Podcast Episode #325: All About Keto with Leanne Vogel

Topics

1. News and updates from Diane [2:04]
2. Something Leanne is digging right now [5:39]
3. About our guest, Leanne Vogel [7:48]
4. First telling her story [13:49]
5. Keto for men versus women [17:37]
6. Carbohydrate timing and cycling [24:43]
7. Tracking and testing [32:01]
8. Women's health; pregnancy and postpartum [37:36]
9. Question about iodine deficiency [42:01]
10. All about fiber [47:27]
11. Keto and diabetes; 1 and 2 [52:52]
12. Keto and not losing weight [57:34]

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You’re listening to the Balanced Bites podcast episode 325.

Diane Sanfilippo: Welcome to the Balanced Bites podcast. I’m Diane; a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo and the new book releasing on January 2nd, The 21-Day Sugar Detox Daily Guide. I live in San Francisco with my husband and fur kids.

I’m the co-creator of the Balanced Bites Master Class, and with my partner in crime, Liz, we’ve been bringing you this award-winning show for more than 6 years. We’re here to share our take on modern paleo living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Liz Wolfe: This episode of the Balanced Bites podcast is sponsored by Primally Pure Skincare. Primally Pure makes skincare products that are truly natural and nontoxic. Using ingredients like tallow from grass-fed cows; organic and fair trade coconut oil, and organic essential oils. In addition to being safe to use, their products also provide users with real, noticeable results.

At www.primallypure.com, you’ll find their bestselling natural deodorant that actually works; face mists made from locally sourced and organic hydrosols, and their newest product, Nature Spray, an all-natural insect repellant. You’ll also find Diane’s favorite Primally Pure product, dry shampoo, and my favorite, the Everything Spray.

As a special bonus for you, Primally Pure is offering a free lip balm with your first purchase of one item or more. Simply add a lip balm to your cart along with any one item, and use the code “balancedbites” during checkout to receive one of their lip balms for free with your order. Head to www.primallypure.com and check out their range of safe and effective all natural skincare products.

1. News and updates from Diane [2:04]

Diane Sanfilippo: Alright, everyone. Just a couple of super quick updates before I get into my interview with Leanne Vogel, which I know you are all going to love. First and foremost, as you have heard on the past few episodes, my brand new book, the 21-Day Sugar Detox Daily Guide released on January 2nd, and I am kicking off a country-wide tour on that day. So I hope to see you in a city near you. Please come see me. It’s definitely my favorite thing ever to be able to meet you guys in person. Get a photo; sign your book, have a conversation. It’s going to be super fun. Bring your friends, and make a night of it, or an afternoon of it.

I’m going to rattle off a bunch of cities where I’ll be. So if you hear one near you, you can kind of perk up your ears and head over to www.21DaySugarDetox.com/tour or you can link to it anywhere. I have links on my website, or on Instagram, etc. So, here we go.

I’ll be in San Francisco January 2nd, Orange County and Huntington Beach January 3rd, Montclair, New Jersey, that’s the closest I’m getting, really, to New York City on January 5th, accessible by train. Philadelphia area in Cherry Hill January 6th. Washington DC January 7th. Atlanta January 9th. Nashville January 11th. Kansas City January 12th. Boulder January 13th. Denver January 14th. Phoenix on January 18th. And I should be in Dallas, I believe, on January 19th. I’m waiting on final confirmation on that one. Austin, Texas, January 20th. Houston, Texas January 21st. And Salt Lake City January 24th.

There are more cities and dates coming in the near future, so stay tuned. I should be heading to the Pacific Northwest probably a second weekend of February. There may also be some dates in the northeast and the southeast as well. But stay tuned, you guys. It is tough to get everywhere. I do my best. Looking at this schedule, I’m thinking that I must believe I can time-travel, because it looks aggressive. But honestly, I’m just over the moon excited to come meet all of you, hang out, and talk about this program.

And also talk about what’s new in the book and my goal for you with not only the program, but the book. Because what I did in this book is really different than I’ve ever done before where I’m talking a lot about how to create your own new normal. And not feel like you have to rely on my rules or anyone’s rules all the time to tell you what is the best way to eat or the right way to eat. And I think that finding your own new normal is definitely a great goal to have. Because that’s just really where we all want to be, right? Where we can kind of feel like we just know what we do, and we do a certain thing most of the time and sometimes we do something else. And it’s all good. It’s all ok. We are all ok.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal. Nutritional therapy practitioners and consultants learn a wide range of tools and techniques to assess and correct nutritional imbalances. To learn lots more about the nutritional therapy program, go to http://www.NutritionalTherapy.com. There are workshop venues in the US, Canada, and Australia, so chances are you’ll be able to find a venue that works for you.

2. Something Leanne is digging right now [5:39]

Diane Sanfilippo: Alright you guys. I’m super excited, as we have Leanne Vogel on the show today to talk about keto and low-carb. Definitely one of the hot topics for all of you guys right now. But before we begin, let me give you a quick intro on Leanne.

Leanne is the founder of Healthful Pursuit; best selling author of over 11 health programs, host of the Keto Diet Podcast, author of the best-selling paperback, The Keto Diet, and the creator of Fat Fueled Living: A Holistic, Paleo-Friendly Approach to a Ketogenic, High-Fat Diet.

She’s been in the field of nutrition since receiving her holistic nutrition certification in 2007. And Leanne shares free videos, podcasts, recipes, and keto-friendly resources over on her blog at HealthfulPursuit.com. So welcome to the show, Leanne.

Leanne Vogel: Yeah, thanks so much for having me, Diane.

Diane Sanfilippo: So what I want to do before we get into our interview is just ask you a new thing that you’re into lately. Just a little ice breaker.

Leanne Vogel: Yeah. I think the mega thing I’m really into right now; it’s been really cold where we are, and I’ve been drinking a lot of bone broth, and I’ve been blending it with bacon grease. {laughs} And I’m sure we’re going to get into why I would do that, but that’s my favorite thing right now. I don’t enjoy making my own bone broth, because it takes forever. So I just use Kettle and Fire. And I blend it up in my Vitamix with some bacon grease. And that’s probably my favorite thing I’m doing right now. {laughs}

Diane Sanfilippo: Interesting. Do you have an Instant Pot yet? It seems like you might not.

