How to lose fat and gain muscle “fast”

People seek “near-magical diet and exercise routines,” which promise regimens with no effort, no hunger, and no muscle soreness. I can tell you right now that this triad also won’t produce weight loss. However, there is so much information “out there” that it’s often hard to choose how to attack this problem. So–get the facts regarding optimizing lipolysis (fat burning) and muscle mass creation. This has been studied and, for the most part- “figured out.” People who want to learn the science of how to lose fat and gain muscle efficiently can take the contents of this article and be successful.

It’s not just about calories in and calories out; something you have heard about for years, but now we know for sure: what you eat matters, and it’s not just about the calories you take in, and it’s not just about the calories you expend….it’s how you expend them. For example, something popularly called “the afterburn” is an additional energy expenditure after exercise. This happens due to “excess post-exercise oxygen consumption.”

Here’s what has to happen after your workout. Your body needs to perform a variety of tasks to recover, including:

• Removal of lactic acid
• Repair of muscle fibers
• Replenishment of ATP in mitochondria
• Replenishment of oxygen

And this is just for starters. All of these metabolic processes require oxygen. Oxygen consumption, therefore, rises after exercise and requires energy. This means additional calories will be burned above the resting rate, giving us the afterburn effect. If you’ve heard of this, I bet you didn’t know that weight training will provide you with far more afterburn than “doing cardio.”

This phenomenon lasts up to three times as long as a weight training session as either low, medium, or high-intensity “cardio” or even strenuous HIIT. On top of this, as you work your large and small muscle groups, gradual muscle hypertrophy leads to longer-lasting metabolic increases. And according to the latest data, muscle cells communicate with fat cells during weight workouts to enhance the fat-burning process even more. I’m trying to make the point that you will lose fat and gain muscle the most efficiently with anti-inflammatory eating and an easy-to-do, quick weight training routine. Here’s the super-cool way that using your muscles helps you burn fat.

How Muscles talk to fat cells 

Recent findings indicate that skeletal muscle secretes packets of substances called myokines that mediate some benefits of exercise. Those benefits include the growth of muscle fibers and the enhancement of lipolysis.

Adipose tissue is the body’s primary way of storing excess energy. It provides nutrition when an organism must go without food, such as during fasting or exercise. As a result, the metabolic role of adipose tissue is critical for determining whole-body metabolic outcomes. For example, Adipocyte (fat cell) lipolysis is driven by the brain chemicals norepinephrine and epinephrine, secreted during exercise. This then enhances insulin sensitivity, lean body mass, and thermogenesis-fat burning!

Now it’s (hopefully) clear that weight training not only gives you a longer metabolic burn than cardio training but also promotes lipolysis. So if you have thought that your time at the gym was best spent walking on the treadmill, you realize that you need to change things up. Now, it’s time to lay out the physiologic environment that best supports how to build muscle and lose fat the most efficiently. So here’s what we’ll cover.

• Get into an anti-inflammatory and anabolic state
• Measure and control leptin and insulin levels
• Balance basic hormones
• Use peptides to lose fat and gain muscle
• Pick the most effective and efficient weight workout regimen

Quell inflammation and Muscle Catabolism 

The relationship between chronic inflammation and obesity has been studied extensively. It is known that inflammation plays a role in the development of obesity; however, the exact mechanisms behind this phenomenon are still being researched.

What exactly is inflammation?: When the body responds to an injury or infection, it initiates a complex set of processes collectively termed inflammation. The goal of inflammation is to eliminate the cause of the problem and initiate repair.

Inflammation is characterized by local redness, swelling, heat, and pain. These signs and symptoms will go away when healing begins; however, if the cause has not been eliminated or recovery has not started, they may last for some time.

Chronic inflammation is usually caused by something we can’t see, such as a splinter, but it’s still an inflammatory response. For example, if you keep prodding at the same spot, you’ll maintain high levels of inflammation, but you can’t feel the splinter or the poking because it’s silent. When inflammation becomes chronic, it can be “silent” and make you feel fatigued or contribute to many other health problems. We’ll discuss diet next, but first, let’s talk about other common causes of chronic inflammation.

Gut hyperpermeability AKA “leaky gut”: Leaky gut syndrome is a problem caused by consuming a poor diet, taking pharmaceuticals (especially antibiotics), experiencing high cortisol levels (especially since the COVID pandemic), and exposure to mycotoxins. This syndrome can be treated with a gut-healing peptide such as BPC-157. However, it might take some time to recognize that you have no symptoms or minor symptoms such as gastrointestinal bloating or mild constipation. Since this is the root cause of all autoimmune diseases, it’s always wise to treat this problem, regardless of your condition.

Your weight: Obesity is associated with increased inflammation throughout the body. Inflammation can lead to cardiovascular disease, diabetes, cancer, and other chronic diseases. Individuals who are obese or overweight have higher levels of inflammatory blood markers than men and women of the same age who are not overweight or obese. According to numerous clinical studies, inflammatory markers decrease when men and women lose weight.

Excessive omega-6 intake: A diet high in omega-6 fats can cause an imbalance in the production of pro-inflammatory eicosanoids, a vital part of the body’s inflammatory response. This can be a problem because when the body produces an excessive amount of inflammatory eicosanoids, it results in more chronic inflammation, which is linked to many serious health problems. The solution is to lower your intake of meat and dairy products—a diet rich in omega-6 fats—and increase your intake of foods rich in omega-3 fats. Doing so can balance your intake of these fatty acids and lower leptin levels.

Insufficient omega-3 intake: Conversely, omega-3 fats are the precursors for anti-inflammatory eicosanoids, which dampen inflammation. Good omega-3 status means adequate anti-inflammatory eicosanoids and blunts the inflammatory reaction to normal stimuli. It’s easy to get good blood levels: eat omega-3-rich fish such as salmon or sardines and take good omega-3 fish oil supplements. Let me mention that leptin also responds to flipping your Omega 3 to Omega 6 ratio.

Lack of sleep: Disordered sleep causes elevated blood inflammatory markers in and of itself. Poor sleep is a chronic problem in the U.S., as many people go to bed too late, wake up too early, don’t get enough hours of sleep, or use electronics late at night to disrupt the sleep quality they do get. In addition, disordered sleep will raise leptin levels, which we’ll discuss further in this article.

Toxins: Heavy metals such as mercury and lead and biotoxins such as mycotoxins and Lyme toxins can cause chronic inflammation in the body.

Chronic stress: Elevated cortisol due to pain, injury, illness, or physical or emotional stress is an independent risk factor for weight gain via several mechanisms, including elevated leptin levels. But that’s not all, as the saying goes. High cortisol can damage your gut lining, your microbiome, and even the neurons in your brain!

It packs pounds preferentially on your belly, too! Note also that a chronically elevated cortisol level is catabolic, meaning it will cause you to lose muscle mass. Coming soon: a better, newer medical device that stimulates the vagus nerve to lower cortisol and inflammation and boost the immune system. We now have the truvaga vagal stimulation device, which is used for 2 minutes, 2x/day. It is by far the best device “out there” thus far. Use my patient discount code for $25 off. It’s just DrKim25.

Job one-Your Anti-Inflammatory Eating Plan

Limit or eliminate processed foods from your diet: Most processed foods contain “bad” carbohydrates, which are low in fiber and are broken down quickly in the body. Processed food is also typically high in calories, thus contributing to weight gain. In addition, processed foods often contain harmful toxins such as artificial flavors and colors, preservatives, and a long list of other unhealthy ingredients. These toxins can hinder your ability to lose body fat and even moreso-belly fat.

Avoid “fast foods” unless you eat from a salad bar, and bring your own healthy salad dressing.

