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  • The Beginner’s Guide to the Keto Diet: Literally Everything You Need to Know

    The Beginner’s Guide to the Keto Diet: Literally Everything You Need to Know

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    If you have questions about the Keto Diet, well my friend, you’ve come to the right place!

    We help our coaching clients completely overhaul their nutrition, including going low-carb, and today we’ll give you everything you need to start a Ketogenic Diet. 




    We’ve learned a lot by helping people begin the Keto Diet: there’s plenty of good, there’s plenty of bad, and there’s plenty of ugly

    Today, we share with you what we’ve discovered. 

    Here’s what we’ll cover in our GINORMOUS Guide to the Keto Diet (click to skip to that section):

    Whew. It’s a lot to cover. Even just typing out the Table of Contents was exhausting.

    But hang in there!

    You’ll learn how to do Keto right, plus I’ll share cute animal gifs to make sure you’re still paying attention, like this one:

    This carrot will definitely knock this bunny out of ketosis.

    If you don’t have a lot of time, but do want an exact plan to follow, I got you. Since this is a MASSIVE article (the longest published on Nerd Fitness!), if you’d rather read it in a snazzy digital guide form, you can download our Beginner’s Guide to the Keto Diet free when you sign up in the box below:

    And yes, that is an egg wearing a cape of bacon.

    Okay, let’s get into KETOOOOOOOO…

    What is the keto diet or KetoGenic Diet?

    Is romanesco part of a Keto Diet? Let's find out!

    The Ketogenic diet, or Keto diet, is a food strategy in which you drastically reduce your carbohydrate intake and replace it with fat in order to get your metabolism to a state called ketosis.

    In ketosis, your body converts fat to fuel to burn for energy like Tony Stark burns Captain America for being uptight.

    Get it?

    Because Captain America is a square. [1]

    Don’t worry, the jokes will only get worse from here.

    When you’re in ketosis, your body is burning fat for fuel, and this can help create a series of big wins for you in the “get healthy, lose weight, look good naked” department.

    In order for ketosis to happen, the body needs to be absent its preferred fuel source: glucose (sugar!).

    When you run out of glucose, then you enter ketosis.

    This can happen in one of TWO ways:

    • Fasting: by not eating at all, your body will burn through your glucose stores and be forced to start converting fat to ketones for fuel.
    • Eating in a “Keto” way: essentially, only fueling your body with fat and avoiding consumption of foods that can be readily converted to sugar.

    Where does that sugar usually come from? Generally speaking, carbs.[2]

    And boy do we love carbs.

    A typical American diet is more than 50% carbs. And more than 60% of our country is overweight. Is one causing the other? Or are they just correlated?

    I’d argue both.

    And I’m the nerd writing this.

    So, there.

    Eat carbs, burn carbs, store sugars, lather, rinse, repeat. Very little fat-burning is taking place – and you’re adding to your body’s sugar storehouse, and that’s what eventually winds up packing the fat onto your body!

    This is an overly simplified video explaining the process:

    So what happens if you get rid of those carbs and replace them with another fuel source? That’s when you start burning fat.

    Compare a typical carb-heavy American diet to somebody who is “Keto” – they eat a diet very high in fat, with moderate amounts of protein and minimal amounts of carbohydrates.

    Still with me?

    Great.

    So if you do an extended fasted period, or only eat foods that line up with the Keto Diet, your body is going to be forced to burn fat for fuel.

    Another thing to note: when you eat carbs, your body produces insulin to deal with the increase in sugar/glucose in your bloodstream. When you minimize carbohydrate consumption, this can result in less insulin production, and your body can become more insulin sensitive, which has a host of health benefits.

    Depending on how strict you are choosing to be with Keto, you’ll probably pick one of the following strategies:

    • Less than 50g of carbs
    • Less than 20g of net carbs
    • 5% of your total calorie intake

    Which one is for you? We’ll get to that. Just know that everybody is a unique snowflake, and everybody will be different when it comes to entering ketosis and staying in ketosis.

    There’s no hard and fast rule to which “Keto Diet” strategy you need to follow, but it helps to start with one to get the ball rolling.

    In short, you’ll need to pick the one that puts you into ketosis, which requires you to pay attention, track your results, and act like a scientist.

    Treat Keto like you would a science experiment

    When you’re in ketosis, this can lead to ramped-up weight loss for some, and increased physical potential, lower insulin levels, increased brain function, and other awesomeness for others.

    Allow me to answer your next question.

    What are ketones?

    Cordite isn't like the "ketones" we will talk about today. So don't start consuming gunpowder!

    If you don’t care what ketones are and are just here for the weight-loss stuff, skip to the next section. If you do care about ketones, strap in and let’s get weird.

    When your body doesn’t have carbs/glucose to burn for energy, you’ll need to dig into your body’s fat storehouse to get fuel.

    Enter the hero of this story: your liver.

    Yes, the same liver you abuse during dollar draft night at O’Houlihans.

    In the absence of glucose, your liver takes your stored fat and breaks it down into usable compounds called ketone bodies, or ketones.

    These ketones can be used by your body and your brain for fuel! In addition, “increased blood ketone levels may directly suppress appetite.”[3]

    The reason many feel differently on a Keto Diet is that their brains are being fueled by a completely different source than at any point in the past.

    There are three types of ketones, which is important to know if you want to sound pretentious at parties:

    • Acetoacetate
    • Beta-hydroxybutyrate
    • Acetone

    It’s also important to note that ketones are different from a keytar, which is what Michelangelo used to defeat Shredder in the cinematic masterpiece, Ninja Turtles:

    Were the Turtles Keto when they defeated Shredder?

    If you are wondering, “Steve did you write this entire section just so you could make a keytar joke?” you wouldn’t be wrong.

    But let’s get back on track: There are two ways for your body to fuel itself off of ketones:

    • It can make the ketones itself during periods of fasting or due to the consumption of fat and the absence of glucose. Woot for home-cookin’.
    • Consume actual ketones – these are called “exogenous ketones,” which I’ll cover later in the article.

    This concludes our boring sciencey section about ketones and allows us to get back to the real reason you’re here.

    Will I lose Weight on the Keto Diet? What are the Other Benefits of Keto?

    Is that ice cream Keto? Likely not...

    Great question.

    The answer: Probably.

    One of the tenets of the Nerd Fitness Rebellion is “You can’t outrun your fork,” which means we believe nutrition is 80-90% of the “lose weight” battle.

    So let’s dig into how the Keto Diet factors in here.

    When your body is consistently in the process of breaking down fat into ketones, you enter ketosis.

    Imagine you have a pile of coal (stored fat) for the winter – when you shovel some of the pile into the furnace for heat (energy), your pile of coal gets smaller. In ketosis, YOU are getting smaller.

    You can find study[4] after study [5] after study [6]in which people on a Keto Diet lost weight and improved tons of health markers.

    There’s also another reason most people lose weight on the Keto Diet.

    Thermodynamics.

    I discuss this in great detail in my “The Perfect Diet” article, but I’ll give you the summary here:

    When somebody eats a Keto Diet, they are nearly eliminating an entire macronutrient: carbohydrates.

    And what foods are primarily made up of carbohydrates? Bread. Pasta. Candy. Soda. Chips. Bagels. Fruit smoothies. These are calorically dense, nutritionally deficient foods that people tend to overeat.

    When you eliminate all of these bad foods in a restrictive diet like Keto, you’re going to consume fewer calories overall.

    The reason Keto works is because you are eating less calories overall.

    And when you burn more calories than you consume, day in day out, for weeks or months at a time, you’re likely to lose weight.

    This is why most calorie-restricted diets result in weight loss regardless of the composition of the food consumed.

    Note this ignores the concept of quality of food, muscle synthesis, body composition, etc. and JUST focuses on a smaller number on the scale.

    Anecdotally, once some people become keto-adapted, they feel satiated on fewer calories – which results in easier weight loss.

    And yes, the opposite is true: one can ALSO overeat on Keto in order to GAIN weight. So don’t expect to eat 6000 calories of butter, avocados, and bacon and lose weight.

    In addition to helping with weight loss, the Keto Diet has been used to treat epilepsy[7], help with Type II diabetes[8], polycystic ovary syndrome [9], acne [10], potential improvement in neurological diseases (Parkinson’s[11] and multiple sclerosis[12]), certain types of cancer[13], and reduces the risk factors in both respiratory and cardiovascular diseases[14]. Emerging studies are digging into its effects on Alzheimer’s [15]and other conditions as well.

    Here’s a video specifically related to Keto and cancer:

    NOTE: I’m not a doctor. I don’t play one on TV. I did not stay at a Holiday Inn Express last night.

    I am not advocating Keto as a panacea for all of your ailments.

    I simply point out the above studies as STARTING points for you to conduct your own research and discuss with your doctor if switching to a Keto Diet is an experiment you should attempt.

    What’s the Difference Between Keto, Atkins, and Paleo?

    Some keto-friendly meat on the grill.

    I’ll cover this quickly!

    Keto, Paleo, and Atkins are all considered “low carb” diets, though “low carb” means different things to different people, different groups, and different studies.

    They each have different things that are important as well:

    Keto targets low carb (less than 5% of your total), and focuses on a very high-fat content – 70% of your diet. It eliminates grains, tubers, and most fruits due to the carb content. You need to be diligent in your tracking and can measure if you’re in ketosis.

    Paleo targets low carb through focusing on protein and fats, eliminates dairy, but doesn’t limit fruit or sweet potato intake. In this diet, you don’t track but rather eat until you’re full.

    Atkins has different tiers of adherence, focuses on low carb, high protein, high fat. You eventually add more nuts, low carb vegetables, and low carb fruits back into your diet.

    I’ve written a monster guide on the Paleo Diet, which I recommend you read in addition to this article if you’re trying to decide which option works best for you. You can also check out our post specifically comparing Keto and Paleo.

    Like every diet, you can absolutely do any of these diets and still gain weight and get unhealthier – so they each come with caveats, and require you to understand the food you’re putting in your body.

    Deal? Deal. Here’s an otter with a baby otter, you’ve earned it:

    You earned this cute otter by sticking with this Guide to Keto.

    How Do I Do the Keto Diet?

    Don't JUST eat meat on your Keto Diet. Get some veggies in there too.

    Steve, I want all the potential benefits and potential good-looking side effects of going Keto. I also want a million dollars. But for now, I’ll settle for the benefits of Keto. How do I do it?

    In my opinion, there are two reasons why somebody wants to go Keto, and that should dictate your level of dedication to the Keto cause:

    • If you are just trying to lose weight, it doesn’t really matter whether or not you’re actually in ketosis – provided you are consuming fewer calories on average compared to how you were eating before. This can be aided by minimizing carbs and upping your fat intake.
    • If you are treating this as an experiment and are tracking your ketosis compliance, then you need to be more diligent in your tracking and actually make sure you’re in ketosis.

    I imagine most people fall into Group A, but we’ll cover both Group A and Group B moving forward – and tracking your results is the best way to make progress.

    So let’s say you’re “going Keto.” This can be a few different things depending on your situation:

    • Tracking net carbs: 20 net grams per day or less
    • Tracking regular carbs: 50 grams per day or less
    • As a percentage: 5% of daily calories

    Although people adjust their ratio of protein and fats, the hard and fast rule tends to be around the severely restricted consumption of carbohydrates.

    Ruled.Me has a fantastic Ketogenic Macro Calculator that simplifies the heck out of this process, but I’ll also show you the math if you want to nerd out:

    #1: Determine your total calorie intake goal. Calculate your “basal metabolic rate(how many calories you burn per day). I am 6’0″, 185 lbs, and my BMR is roughly 1814 calories. I am active, so I’m multiplying this number by 1.375 to get to my active daily calorie burn: 2814 – let’s make this an even 2800.

    #2: Take 5% of that number for your total amount of carbs. Divide by 4 (there are 4 calories per gram of carbohydrate). Some people stick to a rule of “Less than 50 grams total” or “20 net carbs total.”

    I have 140 calories for carbs, divided by 4, equals 35 grams of carbs. That’s a nice round number so we’ll stick to that.

    #3: Next, calculate your protein requirements. If you are active, Target 0.8-1.2 g of protein per pound of weight. This is a simplified version of a complex calculation you can do, which is dependent on your lean body mass, how active you are, etc. If you have a lot of weight to lose, you’ll want to adjust this number down to more like 0.5-.6g per pound (consult the above calculator) You can multiply this by 4 to see how many calories total that would be.

    I’ll again keep it simple and make it 180g for me. 180 x 4 = 720 cal. Which means so far I have used up roughly 860 calories of my 2800 calories, so I have 1940 calories remaining.

    #4: What’s leftover? Fat! There are 9 calories per gram of fat. So divide your remaining calorie count by 9 to see how many grams of fat you should eat per day.

    In my example, I have 1940 calories remaining, divided by 9, which means I need to consume 215g of fats per day. Yup. This is a lot of fat.

    #5: Put it all together, write it down, start tracking your food, sucka! I’m sorry for calling you a sucka, I didn’t mean it. In my example, I’m looking at 215g of fat, 180g of protein, and 35g of carbs.

    This should be a good STARTING point. You’ll need to adjust along the way based on how your body responds, but it can get you going.

    Next, you’ll create a meal strategy of sorts – examples later in the article – that pick the foods in the previous section and combine them in a way that fits your particular strategy to enter ketosis.

    And that means you gotta know your food!

    For everything you eat, you want to know the following:

    • Number of calories
    • Grams of fat
    • Grams of protein
    • Grams of carbs
    • Grams of fiber

    With carb intake requirements being very low, many ‘healthy’ foods would still be enough to knock you out of ketosis depending on how many of them you eat. Which means you need to be hyper-aware of your carb count.

    Let’s quickly talk about the concept of “net carbs,” and why this is so important:

    A vegetable that is 5 grams of carbs and has 3 grams of fiber will have a “net carb” total (subtract the fiber number from the carb number) would be 2.

    Here are a few examples showing the ‘net carb’ effect:

    • Asparagus: 7g carbs, 4g fiber = 3g net carbs
    • Kale: 7.3g carbs, 2.6g fiber = 4.7g net carbs
    • Broccoli: 11g carbs, 5g fiber = 6g net carbs

    WHY THIS IS IMPORTANT: Fiber is really good for your body, and oftentimes when somebody goes from eating hundreds of grams of carbs per day to less than 50g, they are eliminating a lot of high fiber foods they used to eat (bread, whole grains, etc.).

    By consuming leafy greens like kale or veggies like broccoli, one can still get enough fiber and remain in ketosis.

    Of course, no good healthy eating strategy goes unmarketed, why you’ll see plenty of “Keto-friendly” snacks that advertise “zero-net carbs” even though they have many grams of carbs in their nutritional breakdown – it’s countered by the fiber.

    In addition, a lot of “high fiber” protein bars or “low carb snacks” often contain sugar or artificial sweeteners that could knock you out of ketosis.

    Which means two things:

    1. Consuming a pile of “Keto-friendly” processed snacks all day long could absolutely knock your body out of ketosis. Check the ingredients, and try to focus on eating REAL food.
    2. If the occasional Keto snack keeps you from getting hangry (hungry plus angry) between meals, and keeps you from overeating during your regular meals – knocking you out of ketosis – then snacks are fine.

    What Can I eat on the keto diet?

    A carnivore diet wouldn't be Keto, because the protein would be too much.

    Steve, I appreciate you talking to me like I’m 5 years old and walking me through this process step by step. I don’t care what everybody on the internet says about you, you’re an okay guy.

    I now have my macros. What the heck do I get to eat on a Keto Diet?

    As I explained above, in order to be in Ketosis you need to eat a diet that has minimal carbs, high fat, and adequate amounts of protein.

    Following this type of nutritional strategy can result in ketone body production and increased fat-burning. We talked about this in our Beginner’s Guide to the Paleo Diet. Although fat gets a bad rap, fat is an essential nutrient and it’s not actually the fat that’s making us fat.

    Here’s a look at the things you should primarily be eating on Keto:

    • Meat. This includes red meat (like steak) as well as pork products (sausage and bacon and ham) and white meat (like chicken and turkey). Fatty meats can be helpful in a Keto Diet.
    • Fish. Look for high-fat fish, like tuna and salmon.
    • Eggs and dairy. If you think there’s nothing better than butter and cheese, you’re in luck! Eggs, butter, and cheese are all a big part of eating Keto. You’ll want to make sure your items are as unprocessed as possible, so stick to cheeses like cheddar, mozzarella, and blue, and look for butter and egg products that are organic or come from free-range animals.
    • Healthy fats. Nuts, seeds, and avocados are your keys here. Almonds, macadamia nuts, Brazil nuts, and nut butters.
    • Dressings and oils. Greek dressing, caesar dressing (though check the ingredients), ranch, aioli. When you need an oil, stick to extra-virgin olive oil, avocado oil, coconut oil.
    • Veggies. Cruciferous greens like spinach, kale, broccoli, cauliflower, that sort of thing.[16]
    • Meatless proteins. Tempeh, tofu, and seitan can take the place of meats in a vegetarian or vegan Keto Diet. Not as optimal in this nerd’s opinion, but you do you, boo.

    This is an overly simplified breakdown of what you can eat, but it will serve as the foundation for the rest of the article. And yes, I’ll get into specific meals soon.

    Still here? I’m proud of you.

    We're really proud of you for sticking with this MASSIVE guide to Keto.

    What foods Can’t I Eat on the Keto Diet?

