Do You Have Keto Confusion?
Do you have keto confusion? Carb confusion?
Diets are “hot” in the U.S. and the current trend is definitely “Up with Keto” and “Down with Carbs”. What if I told you I like keto and I like carbs, AND keto is dangerous and carbs can kill you? Does that sound crazy or just indecisive?
Actually it’s neither – it’s just science. Science may not be sexy. Science isn’t the “cool” and current fad – it’s just science. You see, while I love my field of nutrition, functional medicine, or what we have coined Root Cause Medicine, I dislike the rapidity with which Americans swing to extremes and jump on diet fads.
All you need is a celebrity you like to tell you to eat “X” to lose 20 pounds (because that’s what they did), and you’re hooked!
All I want to say is “not so fast”- let’s take a moment to look at some truth, some sanity, and some basics that will really keep your body healthy.
Because with all the hype and all the fads, the real goal, the true desire, is simple – You want to be healthy. You want to feel great. We want to help you to get there.
Carbs are both good and bad. Why?
Sugar and refined carbohydrates, like store-bought desserts, bread, white pasta, muffins, crackers – BAD carb! No one in my field thinks sugar or refined carbohydrates are good for anyone. I don’t care if they’re vegan, paleo, keto or something in between – we ALL agree on this point.
Ok, now let’s go to another point of agreement: vegetables, and fruits, are carbohydrates too – GOOD carb! Dark green leafy vegetables such as kale and spinach, the cruciferous vegetables such as cauliflower and broccoli, cabbage and Brussels sprouts, these are all carbohydrates. Almost no one is going to argue against the benefits of such vegetables.
Let’s leave fresh fruit, although berries are extremely healthful, and legumes to the side for a moment, and ask why we might need to eat the RIGHT kinds of carbohydrates.
Your Gut Health and Carbs
As you likely have heard, you gut bacteria, known as your microbiome, has 10 times more organisms in it than you have cells in your body. The current estimate is 100 trillion organisms.
What do these organisms eat? Carbohydrates, primarily in the form of fiber, which is why we aren’t talking about simple carbohydrates being any good for you.
A recent interview with the highly respected and ketogenic advocate, Dr David Perlmutter, had him quoted as saying the following:
“We have “carbohydrate confusion” and we desperately, desperately need to eat carbs.” [yes, he said “desperately” twice.]
He went on to state: “Those who adopt a ketogenic diet and abandon carbs tend to:
- Feel crappy
- Become constipated
- Don’t sleep well
- Become agitated.”
Dr David Perlmutter, keto advocate, gives this advice:
“Those promoting ketogenic diets have failed to understand that we need to eat carbs. We desperately need fiber, complex carbohydrates that we don’t metabolize, but are metabolized by our gut bacteria.”
“100 trillion organisms depend on your food choices to nurture them. They help you to combat the risk of illness.”
But isn’t Dr Perlmutter a promoter of a ketogenic diet? Yes he is, but he’s a smart, caring doctor, a genius in fact, and he sees that the ketogenic diet has gotten misinterpreted and people are making big mistakes in their efforts to follow it.
All Carbs are NOT bad; only some are
Chief amongst these mistakes is thinking that all carbs are “bad”. Some people have gone to the extreme of the carnivore diet – eating only and exclusively meat.
Dr Perlmutter had some comments about this as well:
He said: “you need high fiber [carbs] and good fat in your diet and not a lot of protein”. He noted that in the China Study the author Dr Campbell correlates red meat and colorectal cancer.
Dr Perlmuter went on to say: “red meat is one of the most dangerous foods on the planet”. He stipulated that occasional red meat eaten, provided it’s grass fed is okay, but “the more plant-based your diet the better off you’ll be.”
Dave Asprey, keto promoter, clarifies “plant-based diet” promotion
He was being interviewed by Dave Asprey, another keto fan and a fairly staunch “anti-vegan”. Dave pressed Dr Perlmutter, asking him to clarify that he wasn’t recommending veganism. Dr Perlmutter acquiesced that he wasn’t eschewing ALL meat, but again made the point that “the more plant-based your diet the better off you’ll be.”
Does this make Dr Perlmutter a “traitor” to the keto cause? Of course not. We get way too competitive about these things. He’s just a smart doctor who is clarifying what he believes to be a very healthy diet.
