Dr. Stephen Phinney – ‘Optimising Weight and Health with an LCHF Diet’ – Part 1

Losing Weight and Improving Health with a Low-Sugar and High-Fat Diet Part 1[Keto Good Subtitles Group] (Translation: Zeng Jianzhang, Sa Jingxian) What I want to do is first spend about 10 or 15 minutes talking about a few slideshows Maybe you’ve heard me beforeI’ve even seen my videos on Youtube and I hope they’re not too dull these slides give us some consensus at first and then I’ll close the slides and walk offstage basically I want to have a direct conversation with you guys and so The advantage of doing this is that some people have questions but are not sure whether to ask or not,but some people have the courage to raise their hands and ask the same question. The key points of interest areactually quite repetitive, so I think these questions and answers will be more helpful as an opening. I want to tell you that I sometimes jokebut half seriously I’m a scholar in rehab I was a professor emeritus in the Department of Medicine and in my 50s I felt a sense of what I knew about research and teaching in medical schoolIt was frustrating where I was 10 years ago andthese things weren’t very acceptable so I left and switched tracks andworked in a biotech company for a while and then a guy named Jeff Volek came along and a smart young man Say to meSteve you know what I read your article you should really get back to this field because it’s important so Jeff kind of picked me up and dusted the dust we co-authored a bookand he and his team did it Some great research including an article that came out just last Saturday adds new scientific evidence to the debate on the good and bad of saturated fat that if you eat saturated fat in a healthy diet you mean lower sugar and less refined carbs That’s definitely not harmful or dangerous.We’ll talk about Jeff today and so on. It’s like pulling me back from my self-imposed academic career . where these things are developed into the process of applyingand transferring it to healthcare providers like hospitals or self-insured companies because we are dealing with a diabetes epidemic and if there is no way to reverse this trend it will basically bankrupt the healthcare system Whether it’s Australia or the United Statesor any developed country, there’s a statistic that’s pretty scary that they got last year. In China, they did a survey last year. Only China can do it . It’s type 2 diabetes and in the US we think it’s 9%but maybe it’s actually higher but 11% in a country the size of China you can count over 1.3 million sorry it’s over 130 million we have to figure out a way to reverse it This is the situation so we set up a companyand got some initial funding.It’s not a for-profit company. Our goal is to develop a system that proves to be successful and ultimately estimates In 5 yearswe’ll be giving it away for free because that’s going to be necessary so what we’re going to talk about at the beginning is to give people an idea of what the low-sugar diet process lookslike I put a photo because it wa taken around 1910 Yeah and this was shot on the coast of the North Arctic in Canada with a guy in the background but two women here I tell you any of the women out thereknow a lot more about the ketogenic diet than I do because of this. Groups of Inuit have been living in the Arctic for over 3000 years and they live in very harsh conditions and are able to get food to feed their families we know some of them live to 7 or 80 so it’s not a short lived diet But they were all short-lived. They didn’tlive in harsh conditions from the Neolithic era, but such a dietallowed them to continue their culture for more than three thousand years.They knew what to feed their children. Their grandparents knew what to feed their grandchildren, but unfortunately They didn’t write it downbecause there were no scribes so we didn’t know what the diet was because my ancestors came to North America andran and told them you all ate it wrong and we’ll talk about it later and the interesting thing is there are some people of European ancestryCaucasians and Inuit expeditions I find it interesting that the Inuit are talking and the white people are recording.Usually the situation is upside down. This picture is from the Arctic expedition led by Dr. Frederick Schwatka who arrived in 1878.Arctic search to Canada in 1880 because he wanted to find a copy of the Royal Arctic Explorer’s Log , an explorer who was trying to find the Northwest Passage that went missing in the North Pole A ship of 129sailed to the Canadian North Pole in 1844 and no one came back alive after there was news in 1844 and even in 1878 they still didn’t know what happened to the expeditionwhy they all died so Schwatka just went Look for him actually then a lot of explorers went to the North Pole alot of people died trying to find out why this expedition died and these expeditions before Schwatkatheir problem was they brought all the food with them and if you try to bring a year That’s a lot of food and Schwatka says these people know how to survive in the arcticwe can survive on their diet we can follow them and eat what they eatwe ask them to teach us so Schwatka and another European in this painting have a total of four Europeans and two Inuit families.I think it should be December 1878 whenthey left Hudson Bay on the west coast. So they set off in early winter and lasted 14. A total of 3000 kilometers per month Everyone came back alive. They