What if your doctor told you to eat more fat?
That day might come sooner than you think.
In the scientific community, “High-fat” ketogenic diets are suddenly in vogue. The ketogenic diet is being studied for its potential to treat Epilepsy, Multiple Sclerosis, and even Alzheimer’s.
Today we’re here with a pioneering female scientist, Dr. Mithu Storoni, who eats a diet of 70+% fat! You’re about to learn the surprising reasons why.
On this show with Dr. Mithu Storoni, we’ll explore:
- How a ketogenic diet can prevent (and heal) neurodegeneration
- Why a healthy female scientist would suddenly cut carbs and eat more fat
- Why eating a jar of almond butter is bad for your brain
- How to avoid common low-carb mistakes
- Why cutting back on fruit might do the body good
- And much more…
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Please note: Mithu is sharing her insight for the purposes of discussion only and would like to remind everyone to consult their physician before making any changes to their diet, lifestyle, or medications.
MITHU STORONI: EAT FAT, IT’S BRAIN FOOD
Abel: Today we’re here with a bona fide fat-burning woman.
Dr. Mithu Storoni has been following a ketogenic diet since 2014. She recently co-wrote a pioneering paper that utilizes a Ketogenic Diet for treatment of Multiple Sclerosis. Mithu holds a medical degree from the University of Cambridge, a PhD in Neuro-ophthalmology.
Mithu is also a yoga instructor, avid Matcha drinker, Japan-lover and is always looking for new ways to reprogram her brain.
Joining us from across the world in Hong Kong, thanks so much for being here, Mithu.
You may be preaching to the choir, but why are you so in love with fat?
For years, nutrition was regulated, set in a way, and we never shifted from the pattern. We didn’t question anti-fat recommendations.
We’ve come to a point now in science and medicine where we’re forced to reexamine everything, partially because of some accidental results of studies and partly because certain studies were buried for a long time.
We have incredible brain scans that show positive results we’d never imagined could come from eating fat. These studies demonstrate that fat is incredibly important for us and not the villain we once assumed it was.
Abel: For years, avoiding fat was the ONE thing you absolutely had to do to maintain a healthy diet.
That’s right. I spent a lot of my life, especially when I was younger, being very careful about avoiding fat. I had a diet based on carbs.
As a population, we always want to do the best and go by the data we have to form the best judgment. We want one villain and one good ingredient.
The studies from the Post Second World War pointed to fat as the villain. That’s what the studies we were shown led us to believe.
Now we’ve progressed so much and seen what 50 years of a low-fat diet has done. We have more studies, and as scientists, you should always recalibrate as you go along.
Abel: Science is starting to show surprising benefits of a ketogenic diet. A ketogenic diet has been used for a nearly a century to treat epilepsy, but new research shows its therapeutic benefits for a number of conditions.
Hippocrates used starvation to treat epilepsy. And at the start of the last century, the ketogenic diet was used to treat epilepsy. With the advent of medication, it became far less popular because it’s easier to prescribe a child something than to them what to eat.
The diets at the time were very strict and didn’t allow for the flexibility that a ketogenic diet allows today. Some diets during that time produced negative effects.
Then there was the introduction of The Atkins’ diet, which isn’t strictly ketogenic, but can be. Several papers in literature of people following Atkins showed that their migraines and epilepsy improved. So we have to look at that.
Suddenly the floodgates are opening and we’re noticing all these observational case studies, and that’s bringing our attention back.
THE SCIENCE BEHIND THE KETOGENIC DIET
Abel: When you consider multiple sclerosis, most treatment options aren’t as simple as eating fat and staying away from glucose. But in reading your paper, you can see the power of nutrition to reprogram the way our bodies and brains operate.
What are the long term implications of eating ketogenic?
MS (multiple sclerosis) is a condition that has baffled us for a long time. Its variances have merged over the years—there really is very broad spectrum. We’re usually focused on treating the inflammation associated with MS.
With multiple sclerosis, immune cells attack the nervous system. You have a barrier between your brain and your body’s blood supply. If that barrier breaks, the immune cells from your body can get to your brain. That’s part of the process of getting acute inflammatory episodes when you have MS.
If you look at the retina of people with MS, it’s thinner and progressively gets thinner. You can do imagery in the brain showing there’s something going on apart from inflammation—there’s neurodegeneration, similar to Alzheimer’s.
