The Truth About the Ketogenic Diet with Dr. Sarah Ballantyne

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Hey, it's jj. I am super excited about today's show because we are going to be diving into a topic you guys have been asking so much about. So I had the good fortune last year at Paleo FX to sit on a panel. It was a crazy panel. We had Mark Sisson and Rob Wolf and Dr. Joe Mercola and Dr. Sarah Ballantine and we're talking, we're talking about Paleo. But someone asked a question about keto and I just got a mad girl crush on Sarah. From that moment on, she is a. Well, first I'll tell you about Sarah and why you're gonna be so excited to hear from her. She is a New York times bestselling author, four books and she has the website thepaleomom.com. she has a PhD in medical biophysics and just is a crazy researcher, fact finder. So as she started to talk about this, it was like study after study, pathway after pathway. And I'm like, this is who I need to get on to talk about keto. And I really wanted to dive into keto and talk about because I keep hearing keto as a fad. Well, keto is not a fad. It's been around for thousands of years. But some of the ways we might be applying it aren't the most appropriate for the outcomes we want. And that's what we'll be talking about. What are the benefits of keto? When should you use it? When shouldn't you use it? And Dr. Sarah is a great person to talk about this again, she has a PhD in medical biophysics. But also she is deep into the autoimmune protocol and reversed her own or stabilized her own Hashimoto's and had a variety of health problems that she has fixed through using diet, which is super cool. So I am really, really thrilled to be sharing her with you. Now, before I bring her up, I also want to share with you this awesome, awesome review on my podcast. And just so you know, we are obsessed with reviews over here because it's the way the whole team gets our grades and I so appreciate it when we get these. So I always want to do shout outs. I'd love to shout you out. Yes, that was big hint to leave a review. This one says, thank you for the great information. 5 stars by Lisa Harleychick from Canada. And she says, love your podcast, jj. Your guests and topics are relevant and interesting. I enjoy how you engage your guests and how much valuable information is in each episode. I look forward to tuning into each episode. So thank you so much for that, Lisa. And you can leave a review if you haven't done it yet. I'm kind of begging over here a little bit, I admit it. But here's the deal. There's a lot of noise out there, and my goal is to help a billion people get healthy. One of the ways I'm doing that is by bringing amazing experts and pals onto the show and answering what comes up the most. Because I hear a lot of different things on social media, and so whatever topics are I hear, I go search out the smartest, smartest person in the room to talk about it. So getting those reviews, finding out you're subscribing and sharing means a ton. And it means we can reach a lot more people. So thank you, thank you, thank you, Lisa. And thank you in advance also for leaving a review. And remember, when you're over there to subscribe. And if you feel so like, if you think, oh, I know someone who's been asking a lot about Keto, well, share it with them. Alrighty. Cool. Now I've got another one of my favorites before I dive into the interview on keto with Dr. Sarah Ballantyne.

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All right, Dr. Sarah Ballantyne, welcome to the show. I'm super excited to be with you. I know I'm like going to attempt to extract as much out of that brilliant brain of yours as possible here. And I'm really excited to dive into the subject of keto with you because there's so much swirling in and around about it and I feel like we've kind of destroyed what it was originally intended for and turned it into a fad when the reality, it's kind of like calling Paleo fads. Like these things aren't fads, just, you know, understanding principles and when things should be used. So if that's cool, let's deep dive. What do you think?

I think we should do a download. Yep.

All right. All right. And just for everybody listening, I was on a panel with Sarah. I don't know if I even said anything on the panel except some Kim Kardashian comment, but you like, I was like looking over, going, all right, you just keep talking over there. I'm just going to take as many notes as possible because it was a there a question came up about keto. And then I went, that's it. You must, you must come on the show because we get asked about this every single day. So first thing I would love to start with is what is the ketogenic diet?