did find a lot of artifacts, bones, boats. They found some boats that were washed ashore,but no logs on the ships. No one survived. But it’s interesting that Schwatka wrote this passage in his diary about 100 years ago. Later I resonated with it in his 1880 writings “In the beginning, when the diet consisted entirely of reindeer meat” “It seemed insufficient to supply the body with the nutrients it needed” “It was debilitating and made it impossible to continue this difficult life.” The journey” was highlighted here “but the symptoms disappeared after about two or three weeks” and the reason I resonated I stumbled across this diary when I was writing my PhD thesis I spent three years researching athletes on low-sugar diets That’s what we’ve found is at least two or three weeksbefore these athletes get back to their old athletic performance that’s my new, unprecedented discovery and this guy is 100 years ahead of me but what he doesn’t record ishow much meat and how much fat Is it high protein low fat or medium protein fat what are these people eatingunfortunately he doesn’t record it he is a US Army medical officer not a nutritionist can’t blame him there are other people someone would say because they are in thearctic The polars don’t have to eat anything they have to eat meat and fat I’ll see if anyone else has a diet ofmeat and fat and very low carbs This is a relatively recent phototaken in Tanzania These are the male warriors of the Masai tribe as you can see they are all very lanky and these are not farmers they are nomads they carry spears but do not hunt for a living Cows and sheep live on meat, milk, and blood.Itmay sound disgusting . There is a reason why their diets include blood. Before the Europeans brought crystalline salt, their only source of high concentrations of salt was blood. And when you chase those that want The lion that eats your livestock you sweat a lot you lose a lot of saltif you don’t replenish you will die In fact my ancestors probably used to call these people blood drinking savages Jeff and I came up with a name because they are so clever they get it from blood The salt we call them blood drinkers several Slovaks lived with them for a year in 1920 and studied them to compare so these people lived on the hills and some lived by the valleys or lakes and farmed raw those are Kikuyu people say you eat only meat and fat not enough nutrients to grow these people eat only meat and fat and blood than their neighbors farmers live by the river Kikuyumen are 6 inches taller and women are 3 inches taller so those False idea”you can eat this diet, but you can’t thrive on it” but these people look slim and healthy and that’s what Orr and Gilks discovered and m North American continent my an estors “discovered” the New World but i was inhab ted he We met people who lived on only buffalo meat.These were Native Americans from Osage. These were drawn by a skilled painter, George Catlin. In 1830, there were very few white people in the area. He painted these two men and more than 250 of them, which are still inthe Smithsonian Museum in Washington, D.C. These portraits are more specialthan their bodies. Saying their heads look small if the person is so good atdrawing how could they be so small The answer is they are about 6’6″ to 7″ tall which is pretty normal for these buffalo eaters They’re nomads they don’t farm in summer and hunt buffalo in winter they follow buffalo and live like nomads and these people take pride in itespecially the men they don’t eat any vegetables at all so those who say it’s a stunted diet an unhealthy diet some of them The secretsthey just learned allow them to stay healthy on a diet that most dietitians thinkis unbalanced and dangerous, but not necessarily if we know how they eat.Luckily for this guy, Canadian Stefansson It’s hard to pronounce . My closest pronunciation is probably #$%^&*! That’s his name. He calls himself Willie Stefansson. He’s studying anthropology at Harvard. His research program To study the Inuit so he planned to go to the North Pole for a year but somehow ended up in the North Pole for 10 yearsliving with the Inuit and learning their language for two years without anyone from any Arctic research base seeing him His obituary was in the New York Times and he came back and he saidhey I found a lot of things that no one had observed before and he came back and wrote some booksand published some scientific journals describing his life with the Inuit. What to eat he said they only eat meat and fat mostly fatactually not much meat and then they eat a little bit of plants he came back around 1917 and between 1914 and 1928 all 12 vitamins What we now knoware those essential vitamins that are needed to maintain good health 12 have been found and tested and some are only found in plants like vitamin C so he said I live on their dietI didn’t eat any crops for two full years As a result he was abused in many articles who calledhim a liar and his colleagues called him a liar to defend his reputationhe agreed to be locked up in a research hospital in New York to prove that he could survive and stay healthy eating only meat and fat And the hypothesis of the scientist who did the study was thathe would get scurvy, which is vitamin C deficiency. You will lose your teeth and you willhave some bleeding spots on your skin and your joints will swell up and if you don’t eat foods with vitamin C like citronella, lemon, lime you will die so they put him