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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.

Ketogenic Rule #7: Abs are Made in the Kitchen – Not the Gym

Abs female Abs made in kitchen

“Doc, how do I get six-pack abs?”

I get this question almost daily. Sorry to burst your bubble, but there is NO exercise program that will give you “six-pack” abs.

Really.  You can do sit-ups, leg lifts and crunches ’till the cows come home and it will do nothing other than give you abdominal cramps.  It will also make you hungry.  I don’t care what Men’s Fitness, Bodybuilding.com, Muscle Magazine, Shape or even Doctor Oz said. There are no “6 Best Exercises for Ripped Abs.”  There is only one exercise . . . throwing the carbs in the trash (or giving them to the neighbor you don’t like.)

The “12 Step Ab Program” really only has ONE STEP . . . cut the carbs.  Let me repeat that.  There is only ONE STEP to “six-pack abs,” . . . cut the carbs.  Cardiovascular exercise does nothing for amazingly toned abdominal muscles, other than make you hungry.   Resistance exercise improves insulin resistance, but doesn’t build the abs.  Avoiding the milk, rice, wheat, oatmeal and fruit allows the abs to appear.  Yes, I’m serious.  What do bears eat? Berries.

When did you last see the a bear with “six-pack abs?”

The only way to see your “six-pack” is to remove the fat covering your “six-pack.”  The only way to get rid of fat covering your “six-pack” is to stop drinking it and lower the carbohydrate content to less than 20 grams per day.  Seriously . . .

So you’ve done 100 crunches a day for six months?  Do you see your “six-pack” now?  Exactly.

I’ve said it before and I’ll say it again.  Insanity is doing the same thing over and over and expecting a different result.

Follow the principles outlined in my past articles like The Principle Based Ketogenic Lifestyle . . . Part I & Ketogenic Principles . . . Part II and make sure you are avoiding Common Ketosis Killers.

KetoOS
KetoOS – Drinkable Exogenous Ketones

Staying in ketosis and adding 2-3 days of resistance training will melt 2-5 lbs of abdominal fat away each month.   Yes, I know it is slow . . . but that is weight (fat) that will stay off.  Use whole foods high in fat, moderate in protein and low in carbohydrate.  Use supplements like Keto//OS & Adapt bars to help when you don’t have access to a good meal or as a snack when you are hungry.  Look at the list of Low Carb Links above to get great ideas for meal preparation and sweeteners that you can use.

 

Adapt Your Life

 

 

Paradoxical Effect of Fire & Fat (Ketogenic Rule #4): Why it only takes one match to start a forest fire, but the whole box to start a campfire

 

Start a fire with one match is like Ketosis

It’s been cold this winter and as I was lighting a fire in the fireplace, a thought crossed my mind.

Why is it that only one match seems to start a forest fire, but it takes the whole box to start a campfire? 

So, thinking back to my Boy Scout days, I began walking through the process of what it takes to get a good warm fire going.  As a Boy Scout while camping in the snow, we used to have contests to see who could, using a single match, start the fastest camp fire.  (We would use our most “MacGyver-like” skills). It occurred to me that the same timeless principles that allow one to ignite a fire with a single match are the same principles necessary for “fat burning.”

Maintaining ketosis is much like starting a campfire.  There are some basic principles you need to understand.  First, too much fuel keeps the fire from starting and too much carbohydrate or too much protein keeps the body from shifting into ketosis.  Starting a campfire with a single match requires very fine thin strands of tinder to get started.  If the peices are too big, the fire is smothered and cannot get started. It is the same with ketosis.  Too much carbohydrate or protein smothers ketosis.  You can get a copy of my ketogenic diet through registration on my membership site, by seeing me a patient face to face in the office or through a Tele-Medicine visit.

