Guest Speakers
A special thank you to Lisa Kara and Dr. John Limansky for attending Ketup 2017!
If you have any additional questions for them feel free to reach out through Email or Instagram!
If you have any additional questions for them feel free to reach out through Email or Instagram!
LISA KARACertified Nutritional Therapy Practitioner
|
DR. JOHN LIMANSKYBoard Certified Physician of Internal Medicine
|
Q & A
Can you do the Keto Diet while being pregnant?
Dr Limansky - I would say talk to your doctor about that, I’d probably not recommend doing a strict keto diet while being pregnant. What I’d suggest is a modified version; meaning that your carb intake will be from healthy carbs: greens, vegetables, broccoli and asparagus. So instead of getting carbs from ice cream, if you eat healthy carbs you should have no problems but if you want to stick to strict ketosis I’d probably say no.
How do we know what our meat is eating
and whether it is grain fed or grass fed?
Dr. Limansky - The more you learn about this, the more you begin to realize that it is a hard question to answer. if you live in an area with local butchers I would go to them and ask them specifically, find somebody that you trust. I use a company called US Wellness and Meat, they’re based up in Washington and Alaska, I know that they’re quality is good because I’ve gone up there to talk to them. They have a range of beef, pig and other things, but I do think it’s important to know and that sometimes it can be hard to understand where to get your food sources as well as know where they are coming from. You also have to be careful about the label of organic, it might be labeled organic but that doesn’t mean it is. I’ve got a big freezer so they’ll ship it to you in bulk, cost-wise it’s very comparable.
Which supplements are vital and more important than others?
Dr. Limansky - When you are initially transitioning over to the ketogenic lifestyle, I’d focus on salt, potassium, sodium and magnesium because those three are very important. I use a lot of supplements because I think the quality of the food we have is very poor despite everything we do. I consume a lot of desiccated liver and desiccated hearts to get my micro-nutrients. I use methylene b12 supplements because 50% of the population has a genetic mutation where we don’t convert vitamin D which results in a lot of neurological symptoms like fatigues, headaches, migraines, seizures and even some autoimmune type disorders.
What should I ask for from my physician
if I’m looking to switch to the keto lifestyle?
Dr. Limansky - They’ll check your cholesterol, electrolytes; I don’t check cholesterol because it’s not specific enough. One of the things most people will experience is that their LDL will go up; their doctor will want to put them on statin. Your LDL will go up and it’s usually transient. LDL has been set as the bad cholesterol and HDL is the good cholesterol but that’s inaccurate. When you consume fat you consume the good kind of LDL and so your LDL level will go up but you stop making the bad LDL which is the very small ones that cause all the damage. So chemistry which is your basic labs, I’ll also look at specific LDL particles, I’ll look at things like MTHFR which is the Vitamin B12 mutation to see if you need to take B12 supplements, I’ll ask for insulin level, a lot of labs will check Hemoglobin A1C and that’s the marker of whether your glucose level is high. So when you have a high level and the body can’t actually process it into your cells those things become what are called glycolate end products and they attach to different proteins one of which being hemoglobin. Thyroid function is very important. Let's say you go on a ketogenic lifestyle and you are too strict or workout too hard, one of the consequences could be that you surpass that function. I’d also check testosterone, estrogen as well but some of the things I outlined before would be a few of the things that a physician might check
Are berries allowed?
Dr, Limansky - Yes and no but the best ones would be blueberries raspberries, boysenberries, blackberries. Quick question, how did Grizzly Bears gain their weight? They ate berries in the summer when they were at their best. An interesting thing about globalization is that we had access to berries during the season, but now if you want berries you just go to the store and get them, you can eat them nonstop. But since globalization, it has created this cycle where we have instant gratification and we can get it whenever and wherever we want. Berries are okay but I’d say if you’re in the introduction phase and trying to transition into the keto lifestyle I’d try to avoid the keto sweets and recipes. You have to very careful with sweeteners initially, once you progress through you can reintroduce some berries back into your diet, but obviously it will be different from person to person depending upon age or weight level. If you’re transitioning I’d suggest skipping the sweeteners but a you progress I’d reinstate them back into your diet then check to see the effects they have on you.