Limit sugars, beans, and grains. Most of the research reveals that lectins are inflammatory, and (inflammation-causing high-lectin foods include grains (especially those containing gluten), beans, nightshade vegetables, and low-fat dairy. Nightshades are white potatoes, tomatoes, and peppers, for the most part. Your functional doctor should determine why you have excess weight-is it hormonal, inflammatory, due to insulin resistance, or high leptin? Different eating plans will either work or not, depending on the problem. Since a large percentage of seriously overweight individuals have elevated glucose issues, they would be considered “insulin resistant” and therefore do well on a keto diet. But let’s focus on the “leptin problem” for a moment.

Eating this way is the basis for the good-old Paleo Diet, but please go easy on the meat. Why? There are many reasons—but think about the omega-6 fatty acids we discussed above. It is essential to ask your functional doctor to determine precisely why you are carrying excess weight—is it hormonal, inflammatory, due to insulin resistance, or high leptin? Or is it a combination of a few issues, including others not named here?

Different eating plans should be prescribed depending on the cause of the weight gain. For example, since a large percentage of overweight individuals have diabetes or what is popularly called pre-diabetes, they would be considered “insulin resistant” and do well on a keto diet plan. They also would do well on an anti-inflammatory diet or a frank A.I.P. diet(usually reserved for those with autoimmune issues such as IBD).

Meanwhile, this popular eating plan would hinder weight loss in someone with a high leptin level. Since non-functional doctors and many non-medical people are familiar with the association between insulin, glucose, and weight gain, let’s focus on what typically is not checked or treated correctly, if at all: leptin issues.

Why is Leptin so Important?

Leptin and its receptors are essential regulators of body weight and energy homeostasis. Decreasing leptin’s tissue sensitivity leads to metabolic disorders, including obesity. Mechanisms underlying the development of leptin resistance include gene mutations that encode leptin and its receptors, proteins involved in the self-regulation of leptin synthesis, and even factors that alter blood-brain barrier permeability.

Leptin resistance is a complex pathophysiological phenomenon with multiple “lines of attack” for potential treatment; understanding this process is essential because it is the leading driver of fat gain in humans.

What is Leptin?

Leptin is a peptide (short-protein) hormone that was initially discovered to be secreted solely by fat cells. However, its importance has since been recognized in other body areas, including the kidneys, placenta, and salivary glands. It is crucial to understand that leptin levels increase exponentially, not linearly, with fat mass, so it is essential to know how much fat mass you have. Leptin receptors are found in the highest concentrations in the brain: specifically in the hypothalamus and hippocampus.

In some clinical studies, chronically-elevated leptin levels are associated with overeating,  obesity, and, as mentioned above, metabolic diseases, including hypertension, diabetes, heart disease, and metabolic syndrome.

The exact ways leptin works are unknown, but the leading theory involves leptin release post-meal, penetration of the blood-brain barrier, and satiety signaling in the hypothalamus. The hypothalamus then signals to our brains when we have had enough food and no longer need to continue eating. As a result, caloric burning can continue at a regular rate.

Leptin Resistance

Leptin resistance occurs when the hormone leptin, which regulates appetite and energy expenditure, no longer works to suppress appetite or increase metabolism in fat cells. As a result, tissues become resistant to even high levels of leptin: a similar phenomenon to insulin resistance with (obviously) different hormonal pathways and treatments involved. Since the concept of insulin resistance is reasonably well known, we’ll focus on the leptin issue that most people are unaware of.

Clinical studies have shown that obese people usually have high leptin levels, hormones fat cells produce. One reason is that leptin production is proportional to the size of the fat cells.

When leptin levels are slightly raised, it suppresses the appetite and increases energy expenditure (i.e., burning calories), but when levels get too high, it has the opposite effect. Many researchers feel that this is why most obese people exhibit leptin resistance— they have a decreased response to leptin and therefore exhibit increased appetite and reduced energy expenditure.

Leptin levels can be measured, and researchers have proposed various theories about why people become resistant to the weight-loss hormone. One possibility is that leptin enters the brain less effectively, and leptin receptors decrease. Yet, another is that a person’s body has developed an overactive negative feedback loop due to chronic high leptin levels. Whatever the cause, we now have some excellent ways to combat this problem and assist with weight loss. If you have been told you have high leptin levels, here is exactly what you need to do to lower them. Let’s start by discussing your hormones.

 Hormones to Optimize Body Composition

A hormonal imbalance is a disruption of the body’s endocrine system. The endocrine system produces hormones, chemical messengers that travel through the bloodstream and affect every cell in the body. Hormonal imbalances can cause many symptoms, such as weight gain or loss, hair loss, fatigue, or anxiety. So it’s no wonder people are confused when they try to self-diagnose!

Hormones are the body’s chemical messengers that transport information from the brain to target tissues and organs. The target tissues and organs secrete hormones in response to the initial hormone, which eventually affects target cells.

Next, the cells send their messengers back to the brain to regulate how much message the brain needs to continue or not continue sending. The body contains about 60 trillion cells that must communicate for hormone-based functions to occur. For these functions to be balanced, everything must work together, just as a symphony orchestra’s members must coordinate their actions.

Hormones enter cells through receptor sites, which can be considered akin to a key unlocking a door. Once inside, hormone molecules control the body’s growth, development, and mental and physical functions throughout life.

As we age, the hormones that keep us healthy begin to decline. As a result, hormonal balance is lost, leading to various unwanted symptoms, disorders, and diseases. In other words, the hormonal symphony plays out of tune and out of cadence. Despite the plethora of hormones in our bodies, those that control whether or not we lose fat and gain muscle are progesterone, human growth hormone (HGH), testosterone, and estrogen. In both men and women, testosterone promotes protein anabolism which is the use of protein to build muscle, skin, or bone; it also mitigates against protein catabolism or breakdown.

Next, let’s discuss a total of three peptides that are useful for building muscle mass via two different mechanisms. The first mechanism is via stimulating the anterior pituitary gland to release more growth hormone (G.H.), which is no longer used by most functional medicine practitioners due to excessive mTOR pathway stimulation, creating a risk for triggering diseases such as cancer. We now safely stimulate the anterior pituitary gland to release more G.H. by administering a precise combination of two peptides: Ipamorelin and CJC-1295.

CJC-Ipamorelin

Both Ipamorelin and CJC-1295 are long-chain amino acid peptide hormones that are promising Growth Hormone Releasing Hormone (GHRH) analogs. When used together, CJC-1295 and Ipamorelin stimulate the secretion of Human Growth Hormone (HGH) and can provide a steady increase of HGH with minimal effect on cortisol and prolactin levels. This means increased protein synthesis, thus simultaneously promoting muscular growth and fat loss. The benefits are not limited to fat loss and muscle mass gain, either! Here is what often occurs.

• Increased lean body mass
•  Increased collagen production
• Increased endurance
• Increased bone density
• Improved lipolysis
• Improved/deeper sleep quality
• Increased energy via mitochondrial boosting pathways-stay tuned here for a discussion of MOTS-c!
• Improved cellular repair
• Accelerated injury recovery
• Improved immune system function

For weight loss to occur, an individual must have balanced levels of estrogen, testosterone, progesterone, a reasonable amount of human growth hormone (HGH), and low-ish cortisol. We measure HGH indirectly via a by-product made in the liver called insulin-like growth factor 1 (IGF1). The following peptide to be discussed increases muscle mass by acting on the small actin and myosin motor subunits, causing them to increase in number rather than via enlargement, as seen with testosterone, HGH, or HGH-stimulating peptides.

What is IGF1-LR3?