Tinder wood fire

Second, oxygen is essential.  For a fire to start, the flame needs a very small piece of fuel (wood or dryer lint) and large amounts of oxygen to burn. In ketosis, you have to provide the fat.  If you’ve removed the carbohydrates and moderated the protein, but not provided enough fat to ignite the ketones, the body thinks it is starving, produces stress and shifts into making it’s own form of glucose for fuel through the process of glyconeogenesis (see my articles on why chicken salad makes you fat, and why your oatmeal is killing your libido).

blow on the tinder


Third, campfires often don’t have enough heat to get started. You have to get the temperature up before the wood can catch fire. This can be done in the camp fire by making a “cabin” the tinder can sit on and then building the “cabin” around the tinder as the fire builds and the heat increases. The increased heat and oxygen from under the tinder allows the larger pieces of wood to ignite and stay lit.  In a ketogenic diet, the use of real food is similar to the cabin.  Providing real food sources, instead of processed shakes and bars, allows for all the natural vitamins and minerals to let the ketosis start and ramp the metabolism up.  Providing the correct vitamins also allows for the metabolism to have the ability to ramp up ketosis.  I designed the KetoEnhance Vitamin specifically for this reason.

log cabin firestart

So, there you have it, the Paradoxical Effect of Fire and of Fat.

  1. Don’t use too much fuel: Start with tinder for the fire – Limit the carbohydrates and moderate your protein (see how to balance protein here) to get into ketosis
  2. Provide for increased oxygen for a fire – Provide adequate fat for ketosis
  3. Provide a setting where the heat can build for a fire – Provide real food and appropriate vitamin sources for optimized metabolism in a ketogenic lifestyle.
KetoOS
KetoOS – Drinkable Exogenous Ketones

You can see today’s Periscope discussion on this topic below:

What Are Your Biggest Weight Loss Struggles?

Join Dr. Nally on this evening’s Periscope as we talk about your biggest weight loss struggles in rapid fire style.  We cover topics this evening from the effects of cheating on a ketogenic diet to how to overcome a weight loss stall . . . join us to hear the whole conversation.

Thinking Outside of the Box

Nine dots

The image above has nine dots within a square.  Your task, using only four lines is to connect ALL nine dots WITHOUT ever raising your pen, pencil or finger (Please don’t use a sharpie on your computer screen . . . it doesn’t come off).

You may have seen this puzzle previously . . . it’s made its rounds in corporate training circles. But the underlying principle remains true.  The solution requires you to expand your thinking or to “think outside the box.”out-of-the-box

Whenever you find yourself on the side of the majority, it is time to pause and reflect. (Mark Twain)

Why should we limit ourselves to thinking outside the box.  Can’t we just get rid of the box?

True discovery consists in seeing what everyone has seen . . . then, thinking what no one has thought.

The answer can be found when those four lines are used beyond the box our mind creates:

Nine dots solution

What good has the box done us?  People were burned at the stake because they refused to believe the Earth was not the center of the universe. People were beheaded because they had a sneaking suspicion that the world was not flat.

Why is it so very hard to accept that our weight gain and diabetes are driven by a hormonal signal, and not by gluttony or caloric intake of fat?  The definition of insanity is doing the same thing repetitively and expecting a different outcome.  How long have you been restricting calories and fat with only minimal or no improvement in your weight, blood sugar, cholesterol or general feeling of health?diabetes global warming

The main problem with the current thought model, or dogma, on the obesity’s cause is that it does not account for metabolic syndrome.  Metabolic syndrome is insulin resistance.  It is an over production of insulin in the presence of ANY form of carbohydrate (sugar or starch).

In the practice of medicine over the last 15 years, I noticed that a very interesting pattern emerged.  There was always a spike in fasting and postprandial insulin levels 5-10 years prior to the first abnormal fasting and postprandial blood sugars.  These patients were exercising regularly and eating a diet low in fat.  But they saw continued weight gain and progressed down the path of metabolic syndrome.  10-15 years later, they fall into the classification of type II diabetes.  What I now lovingly refer to as stage IV insulin resistance.

The only thing that seems to halt this progressive process with any degree of success is carbohydrate restriction.  Fasting insulin levels return to normal, weight falls off, and the diseases of civilizations seem to disappear as insidiously as they arose.

So you tell me, is the world flat?  Is the Earth the center of the universe?

Low-carb is bad

What is a low carbohydrate or ketogenic diet?  15 years of practical in the trenches experience have helped me develop a very simple program to help you lose and maintain your weight.  Access to this program, video help and access to blog articles at your fingertips are offered through my online membership site.

You can also hear me each week a I discuss low carbohydrate, paleolithic and ketogenic diets with the Legendary Jimmy Moore on KetoTalk.com