41:11

Dr. Will Cole (he/him) is a leading functional-medicine doctor, author, and ketogenic diet expert. Melissa and Dr. Cole talk about the history and modern applications of the ketogenic diet, examines why your individual goals, context, and health history must dictate the way you implement these principles; how to apply keto in the way that’s right for you; and whether keto plus the Whole30 is a good fit.

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Dr. Will Cole

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Episode Notes

Joe Rogan podcast with Andy Galpin (referenced by Melissa; starts around 43:00)
Electrolytes (referenced at 25:12): Lyteshow dropstablets, or rip packs (Whole30 Approved)

#melissaurbanreads

Ketotarian, Dr. Will Cole
The Inflammation Spectrum, Dr. Will Cole (Oct 2019)

MU: 01:11

Hi, my name is Melissa urban and you’re listening to Do the Thing, a podcast where we explore what’s been missing every time you’ve tried to make a change and make it stick.

MU: 01:25

Today my guest is doctor Will Cole, functional medicine doctor and Ketogenetic Diet expert. If I had a dollar for every time you asked me about Keto, I would be recording this from a private island in The Bahamas. There’s a lot of information and misinformation about what Keto is, who it’s for and how to use it in a way that takes into account your goals, lifestyle and context. Today we’ll dig into the science and the practical application, debunk some common misconceptions about Keto and carbs, and attempt to answer the question, is a Keto approach right for you? Spoiler, we’re going to say “it depends” a lot. My guess today is Doctor Will Cole leading functional medicine expert who consults with people locally in Pittsburgh, Pennsylvania and around the world via Webcam. He specializes in clinically investigating underlying factors of chronic disease and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders and cognitive function.

MU/WC: 02:24

Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is a health expert for mindbodygreen and goop. He’s the author of the book Ketotarian, which melds the powerful benefits of a ketogenic diet with a plant based approach and the soon to be released book the Inflammation Spectrum coming October 15th, 2019. A right, Dr. Will Cole, welcome to Do the Thing. We are so excited to have you on the show today. (WC) Oh my goodness. I’m so excited for you, this show is going to be amazing. (MU) Thank you so much. We have so much to talk about with this Keto 101 episode, but before we start, I ask every guest at the beginning of the show, Will, what’s your thing?

WC: 03:05

My thing is giving hope to people don’t who don’t have it and teaching them tools to regain that hope, and regain their health through functional medicine.

MU: 03:15

That is wonderful. And I’ve seen that of course in real life because you and I are friends and we’ve had many of these discussions and I’ve heard many of your talks and events. You’re the perfect person to dive into this idea of what is a ketogenic diet. So before we get into the history and why it’s so popular now, what does a ketogenic diet mean? What does it mean to be in ketosis?

WC: 03:35

So the ketogenic diet, by its very definition, it’s a high fat, moderate protein, low carbohydrate diet. So it is burning fat for fuel. And if you break that word down, Keto (fat) genic, it’s using fat for fuel. And from a metabolic standpoint, we can either burn sugar or burn fat and most of us in the West are burning sugar. We’re sugar burners. And that is like kindling on a fire. You’ll get light from kindling, but it’s short lived light. You have to keep putting more kindling on the fire. And that’s what sugar does. And things that break down into sugar. And then there’s the western diet with its refined carbohydrates and sugar and processed foods. And then there’s the cleaner kindling, which is whole foods that break down into sugar… but it’s kindling nonetheless. And there’s a place for it….

WC: 04:26

But most people are kind of trapped in that only burning sugar for fuel state. And the alternative is burning fat for fuel. So that is what Ketosis is. Nutritional Ketosis is this natural metabolic state that we all have from an ancestral health standpoint. We would all have been as human beings in, in times of, of Ketosis, uh, when there was a lack of food or a lack of carbohydrates in the diet. Food wasn’t as readily available. Humans have adapted to burning fat for fuel, and we are all born as babies burning fat for fuel. Babies actually produce ketones for neurological development. Every one of us do. So this is what the ketogenic diet is.

MU: 05:13

I think there’s a perception now around Keto that it’s a weight loss plan, but the ketogenic diet actually has a really specific history as medicinal treatment. Can you tell us about the origins of a Ketogenic Diet?

