Insulin Resistance Symptoms (Even with Normal Blood Sugar) with Dr. Georgia Ede

fasting glucose is one of the last dominoes to fall. So, by the time your fasting glucose is high, you're already in trouble because uh what's what's

going on for years before that happens in the background silently without anybody testing for it, unfortunately, is your body is producing more and more

insulin to keep your fasting glucose in a healthy range. So, and it will do that for as long as it can until it can't do

it anymore. So, it can be so fasting

it anymore. So, it can be so fasting glucose um can be totally normal for years while in the background your insulin's going higher and higher and

higher to to keep that fasting glucose normal. So, a better test a much better

normal. So, a better test a much better test for insulin resistance and metabolic health problems is a fasting insulin level, right? Um, that's a much more sensitive

right? Um, that's a much more sensitive and an earlier test to see, you know, what's going on underneath.

And what would you want those levels to be at? Just we have a we have a lot of

be at? Just we have a we have a lot of number watchers in this crew that listens. So, what would you want your

listens. So, what would you want your fasting insulin to be at?

You I mean, you really want it to be below 10. Um, ideally even six or less

below 10. Um, ideally even six or less is better, but in the single digits. You

want your fasting insulin to be in the single digits. And it's not it doesn't

single digits. And it's not it doesn't have to be there every single minute of every single day, but the fasting insulin uh if you see that above 10, that means that you are um that you're

you're producing too much insulin. Your

body's having to work pretty hard to try to keep your glucose levels in check. It

means you're eating too much carbohydrate for your personal metabolism, for what your body can break down and actually do, right? what what's the

mechanism behind high glucose, high insulin and depression.

So this is a topic of intense research.

So we have some theories that are being tested. So for example um uh one of the

tested. So for example um uh one of the theories that that is uh very common in our field is to think about uh mental health disorders as disorders of brain

metabolism. meaning that the brain is

metabolism. meaning that the brain is having trouble turning glucose blood sugar into energy.

So, and if the brain can't turn glucose into energy smoothly and reliably um uh whenever it needs to because the brain's a very high energy organ. It's an

electrical organ. So, and and if it doesn't have access to smooth, clean, reliable flow of energy at all times, then something's going to go wrong. So

one of the theories is that depression um is a reflection of an energy shortage in the brain that there isn't enough energy and so the brain is powering down. You know you your energy goes

down. You know you your energy goes down. You know you don't feel like doing

down. You know you don't feel like doing anything. You have no motivation. You

anything. You have no motivation. You

want to sleep all the time. Uh you're

and and so uh things like that. So so

the brain doesn't have enough energy.

That's one of the theories. Another

theory is that there's a lot of inflammation going on in the brain and inflammation is uh very damaging to the brain and causes the brain to causes the brain to enter kind of a sickness

mode where it it wants to put you into bed and have you rest until you feel better.

Right. Smart. It knows it's intuitively trying to get you to recover.

That's super smart. What? So if the brain's energy powers down, does that mean I know some neurotransmitters are actually produced in the gut and some are produced in the brain. Does that

mean then it's also can't be a factory for neurotransmitters that keep us focused and happy and well balanced?

Yeah. So that's a great question. So

yeah, the the gut has its own nervous system and it produces a lot of neurotransmitters, but those neurotransmitters don't cross into the brain. The brain makes its own

brain. The brain makes its own neurotransmitters.

Great.

And so, but that the balance of those neurotransmitters, we're talking about things like serotonin and dopamine and norepinephrine and glutamate, lots of

different neurotransmitters. Um, uh, the

different neurotransmitters. Um, uh, the the the balance of the production of those neurotransmitters and how how well they work is strongly influenced not

just by how much energy is coming into the brain, but also by how much sugar is coming into the brain.

Right? So if you're eating too much, if if your glucose is running too high too often, your blood sugar is running too high too often. Your brain sugar will also be running too high too often. And

that extra glucose inside the brain will has nowhere else to go. It sticks it starts sticking to things inside the brain and and and that will set off waves of

inflammation inside the brain and and depression is very strongly associated with inflammation of the brain.

Yeah. Fascinating. And how many fuel sources does the brain have?

It has multiple fuel sources, but its favorite fuel sources are very small molecules. Um, primarily glucose,

molecules. Um, primarily glucose, ketones, and to a lesser extent, lactic acid or lactate.

Um, which we we don't need to talk about today. They'll get too complicated. But

today. They'll get too complicated. But

glucose is one of the brain's favorite fuels. Um but it uh it really um the

fuels. Um but it uh it really um the brain is has been described as a hybrid engine. It works best in a mixture

engine. It works best in a mixture of glucose and ketones because glucose is a fast fuel. So there are certain certain operations in the brain that

need that fast energy. Ketones are a slower fuel, slower burning fuel, but they're cleaner and they're smoother and they're more efficient and they cause less inflammation and oxidative stress

when you're burning them. So, it's

really a combination of the two that that works best.

And what like if I have a hybrid car and the I'm not doing anything to facilitate the electrical the you know the electric part of it. I'm only working on the gas.

It seems like I wouldn't be using the car to its full capability. So, as I'm hearing you talk, I'm thinking about the millions of people that never have

really experienced the power of a ketone. What What would happen to the

ketone. What What would happen to the brain if it never got exposed to ketones and it was only exposed to glucose? Does

that cause any inflammation because it doesn't have that second fuel source or any challenges to the brain?

100%. So if your if your brain tries to run entirely on glucose, first of all, it would be very very difficult for that to for that to occur because um you would have to be glucose doesn't last

very long. You have to keep you have to

very long. You have to keep you have to keep uh putting it in. You have to keep it. So So like for example, overnight uh

it. So So like for example, overnight uh when you're not eating carbohydrate, um if unless you're fat adapted on a ketogenic diet, overnight your body will say, "We're running out of glucose.

We're running out of glucose." Um, and your body your body and your brain will try to then switch over to ketones um to uh to bridge that energy gap, but that takes a little bit

of time. And so what's happening is that

of time. And so what's happening is that there's a stressful transition period overnight where cortisol levels can go up and um and people can actually wake up or they

can their their sleep can be disrupted because they've got this surge of stress hormones that are trying to they're looking for energy. Where's the where's the energy for the brain as the glucose

is dropping overnight.

So um so having a smooth having your body be metabolically healthy means that you can switch easily and efficiently between the two and most of us are not metabolically

flexible anymore and it's hard to regain that. You can regain it but it's hard to

that. You can regain it but it's hard to do and and it takes some time to to rebuild that flexibility. But most

people are trying to um for to fuel their brains almost entirely with glucose right?

And that's so a couple of problems with that. One is that your energy level is

that. One is that your energy level is going to be unstable, right?

And and the other is that um glucose it does burn faster, but it burns it doesn't burn as cleanly and or efficiently. And so what you get is you

efficiently. And so what you get is you can get more inflammation and more of something called oxidative stress. And

these are these are damaging forces in the brain. So, if you're running on

the brain. So, if you're running on glucose all the time, it's like you've got your foot on the gas pedal and and you're really damaging the engine. What

you want to do is you want to occasionally take your foot off that gas pedal and and and give your brain some some downtime, some healing time, some some time in a lower glucose state, not

a zero glucose state. You always need some glucose, of course, but but you want but if you're trying to run 100% on glucose, you're really going to have to keep that foot on the gas

pedal to get enough energy. Um whereas

you can let up and let let the ketones do some of that work for you. Um and

that way when you're in ketosis, the brain can enter a healing mode where you're can recycle. You can regenerate.

