A Primer for the Ketogenic Diet

First Things First: What’s the Best Diet?

There are all sorts of diet plans easily available. Simply search the internet, and you will find hundreds of different types of diets—all claiming to be the best. It can be confusing to say the least. So which one is the best? Why are there so many different plans? How can so many experts disagree on the best plan?

One of the reasons there are so many different diet plans is because there are so many different people with different preferences, genetics, experiences, and tastes. Many plans are really healthy and good for you. Some are kind of crazy and should generally be avoided. But still, which one is the best one?

I am honestly not sure if there is a “best” one. The one that is best for you may not work for me.  So the best one for you is the one that works. It’s the one you can actually live on and is healthy for you.

This blog is about the ketogenic diet. It may not work for you. I know it can work for most people, but it may not fit your lifestyle or preferences.

Bye, Bye, Carbs!

The bottom line to weight loss is to use up more calories in your body than you put in. It’s as simple as that and as hard as that. Most of us cannot exercise enough to overcome bad eating habits (and we all have them). So any diet that accomplishes the net negative calorie intake should do the trick. However, not all calories are created equal. While it is true a hundred calories is a hundred calories no matter the source, our bodies are far more complicated than the simple math would imply.

It’s not hard to understand that a hundred calories from an apple is probably better for your body than a hundred calories from a candy bar. The food we eat contains far more than just calories. It actually communicates with our bodies in some wonderful ways.

One of the reasons I like the ketogenic diet is that it generally doesn’t make me as tired as some other diets I’ve tried. The idea behind the ketogenic diet is to limit your total carbohydrates to fewer than 50 grams a day and preferably around 20 grams of carbohydrates. Many of the foods I enjoy probably have 20 grams of carbs in each bite!

When we limit our carbs, our bodies have to turn to fat for energy. Generally, our bodies use glucose or sugar as its primary energy source. It’s easier to get the energy out of sugar as compared to protein or fats. When we don’t consume carbohydrates, our bodies will start to burn fat (a very good thing) for its energy needs.

When we start to burn fat instead of sugar, one of the byproducts of the fat metabolism is ketone formation. When we have ketosis, it tends to curb our appetites and we feel full longer.

Another positive benefit of the ketogenic diet is our insulin levels remain lower. Insulin is a pro-growth hormone. It makes us sluggish and tells our livers to store more fat. Insulin can also stimulate our appetites. High insulin levels lead to insulin resistant diabetes.

When we eat carbohydrates, our blood sugar immediately goes up. When blood sugar goes up, so do our insulin levels. High insulin levels are not good! When insulin levels increase, so do our appetites. That’s one of the reasons it’s hard to eat only one cookie or just one chip.

Eat the Fat

One of the problems with diets that are high in protein and low in carbs and fats is fatigue. It is amplified if you are exercising. The ketogenic diet allows for healthy fats. The fats give us energy and will help with exercise. It does take some adjusting. I find it hard to work out really hard when I am strictly on a ketogenic diet. It takes some time for my body to get used to it, but I can still get a pretty good workout in.

There are several lists of healthy fats on the web. In general, avocados, olive oil, nuts, and butter are good sources of healthy fats. Fish and other meats will also have healthy fats. Several sauces are considered acceptable on a ketogenic diet. I found this website to be very helpful with an overview of foods to eat and not eat: www.ruled.me/ketogenic-diet-food-list/. (I am not affiliated with them in anyway but do appreciate their work. They have some plans you can purchase that are more detailed. I have yet to get one but have thought about it.)

Break It Down

Ideally, on a ketogenic diet, you will get about 70–75% of your calories from fats and about 20–25% from protein. Try to limit the carbohydrates to about 5% of your total calorie intake.

Your calorie input will vary on your needs or desire. A general rule is to take whatever weight you want to weigh and add a zero to it. So if you want to weigh 150 pounds, simply add a zero and that equates to 1,500 calories. If you exercise, you can calculate how many calories you burned and add them back to your total for the day. If you burned about 300 calories working out, and your target weight is 150 pounds, then you should be able to eat about 1,800 calories that day.