My doctor is against keto but I’ve been on it for 2 years now
what should I do?
Dr. Limansky - Educating yourself is very important, in medical school we get 30 minutes of nutrition. We learn about the biochemistry but there is that science background which is also very important, the nutritional side though we don’t get a whole lot of. For the last 12-13 years I used to be a vegetarian and I thought I was doing it for health reasons, but during medical school I was pre-diabetic and metabolically resistant. Since then I’ve devoted the time to learning more about nutrition because I’m passionate about it. I care about my family, my kids and have kind of helped my Dad make that transition as well. I would first bring information about the keto lifestyle to your doctor. They might get really offended at first but you’d be surprised because once a patient starts losing weight the doctor begins asking questions. Why has your weight gone down or what’s your lab work look like? If they don’t have a good answer to those questions then I might suggest looking for another doctor.
What do you suggest if I plateau on the diet?
Do I have to give up on cheese?
Lisa – Honestly short answer would be yes
Dr. Limansky – Pick the cheese you like, a simple test is that you wake up in the morning. Check your blood sugar and ketones before you eat. 2 Hours later after you eat the cheese check your glucose level and it’s over 100 you probably shouldn’t eat that cheese. There are many things that affect if you react to a certain food, the gut microbe is very important in whether or not people can consume food or not. The gut microbe has a tremendous effect on how we lose weight and whether we can digest certain foods or not. Let’s say you eat a certain way and are on the keto lifestyle for a while, I’d go back and check to see how your body will react to those certain foods.
Lisa – It might not be as simple as should I or should I not eat that cheese? But more so where did that cheese come from? How was it handled? How was it processed? And there’s more to navigating and managing your own health instead of “is this keto or not” That’s where I stand on it, there are other things that are harmful to your health but that could be keto.
Dr. Limansky – We are getting so fixated on is this paleo, not paleo or keto and not keto. We should be focused on the quality of the food, what is the source and when we are consuming it. For myself I fast pretty regularly and don’t ‘eat a lot all day, but I do triathlons and marathons so when I do eat my muscles are ready for the food. After my long workout I’ll eat and consume a fair amount of good carbs because my muscles are ready so I wouldn’t usually eat a huge meal once I wake up. It’s very situational in terms of the quality of the food and also when you are eating it. Being that keto is becoming popular I’d stay away from the products, stay away from the bars, treats, cookies etc. A lot of them are still made from sugar substitutes that are destroying the microbial gut bacteria.
Lisa – There is a food and then there is real food along with the difference between junk and junk food. One of the greatest things is not having to think about your next meal. But when you kind of break through and your system adjusts to this lifestyle of eating 4-5 hours will pass and you’ll think “oh yeah I need to eat again.” I recommend keto to my clients and they develop the ability to stay full longer and sleep better
Dr. Limansky – Pick the cheese you like, a simple test is that you wake up in the morning. Check your blood sugar and ketones before you eat. 2 Hours later after you eat the cheese check your glucose level and it’s over 100 you probably shouldn’t eat that cheese. There are many things that affect if you react to a certain food, the gut microbe is very important in whether or not people can consume food or not. The gut microbe has a tremendous effect on how we lose weight and whether we can digest certain foods or not. Let’s say you eat a certain way and are on the keto lifestyle for a while, I’d go back and check to see how your body will react to those certain foods.
Lisa – It might not be as simple as should I or should I not eat that cheese? But more so where did that cheese come from? How was it handled? How was it processed? And there’s more to navigating and managing your own health instead of “is this keto or not” That’s where I stand on it, there are other things that are harmful to your health but that could be keto.