You can you can you can build and repair and clean up.

If you're running on glucose all the time, your cells are too busy processing that glucose for them to actually um do maintenance and repair and healing work.

And so I'm thinking in in application of of what you just said, would it be to my brain's benefit to maybe eat an earlier

dinner? Um maybe even a dinner that's

dinner? Um maybe even a dinner that's more stable for my blood sugar knowing that I'm hoping to go into a mild state

of what we what I refer to as nutritional ketosis. Yes. when when I'm

nutritional ketosis. Yes. when when I'm sleeping. Like, would that be the goal

sleeping. Like, would that be the goal of brain repair is to have everybody be in a metabolic state where they can flip into ketosis when they're asleep?

That is the way I think about it. Uh I

believe that everybody whether they have a mental health condition right now or not or whether they have metabolic problems right now or not, even people who are robustly mentally and physically healthy, which are very few of us unfortunately,

very few. I know

very few. I know you know but but even even if you are in in the you if if you're right now the picture of health it's still this is my opinion based on you know what I've

studied I think it's still ideal for humans who want to maintain their good health to get into ketosis on a regular basis especially overnight. It doesn't

mean you have to be in ketosis all the time. It doesn't mean you have to even

time. It doesn't mean you have to even eat a ketogenic diet. It's just about making sure you're using those pathways and keeping the keeping those pathways

welloiled and well used so that you can flip back and forth easily. Um and and uh so that so that everything stays in working order so that you enter this healing mode every night. Overnight is the perfect

every night. Overnight is the perfect time to do it.

Um and so overnight go into that healing mode and then the next day um eating in a way that doesn't spike your glucose into unhealthy ranges. it. And again,

that doesn't necessarily mean a ketogenic diet. It depends on who you

ketogenic diet. It depends on who you are. So, I agree with you that getting

are. So, I agree with you that getting into ketosis overnight, even just mild ketosis overnight is uh really beneficial for everyone.

Yeah, I've been really, you know, when I started to really understand uh melatonin, I saw that there's an inverse relationship between melatonin and insulin. And so, you know, for from a

insulin. And so, you know, for from a weight loss standpoint, I really started teaching people that they shouldn't eat right before they go to sleep because especially if it's dark out, you've got,

you know, you've got a lot of melatonin going in you, which makes you a little more insulin resistant.

Yes.

It's really And then I just recently saw another study that was showing improved heart rate variability. If people didn't eat 3 hours before they went to bed, it

was easier on the nervous system, the cardiovascular system. So, I feel like

cardiovascular system. So, I feel like we're just getting this arsenal of don't eat before you go to bed.

Don't eat when it's dark out, you know.

And so, we have we have a circadian rhythm just like all all creatures do.

And, you know, we we metabolize our food best during daylight hours. Yeah.

And so, uh, and once it gets dark, that's that you're going to become more insulin resistant. And so, that's that's

insulin resistant. And so, that's that's when you're going to tend to store more of your calories as fat. And, you know, it's just not going to be as as healthy for you. And you're going to lose out on

for you. And you're going to lose out on that precious overnight healing phase that is, I think, one of the holy grails of good health.

So, so amazing. And you know, we're over here telling people that sleep is so important, but we're forgetting the nuance of like sleep is really important and here's some factors to get you the most out of your sleep, which food

timing would be a big one in in your in this new expert consensus. There was a couple of things that were really interesting to me. So one was that you

all decided what the amount of ketones that was best for depression, schizophrenia and

dementia. Is that correct? Those were

dementia. Is that correct? Those were

the three conditions you looked at.

So this paper the the expert consensus was eight eight of us um who have many years of experience uh studying and using ketogenic diets and mental health.

Um we uh we were asked this question uh and tried to come up with an answer and and we we focused on uh what we called what are often called serious mental

illnesses which are major depression, bipolar disorder and schizophrenia. So

those three major mental illnesses were the ones that we focused on in this expert consensus. And so, uh, now we

expert consensus. And so, uh, now we don't know for sure, um, what is going to be the right range of, uh, or or level of ketosis for every person with

with with one of these conditions, right? But what we said in this in this

right? But what we said in this in this paper was that based on our clinical experience and the research that we have available so far, it appears there

appears to be a trend where with these serious mental illnesses, most people seem to do better when their uh degree

of ketosis, their range of ketosis is somewhere between 1.0 mill per liter and 3.0 mill mole per liter most of the time. doesn't have to be all the time.

time. doesn't have to be all the time.

Ketones fluctuate. They naturally

fluctuate quite a bit. But um and you know, we've all seen all of us on this panel had seen people respond to lower levels and see and seen some people need

higher levels, but most of most of what we tend to see people tend to do better when they're in that range. And so we ask people to aim for that range at

first and then they can find out for themselves what their personal optimal range is after they've after they've gotten into good consistent ketosis for a while. See whether they can loosen it

a while. See whether they can loosen it up a little bit or whether they have to actually tighten it up. But between one and three is a nice uh window to aim for.

Which is so beautiful because I get asked all the time from fasters, you know, when people start fasting, they're like, "Oh my god, my ketones were 4.0 0 5.0. And I'm always like, look, I've sat

5.0. And I'm always like, look, I've sat with so many ketogenic experts. None of

them are going for the more is better.

In fact, I've sat in so many conferences where people say 1.5 is my sweet spot.

It's where I feel my best. So, I think it's really interesting that you gave that range because there is what I've seen on my end is this desire to get

more. But it do we know if more is

more. But it do we know if more is better?

We don't know that. Um, I can say that if ketones are too high for too long, uh, you're kind of edging into starvation range and and nutrient deficiencies and so forth,

but most people are not using fasting in that way. Most people are not using a

that way. Most people are not using a ketogenic diet in that way. So, those

are kind of more extreme situations. But

uh with intermittent fasting and with a properly formulated ketogenic diet, getting into that range is not it is uh is considered is considered ideal by a lot

of people, but there are some people who do feel better when they're even higher.

Some people feel better when they're 3.5 or four. Um and and but but I have many

or four. Um and and but but I have many patients who feel quite uncomfortable when their ketones are running too high for too long. um they feel anxious,

can't sleep, they're hungry all the time, can't concentrate. Um and and that and usually that's because they're not getting enough of something they need.

Um and so it depends on it depends on the the devil's in the details. But so,

but I've also seen people who respond to a to a low carbohydrate diet and maybe a little intermittent fasting where they're never really in great ketosis,

but they're just so much better anyway because they've gotten their glucose levels under nice and stable, right? So,

sometimes that's all you have to do.

And sometimes all you have to do is just give yourself a break from food processing.

Yes. Yes. Well said on the body and brain.

