[Transcript] – Everything You’ve Always Wanted To Know About Ketosis But Were Afraid To Ask.

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Podcast from:  https://bengreenfieldfitness.com/podcast/low-carb-ketogenic-diet-podcasts/keto-clarity-book/

[00:00] Introduction

[07:27] Carbohydrate Tolerance Level and How to Find It

[14:52] Determining the Personal Protein Threshold

[22:25] How Much Saturated Fat is Too Much?

[24:34] The Biggest Low Carb Mistakes You Can Make

[28:42] Why You May not be Producing Adequate Ketones

[42:02] End of Podcast

Ben:  Hey folks, it’s Ben Greenfield and I’ve got a question for you today.  Do you know what the similarities are between epilepsy, type-2 diabetes, obesity, cardiovascular disease, metabolic syndrome, polycystic ovarian syndrome, irritable bowel syndrome, heartburn, fatty liver disease, Alzheimer’s, Parkinson’s, dementia, mental illness, schizophrenia, bipolar, depression, narcolepsy, sleep disorders and cancer, autism, migraines, chronic pain, brain injury, stroke and chronic disease? I know that was quite a list but everything that I just listed has been shown to be affected in some way, and usually positively affected, by a low carb, high fat ketosis-based diet.  And my guest today, Jimmy Moore, is gonna tell you all about this, so first of all, Jimmy, welcome to the show.

Jimmy:  What’s up, Ben?

Ben:  Not a whole lot.  So for those of you who don’t know who Jimmy is, he’s one of the world’s leading low carb diet bloggers and podcasters and he’s been on this show before.  Last year, he wrote a book “Cholesterol Clarity” which he penned with Dr. Eric Westman.  I believe Eric worked on you with this other book as well, right?

Jimmy:  He did.  Yeah, he’s my co-author again.

Ben:  Gotcha, and Dr. Westman is a practicing internist, he’s a low carb diet researcher, and in the podcast episode that I did with Jimmy last year, we talked about “The Shocking Truth About Cholesterol” and why you probably don’t even need to test for cholesterol.  I’ll link to that in the show notes for this episode which you can grab over at bengreenfieldfitness.com/ketoclarity.  But Jimmy’s back now with this new book that pretty much answers everything you’ve always wanted to know about ketosis.  It’s called Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet.  I just started to read it and haven’t finished it yet, but basically Jimmy shows you in the book how a low-carb diet goes way into more than we all think about it for, which is to lose weight, but also produces a pretty powerful therapeutic effect on a lot of the things that I was talking about earlier and can also be a pretty cool biohack for physical performance and for mental performance.  So we’re gonna delve into some of the stuff that Jimmy talks about in the book today and kinda get into everything you’ve always wanted to know about ketosis but maybe were afraid to ask.  So Jim, thanks for coming on man.

Jimmy:  Yeah man, this is my heart and soul the last few years so let’s bring it.

Ben:  Yeah, and that’s what I actually wanted to talk to you about.  You started this whole thing off with an n=1 experiment in nutritional ketosis, and I’m curious.  You delve into, in pretty good detail in the book, but can you give us kind of an overview of what your n=1 experiment actually was?

Jimmy:  Yeah, so I’ve been eating low-carb since 2004, very famously lost 180 lbs. that year on the Atkin’s diet, and did very well.  And over the years, it slowly started coming back on again, some of the weight and some of the health issues.  Nothing major but some things that showed up in blood tests and I was going “okay, what’s going on here? I’m eating low-carb, I should be losing weight, I should be controlling a lot of these health issues and the blood markers should be just beautiful.”  Unfortunately, they were not, so in 2012 I read a book called The Art and Science of Low-Carbohydrate Performance” who I know you’re very familiar with:  Dr. Jeff Volek and Dr. Steve Phinney.  And in there, they talked about measuring for blood ketones.

Ben:  Mmhmm.

Jimmy:  And this concept known as nutritional ketosis and I was like “alright, nutritional ketosis and blood ketones, I’ve only heard of urine testing for ketosis” and I’ve heard of ketosis but didn’t know what this nutritional ketosis was.  It turns out through manipulation of the various macronutrients, you can produce ketones in the blood, which is the active ketone body that you’re looking for, it’s called beta-hydroxybutyrate.  And  if you do that, then you’re able to find all these benefits, which you know yourself Ben, goes well beyond shedding fat.  It’s the mental clarity, the hunger control, and we tell all about it in Keto Clarity, but just bunches and bunches of great benefits that you get from doing this.  So I put it to the test, I gained some weight, I had some trouble with sleep, I had trouble with various aspects of my health, so I started putting myself into a purposeful state, testing daily, morning and night, sometimes multiple times every hour-on-the-hour testing.