One of the really tough things on a ketogenic diet is to control what you snack on. If you slip up and get too many carbohydrates, it will defeat the purpose of getting into ketosis. Healthy snacks you might consider would be walnuts, pecans, and pistachios. One of the sneaky secrets to watch out for is that each kernel of nut will have about 10 calories. The count can add up quickly.

Check Yourself

Don’t be surprised if you have increased urination during the first few days. Stored fat being burned for fuel will release a lot of water during metabolism. You will also want to be sure to drink plenty of water.

One of the benefits of a ketogenic diet is decrease in hunger. That is a major clue you are in ketosis. Ketosis will help suppress your appetite. Some people will purchase “keto” sticks for urine testing. It will allow you to know if you have ketones in your urine. Ideally, you will. If not, go back and look and see if you can find where the carbs sneaked in.

I hope this has been helpful information. Life is too short not to enjoy some birthday cake or some special food for a celebration, but I do believe most of us can improve our health with improving our diets. This is just another tool for you to use. Keep trying and eventually you will find a plan or combination of plans that fit you and your lifestyle.

Wishing You an Amazing Life,

Dr. Curtis Brown

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Dealing with Loneliness during the Holidays

The longest night of the year is coming up soon! Dec 21st is the December solstice for us who live in the northern hemisphere.

While this coming 21st is definitely a long night, many people have long nights every night of the year. And the long nights frequently turn into long days, months, and even years. There are many people who suffer alone through long days and nights.

Loneliness seems to be increasing at a rapid rate. Maybe I am simply more aware of it and notice it more. Maybe it is all of the so-called devices that are stealing time away from people. You would think with all of the ways to connect with each other, we would be less lonely.

I do think loneliness is tough on just about anybody. If you think about Jesus who existed for eternity with God the Father and with the Holy Spirit, he suffered tremendously from loneliness when he was on the cross. It was the first time he was ever separated from God the Father and the Holy Spirit. Not only was he experiencing wrath for all of humanity’s sins, he was experiencing extreme loneliness—perhaps for the first and only time.

If you are experiencing loneliness, you are not ALONE! There are many others feeling the exact same way. It is often worse around the holidays. Don’t be afraid to reach out to someone. Ask them to meet you for coffee or breakfast. Join a gym or a civic club. Do something to put yourself into contact with others—physical contact not electronic!

Psalm 68:6 states, “God sets the lonely in families.” I am not sure how this worked in the Old Testament times, but today I think he places us in our church families as well as our biological families.

If you are struggling with loneliness, I would encourage you to get more involved with your church. I may not know where you go to church, but I can promise you they need more help in the children’s area! Getting more involved and being around people is very therapeutic. I believe you will get more back than you give.

We were created to be in a community. We need others around us to thrive. If you have a family member or friend you might think is lonely, drop in on them this week and say howdy!

Wishing You an Amazing Life,

Dr. Curtis Brown

What Is the Best Diet Ever?

I am frequently asked this question: “What is the best diet?” After all, there are some many diet plans available and all of them claim to be the best or have some scientific explanation as to why they are better than the other diets. Stop and think how many different diet plans you have heard of, or better yet, you have tried. I bet you can think of at least a half dozen or so.

Honestly, I do not even like the word diet. It’s a four-letter word! The word itself has painful or limiting connotations associated with it. I prefer to think of it more of a lifestyle of eating, something that I stick with long-term. Not a short-term fix.

So which diet or lifestyle is best? My answer is . . . wait for it, wait for it . . . it depends!

What do I mean by it depends?

The reason most people want to talk about a diet is they want a plan to lose weight. At the very core of weight loss is a simple formula:

Weight loss = Calories in – Calories out.

If you want to lose weight, you have to burn more calories than you consume. If you are not able to lose weight, you are consuming more calories than you are burning up.

Weight loss is obviously more difficult than this simple formula, but the formula is never the less true. (Our bodies are extremely complicated, and there are many hormones that influence our appetites and metabolism.) I have patients tell me all the time that they “feel” like they do not overeat. Something else must be wrong, like their thyroid or their metabolism. Yet, the underlying truth is they eat more than they burn off. It is a hard but simple truth.