Yeah, so ketogenic diet is a really interesting therapeutic diet. It actually has its roots in like Hippocrates. Era medicine where they discovered that fasting could reduce epileptic seizures. And thousands of years ago, right, 2,500 years ago, that was like cutting edge medicine for someone who had epilepsy. There was no other options. And so they would do these, like month long water fasts. The seizures would go away and then the person would eat again. Gradually the epilepsy would come back. So it was always considered sort of this like short term intervention. You could go on and off. And then in the 1920s, a couple of doctors who ran like a, like in clinic, right? So epilepsy patients with severe epilepsy were really institutionalized back then. They didn't live out in the general population and they experimented on their patients, right, that this was what medicine was like 100 years ago. But they discovered that they could mimic the same effects of a fast with a very, very low carbohydrate, very, very high fat diet. And it took about 10 years for them to really figure out the exact formula. It had to be about 80% fat, it could be about 10% protein, 5 to 10% carbohydrate. Initially they found that they, or they thought it had to be low calorie as well. And then they discovered it didn't, like, it could be isocaloric, which means the same amount of calories as the person is eating, not on a ketogenic diet. And about half of the patients with what's called refractory epilepsy, so epilepsy that does not respond to any other drug had complete, like, basically all of their seizures went away. People who were having 200 seizures a day down to zero, it was considered a miracle. And then what happened over time is every time a new anticonvulsant drug came along, the interest in the ketogenic diet would, you know, disappear. Because who wants to do this really, really hard diet that has tons of awful side effects if you can just take a pill every day? And the problem is, of course, that there's no anticonvulsant drug that works for all epileptics. So if you're diagnosed with epilepsy, you end up trying one drug, seeing if that works, trying another drug, seeing if that works. And so the interest in the ketogenic diet, really, it really picked up in the 90s, basically thanks to the Atkins diet revolution, thanks to the movie do no Harm. And the story behind the movie do no Harm. And it has completely exploded in recent years and gone beyond. Right. Like you could think of it as this, like, prescription, right? It's a Prescription for epilepsy. And you can imagine that if there's something going on that's good for the brain, maybe there's some tangential application. So there is some really interesting science showing that it's potentially beneficial for multiple sclerosis for at least some people with Alzheimer's disease. So like neurodegenerative and neurological diseases, you can see some real therapeutic benefits to a ketogenic diet. But what's happening now is it's being used kind of off label and there's this like increasing number of. And this is where it goes from this therapeutic diet for a very specific situation to a fad diet because people are using it to lose weight, they're using it as a cancer intervention. Even though the science behind showing a ketogenic diet as a therapeutic diet for cancer is incredibly weak, it's becoming this, this like all purpose cure all. Even though the science not only doesn't support it, but there's actually some real problems with a diet that is designed to mimic starvation when it comes to overall health. So women are using a ketogenic diet to lose weight and they're basically breaking their metabolisms as a result. Because I think the conversation, has it started with this enthusiasm about this therapeutic intervention for a disease in which there is no cure to. Wow, we must be able to just treat everything with this diet and we just can't.

Yeah, here's where I'd love to like just have the science come out so that people can understand, you know, how this actually works. Because I was reading some promotional copy about someone's keto diet plan that says you have to be in ketosis to burn fat. And I pinged my friend and I go, I don't know who's writing your copy. This is not true. So just understand, explain the biochemistry of this so people understand. Because I think there's still an idea out there that in order to burn fat you must be in ketosis, which when you really understand the biochemistry, you go, oh, that's. No, that's not the case.

It's not actually the case. And also what's not the case is being a ketogenic diet is not the only way to be in ketosis. I think is another really important part that's wrapped in here. So every cell in our body uses this molecule called adenosine triphosphate, or ATP for short. And that is the molecule that every, you know, our mitochondria make it. And then that's what our cell organelles use for energy in all of the different Chemical reactions that, that require energy to propel them. So ATP is considered like the energy currency of every single cell. And we make ATP with a very, very complex chemical reaction called the citric acid cycle, or it's also called the Krebs cycle. Way back when I took biochemistry, it was called the Krebs cycle. And you can input into the Krebs cycle different macronutrients. So the Kreb cycle, the easiest way to make ATP is with glucose, right, the dominant sugar in most of our food. So most of the carbohydrates we consume, starch mostly breaks down to glucose. If we're eating table sugar, that breaks down into half glucose, half fructose. So glucose is the easiest thing to kind of shove into the Krebs cycle to make ATP as energy for our cells. But we can put amino acids, the building blocks of proteins in, into this cycle to make ATP, and we can put fatty acids into this cycle. So what happens in a person, like, if you're just going through the day, you don't have glucose in your. A lot of glucose in your blood all the time. So your glucose in your blood goes up after you eat, and then it gradually comes down as it gets shuttled into your cells and your mitochondria, turn it into ATP in between meals when glucose is not as easily available. If you have a healthy, flexible metabolism, your body goes, hey, we don't have a whole lot of glucose right now. Let's shuttle something else into this Krebs cycle. So most naturally you're going to take fatty acids, which is basically burning stored fat, and you're going to put that into the Kreb cycle and you're going to.

