Well, hello ladies and gents, Robert Sykes, Keto, savage.com. And today I've got special guest Laura Buchanan, MD on the line and we dive deep into the world of blood sugar regulation following a ketogenic diet, low carb diet. She works with patients, She has got some interesting studies coming out alongside the work she's been doing with Doctor TRO. They have a massive client demographic that they've been gathering data from. They've got a rebuttal paper coming out and it's really
interesting. It's always interesting for me to talk to people that are clinicians that are working with people directly that are boots on the ground, kind of getting their feedback on what they're seeing amongst their population, patient population and then just honestly picking her brain about how she's approached nutrition personally.
She's also got a 5 month old son, So what she's doing with his nutrition, she has stayed pretty well keto low carb throughout her pregnancy and breastfeeding and how that's affected him. So just a great around conversation around proper dietary guidelines and blood sugar management, CGM, things of that nature. So thoroughly enjoy the conversation. I've got no doubt that you will take something from it. Without further ado, sit back, relax, enjoy the podcast with
Laura and we are live. Laura, how are you today? I'm doing great. Thank you so much for having me. My pleasure, My pleasure. I'm excited to be chatting with you. You work alongside Dr. Tro, whom I've met several times, and you are like what? What leg of his umbrella, so to speak, are you most involved in? Yeah. So I see patients right alongside and we work very closely.
We each have our own patient panel, but we curbside each other, talk to each other about either interesting cases or just get bounce ideas off of each other. And we both are heavily involved with research and also on the board of the Society of Metabolic Health Practitioners. So many, many different hats staying busy with with that. Many different hats indeed. And you've like on your social profiles, you've kind of taken a stance with a lot of anti aging
content, correct? Yeah, Yep. I my goal is to really help people age successfully. And I think the way to do that is really through your lifestyle choices. Yeah, I can. And that's. Agree there? Have you found the fountain of youth yet? Have you discovered it? I I don't think I've found that quite yet, but I I think a good healthy amount of low carb keto and combination of physical activity, staying active is is
very important to that. Yeah, I always tell people the trifecta of the fountain of youth is, you know, some form of resistance training, you know, activity, a low carb ketogenic diet and then potentially some some form of intermittent fasting if done strategically. But honestly, just the low carb and the real food and activity, that's that's pretty much the the gatekeeper there. Yeah, absolutely. I have. I've heard some interesting theories from different, I mean pretty well impressive
researchers in the cancer realm. But believe if you do some extended fasting, maybe whether that's three days or five days, if it's once a year, there's some period of time that that will significantly decrease your cancer risk. Yeah, I. Believe it. I don't do a whole lot of extent and fasting myself, but some of the data is most definitely compelling. I'd love to get some some back story on you. Like what? What even got you interested in
this stuff? Like, did you have a health scare in your prior life or what? What happened was the catalyst for you kind of going down this path? Yeah, so there's a few different things. I grew up playing sports and was very passionate about that. I played soccer, tennis, ran track, and then in college I continued playing soccer and and
tennis as well. And I actually, while exercising while playing soccer almost five days a week, developed pre diabetes and you've kind of heard the old adage you can't outrun a bad diet. And I think I I fit that bill. I didn't necessarily at the time think I was eating a terribly unhealthy diet, but truly in hindsight it was a a mix of the standard American diet slash trying to be a a lower fat diet. So I was avoiding red meat and did that for about almost a
decade. I avoided red meat due to initial concerns back then that I have since changed about cancer risk and heart disease risk. And so that was kind of one piece of it of my own health. But then I think more importantly, actually during that time I saw people that I was loved aging very differently. So some of them were aging extremely well and others unfortunately were dealing with complications from chronic medical conditions like
diabetes. And it was just so drastic, the different quality of life that they were having in their final decade. And so that really just set it in stone. What I wanted to do, I wanted to help people age successfully and the way I could see this happening was through the way they were eating and living their lives. A decade without red meat is quite the feat. Did you notice anything like abrupt when when you reintroduced it?
Like was there any significant changes like on an acute level that you noticed right off the bat? None. And you know, I probably I did. I'm sure I did have a burger every now and then at a party or something, but it was definitely I avoided all throughout college and I I didn't have any significant issues. I do remember one particular one where I I I did develop severe
abdominal pain, but I was. I wonder if that was more just I I had eaten something bad rather than it having to do with not having had red meat and then to have eaten a large quantity of it that evening. But I I don't know for sure, but I definitely now feel better and that could be multifactorial because not only now do I eat red meat on a daily basis, but I also eat much lower carb than I used to as well and and and ketosis quite a bit. So you are well steeped in the
medical literature. You've got several studies presented on your like Instagram profile for instance. What are some like like what the red meat is an example? There's all these studies that point to it as being contributing towards cancer. When it comes to the research that is hot and prominent right now, are there anything that is just incredibly misguided that you feel is getting a lot of press time that is likely steering people in the wrong direction? Absolutely.