Yeah. Yeah. And so the other interesting thing I I found about this consensus was you there are some recommendation. Now I

understand we're talking about se you know severe depression and some severe mental health conditions. Uh but the recommendation was four to six weeks

consistently. Did I read that right?

consistently. Did I read that right?

With these 1.0 to 3.0 ketones. I my

first question was how did you how'd you get people to stay at that level for four to six weeks, right? So, um most of us agreed that um

right? So, um most of us agreed that um that you wanted to give it at least six weeks uh in relatively consistent ketosis um and in some cases you're going to need a little bit longer than

that. So what I what I what I see in my

that. So what I what I what I see in my practice and many of us have seen is that there when somebody with a mental health issue starts a ketogenic diet I

what I like to say is uh 3 days 3 weeks 3 months some people feel better in 3 days some people it's going to take more like 3 weeks and then there are a few outliers where they're going to have to go a whole three months to really see uh

to turn that corner that's not very common but but you know for people who are really got to really have a a sticky mental health problem, they might need

to, you know, just to make sure it's not going to work to give it a good 3 months before you decide it's not going to work for you.

So, um, but most people within 3 weeks will respond, but we say give it a good six and, um, and and so how do you get people to stay? This is I love this question because

Yeah, exactly. That I was like

Yeah, exactly. That I was like compliance for that long has got to be really interesting, you know. It is. So, so it's a real

you know. It is. So, so it's a real issue. Adherence to these diets is a is

issue. Adherence to these diets is a is a real issue, especially in the very beginning. So, anybody who's tried a

beginning. So, anybody who's tried a ketogenic diet for a few days are like, "Oh, it's so hard. How am I ever going to stay on this?" But those who make it who make it past the adaptation phase,

especially if you can get to week three, it becomes so much easier because all of your pathways have shifted into a different

into a different mode of operation. So,

your appetite is under better control.

You've got good energy flow to your brain. Your cells have are are adapting

brain. Your cells have are are adapting to using more fat for energy and less glucose. They're still using glucose,

glucose. They're still using glucose, but they're using less glucose and now they're using a mixture of fuels. So,

you're everything's quieting down. You

found a kind of a new equilibrium. Your

cortisol levels have come down. Your

acid base balance has corrected itself.

Um, and your electrolyte imbalances, which can happen in the beginning, have sorted themselves out. So, your body's adapted to this new mixture of fuels and

it and it becomes happy and content.

Yeah. And it wants that now.

It wants that now. It's just like, you know, um I have had some uh patients try extended fasting and they they have all said to me uh without exception, get to day three.

You get to day three, suddenly it's like, "Oh, I could do this for another week."

week." Yeah. We do every every January we lead

Yeah. We do every every January we lead a worldwide fast and we get a hundred thousand people to do a three-day water fast.

Wow.

It's and it's so fun because people are like, you know, I always say on day one, tell me what you're feeling. Just get it out. And then by day three, I'm like,

out. And then by day three, I'm like, now tell me what you're feeling. There's

so much apprehension. And then the on the other side, people are like, I couldn't believe I did that. I can't

believe how easy it was. Can I keep going?

It's there is something about priming the metabolic switch that does not get enough credit and and outside of like other diets, it gets easier with time.

When you're well adapted to a properly formulated ketogenic diet, it feels so much easier um than trying to walk this tight rope of how much carbohydrate can

I have and you know and what types and all that kind of thing which can be so can challenging especially for people with carbohydrate addiction

issues which are are fairly common. it

can be hard to moderate. And so, uh, that kind of being completely on the other side where you're in ketosis, it's it's just, um, it it's it's easier. Um,

there's a great study by Dr. Ian Campbell. He's um a researcher at the

Campbell. He's um a researcher at the University of Edinburgh in Scotland who um years ago, eight years ago um he was

a musician in Scotland, a very good one and uh talented and he had bipolar disorder and he you know hadn't found anything that helped him and so he and he was overweight and he's like well you

know I can't fix my mental health. Why

don't I why don't I try to lose some weight? I can at least try to lose some

weight? I can at least try to lose some weight. So he went on the Atkins diet

weight. So he went on the Atkins diet and he within three days his bipolar depression started to lift and he was like, "Oh, that's interesting."

interesting." So um and he tested this over and over and over again and then started learning about ketogenic diets. And then he went back to school, got a PhD, and now he's one of the world's leading researchers

in the field studying ketogenic diets for bipolar disorder. And I tell you this story because you asked um you know isn't it hard to stick on stick to the

diet? So he published a study where 20

diet? So he published a study where 20 people with bipolar disorder um uh tried a ketogenic diet because people said oh you know it's you know people with mental health disorders they're not going to be able to do this. It's going

to be too hard. And he said well let's find out.

So the 20 people with bipolar disorder not they were able to get into great ketosis. They were able to measure their

ketosis. They were able to measure their ketones every day. their levels were about 1.3 on average, which is nice, above three, above 1.0. And um and then so and they did wonderful and and their

mood and their energy and their and and and anxiety and so forth improved. Um

the higher their ketones were, they seemed to do better the higher their ketones were. But the thing that was

ketones were. But the thing that was really great about this and one of the many things that was great about this study was that after the the uh study was over

um there was supposed to be a wash out period where the researchers were supposed to help people uh wean off the diet. That was part of the protocol.

diet. That was part of the protocol.

Seven of them refused to come off the diet.

I bet I I I wondered if you were going there. Yep.

there. Yep.

Yeah. They were like, "Well, we feel too good. We're not we're not we're not

good. We're not we're not we're not doing it."

doing it." Yeah. I you know I I always tell the

Yeah. I you know I I always tell the story that the when I did the last two times ago I do a three-day water fast usually once or twice a year and uh the

last time a couple times ago one of my closest friends knows me enough and was like are you on a fast? You're really

you're you're so happy today and you're so you know you're so clearheaded. I'm

like oh yeah third day. She goes I could tell it was almost like you were on cocaine or something. And I'm like, "Yeah, that's how it feels when you've really tapped into that." So, it's quite

remarkable.

It really is. And there's a strong connection between how we eat and how we feel and and other people can feel it, too. So, in terms of just your outlook

too. So, in terms of just your outlook on life, your tone, um your facial expressions, your energy, kind of the energy you put out into the world, how you roll with things. And so, and I can

tell when I'm uh working with patients, I can tell as soon as we get on screen, because I do I work almost entirely virtually now. I can tell within 10

virtually now. I can tell within 10 seconds if they're on plan or off plan because yeah, by how they're holding themselves, their

look on their face, their tone of voice.

Um and uh so it it really is a lot more powerful than than people realize. You

you bring up a really interesting point because uh when I had my clinic and I started teaching fasting, I could literally tell when the person walked in

the door and was sitting in my waiting room if they were in a state of ketosis like and and I would look at them and I'd be like, "You're doing it, aren't you? You're fast." Because I I taught it

you? You're fast." Because I I taught it through fasting and then I taught carb cycling and all kinds of changes to it.

But you you could see it in them. It's

like you c it's like on one hand they can't lie to you because you can see if they're not doing it. But then on the other hand just to look across the room

you could see the vibrancy and and the and the alertness the and the happiness.

