Is a Low Carb High Fat Diet Heart Healthy?

We hear the words Heart Healthy a lot, especially when it comes to our nutrition.

 

By now, you’re likely used to seeing cereals with the “heart healthy” moniker. Is it really heart healthy? We all too frequently refer to foods as “heart healthy”, or we say that our doctor gave our hearts a “healthy” checkup.  

 

It all sounds nice. But what does it mean? How do we define heart health?

 

How does LDL Cholesterol affect Heart Health?

 

Unfortunately, most of our current definitions center around LDL cholesterol concentration.  While LDL cholesterol plays a role in heart health, it by no means defines heart health in totality.

 

In fact, in many cases it is the least important factor.

 

Our healthcare system has simplified things too much, so as a result we focus on one bad guy, one demon to fight. In reality heart disease is caused, and made more likely to occur, by a constellation of contributing issues.

 

Elevated blood sugar, elevated insulin levels, inflammation, high blood pressure, poor nutrition, and yes, lipids all contribute to heart health.  It does us all an injustice to over simplify it to one single cause.

 

What food is heart healthy?

 

Our superficial definition of cardiac risk is how industrial seed oils containing polyunsaturated fatty acids (PUFAs) became known as “heart healthy.”

 

Studies show that they can lower LDL. But they can also increase inflammation and have no clinical benefit and even increase risk of dying. According to our simplified definitions, that doesn’t stop them from being defined as “heart healthy.”

 

 That’s right! Something that increases our risk of dying is still termed “heart healthy.”  How’s that for a backwards medical system?!

 

Same for blood sugar. If you have a diagnosis of Type 2 Diabetes (DM2) that is a risk for cardiovascular disease. If you don’t have the diagnosis, you are fine. That ignores the disease of insulin resistance that can predate diabetes for decades and increases the risk of heart disease and possibly even cancer and dementia.

 

Cereal can also be called “heart healthy” as they may minimally lower LDL. But is that a good thing if they contain grains that also worsen your insulin resistance and metabolic syndrome? I say definitely not.

 

Time has come to stop this basic, simplified evaluation and start looking at the whole picture.

 

How Low Carb High Fat Diets Improve Heart Health

 

Low carb high fat diets have been vilified as they can increase LDL. But the fact of the matter is that it does so only in a minority of people. The truth is that they can improve everything else!

 

These diets reduce blood pressure, reduce inflammation, improve HDL and triglycerides, and reverse diabetes and metabolic syndrome! Shouldn’t that be the definition of “heart healthy” we seek? Instead of focusing on one isolated marker, shouldn’t we define heart health by looking at the whole patient?

 

Only by opening our eyes and seeing the whole picture of heart healthy lifestyles can we truly make an impact on our cardiovascular risk and achieve the health we deserve.

 

Join me in demanding more. Demand better.

 

Thanks for reading,

Bret Scher, MD FACC

Is LCHF Keto the right diet for you in the new year?

With New Year’s resolutions looming, many people are thinking about reinvigorating their health. In fact, 45% of people want to lose weight or get in shape as their New Year’s resolution.

The LCHF Keto diet has been quickly gaining momentum, and it is piquing a great deal of curiosity.

So, is this particular diet right for you? It may just be.

 

What are your diet goals?

Before selecting a diet, it’s important for you to define why you want to diet in the first place. Are your goals weight loss, general health, or a combination?

If you want to lose weight, reduce your hunger, enjoy your meals, and improve your metabolic health, then LCHF may be right for you.

 

Do you want to lose weight?

The primary reason most people go on a diet is to lose weight. As far as weight loss, low carb has you covered. Out of 60 studies comparing low carb to low fat diets, low carb had better weight loss in 30 and they were equal in 30. Low carb was inferior in exactly zero of these studies. That’s an impressive record, and definitely something to consider if weight loss is your primary goal.

But there is so much more to life and health than weight loss.

 

Do you want to reduce your hunger?