And it seems like there's something coming out all the time, but it's the same bad type of research that just keeps looping around. So the with a lot of these studies they give people a food frequency questionnaire or a 24 hour food recall and say you know either what did you eat in the last 24 hours or what did you eat in the past year and you answer 100 questions about that. And then they follow those people for a decade without any additional follow up.
And they say based on that one food frequency questionnaire or that 124 hour food recall, we are going to make the claim that it is those dietary choices that led to this disease condition. And that I mean that by itself is just terrible data. We know food frequency questionnaires are not very consistent if people were to fill them out on separate occasions. Additionally, though, you don't get the nuance. I eat and I'll eat half a pound or more of ground beef at a single sitting.
But that's ground beef that I just cooked in my pan at home with really nothing else in it. Maybe I maybe add a little salt and pepper, but you compared that ground beef to someone who has gone to McDonald's and got a burger with French fries and a milkshake or a soda in front alongside and those are two completely different diets. Yet both of those are going to check off on that food frequency questionnaire that you're eating half a pound or a pound of ground beef.
Is there any solution to that problem? Like like I don't know if the the way to gather data at scale among such a large population demographic would be some form of questionnaire, like what are some viable alternatives then? One that's has been done with some of the intermittent fasting research that's pretty cool is they actually have people use an app and take pictures of their food.
And so that way you definitely would see, you know, what is that individual eating alongside at that single meal. And that's of course a lot more work both for the researchers and for the person in the study because they're having to take pictures of the food. And then the researchers are having to quantify that potentially with more AI coming out, maybe there will be a newer way that will help us get some better nutritional research going.
But I think that's currently one of the more more able ways to do it. The other way too is if someone says they're eating a ketogenic diet, just measuring ketones, you can't again guarantee what exactly what they're eating. But if they're in ketosis, you know, they are excluding a large
amount of carbohydrates. So that would be another way of just kind of verifying a little bit what someone is reporting on their questionnaire because that's that's another problem I see with one of the study that came out this year from the American College of Cardiology, I think had wrote about it and said that low carb increased cardiovascular disease risk.
But the low carb individuals, if you trust the way they collected the data, we're still consuming over 120 grams of carbohydrates per day, which although is it lower carb than the Standard American diet, it is still not low carb and definitely not keto. Yeah, I would think, you know, with all the people that are tracking their intake via, you know, apps like MyFitnessPal or you know, just the different apps out there, they can certainly find some way to
synchronize all that data. Now granted that would probably contribute to the healthy user bias because people that are tracking their intake probably are doing other healthy habits as well. But I feel like just from a shared data standpoint, being able to access that would be much more viable and informative than just a basic food frequency questionnaire. Yeah, I know that's a great
idea. So when it comes to the the fountain of youth, kind of going back to that when when you were seeing family, friends and loved ones going through these health declines, what were some of the common denominators that you were noticing amongst those that were more resilient as they age versus those that seem to decline at a rapid rate? Yeah, so definitely it was eating home cooked food.
Just whole real food. Not a lot of packaged food and sweets were very rare, limited, and if they did have them it was a special occasion. Again, it was home cooked. Wine or alcohol was also limited to about no more than a glass granny I'm thinking of. She had one glass of wine per day and then she played tennis several times per week until she was 88 and then she continued to be to walk and do activity.
After that, actually. So whereas on the other side it was eating a lot of fast food, probably at at least multiple times a week, sometimes more than once in a day, and enjoying some of the processed sugars and candy on a regular basis as well. And not being as physically active, it's all kind of just opposites from one to the other.
What is what is your take on this big push as of late towards kind of putting the the limelight on seed oils like do you think because it's interesting, I've listened to some podcast with you know, M DS and medical professionals that say look there's not enough data to showcase that in a negative light. Other people are very, very, you know, staunch on their stance that hey look this is 100% the main contributing factor. Like what? What is your take? What is the research showing as
it pertains to seed oils? Yeah, I think I've, I've listened to some podcast too with Brett Palmer who had several researchers on that were were great. He's, he's the low carb cardiologist that brought up really good points pointing towards seed oils being very harmful and then the others having logical reasoning actually why they were not harmful. And so my precautionary principle for me is I avoid them because they're heavily manufactured, very highly
processed. And there is we've seen in our patients just through using thousands of continuous glucose monitors that some people actually do seem to have a glucose response to them, which is interesting and a little bit hard to explain. Then also there is definitely some mechanistic data about how they can be damaging to cells.
I Chris Kenobi, he's recently wrote a book actually, where they say they have met the Bradford Hill criteria is to showing that these are causally very harmful to our body. And so he's he does have some really interesting lectures that make me feel cautious enough and concerned enough to avoid them and to recommend that my patients avoid them until I think we have more data with human studies.