Which is what we want. That's a happy day, right?

That's a happy day. But this is, this is the normal fluctuation throughout the day, right? After a meal, you're gonna use glucose there.

Sarah was metabolic flexibility. Like, the healthier the metabolism, the more you can kind of switch. You're switching around throughout the day. You're not just stuck using one fuel.

And that's what's up the problem for diabetics, right? So diabetics actually have a really hard time accessing stored fat, but they also have a hard time getting glucose into their cells because of insulin resistance. What's fascinating is a ketogenic diet is not creating metabolic flexibility. It's actually creating almost like a weird complementary opposite inflexibility as what you have happen in diabetes, because it causes a type of insulin resistance. It's called Free fatty acid induced insulin resistance. There's not much insulin to get what little glucose is consumed into the cells. And so you end up with a metabolism. It's not like it's just stuck on the fat knob. What happens is when you start having trouble switching back and forth between glucose and fatty acids is, well, amino acids, let's burn those. So you see, when people who do a ketogenic diet for weight loss is you almost have this knob. It's stuck. Right. So the Krebs cycle, the mitochondria can't shift from different inputs and you end up burning lean muscle mass and losing more lean muscle mass, which of course tanks your metabolism. And you end up basically lowering your basal metabolic rate, which has the effect of you don't lose as much weight for how many calories you're eating because you're burning less just lying around. Ideally, we all want to have a high basal benamolic rate because that means that we're going to burn a lot of calories just by doing nothing. Any activity that we do is above and beyond that. And as long as our caloric intake is reined in and we have a flexible metabolism, we're going to be able to achieve healthy weight. What's happening with the ketogenic diet is you're breaking that knob.

Yeah. And when you're talking about basal metabolic rate, I mean, one of the big things with having a good BMR is having a good thyroid function. Yes. So that's the one, that's the key that I saw here. And I really love this talk about metabolic flexibility because I think that's the most important thing is, is you've got to be able to switch fuels. And the other side is you want to have a healthy metabolism. Talk about the research of what ketogenic diets. And this is, this isn't someone who goes on a ketogenic diet for one week, two weeks, three weeks. This is someone who's staying on one of these things for an extended period of time.

Correct, Correct. So all of the research that we use to look at adverse reactions to a ketogenic diet are what are called long term studies. So you'll often hear the term keto adapted. So you have a lot of people say, like, oh, you can't, don't pay attention to any of the horrible symptoms that you have in the first week or the first month. You just need to get keto adapted. And different proponents of keto will tell you how long it takes to become keto adapted.

Okay, let's Talk the bad symptoms of the first couple weeks and then what it means to be keto adapted.

So in the first couple weeks, severe lethargy, headaches, constipation, a lot of other type of GI symptoms are very, very common. People will generally just feel, they can feel achy, they can almost feel like keto flu. Keto flu, Right. So it feels like you have the flu brain fog, sort of like loss of memory. Right. So it's actually affecting what's called working memory. So it's your ability to recall, so access a word. So you'll find yourself like getting into a sentence and forgetting a word that you use all of the time. Studies show that people do have worse problem solving skills in those first few weeks after keto, and that may actually progress farther. And then some people actually will have things like their cardiovascular disease risk factors get crazy out of whack, so their triglycerides and their LDL cholesterol will skyrocket. That doesn't happen to everyone, but it certainly happens to some. Some people will get things like kidney stones, which is of course a real problem. And then because of the impact on the immune system and this actually some of these things get worse once you're keto adapted, and some of them will kind of resolve once you're keto adapted. But because of the impact on the immune system, there's also this increased susceptibility to infection. And in epileptic patients, we see that as being like sepsis, pneumonia, like life threatening infections. What we're seeing sort of the anecdote. And it's really hard to make conclusions based on what people share of their experiences on social media. But you see that people will have things like an abscessed tooth that doesn't seem to get better on antibiotics or they'll get, you know, the flu was so bad and there's always like some other, you know, culprit that gets blamed. Except that we know that a ketogenic diet really strongly suppresses the immune system. At first, that can look like your inflammation is resolving, but after a while that means your immune system's not doing its main function, which is to protect you against pathogens.