One main struggle in health and weight loss is how hungry we are and how much we need to think about food during the day. Studies show that following a LCHF diet reduces our hunger in the long-term. That means less worry about constant snacks, and less concern with needing to eat every few hours. In fact, LCHF works so well at curbing appetite that more people can practice time-restricted eating by compressing eating into a 6-8 hour window, which has indicated potential beneficial effects for longevity.

 

Do you want to improve your focus?

Food, especially the wrong food, can make us feel lethargic and unfocused. Many people report thinking more clearly and having better mental performance when on a low carb diet. The brain loves ketones, whereas carbs can cloud your thinking. Why not switch to low carb and see if your brain fog lifts?

 

Do you want to improve metabolic health?

A recent study showed that only 12% of Americans are metabolically healthy. Low carb diets are one of the fastest and best ways to improve metabolic health. Studies show it puts type 2 diabetes in remission, improves insulin resistance, reduces visceral fat, and improves overall metabolic health.

 

Do you want to decrease your cardiovascular risk?

Fat phobia is gone. Limiting carbs to real food veggies and eating plenty of healthy fats improves our cardiovascular risk profile. It reduces BP, reduces TG, increases HDL and improves the size and density of LDL, which all add up to a net improvement in cardiovascular health.

 

The main reason you should consider LCHF/Keto in the new year

You will love it!

No counting calories, no feeling hungry, no wild glucose swings and post meal crashes, no afternoon slump. With all of this research backing this diet, it’s definitely worth a try.

 

One last consideration

A note of caution, most people will do great. But not everyone reacts to this diet the same way, so you may want to consult a doctor experienced in low carb nutrition.

If you don’t already have a doctor to consult with or want to speak with one who specializes in Keto, I’m a professional who has extensive experience with LCHF diets and how they affect your health. If you’re just getting started, I recommend downloading my free LCHF/Keto starter tips e-book to get you on the right track:

 

 

 

If we can be of any additional service, please let us know!

Thanks for reading,

Bret Scher, MD FACC

Megan Ramos

Humans have practiced fasting for centuries as part of religious rituals, but the medical community has shunned it as risky and dangerous. Megan Ramos, along with her co-founder Dr. Jason Fung, have embarked on a mission to change all that. At IDMProgram.com, Megan and Jason counsel patients how to use fasting safely to help with weight loss, diabetes, management, and overall health promotion. They recently published a case series showing how they can help people get off their insulin in as few as five days! But fasting can be a double edged sword with significant potential risks of hypoglycemia, loss of lean muscle mass, and feeling awful. Megan helps us understand how to overcome those concerns so that we can benefit from fasting in a safe and sustainable manner.

Does Eating Fat Make Us Fat?

Does eating fat make us fat? According to a new article in The New York Times, it just might. With a heavy emphasis on “might.”

The New York Times: Which kinds of foods make us fat? (Paywall)

The article is based on a trial published in Cell Metabolism over the summer, which concluded that feeding mice up to 80% calories from fat causes weight gain. The same was not seen with higher levels of carbs or sugar intake.

Does this end the debate on what make us fat? Does this prove Gary Taubes and all the low-carb pioneers wrong?

Of course not. For starters, this was a study of mice. So, if you have pet mice, then you should definitely pay attention.

The bigger question, however, is does this trial apply to humans? I would argue absolutely not.

Here is what they found. The mice that ate a higher percentage of fat calories ate more total calories and gained more weight. They also found changes in the mice brains with increased gene expression of serotonin, dopamine and opioid receptors — the so-called “reward” receptors. Simply put, that means the mice found the fat so pleasurable, they ate more calories than any of the other mice and they even increased their reward-signaling pathways to match the pleasure they were experiencing.

Here’s the crux of the problem. Humans do the opposite. That’s right. The exact opposite. A review of 23 randomized trials showed that low-carb, high-fat subjects lost more weight than low-fat subjects, plus trials show low-carb, high-fat subjects experienced less hunger and ate fewer calories than low-fat subjects.

What about the reward center upregulation? In humans, that clearly happens in response to sugar, not fat. Once again, the exact opposite of the findings in the mice study.

