[00:00:00] You are listening to episode number 245 of Better Blood Sugars with Delane, Md.
[00:00:08] Welcome to Better Blood Sugars with Delane, MD, where you can learn strategies to lower your blood sugars and improve your overall health. I'm your host, Doctor Delane Vaughn. Ladies, if you know you're capable of doing badass things at work and for your family, but you're confused and frustrated with why you can't seem to stop eating the chocolate cake, this podcast is for you. Let's talk.
[00:00:30] Hello and welcome to the podcast. I'm glad you're joining me today. I'm glad you're taking a minute and taking time for your health and committing to you and, I don't know, just carving out some time for yourself. I think as women, this is hard for us, and so I think it should be celebrated when we do it. So I'm glad you're here. I'm glad you're joining me. Last week, we discussed ketosis, nutritional ketosis. It was kind of a long podcast, and nutritional ketosis and the benefits for reversing your type two diabetes. This week, I kind of want to talk about some pitfalls with nutritional ketosis, some strategies to get through those, just some things to watch for. I feel like nutritional ketosis is a investment in and of itself. One, you have to invest a lot of math into doing nutritional ketosis. And there's more monitoring. It like doubles the monitoring, right? Watching your blood sugars. And now you're watching for ketones. You've got to. Do you know how many macros, and I don't really make recommendations for macros because I find that women get into, quote unquote, get into ketosis at varying macros. So I don't necessarily say you need to have x number of percentage of fat, x number, percentage of protein, x number or percentage of carbs. I don't do that. When I work with women, I tell them to count, cut their carbohydrates to a certain level, usually around 50 grams of carbs. Some women will go into ketosis at 60 or 70 grams of carbs. Some women have to cut back to 40 or 30 grams of carbs to get into ketosis.
[00:02:03] But that's how I tell them to do it. I don't dictate fat counts. I don't dictate, uh, protein counts. I do have guidelines that I help people stick within, but I don't say you need to do these specific macronutrients in order to get there. That's not been my experience. That that's what women have to do. I will say, I am not the guru of ketosis. I know how the strategy works, and I know how to help women get there. And it's very rare that I can't get somebody there. Um, but I just. It's one of the tools that I use to help women normalize their blood sugars, reverse their diabetes. And the reason that it works is because it lowers your insulin level. It utilizes an energy source which is called ketones, which is derived, it's made from fat, so it's the breakdown of your excess fat tissue into these ketone bodies. And those ketone bodies are put into the cell and burned as fuel instead of glucose. And the great news about that is that when you do that, you're no longer utilizing insulin to bring that fuel inside of the cell. So that's why it works, to help you reverse your type two diabetes. I talked about that last week in episode number 244. So check that out. If you want to hear the deep dive into that, I do want to give a warning that if you are going to use ketosis as your strategy to normalize your blood sugars, see better blood sugars, reverse your insulin resistance, normalize your diabetes, come off your meds, all of those things, the things that we're hoping to do to fix our health. If you're going to use nutritional ketosis to do that, you need to be very careful if you are medicated for your type two diabetes, because you can get very sick if you're on meds for your diabetes and you start eating this way. So you really need to get in touch with your primary care provider and get a line of communication open with them so they can guide you through this.
[00:03:51] Certainly in my group, I help women do this. I keep them safe. I tell them, hey, it's time to call your doctor and let them know and find out what they want you to do with these medications.
[00:04:03] I help them do that, but if you're doing this on your own, please hear me. You can get very, very sick, gravely ill, deathly ill, meaning you might die if you try to make these changes while you're medicated. So please don't do that. Call your provider. If you're interested in working in my group, send me a message.
[email protected] and I'm happy to get you set up for a call so we can discuss what it looks like to work together. But whatever you do, please be safe. If you are medicated and you try to use nutritional ketosis, because you can get really, really sick with it. So let's talk about pitfalls with nutritional ketosis.
