241: Ketogenic Diet Therapies for Neurological Disorders

Episode 241: Ketogenic Diet Therapies for Neurological Disorders

With Beth Zupec-Kania

See our guide to keto diet troubleshooting here.

Ashley:
Hello everyone, welcome to Cellular Healing TV. I'm Ashley Smith. Today, we welcome Beth Zupec-Kania, who is the head nutrition consultant for The Charlie Foundation for Ketogenic Therapies, a special non-profit that provides information about diet therapies for people with epilepsy, other neurological disorders, and select cancers. She's joining Dr. Pompa, today, to talk about the relationship between fasting and ketogenic diet therapy, the benefits of both, and they'll also discuss some cautions and advise you on where to start if ketogenic therapy appeals to you.

Just a bit more about our guest, Beth. Beth Zupec-Kania is a registered dietician and nutritionist who has promoted safe and effective ketogenic therapies since 1991. She's managed ketogenic diets in individuals with autism, epilepsy, mitochondrial and metabolic disorders, migraines, MS, rare genetic disorders, various cancers, and Parkinson's Disease. She's authored over 50 publications, co-authored the Modified Keto Cookbook, co-organized three global ketogenic symposiums, and is the designer of the web-based Keto Diet Calculator. Beth has provided diet training to over 250 medical centers worldwide, owns Ketogenic Therapies, LLC, and is, of course, a consultant to The Charlie Foundation.

This is going to be a great episode. Before we get started, this is for you practitioners out there. Dr. Pompa's Live It to Lead It seminar is coming up from November 2nd to the 4th in Las Vegas. We'd love to have you join us, and at the end of this episode, stay tuned for a special code for you to take $200 off your ticket price. Let's get started. Welcome, Dr. Pompa, and his guest, Beth Zupec-Kania, to the show. This is Cellular Healing TV.

Dr. Pompa:
Welcome to Cell TV. We're glad you're here.

Beth:
Thank you for having me.

Dr. Pompa:
I just said, before we got on, I had a big explanation with one of my clients about why ketosis for Alzheimer’s. I get it with a lot. Why this diet for autoimmune? Why this diet for Autism? Why this diet? It goes down the list. We get a lot of questions and people struggling or whatever about ketosis. My team found what you do. I tell you, you've been at this longer than most people. I'm not going to age you here, but you've been at it a long time. I want your wisdom. I think my viewers and listeners want your wisdom. Anyways, I have to ask this first, how did you get into this such a long time ago? Tell them the story.

Beth:
Yeah, and my age will probably come out because I'm going to talk about myself, maybe, a little bit. I don't like normally doing that, but because there is a relative story I will reveal later on if we have time. I got involved in ketogenic therapy 27 years ago when the neurologist at the children's hospital where I worked at at the time came to my office looking for somebody. He was recruiting somebody to work with the ketogenic diet. He walked in. I happened to be sitting there. He said, I need somebody to do the ketogenic diet. I said, the what? I didn't know anything about it.

Then I went back, and I chatted with my colleagues. I did remember, oh yeah, we did learn something about this in school. I had no clue. I thought it was a low-fat diet. That was the early genesis of it. It turned out the reason he was asking was because a man named Jim Abrams had gone on Dateline and had exposed that his son, who had very difficult to control epilepsy, was started on a ketogenic diet at Johns Hopkins, and his seizures stopped within days.

Dr. Pompa:
What movie was that featured in?

Beth:
Jim wrote a movie called, First Do No Harm.

Dr. Pompa:
Yes. I love that movie.

Beth:
Yes, and it's not a story about his son. It's a story about another family who had written to Jim. A lot of families, after he was on Dateline, wrote and said, my kid went through this. We're so thankful that we found the ketogenic diet. This is how we found it. This story that he wrote, First Do No Harm, was very compelling because there was so much drama in it. It was a true story.

I've met the young man that was depicted in this story, the little boy that had bad epilepsy. He ended up in a hospital in Chicago. They do this scene in the movie where the doctors are really just—they're ready to pound him with some heavy drugs to get him into a coma. The nurse just was sympathetic to the family. The family was like, enough, we are so done. Everything is making him worse. The nurse helped get the family out of the hospital against medical authorization.

Dr. Pompa:
I was so mad. I'm telling you, that's an emotional movie. I was mad, I was sad, it was great.

Beth:
I know. It's interesting that you're a doctor. A lot of doctors get pissed off by that movie because it makes them look really bad, but this is what actually happened.

Dr. Pompa:
Yeah, no, I was mad at the dang doctors in the movie, right, because that's the way it went down.

Beth:
That's the way it went down. It turned out well. They got him to Hopkins. They put him on the diet. He turned around right away, so it was another success case. That young man is now, I want to say, in his early 40s. I've met him. Jim has kept in contact with him. He's gone on to lead a perfectly happy life. I believe he's married now. He spoke at one of our fundraisers. Again, this movie is now 25 years old. Jim, at the time, was a neighbor of Meryl Streep's. Their kids went to school together in Santa Monica.