And what about thyroid? So let's talk thyroid, because that's, that's one that alerted me because, you know, I see these things. I did this when Grant was coming through out of his initial brain injury. So we used this temporarily. He did have some rebound issues with the thyroid after it. But that also could be because he had, you know, a severe brain injury. And that can impact a whole lot of hormonal issues. But I've seen this and heard it talked about the impact on thyroid health. So it seems like here you are trying to lose weight and then you've just crushed the thyroid. Exactly.

And I think it is sort of important to say that.

Right.

In the case of traumatic brain injury, neurological and neurodegenerative disorders, the cost benefit analysis is quite different than if you're using keto to lose weight.

Yeah. And this is what I want people to understand is there's all these different diets, know why you're using it and what, what the therapeutic outcome you're trying to get from it is, and then use the right thing for the right time. I mean, I, you know, it's like lowering carbs can be very helpful to lose weight, but ketosis isn't the, isn't going to be your long term solution because of this. So go ahead. Sorry.

Yeah, so. So, you know, the cost benefit analysis being different for certain conditions where maybe you just know that thyroid hypothyroidism is a possible consequence and you just monitor that and deal with it when it comes because it's an okay cost for the benefit you're getting. But if you're doing this to lose weight, it's really important to know that your thyroid gland is like your body's thermostat. It controls your metabolism, but there's also really strong crosstalk between your thyroid and insulin sensitivity between your thyroid and your sex hormones. So thyroid gland is a very, very strong signal towards reproductive function. That's why we see fertility problems in so many women with hypothyroidism. It has also really strong crosstalk with your stress axis. So having a hypothyroid, so a low functioning thyroid is not good. The symptoms include unexplained weight gain, lethargy, migraines, depression and anxiety, constipation, dry skin, hair falling out and brain fog. Right. It's miserable. I can tell you because I have Hashimoto's thyroiditis, which also makes my thyroid not a super functioning organ. It's miserable. So a ketogenic diet. There was a really, really well done study published last year in patients with epilepsy. They were on a ketogenic diet for their epilepsy. They were monitored very, very closely by doctors, but it was actually the first long term ketogenic diet study to actually do a thyroid panel in the patients, which was, to me, I'm like, you guys have been studying this for 100 years and no one thought to do a thyroid panel before. So they did a thyroid panel and they found that one in six of the patients in the study developed hypothyroidism, most of them within the first month. Although they actually followed these patients for a year. And they all ones that developed most of them within the first month, but all of them that developed hypothyroidism was within the first six months and it required thyroid hormone replacement. So they actually gave them levothyroxine as thyroid hormone replacement. So it was like what would get you diagnosed with clinical hypothyroidism? It was reduced T3, the active thyroid hormone, and elevated TSH. And it's kind of important here to sort of like, okay, well, you'll hear people say, well, like, well, any weight loss diet will suppress your thyroid. What's really interesting is studies that have used just calorie restriction to achieve weight loss have also looked at what it does to thyroid function. And it, it does cause a slight decrease in T3. It's considered A, a normalization effect because it doesn't make it tank to the point where you need thyroid hormone replacement. You don't need to take drugs for hypothyroidism if you're just losing weight on a calorie restricted diet, whereas in the ketogenic diet it does, with fairly alarming frequencies. Like 1 in 6 is much higher levels of hypothyroidism than we see in the general population, which is more like 1 in 200.

Wow. It'd be interesting to look at this and go, all right, so ketogenic diet, 5 to 10% of the calories from carbs. If you were sitting at 20 or 30% of the calories from carbs, would you be okay? My sense is it probably is because you haven't shifted. You're still metabolically flexible. You're able to shift back and forth between fuels. You're not creating that problem. You're not creating such low insulin.