on this whichthey think will make him sick or even have Experiments that might die and he eats only meat and fat for a year to stay completely healthy so they published the journal in 1930 in a greatjournal Biochemistry for short JBC and the abstract says the abstract says Stefansson’s experiment failedbecause He wasn’t sick.Morally,we don’t allow such experiments now. Fortunately, he ate the diet that the Inuit taught him to eat. Doctors McClellan and Du Bois, who oversaw the entire experiment , quantified the content of his diet precisely, albeit indirectly. But we finally got something close to whatthese arctic dwellers eat. They eat 115 grams of protein a day. For his 5’8″, that’s 15-20% of his daily energy expenditure. His only carbohydrates The source isfrom some of the glycogen in the muscle in the meat he eats and we calculate that is about 2% of the daily energy expenditure value,about less than 10 grams, the rest comes from fat so we estimate that more than 80% is fat, which is scary. Yesterday I told the guy sitting next door that 75% to 80% of the calories I eat in a day are from fat and the guy responded like “are you dying?” Eating meatis not only the thin part of the internal organs, but alsothe brain, bone marrow, liver, and kidneys, all of which are returned to the dining table. As long as the animal is kept in a clean environment,there are no problems with parasites or chemical pollution. The conclusion is that we have these. So when you limit your protein intake to a moderate amountand eat very little carbs what your body does is convert the fat you eat or the body fat you have into a chemical called ketone bodies. The medical community, the nutrition community has a very bad reputation because the school teaches us that when the ketone levels in the body are very high, it will develop into ketoacidosis. If you don’t actively go to the hospital or the emergency room for treatment,you will die, but ketoacidosis only occurs in the first Typediabetes is congenital diabetes (annotation: congenital lack of insulin) that type of diabetes is your body can not produce insulin if you do not have insulin then the body will go to ketoacidosis and your body will not produce even a little insulin ketoacidosis so type 2 diabetes is not ketoacidosis if you moderate your protein intake and keep your carbohydrate intake down it doesn’t have to be less than 10 grams most people can get to 50 grams your ketone concentration will be around 1 ~3 mmol/L Below 3 is green and above 4 is green.Above should be red.In this range we call it nutritional ketosis. Start at 0.5 mmol/L . juice Eat some kind of sandwich for Chinese food and your ketone levels will be around 0.1 to 0.2. This is the area where people eat a lot of carbs. We didn’t write that on the slidebecause it’s a bit demeaning. We call this area the carb junk area . The condition is that the carbohydrates you eatinhibit your body’s ability to use fat as fuel so this is the nutritional ketosis zone which is safe and harmless this zone is where your body uses ketonesas a very continuous fuel your body can Uses ketones as efficiently as glucose so we don’t eat carbs after a few weeks remember what Schwatka said”two or three weeks before the hard ride” It’s not like carbs are stored in the body just a little bityou have to eat two or three times a day if you run a marathon you have to eat carbs at every refill station toget to the finish and ketones are from body fat or dietary fat me Not particularly fatbut I have 50,000 to 60,000 calories of body fat and that’s all for my fuel and if I eat a lot of carbsto fill my body with carbs as much as possible I’ll only gain about 2,000 calories Calories, so the upper limit of the small fuel tank is 2,000.Even a thin person can store 30,000, 40,000, 50,000 calories of fuel in his large fuel tank, so if you want energy without fear of starvation, this is a more durable and large storage capacity. Source On the other hand if you want to lose weight you can turn this unwanted body fat into energy which is an efficient way to use it and doesn’t require supplementation like carbohydrates areoften needed if we look at the various diets people advocateOr the diet that people choose to eat we can define the range unfortunately this seems a bit distortedbecause switching from one slideshow program to another on top of this is theOrnish Diet I don’t know if you have heard of Dr Dean Ornish The invention is based on vegetarian food,so most of the food is from plants.Almost all of the crops are grown. The content is 70% carbohydrates, 10% protein, and less than 20% calories. It is from fat, so it is very low-fatand very high in carbohydrates. Diet SAD in my country means Standard American Diet You can also call it Standard Australian Diet The diets in both countries are very similarUsually 50% carbohydrates 10~15% calories from protein 30~35% calories are from fat or fat Low just that is very low The Mediterranean diet is 40% fat These are relatively high carb diets You can only be considered low carb when the carbs are below 30% and the Paleo Diet is often heard these days.) Some community football teams also use this diet.About 25% to 30% carbohydrates are mostly from vegetables, fruits and not refined carbohydrates.Usually grains are not allowed. Most Paleo diet peoplesay that carbs should not be lower than 20% why?Because this is not a ketogenic diet. You don’t have that many ketones to supply your body, especially