IGF-1 LR3 is a modified version of insulin-like growth factor-1, containing three additional arginine amino acids to its sequence. The full name of the peptide is insulin-like growth factor-1 long arginine 3. All IGF-1 derivatives play prominent roles in cell division, cell proliferation, and cell-to-cell communication; however, they differ slightly in their effects on the body. Though it has similar effects, IGF-1 LR3 does not adhere to IGF-binding proteins as firmly as IGF-1; this results in it remaining in the bloodstream 120 times longer than IGF-1. This prolonged half-life is due to structural changes in the protein itself, causing it to become resistant to degradation by proteases (enzymes that break down proteins).

Like insulin-like growth factor 1 (IGF-1), insulin-like growth factor 1-like receptor 3 (IGF1-LR3) is a potent stimulus for cell division and proliferation. Its primary beneficial effects are on tissues like muscle and bone.

Again, note that IGF-1 LR3 does not promote cell enlargement (hypertrophy) but promotes cell division and proliferation (hyperplasia). So, for example, in muscle tissue, IGF-1 LR3 does not cause muscle cells to get larger, but it does increase the total number of muscle cells.

IGF1-LR3 indirectly increases fat metabolism by binding to the insulin receptor and the insulin-like growth factor 1 receptor (IGF-1R). This action results in increased glucose uptake from the blood by muscle, nerve, and liver cells. This decrease in blood sugar levels triggers adipose tissue and the liver to break down glycogen and triglycerides. The result is a net decrease in adipose tissue.

Therefore, this little-known peptide can perform dual functions when looking to lose fat and gain muscle. Next, let’s discuss peptides that directly assist with fat loss. But first, let’s cover the two peptides in vogue. They are both new diabetic medications also being used for fat loss.

Semaglutide

Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are hormones involved in blood sugar regulation. Two new peptide medications have been released which use one or both of these mechanisms of action. The first one released was Semaglutide (Ozempic), and diabetics lost weight during clinical studies, explaining why this drug was immediately re-purposed.

Semaglutide is an analog of glucagon-like peptide (GLP-1) as an FDA-approved treatment method for improving glycemic control in patients with Type 2 diabetes. It increases insulin secretion, which is good for diabetes. At higher doses, it can act on centers in the brain and help suppress appetite. In addition, Semaglutide has successfully lowered blood pressure and promoted weight loss when used with lifestyle changes and a reduced-calorie diet.

Some studies show that Semaglutide can reduce appetite, improve control of eating and food cravings, and improve glycemic control. However, some people taking this drug have reported nausea, diarrhea, and vomiting. Including the peptide BPC-157 and Pyridoxine (B6) in injectable or troche (lozenge) formulations help decrease nausea. Compounded peptides have been found to work even better! I have seen that my patients do better with lower dosing and near-daily use.

Tirzepatide

Tirzepatide (Monjaro)is a medication used to treat type 2 diabetes. Tirzepatide is given by weekly subcutaneous injection.

This peptide activates both the GLP-1 and GIP receptors, as well as the glucagon receptor. It’s an analog of gastric inhibitory polypeptide (GIP), a human hormone that stimulates the release of insulin from the pancreas. This activation leads to improved blood sugar control due to its original purpose of stimulating insulin production. However, the weight loss by study participants was effective and rather remarkable. Here’s why.

Research indicates that Tirzepatide can reduce appetite, control overeating, reduce cravings for food and improve glycemic control. Side effects of this medication may include nausea, diarrhea, and even vomiting. However, the inclusion of other peptides and vitamins in conjunction with a modified dosing schedule seems to reduce the potential for nausea due to this effective weight-loss medication.

If you’re one of many people who cannot stand the thought of any nausea whatsoever, you might want to look for a lipolytic peptide which can be given as a small injection or a troche (lozenge).

AOD-9604 peptide

AOD9604 (Advanced Obesity Drug) is a synthetic peptide fragment that comprises a modified 15 amino acid region of G.H. with a tyrosine component to help stabilize the molecule. It was initially developed to find an anti-obesity drug that had the fat-burning effects of human growth hormone (HGH) without the muscle-building effect. AOD9604 aided weight reduction in rodent models of obesity and was initially developed for treating obesity in humans. Here are some of its finest features.

• Prompts fat release from obese fat cells
• Boosts the body’s metabolism
• Promotes lipolysis without affecting blood sugar or tissue growth
• Prevents lipogenesis (fat accumulation)

And now that you have the tools to find the eating plan, hormones, and peptides you need, what about the most effective and efficient weight training workout to help you lose fat and gain muscle? Before we get into that, let me remind you of some odds ‘n ends you should already know about.

Exercise snacks are short bouts of any exercise, and it all adds up, so read up on this, and yes, I’ll eventually write about it. I’ve written about timed eating intervals, and although the data is a little muddied lately, the bulk of the data shows that health is improved and fat is shed when you confine your food and beverage intake to time-restricted eating.

Your weight workout to lose fat and gain muscle

I’ll discuss the tried-and-true workout many of us “fitness fanatics” have been using for years and years. So here’s the basis for my abbreviated workout.

What’s Super Slow?

Super slow training is a weight training protocol invented by exercise enthusiast Ken Hutchins in 1982. Ken was working (loosely) with Dr. Vincent Bocchicchio on a strength protocol that would be safe for women with osteoporosis. The result of the osteoporosis study was the beginning of a new resistance training technique known as super slow strength training.

As most of you know, in a “standard and accepted” Nautilus training protocol, 8-12 repetitions for a particular body part are performed. Each repetition represents a two-second concentric action (muscle contracting), a one-second pause, and then a four-second eccentric (muscle lengthening) action. The time for the set is about a minute or slightly more.

Super Slow Steps

The super slow protocol is made up of 4-6 repetitions. There is a 10-second concentric phase and a slowly and deliberately done four-second eccentric phase. One advantage of super slow training is it involves less momentum, resulting in a more evenly applied muscle force throughout concentric and eccentric movements. And then there are all the recent studies informing us that muscle growth occurs primarily due to the eccentric parts of repetitions.

A  disadvantage of this training is that it is known to be both tedious and challenging. One reason for this is that the weights are much heavier, and the final repetition is “to fatigue.” To clarify, you cannot budge the weight for the last rep you do, and you “feel the burn.”

There is good, quality research on the efficacy of the super slow protocol. Two out of three comprehensive studies show more significant strength gains for those using heavier weights with longer eccentric and concentric contraction times.

In all studies, the “control group” performed one set of exercises, while the super slow group also used one set, but “to failure.” Studies have not looked at multi-set versus the one-set super slow, but “regular single set” results in 75% of the gains with a 50% reduction of injuries, according to most studies.

Is this Going to be a Modified Super Slow workout? 

Yes! But first, let me give you a little background so you know this is relatively scientific. I used to own fitness centers and created the medical model used by many hospital-affiliated health clubs. In addition, I advised the most prominent global fitness consulting firm (CMS) regarding putting in wellness programs, efficient strengthening programs in their fitness centers, and much more. I had many employees and a staff of well-trained and eager personal trainers who were willing guinea pigs at each fitness center.

They each knew that if they could offer their clients an effective and, equally important, time-efficient way to work out, they would spend less time per client, and clients would spend less money. As a result, this would allow them to train two clients at a time and schedule 2 each 1/2 hour rather than one each hour. They were more than eager; they were begging for this. Do you know what else? So were their clients. That is possibly one of the reasons you are reading this- you, too, are sick of spending more time than you need in the gym. Right?

I had 30 (10/10/10) of my intelligent, savvy, and in-shape personal trainers use one of three protocols for 12 weeks. We controlled for weight and diet and took alcohol out of the equation. So, naturally, no one was a smoker. No one was on any pharmaceuticals or had any illnesses, either.

They all begrudgingly agreed to forego weight training for an entire month before starting this experiment. So then, we followed body fat, biceps circumference, and total weight lifted at the end compared to the beginning. Here is what we compared.

Groups A, B, &  C

Group A did the standard three sets per body part and spent the longest time in the gym. Group B did a “bone-crushing” classic super slow workout. We’ll get to Group C in a minute.