And this is where when people start to break the ketogenic diet down or even fasting down. I'm like, you got to try

fasting down. I'm like, you got to try it and then you come back and tell me how it feels because there's no drug on the planet that can give you that lift like ketones do.

Thank you for saying that. That is a great point and we talked a lot about this last time I was on uh on with you is how many how that the many many many

of the same or similar benefits from fasting and ketogenic diets is that you're in ketosis in both in both of those cases, right? And so the ketones are being in ketosis is a different

state of mind. It's a different state of mind. It's a superior state of mind.

mind. It's a superior state of mind.

Yeah. Thank you. You said it. I think so too. I think so too.

too. I think so too.

It really is. People feel better. They

sound better. They uh they get more done. They are better able to deal with

done. They are better able to deal with stress, better able to recover from from uh from uh difficult events in their lives. And so, I mean, person after

lives. And so, I mean, person after person after person that I've worked with has told me, you know, it's not like my life changed. I mean, it's, you know, I'm still in I still have a difficult relationship or I'm still

having trouble at work or my kid is still sick, whatever it is, but I but I don't feel the same way about it. I can

step back from it and I can get get I have like a buffer and I can think through, okay, how am I going to how am I going to work with this today? And you

start to imagine more options. You feel

more flex flexible in your thinking and you feel more capable. You feel more confident and you're less likely to let things really get you down.

Agreed. Agreed. Did your group look at ketones compared to medications at all?

Have we done those kind of analysis?

Not really. No. Um but so I mean you can look at them separately, but they haven't been compared head-to-head. So

we don't yet have any studies where you take a group of people with a mental health condition. Let's say you take a

health condition. Let's say you take a group of people with major depression and you put half of them on a medication and you put half of them on a ketogenic.

We haven't done that yet. Um so uh but what we can what we what has been done for example uh is in fact in just about every study that's been published um in

the field of metabolic psychiatry that's this field that we're in um is uh in almost every case whether it's been a clinical study or whether it's been case

reports or case series that have been published the ketogenic diet has been added to existing treatments. So the

person is already in counseling. They're

already taking 1 2 3 4 five medications and then you add the and and and they're not really responding.

They're, you know, they're not getting much relief uh from those conventional treatments.

You add the ketogenic diet and they improve. So

improve. So off they're going. Yeah. And so this it it it's in fact there was just a study published um there actually several different studies but a study was just

published out of Oxford University a few weeks ago first ever um what's called a randomized control trial which is a more rigorous kind of uh clinical trial where

they took people with so-called treatment resistant depression which just means they have not responded to two at least two different anti-depressants. Um, so they took this

anti-depressants. Um, so they took this group of people with treatment resistant depression. They divided them into two

depression. They divided them into two groups and they put one group on a ketogenic diet. Well, they 30 grams of

ketogenic diet. Well, they 30 grams of carbohydrate per day and they put the other group on this diet that they made up called the phyto diet. And the phyto diet

was just supposed to be like a placebo, like a sham diet that wasn't supposed to do anything, but that people who were in the study would believe it would do something. They said, "Oh, you you have

something. They said, "Oh, you you have to eat one extra colorful fruit or vegetable every day and you have to, you know, replace your cooking fats with olive oil and that's going to be really

good for your depression." So, um, the interesting thing about this study, um, not too surprising, but interesting is that both groups got a lot better.

Both groups got a lot better. The group

got even better, like both groups got better. and and if you had very serious um severe depression, the keto group got especially got much better than the

other group. So you saw some separation

other group. So you saw some separation there. But what this really tells us is

there. But what this really tells us is that, you know, and this happens a lot when you enter a study and people are people are um paying attention to what you're eating and you're trying to of

course you're going to make a lot of changes and you're going to feel supported and you're g you're going to you're going to get better if you pay attention to your diet and if other people are supporting you.

So good.

Really hopeful. Hopeful.

Yeah. Where do you think the GLP1s fit into this? You know, they've become so

into this? You know, they've become so popular and my take is that I can see the benefits, but I also see how all the

fasting lifestyle I've taught people has given a very similar result to the GLP ones can can accomplish. We're we're

seeing hemoglobin A1C come down. Um and

and yet we're seeing some statistics like depression actually goes up because people don't have been using food to help their depressive symptoms. So how

do we fit the GLP1 conversation into into this conversation we're having?

Well, yeah. You know, GLP1s are popular because they work, right? So and and how do they work? They help people eat a lot less.

Yeah, that's the problem. So why are we eating so much more than we need?

Yeah.

Right. So if we need a drug to turn down our appetite, why is that? And and and are you going to do that for the rest of your life?

Are you going to put kids who are overweight and obese on on I mean this we can't medicate our way out of this overeating pandemic. Well said. Well said.

pandemic. Well said. Well said.

Why are we overeating? And so

something is wrong. And it's not because we don't have willpower or it's because the foods we're eating make us hungrier.

They they make you hungrier. And so you you want to eat foods that that are satisfying, that are real, whole foods.

We've been doing that for two million years. And suddenly in the past 50, 75

years. And suddenly in the past 50, 75 years, we're we're not eating food anymore. We're eating factory processed

anymore. We're eating factory processed ingredients. that start out as whole

ingredients. that start out as whole foods, but they don't behave like foods in the human body because they've been concentrated and extracted um powdered and liquefied and crystallized and

that's not what we're supposed to be doing. And they they really throw off

doing. And they they really throw off your appetite regulating mechanisms. Yes. So, they make you more I think they

Yes. So, they make you more I think they make you more hungry is really important. I just did a video on YouTube

important. I just did a video on YouTube about that and I think it was 600 calories more a day. somebody will eat if they are eating an ultrarocessed uh

diet compared to a whole foods diet. So,

and a lot of people who eat ultrarocessed foods diet diets think they're saving money because it's cheaper food, but you actually become more hungry and you're eating more food

than if you spent it eating a whole foods diet.

Thank you. That's exactly right. And

people always say, "I can't afford to eat real food." Well, you can't afford not to eat real food, right? Right. Well, we were not even

right? Right. Well, we were not even talking about the medical bills you'll have to pay for.

Exactly. The the co-pays and the doctor's visits and the surgeries and the hospitalizations and injuries and everything else. So, but yes, actually

everything else. So, but yes, actually there was a study um of people with with uh Alzheimer's disease um where they put half the group on a ketogenic diet and they put the other half into a regular I

think it was a low-fat diet. I can't

remember what the diet was would being compared to. It was kind of more of a a

compared to. It was kind of more of a a standard diet. And uh and they said, you

standard diet. And uh and they said, you know, you can eat as much as you want.

We're not going to limit how many calories you eat, but just, you know, this group on the ketogenic diet and they were just going to look at memory testing, right? And so um the group on

testing, right? And so um the group on the ketogenic diet did a little bit better on the memory testing, not a lot that we could talk for a long time about that, a little bit better. But what was

remarkable was the group on the ketogenic diet, without anybody telling them to and without them trying, they naturally ate 550 fewer calories per

day. Yeah. Yeah. The hunger goes away.

day. Yeah. Yeah. The hunger goes away.