Well, nut you've hit the nail on the head because insulin actually has a, it's a super hormone. It has a lot of roles in our body that have nothing to do with glucose. So it controls muscle protein synthesis, bone remodeling, it controls memory. And one of the things that insulin actually controls is activity of this enzyme called type 2 diiodinase, which is a fun one to say five times fast. But this enzyme is our main enzyme that converts the prohormone thyroid hormone that our thyroid makes into the active thyroid hormone T3. So if you don't have good insulin signaling, Say you're diabetic or you've been on a ketogenic diet for a while, or if you're not making very much insulin because your carb intake is too low, then the activity of this enzyme drops and then you don't convert T4 into T3. And then that can cause a type of manufactured hypothyroidism, which is probably exactly what is happening in these epileptic patients.

And wouldn't that impact. Because it's really important for people to understand. You want your body to hear insulin. You want insulin to come up, to do its job and come back down. So it's not just having low insulin all the time that's a problem. Insulin needs to be here to do its job. But what about insulin? What about menopausal women here going into this and its impact on estrogen? Because. And what would, what would go on there? Is there any issues there?

Well, so what's really interesting is that insulin is very, very important for sex hormone regulation in general. So it, for example, if you're insulin sensitive, having insulin will enhance the production of estrogen and testosterone. So it's really predominantly those two androgens, but it also suppresses a very important little protein that is just floating around in our blood called cell sex hormone binding globulin. So you can be making enough estrogen or testosterone, but if it's all bound up with sex hormone binding globulin, it can't do its thing. Which is why a doctor who sort of specializes in hormone balancing and hormone replacement therapy will always measure, in addition to your hormones, will also measure sex hormone binding globulin to get a sort of like active. What's your actually active amount of testosterone or estrogen in your body and not just your total amount. So insulin.

So it's like looking at TSH and free teeth as opposed to just tsh.

Exactly.

Sex hormones.

Got it. So this is where it gets really, really complicated and really, really muddy. Because insulin suppresses sex hormone binding globulin and enhances estrogen and testosterone production. But as soon as you got this kind of weird thing happening when you say you're on your way to diabetes, which is where most of this research comes from, in terms of understanding the link between insulin and sex hormones. You see hormone dysregulation very, very commonly in diabetes. That's why pcos, for example, which is quite hallmarked by elevated testosterone, really high testosterone in women. PCOS is basically considered a symptom of insulin resistance. It's caused by insulin resistance. It's very commonly co occurrent with type 2 diabetes. And so you see that that insulin has this very complex role because when you're first on your way to diabetes, the first thing that happens is you're making more and more insulin as your cells get less and less sensitive to it. So you end up with this kind of two different things happening is you're making more hormones, but you're binding more of them up. And depending on the exact details right where you are in that process, you can either get sex hormone excess or sex hormone deficiency. The basic thing you can say is it's going to mess up your sex hormones. That's pretty much the most generalization that you can make. But in women who follow a ketogenic diet for epilepsy, there have not been studies in postmenopausal women that have specifically looked at this. But you can see an effect because a very, very large percentage of them end up losing their periods or having some kind of period abnormality. So it's called amenorrhea, you know, when it's reported in a scientific article. But it's up to, I mean, I have seen articles where and typically smaller studies, but it's something like 63% of the women will end up losing their periods. And most of them will have their periods come back when they adopt a regular diet. But I mean, I very, very clearly recall one paper that was fairly small. I think it was nine women, seven lost their period on a ketogenic diet. And when they went off the ketogenic diet, six of them got their periods back. But that one woman and one in nine is like, that's a pretty high percent occurrence, right? You need more, you need larger sample sizes to be able to really dial in. Like what is the risk here? But that one woman basically, you know, made herself infertile with a ketogenic diet. And that is mediated through these effects on sex hormones. So in postmenopausal women, there have been studies looking at whether or not a ketogenic diet is effective for things like weight loss in postmenopausal women, but nobody has gone into the details of and how is this going to impact your hormones given that low estrogen and progesterone tend to be very, very common. Like PCOS is low estrogen, low progesterone, high testosterone. That's one of the things that we see chances are very, very good that it's not going to have a therapeutic benefit on hormones for someone who's dealing with Menopause symptoms.

Makes sense. You wouldn't want to bind up your hormones or lower them further when you're already dealing with.

Right.

So let's switch gears real quick. And I know just for everybody listening, we're gonna. I've stolen stolen Sarah Way for two podcasts, so you're gonna also get a chance to hear her talk about the autoimmune protocol. But I just want to wrap this one up with what you would recommend for weight loss. Cut through the confusion. What would you recommend?

