Episode 8: Ask Me Anything Live | Dr. Simonds & Michelle Kennedy, NP-C

Today, Dr. Simonds and Michelle Kennedy, NP-C were back to answer viewer questions live on Facebook. Just a reminder that our offices are open and accepting new patients in Raleigh and Durham.

Today’s show is all about the keto diet!

Q: What is a ketogenic diet and what is keto?

A: The very first fact to recognize is that keto is a carbohydrate-restricted diet, which allows the body to enter a state of ketosis. The keto diet is considered to be high fat, moderate protein and low carbohydrate diet. It’s important to recognize that true ketosis is achieved when you eat differently and is not a result of eating certain products that claim to make you keto or allow you to eat whatever you desire. Not to be confused with ketoacidosis (a serious medical condition that arises in diabetics), nutritional ketosis is eating a certain way for the body to enter a state of ketosis.

The goal of ketosis is to lower the fat-storage hormone, insulin. Insulin levels rise in the body as a response to eating various forms of carbohydrates such as sugars, grains and other starchy foods which leads to weight gain and fat storage. Therefore, when you eliminate those types of foods that spike insulin, blood sugar levels remain low and steady. This leads to a low insulin level in the body, which then allows the body to begin burning fat while producing the ketone molecule. And now the body is in a state of ketosis. This is a great thing that happens! Ketones have a lot of health-promoting qualities. Restricting the intake of sugar, flour and starch will allow the body to enter a state of ketosis.

Another popular low carb diet, the Atkins Diet is also a form of the ketogenic diet was well. It’s important to recognize that Dr. Atkins did not invent the ketogenic diet, but did promote the ketogenic lifestyle. The first phase of the Atkins diet only allows the consumption of meat, eggs, cheese and butter while keeping carbohydrate consumption to 20 net carbs daily. This is a true ketogenic diet and corrects many medical conditions. The original Atkins diet is definitely considered a ketogenic diet, but has now evolved to involve many food products that have been manufactured following Dr. Atkins death.

Q: Is the keto diet healthy and safe?

A: YES! The keto diet has many healing properties that can actually correct many medical conditions in the body. Many people have many incorrect perceptions about the traditional American diet, which leads to obesity. Obesity is considered a pro-inflammatory condition, which causes many medical problems. The keto diet is a potent, anti-inflammatory diet that actually helps prevent inflammation in the body.

While we encourage our patients to follow a ketogenic diet, we do not require it. We like to educate our patients about the keto diet because we consider it to be highly effective for weight loss and overall health. The keto diet’s healing properties are especially important during these times that we are experiencing. We will support patients that choose all types of diets for weight loss, so please don’t feel like you are required to follow a keto diet at our practice.

Q: What are some things to know before you start a keto diet?

A: Before you get started on a keto diet, it’s important to evaluate any medications that you are currently taking with a medical provider. The keto diet is a powerful, healing diet that results in improved health. Therefore, certain medications may no longer be necessary and can even be harmful as your health improves. Medications for high blood pressure and certain diuretics may no longer be needed while following a ketogenic lifestyle. This is because the keto diet is a natural diuretic and will also help correct blood pressure. We have skilled medical providers that can evaluate your medications to ensure you’re on the right track and make the correct recommendations specifically for your needs.

Q: What is the keto flu?

A: The keto flu is sometimes experienced during the very beginning of a keto diet. It’s basically a transition your body goes through when starting a keto diet. There are many ways to help with this transition, which involves balancing your electrolytes and keeping properly hydrated. Since the keto diet is a natural diuretic, it’s important to replenish electrolytes by consuming broths and dietary supplements. Basically, the loss of electrolytes and hydration may have you feeling achy, tired, and can cause headaches. You essentially feel like you’re coming down with an illness, but remember you are not actually sick or have the flu.

Your body is just going through a transition. Basically, as your body produces ketones which are then flushed out through the urine, you’re also losing excess fluid, sodium, potassium and magnesium. So, if you’re someone who retains excess salt and water weight, the keto diet is especially helpful in fixing this issue. Most patients experience a dramatic difference within 1 week of beginning a ketogenic diet. In fact, the drop in sodium levels is so significant that it’s extremely important to add salt back into the diet. We recommend drinking bouillon cubes and also taking a high-quality magnesium supplement.