WC: 05:27

Yeah, so a ketogenic diet wasn’t called that, but a high fat, moderate protein, low carbohydrate diet would have been used by humans for a long time in different fasting…. Practices of fasting have been used throughout history as well. And fasting producing ketones is one of the benefits of fasting, but specifically the name, the ketogenic diet had its birthplace in modernity in early, mid 20th century when a lot of the research was found to be very beneficial for children with epilepsy and seizure disorders. Uh, so this was revolutionary that a way of eating could actually provide fuel for the, for the brain and to really reverse seizure disorders and reverse epilepsy. Now in the 21st century, the research around the ketogenic diet is as far more broad and more far reaching.

WC: 06:26

And the research of showing the ketogenic diet to be beneficial for a lot of different health problems of and weight loss being one of them, but also diabetes, PCOS, people with other inflammatory health problems because the ketone Beta hydroxybutyrate that your body naturally produces in this metabolic state. It’s a genetic modulator, which just is a big fancy way of saying it does cool things for our physiology. One of them is it, it lowers inflammation, which you and I both know is really the commonality between just about every health problem. So it’s a way to leverage food to code, sort of enhance the anti-inflammatory benefits it has.

MU: 07:07

That makes sense. Why do you think it’s so popular right now? I mean, you can’t walk the floor at Expo West or listen to a podcast or read an article or social media posts without somebody talking about the Keto Diet. Why now? Like, how has it grown to become the most googled diet term in 2018?

WC: 07:27

I think because people are looking for answers and I think that the research is compelling to a, and as these things go, there’s normally a trickle down between research and pop culture, and things that are trending, and people are into biohacking. And I think it’s really born out of the bio hacking trend as well. Um, and it’s also, I believe the popularity of the Ketogenic Diet is having its zeitgeists at the moment because the Paleo movement broke down some of the paradigms of fat is bad for you. And this is sort of the next frontier of that… fat is not only healthy for you, but what would a high fat diet actually look like. So I think it’s, it’s sort of the evolution from the Paleo community as well.

MU: 08:17

Yeah. It’s also really sexy, isn’t it? We really like extremes when it comes to kind of diets and really everything in general. So you know, someone coming on and saying, well it’s moderate, this moderate, that moderate that isn’t super appealing. But the idea of well it’s, you know, really swinging onto the other end of the spectrum. We thought that fat was so bad for such a long time and now the most popular diet is one that’s a really high fat diet. So I think those swings kind of appeal to people. Maybe they feel like, you know, by going to one end of the spectrum or the other, it’s really going to have like the impact or be the thing they’ve been missing.

WC: 08:52

Yeah, I agree. It’s almost like the anti-American western SAD diet cause it’s the complete opposite. And you’re right, it appeals… these are all the foods that everybody was told you can’t eat, you know, bacon and cream. I think you’re right. It plays into sort of this, this, uh, sexiness of that. And it’s appealing for people.

MU: 09:15

It’s also a little reminiscent of Atkins, which is not necessarily a good thing. What’s the difference between a ketogenic approach and the older, older Atkins kind of philosophy?

WC: 09:25

Yeah. There are definitely groups within the Atkins community that are kind of symbiotic with the Ketogenic community. The main difference if you had to say is that the act of a measuring Ketosis, which is an aspect for some Atkins for sure, but it’s the moderating the protein more than anything and making sure you’re in ketosis and not just a high protein, low carbohydrate diet. Because just because it’s a low carb diet doesn’t necessarily mean you’re in ketosis. That’s the main difference.

MU: 10:00

It’s almost like we planned this because that is the perfect segue into the next conversation topic, which is, I’ve heard you describe Keto as moderate protein, high fat, low carb, but everyone has a different definition of Keto. So you know, you read some things and it says you have to be under 50 grams of carbs a day. Other things say no, no, no. It’s closer to like 10 to 20. If you’re a professional athlete, you may be able to be in Ketosis at a hundred or 200 grams of carbs a day. Is it like everyone’s got a different definition? I feel like there isn’t one standard definition and if not, doesn’t that make it really hard to follow?

WC: 10:37

Yeah. Because it is a broad definition of high fat, moderate protein, low carb that is relative to the person, which is really the heart of, of functional medicine, of kind of finding out what works for you and your embodied. And I think that when you look at this state of Ketosis, it depends on your carb tolerance. It depends on your carb sensitivity. It depends on your protein sensitivity to. So the only way objectively speaking that you can see if you’re in the zone or not in the zone if you’re in ketosis or not, is to test. You can go off of how you feel for sure. And I think if someone’s doing it just from a, hey, I want to see if I can boost my brain function or lose weight, then maybe you don’t want to test. And you can just see, hey, does this move the needle in my life in a positive direction in that may be enough for people to keep it simple.

