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The Health Up Newsletter
Created Weekly by Teri Yunus 
Health Up With Teri Health & Wellness Coaching

October 26, 2023 | issue 161

What's Inside This Week:
  1. Ketogenic Diet - What You May Not Know
  2. Eat More Plants
  3. The PQ Group Coaching Program
  4. Did You Know?
  5. Recipe of the Week
  6. Health Tip Tuesday!
  7. My Favorite Quotes

The Ketogenic Diet
Sometimes I read an article online or in a magazine and it's so good, I want to help others to have access to the information. The following article was written by Dr. Pam Popper. The article appeared in her weekly newsletter from Wellness Health Forum. Check it out. This is info that isn't typically known by most and may be useful as you explore different eating patterns. 
There are many misunderstandings about the ketogenic diet, ranging from the conditions for which it can be useful to the right way to adopt it. Many people claim to be eating a ketogenic diet who are not doing so, and many of the claims currently being made about the diet are patently false.

The ketogenic diet is a high-fat, low-carbohydrate diet that has been used since 1921 as an effective treatment for several forms of epilepsy. While primarily used for children, there is some evidence that some epileptic adults may benefit too. The best experts on the diet are at Johns Hopkins Children’s Center. 

The mechanism of action that explains the efficacy of the ketogenic diet is that it mimics a fasting state, and fasting has been known to be an effective treatment for seizures since ancient times.[1] Within a short time after beginning a fast, the body stops using glucose and converts to using stored fat for fuel, a state known as ketosis. During ketosis, ketones are produced, which are useable as a substitute source of energy for both the body and brain. The ketogenic diet results in the same effect. Restricted carbohydrate intake results in burning dietary fat for fuel, which allows for an extended period of time in a fasting state. Fat stores are used up within a relatively short period time, while living off of dietary fat intake can continue for much longer periods of time.

Research shows that the diet works when implemented properly. A 2001 study at Johns Hopkins showed that 75 out of 83 epileptic children who consumed a ketogenic diet for a year had either partial or full resolution of their symptoms and improvement was sustained after stopping the diet.[2]

In another study, 65 epileptic children between 18 and 24 months of age were assessed before starting and after one year on the diet. For those who remained on the diet (52%), mean seizure frequency decreased from an average of 25 seizures per day prior to the diet to less than 2 per day, and was accompanied by significant improvements in both attention and social functioning.[3] 

A meta-analysis of 11 studies showed that 16% of children experienced complete resolution of seizures, 32% experienced a 90% reduction, and 56% had a greater than 50% reduction in seizures.[4]

While ketogenic diets can be effective, there are side effects. One study of pediatric patients treated with the Johns Hopkins protocol showed that during the first 4 weeks, dehydration and gastrointestinal complications were common, and infectious diseases, aspiration pneumonia, hyperuricemia, hypoglycemia, electrolyte imbalances, acidosis, hepatitis, and acute pancreatitis have been reported. After 4 weeks, patients remain prone to all of these complications except dehydration, pancreatitis, and hyponatremia. In almost 15% of patients, osteopenia, kidney stones, hydronephrosis, iron deficiency anemia, and cardiomyopathy developed after one month in ketosis. Some patients dropped out of the study due to the side effects of the diet.[5] Vomiting, constipation, kidney stones and an increase in plasma cholesterol are common. Kidney stones can be prevented by supplementing with potassium citrate, and cholesterol levels return to normal after the diet is stopped.[6] 

The bottom line is that while the diet is effective for most children who adopt it, there are side effects, and patients must be carefully monitored while using the diet for medical treatment. The diet is only adopted for a short period of time, and for many parents of epileptic children, the benefits outweigh the risks since drugs used to treat epileptic children are often ineffective and have even more side effects.

Interest in ketogenic diets has increased recently, in part because of the positive effects fasting has been shown to have on cancer patients. Animal studies have shown that fasting is effective for reducing the side effects of chemotherapy, and for decreasing circulating IGF-1 levels, a known risk for cancer.[7]  The same effect has been shown in human subjects.[8] Fasting can be an effective strategy for both preventing and treating cancer because cancer cells are weakened and normal cells are strengthened in response to food restriction.[9] The reason is that humans have historically lived for long periods of time with limited food and sometimes no food at all. Normal cells are adept at surviving under these circumstances, converting to burning ketones for fuel, while cancer cells cannot live on ketones.

