Creon’s Life Extension and Healthspan Notes and References.
Formerly “Creon’s ketogenic diet notes”
See also Creon's notes on lipidology, coronary heart disease risk, statins, and coronary calcium scans
Summary of my personal situation and progress:
I am a middle-aged (started this document when I was 55) white male living in California who was 30+ lbs overweight. I went on the ketogenic diet (a.k.a. “keto”) and lost over 30 lbs without exercise and without restricting alcohol. My energy levels and mental state improved too. After ~18 months of that, I went onto a program of “time restricted eating” - an intermittent fasting protocol where I only eat during the same eight-hour window every day: 12:00 noon to 8:00pm (see below). I have since lost more weight, kept the weight off, stabilized my blood glucose at optimal levels, and feel better than I ever have in my life.
Although my weight has been stable for about a year, I have continued to lose fat and gain muscle while doing minimal exercise: like two minutes every other day. (I need to make another document discussing this).
While no longer strictly keto, I eat a very-low-carb zero-sugar diet. I now eat nose-to-tail animal foods, eggs, and a few low-carb low-lectin low-oxalate vegetables with 16/8 intermittent fasting. However, I still recommend keto for several months initially, to lose excess weight and learn about your metabolism.
In my view the essential factors to increase your health, length and quality of life are:
1. Maintain relatively low and stable blood glucose levels all the time (as a result you will end up eating only nutritious food). Most of this document is about achieving that.
2. Eat only real foods. Don’t eat processed foods. Don’t eat sugar, seed oils, carbs, lectin-containing or oxalate-containing foods. Eat only regeneratively raised foods, including at least some animal-based foods.
3. Get adequate amounts of high-quality sleep.
4. Increase and then maintain physical strength.
5. Take the right supplements (you only need a few), and avoid the wrong ones.
6. Have lots of good times, good relationships, good sex, and meaning.
7. Engage in lifelong learning, including mindfulness and healthy introspection.
Of course all of the above are tied together and mutually reinforcing.
Basics of the ketogenic diet:
The ketogenic diet is a great way for most people to lose weight fast and transform their health for the better without restricting calories. You can eat as much as you want, but you have to rigorously restrict what you eat. I lost 35 lbs and some of my more overweight friends lost 60 to 80 lbs or more.
While it may not work for everyone, tens of thousands of people and hundreds of doctors are reporting near-miraculous results. So it is certainly worth trying.
Many people ask about the basics of getting started on the ketogenic diet and how to tell if they are in ketosis.
Top level basics:
* The point of the ketogenic diet is to stay in the metabolic state known as ketosis.
* Ketosis is the fat-burning metabolic state which evolved for times of food scarcity. This was common for early humans. However, in modern affluent societies food is never scarce, so you are never in ketosis unless you explicitly engineer it. When in ketosis, the body and brain get their energy from fat. When carbs and proteins are plentiful you are not in ketosis and the body and brain get their energy from carbs and proteins, and excess calories (there are always excess calories) are stored as fat.
* Fat does not make you fat: carbs make you fat. By restricting carbs and proteins, but not fat, you can enter ketosis and burn fat - both dietary fat and body fat.
* To be in ketosis (without fasting) you must get at least 75% of your calories from fat every day.
* To be in ketosis (without fasting) you must get no more than 10% of your calories from carbohydrates each day.
* The most common error people make is to substitute protein calories for carb calories. This will not work. You have to substitute fat calories for essentially all carbs, and for most proteins. Once you have come close to your goal weight, you can add protein back in.
* You should always avoid carbs. Now and forever. Carbs are not essential for humans, and many of them are basically poison. If your doctor or dietician tells you otherwise, find another one. Do your own research and you will see.
* It takes several days to a week to get into ketosis the first time. The transition makes some people feel a little sick (“keto flu”). Once you’re over it it’s done - if you stay in ketosis. Some people never have this complication. It is important to get enough salt to avoid the keto flu, and to live a long life in general. See this video segment. Don’t believe the lies about salt . Don’t believe the lies about the desirability of a low-fat diet. Don’t believe pretty much anything the medical establishment has been pushing regarding nutrition for the last 45 years. Most of it has been invalidated by modern research and cutting edge clinical practice.