Yeah, I mean, we have really great science showing that higher protein intake and eating a lot of vegetables are like the number one and two things that increase weight loss. Healthy weight loss preserve lean muscle mass. And actually, vegetable intake is the number one thing that predicts success of weight loss maintenance. So it's not just about losing weight. Right. You can lose weight a thousand different ways. The trick is keeping it off. That is the hard part.

And that's a different skill set. This is a great study. No one talks about. About what you need to get you there is not what you need to keep. I think if we put 20 nutritionists in a room, the only thing anyone would ever agree on. Well, there'd probably be one outlier in there, is that you should all be eating more vegetables. It's like, it's non starchy we're talking about here, right.

Generally, I mean, I think that a moderate carb consumption, something like 30 to 40% of your calories from carbohydrates, is very consistent with weight loss efforts. A couple of other things you actually need to have a caloric deficit. It's not, you know, I don't want to say calories in, calories out, but calories do matter. So I recommend some kind of portion control. I think tracking and journaling is an amazing tool for weight loss.

Yes. I like to say calories. You know, calories count, but where they come from is what really counts most because your body is a chemistry lab. I loved. I just saw the study come out where they finally said, yes, where calories come from counts. I'm like, oh my gosh. Finally. Like, come on, you know, so there's a big difference between eating apple pie or eating an apple. They're just it see if that's the.

Reality, there's a lot of vitamins and minerals, right? These are the micronutrients that are important for metabolism and for accessing stored fat. So if you're deficient in something like vitamin A or vitamin D or a lot of the B vitamins, or zinc or magnesium or copper, you're going to have a harder time in terms of accessing stored fat. So you, it's basically going to impact your metabolism. So that's, you know, where do you get all those micronutrients? You get them from whole foods, you get them from vegetables, some fruit. Seafood is an amazing food. And then the other thing is lifestyle is also important. Studies show that people who have an exercise regimen as part of their weight loss typically are more successful. It's not because they're burning more calories. It's because the hormone regulation that happens with exercise is really, really important for programming metabolism, programming appetite, helping you sleep. And then sleep is actually the number one thing. And it works two ways. So one, yay.

You make me immensely thrilled to hear the sleep one.

I'm always for harping about the sleep.

Well, sleep does two things. So first of all, it actually is really so it predicts your success with weight loss. If you don't get enough sleep, you are dramatically something 40% more likely to be overweight. You have a 2.4 times higher risk of developing insulin resistance and also strokes and heart attacks and diabetes. All these things, all of these things increase. If you're not getting enough sleep, cancer risk increases. It's really, really important. But our sleep also impacts our appetite and it impacts our reward system in our brain. So when we're sleep deprived, our hunger signals basically get messed up so that we're a lot hungrier than we normally would on a normal day. Studies show that people consume anywhere between 10 and 25% more calories the day after they had six hours of sleep compared to eight hours. Studies even show that people buy more calories when they go grocery shopping if they haven't had enough sleep. So you're more likely to just buy bad food if you haven't had enough sleep, and then you're more likely to eat it. And then studies show that our brains are less responsive to the reward response from food. So you think you start craving these high energy dense foods, potato chips or donuts or whatever it is, and then you don't even enjoy them as much. And because you're not enjoying them as much, you are more likely to eat more of them to try to trigger the same type of dopamine response in the brain as you would normally get from that food. And so all of those things combined, it's like the perfect storm for weight gain and all of the bad things that happen with weight gain when we're sleep deprived. So eight hours of sleep is like a. I mean, I think every single person should be getting eight hours of sleep every single night. But it is absolutely a non starter.

Yeah, I love hearing that. I had a buddy, Dr. Michael Bruce's sleep doctor and he did this. Glamour magazine took his book and put these gals on just sleeping more. They didn't tell them to change their diet or anything else. One month they all lost weight, no diet change. All they did was sleep. So I want to leave everybody with that one. Just if you do nothing else from hearing all this stuff, sleep. All right, so we give great gifts from our guests and I'm super excited about the gift you are giving Everybody your free 15 part Paleo ABCs. Wow. Super cool. Tips, ideas, resources, food lists, priorities, cooking tips, everything you need, guys. So you'll want to make sure you grab that. I'm going to put this@jjvirgin.com Paleomom and you can grab that. And be sure to tune in for the kind of next because as you can tell, we could be doing five hours of podcasts here and I wouldn't even probably be in to scratch the surface, Sarah, of what you've got in there. We're gonna be doing another podcast on the autoimmune protocol and so make sure you tune in for that as well. And Sarah, thank you so much for all your brilliance and sharing it with everybody. I so appreciate you.