Yeah I was one of those people, doing the test for a year and at the end of the year, I’d lost a pretty good chunk of weight and I noticed all the intangible benefits.  That’s what really caught my attention, it really made me spontaneously start to intermittently fast which was providing me side benefits.  I never intended to intermittent fast, it just happened because the ketones were satisfying me so much.  So yeah, it was pretty spectacular and it was that experiment that I said “I need to tell people about some of the lesson I learned from all this, I need to go find some great experts like Ben Greenfield to be a part of this project.”  So we had 22 total experts for Keto Clarity plus myself and my co-author Dr. Westman.  We think we put together a pretty definitive guide to low-carb high-fat diet that unfortunately has never been written.

Ben:  Yeah.

Jimmy:  There’s been books out there about weight loss for ketosis and there’s books out there with epilepsy, but really nobody’s ever come at it from a total health perspective, and here’s the bigger thing that we’re hopefully answering with this book, nobody’s ever give you a practical guide about how to get there.

Ben:  Yeah.

Jimmy:  And so, hopefully that’s what Keto Clarity does.

Ben:  Yeah, and that’s actually something I wanted to ask you.  You talk about how to get there and you’ve got some things that we even talked about before on this podcast, and by the way for people listening in, we have talked about ketosis before.  I’ve got an episode with Dr. Terry Wahls, there’s another episode we’ve done with a guy, a researcher named Dominic D’Agostino, and a few episodes with Peter Attia.  And I’ll put links to all those if you wanna listen to them over at bengreenfieldfitness.com/ketoclarity, but Jimmy, one of the things that you talk about first is that you have to find out what your carbohydrate tolerance level is.

Jimmy:  Yes.

Ben:  Can you explain what the carb tolerance level is exactly, and how people can find out what their carb tolerance level is?

Jimmy:  Absolutely.  By the way, Dr. Wahls and Dr. D’Agostino are both experts in the book as well.

Ben:  Nice.

Jimmy:  So yeah, carb tolerance is kind of a sliding scale from person to person.  You’re a real fit guy, Ben, you probably haven’t had a whole lot of metabolic-resistant issues in your life, unlike the man that you’re talking to right now.  I used to weigh 410 lbs. and has issues from the past that rear their ugly head even all these years later, so you have to figure out what your personal carb tolerance level is.  Now you might say “well how do you do that?” Well, we give some major steps in the book about how to do that.  First of all, if you have no clue and just wanna tinker around, go down to twenty, and  on a week by week basis, just up it 5-10 grams each week and see how you do.  And somebody like me, my tolerance level’s right around 30 grams.  I can do 30 grams of carbs and be fine but if I do 50, 60, 80, 100, I know I’m gonna run into problems…

Ben:  Like, what do you mean when you say problems, what do you mean?

Jimmy:  Weight regain, hunger, cravings, irritability, mental fog starts to come back in.

Ben:  So when that stuff happens, are you out of ketosis?

Jimmy:  Yes, that’s where I was going.  In other words, it’s a telltale sign that you’re not producing ketones which is kinda the purpose of limiting those carbs.  You’re trying to get into ketosis.

Ben:  Yeah.

Jimmy:  So, another way you do that is look at your triglycerides.  People have their cholesterol panel run, I know we did a podcast on this last year, but one of the telltale signs that you’re eating way too many carbs or your tolerance level is your triglycerides will come back over 100.

Ben:  So it’s more the carbs than the fats that are gonna rise triglycerides like that?

Jimmy:  Exactly, carbohydrates is probably the number one reason for hypertriglyceridemia, which is high triglycerides, and so you wanna get that level optimally under 70 but definitely under 100.  If you’re over 100, you probably should titrate back on your carbohydrate, and that’s one way you can find that tolerance level.  And then another thing is the blood glucose monitor, those are so ubiquitous, everybody in America and around the world should own a glucometer and test your blood sugar.  And if you eat a given food and your blood sugar rises well above 140 and doesn’t come back to baseline within two hours, guess what? That’s probably not a very good food for you to be consuming either, especially if it’s carbohydrate-based food, you need to bring back the carbs.  So practical ways for people to do it, very easy testing to do and you can find that carb tolerance level first and foremost.  It’s the “K”, we did an acronym in the book, it’s the “K” in KETO: Keep carbs low.

Ben:  So, by the way I should mention I just preordered this QME device, it was like QME.com or something like that, but it’ll allow me to test glucose and triglycerides and that type of thing with a drop of blood on my iPhone.

Jimmy:  Oh wow.  Oh, I need one of those, dude.

Ben:  Yeah, and I’ve used those, I think you were using breath ketone monitors in the past? Is that correct?