Dr. Pompa:
Yeah, she starred as the woman. Who is the dad, or the grandfather?

Beth:
I don't know -inaudible-.

Dr. Pompa:
Isn't it -inaudible-? Is it Liam? What's his name? He plays in the action movies, Liam? Anyway, fantastic.

Beth:
I'm not very much a movie person.

Dr. Pompa:
You have to watch the movie, folks. I'm telling you it's worthwhile. I've seen it twice, and each time—as a matter of fact, I play clips of the movie in some of my seminars. That's how dramatic it is. It's a real story, obviously.

Beth:
Jim will love to hear that because he's been criticized. He not only wrote, he directed, and he produced that movie. That movie, to this day, is still how people find out about the diet. He gets communications regularly that this is how people found out about the diet. My aunt saw this movie. She suggested it to—

Dr. Pompa:
That's amazing. He got you into this.

Beth:
He went on Dateline, exposes what happened to his kid. Our neurology department at our children's hospital gets bombarded with phone calls. The neurologist comes to my department, gets me involved. Then Jim and I meet. Jim is from this area. He's from Milwaukee, where I now live. He has family here. We started to communicate regularly in person and on the phone.

Finally, I talked him into hiring me. I said, I can help you. I know what the problem is. The problem is that there's not enough people like me trained to get people on this diet. Let me help you do that. After a couple years of me telling him that, he finally—he was, I think, very reticent about getting involved with the health care community because they are the reason Charlie didn't get to the diet in time. Jim found out about it on his own -inaudible- Medical Library at UCLA.

We've been together now since 2005, working together, doing a lot of different advocacy, educating professionals, putting together meetings. I travel all over the world and train mostly pediatric hospitals how to do this, but now I'm getting more involved in adults because now the evidence is out there that it helps adults with epilepsy. It helps with mood disorder. As you've mentioned before, Alzheimer’s. The brain is this fantastic organ that we are just learning so much about.

Lo and behold, diet has a huge impact on your everyday thinking. Fasting, which you are an expert in, has these same benefits. In fact, the ketogenic diet mimics fasting. That's how it came about. It's just amazing to me how people, A, don't know about it, and B, are reluctant to try it despite all these fantastic benefits that it has. What really drew me in is just starting to work with people on this diet and seeing change overnight.

I was working with children, initially, but to see them go from groggy and dopey on their medicines because they have epilepsy, and their medicines usually are in high doses when they're not under good control. Going from that state, and then 24 hours later being bright, alert, and paying attention, and answering questions. To me, it was just unbelievable.

Dr. Pompa:
Let's start there. First of all, I'm going to now label you as the Queen of Ketosis because you outdate anyone I've had on this show, in a good way, with ketosis.

Beth:
-inaudible-.

Dr. Pompa:
I mean, but when you started, for me, is what really ignited ketosis back in this country. Ketosis was really popular at the turn of the century in the early 1900s. There was a fire. All the drugs started coming out for neurodegenerative conditions. Then it lost its vogue, if you will. I think that movie is what made it back in vogue. I mean, obviously, so you're the queen. All right, Queen Beth, so let's start here. Based on what you just said, why does it work? How does it do this to the brain? Tell our viewers about that because I do still get that question all the time.

Beth:
I guess you first have to say for what condition are you talking about because there's different mechanisms, right?

Dr. Pompa:
Let's talk about the brain because we started there with epilepsy, obviously. We even mentioned Alzheimer’s.

Beth:
What Hypocrites knew in 460 BC was that fasting was good for the brain. I mean, he's the father of all doctors. He knew this, and he used it for treating many different conditions. Why that didn't catch on—Jim Abrams always comes back to if it doesn't make money, it doesn't become popular. That's true for fasting and that's true for the ketogenic diet. Both are in that same realm. This cognitive clearing that I witnessed so many times with everybody that I worked with, within 24 hours.

Children go into ketosis very fast. Everything is quicker than when working with adults. I have to remind myself to be patient with adults because they're not as compliant, and their metabolism moves slower. In children, I would see these immediate results. Their brain would just respond beautifully to either fasting or just starting them on the diet. Over the years, we've stopped the fasting to get them on the diet quicker because they go into ketosis so rapidly. Within 24 hours of just—

Dr. Pompa:
I'm just going to say that kids can get in in a day or two. Adults typically take two to four weeks, and some people struggling beyond that because they're metabolically broken. That's another story. You're right, kids, immediate.

Beth:
Yeah, and there's always a parent to make sure they get the food, whereas in adults, they're often on their own. -inaudible- just thinking of what is going on here that they have this miraculous turnaround in 24 hours. It's all about the brain's energy source. Every text book, every health text book that you and I know says glucose is the preferred fuel source for the brain, right? We know that's not true.