    This hot-dog man should be worried, because those dogs will definitely eat some Keto friendly meat.

    We covered what you CAN eat.

    Now let’s cover all of the foods you should avoid while eating Keto:

    • Sugars. This can include desserts like cake and ice cream and cookies. And don’t forget to watch out for hidden sugars in things like ketchup! Your body LOVES to burn sugars, and if it has those, it’s not going to create ketones out of fat to burn.
      Liquid calories. Soda, juices, smoothies, and any beverages that contain carbs and sugar.
    • Starches. This means pasta, potatoes, sweet potatoes, rice, bread, cereals, and anything made with wheat or cornflour. They’re big sources of carbs, and once again, they’ll stop your body from entering ketosis. It also means corn, which is a grain, not a vegetable.
    • Diet foods. We told you to avoid sugars, but “diet” foods are big red flags on Keto as well (and on most healthy eating plans!) They’re heavily processed and high in sugar and tend to wreak havoc on your body.
    • Fruits. What, no fruit? Fruits tend to be high in fructose (a sugar). High sugar = no ketosis. (I feel like maybe I’ve said that already). A few berries can be OK, but only if you’ve planned for their net-carb intake into your daily total.
    • Beans. Wait, what? Steve, I thought beans and legumes were healthy! You even eat them as part of your Paleo-ish diet! They can be, but they’re also higher in carbs and can potentially cause inflammation that works against weight loss.
    • Unhealthy fats. Healthy fats, like those in olive oil and nuts, are great. But that big glob of mayonnaise in your tuna, or the canola oil you’re frying in? Stay away from them on Keto.

    Does this sound like a lot to eliminate all at once? It’s because it is. This is where most people fall off the wagon.

    They see that list and say “I could never give up (insert your favorite non-Keto food here).”

    If you’re already overwhelmed and worried you can’t stick with this diet, I got ya. I made a free 10-level Diet Blueprint (think like leveling up in a video game) that walks you through eliminating many of these foods through a series of small changes you can make that won’t freak you out, and isn’t nearly as restrictive as the Keto Diet.

    For a lot of members of the Rebellion, these incremental changes are a great place to start while you get your feet wet and start to learn about the food you’re cramming down your piehole. I’ll send it to you free when you sign up in the box below:

    How do I KNOW I’m in Ketosis?

    These Lava Lamps won't tell you if you're in ketosis, but they do look cool.

    If you’re going to follow a Keto Diet, you probably want to learn how to determine if you’re actually in ketosis, right?

    I believe there is something more important here to consider:

    • Are you getting results?
    • Does it matter?

    If you are aiming for a “look pretty good, feel pretty good” strategy – as laid out here – an 80% solution that results in a decent physique when combined with strength training and exercise.

    So if you “go Keto” and you are losing weight and feeling better, does it REALLY matter if you’re in ketosis or not? I don’t want your success derailed because you panic about the exact amount of ketones in your bloodstream!

    “Steve, I hear you. But I’m doing this Keto thing as an experiment, or I want to see if I get other benefits too. Tell me how I can measure my ketone levels!”

    Okay okay okay, fine! We’ll do all the things that YOU wanna do.

    There are three ways to determine whether or not you’re in Ketosis:

    • Test your breath
    • Test your urine
    • Test your blood

    In my research, I found that testing one’s breath is the least popular of the options – I only found poorly reviewed expensive testers. So if you happen to LOVE this method and have an inexpensive testing option you want me to link here – put it in the comments!

    Blood testing options are accurate but do require a blood sample (duh) and thus are less convenient than the next option…

    I bought these Ketone Testing Strips and they seem to be getting the job done for testing the level of ketones my body is producing. I simply pee on the strip and then match the color at the end to the side of the bottle to determine the level of ketones in my urine.

    For the first week or two of becoming keto-adapted, testing your ketone levels daily (or once in the morning and at night) is reasonable. Don’t test your levels multiple times throughout the day, especially after just eating, and then freak out if the number isn’t what you wanted it to be.

    NOTE: Once your body becomes fat-adapted, it might use ketones more effectively which means fewer ketones are excreted through your urine/breath. For this reason, your tests could show lower ranges of ketone levels than the actual amount your body is producing. This is normal, expected, and not a problem.

    “WHAT ARE THE DIFFERENT RANGES FOR KETONES!?”

    Ketones are measured in terms of millimoles per liter in your blood:

    • 0-0.4 mmol/L = regular American diet (50%+ carbs)
    • 0.5-7 mmol/L = prolonged fasting / ketogenic diet
    • 15-25 mmol/L = Diabetic ketoacidosis = danger, Will Robinson!

    When you’re in ketosis, you’ll hang out in the second range. Depending on what you’re eating, if you’re supplementing with exogenous ketones, if you fasted, and how long you’ve been in ketosis, where in that range might vary for you – but that’s okay!

    My research also showed that there’s no particular benefit to having a higher ketone amount as long as you are in ketosis.[17]

    Let’s quickly talk about ketoacidosis – it’s a condition in which the body produces too many ketones that can’t be used, rendering the bloodstream too acidic – it’s a concern, but for a small percentage of people.

    Diabetics in particular are at risk for diabetic ketoacidosis, and they should work with their doctor before adjusting their medication or adopting a Keto Diet strategy.

    If you are STILL panicked, speak with your doctor. And relax. Look at these sleeping puppies, calm yourself down, and then we can get back to work:

    These puppies are crashing from too much milk, which isn't really low-carb friendly.

    The Killer Combo: Fasting + Keto Diet

    This LEGO isn't fasting or going low-carb, but it's working for him.

    As previously stated (like, 5 minutes ago), there are two ways to ensure you get into ketosis:

    • Fasting
    • Eating in a way that induces ketosis (low carb).

    As many will tell you in the Reddit’s /r/Keto – and even members of our own Team Nerd Fitness:

    Eating Keto + Intermittent Fasting = a great combo for simple weight loss.

    We actually have an amazing success story here on Nerd Fitness, Larry, who followed our strategies, decided to go Keto and start intermittent fasting. He ended up losing weight, getting stronger, AND overcoming the challenges of rheumatoid arthritis (click on the image for his story)!

    We’ve covered Intermittent Fasting extensively on Nerd Fitness, so I’ll simplify how it works here:

    • Only eat during a certain window of the day. The most popular version (and the one I follow) is ‘skip breakfast’, and only consume calories between Noon and 8PM.
    • Occasionally do a 24 hour fast: eat dinner one night, and then don’t consume more calories until the following dinner. Some people actually do this every day, they call it OMAD (one meal per day).
    • Men and women are affected differently by intermittent fasting, and your results may vary.

    As your body enters a fast period when there are no sources of glucose energy readily available, the liver begins the process of breaking down fat into ketones. Fasting itself can trigger ketosis.

    Fasting for a period of time before kicking off a Keto-friendly eating plan COULD speed your transition into the metabolic state of ketosis, and fasting intermittently while in ketosis could help you maintain that state.

    I personally love fasting for the simplicity: I skip breakfast every day and train in a fasted state. It’s one less decision I have to make, it’s one less opportunity to make a bad food choice, and it helps me reach my goals.

    WHY KETO + IF WORKS = eating Keto can be really challenging. And every time you eat, it’s an opportunity to do it wrong and accidentally eat foods that knock you out of ketosis. You’re also tempted to overeat. So, by skipping a meal, you’re eliminating one meal, one decision, one chance to screw up.

    Note: if you’re thinking “Steve, am I losing weight because I’m skipping 1/3rd of my meals for the day, AND eliminating an entire macronutrient?” – Yes. Now, both Keto and IF have secondary effects that could also be factoring in.

    Your value may vary!

    Like the wheel, it's had to determine exactly how you'll respond to the Keto Diet.

    You need to decide what works for you: If going 24 hours without eating would make it hard for you to be successful on Keto, similar results have been seen when starting the diet without a fast, so don’t worry if that’s not doable right now!

    Some people find success in eating ONE big meal a day, others do 16/8 fasting, and other people eat throughout the day.

    It comes down to total calories consumed, total carbs consumed, and your level of misery while adjusting!

    Keto needs to work for you, not the other way around. And if you want to try Intermittent Fasting, you can download our free IF Worksheet to track exactly when to eat and not to eat!

    How to Avoid the “Keto Flu” and other negative side effects

    This Tic-Tac didn't eat enough supplements when trying to go low-carb.

    So here’s the bad news: While ketosis is a great state for your body eventually, it can feel crappy at first.

    Really crappy. Like, “brain fog, hungry, weak, irritated” levels of crappy.

    Keto-induction, or the period where your body is entering ketosis, is a pretty big shock to the system, especially if you’ve been eating a lot of carbs. It can come with side effects that feel like the flu (fatigue, upset stomach, aching, insomnia and more), but it’s not caused by the ketosis itself.

    Keto flu actually comes from carbohydrate withdrawal. That’s right; your body can basically be addicted to carbs, and have trouble dealing with a reduction in them!

    It takes time for your body to become “Keto-adapted.”

    Think of it this way: your body is a spoiled toddler who has been happily fueled by candy and soda for the past 3 years.

    You suddenly tell the toddler: “no more soda, no more candy. You’re going to eat broccoli and grilled chicken like a big boy.”

    How do you think this kid is going to respond?

    Poorly.

    A trekker throwing a tantrum from the Keto Flu

    Temper tantrums, mood swings, crying, and rage at the lack of delightful sugar. Eventually, this kid will be better off in the long term as a result…but it’s gonna take some time.

    This ‘carb withdrawal’ can be so dramatic for some people that it ruins them for days or weeks, and they give up.

    In these instances, the love affair with Keto ends prematurely, and the person goes crawling back to the comforting, delicious, but ultimately unfulfilling carb-heavy comfort foods.

    Remember that list of ‘worst’ diets with Keto at the top? It’s for reasons like this: people give up on the diet quickly, and it’s tough to stick with long term.

    “STEVE, HOW CAN I AVOID THE KETO FLU?”

    For MOST people, the Keto flu and getting headaches comes down to the body adjusting to becoming fat-adapted, dehydration, and electrolyte imbalances. When you eliminate carbohydrates from your diet, you might also be removing the consumption of certain electrolytes:

    • Sodium
    • Magnesium
    • Potassium

    When you specifically try to add these electrolytes back into your diet, you’ll be able to offset some of the chemical changes in your body and compensate for the lack of those electrolytes that you used to consume as part of your old diet.

    How does one do that? For sodium, you can simply add salt to your food (heyyyy sodium!), and for potassium and magnesium, you can eat kale, other leafy greens, avocado, nuts.

    And in BOTH instances, you can add electrolyte supplements to a bottle of water!

    The LyteShow brand of electrolyte supplement has been tested by Team NF and is recommended

    I have many friends who struggled through the first few weeks of Keto and found that electrolyte supplementation made the process significantly more bearable.

    Which brings us to another important topic:

    This momma dog and her puppies:

    You're almost there! And we still have cute animals to get you to the end of this guide to the Keto Diet!

    And THIS important topic…

    Can I strength Train and Do Keto? Cardio and Keto? Crossfit and Keto?

    This Lego has found his perfect workout under a low-carb diet.

    “Steve, I’m down to try Keto. But I don’t just want to lose weight, I want to build a physique I’m proud of. Meaning I wanna look good nekked.”

    We’re going to approach this section with three caveats:

    #1) “Steve, I like Strength Training. What does Keto look like for me?”

    Great. I do too. In fact, I train in a fasted state four days per week. When you strength train or train intensely, your body starts to use up the glycogen stored in your muscles.

    And you’re probably wondering “Steve if I don’t consume carbs, which becomes sugar, which my muscles store as glycogen…am I gonna run out of glycogen and my strength training might suffer?” Good question. Maybe.

    “Does eating in a Keto way alter your body’s reliance on glycogen stores in the muscles? Does it change how much glycogen your muscles use or how quickly these stores are replenished?” Maybe. We’re still learning.

    I did find multiple studies in which strength training was either not impacted or positively impacted by a Keto Diet:

    • A 2012 study put 8 male gymnasts on a 30 day Keto Diet – they lost more fat mass and increased lean body mass while. Suggesting Keto can help with body composition, which is probably why you are strength training to begin with.
    • A 2016 study looking at CrossFit programming showed no significant difference in muscle mass or performance between a Keto group and a control group.
    • A 2017 study worked with 25 strength training men – both groups gained muscle mass, while the Keto group lost more fat.

    Now, this isn’t law, more studies are being done as we speak, and your results may vary. What this simply means is that there have been studies done that show one can do resistance training or CrossFit while eating Keto and not lose gains or muscle mass. Other studies show the opposite. Which means…

    Your results MAY vary. Make sure you give it enough time to push through the Keto flu, performance-suckage phase to get a true answer for your situation.

    Also: unless you’re a competitive athlete or compete in powerlifting competitions, this might not matter as much! Athletic performance is often negatively impacted once somebody gets to a low enough body fat percentage, but it doesn’t stop people chasing that “ripped” six-pack abs look!

    #2) “Steve, I’m a runner/biker/etc. and I always carb-load. Sounds like Keto isn’t for me, right?”

    Maybe not. Your body can only store 1600-2000 calories worth of glucose at any time – but might have 40,000+ calories worth of fat stored in the body. So instead of having to consistently eat gels and goos and snacks to keep the glucose levels high, what happens if you switch to “Keto-adapted” and fuel yourself with fat?

    Let’s go to the science:

    Earlier studies had suggested that a moderate-carb diet provides better endurance by increasing the concentration of glycogen in your muscles, but newer research seems to be swinging more in the direction of Keto.

    As it turns out, the Keto Diet has been tested in ultramarathoners, Iron Man trainees, and endurance athletes in multiple studies, and in all cases, ketosis resulted in enhanced body composition and some of the highest rates of fat-burning ever recorded!

    A 2016 study looked at 20 ultra-marathoners and Ironman distance triathletes – half of which were instructed to be on a fat-adapted diet for at least 6 months and the other 10 were on a traditional carb-focused nutritional strategy. The results:

    • Both groups had the same perceived level of exertion during a 3-hour trial run.
    • The Keto group had a fat oxidation rate of 2.3 times higher than the carb group, at an average of 1.5 grams per minute.
    • There were no significant differences in pre- or post-exercise glycogen concentrations.

    Just like with strength training, this MIGHT work for you – or you might better off as a carb-adapted runner and athlete. You have to do what works for you.

    My above caveat still stands: unless you are an elite athlete, this should be less of a concern for you – follow the diet that makes you look and feel good, and then base your training progress off your previous day’s results!

    #3) “Steve, I’m not a competition-level ANYTHING, but I like exercising and want to look good.”

    While dietary changes make up at least 80% of your weight-loss efforts, exercise will help you stay healthy and build a body you’re proud to look at in the mirror.

    So track your workouts, track your nutrition, and work on getting better with it – running one second faster, doing one more rep, lifting 5 more pounds, etc. Compare yourself to your past self.

    #4) “Steve I read this study that says Keto + Athlete = good/bad/ugly.”

    Fair. Do what works best for you! In my research, and in learning from people that I trust and admire in this space:

    Studies are often focused on short term ketosis (a few days or weeks), which could result in adverse performance in athletes who have not become fully Keto-adapted yet.

    We are all unique snowflakes and your mileage may vary depending on your physiology. So who cares if you lift 5 pounds less! If Keto works for you and makes you look better, keep doing that.

    If you are going to try Keto + Strenuous Exercise, consider the following advice: Keto might work for you! It might not!

    The recommendation from Dr. Steve Phinny:

    • Allow 2-4 weeks to become Keto adapted
    • Make sure your electrolytes are in balance (see our section on supplements)
    • Eat enough protein to ensure your muscles are getting the tools they need to rebuild themselves.
    • See how your body responds – course-correct as necessary.

    Elite performance chaser? Consider “targeted ketogenic dieting” – which we discuss in our guide on the Keto Diet and Exercise.

    Supplements and Keto – Exogenous Ketones!

    There are lots of supplements being created for the Keto Diet, some good, some not so good...

    You’ve read this far, learning about how our body has to work hard to create Ketones for energy.

    And you’re probably thinking what I’m thinking: “What’s the airspeed velocity of an unladen swallow?” “Can’t I just ingest ketones directly?”

    They refer to these as “exogenous ketones,” if you were wondering.

    You weren’t, but that’s okay.

    Caveat: I have not consumed exogenous ketones, though I have heard they can taste like jet fuel. And they can be pricey – though coming down in price thanks to Keto’s popularity.

    So, if you LOVE to drink expensive jet fuel for some potentially better results or higher athletic performance, best of luck to ya.

    The two types you’ll encounter are:

    This 2017 study showed “exogenous ketone drinks are a practical, efficacious way to achieve ketosis.”

    In addition, A 2018 study showed that consuming Ketones lowered ghrelin [18] and thus our appetite.

    I would put exogenous ketones in the “only if are aiming for strict ketosis” category, if you’re an elite athlete, or seeking a specific outcome of a medical condition under professional supervision.

    If you really want to nerd out about exogenous ketones, consider this article from somebody I respect and trust, Dr. Peter Attia, on his experiences with them.

    I won’t delve too much deeper into the topic until I can experiment with them myself and report back!

    “What about other supplements Steve? I can’t get enough fat in my diet!”

    In the previous section we discussed electrolyte supplementation, and for somebody that’s an athlete or unable to get enough protein in their system, a high-quality protein powder can help – just note the carb content!

    Many people struggle to get enough fat in their nutrition, and have found success fat supplementation with MCT (medium-chain triglyceride) oils and powders.

