampering glucose production in the liver and, it is the primary hormone responsible for pushing triglycerides into the fat cells (essentially, the master hormone for making you FAT). The more insulin you make the more fat you store. Insulin resistance, the inability for insulin to signal glucose dampering at the liver receptors, is the first stage that starts 15-20 years before you become a diabetic.

#DocMuscles #KetonianKing #WeaponOfMassDestructionIn order to lose fat, you have to decrease the insulin to a basal level. If you don’t the fat enters the fat cell faster than it exits and the fat cells get bigger. This is RULE number one to weight loss. You gotta turn down the high insulin surge that 85% of us are really good at producing. If you don’t do this, it is almost impossible for many of us to lose weight.

For at least 1/3rd of the people I see, this cannot be accomplished unless TOTAL CARBOHYDRATES are decreased to less than 20 grams per day. Yes, you read that correctly . . . Less that 20 grams per day.

  • Your banana contains 30 grams of carbohydrate
  • Your yogurt has up to 60 grams of carbohydrate
  • That oatmeal you thought was good for you has up to 200 grams of carbohydrate
  • The half and half you put in your coffee is half lactose (sugar from milk), 10 grams per cup.

You Eat Too Much Protein

Yes, protein can cause weight gain. There is always a body builder that sends me a nasty message after I say this, but it is true. (I’ll keep an eye on my e-mail).

#EatMoreChicken #DocMuscles #KetonianKing #TooMuchProtein

Five of the ten essential amino acids stimulate an insulin response. Remember why carbohydrates cause weight gain . . . ? (I will give you a hint . . . INSULIN).

Certain amino acids that make up proteins can do the same thing. Arginine, Lycine, Phenylalanine, Leucine & Tyrosine, in that order, stimulate insulin (1). We need protein to stay healthy, but too much of these amino acids in someone who is insulin resistant will inhibit weight loss and stimulate fat gain.

So, what foods contain these in the highest amounts? Sea lion liver (I know, this won’t go over very well with the polar bears), soy protein isolate, crab, shrimp, sesame flour, turkey breast, pork loin (it’s the leanest cut of pork – No. BACON is fine), chicken, pumpkin seeds, soybeans, peanuts, spirulina (blue green alge that is found in the sea). Yes, I get it. We’ve been told these were the healthy foods for the last 50 years. But, think about it, when did we start gaining weight as a country? 50 years ago.

Too much chicken, shrimp, crab and soy foods will inhibit weight loss in those with insulin resistance. So, consider whether it should be chicken you add to your salad. Consider, instead, bacon or beef as a wonderfully tasty substitute.

How much protein do you need?  My formula for calculating your individual amount is here in my blog Calculating Protein Needs.

You Don’t Eat Enough Fat

#Snaccident #DocMuscles #KetonianKing #BaconBoy

To successfully lose fat on a ketogenic diet, 60-70% of your caloric intake should come from fat. Yes. You read that correctly.

If we limit carbohydrates (which is currently 80% of the body’s fuel on the standard America plate), and moderate excessive protein which also halts weight loss, you have to replace the fuel. That fuel replacement should come from fat.  Increasing fat will improve the sensation of fullness, provide all the fat soluble vitamins, and actually makes food taste good again.

As long as you are lowering the insulin to basal levels, you can actually eat all the fat for which you are hungry. Add bacon, butter, coconut oil, avocado, hard cheese, and oh, did I say bacon?

But Dr. Nally, what about all that saturated fat?

The saturated fat is only a problem with vascular disease, cholesterol and heart disease when the insulin level is also high at the same time. It’s the high insulin in the presence of large amounts of fat that drives the risk for atherosclerosis (vascular and heart disease).  Instead of cutting out the fat, we’re cutting out the insulin.

How much fat should you be eating? Shoot for 60-70% of your calories from fat.  If your fat grams are slightly higher than your protein grams, you’re there. Listen to your body and eat fat until you’re full. That’s how most of my patients gauge their need and suppress hunger.

You’re Drinking Tea

Black Tea #KetonianKing #DocMuslces #WeightLoss #KetosisI know, I know.  Tea is a national pass time in Europe. And, it is deeply embedded in the culture of many other countries.  I’m probably not winning any friends across the pond by saying this, and it may bring back memories of the Boston Tea Party.  However, the problem is that leaf based teas stimulate a rise in insulin (not taxes).  I have had many patients hit a weight loss plateau because of the use of tea, specifically black tea, oolong tea, and green tea (2,3,4).

Yes, I am well aware of the tremendous benefits of the epigallocatechin gallate (ECGC) found in green tea. ECGC, which can be isolated as an extract, improves insulin resistance and improves GLP-1 signaling.  ECGC has, also, been show to improve triglycerides (5).  For this reason, it is one of the components in the KetoEssentials Multi-Vitamin I developed a few years ago and recommend to all my patients.

It appears, however, that the theaflavin within the leaf of the tea may be playing the offending role in the insulin spike seen with their use (6).

You Don’t Get Enough Sleep

Lack of sleep has been implicated in difficulty with weight loss and weight gain (7). Lack of sleep places the body into a state of chronic stress. This elevates cortisol, lowers testosterone, increases insulin (there’s that insulin problem, again) and increases the other inflammatory hormones. This perfect storm of stress, driven by lack of restful sleep, plays a big role in fat loss.

My average patient needs at a minimum of 6-7 hours of restful sleep to maintain and lose weight.

This is where untreated sleep disorders like sleep apnea play a big role. If you have sleep apnea, get it treated. What else can you do to help improve sleep?