Dr. Pompa:
That's right because they're only comparing it to fat, meaning the brain can't use fat. However, fat breaks down in ketones and the brain loves them.

Beth:
It loves ketones, and it performs better with ketones. I have never met anybody that hasn't performed well with ketones except for a few people that have very rare metabolic disorders. Those have been identified. They're just, like I said, they're very rare, something that we screen kids for before we put them on the diet. It is quite amazing to see the transition. Today is my fasting day. I can even just tell the difference in my brain clarity and my energy level from today versus yesterday. I just know—

Dr. Pompa:
It's 2:38 my time. I still haven't eaten a bite of food. I've exercised in the morning. I went on a bike ride, actually, for an hour. Pretty intense. How did I do that? I had no food. I'm fat adapted. I'm in ketosis. Actually, for fun, my ketone levels were 1.8 this morning because I had a glass of wine and a half last night. I just wanted to see how my body reacted to that.

Beth:
Yeah. Do you also check your glucose?

Dr. Pompa:
I always do, yeah, actually. Especially because I have clients, we check glucose and ketones in the morning, and then we do it before first meal. Glucose should drop, ketones should go up. If glucose is high, you're not really getting the benefit of the ketones. You know all that.

Beth:
Yeah, it's like a see saw effect. That's the way I try to explain it to people. It's not until your glucose is below 100 are you going to start to see ketones. Fasting is great at getting glucose down. It's drawing down the glucose reserves called glycogen in the liver. You've got to draw that down before the body's going to say, all right, I'm done with that source. I'm going to use the fat that's over here in your belly, or the fat that you just gave me in your diet. The body has this very -inaudible- that's switching back and forth between these different energy sources.

Dr. Pompa:
Actually, to your point, and you and I both know Thomas Seyfried well. He would say, you have to get the glucose down to get the benefit of the ketones. A lot of people, the only way to get the glucose down is through restriction, meaning not eating, like we're saying, during the day or doing short times of restricted calories, even. We're not for caloric restriction long-term, but restriction, like we're talking about, it works to get the glucose down.

Beth:
Exactly. They have to do that. Most people, I read 80 to 90% of people that are obese have non-alcoholic fatty liver disease. Part of that is just way too much glucose in their liver, so right there.

Dr. Pompa:
The brain loves ketones. Ketones burn cleaner than glucose. I always like to give the analogy of glucose burns like wood. You need a chimney. Ketones burn like natural gas on the stove. It's one of the reasons why it down regulates inflammation. There's actually new studies. The studies showing the connection between the microbiome and the brain. Ketones change the microbiome. People are trying to fix their gut with probiotics. It doesn't work. See what ketones do. Good point. What are the best applications, if you will, for ketosis?

Beth:
The primary one that it was designed for is epilepsy. Todd will tell you, yeah, but it was also at the same time, in Germany, it was recognized helpful for cancer. Those two came about at the same time. The doctors did not know each other. A doctor at the Mayo Clinic noticed that his patients who were fasting for procedures were reporting fewer seizures. He said, this, there's something to this. He started to fast his patients with epilepsy. Lo and behold, most of them had far fewer seizures. Then he designed the ketogenic diet to mimic it.

Fasting, again, that's the primary condition for which the diet has been used for a long time. As you alluded to before, it was actually used quite a bit in the 1920s. Right after World War II, a whole bunch of anti-seizure medications were released. Everybody put the diet away and said, man, it's easier to use drugs. You just take them twice a day. The fact of the matter is 30% of people with epilepsy have seizures that the drugs do not help at all. New drugs come out every couple of years, and that statistic remains the same. Yeah, so that's primary one. Cancer, I think, would be probably the second to that in that—

Dr. Pompa:
By the way, folks, Tom, we mentioned Dr. Tom Seyfried, brilliant guy doing a lot of studies with ketosis, fasting, and cancer. Wrote a book, Cancer as a Metabolic Disease; get it. I've done two interviews with him here, so Ashley can put up those show notes. Go ahead, sorry.

Beth:
Yeah.

Dr. Pompa:
I didn't want to stumble upon that. We would lose it because the people who have cancer are like, where do I find more information on that?

Beth:
Right, yeah, you need to look at some of Tom's work. Most of it floats over me, but I've watched it enough to know the basics. That is it's much, much more than just glucose being a fuel for tumor, which is the easy—that's the Reader's Digest explanation that understand tumors grow on glucose. It's actually far more than that. There's an anti-inflammatory effect and all kinds of signaling. Tom's work has actually evolved since I met him many years ago. Now, he actually recommends periods of intense carbohydrate restriction, ketogenic with—and then fasting, and then going back to higher carb. Not being on the same, exact, macro intake that we typically use for epilepsy.