    These are two types I’ve experimented with:

    MCT oil can cause digestive challenges and make you immediately run to the bathroom, while the powder version might not cause as much of an issue. This was my experience.

    Your mileage (to the bathroom) might vary! Start with small amounts of MCT before increasing the quantity.

    Outside of these suggested supplements, the best “supplement” is a healthy eating plan. I know I know, a cop-out answer. If you need more sodium, first try adding a little salt to your meals. If you need more potassium, eat some spinach before you head to the supplement aisle at the grocery store.

    Not only will these methods help you feel better, but you’ll be setting yourself up for better long-term eating habits.

    Our overall stance on supplementation here at Nerd Fitness: supplements cannot replace the effects of a healthy diet and regular exercise. But for some people, these might be the right fit.

    Homestretch! Now we just have delicious food and fun stuff to discuss. Yayyyyy!

    This dog probably doesn't care if you're on the Keto Diet or not...just keep petting him!

    Keto Meal Plans and Keto Recipes For the Wins!

    Lose the bun, BOOM, you have a low-carb meal.

    “Steve I know I can eat things like meat, cheese, and vegetables, but I’m gonna go ahead and need you to do the heavy lifting for me. Give me a sample day on Keto and links to recipes.

    I considered saying “Let me google that for you” when it comes to “Keto recipes”, but I’m too nice of a guy.

    Let’s hit the big three meals to start:

    BREAKFAST:

    LUNCH:

    DINNER:

    CONDIMENTS: Ruled.Me has some great resources on what Keto condiments you can use to spice up your dishes without losing ketosis.

    Here’s a quick list:

    • Coconut Oil
    • Olive Oil
    • Heavy whipping creme
    • Full fat cream cheese
    • Full-fat sour cream
    • Mayonnaise
    • Mustard
    • Full fat Ranch, Caesar, Bleu, Cheese, Italian

    Depending on your macros, you might be adding butter, ghee, fatty dressings or oils, or supplementing with MCT/Coconut oil to hit your macros for the day.

    This should at least get you started in thinking that you can still eat AMAZING food while eating Keto.

    If you find yourself eating at fast food quite a bit, make sure to check out our guide on low-carb and Keto recommendations found at popular chains.

    What are Keto-Friendly Snacks and Keto Desserts?

    You're gonna have to make your own pie to make it low-carb friendly. Don't just accept them from clowns.

    Everybody loves snacks. Unfortunately, most of the snacks you’ll encounter anywhere are definitely not Keto-friendly.

    I’m firmly on Team No Snack, as I do practice intermittent fasting and try to eat BIG meals instead of lots of small ones – as I point out in the Intermittent Fasting article, the number of times you eat throughout the day won’t impact your waistline as much as the total quantity of calories.

    That’s right, your metabolism isn’t “stoked” by eating small meals or grazing throughout the day. You can get in trouble if you eat big meals and then eat snacks between those big meals.

    What matters is overall compliance – if snacking in between meals allows you to NOT overeat during your big meals, and ALSO you stay under your caloric intake goal for the day, then snacking is more than okay.

    As far as dessert goes, the same holds true: if you save room in your macros and calories for a low calorie, Keto-compliant dessert, go crazy. Just don’t delude yourself into thinking that eating 5,000 calories of “Keto cookies” and “Keto ice cream” is going to make you healthier.

    Got it? These snacks and desserts need to fit into your macros/calorie goals in order for this whole “I went Keto” thing to actually work for you.

    EASY KETO SNACK IDEAS. If you want a bunch of Keto Snack ideas, check out our MASSIVE 60-snack guide on the subjectHowever, go ahead and think about these for now:

    KETO DESSERT IDEAS:

    Outside of Keto snacks and Keto desserts which everybody asks about, there’s one other big question that you probably have…

    Can I Drink Alcohol on the Keto Diet?

    You'll probably have to abandon beer when going Keto. But maybe a little whiskey or vodka would be okay.

    We’ve talked about alcohol extensively on Nerd Fitness and the same rules apply here for Keto.

    You’re gonna need to be super diligent with your carb counting when it comes to your adult beverage choices.

    A Sam Adams has almost 20g of carbs, enough to knock somebody out of ketosis after just one. As a Bostonian, this makes me sad.

    This is even worse for mixed drinks! No more rum and Cokes. No more margaritas. No more old fashioneds with simple syrup. No more daiquiris or mai tais or piña coladas.

    Dwights is upset he has to give up sugary drinks on Keto.

    Instead, you need to do your research into the carb content and calorie count of your favorite alcoholic drinks:

    • Wines: 4g carbs per 5 oz., 90-120 cal
    • Whiskey, vodka, rum, gin, tequila: 0g carbs, 90-120 calories
    • Low carb beer: 1-4g carbs, 60-100 calories

    If you’re drinking spirits, mix with club soda (NOT tonic, which is loaded with sugar) or learn to drink neat.

    If you’re drinking beers, opt for the low-carb variety! Just Google the beer brand you’re considering and go from there.

    Just like with desserts and snacks, you need to make alcohol work for your macros and your calorie counts for the day.

    Other things to note about alcohol: you might get drunk much faster as a result of being in Ketosis, you might have a worse hangover, and you might wake up in a chicken costume covered in sriracha on the other side of town if you drink too many “Keto-friendly” whiskeys.

    Not that I would know. Shut up.

    Where can I Learn More About the Keto Diet?

    If you go to a street cart, lose the bun and you'll be ready to go for the Keto Diet.

    Phew. This article was focused on telling you everything you need to know so that you can confidently get started with Keto.

    I want to give a HUGE shout out to the book, The Ketogenic Bible, by Dr. Jacob Wilson and Ryan Lowery, which was my first stop in my Keto research.

    If you’re a super nerd and want to learn about all of the science behind this stuff, or if you’re intrigued by the research into Keto + certain health conditions or improvements, it’s absolutely worth a read.

    If you’re interested in going further with your Keto adventure, consider all of the following below!

    OUR COACHING AND COURSES:

    Pardon my shameless self-promotion, but we have helped a few hundred thousand people through Nerd Fitness over the past decade, and we have some key resources that can help people adapt or adopt a more Keto-friendly lifestyle:

    1-on-1 Coaching with Nerd Fitness: partner with one of our trained coaches who will build you a custom workout program, and help you make better nutritional choices. We’ll have you take photos of each meal you consume, guide your decisions, and help you hit longer-term goals. Our average client stays 9-10 months!

    The Nerd Fitness Prime: Learn the right mindset, be surrounded by a supportive online community, follow the workout programs, complete boss battles and quests, and level up your character as you level up your life. Although our courses, like the NF Academy, aren’t Keto-focused, we have a TON of NF Prime members doing Keto who would love to support you.

    KETO RECIPE AND OTHER RESOURCES – In addition to simply googling “Keto recipes” which I know you can do because you’re a big boy or big girl, here are three of my favorite resources:

    PODCASTS ABOUT KETO: If you love to listen instead of reading, I’m doubly proud of you for making it all this way. Here are three of my favorite podcast episodes on the subject, in order of complexity. The science versus is the most approachable:

    Your First Week on the Keto Diet – Start With This

    This LEGO is angry about how he feels on the first week of Keto. We'll give him some tips to calm him down a little.

    Okay, you’re here because you’ve committed to going Keto, and now there’s just one final step: actually doing it.

    So how do you get started? What’s next for you between reading this article and 30 days of Keto success? A plan!

    Fear not, for I have built a step-by-step plan for you right here:

    #1) Take before photos and measurements. 

    • Take front and profile photos of yourself. You don’t need to look at them or share them anywhere, but I PROMISE you’re going to want those.
    • Record your weight and take any measurements you want.

    Write this stuff down and keep it secret, keep it safe.

    You don't have to share your photos and measurements, just like you don't have to share knowledge of the one ring.

    #2) Calculate your calories and macros. You can do the math as I explained above, or simply use the calculator over on Ruled.Me. Know your number of goal:

    • Calories
    • Carbs
    • Fat
    • Protein

    #3) Go shopping for your Keto foods, and order your Keto snacks on Amazon. Look at the recipes above and pick the ones that don’t scare you to make. Keep snacks readily available in case of “holy crap I am so hungry and I just want to eat a damn pizza and spaghetti and snort Pixy Stix.”

    #4) Consider picking up an electrolyte supplement to help you through the first few days/weeks of grogginess/lethargy as you move through the Keto flu stage. You can also look into the urine test strips or blood testers – I find that knowing I’m in ketosis, it helps keep me accountable and motivated that all these changes are actually working!

    #5) Eat out frequently and enjoy fast food? Check out our guide for the best low carb options on the go. Having a plan on what to eat before you arrive will help you stay on track

    #6) Tell somebody. The biggest problem with Keto is simply sticking with it. If you have roommates or a significant other or friends you can speak to and get them on your team to support you. In fact, send them this article and recruit them to try it with you! That way they’re not enabling you to slip up, they’re keeping you accountable!

    Don’t have anybody to tell? NF Prime has the most supportive community on the internet.

    7) Consider kickstarting your week with a fast. This is going to be a mental and physiological challenge. Consider skipping breakfast tomorrow – it’s one less meal you have to prepare, one less chance to knock yourself out of ketosis, and can help kickstart the Keto-adapted phase!

    8) Throughout the week: Focus on big wins, allow yourself to be miserable – Keto flu is REAL, giving up carbs is hard, and your body is going to hate you:

    • Drink plenty of water and supplement with electrolytes if you find yourself getting headaches. Add more salt to your food and focus on consuming more leafy greens to get that electrolyte balance back in place.
    • Lean on your support group. Talk to others who have been where you are, ask questions, share your struggles!
    • Eat snacks when you are miserable. I’d rather you eat some snacks and slightly overeat on your calories than be so miserable that you give up.
    • Track your adherence. Use MyFitnessPal (though not their recommended macronutrient breakdown!) to track every meal you eat – this is very important in the first week as you’re educating yourself dramatically.
    • Do your best – you might slip up with one meal or realize you accidentally ate carbs. This is not the end of the world. Forgive yourself, learn the lesson, and get right back at it with the next meal.

    9) Keep going, or adjust. Depending on your body, your environment, the way you used to eat, and your physiology, this first week will either be “hey, not too bad” or “Never again.”

    Either way, you’ll learn something. I do hope you push through this for a full 30 days and see how your body responds once it’s out of the Keto Flu stage!

    10) At the end of the month, take more photos and measurements and compare them to your starting “before” stats. Do you feel better? Do you look better? Did you enjoy the process? great! Keep going. Hated it? Great! You found a method that doesn’t work for you. Adjust and create your own strategy.

    Other Frequently Asked Questions about The Keto Diet.

    Holmes here is getting to the bottom of this whole Keto-craze.

    1) Who should NOT attempt the Keto Diet?

    Very important question. We all know this article is NOT medical advice, and regardless of your health you should discuss your nutritional strategies with your doctor or dietitian.

    As pointed out in The Ketogenic Bible, going into Ketosis is not recommended for:

    • Carnitine deficiency
    • CPT I/II deficiency
    • Beta oxidation defects
    • Impaired gastrointestinal motility
    • Pregnancy
    • Kidney failure
    • Type 1 Diabetes
    • Pancreatitis
    • Gallbladder disease
    • Impaired liver function
    • Impaired fat digestion
    • Gastric bypass surgery
    • Abdominal tumors

    If you’re concerned about your health with regards to Keto, speak with your doctor and consider a Keto Diet under supervision.

    2) Do I have to count calories on Keto?

    Not necessarily, but it certainly helps when starting out. That is true whether you’re doing Keto or just trying to eat healthier. In fact, I would almost make it a requirement until you learn the basics about everything you eat.

    The most important thing you’ll need to track is your carb and fiber intake. You’re trying to eat less than 20-50 grams of net carbs each day, and making your diet 70% fat. Not all calories are created equal when it comes to healthy eating and weight loss, so they’re not a focus on Keto.

    3) Eating all of this fat and cholesterol is going to make me fat and block my arteries, right?

    Wrong! Dietary cholesterol has been shown to not increase blood cholesterol – check this article here. And fat is healthy when consumed as part of a nutritious meal. As pointed out in this study, a Low Carbohydrate Diet resulted in decreased bodyweight, abdominal circumference, diastolic blood pressure, triglycerides, insulin, and an increase in high-density lipoprotein cholesterol (the good stuff).

    It’s when fat is combined with carbohydrates in diabolical combinations that we start to get into trouble.

    4) I’ve heard my breath and my urine might smell funny on Keto. Is that true? What do I do about it?

    Look, we don’t want you to be self-conscious about how your pee smells. But it’s true; as part of the byproducts produced through the creation of ketone bodies, you may notice a fruity smell in your urine and on your breath.

    This is totally normal, and it comes from the acetone that’s produced through ketosis. Acetone isn’t used for energy, so it’s excreted in urine and breath.

    Not only is this not bad, but it’s a sign that you are fully in a ketogenic state.

    But you probably don’t want your breath to smell like a slightly weird fruit salad, right? The easiest answer is to brush your teeth often, and to wait it out. This effect usually goes away once you’re on the diet for a while as your body learns to use more ketones.

    5) Can I eat Keto if I’m a vegetarian/vegan?

    Yes. We mentioned above in our list of foods to eat that you can substitute meatless proteins for meat in a vegetarian Keto Diet.
    If you also want to remove the dairy and eggs to make a vegan Keto plan, in addition to the vegan meat options, consider adding mushrooms and “vegan dairy,” such as full-fat vegan cheeses, as well as a larger quantity of healthy fats like coconut oil.

    You can follow the low-carb principles of keto along with your vegetarian or vegan eating plan. Also, if you’re interested in following a Plant-Based Diet in general, make sure you check out our massive guide on the subject.

    6) Does this mean no carbs forever and ever? How long am I supposed to go Keto for?

    You will get results from Keto for as long as you stay Keto. If you go Keto and lose a bunch of weight, but then go back to how you were eating before…you’ll end up right back where you started.

    So, our advice would be to give this a true attempt: stick with Keto for 30 days as an experiment. You might find that you LOVE how it makes you feel and want to stick with it.

    Also, as your body learns to become keto-adapted, you can start to mix in sliiiightly higher carb days here and there with minimal adverse effects.

    If you go Keto and decide that this is not the best strategy for you, that’s cool too. Pick the parts of it that work for you, take what you’ve learned, and start to experiment and build your own diet.

    Should You Do the Keto Diet?

    As long as they skip that pie, they'll be eating a Keto friendly meal here.

    If you’ve read this far, congratulations! You get the Medal of Heroes, and you definitely know enough to get started on the Keto Diet.

    You’ve unlocked this gif of a turtle eating a raspberry:

    Berries MIGHT be low-carb, but I doubt this turtle cares.

    Here’s what I think:

    I personally don’t do the Keto Diet. I go with an 80%, ‘pretty damn good’ approach and it fits my physique and strength goals.

    The Keto Diet COULD work for you…if you can stick with it. And even if you stick with it, it might not be the right diet for you. It isn’t for me.

    I do think learning about the Keto Diet, learning your macros, and getting a better understanding of how you fuel your body is a good thing in the long term.

    So here’s what I would recommend: Be less concerned about “staying in ketosis” and instead concern yourself with how to find a nutritional strategy that fits YOUR life.

    If you’re adamant about going Keto, try it out for 30 days. If you have health concerns, discuss this with your doctor first. Take measurements and before and after photos, and then determine after 30 days if it works for you. And if it does or doesn’t, adjust and course correct.

    The worst thing to do would be to go Keto for 30 days to try to lose weight quickly, just to go back to how you were eating before.

    Instead, we want you to make permanent progress. So find a path that allows you to be pretty damn good, nearly all of the time.

    Whether or not Keto is for you, keep looking around here at Nerd Fitness. Maybe Paleo or Intermittent Fasting is a better fit for you, or you’d prefer to work with a coach to help combine all of the above into a system that fits your exact lifestyle.

    Whatever it is, I’m glad you’re here. And I’m glad you’re trying.

    WHAT OTHER QUESTIONS DO YOU HAVE?

    What other questions do you have about Keto?

    Have you had a great experience with Keto?

    Have you had a BAD experience with Keto?

    Favorite snacks or resources?

    Leave your experiences in the comments below!

    -Steve

    PS: If you liked this guide to Keto but need more guidance, check out our 1-on-1 coaching program and schedule a free consultation to see if we’re a good fit for each other!

    PPS: I guarantee I probably pissed off half the internet for some reason with this article.

    Whether it was a typo, the fact that I referenced a particular study that didn’t line up with your already deeply-held view on Keto, or because you don’t like my jokes. I hope we’re still cool.

    If you want to rage and call me an idiot for whatever reason, email me at thatsnotnice@jkdontemailme.biz

    PPPS: Feel free to download this article in good-lookin Digital Guide form. It’s free when you sign up in the box below, Cheers!

    ###

    ALL Photos Sources can be found in this footnote here[19]. Special shout outs to Clement127 and Black Zack who have two amazing streams you should check out!

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    Steve Kamb

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  • Beans IN toast could revolutionise British diet

    Beans IN toast could revolutionise British diet

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    Newswise — Researchers and chefs at the University of Reading aim to encourage British consumers and food producers to switch to bread containing faba beans (commonly known as broad beans), making it healthier and less damaging to the environment.

    The £2 million, three-year, publicly-funded ‘Raising the Pulse’ project has officially begun and is announced today (18 January 2023) in the Nutrition Bulletin journal.

