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Transcript – Keto Q/A

Shawn:         Hello BioTrust Nation, we are back with another amazing episode. I’m very excited. We’re going to follow up that incredible Death to Keto episode we did with a Keto Q&A. And I’ve got my co-host here, Tim Skwiat.

Tim:              Here we are.

Shawn:         You know, I’m excited. I’m excited to form more keto talks.

Tim:              [laughs]

Shawn:         Because I’m known as the keto guy, so I love putting knowledge out there and dispelling myths and whatnot. One myth we want to get rid of [laughs] is people calling it ket-to. [laughs] Why are you calling it ket-to? Its keto. They’re ketones, they’re not ket-tones. It’s not the kettogenic. It’s not I’m in a kettogenic state. I don’t know.

Tim:              Ke-te-te-sis.

Shawn:         It’s ketogenic, its ketones, it’s keto. So, one thing we do in this show is go through reviews and questions. With this show, we’re going to do just pure keto Q&A; with questions we’ve been given by email and our Facebook VIP. You can go to the Facebook group at BioTrust.com/VIP and you’ll get all kinds of cool support and community there. Great stuff.

But here, we are going to first talk about our reviews from iTunes, which is really important. It helps the show, helps us keep getting out there and get more awareness and higher rankings, and all that good stuff. So, we’re really appreciative to you for putting up a review. And if you do that, we’d like to reward you with a free product, when you do so. You just write [email protected]. And Tim, do you have a review for us to read.

Tim:              I do. I have a 5-star review on iTunes. This one is left by—it’s a series of letters, so I’m just going to read those letters out—it’s CDRJVJJ, so that’s who left this review. And if you can email me at [email protected], we’ll make sure we get you the free product of your choice. And this review says, “As a member of the hearing impaired community, many podcasts are hit and miss. Some people are very hard to understand. Shawn and Tim are very clear speaking. The importance of the message doesn’t matter if unheard. Valuable info, plainly explained, and not one long ad for products. Awesome tools for a better life. Thanks guys.” Thank you CDRJVJJ. We appreciate you and we’re glad that that we can resonate with you as well.

Shawn:         It’s powerful.

Tim:              It’s so powerful and just warms our hearts to hear your feedback. Thank you. We know that it takes time to leave these types of reviews, and we want you to know that means so much to us. That’s why we read them and that’s why we want to recognize and reward you with a free product and with our gratitude, the best that we can.

Shawn:         I’d like to recognize someone, it’s Jake Mulder, for one, knowing what equipment to buy, and two, setting up all the equipment here in our studio. That’s the reason that we sound so great. I’d also like to thank the CEO, Josh Bezoni, at BioTrust, for allowing us to spend some money on a good studio so that we have the audio quality. And then two, flying Tim up from Austin to our headquarters in Dallas about once a month so we can record episodes here.

Because it just, it’s not as powerful when we’re not together in studio, and the sound quality just isn’t as strong. And I’m going to be honest, it’s one of the first things that I hear about on a podcast. All the podcasts I’ve done, whether it’s this podcast or I’ve done probably a hundred others, I always hear about audio first before I even hear about like how the topic was. People say like, “The audio was clear. It sounded good.” Then they’re like, “Oh yeah, the topic was cool too.”

Tim:              [laughs]

Shawn:         But it’s really important how the audio sounds, and it really sets you apart. So, I’m appreciative for that review and I’m appreciative that we have Jake, and that we have great equipment here and that we have each other in studio. And I think it does make a big difference. So, I’m really glad that was pointed out.

And let’s roll into our Q&A. And there is at least five questions that we’re going to address here, and we will read their names through this episode. And again, the same rules apply that if you reach out to us by [email protected], you get a free product. So, a lot of free products being given out on this show.

Tim:              Yeah, definitely. And we’ve kind of got in the habit of reading one VIP question and this one there’s just so many on this topic, we thought we’d just make a whole show out of your questions. When we started this podcast, just as an aside, was a big part of that was to answer questions from our community. We want to kind of set the record straight and help you guys out as much as we can. So, thank you for fueling the show with questions and topics that you’d like for us to discuss.

Shawn:         And Tim, feel free to pepper in any questions that you hear on keto that you get often.

Tim:              Sure.

Shawn:         And we’ll throw those in here, too. But the first one by Laura Landingham Burnelis. Hey, Laura, is, “I am a 54-year-old controlled type 2 diabetic. I take no medicine for diabetes.” That’s really good. I mean, that’s impressive. Obviously do what your doctor tells you to do, but I think that’s impressive if you’re working with your endocrinologist and you have type 2 diabetes and you’ve managed to control it without medicine. That’s impressive. “How can I incorporate the keto diet, so my sugar does not drop too low?” She means her blood glucose. “I eat six small meals a day. Thank you in advance.”

