Morel mushrooms, our consolation prize

One good thing about our cool, wet spring weather is the bumper crop of morel mushrooms we have been harvesting at our cottage. This is the first year we have seen them, in fact I was not sure what kind of mushrooms they were and whether or not they are edible. So, I sent an SOS (and picture) to the “all things nature related” expert, my cousin John in Missouri. Whatever would we do without our handy cell phones?

morel mushroom
edible or poisonous?
morel mushrooms
delicious or poisonous?

He sent me this link so I could read up on these delicious discoveries before we sauteed them up in butter for dinner. We did wait until we were in the (relative) safety of our home to try them as the cottage is a bit far from any hospital. I am happy (and alive) to report cousin John was right, morel mushrooms are quite yummy. Lots of work though, to clean them up, as their brain-like crevices hold lots of dirt.

morel mushrooms
first harvest of morel mushrooms

As the (miserable) cool, wet weather continued into June, we are taking some consolation in the fact we have had three weekly harvests of these morel mushrooms now, each collection larger than the last. At first they were hard to find; now we know what to look for and where to find these beauties. And also to check that their stems are hollow, an important characteristic that distinguishes them from their more sinister cousins.

morel mushrooms
third harvest

This week has been much warmer, finally some summer weather, so that may be the end of our mushroom harvesting for this year.

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Modified Keto Diet

Many people (especially us older folks) have a hard time understanding how the popular keto diet can be healthy. Most of us have been warned about cardiovascular disease, so a high fat diet seems contrary to what we have been taught for years. The good news is, there are many versions of a modified keto diet. I have created one for myself by cutting way back on refined carbohydrates like sugar, potatoes, rice, bread and pasta. I was diagnosed with an allergy to wheat years ago, so already switched to gluten free bread and pasta, but even they contain not so good for you carbs.

Food items like pasta, rice, potatoes, bread, crackers and snacks contain high amounts of net carbs, so I have learned to avoid them. A great alternative to pasta and rice is cauliflower. You can purchase it (conveniently) already cut up in “pearls” (like the bags I buy, pictured below) or you can cut up a fresh head yourself.

add cauliflower to your modified keto diet for low net carbs
cauliflower pearls have low net carbs, great for a modified keto diet!

As indicated on their label, these pearls of cauliflower contain a mere 2 grams of net carbs (4 total carbs minus 2 fiber) per 3/4 cup. This is a huge difference from pasta or rice. For example, pasta contains 62 grams of net carbs per 3/4 cup, brown rice contains 22 grams per 1/3 cup and white rice contains 32 grams per 1/3 cup. When you are limiting your net carbs to 25 grams per day, those numbers are quite significant. These cauliflower pearls can even be incorporated (with cheese) into a pizza dough!

Another great substitute for the high carb perils of pasta and rice is zucchini spirals. They too can be purchased already cut up, but you can buy them whole and cut them up yourself too if desired. I’m all about convenience. If an ingredient is easy to prepare, I will be much more likely to use it in a meal. Spaghetti squash can also be used as a substitute for starchy pasta.

I also make sure I have lots of crunchy salad ingredients on hand to throw together a quick lunch option. Leafy greens, broccoli slaw, seeds, avocado, tomatoes and cucumbers (all contain low net carbs) as well as a variety of low carb salad dressings are mainstays in my fridge. These choices of good carbs have always been staples in my diet, often incorporated into a morning smoothie.

For calories formerly taken up by bad carbs in my daily diet, I have increased my intake of fats, although I stick to good fats. Yes, believe it or not, there is such a thing as good fats. I don’t like the way so many animal fats (processed and fatty meats, butter, cream, lots of cheese) recommended on the original keto diet make me feel. Constipation and stomach cramps are no fun!

Therefore, to get my fat macros (that’s the keto term), I consume more plant based omega 3s. Fats like avocado, olive oil, almonds, almond milk, flax seeds and coconut oil are my favourites. It is easy to replace the fats suggested in keto menus with the healthier versions. For example, I substitute almond milk for full fat cream and olive oil for butter.

My protein intake remains about the same. Protein consumption is important to retain muscle mass, especially for post menopausal women like myself. I have always leaned (pun intended) towards lean meats and fish for sources of protein, so that aspect needed no modification.

For four weeks now I have been following this modified keto version. I have lost a few pounds, but weight loss was not my primary goal. More importantly, I have noticed increased muscle tone in my abdominal area. These are the muscles I have not seen in many years, not since before my kids were born. That is impressive (I think) since those four weeks included one week of vacation (lots of margaritas) as well as the holiday season during which tempting goodies were hard to resist.

Salads work on any diet

Are you trying a new diet and having a hard time finding things you are allowed to eat? Most diets, especially the currently popular keto diet, restrict carbohydrates, but salads work well if you include the right kind of carbohydrates.

The good news about salad related carbs is that they contain lots of fiber which means their “net carbs” (what you actually count on keto) are negligible. To calculate net carbs, subtract the grams of fiber from the grams of total carbohydrates indicated on the labels.

For example, the broccoli slaw I love on my salads to add extra crunchiness displays this label:

brocolli slaw contains low net carbs, works great on salads
brocolli, cabbage, and kale slaw, low net carbs, great on salads

You can see the total carbohydrates in 1 cup of this slaw is 6 grams, but the fiber is 3 grams, so the net carbs are 3 grams. Considering you might add one half cup of this to greens on your salad, that is very few net carbs! Of course, you could also eat this slaw like you would traditional coleslaw.

Broccoli by itself has even less net carbs (4 grams of carbs minus 3 grams of fiber per 1.25 cup equals 1 gram of net carbs) That means broccoli would be a great keto approved option for a side dish at dinner. Or cut up on your salad if you don’t like the slaw that I use.