Leanne Vogel: I do have an Instant Pot. I do. So we live full time in our RV, and I actually made a specific spot for my Instant Pot in the RV, and that’s the Instant Pot drawer, and that’s where the Instant Pot sits. So I do have it.

Diane Sanfilippo: I mean, I feel like the broth situation; I feel like I used to think; oh it takes forever. And now I’m like; I can make it pretty fast in there.

Leanne Vogel: Totally. It’s just the power that’s required to make bone broth, when you live in an RV; that’s a lot of power. {laughing}

Diane Sanfilippo: That is true. That is true, I hadn’t thought of that. Good point. Very good point. Alright, awesome.

3. About our guest, Leanne Vogel [7:48]

Diane Sanfilippo: Alright. So we’re obviously going to be talking all about keto and low-carb stuff today. So, before we get into questions from our listeners, why don’t you give folks a little bit of background on how you came to this whole way of eating, and why you decided to focus what you're doing with all of your nutrition work, and everything with your book. Why you decided to focus it on keto?

Leanne Vogel: Yeah, you bet. So I studied nutrition back in 2007, and at that point, I was a vegan. And I learned throughout that process of learning nutrition that hormonal birth control wasn’t so awesome for people’s bodies. So I decided to go off of it. And that was kind of the thing that sparked how I found keto many, many years later.

After 2007, I ended up not getting my period back after I went off birth control. And when I was training for triathlons, specifically, having had some issues with muscle development and stuff, my coach said, “How long’s it been since your last period?” And I’m counting on my fingers, and I said something like 6.5 years, and she’s like, What? {laughs}

So I hadn’t had a period in 6.5 years. At that point I was in my 20s, so I didn’t really care, and I thought I was doing everything right when it came to my nutrition, eating primarily plant-based and all of these things. And that’s kind of what led me down to end up going on hormone replacement therapy; not bioidentical, but just hormone replacement therapy. It ended up making me gain a lot of weight very, very, very quickly. I gained about 25 pounds in less than 2 months. And it was just so quick, and completely out of my control that I went to a naturopath. And she recommended a low-carb diet.

Long story short; I called her crazy, because how is a plant-based individual supposed to eat low-carb? But one of my girlfriends had just gone keto, and she posted a picture on Instagram with the hashtag keto. I clicked on that hashtag; it completely changed my life. And I figured; ok, I’m going to give this keto thing 30 days. And if my hormones don’t improve and I don’t lose weight; I’m not going to tell my community. I’m not going to say anything, I’ll just go back to the way I was eating.

So for 30 days, I ate keto. I counted my calories. I tracked out my macros to try to figure everything out. And after 30 days, I was off my ADHD medication for the first time in 11 years. I lost 8% body fat, 12 pounds. My hormones were improving slightly, and that’s when I went out to my vegan people, and said, “Hey guys. So I’ve been eating bacon every day. {laughs} I’m no longer vegan.”

Diane Sanfilippo: {laughing}

Leanne Vogel: This is kind of what I’m practicing now. And from a business perspective, that completely crushed my business and a lot of people left. But I found a lot of new people, and that’s when I really devoted my work life, and pretty much my entire life to keto. And over time, I learned that women’s bodies are different than men’s when it comes to keto. And that’s kind of how I found my way into keto.

Diane Sanfilippo: I think it’s really important that you not only took time to see how it would work for you, before you shared it with your audience. But then you had the courage to say; this is what I’m doing. And it’s going to be ok if that means I lose part of what I’ve built this business for.

Because it sounds like you had been building a business for at least; what? Three to five years, minimum? If you started in 2007, it wasn’t that long ago. I’m like doing the math; I’m like, you couldn’t have tapped on a hashtag on Instagram until at least 2012. {laughs} Because I know Instagram didn’t even exist when my first book came out. It barely existed. We didn’t know what it was, and #latergram was an actual thing at the time, because nobody posted pictures later. So you would #latergram.

So how long had you been building your business online before you made that switch?

Leanne Vogel: The business online would have been 4 years, going into my fifth year. It was at the peak of five years; starting to kind of figure it all out.

Diane Sanfilippo: Yeah. That’s when you're getting that momentum. Yeah.

Leanne Vogel: Yeah. And it completely grounded to a halt that day. {laughs} But I knew I needed to be true to myself, and I couldn’t keep; it wasn’t lying. But I had found something that worked better, and I needed to share that. I was being called to share that. So I just said; you know what? It will work itself out. And if not, I’ll have to go back to work or something.

But I think deep down, I knew there wasn’t a lot of people talking about it. And because it had been so beneficial to me in such a short period of time, I figured there had to have been somebody else that wanted to hear about it.

Diane Sanfilippo: Yeah. And the reason I kind of highlight that is we have a lot of listeners who are either nutrition students or grads or are considering getting into this line of work. And I think it’s super important to consistently check in with yourself, and only be doing work that is true to who you are. So I think that it is hard to do that; especially. I was like; oh, it sounds like it had been at least three to five years. Your like, yep it was four years! {laughing}

Because I think a lot of people would feel very scared to tell a new truth that long into building something. So I’m just kind of; I’m just highlighting that because I think it’s so important. I just wanted to highlight how brave that is, and how much; I think I’m sure, for you, you were like; this was the only way I can do it. Because that’s not true anymore. But don’t forget that there are a lot of people who still kind of stay paralyzed in that. And they’re like; well I’m afraid to tell them because this is what they think of me. So I think that’s awesome.

Leanne Vogel: Completely. And it’s your livelihood. You know; when it’s your livelihood and it’s how you support your family.

4. First telling her story [13:49]

Diane Sanfilippo: Yeah. Totally. Can you talk a little bit about what happened when you first started telling your story to your readers of not having had a period for 6 years; more than 6 years. Because that’s a huge deal, and it’s also super, super common. I think a lot of women are just kind of at a loss of what to do about it. Did you get a lot of women coming forward saying; I haven’t had a period either. What kind of happened at that point?