Again, I’m going to throw the caveat of we will give generalized advice on these questions. I do not want to give specific advice to a person. This is not medical advice and you need to work with your endocrinologist or your physician and heed their advice. So, this is us speaking in generalities, based on this question, and not pointing it to a specific person. I definitely want to throw that out.

So, if someone was a well-controlled type 2 diabetic and they were working closely with their endocrinologist, and wanted to incorporate the keto diet, I think that makes a lot of sense. One of the most powerful things about keto is that you’re raising ketone levels and you’re lowering blood glucose, because you’re not having carbohydrate in your meals. And this can help type 2 diabetics get off medication, get off that blood glucose rollercoaster, and really have a much more continuous controlled level of blood glucose, to where they’re not feeling that level of fatigue and crashing. Most type 2 diabetics, they just get super tired and just sometimes don’t have the energy to go out and do things.

And this is a way to take your life back, to get off medications, potentially. Again, with your doctor and their supervisions. But I think it’s a strategy worth trying. I would reduce the six small meals a day. I think that makes sense when you’re carbohydrate‑focused, but it makes a lot less sense on the ketogenic diet. You can potentially do fasting over time. But again, you have to be careful with your blood glucose. You want to do things in a slower, more methodical manner, where you’re employing scientifically one small tweak at a time. And then working with your physician, talking it through with them, doing blood testing on your own and then showing them the levels, and getting frequent blood tests with your doctor. And just taking it slowly, taking one step at a time, knowing this is a lifestyle, knowing that nothing needs to happen overnight.

But it’s certainly worth looking into and trying, and there’s many people that do it. And I think there’s a number of things that you can use, like berberine or cinnamon, that might augment your results. But I definitely think reducing carbohydrate makes a lot of sense, when carbohydrate is a problem for you, and you have poor carbohydrate tolerance. I like that strategy more than eat a bunch of carbs all day long [laughs]

Tim:              And then shoot up insulin, right?

Shawn:         Yeah.

Tim:              I mean, you took a very reserved approach to that, Shawn, and I appreciate that you approached it that way. Gosh, to me, it just seems like if carbohydrate is the problem, that should be the one of the first things we look at removing. It just seems like a no‑brainer.

Shawn:         Yeah.

Tim:              But I know it’s not that easy. I know it’s not that easy. And like you said, with medical conditions, we have to appreciate that these are not normal functioning bodies.

Shawn:         Right.

Tim:              And we need to have some kind of medical supervision. And I 100% agree with that. But it really frustrates me that, like for instance, type 2 diabetes is often treated by giving more insulin, so you can eat these carbohydrates. But that’s just like a huge bandaid on the problem. And so, one of the most effective therapeutic strategies, or one of the most effective therapeutic implementations of the ketogenic diet is in diabetic conditions.

And there was a big study recently, the Virta Health study, with Jeff Volek. And they showed some extremely impressive results. Like in this particular question, “so my blood sugar doesn’t drop too low.” Well, don’t we want, in the case diabetes where blood glucose is relatively uncontrolled, don’t we want to lower blood sugar? Isn’t that like a goal of the process?

And so, I think it’s a strategy worth trying. You’re a dietician, so you would have more credibility in saying something like that. I’m just an empassioned individual with a little bit of nutritional knowledge. But anyway, to me, it seems like a no-brainer to try.

Shawn:         Yeah, that’s great. And I think you’re being modest. I think you have a ton of knowledge in this area. But I want to throw out a link that I would love for our listeners to check out. If you go to BioTrustRadio.com, you get the full show notes, you get links. Everything’s transcribed. And it’s a TEDx talk by Sarah Hallberg. And she is a doctor and she provides compelling evidence that type 2 diabetes can be “cured” and the solution might be simpler than you think. I don’t want to use that word. That’s not me using that word. That’s her. But it’s Reversing Type 2 Diabetes Starts with Ignoring the Guidelines. And that’s the TEDx talk. It’s only 18 minutes long, and it’s powerful talk. I’ve had many people watch this video.

And again, she’s frustrated, to your point, Tim, about so many people that are glucose intolerant, that are basically being told to have carbs all day long, to the point of the six small meals that was just discussed or whatever.

Tim:              Yeah.

Shawn:         Not only have carbs, but have carbs all day long. And then, of course, what’s the solution? Drugs.

Tim:              Drugs.

Shawn:         Drugs. Which is oral agents that help with sensitization, and then there’s insulin injections, which there’s no reason a type 2 diabetic should be on insulin. If you are on insulin, I mean, unless you’re just a rare case where there’s some kind of extreme circumstance, which is possible. But typically, it just shouldn’t be that a type 2 diabetic makes insulin. They’re not a type 1 diabetic. You shouldn’t have to take insulin. And this is happening more and more because of the Western diet, because of high glycemic carbohydrate, because of poor exercise, and because of food availability. Because of overeating we’re seeing type 2 diabetics be on insulin. This used to be called non-insulin-dependent diabetes, right?

Tim:              Right.