The biggest take home from this study, therefore, should be the cautionary tale of using a mice study to predict human behaviors. This is especially true when we already have human studies showing the opposite effect. Low-carb diets help us eat less and lose more weight, and sugar lights up our reward centers like a Christmas tree. We don’t need mice studies to tell us that.

Thanks for reading,
Bret Scher, MD FACC

Originally Posted on the Diet Doctor Blog 

Low Carb and Intermittent Fasting Make Traveling a Breeze!

It's challenging enough to stick to your health, fitness, and dieting goals when you're at home. When you're traveling, it can be even harder. Nothing's worse than going on vacation only to be frustrated that you've gained back weight you worked so hard to lose.

Let's be honest. When you travel, it's harder to pay attention to what you're eating, when you're eating and how much you're eating. If you prepre ahead of time, however, you can make this much easier. Focusing on intermittent fasting, limiting your carbs, and keeping up some version of your exercise routine can put you on a path to success. 

How Travel Disrupts Your Diet

We seem to be traveling more than ever. The U.S. Travel Association reports that spending on travel in the U.S. alone averages $2.8 billion per day. Per day! That's a lot of opportunity to fall off the wagon. 

  • You're likely to be less physically active. While it may seem you're covering lots of ground rushing to the airport and flying (or driving) hundreds of miles, you're also spending most of that time sitting down. It's also common for travelers to abandon their usual workout routines.
  • There are snacks and junk food everywhere. It's tempting to grab snacks at the airport or to worry that you may not have a chance to eat for a while, so yo ugrab whatever is available. Most of these choices are high carb, high sugar distractions. 
  • Your internal clock is disrupted. If you're traveling through time zones, your circadian rhythm is a mess and youo will find yourself craving more, with diminished self control. 

But it's not hopeless! Here are some recommendations for counteracting these issues and staying healthy when you travel.

Limit Carbs When Traveling

We can debate all we want the merits of low fat vs low carb diets. Especially when the carbs are high quality, real food carbs. However, when you travel, lower quality carbs are often the biggest temptation. Simple carbs like sweets, foods made with white flour, and many packaged and processed foods are everywhere. 

  • Bring healthy snacks with you. Instead of relying on food counters at the airport or filling up on junk food at rest stops on the highway, take the time to prepare some healthy meals. Prepare snacks that include superfoods such as almonds and other mixed nuts, salads with broccoli, kale hemp seeds and chia seeds, and perhaps some dark chocolate for a treat.
  • Do your own shopping and cooking. Just because you're on vacation doesn't mean you have to eat out every meal! Don't derpive yourself of trying some new restaurants, but remember you can still do some of your own cooking. Look for a hotel or Airbnb that lets you do at least a little cooking and that has a fridge. This gives you more control over your diet.  
  • Research eating options ahead of time. Before you leave on your trip, identify hotels, restaurants, and eateries that offer healthy and low-carb options. Don't forget to find out when and where local farmer's markets are held. I find that is a fantastic way to check out the local scene and partake in healthy local food choices. 
  • Drink water. Staying hydrated can help combat hunger, and it will keep you away from sodas, juices and other sugary distractions.

Happy friends drinking cocktails and eating watermelon fruit in boat party - Young people having fun in summer vacation - Youth lifestyle and rich tour holiday concept - Main focus on right girl face

Incorporate Fasting Into Your Trip 

There are many health benefits to intermittent fasting. It can help you to lose weight and lower insulin, and there's even evidence that it contributes to longevity. But when it comes to travelling, the best part of IF is the convenience!  If you're fasting, you don't have to worry about finding a healthy meal at the airport or on the plane.  Stick with water and you are good to go!

If you are fasting, do it in a responsible and healthy way. If you're on any kind of medication, consult with a health professional before fasting. If you've never fasted, start slowly. Most people can do an 18:6 fast without too much discomfort. This means fasting for 18 hours and then eating for the next 6 hours. When you get comfortable with this, you can increase the duration of your fasts to 24, 48, or even 72 hours. If you want to try fasting on your next trip, it's a good idea to try some short fasts before you begin your journey. 