  • Remove the computer, iPad and cell phones from the room.
  • Lower the room temperature. Men sleep better around 68-70 degrees F and women sleep better when the temperature is <70 degrees F.
  • Close the blinds or shades to add or darken the room.
  • Don’t study or watch TV in the same room you sleep in. Your body gets used to doing certain activities in certain rooms of the house. The bedroom should be reserved for sleep.
  • Go to bed at the same time
  • Get up at the same time.

It may take your body and body’s biorhythm 3-4 weeks to adjust to changes you make around sleep habits. Be patient with yourself.

You’re Married to Stress

Just as lack of sleep is stressful, other forms of chronic stress also raise cortisol, insulin and the inflammatory hormones. Chronic stress also lowers testosterone. It, also, has the potential to lower neurosignaling hormones in the brain like serotonin and dopamine, putting you at greater risk for depression and anxiety.

Other forms of chronic stress can occur from poor relationships, chronic pain, stressful employment, unfulfilled expectations, chronic illness and all forms of abuse. If any of these are playing a role in your life, you need to address them, and address them now.

As a physician, my job is stressful. Dealing with life and death issues with multiple people through the day, six or seven days a week, takes it’s toll. I’ve found that weight lifting, horseback riding, and taking care of my animals are my outlets. Find something physical, that takes you outside in the elements and forces you to break a sweat for 15-20 minutes is the key.

#FightOrFlight #DocMuscles #KetonianKing Bear Chasing ManOur bodies have a “fight or flight system.” 100 years ago, the stress was fighting or running from the bear that squared off with you when you happened upon him in the woods. Cortisol, adrenaline, epinephrine, insulin, glucose, and inflammatory hormones pour into the blood stream.  The heart beats faster, blood flows rapidly to the muscles, sensory awareness is heightened in the brain and increased oxygen flows to the lungs. This lets you fight the bear or run from the bear.

But, you can’t fight or run from your cynical boss. You can’t fight or run from oppressive finances, the person that cuts you off on your one hour commute in traffic, or your coworker who keeps pestering you. However, your body still releases adrenaline, cortisol, epinephrine, insulin and a number of inflammatory hormones prepping you to fight or run. If you don’t burn these hormones off, they halt weight loss, and actually can cause weight gain, increase anxiety and over time disrupt sleep.

So find your favorite way of physically relieving stress, and do it 2-3 times per week. (No, gentlemen, sex doesn’t count).

You Have An MTHFR Deficiency

In the last few years, we’ve been able to identify a number of genetic deficiencies that play a role in weight gain. One of those is an methyl-tetrahydrofolate enzyme deficiency (MTHFR deficiency for short). This is a genetic deficiency in the enzyme that converts adds a methyl ion to the folic acid in the cells of your body.

This is important, because if you can’t methylate folic acid inside the cell, you’ll have difficulty using vitamin B12 and B6 very efficiently to form methionine (a key amino acid in blood vessel and nerve function). There are two genes that encode for the enzyme that does the methylation of folic acid. Deficiency in one or both of these can lead to problems.

In severe cases, it causes homocysteine to build up to unsafe levels in the blood and slow the formation of methionine.  It is associated with B12 deficiency, weight gain, fatigue, migraines, depression, anxiety, neuro-developmental disorders like autism, pregnancy loss, blood clots and neuropathy in pre-diabetic and diabetic patients (8, 9, 10).

Giving extra vitamin B12, B6 and folic acid (vitamin B9) doesn’t appear to help.  Clinical evidence is pointing to the pre-methylated form of the folic acid.  Finding this pre-methylated form has been difficult and notably expensive for patients. I found this deficiency to be so prevalent in my office, I added methylated folic acid to the KetoEssentials Multivitamin.

You Give “Couch Potato” A New Name

We have become a very sedentary people. We have engineered physical activity out of our lives. Remote controls, elevators, escalators, people movers, and automation have made our lives physically easier.

The average office worker burns 300 kcal per day sitting at a desk on a computer. The average farm worker burns 2600 kcal per day. That’s the equivalent of running a marathon every day.

Physical activity doesn’t necessarily cause weight loss.  However, physical activity changes the hormones of the body including increasing a hormone called atrial naturitic peptide (ANP).  ANP opens the fat cell, and lets more fat out (11).

When physical activity is paired with the correct diet, the weight come off.  This is where exogenous ketones may play a role.  The increased presence of ketones in the blood increases the release of ANP helping to activate triglyceride release from the fat cell.

Don’t get me wrong, many of my patients can lose weight with just dietary carbohydrate restriction alone, however, if you’ve hit a stall, you may need to look at your physical activity levels and the addition of exogenous ketones.

Kickstart Ketosis over the Plateau

Is your fat loss on a plateau?  Knowing that these challenges plague people over the coming holidays, and, seeing people get hung up on these issues, I’ve created the Keto Kickstart program for the month of October.  This package provides 30 days of ketogenic essentials including vitamins, exogenous ketones and private interaction with me through the month of October to help you get over the plateau and breeze through the holidays.

Click on Kickstart to find out the details, join me next month and let me help you bridge the weight loss chasm!