* The other way to get into ketosis is to go on an extended fast > 3 days. I will discuss fasting much later in this document.
One common question is “is the ketogenic diet the same as the Atkins diet?”. No it isn’t. They are similar, but not the same. The ketogenic diet has even lower protein- and carbohydrate-to-total calories ratios than Atkins. This means it requires even more discipline, though in some ways it is simpler.
The ketogenic diet has other names such as: VLCHF (very low carbohydrate high fat), HFLC (high fat low carb), Banting diet (historical), or “bulletproof” (a commercial trademark). There are also related diets such as Atkins, modified Atkins, modified Ketogenic, keto-carnivore, vegan keto, etc. These are subtle variations, mostly concerning the fat vs. protein caloric ratios. They are all low carb diets.
The near-miraculous benefits of carbohydrate restriction for controlling obesity and diabetes were well-known in medicine many decades ago and were taught to doctors and nurses. However, the medical establishment “lost the thread” about 50 years ago mostly due to political forces and has been advocating for low-fat high-carb diets (the “opposite” of keto) in recent decades. This has resulted in an explosion in the fraction of the population who suffer from diabetes, metabolic syndrome, hypertension, and most other degenerative diseases during the same period.
The “modern solution” has been to try and reverse these degenerative conditions using pharmaceuticals (drugs). This actually doesn’t work for the patient in the long term, though it works very well for the drug companies. This may sound controversial or even paranoid, but I suspect if you study the history of the US dietary guidelines and many of the resources linked in this document (which contain state-of-the art information from very reputable sources) you will probably see it’s true.
Back to less controversial topics:
Lowering and stabilizing blood glucose is in many ways the purpose of the ketogenic diet, of low-carb diets in general, and of intermittent fasting (see below). Low stable blood glucose (blood sugar) is one of the most important keys for a long, healthy life. Low stable blood sugar is not only a key to losing weight, and keeping it off, but also it helps prevent cardiovascular disease (heart attacks, stroke, etc), diabetes (obviously), inflammation, and probably cancer, auto-immune disease, depression, and dementia (Alzheimer’s). It stabilizes mood and energy levels too. What more do you want?
(here’s something more you might want: it drastically lowers your risk of dying from COVID-19).
What do I eat?
By popular demand, here is what I eat. This is a typical day for me. Very typical. Almost every day I do this and only this:
black coffee, and sparkling water (no, not mixed together:)
more black coffee, more sparking water.
First food of the day. Never before 12:00 noon. Usually some fatty meat (fatty ground meat, or previous night’s leftovers) or tinned seafood. Plus two poached eggs with extra yolks seasoned with salt, pepper, and sometimes other seasoning and/or sauce. All ad libitum but never anything with carbs or seed oils. Five minutes prep time. Delicious. Cheap.
1PM - 7PM
Almonds and/or macadamia nuts. Or not. More sparkling water.
Fatty meat or fish, or occasionally roast chicken, plus optional salad or crispy sauteed brussels sprouts and/or sauteed mushrooms, shallots, asparagus + deglazed sauce. Or salad. Ad libitum. Seasoned creatively. No carby, high-lectin, or high-oxalate vegetables ever.
Nothing to eat.
1.5 oz vodka in 8oz flavored sparkling water. Ad libitum. Occasionally a creative dry martini, or a spicy mezcalita sweetened with erythritol syrup.
Every week or two I skip a day of eating (which makes for a 32- to 40-hour fast). Once or twice a year I skip two or three days of eating. You will not “starve” if you do this. You evolved to be able to do it, and once you’ve regained your metabolic flexibility you can do it easily while maintaining consistently high energy levels.
Of course all animal foods should be sustainably - or better yet regeneratively - sourced. I don’t know what to say if you are vegetarian / vegan, but if you are please let me know if you figure out how to make LCHF work for you.
The basic rules are, in order of priority:
1) No sugar, ever. (Well, maybe once a year). This means no sucrose, raw sugar, fructose, corn syrup, HFCS, honey, agave, molasses, “cane juice”, and yes: no fruit. Also the only lactose I have is from butter or heavy cream.
2) Time restricted eating. Eat only in the same 8 hour window every day