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The Ketogenic Diet Part 5 What I learned and what you should know!

The best way for me to cover all the stuff I want to tell you is in simple bullet point form and that is what I am going to do. But first let me say one thing that is critical: If you are a healthy person this diet is not going to pose any serious risks to you.  That said run it by your own personal health care professional before you try it. So let me start the bullet points with a few “safety issues”

  • Ketosis is not Ketoacidosis. Ketosis is not dangerous. Your body can easily run on ketone bodies for a lot longer than you would think-possibly forever- as long as the nutritional makeup of your diet and the number of calories is sufficient to sustain you in healthy condition. Ketoacidosis happens to insulin dependent diabetics and in some less frequent cases to others. Most Type 2 diabetics will not have ketoacidosis but if you are a Type 2 Don’t try this without strict ongoing (like all day everyday) medical supervision from a qualified professional. Or at least get the blessing of yours before you do this!
  • You have heard me mention “starvation range” when referring to ketones of 4 millimoles and higher. This is a somewhat arbitrary definition but these ranges require sever calorie restriction.  Your average Ketogenic Diet will not get you to these ranges and you may not need them to “treat” certain illnesses.  I chose to go Calorie Restricted to try to fill the 2 main recommendations of the CRKD for “cancer prevention” * low blood sugars and high ketones to starve cancer cells and preserve normal ones.
  • Isn’t starvation unhealthy?  For short periods of times no. How short? Well 7 days is no big deal and if you look at the numbers I was only “there” for about 4 days out of the total.  Short term starvation may be just the thing to recycle sick mitochondria via autophagy (look it up!) and sick cells via apoptosis (you’ve heard me explain that one before too so look it up as well!).
  • Isn’t hypoglycemia dangerous!!!  Answer: it depends how you got there.  If you took too much insulin or skipped a meal on your oral anti-diabetic meds you got there artificially and had no time to generate alternate fuels e.g. ketone bodies then it’s dangerous. If you got there the way I did with gradual calorie restriction and you are generally healthy you will not suffer any symptoms from hypoglycemia because your body will have plenty of ketones to run on alternatively. So using this diet to induce hypoglycemia is not dangerous provided you to it the way I did or follow some recommended guideline.


Ok now on to some cool observations:

*Fish oil Doses: Because there was so little food intake and specifically almost no Omega 6 fat intake there was no need to hit the fish oil hard. One to three caps every other day was plenty enough to keep the blood flowing easily for my finger stick checks of sugar and ketones.

*In Dr Seyfried’s book he recommends avoiding caffeine altogether and no strenuous exercise- just walking!  I did not obey those commands for various reasons but I can tell you the amount of coffee required to wake up when you are not eating anything goes way, way down.  A 6 ounce cup would be reheated several times throughout the day and still have some left when I went to bed.

You will notice my blood sugars were very low on some occasions and much closer to normal on others. Generally this is the effect of exercise which does several things that are actually shared by caffeine consumption.

First it bangs on your adrenal glands and stimulates them to release “adrenergic” (stimulant) chemicals. This drives up our blood sugar even when there is little or no sugar in your diet.

Initially this comes from stored liver glycogen but that lasts hours not days so the only other reasonable source is gluconeogenesis* This means your body is going to breakdown that hard earned muscle you put on in the gym to keep your blood sugar up!  Remember how I told you weight loss was not the primary goal of this experiment?  Well body building sure as heck wasn’t either!

So the further you go into ketosis the more muscle you are going to lose.

OK now some final observations:

  • Mood and mental function: Although one or two people might disagree I did not notice any changes or moodiness at all.  I felt great and great about myself most of the time LOL! There were moments when my brain did not want to tackle any complex tasks or mental gymnastics but this was not all the time.  I found this to be more a function of high ketones than low blood sugar.
  • The one kinda creepy aspect of the whole thing that really hit me during the hypoglycemia and big time ketosis periods was an eerie feeling that it was ok to keep starving.  Almost like they say freezing to death is not so bad. I just felt like I could keep this up forever. Fortunately my first spoon full of high carb sugary dried fruit “healthy” granola knocked me right back into reality LOL! Yum does my body love SUGAR!!!
  • I “failed” to achieve the constant low blood sugars recommended because I refused to give up my exercise routines which would be considered “intense” under the circumstances.  This was personal choice and a matter of curiosity as well.  I did notice I tried a little bit sooner than usual and occasionally skipped the last set or cut a kilometer off a run but in general my performances were on par and on the last gym visit better than ever!
  • Caffeine and fish oil can be reduced because they will be more effective in the face of reduced calorie intake and absorption will be faster. Do take your multi vites though  as you can start missing critical things quite fast.
  • I needed to sleep more. Indeed I would say I slept a lot more soundly than usual easily grabbing 8-9 hours of uninterrupted sleep when possible versus my usual 7. Again reduced caffeine intake may have played a role but I am not a huge user to begin with.
  • I was almost NEVER HUNGRY during this diet.  I am not 100% sure but I have to assume it is the magic of ketosis as an appetite suppressant.
  • I was really surprised at how little my metabolic rate changed with this diet. Even using the accurate Body Gem I was running a resting metabolic rate of just over 2000 calories when in full blown ketosis and having lost almost 10 pounds. Bottom line ketones are an effective fuel for your body and can maintain your caloric needs just fine thank you!
  • I learned how much of my own eating was “habitual” just used to eating at a certain time and making certain food choices which are actually generally healthy but often high in carbs- like certain fruits.
  • I learned that for me personally Carbs Are the ENEMY. They stimulate my appetite and my cravings and they pack on calories fast. I learned this 4 years ago when I was full bore Paleo for the better part of a year but even this short stint brought that message home in a big way.
  • I learned that it is actually very hard to keep your carb intake below 30 grams since even high protein foods have some carbs.
  • Now here is the kicker: I learned it is easier for me not to eat all together than it is to manage carb intake and “eat healthy”.  I suspect like all habits the carb habit will take some time to kick and it will always be hovering around.  It is harder for me to control my carb intake by eating “just the right amount” than it is to avoid them altogether. I am still processing this fact!

My final thoughts: This was far easier than I thought but you definitely need to have the right mind set and discern “boredom eating” from true hunger. I was not ever able to get to water only even for 24 hours and that will be a challenge I undertake in 3 to 6 months when I do this all again. For me there would be a huge difference between even 300 calories and a little flavoring than nothing but water especially since metabolically I was able to achieve pretty much the same thing. I cannot imagine exercising with zero calorie intake over a couple of days and I am not willing to give up exercising even for a week at this point!

I think overall the effects of this little dietary experiment were totally positive and there will be some long lasting good things from learning about what makes me eat and how certain foods control my behaviors more than others!

As a final bit of good news, by the time you read this I will either have interviewed or be about to interview Dr Thomas Seyfried himself!  I can hardly wait!!!!

A thinner leaner more carb free Doc!


The Ketogenic Diet Part 3 How I did it

Ok first if you have not read the first 2 blogs please do so because a lot of info is covered that you need to know: Part 1 and Part 2.

Now here is what I did.

I actually went on the “diet” for a total of 10 days with 8 of them being severely calorie/carb restricted.

Day one was what most people would refer to as a “Juice Fast” that is I consumed mostly juice and water but I was not specifically looking at the total calories I consumed.  I was however looking to restrict Carbs somewhat so I used primarily low glycemic vegetable juice and cut it with about 25% fruit juice.  The total carb count of each 12 ounce serving was probably about 12 grams and I consumed 5 of those the first day.  Calorie wise this size of serving was probably about 180 calories so that alone puts me at 900 calories and 60 grams of carbs. I probably consumed another miscellaneous 100 calories and 10 grams of carbs that day for a grand total of 1000 calories and 70 grams of carbs.

So you have a reference point my height is 6’1 inch my walk around starting dry weight for this experiment was 201 pounds 57+% body water and a body fat of about 12% *

My resting metabolic rate via a Tanita** scale is 2250 ish calories a day which means that is the number of calories I theoretically need to maintain my body weight.  The one big thing that weight alone never really takes into account is water shifts and as we’ll see that becomes a huge factor when you diet and step on the scale.

To summarize Day 1. I was at least 50% below my RMR calorie requirement and I was in what would be considered moderate carb restriction (50 to 100 grams).