The first time the GLPs came out, I was like I went to my to people that I knew that were on them. I'm like, "Tell me what you notice." And they're like, "I'm not hungry." I'm like, "Yeah, that's

not hungry." I'm like, "Yeah, that's what happened to me when I started fasting. I was my hunger went away."

fasting. I was my hunger went away."

Like, we used to have a joke in my clinic when somebody would come in and they'd lost 30 pounds in a short period of time and they're like, "And I'm not even hungry." I was like, "Shh, don't

even hungry." I was like, "Shh, don't say that too loud. You might upset some people in here." So um so you know for me I think we don't give the body enough

credit what it's capable of doing when you give it the right fuel source and we've given GLP1s are all the heroes and yes they've helped some and save a lot

of lives but to your point what's the exit ramp and um how can you do this on your own to take your own power back and save your own money so right the exit ramp and so there was

another study sorry I'm saying a study yeah yeah no I love your studies study nerd. But the but the um another study

nerd. But the but the um another study by Verta Health, that's a a virtual uh type two diabetes clinic that uses low low carbohydrate diets to to help people get off diabetes medications and manage

their glucose levels and lose weight.

Verta Health published a study two years ago, I believe it was, where they took people who had responded nicely to a GLP-1. They'd lost weight. they gotten

GLP-1. They'd lost weight. they gotten

their glucose levels under better control and and then they switched them to a low carbohydrate diet and they were and and took them off the JLP1 and they were able to maintain all

of those benefits even a year later.

So that's that's a great exit frame and it's not the only one. I mean, as you and I have talked about before, there are a lot of similar benefits to intermittent fasting compared to

ketogenic diet. So whatever works best

ketogenic diet. So whatever works best for you, but that's right. Make sure

that you are finding a way to keep your glucose and insulin levels in a healthy range and to keep your metabolic health where it needs to be and so that and and you're eating in a way that that's

doesn't make you hungry, right? Yeah. So, I mean that's such a

right? Yeah. So, I mean that's such a let's just think about that con that statement. Eat in a way that doesn't

statement. Eat in a way that doesn't make you hungry. People eat because they're hungry, right? But but I always think and the way this is literally the

way my brain thinks when I eat a meal I ask myself how do I want to feel two hours from now.

Yeah.

Right. Like I'm like I'm not just eating for my taste buds. I'm eating for performance. I'm like how do I want to

performance. I'm like how do I want to feel two hours from now? And sometimes

I'll dip in I I'm gluten free but sometimes I'll dip into a bowl of gluten-free pasta knowing two hours from now I'll be sitting on the couch watching a movie. I don't really care how I feel. But if it's during a

workday, I'm very methodical about what I eat so that I don't get that glucose too high.

Then you have control. So you understand if you understand your body and how it works and how different foods affect you.

It doesn't mean you can never have that food again. That's up to you, right? It

food again. That's up to you, right? It

just gives you more control. So now you understand, okay, I I want to have this food, but I know I know what it's going to do to me, but that's okay. It's a

conscious choice I'm making. rather than

saying to yourself, I know this is I'm supposed to be eating whole wheat muffins every day because, you know, for fiber.

Yeah. Because my doctor said so, right? And which doesn't make any

right? And which doesn't make any biological sense whatsoever. So, don't

fool yourself into thinking that certain things are good for you. It's okay to to eat things that you enjoy from time to time that might not be it's not about

being perfect. It's about understanding

being perfect. It's about understanding working with your biology and ma and and and having more control.

Yeah.

I love that. I think that's really important.

Well, are there certain groups of people that do better with ketones, their brains do better with ketones than other groups? I mean, we talked about chronic

groups? I mean, we talked about chronic depression and schizophrenia and dementia, but do we have other groups that we know like, yeah, you should be doing ketones?

Well, you know, the thing is that ketones, at least being intermittently in ketosis, we know that that's good for the brain full stop, right? So the brain needs needs to my reading of the science

is the brain needs to be go in and out of ketosis. It needs to spend at least

of ketosis. It needs to spend at least some time in ketosis on a regular basis.

So I think it's good for no matter what the condition is. But the question you're asking is really interesting because um there are like we were saying before some people just need to clean up their diets. Some people just need to

their diets. Some people just need to get their glucose levels under control.

Some people just need to eat less.

whatever it is, all of those things can be uh can help support better brain health. But who are the people who need

health. But who are the people who need those ketones, right?

And especially who need them in a really good range? And we're starting to get a

good range? And we're starting to get a better feel for this. But the the the short answer is we don't know. But the

but I think a better answer is the pe the people who are going to do best with those ketones are the people whose brains have lost some of their ability to use glucose

for energy to full capacity.

Yes. So, if if you've lost some of that metabolic flexibility and you've burnt out some of your glucose pathways um by overusing them and you've made your

brain insulin resistant by bombarding the your brain with too much insulin too many times over too many years, the brain becomes insulin resistant, becomes harder and harder for insulin to get

into the brain. The glucose can still walt in no questions asked. But now you don't have enough insulin because you're insulin resistant. You know, your brain

insulin resistant. You know, your brain can be swimming in a sea of glucose and still starving.

Yeah.

Because of lack of insulin. So, people

who have lost some of their glucose processing capacity, they really need ketones because there is no other molecule that's going to be able to bridge that energy gap. You if your

brain is having trouble burning glucose, more glucose is just going to make the problem worse, right?

You need ketones are your only hope.

Yeah, Obi-Wan Kenobi.

I love that. I am like, "Amen, sister."

I You know, I So, I just since we last talked, I published another book called Age Like a Girl, and it's all about time to do this.

I know. Well, I'm I'm on a hiatus from work bookw writing for a while. I'll

send you a copy of this one. And I have a whole chapter on fueling the menopausal brain. And in all the

menopausal brain. And in all the research I've seen that you we see this as estrogen goes down. I would put menopausal women in the category that

you just said, the menopausal brain cannot use glucose as efficiently as it used to. And then I paired that I paired

used to. And then I paired that I paired that thought with I was actually on a podcast back in January with a neurosurgeon and she says to me, "Did

you know that when a woman's brain goes through menopause and those neurons start to prune away the old neurons?"

Because there is a pruning process.

These neurons get pruned away making room for new neurons to form. the

degeneration of the neuron in the menopausal brain, the byproduct of that is a ketone.

The brain, and I I'm I've been dying to ask you this because basically she's saying that the brain knows it's rewiring itself. It knows it's getting

rewiring itself. It knows it's getting rid of these neurons it no longer needs.

Many of them are those in are in inside the hippocampus. Some of them are in the

the hippocampus. Some of them are in the amygdala areas that were that kept us addicted to people pleasing and

performative mode. We get this pruning

performative mode. We get this pruning away and the brain is so intelligent that it knows that there's a shift happening that is going to require the

fuel source of a ketone.

Well, what I I I haven't looked at that.

So, it's I've written it down because I'm I'm Yeah, I'll send you the study.

Thank you. Um, so but but what I can tell you and which lines up perfectly with what you were just saying is that when you're in ketosis, remember we were talking before about how the brain

enters a a a healing mode um where you're recycling and regenerating and cleaning up and maintaining and that sort of thing. Um, one of the things that happens in ketosis is levels of a

growth factor in the brain called BDNF or brain derived neurotrphic factor.