Dr. Pompa:
By the way, Beth, I was in a master mind with Tom, and Mercola, and Ron Rosedale, and some others. I was talking about how we do this feast famine thing with our—and it forces adaptation. These other guys were like, what, yeah. Ron Rosedale was asking me questions. Tom came out of his skin because he had developed this thing that pushed Paul's thing. He's like, finally because I'm combatting these guys. Tom's like, Pompa's right. It's like, let me tell you what we're finding. Then he went off of why the dietary switch is the key anyways. It was one of my best days of my life because I got validated by Tom. I didn’t have to defend myself anymore after that, anyways, funny story. Go ahead, Beth.

Beth:
Yeah, it’s just amazing the science that he has done and the evolution of it, but the reason he has moved toward this press-pulse is because, in animal studies anyways, some tumors can adapt to ketones and start growing on ketones. That was the reason for the shift. Listeners should know this is all in the early stages and more to come. This is a high area of interest, and there are several researchers in the country taking a different look at this from different angles. What I love about it is that they communicate with each other. They’re not in competition and communicate, so I get to be part of that group. I get to see them at our big meetings, at our big global ketogenic symposiums, so where were we going now with…

Dr. Pompa:
Yeah, we were just talking about the applications for it. Seizures was where it started, right? Like you said, cancer technically started in the early 1900s as well. I mean, Otto Warburg, I mean, a lot of that work that Tom has really expanded upon. Yeah, what about neurodegenerative conditions? I see absolutely stunning results with that myself, I mean, from autism to Alzheimer’s.

Beth:
My experience with neurodegenerative disorders has largely been with the autism community and mostly with children. Again, sometimes we see these phenomenal overnight changes, and sometimes it takes weeks. I always tell people give it weeks. Don’t be frustrated because things could get worse before they get better. I mean, when you’re putting a child with autism who only eats five foods to begin with and most of them are high carb and changing that diet completely, some of the struggle is just coming up with things that that’ll like. Not giving in to the behavior, or tantrums, or whatever. It’s an adjustment -inaudible-.

I’m remotely, and I work with people from around the world. I’m not in a clinic or a hospital setting. I have to be also very cautious, so I tend to do – start it very gradual with kids, especially kids that I feel are finicky eaters. Almost every kid I work with is, so I do it really gradually. I start them up. Just work on one meal a day that’s keto. Keep the other two the same. Then we do that for a week, and then next week we’re going to go to two meals. Then maybe go to three. I’ve had some parents that actually do just two meals, and I have them weighing out these foods so that they’re getting the correct macros. It’s not an intuitive diet. High fat is not intuitive. When I say high fat to people, they think, okay, you want me to fry my foods. You want me to sauté everything. Actually, no, it’s the opposite.

Dr. Pompa:
No, let’s give our listeners and viewers some details there. I know that’s what they want, right? Even the people who’ve watched and know about ketosis, they still want to hear it, so let’s talk about one of those meals, right? If we talk about the kids, then that will apply to adults, right? If we can get the kids to eat, surely you can do it too. Let’s talk about this one meal. What do you have them do? Let’s look at it close.

Beth:
Kids are definitely different animals, and they’re so much more adventurous than adults. Adults have these old habits, and they want to find something that matches what they used to eat. They want something like bread, that looks bread, that tastes like bread, and so you’re jumping through hoops trying to make them happy. Whereas kids, they get hungry, they’ll eat whatever you give them. That’s what I miss about children is that they’re really easy to get on to a ketogenic diet, and you don’t have these food battles. Typically for kids, we tend to use eggs for a meal in different forms two or three times a week. First, people are like, oh, I thought we weren’t supposed to eat eggs. Nope, eggs are fine. Cholesterol is good.

Dr. Pompa:
It’s actually the perfect food in my eyes.

Beth:
Yes, it’s the perfect food. I have parents that have gotten chickens because they eat so many eggs. They send pictures of the chicken in their lawn chair in the backyard. They’re going through so many eggs. It’s cheaper to just have your own chicken, so they tend to have eggs every other day. We always think about a protein food with a carb food and then fat, usually two different types of fat so high-fat yogurt with, say, some raspberries, which is fairly low on carb and then maybe mixing in some oil into that yogurt. I use a lot of MCT oil because it’s a little bit more ketogenic than its source, which is coconut oil, and then maybe another source. If the kid’s okay with dairy, we might do—we might mix some heavy whipping cream into the yogurt to make it larger and tastier.

Dr. Pompa:
Oh, yes, it makes it really good too.

Beth:
Yeah, so that’s typical for kids. Hemp seeds, I have a lot of people asking for vegetarian.

Dr. Pompa:
By the way, that’s a really great tip. You said that you put the whipping cream in, which I love to do. I need grass-fed, 100%. There’s zero carbs in it. It’s basically fat, but when you whip it up, I usually put a little Stevia and blueberries in there. That’s my dessert when I’m in ketosis. You do that to put it in the yogurt so it’s more volume?