if you don’t have enough ketones to supply your brain and your brain Burns 600 calories a daywhich is an amazing number for a three pound head 600 calories a day for some people that’s a third of your daily energy expenditure is what your brain burns and if you don’t have enough What happens to the energy feeding the brain? The power outage hit me when I was teaching a group of medical students and they were all sleepy. I pretended to pass out,but it didn’t hit the ground like that, but a few students panicked and wanted to Help me CPR I’m just imitating it so to get into nutritional ketosisyou have to get below 10% of your carb calories and maintain a moderate protein intake of about 10-20 % Most Paleo diets are around 30 % I’m not trying to criticize the Paleo diet because there are a lot of people who get good results with it but if your problem is diabetes, prediabetes, or severe obesity this area of nutritional ketosis gives people more power Fighting the craving to eatmore sustained fuel can achieve dramatic weight loss goalsand in most cases completely reverse type 2 diabetes as long as people use this diet correctly So here’s what you need to know about a low-sugar diet Is n’t it all because what we didn’t learn from the Inuit is how to eat this diet how to get enough minerals how to supplement calcium what other ingredients are you needbecause the diet includes a lot of things including vitamins which vitamins is what you need and what isn’t necessary Stefansson proves that you don’t need vitamin C for at least a year It’s not at all I can explain why but a lot of details I won’t bother you here one thing is a lot of people I want to talk to tonight There will be problems when they start a low-sugar diet low-sugar ketogenic diet Lets say a woman average height and weight is 200 pounds.Usually a middle-aged woman weighing 200 pounds is about 90 kilograms. The daily energy value is about 2800 kcal. When she eats 1400 pounds a day Cal We usually tell peopleto eat as much as they can as long as they don’t eat carbs. People usually only eat 1400 calories a day. They lose about a kilo of body fat per week. So you can see where this person’s energy comes from if this round cake Pictured is 2800 kcal per day (left) about 5% is from carbohydrates 20% protein is from ingestion 25% is from dietary fat but lose more than 1kg of body fat per week so 50% of the fuel is from the body purple Part of it is the body fat contribution that’s the fat in the diet (green) and that’s the reasonfor the weight loss because you eat less than you burn but someone would say Steveare you saying that calories in equals calories out actually It’s much more complicated not how many calories you eat but how many calories your appetite wants to eatdetermines calorie intake going into nutritional ketosisallows people to burn more body fat when people start to lose weight from 200 pounds to 180 pounds A few things have changed their daily energy expenditure values have become lower becau e they have lost 10kg so th ir metabolic needs have dropped a bit and i is natural for people who have lost some weight that the body ill have some signal to tell You eat more so they go from 1400 liters to 1800 kcal per day and we try to keep the carb intake very low if people want to keep losing weightthey should keep the carbs under 55 or 50 grams as the weight loss continues with the daily energy Expenditure will decrease Tend to eat moreand eat a wider variety of foods to maintain a state Suppose this person loses 50 pounds, about 22 kg, their daily energy expenditure is 2200 kcal and their dietary intake is also 2200 kcal Please note that here is the surprising number without the purple part because she is no longer skinny and does not burn body fat so 70% of the calories in the diet must come from fat in order to stay under 55 grams of carbs So if you want to use this strategy for long-term maintenance to combat severe obesity, diabetes, pre-diabetes and other metabolic syndrome or you have type 2 diabetes but are in remission if you want to maintain long-term you must be able to accept most of the calorie source Got it from fat and if that sounds scary to you I hope you’re okay with it when you finally reach maintenance because for most people that’s necessary if you’re healthy and lean to begin with you might be able to stay on the Paleo diet zone if you use a paleo diet 50% fat 30% carbs 30% protein 20% that worksfor some people so we adjust the composition of calorie intake based on each person’s individual metabolic tolerance there is no single formula so I’m going to give You have a conceptthat there is a progression of what you eat at the beginning and what you eat after can’t be the sameyou have to change over time from a period where you burn a lot of body fat to a period where you end up not burning body fat if you can figure it out We got a lot today because when I saw a lot of low-sugar diet strategies there was a book called the Dukan Diet , a book written by a Frenchman that sold well in the U.S.I readit and it told you how to lose weight and when you read it he mentioned maintenanceBut he didn’t make it clear that it was a change you had to make during your maintenance period to be honest asco-author of the new book “The New Atkins Diet for the New You” Bob Atkins was a pioneer from the 1970s until his unfortunate 2003. Fell down and died of head injury but he never explicitly described this strategy and we