The fact that both of these exist is very interesting. We used to focus on calming the inflammation that gives patients acute attacks. Medication has been useful for that. There are patients that still progress, and when they do, we notice neurodegeneration. That’s where the ketogenic diet’s potential comes in.
What causes the neurodegeneration of Alzheimer’s and aging? No matter how confident we feel, there are going to be many things we don’t know. But we’re coming closer to understanding that neurodegeneration is related to mitochondria failing. When they fail, the energy supply of the brain cell is compromised.
We know that you have brain cells, neurons, and you also have supporting cells known as astrocytes, which are like the scaffolding. You also have microglia, which are inflammatory cells. Astrocytes provide the brain with lactate for nutrition—and we’ve also discovered a lactate shuttle. When the energy supply of brain cells becomes compromised, if you continue to supply glucose, you get an even more negative result than if you give nothing at all.
If glucose uptake is compromised, if there’s mitochondrial damage, or if there’s reduced glucose use by the grain (as in MS and Alzheimer’s)… if you give the brain glucose and you’re not going to use it, you need another fuel supply. That’s where ketones come in.
If you give your brain ketones when the mechanism used to process glucose becomes impaired, then the brain cells survive.
Let’s look at lesions of the brain in MS, or glaucoma, which is a disease of the eye where neurons are affected. If you have a brain cell with good healthy mitochondria that are getting a good energy supply, it can withstand heaps of damage and attack. If your brain cells are neurodegenerating, struggling, they are under attack. In that situation, if you give them glucose you are far less likely to help them than if you give them an alternative energy supply such as ketones.
Abel: So if you’re feeding your brain glucose, it’s like pouring gas on the fire.
That’s right.
Recent research has brought astrocytes into the forefront. We’ve always focused on neurons. We’ve assumed astrocytes had a role, but it turns out they supply neurons with lactate… but also have several other important functions such as clearing away glutamate.
Glutamate excites cells. We use it in our prefrontal cortex where pyramidal cells signal using glutamate. It’s great when we need it, but it excites cells, so we need to clear it away the moment there is too much of it. If we leave too much glutamate around, the cells are too excited and fall down dead. Not literally. It’s called excited toxicity. Lots of mechanisms are triggered and the neurons suffer.
The astrocyte, the second type of cell, clears away glutamate. One of the recent observations with sugar is that hypoglycemia prevents astrocytes from clearing away glutamate levels.
In a neurodegenerative brain, or simply an aging brain, if you have a lot of glutamate there, if you have astrocytes damaged, if you have neurons damaged, if there’s a lot of glucose around and you’re feeding the brain sugar, you’re fueling the fire.
With Alzheimer’s disease, there is definite reduction in the brain’s ability to use glucose. This is demonstrated beautifully in a special type of scan called an FDG scan by several groups, and it’s not something that anyone would dispute at the moment. This is why there are some early reports of coconut oil helping people with Alzheimer’s from MCT content, which breaks into ketones. That’s been proven.
But when does it begin? And is it the glucose problem that actually causes the Alzheimer’s? That is the most exciting point to study.
There’s a team in California looking at female aging brains, and I know that in rats it was discovered that as soon as rats hit menopause, even if they don’t have Alzheimer’s, the ability to use glucose plummets. If this also happens in humans, does it mean in 20 or 30 years time it’s predictive of us all developing some degree of dementia?
There is an inherited mitochondrial condition resulting in blindness affecting young men. In that condition, it takes about 20 years from birth to blindness. There’s another analogy—if you look at people predisposed to Alzheimer’s, when they’re around 40 and 50 (they’re still healthy and young), they have more declined ability to use glucose at that age compared to people who don’t develop Alzheimer’s.
Glucose may be one of the epigenetic triggers of Alzheimer's. @StoroniMithu Share on XAbel: You went ketogenic in 2014. What was the biggest reason and what did you experience?
I was looking at the literature of neurodegeneration. It’s such a frustrating area. There is really no treatment and it’s a huge burden for the western world and beyond. It’s now coming into Asia quite significantly.
Then I saw all the papers on how we can actually hack into the biochemistry of our cells, the mitochondria function, the gluconic function. And what I saw really convinced me on a biochemical level.
I was pretty fit and well, but I thought, “Why not try it? It’s whacky and crazy, but what’s the worst that could happen?”
In my head, I thought I’d try it for three months. And I have a very tolerant husband, all our ingredients have to be slightly changed. After three months, I really felt amazing.