Oh, thank you again for having me.

Sure. Now, after the break, I'll be answering a listener's questions, so stay with me. Ray Ban Meta glasses come with open ear audio so you can listen to your favorite music without blocking out the world around you.

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Sweet. Ray Ban Meta glasses available at Ray Ban stores and other authorized retailers. Welcome back. This is the time where I answer a listener's question. I always like to make it something about what we've got going on. So we've been talking all about keto and carbs and everything else. So this one. And again, I grab these questions. I do a lot of lives on Facebook and Instagram. Love to hang out with you there. It's JJ Virgin on Instagram and JJ Virgin Official on Facebook. I get asked about keto all the time. That's why I wanted to bring Dr. Sarah Ballantine on. And this one comes from Marcy, who said so. Now I'm totally confused. Low carb, high carb, keto, how do I know what to do? I bet you may be able to resonate with that because it's like, how do you really know? And I think it really gets down to there is no one diet that's right for everybody all the time. And that's the big key. Like I think when we really start to unpack the whole kind of diet wars, as I'll call them, is you want to think about dieting and eating. Okay, you're going to go on a diet for a short term for a therapeutic outcome and then you're going to take the things that in that diet were working for you, right. That you learned about yourself and you're going to apply them into your long term eating strategy. We need a new term for that long term eating strategy. That's what I'm trying to figure out. There needs to be a thing there because diet, we use one word for too many different things. So I'm talking about let's take a diet, let's use it therapeutically. And here's what you have going on. You have where you are right now in your life, what's going on with your health, what is your lifestyle like, what are the outcomes you're looking to accomplish from this, from this diet that you're going on right now. Then what's going on with your genetics? So we've got. And how old are you? What sex are you? Right. So you got all that stuff going on because what worked for you when you were 20, probably figuring out now if you're 50 or 40 or 70 doesn't work now. So. Right. We're a different person now. So you got all that stuff going on. Then if you're trying to figure out how many carbohydrates you should eat, that is actually why I wrote the Sugar Impact Diet. It is really to figure out what I call carb intolerance. Where should you be? And so what you do is you go through that program and you're going to first figure out where sugar is sneaking into your diet. You take a sugar sneaky inventory. Okay. There's this process I walk you through. It's super easy and it's all set up so that it's, you know, naturally. We want to be able to just figure these things out and get to a point of unlimited health. So first thing you figure out is where sugar sneaking into your diet and how is it impacting you? That's the Sugar Impact quiz. Then we go through and we start to taper. We taper from high sugar impact foods to medium sugar impact foods. And what's super cool about that is this isn't like, okay, you've been eating french fries and we're gonna have you trade those french fries for celery sticks. Well, that is ridiculous. Like, no one's getting fooled there. But we could take french fries and have you trade those for baked sweet potato fries. And I'm betting that you won't really notice difference. You probably like them even better. So we do a little taper for a week, but where we really focus on you eating from the trifecta of fat, fiber and protein. So you start to really work on blood sugar balance, which is the key. Then for two weeks we go to low sugar impact. So if you were eating, say, some pasta, we switched it to rice pasta, and then we switch it to spaghetti squash. So we're going to taper you down to low sugar impact foods and lower your carbohydrates and we're going to see how you feel during that time. And then we go back and we start to incorporate in some medium sugar impact foods and some high ones and we see how you feel so that you can figure out where is your sweet spot, where do you feel your best? Right, because everybody is different. And again, it depends on your age, where you are with your health right now, what are your goals, what's your lifestyle like, what's your genetics? And then we can design that together. We can design that diet that perfectly works for you. So I love that question. Thank you so much for that. And I want to remind you again to make sure you grab the great resources that Sarah has provided@jjvirgin.com Paleom and I will see you on the next episode. Bye.

Hello, listeners. This is Anne Bogle, author, blogger, and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week, I tag all things books and reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately. And I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment, whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything. You'll learn something about yourself as a reader, and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and Visit our website whatshouldireadnextpodcast.com to find out more.