Dietary and Muscle Ideas

If Dr. Jogi referred you here you are reading this page because you have a fasting insulin level more than 9.9 or you have a need for healthy dietary changes or need to increase muscle mass. Otherwise, this is just educational. Discuss any changes with your doctor before starting

This area in green is summary of the details below the green area. Please read it all but if you want a quick reference then just read the green text. 

Concept:

Your body preferentially burns energy in this order: (1) Sugar/Glycogen (2)  Muscle then (3) Fat

Your preference would be (1) Sugar/Glycogen then (2) Fat then (3) Muscle

If you want to see measurable changes in your body fat and muscle get a baseline DEXA body composition scan to plan for your Physical Retirement Plan (see details below)

Phase 1 -DIETARY / MUSCLE CHANGES:

Phase 2 -DIETARY / MUSCLE CHANGES Discuss any changes with your doctor before starting

Insulin resistance tree and its fruits Dr. Jogi

Processed foods are the leading source of metabolic syndrome /weight gain. But, there are basically 4 reasons/associations for why patients gain weight (fat gain) which are diagnose-able by a physician. 


Dr. Jogi can help you evaluate for these 4 concepts. Beyond these causes, there are numerous genetic causes for weight gain for which there are usually not tests available, nor are there any specific treatments for those gene disorders. We cannot test for genetic causes in our clinic and nor can we treat for those. 

Even if you have all 4 above issues you can still maintain a normal weight with or without medications.  Out of our scope are other causes of weight gain that are related to fluid fluctuations (unrelated to fat gain). Also we cannot measure environmental endocrine-obesogens (flame retardants, pesticides, disinfectants, thermal paper, lipsticks, drugs)

Jogi Rules of Thumb: Concepts for good health

Reference book: Metabolical by Dr. Lustig

There are 4 ways you can try to lose weight (with the assistance of your physician) but all four of which DO NOT work well



PHYSICAL RETIREMENT PLAN? :

If you do not have  physical retirement plan constructed as well as your financial retirement plans, you will be headed down an expensive health downward spiral. If you are not consistently working on your physical retirement plan then you should just hand over your financial retirement $ to health systems now. Start to measure physical retirement planning metrics and you may be surprised how little your body will be able to do once your financial retirement plans come to fruition.  A person cannot improve without some metrics


To plan one's Physical Retirement Plan Dr. Jogi recommends everyone get these three body composition scans, which are not covered by insurance for unknown reasons. Generally the cost is $75-100 for all three.  You would have to search for a local company that provides this service. Then he can recommend to get a repeat scans every 6-12 months to see how your diet and exercise (strength training as tolerated) will hopefully reduce the fat mass and increase the lean muscle mass. If you only your your weight scale to track your progress you will not be sattified and may miss the gradual benefits


These Three Metrics can help prevent the Three Horsemen of Poor Health (Insulin resistance diseases, cancer, dementia):

DEXA scan: this will measure exact amounts of body fat, muscle, water, and bone in one's body. The body fat and muscle quantities are measured not calculated. The goal is to see reduction in fat mass and increase in muscle mass. This is better than measuring BMI or fasting insulin as a metric.  Do not tell Dr. Jogi that you have gained weight because "it's all muscle" unless you can show him a change in your DEXA muscle mass to prove it. Don't ask Dr. Jogi how much you should weigh for your age height... That's the wrong question. A better question is how muscle muscle and fat% you should have....Avoiding sarcopenia is a great way to live well as you age. 

VO2 max: This measure how efficiently your muscles burn oxygen on a scale of 0 to 100. A person should first write down what activities they see them selves doing 20-40 years in the future. Then look up the VO2 max requirement for each activity. A person can set future "physical retirement" exercise goals based on future activity desires, knowing every decade the VO2 Max will drop 10%.  Google search how to improve your VO2 max to achieve your future exercise goals. 

What are your goals as you age?

Dr. Jogi cannot provide specific exercise regimens for individuals. Meeting a trainer and physical therapist is a good first step to avoid injury.