Dr. Limansky – We are getting so fixated on is this paleo, not paleo or keto and not keto. We should be focused on the quality of the food, what is the source and when we are consuming it. For myself I fast pretty regularly and don’t ‘eat a lot all day, but I do triathlons and marathons so when I do eat my muscles are ready for the food. After my long workout I’ll eat and consume a fair amount of good carbs because my muscles are ready so I wouldn’t usually eat a huge meal once I wake up. It’s very situational in terms of the quality of the food and also when you are eating it. Being that keto is becoming popular I’d stay away from the products, stay away from the bars, treats, cookies etc. A lot of them are still made from sugar substitutes that are destroying the microbial gut bacteria.
Lisa – There is a food and then there is real food along with the difference between junk and junk food. One of the greatest things is not having to think about your next meal. But when you kind of break through and your system adjusts to this lifestyle of eating 4-5 hours will pass and you’ll think “oh yeah I need to eat again.” I recommend keto to my clients and they develop the ability to stay full longer and sleep better
What should I do about pairing certain foods together?
Lisa – There is a lot of misinformation out there about what you can and can’t pair food with it. It is very individualistic and depends upon the person. I would be very suspect of those that might say we're all the same and use it as a blanket statement.
Dr. Limansky – I’m a big proponent of checking, the best way to know is to just check and see what the effects are.
Lisa – You are your best doctor and if it makes you feel good, energy levels are up then keep going. Only you know yourself best and if it is working for you then keep going because you’re in a good place so keep working towards that.
Dr. Limansky - Don’t do nutrition within a bubble, some might just address nutrition. A lot of what I see people doing are just addressing nutrition and not focusing on other things that will affect your weight loss. Doing stress reduction, yoga and meditation will all influence your sleep. For 10 years I would work 36 hours and working long days resulted in poor sleep. It took me longer to get into ketosis, the longer I’ve done it the easier it is but I’d make a huge point of focusing on sleep, meditation and stress reduction because if you don’t then the hormones will be driven up. Cortisol will go up, your sympathetic system will be on override and your body as well as mind won’t respond well. Focus on all the other aspects that nutrition will touch; I wake up in the morning and do 5 minutes of meditation. Just that act alone has been show to decrease your cortisol and improve your sympathetic nervous system. If you are plateauing a lot of people will just give up and say “oh it doesn’t work for me.” In reality all you really need to do is tweak a few things and it will start working again.
Lisa – Any style of eating it doesn’t matter how well you are eating there must be an element of stress management. It’s equally as important as nutrition, some yoga will definitely help with that.
Dr. Limansky – I’m a big proponent of checking, the best way to know is to just check and see what the effects are.
Lisa – You are your best doctor and if it makes you feel good, energy levels are up then keep going. Only you know yourself best and if it is working for you then keep going because you’re in a good place so keep working towards that.
Dr. Limansky - Don’t do nutrition within a bubble, some might just address nutrition. A lot of what I see people doing are just addressing nutrition and not focusing on other things that will affect your weight loss. Doing stress reduction, yoga and meditation will all influence your sleep. For 10 years I would work 36 hours and working long days resulted in poor sleep. It took me longer to get into ketosis, the longer I’ve done it the easier it is but I’d make a huge point of focusing on sleep, meditation and stress reduction because if you don’t then the hormones will be driven up. Cortisol will go up, your sympathetic system will be on override and your body as well as mind won’t respond well. Focus on all the other aspects that nutrition will touch; I wake up in the morning and do 5 minutes of meditation. Just that act alone has been show to decrease your cortisol and improve your sympathetic nervous system. If you are plateauing a lot of people will just give up and say “oh it doesn’t work for me.” In reality all you really need to do is tweak a few things and it will start working again.
Lisa – Any style of eating it doesn’t matter how well you are eating there must be an element of stress management. It’s equally as important as nutrition, some yoga will definitely help with that.
I’m having some trouble sticking with the diet
Do you have any suggestions?
Lisa – I think that it is actually relatively common. The most common struggle I do think is staying committed, the stress around the diet could contribute to the weight. How many carbs can I have or what is my commitment level?