    Five teams of researchers within the University of Reading, along with members of the public, farmers, industry, and policy makers, are now working together to bring about one of the biggest changes to UK food in generations.

    This is by increasing pulses in the UK diet, particularly faba beans, due to their favourable growing conditions in the UK and the sustainable nutritional enhancement they provide.

    Despite being an excellent alternative to the ubiquitous imported soya bean, used currently in bread as an improver, the great majority of faba beans grown in the UK go to animal feed at present.

    Researchers are optimising the sustainability and nutritional quality of beans grown here, with a view to encouraging farmers to switch some wheat producing land to faba bean for human consumption.

    Faba beans are particularly high in easily digested protein, fibre, and iron, nutrients that can be low in UK diets. But the majority of people are not used to cooking and eating faba beans, which poses a major challenge.

    Professor Julie Lovegrove is leading the ‘Raising the Pulse’ research programme. She said: “We had to think laterally: What do most people eat and how can we improve their nutrition without them having to change their diets? The obvious answer is bread!

    “96% of people in the UK eat bread, and 90% of that is white bread, which in most cases contains soya. We’ve already performed some experiments and found that faba bean flour can directly replace imported soya flour and some of the wheat flour, which is low in nutrients. We can not only grow the faba beans here, but also produce and test the faba bean-rich bread, with improved nutritional quality.”

    ‘Raising the Pulse’ is a multidisciplinary programme of research, funded by the UKRI Biotechnology and Biological Sciences Research Council, as part of their ‘Transforming UK Food Systems’ initiative.

    As well as consulting and working with members of disadvantaged communities, there will be studies using our novel foods at the University of Reading’s students halls of residence and catering outlets.

    This links ‘Raising the Pulse’ with Matt Tebbit, who runs the University’s catering service and leads the University’s ‘Menus for Change’ research programme. He said: “Students will be asked to rate products made or enriched with faba bean, such as bread, flat bread, and hummus. They will be asked questions about how full they felt, for how long and their liking of the foods. It is hoped that faba bean will improve satiety, as well as providing enhanced nutritional benefits in products that are enjoyable to eat.”

    Before there are products to be tested, the beans must be grown, harvested and milled. ‘Raising the Pulse’ seeks to improve these stages as well. Researchers will be choosing or breeding varieties that are healthful as well as high yielding, working with the soil to improve yield via nitrogen fixing bacteria, mitigating environmental impacts of farming faba beans, planning for the changing climate, and more.

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    University of Reading

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  • Project Open Hand to Receive Over $1.4 Million in Federal Funding to Support Nutrition-Intervention Services

    Project Open Hand to Receive Over $1.4 Million in Federal Funding to Support Nutrition-Intervention Services

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    Funds will help improve infrastructure and increase capacity.

    Press Release


    Jan 19, 2023 09:00 EST

    Project Open Hand, a leading nonprofit nutrition service provider in the San Francisco Bay Area, announced today that it will receive over $1.4 million in federal funding to support the organization’s efforts to provide life-saving, nutrition-intervention services to its clients.  

    The new federal funding will help improve Project Open Hand’s infrastructure, including, but not limited to, purchasing new delivery service vehicles, adding a mobile pantry vehicle, and upgrading kitchen and meal preparation equipment.  

    “The new federal funding headed to San Francisco for critical community projects like Project Open Hand is a major victory for families in our City,” Speaker Emerita Nancy Pelosi said. “This investment in Project Open Hand’s mission to provide nutritious ‘meals with love’ in our communities will help ease food insecurity and advance Ruth Brinker’s vision of a hunger-free San Francisco. Thanks to Democrats’ tenacious negotiating, last year’s government funding package delivered deeply needed federal funds for projects across San Francisco that help meet the specific needs in our City – and we’ll never stop fighting for more.” 

    The planned improvements that will be made with this new funding come at a time when demand for the organization’s services continues to rise and requests for meal deliveries from clients continue to grow.  

    “The funding will go such a long way to update not only our facility in the Tenderloin with new and upgraded infrastructure and equipment, but also the aging fleet of vehicles that deliver our services to clients every single day,” Jonathan Jump said, Vice President of Operations at Project Open Hand. 

    The over $1.4 million in funding is a part of a larger $30 million government funding package aimed to help San Francisco’s neighborhood-serving organizations. The funding was announced by Speaker Emerita Nancy Pelosi and signed into law on Dec. 29 by President Joe Biden.

    “For 37 years, Project Open Hand’s mission has been to serve meals with love to the Bay Area, providing life-saving nutrition for residents who need it most,” said Paul Hepfer, Chief Executive Officer of Project Open Hand. “The funds allocated to our organization by Congresswoman Pelosi will ensure that our programs and capacity continue to reach those in critical need of the medically tailored meals that we provide.” 

    About Project Open Hand 

    Founded in 1985, Project Open Hand is a nonprofit organization that provides meals with love to critically ill neighbors and seniors in San Francisco and Alameda Counties.  

    Every day, we prepare more than 2,500 nutritious meals and provide more than 200 bags of healthy groceries to help sustain our clients as they battle serious illnesses, isolation, or the health challenges of aging. https://www.openhand.org

    Source: Project Open Hand

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  • High fat diet activates early inflammation in mouse brains, supports link to neurologic disease

    High fat diet activates early inflammation in mouse brains, supports link to neurologic disease

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    Newswise — Researchers at Michigan Medicine have discovered that a high-fat diet promotes an early inflammatory response in the brains of mice through an immune pathway linked to diabetes and neurologic diseases, suggesting a possible bridge between metabolic dysfunction and cognitive impairment. 

    For the study, published in Frontiers in Immunology, investigators analyzed activation of the cGAS/STING immune pathway in a high-fat diet mouse model of prediabetes and cognitive impairment or dementia. Though early changes in cognition were not detected, results reveal insulin resistance, as well as inflammatory activation of cGAS/STING and the microglia, the brain’s immune cells, within three days of feeding.

    “While there is evidence suggesting a role for cGAS/STING in obesity and diabetes, both of which make patients more vulnerable to cognitive impairment or dementia, its role in the brain has not been previously studied,” said Sarah Elzinga, Ph.D., first author and a postdoctoral fellow at the NeuroNetwork for Emerging Therapies at Michigan Medicine.

    “We now see that this pathway is involved in an early burst of immune response in the microglia, which plays a critical role in Alzheimer’s disease and related dementias. If microglia are activated in the hippocampus under high-fat diet conditions, that may contribute to inflammation and degeneration in the nervous system and eventual cognitive impairment or dementia.”

    Obesity and diabetes are significantly associated with the development of dementia and other neurologic diseases. Elzinga and the research team say further research is needed to examine if inhibiting the cGAS/STING pathway is a possible treatment target for reversing or preventing harmful changes in the brains of people who develop cognitive impairment or dementias.

    “Innovative ideas that can lead to novel treatment paradigms are critical in our battle against Alzheimer’s disease,” said senior author Eva Feldman, M.D., Ph.D., James W. Albers Distinguished Professor at U-M, the Russell N. DeJong Professor of Neurology and director of the NeuroNetwork for Emerging Therapies at Michigan Medicine. “This research with cGAS/STING is one such innovation and opens doors to exciting new therapeutic possibilities.”

    Additional authors include Rosemary Henn, Ph.D., Benjamin J. Murdock, Ph.D., Bhumsoo Kim, Ph.D., John M. Hayes, Ian Webber-Davis, Sam Teener, Crystal Pacut, Stephen I. Lentz, Ph.D., all of Michigan Medicine, Faye Medelson

    Funding for this study was provided in part by the NIH National Institute of Diabetes and Digestive Kidney Disease and the National Institute on Aging.

    Paper cited: “cGAS/STING and innate brain inflammation following acute high-fat feeding,” Frontiers in ImmunologyDOI: 10.3389/fimmu.2022.1012594

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    Michigan Medicine – University of Michigan

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  • How to Build Muscle as a Woman (5 Workouts) | Nerd Fitness

    How to Build Muscle as a Woman (5 Workouts) | Nerd Fitness

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    If you are interested in learning how to gain weight the right way, you have come to the right place! 

    My name is Staci Ardison.

    I overcame an eating disorder, discovered a love for heavy strength training, and now I help women like you get stronger for a living.

    Believe it or not, I’m 50 pounds heavier in the photo on the right (and WAY stronger, and healthier, and happier!).

    I’m currently a Senior Coach here in the Nerd Fitness Coaching Program, where we train women to pick up heavy weights, get strong, and build confidence.



    Speaking of picking up heavy weights, here I am deadlifting 455 pounds:

    Staci showing you how to deadlift 455 pouds.

    This is what I LOVE to do.

    In this Ultimate Guide to Building Muscle as a Woman, I’m going to be covering:

    Alright, let’s do this.

    Why Building Muscle is Difficult for Some Women

    A group of different LEGO women ready to build muscle.

    As Steve covered in “How to build muscle” and “How to bulk up for men,” the principles of weight gain are all the same regardless of your sex or gender:

    “If you want to gain weight, eat more calories than you burn regularly. Want to put on the right KIND of weight? Exercise and eat the right way too.”

    Now, there’s plenty of nuance to this when comparing men and women:

    • Due to our natural hormones, it’s generally more difficult for people with typical female anatomy to gain muscle than people with typical male anatomy.[1]
    • We have a lot of factors (such as hormonal birth control) that have been proven to make it even harder as well.[2]

    But that doesn’t mean it’s impossible!

    It just means we have to work harder for it.

    Mary isn't happy, but will build muscle anyway.

    Ugh, I know.

    Now, one thing I want to touch on quickly: if you see a woman who is absolutely jacked and at an extremely low body fat percentage, I guarantee she has been working her butt off for a very long time with the goal of building muscle.

    It’s not something that happens overnight, or by mistake.

    In addition, some women with larger amounts of muscle mass choose to take steroids to help assist them in gaining muscle, because we simply don’t have the hormones naturally to get to that size.

    So if you’d like to build muscle, but not as much as a professional bodybuilder – don’t worry, it’s not something that happens by accident.

    With that out of the way, let’s talk about body fat and body types:

    As we point out in that body fat percentage guide, we women can look very different at any weight depending on our body shape and how much muscle we have. It comes down to our own personal goals!

    This picture shows different body fat % of women.

    This guide is going to primarily focus on two things:

    1. How to eat to gain weight and build muscle.
    2. How to strength train to build muscle.

    We’ve helped thousands of women with our online coaching program, many of whom are trying to gain weight and strength train for the first time in their lives.



    Everybody is on their own journey, at their own pace, and everybody will end up with different results too!

    Should Women Build Muscle? (7 Reasons Women Should Grow Muscle)

    This woman built lots of muscle on her journey to became an astronaut.

    If it can be harder for women to gain muscle (compared to men), why go through the trouble?

    I’m glad you asked!

    Here are the top 7 reasons why women should strength train:

    #1) When you’re stronger – everyday life is easier. No need to call for help to get that 50lb bag of dog food off the top shelf, or carrying an air conditioner unit up a flight of stairs. LIFE is easier when you’re stronger. 

    #2) Less injury risk – when you build strong muscles, you’re also building stronger bones, ligaments, and tendons, making you less prone to injury doing things you love (like playing in a quidditch league).[3]

    #3) Helps combat age-related muscle loss,[4] allowing us to remain independent longer as we age:

    #4) Muscle is harder to maintain, which means you need to eat more just to hold on to it.[5]

    #5) Reduce pain – having a strong body makes living easier on your joints, as well as allows you to hold a better posture, and reduce back / hip pain.[6]

    #6) Appearance – this is a personal preference! Some women like to have a lot of muscle, and some don’t. While you can’t spot reduce fat, you can choose to build more muscle in specific areas, changing your body shape. Growing up, I was an extreme pear shape, but due to strength training, I now have more of an hourglass shape. 

    You can see that Staci has changed the way she looks from strength training!

    #7) Live longer – want to spend more time on Earth? Strength training and growing muscle will help you do just that.[7]



    How to Eat to Gain Muscle as a Woman

    This woman knows gaining muscle relies on a proper diet...like seafood!

    As we said above, gaining weight comes down to thermodynamics and science.

    Every day, we burn a certain number of calories just existing, which is called our BMR (basal metabolic rate). We then factor in our daily activity level, and get a number that is called our “total daily energy expenditure.” You can calculate yours below.

    The Nerd Fitness Calorie Calculator:

    (Click here for our Metric calculator).

    (Note: we have used The Mifflin-St Jeor Equation to create this calculator! [8]).

    Since we want to gain weight, we want to take our TDEE and add 250 calories to it to get our daily goal. This should result in gaining about half a pound per week.

    Now, although eating ANY EXTRA calories from any source will result in weight gain, our goal is to gain the RIGHT kind of weight, in a healthy way.

    And thus, we’ll be focusing our efforts on a “healthy muscle building” strategy.

    We could easily add more calories each day, and gain weight quicker, however, the slow method gives you the best chances at gaining mostly muscle, with minimal fat. The faster you try to gain weight, the higher the percentage that will likely be fat – so starting off at half a pound per week is a great place to start!

    A small addition of calories, will help you gain muscle with minimal fat gain as well. So slow and steady is the ticket.

    In addition to the number of calories we’ll be adding, we also want to pay attention to the type of foods we’re eating.

    As we cover in our “Nerd’s Guide to Healthy Eating,” we’re going to build muscle by consuming the three big macros in the correct quantities:

    • Protein: rebuilds muscle after you break it down.
    • Carbohydrates: provides your muscle with fuel and body with energy.
    • Fat: helps your bodily functions and can also be burned as fuel in the absence of carbs.

    Let’s look at each of these individually:

    PRIORITY #1: PROTEIN

    Protein can come from any number of sources, including:

    • Meat (steak, bison, pork).
    • Fowl (chicken, turkey, duck).
    • Eggs![9]
    • Cheese and dairy.
    • Fish and shellfish (salmon, tuna, shrimp).
    • Legumes (black beans, chickpeas).
    • Other vegetarian protein sources here.

    As we cover in our “How much Protein do I need?”, claims for the amount of protein required for muscle growth vary wildly from source to source (and athlete to athlete).

    While meat sticks do have protein, try and stick to something less processed.

    Here is our recommendation:

    • If you’re of healthy weight, active, and wish to build muscle, aim for 1 g per pound of body weight (2.2 g/kg).
    • If you’re an experienced lifter on a bulk, intakes up to 1.50 g/lb (3.3 g/kg) may help you minimize fat gain.

    Let me simplify it for you:

    “To build muscle, target at least 1 gram of protein per pound of body weight (2.2 grams per kg).”

    If you’re curious, from our healthy eating article, this is what a portion of protein looks like:

    A serving of protein should be about the size of your palm, like so.

    Here’s how much protein is in a serving of food:

    • 4 oz (113 g) of chicken has around 30 g of protein.
    • 4 oz (113 g) of salmon has 23 g of protein
    • 4 oz (113 g) of steak has 28 g of protein.

    Want to get more protein? Consider protein shakes.

    PRIORITY #2: CARBS

    After protein, we’ll be filling up our plate with calories from carbs (and fats).

    Here are foods full of carbohydrates you can prioritize:

    • Rice
    • Quinoa
    • Oats
    • Legumes and lentils
    • Sweet potatoes
    • Yams
    • Regular potatoes
    • Whole grain pasta
    • Whole grain bread

    To help you get better at serving sizes:

    Showing you a serving of carbs

    1 serving of a starchy carbohydrate is 1 cupped hand (uncooked), or your two hands forming a cup (cooked).

    Here are some images to help you learn proper portion sizes (thanks to SafeFood):

    This picture will help you determine proper serving sizes for carbs!

    In addition to consuming carbohydrates from these sources, it’s okay to consume plenty of fruit while trying to build muscle!

    For reference, here is roughly 200 calories worth of an apple (thanks to WiseGEEK):

    This is about 200 calories of apple.

    You can read our full “Is fruit healthy?” guide to learn more.

    PRIORITY #3: FAT! 

    Fat is a macronutrient that can help you reach your calorie goals (in the right quantity), as fat can be high in calories. Plus, you can eat lots of it without feeling full. Helpful if you’re trying to put on weight.

    Healthy fat can be found in foods like:

    • Avocado
    • Almonds
    • Walnuts
    • Macadamia nuts
    • Olive oil
    • Almond butter
    • Peanut butter

    Science has recently come around on saturated fat too.[10] Once completely vilified, but now considered okay for moderate consumption.

    Saturated fats can come from things like:

    • Whole milk
    • Full-fat dairy
    • Coconut oil
    • Grass-fed butter
    • Fatty cuts of meat
    • Lard

    To help you gauge: a serving size of fat is roughly the size of your thumb!

    A serving of fat should be about your thumb!

    For reference, this is a single serving of almonds (162 calories):

    Knowing the correct amount of almonds to eat can help you with your calorie goals.

    THIS is a serving of olive oil (119 calories):

    This shows the serving size of olive oil, which is very dense calorie wise.

    As you can see, you can eat an extra 500 calories of “healthy fats” by eating lots of “heart-healthy” fats like nuts or adding more olive oil to your meals.

    PRIORITY #4: VEGETABLES!

    Last but not least, you need vegetables in your diet.

    As you start to eat more food, your stomach, intestines, and other bodily functions will thank you for consuming more high-fiber vegetables! 

    A serving of veggies is about the size of your fist.

    A serving of veggies should be the size of your first (or greater).