Shawn:         Just like it actually used to be called “adult onset diabetes.” [laughs]

Tim:              Right.

Shawn:         Now we’re seeing little children that are type 2 diabetics. We’re seeing little children that are on insulin. And this is very frustrating. This is a very new phenomenon.

Tim:              It’s scary.

Shawn:         And this is something that we should be worried about. It is a metabolic disease and it can be addressed by lowering your blood glucose, which can be done by lowering carbohydrate intake. So, we’ll just leave it at that. But I appreciate the question, for sure. And again, there will be links that we can show in the show notes.

Tim:              Yeah, that was great. Next question comes from Jocelyn Skaling. And Jocelyn asks, “How important is it to supplement potassium and sodium when on the keto diet. I noticed myself getting headaches often and I’m wondering if it’s due to mineral deficiencies. Also, how much water is too much water?” That’s an awesome couple of questions there.

I don’t know how important it is to necessarily supplement with potassium and sodium, but it is certainly critical to make sure you’re getting enough sodium and potassium when on a keto diet. In fact, some would say that’s part of the part of the constellation of keto flu-like symptoms, is an issue with not getting enough sodium and potassium. Jocelyn, you did a great job of asking about those two things together because I do think they balance and they go hand-in-hand.

Shawn:         Agreed.

Tim:              So, a couple things here. When you remove processed foods from your diet, you’re removing a substantial portion of most people’s sodium intake. For the average person, about 75% of their sodium intake comes from processed food. So, for one, when you start to eliminate those processed foods, your sodium intake goes down. Also, what happens when you embark on the keto diet is your insulin levels go down. And so when insulin levels go down, your body also excretes more sodium. And now you’re talking about maybe not getting as much sodium in through your diet and excreting more. So, there’s probably a higher need for sodium. And I would say, from what I’ve seen, probably somewhere in the range of 3 to 5 grams of sodium per day on a keto diet would be ideal. And ,aybe at the beginning, maybe there’s even a need for more. So, that means probably liberally salting foods and things like that with some type of sodium, or with some type of salt.

And then, as far as potassium goes, I would say what I’ve seen in the literature is somewhere between like 300 and 500 milligrams a day. That doesn’t necessarily mean you need to supplement with those types of things, but like avocados are a great source of potassium. It’s a little bit harder to find naturally-occurring sodium, besides salt. So, salt is usually your best friend as far as getting enough sodium.

And that’s a great question, too, about water intake, and how do you know how much water is too much. It’s going to vary from person‑to‑person, depending on body size and activity levels, environmental temperatures, and things like that. You can use your urine as a guide. But again, in the initial phases of a keto diet, your body’s going to be excreting more water.

Basically, as you lose your body’s stores of carbohydrates, called glycogen, your body stores this carbohydrate in the form of glycogen, in your muscles in your liver. And for every gram of glycogen that you store, you tend the store about 4 grams of water. And so, as you lose this glycogen, which could range anywhere from 200 grams to 500 grams, depending on your body size and muscle mass, but you’re losing 4 times that much water. And so there’s a lot of water loss. And if you’re not consuming enough sodium, you’re not replenishing water as effectively because you need to have that osmotic balance. So, there’s a lot of factors there, and it’s hard to say.

For me, it’s more difficult to say exactly how much water you need, but you do need to be careful, especially if you’re active you can get into a hyponatremic state, which means that you are consuming too much water, relative to your sodium intake. So, that would be something you need to be very careful with. And so, the headaches that you might experience, could not only be too little sodium but could also be too much water, relative to too little sodium.

Shawn:         Yeah, that was a phenomenal answer, Tim. The only thing, I think I heard this right but I think you said 300 to 500 milligrams of potassium. I think you need 3,000 to 5,000.

Tim:              Yes, that’s right. I’m sorry, yes, 2 to 3 grams of potassium.  Actually what I was thinking about was magnesium there, so 300 to 500 milligrams of magnesium. Thank you for that point. 2 to 3 grams of potassium, 3 to 5 grams of sodium.

Shawn:         Okay. Yeah, cool. And I agree on that completely. Sodium needs to be higher on the ketogenic diet. I think we have a fear of sodium that’s been irrational that’s, well, I’ll say maybe it’s rational that we listen to all these doctors and scientific sources for decades that were wrong. Again, this is the whole causation versus correlation thing where there was some studies, and epidemiologic studies, which means populational level studies, where you look at how things are related. And they saw worse outcomes with higher sodium. And so they said sodium is bad for you. But the reason that was is because sodium was higher in processed foods. And when you teased out on these epidemiologic studies, the processed food out of the equation, sodium is actually correlated with longer life, with better performance.

And so that’s the way it’s been throughout history. Sodium has been one of the most important minerals. It was traded in Rome like currency, and it’s very important for athletes. It’s one of the things that’s highest in Gatorade. Whenever we hear about electrolytes, 90% of that is sodium. The sodium loss that were concerned with. Yes, there’s potassium, there’s magnesium, there’s calcium, there’s chloride, there’s these other electrolytes, but sodium is by far and away the most important one when we discuss this.