References:

  1. Floyd J et al., Stimulation of Insulin Secretion by Amino Acids, Journal of Clinical Investigation. 1966. 45(9).
  2. Bryans JA et al., Effect of black tea on post-prandial glucose and insulin. Journal Am Coll Nutrition 2007, 25(5): 471-7.
  3. Store KS & Baer DJ. Tea consumption may improve biomarkers of insulin sensitivity and risk factors for diabetes. The Journal of Nutrition. Aug 2008, 138(8): 1584S-1588S.
  4. Hosoda K et al., Anti-hyperglycemic effect of oolong tea on type II diabetes. Diabetes Care. Jun 2003. 26(6): 1714-1718.
  5. Chia-Yu Liu,Chien-Jung Huang, Lin-Huang Huang, I-Ju Chen, Jung-Peng Chiu, Chung-Hua Hsu.  Effects of Green Tea Extract on Insulin Resistance and Glucagon-Like Peptide 1 in Patients with Type 2 Diabetes and Lipid Abnormalities: A Randomized, Double-Blinded, and Placebo-Controlled Trial. PLOS one(online). March 10, 2014.
  6. Cameron, Amy R.; Anton, Siobhan; Melville, Laura; Houston, Nicola P.; Dayal, Saurabh; McDougall, Gordon J.; Stewart, Derek; Rena, Graham (2008). “Black tea polyphenols mimic insulin/insulin-like growth factor-1 signalling to the longevity factor FOXO1a”. Aging Cell. 7(1): 69–77.
  7. Beccuti, Guglielmo, and Silvana Pannain. “Sleep and Obesity.” Current opinion in clinical nutrition and metabolic care 14.4 (2011): 402–412. PMC. Web. 18 Sept. 2017.
  8. Divyakolu S, Tejaswini Y, Thomas W, Thumoju S, et al. (2013) Evaluation of C677T Polymorphism of the Methylenetetrahydrofolate Reductase (MTHFR) Gene in various Neurological Disorders. J Neurol Disord 2:142. doi: 10.4172/2329-6895.1000142
  9. Gilbody, S., Lewis, S. & Lightfoot, T. (2007). Methylenetetrahydrofolate reductase (MTHFR) genetic polymorphisms and psychiatric disorders: A HuGE review. American Journal of Epidemiology, 165(1), 1-13.
  10. Menon, S., Lea, R., Roy, B., Hanna, M., Wee, S., Haupt, L., & … Griffiths, L. (2012). Genotypes of the MTHFR C677T and MTRR A66G genes act independently to reduce migraine disability in response to vitamin supplementation. Pharmacogenetics And Genomics, 22(10), 741-749.
  11. Lafontan M et al., Control of lipolysis by natriuretic peptides and cyclic GMP. Trends in Endocrinology and Metabolism. 19(4): 130-137.
Basal Ganglia Fat DocMuscles #KetonianKing Adam Nally

Habit-Loop Cycle of Weight Gain & Obesity

In my last blog post about willpower, I described habits being neural impulse channels in our brain stimulated by a cue following a path leading to the same outcome each and every time – without exerting much effort. Researchers call the formation of these impulse channels habit-loop cycles.  Much of the original obesity research of the 19th century was conducted by psychiatrists and psychologists recognizing that people had habitual eating patterns.  Because of this, gluttony became the perceived influence of obesity.  This underlying philosophy still permeates the obesity research, treatment and low-carb dietary world today.  Yet, over the last 15 years, I’ve found that the habit-loop cycle is tied to powerful hormone responses. These responses to very subtle and often unknown triggers or cues powerfully drive weight gain, obesity and struggles with willpower.   How does the habit-loop cycle effect you?  Before we can change these habit-loop cycles, we have to understand what they are, and how they were created.

It’s All About That Basal Ganglia

All About That Bass (All About That Basal Ganglia) DocMuscles #KetonianKing

Meghan Trainor tells us that “It’s all about that bass . .  .” However, it’s really all about that basal ganglia. Deep inside our brains, close to the brain stem, at the location where the brain meets the spinal cord, is a little “nub” of neurological tissue called the basal ganglia.  This little nubbin of tissues was identified by the really smart scientists at MIT in the 1990’s as the location where habits are formed and executed.  The brain is – to take a quote from my favorite ogre, Shrek – “like an onion – it has layers!”

The Brain Is Like an Onion

If you picture the outer layers of the brain tissue, those closest to the hair and scalp, you can create a mental image of where our most complex thoughts occur.  When you think up a new invention, create a new way to cook with bacon, laugh at a friend’s joke, or link two complex thoughts about how habits form, you are using these outer layers of the brain.

Brain is like and onion DocMuscles #KetonianKing Habit-Loop Cycle
Like an Onion – It Has Layers! (DreamWork’s Shrek, 2001)

However, our interest today is deeper . . . much, much deeper.  Deep within the center of the brain at the basal ganglia is the location where our automatic behavior originates.  Swallowing, breathing and the startle responses are housed in this little nubbin of brain tissue.  It is this area of the brain that learns to recall and record patterns of neurological thought and stimulating action. This part of the brain has the ability, like the water drops on the mound we discussed last week, to record neural pathways and tracks leading to reduced mental effort and habit.  The basal ganglia even has the ability to store habits while the rest of the brain is asleep.  It is in this location, the basal ganglia, where the habit-loop cycle occurs.

Habits Created by Chunking

The habit-loop cycle is the process where the brain converts a sequence of actions into an automatic routine.  The really smart guys at MIT call this “chunking,” and it is the root of habit formation.  There are hundreds of behavioral chunking activities that you and I rely upon every day.  Some of these are as simple as the process you use to squirt toothpaste on your toothbrush before brushing your teeth.  Others are more complex like getting dressed or making a lunch box for the kids.

