Keto Clarity ~ A Review of the Chaos and Confusion in Memes

Those who follow me on social media know that I broke down and purchased a copy of Keto Clarity.   I'm deciding on whether to bother with a formal review of the book or Jimmy Moore's contribution.  With respect to Jimmy Moore, this is a second volume of convincing himself and the world that his crazy diet schemes are healthy rather than unhealthy, as if repeating it often enough will make it so.  

But for the rest of the world, it is more Dr. Eric Westman's stamp of approval and co-authorship that is problematic for his credibility.  In Cholesterol Clarity, he signed off on a book where Jimmy's horrific lipid panel including, at times, LDL-P over 3000, LDL-C over 300, TC over 400.   In Keto Clarity, the fact that Jimmy Moore's biomarkers did NOT improve, despite a temporary weight loss of almost 80 lbs, is magically presented as a healthy dietary lifestyle.  

The chaos and confusion comes in when one looks at all of the various claims made for low carb diets, Atkins specifically, over the years.  Atkins WAS initially marketed as successful because of ketosis and peeing out excess calories.  Now it's not even ketogenic?  But it is, but it's not, but it is.  Make up your minds!  

For now, I have been Tweeting out various "memes" highlighting contradictory and/or irresponsible information from Dr. Westman -- who co-authored The New Atkins for a New You, and who has his Duke clinic diet plan included in the Appendix of Taubes' Why We Get Fat -- because he is, after all, a doctor specializing in the treatment of obesity.  

It is ironic, or perhaps not, that Jimmy Moore's battle to maintain his losses has only gotten worse since he visited Westman as his "low carb doctor" in the Summer of 2008.  

Without further ado, here are some memes thusfar.  I'll probably sprinkle in some of those Moments of Clarity here and there, and bump this post every now and then.

You should be able to click on all images to view larger (or right-click on them and open images in new tab and use your browser zoom to view larger).

This meme includes sections of Ketogenic Diets: Treatment for Epilepsy and Other Disorders by Doctors Kossoff, Freeman, Turner and Rubenstein.  It is important to note that Kossoff wrote the forward to The New Atkins which included numerous references to ketosis in the context of epilepsy treatment, but made no mention of desiring or monitoring "nutritional ketosis" as a part of the success of the diet for weight loss.  

In this meme I call out Westman for his obvious hypocrisy.  His involvement with a 10-day nasogastric feeding diet only takes this up several more notches.

In this meme, I point out the contradictory nature of Westman basically celebrating Jimmy's butter gorging antics and contrast them with the section in The New Atkins where fat and calories are addressed for those who stall in weight loss.  It is important to realize that the picture of Jimmy (predating the half pound of butter as meal stunt) is from January 2014 and Westman witnessed this in person.  Some 8 months after ending his experiment, but still "thriving" in nutritional ketosis, he had again visibly regained weight.  Given as Jimmy's only real personal claim for the glories of NuttyK is weight loss, this is more than irresponsible of the doctor.

This one is just funny.  "They" say that the weight loss is just water based on an unnamed study.  Nobody doubts that fat is lost on "ketogenic" diets in the long term, but the large early losses are irrefutably dominated by water weight losses.   But the funny thing is that Westman then considers this water weight (that wasn't lost) returning when you eat carbs.  


charles grashow said…
Let the good Dr Westman discuss the diet in his own words
charles grashow said…
Another of the experts in the book

Zeeshan Arain - Should We All Be on A Ketogenic Diet?
charles grashow said…

Jimmy Moore - 'Nutritional Ketosis'
charles grashow said…
Compare how he looked in 2012 with how he looks now (AHS14) and tell me that his diet is working!
Nigel Kinbrum said…
Funny how he didn't have a "BFL after eating" graph. Fat would have given the biggest spike. Funny how he didn't have a "BPL after eating" graph. Protein would have given the biggest spike.
I stopped watching at that point. Biased garbage.
Nigel Kinbrum said…
Thanks for clarifying that.

I still think that a properly-done short-term PSMF a la Lyle McDonald's Rapid Fat Loss Handbook is the best approach for those who can handle that type of diet without getting uncontrollable cravings. It rapidly (within 8 weeks) clears liver fat, something that a LCHF diet doesn't do.
Kitty said…
"When you change your lifestyle, you're not supposed to go back to eating the same amount of carbohydrate that you did before..."