It's kind of like fertilizer for the brain and it helps you sprout those new connections and create those new circuits. Um, and so that's what's

circuits. Um, and so that's what's responsible for something called neuroplasticity where the brain is rewiring itself and remodeling itself.

If you're not in ketosis on a regular basis, your BDNF levels will be lower.

And so if you want your brain to be able to remodel itself and rewire itself and heal from injury and create new connections, which is essential for learning and memory, the way you learn

or memorize something is you have to create a new circuit that understands what that new word was or that new skill was.

Um, so that requires building a new little circuit. And you can't do that

little circuit. And you can't do that unless you've got a some insulin coming into the brain. So, you can't be insulin resistant, right?

You've got to have um you got to spend some time in ketosis to get the brain derived neurotrophic factor up because that th those those new

sprouting those new connections requires BDNF. So, um lots of reasons um why um

BDNF. So, um lots of reasons um why um uh it's good for everybody to be in ketosis um from time to time, but especially you know the pmenopause

and postmenopause. One of the major

and postmenopause. One of the major things that happens for women I'm and I'm sure this is a major focus of your book is that you know we become more insulin resistant.

Yeah.

And you know the the shape of our bodies change that our metabolism changes and we catch up to men. Men are men who tend to gain weight around their midsection even when they're younger. Women tend to

gain it in their hips and thighs but then when they go through menopause everything changes. So women become more

everything changes. So women become more insulin resistant as estrogen falls away and so that is a major challenge for a lot of women to maintain their metabolic

health.

Yeah. I was just curious do we have any research showing waist circumference because that seems to be for both men and women as they age that seems to be

where fat accumulates more easily. Do we

have waist circumference and cognition or dementia? Do we have have we seen any

or dementia? Do we have have we seen any studies that are showing the bigger your waist, the more cognitive decline is happening?

Oh, what a great question. I'm going to say I don't know, but I bet I bet we do, but I don't have it at my fingertips.

I'm going to I'm going look it up, but that's a great question because I bet there is. I know that there is for

there is. I know that there is for glucose levels um but I don't know if there is for uh waist circumference in particular but I wouldn't be surprised

because I'm thinking it's visceral fat and it's the out expression of metabolic dysfunction. So if you want to know if

dysfunction. So if you want to know if your brain is suffering from metabolic dysfunction my intuitive sense would be look at your waist circumference you

know what are we seeing there? Yeah, I

mean waist circumference is a really good marker of insulin resistance. It's

not perfect, but it's very very good. I

mean, there's no one perfect marker for insulin resistance, but but waist waist to height ratio. So, if your waist is more than half your height, um then that

then you're very likely to have insulin resistance. And uh and and often that's

resistance. And uh and and often that's has to do with visceral fat, the fat around the organs and fat in the liver.

And um you know and I think what a lot of people don't realize again is if you if you're eating too much carbohydrate for more than you need more than your personal metabolism can handle and

that's going to be a different level for every person. Then every single extra

every person. Then every single extra molecule of carbohydrate that you eat that you can't burn or store right away your body turns into your liver turns it

into saturated fat.

Right? right there on the spot because there's else to put it, right?

Where else to put it? So, it's just doing the best it can with a difficult situation. So, really want to make sure

situation. So, really want to make sure that you're not eating more than you need. And it again, it doesn't mean that

need. And it again, it doesn't mean that everybody needs to be on a ketogenic diet. Um, it just means that what it

diet. Um, it just means that what it means most people are eating so much more than they can handle and process that of course where else is it going to go? has to go somewhere,

go? has to go somewhere, right? What how do we support uh the

right? What how do we support uh the communities that either are like a lot of uh women that follow this podcast have aging parents with Alzheimer's

and also may have grandchildren who have, you know, ADHD. And I look at those two groups of people and sometimes

it can look impossible to keep put them on a low carb diet or to even have them intermittent fast. Um did your group

intermittent fast. Um did your group look at all at the possibility of exogenous ketones or how we help those two populations that might really struggle to get on to a keto ketogenic

diet?

Yes. So there have been a number of studies um in Alzheimer's disease and mild cognitive impairment. So mild

cognitive impairment for people out there who who don't know that's you can think of it as kind of pre-dementia the way pre-diabetes and diabetes you know so um mild cognitive impairment about

10% of those people every year will go on to develop an Alzheimer's disease diagnosis or dementia diagnosis and so um they've done studies um of ketogenic

diets in both of those types of types of situations and they've also done studies of exogenous ketones and MCT oil in those situations.

And so we still don't have a large randomized control trial and and I believe one is in the works um for the ketogenic diet but um but uh we still

don't have a an a well conducted large randomized control trial which would be wonderful in this in this population.

Yeah. But the studies we do have, they show promise. Meaning that, you know,

show promise. Meaning that, you know, there are lots of people in that situation, as you said, who, let's say they're in assisted living or they're in a skilled nursing facility and they can't change their diet or or they have

enough memory challenges that they can't learn a new diet or can't stick to a new diet. Um uh so and I've had I've had

diet. Um uh so and I've had I've had patients in these situations. In those

cases where the person either can't or chooses not to follow a ketogenic diet, exogenous ketones and MCT oil are going

to be your best bet because they can raise ketone levels even if you're eating a a high carbohydrate diet. So,

it's better than, you know, it's it's not it's not perfect, but it's better because those ketone the brain is still going to appreciate those ketones even though your glucose levels are still too high

and your insulin levels are still too high because you're eating the wrong foods. you'll your brain will be getting

foods. you'll your brain will be getting some ketones and those ketones can energize help support better brain energy and can you can see this in the

studies can support um some degree of improvement in in cognition and mental clarity. Yeah. And that's what we used

clarity. Yeah. And that's what we used to do in my practice. A lot of people would ask about well what about my mom you know she's in first stage of Alzheimer's and we would we would try

exogenous ketones and you know this was like 10 years ago so it was like there wasn't a lot out there about it and um you would see some brightness come back

and I think it's it's an interesting approach even I was even thinking as you were talking about like TBI people who have had concussions if the brain is is

definitely searching for energy And it feels like a ketone would be really helpful.

Yeah, there's some there's some early research on that, too, that the ketogenic diet has tremendous potential for a traumatic brain injury again because when you're in ketosis, you enter healing mode, and that's what you

need if you've had an injury. You want

your brain to heal. Um, and so, uh, yeah, and I'm actually working right now with a patient who, um, had a concussion from a car accident, um, in August. And

so, I'm excited to see what made possible for him. Um the uh it always makes sense.

It always makes sense um to consider a ketogenic diet no matter what the brain condition is.

Um it doesn't mean it's always going to be the right thing to do or the safe thing to do or even the feasible thing to do, but it's always the right thing to consider. And that's where our

to consider. And that's where our consensus um expert consensus comes in because there are situations where you don't necessarily want to just jump right to a ketogenic diet or and and and

there are many situations where you're going to need some extra knowledge and skill in order to be able to do that safely.

Yeah. Why do you think the ketogenic diet was dismissed is what I'm going to say.

