Keto Diet Interview – The Nuts and Butter of a Keto Diet

The ketogenic diet is not just another diet…

The ketogenic diet requires commitment and also wisdom for proper application. In this interview, ketogenic expert, Alessandro Ferretti, shares insight from his journey and what he’s learned from his patients to help maximize the benefits from the ketogenic diet.

Are you experiencing all of the benefits of a #ketogenicdiet? Watch the interview with @alexequilibria

Dr. Ben: We’ve got a star guest today, Chubster. Great to see you here today, bud. Chubster has had some issues lately, and he learned that he can lose a lot of weight by going ketogenic. I mean it’s a valid buck.

Dr. Alessandro: Yeah most times.

Dr. Ben: Most times, but hey look he’s still pretty good down here. What he did is he started having some coffee with a big wallop of butter in the morning and he wasn’t feeling quite right, were you? So he wasn’t doing very well from that, so he thought, “Well, what can I do?” So he went back to the internet and he started researching and started taking things like what? What are they called?

Dr. Alessandro: Ketones and MCT oils. These would be the most common.

Dr Ben: Is that were you doing?

Chubster: Yeah.

Dr. Ben: Did it work?

Chubster: Obviously not.

Dr. Ben: Chubster, can you leave?

Chubster: Sure. He struggled and he now is going to a different program. We’ve got Alessandro Ferretti here to set him straight. We’ll revisit him later. What happened here? Why did Chubster not get the ideal results? There’s all this information about eat fat lose fat. There is all this information about you get great tremendous brain energy. You struggle in the morning or you want to eat less. Say coffee and put some butter in it or MCT oil. If you want increased performance, then take a bunch of exogenous ketones which are basically ketones in a pill or MCT oil. What we do here?

Dr. Alessandro: I think that the first point to make is that ketogenic diets, low-carb high-fat diet are not suitable for everyone. That’s the first thing that I would probably want to assess. Most of the times if people found problems within that type of dietary approach, I would suggest work with a practitioner that would understand well who’s suitable and who is not. Just leaving that aside for a second.

Dr. Ben: Hold on. Are you saying that not everyone can just go right into trying ketosis without additional support?

Dr. Alessandro: Totally. I’ve never so far in my short-term colorful nutritionist career have re-said something in this depth and advised so many people not to go on it. It’s a very powerful tool that can be a medical tool for epilepsy, cancer, and etcetera. All four types of diabetes for example yet it has to be used wisely.

Dr. Ben:  So this isn’t like gaps or paleo or not low carb or Atkins or all these other types of diets.

Dr. Alessandro: That is correct. You have a low-carb higher fat which probably the vast majority of people can feel better. Now we know that the fat is not the enemy but is perhaps the amount of sugars we have and simple carbohydrates that we have in really high amount. But yet at the same time I would say that to make a ketone, that that’s an extra step and that my view always request supervision.

Dr. Ben: Explain to me why the body would naturally go in ketosis. I mean obviously we can get our bodies into ketosis. What is that? Define to the listener here why the body would go into ketosis.

Dr. Alessandro: Generally speaking—and this is still true for pretty much across the board—the body will go in ketosis to compensate for a lack of glucose available within the diet. In fact, the easiest way that I have found and me and my colleagues have found when ketosis is fasting.

Dr. Ben: If you have a lack of glucose in the diet which comes from what?

Dr. Alessandro: Carbohydrates mainly.

Dr. Ben: If you have a lack of carbohydrates in the diet, then your body will start to conserve that glucose for other things.

Dr. Alessandro: Precisely.

Dr. Ben: Such as what? What is highly needed for glucose in the body that can use ketones?

Dr. Alessandro: The main one will be some areas of the brain. Some cells in the brain will still require glucose. Even in a fasting state, the liver can manufacture glucose from every substrate we have. I was going to get glucose from carbs, can get glucose from fat, and can get from protein.

Dr. Ben: But primarily the body will shift into ketosis when there’s low amounts of glucose and will conserve that glucose for cells that are highly requiring it.

Dr. Alessandro: That is correct.

Dr. Ben: You get the low amount of glucose typically and naturally from being hungry, being starved, fasting.