Other Tips to Stay Healthy on the Road

  • Exercise regularly. Try to stay somewhere with a gym. Or a neighborhood that has a gym you can use. Even without this, you can schedule in a walk, jog or bike ride. If you're visiting tourist attractions, think of a walk or bike tour rather than a bus tour. Look into places where you can explore nature and get fresh air.
  • Get enough rest. Travel can also disrupt your sleep patterns. Lack of sleep is associated with anxiety, depression, hypertension, and many other health problems. If you're going to be traveling through time zones, start adjusting to the new time before you leave for your trip. When on your trip, be careful not to burn the candle at both ends. If you're getting up early for a long day of sightseeing (or business meetings), go to bed at a reasonable time. 
  • Limit your intake of alcohol. It seems that alcoholic beverages are everywhere when you travel. Whether you're ordering a cocktail to help you relax on a long flight, downing tropical drinks on the beach, or sampling local craft breweries or wineries, the temptations are everywhere. Alcohol is high in calories and sugar. It can also disrupt your sleep patterns. If you do drink, limit it to one or two per day. 
  • Don't stress out. Stress is never healthy and travel, even the kind that's supposed to be relaxing, can contribute to it. Avoid trying to fit in too many activities on your trip. Rushing around tends to make you reach for junk foods for quick comfort or energy. When planning your schedule, leave time for spontaneous exploration or just lounging around. 

Watching your diet when traveling is important, especially if you frequently find yourself on the road. It's easy to slip into bad habits when traveling which means you have to start all over when you return home. It's better if you can stay consistent even when you're away from home. Limiting your carbs, fasting, and maintaining regular exercise and sleep routines all help you maintain optimum health when you travel. 

 

Dr. Michael Arata & Stephanie Kennedy

Dr. Michael Arata, founder and lead physician at Arata Medical, is the most unique radiologist I have ever met. He specializes in limb-salvage interventional procedures, and as such, is the last resort to prevent a patient from having an amputation. Luckily, he realized that he could potentially have an even bigger impact by taking a functional medicine approach to prevention, rather than last minute heroics. That’s when he teamed up with his star health coach Stephanie Kennedy to teach people how to use plant-based ketogenic diets and a wholistic approach to their health to prevent the chronic disease that plague our society. Their upcoming book, Keto with Plants, is an accumulation of their experience and their attempt to help thousands of patients with their message. I love their patient care philosophy, and it was quickly evident that they are experts in helping their clients practically implement lifestyle changes that will help them today and for the long haul. You are sure to learn some valuable tips in this interview!

More False Claims About Keto- Bias and Lack of Evidence Beware!

There is a lot of “Fake Science” out there. It’s clear that we live in an age of misinformation and sensationalized headlines, and it’s often difficult to discern what contains real evidence, and what is lacking. This week, I’m motivated by a particular article by a “reputable” source. Aside from pointing out the specifics of this particular article, I want the larger lesson to be to understand how to read between the lines of an article and search for evidence, regardless of how credible a source may seem.

 

Who’s the Culprit?

 

Harvard Health strikes again with ignorance and false claims. I try not to respond negatively too often, but I couldn’t let this one go.

 

Does talking about an awful publication give it more attention than it deserves? Or is it more important to point out the fallacies for all to see? I don’t know that there is a “right” answer to that question, but in this case the critic and vocal dissenter won out. We can’t let flat out wrong claims perpetuate and become “truth” as happens too often in medicine.

 

Bias in Language

 

  • It starts right off the bat by the language use in this article. “The keto diet aims to force your body into using a different fuel.” Force your body? That assumes your body doesn’t want to burn fat, so we have to force it against its will to do so. That is certainly a “carb centric” view point!

 

Why not say “allow your body to use a different fuel.” The clear assumption/bias is that we are meant to be carbohydrate eating, glucose burning machines. But is that true? Is that how we were meant to be? Snackwells, Nabisco and Tony the Tiger sure think so, but I think evolutionary biology may differ.

 

  • “It requires that you deprive yourself of carbohydrates.” Deprive? There is certainly no deprivation on a wonderful array of veggies like cabbage, Brussels sprouts, cauliflower, broccoli, peppers, green beans, and so on. I also don’t think anyone would complain about the health risks of depriving ourselves of white bread, bagels, candy, cookies, cakes etc. Would Harvard also talk about how vegans deprive themselves the nutrient density found in eggs, fish and meat? I think not.

