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45: John Kiefer & Dr. Rocky Patel | Cyclical Ketogenic Diets For Health And Performance

AIR DATE: September 12, 2013 at 7PM ET
FEATURED EXPERT: John Kiefer & Dr. Rocky Patel
FEATURED TOPIC: “Cyclical Ketogenic Diets For Health And Performance”

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At the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month, Jimmy Moore was the moderator of a fantastic panel of experts addressing the topic “Ketogenic Diets & Exercise Performance” featuring a star-studded line-up of Paleo fitness studs that included Robb Wolf, Mark Sisson, Ben Greenfield and Jamie Scott. The general consensus by most of these top names regarding the future use of the ketogenic approach for exercise and general health is the idea of regularly cycling in and out of ketosis to experience the maximum benefits. This is something that our expert guests this week know just a thing or two about. They are an exercise scientist, nutrition expert, and the author of The Carb-Nite Solution as well as Carb Back-Loading 1.0 named John Kiefer and a board-certified family physician from Gilbert, Arizona named Dr. Rocky Patel. These two knowledgeable men were here in Episode 45 of “Ask The Low-Carb Experts” addressing the issue “Cyclical Ketogenic Diets For Health And Performance.”

TENDERGRASS FARMS GRASS-FED/PASTURED MEATS:

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Here are some of the questions we address in this episode:

PEGGY ASKS: I see no reason why I should “cycle” in and out of ketosis. That seems a bit ridiculous to me, actually, when my performance is so fabulous remaining in ketosis virtually all the time. It’s been truly miraculous for me. What added benefits will I get from going out of ketosis on occasion rather than simply staying in a constant state of ketosis for my exercise performance?

ALAN ASKS: Dr. Peter Attia on his “Eating Academy” web site says that research shows “someone in nutritional ketosis – even if eating zero carbohydrates – still has about 50-70% of a normal glycogen level, as demonstrated by muscle biopsies in such subjects.” I have been on a ketogenic diet myself since May 2013. And as a recreational athlete, I like to do long endurance runs of 13+ miles at a time. Sometimes my runs are great, but other times the performance is poor and I bonk near the end. It feels like I have depleted my muscle glycogen stores at this point. What strategies would you recommend that I do to boost the muscle glycogen prior to going on a long run while on a ketogenic diet?

ADAM ASKS: Is there such a thing as bulking up on a ketogenic diet? If you can’t bulk up in the traditional sense, then can you at least build muscle or see body recomp changes using a ketogenic approach?

JERIS ASKS: I do a lot of Bikram Yoga and I’ve been on a low-carb, high fat ketogenic diet for several months. I noticed at first I was getting that ammonia smell and bonking near the end of the 90 minutes. I tried loading up on different carbs and experimented with this on several occasions. A bunch a fruit right before, sweet potatoes the night before–nothing worked.

Finally, I heard Ben Greenfield talking about MCT oil and I was already putting that in my coffee in the morning. So I tried putting it in my water for the yoga and amazingly I could do the whole class with no carbs and without bonking or getting the ammonia smell. Maybe I just wasn’t getting enough calories of any kind or I was eating too much protein.

My question is this: Is it okay to use MCT oil daily in order to stay in ketosis? I guess cycling in and out would mean back-loading with a sweet potato or some other “safe starch” once or twice a week. I’m not doing that right now, I’m just eating a bunch of veggies and a little bit of berries for carbs, so I THINK I’m staying in ketosis. If you stay in ketosis, then won’t you become fat adapted more quickly?

DENNIS ASKS: If someone is engaging in a 24-hour intermittent fast a couple of times a week, then should they break the fast with starches?

LINDA ASKS: I am a 50-year old female runner who has been running for nearly three decades. I’ve always eaten carbs and low-fat protein 5-6 meals a day up until a year and a half ago when I started to lower the carbs and up the fat. I am at a healthy weight, but found that adding the fat made me feel so much better. I’ve been eating mostly Paleo with a little bit of dairy. I’ve really enjoyed listening to the ketogenic success stories of athletes like Ben Greenfield, Vinnie Tortorich, and of course Jeff Volek and Dr. Steve Phinney. My question is how is this working for the ladies? Even all the male podcasters have female co-hosts that seem to whisper in the background that they need more carbs, especially when they race or train at high intensity. I will admit, when I posted to Ben about how many carbs to eat when training for a half marathon, he said at least 100g on high volume days and scale back on rest days. I know eating for leanness and eating for performance are two different goals, but I would like to hear more about low-carb performance for women, especially at you get older.

DAMON ASKS: If someone ate a cyclical ketogenic diet but never got blood ketone levels to a significant level, then it seems to me that they would be in no man’s land where they have no ketones for energy but are also carbohydrate depleted. How can someone with this issue of low ketones and depleted carbohydrate stores figure out how to increase ketones to improve their health and performance?

LAWRENCE ASKS: Keifer says that staying on a ketogenic diet for too long can lower your testosterone levels. But low-carb researchers like Dr. Steve Phinney and Dr. Jeff Volek never mention this as a long-term problem for people in a constant state of nutritional ketosis. On what basis does Keifer make this claim?