    Here’s a quick, non-complete list of high-fiber veggies that can fill your plate:

    • Broccoli
    • Broccolini
    • Cauliflower
    • Spinach
    • Kale
    • Spaghetti squash[11]
    • Brussels sprouts
    • Zucchini
    • Cucumber
    • Carrots
    • Onion
    • Asparagus

    BRINGING IT ALL TOGETHER: A HEALTHY MUSCLE-BUILDING PLATE

    A plate that that contains a portion of protein, healthy carb, veggies/fruit, and unsweetened drink.

    This plate and serving size stuff above is just to help you get started thinking about healthy food differently and in proper portion sizes.

    TO RECAP, HERE’S HOW TO EAT TO BUILD MUSCLE:

    • Calculate your TDEE (Total Daily Energy Expenditure) and add 250 calories over your number.
    • Consume 1-1.5g per pound (2.2-3.3g per kg) of body weight in protein every day.
    • Consume the rest of your calories from foods composed of carbs and fats.
    • Always eat vegetables so that your body can actually PROCESS all this extra food. I like to aim for half of my plate of vegetables.
    • If you are not gaining weight, (and you’re hitting your protein goals), add more carbs and/or fats to your meal.

    It really does come down to the following:

    If you are not gaining weight fast enough, you’re not eating enough. Increase your portions of carbs and fats!

    Whenever we work with coaching clients who struggle to build muscle, this is the area we target: adding more carbs and fats to each meal.



    8 Strength Training Exercises For Women to Build Muscle

    This woman knows exactly how to build muscle...she does it by lifting that sword and shield!

    Years from now, you’ll look back and thank “Past You” for starting strength training today.

    And don’t worry, I’m going to tell you exactly what to do so you can start strength training TODAY!

    Here’s why strength training is so important: when you eat a caloric surplus (more calories than your body needs each day), the extra calories have to go somewhere.

    • If you don’t do any exercise, your body will choose to store the extra calories as fat for later.
    • However, when you strength train, your muscles are broken down. Then they’ll use the extra calories to rebuild themselves bigger and stronger over the next 48 hours!

    “Staci that sounds great, but I’ve never strength trained before, and I don’t know what I’m doing…Halp!” You might be saying into your computer or phone.

    Fear not! I’ll help. Strength training doesn’t need to be scary or overly complicated.

    Gonzo knows he has to eat protein to match his strength training goals, but he doesn't eat chicken, for obvious reasons.

    Simply put, “strength training” means two things:

    #1) “Movement of any weight against “resistance” (including your body weight) – Doing ANY exercise that pushes your muscles outside of their comfort zone, forcing them to rebuild stronger to prepare for the next challenge.

    #2) Progressive overload: doing slightly more than last time (lift a heavier weight or do 1 more rep) consistently. Your muscles will have to constantly adapt and rebuild themselves stronger. This is called “progressive overload.”

    Coach Jim breaks down different strategies for progressive overload in this video:

    This means if you drop down and do ONE push-up or knee push-up right now…

    Knee push-ups like this are a great way to progress to a regular push-up!

    Technically, you’ve strength trained.

    Now do that and then do a bodyweight squat…

    Do a proper bodyweight squat to work out your legs

    Boom, you just did a strength training workout.

    Here’s what you need to know about strength training:

    1. Strength training is one of the BEST things you can do for yourself.
    2. Strength training will help you put on muscle while eating in a surplus.
    3. While you can’t spot reduce fat, you can focus on building more muscle in specific areas, which can help you attain the specific look you’re going for.
    4. If you don’t like the gym, you don’t need to go, ever. But I hope you do. Because that’s the easiest way to start training with weights.
    5. Regardless of your fitness level, body fat percentage, strength level, or biological sex, you have every right to be in the free weights section in the gym, training with heavy weights, with everybody else. The people in the gym who are very strong with a lot of muscle started somewhere, too!

    I used to be a CrossFit instructor, and my favorite thing about CrossFit was that it destigmatized barbell training and heavy lifting for many women.

    Crossfit is great in that in shows it's okay for women to lift heavy weights.

    In order for us to strength train and build muscle, we’re going to approach this intelligently. 

    We’re not going to pick up small dumbbells and do lots of reps.

    We’re not going to sit down at various machines and scroll through our phones while doing leg curls.

    Instead, we’re going to:

    • Get very strong with compound movements that recruit LOTS of muscles to work together.
    • Do our workouts quickly and get out of there. The workout should take no longer than 45-60 minutes.

    This is how we efficiently build muscle in the minimum amount of time. What are the exercises that we’re going to target?

    1) The Push-Up: The best exercise you could ever do for yourself when it comes to using your bodyweight for push muscles (your chest, shoulders, and triceps):

    2The Bodyweight Squat: This exercise serves a dual purpose: it is the foundation for building strength AND helps build proper mobility. If you are going to ever do barbell squats, you need to work on hitting proper depth with a bodyweight squat first!

    3The Inverted Bodyweight RowUntil you can get your first pull-up or chin-up, these exercises are GREAT to start building your pull-muscle strength (your back, biceps, and forearms).

    4) The Pull-Up and Chin-UpOnce you can support your body’s weight above the bar, the world becomes your playground. No strength training routine should be without pull-up or chin-up work! (Click here if you can’t do a pull-up or chin-up yet):

    And now we’re into the best weight training exercises:

    5) The Barbell SquatProbably the best exercise when it comes to building strength and muscle throughout your whole body. It also burns crazy calories and makes life better. This is a MUST:

    6) The Barbell DeadliftMaybe the best exercise of all time. Actually no, it IS the best exercise of all time. It’s certainly the most primal: “pick the weight up off the ground. Done.”

    This is a very technical lift, so make sure you read our article on how to deadlift with proper form:

    7) The Barbell Bench PressLie on a bench, squeeze your shoulder blades to keep your back tight, and then lower a barbell until it almost touches your chest. Pause, and then press it back up towards the sky. Repeat! And get strong.

    8) Barbell Overhead Press: Stand with your feet about shoulder-width apart and lean back by pushing your hips forward. While keeping your entire body tight, press the bar overhead.

    Once the bar passes your forehead, move your body back under the bar by driving your torso forward and back into a standing position. At the top of the lift shrug your shoulders slightly and lock your elbows.

    These are some of the best compound exercises you can complete in order to build muscle. Want more muscle? Great! Get stronger at these movements!

    One quick note: when I first started lifting, it took a while to build up the strength to be able to bench press or overhead press with the 45-lb bar. If your gym doesn’t have a lighter bar, dumbbells are a great option!

    Your mission, should you choose to accept it:

    Commit to trying ONE of these movements in the next week. Use 20 seconds of courage, recruit a friend who has lifted or trained before, and try your best.

    We know you can use this guide to start building muscle...you got this!

    I have three options for you next:

    1. Select one of the muscle-building routines for women in the next section.
    2. Build your own workout routine using these exercises!
    3. Work with me and our coaching program to follow a custom strength training routine for your goals.



    5 Muscle Building Workout Routines For Women

    No matter which version of wonder woman it is, she always knows the fastest way to build muscle (fight for justice).

    I’m going to walk you through three different levels of strength training, and by the end of today, you’re going to know exactly how to get started.

    My advice: do 2-3 strength training routines per week, with 1-2 days off in between. As the saying goes: “muscle isn’t built in the gym, it’s built in the kitchen!”

    The Swedish Chef knows how to eat to build muscle (lots of food), which is why he's always cooking.

    So your goal should be to do a strength training routine, and then make sure you eat a caloric surplus so that your body has enough calories to rebuild your muscles bigger and stronger!

    LEVEL 1: BODYWEIGHT TRAINING

    Here’s a beginner bodyweight training routine you can do in the comfort of your own home:

    • 20 Bodyweight squats.
    • 10 Push-ups.
    • 10 Walking lunges (each leg).
    • 10 Dumbbell rows (use a milk jug or other weight).
    • 15 Second Plank.
    • 30 Jumping jacks.

    We also have a downloadable worksheet of this beginner’s workout that you can print out and hang on your fridge to track your progress! Get it when you sign up below:

    LEVEL 2: DUMBBELL WORKOUT

    If you have dumbbells at home or access to a gym, you can pick our Level 4 workout from our 6-Level Gym Workout Routine.

    So your Dumbbell Workout is 3 circuits of the following:

    • 10 goblet squats (holding the dumbbell like a goblet with 2 hands):

    The goblet squat is a great way to build muscle for women.

    • 10 push-ups (or knee push-ups):

    This gif shows Staci doing a push-up in perfect form.

    As you get lower, like this, the row will be harder to do. Great way to progress into a pull-up.

    (By the way, these are two GREAT exercises towards getting your first pull-up)

    LEVEL 2: BEGINNER KETTLEBELL WORKOUT

    If you have a Kettlebell at home, here’s a 20-Minute Beginner Kettlebell Workout you can do:

    Do 3 circuits of this Kettlebell Workout: 

    • 8 Halos (each side)
    • 10 Goblet Squats
    • 8 Overhead Presses (each side)
    • 15 Kettlebell Swings
    • 8 Bent Over Rows (each side)
    • 6 Front Rack Reverse Lunge (per side)

    If you like this Kettlebell workout and want to follow along on a worksheet, simply print out our Kettlebell Workout and bring it with you:

    LEVEL 3: BARBELL GYM WORKOUT

    Here’s a Barbell workout you can follow from our Level 5 Gym Workout Routine.

    BARBELL BATALLION WORKOUT A:

    • 3 sets of 10 barbell squats

    This gif shows Staci doing a push-up in perfect form.

    • 3 sets of 10 bodyweight rows:

    Start with inclined inverted rows for your pull-up workout. Then drop lower for more required effort.

    BARBELL BATALLION WORKOUT B:

    • 3 sets of 5 barbell Romanian deadlifts (video pulled from our courses in Nerd Fitness Prime)

    • 3 sets of 10 bench presses:

    • 3 sets of 5 pull-ups, assisted pull-ups, or negative pull-ups:

    A box can be used instead of a chair for a pull-up.

    PICK A WORKOUT, AND GET STARTED!

    The whole point is to do challenging movements that really make your muscles work, and then try to do ONE more rep, or lift a SLIGHTLY heavier weight next time! 

    Don’t sweat the small details and instead use 20 seconds of courage to get started!

    Track your workouts by writing down what you did, and then do what you can next time.

    If you really want to level up quickly, LEARN HOW TO DO SQUATS AND HOW TO DO DEADLIFTS. These two exercises changed my life!

    Squats and deadlifts helped me build muscle and changed my life.

    “Staci, that’s still too many choices! Can you just tell me what workout routine to follow?”

    Okay fine! Here’s what I would do if I was you.

    Still overwhelmed? Check out our coaching program. We get to learn your story, and then build a program and strategy around your goals that you CAN do.

    Christina learned to do pull-ups with NF Coaching

    10 Tips for Building Muscle as a Woman

    This woman is on her way to build muscle and to find water.

    I interviewed multiple other coaches on our team and asked for their best advice on how to build muscle as a woman.

    Here’s what they said:

    Susy (Coach, BS in Psychology, Certificate III & IV in Fitness, 5+ years of experience)

    Tip #1: Food is your friend when you are looking to build muscle and get stronger – your body will need fuel, so you may need to eat more on the days that you work out!

    Tip #2: Strength and muscle building requires structure to your workouts – you progress through getting better at specific movements, so make sure that you enjoy the style and structure of your workouts so that you can be as consistent as possible.

    Tip #3: Your progress will always be fastest if you avoid injury, so correct form and listening to your body is super important. Your muscles will fatigue and feel sore, but joint pain and sharp, stabby pain means something isn’t moving quite right.

    Kerry (Coach, NASM-CPT, 6+ years of experience)

    Kerry is one of our great female coaches here at Nerd Fitness.

    Tip #4: Fall in love with the process. Getting stronger is a journey, one that is both rewarding and challenging. So no matter where you are starting from, take the time to celebrate each small step along the way towards a more badass version of yourself!

    Christy (Coach, BS in Applied Health/Fitness, National Personal Training Institute Graduate, Precision Nutrition Certification, 6+ years of experience)

    Christy is one of our great coaches and loves everything Star Wars, as shown here.

    Tip #5: To get strong, you gotta lift weights. When lifting weights to get strong, you gotta be okay with testing your boundaries every now and then.

    After exercising with your current weight, for the next training session…stop…and try a few reps with the next weight UP to test it out! It might surprise you how much more weight you can lift!

    Here are some other tips to help you build muscle.

    Tip #6: Boost your testosterone naturally: Consume enough saturated and monounsaturated fats, keep your sugar intake low, and make sure you’re getting enough Vitamin D and Zinc.

    These are items linked with boosting your testosterone naturally.[12]

    Speaking of testosterone – I know you may think of this as a “male” hormone, but it plays a huge part in women muscle building,[13] fat loss,[14] increase bone mass,[15] and many other health-related issues[16](remember: estrogen is made from testosterone).

    Yes, women need plenty of testosterone too.

    Men make about ten to fifteen times what we make naturally,[17] but it doesn’t mean we don’t need it too.

    Another way we can help our testosterone levels is to watch our cortisol levels.

    Cortisol is a hormone that is promoted by stress and reduces free testosterone levels (in addition to signaling for your body to store fat).[18]

    Want a way to naturally lower your cortisol levels? Try meditation.[19]

    Tip #7: Not getting bigger? Eat more food.

    Focus on more fats and carbs. They are the easiest ways to increase your total calories.

    You can check out our Guide to Build Muscle for more specific tips on how to eat more food.

    If you're not bulking up, eat more, like Kirby here!

    Tip #8: Make sure every meal has a solid protein source.

    Protein is needed for building muscle, so prioritize this above all else when you sit down to eat.

    Having trouble getting it all down? Buy a blender!

    A blender can help you obtain more calories for weight gain.

    Steve drinks two smoothies a day to reach his protein goals and you can check out our Guide to Protein Shakes for his personal recipe.

    On the go with no blender? I like to keep protein powder with me in a small Ziploc bag – that way I can grab a bottle of water, rip off the corner of the Ziploc bag, and use that as a funnel to get the powder into the water bottle. Then, just replace the cap and shake and you’ve got a protein-filled snack!

    Tip #9: Get more sleep! When you build muscle, your body is working overtime, burning extra calories. It’s going to need some time to recover. Remember, muscle is built when you rest, not when you actually lift.

    Go to bed!

    Tip #10: Start today!

    Gaining muscle comes down to eating right and strength training. Let’s get you lifting today!

    Try some push-ups and squats as we discussed in our strength training section. Tomorrow we can work on eating right and lifting more.

    The most important step you can take today is to begin.

    Like Bugs here, we want you to start! No matter what you do, take one small step today!

    Let’s give you some more tips to get you going.

    Building Muscle: Next Steps!

    Climbing mountains is a great way to build muscle (man or woman).

    If I can narrow down building muscle for women, it would be three main points:

    1. Get stronger by picking up heavy stuff or doing more challenging bodyweight movements.
    2. Get bigger by eating lots of food.
    3. Recover faster by sleeping enough and giving your muscles days off to rebuild.

    That’s it. You can do this.

    We know that you are ready to start your muscle building practice today!

    If you made it this far, and you want more specific instruction and guidance, we have a few options for you:

    1) If you are somebody that wants to follow a tailor-made program designed around their life and goals, check out our popular 1-on-1 Online Coaching Program.

    You’ll work with our certified NF instructors who will get to know you better than you know yourself, check your form, and program your workouts and nutrition for you.

    Nerd Fitness Coaching Banner

    2) If you want an exact blueprint for growing strong, check out NF Journey. Our fun habit-building app helps you exercise more frequently, eat healthier, and level up your life (literally).

    Try your free trial right here:

    3) Join the Rebellion! We need good people like you in our community, the Nerd Fitness Rebellion.

    Sign up in the box below to enlist and get our guide, Strength Training 101: Everything You Need to Know. It’ll help you begin your journey on building muscle.

    Lastly, I’d love to hear from you!

    PLEASE leave your questions, eating or strength or otherwise below so we can answer them and become best friends and practice karate kicks in the garage:

    How can I help you get bigger and stronger?

    What part of this journey are you still struggling the most with?

    What are your favorite bulking-up foods!?

    Share with your friends in the comments so we can all go buy it in bulk at Costco.

    -Staci

    PS: Make sure you check out the rest of our Strength Building Articles!

    ###

    Photo sources: Women’s Day 2015, Sea spray, The Viking, The Evolution of LEGO Wonder Woman, Apocalyptic Motorcycle, Person Mountain,

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  • How to Achieve Superhuman Levels of Focus with Nutritional Psychology

    How to Achieve Superhuman Levels of Focus with Nutritional Psychology

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    Have you ever considered that your inability to focus is due to your nutrition, not your lack of will power?

    Download the free daily journal pages (limited time only). And grab a copy of Ben’s award-winning book, Unstoppable, which has been read by more than 70,000 people worldwide.

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  • Fast-Food Fans May Face Liver Damage

    Fast-Food Fans May Face Liver Damage

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    Jan. 13, 2023 – A new study that shows the harm to the liver of eating fast food might provide people with motivation to eat less of it in the new year. 

    The study found that eating at least 20% of total daily calories from fast food can increase the risk of nonalcoholic fatty liver disease, a potentially life-threatening condition where fat builds up in the liver. The disease can lead to cirrhosis and its complications, including liver failure and liver cancer. 

    People with obesity or diabetes are more vulnerable to the harmful effects of fast food on the liver, although the general population is not immune to the harm. 