Jimmy:  I was actually using urine ketones originally when I first started Atkin’s, and then I switched to the blood ketones during this one year experiment, and only recently in the last 8-12 months, I’ve been tinkering around with various breath ketone meters.  There’s actually several that are on the way, there’s one being in development in Japan right now for your smartphone that you’ll be able to blow into.  Yeah, this is emerging technology that I think by the late 2015, early 2016, we’re gonna see breath ketone meters on the market.

Ben:  Cool, I like it.

Jimmy:  Very ubiquitously.

Ben:  So this whole carb tolerance level thing though, it’s gonna change for athletes, right? And the reason I’m asking that is just because for me, training for Ironman, I’ve had some days where I’m out there doing hardcore exercise for 3-4 hours some weekends, and I can eat a ton of carbs and still be in ketosis.  So, when you were writing this book, did you find any general consensus among athletes and cross-fitters or extreme exercisers about what worked for them for carb tolerance levels?

Jimmy:  Yeah, certainly athletes are a different beast than the rest of us mere mortals, as I’ll call it [laughs] because you can tolerate more, and I think just being able to burn off those carbs gives you a little bit more leeway, more ability to handle more carbs.  Unfortunately, most people out there aren’t those elite athletes like your hardcore listeners of this podcast are, and so I wrote it specifically for them in mind.  But yeah, if you’re an athlete keeping your carbs to your tolerance level, it’s going to be a bit higher for you, especially if you’re primarily being a sugar-burner and you want that to fuel you, you wanna be eating more carbs.

Ben:  Okay.

Jimmy:  And I know you actually told me on race days that you wanna fill up the glycogen stores but you’re still a fat burner, you’re still producing ketones so you kind of had a healthy mix of both.

Ben:  Yeah, and to clarify on that, by filling up the glycogen stores, a lot of people see that as pancake breakfasts and pasta feeds.  And for me, filling up the glycogen stores or keeping them from getting totally exhausted during the race, all that means is I’ll use about 100 calories, which is like 1/4th of what you’d see recommended for carbohydrate intake during exercise.  And I’ll take in that 100 calories from super starch.

Jimmy:  Right.

Ben:  I use this stuff called UCAN Super Starch.

Jimmy:  Yup.

Ben:  This is a super slow release starch, and then all my other calories come from MCT oil and amino acids.  And then the only other thing for a super long day like an Ironman triathlon is I’ll add in around 100 calories or so of solid food like a gluten-free bar at the end of each hour or something like that.  But it’s a drop in the bucket compared to, I used to go for a day in Ironman, I eat almost 50 sports gels.

Jimmy:  Yeah.

Ben:  Like the fructose, maltodextrin-based gels, nuts.  And you just get fermentation and free radicals and all sorts of nasty stuff going on.

Jimmy:  I remember interviewing Timothy Allen Olson on the Living La Vida Low-Carb show, he’s an ultra marathoner, a very successful one and he said the same thing.  He used to have multiple of those Gu’s in an hour, and now he’s lucky if he uses that in a 2/3/4 hour period.  You really don’t have to have as much when you’re fueling your body primarily with the fat now.

Ben:  Yeah, and now what I’m using for some of my Spartan races is just nut butter and that works pretty well too.

Jimmy:  Yup, that sounds good.

Ben:  So, yeah it is.  So, you also talk about something, in addition to this carbohydrate tolerance level, called a personal protein threshold.  How’s the personal protein threshold fit into this?

Jimmy:  Yeah, that’s the “O” in KETO, overdoing protein is bad.  I think a lot of people don’t realize, and we’re gonna talk about some mistakes I made in my low-carb diet, and this is one of the biggies that people make is they automatically assume “oh, if I keep my carbs low, then I can eat all the protein and fat I want.”  Well unfortunately for the purposes of ketosis, if you are sensitive to carbohydrate, you’re probably gonna be pretty sensitive to protein too, which requires you to not go too heavy on the protein.  Now I know the media likes to call a low-carb diet a high-protein diet, it’s really not a high-protein diet, never has been.  By definition, the ketogenic diet is one that is high in fat and moderated in protein, so when we’re talking about finding your personal protein threshold, that’s what we’re talking about.  Don’t go overboard on the protein and you might wonder why.  Well there’s this long G word that we talk about in the book called gluconeogenesis, and if you consume too much protein for your body to use, guess what happens to the excess?  The liver says “hmm, let’s turn that into glucose in the body” and so it’s not the same necessarily as eating carbohydrate, but it does produce the same results, it will kill your ketones.  So moderate down that protein, I told you my tolerance level for carbs is right around 30, my protein threshold is right around 80-100 grams of protein in a day, which is about 6 oz. of meat maybe, for the whole day.

Ben:  Right.

Jimmy:  And I’m cool with that, I just then supplement it with a lot of fat and I’m good to go.