Beth:
More volume, right.

Dr. Pompa:
Okay, so they feel like they’re eating a lot more.

Beth:
Yes, one of the complaints about the diet is the portions are small, and that’s true. The portions are small, so I’m always trying to think about volumizing things for people that love the physical delight of putting things in their mouth. The other tip I give people is that you can whip cream in a blender. You don’t have to get out the mixing bowl and the beaters, and that’s a big mess. You can do it in a blender, like a Bullet blender or a Ninja blender. Even though it has blades, you can whip the cream in, literally, less than a minute, and then it stores very nicely for about a week. Once people learn these little tips to make their life easier, then they’re, okay, we can do whipped cream. People don’t know whipped cream is something that you make at home. They think it’s in a can or in the freezer in a container. No, it’s something you can make at home. We use cream a lot for children.

Dr. Pompa:
By the way, most kids will do cream. Sometimes they can’t do the lactose. There’s no lactose in cream.

Beth:
Can’t do milk. Can’t do milk because milk has carb, although I will do it for kids that really like milk or the taste of milk. We can do some of the nut milks, which are like almond milk.

Dr. Pompa:
Yeah, unsweetened almond milk.

Beth:
Unsweetened, then you can always mix some heavy cream into it to bump the fat up a little bit or some oil into it, so there’s a lot of little tricks. This is what I do. I write guides, very practical guides. I have one for kids. I’ve got one for adults, one for blender diet. I have a lot of people with feeding tubes, so I don’t want them on a commercial ketogenic formula. I want them eating real food if they can.

Dr. Pompa:
Do you have resources for some of your guides that our viewers and watchers—give them your information.

Beth:
Yes, charliefoundation.org. I write these guides, and then The Charlie Foundation sells them, and that’s a source of income for them.

Dr. Pompa:
Charlie Foundation is a great resource for ketone, so thank you.

Beth:
Yeah, they primarily were for epilepsy for many years, and then, in 2012, they just said open the door to all comers. We know this diet can help everyone, so we’ve expanded beyond epilepsy. We talk about other conditions, pretty heavy on recipes. That’s what people go to our site for. We notice that that’s the highest used area of the website is the recipes, so we’ve done a lot of special recipes and are into the gluten free. A lot of people are doing vegetarian, so we try to highlight those to give people variety. People tend to get stuck on a ketogenic diet eating the same thing every day.

Dr. Pompa:
True.

Beth:
I was going to mention, speaking to that, porridge made with hemp hearts which are nearly carbohydrate free, very high protein. It’s vegan. They’re high in omega-3’s. I mean, there’s nothing bad about them. They have fiber.

Dr. Pompa:
Actually, they have a perfect ratio, a four to one ratio of omega-3 and 6. You need the 6 too. Everyone talks about the 3, but the 6 is the key to the membrane. Yeah, that’s a great. What’s this recipe? I get porridge. What do you do?

Beth:
It’s simply use the hemp just like you would oatmeal, and you can heat it up with milk or just water. I use water myself, lots of butter. You can throw some berries. I put tons of cinnamon, like a half teaspoon of cinnamon. I love the cinnamon taste on there. On a cold winter day, which we have many here in Wisconsin, that is very—a warming meal for me. I don’t eat breakfast. I don’t eat until usually 1 o’clock, so I’ll have that as my first meal of the day. I’ve put pecans in it just like you would for oatmeal. You just think about…

Dr. Pompa:
Yeah, exactly. You just boil it in water, same way as oatmeal.

Beth:
Yeah, I don’t even boil it. You pretty much are just heating it up because it’s not uncooked.

Dr. Pompa:
It gets soft and gooey like oatmeal

Beth:
Yeah, but very high in protein. You can get a good 10, 12 grams of protein in a serving. Yeah, so that’s another one. That opens the door for people when they hear I can have porridge. I don’t have to give up my oatmeal.

Dr. Pompa:
Great idea. I never thought of that, yeah. You could even add a little flax too, and make it a little gooier if you wanted.

Beth:
You can, definitely. Yeah, I would add the flax at the end because it does get gooey when you mix it into hot water, right.

Dr. Pompa:
Yeah, that’s brilliant. Okay, now I want to know more. You said that people get stuck, right? What are some other things? I guarantee you half my viewers are like, yeah, that’s me. I’m stuck. I’m eating the same four things.

Beth:
Right, I’ll never forget. I went to a wedding recently, and I checked in at the desk. The guy that checked me in asked me for my email address, and my email address has keto in it. He goes, “Keto, I did that keto. I did that last summer. All I ate was bacon for two weeks. I felt horrible.” I just thought no kidding.