think when we use it properly it will be more than just a short-term diet for a few months inorder for people to wear small fours Clothes that fit is a long-term lifestyleand are healthy and have no long-term risks.In fact, it reduces the risk of diabetes, prediabetes, hypertension, etc.,as well as diseases related to insulin resistance. Another important point After entering the maintenance period, in the long run,fat will be the main source of calories in the diet, but all kinds of fat should not be treated equally. Some fats should be eaten with every meal. Some fats should be completely avoided. It’s because the school teaches them that “polyunsaturated vegetable oil is a good oil for health.” Everyone says it’s a good oil because polyunsaturated fats are essential fatty acids. It’s true that they don’t contain cholesterol, and it’s true. Look at the lard chart. Drawn by people who have a negative opinion of saturated fat because saturated fat is red forbidden red it is not pointed out that animal fats like lard, tallow, butterhave cholesterol and people say it’s dangerous you should never eat safflower oil , sunflower oil, corn oil , soybean oil, peanut oil, cottonseed oil they have a high percentage of essential fatty acids. The blue part in the diagram and no cholesterol must be good for the body. The pun used here seems not so good,but vegetable oils There’s still a glimmer ofbenefit (Annotation: Grain of truth, grain also means grain) that we really need a little bit of those blues (polyunsaturated fats) a little bit every day but we need less than a teaspoon I eat 200 grams of fat a day and a teaspoon is 5 grams so that’s 2% of my daily fat intake I’ll only eat 2% polyunsaturated fat Butter 3% I can get enough Omega from butter alone -6 fat I can’t get enough omega-3 fats because shea butter is only 1% I need 2% omega-3 which is commonly called fish oil and canola oil is often found in vegetable oils andsoybean oil is also not listed here Up to 50% of the flaxseed oil is Omega-3 but you only need to get a little Omega-3 Omega-6 you don’t need 50% when we put people on high fat diet to get alot of corn oil, soybean oil I personally tried this experiment too I’m nauseous and I’ll skip the details.When I’m on a ketogenic diet,these vegetable oils make me sick. My body can’t stand it. When I switch to olive oil, the monounsaturated fat of olive oil is as high as 70% of the polyunsaturated fat. I can eat 200 grams of olive oil a day without any problem. In fact, I used to eat 200 grams of cream a day and it was fine. I only eat 200 grams of cream a day? No I add cream to my food but I also eat many different fats including coconut oil olive oil cream lard butter Fatty sea fish doesnt have to be the main meal. It can be breakfast with smoked salmon fillets with cream cheese. Wrap it in lettuce like smoked salmon.Bagels just dont have bagels. Saturated fat fat people came up to me with a lot of polyunsaturated fats and you know what I tried the ketogenic diet it was good at first but when my weight stabilized I couldn’t take so much fat it made me nauseous yours The diet is really not very good. They are eating what they used to consider so-called “healthy” fats. The biggest problem in the United States is that the popular way to eat fat is to eat mayonnaise. I don’t know if it is common here. Almost all brands of mayonnaise in the US use Soybean oil is made of canola oil. I dont like canola oil very much, but if you must buy mayonnaise, you must eat mayonnaise.The best choice is canola oil mayonnaise. Stay away from soybean oil mayonnaise. Sometimes you can find some special brands. It is best to make mayonnaise by yourself. Egg yolks, oil, lemon juice and some spices are not difficult. If I use olive oil, I make a large batch at a time, and it can be stored in the refrigerator for a week.Usually, my family will eat it in less than a week. I have to Making more and eating the right oils is very important if you want to make this a long-term lifestyle people tell me that but Steve you are a doctor with a high income and you can afford olive oil we can’t I get it from a grocery store near my house Has the olive oil been invaded by Costco? America has long been conquered by Costco. I go to the Costco near my house and I can buy a set of twobottles of 3 liters of olive oil that are tied with straps for only NT$700 I just need 18 NTD per 1000 calorie.I burn 2800 calories a day. If 1/3 is olive oil, it will only cost 18 NTD. Said Steve “I got an email from the US today” “Mentioned that a lot of olive oil imported from the US has bad things” “But I didn’t do much testing” “Some sunflower is mixed with other oils” Seed oil, etc.” “Because olive oil is expensive” “It is impure with other oils” “May be worse than other oils” Many brands of olive oil are blended with oils from different sources. In fact, there is a market in Italy. Economists count how much olive oil is produced locally in Italy and how much olive oil is imported. Finally, they look at how much olive oil is exported. The sum of self-produced and imported olive oil is less than that of exported olive oil. This means that the Italians have added a lot of material. “They say it’s made in Italy” Many say it’s made in Italy Bought it at Costco I trust Costco why because because my friend Doug Bibus in Minnesota specializes in fatty acid analysis I sent him some samples and we know it’s pure because oleic acid is 77% monounsaturated fatty