The salad in a bag (romaine, carrots and cabbage) that my husband likes has a net carbs value of 2 grams per 2.5 cups (4 total carbs minus 2 fiber). I prefer my salad base to contain spinach and kale however, which have even fewer grams of net carbs. I also like cucumber, avocado, flax seed and cheese on my salad…

Ingredients for salads that are low net carbs and healthy fats
brocolli slaw, cucumbers, avacado and cheese, low net carbs and healthy fats

The cheese (shredded Tex-Mex in this case), avocado, flax seed and salad dressing contain the fat necessary on this keto diet. I top the salad with a creamy, roasted garlic and Greek yogurt salad dressing from (my favourite) Renee’s line of all natural, no preservatives added products. The assembled lunch plate looks like this.

I don’t really count the net carbs as they are so negligible in a salad like this. These carbs though (as opposed to the bad ones) are packed with vitamins, minerals and fiber, a fact that I think is very important to overall health.

Protein is accounted for in the broccoli and cheese as well as the Greek yogurt based dressing and lax seeds. A sliced hard boiled egg or cooked chicken would also be great sources of additional protein.

Concoct your own salad, the variations are endless!

Buy Local, Support Small Business

As a small business owner myself, I am all for supporting and promoting local entrepreneurs. When you buy local, from growers, artisans or crafters alike, you are investing into the economy of your own community. That’s healthier on so many levels.

TruLOCAL is such a business delivering their local meat products anywhere in Ontario. Your chosen products arrive frozen in airtight packages, packed with dry ice to keep the container cold for many hours. That means it can sit on your step until you get home. You also receive email notification of when it will arrive.

I have received several shipments now, and must say, I love the products and the ease of ordering online. You can easily change the frequency and size of your order as well as the products in each order. There are so many items to choose from. Each order is based on a point system, you simply fill your order until your “box” is full. For example, with BBQ season coming soon (I hope) I will be ordering more steaks and less roasts.

The best part? Their meat products come from locally raised, free run and grass fed animals, that are free of hormones and antibiotics. In this era of heightened awareness, these qualities cannot be ignored. Sustainable foods are popular today, cows raised in pastures instead of feedlots turn out healthier, tastier meat with more vitamins and minerals.

If I have convinced you to give TruLOCAL a try, use my referral code of
TRULOCAL2097 to earn us both free products!

Does Tryptophan in Turkey Make You Tired?

Written by Nate Martins • November 20, 2018. Originally published on HVMN, adapted for use on Lorieb

Forks no longer clang against plates. Conversation lulls. Chairs scrape against the floor as family members make their way from kitchen table to Lazy-Z-Boy. The Thanksgiving feast is over. Now, eyelids drowse. Everyone starts to fall asleep, wine glasses are half full, football commentators hum in the background, crumbs stuck to mustaches flutter in the rhythm of each hot, heavy breath. Is this your Thanksgiving meal aftermath? Maybe your astute, know-it-all cousin points out that tryptophan, present in turkey (and many other foods) is causing everyone to fall asleep by 6pm.

You can tell them that’s just a myth. Tryptophan isn’t the reason your living room looks like an kindergarten nap time, it’s all the other stuff you’re eating alongside it.

What is Tryptophan?

It’s an amino acid. Amino acids form the building blocks of protein, the main structural and functional compound in the body. Tryptophan is one of nine essential amino acids, meaning it cannot be produced by the body and must be obtained directly through food.

This amino acid plays a part in some vital, bodily processes. It helps regulate nitrogen balance in adults and growth in infants. It also is important for production of creating niacin which is essential for creating serotonin. Serotonin is a neurotransmitter associated with sleep and melatonin levels. This is where the villainization of turkey comes in. But tryptophan isn’t just in turkey; it’s also in other high-protein foods. In fact, many foods such as seeds, cheese and soybeans, have more than turkey.

You’re Tired Because

You overate.

Yes, turkey can make you drowsy. But the other foods that contain tryptophan in high amounts don’t get the same bad rap as turkey. So what’s causing the sleepiness?

Really it’s mixing tryptophan-rich turkey with other carbohydrates–like, say, mashed potatoes and stuffing and bread and pie–that is to blame.

Consuming carbs triggers insulin release, which causes uptake of other types of amino acid into the muscles (but not tryptophan). This means that tryptophan levels are higher than usual, especially relative to other amino acids. Normally amino acids compete with one another for uptake into the brain, but when tryptophan is present at higher-than usual amounts, more of it gets in.

Without competition, the floodgates open, allowing more and more tryptophan to enter the brain. From there it’s used to produce serotonin and eventually, melatonin.1 Any big meal containing tryptophan and lots of carbohydrates can induce drowsiness. And of course other factors, like drinking alcohol, can also play a role in that sleepiness.

Even if you ate a large meal without any tryptophan, you’ll likely still be tired–especially if it’s rich in carbohydrates.2,3,4 Large portions of food force the body to digest, which requires significant energy use. You’ll get the signal from your brain to chill out while your gut kicks into overdrive. This feeling is likely unavoidable, because the parasympathetic nervous system (responsible for telling your heart to beat and your lungs to breathe) automatically triggers this process, informally known as “rest and digest.”

Tryptophan may play a role in post-meal tiredness, but it’s largely everything else you ate putting you into a food coma.

Access Scientific Citations

Keto Diet Fundamentals

Authored by Dr. Brianna Stubbs and Nate Martins • January 2, 2019. Adapted for posting on Lorieb

You’ve heard of the keto diet. Everyone from Lebron James to the Kardashians has used the low-carbohydrate, high-fat diet for reasons like performance and weight loss.