Now, there is a sodium/potassium balance. There’s a sodium/potassium pump in the cell and they’re like brother and sister, let’s say. If you remember your element chart or your element table, they’re both a plus-one valence. They’re both in that first column in your in your chart, if you go back. Which means they electronically work on a similar level. And that’s why I like think of chloride, when you have sodium chloride, which we call table salt, that no salt product is potassium chloride. And that’s why those can actually be interchangeable, sodium and potassium, with the chloride. And that’s a little a chemistry lesson from ninth grade or whenever you had it. [laughs] I just wanted to throw that out there.

But yes, make sure you get enough water. Make sure you’re getting enough sodium and potassium, and magnesium. I agree with Tim, when you’re on keto, especially early on, or else you can get cramps, you can potentially get some arrhythmias if you’re really far off. So, it’s important to keep these electrolytes high enough.

Tim:              Yeah, there’s a great book by Dr. James DiNicolantonio on salt and how we got it wrong. And there’s an article on our blog, too, about salt. So, we’ll link to that in the show notes. And moving on to the next question. This is from Jessica Eversoll, who asks, “What’s the difference between a regular and keto low-carb diet, and can you eat keto low-carb on regular low-carb?” So, that question is phrased a little confusing to me. But I think what Jessica may be asking here is just what’s the difference between keto and low-carb, and we can we can definitely talk about that.

Shawn:         Massive.

Tim:              [laughs]

Shawn:         This is a massive point.

Tim:              This is a super question.

Shawn:         It’s a huge question. There’s so much confusion about this, and so many people think they’re the same thing, and they are not. While keto is in fact low-carb, it’s extremely low-carb, or sometimes it’s listed scientifically as very low-carb because it’s like 5% or less carbohydrates. Low-carb really doesn’t have a clear definition. I’ve seen it as high as 50% in some older studies. [chuckles] And there’s some studies where it’s 40% or less, and some studies where it’s 26% or somewhere around there. There’s not a clear definition.

And the problem here, without that clear definition, is how do you compare this? When people talk about, “Oh low-carb diet. I’m on a low-carb diet.” Well, that can mean a lot of things. But I can tell you what that most likely means is you’re not producing ketones, so they’re not very equivalent. The ketogenic diet is a strategy to promote the elevation of ketones in your body and lower blood glucose, so that you focus on ketones as a fuel, and you’re breaking down fat more readily to increase the ketones. So, that’s a very different strategy than simply using a low-carb.

Another difference that I would say with low-carb and ketogenic diets are a lot of low‑carb dieters eat very high protein, because everyone loves their meat, everyone loves protein here, especially in America. They just love to eat their burgers and their steaks and their whatever, chicken breasts. A lot of bodybuilders eat super‑high protein and very low-carb. That will not induce ketones, because of something called gluconeogenesis. And gluco, think glucose; neo means new; genesis means creation; so you’re creating blood glucose from protein. You’re converting that protein to glucose. Once you get above that 20 or 25% threshold with your percent of calories, you start converting that protein into glucose. And therefore, you’re impairing your ability to get into ketosis and have elevated ketone levels.

So, those are very important distinctions between low-carb and keto. Two just very different things. And especially like if we get into some of the disease states that keto has been researched with: Alzheimer’s, epilepsy, cancer, diabetes, and all this stuff. There’s just a drastic difference there. The ketones become extremely important, therapeutically, and a low-carb diet is not getting that done. So, there’s a lot of distinctions there.

Tim:              Yeah that’s awesome, Shawn, because like you said, low-carb is not even clearly defined in the scientific literature. And I think that’s the point you’re making. It’s like 40%, 45%, 26%. So, it’s so it’s hard to really summarize the benefits or potential risks and things like that. The only clearly-defined low-carb diet is the ketogenic diet. And if we looked at it, it’s like you said, 5% or less than 30 grams of carbohydrate a day is kind of the bar where it’s set. It can vary from person-to-person, depending on some factors, but the typical very low-carbohydrate ketogenic diet would be in that area.

Shawn:         Well, and really it’s more even definitively [chuckles] defined as when you’re at 0.5 millimoles.

Tim:              A ketogenic state?

Shawn:         Yeah, so you have to have a certain level of blood ketones to be considered ketogenic, in most of these studies. So again, what is it? Is there a marker like that for low-carb? No.

Tim:              [laughs] No.

Shawn:         So, keto actually has a lot of scientific validity because it is clearly definable.

Tim:              Right.

Shawn:         In terms of macronutrients for your diet, with fat, carbohydrate, and protein, but as well as a blood marker level. So, yeah, there’s some clear delineation there that’s important.