How a ketogenic diet with high protein can raise your blood sugar
Dr. Perlmutter also pointed out some basic science that I have mentioned on my YouTube channel and in earlier blogs. It’s one of those counterintuitive “things” the human body does – it’s no wonder it’s met with confusion and disbelief by the lay public.
If you’re avoiding all carbs and eating a lot of meat, it can not only be detrimental to getting or staying in ketosis, but it can raise your blood sugar.
How can that possibly occur? Increased amino acid levels from eating a lot of meat can be reassembled in your liver. The process is called gluconeogenesis, whereby your liver makes more/new sugar when you’re eating a high protein diet.
A high animal protein diet increases aging and cancer risk
A high animal protein diet also stimulates the mTOR pathway, which when elevated can cause growth, specifically of cancer cells, while simultaneously speeding us along the highway of aging, leading to premature cell death and mitochondrial (cell energy) failure.
You definitely do not want a lot of mTOR stimulation. You can learn more about mTOR in this blog.
The type of ketosis we recommend
There’s daily ketosis we recommend in the form of a 12 hour fast. It’s fairly easy to do because you’re sleeping most of the time. If you eat your last meal at 8 p.m., you simply need to wait until 8 a.m. to break your fast. Why not go longer, say 14 to 16 hours as many promote? Dr Valter Longo, author of The Longevity Diet, and expert on anti-aging warns against fasting more than 12-13 hours in any given day.
Skipping breakfast is associated with a higher risk of gall bladder disease and elongated fasting times are also associated with heart disease and a shorter lifespan. For those reasons we stick with the 12 hour recommendation for our patients.
There’s monthly, bi-monthly or quarterly ketosis recommendations for those whose health is being compromised by obesity, heart disease, diabetes and autoimmune diseases.
These individuals are recommended to follow a 5 day fasting mimicking diet which gets your body into a longer period of ketosis, followed by autophagy. I discuss this in more detail in this blog.
How do you achieve health and a long life?
Eat a diet with lots of carbs (just not the simple carbs), high fiber, fish 1-2x/week, very little to no meat, eggs or cheese, and protein from mostly plants.
Basically, conforming to a whole food plant-based with animal protein 1-2x/week from fish and only occasional other sources of animal protein is what’s recommended by research I trust.
The science doesn’t lie, and more and more keto promoters are clarifying how to enjoy the benefits of ketosis without the dangers of zero carbs or high animal protein.
Dr Perlmutter ended the interview with these “Broad stroke recommendations”:
- Cut down simple carbs
- Understand net carbs
- Eat a lot of healthy fiber
- Get good dietary fat
- Avoid protein from meat
- Sleep – 8 hours seems to be a “sweet spot” for most
- Exercise – we’re too sedentary and we need aerobic and resistance exercise.
Guess what? I completely agree!
The “fences” and “walls” we erect to create camps such as the vegan camp, the keto camp, the paleo camp, etc, are just plain unnecessary. The promotion of such “camps” doesn’t have your best interest at heart and as clinicians, it tends to limit our ability to help.
The bottom line is that your best health and your family’s best health is what we’re all trying to accomplish, nothing more.
The only label we use is Root Cause Medicine
We create personalized programs to identify and address the underlying root cause of your health problems.
Is your problem a food related one? Digestive imbalance? Immune weakness? Hormonal? Structural? Genetic?
Whatever it is, we do it all here at Root Cause. We don’t “hobby-horse” a particular diet, food, or supplement company. We discover what is compromising your health and assist in the removal of any burdens or stressors while allowing your body to heal.
We’re all pretty unique in how we got to our current health status, which is why it’s important to have many tools. As a team of doctors we have many tests and tools at our disposal and we utilize those appropriate to you and your condition.
Are you ready to get healthy?
We’re ready too.
Contact us for a Free Consultation – Call (408) 733-0400.
If you are not local to us you can still receive help; our Destination Clinic treats patients from across the country and internationally.
We help the world’s busiest people regain, retain and reclaim their health, energy and resilience.
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To reclaiming your best health,
Dr. Vikki Petersen DC, CCN
Certified Functional Medicine Practitioner
Founder of Root Cause Medical Clinic
Author of “The Gluten Effect”
Author of the e-Books:
- “Gluten: What You Don’t Know May Be Killing You”
- “5 Simple Ways to Regain Your Health”
- “Hiatal Hernia, Many Symptoms, One Cause”