The goal of the keto diet is to get the body producing ketones– a fundamentally different energy source than the carbohydrates and fats your cells typically use for energy. It can take several days of ketogenic eating before the body starts to produce ketones. And the time it takes to get into ketosis varies between individuals. “Keto” comes from the word “ketogenic.” This is a nuanced term meaning that the body is producing ketones from fat.1 When blood ketone levels exceed 0.5mM, the body has achieved ketosis. So ketosis can be achieved either through diet or fasting (meaning the body is producing its own ketones to be ketogenic), or also by consuming products that raise blood ketone levels.

Limiting carb intake and protein intake encourages the body to burn fat–and thus produce ketones. Importantly, restricting proteins as well as carbohydrates limits the amount of substrate available for gluconeogenesis. This is the process of making glucose from non-glucose molecules such as lactate, glycerol, or protein.

Because the ketogenic diet is low-carbohydrate, it often gets confused with other low-carb diets out there. Just because a diet is low carb doesn’t mean it’s keto. It’s subtle differences in the macronutrients provided in the diet determine if the diet is ‘ketogenic.’

A macronutrient is something humans consume in large quantities to provide the bulk of energy to the body. The primary macronutrients are carbohydrates, fats, and proteins. For a diet to be ketogenic, it must be high in fat, low-moderate in protein, and very low in carbohydrates.

Here are some helpful definitions of diets with an element of reduced carbohydrate intake:

Ketogenic Diet

  • The aim is to trigger the production of ketones in the body
  • High fat, low/moderate protein, and low carbohydrate

Low-Calorie Ketogenic Diet

  • The aim is to severely restrict calories to a level below the basic metabolic needs (i.e., <800 kCal)
  • Even if this diet is relatively high in carbohydrates, the calorie deficit created can still lead to a state of ketosis
  • Not sustainable long-term

Low-Carbohydrate Diet

  • Defined in medical literature as a diet with < 30% energy from carbohydrates2
  • May not lead to ketosis as the carbohydrate and protein intake could be too high

Atkins Diet

  • This diet has several phases
  • Initially, the aim is to restrict the carbohydrate intake to less than 20g per day. This degree of restriction is likely to lead to ketosis, although this is not an explicit aim
  • Subsequently, the diet reintroduces carbohydrates to a level “the body can tolerate”3
  • Less restriction on protein compared to a ‘true ketogenic diet–high fat, moderate protein, low carbohydrate.

Paleo Diet

  • The aim is to limit the diet to foods that would have been available to Paleolithic man4
  • Wide variability in interpretations
  • Foods allowed include vegetables, fruits, nuts, roots, and meat
  • Foods excluded include dairy, grains, sugar, legumes, processed oils, alcohol, and coffee
  • No structured macronutrient target; however, following a Paleo diet results in higher protein and fat consumption than an average diet

Now you have a grasp of what makes the ketogenic diet unique–but where’d it start?

Fasting and Early Pioneers of the Ketogenic Diet

The concept of fasting (taking in zero calories) predates the ketogenic diet as we now understand it. Many of the benefits of fasting are likely due to the presence of ketones in the body.

Since the earliest days of man, fasting has been used as a tool to physically and spiritually cleansing.

The Bible describes fasting as a treatment for convulsions. The ancient Greek philosopher Hippocrates said, “To eat when you are sick is to fuel your sickness.”

Early advocates of fasting were obviously unaware of ketosis as a crucial factor in the anticonvulsant effect of fasting. In the early 1900s, physicians at the Mayo Clinic observed a link between a low-carb diet and fasting. They discovered that severely restricting dietary carbohydrates and increasing fat intake could decrease seizures in the same way as fasting.5 It was not until the mid-1900s, when scientists could measure ketones, that we understood fasting led to the presence of ketones in the body.

Epilepsy was not the only disease historically treated with a low-carbohydrate, high-fat diet. Low-carbohydrate diets were also advocated for patients with diabetes and obesity. Before the discovery of insulin in 1921, diabetes was managed through carbohydrate restriction. William Banting, an obese British mortician, popularized the weight loss benefits of a diet “stripped of starchy foods” in a pamphlet called “Letter on Corpulence, Addressed to the Public.”

The Dark Ages for the Ketogenic Diet

To many, a low-carbohydrate and high-fat diet is a counter-intuitive approach to support health. There is a widespread fear dietary fat is linked to obesity, high blood pressure, high cholesterol levels and other associated health complications.

In 1953 Ancel Keys, an American biochemist published an epidemiological study that introduced the “diet-heart” hypothesis. The study claimed dietary fat was a key risk factor in developing heart disease. The “diet-heart” hypothesis proposed blood LDL and cholesterol derived from dietary fat accelerates the development of atherosclerotic plaques.6This led to radical changes in global food policy and public practice. In 1977, the USDA Dietary Goals for Americans recommended a decrease in dietary fat intake, and a diet based on grains and cereals.7

At the time, there was still no clinical evidence supporting Keys’ “diet-heart” hypothesis. Subsequent large trials, including the Framingham Study and Women’s Health Initiative Randomized Controlled Dietary Modification Trial, failed to illustrate decreasing dietary fat lowered the risk of heart disease.8,9

Obesity rose following the adoption of the USDA guidelines. Some investigators hypothesized that increased dietary carbohydrates were responsible for the developing health crisis. John Yudkin, a British physiologist and nutritionist, described this phenomenon in his book “Pure, White and Deadly”10–the widespread fear of dietary fats caused scientists and nutritionists to overlook the role of sugar and starch.