Tim:              That matters for many reasons, and I think what are the benefits that you’re looking for, right? Like in the case of a therapeutic instance, the being in a ketogenic state would have maybe more importance than someone who’s just interested in weight management, perhaps. In that case, how much might be what you’re eating, like we’ve talked about before.

Shawn:         Yeah, dead-on. Loved it, Tim.

Tim:              So, moving on to Paula, Paula Kaufman. Paula says, “Have you had podcasts on carb cycling, OMAD? As in the acronym O-M-A-D, and then IF or intermittent fasting, and keto. I have never heard of OMAD before today.” [chuckles] And OMAD’s kind of new to us as well. But it stands for One Meal A Day, which would technically make it a type of intermittent fasting.

Shawn:         Yeah, that’s interesting, too. Again, I haven’t heard that term either, but that definitely is intermittent fasting, and it’s very lion-esque, I’ll say.

Tim:              Yeah.

Shawn:         There’s definitely examples of that in the animal kingdom, and I’m fascinated by that approach. And if you were to employ that approach, you can’t take—again, like we always talk about keto adaptation, there’s all kinds of adaptations that take place. And when you’re changing up your macronutrient ratios or you’re changing up your meal timing, there’s changes that will take place over time. And in this case, you would have a change in protein kinetics, like you would oxidize protein in a very different way when you’re having one meal a day versus six meals a day. There’s so many changes that would take place over time.

So, if you employ like these different strategies: intermittent fasting, keto, one meal a day. Whatever it is you’re doing, don’t take what initially happens and go tell your friends and say, “Well this is what happened to me,” and this is what this diet does or this is what this technique did for me. You have to let yourself adapt, over time, to these things. And so, I would not employ multiple changes at once, scientifically. You want to employ one change at a time. Do it for a while. Make it a lifestyle. See what happens and then go from there.

Certainly, if you have all kinds of side effects and you’re miserable, then I wouldn’t do that. I would look to modify that or try something else entirely. But it’s definitely an interesting approach.

So, carb cycling. We’ve talked about the cyclical and targeted ketogenic diets. I haven’t talked about carb cycling on a broader level of just cycling macronutrients. Some people cycle all the macronutrients, and I think that’s a fascinating approach. I wish there’s a lot more data there. There’s something to a lot of that, manipulating the macronutrient ratios. I mean, as you can see, we talk about metabolic flexibility. And if you were very high carb/low fat for certain periods, then you’d become reliant on glucose, but you wouldn’t be getting that caloric density of having the processed food that has the high fat/high carb that we talked about.

Tim:              Yeah.

Shawn:         Which can blunt fat oxidation, fat breakdown, and can promote fat storage. So, I think it’d be interesting to do very high carb/low fat and then do keto with very high fat and very low-carb, and then at times like manipulating protein. I know people that, on keto, on certain days, like lifting days, they actually go very high protein, which would be like gluconeogenic, potentially. And again, converting the protein to glucose, and you think that’s counterproductive to a ketogenic diet, but they’ve shown some super compensation, if you will, because on keto you’re not oxidizing protein as much and you’re more leucine-sensitive, and you’re protein-sensitive to be more anabolic. Essentially you need less protein to be as anabolic as someone who’s on a glucogenic diet or who’s on a high carb diet. That’s interesting. But, you can manipulate that because your body’s now adapted to this state to give it a large protein bolus at times.

Tim:              Yeah.

Shawn:         So, there’s some really interesting stuff there. We just don’t have a ton of data. It’s a lot of case studies, if you will, just personal reporting. So, there’s some interesting stuff there.

Now, with carb cycling with keto, you can talk about targeted and cyclical ketogenic diets. Targeted would be around your workout. And we talked about this on the Death to Keto show, that you really only need like 15 to 20 grams. I read, I think like 17 gram of carbohydrate. A high glycemic carbohydrate, potentially, right before a workout to get all the efficacy if you need that. But we talked about this before, too, that most people that aren’t really looking for elite performance or have exhausted all the other tools in the tool bag, if you will, they don’t need this. They don’t need this. You can do your workouts fasted and perform extremely well.

But there is something to it and if you feel great by having a little bit of carbohydrate before a workout. Especially, I like to delineate here, where I like to train low/compete high. So, all my training I do, like I play volleyball or workout six times a week. I like to be in that fasted state when I perform, when I work out. But when I’m actually playing competitive volleyball, and every bit of performance matters, and I like to just have fun and feel my best. That’s when I have sugar. I have carbs. And so that might be once a week that I do that.

I also do the cyclical ketogenic diet. There’s been studies that have shown the two‑day thing where you’re on keto for five days and then you have two days where you blow it out. Let’s say on the weekend, and you have all the carbs you want. My friends, Dr. Jacob Wilson and Dr. Ryan Lowery, have shown that it took until Thursday [chuckles] to get back into ketosis. So, that’s not a very effective strategy.

Tim:              Right.