Dr. Alessandro: Yes. There is a slight differentiation to make here which is really important. Someone can feel hungry and someone can have a craving. With my with my ten-year-old, she says, “I’m hungry” and I say, “Okay is it coming from here or is it coming from here?” If it comes from here, most of the time, it’s true hunger. If it comes from there that they want something, then normally it’s a craving. In fact, when we measure blood glucose level, if it comes from here, it’s all nice and stable and has been stable already for a while. That can be hours. Whereas the drop in glucose, if someone has a very high level of glucose and he drops, it’s still high level but there is a drop, normally in European terms going to say millimolar or being US terms is 10-15 mg/dl, that’s the craving and is the drop that creates that specific craving.

Dr. Ben: That’s a pretty key point. You might have to rewind that to listen to you that again. That is a really, really key point because you need to tune into that. If you have a craving versus a true hunger, you need to evaluate that. If you find yourself getting up frequently and going to eat something unconsciously, then at some point you check in before you reach for that food item again and looking up what it is before you just start consuming. I have this problem. I was studying and preparing for a conference. I found that I was eating more carbohydrates that I usually would and it was because I was stressed out. It basically hit me when I got up about every five minutes literally. I was eating chips or crackers or stuff that I basically never eat. I was going into ice cream and trying to find cookies and my kid’s candy snacks that my wife hides. I finally checked in and I was like “Whoa wait a minute. I’m eating this stuff for the wrong reasons.” I interject my stress. Going back to keto—well go ahead.

Dr. Alessandro: That is the typical scenario. Generally speaking what happens when we are stressed, the glucose becomes highly unregulated. It keeps going up and down and up and down and up and down, and we work toward that. They will take time and then it crashes. These fluctuation can happen with the peaks distance as little as 15 minutes. 15 minutes. I observed that by implanting myself with a ongoing glucose monitoring system. For example, yesterday we went for that five-hour hike and I was fasted all throughout hike. When we go down, I started to relax, I started to feel the churning and the noises from my stomach. These are truly associated with hunger. I wanted to train my body  work in that my head never lost lucidity. That’s the difference. It’s a very settled yet very important difference.

Dr. Ben: If someone is not very active, let’s create some scenarios here. Chubster, the bear. My son Theo said, “Dad, you’ve got to put Chubster in the video today.” He wants to be in the video. But Chubster is a great example because Chubster, well, he’s lazy and we will refrain that. Chubster is not a very active there and his food choices were the same. He still ate the same amount of carbs that he was normally eating and the same amount of protein. Then he decided to go taking this coffee with a bunch of butter and then he started taking exogenous ketones. He kept gaining weight. What happened there, I mean just in terms of fuel?

Dr. Alessandro: I call it metabolic confusion. You still have the carbs, and given the choice especially the start, the body has been working. I don’t know how old Chubs is.

Dr. Ben: Six.

Dr. Alessandro: He’s six. That’s not that bad. But imagine people for two three decades have been functioning on glucose all the time not really have ever been in a situation when there is a lack of food. The body is really accustomed to use glucose as the main source of fuel. That’s where the body preferentially would go because this is what the body is used.

Dr. Ben: So his body is still burning the glucose from the carbs that is ingesting.

Dr. Alessandro: Precisely.

Dr. Ben: What’s happening to all the MCT oil, the exogenous ketones that he’s eating?

Dr. Alessandro: If and when these would be converted into ketones which they surely may do, then you have two different sources of fuel to basically enter the mitochondria. You would have confusion on what the body has to use. That, without going too technical, that creates metabolic confusion. There is an overabundance of Acetyl coenzyme A and this would start to affect the TCA cycle and the electron transport chain in a negative manner.

Dr. Ben: What would the result be? What would the hormonal trigger be by the body in that situation? If you have an excessive amount of glucose and excessive amount of ketones, what happens?

Dr. Alessandro: Put it this way. People that do that have normally the worst transition to the ketogenic diet, what we call in slang keto flu when people are making that transition. It’s really trusting because exogenous aids can be really helpful, but they have to be used in a correct manner.

Dr. Ben: We’ll put that arrow here in a second.

D. Alessandro: Normally literally confusion, poor clarity in thinking, low energy, dysregulation of energy throughout the day is constant, gastrointestinal symptoms. You have an awful lot of things that can potentially go wrong.

Dr. Ben: Weight gain. Chubster was experiencing weight gain.

Dr. Alessandro: Absolutely.

Dr. Ben: But he was supposedly following a ketogenic diet.