If you are struggling with losing weight, you either must eat less (maybe different) or burn up more calories. I believe weight loss is about 80% what we eat and about 20% what we do. It is easier to lose weight by controlling the input than by increasing the output.

Now, the secret answer to which diet is the best is simply the diet that works for you! We all have different histories, different preferences, different sleep cycles, different exercise preferences, and different metabolic rates. So in the end, the best “diet” for you is the one that works.

So when you are reading an article that claims the latest diet to be the “best diet ever,” it is probably true for the person penning the article. But it may not be the best diet for you.

I personally try to limit high glycemic carbs from my lifestyle. (I prefer not to call it a diet!) I will try to live my Ten-Day Diet Challenge throughout the week and splurge some on the weekends. About every 6–8 weeks, I will do the Ten-Day Diet Challenge for 7–10 days. This seems to work for me.

I know a lot of people love the Paleo Diet. They tend to love meat. It works for them. Others go vegan and seem to do well. You have to find what works for you. I would encourage you to think of it more of a lifestyle than a temporary diet.

So the best diet for you is the one that works and one you can live with long-term. No matter what “plan” you go with, you will need to burn up more calories than you consume if your desire is to lose weight.

Wishing You an Amazing Life,

Dr. Curtis Brown

Can You Trust Your Fitness Device?

Technology is very cool and has amazing applications as it relates to our health and fitness. Fitbits and other devices are used to measure heart rate, steps, calorie expenditure, and other biometrics. Plus, they are extremely popular. But can you trust them? How accurate are they?

There are several studies out recently, and they all seem to agree. They are generally pretty accurate when used to measure heart rate and steps or distance. Most popular devices such as the Fitbit and the Apple Watch were within about 5% of heart rate and distance. That is pretty good!

Calorie expenditure is another matter. In various studies, it seems they are often as much as 30% off and some even much more. There are several reasons for this, but ultimately you should not rely on them to get an accurate reading of your calorie expenditures. There are many resources you can use along with your device to help get an idea or an estimate of your calorie burn.

If you simply do a search, you will find programs that will help you. If you want to get as good a number as you can, find an online program and use it and your device together. It should get you quite close and give you a general idea about how many calories you are burning.

Counting calories can be critical when trying to lose weight. You will lose weight when you burn up more calories than you consume. If you read about calories and weight loss, it is generally reported that one pound of fat is equal to 3,500 calories. In order to lose one pound then, you would want to burn up or decrease your input by 3,500 calories.

The problem with the 3,500-calorie number is that it is just way more complicated than that! If we are in a controlled setting (such as a laboratory), this number is probably really accurate. But counting calories or estimating how many you consume is at best an educated guess. Even the professionals are off as much as 25% and our devices may be off as much as 30%!

I believe it is still a good idea to try to understand how many calories you are consuming and/or burning up, but it is a guessing game. Hopefully, you can get to within about 10% to 20% with some education and help from your device. Chances are your device is really close on the distance and heart rate, but not so much on calories.

Do you have a Fitbit or Apple Watch? Do you think they’re accurate?

Wishing You an Amazing Life,

Dr. Curtis Brown

The Midsummer Five-Day Diet Challenge

It’s midsummer and the Fourth of July is behind us! If you’re like me, you’ve let your diet slip a little. It’s so easy to cheat, especially around the Fourth. I’ve found challenges like this one (even if it’s relatively short) help me reset my mindset and appetite and improve my success with eating clean.

My goal with this five-day challenge is to lose about 2.5 pounds. Perhaps more importantly, I want to improve my healthy eating moving forward for the rest of the summer. I firmly believe we become what we eat and if we are not eating a healthy diet, we will not like the ultimate results.

This is a simple challenge I am starting on July 17 and ending the evening of July 21. It’s a Monday through Friday challenge. For five days, I am going to avoid any bread, potatoes, pasta, rice, sugar, and milk. Wednesday, I am going to do at least a 12-hour fast from any calories. (I will drink water and maybe tea or coffee.) I might do a 24-hour fast, but this will be a game day decision.