 

 

Lacking Evidence

 

Next comes the section on “Keto Risks.”

 

 

  • Saturated fat is the obvious one, and I have written enough about that one to not address it in this post. You can read more here, here, and here. The article also seemingly adds a source with what sounds like evidence, but provides no link to the study.

 

  • Liver problems. How could they reference “liver problems” with no references or specifics and fail to mention that LCHF is one of the best nutritional interventions to treat fatty liver, the fastest growing cause of liver disease in the country. And what does “liver problems” even mean? It seems clear that there is a clear lack of understanding here.

  • Kidney problems. The only concern of too much protein is in individuals with complete kidney failure. In healthy individuals, high protein consumption can increase the renal filtration rate, but there is no evidence to show resulting kidney damage. And where did they get the current recommendations for protein intake? 46 grams per day for women and 56 for men? Even using the lower estimates of 0.5 grams per pound would make this 90 grams per day for the average 180-pound man. And this is a minimum recommendation.

 

  • Fuzzy thinking and mood swings- This one is my favorite. Actually, LCHF keto diets are phenomenal at treating “fuzzy thinking and mood swings.” The article claims, “the brain needs sugar from healthy carbohydrates to function.” That could not be further from the truth. No matter how low our carbohydrate intake, glucose levels never drop to zero. I hope they have heard the term gluconeogenesis at Harvard because it is something our bodies have been doing for a few years. Well, maybe a few thousand years but let’s not be too picky. Yes, our brains require glucose. By no means do we need to eat that glucose.

 

  • Last, they get one more jab in to say how “restrictive” the diet is.

Eating all the meat and veggies you want is restrictive? I like how they don’t refer to vegetarian or vegan diets as restrictive. Bias is very hard to overcome.

 

Also, you have to love the part about the weight returning when you resume a “normal” diet. Let me get this right. We shouldn’t change from a standard American diet to a low carb diet because the weight will come back if we go back to a SAD diet? So, we shouldn’t even try? Great rationale. How’s that working for our country?

 

The Danger of These Biased Articles

 

Now let’s look at the bigger picture. An institution with a reputable name publishes this paper.  This paper has no scientific references, it is clearly biased, and has many statements that are blatantly false.

 

How are most people going to respond? I am afraid most people will accept it at face value. I mean, it’s Harvard for Pete’s sake!

 

My guess is most of my readers (you!) will say, “No way. People won’t fall for this garbage.”  And for that I am thankful. But the problem is that my readers (you!) tend to be more astute and more interested in these topics and by habit critically analyze what they read. My fear is that does not translate to the rest of the population.

 

That is why the publishers at Harvard Health should be ashamed of themselves to allow their name on such an obviously biased and tainted article. Whether you believe in a low carb diet or not should have nothing to do with recognizing the falsehoods in their article.

 

In the end, I hope this will serve as a cautionary tale to remind us that everyone has a bias. Some hide it better than others. Some can be more objective than others. And as Harvard has proven, notoriety has nothing to do with it.

 

Let’s strive to be better.

 

 Thanks for reading,

Bret Scher MD FACC

Is Aspirin Dangerous? New Evidence Sheds New Light

Is Aspirin Dangerous?

 

No medication is sacred. Doctors have long regarded Aspirin as an easy “no brainer” for potential benefit with minimal downside. Many of us don’t even notice when Aspirin is on a patient’s medication list. It hardly warrants our attention.

 

Now that needs to change.

 

Aspirin had a bad week earlier last month. Two studies yielded four separate publications, all casting serious doubt about the risk/benefit ratio for Aspirin in those at moderate risk for Cardiovascular Disease (CVD).

 

In brief, the ASPREE study investigated 19,000 US and Australian individuals older than 70 without a history of CVD. Half got 100mg of Aspirin and half got placebo. No other changes were made. After 4.7 years, they found the following:

 

Another study, The ASCEND trial, investigated 15,000 subjects with diabetes and likewise randomized them to 100mg of Aspirin or placebo. After 7.4 years they found a 1% reduction in vascular events in the aspirin group (8.5% vs 9.6%.) However, this was offset by a 1% increased risk of major bleeding (4.1% vs 3.2%).