WC: 11:25

But to actually know am I hitting this state of nutritional Ketosis? You’re going to want to get a ketone blood meter, or a breath meter would be the two best ones and then you know, urine strips aren’t the best, especially as you get more fat adapted. All it’s really telling you is that you’re good at peeing out ketones, which isn’t really helpful from an am I burning ketones perspective. We have to find our carb sensitivity but I think that comes down to bioindividuality and like you said, we can have upwards of a hundred grams of carbs a day and be producing ketones for some people. But then some people are extra carb sensitive and they’re going to have to be under 50 or under 20 but when I wrote Ketotarian because I want people to be more plant centric and not fear vegetables, which is one of the problems I have with the conventional ketogenic diet.

WC: 12:16

It was radical among the Keto zealots to see 55 grams of carbs for eight weeks while you get fat adapted. They thought that was crazy because for them they want to stay under 20 grams. But uh, this is not the case. People can have a more of a liberal, perspective if the carbs are coming from fiber rich vegetables, which actually has been shown to be beneficial for glucose and beneficial for your blood sugar basically. And of course your gut microbiome. So yeah, it’s a nuanced conversation, which isn’t so sexy in our culture, but we need to start having this. If we’re going to do Keto, right, we need to have these conversations.

MU: 12:55

I mean, what percentage of our conversations involve the idea of context matters? Like 100%. We’re always saying, it depends, what are your goals, what’s your context? So it is important. You’ve talked a lot about the benefits of a ketogenic diet for a very specific medical conditions like epilepsy, neurological conditions. You’ve talked about recent research that talks about Keto being very good for people with Metabolic Syndrome and for weight loss and for people who maybe need an anti inflammatory diet. So it sounds like a ketogenic approach might be a good experiment for a bunch of different kinds of people, but who isn’t a kenogenic approach good for? And I have a long list of questions to ask, but maybe you can cover a bunch of them all at once.

WC: 13:37

A ketogenic diet wouldn’t be good for someone who loves donuts. That would be number one. Beyond that, I mean I would say you’re going to want to find why you’re going into this cause I think when you’re talking about carb restriction and measuring Macros, potentially not saying you have to do that, but when you start having this conversation of carb restriction, macro counting, I feel like it could feed into things like Orthorexia and basically of fear and anxiety and stress about eating healthy foods. Those people that are prone to eating disorders. I would say not that you can’t do the ketogenic diet, but I think you need to get the foundations right first to get a healthy relationship with yourself and healthy relationship with food. And then from there you can lean into the ketogenic diet. Um, and then feeling great and stable hormones and inflammation levels can actually be really beneficial using the ketogenetic diet healthily.

WC: 14:35

But I find this phenomenon across the wellness world, but probably a little bit higher in the Keto world of people becoming orthorexic because they are obsessing and stressing about eating, which is really the antithesis of what my message is with wellness and functional medicine. So that would be one group of people. Uh, and then, I mean there are a few genetic disorders where they don’t break down fat very much. I think that that could be a problem for some people. But I would say this, on the blogosphere, the people that are told they should maybe not doing the ketogenic die…. I would argue it’s just the ketogenic diet done wrong for their body. It would be people with thyroid issues and people with adrenal fatigue. And for those people, I think it’s just tailoring the ketogenetic diet for their bodies.

WC: 15:26

That is the issue. It is. What does the carb count look like? Do we do a cyclical ketogenic approach for these people because I don’t think you necessarily have to throw the baby out with the bath water, so I feel like the nuance matters. Their context matters there. It’s not the Ketosis is wrong. It’s like, okay, are you doing this? Are you doing too much too soon? Are you being too aggressive? Just like with fasting, fasting isn’t bad, but if someone is punishing their body with fasting, that’s a problem, so I think that that’s the same with the ketogenic diet or you being super punitive and being super carb restricted long term. That’s probably not going to be good for a lot for some people, but you still can get the benefits of ketosis but maybe have a little bit of more of a moderate perspective and maybe consider things like a cyclical approach or even doing it seasonally. It doesn’t have to be ketosis all day, every day for the rest of your life, which I don’t think is needed for everybody.