Leanne Vogel: Yeah, awesome question. So when I decided to go on hormone replacement therapy, I created a series of posts on Healthful Pursuit, just about my experience with having amenorrhea. And I remember writing that first post being really ashamed, because when you're in the health space and you're trying to help other people, and there’s this dirty secret that you really don’t want to tell anyone that really points to the fact that you're not healthy. {laughs}

I remember writing that post, and publishing it. And it was just like you said, Diane. This influx of women saying; “Oh my gosh, it’s not normal to not have a period? I haven’t had my period for 7 years. Mine’s been 3. I just gave up after 20 years.” All of these women coming forward, saying that they experience the same thing. It really opened my eyes to the fact that this is a very common problem, and something we probably don’t talk enough about.

And you know, every doctor that I went to for those six years; I really stopped caring, because no doctor cared. I went to multiple doctors, and they asked me if I wanted to have children; I said, heck no. Never wanted them. It’s just not my path. And they said; well what’s the big deal? And that really forced me to not care about it.

And when I came out with that first post, a lot of people came forward and said; this is a big problem for me too. I’m really interested to see how this goes for you. And you know; fast-forward a couple of years later. Having done keto and really found a space that worked well for my body. Specifically in healing and balancing my hormones. Having gotten my period for the first time, and now it’s been two years of ovulating and all those awesome things. To be able to go out and say, “Ok guys! I got it and here’s what I did!” That was really exciting as well.

Diane Sanfilippo: {laughs} I am kind of dumbfounded that doctors said no big deal, or just did not press on that at all. I mean, I’m literally sitting here. I believe and I don’t, you know what I mean? I totally believe it because I think a lot of people; there are many, many smart doctors, and there are many who are just not really thinking, you know. They’re just kind of executing. And sometimes mistake when I say things like that as hating all doctors. I definitely don’t; I just think, how can you have a good impression when most of the people who come and talk to you have said, every doctor I went to really said that this wasn’t a big deal. You know? And it’s like, actually, that’s kind of the first sign of something being wrong. Is just that hormonal balance being so far off. It’s really crazy.

And I think what you said about it being this “dirty little secret”. That’s so interesting, because for a lot of people they’re looking visually at their health and wellness professionals, or people who are a voice in the community. And they’re using the way people look; whether it’s they're lean and shredded and have abs, or whether it’s just their skin. Anything. I’m sure people look at me the same way. They look at us, and they say, I think that person is healthy based on how they look. And there’s so much more to it than that. There’s so much more going on under the hood. Anyway; it’s just an interesting story.

5. Keto for men versus women [17:37]

Diane Sanfilippo: So, you were saying how the way this works for women versus men is pretty different. So what are some of the big things that you’ve noticed for the way that keto and low-carb works differently for women than for men?

Leanne Vogel: Yeah. So for the first 6 months of eating keto, after I came out with that first post after 30 days, saying, “Guys, I figured it all out! This is so crazy!” I cam out with my first digital program, The Keto Beginning. And that really guided people through a couple of things that I didn’t find in any other keto book. And those were like the issues that pop up; like keto flu, and muscle spasms, and heart palpitations. All these scary things that nobody really talks about, I think because if somebody says, “Hey, you're going to go on a new eating style, and you're going to get heart palpitations.” {Laughs} Not many people are going to try that. But I think, depending on your body and how you're treating it, that’s really how it’s going to display on a ketogenic diet.

So those were the first couple of things that I think both men and women will go through. But after those first six months of eating keto, I started to experience things that weren’t normal that not all the people were experiencing. Like pins and needles to the point where I couldn’t practice yoga anymore because my left leg would fall asleep so bad for about 20 minutes after doing pigeon pose, that I just couldn’t even. {laughs} It was just dead. It felt dead.

And I would get so tired and so dizzy in the afternoon working out, when I could before. I started obsessing about food quite a lot. My hormones actually got worse. My cortisol started spiking up super, super high. I wasn’t sleeping. I went 6 solid days without sleeping. And that was kind of the turning point. After those 6 days of having not slept, I’m like, “I need to do something about this.”

But the problem was, very similar to what you said, Diane. On the outside, I looked great. This was the only time I’ve gotten down to my “goal weight.” I had 6-pack abs without really doing anything. I looked amazing. But I felt not so great on the inside. And when I started digging into research, and talking to my community about; “Ok, we’ve all been doing keto for maybe 4 to 6 months for most of us. What kind of issues are you having?” And all of the women said the very same things that I was experiencing.

And so then I kind of looked at keto. And because men work on a 24-hour hormone cycle, and women work on a 28-day hormone cycle, our hormones are going to be different, clearly, every day than men’s, and we need to adjust for that. I think in the keto space; well, I know in the keto space there are a lot of men that talk about keto. And really it’s quite easy for them. Seeing my husband do it; he just eats low-carb, high fat all day, every day. He can get away with very, very, very minimal carbs. Maybe some cauliflower every other day. And he looks great, he feels great. His blood work says he’s great. But if I do the same thing, I’m not sleeping, I’m getting pins and needles, I’m getting really dizzy.

So the first one I noticed is that women clearly, usually, need to eat more. They need to have probably more carbohydrates than men. And when you're in reproductive age, I find that more women have issues fasting than men do. So just keep in mind of how much carbs you're eating, and comparing it to your husband and probably eating more than that.

Then I delved a little bit deeper, and found a thing called cyclical ketosis. And we can get into that, for sure, of how to time carbohydrates. So as a woman, you can continue to be a fat burning machine in keto, but you can also have, I don’t know, a gluten free donut. Or maybe a paleo treat once in a while.

Diane Sanfilippo: Now you're speaking my language. {laughs}

Leanne Vogel: Yeah, it’s not going to ruin your keto-ness.

Diane Sanfilippo: {laughs} Your keto-ness.

Leanne Vogel: So those were a couple of things I noticed.

Diane Sanfilippo: Six days without sleeping? You just breeze through these things and I’m like; hold on, what? Six days without sleeping?

Leanne Vogel: {laughs}

Diane Sanfilippo: Six years without a period, six days without sleeping. I mean, {laughs} this is. How do you get to 6 days? I don’t even know what that would be like. I didn’t even go one day without sleep in college, because I was like; eh. That test is not that important. I’m just going to go to sleep now.

Leanne Vogel: Yeah.

Diane Sanfilippo: I mean, at two or three you weren’t thinking something’s wrong? Or were you? What was going through your mind? Like, literally, awake for 6 days, or you slept for one or two hours and just weren’t really sleeping.