Resurgence of ‘Low-Carbohydrate’ Diets

‘Low-fat’ dieting was widespread in the late 1900s. During this time, Dr. Robert Atkins became an infamous spokesperson for the keto diet. Dr. Atkins brought his version of the ketogenic diet to the masses in his 1972 book “Dr. Atkins’ Diet Revolution.” In his 40 years of practice, Dr. Atkins treated an estimated 60,000 patients for obesity and related conditions. At that time, there were no clinical studies to validate the benefits of the diet. Many patients reported side effects while starting the diet, including fatigue, weakness, dizziness, headache, and nausea. This uncomfortable induction phase was labeled the ‘Atkins Flu.’

After Atkins’ death in 2003, others started to promote the ketogenic diet for health. The Atkins Foundation recently funded a group of scientists to study the effects of the Atkins diet formally. This group of scientists includes Jeff Volek, Stephen Phinney, and Dr. Eric Westman. They discovered that the Atkins diet outperformed a diet based on the 1977 USDA guidelines with respect to measured coronary risk factors, including decreased low-density lipoprotein-cholesterol and total blood saturated FFA alongside increased high-density lipoprotein cholesterol.11 This outcome may be due to the decrease in carbohydrate and concomitant changes in the hormonal milieu, or due to effects of ketone bodies on substrate metabolism.

The pendulum of public perception begun to swing in favor of diets higher in fat, thanks to the emergence of influential writers and speakers such as Gary Taubes, Robert Lustig, and Nina Teicholtz, and clinicians and scientists such as Professor Tim Noakes, Dr. Jason Fung, and Professor Thomas Seyfried. The work of these individuals exposed flaws in the ‘diet-heart hypothesis.’

These influencers helped expose corruption in the political decisions that resulted in the last decades of vilification of dietary fat. Evidence illustrating the role of high dietary carbohydrate intake in the development of obesity and diabetes has started to grow. Much of the recent research suggests that low-fat diets may be harmful to health. This culminated with a recent meta-analysis of data from 18 countries, which linked increases in carbohydrate intake with increases in mortality.12 

The fear of fat has continued to reverse. Over the last few years, the ketogenic diet has grown in popularity. Popular culture is starting to recognize and adopt the keto diet, and online searches have grown. More and more doctors now encourage and prescribe the ketogenic diet to treat metabolic disorders and obesity. Large online communites bring thousands of people together to discuss research, share keto diet before and after photos, and encourage each other. 

Keto Diet for Weight Loss

The ketogenic diet can be used to help with weight loss and also to treat some diseases (discussed in detail elsewhere). Recently, the number of positive keto diet reviews has increased. The rising popularity of the diet has led to a demand for further randomized control trials to study its long-term efficacy. A key reason why the ketogenic diet helps weight loss is that it decreases hunger. This makes it easier to maintain a calorie deficit. It is important to stress that the overconsumption of calories will prevent weight loss regardless of the macronutrient composition. You may be doing keto wrong.

There’s a ton of misinformation out there about the keto diet. We’re on top of the scientific literature. Be the first to read our commentary on the research by subscribing to HVMN.

Macronutrient Composition of a Keto Diet

Macronutrients are food groups that humans consume in large quantities. They provide the bulk of the energy to the body. The primary macronutrients are carbohydrates, fats, and proteins. The macronutrient composition of a diet can be described using the mass of each macronutrient, the ratio of macronutrients in the diet, or the percentage of each macronutrient in the diet. The variety of descriptions can make things a little confusing! 

For example:

  • A ketogenic diet contains about 5% of energy as carbohydrates. 
  • A ketogenic diet has a ratio of 2-4g of fat to every 1g of carbohydrates plus proteins.
  • A classical ketogenic diet contains 20-30g of carbohydrate per day

Examples of food rich in:

  1. Carbohydrates: bread, pasta, potatoes, cereals, sugary food (sweets). 
  2. Fat: oils (olive oil, coconut oil), butter, fatty cuts of meat, brazil nuts, macadamia nuts, avocado.
  3. Protein: beef, chicken, pork, fish, milk, cheese, yogurt, eggs.

Carbohydrates

The main function of dietary carbohydrates (‘carbs’) is to be a source of energy. Some say that dietary carbohydrates are not ‘essential’ as they can be made from dietary protein and fat.13 

Carbohydrates are biological molecules that contain carbon, hydrogen, and oxygen, usually with a 2:1 ratio of hydrogen:oxygen. Carbohydrates occur as a collection of single units (monosaccharides, e.g. glucose), two molecules joined (disaccharides, e.g. sucrose), and chains of molecules (oligosaccharides and polysaccharides).

When following a ketogenic diet, the carbohydrate intake should be very low. This contrasts with the modern western diet, where most dietary calories come from carbohydrates. Consuming carbohydrates causes insulin release, which inhibits ketone production in the liver and thus ketosis. Therefore, monitoring and modulating your carbohydrate intake is an important part of following the ketogenic diet.

When you’re following the ketogenic diet, key concepts are the total amount of carbohydrates, the ‘net’ amount of carbohydrates (accounting for the accompanying fiber), and the speed with which carbohydrates raise blood glucose (glycemic index).

With a standard ketogenic diet, it’s recommended to keep the total amount of carbohydrates limited to less than 5% of energy intake.15 See the table above for a calculation of the advised carbohydrate intake grams for a 2000 kCal per day 4:1 ketogenic diet.

Dietary fiber is carbohydrate-based material from plants that is not entirely broken down by the small intestine. Instead, it passes to the large intestine, and either undergoes fermentation (which supports the growth of beneficial bacteria),16 or excretion. 

Fiber is a significant part of a well-formulated ketogenic diet. It helps to maintain gut health, and also increases food bulk and helps with the feeling of ‘fullness.’ Green and cruciferous vegetables are rich in fiber and are helpful to include in a ketogenic diet. Digestion-resistant fiber does not contribute to calorie intake, as it is not broken down.