RMR - resting metabolic rate is measured and NOT CALCULATED... the calculations make assummptions about a persons body that may not be true. So when you calculate the expected calories allowed for your weight it is an assumption.

DIETARY PLANNING HOW-TO's:

Dr. Jogi has some specific recommendations for dietary health and weight loss for his patients. Consult your doctor for what is right for you

There are 5 steps that Dr. Jogi can suggest. Try "baby-steps" by doing one step at a time. Please set your expectations first: if you were to follow all the steps, a good amount of weight loss would be 1-2 pounds every 1-3 months, with intermittent intervals of no weight gain or loss for several months. Anything more suggests you are doing something to lose weight that is not sustainable. 

First a brief digression on exercise:

Jogi Rule of Thumb- Less is more. Do not waste time with excess exercise unless you a training for a specific sport or event, do not lose muscle with exercise, hack the metabolic system to lose fat, and know when patients age into the 80+ years they lose muscle (sarcopenia). Eventually when they fall down it will not matter how much dumbbell or machine weights they could lift. They will rely on their ability to move their own body weight (bridging, then sit ups, then push ups, then squats, and pull ups)

Exercise is fine to do for mental, cardiac, and bone health. Get as much daily activity as much as possible. Please do no over-do cardio. Ideally for a impactful exercise regimen for fat loss can be done as below. First get cardiac clearance from your doctor. 

a. Pre-eat 20-30 gram of protein to promote fat loss instead of muscle loss during the following exercise. If this is not done then any exercise will first eat up your muscle before fat loss. 

b. High intensity short period exercise- When: Anytime ideally etween 10 am to 7pm. How often: every 1-2 days. How much: (40 to 80 seconds)  Where: Anywhere, anytime. Reference: Fast Exercise. Warm up with your desired activity, then do at least 2 sets to the peak of your ability of your desired exercise activity (running, rowing, swimming, etc) at peak intensity for 20-30 seconds.  Generally the goal is to get to a heart rate of [0.85x (220-age)] for the 20-30 seconds. Rest in between sets until heart rate reduces to less than 105, then do it again.  This will induce a series of metabolic changes. The biggest risk if pulled muscles so please warm up and stretch as necessary. The purpose of the intensity is to deplete your glycogen stores to further enhance the low-insulin effects in your body and simultaneously stimulate a cascade of metabolic events that will increase mitochondrial function/ "metabolism'  for the next few days. 

c. Strength training without weights or gyms- When: Anytime ideally etween 10 am to 7pm. How often: every 1-2 days. How much: 10 minutes or less. Where: Anywhere, anytime. Reference: Convict Conditioning. There are 6 basic exercises, 10 levels for each exercise. Each level has a beginner quantity, then maintenance level, and a progression level to the next level. There are downloadable apps related to this book that can help you easily track your progress. No gym membership required. No special machines. No dumbells.


You should have no expectation that exercise alone will lead to sustained weight loss, usually studies have show prolonged chronic exercise can lead to weight gain. Fasting is not recommended for pregnancy nor patients with eating disorders. A good overview in video format is "Limitless" on Disney plus, episode 3


1. Time restricted feeding - 

Also called intermittent fasting. The "16:8" is a good place to start but is not the final goal because this should be the normal feeding period. If you are overweight , after several years the final goal is several longer-fasts per week and a very long fast once per month.  Use your watch by compressing the time that you eat any food into a continuous 8 hour period. For example: 12pm to 8pm or 10am to 6pm. Stay consistent. Then the subsequent 16 hours you may only drink non-calorie liquids (Best is water). This is generally safe for 95% of patients to start. Dr. Jogi may provide additional details for individuals during clinic visits. Some but not all patients may need to work up to a 36 hour fast, 2 times per week.