I am going to try to eat around 1,750 calories a day except on Wednesday when I will be fasting. If you do this challenge with me, I would suggest you pick your ideal body weight (whatever it is you want to weigh) and then add a zero to it. This number will be the number of calories to eat daily. I want to weigh around 175 pounds so I’m going to limit my total calories for the day to 1,750.

It is my hope many of you will join me on this short challenge and post comments and/or questions of my Facebook! It is always more fun and seems easier when doing these challenges with friends and family. I do have some good recipes for smoothies and meals on the blog.

Let me know if you are in!

Wishing You an Amazing Life,

Dr. Curtis Brown

Attitude of Gratitude

 Last week, I had tried to get you to try a simple experiment. It was to simply stand in front of a mirror and get you to smile for three minutes a day. I know it sounds silly and I am not promising to cure you of all ailments, but if you did the challenge, I bet you felt a little better.

Motion leads to emotion. If you act a certain way, you will eventually feel that way. Something as simple as smiling can change your current mental state. I dare you to try it!

Another key to feeling less stressed (code word for fear) is to change your focus. Focus will lead to feelings. We become a summation of our thoughts. If you have a bunch of depressed or stressed thoughts, you will feel depressed or stressed. Every thought has some emotion tagged to it. If you change your focus, which is simply controlling your thoughts, you can change your emotional state.

Do a quick inventory of your emotional state for the week. Write down every emotion you had this week. Try not to edit it—just write them down as they come to mind. Hopefully, you have had a good week, but go ahead and do this little exercise. Try to determine what your primary emotion for the week has been. Honestly, I think mine has been frustration.

Now, the primary reason we feel frustrated or stressed is because our current situation doesn’t match up with our expectations or our blueprint for life. If we are feeling good, chances are our current situation matches up with our blueprint for life.

If things are not matching up with our blueprint for life, we can either change our blueprint (our expectations) or change our situation. Often, our situation can change simply by changing our focus. If we remained focused on the negative outcome or negative possibilities, chances are that our emotions well be negative. If, however, we focus on the positive things or possibilities (the glass is half full), we will tend to have positive emotions.

We all have a tendency to take a negative thought and go to the darkest corners in our minds with them. This is why solitary confinement is the worst punishment for prisoners. They are left alone with their thoughts.

You have to learn to control your thoughts. Most of the things people tend to worry over are outside of their control. They really have no influence over the outcomes. Take captive every thought you have and dwell on the good, the pure, the noble.

If you are having repetitive thoughts in your life that you really cannot control the outcome of, discipline your mind not to think about it. I have no control over the changes coming in healthcare. I can worry about it all, but it will not change the outcome. Now, I need to be aware of changes, but it will not help me to worry about Obamacare or Trumpcare. I have no control. So, when I am tempted to worry about it, I try to take control of my thoughts and focus on something else.

Focus will lead to feelings. Control what you focus on! If you want to take a deeper dive into this subject and other ideas for healthy living, take a look at my e-book, The Caleb Journey.

Wishing You an Amazing Life,

Dr. Curtis Brown

What Is Your Purpose in Life?

WThe most popular book in the world is The Holy Bible. It has had more copies produced than any other book. The second most published book is not even close to the Bible. The second one, however, is fairly recent. It is The Purpose-Driven Life by Rick Warren.

Knowing one’s purpose is essential to living a fully productive life. If you do not understand why you exist, then you will have difficulty making good decisions about your future and even your present. You will be taken with the current of popular opinion and may end up in a place you do not want to be in.

Earlier in the year, we talked about what you want written on your tombstone. How do you want to be remembered? This really gets you thinking about your character and your influence. I think this is a good starting point (the end of your life) on understanding your purpose.

Everyone and everything has a purpose. Even if you do not believe in a Creator, honest people will come to the conclusion that everything has a purpose. If you really believe we evolved from some primordial mist, then the only thing that makes sense is that we evolve to a specific end or purpose. We cannot evolve, and it not serve a purpose or benefit. Everyone and everything is designed for some purpose or use. We may not understand it with our limited sight or knowledge today, but there are no accidents.