What do you think 'cause like with the, if you're noticing increase in blood glucose with patients that are consuming more seed oils, is that 'cause there's no carbohydrate in the, so it's just is that just an acute form of inflammation that's causing that glucose response? That's I wonder, yeah, it's somehow impacting insulin resistance. And for some people, I think like you point out, the inflammation component there is
very interesting. A case report was written in an individual with Crohn's disease and they reversed his Crohn's by putting him on an animal food based ketogenic diet and they removed all seed oils from diet and were very strict on that and even things as far as avoiding certain spices like cinnamon
that had oils in them. So they truly just wanted animal based only and he had an extremely leaky gut so that you can measure that by having people take certain proteins in and you can see which proteins go through the gut barrier. And his was entirely reversed and inflammation gone by consuming only animal products. Yeah, that is pretty compelling indeed. I I think the jury is still out on the seed oils and and to what degree they are contributing towards the obesity epidemic for sure.
But for me, it's like you just simply look at how it's made. The fact that they have to go through all these processing, there's it's deodorized, it's rancid. Like if if it was not deodorized, you wouldn't even be able to get it past your nose to consume it in the 1st place Like that just doesn't seem like something I would want to eat on
a daily basis. Yeah, that's that's exactly you look at the if you've seen pictures that are manufacturing plants and they're just this enormous industrial complex and they go through yeah like you mentioned deodorizing and several other heavy heavily processed. So I I do tend to focus more towards whole food as the goal.
I mean I definitely use and for patients especially as they're initially starting a low carb ketogenic diet, do use replacement products, replacement low carb foods to kind of help when the cravings hit Or if they're in a situation where people are eating cake around them to use a low carb replacement that maybe does also have some of that heavily
processing. And I acknowledge that's probably not a health food, but if it's helping them maintain their ketogenic lifestyle over time, you can slowly start using less of those replacement products and that's that's the goal of working towards more all natural whole food, less processed things. Yeah, 100%.
I mean, I feel like, you know, if if somebody was to come into the space having not known anything and following the standard American diet and everybody was just hand them all the information, things they needed to avoid right off the bat, it would be incredibly overwhelming and not likely sustainable. But finding stepping stones where they can just gain some momentum and make it sustainable
is key. And if you know, if it's better than what they were consuming the day prior, then it's certainly a step in the right direction. There shouldn't be this, you know, food judgment that's going on in the space right now. Like people just need to get better than they were yesterday. Absolutely. Oh, I love that. Better than you are yesterday. Totally. So you like what does your
day-to-day look like? Are you primarily working as a clinician with patients or is it more on the research side, like what? What does that look like for you on a day-to-day? Yeah, so I am blessed in that I now have a 5 month old and his his name is James and he's just the the light of my life. But I I get to hang out with him in the morning before my nanny arrives. And then once my nanny arrives, I start seeing patients and I'm
just part time seeing patients. And so I do that four days a week, and I have blocks cut off every couple of hours so that I'm able to go downstairs and actually continue breastfeeding. And then on part of the days when I don't have patients scheduled, that's when I'll do a little bit of research during the middle of the day. But come 4:00, my nanny leaves and then it's back to getting to just hang out with James for the rest of the day. And yes, it's great.
What? What is your typical patient avatar like? What are they generally coming to you for? Yeah. So I see almost two separate kind of patient populations, but a handful of patients that are looking to improve their metabolic health and specific kind of focused on weight loss and often times diabetes or hypertension kind of other metabolic issues and coming in for a weight loss program.
So we have two different programs you could come in for a six month kind of high, high accountability. You're having weekly appointments with myself for the health coach for that six months. And then the other program is it's just seeing me and we can we might have you know five or six appointments maybe a little bit more during that first year and that again it could be people who are focusing on weight loss.
But also, and I I really like working with both populations, but people who are already healthy but they're trying to optimize their health, trying to figure out what is that next thing I can do. I feel like I'm already eating, right? I'm doing some exercise. What additionally can I add to age better and to stay active as I get older? Because that's, I think something that is underappreciated is sarcopenia, which is just a loss of muscle mass and function as we get
older. And it is so prevalent now that we have to see people who are suffering in their later years because they just don't have the muscle to actually be able to do the things they want to do. What would you say the average age of the demographic you're working with is? Oh, that's tough because I see people all over the place, but it's maybe 40s to 50s. It would be average, but I see people in their 20s as well as in their 70s.
Are those older demographics, are they starting to come to you proactively asking about keto and low carb, or is that something that they're just not familiar with at all? Some of them are actually wanting to use low carb keto and I've had a few that have. They've started on their own, but then kind of want some additional guidance or
accountability. And definitely in the demographics where it's kind of this the 70 year olds often times it's wanting to figure out how we can make these final hopefully, maybe hopefully several decades, but these final years maintain their level of activity and functional ability during during that time. And a lot of that is I think actually trying to like you mentioned earlier but get people
resistance training. So you've got to muscle mass and strength is just going to naturally decline with age and it it it increases definitely over 50 and then even further over 60. So really trying to help people get resistance training back into their lives. Have you noticed that a lot of your older population is just simply not eating enough food in general? Like I think of my own, you know, grandparents and my my mom and she just often times was not eating enough.