... Because your metabolism is now so screwed up that you can't even eat carrots without sending your blood sugar into the stratosphere and gaining ten pounds of water bloat. Keto advantage! I think I'll stick to being a sugar burner, since, unlike the "fat burning beasts," I am able to eat salad without having to change pants and lie down for an hour.

I love that Westman can vouch for the high-fat eating habits of a patient who is obviously gaining weight and losing muscle. Does he think that anyone was shocked to see a guy who looks like Jimmy eating the "Defibrillator" with butter? It sounds like a perfect meal for maintaining one's morbid obesity.
EJ said…
The Lyle McDonald protocol is meant to be for 11-12 days, like if you want to look good at an upcoming event. Jimmy Moore lost a lot of weight during the first 11-12 days of his experiment as well.

The problem isn't really short term weight loss. Anyone can lose weight on a two-week diet. The problem is sustainability and avoiding potential weight regain. This is much more tricky and there's very little good information about it.

I hadn't heard of the Lyle McDonald protocol, so I've only just skimmed it. A couple of nits - it claims to be whole food based but then has things like fish oil supplements, flax oil supplements, skinless chicken breast, fat-free dairy, egg whites, diet soda, Crystal Light. These aren't actually whole foods. Not that it matters too much for an 11 day diet.

However, I really don't understand when dieticians call for lean fish AND fish oil supplements in the same diet. Ornish does this same thing and it irks me. Why not simply recommend small, sustainably-caught fatty cold-water fish such as sardines, mackerel and herring? A 100 gram can of sardines contains approximately 5,000 mg of unrefined fish oil, including approximately 2,300 mg of Omega-3.

I do agree that a small amount of fish and an enormous amount of non-starchy vegetables is a great weight loss meal, and that it can become a good weight maintenance meal simply by adding a moderate amount of rice, potatoes or green peas.

I see this same thing in the HFLC circles. A can of fish and an avocado and a bunch of green leafy vegetables is high fat, low carb, moderate protein, nutritionally dense, probably ketogenic, etc etc. Same with a curry made with lots of veggies, coconut milk, some anti-inflammatory spices and a small amount of meat.

But butter is not a whole food. Coconut oil is not a whole food. Heavy whipping cream is not a whole food. And a stick of butter in a cup of coffee is not the same as "fasting".
Nigel Kinbrum said…
Supplements are a good idea for a "whole food" diet that contains sweet-F/A food!

Good point about the oily fish. It may be that many people don't like the taste of oily fish, so lean protein + FO caps caters to a wider audience.
Nigel Kinbrum said…
The thing is that a PSMF depletes liver glycogen and liver fat (unlike a LCHF diet), so after a PSMF, wet carbs* and fats can be added back in. I.E. A relatively balanced diet can be eaten.

charles grashow said…

Originally Posted by Lyle McDonald

Getting Rid of Stubborn Bodyfat- by Lyle McDonald

Without going into the brutally long and complicated mental computations
that led me to this (and I'm still working on the overall scheme),
here's my current thoughts on how to approach it.

First and foremost, this is one of the places where morning/pre-breakfast cardio is probably crucially important.

An hour or two before cardio, take 200 mg caffeine with 1-3 grams of L-tyrosine (NO ephedrine).

There are two segments to the cardio:

- The first segment is for mobilization, to get those stubborn fatty acids out of the fat cell.

- The second segment is the oxidation part, to burn them off in the muscle.

For the first segment of the cardio, use a machine that you don't
normally use. So if you normally do the treadmill, do the first segment on the stairmaster or bike or something. Just make it different.

First segment:

warmup: 3-5 minutes

go hard: 5-10 minutes. I mean hard, as hard as you can stand for the entire time. This will NOT be fun on lowered blood glucose. I've
considered putting intervals here but haven't found the data I need to make up my mind. If you do intervals, go something like 5X1' all out with a 1' break (10' total intervals)

Rest 5', just sit on your butt, drink water, try not to puke.

Go to your normal cardio machine. Do at least 30 minutes at
moderate/high moderate intensity (below lactate threshold but decent intensity). I'd say 45' maximum here but I'm still making up my mind and looking at data.

