Kerry, a legal professional, was postmenopausal and suffered from mood swings and brain fog, along with chronic joint pain. Kerry came my way for help with her persistent weight issues. She was clinically obese, and her blood chemistry profile showed signs of her metabolic disorder: elevated fasting glucose, elevated triglycerides, borderline high Hgb A1C, and higher cholesterol. She also showed depressed serum levels of vitamin D3. Luckily, in her case, she showed no signs of thyroid issues or thyroid antibodies and was not yet diabetic. I suspected the presence of possible autoimmune issues, particularly since her son had been diagnosed with one (and these things tend to run in families), and because her symptoms were so doggedly persistent. Unfortunately, Cyrex Labs, which offers a number of highly accurate tests for identifying autoimmunity in its earliest stages, as well as food sensitivities, wasn’t available then. We had to make do and proceed as best we could. She was a little on the functionally anemic side from a lack of iron, and as a result she struggled with fatigue, as well.
Kerry was an enthusiastic client out of the gate, eager to get started. Right away, she eliminated all grains and dairy, all processed foods, and all dietary sources of sugar and starch. She dialed back on her protein intake to just what she needed and made sure she was getting enough healthy fats and essential fatty acids (the supplemental EFAs were mainly from Antarctic krill oil—a pure and concentrated source of important omega-3s, EPA, and DHA). She committed to the primal fat-burning dietary approach and began sourcing a lot of food at her local farmers’ markets. She also started culturing her own vegetables as well as making bone broths at home—which she discovered she really enjoyed doing. Fortunately for Kerry, her family was supportive and everyone began to eat the same way. This always makes a big difference.
Kerry’s enthusiastic attitude was a great asset in resolving her long-standing issues. She never complained about the rather large lifestyle adjustments she had to make—she made it an adventure (an attitude I highly recommend, by the way), finding new places to procure her food, meeting farmers face-to-face at the farmers’ markets and their actual farms, and reveling in the delicious dishes she was cooking. (In fact, she would mischievously comment how her fat-rich meals felt so wonderfully indulgent, almost like she was really getting away with something.) I could tell that it was a pure delight for her to turn her own life around. Kerry steadily lost more than forty pounds over the next six months or so and turned her obsession about weight into a focus on health and making healthy choices. Her metabolic lab test results and ferritin (iron) levels normalized, and she was able to bring her vitamin D3 levels back up into a healthy range. She was also far less emotionally reactive to sources of stress that had previously driven her to snack—she was seeing her world through a clearer lens and knew that she could deal with things as she had to.
Kerry has happily maintained this new level of health in the years since we first met. Her remaining excess weight has gradually melted away, and she has become even more passionate about the power and pleasure of truly good food.
Becoming a primal fat burner is not a program for dietary dilettantes. It is really for the person seriously committed to restoring or maximizing their health for the long haul, and someone who isn’t afraid of challenging the status quo. As such, you do have to be prepared to work at it a little. This isn’t an 80/20 approach, where you follow a recommended plan 80 percent of the time and the other 20 percent of the time eat whatever you like. This is a 100 percent approach—a high goal that promises and achieves high results.
The healthiest and most effective state of ketogenic metabolism is achieved through getting 70 to 80 percent of your calories from dietary fat, while strictly moderating your protein consumption so you meet but don’t exceed your daily requirements of no more than 6 to 7 ounces of meat, fish, or eggs per day, or about 50 to 70 grams of protein (that’s about 0.8 gram of protein per kilogram of estimated ideal body weight per day). I’ll walk you through how to do this—rest assured, it does not mean eating coconut oil out of a jar all day or drinking lard, nor does it mean doing percentage calculations over the breakfast table!
In addition, you will be essentially eliminating sugar and starch and instead eating as many non-starchy fibrous vegetables and greens as you want: broccoli, cauliflower, asparagus, kale, spinach, field greens, lettuce, cabbage, Brussels sprouts . . . the list goes on. (See complete lists of foods to eat and foods to avoid in Chapter 11.) These vegetables provide additional potassium, magnesium, phytonutrients, and antioxidant activity–promoting substances, which help to protect you from numerous cancers while helping to detoxify you. Include some naturally fermented, probiotic-rich foods, too (all cheaply made at home), such as sauerkraut, coconut kefir, other cultured (not simply brined) vegetables, and kvass, and you will be vastly improving the nutrient density and health value of those plant foods. The fermentation process allows the healthy bacteria to produce enzymes and additional nutrients that make them more digestible and provides even more nutrition than you would have gotten from the raw vegetables.