JASON ASKS: Is a cyclical carb strategy REALLY necessary for everyone or is it more dependent on the specific kind of activity you are engaging in? I stay in a constant state of ketosis and run 20 hour/week as well as hit the gym twice weekly. I never feel low on energy and actually feel great pretty much all the time. In fact I do NOT like the feeling I get when I am kicked out of ketosis. In light of this, is there some unknown performance reason why I should be cycling in carbohydrates into my diet? And if I do decide to add in some carbohydrates, how do you determine the correct quantity so you don’t prevent keto-adaptation from taking place?

MINDY ASKS: I’m a 47-year old female who weighs ~175 pounds and I want to lose body fat. I’ve been on a Paleo/low-carb plan for about 3 years and I swing kettle bells a few times a week for exercise. I am currently attempting to do my own version of Kiefer’s CarbNite plan with a very low-carb, higher fat program for six days followed by a smaller carby snack, carby dinner, and ice cream on day 7. I’ve had blowout CarbNites before and then end up spending the next 6 days just losing what I gained from that event which is why I’m scaling back on them. Also, I initially did your high protein protocol and started gaining weight. I have found that much lower protein and higher fat just works and feels better for me. What, if anything, would you advise I change about the way I’m implementing a cyclical ketogenic diet?

DAMON ASKS: What is the maximum amount of time that you suggest being low-carb before beginning to cycle in and out of ketosis? Other than diabetes, are there any other conditions that may prevent someone from getting into ketogenesis if they are eating low-carb, high-fat?

MARK ASKS: What is the relationship between ketogenic cycling frequency, the amount of workload during exercise, and lowering body fat percentage if your goal is continual fat loss?

GREG ASKS: Does Kiefer or Dr. Patel promote using tools like blood glucometers or blood ketone meters along with the carb back loading protocol? I am particularly interested in the context of someone like myself who is around 15% body fat while doing heavy lifts like back squats, deadlifts, bench presses, and military presses a few times per week. Is there a particularly good way someone could use these meters to optimize and individualize things like carbohydrate intake post workout?

PAUL ASKS: On The CarbNite Solution, is it possible to kick start things by lowering your protein intake down to the bare minimum needs perhaps around 30-40g a day? If so, is this something you’d do for 6 of the seven days or just a few of them?

DEBBY ASKS: I’m currently using the CarbNite Solution protocol and an avid baker using coconut oil and coconut milk predominantly in my baking. I live a primal/Paleo lifestyle and limit my carbs to rice, sweet potatoes, and other real food starchy carb sources. I have heard that combining MCT oil with carbs, like sweet potatoes, raises insulin levels. If this is true, then would using coconut oil with other clean carbs such as the ones I listed above do the same? And if so, is there a limit to how much coconut oil to consume with our carbohydrate on a CarbNite plan?

JULIE ASKS: I am a 34-year old female currently following the CarbNite Solution program. I had gestational diabetes with both of my kids 2 and 3 years ago. At my heaviest weight I was 260 pounds and my fasting blood sugar level was about 104. I gradually reduced carbs and finally discover CarbNite Solution that helped me get down to 185 pounds with an 84 fasting blood sugar in the morning and 5.4 A1c level. However, my blood sugar sometimes goes up to 97-104 on other mornings. Is this something to be concerned with? Should I consume less carbs on my CarbNite until my readings return to normal the next morning? Or am I just overthinking this?

JOS ASKS: I’m a 34-year old female and just started weight training about almost a year ago. I am 5’5” and weigh 110-112 pounds with about 19% body fat. My goal is to increase muscles while minimizing fat gain. My current workout program mainly focuses on basic lifts such as a glute bridge, squats, deadlift, push and pull. I’ve been on CarbNite Solution for almost a year and have lost a good amount fat and gained a bit more muscle. I used to be that skinny fat Asian girl.

Recently I’ve just started to increase my training intensity by going a bit heavier in weights. I heard that once you increase the workout intensity that we need to increase our carb re-feeds during the week, as opposed only having it once a week. What do you consider “working out with intensity” and why can’t we just increase the amount of carbs in our once a week carb re-feed CarbNite instead of eating more carbs during the week? Or do you think I should start switching to your other protocol, Carb Back Loading?

  • Mindy Noxon Iannotti

    I’m so excited for this show!! Wish I could think of a question!

  • Wenchypoo

    Speaking of BG testing being burdensome, it doesn’t help when the meters themselves can be as much as 20% off 95% of the time–this is what current federal law allows the meters to be. Example: my husband had a doctor’s appointment, and fasted overnight for the blood draw. He tested at home right before he left, and the meter read 102. An hour later, when the doctor drew blood and tested, her reading was 82. Short of an insulin dose, what would cause blood sugar to drop 20 points in an hour?

    I went on the web, and discovered it’s the meter–not just OUR meter, but ALL OF THEM! So are we supposed to hang out around a lab all day just to get accurate BG numbers? The 20% difference can be in either direction, and you don’t know which one!! 13 people have died so far from too high BG readings, and took insulin when they needed sugar.

    Then I got to thinking about ketone meters–are they off by as much? And worse, is it baked into the cake via federal regulation just like with the BG meters?

    How are we supposed to be proactive about our health when we can’t even get accurate, reliable data from devices meant to be used at home? I think (welcome to Crazy Town) that we AREN’T meant to have control over our own health, and that the government is using regulations such as this as one more way to kill us off before we reach Social Security age. Doesn’t it seem like they’re thwarting us at every step in this (the latest hurdle being Obamacare)?

  • AriD2385

    This was such an informative podcast. Thanks so much!