Shawn:         I think when I do it, I do maybe like a meal a week where I just have whatever. And that’s enough for me. I look forward to that meal. I plan for it. It’s fun. I have cake, I have pizza, I have peanut butter and jelly, you know, whatever. I have something that’s like a comfort food that’s fun. I’m out with friends. I have that meal. It’s enjoyable and I just go back to my thing.

And it’s not a big deal. We’ve talked about this. One meal, in the grand scheme of things. And again, it can even be artificial junk. I don’t recommend going out of your way to do that, but if it’s stuff that you really crave and it’s what you want, one meal [laughs] is not going to radically throw you off course. So, if you want your carbs, if you want something that’s not so great for you, then have it. Put it in its little box. Enjoy it. Call it what it is and then go back to your thing.

We’ve talked about this that like if you were to eat McDonald’s for every meal but one a week and then have some salad that’s some super healthy salad with olive oil and grilled chicken and all this stuff, [chuckles] that salad’s is not going to make a bit of difference. And the reverse is true.

Tim:              Yeah.

Shawn:         The reverse is true. So, if you’re eating healthy all week long, you’re on-point all week long, and you have one meal, it’s not going to make a difference. And where it is going to make a difference is in your mind.

Tim:              Right.

Shawn:         And in your health. And you’re staying on track. And assuming that you’re this type of person that can do this, that can have a fun meal and then go back to your thing and not just give everything up and all or nothing. But if it’s something that helps you stay on track long-term, then that’s a good thing. That’s a good thing. And if you’re someone that gets frustrated when you’re out with your friends for the weekend and they’re having a fun meal and you’re going to sit there and eat your [chuckles] salad and grilled chicken, and they’re enjoying—I don’t know—some decadent dessert and you’re like, “Gosh,” then just then give yourself one meal. It’s not a big deal.

But where it’s important is that you need to put it in its box, put it in its place, plan for it and have a healthy thought around it, and then go back to your thing. Get back on track and you’re good. It’s not a problem. But you need to have a healthy relationship here and not beat yourself up and make it a big negative. Nothing’s a big negative. It all tracks back to wellness and mindset. So, can you have a happy mind? Can you have a happy life? And to me, you can’t do that very easily by always restricting yourself, or even looking at it is restriction.

We talked about the these: paleo diet, whole food diet, a Mediterranean diet. These ways of eating that are healthy, they can be delicious. But I think it’s also important that you have some fun food every now and then, too.

Tim:              Yeah. Well guys, this guy is just on fire today. [chuckles] That was awesome, Shawn. There was so many brilliant points, I think, to capitalize on there. For instance, you talked about the protein in the ketogenic diet. I think on one hand, one thing I was going to mention was that ketones may be like a signaling molecule for increased protein synthesis, so we use protein more efficiently.

Shawn:         Yeah.

Tim:              So that’s why proteins are lower. So that’s something to watch out for, and I’ve seen that with ketones after exercise, increasing protein synthesis and increasing glycogen resynthesis.

Shawn:         Amazing.

Tim:              So, very cool stuff there. Another thing about protein restriction is that some might argue that protein restriction may be part of being responsible for at least some of the benefits of fasting. So, always having this high protein intake may not be healthy. And it may be related to activating this…

Shawn:         IGF-1?

Tim:              IGF-1 or mTOR in the body. So, in general, I think a higher protein diet is probably a useful tool for most people. But that doesn’t mean you have to have high protein six meals a day, seven days a week, 52 weeks out of the year, and that kind of thing. So, I wanted to mention that.

And I think with intermittent fasting, one of the things that intermittent fasting has really helped us get our hands around is that we don’t have to eat exactly the same amount of food or the same types of foods every single day. That gives us a little bit more flexibility. I’m not saying that you can go binge and gore and then purge. But it gives us the flexibility to have that meal that may not be normal for us and then maybe the next day we cut back a little bit.

There was a really fascinating study not too long ago. I think it was called the Matador Study. And basically what they looked at was two dieting groups. One group—and I’m going to get the amount of time wrong here—but basically, I think one group dieted like your normal everyday 500 or 1,000 restriction diet for 16 weeks. The other group dieted for two weeks and then ate normal for two weeks. So, their dieting period ended up being twice as long, but they lost significantly more body fat during the same dieting period, by having those two-week diet breaks, essentially, interspersed with two weeks of dieting. And what they also noticed was that their metabolic rate, which typically declines with weight loss, it wasn’t as damaged. I say “damaged” because most people talk about metabolic damage. That’s not what’s going on. It’s some kind of adaptive thermogenesis. But, their metabolic rate didn’t downshift as much, basically, with the weight loss, as what they would expect.

So, having these cyclical—and is what made me think about Paula’s question that was about carbohydrate cycling—I think cyclical dieting may have application in terms of sustainability. It may take longer to get there, but it may be under better maintenance. And I think Paula’s question about carb cycling is legitimate. It’s definitely a tool that would be way down the totem pole for me. Like there’s so many other things that I would want to do first.