To cultivate and maintain a state of effective ketogenic adaptation—where you produce and actively use ketones as your primary source of fuel—you need to avoid the “cheats,” like the occasional donut, daiquiri, hunk of bread, handful of snack chips, or slice of pizza. One single slip-up can knock you out of effective ketosis for a day or two, not to mention that cheating with foods containing gluten (and quite possibly also dairy) has the potential to severely adversely affect autoimmunity and damage your gut and brain. Not worth it, ever. Also, even if you happen to be ketogenically well adapted when you decide to have that sugary dessert or a bag of corn chips, it may take a couple of days or longer to return to a full state of efficient ketone utilization again, while firing up your previously conquered cravings all over again.
It is impossible to avoid all carbs forever (there will always be some in the vegetables and nuts you eat), plus there will be occasions where you might want to have a bowl of berries, some dark chocolate (really not the worst thing in tiny amounts), or even a glass of champagne to celebrate something special. There are times when things like this are decidedly worth it (though read the label on that dark chocolate carefully first for signs of gluten). But if you do make such infrequent exceptions, it becomes easier for some to rationalize more serious indulgences or “cheats,” so you need to consider these occasions carefully. Things like sugary desserts, a pitcher of margaritas or a daiquiri at girls’ night out, a bowl of popcorn while watching Netflix, or stopping on the way out of town on vacation for crappy fast food may result in a noticeable and frustrating backslide where you gain a couple of pounds overnight, feel the return of certain symptoms (and old cravings), or stop losing weight for a few days or more. Those having diagnosed or undiagnosed autoimmune issues tend to experience a lot more backlash from such slips. Others for whom this is not so forgiving include migraine sufferers, seizure sufferers, and those with mood instabilities or bipolar disorder. One indulgence tends to trigger more, and cravings often rush right back in to torture you. This is especially a danger if you have been heavily addicted to sugar in the past. You need to know that it can take a few days and some extra discipline to get back on track again. The best policy is generally to keep these rationalized indulgences to a minimum.
How many carbs you may personally be able to tolerate depends in part on how insulin sensitive or metabolically dysregulated you are to begin with. People who are not overweight or who are especially athletic might be able to get away with eating slightly more carbohydrates than others while maintaining a state of EKA, but once your body has fully adapted to the primal fat burner metabolism, ketones in particular become even more efficient at producing energy than either glucose or free fatty acids and are far better for you. The more adapted to making efficient use of fat you are at any weight, the better off you will be! And the less you stray, the less you will rock the boat.
It’s not just the nutrients in the food you eat, or even their quality, that determines whether your cells get the substances they need for life; it’s also the proper digestion of these nutrients that can make or break your health. There are two aspects of the digestive process that bear looking at to ensure you safely and optimally become a primal fat burner and achieve its full promise.
A considerable segment of the population is deficient in the stomach acids required to fully break down proteins (and absorb vitamin B12 and minerals). This can be because of age (those over forty have less of it), stress, thyroid issues, certain nutrient deficiencies (B vitamins, zinc), and other problems. This is problematic in general—and becomes even more important when following a moderate-protein primal fat burner diet, where you want to get as much as you can from each meal. Digestion is a north-to-south process: everything begins in the stomach (following signaling from the brain), and having a properly acidic pH in your stomach sets the tone and initiates the subsequent signaling for all that follows. But this part works well only if you have the right conditions: a calm, relaxed autonomic state of parasympathetic functioning and the presence of about seventeen different nutrients.
Without enough hydrochloric acid production, you simply cannot properly digest protein into its component amino acids and peptides needed for proper protein synthesis in the body (and poorly digested proteins are more likely to eventually result in triggering food sensitivities). You also can’t properly digest and absorb dietary minerals from any source, much less digest and absorb the critical vitamin B12 (even if you are eating lots of animal-source foods) without sufficient stomach acid. If you also happen to have a “leaky gut” (small intestinal gut barrier compromise), you run a greater risk of mounting an inappropriate immune response to the foods you eat, which can lead to rampant food sensitivity issues, systemic inflammation, and autoimmune conditions. Poor protein digestion also readily results in things such as muscle loss, the inability to form collagen, and hair loss. It can also lead to an increased risk for H. pylori infection and ulcers, gastric reflux symptoms, dysbiosis (unhealthy composition of bacteria in your gut), and parasitic infections.