Go home, and wait and hour before having a small protein meal (25-50 grams or so). No dietary fat. 2-3 hours later, go back to normal diet eating. Your daily calories shouldn't be any different than they were already, they are just distributed differently, you only have 100-200 immediately after cardio, and then the rest afterwards.

I'd do that maybe 3 days per week to start, and see what happens.

Why this works

To get stubborn fat mobilized, you have to overcome a fairly severe resistance in terms of both blood flow and lipolysis, this requires very high concentrations of catecholamines (adrenaline/noradrenaline). Sadly, jacking up levels of catecholamines (necessary for mobilization) limits burning in the muscle which is why you follow the high intensity with low intensity.

Basically, you jack up levels to get the fat mobilized, and then let
them fall so that the fatty acid can be burned in the muscle.

I have a study showing that Ephedrine before intense activity lowers the catecholamine response, that's the reason for avoiding it. Studies also show a lower than normal catecholamine response as people adapt to a given type of cardio; doing a different machine will result in a higher catecholamine response than you'd other wise get.

The bigger problem with stubborn fat has to do with:

- Blood flow to the fat cells: which is typically very low, odds are
your butt is cold to the touch compared to other areas of your body

- It's harder to mobilize: both because of impaired blood flow, and because of adrenoceptor issues.

Oral yohimbe (0.2 mg/kg) can be effective when used over the long term. Don't take it within 3-4 hours of taking ephedrine, and start with a half-dose to assess tolerance (some people get really freaky responses from it). IF you can find pharmaceutical yohimbine, it's far far better than the herbal version (and most of the herbal versions are crap, the only one I trust is Twinlab Yohimbe Fuel).

Taking the yohimbe with caffeine prior to morning cardio does seem to help with very stubborn fat.

The Stubborn Fat Solution is aimed at lean dieters trying to
achieve extreme levels of leanness. Until men are 10-12% body fat and females are ~15-17% body fat, the information in this book is not necessary (although it will still be informative).
Steve G said…
Well, do more skimming, you're review was "just a bit outside" Of course to do that you'll have to buy the book. Or I suppose pirate a first addition. The diet can last for days, weeks or months depending on what body fat category the dieter falls in.

And based on your theory of what constitutes a whole food, if I want anything made from a coconut must I pulverize the entire "whole coconut" and eat the goo. A "skinless chicken breast" is not a "whole" food? Why, because it skinless. Well then, I must eat the entire chicken feathers, entrails and all for it to be a "whole" food.

Do you eat the stems of your fruit, the skins of avocado & grapefruit. Not trim the fat from "skinned" beef and pork. Do you indulge in dairy, it's pasteurized, been altered, missing things, not whole.

Good grief!
Lighthouse Keeper said…
I agree with your point about tinned sardines but watch out for absolutist whole foodism. For instance, why a vegan can't have a couple of teaspoons of flaxseed oil because it is no longer a whole food having been pressed from the seeds is beyond me.
Paleo Nouveau said…
It's one thing for any of us "armchair quarterbacks" to make claims that are based on nothing much other than conjecture. However the to have professionals with accredited degrees fall do this is totally different. They are in a position of influence that is far more persuasive than the rest of us & should have the proper scientific background to know better. Looking at JM's blog and interactions it is evident that he is influencing many as well. Sad. How can you claim to be a weight loss guru while battling weight gain at every turn?

Unfortunately he is not only gaining & losing weight constantly but it seems he is decimating his health at the same time. Worse even is he is encouraging others to do the same.
carbsane said…
Yeah, the biggest issue is the encouraging of others to follow suit and misrepresenting what is known about the potential side effects of the diet. In his podcast with Sean Croxton, Sean repeatedly chided Jimmy how he could be making money on keto supplies! I mean, nevermind that the diet is not indicated for various conditions? Sigh.

Westman is being utterly irresponsible lending his name to this fiasco.
charles grashow said…
I use FO as part of a protocol to try to stabilize/regress my CAC
Nigel Kinbrum said…
Luckily for me, I love oily fish. Sardines in tomato purée are a favourite. Smoked salmon is another. Just had 200g of smoked salmon!
Same angle repackaged and under another new figure. Same talk points. Same arguments. It's like the same old goods from 2007.
carbsane said…
I purchased the book. It is horrible.

I will continue to add info as I am able to.
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