I felt calmer. I didn’t have fluctuating stress levels. I felt my head was clearer. Some of them probably have a placebo affect, but I really felt so good that I wasn’t going to stop. Then I looked into it more, and the more I did, the more fascinated I became by it. I was so impressed by the research results from all the teams working on this around the world.
I thought, my brain is really important to me… why not?
HOW TO START EATING FAT
Abel: When I first researched the benefits attributed to fueling the brain with fat, I thought “Whatever, that sounds totally whacky!”
But then my personality actually changed.
Once I started fueling primarily with fat instead of carbs, and my brain became fat adapted, my mood and temperament transformed. I suddenly felt clear and balanced, without cravings and lags and energy throughout the day.
Fueling with fat isn’t the jittery energy you might get from too much caffeine.
You feel very balanced as long as you’re eating enough… Eating enough calories can be one of the challenges of starting a ketogenic diet since it tends to suppress hunger.
What else surprised you about the ketogenic diet?
It was an experiment on myself. I could be as crazy as I wanted to.
I started off measuring my visceral fat level and got my body fat and other areas tested. My diet before was pretty healthy: Proteins, a lot of vegetables, huge amount of fruit. Mangoes are my weakness.
When I started doing this diet, the first thing that went was the fruit. When I followed keto very specifically, I started mapping my macros. How can I get my fat up? Protein became difficult to measure because I was probably eating more protein than would put me into ketosis in initial stages. In order to buffer that, I made sure a lot of my fat came from coconut oil, like MCTs. You can stay in ketosis even if you go a little higher in protein.
Coconut oil became my staple. The studies I read on what happens to the different types of fat on a ketogenic diet. We know a ketogenic diet and ketosis are beneficial, but we don’t want to fall into the danger of saying if something is good, it’s good in all its forms. There might be some things in it we can do a little bit better.
With fat, the longer-chain the saturated fat is, the slightly more likely it is to lead to inflammation if it’s ingested alone. Most of the studies we’ve done on a high fat diet we’ve done using palmitic acid. We do need palmitate and our body produces it, and most of the fat in our body is stored as palmitate. But when we eat palmitate, when it goes through our intestine, it causes inflammation.
If you eat only palmitate on a keto diet, it’s going to be causing inflammation. But if you eat other fats, it can balance out.
I started off eating quite a lot of longer chain fats in the form of a huge amount of cheese, for instance. But even with cheese, you can be selective about which cheese you choose. Some types have less than others. The oleate ratio is higher in some types of cheese than others, and that can balance out.
I was eating a lot of almond butter, which is good in some portion, but you have the Omega-6 to Omega-3 ratios to think about. Vegetarians can increase inflammation and risk of cancer by not watching their omega-6 to omega-3 ratio.
I also liked pecans. Pecan nuts and cheese and nothing else is not a good idea.
I started switching that, looking more at my fatty fish and omega-3 intake. I moved nuts as well to reduce omega-6s. I shifted my fats to medium-chain, and increased my fiber intake… but not through eating resistant starch in the form of fruit and starchy vegetables, but through leafy greens.
Abel: When you look at scientific research, the ketogenic diet isn’t well-defined. You could be feeding a rat 100% corn oil, or feeding them nothing, in which case your body starts breaking down muscles and so forth.
I hope future research addresses a balanced keto diet. What do you consider balanced?
The honest answer is that I still don’t know for sure.
My first priority would be to make sure the fats are balanced. Stay away from the long chain fatty acids as much as possible, bearing in mind we need some and that our body already has some.
Having a lot of mono-unsaturated fatty acids, such as is what’s found in a mediterranean diet, is good. Primary cardiovascular markers show that a mediterranean ketogenic diet which has lots of monounsaturated fats has very beneficial effects on inflammation and other conditions.
Eat more avocados, olive oil, olives, macadamia nuts… everything that tastes good!
Omega-3s mitigate some of the inflammation from longer chain fatty acids. And then add coconut oil, or MCT oil. The reason I find coconut oil fascinating is because of the emerging research regarding it’s use. There’s been studies of adding coconut oil to existing inflammatory oils and that inflammation is reduced.
Also the production of MCT’s means there isn’t as great of a production of chylomicrons, these are the packages in which long-chain fats have to be put to move from the intestine. Coconut oil is a good thing to include in a ketogenic diet.