Ben:  Okay, so you were talking about measuring blood glucose and measuring triglycerides to kinda get an idea of your carb tolerance level.  Is there something similar for proteins? Are you measuring insulin or something like that?

Jimmy:  Yeah, you certainly can measure insulin.  That helps with that, there are different things that you can do for measuring for your protein threshold.  I think getting the carb tolerance down first and once you dial that in, then you look at the protein and you can use those same parameters.  Looks at triglycerides, looks at blood sugar because it will show up in your blood sugar if you’re overconsuming protein.  That’ll shock some people, they’ll be like “wait a minute, protein’s not supposed to raise my blood sugar, just carbs.”  Uh-uh, protein can do it too if you’re doing it in excess.

Ben:  That actually shocked me the first time I realized that, and this was a few years after I gotten out of school where I studied nutrition.  I had a personal trainer certification and everything, and then I saw that steak can jack up your insulin levels higher than eating a loaf of bread.  Just crazy.

Jimmy:  Yeah.

Ben:  And that’s when I started to realize that maybe protein isn’t the best way to kinda hack yourself into stable blood sugar levels.  One question I have for you, and I don’t remember seeing this anywhere but you may have looked into this.  Have you ever investigated the difference between some of these hydrolyzed protein sources like collagen or gelatin or branch chain amino acids or amino acid supplements versus protein from meats and fish and things of that nature?

Jimmy:  I didn’t look at that specifically, coz most people, if you can just get them to eat meat without freaking out, that’s probably half the battle.

Ben:  Yeah.

Jimmy:  So no, I haven’t actually investigated that.

Ben:  I was just curious, just because from the data I’ve seen, it’s a little bit less insulinogenic than whole protein sources, so it allows an athlete for example, to get enough amino acids on board to repair muscle without actually jacking up insulin levels.  So that’s something…

Jimmy:  And would be extension be more ketogenic too.

Ben:  Yeah, exactly.  So let’s say, coz we have a lot of athletes that listen in, it’s evening and you don’t wanna get out of ketosis or you don’t wanna jack up your blood glucose level, your insulin levels, you could do for an evening snack, maybe some coconut oil, a little bit of nut butter or something like that, but then to add in even more amino acids rather than doing whey protein or protein shake or some meat, you can just use amino acid powders or amino acid capsules or an organic gelatin source or hydrolyzed collagen or something like that.  You get amino acids without all the protein calories and the insulin response from protein.

Jimmy:  I’m gonna have to look into that now, [laughs] you got me curious.

Ben:  There you go.  Your next book could be called Protein Clarity.

Jimmy:  There you go. [laughs]

Ben:  You got some word other than clarity that rhymes with protein? So the next thing is fat, and one of the things that you talk about is how much of the total amount of fat that you eat can be saturated fat.  Can you get into that because obviously there’s obviously a ton of different types of fats, like avocados and olives and olive oil and seeds and nuts and butter…

Jimmy:  Right.

Ben:  How do you decide what kind of fats are gonna be the best fats to eat when you’re on a ketosis-based diet?

Jimmy:  Well the two that are the very, very best that you want to be gravitating to are the saturated fats and the mono-unsaturated fats.  The saturated fat is butter, meat, cheese, whole food fats, real food fats like God made them.  Mono-unsaturated fats: avocados, olive oil, avocado oil, macadamia nut oil, that kind of stuff.  You wanna be consuming those kinds of fats, the ones that we’ve been told are healthy, and I know we talked about this with Cholesterol Clarity, the vegetable oils, that is not the kind of fat we’re talking about.  So please do not hear this podcast and go out and run out and buy a big jar of mayonnaise and put it on top of everything coz that’s pure soy bean oil, it’s vegetable oil fat, highly inflammatory.  You’re gonna be counterproductive to what you’re trying to do to get healthy, and definitely with everything that you’re doing, it’s all the real food-based fats.  So we’re not doing fake fats.

Ben:  I think people probably know though, that vegetable oils are bad.  It’s pretty common knowledge.

Jimmy:  Your audience knows that.

Ben:  Yeah, my audience does but if my audience is looking at how much butter should I eat versus extra virgin olive oil, is there a percentage out there, the actual percentage of saturated fat that your diet should be in the percentage of your total fat intake?

Jimmy:  I think it’s gonna vary from person to person because we all have different, kind of like the carbohydrate tolerance level and the protein threshold, I think we all have to figure out what fats are gonna keep us fuller, what fats are gonna allows us to intermittently fast for hours on end, what are the fats that you need to feel satisfied.  I’m kinda infamous because I carry around Kerrygold butter with me everywhere.  I’m sure you saw me at Paleo f(x), I’m sitting there eating my meal with half a stick of Kerrygold butter and people are like “is that really good?” I’m like “for me, it works because I need that amount to keep me satisfied, to give me all the benefits of ketosis”, but for that fat I can’t get the ketosis that I need.