[00:04:38] So there are many pitfalls that are concerning, and I'm going to talk about a few of them in no particular order. Like, one's not more important than another. These are just the pitfalls that I see happen with women as they use ketosis to normalize their blood sugars. So keto foods, like anything. Keto. Keto wraps, keto bread. I meant to look up on Facebook, in the Delane, MD Facebook group, there is a picture of a bread that somebody put up, and it's a keto bread. It literally, I think, says keto bread on it, and it sounds great. Sounds amazing. Like keto bread. Yes. And then it says 4 grams of net carbs, and it's like, wow, that must be amazing. 4 grams of carbs only for a piece of bread. And you're like, cool. I get to eat, like, 45 or 50 grams of carbs in a day, and I can have, like, just one piece of bread is for, oh, my gosh, this sounds amazing.
[00:05:44] Well, jokes on whoever eats that bread or buys it. If you flip it over and actually look at the label, I think it was, like 34 grams of carbs per bread, per slice of bread.
[00:05:57] And, you know, the net carbs, which is the dietary fiber. I'll talk about that here in a minute. But the dietary. The total carbs minus the dietary fiber, once they did that math, you could get down to 4 grams of carbs, which just means there's a ton of fiber in there, which is not a bad thing, but it does not negate the carbohydrates that are there. Those carbohydrates will still knock you out of ketosis, and you still have to keep that total carbohydrate below 45 or 50, or you're never going to get into ketosis. So I call these keto B's. Like, b's, keto foods. These foods, they say keto. It's a gimmick they're trying to get you to buy. Okay? You don't need keto foods to get into ketosis. You need to eat like a human being eats and just cut the carbohydrates out so that you can drop into ketosis. That's all you need to do. You don't need keto foods. You don't need keto bread. You don't need keto wraps. You don't need keto bricks. If you don't know what a keto brick is, I highly recommend that you google keto bricks. And then I want you to question, is that health food? Is that really health food, or is that some gimmick for me to eat that makes me believe I can get into ketosis and still feed my brain sweet, tasty treats that it wants? Because that's what a keto brick is. It is not health food. That is not food for a human being. It's like astronaut food and the worst kind. Okay, so any B's, keto foods, that's literally in my notes right here. B's, keto foods, any of those foods that say keto on them, you still need to evaluate them as if they were any other food. You cannot trust that they will keep you in ketosis, help your blood sugars, and improve your health in general. You cannot trust that unless you read the label. Okay, what does that mean? It means that a lot of these foods are either doing that trick, like that net carbohydrate trick, where they add a bunch of fiber, and, like, literally, when I say add a bunch of fiber, they are not having the food in its natural form, bound to fiber. They're literally dumping, like, metamucil into the batch. I'm sure they're not using metamucil, but some similar form of fiber. They're just dumping it into the batter and then baking that up. Okay, so that is one reason that it's an issue, is that there's still, like, I don't care if they use almond flour. I don't care if they use pistachio flour. I don't care what kind of flour. Macadamia flower. I don't care if they're using any flour. Flour, by definition, is a pulverized food, and it's going to be high in carbohydrates. So I don't care what kind it is. It's going to be high in carbohydrates. They're just trying to promote that it's keto because it's not as high.
[00:08:36] Maybe it's a little. Maybe it's 60% of what would be in wheat flour, but it's still a huge amount of carbohydrates. Okay, so that's one reason keto food is b's food in my brain. The other reason is they have to make it taste good, and they're not going to put sugar in it. And the other ways to make it taste good is to put artificial sweeteners in it. And the artificial sweeteners will not drive the carbohydrate count up. Unlike that net carb trick that they do, which there's still a high carbohydrate count. They just put enough fiber in it that you don't have to quote unquote count it if you're only counting net carbs, which is a total. Another issue, I'm going to talk about it. Um, but the sweeteners get in there, and even though the sweeteners don't drive that carbohydrate count up, they do cause you to make insulin. Or they can.
[00:09:22] The literature out there is mixed. The evidence out there is mixed about this. But they can cause you to make insulin. And if you're already insulin resistant to the point that you have pre diabetes or type two diabetes, you should assume that artificial sweeteners are doing this for you, that they are causing you to make insulin, and that insulin causes you to be insulin resistant. So the artificial sweeteners are a problem for that reason. For the second reason, artificial sweeteners are a problem because they alter your gut microbiome. And that gut microbiome is a huge endocrine player. It signals satiety, it signals all sorts of things. And when you feed artificial sweeteners, you're poisoning it.
[00:10:03] So when you're looking at keto foods, these B's, keto foods, recognize that they are almost always some sort of gimmick, right?