The Habit-Loop Cycle in Your Car

A habit-loop cycle is performed by this little nubbin of tissue by millions of people every morning.  Take, for example, backing your car out of the garage.  When you first learned to do this, it required huge amounts of concentration – and for very good reason. You’re steering 3000-5000 lbs of steel between a 16 foot garage-door opening into oncoming traffic.  Basal Ganglia DocMuscles #KetonianKing Habit-Loop Cycle

Safely backing your car requires you to open the garage door, unlock the car, adjust the seat, insert the key into the ignition, turn it clockwise, move the rear-view mirror and the side mirrors to visualize any obstacles, put your foot on the brake, put the car into reverse, gently remove your foot from the brake, mentally estimate the distance between the garage and the street while keeping the wheels straight and looking over your shoulder, applying a slight pressure between the gas pedal and the brake, and in some cases, slapping your teenagers hand while they fiddle with the radio dial.

But think about it . . . did you actually put any thought into these actions this morning?  You and I probably did this once or twice today without any additional thought.  It happened because the basal ganglia took over and created a habit-loop out of it.  This routine, repeated hundreds of times, became a habit, requiring very little mental effort.

Your Basal Ganglia Makes You Fat

The habit-loop cycle occurs hundreds and maybe thousands of times throughout our day. It is the cycle that drives hundreds of our activities.  In fact, it is this same cycle, in combination with 30 different hormones, that drives our weight gain or weight loss.  Yes, I said it, your basal ganglia can make you fat.

Habits Make for a Smaller Brain

Your brain will try to turn any regular routine into a habit, because habits allow our minds to slow down and conserve effort, energy and fuel. The efficient brain allows us to stop thinking about basic behaviors like walking, breathing and eating. This effort-saving effect of the brain is a major advantage, otherwise our brains would be huge, requiring heads the size of watermelons, or even the size of a water tower, causing their own weather systems.  Your wife will thank you for an efficient brain that is smaller and requires less room. Can you imaging giving birth to a watermelon or a small Chevy?  (Did you notice the size of Shrek and the Donkey’s head? Just say’n . . . )

Habits Are The Root of Behavior

What all this leads to is this – habits, as much as memory and reason, are the root of our behavior.  We often don’t remember the experiences that create our habits. However, once they are created, they influence our action without our own realization. Charles Duhigg’s book, The Power of Habit is a great resource for further information on how habits drive our behavior.

The Habit-Loop of Obesity

So, how does all this affect obesity and weight gain?  Let’s, first, look at the habit-loop cycle.  Researcher, Larry Squire, documented the habit-loop through three decades of research.  He and others published numerous articles showing that habits have a cue or trigger that stimulates a routine.  The routine leads to an outcome or reward.  The reward usually satisfies a craving.  Cue-> Routine -> Reward.  What we learn through our studies in obesity is that the reward often stimulates a hormonal response of 1-30 different hormones in brain and body leading to repeat cues or triggers.  The cravings are hormonally driven.  I call it the Habit-Loop of Obesity.

Habit-Loop of Obesity DocMuscles #KetonianKing Adam Nally

 

The Craving is the Key

Human psychology and emotion is the key behind habit creation.  First, there must be a trigger or cue.  Second, the trigger is attached to  a previously experienced emotion or craving tied to the cue.  The key to habit formation is the craving.  The craving is what stimulates the physical routine to occur.  It is an emotion or craving that drives the brain to create the habit. Third, there must be a clearly defined outcome or reward that satisfy the emotion or the craving. The emotion or craving doesn’t have to be associated with hormones, however, in the relm of obesity, it is usually tied together.

I am all about making things easier.  Your brain does it. We all do it.   And, I’m all about trying to help you lose fat and get healthy more easily. Let food be your medicine, let medicine be your food. That’s my mantra and that is as easy and natural as it gets.  But, in our day and age, we don’t always have access to growing and raising our own food.  That’s why my second mantra is – better living through chemistry.  So, I created the KetoKart.  Over the last 15 years of medical practice, I’ve found products and supplements that aid in letting food be your medicine, changing triggers, modifying hormones, and help to satisfy cravings in a healthy way to make your decisions easier.  Go to the KetoKart, see which package works for you and order it.  You’ll thank me.

How do  we change our obesity habits?  Stay tuned for the third part in this series: Fixing the Habit-Loop of Obesity.

So, I want to know . . . which package did you choose?

 

Quest for Life of Happiness #DocMuscles #KetonianKing #BaconBoy

Keto Happy – Do You Live A Life of Happiness?

Founded by the Secret Society of Happy People in 1999, August 8th was officially named the National Day of Happiness.  It was a day created to recognize and express happiness.  (I personally think it should involve the sharing of bacon, but some may disagree.)  Most people, whether they admit it or not, are searching for happiness.  (Most people are searching for bacon, too, . . . but that is for another article.)  We hope for happiness, we aim for happiness,  and we wish happiness upon our family, friends and neighbors at holidays and birthdays.  It appears to be a desired condition of the soul.

In medical school, we learn that the body is almost 80% water.  One of my professors intelligently quipped, “if you’re unhappy all day, that means you are essentially a cucumber with anxiety.”  For many people, happiness is really hard to find.  Money is hard to find . . . but, that’s because it gets wasted by people trying to find happiness

What exactly is happiness?  It is a transient condition or state of cheerfulness, contentment, satisfaction or pleasure.  Many people mistake meaningfulness as happiness.  Meaningfulness to one’s life is more enduring.  For example, suddenly having a wind-fall of cash may make you happy for the short term.  However, what you actually do with that cash over the next few days, months and years is what brings degrees of meaning to your life.