Dr. Pompa:
I’d say, okay, that’s the Atkins diet. Not to throw Atkins under the bus. You know what I’m saying? He did a lot, but that would be a type of a good Atkins Diet.

Beth:
Right, this is what people think about is bacon because it’s high fat. It tastes good. It’s got protein in it. I rarely eat bacon. That’s just not something that I grew up eating. I’ll have it at a restaurant, but I don’t like the greasy mess it makes. I don’t have it very often, but there’s a lot of other options besides bacon. One of my most favorite options that I share with everybody and especially with kids because kids are not great fish eaters is an au gratin recipe that’s so simple.

I have to back up a little bit. One of the ingredients is mayonnaise, but I don’t recommend people use mayonnaise from the grocery store. Most of them are made with soybean oil. You can find avocado oil mayonnaise, or you can make your own, which is much cheaper, and it’s very simple once you do it, right? It’s, basically, whipping oil in a blender with some egg yolk and adding a little bit of mustard. Anyways, homemade mayonnaise, and then put -inaudible- in there and a little bit of lemon juice. It’s a nice creamy sauce that you put over your fish. If it’s a very thin fish, you can put it over the fish raw, and you just broil it. If it’s a thicker fillet, you should broil your fillet for a few minutes. Then put the topping on, and then finish broiling it. It’s nice and brown.

I like making it in a little individual pan so that it becomes that person’s full—pretty much their full meal. They’ll have broccoli or asparagus on the side, but it is a delicious way to eat fish, very rich in fat. You lick up every last bit of the fat because it’s so good, so that’s another one I like to share. That’s also on The Charlie Foundation website in the recipe section.

Dr. Pompa:
Yeah, that’s great. What did you call it?

Beth:
Fish au gratin.

Dr. Pompa:
Okay, yeah, I’d just eat it. I’d put that on everything, actually. I’d put that on my avocado. I like putting things on avocados, right? I like olive oil, mustard. I mean, just things go on avocados.

Beth:
Yeah, another perfect food for the ketogenic diet, right, yeah, magnesium and fiber and omega-3 and fat, of course, and Vitamin E. I mean, it is such—it’s a super food. It’s like eggs. There’s nothing to compare.

Dr. Pompa:
I mean, just for new people, I mean, give the basics then. People are like, okay, wait. I mean, tell someone how to get into ketosis. For some people, that’s review, but I think it’s still worth saying.

Beth:
Yeah, I would first say don’t do this on your own. Despite all the amazing effects that we’re talking about here, I’ve run into a lot of people or people have come to me who get into trouble, and it’s because they just don’t realize that this is not—this is more than just changing your food. This is a metabolic change that your body’s going under, and these are people that aren’t super healthy.

Dr. Pompa:
Yeah, get a coach.

Beth:
They’re comprised. I also encourage people to get some bloodwork done too because that’s a good way to catch things before they get worse. I had someone recently who felt horrible in ketosis. Fortunately, we had her bloodwork done in advance, and her electrolytes were low. Here it is in summer. She’s out exercising. She doesn’t increase her salt intake and puts herself on a ketogenic diet. She was dehydrated, and her electrolytes were really low. That’s a very preventable…

Dr. Pompa:
Yeah, it’s a classic mistake. When you’re in ketosis, you dump out glycogen, stored sugar, and you lose electrolytes. Just a teaspoon or two of sea salt fixes it.

Beth:
Right, who would think of that on their own? I mean, people are like you’re kidding? I have to have salt? I have to put salt in m y food? Yeah, lots of salt, like a teaspoon or two. I talked to a gentleman who has been in and out of ketosis for years. He pulled out of his pocket his salt capsules. He puts them in capsules, so he doesn’t have to take them like…

Dr. Pompa:
Yeah, I have many clients that do that because they just don’t like salt so encapsulate it, exactly.

Beth:
Then they just swallow it. That’s a simple thing, but I’ve had some more severe issues that have required hospitalization. I know it doesn’t happen to a majority of people, but I think it’s just a good idea. Talk to your doctor. If your doctor’s not schooled in this, you have physicians that you have on your website, right, that people can go to?

Dr. Pompa:
Yeah.

Beth:
The Charlie Foundation has a list of also ketogenic specialists who work with—will work with you or a physician, but just get some help. It can save you hospitalizations, losing worktime, and feeling crummy and all that. There’s a good way to get into ketosis safely is what I’m trying to get across, if you get some help rather than struggling through this. I see people struggle through it, and then they give up. They don’t go back. They’re afraid. They just don’t want to go back. They just mark it off their list, so I don’t want that to happen to people. I want them to get into ketosis safely and get to the point where they’re really enjoying it, and they don’t want to go back into what they’re doing.

Dr. Pompa:
There’s something known as the keto flu. Talk about the keto flu. It makes people feel bad. It typically happens the first three days, right? By the way, electrolytes, we already mentioned one. That could actually cause a keto flu, but there’s other reasons for it.

