Transcription
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 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 test for insulin resistance and metabolic health problems is a fasting insulin level, 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 number watchers in this crew that 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 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 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 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 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 don't feel like doing 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 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 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, 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 >> glucose is one of the brain's favorite fuels. Um, but it, uh, it really, um, the brain is has been described as a hybrid 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 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 keep, uh, putting it in. You have to keep it. So, so like for example, overnight, um, 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 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 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 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 or 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 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 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 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 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 >> 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 eat a ketogenic diet. It's just about making sure you're using those pathways and keeping the keeping those pathways well-oiled 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 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 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 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 three hours before they went to bed. It was easier on the nervous system, the 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 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 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 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 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. 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 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 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 millimole per liter and 3.0 millimole per liter most of the 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 have 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 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, 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 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 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 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 recommendations. 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? 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, that you wanted to give it at least six weeks, um, 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 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, three days, three weeks, three months. Some people feel better in three days. Some people it's going to take more like three 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 three months before you decide it's not going to work for you.
So, um, but most people within three 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 compliance for that long has got to be really interesting, >> you know.
It is. So, so it's a real issue. Adherence to these diets is a is a real issue, especially in the very 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 to using more fat for energy and less 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, without exception, >> get to day three.
You get to day three, suddenly it's like, "Oh, I could do this for another week."
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, 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 tightrope 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 University of Edinburgh in Scotland who, um, years ago, eight years ago, um, he was a musician in Scotland, a very good one and 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. 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." 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 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 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 their mood and their energy and their and and anxiety and so forth improved. The higher their ketones were, they seemed to do better the higher their 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 washout period where the researchers were supposed to help people, uh, wean off the diet. That was part of the protocol. Seven of them refused to come off the diet.
I bet. I I wondered if you were going there. Yep.
Yeah. They were like, "Well, we feel too good. We're not we're not we're not doing it."
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 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 clear-headed." 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 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 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 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 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.
Yeah. Thank you. You said it. I think so 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 stress, better able to recover from from, uh, from, uh, difficult events in their 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 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, 5 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 >> 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 antidepressants.
So they took this group of people with treatment-resistant depression. They divided them into two groups and they put one group on a 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 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 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 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.
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, we're we're not eating food anymore. We're eating factory processed 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 your appetite regulating mechanisms.
Yes. So, they make you more I think they make you more hungry is really 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 talking about the medical bills you'll have to pay for.
Exactly. The co-pays and the doctor's visits and the surgeries and the hospitalizations and injuries and 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 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 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. 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 what happened to me when I started 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 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 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 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 ramp 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 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 let's just think about that con that 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 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 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 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 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 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 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 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 those ketones, right?
And especially who need them in a really 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 waltz in, no questions asked. But now you don't have enough insulin because you're 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 book 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 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 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 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 amygdala areas that were that kept us addicted to people-pleasing and 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 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 neurotrophic 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 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 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, 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 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 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 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 look it up, but that's a great question because I bet 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 outward expression of metabolic 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 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 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 nowhere 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 that you're not eating more than you need. And it again, it doesn't mean that everybody needs to be on a ketogenic 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.
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 look at all at the possibility of exogenous ketones or how we help those two populations that might really struggle to get onto 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 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, 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 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 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 to do in my practice. A lot of people would ask about, well, what about my mom, you know, she's in the 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's 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 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 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 overeating 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 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 better, uh, evidence do you need that the ketogenic diet can stabilize brain chemistry, um, than 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.
>> 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 diet that was designed to get ketones into a very high range, 5 to 8 millimolar per liter, >> very high, and keep them there for a year 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 percent of calories. It required minimizing protein, bringing protein down to about, >> um, I want to say, I think it was about six percent 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.
>> 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, let's make that bad, >> right? Like, oh, you, that can't be good for you. I, you know, so there's an emotional reaction to it. It's like, oh, really? I can't imagine living without 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, 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 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 I enjoy during this window, and that's how I'm going to manage my 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 too addicted to them, and I, it becomes difficult for me to, to stay in 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, 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 gets you into ketosis, and a ketogenic diet gets you into 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. How is the mental health community taking this good news of the ketogenic diet and ketosis? 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 a 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 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, 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. It's 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, 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 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 is 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 can access the healing benefits of ketosis regardless of their dietary 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 is how you would approach that situation. Here are the lab tests you 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 who are 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 first couple of weeks, you kind of have to navigate, >> the, the, the rocky shores of, of the diet first, just so 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 meta-analysis. 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. Neurodegeneration 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 breakthrough in the fasting community because now doctors were not looking at this as like a fad. They were looking at it prescriptively, like you were talking about. And I'm thinking, wow, now we have two really powerful combination, the 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 going to accelerate doctors' 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 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 toolbox, and a really powerful one. And so, um, you know, 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, 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 kindred ketone sister here.
Yeah. Yep.
I really, because I've watched from a different lens. I've watched millions of people heal themselves with fasting, and it, it 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 results.
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.
>> 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 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 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 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, 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 accredited course for clinicians on 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, 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 it. Thank you. I hope it's helpful to people.
Yeah. Thank you. Appreciate you.
Thank you. You too. Bye, Mindy.
Bye.