Basics of Happiness

Happiness is based upon your emotional & spiritual vision, and how living your life aligns with the principles you hold most valuable.  You can’t control all of the circumstances of your life. Things both good and challenging will happen to you that you never expected. However, you have control of your own happiness. You and I are the architects of it.

In working with a majority of patients who are over 65 years old, I have found that the older we get, the more we look back and realize that external circumstances don’t really matter or determine our happiness. We determine our happiness.

How do we increase our level of happiness?  There are 10 Simple Steps to Happiness:

1. Improving Health

As a doctor, I’m a huge advocate of improving your health which plays a dramatic role in happiness.  Losing as little as 10 lbs has been shown to improve energy, decrease your risk for major disease, improve sleep, improve sex life, and decrease inflammation.  Improvements in any of those areas will reduce stress and anxiety and increase happiness so you can imagine while improvements in ALL of these areas could dramatically change your life.

As an advocate of the ketogenic lifestyle, I’ve found that the majority of my patients are able to lose 5-15 lbs each month for the first three months using this approach.  They average 2-5 lbs pf weight reduction each month there-after while following a ketogenic approach over the long term.  Understanding that this is one of the long term keys to success in happiness I want to make sure you know that I’ve developed some custom strategies to help with this and will share them with you below.  This lifestyle decreases risk for diabetes by 75%, improves mental clarity, and slows the aging process. (Who wouldn’t want those side effects while eating bacon?)

2. Savor Daily Experience

BaconWrappedJalapeno #DocMuscles #KetonianKing
Bacon Wrapped Jalapenos

First, savor the daily experiences.  We live our lives at such a high speed, we often neglect to take time to enjoy the experiences around us.  A recent trip in down town Amarillo, Texas, brought me to the front doors of a restaurant that served cream-cheese & sausage stuffed, bacon wrapped, jalapenos (try saying that 5 times fast).  I had a bit of time and decided to try them.  It was the first time in 3-4 days that I actually had the chance to slow down and savor the place around me, the flavors of the food, and the atmosphere of the restaurant.

BaconWrappedJalapeno #DocMuscles #KetonianKing
Bacon Wrapped Jalapeno’s & Happiness

Just taking a bit of time to savor these things made this experience a very memorable and happy experience that I probably won’t soon forget.

Take 3-5 minutes today to just think about where you are.  Savor the smell of a rose, the color of the sky, the shape of the clouds or the sight of a bird. These sensory images can, and will, leave indelible memories and release dopamine and serotonin naturally in the brain.  Savoring the daily experiences of life can be part of the process of meditation we will talk about below.

3. Volunteer

Volunteer #DocMuscles #KetonianKing HappinessGet involved and volunteer in meaningful activities around your neighborhood, church & community.  Research shows that voluntarily giving of time increases happiness in the giver.  It also allows one to see, participate with and help those around you who may be less fortunate.  Volunteering your time and energy regularly increases your gratitude we will discuss further below.

4. Express Gratitude

Expressing gratitude daily has been shown to dramatically increase your sense of well-being and happiness.  Expressing gratitude requires awareness.  It requires you to take inventory of everything around you (something you will already be doing if you are savoring your daily experiences).  Gratitude can be expressed in a journal, through prayer & meditation, or directly to those around you.  However, expressing gratitude requires effort.Christ Leper #DocMuscles #KetonianKing

In the Judaeo-Christian view, expressing gratitude is actually a method of expressing faith.  The 17th chapter of Luke holds a biblical example of this concept. When the leper returned to express his thanks to Jesus Christ for being healed, he wasn’t told “Your gratitude made you whole.”  Christ told him, “Thy faith hath made thee whole.”  He implied that the act of expressing gratitude is a demonstration of faith, a necessary and essential process in human development.

5. Recognition of Personal Value

I’m not talking about your bank statement or personal financial statement.  I’m talking about recognizing the value of your soul.  The only successful non-medication based program to help people overcome addiction is the 12-Step Program through Alcoholics Anonymous.  The essential second step of the twelve is recognition that a power greater than ours is involved in our lives.  Whether, you believe in God or a greater universal power, recognition of your value is an essential perspective to gaining happiness.  This has been demonstrated thousands of times through the 12-Step Programs.

Often, the feeling we have of our personal worth is based on the love and interest we receive from those around us. Yet, this love is sometimes lacking. The love of men is often imperfect, incomplete, or selfish. What if you looked at yourself with the same benevolence, love, and confidence that God does? Imagine the impact it would have on your life to understand your eternal potential as God understands it. If you could view yourself through His eyes, what influence would that have on your life?  Recognition of this principle is essential to making any lasting change.

6. Become Who You Are

The celebrated Greek poet, Pindar, said, “Become who you are.”  Isn’t this a paradox?  How does one become who they already are?

Many of my and the younger generations grew up to the sounds and images of The Lion King. You probably remember the scene where Simba receives a visit from his father, Mufasa, the deceased king. After his father died, Simba fled from the kingdom because the guilt he felt about his father’s death. He wanted to escape his responsibility as heir to the throne.

Lion King #DocMuscles #KetonianKingHis father appears to him and warns him: “You have forgotten who you are and so have forgotten me. Look inside yourself, Simba. You are more than what you have become. You must take your place in the circle of life.” Then this invitation is repeated several times: “Remember who you are. … Remember who you are.

Simba, completely shaken by this experience, decides to accept his destiny. He confides in his friend, the shaman monkey, that it “looks like the winds are changing.”

The monkey replies, “Change is good.”