Leanne Vogel: No, like no sleep. No sleep. We were in Mexico. I guess I was just; I don’t know if you’ve ever been in this space, or maybe some people that are listening have been there. But when you become so diet focused that it becomes your entire life. And you look good, and people are saying you look good. When you start dealing with issues, you kind of just ignore them. Or you think it’s something else.

I was making up excuses; like, I don’t know. I had some chocolate, therefore I’m not sleeping. Or I’m just really excited because we’re in this new place that I’ve never been. So I was making up excuses for myself. When in actuality, I think the diet just completely overcame my existence, and I became so obsessed with it I couldn’t see that it was actually a problem. And on that sixth day, having watched my husband eat one Oreo cookie. I’ll never forget just watching him chew this Oreo cookie. And I could hear it, I could smell it. I was watching his mouth; and I’m like. Girl, you have to do something. {laughing}

Diane Sanfilippo: You were literally in a girl, eat a cookie moment. Give that girl a cookie, you know. {laughs}

Leanne Vogel: Yes!

Diane Sanfilippo: We joke about it. I mean, I’ve been there. Not in such an extreme state, I guess. I was super lean, and had the 6-pack abs. I was probably 30 years old. And loss my period for a couple of months. But a couple of months, you know. And that’s not like; oh. This doesn’t say anything about our character. It’s just, for whatever reason; I don’t handle discomfort for too long. You know {laughs} I can’t handle being super tired. I won’t put up with things for too long. I guess I don’t justify things. Maybe I do.

Anyway, I lost it for a couple of months. And I definitely had that experience where I was working out so much. That was really it for me. It was just over-exercising, and was just flattened with adrenal fatigue. This was 9 years ago now, I’m sure. But anyway. I’ve definitely been there to a degree. And I’m sure a lot of our listeners have been there. And I think that’s a really good point to make.

6. Carbohydrate timing and cycling [24:43]

Diane Sanfilippo: I think it’s really great that you talk about having come from that place. And you're talking about a way of eating that a lot of people think is extreme. But actually, one of the things I like about your book, The Keto Diet, is that it’s not extreme. It’s actually pretty balanced. And you give people a lot of different ways to “do keto”. Or ways to eat keto that allow for way more carbohydrate than a lot of people ever talk about.

So you were just mentioning about carbohydrate timing and all of that. Why don’t you talk a little bit about that, and just the different approaches that you present, for example, in your book. And different ways that people can still be eating keto, but they basically get to eat more carbs.

Leanne Vogel: Yeah, you bet. So there are a couple of ways that you can do a cyclical ketogenic practice. There’s one where you just eat low-carb, high-fat for say 12 weeks. And then you go “off” keto. You increase your protein, increase your carbs for a couple of weeks. The problem with that, though, you're kind of starting back at square one. Maybe square two, when you start eating keto again. So it can be hard for people; most people. I’ve tried it; it’s not the funnest thing.

And then there’s other cyclical ketogenic practices where there’s a thing called backloading. Where if you lift really, really heavy weights, you end up eating carbs the night before or right after. There’s no attention to quality of the food that you're eating, so that can be detrimental if you thrive on more of a paleo type of whole food eating style.

Then there’s protein fasting, where for one day a week, perhaps, you lower your protein to about 15 grams a day and eat pretty much all the carbs and fat that you want. And that can help with autophagy and cellular turnover. So that can be one approach. I never felt good on that approach, so my carb-up or cyclical ketogenic practice is more in line with carb night, and eating carbs in the evening to reset hormone levels, replenish your system, support muscle growth and development, increase sleep quality.

So how this works is you're actually boosting your serotonin levels, which help with your tryptophan. So, in all of this, with carb ups, what you're basically doing is you eat low-carb, high-fat usually for the first 15 to 30 days. You just get very fat adapted. And once you're fat adapted, what’s happening is your body built up all the enzymatic processes it needs to know that fat is your number one fuel. It has no mistake about that. So when you eat a little bit of carbs; say you have a sweet potato at dinner. It will burn through those carbs and go right back into fat burning.

So I think there’s a lot of, you know, if I’m keto it’s this delicate balance of if I have just a touch of carbohydrates I’m all the way back at square one. And just like how your body burned carbs; or tried to burn carbs really efficiently, and it kind of forgot about fat burning. It’s the same thing when we switch over to ketosis. It starts to know that fat is a preferred fuel. So in this carb up, you eat low-carb high fat, 15 to 30 days. Once you're fat adapted, you start incorporating carb ups.

And when you start incorporating them, and how you do, really depends on the status of your health. If somebody, say, has massive adrenal dysfunction. Maybe it’s so bad they can’t even get out of bed. The process of becoming fat adapted and going through the ketogenic diet for the first 14 days might be too ridiculous for them to even try; it’s just too much. Or maybe they have a history of disordered eating and restricting their eating style to the point where they have to become fat adapted in order to have carbs again is just too much. They would start off with carb ups right away. So this is just about eating low carb, high fat all day and then having a touch of carbs at night.

If you can go the full time of becoming fat adapted, those 14 to 30 days, ish, then you're having carb ups maybe once a week if you aren’t that active. Or maybe a couple of times a week if you have hormone dysregulation. Perhaps every night. When I was working to get my period back after having not slept for those six days, and I was like; ok, I’m just going to try this. I ate carbs every night. And the crazy thing is, when I woke up in the morning around noonish, by noon my ketones level were where they were the day before. So that was really interesting to me, to just have a touch of carbs. Like half an apple, or a sweet potato. Maybe a couple of medjool dates. Just with dinner. And then your body burns through the carbs, or the glycogen or glucose, and then switches right back into fat burning mode.

So, there are a couple of ways to do it, and I outline them in the book. Also more in detail in my Fat Fueled program. But it’s a really fun practice, and allows you to have more of a life. Because, let’s be honest. When you're eating keto, or something that is really restrictive. The base of keto is quite restrictive. And it can get kind of boring. This just allows you to create permission to have birthday cake or go out with your girlfriends and have a glass of wine. So you can live. Because if you're on a diet that’s quite restrictive, you know there’s going to come a point where you end up in front of the TV eating a pound of ice cream, and you're like; how did I get here. Right? {laughs} Because we just feel too restricted. So that helps with that, as well.