MU: 16:25

Exactly. There’s been a lot of conversation and I’ve done a lot of reading recently around Ketosis for athletes, specifically those who participate in sports that require glucose, the high intensity stuff. And you know, I heard Andy Galpin on Joe Rogan talking about how context matters and if you are doing a sport that is reliant on carbohydrate for fast energy, you’re going to need to feed your body with some carbohydrates. But that doesn’t mean that he wouldn’t put some of his athletes on a ketogenic approach on the off season or during certain training cycles, just not in the heat or the throes of competition. So you know that context really does matter. You have to think about what are you using it for, what are your goals, and then how do you apply it in a way that’s right for you.

MU: 17:10

Has there been research on a Ketogenic approach and the success of it on men versus women? Cause I’ve read a lot of research on fasting and how intermittent fasting isn’t necessarily as health promoting for women.

WC: 17:21

Yeah, there are studies that are coming out and they’re the, mostly mice studies looking at female mice versus male mice. Um, and I believe, I mean what we see with these early reports is that women though at least the female mice tend to have different behaviors to the ketogenic diet and may not get all the benefits that the male mice get. Obviously there’s limitations in that study, with it being a mouse study, and more studies need to be done. And there are other studies that show that women with insulin resistance, weight loss resistance actually are really benefiting from a ketogenic diet. So I think that again, context matters. We’re going to be redundant when it comes to that. So it depends on the case that you’re talking about. But, um, there is a protein that women tend to make more of which makes them more sensitive to fasting, and the ketogenic diet can be seen as a fasting mimicking diet.

WC: 18:17

So you get a lot of the same benefits that fasting has, but you’re still eating food. Um, so that can make some women more sensitive to Ketogenic Diet and fasting. But again, it’s a balance. It’s the Goldilocks principle. You can still leverage the benefits that we’re talking about here, the anti-inflammatory brain boosting and weight loss benefits of Ketosis. But let’s talk about balance and let’s talk about maybe refeeding with carbs and cycling carbs in to get your body the thing that needs. And we all need balance. What we want to do is get somebody to the place of metabolic flexibility. Most of us are not metabolically flexible. So how I see the ketogenic diet done properly is do it with clean foods, do it with real foods, but let’s get you from a sugar burner to a fat burner over a couple, you know, eight weeks, maybe a couple months. And for some people they may need longer than that. But then from there they’ve created some metabolic flexibility. They can burn sugar when they want to and burn fat when they want to, but they have that grace and that flexibility to do that. The problem is most people are just stuck in sugar burning and they don’t have that flexibility. So we can use the ketogenic diet to regain that, the ability to burn fat as well.

MU: 19:41

Absolutely. And again, for athletes that would be an incredibly important ability to be able to kind of turn it on and tap into both fuel sources.

WC: 19:48

There’s a place for kindling on a fire. I mean, like you said, I mean endurance athletes, they’ve may need that kindling. And you can do that.

MU: 19:56

Yeah, absolutely. So we’re going to take a short break, but after the break I’m going to ask you about how to do Keto the right way and all the ways people seem to get it wrong. We’ll be right back on Do the thing with Dr. Wilson.

MU: 20:47

All right, we’re back on Do the thing with Dr. Will Cole, who is giving us the Ketogenic Diet 101. Let’s talk about the right way to do a Ketogenic approach. A lot of people have questions like, do you have to test your ketones? What’s the best way to test them? Do you have to take exogenous ketones? Do you have to weigh and measure to the gram? What is like a general good approach to a ketogenic diet for people who are just getting started?

WC: 21:46

For somebody just getting started, again, like I said earlier, I want to somebody to have a healthy relationship with food, understand what eating real food looks like. So when I wrote Ketotarian I wanted to have keeping it simple options and then the sort of biohacker like technical stuff too because some people, I would say a lot of people that are listening, just people that want to better their health will get benefits by just keeping it simple by just focusing on healthy fats, limiting their carbohydrates and instead of just focusing on healthy fats and then lots of good non starchy vegetables. So that’s that side of things because most people start getting that, so producing some ketones whenever they just do that. And then on the other side, the only way to know for sure is to test a blood ketone meter being the best…

WC: 22:38

Then breath test or a breath Keto analyzer would be the next best option. And then you want to see if you’re producing ketones, if you’re in nutritional ketosis or not, or you could just go off of how you feel. Do you have more energy while you’re losing weight, better brain function. These are sort of the natural indicators that you’re producing ketones and you’re seeing these benefits here. And then how to do the ketogenic diet is really, really important because there’s a lot of #Keto things out there on social media. Just because it’s Keto doesn’t necessarily mean it’s healthy; you have to start with real food. And then from there leverage real food to tap into this metabolic state of Ketosis.