Day 2  This was also an “induction day” designed to ease me into the more severe carb and calorie restriction.  For this day I did exactly what I did on Day 1 but I replaced half of the juice with plain water to dilute it. Thus I wound up around 500 calories and 40 grams of carbs.  I was not really checking any numbers yet since the “diet” had not officially begun.

For the next 8 days I pretty much followed this script:

Calorie intake between 200 and 400 per day.  Almost all of this was supplied in the form of “Ideal Protein” soups of various flavors.  All of the soups I chose had 90 calories per serving and 3 grams of carbs.  Depending on the day I ate between 2 and 4 soups at typical intervals of 4 to 6 hours.

Additional calories were supplied by adding a tablespoon of almond milk to 4 ounces of regular coffee which I consumed once to twice daily.  I should note that Dr Seyfried recommends avoiding all caffeinated beverages because they can increase blood sugar. More on that in the next blog.



** Tanita is a registered brand name of a scale. I use the IronMan model but there are other makes and models.  The particular method of measuring values is known as electrical impedence and has some inherent inaccuracies. I will mention the Body Gem device which uses end expired CO2 to more directly measure metabolic rate at that particular moment.  Usually they correlate more closely than you might think so I rely on the Tanita on a daily basis with occasional correlation from the more expensive Body Gem.  Also if you look at those body fats and know anything about the subject you would be thinking, “What a stud Dr Dave must be!” Well sadly I have to be honest.  There are 2 settings on that scale and I have traditionally set it on “athlete” which means 10 hours of hard core exercise a week.  I probably roll in closer to 7 so you need to add about 5% to the body fat numbers. Be nice now and take into account my mid 50’s age and you will see that while I am not true stud material, my body composition is far better than average for my age J

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Is Aging Unstoppable – Baby steps come first!

Doctor looking into a microscopeArguments continue among the best and brightest scientists concerning the question: Is aging unstoppable.

If you think about it, that question has already been answered in a functional way. There are several mammalian cell lines that have been made “immortal” simply by turning on telomerase and expressing it at a higher level than normal.  Most surprising is the absence of increased cancer in many of these experiments.

If you look closely at the scientific literature, the question of whether telomerase causes cancer has already been answered many times over with a fairly resounding “No, telomerase does not cause cancer!” It has been almost 8 years since a scientific paper has raised that question. Understand this is different than commentary, different than blogging, different than social media and all the other places where people get their “information” these days.

Just like there are still people who are dedicated to the notion that telomerase might cause cancer, there are also people dedicated to the “Anti-Anti-Aging” agenda. This group ranges from the “We should all die to make room for the youth” to the “Well we might live forever but telomerase is NOT the answer” crowd.

To the first group, I say, “Put your name on a list and we’ll make sure you don’t get anything that would prolong your health span and life span – then you can die happy in the fact that you’ve made room for someone else”.

To the second group, I say, “Well then, show me what the answer is and please show me anything else that has immortalized cell lines or added life and health span to mammals.”

The recent issues surrounding the failure of calorie restriction to deliver the former should be noted. Increasing health span (how long you are healthy) with increasing life span is the bailiwick of telomerase expression alone.

And if you think about it, if you could be healthier while living longer, why not?

Now it’s time for a couple of concepts that have been really hard for me to get across.

1)      Aging has been partially reversed in living mammals (mice) by increasing telomerase expression. In at least two separate studies (Ron DePinho and Maria Blasco) the reversals were dramatic. Additionally, Dr Blasco later showed that mice are indeed a valid model for human aging, shutting down the argument that “mice don’t age by telomere loss”.  Yes, they do and I have detailed that study for you in other blogs and plan to discuss it directly with Dr Blasco in the next couple of weeks again.

2)      Telomere loss is the result of two main things: cellular replication and direct damage that can happen pretty much any time.

Cellular replication is unstoppable and a necessary part of being alive. The only way to slow down the loss of telomere segments during replication, which is always there and always chewing away at them, is with a Telomerase Activator such as TA-65.

The rest of the damage is environmental/lifestyle and can be slowed down by proper lifestyle choices including stress relief, exercise, nutrition and so on. But this is only going to slow the process, not reverse it.