Diane Sanfilippo: Yeah, I think that’s really important for people to keep in mind. It’s not about; oh, I’m trying to add carbs when that’s not really what keto is. It’s about making it something that you can maintain. And there are always people here and there who do well with more carbs on keto, and some people who don’t. Just because their body has gone through a lot in terms of blood sugar regulation, and different issues over time. And everyone is a little bit different. I think your point about paying attention to how you feel, and not necessarily just doing exactly what your husband does, for example. Because that doesn’t feel good for you. That’s just one of the big lessons that we’ve been trying to get through on the podcast for a long time now.

I recently talked with Emily Schromm, who pretty much does keto the way you talk about it. Where it’s like, most of the day low-carb. After a workout, or right before and right after a workout, she’ll have her carbs, and feels really great doing that. And I think that’s just important for people to just know that there is wiggle room. It doesn’t have to so black and white, all or nothing.

Leanne Vogel: Yes. So true. And especially if you have metabolic damage, or insulin resistance. Your keto is going to look different. That’s not to say a year from now you’ll perhaps be less sensitive to carbs and you can handle a bit more. So it’s really about creating that permission to define your own keto. And I think that’s what was massively missing. And it excites me a lot that you're having these sorts of conversations with other people, too. That’s awesome.

7. Tracking and testing [32:01]

Diane Sanfilippo: Yeah. And I think for people to know; so one of the things that you are, you mentioned your ketones levels being at a certain place the next day. I know you talk about sort of the pros and cons of testing ketones, and where it can be beneficial and where it can actually not be that important compared to judging how you feel. Can you touch on that a little bit? What’s you're take on that; the importance of testing or not.

Leanne Vogel: Yeah. So I think testing your ketones can be a super fun thing if you have a pretty good relationship with testing. If you're the type of person who jumps on the scale, and if it gives you the wrong number or something you're not happy with it completely ruins your entire week, I wouldn’t suggest testing. A great example of this is; so my husband Kevin. He started eating keto right around my book tour. So he started eating keto on tour with me. And after about 3 weeks, we got back home for a couple of days and he decided to test his ketones. And I was like; babe, you're doing really good. You feel really good. Why bother? And he’s like, I’m just curious. So then he tested his ketones via his blood, and he got, I think it was like 0.8 millimoles. Which is good-ish, but you kind of want to be above 1.5, 1. And he got super disappointed, and he got upset, and then he ended up eating all the carbs that night. So had he not tested, he would have just continued eating the way that made him feel good.

So, I think if you're the type of person that gets side tracked by those sorts of things, don’t test. But it can be really fun to see, I really enjoyed testing my blood after certain foods, or activities. Or like, what did my ketones or blood sugar do after I worked out, or before my workouts. Before coffee, after coffee. So I spent a lot of money testing my blood; because those strips are not cheap. Just to kind of see how my body responded. Also so I could educate people. So if somebody came to me and said; you know, my ketones, or my blood sugar is spiking after a fatty coffee, why is that? What could I try instead? I would have some tools to provide to them.

But I think if you don’t want to test, there are lots of things you can do instead. An alternative to testing is to just go by how you feel. So if you’ve been eating keto for two or three weeks, some signs that may point to the fact that you're in ketosis is that you can skip meals without getting angry. {laughs} You know, that hangry feeling of, “Give me food right now! I won’t be able to survive!” It becomes quite effortless for you to be able to skip meals.

If you have an abundance of energy that you're not really sure where it came from, that could be a good indication. If you can go three, four, five hours; sometimes even six hours without a snack. Or you wake up in the morning and you go about your day and you realize at 1 p.m. that you haven’t eaten, great indication that you're in ketosis. If you don’t get ravenous or crave carbs two or three hours after your last meal. I know that when I was carbohydrate focused, after every meal I would just crave something sweet. Even if I didn’t have a sweet meal, I just wanted some sugary stuff. Now, I just don’t want that.

Another good sign is that you don’t crave carbs after exercise, or you don’t need carbs. You're not bonking like you would if you were a carbohydrate fueled athlete. You're kind of just pushing through those episodes without even a bother. So those are some signs that you can go for if you don’t feel like testing. Because testing can be quite expensive, and I personally don’t recommend urine testing, ever. Because you’ll test your urine, it will say you have ketones, you have ketones, you have ketones. And as soon as your body becomes pretty efficient at using those ketones, it will stop dumping it in your urine, and you’ll wake up one morning, test, and be like; oh shoot. I’m no longer in ketosis. And it’s not actually that, it’s just your body is becoming more efficient at using those ketones.

So, that’s kind of my thought on testing. I think a lot of people think they need to spend $300 a month on testing in order to do keto “right.” That’s so not the case.

Diane Sanfilippo: Yeah, I think that’s a good point. And to your point, also, about really paying attention to how you feel. This is something that in my years of eating keto, or not, or just kind of eating more generally low-carb most of the time, I would say. I just naturally tend towards smaller portions or not having carbs with every meal if I have them. Or just having a little bit. And I actually find, for me, that helps me not crave anything additionally. You know. It’s like, if I’m still hungry, I’m still hungry. But it’s not a craving if I had a really small portion of carbs with that meal that just kind of felt right for me. Whether it’s literally four small pieces of plantain or something like that. But it’s not a whole plantain every time I eat carbs. I think everyone can find a different balance. And I may or may not be fat adapted with that, but I think it’s just finding what works and feels good for you.

And I think your point about it not making you crazy; you know, emotionally, is really important. It should be more liberating than not. I think whatever way you kind of land on eating should feel good for you physically and emotionally. I just think those are really important signs that you're not feeling deprived for a lot of different reasons.

8. Women’s health; pregnancy and postpartum [37:36]

Diane Sanfilippo: So can you talk a little bit about; specifically if we look at women’s health. Keto and pregnancy, or postpartum. Have you worked with women through that time? Have you seen upsides or downsides? What have you seen with that?

Leanne Vogel: Yeah, I haven’t really worked a lot with women in pregnancy. I have a couple of thoughts on it, as you know, women in our community have said, I’m pregnant, I’m doing this, and just anecdotal things.