I believe we are uniquely created by a loving God and that we all have purpose or reason for existence. I believe God has created each of us to fulfill roles only we can. The roles may be similar to others, but they will be unique to each of us.

Our purpose for life may be experienced differently as we go through different stages of life or life events; but at the core, our purpose or reason for breathing stays the same throughout our life spans.

We are never too old (or too young, for that matter) not to have a purpose. Many of my geriatric patients struggle with why they are still alive. They often feel like they have completed their purpose for living. There are many reasons for this, but at its core is the belief that they are no longer contributing.

Our sense of worth often comes from our sense of how we contribute to society, especially our families. If we feel we are not contributing, then often we will feel worthless. Eventually, we feel worthless.

I was at both of my grandfathers’ deaths. I watched as they took their last breaths and watched the monitors flatline. To this day, I am still learning from them. I will compare myself to them when I am close to the end. They showed me how men end well. They never quit leading me. You are never too old or too sick not to have a purpose. You will always have a purpose as long as you have air in your lungs.

You must know what your unique purpose in life is! I want to challenge you to think about your purpose, your reason for breathing. And I want you to write it down. It does not need to be elegant or even elaborate. I think the simpler it is, the easier it is to understand and to follow.

I recently reviewed my purpose and wrote down thoughts as they came to my mind.

“I exist to glorify God in all I say and do. I do this mainly through helping others to improve their health and lives. I experience God most when I am serving His children and enjoying the outdoors. Learning is another common way I enjoy God. Therefore, I will be a lifelong learner who loves God and helps others on their journey.”

This statement is basically a filter for me when it comes to decisions about how I am to spend “my” (it is all His anyway) money and time. It is a fairly broad statement and leaves me lots of leeway, but it is still one of my first filters. The things I do and spend my time on need to fit with this in some way or fashion.

We all have a purpose and a unique design. What is yours? Don’t be shy: tell me in the comments.

Wishing You an Amazing Life,

Dr. Curtis Brown

Supplements: Are They Right for You?

It has been estimated that Americans spend $25–33 BILLION a year on supplements! Now that is a lot of supplementing. Multivitamins are very common and probably the most taken across various ages and cultures. I did a search on supplements and got over 15 million hits on Google.

So, are they really good for you? Don’t most of the supplements or vitamins just run right through us? How do you know what to take? These are very common questions people have and there are many different opinions and answers to these questions.

I want to be real clear. I take supplements. I do not have any great studies to support my use of supplements. I only have my years of experience as a family doctor and my own personal experiences with the use of supplements. I have done extensive reading and continue to improve my own knowledge on the subject. I am in no way an expert on supplements.

So, if you are still reading this, understand these are my opinions.

I am often asked about the absorptions of supplements and how your body uses them. I do believe some of the supplements are probably excreted from our bodies fairly rapidly. If you take a B vitamin, it does not take very long (15–30 minutes) before your urine becomes bright yellow. So why take them if they get out of your system so fast?

My first answer is to compare supplements to water. Water basically just goes right through our system. But I have to believe the water does some good along the way. I think supplements are much the same. They may go right through us, but I think they do some good along the way.

Secondly, I am sure not all the B vitamin ends up in my urine right away. I do think it will circulate through my body and be used if needed. It helps ensure the systems in my body that use the B vitamins have plenty of it.

Which supplements should you take? Again, a very common question. My answer is: it depends. It depends on what you are expecting or needing as far as supplements. It depends on your overall health status and your nutrition. It depends on your genetics. I do not think there is a one-size-fits-all. A growing athletic adolescent is going to have some different requirements than a guy in his sixties.

I do think the first thing to start with is to be sure you are doing the basic things well. Eating clean will help your overall wellness and health more than any supplement can. If you are not exercising regularly, get started. Try to get 7–8 hours of sleep and drink plenty of water.

My next blog will be about my personal favorite supplement.

Wishing You an Amazing Life,

Dr. Curtis Brown

Supplements: To Take or Not to Take?