As just noted, any inhibition of normal hydrochloric acid (HCl) production also affects your ability to digest and absorb vitamin B12—an animal-source nutrient essential for healthy cognitive function and healthy blood cells. Deficiencies of this critical substance have been widely associated with B12-based and/or pernicious anemia, poor sleep, cognitive decline, brain shrinkage, memory problems, Alzheimer’s, and other dementias.
A compromised thyroid almost always compromises the digestive process, as the thyroid gland partly controls the release of the hormone gastrin, which signals for additional production of HCl when the presence of complete protein is detected in the meal. HCl production is a precise orchestration, without which no other digestive processes in the body can properly take place.
If you have any of the signs and symptoms of poor digestion, you may likely benefit from hydrochloric acid supplementation taken with meals, as long as your stomach and esophagus aren’t inflamed. If they are, then you will need to heal the inflammation first. (Medications for acid reflux, by the way, are almost never the answer and only deepen the problem. They are also linked to numerous additional problems, including neurological problems such as dementia.)1 HCl tablets and capsules can be readily purchased over the counter, but finding the right amount for your needs can be tricky. Work with a qualified health care provider (holistic or functionally oriented practitioners should be particularly familiar with these issues) to walk you through the process of determining the dosage that is right for you, as it can vary widely from person to person. Over time, when or if your HCl production improves, you may find you can take fewer capsules, though some people do need to supplement with HCl on an ongoing basis. People in their seventies and beyond particular may require supplemental HCl and pancreatic enzyme digestive support in order to make the best use of protein, vitamin B12, minerals, and other nutrients in their diets; these supplements may also indirectly help improve biliary health. On the Primal Fat Burner Plan, you’ll be encouraged to pay attention to your digestion. Poor production of hydrochloric acid and pancreatic enzymes, as well as thyroid-related issues, can also predispose you to have biliary issues—and you need a healthy gallbladder to optimally digest your fats and fat-soluble nutrients.
Though it’s small and underappreciated, a healthy gallbladder confers the considerable capacity to digest fat and is absolutely key to long-term mental and physical health. Many people, especially in the medical establishment, believe that eating animal fat or adopting a fat-based, ketogenic diet leads to the creation of gallstones. This is not supported by the research available. It is true that gallbladder attacks tend to occur following fat-containing meals, but only if you already have preexisting gallstones in your gallbladder. The actual dietary causes seem to be associated with low-calorie, low-fat, higher-carbohydrate diets as well as the low levels of intracellular magnesium that are common with high-carbohydrate diets.
A quick primer: Located beneath the liver under the right side of your rib cage, the gallbladder’s main purpose is to collect, hold, and dispense the bile from the liver, which allows for the proper emulsification, digestion, and absorption of dietary fats and fat-soluble nutrients. Bile also works to emulsify, or make water soluble, spent hormones and other substances so they readily move safely out of the body with bowel movements. We were all born with a gallbladder for good reason: to be able to consume natural dietary fat in considerable amounts. We can get into trouble, however, when unaddressed digestive and nutritional problems—as well as other issues such as diabetes, excess belly fat, excess estrogen, or cirrhosis—conspire to thicken and slow down the bile, which can ultimately precipitate gallstone formation.
There can be serious ramifications to having gallstones. The consumption of a fatty meal naturally causes your gallbladder to contract, and this may inadvertently force one or more of these stones into your bile duct, where they can become stuck, causing tremendous pain, inflammation, and a dangerous blockage that may require surgical intervention. The passing of small stones or sluggish bile following fatty meals can also result in painful gallbladder attacks. Note whether you feel aching or pain under the right side of your rib cage following meals. This could be a problematic sign that should be checked out by a qualified health care professional. If left unchecked and unaddressed for too long, the gallbladder itself can become infected or the bile duct blocked to the point where immediate surgery becomes necessary.