    “My hope is that this study encourages people to seek out more nutritious, healthy food options,” says lead investigator Ani Kardashian, MD, with Keck Medicine at the University of Southern California.  

    “At a policy level, public health efforts are needed to improve access to affordable, healthy, and nutritious food options across the U.S. This is especially important as more people have turned to fast foods during the pandemic and as the price of food as risen dramatically over the past year due to food inflation,” she says. 

    The researchers analyzed data on diet and fatty liver measurements for nearly 4,000 adults.

     Nearly 30% of them got 20% or more of their total daily calories from fast food, such as burgers, fries, pizza, and the like. 

    They found that people with obesity or diabetes who take in one-fifth or more of their daily calories from fast food had severely high levels of fat in their liver, compared with those who eat less or no fast food.

    The general population had moderate increases in liver fat when one-fifth or more of their diet was made up of fast food. 

    The findings are particularly “alarming” given the increase in fast-food consumption over the past 50 years, regardless of socioeconomic status, Kardashian says. 

    “If people eat one meal a day at a fast-food restaurant, they may think they aren’t doing harm. However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk,” she says. 

    For people who have limited options and need to eat fast food, “there are healthy choices at most restaurants; you just need to be smart about reading labels, watching calories, and ordering the healthier options,” says Nancy Reau, MD, with Rush University Medical Center in Chicago,  who wasn’t involved in the study.

    Lisa Ganjhu, DO, with NYU Langone Health in New York City, agrees. 

    “I am a firm believer that fast food can cause fatty liver. It goes hand in hand, and I counsel and coach my patients on healthy diet and exercise, and I’ve been pretty successful,” she says. 

    “If my patient is eating at McDonald’s a lot, I basically walk through the menu with them and help them find something healthy. When patients see the benefits of cutting out fat and reducing carbohydrate, they are more apt to continue,.”

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  • Consumption of fast food linked to liver disease

    Consumption of fast food linked to liver disease

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    Newswise — LOS ANGELES — The new year has begun, and with it, resolutions for change.

    A study from Keck Medicine of USC published today in Clinical Gastroenterology and Hepatology gives people extra motivation to reduce fast-food consumption.

    The study found that eating fast food is associated with nonalcoholic fatty liver disease, a potentially life-threatening condition in which fat builds up in the liver.

    Researchers discovered that people with obesity or diabetes who consume 20% or more of their daily calories from fast food have severely elevated levels of fat in their liver compared to those who consume less or no fast food. And the general population has moderate increases of liver fat when one-fifth or more of their diet is fast food.

    “Healthy livers contain a small amount of fat, usually less than 5%, and even a moderate increase in fat can lead to nonalcoholic fatty liver disease,” said Ani Kardashian, MD, a hepatologist with Keck Medicine and lead author of the study. “The severe rise in liver fat in those with obesity or diabetes is especially striking, and probably due to the fact that these conditions cause a greater susceptibility for fat to build up in the liver.”

    While previous research has shown a link between fast food and obesity and diabetes, this is one of the first studies to demonstrate the negative impact of fast food on liver health, according to Kardashian.

    The findings also reveal that a relatively modest amount of fast food, which is high in carbohydrates and fat, can hurt the liver. “If people eat one meal a day at a fast-food restaurant, they may think they aren’t doing harm,” said Kardashian. “However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk.”

    Nonalcoholic fatty liver disease, also known as liver steatosis, can lead to cirrhosis, or scarring of the liver, which can cause liver cancer or failure. Liver steatosis affects over 30% of the U.S. population.

    Kardashian and colleagues analyzed the most recent data from the nation’s largest annual nutritional survey, the 2017-2018 National Health and Nutrition Examination Survey, to determine the impact of fast-food consumption on liver steatosis.

    The study characterized fast food as meals, including pizza, from either a drive-through restaurant or one without wait staff.

    The researchers evaluated the fatty liver measurement of approximately 4,000 adults whose fatty liver measurements were included in the survey and compared these measurements to their fast-food consumption.

    Of those surveyed, 52% consumed some fast food. Of these, 29% consumed one-fifth or more daily calories from fast food. Only this 29% of survey subjects experienced a rise in liver fat levels.

    The association between liver steatosis and a 20% diet of fast food held steady for both the general population and those with obesity or diabetes even after data was adjusted for multiple other factors such as age, sex, race, ethnicity, alcohol use and physical activity.

    “Our findings are particularly alarming as fast-food consumption has gone up in the last 50 years, regardless of socioeconomic status,” said Kardashian. “We’ve also seen a substantial surge in fast-food dining during the COVID-19 pandemic, which is probably related to the decline in full-service restaurant dining and rising rates of food insecurity. We worry that the number of those with fatty livers has gone up even more since the time of the survey.”

    She hopes the study will encourage health care providers to offer patients more nutrition education, especially to those with obesity or diabetes who are at higher risk of developing a fatty liver from fast food. Currently, the only way to treat liver steatosis is through an improved diet.

    Jennifer Dodge, MPH, assistant professor of research medicine and population and public health sciences at the Keck School of Medicine of USC and Norah Terrault, MD, MPH, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases at the Keck School, were also authors on the study.

     

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    For more information about Keck Medicine of USC, please visit news.KeckMedicine.org.

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  • Can Diet Combined with Drugs Reduce Seizures?

    Can Diet Combined with Drugs Reduce Seizures?

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    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, JANUARY 4, 2023

     

    Newswise — MINNEAPOLIS – Following a modified Atkins diet high in fat and low in carbohydrates plus taking medication may reduce seizures in people with tough-to-treat epilepsy, according to a study published in the January 4, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

    “For people with drug-resistant epilepsy, or those who have been unable to find effective treatment to reduce seizures, it’s encouraging to see that there are lifestyle changes that can be combined with standard drug therapy to reduce the number of seizures,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “Our study found that this combination may reduce the chance of seizures by more than half.”

    The modified Atkins diet is a combination of the Atkins diet and a ketogenic diet that includes food items such as soy products, heavy cream, butter and oils, leafy green vegetables, and animal protein including eggs, chicken, fish, and bacon. While the ketogenic diet has been shown to be effective in reducing seizures, its stringent requirements and restrictions can make it difficult to follow.

    The study involved 160 adults and adolescents who had epilepsy for more than 10 years on average and had at least 27 seizures per month despite trying an average of four antiseizure medications at the maximum tolerated dose. They were randomly assigned to receive either standard drug therapy alone or drugs plus the modified Atkins diet over six months.

    Participants logged their seizures and meals. They were given food lists, sample menus and recipes. Carbohydrate intake was restricted to 20 grams per day. Federal dietary guidelines recommend between 225 and 325 grams of carbs per day.

    After six months, researchers found that 26% of people who had both drug therapy and followed the modified Atkins diet had more than a 50% reduction in seizures compared to only 3% of the people who had drug therapy alone. Four people in the diet group were free of seizures by the end of the study, while no one in the medication-only group was seizure free.

    The study also looked at quality of life, behavior and side effects at six monthsThe group that had drug therapy and followed the modified Atkins diet showed an improvement in all areas compared to the group that had drug therapy alone.

    Tripathi noted that 33% of the participants did not complete the study due to poor tolerance of the diet, lack of benefit or the inability to follow-up in part due to COVID-19. However, Tripathi said tolerance of the modified Atkins diet was better than what is seen with the ketogenic diet.

    “While the modified Atkins diet may be an effective treatment in controlling seizures, further research is needed to identify genetic biomarkers and other factors associated with the response to this diet,” Tripathi added. “This may improve patient care by encouraging targeted precision based  earlier use of this diet.”

    A limitation of the study is that seizures were self-reported or reported by caregivers, so some seizures may not have been reported.

    The study was supported by the Department of Biotechnology, India.

    Learn more about epilepsy at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 38,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

     

     

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  • O nutricionista da Mayo Clinic responde: seria um smoothie de frutas uma boa opção para substituir uma refeição?

    O nutricionista da Mayo Clinic responde: seria um smoothie de frutas uma boa opção para substituir uma refeição?

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    Newswise — PHOENIXUm smoothie comum é uma bebida feita com uma mistura de frutas ou vegetais. Há muitas maneiras de preparar um. Embora eles forneçam vários benefícios à saúde, beber muitos smoothies pode afetar negativamente a sua saúde. Eles podem adicionar muitas calorias inesperadas à dieta, especialmente quando um smoothie é uma bebida que pode equivaler a uma refeição. Lorraine Fye, nutricionista da Mayo Clinic, dá algumas dicas sobre como consumir smoothies de frutas de uma forma inteligente. 

    Smoothies são bebidas deliciosas e fáceis de fazer. Mas, eles são bons para a sua saúde? 

    “Eu diria que essa é uma maneira muito fácil de consumir muitas frutas e vegetais benéficos para a sua saúde. Em um pequeno copo, você pode obter muitos nutrientes”, diz Fye. 

    Mas o excesso, mesmo de uma coisa boa, pode ser prejudicial. 

    “Um smoothie que pode ser prejudicial à saúde seria um que talvez tenha só frutas ou com muito suco de frutas, com a adição de muito açúcar e não muito equilibrado”, diz Fye. 

    Um smoothie pode ser delicioso e ainda ser saudável. Você só precisa incluir os ingredientes certos. 

    “O smoothie saudável: esse é o equilíbrio que estamos realmente procurando. O que você precisa é de bons carboidratos, boas proteínas e gorduras boas e saudáveis,” ela diz. 

    Depois de encontrar o equilíbrio e o sabor certos, esse smoothie pode ser uma coisa boa. 

    “É muito bom tomar um smoothie todos os dias. Ele pode substituir uma refeição de maneira conveniente, desde que você se certifique de que realmente está substituindo a refeição. A quantidade de calorias deve ser suficiente”, diz Fye. 

    Receitas de smoothies: 

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    Jornalistas: um vídeo com qualidade para transmissão (1:00) está disponível no final da publicação em inglês na Rede de Notícias da Mayo Clinic. Lembrem-se de incluir “Cortesia: Rede de Informações da Mayo Clinic.” 

    Sobre a Mayo Clinic A Mayo Clinic é uma organização sem fins lucrativos comprometida com a inovação na prática clínica, educação e pesquisa, fornecendo compaixão, conhecimento e respostas para todos que precisam de cura. Visite a Rede de Notícias da Mayo Clinic para obter outras notícias da Mayo Clinic.  

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  • يستجيب اختصاصي التغذية في Mayo Clinic: هل عصير الفاكهة خيار بديل جيد للوجبات؟

    يستجيب اختصاصي التغذية في Mayo Clinic: هل عصير الفاكهة خيار بديل جيد للوجبات؟

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    الشراب المخفوق التقليدي (السموذي) هو عبارة عن مشروب مصنوع من خليط الفواكه أو الخضراوات، ويمكن تحضيره بعدة طرق مختلفة. على الرغم من فوائده الصحية العديدة، فإن الإفراط في تناول المشروبات المخفوقة (السموذي) بمعدلات كبيرة قد يؤثر سلبًا على صحتك. إذ إنه قد يضيف الكثير من السعرات الحرارية غير المتوقعة، لا سيما عند تناوله مع وجبات طعام. لورين فاي، اختصاصي النُّظم الغذائية لدى مايو كلينك، لديها بعض الطرق البسيطة للتعامل بذكاء مع شراب الفاكهة المخفوقة (السموذي).

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  • Understanding the “eating just one potato chip is impossible” gene

    Understanding the “eating just one potato chip is impossible” gene

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    Newswise — High-calorie foods—high in fat, oil, and sugar—can taste good but often cause overeating, leading to obesity and major health problems. But what stimulates the brain to cause overeating?

    Recently, it has become clear that a gene called CREB-Regulated Transcription Coactivator 1 (CRTC1) is associated with obesity in humans. When CRTC1 is deleted in mice, they become obese, indicating that functioning CRTC1 suppresses obesity. However, since CRTC1 is expressed in all neurons in the brain, the specific neurons responsible for suppressing obesity and the mechanism present in those neurons remained unknown.

    To elucidate the mechanism by which CRTC1 suppresses obesity, a research group led by Associate Professor Shigenobu Matsumura from the Graduate School of Human Life and Ecology at Osaka Metropolitan University focused on neurons expressing the melanocortin-4 receptor (MC4R). They hypothesized that CRTC1 expression in MC4R-expressing neurons suppressed obesity because mutations in the MC4R gene are known to cause obesity. Consequently, they created a strain of mice that expresses CRTC1 normally except in MC4R-expressing neurons where it is blocked to examine the effect that losing CRTC1 in those neurons had on obesity and diabetes.

    When fed a standard diet, the mice without CRTC1 in MC4R-expressing neurons showed no changes in body weight compared to control mice. However, when the CRTC1-deficient mice were raised on a high-fat diet, they overate, then became significantly more obese than the control mice and developed diabetes.

    “This study has revealed the role that the CRTC1 gene plays in the brain, and part of the mechanism that stops us from overeating high-calorie, fatty, and sugary foods,” said Professor Matsumura. “We hope this will lead to a better understanding of what causes people to overeat.”

    The research results were published in the FASEB Journal on November 9, 2022.

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    Osaka Metropolitan University is a new public university established by a merger between Osaka City University and Osaka Prefecture University in April 2022. For more science news, see https://www.omu.ac.jp/en/info/research-news/, and follow @OsakaMetUniv_en, or search #OMUScience. 

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  • A nutritionist shares the best snacks to bring on a plane to boost your immune system

    A nutritionist shares the best snacks to bring on a plane to boost your immune system

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    Travelers have a host of pathogens to dodge this winter, including the “tripledemic” of infections caused by Covid-19, flu and RSV (respiratory syncytial virus).

    But there are steps people can take to reduce their chances of getting sick, say health specialists at Spain’s SHA Wellness Clinic.

    The key is to develop “a resilient immune system that can defend itself from attack by viruses and bacteria,” said Dr. Vicente Mera, SHA’s head of genomic medicine.

    What to eat

    “The most important thing is nutrition,” Mera said.

    But drastic dieting isn’t necessary, he added. Rather, travelers can simply eat whole, plant-based foods, which can help decrease inflammation, he said.

    Fiber in plant-based foods also helps the gut microbiome “fight pathogens that enter or are activated through the digestive tract,” he said.

    Dr. Vicente Mera, Melanie Waxman and Philippa Harvey of SHA Wellness Clinic in Alicante, Spain.

    Source: SHA Wellness Clinic

    Eating a nutrient-dense diet is the top recommendation from Melanie Waxman, an integrative nutrition specialist and eating coach at SHA Wellness Clinic.

    That means eating “lots of vegetables, whole grains, fresh herbs, beans, sea vegetables, fruits, nuts, seeds and fermented foods,” she said.

    What to pack on a plane

    Waxman said travelers should snack on alkaline foods to combat acidity that is commonly caused by air travel. She recommended these easy-to-pack foods:

    • Toasted nori snacks: “Great for travelling as they are light and easy to carry in small packs. Nori is alkaline and provides a good source of vitamin C, as well as omega-3 fatty acids, protein and minerals.”
    • Instant miso soup: “Contains all the essential amino acids … and restores beneficial probiotics to the intestines … great for flights and in hotel rooms as you only need to add boiling water to the sachet.”
    • Spirulina powder: “Packed with calcium and protein. It has a high chlorophyll content … is especially beneficial after spending hours in airplane cabins. The flavor can be strong so add it to a refreshing vegetable juice … [or take] as a capsule.”  
    • Plum balls: “A wonderful travel companion, as they are extremely alkaline, full of minerals that help increase energy, aid digestion, boost immunity and improve liver functions … the balls come in a container and are easy to pack in a cabin bag.”

    A fermented plum, called umeboshi in Japanese, can be added to a cup of tea on a flight. It is a “very sour plum that has been fermented for at least three years,” said SHA Wellness Clinic’s Melanie Waxman.

    Tomophotography | Moment | Getty Images

    Breakfast

    Waxman recommends drinking one tablespoon of apple cider vinegar mixed with a glass of water before breakfast. The vinegar is “a powerful immune booster … full of probiotics,” she said.

    For breakfast, a “wonderful” choice is oatmeal topped with berries, chia seeds and flax seeds, she said.

    “Oats actually help the body produce melatonin more naturally,” she said. “Oats contain amino acids, potassium, B vitamins, magnesium and complex carbs … berries pack a punch of vitamin C, and the seeds provide extra omega-3 and protein.”

    Jet lag

    To combat jet lag, Waxman recommends taking more vitamin C.

    She recommends eating sauerkraut, both before and after flying. “Fermenting cabbage causes the vitamin C and antioxidant levels to skyrocket,” she said.

    Fresh vegetable juice is also great for immunity and jet lag recovery, she said.

    Getting enough sleep

    Sleep and immunity are closely linked, Mera said.  

    “Restful sleep strengthens nature immunity,” he said, adding that poor quality, or quantity, of sleep increases the chances of falling sick.

    People who average less than six hours of sleep a night, or 40 hours per week, have “a serious risk of illness,” he said.

    Exercise — but don’t overdo it

    Moderate exercise strengthens the immune system, Mera said.

    But “30 minutes a day is more than enough,” he said. “Prolonged intense exercise can suppress the immune system.”

    To avoid suppressing the immune system, travelers shouldn’t exercise to the point of exhaustion, said Dr. Vicente Mera, head of genomic medicine at SHA Wellness Clinic.

    Westend61 | Westend61 | Getty Images

    Examples of beneficial exercise include running, walking, swimming and cycling, he said.