I have been helping people with their health issues for 30 years now and I believe I have learned a lot of things over those decades. I have learned we do not necessarily always know the truth. Medical opinions change with increased knowledge and better information.

I remember when we told everyone to quit eating eggs if you needed to lower your cholesterol. Well, now we have decided it is okay to eat some eggs in moderation. It used to be common practice to advise all women to take calcium. Now, not so much. Calcium probably will not hurt you, but it also probably does not help as much as we thought.

Medical advice and opinion tend to shift and change all of the time. There are some basic truths (at least, I think there are) that still make sense. For instance, if you have high blood pressure, you should do everything you can, including taking medication if necessary, to reduce your blood pressure to normal levels. This will dramatically lower your risk of heart attack and/or stroke. Getting regular sleep is really good for your overall energy and mood. Regular exercise will increase your energy and enhance your life. Still true!

Supplements are very popular today. I personally take them and I think they are helpful. However, recently I was listening to a popular wellness radio show and the host was taking lots of supplements. He was recommending all sorts of stuff to help with weight loss, memory, fatigue, energy, skin, bloating, and a multitude of other common ailments.

I tried to calculate how much it would cost to take everything he was recommending as a must-have. NO ONE could afford to spend that kind of money! It was over a thousand dollars a month.

Again, I am not against supplements. I take them myself. But I think some common sense should be used in deciding which supplements to take. Part of the problem of deciding what to take is filtering through all the noise around supplements.

Many mainstream doctors avoid recommending supplements altogether. We have been trained to look for documentation of efficacy through double-blind studies. It is really hard to find long-term, double-blind studies when it comes to supplements. I know there are a few good studies, but they are often biased in their design.

Over the next few weeks, I will blog about my thoughts and recommendations on supplements. I will not quote any studies. These recommendations will be based off of my personal experience and my own research of available information (which changes frequently).

I hope you will find this information practical and informative.

Wishing You an Amazing Life,

Dr. Curtis Brown

20 Pounds in 2017

It's that time of the year that most of us at least start thinking about goals for next year. I try to be realistic and not set unachievable goals like starting for the OKC THUNDER at point guard. Still, I usually struggle with staying connected to my goals.

If you are like me and are thinking about dropping about 20 pounds in the year 2017 (did not make it in 2016), one of the first questions to ask yourself is not what diet or exercise plan, but why. Why do you really want to lose weight? What is your true motivation?

The sad truth is that for most of us, losing weight because we know it will be good for us and improve our health simply isn’t enough for when times get tough and we are in the messy middle. The messy middle is when you have been at it for a little while but the finish line is still weeks if not months away. There is always a messy middle.

I have found that a major event in one's life is great motivation for about 6 months. Most of my patients who have had a heart attack or stroke are really motivated for rehab for about 6 months. Then the messy middle shows up. The pain and loss suffered becomes a fading memory and many revert back to the same lifestyle and habits that got them to the event in the first place. Their motivation wanes. Only about 1 in 7 will stay with it and change their lifestyles long-term.

I am the same way. I know that dropping 20 pounds will lower my cholesterol and improve my blood pressure. I know that I will feel better and have more energy. I know it all intellectually, but here I am again trying to lose those same 20 pounds from 2016. So what can I do to be that one in seven that sticks with it? Where can I find my motivation in the messy middle?

I think there is a lot that goes into reaching your goals. But, I believe the most important question is to ask why. Why do I really want to lose the weight? Yes, I know in my mind that it is good for me, but I have proven that simply knowing so doesn’t tend to motivate me enough in the messy middle.

I am somewhat embarrassed to admit that I need something more tangible and more rewarding than simply knowing that it is really good for me, but that is the simple truth. I am a simple person. I need simple answers to the whys.

My plan is to set up some rewards along the way. I have not yet decided what they will be, but I know they will be simple. If I lose 5 pounds I will (fill in the blank). I am also going to set a timeline. I think a goal without a timeline is simply a dream; however, that is another topic.

I would love to hear from you if you have some good ideas for my simple solution for the messy middle. Also let me know if there is a certain health or wellness topic you would like to learn more about.