One of the people I admire greatly, Dr. Terry Wahls. In her diet, which she used to overcome MS, is the inclusion of lots and lots of colors of vegetables. That’s also really important.
Lastly, I think that one point which many of us seem to miss, especially if we’re not as athletic as you are (many of us are more sedentary), a ketogenic diet is most effective if you restrict your calories to as much as you need and not much more.
If you overfeed on a high fat diet, you will store fat. Eating to excess is not a good idea. That brings me full circle to the way in which we are designed. Is it really that eating fat is the principle thing, or is restricting your calories and avoiding carbohydrates the combination that matters? If you restrict calories and cut carbs you will end up in ketosis assuming your protein isn’t too high.
In the past we were designed to live in a fasting feeding mode, and the fasting intervals are what we don’t have any more. Is it really elimination of sugar and fasting that puts us into ketosis?
THE KETOGENIC DIET FOR WOMEN
Abel: There’s the secret to longevity and health: make sure you’re not overeating.
Restrict glucose or spikes in glucose—like when you eat a bagel or donut or a bunch of bread, which makes up the majority of our diets these days. 68% of our food in America is processed – and most of that is junk carbs.
This isn’t about eating a TON of butter, bacon, and coconut oil. It’s about letting your body become fat adapted so you’re finally off the sugar rollercoaster.
For most people, it’s harder to overeat fat and protein than carbs and sugar. Some people do struggle to burn fat, especially at the beginning.
When some women go low carb, they run into problems. What’s the best way to go low-carb for women?
From my personal experience, when you start on this kind of diet, get everything checked. Get a full blood screen. Often, if you’re young and healthy there are things that haven’t been flagged that will be when you start on a diet. I should also say it should always be done under strict surveillance by someone who knows what they’re doing.
As a female, you need to keep your calories right when you begin. When you drastically cut down on carbs and increase fat, your appetite goes. At least mine went. When there’s drastic weight loss, regardless of where it comes from, you do get some hormonal implications from that. In terms of women, there are reports of polycystic ovaries being resolved or improved following a keto diet. And it has an antiinflammatory effect.
Getting supervision, keeping your calories constant, making sure all micronutrients are coming in. If you’re eating a huge amount of fat (you shouldn’t need to), many people find it difficult to absorb what they’re eating and end up with micronutrient deficiencies.
If you’re eating jars of almond butter, you’re probably not absorbing your iron, zinc, and many essential minerals. Your thyroid needs them. Your body needs them.
Make the diet as mediterranean in style as possible. Sometimes when I’m eating at a restaurant, what I eat may not seem remarkable to the people I’m dining with because essentially it involves lots of leafy greens, heaps of olive oil, avocadoes, seafood, chicken, it’s the standard diet without anything odd about it. I’m not putting a cup of butter on my food.
I just try to stick to: 70% fat, 20% protein, 10% carb ratio. Focus on that rather than too much fat, that helps you avoid the pitfalls.
Abel: How do you know how much food to eat if you’re not counting calories?
This ties into my interest in stress. We live in a world where everything is instant. We are losing our ability to rely on delayed gratification. Food is one of the prime examples of it.
My old habit was, in the morning I’d wake up go to Starbucks grab a bagel and coffee. You have the bagel and you get a high, you have that coffee and your eyes flip open. You’ve had that signal that you’ve had breakfast.
No matter how many raw pumpkin seeds you have, you won’t get that signal.
As I hope most people know by now, if you have a large carb load you get that spike, it crashes, and then you suddenly feel hungry. In a ketogenic diet, that completely went away for me.
Just like you, I have very good control over my appetite. Everything, including food, is used to trap us. To attract our attention. To entertain us during the day. You wake up and go to work and walk past coffee shops—there’s a sign on my street telling me there are masses of donuts at the bottom of some stairs.
This whole society is saying we want something now, want a signal now. It has become so ingrained in our world. We are not prepared to cook or think of the consequences of what we are eating.
With the ketogenic diet, you’re not just drawn to the food signal. You can think. You can plan. You can do well. That keeps you in such a calm state of mind, and you can apply that to other things.
WHERE TO FIND DR. MITHU STORONI
I’m working on a book called The Resilient Brain, it’s on stress and the scientific ways you can use to make your brain and yourself resilient to stress.
I also have a fun blog which you can check out in the meantime: www.brainboostcamp.com. And you can find me on twitter @StoroniMithu.
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Do you fuel with fat? How does it make your brain feel? Let us know in the comments below.