She is now because I've kind of talked about this, but so many of the older demographics especially that the women, they just, they don't move as much, they're not as active, they stop eating as much and that obviously contributes to the sarcopenia as well. 100% You know, I initially I always ask people what they're eating on a daily basis and each meals,
snacks, all that stuff. But almost inevitably they're not getting enough protein in their diet and they're not getting enough protein in a single sitting. Because there is, as we get older, we developed this anabolic resistance where we basically, in order to trigger muscle protein synthesis, we need to consume a higher level of protein in a single sitting. And often times that's just hard for them that you have to actually work with them to increase the proteins at A at a given meal.
And most of the research as of late is showing that to be about 30 grams, kind of as a a rough minimum. Yeah, that's what I've seen as well. Yeah it's it's crazy cause like I think of what I eat in a day-to-day basis and I could put down, I could put down a lot of protein without even batting an eye. But so many people just under eat and they're eating all these
a lot. A lot of the older population, they're they're turning to like boost shakes or something like that, something that says contains 8 grams of protein with an exclamation point. And they're like, oh, I'm getting my protein in for the day, but it's like not nearly enough in a sitting, not nearly enough for the total day. There's just so much ignorance around what adequate nutrient intake is. And people are especially like as they age, they they lose muscle, they gain body fat, and
they want to lean out. So they kind of eat less by default. But they're not eating any of the right foods by default. So it just is a downward spiral that plagues them for years. Yeah, I I couldn't agree more. The, you know, I was thinking like you mentioned your mom, My mom as well, I've talked to her about this, this I'll tell her, hey, you need to eat 4 eggs to get close to about 30 grams of protein. And she looks at me like I have
to eat 4 eggs at once. And meanwhile, you know, I'll eat 6 eggs at a time and my husband will eat six or more. And in addition to the other food we're having alongside that, but it's people wouldn't bat an eye about eating, say, 2 slices of pizza and two slices of pizza if you decide to equate the calories you're going to be eating. I mean, you might be eating 12 eggs depending on how large of a slice of pizza, or maybe 6 to 8 eggs.
But there's also, I think, something been lost there with just our processed food. Do you notice more pushback from that older demographic when it comes to increasing dietary fat? Because I feel like so many of them are steeped in that old school way of thinking of you can't eat fat or else it's just going to make you fat. Yeah, I think it just needs a little bit more education because it is true there. There is that concern there. But I have a PowerPoint that I
like to go over with patients. It's really the carbohydrates that are driving your insulin levels to go up, which are going to be driving storing fat rather than fat, which actually has a very minimal response on insulin will not be driving that process. And so usually once we go through that, they're OK with trying to alter their diet that way. How do you get them to cut out a lot of the the sweets, you know like these?
Again I keep going back to the older demographic, but I feel like you know we all, everyone listening to this has parents, grandparents, great grandparents that we'd want them to get healthier but they they seem to be the hardest population to educate. I don't know if it's just because they're just they're they're steeped in their own ways of thinking they they've got their own pattern routines. But in family especially family is the hardest demographic to
get this shift. I mean, how have you, how have you navigated those waters? Yeah, I think just often times it's starting with finding replacements and you know if they if someone says I can't live without that food, then that's a food you really typically want to get out of their life and but then find something that they can replace
it with. Because if you just try to say you're never going to have that again and you don't give them an alternative and that's really hard and it's probably not going to be going to work. So that's the the first thing. And then often times, you know, I think I've, I use a lot of
continuous glucose monitors. And when my patients put those on and they see what these foods are doing to their blood sugar in real time and they see the monitors kind of spike up, they realize wow this is not good for my body. I'm going to try to remove that food and then they can go have the alternative and they see that their sugar stays nice and flat and that that is some great motivation. When it comes to the CGM's, I'm a huge fan of CGM's.
I don't have one in currently, but I'll I'll throw one in whenever I'm doing any type of experimentation and mine always stays relatively flat as well. When you're when you put ACGM on someone that's not following a low carb diet and they do experience a spike but then it has a healthy drop afterwards because their body is insulin sensitive and doing as it should. Is there like how would you have a conversation with them around that?
Like do you try and suggest that it's better to to not have the spike in the 1st place? Or if it's responding as it should, you just kind of let them go about their ways? Yeah. So it depends if they have pre diabetes or diabetes then even if their body actually responds fairly quickly then I'd still say hey we've we've got work to do. And same thing.
If we see a lot of insulin resistance either through checking something called an LPIR but a lipoprotein insulin resistance score or their fasting insulin and their fasting insulin level is really elevated then their sugars they might respond and look OK but we know that insulin is actually still damaging their body. So kind of explaining that they're still having damage done to their body even if that monitor is showing an OK, a healthy looking response.