Recently I saw yet another blog that said, “Fish oil leads to longer telomeres!”  By now you should know I am a huge champion of fish oil.  I would love nothing better than to see it “lengthen telomeres”. But it does not. It slows down the loss. This is huge and meaningful and wonderful, but it’s not TA-65!

The problem arises because, compared to the people who did not take fish oil, the ones that did have “longer telomeres”.  But no one looked at their telomere length to begin with, only after the fact in the two groups. If they had, they would see that concept #1- telomere loss due to cellular replication caused BOTH groups to have shorter telomeres than when they started, so NO ONE actually had longer telomeres than when they started.  The fish oil group had longer telomeres than the other group at the end of the study when they were measured but still lost telomere length overall due to cellular replication.

There is no easier way to explain it!

OK so what is the bottom line?

1)      Aging can and has been stopped by telomerase activation to lengthen critically short and eventually most telomere lengths.  In this way you can stop the #1 loss – replication.

2)      TA-65 is the only compound with solid human (or actually ANY human) data showing its effects on telomere length and causing health benefits in human beings that correlate with “anti-aging” effects. TA-65 increases telomerase expression.

3)      Live organisms have had their life spans extended past what is known to be the maximum in the wild and in the lab by increased telomerase expression with no increases in cancer.

4)      Health span and health parameters parallel each other from human cell lines to mammals to human beings – with similar systems being improved, including: immune, skin, brain, behavior, inflammation, sugar handling, fat handling.

5)      Fish oil, especially fish oil, has been shown to slow telomere loss in meaningful (clinical) fashion as well as some other antioxidants, but none have shown increased telomere length in humans. Slowing down loss is NOT THE SAME as adding length. But when you look at oxidative environments, antioxidants and Omega 3’s can reverse some of this damage and telomerase seems to take care of the rest.

What steps should you take to lengthen your telomeres or at least slow the loss?

Read our book The Immortality Edge if you are not already clear on what lifestyle modifications matter.

Next, get and take enough fish oil to reverse the omega3 deficit in your body. If you are not sure where you stand, then get our Ideal Omega test and find out.  Yes, you can also reduce your Omega 6 intake to a great extent and this will be included in both of my forthcoming books.

If you can afford TA-65, by all means do so. If not you might be interested in the new and improved Telomere Edge Packs.

If not, then focus on things like Vitamin D and CoQ 10 to boost your antioxidant defenses.

I firmly believe that aging can be stopped in humans. I also believe that it will take baby steps first to get there and yes, we are in the “baby step” age right here, right now. But if you don’t take those baby steps now you may not be able to walk or run when the time comes.


Curr Aging Sci. 2013 Jan 22. [Epub ahead of print]

Telomere Shortening Is a Sole Mechanism of Aging In Mammals.

Mikhelson VM, Gamaley IA.

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Life without Twinkies – Calorie restriction and Telomerase

twinkie pictureBottom line of this whole blog:  Supplemental Telomerase Activation is Required for increases in Longevity whether you calorie restrict or not.

There are probably three or four studies now that show one simple irrefutable fact: you must turn on and increase telomerase expression to improve longevity. Most of them have come from Maria Blasco’s lab in Madrid Spain but the first one actually came from a lab in Texas by a fellow I have had the good fortune to speak with as well: Jerry Shay.

There have been a couple of ways to do this. Originally it was done with oncogene (cancer) promoters attached to the telomerase gene to turn it on. Ironically in these cells the experiment ended not because of cancer but because of boredom and expense.  Basically the lab tech pleaded for mercy after the number doublings (effectively the replicative lifespan) exceeded 700% normal. At that point the cells were mercifully sent on into the great beyond since they had become immortal already and new studies with new cell lines were begun.

What is the take-home message from this study?

Add in enough telomerase to healthy cells and you will get healthy immortal cells without cancer.

Since that time others have replicated the data and found more or less the same thing: Telomerase activation improves healthspan and if you turn it up high enough (but not to high! Remember Goldilocks – JUST RIGHT!) you also get longevity improvements.

There have been other interesting finds that point to telomerase being one of the major keys to health and longevity.