    Supplements, for some

    Studies indicate that certain supplements — such as vitamin C, vitamin D, zinc, garlic, echinacea and green tea — may strengthen the body’s immune response, Mera said.

    But, he said, they’re not necessary for everyone.

    “It only compensates for nutrient deficiencies, which usually occur when nutrition is inadequate, or the immune system is very depressed,” he said.

    Other recommendations

    To strengthen the immune system, Waxman also suggests Epsom salt baths (“magnesium is easily absorbed through the skin”), using essential oils (“especially lavender, eucalyptus or tree tree oil”), drinking plenty of water and cutting back on alcohol, caffeine and sugar.

    Mera added that relieving stress and anxiety is critical to immune health. He recommends meditation, yoga, tai chi and mindfulness to better manage emotions.

    Philippa Harvey, head of SHA’s traditional Chinese medicine department, said travelers should start taking steps to strengthen their immune systems about a week before traveling.

    “In TCM when someone is healthy and happy we say they have good qi, pronounced ‘chee’” she said.

    She recommends eating foods that are in season, especially garlic and ginger in the autumn and winter.

    She also recommends exercise and acupressure to stay healthy.

    “Before we travel, a nice brisk walk in fresh air is the simplest solution,” she said.

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  • Research shows fatty liver disease endangers brain health

    Research shows fatty liver disease endangers brain health

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    Newswise — In a study examining the link between non-alcoholic fatty liver disease (NAFLD) and brain dysfunction, scientists at the Roger Williams Institute of Hepatology, affiliated to King’s College London and the University of Lausanne, found an accumulation of fat in the liver causes a decrease in oxygen to the brain and inflammation to brain tissue – both of which have been proven to lead to the onset of severe brain diseases. 

    NAFLD affects approximately 25% of the population and more than 80% of morbidly obese people. Several studies have reported the negative effects of an unhealthy diet and obesity can have on brain function however this is believed to be the first study that clearly links NAFLD with brain deterioration and identifies a potential therapeutic target. 

    The research, conducted in collaboration with Inserm (the French National Institute of Health and Medical Research) and the University of Poitiers in France, involved feeding two different diets to mice. Half of the mice consumed a diet with no more than 10% fat in their calorie intake, while the other half’s calorie intake contained 55% fat; intended to resemble a diet of processed foods and sugary drinks. 

    After 16 weeks researchers conducted a series of tests to compare the effects of these diets on the body and more specifically, on the liver and the brain. They found that all mice consuming the higher levels of fat were considered obese, and developed NAFLD, insulin resistance and brain dysfunction.  

    The study which was funded by the University of Lausanne and Foundation for Liver Research also showed that the brain of mice with NAFLD suffered from lower oxygen levels. This is because the disease affects the number and thickness of the brain blood vessels, which deliver less oxygen to the tissue, but also due to specific cells consuming more oxygen while the brain is becoming inflamed. These mice were also more anxious and showed signs of depression. 

    By comparison, the mice consuming the healthy diet did not develop NAFLD or insulin resistance, they behaved normally, and their brain was completely healthy.  

    “It is very concerning to see the effect that fat accumulation in the liver can have on the brain, especially because it often starts off mild and can exist silently for many years without people knowing they have it,” said lead author Dr Anna Hadjihambi, sub-team lead in the Liver-Brain Axis group at the Roger Williams Institute of Hepatology and honorary lecturer at King’s College London.  

    To try and combat the dangerous effect that NAFLD has on the brain, the scientists bred mice with lower levels of a whole-body protein known as Monocarboxylate Transporter 1 (MCT1) – a protein specialised in the transport of energy substrates used by various cells for their normal function. 

    When these mice were fed the same unhealthy fat- and sugar-rich diet as those in the initial experiment, they had no fat accumulation in the liver and exhibited no sign of brain dysfunction – they were protected from both ailments. 

    “Identifying MCT1 as a key element in the development of both NAFLD and its associated brain dysfunction opens interesting perspectives,” said Professor Luc Pellerin, director of the Inserm U1313 research unit at the University of Poitiers in France and senior researcher in the study. “It highlights potential mechanisms at play within the liver-brain axis and points to a possible therapeutic target.” 

    Dr Hadjihambi added: “This research emphasises that cutting down the amount of sugar and fat in our diets is not only important for tackling obesity, but also for protecting the liver to maintain brain health and minimise the risk of developing conditions like depression and dementia during ageing, when our brain becomes even more fragile. 

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  • International recommendations for diagnosis and treatment of new-onset refractory status epilepticus (NORSE)

    International recommendations for diagnosis and treatment of new-onset refractory status epilepticus (NORSE)

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    Newswise — The following is the transcript from an episode of ILAE’s podcast, Sharp Waves.

    Sharp Waves episodes are meant for educational purposes only, and not as medical or clinical advice.

    Download the episode 

    You can listen to and download all Sharp Waves episodes, including this one, on SpotifyApple PodcastsGoogle PodcastsAmazon Music, or the ILAE website.

    First-line immunotherapy and the ketogenic diet are two main recommendations for treatment of NORSE of unknown cause, according to results from an international consensus group. Dr. Maryam Nabavi Nouri interviews first author Dr. Ronny Wickstrom.

    Dr. Nabavi NouriSo thank you for joining us on this episode of Sharp Waves – I’m joined by Dr. Ronny Wickstrom from Stockholm. He’s going to tell us about the international consensus recommendation for management of new-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES), and I know there are two papers published: one is on summary and clinical tools and the other one statements and supporting evidence.

    Dr. Wickstrom: Thanks for the opportunity to present these papers. I’m Ronny Wickstrom; I’m a pediatric neurologist and epileptologist in Stockholm in Sweden. I’m also professor of child neurology at Karolinska. 

    So my field for a long time has been working with neuroinflammatory diseases, both demyelinating diseases and also encephalitis cases of different kinds, and then I work with epilepsy. And these have been my two fields, and these two fields meet in FIRES, so that’s how I came to start with this. 

    I had a case actually, six or seven years ago, a FIRES case, that did not end well, of course, like they often do not. He survived but he had severe sequelae. It sort of puzzled me, this whole FIRES thing and I wasn’t aware of FIRES until then. I’d heard of it, but this is an epilepsy phenotype where we believe that autoimmune or some sort of immunological at least components are involved. So that’s where I came into it, because those were my two worlds met anyway. 

    But when it started out, it started as a FIRES discussion. And we in the pediatric field had some FIRES communities. And what’s happened over the last couple of years, and which I’ve had the privilege of being involved in, is that this has merged with the NORSE community, which was also existing. So NORSE was perceived as an adult disease and FIRES as a pediatric disease, and one of the things we want to emphasize here is that that’s probably not true.

    One of the things we were doing in the FIRES field and also in the NORSE field is there’s a lot of research trying to be done, and there’s some data coming out, but it’s very hard, these are hard areas to study. One of course is that this is new onset, so there’s no population to study until they end up in refractory status epilepticus. And this, it’s very rare, and also it’s rare in a very hyperacute thing, so if you try to set up clinical trials, with standardized sampling and standardized testing and standardized treatment for these patients, it’s very difficult because you’re in a hyperacute situation where you have to do everything for your patient. So designing trials is extremely difficult. 

    We went through all the data before we started this and there’s a lot of case series and case presentations, and even in the larger case series and the ones we tried to compile, for instance, all the children that have been treated with IL-1 inhibition – one of the lessons we learned from that is even though we tried to standardize the data when we looked at it, it really ended up being 26 children, 26 individuals. It’s really, really difficult. That means what you’re left with as a clinician is there’s not a lot of solid data to base anything on. 

    So what we wanted to do with this Delphi approach, which, I’d been a part of another Delphi approach where we tried to summarize treatment in NMDA encephalitis. So I thought one way to do this or to try to summarize what we do know and give some sort of recommendations — we’ve been careful not to call these guidelines or anything like that because they’re not — we don’t have any evidence to say that they are guidelines. This is a recommendation, something to hold onto as a clinician and as a researcher. And we tried to compile this group of people that we thought for one or another reason were important to have as a part of it, and compile recommendations that covered everything from what is NORSE and FIRES, and also diagnostics and workup, treatment and long-term treatment, and then, and that’s the second part of why we undertook this and why I thought it was important, it also provided a possibility to try to bring everyone together because that’s the next step here. 

    This is a very rare and hyperacute and complicated thing. We at least need to try to, I mean we obviously need to study it better and we need large consortia to do this, and we need a common understanding, and common data elements, and speak the same language, and tests standardized and things like that, even if it’s only real-world studies. So the second idea of bringing this together was to create a platform like a solid ground, and this is the first step, to start a research consortium and international consortium where we can do these studies.

    Dr. Nabavi NouriThank you. I understand there was a core group, and then a bigger group, an expert panel of 48 people internationally. Of course the Delphi method is quite interesting too, in that in this particular project there was a pre-set of questions and then it led to a stage 1 and a stage 2.

    Dr. Wickstrom: Yeah, so the Delphi methodology is an interesting way of doing things. It’s a standardized way of reaching a consensus, basically that’s what that is. You can be very orthodox or less orthodox and there are different ways of doing it. But the basic principle is the same. The idea is that rather than asking questions, you try to phrase statements like a recommendation or a guideline, if you have enough data for that. And for statements where you reach a consensus that’s all fine, and in statements where you do not reach a consensus for some reason, the idea is that you try to mold or adjust these statements until they are acceptable by the group as a consensus. 

    So a couple of things here. One is of course how do you select the group, how do you choose what group? How do you form the questions or the statements? And then, what is a consensus? I mean 100% is obviously a consensus but is 70% a consensus? There’s no definition, I mean no clear definition on this. We chose the methods that had most often been used in how to do this.

    So a couple of things were unusual in this case. One is that for a Delphi process, having 48 experts is a very large group. It’s almost impossible. Of course this gives you so much input, and so that’s not the problem. The problem of course is if there’s too much input, and trying to get a consensus, and also trying to get all of these people together is very difficult. The other side of that is that I think the people in this group were perfect. I think we could have probably found 48 others too that should have been on this group. Looking at representation, it’s very heavy in Europe and North America and there’s a lot of great research coming out of Asia, for instance, and we have suboptimal representation from Japan, Korea, China, and other places. 

    And then what we did, which is also unusual, is that we had this initial question of, we’re dealing with two things, there are two ways of slicing this if you want to. We’re dealing with adults and children, and should we, are the questions usable for both groups or should we divide them? 

    And also we’re dealing with NORSE and FIRES and those are more or less the same, because NORSE children are perceived to have FIRES and adults have NORSE. So we asked the group, and we were divided on this: Should we perform one Delphi, which is what we did, or should we divide it and do a pediatric and an adult one? 

    The reason we actually decided to go with the Delphi, one Delphi, is that there’s not a whole lot of evidence supporting that this is pediatric disease on one hand and NORSE is different. A lot of evidence points to this being very overlapping diseases or conditions. And if nothing else the traditional or the use of anti-inflammatory treatment in children as, for instance, IL-1 inhibition using anakinra, whereas in adults it’s IL-6 inhibition and in this case it was tocilizumab. There’s no real reason for this, it’s just in adults that’s been used more and it’s different traditions. We felt in this case the differences, we can probably learn more from the differences from the adult and pediatrics sides that it won’t cause a problem. 

    Joining or defining FIRES as a part of NORSE, we corroborated that here. But that’s in the definitions that was published in 2019 and 2018, even. So that was nothing new, but it’s important to emphasize that if you look at adults with NORSE in the Yale cohort for instance right now, their preliminary data show that more than half of the adult NORSE patients actually fulfill FIRES criteria as well. And conversely there are children who don’t fulfill FIRES criteria. But it’s quite rare. It’s obvious that the children, in children, in younger ages, the prevalence of an infection preceding the illness is much higher. It’s not 100% but it’s getting there.

    The important things in this is to try to look at all kinds of NORSE, including FIRES, as a potentially immunological problem. Especially cryptogenic NORSE. So NORSE today is a condition that can include infectious diseases, it can include autoimmune diseases, and if you find that of course you treat that. If you don’t find that and then you’re stuck with, so you have inconclusive results, cases of no etiology, we want to emphasize the importance of trying to break a vicious circle which is probably, I’m not going to say it’s inflammatory but at least it’s immunological. And that’s been more used in the pediatric field because it’s so obvious, I mean from a preceding illness, that this could be some sort of activation, whereas that’s not the case in adults. There are some data looking at refractory status epilepticus in adults showing that immunological treatments are not really on the table, or definitely not as early as they should be. 

    So to think that this is possibly immunological, there’s an immunological component in this and you have to target that, because if you don’t break that circle, none of your regular anti-seizure medications are going to work. So that’s one of the things, to start early with first-line immunotherapy, and escalate early and aggressively to second-line immunotherapy.

    The other thing that’s also in this, which is not primarily immunological, is that we advocate the use of ketogenic diet as early as possible. And that’s also used in pediatrics but not so much in adults. The reason for advocating that is that’s one of the few treatments that has actually been shown in small but still case series to be effective. So we believe that adding ketogenic diet early, which is in this case was defined in the recommendations as seven days, is of importance. 

    Dr. Nabavi NouriThank you. What would be the implications of the results?

    Dr. Wickstrom: The important implication is to look at your local guidelines on how you treat status epilepticus and refractory status epilepticus in your hospitals. We can see, we haven’t shown that here but there’s data showing that a lot of hospitals don’t have clear guidelines on this and the ones that do have them rarely include immunotherapy. So looking at these guidelines, this would affect your local guidelines for refractory status epilepticus and super-refractory status epilepticus, if these are new onset, during the first week of treatment. 

    When it comes to workup and diagnostics, there’s a lot of recommendations on how to do this. And this also differs a little bit. We know that in pediatrics, for instance, we sometimes don’t take all the antibodies that we should do. We know in adult situations, it’s perceived as not so important to look at genetics or metabolic disease, of course because it’s not as prevalent, but it should be part of your workup. So during the first couple of days, during the workup, the implications of these papers is that that it can give you recommendations on where to look and try to widen your screening. 

    And then the big implications is of course the treatment implication from day three, and that includes primary immunotherapy or first line immunotherapy, and then escalating that by day seven.

    Dr. Nabavi-NouriWell I think having those timeframes arguably could be altering outcomes, especially when we’re really dealing with, as you mentioned you had one case and it will never leave you for the rest of your career, always trying to understand what you can do better. What would be the next steps of this, next steps of this very impressive consensus group?

    Dr. Wickstrom: So the next step everyone is dreaming about, which we were thinking about, I mean it’s been a couple of years that we’ve been thinking that this should have been started, is clinical trials of treatments. It’s just it’s very, very difficult it turns out. It’s difficult to agree on if we do a treatment, how do we do it, is it head-to-head treatment and if so, what do we use? It’s going to be really, really hard to design those trials at this point. I don’t think we have enough data for anyone because you as a treating clinician, you need to treat your patient the way you think is best, and it’s hard to randomize patients. You have to have compliance from the group. And that was part of doing this, was to increase compliance and let everyone have a say in how to design these clinical trials. 

    I’m hoping we can fairly soon arrive at clinical trials, but I also think we need to think differently than that and think about how we can design real-life studies that are usable. For instance, can we look at some sort of clinical decision support that can serve both the purpose of filling up a biobank of data and possibly samples, at the same time that it offers you as a clinician help.

    But I hope the work that we’ve done is to create awareness in this group and in other groups that there is a consortium or there will be a consortium and this is open – the more people who want to join the better the stronger we can get. And we can use this to do good research, to get funding to do research and also to try to help these children and adults. And hopefully expand into refractory status epilepticus (RSE), because I mean – one debate now is, what actually differs? Why is NORSE different from other RSE? That’s a valid question.  I think in many cases it will be, for instance if you have structural, some sort of etiologies, or if you have an ongoing epilepsy, that’s probably a different sort. But immunological components may be a part even in that case. 

    But I think what NORSE as a concept offers is it offers a sort of umbrella that can help us in forwarding and advancing our knowledge. And maybe in 2 years or 5 or 10 years we’ll decide there’s no such thing as NORSE, it’s just RSE that happens to be new onset and we understand what it is. 

    Dr. Nabavi NouriLastly, and second to last question would be about the CSF cytokines. I’m very intrigued that it made it to the consensus. It’s been a big point of debate for two reasons: one is for clinical availability in terms of using reliable labs that can give you a clinical turnaround time as quickly as you would like to use it as a biomarker to guide treatment, and the other one is always timing, I find, because the cytokine profile can change quite drastically. I see there were two questions in the consensus – one whether it would be used for a biomarker of disease progression and response to treatment, and the other one was a choice of medication. 

    Dr. Wickstrom: So one of the hypotheses concerning FIRES and also NORSE is that it at least involves, maybe that’s not the whole mechanism, but it involves cytokine release. And that part of the immunological activation is actually the problem. There is some evidence to support that from animal data, and also there’s evidence in humans from blocking IL-1 and IL-6 mainly, with good results. So that’s the idea why cytokines appear to be important. 

    Just as you mentioned, there are several problems with cytokines. One is that it’s hugely complex – it’s really a web of different cytokines and they affect one another. For instance, we know that IL-1, which is a regulator of the proinflammatory system, we hardly ever see it because it has a very short half-life. Just by looking at lab data we have for IL-1, for instance, you would never use an IL-1 blocker, that would be a logical result of that, and still we know that it works. Looking at IL-1 levels doesn’t really help. 