Water-only fasting can be undertaken by many people for a few weeks, and obese people can fast for several months. But people cannot fast indefinitely, and some aggressive cancers, particularly brain cancers like glioblastoma, do not completely resolve after a few weeks of fasting. Traditional treatments are notoriously ineffective for these patients, who have grim prognoses and usually only a few months to live after diagnosis. 

Thomas Seyfried, Ph.D., has spent his career studying the use of metabolic therapies to manage mainly chronic and difficult-to-treat conditions like epilepsy and brain cancer. In his book, Cancer as a Metabolic Disease, he provides extensive documentation showing that cancer is not a genetic disease, but rather a mitochondrial metabolic disease. This is not a new idea, but one that was largely forgotten as very profitable cancer treatments such as surgery, chemotherapy and radiation became standard practices. He proposes the use of several therapies which include calorie restriction, fasting, and a ketogenic diet for addressing difficult-to-treat cancers. He presented a lecture on this topic during our 2016 conference, citing a few case reports, one of whom was a woman who lived for 7 ½ years after her diagnosis, almost unheard of for glioblastoma patients. 

And this brings me to the current misunderstandings about the ketogenic diet, which originate both from those who advocate a plant-based diet and those who promote Paleo and other diets. 

First, the Paleo diet and the Atkins diet are not ketogenic diets. Just eating animal foods while restricting grains and beans, or eating a high-saturated fat diet will not result in ketosis, which is required for the diet to have any therapeutic effect. A ketogenic diet requires the assistance of well-trained professionals because the macronutrient make-up of the diet must be exact and consistently maintained. A keto monitor is required, and patients must test themselves several times per day to make sure they remain in ketosis.

Second, due to the side effects of the diet, some of which are quite serious, the ketogenic diet should only be adopted by patients for whom the benefits outweigh the risks. For example, a glioblastoma patient with only a few months to live is better off staying alive while taking potassium supplements to avoid kidney stones than dying with low plasma cholesterol levels. On the other hand, the risks of side effects from the ketogenic diet are not warranted for a person who wants to lose weight or reverse type 2 diabetes. Low-fat, plant-based diets have been proven to be effective for these purposes without the negative side effects. 

On the other hand, advocates of plant-based diets can become almost apoplectic when the ketogenic diet is mentioned for treatment. A diet high in fat and that restricts healthy carbohydrate foods like potatoes seems like heresy to them. They think that a very low-fat plant-based diet is the answer for everything. It’s the answer for a lot of things, but not everything. Those who take this stance - a one-size-fits-all approach to treating patients - are both practicing reductionism and abandoning the use of clinical judgment, which is desperately needed in the practice of medicine today. People are not all the same, and their age, limitations, medical history and current state of health must all be considered when making any health-related recommendations, including those concerning diet. 

Dietary advice must be tailored to the particular condition of the patient, and often must be combined with other treatments that include dietary supplements, cognitive therapy, exercise, physical therapy, and some conventional treatment. It is important to avoid dogmatic adherence to ideas, and to think outside the box as we seek solutions for our healthcare crisis. 

In summary, the ketogenic diet is an option to be considered for very specific situations for a very small percentage of people. It requires a rigorous and disciplined approach in order to be effective, and almost always involves hiring an expert for assistance. The diet has serious side effects, which should be disclosed to patients before adopting the diet, and which make it a good choice only when the potential therapeutic benefit outweighs the risks.