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The inflammation she talks about coming from saturated fat, could that be due to grain fed animals and their high omega six? If she studied the saturated fat with only 100% Grass fed beef and or wild king salmon perhaps there would be no saturated fat inflammation problem?
This is a great point, Sky. Future research needs to focus on real food fats – there’s a massive difference between extra-virgin olive oil and corn oil, for example. As you say, the same goes with fats from grain-fed animals vs. pasture-raised. There are many kinds of saturated fats, some better than others.
The good news is that therapeutic ketogenic diets (and other high-fat, lower carb approaches) are getting traction in the scientific community, and I believe there will be many more studies to come. Thanks for your thoughts!
Is there an example of the palmitate vs. oleate in cheese that was discussed. What types of cheese would be ideal?
I would like to read her paper, where can I fine it.
Great information, Thanks!
I found one of her papers here.
https://www.researchgate.net/publication/288917724_The_Therapeutic_Potential_of_the_Ketogenic_Diet_in_Treating_Progressive_Multiple_Sclerosis
You can read her paper here: http://www.hindawi.com/journals/msi/2015/681289/
Thanks!
I too am interested in the better cheeses for a ketogenic diet……..I find women have the hardest time giving up cheese.
Thanks for all you do, Abel
I’ll see if I can get a cheese expert on the show – that sounds like great fun!
What a great interview! Loved the perspective from a scientific/medical point of view and the real world experiences. Just wish there were some actual examples given as to which types of cheeses had the better ratios of palmitate/oleate . All in all really helping me to fine tune my diet.
Fascinating interview!
Thanks
I have been on a modified (cyclic) ketogenic diet for a number of years. I started out on the Specific Carbohydrate Diet (also called GAPS) and took the program low-carb for the best results. All my health problems went away including my epilepsy. I found Dr Mary Enig’s book, Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils and Cholesterol very helpful. The Weston A Price Foundation was also a great source for information. The organization’s materials helped me consider the possibility that eating more fat wouldn’t be the death of me… In fact, eating (much more) fat was the missing key to greatly improving my health and healing myself.
In summary, stop eating industrial foods and all the food additives in these foods. Eat whole foods from quality organic or pasture sources. These changes will help just about everyone. For people with neurological problems or metabolic syndromes consider taking a whole food diet low-carb or ketogenic. The ketogenic diet isn’t for everyone. Some people are very carbohydrate tolerate and don’t do well on a low-carb diet.
Here’s a recipe for ketogenic creamer: http://eatkamloops.org/ghee-coconut-creamer-for-camping/.
What a great interview! Mediterranean style of eating – great idea! I need to learn more about which cheeses to pick. Thank you!!
I noticed the conspicuous absence of any mention of animal fat in this (fascinating) discussion. Is that because Mitha doesn’t eat meat? I live in France, where all of the meat I eat is pastured, and quite low fat ….. I have been using duck fat to cook lately, yum! What do you think?
Duck fat is one of our favorite cooking fats! It is high in Omega-6’s, so you’ll want to balance it out with Omega-3 fatty foods like Wild salmon. Enjoy!
As a female who suffers from PCOS I am stuck on birth control pills. One problem I encounter from low carb dieting is everything goes well until the third week. Then I experience mid cycle bleeding. This has happened to me three times. Does anyone have any information about this?
Hey Abel! Cool episode! However, why introduce her as a “female scientist”, not just “scientist.” Feels a bit like it’s weird to be a female and a scientist, which I hope you don’t mean. 😉
Thanks Laura! I agree with you – that sounds weird. To be honest, words come out funny sometimes… What I meant to highlight is this: Mithu provides great scientific insight about low-carb diet and lifestyle concerns specifically for women (and from the female perspective). Telling the whole story in 140 characters or less is always a challenge – thanks for keeping us honest. 😉
Hey Abel! To be honest, I usually fall asleep when listening to sciency stuff and researches and whatnot, but you (and your guests) can make any topic sound interesting. I was almost on the edge of my seat the whole time while listening to this. MS is such a terrible disease, any way we can fight it is something we should embrace and look into. Fortunately, I hear more and more people talk about keto and its possible advantages, so I might just go ahead and give it a try sometime in the future. Oh, and definitely try to bring in a cheese expert. I think it would be one of the most popular episodes on the show! 😀
I have been in the ketogenic diet for a year and I feel amaizing. I only found some problems with the micronutrients absortion 2 months ago. I had cramps almost every night. I didn’t understand as I take magnesium and potassium supplements and two teaspoon of salt every day.
