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Fact: The food is a huge part of the diet, yes, but don’t overlook the other ways the Mediterraneans live their lives. When they sit down for a meal, they don’t sit in front of a television or eat in a rush; they sit down for a relaxed, leisurely meal with others, which may be just as important for your health as what’s on your plate. Mediterraneans also enjoy plenty of physical activity.
Mamalaki, E., Anastasiou, C. A., Ntanasi, E., Tsapanou, A., Kosmidis, M. H., Dardiotis, E., ... Yannakoulia, M. (2018, September 5). Associations between the mediterranean diet and sleep in older adults: Results from the hellenic longitudinal investigation of aging and diet study. Geriatrics & Gerontology International, 18(11), 1543–1548. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/ggi.13521
You may also want to try a cyclical keto diet, or carb cycling. You follow the standard keto diet for 6 days of the week, when you eat less than 50 grams of net carbs a day. But on one day of the week, you increase your carb intake to roughly 150 grams of net carbs. Doing this satisfies any carb cravings you might have, making it easier to sustain keto in the long-run. Learn more about the benefits of carb cycling and weight loss here.
Some patients constantly graze on "legal" keto foods that can stall fat loss. Intermittent fasting is the answer here: You naturally reduce your caloric intake and give your gut a break. By not eating, you're allowing inflammation to quiet down in your body, which helps with blood sugar balance and weight loss. As an example, some plans combine daily fasting with a ketogenic diet. Have a big dinner, close up the kitchen, and push breakfast as far back the next morning as you can. I talk more about this type of keto diet, which I call a Cyclitarian plan, here.
This is the ultimate “trimmifying” oil, with 100% Medium Chain Trglycerides that boost your metabolism life rocket fuel. MCT Oil has become the delicious and multi-talented dietary BFF of Trim Healthy Mamas all over the globe. Its succulent silky texture and neutral taste make it perfect to whip into your morning coffees that we call “Trimmies” and to drizzle over large leafy salads topped with protein. It delivers a very fatty mouth feel but provides the fewest calories of any oil!
On Cyclical keto, I noticed these weird bouts of depression every time I carbed up on the weekends. I saw this study and they were linking inflammation to depression and it makes sense because every time I knock myself out of ketosis, I deal with this weird depression, then a few days back into keto, my head feels more clear. Strict keto is where I feel the best. This is where I’m getting the best results. I keep my fat percentage higher, around 80 percent."
Day 10: I'm starting to get sick of the same foods that I know are safe bets. And the number of times I've Googled: "Is _____ keto?" is getting out of hand. I've realized that the only real gripe I have with the keto diet is that there are so many healthy, nutritious foods that you can't eat while on it. (Maybe that's why experts say you should give up restrictive diets once and for all.) Carrots? Sweet potatoes? Brussels sprouts? What vitamins and nutrients am I missing out on by leaving these foods off my plate?
“Net carbs” and “impact carbs” are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less “usable” carbohydrate than is listed. [6] Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss. There is debate even within the ketogenic diet community about the value of using net carbs.
What is even more surprising is that the monounsaturated-fat-rich diet and saturated-fat-rich diet were equally damaging. “The monkeys fed monounsaturated fat developed equivalent amounts of coronary artery atherosclerosis as those fed saturated fat,” wrote Dr. Lawrence Rudel and colleagues at Bowman Gray School of Medicine at Wake Forest University in Winston–Salem, North Carolina.
Most people in the Mediterranean eat a balanced breakfast within one to two hours of waking up, which starts their day right by balancing blood sugar when it’s at its lowest. They then typically eat three meals a day that are filling, with plenty of fiber and healthy fats. Many people choose to have their biggest meal mid-day as opposed to at night, which gives them the opportunity to use that food for energy while they’re still active.
“Dietary fat is rewarding,” said Dr. Andreas Fritsche, study co-author and nutritional medicine professor at the University Hospital Tübingen in Germany. So rewarding, in fact, that it could be used as an effective dieting tool, though further studies are needed. “If you eat a fat-free aroma extract which is commonly associated with fat, it is possible that you get the rewarding effect of fat-triggered sensations without calories,” Dr. Fritsche said. 
The Harvard pyramid is based on the Mediterranean diet. Its structure came from the diets of the inhabitants of Crete and Southern Italy in the 1960’s. The study was presented in 1993 by Walter Willett of the Harvard School of Public Health at the International Conference on the Mediterranean Diet held in Cambridge Massachusetts. Note that oil is one of the basic components, in direct opposition to the current USDA pyramid. This pyramid has enjoyed a decade of increasing acceptance.
I'm not usually a fan of prescribed "diets"-I live by more of the anti-diet mantra. Call me jaded, but the word "diet" has a bit of a negative connotation these days, with "fad" and "restrictive" usually preceding it. So, when I had the chance to give Dr. Axe's new Keto360 program a two-week test run, I did some serious digging on the ketogenic diet and whether it's healthy.
The Mediterranean diet is a primarily plant-based eating plan that includes daily intake of whole grains, olive oil, fruits, vegetables, beans and other legumes, nuts, herbs, and spices. Other foods like animal proteins are eaten in smaller quantities, with the preferred animal protein being fish and seafood. Although the pyramid shape suggests the proportion of foods to eat (e.g., eat more fruits and vegetables and less dairy foods), it does not specify portion sizes or specific amounts. It is up to the individual to decide exactly how much food to eat at each meal, as this will vary by physical activity and body size. There are additional points that make this eating plan unique:
Keep moving — In addition to ketosis, the best thing you can do for your weight-loss journey and your overall health is to get moving! It’s extremely easy to wake up, go to work, sit at a desk all day, come home, and then sit on the couch for the rest of the evening. But when you do this, you aren’t burning calories like you should if you want to lose weight. For best results, take up a combination of resistance training and cardio. Building muscle will give your metabolism a boost since muscle in your body burns more calories than fat, and cardio will further help you burn calories. And even if you don’t want to go to the gym or get outside for a run, try to get in a 30-minute walk 3-4 times per week. A 30-minute walk at a brisk pace can help you burn about 150 calories. Plus, working out will boost your mood and help you stay motivated on your health journey.