Now say they have no signs of insulin resistance and they are, you know, they're healthy, they don't want to go keto necessarily If they're not having big spikes over kind of 40 points is what I've recommend, then I'd say hey, it's it's looking good. And the reason I picked 40, I've talked with several other docs and a researcher who's been studying diabetes for decades is on the initial Accord trial.
But we think 40 is a safe guess because we really don't know what is the acceptable or what is the optimal increase that is not going to be damaging the body when you eat carbohydrates because we know there's going to be some increase that's that is normal. But there is some data suggestive that if you have blood sugar increases above 65 points that that is causing damage.
So even if you have a normal A1C, but you're having that much glucose variability that it can increase risk for heart disease. So if 65 is damaging, hopefully 40 is safe until we have more studies done with. Now, I think as prevalent as continuous glucose monitors on these studies will be done, probably not in the too distant future, but that's that's my
typical approach to people. So generally speaking, a healthy glucose range being between 70 and 90 for instance, so not exceeding 40 beyond that baseline at any point. Yep, exactly. Gotcha, gotcha. Yeah, I'm constantly trying to get my family to prick their finger or use ACGM just to enlighten them. I feel like if they're if they see the date, if they see something reflected back them on a screen, that can be incredibly empowering, especially if they're not really well versed
in low carb keto, how it works. But they could just Simply put them their arm, eat as they normally would, but then retroactively look at what the data is showing. It kind of opens their eyes. Yeah, yeah, because that's, I've seen many people who, you know, they're an A1C of 5.9, so it's slightly elevated in the pre diabetes range. They put on ACGM and they see the oatmeal they're eating as an example, bumps them up to 180 or 190 and for them it's not a big
deal. That's an eye opener and they just switch from oatmeal to eggs. And even that little change right there can be enough for some people to normalize their sugars. What are some other signs and symptoms apart from blood glucose? Like if somebody is honestly, if
somebody is not overweight. And I feel like with the people that are not overweight, they are often times more blinded to the fact that they may be not optimal because there's no outward expression of that in the mirror that they're seeing every single day. So what, what are some other signs and symptoms independent of being overweight that you would suggest people kind of take proxy of?
Yeah. So if blood pressure is rising that that's something if you're checking labs, the insulin level you can definitely still see rising even if they're they're not overweight. The CGMI think is still one of the best features or tools in individuals like that.
I mean, my mom is a perfect example of she has, you know, a BMI of probably 21 and when she put on a CGM, she was seeing a lot of variability with what she was eating sugars hitting the 200 point, which would be a diagnosis of diabetes. If if you're having symptoms and sometimes people can get what you call acanthosis. Nitricans, which is darkening of the skin folds underneath armpits or behind the neck. Skin tags can also be a sign of insulin resistance.
And then other labs you can see the liver enzymes start to go up so math will be or massively metabolic associated fatty liver disease. We also see that individuals with normal BM is, but are eating kind of the typical standard American diet or a lot of higher sugar, higher carbohydrate foods. Gotcha, gotcha. What about as far as the CGMS go? Is there like a specific brand or company that you tend to
point people through? I know there's been several that have popped up lately, like Nutrisense levels. Is there like a good user friendly one that people can just be directed towards? Yeah. So those are both great if you know you pay for the monthly membership, you actually get feedback on your what's happening with your blood sugar responses if your doctor will prescribe you one and you don't necessarily need kind of that program associated with it. The Dexcom or the Freestyle
Libre are both great. The Freestyle Libre is typically much more affordable when insurance does not cover it.
You can get it for about 75 to $100 per month and each sensor lasts for two weeks and that's if you when you go to the pharmacy you say hey I'm paying out of pocket I'm not paying the the with my insurance company as they will not cover it And if your doctor does not feel comfortable prescribing you a CGM because you maybe you don't have diabetes, you're not on insulin, then people can actually go into the doctor tro app and you can order ACGM from us on the app.
We have to have one face to face visit just to give let people know some risks and benefits required by state laws. But after that, if you want to keep on refilling it, there's no more visits required and we can keep on sending you the CGMS. And that's with the the Freestyle. Can we do it with the Dexcom as well? Just with the freestyle. Gotcha. Well, shoot, I might. I might have to do that because I've got I've, I've used the freestyle several times.
But that would be something that I would totally do for my family and friends. Like, just simply, proactively, hey, look, here's the CGM. Slap it on your arm for two weeks and see what happens. Yeah, yeah. It's really I just there's not another tool currently that we have available where you can get that type of immediate feedback. Yeah, you mentioned that you have a 5 month old son named James. Talk to me a little bit about how you've approached his nutrition through your pregnancy
and breastfeeding. Like, how is what you know now about nutrition kind of shaped how you've started your parenting journey? Yeah, so I throughout my pregnancy and postpartum while breastfeeding, I've been low carb and probably I don't know the percent of time in ketosis, but because I only check my ketones periodically, but most of the time when I would check them, I'm in some mild level of ketosis, maybe .5 to one, and I just eat.