[1] Huffman J, Kossoff E. "State of the ketogenic diet(s) in epilepsy." Curr Neurol Neurosci Rep 2006 Jul;6(4):332-340
[2] Freeman J, Kossoff E. "Ketosis and the ketogenic diet, 2010: advances in treating epilepsy and other disorders." Adv Pediatr 2010;57(1):315-329
[3] Pulsifer M, Gordon J, Brandt J, Freeman J. "Effects of ketogenic diet on development and behavior: Preliminary report of a prospective study." Dev Med Child Neurol 2001 May;43(5):301-6.
[4] Lefevre F, Aronson N. "Ketogenic Diet for the Treatment of Refractory Epilepsy in Children: A Systematic Review of Efficacy." Pediatrics 2010 Apr;105(4)
[5] Kang H, Chung D, Kim D, Kim H. "Early- and late-onset complications of the ketogenic diet for intractable epilepsy." Epilepsia 2004 Sep;45(9):1116-1123
[6] Freeman J, Kossoff E. "Ketosis and the ketogenic diet, 2010: advances in treating epilepsy and other disorders." Adv Pediatr 2010;57(1):315-329
[7] Lee C, Safdie FM, Raffaghello L, et al. "Reduced levels of IGF-I mediate differential protection of normal and cancer cells in response to fasting and improve chemotherapeutic index." Cancer Res 2010 Feb 15;70(4):1564-72
[8] Safdie F, Dorff T, Quinn D et al. "Fasting and cancer treatment in humans: A case series report." Aging (Albany NY) 2009 Dec; 1(12): 988–1007. 
[9] Brandhorst S, Longo V. "Fasting and Caloric Restriction in Cancer Prevention and Treatment." Recent Results Cancer Res 2016;207:241-266
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Eat More Plants
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When considering what you can do for your health, my best advice is to shift to a 100% whole foods plant-based way of eating. For your health, for our planet and for the animals. Not everyone is open to this advice, however. So the next best thing is to simply eat more plants. Find ways to add plants to your routine whether it is by eating a large salad every day that is packed with a variety of different plant foods or by making a big pot of vegetable soup to enjoy throughout the week. Getting more plant foods into your body will boost your health even if it's just a little bit at a time. The thing about plant foods…well, all foods, really…is that what we eat becomes what we WANT to eat. The more plant foods you eat, the more you will love them. And, the coolest part is that these foods love you back. They provide the best energy, the best digestion, just the best, overall. Eating more plants transforms our lives in the most amazing ways!
One of the ways many people are getting more plants into their diets is to do Meatless Mondays. It’s a great way to hold yourself accountable to eating more plants. You can change it up to make it work for you…maybe Tuesday or a Friday works better, do it! Plan ahead so that all your meals that day include all plants and no animal products. You may find it awkward at first and then it becomes fun…make it fun. It doesn’t have to be a chore. Think of it as a challenge…challenge yourself to step out of your eating comfort zone and do something different.
Another way to get more plants is to create a meal around a plant food. This could be a Mexican night  where you enjoy cauliflower tacos as the main dish. Add some rice and beans on the side and it’s a great meal. These foods can be enjoyed without cheese, believe it or not 😊 Another idea is to add a bunch of vegetables to your spaghetti sauce and have a meatless spaghetti dinner. Add some whole grain or sourdough bread for a tasty all American meal…minus the meat. Or keep the meat if you can’t wrap your head around getting rid of it. Just add the plants and you may find that it’s just as tasty, if not more!
It's easy to add greens to all kinds of dishes. These can be blended into smoothies or added to soups or stews. Making a big green salad and using it as the main dish or a side dish is an easy way to add green leafy vegetables to your life. These are some of the healthiest foods on the planet to eat, so enjoy them freely. Snacking on raw veggies and hummus or on fresh fruit is another way to eat more plants. Sliced apples, clementines, bananas or chopped carrots, celery and cucumbers add crunch and nutrition to your diet. These foods are naturally low in calories so if you are a snacker, they are great choices to reduce the calorie load your body may not need while increasing the nutritional value of what you are consuming. Win-win. 
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The PQ Group Coaching Program 
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For the last few weeks I have been talking a lot about Positive Intelligence. In the current milieu we find our world today, more positivity is highly desirable by many of us. Below is a brief description of the program I will be offering soon. 