Due to the heavy weight and slow concentric phase, I was so sore each time I tried a standard super slow workout; it almost hurt to breathe the next day, and I’m a jock! No matter how efficient, that type of extreme workout was not “in the cards” for my mostly 45+ fitness center population. Not even for those ten super sore personal trainers, either!

These Group B personal trainers were in the gym for shorter workouts but only needed two per week due to the muscle damage and repair we see with super slow workouts. So yes, twice a week would be an advantage. But again, it’s grueling during the workouts. Not to mention, you are sore as heck until the next activity. My elite trainers all found this to be true.

Group C did “my workout,” which I had been experimenting with for a couple of years, in conjunction with the famed Tasso Kiriakes, a well-known super slow expert.

Groups A and B had similar results. However, they had complaints.

Group A wanted less time in the gym, and group B said the workouts and after-effects were “killing them.” In addition, they felt that their clients would never “go for it.”

Group C was happy about their time in the gym and had the same amount of DOMS (delayed onset muscle soreness) as with “regular training.” Further, they had about 80% of the results of the other two groups but lost body fat just as fast! No one had any injuries, either. After observing my clientele doing “my workout” for 20+ years, I honestly feel this is more effective and much less injury-producing than a traditional workout. And yes, it’s how I train, twice weekly.

Just 18 minutes, 2x a week!

First, you need to warm up, but who says it must be at the gym? To make this all go smoothly, you will need to see the row in the parking lot that is a good 3 minutes away from the gym’s front door. Your warm-up will be a brisk walk from your car to the gym and if there’s a check-in line, keep stepping in place.

So, that’s 3 of the above minutes. You now have a workout that is not more than 11 intense minutes. Get familiar with your training, as 25 seconds are allowed between sets to travel and set weights. The extra five seconds usually go to the exercise. It’s cool once you get the hang of it all, and it works. So, here are tips to get ready.

You’ll need to locate all your equipment,  with backup equipment, in case your “next step” machine is occupied. This can be a frustrating workout if you go during crowded times, so keep that in mind.

Due to set-up time and stability, most exercises will be with machines, not dumbbells. This is a solo workout. If you have a workout buddy, you can swap out and do this routine together, but there will be no waiting for 2 minutes while the buddy does their workout. That is unless you want to more than double your time in the gym, which is not the aim of this article. If you are not familiar with gym equipment and don’t know what a one-rep max is, I suggest you enlist the help of a personal trainer for 1-3 sessions.

Weights

In a “normal” workout, you use an amount of weight that you can lift for 12 repetitions. On the 12th rep, the feeling is like, “OK, I’m done,” but it isn’t to the point where you have pain, and the muscle is fatigued. So you are working at about 70% of your one rep max. To calculate that, here is a one-rep max calculator. This same calculator can be used to see what weight you would use for a super slow routine, which you do at about 90% of a one-rep max (ouch!).

Use the calculator if you are currently on a “regular regimen” to see what 80% of your one rep max would be-that’s what you use for my (now your) workout. You are using more weight because I’m asking you to do fewer reps. Note: Inhale and exhale properly when lifting, especially when doing exercises, as I will describe where your contractions are longer than in a traditional workout.

Equipment

Most gyms have the following equipment: a lat pull down, a chest press, an incline, and decline chest press, a leg press or a squat machine, a posterior delt machine, a lateral delt machine, a calf raise machine, a biceps, and triceps machine, “innies and outies” meaning inner and outer thighs machines and a glute kickback machine. They also have abdominal crunch machines, but I prefer that you use perfect form and “crunch away.”

L.A. Fitness and Planet Fitness have all of these machines. In addition, you can use dumbbells for lateral delts, biceps, and triceps if you don’t need to travel three minutes across the gym. Otherwise, you can add that time to your workout.

Regarding technique, you get 1 minute for one set and 30 seconds between exercises. Those five spare minutes include time for fumbling with weight stack pins and finding the free weights you need. The point of this whole workout is to “keep moving” while alternating upper and lower body parts so you don’t fatigue out 1/2 of your body.

You want a heart rate “up” (about 60-65%-max of 220-your age), but you do not want to get winded as this is not a real circuit workout that reduces your intra-work-out strength and overall outcome.

The Basic Workout

Warm up with your 3-minute brisk walk into the gym. Be dressed and ready to rock and roll. Hang your keys on the rack and get to the lat pull-down machine. Know your routine so well that you can substitute muscle groups if you see that a machine is occupied.

If you get stuck, drop and do abs. Unless you are experimenting, know your weights before you start so you are not “fumbling.” If you are experimenting the first few times, that is fine. However, be aware it will take you longer than when you are on a roll with this.

So, you will start with either a large upper body group or a large lower body group- your choice. Then, you will alternate upper and lower body exercises. You will work from large to small muscle groups. When you are familiar with “your routine,” switch it up.

The substitutions you are given here are to replace the stated exercise with another one to use in rotation with the original movement as you watch your body and “see what’s needed.” As an example, men generally need more calf work than women. I like to work my inner thighs, which most men don’t want to work, but most women do. The same goes for the glutes. Here’s the basic workout below with suggested rotations and substitutions.

Concentric and Eccentric Contractions

If you already weight train, you’re likely used to doing 2-sec concentric contractions (curling up the biceps). Next, a 1-second pause follows. Then, you spend 4 seconds lowering the bar or dumbbell (eccentric contractions).

I would like you to take 2 seconds up (concentric) and 5 seconds down. Most of the muscular hypertrophy that occurs from weight training has been discovered to be due mainly to the eccentric phase of the exercises.

Count in your head to ensure you are doing this correctly until it comes naturally. By rep 5,6,7 or 8 (eight is the absolute end, not twelve), you should only be able to lift the weight with great effort. This routine is not to total failure but to near failure. Here’s the sequence if you’re starting with your upper body, which is the choice for most of us.

The Routine

Lat pull-downs

Leg press or a squat machine: Don’t squat past a 90-degree angle with your knees. If you are a runner or have any signs of arthritis in your knees, don’t even go down to 90 degrees.

Chest press: Alternate workouts can substitute an incline or decline press. Watch your body symmetry and adjust accordingly.

Leg extensions: This is another range-limit option if you have knee issues.

Posterior delts: Most of these machines also work other small muscles on the posterior rotator cuff, so this is an early small muscle group to beat the fatigue.

Hamstring curls: Range limit as needed.

Lateral delts

Back extension: This is a large muscle, but due to heavier than usual weights sometimes being problematic for backs, I do NOT want you lifting this at an 80% one rep max. Use your standard 70% on this and go to 12 reps on this one muscle group.

Calf raises or Biceps or “Your Choice”

Triceps kickbacks

Biceps or “Your Choice”: Your last exercise (other than abs) is the biceps unless you want to add the “your choice” exercise here. If you do that, you can either tack on a minute or leave out one of the above exercises. What’s a minute, anyway? You may want to add inner or outer thighs (can alternate) or the glute machine if you’re a female. You likely want to add more upper body if you are a male. Also, if you want to add, let’s say, incline presses, you need to work them in when we’re doing large muscles. Does everyone get it? And men-please work your calves. This is a Fitness Industry inside joke, wink, wink.

Abdominals: Don’t do the seated crunch, and don’t try to use the one where you hang and pull up your knees-almost everyone who uses that ends up working their psoas muscles, not their abdominals. This is one exercise where you need to put a hand on your belly and feel the area you are working. I am a fan of the “well-done crunch.” Work up to 100. If you do crunches correctly, they work!

You’ll notice the fat loss and a more “cut” appearance within about a month if you stick to this workout faithfully while adjusting your eating plan, and so on.