acids look at other safflowers Oil Sunflower oil contains more than 80% of the polyunsaturated fat.You can see how otheroils can pass off as olive oil. You can’t do anything about it. Just add other oils and fatty acids. The source of bottling in Italy is Italy, Greece, Tunisia, Spain, Portugal. Wherever they are, they are honestlynot entirely made in Italy, but they are bottled in Italy. When I send it for inspection,I certainly don’t send it every week because every week. The second cost is 100 dollars. He is my friendbut the friendship is not good enough to check for free. So I believe in this brand. “What is this brand? Their own brand Kirkland I’m not trying to sell Costco’s olive oil they have a lot of stuff that is also harmful to the candy section “We also have great olive oil” Do you have olive oil in Australiacool just buy the local one and just buy it from an acquaintance Rice bran oil (brown rice oil)? I did research for the California Grain Association in 1989.I ‘m old. If I remember correctly, the composition is close to cottonseed oil. If you can get pastured grass-fed cream, the best poultry, wild fish, I dont just eat 200 grams of fat a day, but add cream, olive oil, and coconut oil. In the process of cooking, I use a lot of olive oil in my homemade salad dressing. My kids and I both love them and they’re all in college. I used to love feeding kids as an experiment. I made a combination of cream and olive oil. Half of the cream and half of the olive oil were kept in the refrigerator at room temperature.They were soft and fried. The meatwill melt very quickly. Put half cream and half olive oil on the vegetables and fish. It’s easy to put some garlic basil and oregano in the blender to make Italian flavor. So this oil and cream mixture Cheap and easy to do The strategy to be sustainable is to find a source of fats first healthy second affordable third delicious delicious once the ratio is right the food tastes some experts study taste and human behavioral responses to food they say it is best to reduce Taste Conditioning Response Some foods are amazing the first time you eat them the third time they feel normal Jeff Voleks, he’s a state champion in the fitness competition.Not when he was a kid, he was an adult, he was much older than me, he was low in sugar, but the diet was close to the content of the Paleo diet.30-35% protein.He said I was good. Love steak dinners I sometimes eat two pieces I say is there any problem with that and he said have you ever met someone who is allergic to steak but since we worked together and researched I didn’t change him on purpose he now likes 8-10 oz steak plus 2~3 tablespoons of cream instead of two steaks for less cost sharing protein with others who need it I should have continued I often hear it is good but you eat the same meat, meat, fish, meat facts every day You can go and make a lot of combinations in the book we have seven days of recipes like this but you can also use some ready made I can put four sausages in the microwave and make a cup of instant coffee and I can do it in five minutes Get your breakfast ready and leave the kitchen of course if the sausages are good quality not fake or low fat I won’t be hungry until lunch I can have breakfast at 6 o’clock and 12:30 lunch has no effect at all very fast lunch can be very fast Simplesalad with meat or tuna with a fatty dressing You need fat for your daytime snack Nutty bone broth soft cheese and some veggies if you don’t want a snack don’t eat but if you’re at 3pm Suddenly hungry, have these snacks on hand, you can eat the right food to fill your hunger If you don’t have it on hand, but there is a box of donuts in the pantry next door, it’s better to prepare it and not eat those carb junk, you can also try my cooking The soup uses my own bone broth as the soup base.After the two slides, it will be mentioned that bone broth is made with fresh cream and my own tomatoes. Tomatoes actually have a lot of carbs, but if I make creamy tomato soup, a cup is only 2 ounces of tomatoes I eat 4 ounces of berries a day so I can eat cranberries, blackberries, blueberries, olives, tomatoes add up to 4 ounces a day I have a very hearty Soup Steak, Cream, Beans and Mushrooms There is no low carb ice cream readily available in the US but you can make your own I make a whole bunch at a time a litre but my servings are about 120ml so I make 8 at a time and I make them on Saturdays Put it in a container and freeze it If I get a “fat craving” later you’ll know what a fat craving is If I biked 40 miles yesterday I’ll have a fat craving tonight I I know so I have to prepare some good fats.You can use sucralose. We are not completely against sugar substitutes, but I don’t really like the taste of sugar substitutes. My personal choice is to use natural, more expensive xylitol. I buy a pack of $4 per pound but i only use a few teaspoons of xylitol at a time it doesn’t stimulate insulin it doesn’t stop me from burning fat efficiently over time you’ll learn these tricks or ask a friend of yours to do it for you anyway you can Foods rich in fat and variety and low enough in carbsallow you to use fat as fuel. “How about Stevia? Stevia is a natural sugar substitute. It is extracted from a plant leaf and is naturally loved by many people.If you like it, use it. Some people say that sucralose is also called Splenda . It is an artificial compound. If I have to choose sucralose or 5 tablespoons of sugar Which one is