If the thought of not eating for a 12-16 hour period seems impossible for you, then for more details you can google search "Dr. Fung diet" and his books are very useful. A good beginners' introduction to intermittent fasting is called "Life in the Fasting Lane" which Dr. Jogi recommends highly.  For more technical details there are two other books that go into more details: "Obesity Code" and "Diabetes Code". Or you can simply watch his free youtube videos. Expectation is at least 2-3 pounds every 2-3 months. If you are significantly over-weight, try a change to a 24 hour period twice per week. After 2 months, if weight still not coming down, then increase to 36 hours 1-2 times per week but need MD supervision for this. For very details help on implementing and maintaining any new habit Dr. Jogi recommends the book "Atomic Habits" by James Clear

Start with 16 hours, then later alternate 16 and 18 hours. Add in a 24 hour period once or twice a month if desired weight loss not reached. 

Women need to know that fasting may cause temporary irregular menses and so talk to your doctor about fasting longer than 36 hours. 

How do you know effective is your fasting and feeling? Buy a blood ketone meter like what Dr. Jogi uses- a Keto Mojo to see if you reach a target. Effective fasting and dietary changes should get your levels to greater than 1.0 after 24 hours as a minimum criteria. Remember that the metabolic switch to burn fat is blood insulin levels less than 7, but this testing is only available in blood labs. Blood ketone levels more than 1.0 can indicate you are beginning to enter this metabolic switch. Patients with Type 1 diabetes or on certain medications like SLGT2 inhibitors should definitely talk to their doctors first before starting on ketone monitoring. 

Types of Fasting with possible benefits:

Autophagy fasting 17 hours

Gut reset fasting 24 hours

Fat burning 36 hours

Dopamine reset fasting 48 hours

Immune reset fasting 72 hours



2. STOP PROCESSED FOODS. Reduce the carbohydrates and processed foods you are eating to less than half of your current intake. Using the google to search "grams of carbohydrates in ...."  Reduce pastas, grains, potatoes, and added sugar.  Eat fruit rarely/ (once a month or so) and consider it a dessert. Patients with BMI with BMI more than 24, not pregnant, no seizure disorders, with no eating disorders, and not on hypoglycemia inducing medications can consider this nomogram for grams of carbohydrates per 24 hour period: height more than 6 feet: take less than 100grams, 5'5" to 6' take less than 70 grams, Height less than 5'5" take less than 60 grams.  

Jogi Rule of Thumb- if it is sold in a box or a bag, avoid it. 

PROVE IT TO YOURSELF IN REAL TIME with CGM- SEE DETAILS HERE TO AVOID COMMON PITFALLS 


3. Convert your entire diet to 80% + vegetable-based.  If this seems daunting try the "Broccoli 2" approach and please review the reading list below.  We do not recommend "fake meat" products which are just as unhealthy as any processed foods. Eat "real" food. Feed the gut (fiber) and stop damaging your liver (toxins) - Reference book Metabolical by Dr. Lustig.  Your meats should be anything but chicken as the poultry industry is highly processed. Meats that are fine include goat, lamb, duck, some beefs, some fish. Fruit is not recommended (once a month is reasonable) as fruit contains fructose and is just a sugar source.

Jogi Rule of Thumb- If the individual food components a persons consumes do not rot within 24-48 hours of leaving it out on a countertop after soaking in water, it probably should not be eaten. Your entire digestive process is a symphony of the microbiome to compost (rot) your food. If the bacteria outside your microbiome cannot digest the food on your countertop, how can your gut bacteria? A good example of this is most store bought shelf bread. 

Try this experiment at home to prove it to yourself: take the store brought bread or any other boxed or bagged food, soak in water, add some bacteria (yogurt or other sources- use your imagination) leave in your oven for a week at 98-100 degrees Fahrenheit (body temperature), come back after a few days to see if it has become rotten and growing visible bacteria or fungus. Use an apple or a cut vegetable as a control (add water and bacteria too). Compare the samples. 

Jogi Rule of Thumb- Purchased non-home made "probiotics" pills or other supplements are a waste of money and potentially harmful.


4. Prepare it yourself. Don't eat food from outside of your home: more than twice a month is too much. Yes, you do have to cook at home to be healthy. Sorry, there is no short cut here. Remember the goal of outside establishments that make food for you is to sell more and often, not your health.