Conclusion

You now have the tools needed to lose fat and gain muscle. The right food, the proper workout, along with the right hormones and peptides will all work in combination to get you to your fitness goals. Research to watch includes manipulating the microbiome to favor bacterial species that produce metabolites to aid in weight loss and more!

Introduction to Leptin and Leptin resistance-NOTE: we now have Semaglutide and Tirzepatide!

Leptin and its receptors are essential regulators of body weight and energy homeostasis. Multiple studies show that decreasing leptin’s tissue (or receptor) sensitivity leads to metabolic disorders, including obesity. Physiologic mechanisms underlying the development of leptin resistance include gene mutations that encode leptin and its receptors, proteins involved in the self-regulation of leptin synthesis, and even factors that alter blood-brain barrier permeability. Leptin resistance is a complex pathophysiological phenomenon with multiple “lines of attack” for potential treatment. Why is this important? Leptin resistance is the leading driver of fat gain in humans so let me break down how I’ll discuss this complex topic.

• What is leptin?
• What are normal leptin levels?
• What is leptin resistance?
• Ways to lower leptin and treat leptin resistance

1. Raise BDNF (this topic is complex)
2. Lower cortisol and stress levels
3. Lower inflammation levels
4. Improve sleep
5. Correct “eating habits”
6. Fix SIRT1 enzyme issues
7. Miscellaneous tips

What is Leptin?

Leptin is a peptide (short-protein) hormone, originally thought to be secreted solely by fat cells; now known also to be secreted by the kidneys, placenta, salivary glands, and stomach. It’s important to note that leptin levels increase exponentially, not linearly, with fat mass. Leptin receptors are found in their highest concentrations in the brain, specifically in the hypothalamus and hippocampus.

In some clinical studies, chronically-elevated leptin levels correlate with overeating, obesity, and, as mentioned above, metabolic diseases, including diabetes, hypertension, heart disease, and metabolic syndrome.

The exact way “leptin works” is unknown, but the leading theory involves leptin release post-meal, penetration of the blood-brain barrier, and satiety signaling in the hypothalamus. The hypothalamus then signals to the rest of the brain (and probably to fat cells and our microbiome) that we have enough fat stored, we no longer need to continue eating. As a result, caloric burning can continue at a regular rate.

What Are Normal Levels?

We can measure leptin levels with a simple blood test. The results are in ng/mL (nanograms per milliliter).

Normal leptin levels are approximately 4.5 – 23.5 ng/ML and vary slightly between labs. They depend on a person’s BMI, age, gender and tend to get higher throughout the day, towards nighttime when they peak. Degrees of severity are loosely given with “mild” as 15-20 ng/ML and “severe” as 50ng/L or more, but this varies from person to person.

It has been called the “weight loss hormone,” the “satiety hormone,” and even the “starvation hormone.” We know that leptin resistance potentiates the extreme hunger experienced by a high ghrelin state. This (leptin-resistant) physiologic state somehow makes fat cells “think” that they must hang onto fat for dear life. This particular metabolic problem makes weight loss quite tricky unless you deal with the leptin resistance head-on.

Leptin Resistance

Leptin resistance occurs when leptin effectively decreases appetite or increases energy expenditure through basal metabolism or lipolysis in fat cells. As a result, tissues become resistant to even high levels of leptin: a similar phenomenon to insulin resistance with (obviously) different hormonal pathways and different treatments involved.

Clinical studies demonstrate that obese people usually have very high levels of leptin that don’t perform their job correctly. One of the reasons for this is that a leading leptin production site: fat cells, make leptin in proportion to their size.

Although leptin suppresses the appetite when slightly raised, it seems to have the opposite effect when it gets too high. That’s why most researchers feel that leptin resistance leads to increased appetite and decreased energy expenditure.

We can measure leptin levels and speculate on why people become leptin resistant. Theories include leptin entering the brain less effectively, decreasing leptin receptors, or an over-activation of negative feedback loops due to chronically high leptin levels. No matter what causes it, we now have some excellent ways to combat this problem and assist with weight loss. As you’ll see, it’s never a one-size-fits-all (no pun intended) when it comes to effective weight loss strategies. Let’s now get into how we address leptin resistance in the functional medicine world.

How to increase BDNF and therefore lower leptin

Regular and especially Intense Exercise

Autophagy is a term that you will be hearing about more and more as a contributor to disease and aging. It’s a process by which cells remove and recycle junk proteins, and some studies link it to leptin resistance. No matter what, we are starting to recommend “meds” to enhance autophagy even now. Next, let’s discuss hormones, many having positive effects on aging, disease, and metabolic issues, including excess fat. In particular, estrogen deficiency is likely to cause leptin insensitivity in the brain based on good animal data.

And believe it or not, there is more research about how what we eat might impact leptin. Some theories suggest that lectins (e.g., gluten, beans, grains, dairy, nightshades)  bind to surface receptors of cells–including leptin receptors–and mimic or block the effects of that receptor. This theory posits that lectins could interfere with the function of leptin, exacerbating leptin resistance. To “cover all bases,” I advise my moderate to severely leptin-resistant patients to avoid lectins.

New data is evolving consistently regarding the use of cold therapy, whether that be cold showers, ice baths, or even cold weather. Of course, cold might play a role in leptin regulation, so stay tuned for more data on this. But, at least we know that cold is excellent for your mitochondria and, therefore, your energy levels, so why not?. One last and critical note- if you are trying to lose weight and have leptin resistance, don’t do a ketogenic diet, or it will worsen the leptin problem; seriously! (Use keto for insulin resistance).

In my clinical practice, I find that adjusting eating and exercise plans, normalizing cortisol, sleep (often using DSIP), and prescribing NMN and dihexa do the trick every time. The “weight loss peptide” AOD-9604 then “kicks in” when leptin is low enough to allow it to accelerate lipolysis. Bon appetit!

Is a Keto Diet Plan the Best Way to Lose Weight?

If you’re able to alter the way you eat and stick to the keto diet plan, this definitely does “deliver.”  Perhaps, you’re a “dieting” veteran, but still, that doesn’t mean you are versed in how to get ketotic, stay ketotic, and know exactly what to eat and when to eat it. You are also likely unaware of how long you can safely “do” ketosis, how to prevent side effects, and so on. Don’t fret—I’ve done all of the heavy lifting for you. In future articles, I’ll get into the health benefits of “going keto” such as control of Type 2 Diabetes, the role in the treatment of cancer, the prominent role in treating some types of cognitive impairment, epilepsy, diseases of female hormones such as polycystic ovarian syndrome and even Parkinson’s disease. Note: the verdict isn’t in regarding the long-term use of this keto diet plan, so my advice would be to use it when you need it and then eat an anti-inflammatory diet when you don’t. This particular article will focus on how and why to use the keto diet plan for weight loss.

Here’s a significant caveat: If you are using the keto diet plan to self-medicate a disease (which I never recommend, by the way), be careful that you don’t drop weight you don’t plan on dropping.

The new way to “do ketosis” is similar to the Atkins diet, which boosts the body’s fat-burning abilities by eating only low-carb foods and getting rid of foods high in carbs and sugar. Removing glucose and fructose from “carb foods” will allow the body to burn fat for energy instead of glucose. The major differences between the standard keto diet and the Atkins diet are the use of only healthy fats, less overall protein, and no bacon or other processed or seared meat. As an aside, I hope you know to never sear or burn your meat. High temperatures produce toxic, carcinogenic fats. Here is what I’ll cover in this article.