more bad for me must be sugar Pure, White and Deadly Who wrote that book John Yudkin has been right since 1975 Let me finish the last few pagesand then open the Q&A I hope you all think about it and you can discuss the Q&A How to make this a sustainable lifestyle. Anyone can follow a certain diet for a month. Almost everyone. Even two or three months is long enough to be useful so that you can maintain weight, lower blood pressure,or improve Diabetes I don’t want to simplify the process too much My wife always says”he always makes it complicated” First this is not a high proteinbut a medium protein diet once you reach the maintenance period youmust have enough energy sources because if you don’t feed your body will make you eat most of the energy from fat you must not be afraid of saturated fat saturated fat is finally starting to change the scientific evidence is very clear but like you Dr.Stuart C from Perth, Australia . Marshall in 1985 proved that gastric ulcers are not caused by stomach acid but bacteria(Annotation: Helicobacter pylori) can be solved within a week with antibiotics In 1985 they confirmed this hypothesisThere is no doubt that one of them drank the bacteria directly tolet themselves Infected with acute abdominal pain , looking at the endoscope, it’s a red inflammation, and taking antibiotics, it will be fine until 1995(Annotation: 10 years later….) The United States began to use antibiotic therapy. Still continuing to bleedfrom a stomach ulcer until at least four units of blood were needed before the bleeding stopped. I was a practicing doctor before I left. Before I became an academic physician in rehabilitation, if four units of blood were given and the blood returned If it doesn’t stop, it can only be sent to the operating room toopen the ulcer and suture it.The stomach becomes smaller. This situationwill cause damage to the gastrointestinal function after a few times. In fact, it is good to take two antibiotics directly. It sounds bad, but doctors and medical staff The culture doesn’t change overnight. It took a decade for the obvious to be accepted. Andit’s not the first time we’re back to saturated fat. I’m not lost on the subject.We now have enough science to prove thatsaturated fat is harmless. So you don’t have to be afraid to eat the right ones. Stay away from those blue ones. It’s important. It means you can eat saturated fatsbut pay more attention to monounsaturated fats. Our biggest struggle right now is probably mineral supplementation, especially potassium and sodium. A person eating from the menu I just had if they seasoned the food a littleThe sodium intake per day is about 3 grams.The average American in the United States eats 5-7 grams of sodium a day, so 3 grams of salt is not much at all. The US government wants everyone to limit sodium intake to 2.3 grams per day because there is a very small portion of the population.If you take more than 3 grams a day their blood pressure will go up a little and they estimate that if your blood pressure goes up because of that and we have 300 million people there could be thousands of people dying each year fromcomplications of high blood pressure so we’re going to limit the country to every day 2.3 grams of sodium but when you are in nutritional ketosis it makes your kidneys excrete salt faster you are like someone from a different planet ketogenic planet or what we call “keto paradise” if you only eat 3 grams of salt a day You’ll have mild headaches, dizziness, fatigue and sometimes constipation.It’s nicknamed”Atkins’ Flu” because a lot of people have this problem on the Atkins diet because Bob Atkins didn’t talk about salt The ingestion issue maybe because he’s smart that might make the Arkin diet more criticized even if you eat 3 grams of sodium a day you’llstill have the cold symptoms so we found that adding an extra 2 grams a day if the carb intake is at 50gGenerally speaking, you will need 5 grams of sodium per day when you are in ketosis,so that you will not feel fatigue, headache, and dizziness. If you go out for strenuous exercise for more than 50 minutes, you thinkyou are running out of energy, but you are not running out of energy.It is actually salt Not enough circulation in the body because the blood doesn’t have enough salt in the blood to provide enough nutrients for the brain when exercising so I’m emphasizing thisbecause it’s very important If there’s not enough salt in the body, the body throws away potassium. An example of this is a book calledThe last chance diet written by a doctor who doesn’t understand nutrition and doesn’t understand minerals. There are at least 50 examples of people using thisvery low-salt, low-carb ketogenic diet and never had a history of heart disease before. Sudden death from arrhythmia because they lack salt in ketosis and then lose potassium leading to arrhythmias This is a very important solution to add more salt to bone broth or stock instead of sprinkling a heap on top of food Drink homemade bone broth twice a day Another option YesI have a small packet here and this is my stock cubes and people say it’s full of chemicals but it’s just stock cubes that are generally available and the ones I bring have 1 gram of sodium each when I’m at home usually I have my own bone broth and The recipe for bone broth was in the book when I was traveling because they wouldn’t let me into Australia “did you bring any meat?”No, I just brought Bone Broth” I carry these two a day when