The PQ Program is a mental fitness program that enables wellness, performance, and positive relationships. The six-week program empowers you to create sustained change toward a more positive mind by laying down neural pathways to form new habits through consistent daily practice.
The PQ operating system provides the opportunity to identify and decrease negative thoughts, what we call Saboteurs, and work to increase positive thoughts, what we call Sage. You will complete a Saboteur assessment as you begin the PQ Program to help identify your top Saboteurs.
As your coach, I guide you through the six-week program where you experience daily practice, a weekly focus, the PQ gym, and community. You can access the content using the PQ app and measure your progress. The PQ Program also includes a Pod facilitated by your coach. These small groups provide weekly discussion opportunities and consist of as few as two people (client and coach) or five individuals going through the PQ Program with me simultaneously.
Build powerful habits for a positive mind. During the PQ Program, you get to build a foundation of mental fitness by strengthening three critical mental muscles to shift the balance of power from your inner Saboteurs to your inner Sage. With lifelong applications to work and life, the opportunity is yours to continue to grow.
What the PQ Program includes:
● PQ app - available on Apple and Android, as well as a desktop version
● Focus - weekly hour-long videos and daily 15-minute app-guided exercises
● Gym - includes guided sessions to practice and log PQ reps, a foundational practice for building your mental fitness
● Community - the internal social network for the PQ Program
● Modules - lessons essential for completing the program
● Pod - support and accountability group, to meet once a week to discuss the week's training
Watch for more information on my upcoming group program. The offering is small. No more than 5 people so if you have any interest, reach out to me today to hold your slot. Have you tried to make a health change in the past and found it to not last? This program is for you. This method shifts the wiring in the brain for sustainable change. Isn't that what we want…to stop the yoyo cycle and just be? 
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Our Thoughts & Beliefs Can Change Our Biology
Positive and more optimistic thoughts can make us healthier and live longer. According to research in the journal J Pers Soc Psychol., which followed participants around for 23 years, having a positive attitude increased longevity and health to a greater degree than blood pressure, cholesterol, smoking, weight and level of exercise.
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Recipe of the Week
“Sniffle” Soup
"Sniffle" Soup
Even if you don’t have the sniffles, this soup is altogether comforting and delicious–sure to be a favorite!  Serves 5-6.
  • 1 1/2 tablespoons plus 3 1/2-4 cups water divided
  • 1 1/2 cups diced onion
  • 1 cup diced carrot
  • 1 cup diced celery
  • 3 large cloves garlic minced
  • 1 teaspoon paprika
  • 1 teaspoon mild curry powder
  • 1/2 teaspoon sea salt
  • 1/4 teaspoon dried thyme
  • Freshly ground black pepper to taste
  • 2 cups dried red lentils
  • 3 cups vegetable stock
  • 2 teaspoons chopped fresh rosemary see note
  • 1 - 1 1/2 tablespoons apple cider vinegar or lemon juice
  • In a large pot over medium heat, add 1 1/2 tablespoons of the water, onion, carrot, celery, garlic, paprika, curry powder, sea salt, thyme, and black pepper and stir to combine. Cover and cook for 7-8 minutes, stirring occasionally. Rinse the lentils. Add the lentils, the remaining 3 1/2 cups of the water, and stock and stir to combine. Increase heat to bring mixture to a boil. Once boiling, reduce heat to low, cover, and simmer for 12-15 minutes. Add rosemary and simmer for another 8-10 minutes or more, until lentils are completely softened. Stir in vinegar, and add more water to thin the soup if desired. Serve.
Rosemary Note: Fresh rosemary is quite exquisite in this soup, but if you don’t have it, you can use dried. However, if you’re using dried, add it at the beginning of the cooking process, along with the other dried spices, and use less, 1/2-1 teaspoon.
Recipe from Plant-Powered Families by Dreena Burton.
Catch my Health Tip Tuesday video on Facebook on Tuesdays to hear my health tip for the week! 
Share with your friends and family. Sharing and commenting along with liking or loving <3 increases the exposure so more people can become aware of the value of healthful living.

My Favorite Quotes
“All stress is Saboteur generated.”  
― Shirzad Chamine, Positive Intelligence

Important Disclaimer
The content in this newsletter is intended for educational/informational purposes only. It is not intended to replace the advice of your health care professional. 
hen Basics tea
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