Dr Blasco’s lab pioneered the use of a non-cancer-causing viral vector called AAV9 which has some special properties when coupled with telomerase. First, it is trophic, meaning it gets into lots of different cell and tissue types and next, it is “non-integrative” which means it does not insert itself into the DNA (genome). Two things happen because of this.

First, these little “virosomes” churn out telomerase like little telomerase factories. But with each cell division the effect is diluted out. This is important because in the past some integrative viral vectors (those that got into the genes) caused ongoing expression of telomerase from embryonic age on and did increase cancer incidence in measurable if not massive amounts. The dilutional aspect of the AAV9 virosomes allowed them to be added in mouse “middle age” and old age and the increases in telomerase were limited in amount and time compared to the mice that were genetically engineered.

The result of AAV9?

Middle aged mice lived 24% longer old mice lived 14% longer. So it does appear in mice at least that earlier treatment results in more effects. Now I have to tell you that is actually the opposite experience that I have seen with TA-65 because often the fastest and most dramatic effects are seen in older people who ostensibly would need it more. Keep in mind that younger and middle aged people also can benefit tremendously and there is value in “preventative” telomere maintenance.

The other critical thing to note is: unlike calorie restriction it appears that not only does the “average mouse” live longer than its non-telomerase-activated relative but also the oldest of the old mice gain in lifespan.

So you can no longer say that calorie restriction is the only way to lengthen life. In mice it does not seem to work that way UNLESS you add in telomerase.

That is the result of Dr Blasco’s most recent paper released just today.*

Calorie restriction did not lengthen life in her mice. It did improve neurologic parameters and decrease the incidence of cancer and metabolic disorders, but the mice still died at the typical age of mouse death.

When you added in telomerase by the genetic manipulation, which normally causes cancer, the calorie restriction appears to reduce the cancer risk associated with the ongoing high level telomerase expression back to baseline.  Only problem: the mice were only 3 months old when the calorie restriction started, which equates to about 18 years old in people.  That is a long time without Twinkies!

I hope you understand the importance of all of this work. These scientists have identified the level of telomerase, the ways it can and should be expressed and the direct effects on longevity without causing cancer.

In addition, Dr Blasco has found a way to extend mammalian life span with and without calorie restriction.

It’s called telomerase.

Dr Dave

*In case you are wondering how I got all this info the same day the info hit the presses, I spent an hour on the phone with Maria Blasco today – something I get to do more often than most!

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The sad failure of calorie restriction

calorie restriction and your waistlineI can’t say it’s a surprise that calorie restriction has failed to extend life in higher primates.  It was at least successful in flies, worms and some lower mammals.  I understand it has not led to mass gorging on the part of the CR society, who bravely soldier on in the face of this recent finding, perhaps refusing to believe it, or maybe just having too much invested to quit now.

CR, as a way of life, is no picnic. If you have seen some of these people, they are thin to the point of emaciated. Clearly, it takes a determined and brave person to fight one of the most basic urges – the one to eat. I believe the current plan is for the CR society to look at their data around 2030 to 2050.

You have to hand it to them. They are in truth doing the world’s only attempted human longevity study, where people are actually followed into their old age and death over several decades.  When people say things to me like, “Well, TA-65 is not proven to extend life!”,  I say “You are right! Nothing is, because no one has ever done a study that goes out long enough to prove that point.”  The CR society may be the very first to do this and win, lose or draw, on this one I have to say they have some serious guts.

Especially in the face of what has to be a very basic mistake on the part of people researching this. In case you missed it, the big glitch was that the longer lived monkeys were actually fed a much healthier and more controlled diet than the shorter lived ones, who were given the equivalent of McDonald’s every day, in monkey terms.  I think there is enough human data to prove that would kill people off early, too.

Still, there is a lot we have gained from these experiments and much more to learn.

We now understand the interaction of some “metabolic stress handlers” like mTOR, FOXO and the sirtuins. We know they build up the antioxidant defenses of the body to a greater degree than an ad libitum diet, and we know that they help manage insulin and glucose in the process. Such knowledge could come in very handy when developing new treatments for diabetes. We also know these metabolic stress handlers help control the expression of telomerase, the enzyme that lengthens telomeres. It won’t be long before we know how telomeres control the expression of these proteins in reverse, so to speak.