• What’s in the Standard Keto Diet Plan?
• Does Ketosis Suppress your Appetite?
• Your metabolism and (therefore) calorie count in ketosis
• Is the keto diet plan safe?
• Protecting your Microbiome During Ketosis
• What foods should you simply get out of your house?
• Step by step: the beginner’s guide to doing a safe keto diet plan
• What about the “Keto Flu”?
• What are all of the Specific foods, beverages, condiments I can have?
• How to calculate how much protein you need per day
• How many carbs?
• How much fat?
• What should your week and day look like?
• Your ketotic day at a glance

The Standard Keto Diet Plan

There are several ketogenic diets “out there” for people with mitochondrial dysfunction, athletes, and so on. However, for weight loss, we use the standard ketogenic diet. The guidelines are 70-80% healthy fats, 10-20% protein, and 5% carbohydrates. I’ll later translate this into a menu of what you should be eating. Also, remember there is actually no absolute limit to fat intake because energy requirements vary from person to person.

If you are already following my anti-inflammatory diet plan, you will notice the foods are quite similar. However, the noticeable difference is a significant increase in your intake of healthy fats. The key to this eating plan is that you will not feel hungry. Let me explain why.

Using Ketosis to Suppress Appetite

Ketosis is one of the best natural appetite suppressants. If you are eating a typical high-carb American diet, you are experiencing blood sugar swings that cause you to have bouts of intense hunger- sometimes within two hours of eating a meal.  When you start burning fat for fuel (ketosis) rather than using glucose for fuel (“regular eating”), your blood sugar will stabilize at a lower, healthier level, and the ketones made by your liver will suppress your hunger via two major mechanisms.

When it comes to the bulk of hunger pangs, we’re talking about ghrelin. Ghrelin increases appetite. When you eat a meal, ghrelin levels drop, but less so if you are overweight. When you lose weight, your body senses starvation, and ghrelin levels increase, but they do not increase if you are in ketosis. And then there’s leptin.

Leptin gets a lot of publicity as the “hunger hormone, ” but it’s really more of a “fat-storage hormone.” Ketosis doesn’t suppress leptin when you first start this diet. So at first, you might get a little hungry and even have some cravings. It’s not super common, but it’s possible via a couple of complex biochemical changes, including an increase in the relaxation brain chemical called GABA. If this happens, just “power through it” if you don’t have a Functional doctor like me, it won’t last long.

Anyway-back to leptin because this hormone is rather complex. If you are stressed, your cortisol level is up, which then raises your leptin level. Consuming a lot of grains and fruits (fructose) will raise leptin. Having an undiagnosed mold and mycotoxin illness will always raise your leptin. Doing this keto diet plan will help lower your leptin, allowing your fat cells to stop clinging to every calorie you eat. And then there’s the satiety hormone, CCK.

Ketones and CCK—the feel full hormone

CCK is a hormone released by your intestines after you eat. It seems to be a pretty intense regulator of food intake. In clinical studies, CCK injections make people stop eating. The normal decrease in CCK secretion with weight loss is circumvented when you eat a ketotic diet. So, another benefit of a keto diet plan for weight loss is that you won’t experience those annoying plateaus that occur with regular diets.

Your metabolism in Ketosis

You’ll be happy to learn that you don’t have to count calories. You. Just. Don’t! Eat until you are full and don’t snack. Ketosis is a natural metabolic booster, so don’t be afraid of the “fat calories.” You’ll convert the fat to brain-healthy ketones and use them for fuel, with the excess being excreted in your urine. Be careful not to add excess carbs, which could throw you out of ketosis. More about the number of fats, carbs, and protein you can eat coming up later in this article.

Is this diet safe?

Ketosis is safe if you are a healthy adult. If you have Type 1 diabetes, check with your doctor. If you have any lower GI issues such as Chrohn’s disease or leaky gut, you need to be very careful of food choices and length of time in ketosis. I always advise patients with “gut issues” to take the right supplements to heal the most common gut symptoms such as post-meal bloating, watch for flares and add a good fiber supplement to their regimen that serves as prebiotic fiber. Details about this coming up. During the first two weeks of your diet, it’s common to have some fatigue and brain fog.

Some people also develop dry eyes and sinuses. In addition, there is evidence that ketosis might disrupt mucous production in the gut, predisposing you to a possible leaky gut. It also might disrupt the microbiome.  I’ll therefore give you my recommendations on how to protect your gut below when I also discuss prebiotics and probiotics. Meanwhile, if the level of ketosis is too much for you, just adjust your level as I’ll instruct you to do further in the article.

Protecting your Microbiome During Ketosis

To maintain a healthy gut during the keto diet plan, use gut lining reinforcing products such as l-glutamine, colostrum, or even the peptide BPC-157. Also, eat or use prebiotics and probiotics: let me explain exactly how to do this.

Prebiotics are nondigestible carbohydrate compounds found in fibrous foods which assist in the growth of healthy bacteria in the gut. One mechanism of action: good prebiotics often create short-chain fatty acids such as the very healthy-bacteria-friendly short-chain fatty acid called butyrate. Good sources of prebiotics include unripe bananas, raw leeks, raw or cooked onions, raw dandelion greens, Jerusalem artichokes, chicory, asparagus, raw garlic. You can also purchase prebiotic fiber blends and put them in smoothies or shakes.

Probiotics are live bacteria that are ingested, multiply in the gut, and have beneficial effects. One benefit you’ll love is that they increase your metabolism. Sources of probiotics are dairy or coconut kefir or yogurt and fermented foods such as kimchi and sauerkraut. A complete list is below.

• Yogurt (sugar-free), including non-dairy coconut yogurt (Homemade from starter cultures is best.)
• Cheese made from raw (unpasteurized) milk with the latest research showing that A2 dairy is the healthiest choice
• Kefir (fermented milk or coconut drink)
• Pickles (refrigerated, nonpasteurized)
• Olives (organic, no additives)
• Kimchi (spicy Korean condiment)
• Sauerkraut and other fermented vegetables (refrigerated, nonpasteurized)
• Kombucha (sugar-free, effervescent cultured drink)

Since you have to make a daily effort to eat sufficient probiotics, many people use probiotic supplements instead. State-of-the-art supplementation combines Lactobacillus and Bifidobacterium species plus sporulating probiotics (Bacillus species) to create more gut diversity and even some healthy yeast (Saccharomyces) if you do not have mold mycotoxins in your environment, making you sick.

In addition to the dietary additions above, there are modifications to typical keto diet plan foods, which are suggested by functional doctors who want to protect your gut. Multiple clinical studies show that plant-derived protein is far more beneficial for your microbiome (and your metabolism) than animal-based protein. A way to augment this effect is to take omega-3 fish oil supplements to offset the high amount of omega-6 fatty acids you consume when eating meat. Lastly, let me remind you how harmful to the gut processed foods and most artificial sweeteners are.  And while I’m discussing harmful foods, let’s segway right into what foods to get out of your house before you get started on your keto diet plan.

Get rid of these foods

Those of you reading this are coming from many different food worlds. Some of you are already trying to follow a healthy diet. Unfortunately, commercial diet plans may have hoodwinked others and now eat many processed (just like junk) foods from the diet plan. Still, others might be eating what they think are healthy foods such as whole-grain bread. So what’s wrong with whole-grain bread, you ask? Sadly, whole-grain bread cranks up blood sugar more than eating sugar!

Lastly, there may be some of you who are still eating a typical American diet filled with processed and fast foods, sugar, and starchy, processed carbohydrates. No matter what food world you are coming from, you need to clear your pantry and your life from a host of unhealthy and decidedly weight-gainer foods so you can lose the pounds once and for all. Please clean out the sugars, starches, packaged and processed foods from your pantry and freezer. You are going to eat whole, fresh, real food. Guess what? You will feel satisfied, and you’ll love it!

Other no-nos include eliminating most (but not all) dairy products (high in the sugar: galactose) and all grains. Recall you will only consume “healthy fats,” so hydrogenated vegetable oils (cottonseed, canola, sunflower, etc.), peanut butter, and soy products need to go. Don’t worry about the peanut butter because you can have healthy (raw, sprouted) cashew butter and some almond butter.