Q: How much weight can you lose on a keto diet?

A: This will vary from person to person as there are many factors to consider. Factors such as gender, how much weight is needed to lose, and medications that you are taking will all affect weight loss. Universally, people WILL lose weight when they follow a ketogenic diet. The early weight loss is mostly due to water weight, but pure fat loss soon follows as long as a patient is committed and on the right track.

Our practice has special scales to help monitor a patient’s progress. This is especially important for weight loss and keeps us informed on how much fat a patient is losing and how much muscle mass a patient is retaining. It’s important to not lose muscle mass while losing weight and the keto diet is especially helpful for achieving this. The ketogenic diet ultimately preserves the lean muscle mass and burns the fat mass.

Q: What foods can be consumed on a keto diet and what should be avoided?

A: Besides the obvious choices such as cake, candy, sweet tea and regular soda, it’s important to avoid certain foods while following a keto diet. Many patients are confused and unintentionally sabotage their diet by consuming certain foods. It’s especially important to avoid sugar, which also includes fruit sugar and sugar found in liquid forms such as sports drinks and fruit juices. It’s also important to avoid many grains such as oatmeal, cereals, crackers and noodles. Potatoes, rice (including brown rice) and other grains should also be avoided.

Remember, it’s not about consuming the types of foods that are considered healthy. It’s about consuming foods that will not cause a spike in insulin levels and a rise in blood sugar. This is the ONLY way for the body to be in a state of ketosis. Make sure you are consuming animal products and what you can grow that’s not fruit. It helps to think about what our ancestors ate. Beef, chicken, eggs, cheese and butter are all great on a keto diet. This is NOT a low-fat diet and the keto diet is not harmful and will NOT cause clogged arteries. “Remember, it’s not the salt, it’s the biscuit you put it on”- Dr. Simonds.

We can also guide individuals that choose not to consume animal products for weight loss. We work with all types of diets and will work with you and support whichever diet you choose. We’re here to help you!

Q: Can alcohol be consumed on a keto diet?

A: YES! But, in moderation only and it’s important to avoid sugary cocktails and mixers. Stick with liquors and club soda or other sugar-free mixers. Pay attention to what you are drinking and the amount you are consuming. And, the less alcohol you consume, the more weight you will lose. Keep wines to a 4-ounce serving and only consume dry wines such as a chardonnay, merlot or pinot grigio. Definitely avoid dessert wines that are high in sugar. Low carb beer is also perfectly acceptable on a keto diet. Dr. Simonds’ new favorite is by country star, Luke Bryan’s Two Lane Golden Lager, which contains only 99 calories and 3 grams of carbs. There are many other low carb beers on the market to choose from. Seltzers, such as White Claw are also booming on the market and can be consumed on a keto diet.

Q: How long can I be on a keto diet?

A: Forever! There is no danger to being on a keto diet long term.

Q: What are the common mistakes when following a keto diet?

A: It’s important to recognize and avoid foods that contain hidden sugars such as condiments, dressings and sauces. It’s more about excluding certain foods and recognizing that you do NOT have to fast or consume shakes or bars for the keto diet to be effective. There is a lot of variety of foods that can be consumed on the keto diet and it can be very simple to follow. We will be happy to guide you on the correct way to follow a ketogenic lifestyle.

Remember to be kind to yourself while on a weight loss journey. No one is perfect and diet slip-ups will happen. We are always here to help you restart your journey and we never judge! We try to make it easy for patients to see us.

Q: What are your go-to keto meals?

A: Remember, dining out is NOT off-limits when eating keto. A piece of protein with a vegetable is a great go-to. Seafood, wings and Cobb salads are also great choices when dining out. Most restaurants are accommodating and will offer many low carb substitutions for keto dieters. Low carb options are on the rise in many restaurants and even available at many fast-food spots too.

Q: Can I intermittent fast while on a keto diet?

A: Absolutely! If you’re already on a keto diet and burning ketones for fuel, you’ll find that your appetite decreases. This makes fasting even easier!

Thank you so much for joining us today and submitting your questions! Our experienced obesity experts at Dr. Simonds Metabolics & Weight Loss are ready to help you achieve your goals and get you started on your weight loss journey. Contact us for more information or to schedule an appointment. We are here to help!