I've been teaching ketogenic diet to my patients for 15 20 years. It's got its roots in epilepsy. Um, I mean there's so much good research, but it seemed seems

to me as it became more of a fad, just like every nutritional strategy is everybody's all excited about it and then people start criticizing it. Why do

you think people went after the ketogenic diet?

Oh my gosh. Well, lots of reasons. I

mean, first of all, um, there's a lot of confusion and misunderstanding about what a ketogenic diet is. I mean and and and like any diet there are there are healthy ways to do it and unhealthy ways to do it.

Same same thing with fasting. I mean any any nutritional approach can be done well or less well and so so um you know you can eat a

ketogenic diet where all you're eating is keto junk foods all day long. um you

know and you're and you're overeing all day long and you're never giving your body a break and you're eating all the wrong foods and you're eating too many calories and you're eating all the so there's a that's not the right way to do

it. Um there are other versions of

it. Um there are other versions of ketogenic diet especially the the original version which 1921 the we think of the ketogenic diet as a weight loss diet but as you were saying was

originally designed over a hundred years ago to stabilize brain chemistry in children with severe epilepsy and which it actually is extremely

helpful in those cases. So, what better, you know, what what better uh evidence do you need that the ketogenic diet can stabilize brain chemistry um than

stopping seizures? And so, um yeah, it's

stopping seizures? And so, um yeah, it's uh the ketogenic diet, the original version of it was very strict and extreme.

Yeah, it was like it was like 10 10 grams of net carbs. It was it was almost Atkins. It was like just just eat meat.

Atkins. It was like just just eat meat.

It was Well, unfortunately, no.

The original version of it.

Oh, the original original.

The original. We're talking

way back 1921. The original version was designed to get as close to fasting as possible while still providing some nutrition for these children because all they knew at that time was that fasting

helped with seizures.

But you can't fast forever. And so what do you do? So what do you feed the child? And so they what this was was a a

child? And so they what this was was a a diet that was designed to get ketones into a very high range 5 to 8 mill mole per liter very high and keep them there for a year

or two. Um wow and I know and so it it

or two. Um wow and I know and so it it required not just bringing carbohydrates down to about um five uh four or five%

of calories. It required minimizing

of calories. It required minimizing protein, bringing protein down to about um I want to say I think it was about six% of calories far too low.

And so for sure so it just wasn't nutritious enough. It

wasn't enough protein to support growth and reproductive pathways. So you saw side effects and so again that so there's criticism of the ketogenic diet

is often rooted in some of those older studies where the diet was very extreme and not nutritionally complete. Um and

uh so so part of this has to do with misunderstandings of the definition and how best to do it and what what the right way is to do a ketogenic diet. But

another I think another source of criticism about the ketogenic diet is that it's often misunderstood. Well, you

have to eat red meat and you have to eat dairy. No, you don't.

dairy. No, you don't.

Nope. Nope.

Ketosis is not about plants and animals.

You can have a vegan ketogenic diet. You

can have a ketogenic diet. Y

it's not about the plants and animals.

So and and a lot of people, you know, are are have strong reactions to diets that that include animal foods and and that's and so there's that backlash.

The third backlash is people love carbohydrates. And so they're like,

carbohydrates. And so they're like, let's make that bad, right? Like, oh, you that can't be good

right? Like, oh, you that can't be good for you. I you know, so there's an

for you. I you know, so there's an emotional reaction to it. It's like, oh, really? I can't imagine living without

really? I can't imagine living without these things. Really? I can't ever have

these things. Really? I can't ever have these things again. And so,

yeah, I think there's a lot going on there.

Yeah. And that's why I actually switched over the years of talking about ketosis more from a fasting lens because I look at a 24-hour cycle and I'm like, you have a fasting window and you have an

eating window. When you switch into that

eating window. When you switch into that eating window, you get to decide what you're going to eat. If you want to stay in ketosis, then you're going to need to look at keeping that carb count down.

So, but for that exact reason is that the confusion, the blame, and I was like, "Okay, let's just stop talking about the diet and let's talk about how you can use fasting to get into

ketosis." And I found that people were

ketosis." And I found that people were more receptive once I did that.

Oh, yeah. I mean, there So, you have to know who you are, right? So, some people are all or nothing people and and they it really helps to have those those black and white lines. Okay,

I'm going to not eat during this window and then I'm going to eat what I what what I enjoy during this window. and

that's how I'm going to manage my metabolic health. That's how I'm going

metabolic health. That's how I'm going to get healthier.

There are other people who um and and I would count myself in this group.

I can't go back and forth because it I just it's too triggering for me to be able to include some carbohydrates. I I

I'm I'm too addicted to them and I it becomes difficult for me to to stay in that lane. And so, um for me, I know

that lane. And so, um for me, I know myself because I've tried it many many times. It's just too hard for me. So,

times. It's just too hard for me. So,

and I feel better when I just kind of stick stay in ketosis. But the um uh I think that you know there are different ways to get into ketosis. Fasting gets

you into ketosis. Intense exercise can get you into ketosis.

Well said.

Calorie restriction get you into ketosis and a ketogenic diet get you into ketosis. And so, um you know, choose the

ketosis. And so, um you know, choose the methods that work best for you. But

however you can get there, make sure you spend some time there because that's I really think is going to be the key for most people as you say to kind of unlock

unlocking their own good health. Like

they we we all have access to this. We

just need to find the best way that works for us to our rhythm. Yeah. H how is the mental

our rhythm. Yeah. H how is the mental health community taking this good news of the ketogenic diet and ketosis? I I

I'm assuming this this consensus, expert consensus was important probably in a large way to your own community to say this is what we are

finding as protocols. But do you think we're still years away from the mental health world, psychologists, behaviorists, psychiatrists really accepting this diet as treatment?

I think we're probably two to five years away from that. And the reason I say that is because it's already changing.

The every time the study comes out, um, more and more people hear about it.

And, you know, there are studies being done around the world at some of the most prestigious institutions.

um uh you know Harvard, Stanford, the University of Edinburgh in Scotland, James Cook University in Australia, Leiden University in the Netherlands, I mean I could go on and on and on.

Oxford, I mean there just uh this is a reputable field of academic exploration where we're seeing really promising results in conditions which where a lot

of people have lost hope.

Right. Right. the treatments we currently have, it's not that they don't help anybody. It's that they they do

help anybody. It's that they they do unfortunately they're extremely limited in what they can do for people and they they come with tremendous side effects and um and

and they they unfortunately fall short for most people.

Yeah. So we need another way forward.

And so I think there is the every time a study comes out it kind of chips away at that either lack of awareness or that resistance or the the worry about these

diets for mental health. And so I think it's and as the the next study that's going to come out is going to come from James Cook University in Australia is going to be a 100 patient very very

carefully conducted randomized control trial of ketogenic diets in bipolar disorder in schizophrenia conducted by very careful reputable researchers.

Amazing.

I'm very curious to see what the response will be to to to that study when it comes out. Um and so uh I mean I in very in a very short period of time I

think that any clinician in the mental health space who does not know about ketogenic diets and is not able to talk intelligently with their patients about them is going to be left behind.

Yeah. Yeah. And I and you know there's I've watched nutrition trends my whole life. I've been fascinated with

life. I've been fascinated with nutrition since I was a young girl.