And Simba says: “But it’s not easy. I know what I have to do. But going back means I’ll have to face my past. I’ve been running from it for so long.”

“Where are you going?” the monkey asks him.

“I’m going back!” cries Simba.

(This is also a great movie because of the “bacon references:”)

Admit it. You smiled didn’t you!

7. Meditation

Meditation Grand Canyon #DocMuscles #KetonianKingMeditation and prayer have been shown to actually change areas of the brain that relate to stress management and mood regulation.  People who meditate regularly over long periods of time have better ability to find and maintain positive states like joy and compassion. Richard Davidson and his colleagues found that meditation increases brain activity in areas related to happiness as well.

8. Relationships

Happiness has been linked to quality relationships as well.  Robert Wallinger, psychiatrist at Harvard University, conducted a 75 year multi-generational study on happiness.  He found that the quality of the relationships was powerfully connected to happiness. Lonely people were less happy and had poorer health.  People with higher-quality relationship or social ties were the happiest.

However, it wasn’t just having a relationship, but having one with a stable and consistently caring person that made the difference. Having lots of acquaintances or being in a relationship with an unreliable or abusive partner did not make people happier.  Amazingly, listening (savoring shared experiences) and complimenting (expressing gratitude) improve the quality of relationships.  (Sharing your bacon improves relationships as well.)

9. Food

A number of studies have demonstrated that a ketogenic diet increases gamma-aminobutyric acid (GABA), a key neuro-hormone signaling satiety and pleasure, in the brain.  GABA increases sensations of happiness and euphoria.  (Yes, this is why eating bacon makes you and I happier.  It’s probably why the thought of bacon in the video above made you smile.)  Shifting into a ketogenic state at least periodically has the effect of increasing your sense of happiness throughout the day.   It is actually the ketone that does this.  Whether you get into ketosis through diet alone, or through the use of exogenous ketones, both methods are effective in aiding you in your quest for happiness.

10. Allow Others to Help

I know you are probably familiar with the term it is better to give than receive but did you know there is evidence to support the reverse is true too?  That happiness also comes from allowing others to help? Think about it. When you are helping others, especially when they appreciate it, you feel happiness or joy. Others experience those same feelings when they are able to help you. Think of a child that wants to make you a meal. No matter what it looks like when it gets to you, you smile and feel happy at the effort, the child smiles back proud at their success. There is happiness in giving and receiving. 

 

So today’s your chance to receive.  As a doctor, I find myself shying away from sharing this information with you directly because I never want anyone to feel like my efforts are about me. I’ve spent years learning and understanding the benefits of a Ketogenic lifestyle and spent additional years researching products that work and my local patients are experiencing tremendous results! A friend told me that not sharing this information with people directly was actually being selfish. (Ouch!) “When you know someone has a problem that you can solve, shouldn’t you share it and let them make their own decisions?”

Although that was painful to hear, it helped me commit to being more direct about how I can help all of you to feel better. If you are ready to change the way you feel and want to live a happier, healthier life, the time is NOW.  Put these 10 steps in action and enjoy the benefits of a KetoLifestyle. If you want to know more about what I do, keep reading my blog, join my weekly newsletter and watch me Live Stream every week on Facebook Live & Periscope giving you free tips and tricks to stay healthier. If you know you are ready for a change, and you want to see how I can help, check out the variety of Ketogenic programs I offer to help you find the Happiness inside You! Because we all love gifts and they make us Happy, in honor of #NationalHappinessDay, you should see a pop up here for something special!  ] Be sure to click here to go to the Keto Kart and cash in on better health!

However you decide to approach your day today, choose to be happy.  It really is up to you.

Fat Lock Box #DocMuscles #KetonianKing

Ketones – One of the Keys to the Fat Lock-Box

Do you have the keys to your “fat lock-box?”

Lock-boxes have always fascinated me.  Lock-boxes with special keys are even more fascinating.  The more I’ve learned about fat cells (adipocytes), the more I think about them as special fuel depositories or fat lock-boxes.  Before the invention of refrigerators, fast-food, Bisquick and beer, our bodies preserved and reserved fat as a precious commodity.

The body, when given fat with carbohydrates or excess protein, quickly places the fat into a lock-box for safe keeping.  It does this for two reasons. First, the body can store fat very efficiently. Second, hormone signals stimulate fat storage when other fuel sources (carbohydrate & protein) are present in excess. The body can access this stored fuel only when the right presentation of hormonal keys are present.  Fascinatingly, we now know from recent research, there are actually three types of lock-boxes for fat in the human body (white adipose tissue, brown adipose tissue, and tan adipose tissue).

The greatest challenge for the obesity doctor is getting into the fat lock-box.  Some people’s boxes are like the “Jack-in-the-Box” you had as a child – just add a little exercise spinning the handle and the box pops open (These are those people that say, “Oh, just eat less and exercise and you’ll lose weight.”)  For the majority of the people I see, it’s more like the lock above with a four or five part key required to turn the gears just right.  (And, that key often only seems available on a quarter moon at midnight when the temperature is 72 degrees.)  Fat cells, called adipocytes, require four, and possibly more, keys to open them up and access the fuel inside.  Exercise is only one of those keys.  However, exercise alone often fails.

Over the last 18 months, I have been surprisingly impressed with the results patients have by the addition of both medium chain triglycerides and exogenous ketones.   A number of people have asked me, “Why do you encourage the addition of exogenous ketones to a person already following a ketogenic diet?”

Others just accuse me of self promotion, saying, “You’re just trying to sell a product!”