After lisening Dr Mithu Storoni saying” If you’re eating a huge amount of fat (you shouldn’t need to), many people find it difficult to absorb what they’re eating and end up with micronutrient deficiencies”
Now I understand: I was eating too much fat, as I have increased my coffee with butter consumption,but why do this happen? Is it the fat which prevents from micronutrients absortion? Or too much calories? And why do this happen?
Thanks from Spain for your great work ?
Some people that have been on a low-carb or ketogenic diet for a long time benefit from going high-carb once in a while. What I mean about high-carb is doing just one high-carb meal, usually dinner. For an inactive person once every 7-10 days might be about right. For a very active person more often would be tolerated. A person would have to experiment to find out how often was enough.
For me, a high-carb meal will be a feast on sweet potatoes or a big feed of whole fruit. (Personally, I don’t tolerate very many starchy vegetables.) When I do my high-carb meal I usually sleep like a rock. I wake with a dry feeling in my mouth. I’m good for about 7 days. I do find intermittent fasting more difficult after a carb-loading dinner.
I first learned about “carb-nite” (carb backloading) from Kiefer. He theorizes that carb-loading for the normally ketogenic person will use the body’s insulin like a drug. (Kiefer also eats what I would call garbage-carbs but it works for him. I do my carb-load with whole foods only.)
Great point Caroline – I’m also a whole food carb-cycler (sweet potatoes, quinoa, rice, oats, etc.). You might enjoy my interview with Kiefer here: http://fatburningman.com/john-kiefer-trashing-paleo-ketogenic-diet-mistakes-why-its-good-to-be-wrong/
Yes, I enjoyed listening to your podcast with Kiefer. I was shocked at Kiefer’s consumption of junk-carbs — but nevertheless he has had awesome results. With my health history, I couldn’t get away with how he eats. I’m with you. I’m a low-carb or ketogenic eater most of the time. I do intermittent fasting which avoids the potential problem of overeating. I usually eat one meal a day Monday, Wednesday and Friday and two meals a day for the rest of the week. When I eat carbs, I am a whole food carb-cycler though unlike you I cannot eat any grains, legumes, beans or potatoes.
The hardest change I made was to stop eating breakfast. I have been taught to think breakfast was the most important meal of the day… But personal experimenting has taught me that giving up breakfast (and the related insulin spike in the morning) makes fasting until lunch (or even dinner) really easy!
Hi Eva, no matter what macronutrients you’re eating, it’s important to get nutrient-dense foods (and a wide diversity of them) into your diet. Overeating fats can push out other nutritious foods – especially those higher in carbs but rich in potassium such as bananas, sweet potatoes, and potatoes. It’s all about finding the right balance for you. 🙂
This is what fat burning man is all about! Eat fat to burn fat and have a super charged brain. My wife especially loved/hated this podcast as she is trying to get off the glucose she loves/hates so much. Overall a very in depth discussion and it was very informative and great answers and it seemed the interview was over way too fast! Thanks Abel.
Thanks Ryan – many more to come!
I have a question for you about something that Paul Jaminet stated in the Perfect Health Diet. Maybe you or your guest speaker have an opinion on this issue.
Paul Jaminet thought that it was important to look at our macro-nutrients after digestion. He stated in his book that: “Herbivores obtain little glucose from diet, but up to 70% of their energy needs from short-chain fats produced by bacterial fermentation. These short-chain fats are transformed in the liver to ketones which nourish neurons, substantially reducing the body’s glucose needs.” Of course, many herbivores have four stomachs but he suggested that human digestion did the same thing and we also produce these same short and medium chained fatty acids.
It theory goes something like this: Insoluble fiber just passes through the body. Soluble fiber can be consumed by our gut flora. The gut flora thrives on the carbohydrates in the fiber. The gut flora also produces short and medium chain fatty acids from the fiber but cannot consume these fatty acids in the anaerobic environment of the bowel. These fatty acids are reabsorbed in the large intestine and used by our body. These special fatty acids are being researched for their health promoting qualities. The fantastic part of this process is that eating soluble fiber from greens is like eating high-fat, after digestion… And you get these very special fatty acids produced just for you by your gut flora!