[00:10:11] A red bell pepper can be a keto food, right? An egg can be okito food. The eggs don't need to tell you that they're keto foods. You know that they're healthy for you. They're food that's meant for a human being. The bell pepper doesn't need to tell you it's keto food. You know, it's food that's meant for a human being. Okay? So whenever you're looking at food, if you see food and it has keto on it, keto friendly, any of those phrases, you need to seriously scrutinize that food label and you need to decide, is it really keto friendly or not? Okay, the net carb issue again, the calculation for net carb, if you're interested. I don't recommend this. If you're interested, the calculation for net carbs is you take the total carbohydrates of the food and then you subtract out the dietary fiber, and that gives you the net carbs. So lots of people are like, yes, I'm just going to count net carbs because the fiber is so good for me. I don't need to worry about it. I'm just going to tell you that's not the case. The fiber is good for you, but the fiber that they put in those foods are not fibers in their natural form. Fiber and its natural form and natural food is bound to the carbohydrate component of the fiber. I'm sorry, the carbohydrate component of the food. So fiber binds to carbohydrates. Okay.
[00:11:27] When this happens, it slows the body's absorption of the carbohydrate, and that gives you a moderated, a lower spike of glucose in your system, and you get a lower spike of insulin because of it. Okay? So fiber that is in your food, that is free fiber, not bound to the carbohydrate, is not as beneficial to you as fiber that is found in natural food when it's still bound to the carbohydrate. Remember these foods, fiber in its natural form, bound to the carbohydrate. The difference between the unbound and the bound version happens if you look at, like, carrots. I always use carrots as an example. When you have raw carrots, they are hard and they're like, they're like firm and they're crunchy and there's structure to it. If you cook the carrot, it suddenly becomes soft and mushy. Okay. When we cook the carrot, we break down the fiber. The heat breaks the bond between the carbohydrate and the fiber, and it dissolves the fiber. The heat does that. Suddenly we have this mushy carrot that's sweeter than a raw carrot. And the reason that it's mushy and sweet is because we've broken down the carbohydrate concentration. Okay? So recognize, and again, I don't know that you need to do big alterations over cooked carrots versus raw carrots or raw carrots. Better for you? Yep, absolutely. Hands down, they're going to be better for you. But nobody got diabetic because they're cooked carrot problems. So don't go stressing about that. But do understand if they are just adding free fiber to a bread loaf to, you know, bread dough, so that they can drive the dietary fiber count high, so that we can subtract from the 36 grams of carbohydrates in a slice of bread so that you can get 4 grams of net carbs. That is not going to cut it. Is it going to help your insulin resistance? It isn't going to help your blood sugars. If you want my personal opinion, this is not necessarily evidence supported, but my personal opinion, net carbs are just a gimmick that food manufacturers use to make you buy their food.
[00:13:35] Take it or leave it. That's what I. My opinion of it. My experience as women who use Netflix net carbs as a guide, they're, like, trying to keep their net carbs under a certain amount. They have to drop their total carb intake, like, their total net carbs. So how many net carbs can they allow in a day? Instead of 50, they have to drop it to, like, 30. Okay, so my feeling is net carbs is just extra math and it's a gimmick, so I would not rely on that.
[00:14:05] The other thing that you have to watch for when doing keto is the keto flu. I talked about this a little last week. But when your biology or biochemistry switches from burning glucose in the cells to burning ketones or fat in the cell, there is a time period where there's a little less energy available to your cells that manifests for you as feeling very sluggish, maybe headaches, just feeling unwell. And that is what we call the keto flu.
[00:14:37] Um, it does pass. Usually you've got to give yourself ten to 14 days to let that pass, let that transition into that new biochemistry occur.
[00:14:48] Some people never feel great in ketosis. I am one of those people that I just don't ever feel great in ketosis. And so I don't do keto unless I'm doing it with a client and they, like, want support. I'll do keto. I am very upfront with them. I'm like, I'm not going to do keto long term, but I'll do it until you get stable. I can handle a little discomfort until you get settled into it. Um, I will do it for other things, but I never intend to be in ketosis long term. I don't feel good in ketosis long term, and some humans don't feel good in ketosis long term. And that's okay. There's nothing wrong with that. It is simply a tool that you can use short term. Some people love ketosis, so you can use it short term. Or if you're one of those that love ketosis and you want to do it long term, that's fine, too. But it is simply a tool to help lower your insulin levels and reverse your insulin resistance.