Beth:
Yeah, your body’s detoxing, and you go through this detoxification process. That can make you feel crummy.

Dr. Pompa:
By the way, because we hold toxins in fat, visceral fat, and when you go into ketosis, you start burning that fat. Out comes the toxins.

Beth:
Yeah, so if you can think of that—and if people are warned about this, you’re going to go through this. Think of it as a good thing. When you are going through this horrible crisis, I am getting better because my body is releasing toxins. Try to be very positive about it instead of calling everybody and complaining or just laying in bed. I mean, get out, walk, breathe. Breathe fresh air. Drink fluids. Get your salt. Talk to people. You’ll get through it, and you’ll feel better.

Hydration, electrolytes, you’re releasing toxins. Good fats are important because bad fats can make you feel horrible. I like to talk to people about, yeah, there’s a big difference between good fats and bad fats.

Dr. Pompa:
Yeah, there’s confusion there. We talked about a lot of foods that have very high-saturated fat and cholesterol. Most people listening would go, well, aren’t those the two bad fats? We’re saying, hey, we love those fats, so explain bad fats to people.

Beth:
Right, I will first explain that our US Department of Agriculture proclaimed in 2015 that saturated fat alone does not cause cardiovascular disease after much debate, and Gary Taubes was at the top of this effort to un-vilify fat. I always think of him when I think about that Time Magazine curl of butter saying fat has been exonerated from all of these myths, so saturated fat is good. Jeff Volek says that about half of our body fat is saturated, and the other half is monounsaturated. He feels that your diet should mimic that. You should look for both sources, so let’s talk about saturated fat sources. I mean, we already talked about eggs, butter. Butter is about 60% fat.

I’ll go a little further with the butter. I like buying European butter or cultured butter because the Vitamin K2 level— if it’s grass-fed and they add cultures to it, the Vitamin K2 is really high, and that’s an anti-inflammatory. It’s good for your bones. That’s a unique type of butter to look for. Coconut oil, to this day, the American Heart Association is still telling people that coconut oil is bad for you.

Dr. Pompa:
There was just an article out last week. Coconut oil is bad for you. I’m sure you got emails.

Beth:
Yep, I did. I did, yeah. Why they aren’t looking at the new evidence, I don’t know. I suspect it’s because they are being supported by the industry that doesn’t support coconut oil.

Dr. Pompa:
That’s what it is. It’s who’s supporting that, yeah.

Beth:
Yeah, that’s horrible. It’s just a crime, which we won’t get into. Coconut oil and then we have the derivative of coconut oil, which is MCT oil which is a little more powerful. I tend to use that with my really sick folks who aren’t expending a lot of energy because it just gets them ketones a little better. Those are the saturated fats and then, of course, visible fat in meats. Again, you mentioned grass-fed. Fat is where toxins harbor, and that’s why we prefer, if you’re going to eat the fat on any beef, pork, veal, whatever, you should have the animal that has not had hormones and pesticides, whatever added to it. Those fats are also good, and now you can buy lard and duck fat and other fats in a jar if you’re not getting them in the lean meats that you’re purchasing. Those are highly saturated, and then we have our monounsaturates, avocado oil.

Dr. Pompa:
Olive oil.

Beth:
Olive oil, I prefer using my avocado oil for sautéing because it -inaudible-.

Dr. Pompa:
Me too, it takes heat.

Beth:
It takes heat better than olive oil. Olive oil, you can easily overheat. Then you’ll see the smoke come up, and that’s not a good thing.

Dr. Pompa
Yeah, make good fat bad is what I say.

Beth:
Right, what you don’t want to have are the canola and other seed oils, safflower oil, right, corn oil. These are highly polyunsaturated, and it’s been proven that those are inflammatory. When you go to the grocery store and you look at all the oils, mostly polyunsaturated oils populate the shelves.

Dr. Pompa:
When you go into Whole Foods, canola oils and just about everything, it’s bad. These polyunsaturated fats get in the cell membranes and disrupt them for—130 days of dysfunction is what I like to call it. I think that’s why I’m not a fan of fish oil because it’s polyunsaturated. It’s actually even more—it’s more fragile than even these vegetable oils that we’re discussing. I prefer getting that in fish. That’s my opinion, and I’ve done some shows on that. Yeah, I’m not a fan. I’m not even a fan of just too much DHA. I think it’s overblown, especially now that we’ve looked at new testing. I’ve done shows, folks, on the dangers of fish oil. Watch them.

Anyway, yeah, so those are—I mean, there you go. Those are the bad fats, the vegetable oils and things. We talked about the good fats. All right, I mean, that’s—these are really good things. This is a question, though, I have. The key to ketosis—we’re talking a lot about fats, but really, the key is dropping the carbohydrates. Therein lies the magic of why your body would start to switch over to be a fat burner so talk about that. What level of carbohydrates do you have to draw to to actually create the ketosis?