Dr Limansky – I think what you’re describing is the biggest frustration, first off during that transition period you don't know if you are doing it right because we've been told since we were kids that consuming fat is dangerous for you. I’ve been doing this for so long and I’m a doctor of science and people still question why I say this.. I’d ask do you test your ketones and glucose levels because I care about what your glucose and ketone levels are. If you are worried about costs with ketone strips I’d start with urine, do it till it stops showing up then go over to blood or breath. That way you know because you might kind of think you’re in it and macros are okay but you have no idea. I’d start there then consider incorporating intermittent fasting, it will help kick you into ketosis and I would also focus on the micro nutrients too. One of the biggest issues with going keto is we focus on the grains and veggies but I’d focus on the micro nutrients. And I’d give yourself a realistic goal, say one year for now I’d like to be in ketosis and be fat adapted. When you start incorporating the products, sweeteners and baking it’s harder to stay in ketosis. Get rid of the sweeteners like stevia and xylitol: stevia is either going to be a powder or a liquid and stevia as a powder if you don’t’ add something to it then it will solidify. There was a recent book that came out that said it was having a negative impact on our microbial gut. If you’re consuming anything like diet sodas then it triggers the brain to crave carbs.
Lisa – If there’s a package and there’s a health claim on it then it should be generally avoided if possible
Dr Limansky – I think what you’re describing is the biggest frustration, first off during that transition period you don't know if you are doing it right because we've been told since we were kids that consuming fat is dangerous for you. I’ve been doing this for so long and I’m a doctor of science and people still question why I say this.. I’d ask do you test your ketones and glucose levels because I care about what your glucose and ketone levels are. If you are worried about costs with ketone strips I’d start with urine, do it till it stops showing up then go over to blood or breath. That way you know because you might kind of think you’re in it and macros are okay but you have no idea. I’d start there then consider incorporating intermittent fasting, it will help kick you into ketosis and I would also focus on the micro nutrients too. One of the biggest issues with going keto is we focus on the grains and veggies but I’d focus on the micro nutrients. And I’d give yourself a realistic goal, say one year for now I’d like to be in ketosis and be fat adapted. When you start incorporating the products, sweeteners and baking it’s harder to stay in ketosis. Get rid of the sweeteners like stevia and xylitol: stevia is either going to be a powder or a liquid and stevia as a powder if you don’t’ add something to it then it will solidify. There was a recent book that came out that said it was having a negative impact on our microbial gut. If you’re consuming anything like diet sodas then it triggers the brain to crave carbs.
Lisa – If there’s a package and there’s a health claim on it then it should be generally avoided if possible
Would being on keto be a problem for someone
that maybe doesn’t want to lose weight?
Dr. Limansky – I'm more focused on what keto will do to your body internally. When you go on a keto lifestyle you actually preserve your lean body mass and the ketones are used by your muscles as energy. So you might actually gain muscle mass, but will you lose fat? No, but you’ll determine based on your hunger levels how you feel. Without being in strict ketosis you can consume higher fat and moderate proteins with low carbs.
I suffer from morning brain fog and was recently diagnosed
with reactive hypoglycemia how can I treat it?
Dr. Limansky – When you are in ketosis you get ketones and they can be used as fuel. I’d definitely recommend the keto lifestyle because it will help with that morning brain fog and give you energy in the mornings. I’ve done 10 day fasts and my glucose levels will get pretty low in the 40s or 50s.
Lisa – This is a good reason to explore this lifestyle and diet. Just start small and exploring the keto lifestyle, you don’t’ have to dive into checking your levels every day. Just start incorporating a higher fat diet and see how you feel. You’re gonna feel good and you’re gonna feel great, it's definitely going to improve your brain fog. My whole life I suffered with hypoglycemia and horrible brain fog, I didn’t want to go on those diets because I didn’t want to lose weight. But since I switched its drastically improved with the brain fog and hypoglycemia
Lisa – This is a good reason to explore this lifestyle and diet. Just start small and exploring the keto lifestyle, you don’t’ have to dive into checking your levels every day. Just start incorporating a higher fat diet and see how you feel. You’re gonna feel good and you’re gonna feel great, it's definitely going to improve your brain fog. My whole life I suffered with hypoglycemia and horrible brain fog, I didn’t want to go on those diets because I didn’t want to lose weight. But since I switched its drastically improved with the brain fog and hypoglycemia
Is there a way to increase the microbial gut bacteria?