Net carbs refer to the mass of total carbohydrates, minus the total fiber, which could be a better metric to judge carbohydrate intake because:

  • Fiber is mostly digestion-resistant and so should not increase blood glucose.16
  • Studies have shown an increase in fiber does not affect blood ketone levels.17

Proteins 

Proteins are large molecules composed of chains of amino acids. The functions of dietary protein are:

  • Building structural and functional components of cells
  • Conversion to glucose via gluconeogenesis
  • Top up intermediates in other metabolic pathways, such as the Krebs Cycle

While it is possible for a protein to be used as a fuel, this isn’t its primary function.

When following a ketogenic diet, there must be a balance of sufficient protein to maintain muscle mass. If dietary protein exceeds 20-25% of calories, gluconeogenesis from protein can stop the ketone production. Initially, target a protein intake of 0.8-1.2g per kilogram of body weight. This target balances the need for protein against the chance of excess gluconeogenesis.18

Some individuals (such as strength or endurance athletes) may have higher protein requirements. They might require a modified ketogenic macronutrient ratio of 2:1 fat:non-fat (where 65% of energy is fat, 30% is protein, and 5% carbohydrate) and can still be effective for therapeutic ketosis.

Fats

Fat gets a bad rap. In nutrition, fat is the dietary macronutrient made up of triglyceride molecules. The main functions of fats in the diet are to provide increased energy levels and makeup key functional and structural parts of the human system.

But we often misuse the word “fat.” There’s a difference between fat in cells and different types of fat molecules:

  • Adipose tissue: the tissue that stores energy as fats/lipid droplets inside adipocytes (fat cells). This is body fat
  • Adipocytes: individual cells that store fats/lipids
  • Lipids: the most general term for insoluble and polar biological fat molecules. The lipid class of molecules includes mono-, di- and triglycerols, cholesterols, and phospholipids
  • Triglycerides: a lipid molecule made up of glycerol (that acts as a backbone) joined to three fatty acid molecules
  • Fatty acids: a molecule composed of a chain of carbon atoms bonded to one another with a carboxylic acid at one end

To be specific, our diet includes many sources of lipids. Lipids are digested and travel in the blood as triglycerides and fatty acids before being used as a fuel, or stored by adipocytes in adipose tissue. Dietary lipids undergo many tightly regulated metabolic steps before storage in adipose tissue. Dietary fat does not equal stored body fat.

Triglycerides are the most important source of energy in a ketogenic diet. They account for > 70% of dietary calories. For those following a ketogenic diet, it’s helpful to understand how the lipid source in the diet is processed in the body.

Fatty acids can be saturated (no double bonds between carbons), or unsaturated (one or more double bonds between carbons). Saturated fats are relatively stable and tend to be solid at room temperature (i.e. lard, butter, coconut oil). Historical guidelines recommended limited the intake of dietary saturated fats because fat consumption was thought to be associated with heart disease and high blood pressure. However, emerging research has shown saturated fat can have beneficial effects on blood biomarkers (i.e. increase ‘healthy’ HDL levels).12

Unsaturated fatty acids can be further divided into monounsaturated fats (only one double bond between carbons) and polyunsaturated fats (multiple double bonds between carbons). The number of double bonds is important as it determines how the fatty acid behaves both inside and outside of the body. They tend to be liquid at room temperature (i.e. vegetable-based fats such as olive oil). Unsaturated fats are thought of as healthier than saturated fats (also known as “healthy fats”). Increased consumption of mono- and polyunsaturated fats have been linked to improved blood biomarkers (i.e. lower blood triglycerides).19 Eating enough unsaturated fats is important when following a ketogenic diet.

Increased fat consumption is not associated with cardiovascular disease.20Eating a moderate amount of saturated fat is unlikely to be as harmful as previously believed, and saturated fat consumption as part of a ketogenic diet is unlikely to increase the risk of cardiovascular disease.

Trans-fats are produced artificially when hydrogen is added to unsaturated fatty acids in order to solidify it and make it last longer. Because of associations with poor health outcomes, these artificial fats had their generally regarded as safe (GRAS) status removed in 2015 by the FDA. 21 Avoid high levels of trans-fat consumption by eating a diet based around whole foods.

Essential fatty acids are important to include in the diet because the body cannot naturally produce them. This group includes poly-unsaturated omega 3, omega 6, and omega 9 fatty acids. It’s believed the anti-inflammatory effects of essential fatty acids may have broad benefits for health and performance. Oily fish, such as sardines and mackerel, and seeds (i.e. flax) are good dietary sources of essential fatty acids.

The number of carbons in the fatty acid chain also has an important effect on its metabolism. The carbon chain of fatty acids can be up to 28 carbons atoms long. If there are > 13 carbons in the fatty acid, it is called a long-chain fatty acid, between 8-12 is a medium-chain fatty acid, and under 5 carbons is a short-chain fatty acid.

The body metabolizes fats differently according to chain length. Long-chain fatty acids are absorbed and go from the gut into the lymphatic drainage system and from there are released directly into the blood. By comparison, medium- and short-chain fatty acids do not go into the lymphatic system. They travel in the blood from the gut directly to the liver.22 If a large amount of these short- and medium-chain fats are delivered to the liver at once, this can trigger the liver to convert them into ketones, even without dietary carbohydrate restriction.

Medium-chain fatty acids are highly ketogenic. They can be found in natural sources such as coconut oil or in an artificially purified form. However, for many people, consuming a high amount of medium-chain fatty acids can cause an upset stomach. This limits their use to raise ketones artificially.

When integrating these concepts into a ketogenic diet: target the majority of dietary calories as fat. Aim to include a variety of fats from different animal and plant sources (i.e. red meat, poultry, fish, dairy, olive oil, coconut oil, nuts, and avocados).