Beth:
Yeah, so that’s pretty individual. I’ve had people have ketones with 50 grams of carb, which is amazing. Ketosis tends to be really strong when you go low carb. You tend to get very strong ketosis in the first weeks, and then it tapers down. People might start off saying yay; I can do 50 grams of carb. Then in three months, they might need to come down, and then maybe go up again. Again, you got to think about ketogenic restrictions in terms of diet tend to be temporary depending on what you’re treating.

For example, I worked with somebody recently with migraines, and she’s been on every known medication. She’s been on some of the anti-seizure medications. She’s been hospitalized for dehydration and vomiting because of her migraines. She contacted me about doing keto, and I gave her guidance and didn’t hear from her for a while. She came back to me, and she said, “I’m so busy sharing my new life with people that I didn’t get back to you,” but amazing turnaround. She was pretty restrictive. I got her down to about 20 grams of carb. She said she can vacillate up to 30 or 50 and not have a headache come on. She’s just learned to watch for the symptoms of a headache coming on, making sure she’s well hydrated, getting her magnesium, and those kinds of things.

It’s variable, and then it’s also I think maybe age dependent. I could eat a lot more carbohydrate in my earlier years. As I’m aging, I’m getting closer to 60. I can’t. We know that you become more insulin resistant as you age, so that goes along with it. I have become more diligent about checking my glucose first thing in the morning, especially if I have a glass of wine like you did the night before.

Dr. Pompa:
That’s why I checked.

Beth:
Yeah, that tends to be…

Dr. Pompa:
My glucose actually trended up. I think I was 92. I’m in ketosis. Normally, I’m way lower than that. It could be high 70’s, low 80’s, but I definitely saw the glucose shift.

Beth:
Yeah, it’s really -inaudible- feedback to do that and say, whoa, I got to pull back here. I was also going to mention even time of day. You become less insulin sensitive as the day goes on, so that’s why you should not eat three hours before you go to bedtime—go to bed, right? Individual variations, especially age, and then time of day all affect your -inaudible-.

Dr. Pompa:
Last question, what about our vegetarians? Can I do ketosis?

Beth:
I work mostly with vegetarians that allow dairy and fish, and it’s easy.

Dr. Pompa:
Yeah, it is easy. Again, it’s carbohydrates, right? There’s plenty of other fats to help with the calorie difference.

Beth:
You get plenty of protein from dairy, fish, poultry, if they’re doing poultry. I do have a woman that I’m working with on a vegan diet, but she has a tube feeding. Her diet is actually very limited, so she’s not tasting it. It’s going through a feeding tube, and she’s doing very well. I have her on gobs of supplements to make up for what she’s not getting. It is limited in types of foods. It’s possible. It’s just vegan is very difficult. I encourage people, if you’re…

Dr. Pompa:
I’m not a fan of vegan. I mean, well, short period, I’m fine with it for short periods. I’ve had people successfully do ketosis with a vegan diet, actually, one of my doctors that I train. It’s possible. Not easy but it’s possible.

Beth:
No, not easy, but right, people will do it. If they have a goal in mind or a condition that they want to change, they’ll make it work.

Dr. Pompa:
Yeah, absolutely. The queen of ketosis, you’re going to have to change some of that and just start calling yourself the queen of ketosis. That’s what I’m going to refer to you as. Beth, thanks for being here. Gosh, what a wealth of knowledge in this area. Hey, get the movie. I’m telling you, First Do No Harm, great movie. Go to The Charlie Foundation, I mean, great stuff. Wow! I didn’t know that you were the one putting all that information out there. You’re the queen.

Beth:
Thank you. That’s so sweet. Yeah, if you want to contact Jim Abrahams, go to the Contact Us link on charliefoundation.org. He’s the one that receives all of those posts, and he will respond to you.

Dr. Pompa:
Do me a favor. Let’s get him on the show.

Beth:
He’ll happily do that. He’s a great interviewee.

Dr. Pompa:
Yeah, we reach hundreds of thousands. We got to get him out there. He needs recognition just because of who he is. I’m so impressed. All right, hey, Beth, thank you for being on the show. Really, it was great, such great information. Thank you very much.

Ashley:
That’s it for this week. We hope you enjoyed today’s episode, and practitioners, you are invited to join us at Dr. Pompa’s Live It to Lead It seminar in Los Vegas from November 2 to the 4th. You can go to hcfevents.com for more information, and you can use the promo code CHTV to take $200 off the ticket price. We would love to see you there. We’ll be back next week and every Friday at 10 a.m. Eastern. We are deeply grateful for your support. Please remember to spread the love by liking, subscribing, giving an iTunes review, and sharing the show with anyone you think may benefit from the information heard here.