MU: 23:25

I am like throwing up the praise hands behind this microphone when you said just cause it’s #Keto doesn’t mean it’s healthy. Obviously, you know, you see a lot of things now that are like, it’s Keto cookies and Keto cakes in Keto fat bombs and all of these other things like just cause you slap a Keto tag on it doesn’t mean that it’s appropriate for your diet or your context. So those are, that’s a good kind of overview of how to get started with the ketogenic diet. But I do know from the reading and research that I’ve done and from my own like kind of experiment with a low carb approach that the transition can be pretty rough. Like it can take a few weeks… a little while for you to get into ketosis and it will take your body a few weeks to learn on relying on ketones for fuel. And during that kind of transition phase you can get what is called the Keto flu. You can feel lethargic and tired and cranky and foggy. How do you know if your ketogenic like experiment is just in this sort of transition period or if you’re honestly just digging yourself into a metabolic hole?

WC: 24:24

Yeah, that’s a good point. So not everybody has a Keto flu. Some people don’t. And some people that do have something like the Keto flu have it to various degrees. I would say that most people, it’s mild and it’s short lived. If something’s going on weeks and weeks and it’s not relieving, I would say we want to check into what the person’s doing. Are they hypocaloric or are they just not eating enough food? Cause I find this to be the most common problem is when they quote unquote go Keto, they’re just calorically not eating enough food because they don’t know how to eat foods that aren’t carbs. So even if they were eating real food carbs, they’re not having all the fruits and the sweet potatoes and the tubers and the, even the grains, the gluten free grains, then not having those necessarily with the, this ketogenic experiment that they’re doing.

WC: 25:12

And then they’re just at a caloric deficit and maybe they’re still working out and they’re not giving their body that grace time to start burning fat for fuel, which you’re right, it takes time to do that. Your Mitochondria has to learn to burn ketones instead of sugar to produce ATP. So that takes time, that, that transition period. And I find that a lot of people find themselves in this sort of metabolic purgatory. They’re not fully burning fat for fuel, but then they stopped eating all the carbs. So, and then they’re feeling like crap because they’re in this metabolic purgatory. So the goal there is to kind of speed up that transition into ketosis if that’s their goal. So that’s what I would say for somebody that is having that transition time of burning fat for fuel, stay hydrated and make sure you’re drinking enough water, making sure your electrolytes are balanced and most electrolytes are found in plant foods.

WC: 26:08

So there you go. So a lot of green leafy vegetables and things like spinach and even nuts and seeds have sodium and magnesium and potassium and that they need to have balanced blood sugar and healthy cardiovascular system because as someone’s burning fat for fuel that becoming fat adopted, they’re losing a lot of that inflammation and that water weight, and when that water weight leaves them, that can throw out some of the electrolytes. So you want to make sure that your electrolytes are balanced during this time too. Again, I don’t want to over dramatize it. For some people it’s not issue at all and they just have that they can start producing ketones and they feel fantastic, but it’s important to talk about obviously.

MU: 26:50

Yeah. And I see that a lot with the Whole30 too, where people love the idea and are starting to embrace the idea that fat isn’t the devil. And so they get the idea that okay, I can start eating dietary fat, but they’re still a little bit fat phobic. It’s a little bit hard to make the swing between the, the low fat standard American, even the healthy diet that you are eating into a Whole30 or ketogenic approach. So I think it’s really smart to say very first and foremost are you eating enough? What are some other common pitfalls you see people stumbling into with the Ketogenic Diet? Like they’re not eating any veggies, their food quality is poor. They’re trying to apply Keto in like a mismatch with their current athletic training or context.

WC: 27:32

Yeah, for sure. I think that quality of foods matter just because, like we said, just because it’s high fat, low carb doesn’t necessarily mean it’s good for you. And macronutrients matter, but I believe that food quality matters more. So you need to be focusing on healthy foods again. And from there you can adjust the macros as you want to, to kind of lean in yourself into this more of this ketogenic state. Um, and I find a lot of times people, uh, are focusing a lot on, you know, fatty meats and a lot on dairy. And a lot of people have dairy sensitivities and then they get this… there’s freedom to that. You’re going Keto, so they can have all this dairy but they have a casein sensitivity or they’re lactose intolerant or they’re having some dairy response, and that’s not going to work for them.