5. Calorie tracking can be frustrating and does NOT work well since it does not take into consideration food science (ground to packaging) but only nutrition content which is missing the processing of foods which have slow poisons, but sometimes patients enjoy this process of counting. Download myfitnesspal app to track your calorie intake for a week, note the average calories per day. Then plan to eat 150 less calories less per day from that day forward. BUT REMEMBER A CALORIE IS NOT A CALORIE. ie// 1 calorie of cake is a not the same as 1 calorie of broccoli when metabolized by the body.  The type of food matters (see below). Alternatively you can try Weight Watchers online system and follow their point system. Physically going to Weight Watcher meetings is very useful. If you are overweight, place "sedentary" as lifestyle and you do not get credit/extra calories for exercise until you are at your goal weight.

Expectation is a loss of 4-7 pounds per year. If you feel you need to lose weight much fasting than 4-7 pounds a year, then you should consider a meal-replacement program such as the Methodist Medical Weight loss program 832.667.5673 in which you meet weekly and interact with dietitians, nutritionists, psychologists, and internist. They frequently have free information session. Remember that it is best to stick with these types of meal-replacement programs for at least 3-5 years to maintain the lowered weight.

6. Ketone Milestones: Check blood ketone levels before your break your fast. A blood ketone should be positive if your insulin levles are lower than 5. A fasting insulin level chronically above 10 is the hibernation zone - you will be tired, sleepy, and moody. So Dr. Jogi suggests to purchase a blood ketone testing device to check levels before a fast is broken. If ketones levels are less than 0.2 then its either (A) low muscle mass/quality and/or (B) too high carbohydrate diet in the previous 24-60 hours. To test which one, do some moderate to intense physical activity for 20 minutes while still fasted and then check ketones again. If ketones still zero, then you have both (A) and (B): start exercise and above diet phase 1. If ketones are positive or rise, then you may have adequate muscle, just change the diet, 


Diagrams:

These below are merely for illustration/education and Dr. Jogi would have to provide more specific for individuals based on their medical history and medications after a meeting with him. This is not meant for pregnant persons, breastfeeding, persons with eating disorders, persons with advanced kidney disease, or anyone with BMI less than 24. Caution and  Medical supervision is needed in most cases, especially if on insulin, oral hypoglycemia medications and anti hypertension medications. The doses may need to rapidly be reduced or stopped in order to avoid hypoglycemias and dangerously low blood pressures.

Only certain fluids can be consumed during fasting periods: water, tea and coffee (hot or iced), and homemade broth.

REMEMBER: your body can only be in one of these two places in terms of fat storage

1) Fed State- insulin (fat storage hormone) levels are HIGH and you will store glycogen and fat

2) Fasting State - insulin levels are LOW, and you are more likely to use up your glycogen and then burn fat. Use a blood ketone meter (See above) for monitoring of effectiveness. 



All the these fasting approaches beyond 18 hours will require medical supervision and only suggested in some cases. It is best if the person has a BMI more than 25 to begin with:

Usually would alternate 18 and 16 hour fasting every other day. Add in a 24 hour period twice a month if desired weight loss achieved. Can go longer but really need to determine carbohydrate intake if needing more. 


Instructions for starting a fasting program

Basic 16: 8 diet

This is how everyone should be eating in general. Start with this regimen. If you are unable, work up to this schedule with 14:10 or 12:8. 

Monday: EAT 10am-6pm & FAST 6pm to 10am 

Tuesday: EAT 10am-6pm & FAST 6pm to 10am 

Wednesday: EAT 10am-6pm & FAST 6pm to 10am 

Thursday: EAT 10am-6pm & FAST 6pm to 10am 

Friday: EAT 10am-6pm & FAST 6pm to 10am 

Saturday: EAT 10am-6pm & FAST 6pm to 10am 

Sunday: EAT 10am-6pm & FAST 6pm to 10am  

Basic 18: 6 diet

After 8 weeks of  16:8 change to this schedule if more weight loss desired. 

Monday: EAT 12pm-6pm & FAST 6pm to 12p

Tuesday: EAT 12pm-6pm & FAST 6pm to 12p

Wednesday: EAT 12pm-6pm & FAST 6pm to 12p

Thursday: EAT 12pm-6pm & FAST 6pm to 12p

Friday: EAT 12pm-6pm & FAST 6pm to 12p

Saturday: EAT 12pm-6pm & FAST 6pm to 12p

Sunday: EAT 12pm-6pm & FAST 6pm to 12p

24 hour fasting

After accomplishing the above, add this twice a week.