    The second problem with cytokines is that they’re hard to analyze, if you don’t have access to a lab, but they’re also hard to sample. Whereas antibodies are very stable, cytokines are not stable, so you really, if you don’t sample it the right way for instance from the start, then you go to your bacterial or microbiology lab and say do you have any CSF left, and it’s been standing on a lab bench for two hours and cytokines have degenerated.

    I would love to say you should look at cytokines and you should use that, but we don’t know that. But tentatively, if we believe that cytokines are involved in this, it should or could be possible to have it both as a marker of disease and also as disease progression. But just like you said, it’s not a question of whether this goes up and then it goes down and then it’s gone. Inflammation is a tricky thing because it’s an endogenous response you want to have. And one of the consequences of a proinflammatory response – when we say inflammation, we usually mean proinflammation – the other thing is we have anti-inflammation. The proinflammatory cytokines will increase the anti-inflammatory response and we know for instance in studies of encephalitis cases, you really need to look at the ratio between pro- and anti-inflammatory to understand it. 

    Dr. Nabavi Nouri: What do young clinician researchers listening, how can they get more involved in this type of research? Are there any organizations or consensus groups with in the ILAE or within this consortium that they could approach and explore being more involved in this type of research?

    Dr. Wickstrom: Right now this consortium that I’m referring to isn’t really a consortium, it’s something we want to evolve into. But people are there and it’s open, 100% open to everyone who wants to join, both from a learning perspective and because this is an area to which you want to contribute is fantastic. 

    One way of accessing this or being involved is via the NORSE Institute. And that’s NORSEinstitute.org. It’s a North American institute that was started by the mother of a patient who died from this, and she’s done a fantastic job in trying to promote this research and bringing all of us together. You can find the names and email addresses of many of the people who have been part of this, and we regularly update it with published literature and how to find your way to the different ongoing studies, and that’s a way in.

    Dr. Nabavi-Nouri: To conclude, I’d like to ask if there’s anything more that you’d like to add and most importantly any take home messages that we’d like to leave our listeners with.

    Dr. Wickstrom: I really, really want to emphasize the immunological treatment because I can see that’s not working perfectly, of course not, but it could be improved a lot in kids, but even more so in adults, because they’re not using immunological treatment at all, and I’m convinced it will help so many adults with NORSE. And FIRES, probably both NORSE and FIRES. That’s an important take-home message.

    ##

    The recommendations and clinical tools are available now:

    International consensus recommendations for management of new-onset refractory status epilepticus (NORSE) including febrile infection-related epilepsy syndrome (FIRES): Summary and clinical tools

    International consensus recommendations for management of new-onset refractory status epilepticus (NORSE) including febrile infection-related epilepsy syndrome (FIRES): Statements and supporting evidence

    Families affected by NORSE/FIRES can join the NORSE Family Registry and contribute information that may help shape and initiate research. NORSE Family Registry registration is available in multiple languages: English | français | Mandarin | español

     

    Founded in 1909, the International League Against Epilepsy (ILAE) is a global organization with more than 125 national chapters.

    Through promoting research, education and training to improve the diagnosis, treatment and prevention of the disease, ILAE is working toward a world where no person’s life is limited by epilepsy.

    Website | Facebook | Instagram | YouTube

    Twitter: English French Japanese Portuguese Spanish

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  • Walnuts the new super food for stressed university students

    Walnuts the new super food for stressed university students

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    Newswise — Stressed university students might want to add walnuts to their daily diet in the weeks leading up to their next exam.

    A new clinical trial of undergraduate students during their university studies has shown positive effects of walnut consumption on self-reported measures of mental health and biomarkers of general health.  

    The University of South Australia study, published in the journal Nutrients, also suggests that walnuts may counteract the effects of academic stress on the gut microbiota during periods of stress, especially in females.

    Lead researchers, PhD student Mauritz Herselman and Associate Professor Larisa Bobrovskaya, say the results add to the growing body of evidence linking walnuts with improved brain and gut health.

    “Students experience academic stress throughout their studies, which has a negative effect on their mental health, and they are particularly vulnerable during exam periods,” Herselman says.

    Eighty undergraduate students split into treatment and control groups were clinically assessed in three intervals, at the beginning of a 13-week university semester, during the examination period and two weeks after the examination period. Those in the treatment group were given walnuts to consume daily for 16 weeks over these three intervals.

    “We found that those who consumed about half a cup of walnuts every day showed improvements in self-reported mental health indicators.  Walnut consumers also showed improved metabolic biomarkers and overall sleep quality in the longer term.”

    Students in the control group reported increased stress and depression levels in the leadup to exams but those in the treatment group did not. The walnut consumers also reported a significant drop in feelings associated with depression between the first and final visits, compared to the controls.

    Previous research has shown that walnuts are full of omega-3 fatty acids, antioxidants, as well as melatonin (sleep inducing hormone), polyphenols, folate and vitamin E, all of which promote a healthy brain and gut.

    “The World Health Organization has recently stated that at least 75 per cent of mental health disorders affect people under the age of 24 years, making undergraduate students particularly vulnerable to mental health problems,” Herselman says.

    Assoc Prof Larisa Bobrovskaya says mental health disorders are common in university students and can adversely affect students’ academic performance and long-term physical health.

    “We have shown that consuming walnuts during stressful periods can improve mental health and general wellbeing in university students, as well as being a healthy and delicious snack and a versatile ingredient in many recipes, to fight some negative effects of academic stress,” Assoc Prof Bobrovskaya says.

    “Due to fewer numbers of males in the study, more research is needed to establish sex-dependent effects of walnuts and academic stress in university students. It’s also possible that a placebo effect might have come into play as this was not a blind study.”

    Notes for editors

    The Effects of Walnuts and Academic Stress on Mental Health, General Well-Being and the Gut Microbiota in a Sample of University Students: A Randomised Clinical Trial” is published in Nutrients.

    It is co-authored by UniSA PhD student Mauritz Herselman, and colleagues from the Clinical and Health Sciences and Allied Health and Human Performance academic units at the University of South Australia.

    The study was co-funded by the California Walnut Commission.

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    University of South Australia

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  • A Mediterranean diet not only boosts health, but also improves fertility

    A Mediterranean diet not only boosts health, but also improves fertility

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    Newswise — With an emphasis on fruits, vegetables and legumes, the Mediterranean diet has long been applauded for its multiple health benefits. Now, new research shows that it may also help overcome infertility, making it a non-intrusive and affordable strategy for couples trying to conceive.

    Conducted by Monash University, the University of the Sunshine Coast, and the University of South Australia, the review found that the Mediterranean diet can improve fertility, assisted reproductive technology (ART) success, and sperm quality in men.

    Specifically, researchers identified that the anti-inflammatory properties of a Mediterranean diet can improve couples’ chances of conception.

    Infertility is a global health concern affecting 48 million couples and 186 million individuals worldwide.

    UniSA researcher, Dr Evangeline Mantzioris, says modifying preconception nutrition is a non-invasive and potentially effective means for improving fertility outcomes.

    “Deciding to have a baby is one of life’s biggest decisions, but if things don’t go as planned, it can be very stressful for both partners,” Dr Mantzioris says.

    “Research shows inflammation can affect fertility for both men and women, affecting sperm quality, menstrual cycles, and implantation. So, in this study we wanted to see how a diet that reduces inflammation – such as the Mediterranean diet – might improve fertility outcomes.

    “Encouragingly, we found consistent evidence that by adhering to an anti-inflammatory diet – one that includes lots of polyunsaturated or ‘healthy’ fats, flavonoids (such as leafy green vegetables), and a limited amount of red and processed meat – we can improve fertility.”

    The Mediterranean diet is primarily plant-based, and includes whole grains, extra virgin olive oil, fruits, vegetables, beans and legumes, nuts, herbs, and spices. Yoghurt, cheese, and lean protein sources such as fish, chicken, or eggs; red and processed meats are only eaten in small amounts.

    In comparison, a western diet comprises excessive saturated fats, refined carbohydrates, and animal proteins, making it energy-dense and lacking dietary fibre, vitamins, and minerals. Typically, a western diet is associated with higher levels of inflammation.

    Monash University researcher, Simon Alesi, says understanding the association between anti-inflammatory diets such as the Mediterranean diet, and fertility, could be a gamechanger for couples hoping to start a family.

    “The Mediterranean diet is consistently ranked among the healthiest diets in the world. But knowing that it may also boost your chances of conceiving and having a baby is extremely promising,” Alesi says.

    “Modifying your diet is a non-intrusive and affordable strategy that could potentially improve infertility.

    “Of course, more research needs to be done, but at the very least, shifting to a Mediterranean diet will not only improve your overall health, but also your chances of conceiving.”

     

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  • Middle Aged Fitness Releases Promising Workout Plan for Those 50 Years and Older

    Middle Aged Fitness Releases Promising Workout Plan for Those 50 Years and Older

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    Press Release


    Dec 9, 2022 09:00 EST

    Middle Aged Fitness is a fitness company founded by a Certified Nutrition Coach who saw a huge gap in workout programs based on age.

    “You’ll find a bunch of information these days that describe the best ways to exercise, but they are often written by younger people for younger people. Some of that advice is actually dangerous for older adults, especially those in their 50s or 60s. I wanted to create a fitness plan for those who are older,” said creator Dennis Hodges.

    Hodges, age 51, decided to take action after his daughter got engaged. He didn’t want to be remembered for being overweight on his daughter’s special day. At the time, he weighed over 250 pounds. All of that triggered his first self-experiment to see what works for the population of his age group. 

    After seven months, he got his weight down to 182 pounds with body fat under 10%. By following a specific workout and meal plan, Hodges actually gained more muscle mass than he has ever had before in his life. He used all this knowledge and information to create a custom-tailored fitness plan for those 50 and 60 years old.

    “I knew that after much success in this regard, if I could maintain good health for the rest of my days, I had something worth sharing. I believe that oftentimes, this age group is frequently overlooked in the health and fitness industry. I believe that at this stage in our lives, it’s the most imperative thing that we should be focused on. This program is entirely holistic, which is what I believe is warranted at this age. I will be sharing with you the things that I did in my journey as a guide, supported by science, but my main objective is for you to come out of this program understanding your own body and what works best for you,” said Hodges.

    Older adults who strength trained at least twice a week had a 46 percent lower chance of death for any reason than those who did not, according to researchers at Penn State and Columbia University. They also had 41 percent lower odds of cardiac death and 19 percent lower odds of dying from cancer.

    “I think the research is clear. Fitness is the key to longevity,” said Hodges.

    Middle Aged Fitness includes a full workout plan, meal plan and community. It’s available for purchase on the website middleagedfitness.com.

    Source: Middle Aged Fitness

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  • Home Health Lab Startup Bisu Collaborates With Polaris Dawn to Develop New Ways to Monitor Astronaut Health

    Home Health Lab Startup Bisu Collaborates With Polaris Dawn to Develop New Ways to Monitor Astronaut Health

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    Bisu’s “lab-on-a-chip” urine and saliva analyzer is intended for both consumer and astronaut use.

    Press Release


    Dec 1, 2022 10:00 EST

    Traveling in space leads to bone loss, muscle loss, and an increased risk of kidney stone formation, often starting within the first 24 hours of spaceflight as calcium levels in bone and tissue decrease and are expelled in urine. A new research experiment, selected for inclusion in the upcoming Polaris Dawn spaceflight mission, aims to show if monitoring the first urine sample in the morning could provide a simple way to track astronaut health in space. If successful, the research will provide a pathway to use compact, new inflight monitoring techniques. The day’s first urine sample typically has the highest urine calcium levels in the day and taking measurements from this sample might offer a workable way to assess in-flight bone loss and kidney stone risk. As both space accessibility and long-duration human spaceflights increase, keeping crews healthy by providing personalized, targeted countermeasures will be essential. This will require small, easy-to-use, low-power devices that can provide actionable information using easily obtainable samples of urine or saliva, such as a first-morning void.

    Bisu is a startup that helps people improve their health and fitness through lab-grade testing at home. Working with former astronaut Jay Buckey, MD, Professor of Medicine and Director of the Space Medicine Innovations Lab at the Geisel School of Medicine at Dartmouth, Bisu will support the post-flight analysis of first-morning void urine samples gathered from the Polaris Dawn crew to assess the effect of spaceflight on markers of bone loss, muscle loss, and kidney stone risk. If successful, this research could pave the way for inflight monitoring with new technologies, such as the microfluidic urine and saliva analyzer Bisu has developed. Because weightlessness affects people differently, this kind of in-flight monitoring could provide targeted countermeasures.

    “People will be spending longer times in space, and they may not be able to do the extensive countermeasure programs currently used on the space station,” says Prof. Jay Buckey. “We need simple ways to monitor people while they are in space so that the countermeasure program can be targeted to each person’s individual needs. This research puts us on the path toward that.”

    “We’re delighted to be working with Polaris Dawn and Prof. Buckey on this pioneering research,” says Daniel Maggs, co-founder & CEO at Bisu. “This research reflects Bisu’s commitment to advancing human health by making valuable health data accessible to all – whether on Earth or in space.”

    About Polaris Dawn

    Polaris Dawn is the first of the Polaris Program’s three human spaceflight missions. SpaceX is targeting no earlier than March 2023 for Falcon 9’s launch of Dragon and the Polaris Dawn crew from Launch Complex 39A at NASA’s Kennedy Space Center in Florida. Polaris Dawn endeavors to reach the highest Earth orbit ever flown, attempt the first-ever commercial spacewalk, conduct extensive research to further our understanding of human health on Earth and during future long-duration spaceflights, and test Starlink’s laser-based communications in space. For more information, visit polarisprogram.com/dawn.

    About Bisu

    Bisu is a healthtech startup that provides personalized, preventative advice at home, through nutrition and hormone tests using microfluidic “lab-on-a-chip” technology. In late 2021, Bisu announced a $3.2m seed round and collaboration with ASICS, took home the Good Design Award in the wellness category, and won the US Sports & Fitness Industry Association’s startup challenge.

    Bisu’s flagship product, Bisu Body Coach, is currently in beta and can be applied for at www.bisu.com.

    About the Space Medicine Innovations Laboratory at the Geisel School of Medicine at Dartmouth

    The Space Medicine Innovations Laboratory is devoted to solving biomedical problems presented by long-duration space flight. The lab has performed work on bone loss, decompression sickness, motion sickness, and psychological countermeasures for isolation and confinement. The lab also advances work that began with NASA into other areas of research. 

    Please address all press inquiries to press@bisu.com.

    Source: Bisu, Inc.

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  • Are Americans Eating Enough Whole Grains? It Depends on Who You Ask

    Are Americans Eating Enough Whole Grains? It Depends on Who You Ask

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    Newswise — A diet rich in whole grains, which are naturally high in fiber, is associated with lowering a person’s risk for various health problems. Overall, Americans are eating more whole-grain foods than ever before, researchers from the Friedman School of Nutrition Science and Policy at Tufts University report in a new study, published November 30 in the American Journal of Clinical Nutrition. However, the increase in whole-grain intake over the past two decades could be 39.5% or 61.5%, depending on which definition of a whole-grain food is being used. In addition, Americans’ mean consumption of whole-grain foods remained far below the recommended consumption of at least three ounces each day and varied considerably by each definition.

    The researchers say there’s a clear need to standardize how consumers, researchers, and policymakers talk about whole-grain foods. The study compared overlapping definitions from five institutions: the Dietary Guidelines for Americans, the U.S. Food and Drug Administration (FDA), the American Heart Association, the American Association of Cereal Chemists International, and the Whole Grains Council. The research team applied the various definitions of a whole-grain food to the dietary intakes of over 39,700 adults captured by the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2018.

    “We found that each definition captured very different types of grain- or flour-containing foods as whole-grain foods, resulting in differences in the average consumption of whole-grain foods and the associated trends,” says lead author on the study Mengxi Du, a PhD candidate in the Nutrition Epidemiology and Data Science program at the Friedman School. As a consumer, she said she has had the experience of struggling to identify what is or isn’t a whole-grain food via the packaging labels. Recent surveys suggest nearly half of American consumers have similar challenges.

    When looking at the different categories of whole-grain foods identified by these definitions, while some similarities were identified—whole-grain bread consumption increased under all definitions—there were more differences. The government-led FDA’s definition was the strictest, categorizing the fewest foods as whole-grain foods compared to the industry-led Whole Grains Council’s, which was the most lenient but could be least healthy based on a prior study.

    One surprising finding was how the foods of different population subgroups were classified depending on the applied definition. For example, individuals who are non-Hispanic white had a higher intake of whole-grain foods compared with other racial/ethnical groups under all definitions, except for the definition proposed by the American Heart Association, under which Hispanic individuals had the highest intake. The possible reason is that the American Heart Association’s definition is more sensitive to identifying dishes such as corn-based burritos, tacos, and nachos as whole-grain foods.

    “We can’t say which is the best definition yet as we need to assess the nutrient profiles of each and how these different definitions are associated with health outcomes. Our findings, however, underscore the imperative need for a consensus on whole-grain food definition. A consistent definition across agencies is essential to further promoting whole-grain food consumption in the U.S. population,” says Fang Fang Zhang, senior author on the study and interim chair of the Division of Nutrition Epidemiology and Data Science at the Friedman School.

    Research reported in this article was supported by the National Institutes of Health’s National Institute on Minority Health and Health Disparities under award number R01MD011501. Complete information on authors, funders, and conflicts of interest is available in the published paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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    Tufts University

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