The beginner’s guide to using ketosis for weight loss (how-to’s):

1. Throw out (or donate) the unwanted foods and get psyched.
2. Get a ketosis meter or urine strips that measure ketones. Check morning and evening: .5-3.0 mmol/l is the range you’ll want to be in. I’ll discuss where “you should be” when discussing the keto flu in the next section.
3. Get a scale and weigh yourself in the morning before consuming anything.
4. Make a grocery list, health food store list, and online purchase list for the products and foods you will need for success. Find out local sources of organic, non-GMO vegetables, grass-fed meats, wild-caught seafood, grass-fed butter, and pastured organic eggs. Source out good, guar gum and carrageenan-free coconut milk. Source out natural shredded coconut and raw non-pasteurized nuts and nut butter. If you will get fancy and start baking, you will need to source out nut flours. You can get some of these things in health food stores, including MCT oil and a delicious casein-free butter called ghee. I love ghee. It adds a depth of buttery flavor to vegetables and even eggs.
5. Secure your healthy fats and the one type of fat that will get you into ketosis faster than any fat, MCT oil. Coconut oil has a fair amount of medium-chain triglycerides, but for best results, you’ll need some MCT oil.
6. Consider purchasing some “exogenous ketones,” which are supplements or supplement powders containing beta-hydroxybutyrate salts if you need a “ketone boost” in the situations described below.

You should not stay in ketosis for more than 2 weeks in a row for best results and overall health. Recall I discussed changes in GI mucous above. When GI mucous is disrupted, so is the microbiome, or gut bacterial protection. We don’t know the long-term ramifications of prolonged uninterrupted ketosis, but studies suggest possible leaky gut. In addition, studies show that one day of very low protein is likely a great health practice for everyone to do weekly. Some people notice drying out of mucous membranes, which isn’t good for prolonged periods, either. For most people, this results in dry eyes, easily relieved with lubricant eye drops.

For all of these reasons, you will “do ketosis” for 2 weeks, and then each week, you’ll pick a day when you’ll go very low-protein (less than 10 grams) and high-carb (up to 200-300 grams-but only with “allowed foods”). To follow, the next morning, you’ll get back into ketosis with your MCT oil or your ketone supplements. If you are having trouble with this diet on weight training days, you can do a high carb day 2-3x per week and still lose weight. Obviously, the high-carb days would be your “lifting days.”

Will I Get the “Keto Flu”?

The ketogenic diet will change your metabolism by putting you into ketosis and turning you into someone who uses fat for fuel rather than sugar for fuel. As a result, you’ll notice some (hopefully) minor issues in the first two weeks. The following symptoms have been named the keto flu.

Keto flu symptoms can include having difficulty sleeping, feeling lethargic, getting constipated, being moody, losing sex drive, getting foggy-headed, and having bad breath. Fortunately, these side effects don’t affect everyone and usually only last for 1-2 weeks. Symptoms will abate as your body adjusts to being in ketosis. Remedies include reducing your levels of ketosis and finding a balance of hunger control and symptom relief. Note that the ingestion of ketone pills makes keto flu worse. Here’s what helps.

Melatonin helps sleep—fiber and water help constipation. Lastly, “cold-shocks” (see mitochondria article referenced earlier) help brain fog and energy levels, and so does the supplement, nicotinamide mononucleotide (NMN).

Specific foods

Healthy Fats

Healthy fats include saturated fats such as grass-fed butter, ghee, MCT-containing coconut oils, and sustainably produced palm oils. Even gross-sounding things such as lard, chicken fat, and duck fat are allowed. Monounsaturated fats such as olive oil and avocado oil are also quite healthy fats, but olive oil should not be used for cooking. MCT oil can be used for cooking and can be taken on a spoon or added to drinks. If MCT oil gives you intestinal cramps or diarrhea, just take the ketone supplements when you need a ketone boost. I’ll go into this more in-depth in a moment. Omega-3 fatty acids are very healthy and should be supplemented if healthy seafood is not plentiful.

All fat should be used liberally except for omega-6 fatty acids found in animal products. You should consume more omega-3s than omega-6s. If you supplement with DHA/EPA omega-3 supplements, you don’t have to “watch everything” you eat regarding the recommended 2:1 ratio of omega-6 to omega-3 fats. Introduce MCT oil slowly, or it will upset your stomach. Start with a daily teaspoon. Your goal is 1-2 or 3 TBSPs of MCT in the mornings to help power your ketosis throughout the day. You don’t have to “eat fatty foods” specifically, as doing so would lead you to a lot of animal protein, specifically beef and pork, which I’m decidedly not recommending for health, and environmental reasons. I won’t “pound this concept,” but I would again like to urge you to source your animal protein products from small farms and avoid factory-farmed meat.

Proteins

Animal proteins contain few carbs but can be used by the body to make glucose, so don’t overdo it on these foods. This particular diet isn’t an “open bar” regarding meats as you might be used to if you have followed the Atkins diet in the past. However, with all the hunger-suppressing fats you will be consuming, you shouldn’t have to worry about the amount, especially during the first two critical weeks of this diet.

High omega-3 fish include sockeye salmon and sardines (in water) as the best choices. Beware of other fish unless you are sure it’s not farmed. Wild bass, mackerel, flounder, mahi-mahi, dolphin (no-not Flipper–the fish!), and anchovies are all healthy choices.

• All meats which are grass-fed, organic, and certified to be such are acceptable.
• Grass-fed organic meats are higher in omega-3s are just plain healthier for you.
• Organ meats are technically permitted, but I’m not crazy about recommending parts of the body such as a liver or a kidney because they are the toxin-filtering organs of the body.
• Cage-free “pastured” eggs are full of healthy cholesterol, and consumption of these products is no longer restricted. Poultry is the “least reliable organic” meat, but everything from chicken to quail, duck, goose, pheasant, and turkey is permitted. As always, source these products from family farms.

I allow all nuts other than peanuts. Other keto diets restrict nuts and seeds due to the amount of protein people eat when consuming nuts. However, you are all adults and can budget for the protein of walnuts, pecans, macadamia nuts, hazelnuts, and even high-protein almonds. Coconut can be consumed liberally and is encouraged.

Yes, I did say that dairy was a no-go, but you can absolutely budget some raw cheese and yogurt into your diet after the first 2 weeks.

Non-Starchy and Starchy Vegetables

During your first two weeks, you want to limit your veggie consumption to the very low carb group, with some of the low carb group carefully included. Then, after week 2, add in the moderate and high-moderate carb groups of foods and use the high carb veggies for your high carb day(s). Here are the groupings of your veggies.

Very low carb: Fresh herbs—close to 0 grams net carbs per 1-2 tablespoons. All leafy greens include romaine lettuce, endive, escarole, radicchio, spinach, collards, turnip greens, chicory, fennel, chard, and kale are most of the veggies in this group.

Low carb: Cucumber, zucchini, leeks, and chives, as well as onions and (my fave-on everything!) scallions, make up this flavorful group.

Moderate carb: Healthy and tasty cruciferous vegetables such as cabbage, cauliflower, broccoli, and brussels sprouts.

High-moderate carb: Asparagus, bell peppers, radishes, jicama, green beans, wax beans, water chestnuts, bean sprouts, bamboo shoots, and wax beans. Eggplant, bell peppers, and tomatoes are at the high end of the carbs and sometimes questioned as to their consumption during ketosis as the highest lectin-containing  “nightshade vegetables.” (Those with leaky gut or autoimmune disease should not consume nightshade vegetables, and so this question is “out there” as to whether or not they should be consumed in ketosis. I choose not to, personally).

High carb: All types of squashes, sweet potatoes, carrots, turnips, beets, parsnips, and rutabagas.