Or they exclaim, “Giving more ketones is just a waste of time and money.”

A few of the uneducated holler from across cyberspace, “You’re just going to cause ketoacidosis!”

Believe me, I’ve heard it all.  And, the skepticism is understandable.  I work with people every day, looking closely at weight gain/loss, metabolism, cholesterol, blood pressure, inflammation, etc.  With any “low-carb” or “ketogenic product,” I test it out on myself and my family, before I offer it to my patients or even consider encouraging its use in my practice.  I have this desire to understand “the how” and “the why” before I prescribe the who and when.

The Fat Lock-Box Keys

First , let’s talk about the adipocyte as a fat lock-box – and where you find the keys. Then, we’ll discuss how products may or may not help.

Insulin

There is only one door INTO the adipocyte for the fat, and the key to that door is insulin.   Insulin stimulates an enzyme called lipoprotein lipase that essentially pulls the fat from the cholesterol molecule into the fat cell.  Without insulin, fat doesn’t enter the fat cell.  As a result, type I diabetics (those that make absolutely no insulin) look anorexic if they don’t take their needed insulin.   Insulin is also the first key to the back door on the adipocyte.  Actually, if there is too much insulin in the system, fat enters easily through the front door but cannot exit the back door (Picture 1). Insulin seals up the back door so that fat cannot exit very effectively.

That’s why insulin is the master hormone when it comes to obesity.  You’ve got to lower the over-all insulin load to get the adipocyte slowing fat entry and increasing fat exit.  If you don’t do that, I don’t care how much you exercise, 85% of the population will struggle with weight loss.  Hmmm, seems kind a familiar to the last 50 years of our obesity epidemic, No?

Stimulation Lipolysis #DocMuscles #KetonianKing
Picture 1 – Four Key Pathways to Adipocyte Stimulation of Lipolysis

Catecholamines

The second key to the back door of the fat cells are the catecholamines.  These are adrenaline (epinephrine), norepinephrine, adrenocorticotropic hormone (ACTH) and even serotonin.  These hormones are produced in the adrenal glands through exercise, fear and even recollection of powerful memories. Medications can also stimulate production of these hormones.  The catecholamines stimulate cAMP.  cAMP opens the fat cell, releasing fatty acids for fuel.

#WhereIsBaconBoy #DocMuscles #KetonianKing

The thyroid hormone conversion of T4 to T3 also plays a role in uptake of the catecholamines by adnylyl cyclase (AC).  Low levels of T3 (like those seen in hypothyroidism or in cases of thyroiditis) also inhibit unlocking of the fat lock-box.  Conversion of T4 to T3 is driven by the presence of bile salts in the gut.  Increase fat intake increases the presence of the bile salts which naturally leads to better T3 conversion.  Hence my constant references to eating more fat and bacon. .

Inflammation & Medications

The third key is an inhibitory effect on adenylyl cyclase (AC) activity by alpha and beta adrenoreceptors, adenosine, prostaglandins, neuropeptide Y, peptide YY, HM74-R & nicotinic acid.  These inhibitory and inflammatory hormones produced in the brain, gut and other areas decrease cAMP activity in the fat cell and slow fat loss.  The fancy long names are all hormones causing inflammation.  Of note, many are also stimulated by medications including blood pressure lowering drugs. Check with your doctor if the medications you are taking may be causing weight gain, or halting your weight loss.

Please note that the first three keys have effect on the cAMP pathway for release of fat from the adipocyte.  These three keys turn on or off effective function of cAMP leading release of fatty acids from the fat cell.

Naturitic Peptides

The fourth key follows a separate pathway.  This is why I’ve clinically seen patients experience weight loss even in the presence of higher insulin, inflammatory disease or hypothyroidism. This key activates release of the naturitic peptides (ANP, BNP).  These hormones are released from the heart when it squeezes more powerfully.  As the cardiac muscle contracts, it releases ANP & BNP hormones.  These hormones stimulate the cGMP pathway in the adipocyte.   It then activates hormone sensitive lipase (HSL) and perilipin to release free fatty acids.  Again, this pathway is separate from the pathway by which the first three keys released fat.   Exercise increases heart contractility, but is inhibited by high insulin levels.  However, ketones themselves also stimulate this increased contractile effect.

Hypothalamus-Pituitary-Gonadal (HPG) Axis & Testosterone

There actually is a fifth key not referenced above.  The fifth key to the fat lock-box amplifies testosterone’s presence through the HPG axis.  Insulin resistance and leptin resistance lower testosterone in men and raise it in women, causing poly-cystic ovarian syndrome (PCOS).   Normalizing insulin levels (with a ketogenic diet) while at the same time increasing ketones as the primary fuel powerfully resets the HPG axis through a complex series of hormonal reactions.  Growth hormone is balanced and testosterone returns to a normal range.

Clinically, 60% of the people I see in the office have abnormal testosterone due to insulin resistance. This leads to hypogonadism in men and PCOS (abnormal periods, facial hair growth and/or infertility) in women.  Restricting carbohydrates and maintaining nutritional ketosis by diet and/or addition of exogenous ketones has a powerful corrective factor in these people.

Testosterone influences the up-regulation of the alpha & beta adrenergic receptors (the 2nd & 3rd key above).  Hence, if your testosterone is low, it has a suppression on the way that the catecholamines influence fatty acid release from the fat cells.  If your testosterone and growth hormone are normal, muscle development and adrenaline stimulus from exercise helps amplify the use and mobilization of fat from the fat cell.  In people with insulin resistance and leptin resistance, exercise and the catecholamines don’t have the same fat burning effect.