First off, if I were to get pregnant tomorrow, having eaten keto for as long as I have, I’d be like; cool. Still eating keto. But I do know that depending on the trimester you're in, sometimes it can be quite challenging to continue eating keto. Specifically the second trimester, I’ve heard, is just kind of impossible. You end up just needing more carbohydrates, and sometimes for a lot of people that’s all that they can handle.

But then I’ve met women that, having been keto before, and they’re pregnant, and they just keep eating keto, and then they have their baby and they’re keto, and they’re breastfeeding and keto and it doesn’t matter. But I think if you're listening and you're either planning to get pregnant soonish or you're pregnant right now, I’m not sure if eating keto is the best option for you. It’s something you could definitely look at in the future.

I think there’s nothing wrong with increasing your fat intake, so maybe getting accustomed to eating more saturated fats. And looking at the types of carbohydrates you're eating, and going for; if you aren’t paleo right now, just kind of switching out. Moving the grains aside, bringing in other things, and kind of just becoming conscious to the types of carbohydrates you're eating. The types of fat you're eating. And even looking at fat quality. Removing maybe margarine from your house and going to butter. Or, if you're already beyond that, kind of looking at the quality of fats, and the omega ratios of the fats. How can we reduce inflammation with the types of fats we’re eating and those sorts of things? But I think if you're not pregnant, and maybe you're planning on it years from now, keto could be a good option for you.

I don’t know if I; I’m pretty darn positive had I not gone keto, I probably would never have gotten my period back. So I’ve met a lot of women that have been told by many doctors that they would never have children. And I think that’s probably my favorite part of going on tour; meeting women that were trying to get pregnant that couldn’t, that tried keto and they brought their children to the events. {laughs} I thought that was really cool. But those are some of my thoughts on pregnancy.

Diane Sanfilippo: Yeah, I think to your point about it being different for everyone, too. There are some women for whom getting their hormones balanced really hinges on getting that blood sugar under control and switching to this fat burning state. And that may be something that somebody who is listening needs; and it may totally not. We’ve had women literally completely divided on both sides of this. Some women who are like; I was eating low-carb and I wasn’t feeling energetic and I was stressed out, and they eat carbs. You know what I mean?

We all have to get to a place of more balance, so that our body isn’t overly stressed. The reasons and the mechanisms behind that for everyone can sometimes just be a little bit different. What will bring you back to balance is not always the same as what will bring someone else back to balance. So I just think that’s important to pay attention to.

And we’ve had plenty of women that have said eating low carb, their milk supply drops after they’ve given birth. And then like you said; some who don’t seem to notice a difference. So there’s no one answer for it, you know. It’s just about paying attention to what’s going on with your own body.

Leanne Vogel: Totally. And I think with the carbs piece, too. A lot of people say; well I don’t have a lot of energy on low-carb. And then they start eating carbs all the time. You might even benefit, before you go way off in left field on that. If you're already eating low-carb, try to incorporate just some carbs in the evening and see if that allows you to have the energy you need the next day without kind of funking up your insulin levels and things like that.

Diane Sanfilippo: Yes.

Leanne Vogel: By just boosting up the carbs in the evening, and try that too, as an option.

Diane Sanfilippo: That’s a really good point, too. People like to kind of go all in or all out. And it’s like; actually, if you have a little bit, you might feel a lot better. Way better than you thought with just that little bit.

9. Question about iodine deficiency [42:01]

Diane Sanfilippo: So there’s a question about iodine deficiency, and it’s somebody who listens to your podcast, I guess. She says, this is Coco’s Paleo Kitchen. I’ve met her before on one of my tour stops. She says, “On one of Leanne’s podcasts, she and her guest were chatting about iodine deficiency and a symptom of that would be that one doesn’t sweat. My daughter never sweats. She’s 20. We did an iodine test by swiping iodine all over her tummy. The iodine disappeared into her skin within seconds. She did it again a day later on her inner thigh, and again gone in seconds. Can you elaborate on what foods would help, and any supplement recommendations? I’m trying hard with the higher fat approach with her because she’s pretty out of whack, hormone-wise. Trying to do it naturally; doctors want to put her on the pill.” What do you think?

Leanne Vogel: Ok. So, that could be a really strong sign for more thyroid stuff going on. If you're not sweating, that can be a huge sign that your thyroid is off-kilter. And with the thyroid, there are many, many things you can do. I ended up having to take desiccated thyroid. I just couldn’t function as a normal human being without going on some sort of medication. So I think if you end up going down that right, definitely get educated on what option is best for you. I found that desiccated thyroid was going to be best for me, personally. But there are lots of other options out there. I just feel like desiccated is the most natural option.

As for iodine rich foods, and iodine supplementation; a couple of years ago if somebody were to ask me, should I supplement with iodine? I’d be like, yeah, sure. Just be careful. And now I would probably say no. A lot of the studies coming out, especially this year, have kind of pointed to the fact that iodine can actually be quite harmful, even if you're supplementing in small, small doses. So things like Lugol’s iodine, I no longer recommend. So if you're concerned about your iodine, specifically any sort of sea vegetable would be helpful. Nuts, seeds when you are doing your carb ups. If you do end up doing carb ups. Things like potatoes, or strawberries. If you do any sort of plant-based proteins, some beans maybe.

But I think it goes a little bit deeper than just iodine. What you might want to look at is going to see if you want some additional support, an orthomolecular doctor. I really enjoy those. If you know you're maybe low in a certain mineral, and you kind of want to see the entire profile of which mineral interacts with which, and the vitamins and how you can megadose them up. I’d just be cautious of iodine.

On the flip side, if you're thinking maybe it’s the thyroid. You're testing your body temperature and you notice; oh my gosh, this might be a problem. I’ve had a lot of success, especially recently, using red light therapy for my thyroid. I’ve been using it every day for the last, I want to say 3 weeks, at this point. And I’m noticing that my desiccated thyroid supplementation, I’m at 60 mg right now, and I just moved down to 30 mg a couple of days ago because I found 60 was too high. And I’ve never been at 30, ever, ever. This is the lowest ever. And I’m feeling pretty good. So you could also look at other alternative therapies, as opposed to just supplementing with iodine foods, too. If it’s specifically thyroid related. Diane, what do you think?