Since MCTs are processed in the liver, they are absorbed quickly and provide fast and sustained energy. MCTs move passively via the hepatic portal system to the liver without the need for a longer digestive process. Unlike almost all other foods, MCTs do not require energy to be absorbed, stored or used in the body, making them an almost perfect source of natural energy.


Another key component of the Mediterranean diet is lifestyle. Enjoy the social component of eating by sharing meals with family and friends as often as possible, whether on a weeknight or special occasion. Slow down, savor each bite, and don’t be afraid to have a glass of wine (or two) in moderation. While wine packs antioxidants, you should also drink plenty of water, as staying properly hydrated keeps your body functioning. The last bit of the equation is making physical activity a part of your daily routine, whether it’s biking to work or simply taking a walk during your lunch break to enjoy the fresh air.

When your body goes into ketosis, it will start to produce by-products called ketones. This includes acetone—yes, the same chemical found in nail polish remover, which your body actually naturally makes on its own, according to a 2015 review of research. Because acetone is a smaller molecule, it tends to make its way into your lungs. You’ll eventually exhale them out, resulting in “keto breath.” Your mouth might also have a metallic taste, but it won’t last forever as you adjust to the diet. Just be diligent about brushing your teeth!
Concentrated MCT oils are often derived from “a blend of coconut and palm oils.” I personally always look for MCT oils sourced only from coconut oil  or sustainable and rainforest friendly palm oil because the palm oil industry is responsible for the deforestation for large parts of the rainforest. Thousands of acres of rainforest are being destroyed to make room for palm production. This has also driven many animals out of their natural habitats and greatly threatens species like the orangutan and Sumatran tiger, which are both in danger of extinction.
On a less serious (but still important) note, it is important to start using MCT oil slowly. Because it is so readily and quickly used by the body, it can lead to all kinds of (temporary but embarrassing) digestive disturbances if you jump in to quickly. I’ve even stumbled across entire threads in online forums bemoaning the “disaster pants” that resulted from using too much MCT oil too quickly. It is generally considered safe to start with 1/2 to 1 teaspoon and work up as the stomach permits.

Dr. Wendy Kohrt, of the University of Colorado Denver, leads its IMAGE program (Investigation into Metabolism, Age, Gender and Exercise) and has been studying the impacts of menopause for more than 20 years. She has found that during menopause women’s metabolisms slow by about 50 calories a day and that women experience more food cravings, less movement and more muscle loss, which together create a quadruple whammy for gradual weight gain over time. Kohrt notes, however, that menopause itself has been vastly under-researched over the years, a point shared by other commentators, considering the impact it has on the health and wellness of millions of women.


A plant based diet, one that includes lots of fruits and vegetables, is the cornerstone of the Mediterranean diet, which can help fight cancer in nearly every way — providing antioxidants, protecting DNA from damage, stopping cell mutation, lowering inflammation and delaying tumor growth. Many studies point to the fact that olive oil might also be a natural cancer treatment and decrease the risk of colon and bowel cancers. It might have a protective effect on the development of cancer cells due to lowered inflammation and reduced oxidative stress, plus its tendency to promote balanced blood sugar and a healthier weight.
Loading up on fat lowers your levels of insulin. Insulin is a hormone that tells your body to store energy, either as fat or glucose.[4][5] The more insulin your body releases, the more fat that gets stored. Insulin also blocks leptin, the hormone that sends a signal to your brain when you’ve eaten enough to meet your energy needs.[6] That means when you eat carb-heavy foods, you’re at risk of overeating and won’t get that full feeling before reaching for a second helping of potatoes.