I make sure I get enough protein during my pregnancy and still a while now, breastfeeding. I'm probably getting close to 150 grams of protein a day and that's through rib eyes, ground
beef, salmon, sometimes chicken. And then I do eat non starchy vegetables and salads and sometimes it's just the quantity of non starchy veggies that will sometimes bump me out of ketosis and James. There was one point during my first trimester where I actually had the most intense carbohydrate cravings I can remember truly ever having. And I did have a little bit of carbohydrates for about 3 weeks
during that first trimester. And then after those cravings passed, I went back to low carb in ketosis and and everything went great. I you know, I'd never developed any leg swelling. I played tennis up until 38 weeks pregnant. I played on a tennis team until 32 weeks pregnant and it was after that 32nd week I decided to stop playing in matches and and then the delivery and I was
very fortunate. Everything just was, you know, very smoothly and now with breastfeeding it's been going really good and he I'm still been in ketosis for probably most of it and he just seems to be thriving on that. Yeah, it's it's crazy that there's so much information out there suggesting that, you know, pregnant mothers should be consuming these excessive amounts of carbohydrates in order to further the development of the fetus. And it's like I I don't think that's the way it works.
I mean, like my wife Crystal, she was keto all throughout pregnancy as well and has been all throughout the the breastfeeding. And our son is in like the upper 99th percentile of all the growth metrics. It's like I don't know where that misnomer came from, but it certainly doesn't seem to be the case. Yeah, and it's it's really interesting. I actually there's a something called lactation lab where you can send your milk till you get analyzed.
And so I wanted to just do some testing and I'm still in the process of a couple other tests. But I wanted to test what the composition macro nutrients of my breast milk when I was in ketosis versus kind of lower carb versus kicked myself out of ketosis. And the if you look at the K cal's per oz kind of the average is about 20 K cal's per oz for kind of your regular milk or the common formula.
And while in ketosis mine was 27 K cal's per oz and it was kind of above the normal on fat and then upper limits of normal on carbohydrate and protein. And then when I ate sweet potatoes and had some grapefruits got me out of ketosis, the the fat content dropped was cut in half, actually still in the normal range and the fat and or in the carbohydrate and protein stayed still kind of in the upper end of normal. Because I still.
I think I was getting close to 150 grams of protein even though I was just adding extra carbs in and the cacals per oz dropped down to 23 compared to 27. So the carbohydrate content of milk stayed the same whether you were consuming higher carbs or keto. Yep, exactly, which I was very interested to see that high carb count. I was wondering if that would be impacted, huh? That is interesting. Yeah. We we've saved some fur breast smoke, so may have to send that.
What? What's the name of the the lab company again? Lactation Lab and they actually have a 20% off right now with the holidays. Yeah, we may have to try that for sure because I'd I'd be curious to see what that data comes back as because I look at, you know, it just, it just makes intuitive sense like we are a species, I mean we're monogastric species.
We're not really up regulating what we're consuming like a cow or something would be. And you look at a a fetus that's developing or some of this drinking the breast milk an infant, it's like you really need to just prioritize the quality of food that you're consuming for their benefit. And if you're following a real food ketogenic diet, it seems like that would be the most definite way to do so.
Yeah, absolutely. And that's James, his demeanor, he's just he's such a happy baby and he, you know this first month of life I think he maybe cried for a couple of minutes. I mean there is and he now is just is the biggest smile and he's so he's just happy all the time and I definitely think the the nutritional healthy eating is helping that and he with his milestones. I mean he, I have a picture when he was a few days old he was holding his head upright.
I was just a few days old and you know he's continued to just have really incredible muscle strength from that developmental standpoint. And I, you know, could be genetics, but I think there's also definitely got to be some the fact of the way I'm eating and therefore his nutrition. So at five months, he does not likely have any teeth coming through yet, right? Yeah, no teeth yet. We've we gave him just like a lick of peanut butter just for hopefully decreasing chance of allergy.
There's about maybe a 5% reduction in some of the studies if you look at in developing an allergy if you introduce those more allergenic foods early on. But his first real meal, our plan is going to be rib eye. Nice, nice. That's a good first meal for sure. Yeah, Rigel's eating like steaks and eggs. He eats the exact same things we eat, just in smaller quantities. Cut up into smaller pieces, obviously.
But this idea of there needing to be a baby food or an infant formula are just something separate from. What we as adults consume boggles me like if it if it fuels us properly, it's going to fuel them properly. I am totally with you. That is our plan all the way. We we are, you know, eating healthy, whole, real food like you are. And he's going to do the same. And that's there's a lot of processed food now that's just geared towards kids or fortified with different things.
And recommending cereals is kind of some of the first introductory foods to kids, and it's the the nutrition content of those is just not the same as the animal products. Yeah, I mean, you got a ways to go, but have you kind of thought about how you're going to mitigate against him just eating everything that he does at home, but then going out and, you know, going to school, going to daycare, going to social settings outside the home and not having that control?