 

Does Aspirin Increase Risk of Cancer?

 

The most shocking finding for me was that those taking Aspirin seemed to have a higher risk of cancer. This is in stark contrast to the studies showing that aspirin reduces the risk of cancer, especially colon, breast and prostate cancer.  One study does not necessarily disprove an accumulation of data, but it sure does suggest a problem, especially when the new study is a randomized trial and the prior studies are mostly observational trials. For me, that is enough to stop thinking of aspirin as protective for cancer until we have more solid randomized data.

 

Of note, while some of the data comes from randomized studies, most of it comes from observational trials (more on this later). Large meta-analysis of randomized trials demonstrated a very small 0.6% reduction in cancer deaths for those taking Aspirin. Should we view this as caution against very small outcome differences? (More on this later)

 

Is Aspirin Beneficial?

The big picture take home, however, is that in a primary prevention setting, Aspirin is not protective for death, cardiovascular disease events, or risk of dementia and disability. At least not without any benefit being off-set by an increased bleeding risk.

 

Again, the randomized trial finds contrary evidence to what prior observational trials suggested (although some randomized trials were also negative, such as this one and this one, although they were twisted to promote a beneficial finding despite the statistics not supporting that). This is such a powerful lesson on why we need randomized studies and cannot rely on observational trials or trials with miniscule differences to make definitive recommendations.

 

 

Importance of Randomized Studies Over Observational Trials

 

Does this sound familiar? I have been harping on this when it comes to low fat vs. low carb eating for years. The statistical counter argument is that, sometimes, it is just obvious. Smoking should not need a randomized trial to see if it causes lung cancer. Parachutes don’t need a randomized trial (this is my personal favorite anecdote, as it shows how absurd people can get).

 

And that is true. The observational trials in smoking had a hazard ratio of over 3. That means there was over a 300% increased risk of developing cancer if you smoked.

 

The differences we talk about with animal protein intake and risk of cancer or cardiovascular disease tends to be a 10-20% increase at most (with many trials refuting that completely). But the point is that small differences like this may be simply noise or chance when it comes to observational trials. Small differences, especially in observational trials, are not causative or conclusive results. They are suggestions that require further follow up studies before drawing conclusions.

 

Last, we also need to consider the outcomes. Are we measuring a marker that may be important in the long run? Or are we measuring what really matters to people, like living and dying, or life free of dementia and diasbility. Reducing one risk while increasing another is hardly a victory. That is why measuring the right outcome is so important.

 

That is when we need the randomized trial to answer the question. ASPREE and ASCEND have done that for Aspirin.

 

May Aspirin for primary prevention rest in peace.

 

And may science live on, with randomized controlled trials and meaningful outcomes leading the way.

 

Thanks for reading,

Bret Scher MD FACC

 

A Guide to Keto-Friendly Meal Prep

 

Let's be honest. Changing our eating habits is hard. No matter how inspired and gung-ho we may feel when we first decide to go keto, inevitably, we will face temptations and frustrations. Whether you're brand new to the low carb or ketogenic diet or you've been following it for ages, adopting a meal prep habit can help traslate that initial enthusiasm into success. It can even save time and money along the way!

What is Meal Prep?

Meal prep is the practice of preparing a number of meals in advance, typically all at once on one day per week. I enjoy doing this on Sunday and trying to involve my kids as well! You can be flexible with this to fit your schedule. For instance, you can prepare and freeze an entire week of food, or make only certain meals or plan for only a few days at a time. 

Why Meal Prep?

It saves you time.

The more you prepare in advance, the less time you spend running to the grocery store, and my personal favorite, less day to day clean up! While yes, you prepare about the same amount of food, efficient meal prep typically relies on multitasking to significantly speed up the process.

It cuts your food bill, sometimes drastically.