WC: 28:27

So I find that most people find them themselves with this honeymoon period, but the conventional ketogenic diet, because they are off of the carbons and the junk food and all that stuff, and they’re like, this is amazing. But then they get stuck at this plateau because they’re avoiding vegetables because fiber by its very definition is a carbohydrate. So they’re like, well, I have to count total carbs. And if I’m above 20 or 50 grams of carbs is good, I’m going to be out on my carb count pretty quickly if I have vegetables. And they don’t understand that all carbs aren’t created equally in fiber is actually needed for a healthy gut microbiome and detox pathways and cardiovascular health. Uh, so this is a whole conversation that you have to be well informed when you’re going Keto and not just avoiding vegetables are becoming obsessed with, with, you know, restricting carbs. Because for long-term wellness, which is what my goal is from a functional medicine standpoint, we have to avoid these potential pitfalls of the Ketogenic Diet.

MU: 29:28

Yeah. And so for people who do Keto, and you mentioned like they have this honeymoon period and then they hit a plateau or maybe they have a honeymoon period and that honeymoon period last four, five, or six months. The question I keep hearing over and over again is, do I have to keep doing this forever? Do I have to keep doing exactly this way with the testing and the weighing and the measuring this way? Or is it something that I can cycle in and out of or that I can maybe hit when I feel like I need a little bit of a reset and then go back to sort of my normal diet and still keep the benefits that I gained when I was in Ketosis.

WC: 30:07

Yeah, that’s a great question. So what I, what I typically recommend, and I write about this at length in Ketotarian, is just to go eight weeks clean, mostly plant based ketogenic diet. And then from there you can find your sweet spot. You can do a cyclical ketogenic approach, which I think works for a lot of people. They can do three, four, maybe even five days in Ketosis. And then they moderate their carbs the other remaining days of the week. And that looks like, you know, 75 to 150 grams of carbs a day from things like sweet potatoes and more fruit and rice, things like that. Um, and then some people I find really do well with a more of a seasonal keto approach where in the winter they would be in more ketosis. And then the summer they’re having fresh fruit and going into the farmer’s markets and all of that. And then from an ancestral health standpoint, that resonates with a lot of people and they thrive there.

WC: 31:05

And then some people will do it when they need a little reset. Maybe they went a little too carb heavy for those last couple months and they want to just sort of calm things down and do sort of a 60 day reset that way. And for some people keep longer term, ketosis makes sense. So they test it after this initial eight weeks and they find their carb sensitivity and they feel, oh, I don’t feel as good when I’m having these higher carbs. Lower it a little bit. And again, people can be producing ketones upwards of a hundred grams of carbs. Not everybody, but I would say 50 is a, is it 50 or below is typically a good average for some people. But the point, is how can you use this tool in a way that works for your lifestyle? And I think that that we can start to really customize this or utilize this on an individual basis and using those initial eight weeks to shift your body into being a fat burner, gain that metabolic flexibility and then from there you can have that, that ability to use it in a way that makes sense for you.

MU: 32:09

Yeah. This is less dogmatic and it’s far more self-experimentation where people get to take their own unique goals and context and lifestyle into account, which is part of why I wanted to have you on the show, because I know that your approach is very common sense and very practical. We need to take one more short break but when we come back I want to talk a little bit about Keto and the Whole30… can they co-exist. We’ll be right back with Dr. Will Cole on Do the Thing.

MU: 32:44

All right, we’re back on Do the Thing with doctor will Cole, he’s been talking about the basics of a ketogenic diet from his perspective. The next question I want to ask is, do you, do you think that people can achieve most of the benefits? This is kind of a loaded question. Can you achieve most of the benefits of a ketogenic diet with like a looser, less structured, very low carb approach?

WC: 34:05

I would say yes. It’s a spectrum. I think if your body’s not producing Beta hydroxybutyrate, you’re not going to get the benefits that is centered around Beta hydroxybutyrate. So I almost see it as an amplification of the benefits of a lower carb approach. So if you’re in a real food lower carb, even, let’s just say moderate carbs, by that I mean, you know, a hundred grams, even 150 grams of carbs, you’re there, right? But you want to amplify the benefits here. Then lowering that a little bit, focusing on more on the healthier fats can really amplify the benefits that you’ve seen so far. So that is the ketones ability to pass through the blood brain barrier, providing the brain clean fuel, increasing these pro-antioxidant pathways.