Like how do you plan on navigating that? That's a great question. I think we're still trying to figure it out. We, you know, we want to and hopefully just instill in him that we're eating healthy food to make our bodies strong. And so the other foods are not going to be making his body strong. And if he can focus on, I've just eating things to improve my
body's health. And you know, at a young age, if we can start getting him to think about things that way, hopefully that will just make him less likely to be tempted. But I think it is going to be really challenging. We'll probably have to do a little bit more figuring out things when when he is going to school and has the option to eat all those things. Now, I've heard other people who have, they try to help make their kids have associations.
So say they went to a birthday party and they ended up eating a lot of cake and pizza. And then they have a stomach ache later and say, you know, what led to that stomach ache? What did you did you do something differently than you usually do? Oh yeah, I ate the cake. And just trying to make them make the associations of how their body feels based on what they're putting in it. How young is too young to slap ACGM on a kiddo? Oh man, that's a that's a great question.
I don't, you know, with James, I think I I don't see myself putting one on him anytime soon. I think Tro's, I want to say, one of Tro's kids did, he wanted to put one on, I want to say around nine years old because he was just very curious. So I think if James saw me wearing one, which he definitely will see me wearing them and was curious, I'd be OK with that because I don't think there's going to be harm from it and I could just help educate him what he's seeing on there.
Yeah, I think that would be super cool. I mean, like if if you can kind of parent in such a way that makes that seem like a cool thing. So like if they're out with their friends and they they've got CGM on and you obviously don't want to make them obsessive or like, you know, fixated on it in a negative light. But like if they can just simply look at that and be like, OK, this is this blueberry muffin that my friend's mom made that's full of sugar.
It's probably not the best thing for me. I think just giving them that as an option and empowering them would be great. Yeah, yeah, I I love that idea. And I think I'll probably let him kind of make the decision of if, if and when he wants to try one on. But I I'm sure seeing the excitement and the fun that I have with it, it's he'll probably be curious to try one at a fairly young age as well. Yeah, totally, totally. Well, what is in the the pipeline for you?
What studies have got your interest? What are you working on that's specifically exciting? Like what, what? What's got you stoked right now? Yeah. So right now the Society of Metabolic Health Practitioners, the and you find out more about them about the US on the smhp.org. I'm a board member of that society.
But we have now, we have now have an Official Journal, the Journal of Metabolic Health and this is going to be focusing on therapeutic carbohydrate reduction, so low carb keto, but the actual hopefully either case reports, prospective trials, case series on different medical conditions that TCR benefits. So there's so much data now coming out there, but there's not an Official Journal really or there wasn't prior to this
that emphasize this. So I'm very excited that this is now it's set up and we are actually going to be having, we have, we still have to submit to the journal, but we are hopefully going to be having a a rebuttal published to the American Academy of Pediatrics paper that was just recently released on implementing low carb for children with type one diabetes, type 2 diabetes or at risk.
So children with obesity and they basically medicalized low carb eating to such a degree that if I were a doctor not trained in this area, I would never recommend that diet for of the patient. Because they said you needed to check their the child blood work five different times during the first year that they started a low carbohydrate diet. And they had you check 14 different blood markers of
concerns and deficiencies. And these included things like carnitine and selenium, which carnitine you're the primary source of that is actually from animal products. And so the idea that going on a low carb ketogenic diet would lead to a carnitine deficiency is just silly. And the how this happened was the studies that they were citing in their paper were based on primarily 4 to 1 ketogenic diets, meaning diets that are made-up of 90% fat and only 10%
protein. And these are some of the kind of earlier initial main diet used for children with epilepsy who must have very high levels of ketones to keep their seizures in remission. But because of that very high fat, much lower protein content, you do have to worry about some nutritional deficiencies and you have to be cognizant of that. But on a well formulated ketogenic diet, you really should not have to be worried about that.
It is a very nutritionally dense diet of whole real food and you can still eat your non starchy veg cheese and you can still even eat some fruit and maintain great improvements in metabolic health for children with either type one type 2 or at risk for diabetes. And so we, we wrote a rebuttal to kind of go over some of the different concerns they brought up and kind of explained why they're not valid and we need to
actually really reconsider this. So hopefully that'll be published in the not too distant future. And and then I'm also working with TRO right now on our, we're making data, one year data from a cohort of individuals. We've been working with this employer program and with it was less than about 100 patients in the past year. We've had about 3000 lbs of weight loss, so that that's
really exciting. And there's some other pretty cool improvements as far as stopping think over 70 medications while having improvements in their A1C, in their blood pressure. And so we'll be presenting a poster at the Symposium of Metabolic Health in Boca Raton in January. Nice, nice. That's awesome. I'm super excited about seeing that information. Yeah.