Meal prep can save you a lot of money on food. How? Consider that the average U.S. consumer will dish out $5,400 on impulse purchases each year. Having a grocery list and sticking to it can dramatically decrease the likelihood that you will give into these types of impulse purchases. (anyone can make a list, but can you stick to the list? Seinfield reference anyone???) Also, preparing a week's worth of food at once makes it easier to buy in bulk, which is often more cost-effective. You'll also find it a lot easier to form your shopping list around sales when you're forced to plan in advance.

It helps you avoid impulse decisions about food.

When you're busy, it's very easy to give into carb-laden fast food temptations. When you're drained after a long day of work, you may think, Whi has time of energy to make dinner? That can lead to less healthy take out choices. Meal prepping helps you avoid this kind of impulsive decision because you'll always have a healthy meal ready for you at home. Just walk in the door, heat it up and viola, dinner is served.

It can facilitate your keto diet.

Since staying in ketosis depends on a certain percentage of macros each day, a meal plan can be invaluable. By planning your meals in advance, you can be certain that you won't get to the end of the day and realize you've gone way over your carb allotment. Meal prep makes it even easier to stick to your meal plan because you can reuse the same base components in multiple meals, making the macro calculations much easier. You're also less likely to deviate from a meal plan when the food is already in your fridge, ready to eat.

 

How to Start Meal Prepping

Getting Started

As with any lifestyle change, when you first start out with meal prep, it's important that you start slowly so that you don't overwhelm yourself. You don't need to prepare an elaborate menu with a different entreé each night. Instead, try the following steps to get acclimated to the habit.

  1. Start by picking two keto-friendly protein options that use different cooking methods. For instance, if one requires the oven, pick something that you can prepare stovetop for the other recipe. You may also pick a side dish or two if you'd like.
  2. Buy enough ingredients to make at least 3 servings of each recipe. You might also consider buying some extra meat and vegetables that you can prepare early and use throughout the week for lunches (think salads and lettuce wraps).
  3. Set aside enough containers to hold your meals for the week. You'll likely want to pre-portion the meals to keep your macros consistent, so you'll need one container per individual meal (Tip: glass is much better than plastic).
  4. On your chosen meal prep day, Sunday in my house, prepare your recipes. Be sure to prep your ingredients all at once and find ways to complete multiple tasks simultaneously. While your chicken is in the oven, for instance, you can be steaming or stir-frying some veggies.
  5. Cook any extra meat and vegetables as well, if you chose to purchase some. A slow cooker can be extremely useful here to free up your other kitchen appliances for your main recipes.
  6. Once you've finished cooking, portion out the meals into their containers. Consider freezing half of the meals to prevent any issues with spoilage. Put the extras into larger containers to portion out as snacks or side dishes.

Refining Your Routine

Throughout the first week, pay attention to the following questions:

  • Did I prepare the right amount of food? If you don't eat all the meals, consider cutting back. If you run out early or don't feel like you've saved yourself any time, consider preparing extra next time.
  • Am I bored with these meal options? If so, next time try preparing slightly different variations on the same recipe or add another entreé entirely.
  • Did meal prepping benefit me this week? Think in any terms you want: time, money, healthy decisions, etc.

It will take some trial and error to determine how often to meal prep and how much to prepare each time. Experiment with different schedules and menus until you are completely satisfied with the answers to these questions.

Keto-Specific Meal Prep Tips

Making meal prep work for any diet is all about planning, and keto is no different. The key is to prepare foods that will help you comply with the diet.

Add variety.

One of the main objections to meal prepping is that people don't want to eat the same meal over and over throughout the week. People who aren't following keto will often use a different carb with each meal to change things up. This isn't possible when following keto, unless you use alternatives such as spiralized or riced vegetables. If variety is important to you, consider one of the following ideas that take less time than adding a whole extra recipe to your prep day.

  • Prepare the same marinade, sauce, or seasoning, but use it on different proteins.
  • Stir-fry different combinations of vegetables with the same sauce or spices.
  • Portion your protein, vegetables, or both into sections and season each differently before baking or frying.

Don't skimp on snacks.