What Does This Actually Mean?

Yes, I have greatly simplified a series of very complex hormonal pathways in the explanation of the keys above.  Why do you think understanding obesity has been so difficult?  Think of your adipocytes as a fat lock-box.

What’s even more important is the knowledge that the fat cell DOES NOT open or close because of calories.  There is no dogmatic calorie-meter on the wall of the fat cell.  There is no calorie key to the fat lock-box.  Really, . . . in the 50 years of studying fat, researchers haven’t found one.  (Prove me wrong when you show me an electron micro-graph of a calorie-meter in the wall of a cell).  Science has demonstrated multiple times that the lack of food from starvation or excessive fasting suppresses thyroid function (an inhibitory effect on key #3).  Restricting calories actually inhibits fat loss in many people.

The fat lock-box keys I refer to above are hormone responses to the presence of macro-nutrients (food).  That means, first reduce your carbohydrate intake by eating real food from good sources. You can learn how to get started by registering for my FREE six part weight loss mini-course.  Second, be as active as you can. Third, reduce stress and medications that have inhibitory effect on catacholamines. Fourth, balance your thyroid. And, fifth, get into ketosis and consider adding exogenous ketones to your dietary regimen.  It really is that simple.

References

(For those of you that still believe there is a calorie key – or just need something to do while in the bathroom):

  1. Lafontan et al. Arterioscler Thromb Vasc Biol. 2005
  2. Lenard NR, Obesity, 2008
  3. Li XF et al, Endo (April 2004) Vol 145
  4. Liu YY& Brent GA, Trends Endocrinol Metab. 2010 Mar; 21(3): 166–173
  5. Max Lafontan et al. Arterioscler Thromb Vasc Biol. 2005;25:2032-2042
  6. Skorupskaite K et al, Hum Rep Update, Mar 2014, vol 20

Why Be In Ketosis – Part XII (Thyroid)

There is a pattern that I’ve noticed on every live-stream that I’ve appeared on talking about ketosis that someone always asks the question: “What about the thyroid?”  That’s literally how it’s asked. . . someone I am unfamiliar with keys in the question, “What about the thyroid?”

The blunt sarcastic response in my head is usually, “Well, what about it?”

Buried within the vague periscope or twitter question above is the real question that is on the minds of thousands of people,  “Does ketosis effect the thyroid . . . ?”

There’s loads of information about the thyroid on the internet.  Much of it is garbage.   Seriously.  Ask Google about “thyroid,” and you’ll see thousands of articles, posts and comments on WebMD, Women’s Health, and Wikipedia all across the “interwebby.”  Everyone, and I mean everyone, seems to have a “thyroid opinion.”  Much of the “wikopinion” out there is here-say, conjecture and anecdotal. It doesn’t really give people any foundational understanding of what their thyroid is doing, or more importantly for that matter – what their thyroid isn’t doing.

Of late, the Paleo and Vegetarian thought leaders seem to decry nutritional ketosis because they claim that this dietary approach suppresses thyroid function. This wiki-theory (yes, it is just a theory) was extrapolated from a single study where the T4 level dropped in the first few weeks after ketosis was entered.  But just because T4 drops, doesn’t mean the diet suppresses the thyroid.  Using T4 as a screening test alone for assessment of thyroid function is 1987 thinking (1987 brought us the Kia Concord and the Subaru Justy just so you get the mental picture).  T4 fluctuates with a number of binding proteins and following this number alone is really bad medicine.  Taking thyroid advise from the Paleo people is like asking your Fed Ex driver about the correct lift on your 4×4 truck.  Really?

Excessive insulin, the hormone produced when you eat sugar, starch and some proteins, actually stimulates thyroid peroxidase antibodies and can cause exacerbation of thyroiditis (causing over-production or under-production of thyroid hormone).  Because 85% of the people I see in my office over-produce insulin (this is referred to as insulin-resistance), in response to starches, there is a significant flux in thyroid function due to  this pre-diabetes state (insulin over-production) on high carbohydrate based diets.

Leptin, the hormone produced by fats cells when they are “full,” actually stimulates the conversion of T4 to T3.  At least 40% of my obese, insulin-resistant patients are also leptin-resistant, meaning they over-produce leptin as well.  This has a suppression effect on T4 (by converting it to T3) and is the usual cause of the T4 levels being lower when initially staring a ketogenic diet.  It is also the reason that some people feel anxious or “activated” when changing to nutritional ketosis.  Leptin-resistance is driven by a high level of fructose in the diet and the presence of high triglycerides, inhibiting the leptin signal from crossing the blood-brain barrier.  As a person follows a ketogenic diet and lifestyle, leptin returns to normal over 3-6 months and T4 levels normalize.  The Paleo and Vegetarian nay-sayers never mention that . . . do they?  What they won’t tell you is that calorie restriction, which is a must for weight loss, on the DASH, Mediterranean, Paleo or Vegetarian diet causes suppression of testosterone, leucine, and thyroid function, causing worsening T4 suppression over time.  Hmmm . . .  put that in your low-fat green vegetarian taco, and smoke it.

Wait . . . I don’t advocate smoking so, ignore that.

The point is, a ketogenic lifestyle stabilizes thyroid function and improves auto-immune thyroiditis. I’ve seen it happen clinically for over 12 years.  It, also, dramatically helps stabilize the other 30 hormones involved with the diseases of civilization including obesity, insulin resistance and diabetes.

Watch my live-stream recording below to find out more about the thyroid.