[00:15:41] The other warning I want to give you about using ketosis is over concentrating your carbohydrates. What do I mean by that? I mean that if you're allowing 40 to 50 grams of carbs a day and, say, for breakfast you have.
[00:15:58] This is not a healthy meal, but we're going to run with it because this is the typical keto thing. You have three hard boiled eggs and four slices of bacon, and there's going to be one or 2 grams of carbs in that, depending on what resource you look at. I don't have any problems with the hard boiled eggs or the eggs. I have a bigger problem with bacon. Like, I don't think bacon is a great source of protein or meat. Um, but it's a pretty common meal. So say that's your breakfast, and say your lunch is three slices or three chicken breasts, and then your dinner is like, maybe it's just, maybe it's a. Maybe it's a sweet potato, maybe it's a salad and sweet potato, whatever it is. But you get all 40 to 50 grams of carbs in one meal. That amount of carbs in one meal may knock you out of ketosis, and it may take you 24 to 36 hours to get back into it. So you can have maybe 40 or 50 grams of carbs a day. You cannot have 40 or 50 grams of carbs a day in one sitting because you may knock yourself out of ketosis. So watch for that. And you're going to know, because I talked about this last week, how to monitor for ketones in your urine and in your blood. You monitor and see if you knock out of it. So if you're. And this is the truth about, um, you know, even eating, like, I'm going to have a handful of M and Ms or something, like, there may be so many carbs that may be so concentrated in that one handful of M and Ms, that it knocks you out of ketosis. I would never recommend a handful of M and Ms for anything. I don't think that that's. Again, it's not healthy food. But, um, just examples of what I mean by getting concentrated carbohydrates that would knock you out of ketosis, overdoing it on protein. I used to say this was an issue. I don't know that I think this so much anymore. What I've realized is humans probably need more protein than we get, and it probably takes a whole lot of protein to start converting, like, into glucose. So we know the liver will take amino acids, which are the building blocks of protein, and we'll convert those into glucose if you need them. There is this thought that eating a super amount of protein, like a super increased amount of protein in your diet in a day, will instigate this conversion into glucose. So it'll initiate the liver to start converting amino acids into glucose.
[00:18:14] I used to think that this was an issue, and I used to watch my protein count on my clients logs very carefully to prevent this.
[00:18:23] I don't think the literature really supports that that's an issue. Now, that being said, when you're not getting enough glucose and your brain needs fuel, or some other organ in your body needs fuel in the form of glucose, your liver will totally take amino acids first that are floating around in the blood. And then maybe if it needs, if there's not enough floating around in the blood, it may take amino acids from muscles, convert those into glucose, so your body can use the glucose that it's needing. But I don't know that I necessarily feel like overdoing protein is gonna knock you out of ketosis or cause this to happen.
[00:19:00] So the last thing that I wanna talk about, kind of a pitfall to watch with ketosis. The one time that I really recommend ketosis for women is when they are really incredibly averse to feeling hungry. Like they just can't gain any traction with getting improvement in their blood sugars because they are so averse to feeling hungry.
[00:19:23] A lot of times this is tied up in desire for food. Okay, so I will frequently recommend ketosis, nutritional ketosis, for those women who are averse to being hungry, because you can eat frequently throughout the day and stay in ketosis, keep your insulin levels low, allow your cells to heal up like that's totally possible to do during. When you're utilizing nutritional ketosis, eat frequently during the day and still keep your insulin levels low, unlike fasting, if you're using just intermittent fasting. Straightforward. The whole point behind that is that you don't eat for a period of the day so that you can keep your insulin low. And then when you eat, you understand that your insulin levels are going to go higher.
[00:20:05] So for women who are averse to being hungry, I do believe that utilizing this solely as a way to manage food, desire is not going to be effective long term. Okay, I just did a webinar. It's up on the delane Md YouTube channel. So you can go to YouTube, search Delaine, Md. It will come up. The webinar is called doing the damn thing. But it talks really about how to do, like, what is creating this food desire? What is creating really the thing that is so hard? It's so hard to not eat the food. It's so hard when the ice cream is calling me from the freezer every night. It's so hard when the chocolate bowl is calling me from the, you know, my colleague, my, you know, work colleague's office. I want to go eat all their chocolate. It's so hard.
