Dietary and Muscle Ideas

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 ...."  Eliminate corn products (tortillas, corn), wheat products (bread, pasta), rice products and added sugar.  Any vegetable cooked at homeis  fine, less starchy ones if possible. Fruit- 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.  

Limit US manufactured wheat and corn products. If you can verify (very difficult) that the corn or wheat flour is 100% European (Italy, Spain, etc) the n those foods may be better. Avoid "protein powders" "protein shakes". The book End of Craving gives clear reasoning on why. Know that the source of your food (even protein) can dramatically change the insulin response from your body. In this study, processed protein foods cause a large spike in insulin levels, mimicing carbohydrates. Eating natural sources of protein like eggs, lamb, goat, and other whole foods will have a much lower impact on insulin secretion. 

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 60% + 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 veal, duck, goat, lamb, duck, some grass fed beefs, some non-farm fish. Fruit shoud be a dessert. If diabetes, then do not eat fruits that push your BG to more than 180.

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. 

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:

1. The Game Changers

2. What the Health

3. Supersize Me

4. Food, Inc

5. King Corn

6. Fast Food Nation

7. Forks Over Knives

8. Planeat

Read the following books:

1. How Not to Die. by Dr. Michael Greger

2. Metabolical: by Dr. Lustig

3. The Original Fast Foods by James and Colleen Simmons

4. The China Study by T. Colin Campbell

5. Fit For Life by Harvey and Marilyn Diamond

6. Eat More, Weigh Less: Dr. Dean Ornish's Life Choice Program for Losing Weight Safely While Eating Abundantly by Dr. Dean Ornish

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.