Monday: Breakfast FAST; Lunch FAST; Dinner EAT

Tuesday Breakfast EAT; Lunch EAT; Dinner EAT

Wednesday Breakfast FAST; Lunch FAST; Dinner EAT

Thursday Breakfast EAT; Lunch EAT; Dinner EAT

Friday Breakfast FAST; Lunch FAST; Dinner EAT

Saturday Breakfast EAT; Lunch EAT; Dinner EAT

Sunday Breakfast FAST; Lunch FAST; Dinner EAT

36 hour fasting

Add this once a monthfor 1 year. For females you should not go past 36 hrs without consulting your doctor

Monday Breakfast FAST; Lunch FAST; Dinner FAST

Tuesday Breakfast EAT; Lunch EAT; Dinner EAT

Wednesday Breakfast FAST; Lunch FAST; Dinner FAST

Thursday Breakfast EAT; Lunch EAT; Dinner EAT

Friday Breakfast FAST; Lunch FAST; Dinner FAST

Saturday Breakfast EAT; Lunch EAT; Dinner EAT

Sunday Breakfast FAST; Lunch FAST; Dinner FAST

42 hour fasting

Upgrade from 36 to 42 hours once a month (males), talk to your doctor about further upgrades. 

Monday  Breakfast FAST; Lunch FAST; Dinner FAST

Tuesday  Breakfast FAST; Lunch EAT; Dinner EAT

Wednesday Breakfast FAST; Lunch FAST; Dinner FAST

Thursday Breakfast FAST; Lunch EAT; Dinner EAT

Friday Breakfast FAST; Lunch FAST; Dinner FAST

Steps to to increase vegetables (INSOLUBLE FIBER) in your diet.

Following a vegan dietary regimen is NOT necessary, but many patients ask how to begin such a diet. Below are suggestions and reading material.


This is a long process and so get informed

Watch the following films:


Read the following books:


Consider visiting the following websites for RECIPES.

FYI Vegan DOES NOT MEAN EATING SALADS EVERY DAY and does not include processed vegan items (fake meat, sodas, chips, etc).:

http://www.veganpeace.com/animal_cruelty/animal_cruelty.htm

http://www.tcolincampbell.org

http://www.vegfamily.com/vegan-pregnancy/index.htm

http://www.vegansociety.com

https://cleanfooddirtygirl.com/ also has support group


Ditch dieting and start permanent changes

You don't have to be vegan. But you should pick one type of diet and stick with it

Baby Steps

Dr. Jogi recommends a gradual approach to improving you diet. It takes years to build a habit, so don't change it overnight. Make these very gradual changes:

a. Take into account all of the junk food in your home. This includes anything with sugar, refined flour, and has been processed. Make a list of it and post it on the fridge. This should also include fake faux meats, chips, crackers, tortillas, and pasta.

b. On a weekly basis, target one junk food that you have decided you are not going to buy anymore and replace it with a healthier food that you like. For example, if you cook with white flour start buying whole wheat flour. If you buy potato chips and cheese dip every week, start buying corn chips and salsa instead. If you eat raisinets every day, start buying plain raisins or grapes instead.

Shop the perimeters of a grocery store

Reduce the Eggs

Avoid dairy and chicken meat

If you really are not taking any meat, eggs, or dairy, then Dr. Jogi strongly recommends vitamin B12, 1000 units daily.




DRUG THERAPY FOR WEIGHT LOSS

Since 2020 Dr. Jogi no longer prescribes Contrave or Orlistat or Qsymia. He does not believe the modest weight loss from these medications is worth the medication interactions or side effects. 

He may prescribe GLP1 agonist medications for weight loss (Zepbound, Wegovy, Saxenda) but only if the patient fully understands the risks. Details on these types of GLP1 drugs that are FDA approved for weight loss, please click this link