Shawn:         Right. Yeah.

Tim:              And for most people, that carb cycling may have some benefit along the same lines of calorie cycling. And, in fact, when I was in undergraduate school, I happened to be mentored in the gym by a guy who was about 20 or 30 years my elder, and he was like the biggest guy in the gym. So I was doing everything he told me to do. And he introduced me to a strength coach named Fred Hatfield.

Shawn:         Oh, nice.

Tim:              Fred Hatfield.

[both]           Dr. Squat.

Tim:              [laughs] Yes. That’s Dr. Squat. His nutrition paradigm was such that you match your calorie and carbohydrate intake with your activity level.

Shawn:         Yeah.

Tim:              I mean, we got really super scientific. Like we were measuring METS, which is like a metabolic equivalent of energy expenditure and we were like matching our meals to our energy expenditure.

Shawn:         Oh, man.

Tim:              It seems crazy. But anyway, what we did was on harder training days we ate more calories, we more carbohydrates, and on lighter days we ate less. And we both really thrived. Of course, I was about 20 at the time, so who knows. I could have been doing anything and it probably would’ve worked. But this guy was 50 years old and was making gains, and I attribute it to his nutrition, which that was part of it.

Shawn:         I love that. I love that guy. And I also loved Dr. Mauro Di Pasquale.

Tim:              Yes. Yeah, who is also keto, right?

Shawn:         Yeah.

Tim:              Cyclical keto, I think.

Shawn:         Yeah, he talked about macro, micro, meso cycles.

Tim:              Yes, yeah.

Shawn:         As zig-zagging your calories when you’re dieting down, like so that you’re not just quickly adapting your metabolism. It’s fascinating stuff. This is back in the 80s. Dr. Squat actually used, he got cancer, and he’s friends with Dr. Jacob Wilson and Dr. Ryan Lowery, and he used keto, and effectively beat cancer. So, really cool story there. Yeah, a huge fan of what he’s accomplished. Those are two rock stars for me, so that’s very cool.

Tim:              One final thing here. So, OMAD, Paula’s question about the OMAD, one meal a day. That is something I have experienced or experimented with. And I kind of came across it with the Warrior Diet by Ori Hofmekler. And I think for someone who’s kind of in‑tune with how much they’re consuming, for me it was never about the when or the how much, it was just still about the what. What foods am I eating that mattered. And I didn’t notice any difference in terms of like body composition or weight management, recovery, anything. I can’t say that I noticed anything specifically there, in terms of differences. And most people, in my opinion, are not going to be able to eat as much in one meal as they would over several meals over the course of a day.

Shawn:         Sure.

Tim:              So, it would be probably a way to restrict calories. The issue there is obviously going to be getting enough nutrients and making sure that you’re still making the best food choice. Like it would be very difficult to eat an adequate amount of protein, an optimal on a protein, and an optimal amount of like vegetables and fruits, and things like that, in one meal. So, it’s just probably not like an optimal choice for most people.

Having said that, what we know about intermittent fasting is maybe that the one meal a day approach might be good once or twice a week.

Shawn:         Right.

Tim:              Alternated with normal eating or something like that.

Shawn:         Right, yeah.

Tim:              Almost like an alternate day fasting type of approach.

Shawn:         Yeah, that makes sense. Great stuff, Tim.

Tim:              I don’t know if we want to—

Shawn:         I want to do it. [laughs] I want to do one last question.

Tim:              Okay, here we go.

Shawn:         [laughs] Rebecca Hedlund.

Tim:              Can I say, Rebecca Hedlund is a related sister, I do believe, of Howard Hedlund, who was our transformation winner and who we interviewed on show.

Shawn:         Nice. Okay, so, “There was a recent study indicating that long-term low-carb diets can decrease your life up to four years. Many of us trying to lose weight with the BioTrust low-carb protein powder have been taking a very low-carb approach. Are we putting ourselves at risk? Can you respond to the findings of the study?” I will say this requires maybe its own episode.

Tim:              Yeah.

Shawn:         There is a lot to cover there, but I just wanted to address this quickly, that we will cover it. And I want to say that I don’t believe there is risk. I think this study was extremely poorly put together, on a lot of levels. I don’t like epidemiologic studies to really be that—they’re somewhat directional, but you can’t really make big inferences because there’s always that correlation versus causation. Correlation is there’s a relationship there, statistically. Why that is can always take some teasing out. And it depends.

There’s that old computer term that applies with all kinds of science that’s called garbage in/garbage out, GIGO. And what you’re looking at with statistics and what you’re excluding becomes very important. This is true with something called meta‑analyses, too, where you take like 20 studies and you try and say like well here’s some common things and we’re going to make inferences based on these 20 studies, statistically. But it always matters whoever is conducting the meta-analysis, like what they include and what they exclude. Because there’s always things with each study that don’t line up; unless someone’s done the exact same study, the exact same, way which rarely happens. And that’s not typical of a meta-analysis.