Diane Sanfilippo: {laughs} That’s what I was going to say as well. I would have definitely pointed to thyroid if she’s not sweating, that’s just one of those classic signs of low thyroid. And the thing is, the way that thyroid symptoms present these days. It’s not always all of the classic symptoms together. So it won’t always be that she’s overweight, has a thinning outer third of her eyebrow, has cold hands and feet, and doesn’t sweat. Sometimes it’s just one of these symptoms.

Because I feel like thyroid these days is super sensitive. We have so much stress going on, whether it’s environmental toxicity or other stressors. And our thyroid just really doesn’t hold up to a lot of insults. It seems like our adrenals and our stress system seems to deal with a lot, and then kind of comes crashing down. But our thyroid seems to be a lot more sensitive. And shows symptoms; we experience symptoms much more quickly when it’s really taking a hit. So yeah I would say the same thing.

And to get that tested; to get her thyroid tested by a naturopath who is going to test more than just TSH and T3 and T4, to get the full, full detailed panel. And I’m sure there are plenty around her area. I think she’s in southern California, so there are some. She might want to reach out to Dr. Lauren Noel. She might be able to do some testing.

And Liz has done some stuff with red light therapy, personally I think, as well. I can’t remember if she talked about it on our podcast recently. So I know she’s been interested in that, too. So maybe we’ll find some more information on that, as well. It’s really interesting. I’m super into the ideas of all the alternative therapies. So that’s definitely a good note.

10. All about fiber [47:27]

Diane Sanfilippo: What about fiber? This is just a hot topic. How do people get more fiber? Somebody was asking what to about constipation. There’s a few people asking kind of the same question regarding fiber. So what do you usually tell people about that?

Leanne Vogel: Ok, so I have a couple of thoughts on constipation, fiber, all these things. Especially for me, when I went from the diet I was eating before. Which was quite a lot of food. The volume of food I ate on a daily basis was quite phenomenal. To go down to keto where, for example today, it’s what? 3 o’clock and I haven’t eaten anything. I had a fatty coffee about 5 hours ago.

So if I’m not eating as much stuff, or as much food volume, I’m probably not going to go to the bathroom as much, because I just don’t have that volume in my body. So that’s the first off. You might find that you're not going as much. And if you're having one solid movement a day on keto, that’s usually pretty good because you're just not eating as much. But if you're finding you're going days and days without going, then that’s an issue. And constipation is a real thing. Especially as you first get started, and that’s where fiber plays. And we’ll kind of talk a little bit about the opposite; about diarrhea and fat absorption, because that can be a problem too.

But there’s a lot of misconception about fiber, and should I count total carbs or net carbs. So total carbs are like all the carbs that you eat in a day, including the fiber and everything. And net carbs equals the total carbs minus the fiber. So if you were to eat 50 total carbs in a day, and 30 of that was fiber, then your net carbs would be 20 grams. So the way that I make sure I have enough fiber is really looking at whole food based vegetables. Instead of counting;

Ok. Here’s the problem with keto that I have. A lot of people eat keto, and they’ll get so consumed with the carbs that they’ll go for; you know those bars and snacks and baking mixes and everything that have the pre-biotic fiber in it. So it’s messing up the total carb count, and they’re actually eating a lot of carbs. But because it has “high fiber” their net carbs are low, and they’re telling me that they’re eating all this fiber. But it’s not actually beneficial fiber.

So instead of focusing primarily just on those prepackaged keto things, which many of us can get into just as we get started with keto because we’re confused. If you make sure that when you are eating, you fill up half of your plate with low-carb vegetables. Like broccoli, or cauliflower, or kale, it’s usually not a problem to hit at least 30 grams a day. If you're still having a hard time with fiber, I really like ground flax. Now, if you're estrogen dominant; I don’t know, the verdict is really out whether or not flax would be good for you. If you're concerned about it, don’t go there. Things like chia, nuts, seeds, those sorts of things can be great. But I think as long as you're going toward more of the whole food based keto items, like vegetables, I don’t really see it being an issue.

And if you are constipated, and you're doing all these things, just adding a little bit of magnesium powder to your water at night can be beneficial. I really like magnesium oxide. But I find because of the food volume, you're going to be going less, and it’s going to be different.

And then on the flip side, if you're going all the time, and you're concerned, you could still bulk up the fiber. But it’s probably that you're not digesting the fats well. And then I would increase your fermented vegetables. Drink sauerkraut juice. Put apple cider vinegar in basically everything. Make sure you're drinking plenty of water. And you could supplement with a digestive enzyme if you want. And even that could be helpful for constipation, too. Because it could just be that your body, especially when you first get going with keto, is like; what is all this fat. What is happening.

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Diane Sanfilippo: Definitely. We’ve definitely seen people on both sides of that. Sometimes it’s just when they switch to eating real food, and they’re eating just a little more fat. So going keto, it’s definitely potentially pushing that even further. And I think you made a really good point about “keto products” versus real food. If you're getting most of your carbs from vegetables, you are getting tons of fiber that way, and it’s not going to be a problem. But I think that’s definitely; you know, there’s always this transition period where people feel a great loss, and they want to grieve about losing some type of food in their diet. So they’re kind of eating keto breads and whatever it might be that may not have as much quality fiber, the right kind of fiber, to keep their digestion going.

11. Keto and diabetes; 1 and 2 [52:52]

Diane Sanfilippo: So, a couple of last questions here to wrap it up. One of them is about eating keto for type 1 diabetics. Because I’m pretty sure that we would agree that for a type 2, this is a great way to potentially reverse type 2 diabetes. We’ve seen it time and time again with a low-carb diet. Even if it’s not that real food carbs are what give type 2 diabetes; however, pulling those carbs out can really reverse that. And it doesn’t mean that they need to stay there for forever.

But what about somebody with type 1? Have you seen this working safely for a type 1? Can it be too extreme for them? Do they need a different level of carbs? What have you seen?

Leanne Vogel: Yeah. So I haven’t worked personally with type 1 diabetics. But I always say if you're interested in this, it could be beneficial to work with a healthcare practitioner, somebody in your area, that can kind of monitor everything and make sure that everything is ok.