A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods.  The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose—the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods—an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic). The brain demands the most glucose in a steady supply, about 120 grams daily, because it cannot store glucose. During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. [1]
Loading up on fat lowers your levels of insulin. Insulin is a hormone that tells your body to store energy, either as fat or glucose.[4][5] The more insulin your body releases, the more fat that gets stored. Insulin also blocks leptin, the hormone that sends a signal to your brain when you’ve eaten enough to meet your energy needs.[6] That means when you eat carb-heavy foods, you’re at risk of overeating and won’t get that full feeling before reaching for a second helping of potatoes.
In the famous Lyon Diet Heart Study, people who had heart attacks between 1988 and 1992 were either counseled to follow the standard post-heart attack diet advice, which reduces saturated fat greatly, or told to follow a Mediterranean style. After about four years, follow-up results showed that people on the Mediterranean diet experienced 70 percent less heart disease — which is about three times the reduction in risk achieved by most cholesterol-lowering prescription station drugs! The people on the Mediterranean diet also amazingly experienced a 45 percent lower risk of all-cause death than the group on the standard low-fat diet. (11)
The kidneys play an important role in metabolizing protein, and it’s possible that eating too much of the nutrient can have a negative impact on kidney function. While ketogenic diets are supposed to be much higher in fat than they are in protein, many keto eaters make the mistake of loading up on lots of meat, Mancinelli says. The result? You could end up eating way more protein than you actually need.

In 2007, a team of eight research scientists compared the impact of the Atkins diet on body mass and body fat with three other diets in a 12-month randomized controlled trial. The team recruited 311 overweight and obese, premenopausal women with no history of diabetes or cardiovascular diseases. The women had an average age of 41 years, BMI of 32, and body fat percentage of 40. After taking baseline measurements, researchers distributed the subjects to one of four different groups.
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As the tide began to turn in the early 2000s and the claims for low-fat diets grew more dubious, new dietary culprits were called into question, such as refined carbohydrates and gluten. Meanwhile, more research emerged exploring the benefits of diets rich in healthy fats. These days, Flynn is noted for seemingly having known before others that low-fat diets were not optimal for health. “I constantly hear from people now ‘How did you know low-fat diets were unhealthy?’ ” She laughs this off remarking that she would simply always read the references supporting dietary guidelines and was a critical reviewer of the evidence. “I constantly tell my students to not take dietary guidelines at face value; look into the evidence.”
Research suggests that the benefits of following a Mediterranean-style eating pattern may be many: improved weight loss, better control of blood glucose (sugar) levels and reduced risk of depression, to name a few. Eating like a Mediterranean has also been associated with reduced levels of inflammation, a risk factor for heart attack, stroke and Alzheimer’s disease.

Starting in Italy thousands of years ago and spreading to Greece, Spain and other areas around the Mediterranean, this diet is now successful all over the world for promoting health and longevity. While it’s always existed, even before books and studies were dedicated to it, the diet really began to take hold around the world in the 1990s, when a Harvard University doctor showcased it as a diet useful for improving heart health, losing weight and clearing up other health issues.
So is the Mediterranean diet still healthy? Absolutely. While this one study may have been flawed, it doesn’t change the fact that fresh fruits, veggies, lean proteins, whole grains, fish and healthy fats like olive oil (along with the occasional glass of wine!) are all foods that are proven to be good for you on their own. Together, they comprise a diet that can be terrific for your health — study or no study.

Add in intermittent fasting: Once you are fat-adapted, hunger pangs diminish and it is easy to go for longer periods without eating. Many people naturally stop eating breakfast — they just aren’t hungry when they wake up. The number one rule of low-carb eating is “eat when you are hungry and stop when you are full.” So if you are not hungry try fasting for 16 hours, and then eating just lunch and dinner in an 8-hour window, called a 16:8 fast. Or try eating dinner one night, than fasting until dinner the next night, doing a 24-hours fast.
Consuming Onnit MCT oil isn’t just good for humans, it’s good for orangutans! Palm oil, the leading constituent in most MCT oils, is typically harvested from native palm forests, contributing to the destruction of some of the last remaining habitats for orangutans. So enjoy our super premium MCT oil and send a karmic high five to the great red ape.