Conversely, micronutrients must be obtained in the diet in small quantities, but are essential to health. Vitamins and minerals are examples of micronutrients.

Micronutrients in a Ketogenic Diet

When following a ketogenic diet, it is important to be mindful of micronutrient intake because:

  • Reducing carbohydrate intake can lower consumption of micronutrient-rich foods (i.e. fruits and vegetables)
  • In the initial 28 days of following a ketogenic diet, the balance of some micronutrients (such as sodium, potassium, magnesium, and calcium) can become disturbed due to an increase in their excretion.23 The body resolves this issue naturally after adapting to the diet

Sodium is the principal cation in extracellular fluid. Its functions are related to blood volume maintenance, water balance, and cell membrane potential. Sodium is also essential for acid-base balance and nerve conduction.

The level of sodium can fall at the start of a ketogenic diet. Adding extra sodium to meals (like adding salt or consuming bouillon/ bone broth) can reduce the chances of feeling the common side effects associated with low sodium (like cramps).

Potassium is the principal cation in the intracellular fluid. Its primary functions are related to maintaining cell membrane potential and electrical activity in cells such as neurons and cardiomyocytes. As with sodium, levels of potassium fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of potassium like nuts, dark green vegetables, and avocados.

Magnesium is an essential element in biological systems, especially for nerve, muscle, and immune function. Levels of magnesium also fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of magnesium like oily fish, dark green vegetables, and seeds.

Calcium has a role in muscle contraction and is important for cardiovascular and bone health. Calcium deficiency is less common during a ketogenic diet, as staples of the diet such as fish, cheese, and leafy greens are rich sources of the mineral.

Now that an understanding of the biology of the ketogenic diet has been reached, we’ve arrived at the fun part: how to start the keto diet.

Keto Diet for Weight Loss

There’s a growing consensus that the keto diet can help with weight loss. The rising popularity of the diet has led to a demand for further randomized control trials to study its long-term efficacy. The ketogenic diet helps weight loss because it decreases hunger. This makes it easier to maintain a calorie deficit. It is important to stress that the over consumption of calories will prevent weight loss, regardless of the macronutrient composition.

How to Start a Ketogenic Diet

Don’t try to start the diet gradually. If carbohydrate intake is moderately-low, blood sugar levels may not be enough to fuel the brain, and the presence of carbohydrate in the diet might still be enough to stop the body from making ketones.

The main objectives when starting the ketogenic diet are to:

  • Restrict carbohydrates to 20 digestible grams per day or less – a strict low-carb diet
  • Consume plenty of fiber
  • Restrict protein to moderate levels. If possible, stay at or below 0.45 grams of protein per day, per lb of body weight (1g/kg). So about 70 grams of protein per day if you weigh ~155 lbs (~70kg). If your goal is to lose weight, aim for 1 gram of protein per kg of your target weight
  • Consume fat until you are satiated

Tips for Starting the Ketogenic Diet

  • Make a keto diet menu. It’s a good idea to keto meal plan before starting the diet. Make a shopping trip to stock up on a range of foods that are low in carbohydrates and high in fat
  • Use an app to track macronutrient intake. Apps such as My Fitness Pal are great to get an idea of the macronutrients in common foods. There is also a range of special online keto diet calculators
  • Search for a few keto recipes to adapt cooking methods. Due to the high-fat consumption required to get into ketosis, it may be beneficial to change daily staples or cooking methods. Keep an eye out for coconut oil, heavy cream, and lots of cheese
  • Make an approved list of keto foods and eliminate carbohydrate-rich foods. It will be easier to follow the diet by throwing out any foods to avoid. It’s recommended to check the labels for hidden added sugars
  • Consider starting the ketogenic diet within a short period (16-36 hours) of fasting (consuming zero calories). Fasting depletes carbohydrate stores and can accelerate ketone production.
  • Gentle cardio exercise (~30 minutes) or some short high-intensity intervals (10-second sprints) can deplete carbohydrate stores and speed up ketone production

Cyclical Ketogenic Dieting and ‘Cheating’

At the moment, there is not a clear answer as to whether the benefits of the ketogenic diet can be achieved by cycling on and off the diet. It’s best to stick to the diet for 1-2 months minimum to see benefits. It can take several days to get into ketosis1 and 3-6 weeks to become “fat adapted.”18

Some research indicates ~40 days on the ketogenic diet interspersed with periods of healthy eating with more carbohydrates (Mediterranean diet) could maintain weight loss.24

“Cheating,” and consuming high-carbohydrate food, quickly stops ketone production by the liver. It can then take a considerable amount of time for the body to get back into ketosis. Time taken to get back into ketosis will depend on many factors. These include the amount of carbohydrates consumed, how adapted the body is to produce ketones, activity level, etc.

However, cyclical ketogenic diets are a promising area of scientific investigation. Recently, scientists studied the effect of long-term cycling of the ketogenic diet (one week on, one week off the diet) compared to a normal diet in mice. Cyclical keto dieting reduced mid-life mortality and increased healthspan.25

Optimal Range of Ketosis

As with all processes in metabolism, the state of ketosis is a spectrum. Past a threshold (which varies from person to person), even a small increase in dietary carbohydrate intake can trigger enough insulin release to take the body out of ketosis.

The level of ketosis required for different physiological benefits is unknown. For endurance sports, a higher level of ketosis (~4 mM) appears to be superior to lower levels.26,27 This is possible because ketones fuel athletes. However, some other benefits of ketosis, such as reduced appetite may be seen at much lower levels (0.5 mM).28 The best way to know if you are in ketosis is to measure the levels of ketones (BHB) in your blood or urine.

Physiological Ketosis

The typical methods used to generate physiological levels of ketosis are fasting, the ketogenic diet, and consuming exogenous ketones.