So, these epidemiologic studies we’ve talked about before, like even earlier about the sodium thing. That, for example, that everyone thought sodium was bad for you. But it was what they attached it to, because sodium is higher in processed foods and processed foods are bad for you. Sodium isn’t bad for you. And so, for a long time, everyone was saying, “Eat lower sodium. Make sure you’re not getting too much sodium.” And people were actually becoming hyponatremic, which had health problems, [chuckles] which means low salt. Hyponatremic means low salt state.

And the same is true with the fat and saturated fat, and cholesterol, and all those things, that again, got associated with processed foods. And for years we thought that fat was bad for us in the diet. We were telling people eat low fat, eat low sodium. So, these epidemiologic studies, they’re a little bit garbage in/garbage out [chuckles] for me. There’s some value because they’re often so large, like in this case it’s hundreds of thousands of people. It’s interesting to look at some things. But you can’t make that kind of statement out of these kind of studies. That’s very dangerous and very clickbait.

Tim:              Right.

Shawn:         And it’s just not true. There’s no reason to think this. There’s huge populations that have been doing keto for long periods of time now. I mean you have epileptics that have been on it. I mean, that was over a hundred years ago that we have people that started that. But this diet has been done easily since the 70s, with people doing Atkins and then more true to the ketogenic macronutrient ratios now, for at least five years. And we have massive datasets, and we have all kinds of animal models where it actually shows that keto extends life. There’s mouse models, rabbit models, dog models, where it shows it extended life, in the rodent model, like up to 20%.

And that, again, I think is because of reduced inflammation, reduced glycation, blood sugar damage, reduced oxidation with reactive oxygen species, ROS. And so, those are all like markers of aging, and all those get reduced in the ketogenic state.

Another point of clarity here is keto versus low-carb. And it’s very different to say low‑carb versus keto. But I do not think there’s a danger in any of these, in any diet per se. It’s more about the foods that you’re eating.

Tim:              Yeah, definitely.

Shawn:         Not in macronutrient ratios. I think that’s absurd to make that kind of claim. There’s a lot of problems with the study that we could literally go point-by-point on, and if you guys want us to, we can, but I would just openly say no, don’t make those kind of inferences.

Tim:              Yeah, that’s super, Shawn. We don’t have to go too far down the rabbit hole there. But basically, the researchers collected data and they reported what they found, and who took it out of context? The media.

Shawn:         Exactly.

Tim:              Here are some headlines: Low-Carb Diets May Shorten your Life, Low-Carb Diets May Not be Healthy in the Long-Run, Low-Carb Diets May Do More Harm than Good. That’s not what the study said. That’s not what the author has reported, necessarily. But that’s what the media said. Then those were like the more moderate ones. They’ll Kill You, and things like that. But basically, the study was an observational study, which you said is an epidemiological population-based study where they just collect data. So, it’s observation. It doesn’t show any cause and effect. However, when you’re looking at mortality, which is like the science-speak for death, you can’t really do a clinical trial, necessarily, so it’s kind of tricky for that one.

But it was an observational study and how they collected data was dietary recall. So basically, Shawn, once every six years I’m going to have you come in—that’s what they did—once every six years. Two times. Once at the beginning of the study, once that one that when I started collecting data from you and then in six years I’m going to collect it again. And I want you just to write down what you ate.

Shawn:         By memory.

Tim:              By memory.

Shawn:         And expect to be truthful, 100% accurate.

Tim:              So dietary recall is erroneous, like notoriously erroneous. It’s poor, it’s a poor way to collect data. But I’m talking about like they collected data twice, over six years. Dietary patterns can change significantly over six years.

Shawn:         Wouldn’t you say that people that might who eat low-carb might be people that might be either image-conscious, like bodybuilders, that maybe have a certain lifestyle, or people that are overweight.

Tim:              Sure.

Shawn:         And are employing this as a strategy to lose weight.

Tim:              Yeah.

Shawn:         Again, this is where correlations get messy.

Tim:              Yeah.

Shawn:         And you have to dig deeper. But it’s a messy study, all the way around.

Tim:              The point that we’re trying to make though is that what you eat is, in many cases, is going to trump how much, in terms of percentages.

Shawn:         Totally. That’s what it comes down to. So, we appreciate you people. Thank you for listening to yet another BioTrust Radio episode. Check out BioTrustRadio.com for all the transcripts and notes, and links to studies, and all the fun stuff we have there. Go to BioTrust.com/VIP to join the VIP group. Ask us a question there and we’ll give you a free product, if we mention that question on the show. Yeah, give us a rating if you could on iTunes. That means a lot. It really goes far in terms of getting us notoriety and weighting our show more on searches, and all that kind of stuff. So, we really appreciate your support, and we’ll continue to support you the best we can. So, thanks gang.

Tim:              See you.