Well, I I actually went to the Pritikin diet and did the whole Pritikin diet.

Yeah. When I was 16 years old. I've like

just because I wanted to understand. I

just love how diet makes us feel. And

you see diets come and go and you see some stand the test of time and this one standing the test of time. And yes, it's had some arrows. Ketogenic diet has had

some arrows at it. But I think the way you describe that is that we're going to start to see more and more people come back to it and find their own rhythm

with it because this is not prescriptive of keep your carbs at 10 grams. This is like you said, it could be fasting, it could be exercise, it could be plant-based, it could be carnivore. And

I think that's so important, the flexibility of it.

Oh, yeah. I mean, you know, I I'd like to say I'm nutritionally pro-choice, you know.

Yeah, right. That's good.

So, you know, it's it's I you know, uh whatever diet you feel most com whatever dietary pattern you feel most comfortable with as long as it doesn't involve like Twinkies and Oreos and things like that.

That's right.

Um there's a way there's a way for you there's a way for you to design a ketogenic diet to um to suit your dietary preferences. And so um everyone

dietary preferences. And so um everyone can access the healing benefits of ketosis regardless of their dietary preferences. Um and the the reason why

preferences. Um and the the reason why we why we published this expert consensus what was I mean partly for clinicians who uh around the world who

they have their patients coming to them and saying I've heard ketogenic diet might help me with my depression or my ADHD or my bipolar disorder whatever it is um can you can you uh can you work on

this diet with me and and they may not have any experience or knowledge yet about it. So, we said, "Okay, this here

about it. So, we said, "Okay, this here is how you would approach that situation. Here are the lab tests you

situation. Here are the lab tests you would get. Here are the things you're

would get. Here are the things you're going to think about. Here are who these are the people who are going to be good candidates. Here's the people going to

candidates. Here's the people going to need extra monitoring. Um, this is this is what you're this is what you're going to be looking for and this is how long you should try it and this is all kind of those

just practical information for clinicians, but also for patients. So

patients who go to their psychiatrist or their therapist or their primary care and say, "I want to do a ketogenic diet for mental health." And they look at you like they've never heard of this.

And they can bring this paper. It's an

open access paper. Bring this paper.

It's free. And you know, um, and and hand it to them and say, um, would you be willing to learn more about this and help me with this? Because there are

many situations where you you're not going to want to start a ketogenic diet on your own without professional support, especially if you are taking

any kind of prescription medication or if you have any kind of medical health issue, a high blood pressure, cardiac disease, type 2 diabetes. I mean all

kinds of situations where the medicines and your health condition is going to need to be carefully monitored because beautiful.

This is a powerful intervention which is of course exactly what you want but you but you want it to be safe and comfortable in the the first couple of

weeks. You kind of have to navigate

weeks. You kind of have to navigate the the the rocky shores of of the diet first just you can get to that other side in that better state of mind that you're looking for.

It reminds me of the New England Journal of Medicine did something very similar with fasting about six years ago where it it was a metaanalysis. They actually

went in and looked at several different studies and just came out with a prescriptive plan that was like these are the five conditions.

Neurodeeneration was one of them that we you should consider intermittent fasting for and they even have if you go and look at the study they have protocols.

They show like do this week one, week two. Um, and it really was a

two. Um, and it really was a breakthrough in the fasting community because now doctors were not looking at this as like a fad. They were looking at

it prescriptive like you were talking about. And I'm thinking, wow, now we

about. And I'm thinking, wow, now we have two really powerful combination that New England Journal of Medicine, which we'll leave the link to that and your expert consensus. We'll leave links

to both of those. And I love your suggestion of take that take that to your doctor and say, "Can we talk about this and I just think what you did is

gonna accelerate doctor's willingness to take this in as therapy."

I hope so because um you know these are it's a really powerful tool that you can add to existing care. So you don't That's right.

you don't have to pull the baby out with the bathwater. Yeah. So if the therapy

the bathwater. Yeah. So if the therapy is working, if the medicines are partly helpful, it's not about either or or you know this is better than that. It's

about another tool in the tool box and a really powerful one. And so um you know it it I think it's really for I think there are a lot of clinicians out there who are curious about it but they just

don't have the experience um or the or the information they need to be able to feel confident in supporting their patient. So that's why we published this

patient. So that's why we published this this document is to to support clinicians and patients around the world who want to explore the potential of

this really powerful metabolic intervention. Feel like like I've got a

intervention. Feel like like I've got a kindred ketone sister here.

Yeah. Yep.

I really because I've watched from a different lens. I've watched millions of

different lens. I've watched millions of people heal themselves with fasting and it it's hasn't been all weight loss. I

mean, we it's it's a combination and brain brain health is a big piece of people's result.

Well, you know, there's nothing wrong with wanting to lose weight, right? Who

who is overweight that doesn't want to lose weight, right? So, right,

but and the wonderful thing is that you get these wonderful side effects, side benefits.

So, yeah, you're going to lose some weight. That's great.

weight. That's great.

And guess what else? Your mental health is going to improve. Other your other aspects of your physical health is going to improve. You're getting all these

to improve. You're getting all these side benefits. And so, um, all kinds of

side benefits. And so, um, all kinds of things are going to get better. And hey,

you're gonna look better and feel better, too. So, you know, what's not to

better, too. So, you know, what's not to love?

It works so well. I always say when I tell people they're like, "Oh, I'm interested in fasting." I always say, "Yeah, if you want to come for the weight loss, that's great, but stay for the rest of the results. Don't leave

after the weight loss because there's so many incredible results." So,

so many things to look forward to and that people have can access. like you

said is if you trust your body um and you give it what it needs, it will respond.

Yeah, you can. It will. It knows it knows how

you can. It will. It knows it knows how to heal itself if you get out of its way.

Oh, it's so true. It's so true. Well,

Georgia, I love talking to you. How do

people find you? I know I mean you've got the book Change Your Diet, Change Your Mind. What else are you up to? And

Your Mind. What else are you up to? And

um if people want to dive into your work, where can they find you?

Yeah, so uh I I have a website which is uh um Diagnosis Diet. Uh that's the name of my website um that you can find information about the book there, but you can also find all kinds of writing

there. And I I teach a a course, a CME

there. And I I teach a a course, a CME accredited course for clinicians and ketogenic diets for mental health. Um

and so uh that's between the course and the book and writings and conferences.

I'm going to be speaking at a couple of conferences coming up. I don't know when this episode airs in Italy in uh in at the end of April and in London at the end of April. uh speaking at a couple of

metabolic health conferences because the book is coming out in Italian um which is really exciting. Yeah, that's

Italian. That's fun for me. But uh um so so there'll be a conference in Italy where where the book will be coming out at that same time and then an integrative uh health conference in London.

I'm just convinced on the power of ketones more than ever and uh when I saw the new consensus come out, I was like we got to bring this back to the surface. Great. I I really appreciate

surface. Great. I I really appreciate it. Thank you. I hope it's helpful to

it. Thank you. I hope it's helpful to people.

Yeah. Thank you. Appreciate you.

Thank you. You too. Bye, Mindy.

Bye.