After an overnight fast, a low amount of ketones (0.1-0.2 mM) can often be detected in the blood. As the time spent fasting increases, blood ketone levels slowly rise until a plateau at 8-10 mM of BHB has been reached after many days. Scientist Hans Krebs described this plateau as “physiological ketosis.”29

Fasting long-term is unsustainable, so following a strict ketogenic diet can be used to maintain a low level of continuous ketosis. Research suggests blood BHB levels between 0.4-1mM can be achieved while following a ketogenic diet.18 Anecdotal evidence suggests it’s sometimes possible to reach higher levels.

Using exogenous ketones can raise blood ketones to a physiological level without the ketogenic diet or fasting. The level of ketosis reached depends on the exogenous ketone supplement used. Reported levels range from 0.6 mM with a ketone salt or a medium-chain triglyceride supplement26,30 and up to 6 mM with HVMN Ketone.27

Pathological Ketosis

Sometimes, the body starts producing ketones as a result of a disease (pathology). This can lead to dangerous levels of ketones in the body, though these high levels are very uncommon in healthy people following the ketogenic diet.

Alcoholic ketoacidosis (AKA) is a result of chronic alcohol consumption usually accompanied by malnutrition. AKA is characterized by increased ketone production (levels > 15 mM) via liver alcohol metabolism, in conjunction with a mild elevation in blood glucose levels. Symptoms include nausea and vomiting, fatigue, altered breathing, and abdominal pain.31

Diabetic ketoacidosis (DKA) occurs most frequently in patients with type 1 diabetes. DKA is the simultaneous occurrence of high blood ketones (> 20 mM), high blood glucose, and acidification of the blood.31 It develops when insulin is absent, or insulin signaling is no longer functional.

This means the physiological state of starvation is triggered, even in the presence of high blood glucose. As during starvation, lipolysis (fat release) increases. This causes the liver to produce a high amount of ketones and blood pH to fall (as ketones are an organic acid).

As glucose levels are very high, the excess is excreted in the urine. This draws water and electrolytes out of the body, causing dangerous dehydration. Symptoms of DKA include nausea, vomiting, altered breathing, abdominal pain, and unconsciousness. The rapid onset and alarming nature of DKA is a reason why ketosis has a bad stigma in the medical community.

Who Should Avoid a Ketogenic Diet?

Following a ketogenic diet may not be suggested for people with the following medical considerations:

  • Pregnancy
  • Kidney failure
  • Impaired liver function
  • Impaired fat digestion (gallbladder disease, gastric bypass, pancreatitis)

Genetic defects in metabolism (CPTI/II deficiency, beta-oxidation defects, fatty acyl dehydrogenase deficiency)

Potential Side Effects of the Ketogenic Diet

When starting a ketogenic diet there can be a period of 2-3 days where blood glucose levels are low, but ketone production has not reached a sufficient rate to provide enough fuel for the brain. This can result in a series of symptoms known as the keto flu which include:

  • Headache
  • Muscle cramps
  • Fatigue 
  • Nausea
  • Dizziness

Exogenous ketone supplements can be used to reduce symptoms of keto flu. They provide the brain with a source of energy without carbohydrate consumption. These supplements increase the levels of ketones in the blood artificially. Exogenous ketones do not increase the body’s ketone production (called endogenous ketones) and can inhibit32 the release of fatty acids from adipocytes.

It can be initially tricky to adjust food intake to ensure adequate nutrition when following a ketogenic diet. Also, some people find the diet isn’t sustainable due to individual differences in metabolic state or lifestyle. If the diet does not provide the correct balance of macro and micronutrients, some individuals develop other symptoms beyond the keto flu after the adaptation period. These include:

  • Constipation
  • Bad breath
  • Difficulty in maintaining physical performance
  • Hair loss
  • Gallstones
  • Elevated blood triglycerides or cholesterol

To treat these symptoms, ensure the diet provides enough calories and micronutrients. Many people reduce fruit and vegetable consumption on a ketogenic diet (due to carbohydrate content). This means it is easy to become deficient in vitamins and to under-consume fiber.

The ketogenic diet can alter the way that the kidneys excrete electrolytes (such as sodium), so electrolyte supplementation can reduce the side effects of an electrolyte imbalance.

Possible Clinical Applications of the Ketogenic Diet and Ketosis

Some of the earliest reports of the ketogenic diet describe its use in a clinical setting.

In the early 20th century, ketogenic diets helped treat drug-resistant epilepsy. Doctors also prescribed ketogenic diets to treat type 1 diabetes before the invention of insulin.

As analytical techniques progressed, scientists learned that ketones themselves might be a crucial part of the success of the ketogenic diet to treat disease. From this finding stemmed a field of research to examine the potential benefits of ketosis in a range of disease states:

  • Weight loss
  • Diabetes and metabolic syndrome
  • Neurological disease: epilepsy, Alzheimer’s disease, Parkinson’s disease, migraine, concussive disease, and traumatic brain injury
  • Cancer
  • Inflammatory diseases

While the ketogenic diet is not yet a first-line treatment recommended by doctors for any of these diseases, it’s a relatively easy and tolerable step that patients with these conditions can take to improve their health. Emerging research suggests there may be beneficial effects of ketosis for some people, and further studies are required to confirm how best to use the diet in these clinical settings.Not seeing results from the keto diet?

You’re not alone. Many think they’re in ketosis but aren’t–the newness of the diet leads to misinformation online. HVMN provides the latest science around meal-timing, supplements and macronutrient composition. Subscribe to HVMN and be first to know the newest techniques for keto diet results.