[00:20:58] So I want you to understand, you have to learn to get that desire in check and managed. There's no amount of ketosis that's going to make that go away. Yes, ketone bodies floating in your system can have an effective satiety, but satiation, being satisfied from the food that you eat does not undo your desire for tasty treats, whatever those tasty treats are. And the way that you know this is because of satiety for the food made the chocolate ice cream unpalatable or unnecessary. You wouldn't need the chocolate ice cream at the end of a meal because your belly is full and satisfied.
[00:21:42] Your fullness, your satiety has nothing to do with your desire.
[00:21:46] Okay, so you're getting like, if you are utilizing again, I recommend to women just to get some wins, just to get some traction, just to start seeing better blood sugars. I'll totally recommend recommend use nutritional ketosis. Let's get you started. Let's see how it goes. But you have to work on that desire component also. You cannot just use the nutritional ketosis for the rest of your life and expect that you're never going to desire chocolate because that is not like the ketone bodies satiety. None of that is what manages the desire for chocolate. The desire for chocolate is something entirely different. And I go into it in that webinar. So check out that webinar on YouTube. It's called doing the damn thing. I dive into that pretty deeply in that.
[00:22:27] That is what I have for you this week. I want you to keep listening. I want you to keep avoiding foods that are making you sick. Keep making the decisions and the choices for your health and your vitality and your longevity. I will be back next week and we will talk then.
[00:22:42] Before we end, I do want to again remind you if you are medicated for your type two diabetes, please be careful if you make the changes that I recommend in these podcast episodes. You have been medicated for the way you have eaten in the past. And if you change the way you eat, you will need to change the food. Or if you change the way you eat, you're going to need to change the medications that you're on. If you don't, again, you can get very, very sick. So what I need you to do is I need you to call your primary care or your providing physician or providing doctor clinician that prescribed these medications and I want you to let them know what you intend to do, and I want you to get clear on how they expect you to share your blood sugar. Log with them and they will tell you how they're going to share medication changes with you.
[00:23:26] And then you will know what they want you to do to change your meds so that you can stay safe as you make these healthy choices. If you do not do this, you can end up quite sick, the kind of sick that looks like hospitalization and possibly even death. And we don't want to do that. So make sure you call your medical provider and get a good line of communication open with them. I also want to offer to you there is a 14 days to better blood sugar workbook that you can access. It
[email protected] forward slash better. That's b e t t e r. It is 14 days of breakfast, lunch and dinner menus. There's some modifications made on that and I'm going to have some training sessions about how to take that forward going forward more than the 14 days. So stay tuned for those. But that's where you can get started. If you have had the thought that no matter what I eat, I can't get better blood sugars. If that has ever crossed your mind, I want you to check this workbook out. This workbook is incredibly powerful. Again, the med warning still stays there. If you are medicated, be very careful as you use this workbook. It is incredibly powerful. You will see better blood sugars. You can also, um, you'll get on my mailing list when you sign up for that workbook. You can opt out at any time if you need to from that mailing list. But there are, um, updates or like webinar announcements. All sorts of things are shared in that mailing list. So you will get on that mailing list and get help that way. Also recognize you can find me on Facebook and Instagram at delanemd. And as always, if you have any questions, don't hesitate to send me a message. Delanemd.com and lastly, I have an ask if you found this podcast helpful. If you find good information in this podcast, if you've seen your blood sugars drop from listening to the information in these podcast episodes, please rate and review the podcast on your podcast app. If you don't listen on the app, if you go to my website, delanemd.com, to find the podcast each week, then share it through your social media. Nine out of ten Americans are insulin resistant. If you're having this problem, likely nine out of ten of your friends are also having this problem, or at least the root cause of this problem. They, too, will benefit from this information. Get the message out there. Help me spread the word that you don't have to be sick and tied to the healthcare system for the rest of your life. It is entirely possible to live naturally healthy lives. People need to hear this. And the more you share it, the more people will. All right, I will be back next week. Bye.