Ben:  Okay.  So do you know if there is any number out there in terms of just how much saturated fat is too much?

Jimmy:  Yeah, people ask that question: what is too much? And my answer is generally, if you throw up, you probably ate too much of it. [laughs]

Ben:  [laughs]

Jimmy:  And so I think it’s gonna vary, I think tinker around.  And that’s a major thing we put in the book, Ben, was don’t ask me about macronutrient ratios.  I eat kinda 80:15:5, but that doesn’t mean you need to eat 80:15:5.

Ben:  You mean 80% fat, 15% protein, 5% carbs?

Jimmy:  You got it, and then like my wife for example, she can eat 55% fat, 30% protein and the rest carbs, and still be in ketosis better than me.  So [laughs] it’s gonna vary from person to person, you kinda have to tinker around with this and find what’s right for you and that’s kinda the overriding theme we tried to communicate in Keto Clarity.

Ben:  Okay, got it.  Yeah, I wish I had the number in front of me but I think somewhere, Dr. Paul Jaminet goes into perfect health diet.  He has some percentage and I wanna say it’s between 20-30% in terms of total fat intake.

Jimmy:  Ahuh.

Ben:  Not total diet, but your total fat intake should be saturated, so it’s roughly 1/3-1/4, I wana say is what he goes into in his book.  But I don’t have the number right in front of me right now, but if anybody’s listening in, you can check out the “Perfect Health Diet” book is the book in which they talk about that a little bit.  So Jimmy, you talked about or you kind of alluded to mistakes that people make when they’re doing nutritional ketosis and in your book in chapter 10, you go into five low-carb mistakes.  And this is kind of a, it’s actually a topic that’s near and dear to my heart because I wrote an article a while back about four mistakes people make on a low-carb diet.

Jimmy:  Mmhmm.

Ben:  And I find that people read that article and they think I’m an enemy of low-carb diet.

Jimmy:  [laughs]

Ben:  That’s not the case, I’m just like “be careful.”  But what were the mistakes that you found that people make when they’re eating a low-carb diet?

Jimmy:  Yeah, and these were all mistakes that I personally made and then saw over and over again in emails from people.  We already talked about the protein one, definitely overconsuming protein because we all thought it was a high-protein diet, so people are like “okay, chicken breast is okay.”  You gotta back off on the chicken breast guys and eat more of the fatty meats.

Ben:  I actually tell my clients if they’re gonna eat chicken breast, they have to drench it in MCT oil. [laughs]

Jimmy:  [laughs] And even then, you’re still getting an absolute amount of protein that is probably gonna kick you into gluconeogenesis, so yeah it’s gonna be problematic.  Another big problem that we kinda alluded to this one as well, is you rely on the urine ketone test strips.  If I get one email over and over and over again, Ben, it’s this: “I’m testing with the sticks and the sticks tell me I’m in ketosis but I’m not feeling any different, I’m not losing weight, I’m hungry” blah blah blah.  And I’m like “how are you testing for ketosis?” “Oh with urine, is there any other way?” “Uh, yes there is.”  [laughs] So that’s when I point them to the blood ketones and then they start testing blood and they see they’re 0.3.  Well that’s below the level of nutritional ketosis, and so you got to stop relying on the urine ketones.  And the other thing, the urine ketone test strips do for some people is, once they’re keto-adapted, you lose your urine ketones because the acetoacetate become beta-hydroxybutyrate, goes out of the urine and starts spilling in the blood…

Ben:  So you just get better at utilizing ketones so your urine shows fewer ketones?

Jimmy:  That’s right, and so that freaks people out because they think “oh, I’m not doing well” so then they start trying to change things when they’re doing just fine.  They’re feeling fine, they got all the hunger control, ketosis is rockin’ and rollin’ and yet they’re not getting that verification about it on the urine strips, which is why in the book, we have a whole chapter on why urine’s probably not best, blood right now is the gold standard for testing.  But there’s the emerging technology with the breath being pretty good too.

Ben:  Okay, got it.  What are a few of the other mistakes people make?

Jimmy:  Yeah, and we talked about this one a bit too: not eating enough saturated and mono-unsaturated fats.  And I’m probably gonna be writing a blog post on this soon, but I think we are a fat starved nation.  We have, for far too long, been told fat is the enemy in our health and we’ve obediently cut down on it, even those of us who know fat’s not harmful maybe subconsciously in the back of our minds, we still aren’t eating enough saturated fat in our diet and mono–unsaturated fat.  So, if we ate more of those things, ketosis would happen so much easier, that’s why I have a little bit of butter in just about every bite of food that I eat because I want the benefits that I can get from having that fat in my diet.  And all these years we’ve cut it, it’s time to add fat back, baby.