Dr. Limansky – Yes there is a way to improve your gut micro, doing pro-biotics is not the way to do it. The best way to increase it is through going the ketogenic diet, reducing the refined carbs and increasing fermented foods Sauerkraut, kimchi or apple cider vinegar. and fermented foods.
Lisa – Because it’s real and alive, you can smell them, hear them and taste them. They’re alive and replicating in the actual food
Dr. Limansky – The other thing about the probiotics is that the acid will destroy them in your stomach, by the time it reaches the end of the line in your stomach there’s virtually nothing left. I’d also suggest going to a real organic farm where the soil has improved, one of the biggest issues where these microbes live is in the soil is because they’re destroyed due to big corporations through pesticides or fertilizers, also the sprays like Roundup eliminate microbes.
Lisa – The key is to starve the bad ones and your body will repopulate the good ones and your body will replenish itself. I always suggest fermented foods, try eating one at every meal, I always encourage the 2 F’s with every meal, fermented foods. Food is your medicine.
Lisa – Because it’s real and alive, you can smell them, hear them and taste them. They’re alive and replicating in the actual food
Dr. Limansky – The other thing about the probiotics is that the acid will destroy them in your stomach, by the time it reaches the end of the line in your stomach there’s virtually nothing left. I’d also suggest going to a real organic farm where the soil has improved, one of the biggest issues where these microbes live is in the soil is because they’re destroyed due to big corporations through pesticides or fertilizers, also the sprays like Roundup eliminate microbes.
Lisa – The key is to starve the bad ones and your body will repopulate the good ones and your body will replenish itself. I always suggest fermented foods, try eating one at every meal, I always encourage the 2 F’s with every meal, fermented foods. Food is your medicine.
Do you believe that things are changing in the
medical community in regards to keto?
Lisa – I am confident that it is but very slowly and you can see it in the food trends. If the "big guys" acknowledge the trends of keto and organic and higher fat then people will want it. Half the time they don’t know why they want it but it’s still going so slow.
Dr. Limansky – It depends upon where you are, in progressive places like Los Angeles and San Francisco a lot more people are talking about it. The way the medical system works is that you have big groups like the American Heart association and American Diabetes Association who make the guidelines and they're based on the latest and greatest research. Then based on those guidelines everyone has to follow that and if you don’t then it’s the end all be all. The problem with those guidelines is that they are kind of behind the curve but I still think it’s still going to take another 20 to 30 years before things really begin to change more.
Lisa – The beauty of working as a holistic practitioner is that we aren’t forced to work by these guidelines. Although we aren’t licensed health professionals we are much more up to date and educated on the new stuff. That’s why we need to work together and see a holistic practitioner and work with the doctors as well. We have more freedom in the holistic space.
Dr. Limansky – The real change is going to come from social media, consumers and people who will start noticing, I think it’s going to come with the grassroots movement because It really starts with people tuning in on social media and people just wanting to learn on their own to get more information.
Dr. Limansky – It depends upon where you are, in progressive places like Los Angeles and San Francisco a lot more people are talking about it. The way the medical system works is that you have big groups like the American Heart association and American Diabetes Association who make the guidelines and they're based on the latest and greatest research. Then based on those guidelines everyone has to follow that and if you don’t then it’s the end all be all. The problem with those guidelines is that they are kind of behind the curve but I still think it’s still going to take another 20 to 30 years before things really begin to change more.
Lisa – The beauty of working as a holistic practitioner is that we aren’t forced to work by these guidelines. Although we aren’t licensed health professionals we are much more up to date and educated on the new stuff. That’s why we need to work together and see a holistic practitioner and work with the doctors as well. We have more freedom in the holistic space.
Dr. Limansky – The real change is going to come from social media, consumers and people who will start noticing, I think it’s going to come with the grassroots movement because It really starts with people tuning in on social media and people just wanting to learn on their own to get more information.