Do you think this process is happening in the human body after digestion? Or do you think this is wishful thinking? If this is true, we can eat more greens (the vegetative part of the plant) and still still stay in ketosis while self-producing these special short chain fatty acids.
Excellent article loaded with helpful, doable tips. Inflammation is a major health and weight issue that doesn’t receive enough attention as something that can be changed through diet. Thank you!
She has a beautiful voice/accent for listening to on a podcast. Could listen all day.
However it just seems so depressing to me… mainly coconut oil, avocados, macadamias, certain cheeses..these foods are sooo calorie dense it would be easy to overeat.
Hi everyone, thank you so much for your comments, questions and feedback! I am so glad you found this useful and thank you again, Abel, for having me on .
I agree with ‘c’ above -, it is absolutely correct that many people may not do well on a ketogenic diet. Just to remind everyone, I tried the KD as a fun experiment, because I am fascinated by the emerging literature on its potential benefits in the context of brain health and wanted to know what it ‘felt’ like. I enjoyed it and felt well on it – but I did *not* attempt the diet in order to become *more* healthy or to lose weight. There is at present no evidence or reason to suppose that a healthy person needs to follow a ketogenic diet.
The ketogenic diet should always be attempted under careful supervision as it still covers unexplored territory. There are potential side effects of the KD, beyond those Abel and I discussed and we still don’t know its long-term effects. There are no available studies on its long-term effects in a healthy population.
Consider, for instance, the role of the microbiome. The microbiome is emerging as an important player in a wide variety of illness, from insulin resistance to Parkinson’s disease. If you look at the KD through the angle of the microbiome, there are some important considerations. The microbiome is thought to thrive when it is diverse. Diversity of diet breeds diversity within the gut. A ketogenic diet is highly restrictive and does not allow for dietary diversity. Interestingly, the flip side of this involves irritable bowel syndrome. IBS may respond well to a low FODMAP diet. Fodmaps are also restricted when reducing carbs as in a ketogenic diet, and this may explain, at least in part, some of the anecdotal reports of better digestion and wellbeing on a low carb diet. This acute effect however does not necessarily safeguard the microbiome from the *potential* long term negative effect of limiting dietary diversity. We really don’t know the answer.
Then there is the issue of insulin resistance. A diet that is heavy in processed, refined carbohydrates may adversely affect the microbiome and exacerbate insulin resistance. A disturbance in the microbiome can in itself influence insulin resistance. Removing refined, processed carbohydrates by following a KD may improve symptoms of insulin resistance, but there is also emerging evidence to suggest that dietary long chain saturated fatty acids (especially palmitate) may be linked to insulin resistance. If the microbiome is disturbed, this *could* lead to metabolic endotoxaemia which contributes to chronic inflammation which is also linked to insulin resistance. Another angle to insulin resistance is the issue of advanced glycaemic end products or AGEs, which may form in the setting of raised blood glucose levels. AGEs are thought to lie behind several disease processes. There are anecdotal reports of some people having high fasting blood glucose levels on very low carbohydrate diets and we don’t know if this increases AGE formation in the long run and if this causes harm.
The ketogenic diet is still incompletely understood in the context of wellness and it is important to recognise the different contexts of wellness vs. illness. The observation of glucose hypometabolism is ubiquitous in a broad spectrum of disease from ageing and the menopause to multiple sclerosis and dementia and this and other observations relating to impaired mitochondrial function present great hope for the potential benefits of a KD in the setting of neurodegeneration and other conditions that affect the brain.
Nature has, however, designed our magical life giving every yang a yin and every yin a yang, so what is good for the brain may not always be good for another part of the body, and vice versa. If your priority is the brain then all other side effects become less important. If you are healthy to begin with, you may do good to one thing while causing harm to another.
The one undisputed observation in the context of diet is that eating food that is as close to its original form as possible is the most important factor for a healthy diet – whether we are talking about fish or coconut or sweet potato. This approach automatically eliminates refined, processed carbohydrates and processed fats, limits AGEs and incorporates dietary diversity for the microbiome. If you couple this with making sure you don’t overeat, exercise regularly and observe a circadian pattern of eating with a good portion of the day filled with no food, you are likely to switch in and out of mild ketosis while being able to reap the benefits of Nature’s diverse food. Metabolic flexibility of this kind may be a good thing to aim for in the context of general nutrition and Abel and Alyson’s Wild Diet sounds like a great solution! 🙂
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Thank you once again
What is David Perlmutter’s latest book?