But all that needs to be put into proper context: the gallstones did not form because of a high-fat diet, and in fact, it’s often just the opposite. (On a carb-heavy diet, if you don’t “use it”—your gallbladder—you can “lose it.”) And for people with normally functioning gallbladders, a high-fat diet is not only okay, it is optimal. Furthermore, a weight-loss study on obese people found that a higher-fat diet prevented gallstone formation in comparison to a low-fat diet.2 High-carb, low-fat diets consistently lead to a higher risk of gallstones.3, 4 One study in 2014 summed it up neatly by stating that “Diets high in fat content reduced gallstones, compared with those with low fat content.”5
The Primal Fat Burner Plan includes foods with gallbladder-supportive properties: foods rich in EPA/DHA, along with beet kvass, which contains betaine (also known as trimethylglycine or TMG, an important methyl donor capable of promoting the regeneration of liver cells and the flow of bile, as well as promoting fat metabolism). I heartily encourage you to make beet kvass from the recipe in this book and enjoy it regularly. In addition, including things like garlic and onions, turmeric, and daikon in your everyday fare will help support your biliary function.
If you have a known gallbladder issue or no gallbladder at all, please see the box on page 99 before proceeding.
Just like converting your home to run on solar power or your car to run on biodiesel, there are adjustments that need to happen when you convert from sugar burning to fat burning. Numerous metabolic pathways are involved in this process, and it pays to understand them, because for almost everyone, the shift away from carb-based foods is a big deal—it’s quite frankly the change of a lifetime. This gets slightly technical, but stay with me (unless you would rather skip the science class and jump ahead).
One particular enzyme, called hormone-sensitive lipase, is key to this process. It is normally inhibited by insulin, but once you stop consuming sugar and starch, insulin tends to get out of the way and allows hormone-sensitive lipase to begin to work its magic. Hormone-sensitive lipase allows for the breakdown of triglycerides and the formation of free fatty acids to be used as an energy source. Your body then makes use of free fatty acids for energy by moving them from the periphery of your circulation into your liver, where they undergo something called beta-oxidation in the hepatic mitochondria. This converts the free fatty acids into acetyl-coenzyme A (acetyl-CoA).
Now, as long as you are a carbovore (i.e., a sugar burner), this acetyl-CoA enters something called the tricarboxylic cycle. To do this, acetyl-CoA first needs to pair with something called oxaloacetate, which is derived from pyruvate during regular sugar burning (glycolysis). But when sugar is not available for this oxaloacetate, activity gets shifted instead toward the gluconeogenesis pathway, allowing you to make your own glucose. The buildup of acetyl-CoA then gets diverted instead toward ketone body formation. Voilà! You now have the energy units from fat beginning to form! Unfortunately, your body is not so quick to give up its dependence on sugar and initially treats most of the ketones you are making as waste products.
Once your body begins producing ketones in earnest, it is also desperately trying to create sugar by stimulating your body’s blood sugar hormones (glucagon, adrenaline, and cortisol). These initially serve to raise your blood sugar back up by using the glycogen in your liver (breaking it down through the process called glycogenolysis), which makes more glucose available to your cells. All this transpires quite rapidly and takes far less time to happen than it has taken you to read this. The more you restrict sugar and starch intake in the beginning, the more your glucagon (blood-sugar-raising hormone) output becomes amplified. During this time, you may notice a temporary increase in your blood sugar level measurements as your blood sugar hormones attempt to overcompensate for the lack of dietary glucose by creating more of it internally. Glucagon, seeing the writing on the wall and looking for help, also begins stimulating hormone-sensitive lipase as an indirect means of increasing the release of free fatty acids from your triglycerides. Glucagon then stimulates the uptake of these free fatty acids by the liver and its mitochondria so they can begin to be burned for energy.
Once the demand for energy overwhelms this process, it further promotes the more efficient production and eventually utilization of ketones. The entire adaptation process takes roughly three to six weeks for most people. Even though glucagon—normally the key hormone that upregulates blood sugar—is also an important part of generating ketones, it can play this fat-burning role only in the absence of insulin.6 This complex metabolic dance is regulated and carefully orchestrated by two master hormones, leptin and insulin.
Before you flip your own fat-burning switch, read on to discover the often overlooked critical importance of fat-soluble nutrients and how the Primal Fat Burner Plan can help protect you against the vast range of diseases of modern civilization—and support you in maximizing your sports and fitness goals.