Thank you. When when you like, if you were to step back and look at all of this from a 30,000 foot view and you, you look at the cause, like when you look at diets and dietary trends, you know you see things come and go. You see these hypes form and then fall off. And a lot of people assume the same is going to happen with keto. But I feel like from a a medical standpoint, there's just this overwhelming sea of data and research studies being done that all cater towards a well
formulated ketogenic diet. And I would think, and I would hope, that as more legitimate medical scientific research comes to light about the benefits of a ketogenic diet, the general public will start to see it more as an efficacious way to go about eating, as opposed to some dietary trend
that comes and goes. Yeah, I think you are on track that it's in the early 2000s when Doctor Westman really started doing some of these studies with kind of showing that a ketogenic diet is safe and effective and kind of for metabolic health. The from there it's just exploded and we're seeing case reports of Crohn's disease, ulcerative colitis, so that's inflammatory bowel disease.
There's so many anecdotes now and we need more of these anecdotes to actually be written up as case reports but of different autoimmune conditions, rheumatoid arthritis and psoriasis. Just kind of debilitating conditions being reversed entirely on a ketogenic diet and for some individuals even go into a carnivore diet having this amazing improvements in their health.
And I think 1 area that I'm excited about and will actually help maybe have the the public become more accepting of this as well is if we can get the medical professionals as trained in it. And when I went through medical school, we had a two week nutrition elective that was just
very underwhelming. And if we can actually create and we we did actually in our residency, me, my husband and another one of my Co residents, we created a nutrition elective that people would take that was a month long. That started with how did we get here? How did the dietary guidelines come about and how do you properly analyse studies? Why are those studies that said red meat causes cancer? Why are they not valid studies? And then went into low carb nutrition and the benefits that
it can have on the body. And another resident actually took this course and since then the other resident has stayed on his faculty and she is continuing this forward and is continuing to grow it. And if it is successful and residents continue to take it, provide positive feedback, then potentially that could spread to other residency programs in our area, other medical schools almost like a grassroots movement of getting low carb nutrition accepted from the ground up. Yeah, that.
I mean I think it's definitely going to be a grassroots movement, but seeing how much has come to light from the medical space, from the scientific community, I'm hopeful that it just keeps making itself more mainstream and that trajectory continues to to go as such. Because I mean like the the anecdotal data is hard to deny.
And I just speaking for myself, like how I feel and perform on a day-to-day basis is night and day compared to what it was when I was following the Standard American diet. And yeah, the more people we can get to move in that direction, the better. So hats off to you and the people in the medical space that are, you know, boots on the ground, working with patients, working with clientele and making a difference. I feel like that is what it's going to take. Yeah.
Thank you so much. And I mean it's what you're doing with this podcast as well and the information you're helping spread and get out there and that's it's also I think really going to be so important to to just increase awareness.
You know, another area that is just want to bring up because it's so exciting is this work that Chris Palmer is doing and he's yeah, the work in the mental health field showing so much significant improvement and bipolar, schizophrenia, schizoaffective and other mental health conditions is just it's really incredible. It truly is, yeah.
I think I've, I've seen him speak at a few different conferences now and there there's just so many different angles that that this is coming to light from Now you get it from a a diabetic standpoint, you get it from an overweight and obese standpoint, you've got it from a psychological standpoint. Now with Chris Palmer's work, you I'm, I'm trying to move the needle from a performance
athlete standpoint realm. And. Like, I feel like the more people from all these different facets of life that are showing the benefits of this way of eating, like you can't ignore that forever. Yeah, yeah, that's. It's one of my mentors, he he said. It's so unbelievable, it's unbelievable. But as as the data accumulates, I think you just you can't, you can't deny the data.
Yep, 100%. Well, Laura, I can't thank you enough for taking the time, sharing your story, talking about the, the demographic that you've worked with and just what you're doing in the space right now, what you've got coming with this research study and just how you're educating people. So huge appreciation there. Where do people go to find out more about you get plugged in and just see kind of what you're working on on a day-to-day basis?
Yeah, so you can find me on Twitter and Instagram at Laura Buchanan, MD and I've got a sub stack agingsuccessfully.substack.com and then if you go to doctortro.com if you're we are a telemedicine practice and are accepting patients in about all 50 states, so would love the opportunity to try to help improve your metabolic health. I love it. I'll link out to all those, make it easy for people to find you all totally separate question.
But how do you like sub stack like when it comes to different mediums to relay information like how is sub stack compared to the others? I I've enjoyed using it, I've just only follow a few people right now. Anita Tyshols as a great sub stack, so I haven't delved into it honestly a ton compared to say Twitter, but I have my little experience in it. I I have enjoyed using it.
Nice. Well, I will definitely have to check that out myself and see how it works for sure, because I don't even know how to use Twitter. I'm kind of, I'm kind of behind the 8 ball in some of this stuff, but awesome. Thank you so very much Laura. I can't thank you enough. I appreciate your time and keep making a difference in the world out there. Thank you so much. It was my pleasure. Have a good one all. Right, you too.