Ben:  Hmm, nice.  Yeah it is kinda interesting how, even me having been in ketosis and having done the low-carb thing for a while, it seems hardwired into the back of my brain sometimes, this whole fat-phobic thing.  And I think that, for me, it’s from back in the days when I was a bodybuilder and you would literally strain your cottage cheese and your yogurt just to make sure that it was as fat-free as possible.  But it’s weird because my kids have grown up on sardines and butter and oil and avocados, and they’ll eat a piece of beef and just eat all the fat around the bone and not even think twice about it.

Jimmy:  [laughs]

Ben:  Coz they haven’t been brainwashed, basically.  So it’s really interesting.  Okay, so you’ve got more mistakes that you talk about in the book, but I wanna just cover a couple of other things that you discuss in the book that would be helpful for people.

Jimmy:  Mmhmm.

Ben:  One would be, in chapter 14 you go into 10 reasons you might not be producing adequate ketones.

Jimmy:  Right.

Ben:  What are some of the reasons that people might find that they’re not producing ketones? Coz obviously the whole idea here for the therapeutic and the brain and performance benefits is that you want ketones.  So if people aren’t producing adequate ketones, what’s keeping them from doing that?

Jimmy:  I think the biggest one is, and I believe it’s number one in that chapter, people just assume if you’re low-carb, you’re just automatically gonna be ketogenic.  And I’ve seen that on some of the forums that are out there, “well I’m eating ketogenic.”  I’m like “what does that mean?” [laughs]  I always ask that question, what does it mean?  “Well I’m just keeping my carbs low.”  You do know that’s like one leg of a three-legged stool to get into ketosis.  Being low-carb does not automatically mean ketosis, now most people can probably eat 50 grams or less of carbs and find ketones, and I’m sure in 2004 when I did the Atkin’s diet, I wasn’t exactly measuring everything.  But I bet I was producing adequate ketones to be seeing the results that I did, but it’s not an automatic thing.  So you have to be mindful that it’s not just low-carb, you really do have to moderate down the protein and eat plenty of fat with that low-carb.  That really is the trifecta that helps you get there.

Ben:  Gotcha.

Jimmy:  Another one is people just assume they’re in ketosis because they’re eating the low-carb and they’re not really testing.  So if you’re not testing, it’s like not stepping on a scale.  “How much do you weigh, Ben?” “Well I dunno coz I don’t step on a scale.”  So if you don’t test, there’s no way for you to know.

Ben:  Yeah.

Jimmy:  So you kinda have to test, if you’re not testing, that might be why you’re not producing adequate ketones.  Coz you’re in the dark, you really don’t know how well what you’re doing is helping you or not.

Ben:  Have you ever, and this is something that I kinda thought about a little bit while you were talking about how being in ketosis isn’t just about eating low-carb.  Have you ever run into folks who have used these liquid ketones to still eat lots of carbs and somehow fill up their bodies with ketones that way?

Jimmy:  Yeah, and with MCT oil and ketone esters and all these other beta-hydroxybutyrate salts, I’ve heard all these things.

Ben:  Yeah, there’s a supplement called KetoForce and you can actually buy from labs beta-hydroxybutyrate salts.  Do you talk about that much in the book or is that something that you run into much?

Jimmy:  Yeah, can I just tell you, I think those products are counterproductive to what we’re trying to communicate in the book.  Because I think they can be helpful in a short term need for energy for an athlete like yourself, I think in the short term they can be amazing because those things, I’m not sure about some of the other ones but I know MCT oil can boost the ketone levels in your body for like a 2-3 hours period then they’re gone.  It doesn’t stay sustained.  I would much rather see somebody try to pursue ketosis nutritionally through manipulation of the macronutrients, so the carb level low, the protein level moderate with plenty of fat, and do it naturally without the need for those things.  Because I think overall, in the long term you’re gonna see more benefits from doing it.  Yeah, those other things can allow you to have a few extra carbs with a little more protein than you would have, but what are you really trying to do here? Are you trying to artificially raise ketones or are you trying to do something therapeutically that’s gonna be natural and sustainable over a long period of time? I’d rather have the latter.

Ben:  Yeah, I think you make a good point that the exception would be athletes who may not care about the health benefits of keeping chronically elevated levels of blood sugar at bay, but may just wanna like, for example, ketones.  And I don’t think we’ve talked about this yet in this podcast, but ketones are preferred fuel for the diaphragm, for the heart, and for a lot of these tissues that the brain uses during endurance activity, for example.  So a marathon or a triathlete or something like that.  And you could technically still eat carbs, still eat whatever, couple of energy bars an hour and you take something like beta-hydroxybutyrate salts and also be dumping ketones into your body and kind of have, from a performance standpoint, the best of both worlds, but from a health standpoint, all those things that you talk about that I opened up this podcast with in terms of health benefits, you’re not getting those if you’re not keeping blood sugar levels low, right?