WC: 35:02

And these talk to the pro-inflammatory pathways, that kind of stuff. That cool anti-inflammatory epigenetic stuff can be sort of the next level. Once you have got like a general real food moderate carb approach under your belt, you know, you’ve got that down, but you want to lean into the next stuff. I find that that is a great idea to experiment with that and find out where your body feels the best at, and do more of the things that make it feel great. So I think that that, I don’t know if that answered your question or not, but that’s, that’s what I would say.

MU: 35:39

Yeah, I think it does. You know, if people want to kind of ease into it with the idea of, okay, I’m just going to start being more conscientious about my food choices and take a a lower carb approach by virtue of my food choices. And you start to see some benefits and that gives you a good indication to maybe take it to the next level when you’re ready. When you feel like you’ve got this experiment on lockdown and your relationship with food is healthy and you have the capacity to start paying attention to your food choices even more, then maybe is the right time to pick up a an eight week Ketogenic program like yours.

WC: 36:09

Yeah. Great. Well said.

MU: 36:11

Thank you. The next question I want to ask you is something I get all the time, and you and I have talked about this on many occasion over dinner, but can you do a ketogenic approach and the Whole30 at the same time?

WC: 36:24

So I would say no. If someone’s going to do Whole30, do the Whole30, like it’s written about in the book. Because I feel like the Whole30 is reframing your relationship with food. It’s finding out with your body, how does it feel eating real food. And it’s a real food reset done in a very specific way. And I feel like once they get that foundation done right, then I would say they could use Whole30 approved foods and leverage the benefits of ketosis. So I almost see you could do like a Whole30 keto later on, like after you’ve done your food freedom, after you kind of know how foods make you feel, and then from there you can lean into this stuff. Because I mean I would only advocate someone doing the Ketogenic Diet with Whole30 approved foods. But that’s, that’s afterwards, if someone’s new to this whole like real food stuff, start with just the Whole30 keep it simple, learn how to use food to feel great. And then from there you got weeks and months, maybe for some people, even years under their belt before they feel like, you know, I want to kind of take this food information that I learned with Whole30… how can I use specific Whole30 approved foods to shift my body into this state of Ketosis?

MU: 37:47

Well, you know, I agree with you 100%. These are two self experiments and if you try to do them at the same time, you’re not going to know what to give credit for if things go really, really well and what to blame if the wheels start to fall off the bus. So if you’re already doing a ketogenic approach, you’ve got it kind of on lockdown, you know what your diet looks like, you’ve got the cycling in or out, down and you just want to see what would happen if you change the specific kinds of foods that you’re eating, and you want to layer a Whole30 on top of it, you certainly can because it’s almost like that first experiment is settled and now you’re able to take on a new experimental factor. And it works the same in reverse. If you’re locked down in your food freedom and your choices are 100% and you feel like you know what you’re doing and then you want to experiment by adding a ketogenetic approach on top of that, again, one experiment is settled and you can introduce something new, but I totally agree. I don’t like doing them at the exact same time. We could talk about this for like 17 more hours, but I think this has been such a fantastic primer. At the end of every episode, I ask all of my guests, what’s one piece of advice you can share with our listeners who are ready to Do the Thing?

WC: 38:50

I would say take the information that you’ve learned through Whole30, and if you haven’t done one, get that experiment in your life down and done. And then from there I would say lean into a clean real food. I would advocate a mostly plant-centric, ketogenic approach like Ketotarian to see how you feel producing ketones.

MU: 39:16

Fantastic. And if people want to learn more about your Ketotarian and approach, try your eight week program or just connect with you and learn more about your work. Where can they find you?

WC: 39:25

Everything is that drwillcole.com.

MU: 39:31

And don’t we have new books coming out around the same time? Tell us about your new book.

WC: 39:35

Oh my goodness, thank you. Yeah, it’s called the Inflammation Spectrum. So it’s this concept that I talk about in Ketotarian but it’s a deep dive into the inflammation spectrum, something that I’ve seen over my years of being a functional medicine practitioner. It’s going to come out October 15th, 2019 the Inflammation Spectrum, but it’s on preorder now.

MU: 39:56

Fantastic. I cannot wait to read it. Dr. Will Cole, my friend Will, thank you so much for being on Do the Thing and having this conversation with me. I so enjoyed you.

WC: 40:05

Yes, I love you so much and I will see you soon. Thank you. Talk to you soon.


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