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Keto diet: how to fuel weight loss

keto diet can fuel weight loss
less carbs, more fat to fuel weight loss on keto diet. Photo from Pexels

By now everyone has no doubt heard of the keto diet. Similar to lots of other diets, carbohydrates are restricted. What makes keto different however is the considerable fat allowance. And that increased fat intake is what confuses most of us. How can we lose fat (weight) if we eat more fat?

The answer is (reportedly) that a diet high in fat, moderate in protein and low in carbohydrates keeps your body in a state of ketosis. Hence the name keto. So, what is ketosis and why is it good for weight loss? It is defined as a metabolic state in which ketones (acids) are produced when stored fat instead of carbohydrates (sugar) is burned for energy. This happens naturally every time we fast. You know that “morning breath” we all wake up with? That’s caused by ketones that are produced because we technically fast while we sleep.

So basically, the keto diet encourages your body to burn stored fat by decreasing the amount of carbohydrates available for fuel. Sounds easy doesn’t it? Well, there may be annoying side effects to the process. Like bad breath, initial fatigue (as your body adjusts) and constipation (from increased fat ingestion). As the fat begins to melt off your body however, you may find the side effects easy to deal with.

The constipation can be alleviated by adding more fiber to your diet. The fat your are consuming in large amounts does not have to be saturated fat like cheese, fatty meats and butter. And they should definitely not be trans fats like margarine and processed vegetable (corn, sunflower, canola) oils. Instead, choose unsaturated fats such as olive oil, eggs, avocado, coconut oil, unsweetened almond milk, seeds and nuts for the majority of your fat intake.

The bad breath is easy to deal with by chewing (sugarless) gum and brushing your teeth more frequently. Drinking more water and adding electrolytes to your diet will combat the initial fatigue.

The keto diet is not a quick fix, but more like a lifestyle change. The hardest part will be restocking your pantry and rethinking your grocery choices. Throw out the pasta, bread, and packaged foods loaded with sugar and other carbohydrates. Keto meals will require more planning since convenient and fast foods are not on the menu.

Bananas get a bad rap but deserve respect

Even though grocery stores sell more bananas than any other fruit, (my son told me that when working in the produce department of Loblaws years ago) the jury is out on whether they are good for you or not.  Some believe their high starch and (natural) sugar (fructose) content should be avoided when watching your weight.  Others believe their high potassium and fiber levels as well as good protein content are all good for our muscles and energy levels before and after a workout.  The potassium also helps regulate blood pressure levels. So, who is right?  Both, it just depends on your goals.

For example, if I am trying to lose a few pounds I avoid bananas, relying on healthy food choices with less starch and sugar levels. That’s because this sugar and starch causes a rise in insulin levels which in turn results in fat storage.  Not good if you are battling those dreaded love handles or sporting a not so flat stomach.  My diet motto however is “moderation is key.”  I believe if you totally restrict things you like, you will tend to crave them more.

Bananas are very convenient for providing a quick energy boost and light snack.  They do not require refrigeration and transport easily.  In fact, I resort to one often when working in my gardens because I can easily peel one without touching the edible portion with my not so clean fingers.  They also provide creaminess in my morning smoothies and make an excellent substitution for unhealthy fats in baked goods.  I also found them effective at reducing morning sickness way back when. But only if almost green, the over ripe ones made me gag.

Bananas are also particularly effective after a bout of the intestinal spasms and diarrhea experienced when I eat something I am sensitive to.  That is because bananas represent the B in the BRAT diet (with rice, apple sauce and toast) I learned about when my kids were young.  All bland foods, these four staples were recommended to get their system back to normal after flu symptoms of diarrhea and vomiting.  For the same reason, bananas are reportedly good for curing hangovers.

In my humble opinion, bananas get a bad rap, with the pros far outweighing the cons.  For that reason, there is always a bunch of bananas on my kitchen counter.  Not to mention my grandchildren love them.

bananas

Culinary World Cup 2018 in Luxembourg

On his blog, Michael Hauschild describes the  Road to Luxembourg, AKA his culinary journey, to represent Canada abroad.   Passionate about all things culinary, his training has been particularly intense since he was selected a year ago to compete on Canada’s Youth Culinary Team in Luxembourg later this month.

In Canada (and many other countries too) we are all aware of a World Cup for hockey, skiing, curling and many other sports.  I’d be willing to bet though that most people, myself included, are probably not aware of a World Cup competition for culinary skills. If you aren’t or even if you already were, check out the team’s Facebook page for more details.

I heard about this event from Michael’s (very proud) grandmother, one of my gardening clients, whom I also know from my days as a hockey manager.  Michael, you see, is one of my son’s hockey teammates that nicknamed me Lorieb many years ago.  Obviously his biological family is very proud of him as is his (very large) hockey family.

We and the rest of Canada are rooting for you Michael and your new team.  As Luxembourg’s primary language is French, I will end with Bonne Chance!

culinary

 

 

Avocado Every Day keeps the Doctor away

Move over apples, the new health axiom is “an avocado a day keeps the doctor away.”

avocado
pictures courtesy of Pexels

Even though a medium sized avocado adds around 250 calories to your daily intake and 24 grams of fat, the fat is predominantly the “good for your heart” monounsaturated variety.  Avocados also lower our “bad cholesterol” or LDL (low density lipoproteins) because they contain high amounts of plant based phytosterols.

avocado

Start by incorporating avocadoes into your daily meals.  Chopped, pureed, or mashed, use your imagination to try avocados for breakfast, lunch and dinner.  Just be careful what you eat them with (skip the chips).  Keeping in mind that a healthy allotment of fat is 65 grams within a daily diet of 2000 calories, simply replace the fats you have been eating for years with avocado.  Eliminate the “not so good for you” fats  like margarine or butter, peanut butter, oils, and mayonnaise.  As well as the heart healthy fat, you will be adding vitamins, minerals and fiber with this substitution.