Jimmy:  Right, and I think that’s the hallmark of true nutritional ketosis is you’re gonna have elevated levels of ketones in the body but that also comes with a simultaneously lowered level of blood sugar.  And I haven’t personally tested to see what would happen testing for with MCT oil or some of these other products we were just talking about.  Ketone esters, beta-hydroxybutyrate salts, what would happen to your blood sugar at the same time? Does it stay elevated or does it go down in response to those higher ketones from these means.  I don’t know the answer to that, do you know?

Ben:  No, but I see no reason why it wouldn’t stay elevated.

Jimmy:  Right.

Ben:  Because ketones don’t by nature mean that your blood glucose is low.  You could technically have high levels of circulating ketones and also high levels of circulating glucose.  The two are not gonna cancel each other out necessarily.

Jimmy:  And definitely for type-1 diabetics, that’s kinda the issue du jour is ketoacidosis is the hallmark of very, very high blood sugar and very, very high blood ketones.  We can talk about that if you want to, kind of the difference between what we’re talking about with nutritional ketosis and that diabetic ketoacidosis, two very, very different metabolic states.

Ben:  Ketosis doesn’t mean ketoacidosis, you mean?

Jimmy:  Right. That’s exactly right.

Ben:  Yeah.  And what’s the main difference between the two, just to clarify for people?

Jimmy:  Yeah, so if you have any beta cell function at all with your pancreas being able to squirt out insulin into your body, guess what? It’s impossible for you to get into ketoacidosis.  This is only for people who are type-1 diabetics and those truly insulin-dependent type-2 diabetics who cannot make any insulin at all.  They have to be wary of diabetic ketoacidosis, and what that is is extremely high levels of blood sugar, in excess of 240, and then extremely high blood ketone levels, reaching closer to 20 millimolar on the blood ketone.  Now the highest reading I’ve ever gotten on blood ketones is something like maybe 6.7 I think was my highest reading.

Ben:  Mmhmm.

Jimmy:  But my blood sugar at the same time was like 63.  [laughs] So the hallmark of nutritional ketosis though, by contrast to diabetic ketoacidosis, is you’re gonna have that lower level of blood sugar in conjunction with a moderately high level of ketones.  So I got nowhere near the 20 millimolar with my 6.7 but the biggie was my blood sugar was lowered.  So that’s a huge one.  I know people worry about that and in one of the chapters in the book, we kinda take on all the criticisms that the major health organizations have about ketosis.  And they all call it a dangerous toxic state.  Well they’re talking about ketoacidosis and they’re extremely right that that is a dangerous state, but that’s not what we’re talking about with nutritional ketosis.

Ben:  Yeah, yeah.  That’s a really good clarification, that’s a good explanation of it too.  So in your book, you go into this 20-day kickstart keto meal plan, you got some low-carb high-fat recipes in there.

Jimmy:  Yup.

Ben:  Food shopping list, bunch of cool stuff, and I know that some people didn’t like to necessarily hear me talk about diets to manage disease, but really.  I wouldn’t bring this stuff up just off the cuff if there isn’t some really good research behind it.  And you guys go into this research in the book.  Now, one last question I wanted to ask you, Jimmy, was the emerging areas of research on the use of ketones.  What are you starting to see folks looking into now for ways that ketosis could be used or the effects that ketones have on the human body that are things we’re gonna be hearing about in the future?

Jimmy:  Oh man, this is the most exciting part of the whole book, and we go through it thoroughly in chapter 18.  16 we kinda give an overview of how to look at studies and which studies are most important because just because the news media highlights a headline that talks about a “study” doesn’t mean that study really means anything to humans.  So we kinda give a “here’s how to read studies” primer at the beginning of 16.  We also share the strong evidence for ketosis in that chapter, chapter 17 we look at the good evidence, things we have up to one year.  Strong evidences of anything we have, 2 years and beyond good evidence is up to one year.  But chapter 18, with the emerging areas that you were talking about, this is so exciting because there’s so many areas of our health that can be improved with a ketogenic diet.  It just needs to be proven in a scientific-controlled clinical trial, like cancer.  This is a big one.