Fruit

You can consume berries, apples, and citrus in small amounts, starting after the first two weeks, as they are lowest in fructose. You should know by now to exclude fruit juices if you have been following my anti-inflammatory diet. If not, now you know! Let me do a big shout out to the fruit many people think of as a vegetable, the avocado. It has up to 8 grams of carbs per the whole avocado. Try to work this in as much as possible as it is one of the healthiest foods you can eat.

Condiments

Spices and herbs, apple cider vinegar, hot sauce (with no additives or sweeteners), unsweetened mustards, homemade mayonnaise (egg yolks, lemon juice, apple cider vinegar, extra virgin olive oil), and homemade salad dressings are all “on your list.”  Check out the Keto Social media groups for recipes. Also, check out the Keto Etsy bakers and the companies that now cater to making keto foods, snacks and desserts. Sweeteners considered safest for health include stevia and monk fruit. However, I’ll also include xylitol (toxic for dogs, so–pick up your gum!) and erythritol-not sucralose, which destroys the microbiome.

Drinks

Of course, you can drink water and unflavored sparkling water. Lemon wedges really add a lot of flavor, but remember to count the carbs from them. I hope you know that diet soda is “toxic waste.”   Coffee doesn’t need to be black and unsweetened or filled with “bulletproof” butter and MCT oil. I love my morning coffee and cannot stand oil in my coffee, no matter how good it might be to get me into ketosis when I occasionally “do ketosis” for health reasons.

However, if you want to try putting grass-fed butter and MCT oil in your coffee, go right ahead. Just heat your blender and blend this concoction. Power to you if you like it. I just don’t like it and can only “go so far” regarding healthy practices. For me, my morning cup of coffee is just plain sacrosanct. You can have coffee with stevia and coconut creme or a blend of coconut creme and almond milk. Or you can have heavy cream. You just need to account for the carbs. Drink all the organic (not teabag) tea you want, but the same rules apply. You’ll be happy to note that you can have very dry wine, champagne, or clear alcohol such as vodka, tequila, or gin in moderate amounts on my keto diet plan. As always, you need to account for the carbs.

How to calculate how much protein you need per day

You’ll need to keep re-calculating as your fat mass goes down and lean mass goes up. You can calculate this by figuring out your lean body mass. If you don’t have access to calipers or other body fat measuring scales, do an estimate. If you cannot take a “real” body fat measurement, use this calculator and then just experiment with amounts of protein, carbohydrate, and fat that can keep you in ketosis. It isn’t hard at all. Stick to the right foods and eat enough fat.

The Formula

Do you have your % of body fat? Your % of lean body mass is 100 – your % of body fat. Figure out what you weigh in kilograms by dividing your weight in pounds by 2.2. Take that number and multiply it by the % of lean body mass you have. That gives you the number of lean body kilos you weigh in with and tells us how much protein you need. You need a gram of protein per kilo of lean body mass.

An example is a 120 lb woman with 30% body fat, meaning, by definition, 70% lean body mass. 70% of 120 is 84. 84 divided by 2.2 is 38. Therefore, she only needs 38 grams of protein per day. This might be shocking as you are probably familiar with much higher quantities of protein in low-carbohydrate diets, right? Well, if you eat too much protein, it will convert to glucose. As a result, it will kick you out of ketosis.

So, watch the protein. It adds up really quickly. Ten almonds have six grams of protein! One egg has 6.3 grams. A piece of meat or fish the size of a deck of cards (4 ounces) has 20-25 grams. Be careful not to load up your protein into one meal, either. Your liver will kick you out of ketosis with more than 20-25 grams of protein at one sitting. All of this is obviously individualized. Everyone is unique. Figure out what you need and how much protein is in what you like to eat. Make a list if it helps.

How many carbs?

This is where you get to do some personal experimenting. Most people do the best eating somewhere between 20-50  grams of net carbs daily. “Net carbs” means you can subtract fiber and sugar alcohols (like xylitol) out of your daily carb count, but now that I’ve told you that- you could forget it; just eat what’s allowed and measure your ketones. I know this flies in the face of advice to “weigh everything,” measure everything and count all grams of everything at all times. I have read that sort of advice, and it makes me want to stab my eyes out just reading and imagining doing all of that. Doing this my way (which I’ll re-iterate at the end) just makes it all easier and more doable. Note that it is typical to lose a lot of water weight the first two weeks and experience thirst. Make sure to drink plenty of water during this time.

How much fat?

Let’s just say it will be more fat than you have ever eaten if you are a chronic dieter. It will feel quite odd eating so much fat, and you’ll wonder, “how can this be?” Well, let me assure you that the process of ketosis does indeed increase your metabolic rate, and you can just get yourself into ketosis and stay there with fat at every meal.  Again, you want to eat what amounts to up to 2-3 TBPS of fat at every meal—calculate this in with the fat in your meat, eggs, and so on.

What should your week and day look like?

Your week: Eat high fat, very low carb (<50g net carbs/day) 6 days a week, then have a carb re-feed on day 7 (150-250 grams of net carbs). Remember, this day is your low-protein day to help your body detox. This is 5-10 grams of protein only, and it “goes quickly!” If you have carb cravings on your re-feed days (it happens), have l-tyrosine and the SAMe handy to amp up your dopamine. If you can’t do the 6 and 1 as suggested for athletic (or just plain intolerance) reasons, do re-feeds as many as 2-3 days per week on your training days. Only restrict protein one day, though. These instructions assume you have done your first two weeks of ketosis where you eat controlled protein, high fat, and very low and low carb veggies only.

Your ketotic day at a glance 

Breakfast: If you get yourself right into a high level of ketosis each morning, you’ll have more “brain energy” and absolutely no hunger all day. Have your morning coffee as described above. Use MCT oil or ketone supplements as needed. After the first two weeks, if you want to add some eggs, that’s fine.

Lunch: Since this all “works better” and is healthier (due to good biochemical pathways being activated), if you confine all eating to a 6-8 hour window, and you will not be hungry until 3-5 P.M. anyway, delay lunch until 2 to 3ish. Then have a ton of low-carb veggies with a 1/2 card deck size of meat or fish protein.

Dinner: How does dinner at 7 or 8 sound? After the first two weeks, we can really have fun with this meal. Have some olives or a deviled egg made with your special mayo. Enjoy a cocktail; no mixers, but just as listed above. Have a lovely salad with homemade dressing. If you are at a restaurant, ask for EVOO (extra virgin olive oil) and lemon. Give back the breadbasket. Better yet: ask them not to bring it. Instead, have tons of vegetables, drenched in ghee and seasoned well.

Make your veggies creamy by taking 1/3 of whatever you made, putting it into a blender, and then blending it back into the veggies. Yes, you’re back home again. Now, go ahead and have some dessert. First, you can make “jello” by using flavored herbal tea, gelatin, and stevia. Next, you can make an amazing keto pumpkin pie and shave a teensy bit of dark chocolate and top it with whipped coconut creme.

Indeed, have dessert every night! In my world, that makes this eating plan 100% doable. You won’t miss chips if you can have chocolate mousse and/or specially made ice cream every night, will you? You can shave 85% chocolate on top of your coconut whipped cream every single night if you budget correctly!

I didn’t list “it” as I don’t want to encourage too much dairy, but you certainly can budget for some real whipped cream, stevia-sweetened, too. Search the internet, look for “keto bombs,” find a good cookbook and go to town. You can actually enjoy losing weight on the keto diet plan if you get creative enough.

Many of my patients tell me that they experience a surge of energy, brain focus and are just “happy as clams” doing this keto diet plan. It may or may not “be for you,” and you’ll know if it is “right” within the first 6 weeks. If it is “right for you,” my wish for you is that you achieve and then maintain your ideal weight for the rest of your life.