All of this helps us understand the aging process better and develop new strategies to combat disease, suffering and aging as a whole.

So it’s time for a prediction. When the CR society data is finally in, I think we will see that they are dying far less of stroke and heart disease complications, and far more of immune dysfunction and cancer.

Unless of course, they remember to take their fish oil and TA-65!

Brave souls, I commend you and wish you well!


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My current take on calorie restriction

Calorie restriction is quite intriguing, but in the end run, we will find a few things that make it of limited value, including the fact that we now have 68% obesity and overweight, in this country. We can’t even get to near ideal weight and now we are to tell people to restrict well below their needs, for that?

So first, it is nearly impossible for most people to do. That does not make it “wrong”, it simply makes it impractical. You might think the promise of health and longevity would be enough, to get people to do some things on a habitual basis, to extend those qualities. Generally speaking, those promises are not enough. In point of fact, food is one of the main entertainments people have and entertainment seems to be far more important, to most people, than health and longevity, as witnessed by the fact they will spend thousands on cell phone apps, cable TV channels they never watch and countless non-productive hours on “social” networking, where no one actually meets face to face!

Second, as nearly we can tell from nutritional anthropology, our Paleolithic ancestors were not, as a whole, calorie restricted. Clearly, there were some lean times and survival issues, but when we evaluate what they ate and how they ate, their overall calorie intake was actually greater than ours today, but far more nutritionally dense, per volume of food. Simply put, they pretty much made a career out of finding food and eating it. Since our genetics haven’t changed much at all since then, this would seem to make the most sense. I highly doubt our ancestors willingly practiced calorie restriction, although I admit, I was not around 50,000 years ago, so I say what I say with that caveat.

Third, the most calorie restricted (and protein restricted) populations, on the planet, are generally the unhealthiest. The largest example of this is our elderly. It is a little unfair to lump Western elderly into this group, I realize, since they are the victims of Western diets. Protein calorie supplementation, in this group, generally improve their health and longevity, albeit not by much, since the “cat is probably out of the bag” at that point.

Fourth, much has been made about higher primates and calorie restriction, citing chimps that are calorie restricted live longer. If you use percentages, it is impressive, less so if you look at absolute longevity in years. And if you look at the two most famous examples “Canto” and “Owen”, for restricted and unrestricted ( I think the clips are still somewhere on youtube) you will see the behavioral differences between calorie restricted and non-calorie restricted higher primates and you will clearly not want to be the restricted one!

Calorie restriction in mice, extends the absolute longevity (the oldest mice are restricted), but does not change mean (average total) longevity.

Next, while there are clear cut genetic similarities between us and higher apes, there are still differences. One of them is the tiny matter of epigenetics, which will eventually prove to be central to all of our research.

I could go on, but here is the most important point for me anyway. CR (calorie restriction) has been intimately linked to the sirtuin pathway. This pathway is linked to p 53 and PPar gamma in humans. I have called these, the cellular gatekeepers. Ultimately, they seem to be under the control of their interactions with telomeres (as we recently found viz mitochondria-telomere length and function seems to control mitochondrial health and biogenesis, not vice versa). I think, whatever benefits on aging CR may have, will be far outweighed by focusing on telomere health. And finally, the effects of cellular regeneration and somatic (body) repair of calorie restriction are, at best, all over the place. Not so with telomerase activation. When the CR society does a mouse (or better yet a human study), that shows the kinds of AGE REVERSAL that DePinho and earlier researchers showed with mice, I will stand up and take notice. Until then, I personally practice a Paleo diet, which to a large extent, mimics the nutritionally dense, but relatively low calorie per unit of food patterns that fit our genetics.

Eventually, we may have a functional calorie mimetic (pterostilbene/resveratrol are not going to be the answer!).

My final point for today on this is CR may actually work (or not), but it will have no more success in an obese population, that loves to eat and we are far from understanding how to mimic CR at levels of the cell, in humans.

All of the above and much more, I have written and said/written, have made me unpopular with the CR people. I am open, to learn more, if I am missing something! I should end by saying that, NO DIET plan has been studied, with regards to human longevity and, given the difficulties involved, probably never will be, in a classic basic research fashion.

Dr Telomere