Our previous neighbor, actually, he had type 1 diabetes. And a couple of his friends, he went to summer camp for diabetics. And there was a whole keto thing that a lot of the kids could do. And a lot of them were type 1, and they were doing quite phenomenally on it. And his mom was telling me about the different kids. They can kind of choose their diet when they’re there and what they want to do and what they want to learn. Which I think is phenomenal they’re doing this for children.

But yeah, I’ve heard of a lot of success with this. I think it’s just a matter of if you have diabetes, or a kidney imbalance, or you're pregnant. Just making sure that you're chatting with your doctor to make sure everything is ok, and you have a team on your side that’s willing to do this. But when it comes to any sort of blood sugar dysregulation. Or you just can’t handle as many carbohydrates, I just think if the body can’t manage carbohydrates, it doesn’t make sense to continue eating them in the large quantities. Even if that large quantity is, say, 150 grams a day. Perhaps that’s too much for your body.

It’s very similar to the fact that I know I’m sensitive to eggs, and when I eat eggs I don’t feel well. So I’m not going to continue to eat eggs, knowing they don’t make me feel well. So I remove eggs, and I don’t eat eggs. {laughs} So I think it’s very similar in that, if you're sensitive to carbohydrates, it only makes sense to try to eliminate them as much as possible.

But I agree with you. I think of both types of diabetes, diabetes type 2 I see a lot of success with, just because of the state that they’re in and how they’ve gotten to that point. But with type 1, I could see it being beneficial as well, and I’ve heard a lot of great success stories. But I think it comes down to working with a medical professional on it.

Diane Sanfilippo: Yeah, definitely. Obviously if a type 1 diabetic doesn’t make insulin, and can’t process it on their own. Can’t process carbohydrates without taking that exogenous insulin, it totally makes sense to say; avoid carbs. But then it also depends on what type of activity they’re doing, how they want to train and workout. I mean, they definitely could do this. I think with the notes that you had earlier about; how do you feel. Do you feel better if you have some? And then knowing that are going to need to adjust your insulin dosing in response to much lower carbohydrate, you're going to need a lot less insulin overall.

I think Robb Wolf has probably talked about this a lot, because I’m pretty sure he’s in the camp of; if you're type 1 diabetic, the best thing you can do for your longevity. And don’t quote me, quoting him on this. But I’m pretty sure this is his stance, or has been. As a type 1 diabetic, for your longevity, the less insulin you have to take exogenously the better. But that doesn’t mean take none. It just means don’t follow the old doctor’s orders; previous doctor’s orders of, “Eat whatever carbs you want. Just take the insulin to support that.” Because that’s not healthy for anyone. That’s how people get type 2 diabetes. You know? Because they're eating all the carbs they want and just letting their own insulin deal with it. That’s just not the right way to approach it.

But I think they just totally need to work with their doctor. Make sure they have what they need to either bring sugar up or bring it down if they were to get into a situation where they kind of overdid it or under did it, so that they’re prepared for that. Because their body is not going to naturally rebalance the way ours will. Ours might rebalance and leave us feeling not so great in the process, but it will rebalance on its own. A type 1 obviously, they’re not making insulin. So it’s an interesting subject.

Leanne Vogel: Yeah.

12. Keto and not losing weight [57:34]

Diane Sanfilippo: Alright, so we have one last question that’s kind of opposite day, here. Do you have advice for people who want to eat keto, presumably for all of the amazing health benefits that we can get from it, that don’t have anything to do with losing weight? So is there a way to do keto without losing weight?

Leanne Vogel: This is so great. And a question I’ve been getting so much lately. And a couples of years I’d be like, I have no idea. But I’ve been maintaining my weight now for about a year and a half, and I’m not interested in losing weight at this point. So it becomes a lot easier for me.

I think if you don’t want to lose weight on keto, you really don’t even need to bother with testing your ketones, or tracking your macros, or anything like that. My advice to you would just be start eating more fat, lower your carbs. When you're hungry, eat. And this really goes for anyone. But for weight loss, you have to be a little bit more meticulous about how much fat you're getting. Where your protein is at. How much carbs you're getting.

And then for you, if you find that you are losing weight, and you don’t want to lose weight, I would end up practicing carb ups. Where in carb ups, really what we’re doing is we’re lowering our fat and increasing our carbs for that one meal. I would keep your fat where it is, and just add carbs to your meal. So you're having the fat and the carbs at the same time in the evening. And that has really helped me maintain my weight and where it is right now.

But it’s totally possible. And it’s a growing trend, which I love that people just want to be healthier and try something else. Maybe paleo isn’t just cutting it, or there’s a couple of things you want to change. Just by increasing your fat and lowering your carbs. And if you find you are losing weight; again, just practice the carb ups and have the fat and the carbs at the same time of your carb ups. And I’ve seen that work really, really well.

Diane Sanfilippo: That’s awesome advice. I love that. Well thank you so much. Thanks for spending time chatting with me today. I think our listeners are going to mark this one as one of their favorites in recent history, because this conversation is always so fascinating and it’s so great to hear a lot of different perspectives. And I really appreciate your perspective that is decidedly keto, but also extremely balanced in that. So thank you for having that take and perspective, and for sharing it with so many people. We really appreciate that.

Leanne Vogel: Thanks so much for having me on the show, Diane. I’ve been listening for like ever, so it’s pretty crazy to be on the show this time. {laughs} So thank you so much for the opportunity.

Diane Sanfilippo: {laughs} Oh, my pleasure. So your book is The Keto Diet. And where else can people find you?

Leanne Vogel: Yeah. You can go to HealthfulPursuit.com. That’s my website. I also have an Instagram, Healthful Pursuit. If you want to learn more about the book, maybe you have more questions. You can go to KetoDietBook.com. I also have a podcast called The Keto Diet, and a YouTube channel of the same name. So I’m out there in a lot of places. {laughs}

Diane Sanfilippo: Awesome. Alright, you guys, that’s it for this week. Don’t forget, you can find me, Diane, at http://dianesanfilippo.com. You can find our guest, Leanne, at www.HealthfulPursuit.com. Don’t forget to join our email lists for free goodies and updates you don’t find anywhere else on our websites or on the podcast. While you’re on the internet, leave us an iTunes review. We’ll see you next week.