Keto flu is a real thing. Cutting your carbs to the bone and going into a state of ketosis (where your body burns fat for energy) can bring on a cluster of uncomfortable symptoms, such as headaches, fatigue, muscle aches, nausea, and diarrhea. The side effects are the result of your body transitioning to using fat as its primary source of energy instead of carbs, explains Kristen Mancinelli, MS, RDN, author of The Ketogenic Diet. Once it adapts to the new fuel source (usually within a week or two), you’ll start to feel better.
Day 10: I'm starting to get sick of the same foods that I know are safe bets. And the number of times I've Googled: "Is _____ keto?" is getting out of hand. I've realized that the only real gripe I have with the keto diet is that there are so many healthy, nutritious foods that you can't eat while on it. (Maybe that's why experts say you should give up restrictive diets once and for all.) Carrots? Sweet potatoes? Brussels sprouts? What vitamins and nutrients am I missing out on by leaving these foods off my plate?
The 2017 meta-analysis by Drs. Kevin Hall and Juen Guo provide us with very convincing data, but we must also consider the fact that the data came from studies where all the food was provided by the scientists. Although this is a great way to assess the difference between low-carb and high-carb diet, this does not simulate the real-world effectiveness of each diet. For this reason, we must investigate data from less strict studies. In other words, we need to look at what happened when subjects were told to follow a specific diet on their own.
This meta-analysis also provides us with an explanation for why keto and low-carb diets have not always been found to confer better weight loss than low-fat diets. When protein and calories are controlled, changes in weight loss results remain relatively equal. This not only supports the theory that calorie deficits are the key to weight loss, but it also provides evidence against the hypothesis that carbs and insulin are the cause of obesity. [25]
Nine months ago she decided to try the stricter keto diet and followed our advice to help support this way of eating. By testing her urine with keto stix she could see she was expelling ketones in the low to moderate range. But still her weight was increasing — she gained a total of 7 lbs (3 kg) over nine months of keto eating. And her clothes were feeling tight and uncomfortable. What was she doing wrong?
One of the ways to do this that is yielding promising results in research is the ketogenic diet. In a 2017 study evaluating the ketogenic diet in the management of diabetes, researchers showed the diet had the potential to decrease blood glucose levels, the rudimental key to minimizing the occurrence and diagnosis of diabetes. This was further supported in a study evaluating the long-term effects of the ketogenic diet in obese patients, offering similar results in its ability to lower blood glucose levels, as well as decreasing total cholesterol and triglyceride levels.
Good fats in olive oil, nuts, and fish are beneficial for our health, and science is continually proving this to be the case. Recent studies have shown that consuming a Mediterranean diet with extra virgin olive oil leads to lower rates of cardiovascular diseases and cancer. And now there is evidence that the healthy fats in olive oil is linked to weight loss.
Olive oil is also beneficial for lowering hypertension because it makes nitric oxide more bioavailable, which makes it better able to keep arteries dilated and clear. Another protective element is that it helps combat the disease-promoting effects of oxidation and improves endothelial function. Keep in mind that low cholesterol levels are worse than high sometimes, but people in the Mediterranean don’t usually struggle to maintain healthy cholesterol levels either since they obtain plenty of healthy fats.
As evidence continues to mount affirming that inflammatory substances in the blood promote plaque growth, plaque rupture, and clot formation, all of which likely increase the risk of heart attacks, “we’ve got to start asking ourselves: ‘Is any fat, even so-called good fats, beneficial in terms of preventing heart attacks and strokes?'” says Kimberly Gomer, MS, RD, Director of Nutrition at the Pritikin Longevity Center.
Mamalaki, E., Anastasiou, C. A., Ntanasi, E., Tsapanou, A., Kosmidis, M. H., Dardiotis, E., ... Yannakoulia, M. (2018, September 5). Associations between the mediterranean diet and sleep in older adults: Results from the hellenic longitudinal investigation of aging and diet study. Geriatrics & Gerontology International, 18(11), 1543–1548. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/ggi.13521
Dr. Fung suggests not doing the same fasting routine, day after day, but to “switch it up”; 16:8 one day, 24 hours IF the next, then a day of regular eating. That is because the body has a strong physiological drive to seek homeostasis — energy balance. “Whenever the body is exposed to a constant stimulus, it will become acclimated to it,” he says.
Constipation is a common side effect of low-carb eating plans, including the ketogenic diet. Severely curbing your carb intake means saying goodbye to high-fiber foods like whole grains, beans, and a large proportion of fruits and vegetables, says Ginger Hultin, MS, RDN, Seattle-based nutritionist and spokesperson for the Academy of Nutrition and Dietetics.
The second reason is arguably more important: Vegies taste better with olive oil, so people are likely to eat more. “My rule of thumb is one tablespoon of extra-virgin olive oil to one cup of veg,” Flynn says, adding that sautéing them or roasting are tasty options, plus these methods maintain much of their nutrient value. “Eating veg like this fills you up and stops you being hungry.” An added bonus, she says, is fibre from the veg also improves bowel regularity.
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