I’m not at home so I can stand on stage and talk to everyone without having a headache and passing out in front of everyone so is it safe to eat so much sodium 3 grams from food 2 grams from stock sounds like a lot of sodium but the US government says 2.3 grams luckily there lives a bunch of smart people next to the US called Canadians who not only tolerate usbut have done a really good study this is done by the University of Ontario in Canada The scholars of Quebec are not part of Canada(Annotation: Quebec always wants to be independent) They did research In the past the US government set a standard of 2.3 grams that is based on how much people say they eat and write down the food they eat these days . It comes out at 2.3 grams of sodium per day but people can’t believe it, especially when you’re asking what they shouldn’t eat. These researchers traveled to 17 countries to collect 100,000 urine samples. 2 Thousands of people and these urine samples contain a true reflection of how much sodium was ingested the previous day and then they tracked the mortality of these people for 3.7 years and they found that there is a ratio here .The lowest death rate is 5 grams of sodium a day not 2.3 gramsif you look at the 2.3 grams in their data if everyone in the U.S.Eats 2.3 grams the chance of dying increases by 60% based on that data this is the first completely objective experimentto measure urine The way to excrete sodium is not to guess sodium intake from dietary records. There are other experiments with similar resultsbut with much smaller participants or only one country. They did 102,000 people in 17 countries. This is very large. Experiments this tells us this tells us that 5 to 8 grams only slightly increases the chance of death I’m talking aboutthings that used to be considered dangerous and extreme in the past You can eat saturated fat instead of carbohydrates and add salt and it won’t hurt your body “If your body needs it, Why is it still excreted? Because there is continuous fluid circulating in the body, if you drink two quarts of water a day, this water will be excreted, whether it is sweating or urinating, and some things will be excreted along with it.We call it the loss rate. This is a good The problem kidneys are actually very smart we don’t need 500 milligrams of sodium a day it may be lost through sweat but the kidneys are not perfect if you have very very low sodium intake the kidneys will start to excrete potassium potassium is necessary for growth and maintenance of muscles to maintain normal nerves If the system works, if potassium is low , there will be muscle cramps and arrhythmias. Humans have only evolved for a million years to deal with these details. Maybe it will evolve better in another million years. This is a good question. In terms of human physiology, we must have salt ” What do the annotations on the slide mean?” If you’re in the ketone state like I said, the salt will be excreted faster, which indicates the range of the first and second red arrows Mortality will slowly increase but we don’t actually know but in this experiment 102,000 peopleprobably none of them are in nutritional ketosis we are a rare group in developed countrieswe only make up about 1% of the population I wish it was that high.That’s what that note means. If nutritional ketosis moves, the safe zonemust move to the right. That means the risk of getting too much salt is very low, unless you eat a few kilos of sauerkrautand don’t cook it first. Soaking in water is possible in some places like in Japan some placespeople get 15 to 20 grams of sodium a day because they marinate the fish with soy sauce etc etc but like we don’t have this diet we have high salt in the left area which is not dangerous Low salt is dangerous.Not enough salt, and you will have these symptoms. If you ignore these symptoms, youwill have problems. So prevention and maintenance are very important. I will mention a little in my experience with patients many years ago. People who do not have type 2 diabetes will also cramp. The common cause of cramps is, ofcourse, not the only reason for insufficient magnesium intake. If you have cramps, taking a little magnesium can effectively solve the problem.I think the best solution is My therapy for my patients is not feasible in Australia so it’s a bit of a bind.Maybe in a year Rod will figure out how to get around this. It’s not expensive to import . Is my diet okay? Should I change? Cut carbs when in doubt. Carbohydrates in the dietare not the minimum required for health if there is the right ratio of meat to fatand adequate vitamins and minerals eat more fat when in doubt Also if you want this to be a sustainablediet for many years Or a diet that has been maintained for decades.It has to be happy to satisfy your appetite and satisfy your palate. You can eat it without guilt . You can add more sauce whenyou see a generous point. You can ask for more cream . The waiter came to my table and asked, “Do you want bread?Put down the bread “I don’t eat bread” They are about to take the basket away”But I want cream” Just do it generously you know don’t feel guilty because if you don’t get enough calories you’ll crave food, be hungry Break this diet and find satisfaction Enjoy the fun to last I used to live in MinnesotaI always say come and visit me I’ll accommodate you and you don’t need air conditioning Thank you all for open questions below

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