Pre-portioning keto-friendly snacks during your meal prep time can help ensure that you always have healthy options to keep you from dipping into the office candy jar, or in my case, snacking on the muffins and doughnuts in the doctor's lounge (I know that's absurd, but that is what they serve in the hospital!).

Label your food containers.

You should always label your food containers with the dish and date it was prepared. It's also helpful if you're following keto to mark the net carbs and other relevant macros in case you end up mixing and matching your recipes you can still stay on point.

With these tips, you should be well on your way to an efficient and effective meal prep routine. Once you see how much easier it is to follow the ketogenic diet with meal prep, you'll never go back.

 

Food Appreciation through Fasting on Yom Kippur

I still remember Yom Kippur 2013. The year I had to fast.

 

I know I am “supposed” to fast every year, but in my mind that ship had sailed long ago. I am not the best rule follower, especially when I don’t see the purpose of the rule. What does not eating have to do with being a good person?

 

But in 2013, my son was old enough to ask, “Why isn’t daddy fasting for Yom Kippur like we are supposed to?” That was the end for me. I had to lead by example, and fast. Back then fasting was a four-letter word. It was something I was forced to do. It was uncomfortable, it made me grouchy, and it seemed like a waste of a day.

 

How times have changed. Now I practice intermittent fasting on a regular basis. I regularly experience the physical and psychological benefits, and I know that science supports even greater long-term benefits. Plus, it’s easy now. 

 

This year I learned that like with most things, I have started take fasting for granted.

 

A good friend of mine unknowingly reminded me of this when we met for lunch the day after Yom Kippur. He does not fast regularly, so the Yom Kippur fast is a big deal for him. I was fascinated listening to him describe his experience. His focus wasn’t the hunger, or lack of energy, or the headaches some people experience. Rather, his was the appreciation he had for cold, crisp water. The joy of his first taste of food in 24 hours. The smell, the texture, the flavors. He had taken food for granted and fasting helped him appreciate it all over again.

 

I felt the same appreciation as my friend when I did my five-day fasting mimicking diet. But on a regular day of fasting, I don’t experience the same appreciation. It made me wonder, why not? Why had I lost that heightened appreciation?

 

I eat high quality, minimally processed, real food that comes from the ground or from an animal. It is food as nature intended it to be. It nourishes my body and is delicious. I should celebrate it every day.

 

Yet, I learned that I can sometimes take my food for granted.

 

A prolonged period without it is a stark reminder of how much I should appreciate my food. But why don’t I appreciate it to the same degree every day?

 

This reminds me of the comedian, Louis CK, who tells the story of someone sitting next to him on the plane complaining that the WiFi wasn’t working at 30,000 feet in the air. The comedian responded that every time a plane takes off and is in the air, we should all scream “Holy $&!% we are flying! I mean literally flying!! Can you believe that?!?!?” Again, that is a perfect example of something we easily take for granted.

 

So, what is the secret? How do we not take for granted the things we experience every day, regardless of how amazing or awe inspiring they may be? How do we appreciate what can easily become mundane?

 

In our family, we say a short prayer every meal. Maybe prayer is the wrong word. It is more of a thank you. We try to remember to thank God for growing the food, the field workers for harvesting it, me or my wife for cooking it, and all of us for appreciating it. But I would be lying if I said that we did that at every meal.

 

We are quick to point out when something is from a factory or packaged in a box or bag.  That helps us recognize the simplicity and pleasure of eating real food (in fact, my kids were freaked out when they saw me eating food from a box during my 5-day FMD).

 

Yet I feel like there should be more. I feel like I still underappreciate the treasure that is our food. Is that setting too high of an expectation? Or should I strive for a greater appreciation?

 

What are your thoughts? What are your rituals? How to you remember to appreciate what you have? It doesn’t have to be just food either.  We should be thankful for anything we are fortunate enough to have. Please comment below so we all can benefit from our collective knowledge and experience.

 

For now, I am going to appreciate my freshly steamed veggies and my grass-fed steak. I don’t want to have to wait for my next FMD to appreciate that!

 

Thanks for reading

Bret Scher, MD FACC

 

 

Bret Scher, MD FACC

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