I’m actually gonna be moderating a panel at the Ancestral Health Symposium on this very subject of ketogenic diets and cancer.  They’ve never done a 90 minute panel discussion on any topic before, but they’re giving us 90minutes for this one, so we’re real pleased.  We’re gonna have some of the leading voices on this on that panel.  Dominic D’Agostino as you mentioned earlier as well as Dr. Colin Champ from Pittsburg.  So that’s a big one.  Autism is another one that’s kind of emerging now, fibromyalgia and migraines, one that Robb Wolf talked about at Paleo f(x) was traumatic brain injury.  This is a big one as well, and there’s several examples of that.  People who have seen improvement with that, I know Doctor Terry Wahls is wanting to do a ketogenic version of her diet to help people with traumatic brain injury, gum disease, tooth decay, acne, eyesight.  Interestingly, my wife Kristine went pretty darn ketogenic and she has been blind in one eye since birth and pretty bad vision.  In fact she was supposed to be totally blind by now, she found the year that she got hardcore ketogenic, her eyesight for the first time in her entire life, got better.

Ben:  Wow.

Jimmy:  She actually had to change prescriptions, but in the other direction because it got so much better, and we think it’s because her blood sugar got normalized and yeah.  We need more research on these kinds of things.  ALS, Lou Gehrig’s disease, multiple sclerosis, aging I know that’s a big one that one of my experts Dr. Ron Rosedale talks about aging quite a bit.  Kidney disease, on and on and on, there’s so many issues that this really needs more testing in the coming years.  And I think we’re gonna see it, hopefully books like mine spur and shine a spotlight on the need for that more research and the quality research.  Let’s stop looking at mice and thinking it means something to humans.  Let’s do human studies, let’s help these people that can be helped with a ketogenic diet.  The anecdotal evidence is there, now let’s prove it in the lab.

Ben:  Yeah, cool.  Cool.  This is a really good book, it’s the most comprehensive book on ketosis that I’ve seen before, so…

Jimmy:  Thank you.

Ben:  Keto Clarity is what it’s called.  I’ll put links in the show notes to some of the previous podcasts I’ve done with Jimmy and some other experts on ketosis over at bengreenfieldfitness.com/ketoclarity.  I definitely recommend you grab this book.  Pick it up, even if you’re not interested in ketosis, you’re gonna learn a lot about facts in general and it’s a really good primer on how the body deals with fatty acids.  Really good stuff, and Jimmy, thanks for writing this and coming on the podcast man.

Jimmy:  Thank you man.



Do you know what the similarities are between epilepsy, Type 2 diabetes, obesity, cardiovascular disease, metabolic syndrome, polycystic ovarian syndrome (PCOS), irritable bowel syndrome (IBS), heartburn (GERD), nonalcoholic fatty liver disease (NAFLD). Alzheimer’s Disease (AD), Parkinson’s Disease, dementia, mental illness, schizophrenia, bipolar, depression, narcolepsy, and sleep disorders, treating cancer, autism, migraines, chronic pain, brain injury, stroke, and kidney disease?

They can all be positively effected by a low-carb, high-fat, ketosis diet…

…and my guest today, Jimmy Moore, is going to tell you all about it.

Jimmy is world’s leading low-carb diet blogger and podcaster.

Last year, he wrote the book Cholesterol Clarity with coauthor Dr. Eric C. Westman, a practicing internist and low-carb diet researcher, and I interviewed him about that book in the podcast episode “The Shocking Truth About Cholesterol & Why You Probably Don’t Even Need To Test For It.

Well now, Jimmy's back with a new book that pretty much answers everything you've always wanted to know about ketosis but were afraid to ask.

The new book is called Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet and in the book, Jimmy shows you how a low-carb diet can be much more than simply as a means to lose weight, and how ketosis produces not only a powerful therapeutic effect on a wide variety of health conditions (that most people think requires medication to control) but can also be a pretty incredible biohack for both physical and mental performance.

The book includes interviews from twenty of the world’s authorities on low carb and ketosis diets, along with a step-by-step guide to help you produce more ketones and track your progress, real life success stories of people using a ketogenic diet, and more.

During my discussion with Jimmy, you'll find out:

-Why not all low-carb diets are created equal…

-How to find your carbohydrate tolerance level…

-How to determine your personal protein threshold…

-How much saturated fat is too much…

-The biggest low carb mistakes that you can make…

-Why you may not be producing adequate ketones…

-And much more!

If you enjoyed this episode, you might also like:

Ketosis Dangers: How To Maximize the Nutrient Density of a Low Carb Diet with Terry Wahls

A Deep Dive Into Ketosis: How Navy Seals, Extreme Athletes & Busy Executives Can Enhance Physical and Mental Performance With The Secret Weapon of Ketone Fuel with Dr. Dominic D' Agostino

The Ultimate Guide To Combining Fasting and Exercise: Everything You Need To Know with Dr. Peter Attia

Do you have questions about ketosis, Keto Clarity or the high-fat, low-carb approach we discuss in this episode? Leave your thoughts below!

Ask Ben a Podcast Question

One thought on “[Transcript] – Everything You’ve Always Wanted To Know About Ketosis But Were Afraid To Ask.

  1. Fernda says:

    Good info! Thanks for sharing!

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