A ketogenic meal is comprised of approximately 10% of calories coming from healthy carbohydrates such as leafy greens, non-starchy vegetables, and limited amounts of legumes and berries; 20% of calories coming from proteins such as omega-3-rich fish and grass-fed animal protein; and ~70% of calories coming from high-quality fats such as avocado, unsaturated and medium-chain triglyceride oils, nuts and seeds, and coconut.
This 10/20/70 ratio is a guideline for the macro nutrient distribution for a given day, including meals, snacks, and beverages. You may recommend a slightly modified ratio based on your physical activity and personal health goals. The diagram below highlights how the calories provided from carbohydrate, protein, and fat differs between a standard American diet and a typical ketogenic diet.
Here are some healthy Keto options:
Tennis is a great game for staying in shape. The fitness you develop from a tennis game has an added bonus: It carries over into the rest of your life. By playing tennis, you also improve your functional fitness or your ability to do ordinary things, like carry a sack of groceries in from the car or climb a flight of stairs. The better your functional fitness, the better you can get through all the usual activities of your typical day with ease—and with energy left over for tennis.
Exercises to build functional fitness aim to mimic the activities of daily living by working several muscle groups at once. They’re designed to improve your strength, flexibility, endurance, range of motion, and balance, because you need all those abilities every time you do something like pick up a toddler, or reach for something on a high shelf, or carry a briefcase. Because they build overall fitness, they’re also great for your tennis game!
Exercises for functional fitness
Functional fitness exercises focus on building a strong core and then working several major muscles groups of the body at once. The five exercises I suggest here are a good basic workout that doesn’t require any special equipment—you’re going to use just your body weight. Plenty of other exercises also build functional fitness, so once you’ve mastered these, change up your routine by swapping some other exercises in and out.
This most fundamental of exercises is key to a strong core—it engages your abs, lower back, hips, and arms. This is the one functional fitness exercise that should always be part of your workout routine, because your core muscles are continually engaged when you play tennis.
Two-Legged SquatThis is a great functional fitness exercise for building up and coordinating your leg muscles, especially the quadriceps, hamstrings, and calves—the muscles that control your knees and hips. By doing this regularly, you improve your ability to get up and down from chairs, pick things up off the ground, and climb steps. For your tennis game, strong legs give you a strong foundation for your strokes and improve your ability to transfer your weight.
The plain old push-up is one of those basic exercises we tend to overlook, but it’s great for strengthening your core, your gluteus maximus and the chest, shoulder and arm muscles. You’ll notice the difference when you’re lifting or carrying something heavy or reaching up to get something in or out of a cabinet. You’ll also see a difference in your strokes—strong arms and shoulders are key to good control.
Bird dogs, also known as pointers, are great for the muscles of the lower back and thighs and the upper arms. If you do these, you’ll notice the difference in anything you do that requires lifting or bending. You’ll find that you’re more flexible on the tennis court.
About Robert SilvermanRobert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR is a chiropractic doctor, clinical nutritionist and author of Inside-Out Health: A Revolutionary Approach to Your Body, an Amazon number-one bestseller in 2016. The ACA Sports Council named Dr. Silverman “Sports Chiropractor of the Year” in 2015. He also maintains a busy private practice as founder of Westchester Integrative Health Center, which specializes in the treatment of joint pain using functional nutrition along with cutting-edge, science-based, nonsurgical approaches. Dr. Silverman is a seasoned health and wellness expert on both the speaking circuits and within the media. He has appeared on FOX News Channel, FOX, NBC, CBS, CW affiliates as well as The Wall Street Journal and NewsMax, to name a few. He was invited as a guest speaker on “Talks at Google” to discuss his current book. As a frequent published author for Dynamic Chiropractic, JACA, ACA News, Chiropractic Economics, The Original Internist and Holistic Primary Care journals, Dr. Silverman is a thought leader in his field and practice.
View all posts by Robert Silverman →
If you’re trying to maintain a healthy weight, counting sheep may be as important as counting the carbs on your plate or weight repetitions at the gym. Because, while physical activity and a balanced diet are key factors, sleep may be the most overlooked aspect of your weight management plan.
Can you sleep your way to your dream body? Perhaps not. But if you are sleep deprived, more sleep may help you reach your weight goals. Here’s what you need to know about the sleep-weight connection.
Are you sleep deprived? The National Sleep Foundation recommends seven to nine hours of sleep per night for adults 24-64, slightly more for younger adults and a bit less for those older.1 But due to electronic gadget lights, chronic stress, habitual caffeine, shift-work, and many other reasons, few folks get their target rack time. In fact, according to the Centers for Disease Control, insufficient sleep is a public health problem2 with serious concerns for our productivity, safety, and health—including your waistline.
It’s not just when you’re sleep deprived and find yourself battling the bulge, you’re in good company. Studies have found consistency in the sleep-weight connection; sleep deficiency is linked to weight gain. The largest study of its kind involved over 200 participants and simulated a sleep-restricted workweek. It compared the effects of restricting sleep to only four hours per night compared to unrestricted sleep, up to ten hours per night.3 After only five days, the sleep-restricted subjects had gained about 2 pounds. In contrast, the control group, allowed to sleep for up to 10 hours a night, gained virtually no weight.
If sleep restriction can cause you to gain two pounds in just five days, what can happen on the scale long-term?A lot, according to women tracked for 16 years in The Nurses’ Health Study. Women reporting six hours of sleep per night were 12% more likely to gain at least 30 pounds during the study compared to the women who slept seven hours per night. But those women who were even more sleep deprived, reporting no more than five hours per night, were 28% more likely to gain at least 30 pounds during that same period!4 Apparently, with the sleep-weight connection, every hour counts.
How does less sleep = less svelte? There are several underlying factors behind the sleep-weight connection. But a common thread is our own chemistry, which almost seems to revolt when restorative sleep is intentionally or unintentionally withheld. It’s you against them—and it’s not a fair fight.
Getting to know your hunger chemistry. There’s more than your sensation of fullness and stomach-brain communication involved. Rather, when it comes to hunger regulation and sleep, we have several chemical messengers at play. And when it gets complicated between you and the sandman, those messengers are not on your side. So get to know them:
As you can see, proper balance of ghrelin and leptin is very sleep-dependent. And for the caveman, perhaps these hormones were key to survival during the shorter, sleep-heavy but food-poor days of winter. They also played a part in the ability to capitalise on the longer, lighter sleep and more food-abundant days the rest of the year.
Today, our sleep-deprived bodies are prone to having too much ghrelin and not enough leptin. The result is that the body doesn’t feel satiated, thinks it’s hungry, and needs more calories—and squirrels away those calories for the long winter. In short, ghrelin and leptin kept the caveman alive, but they may be making you heavy.
What to do?
That depends. There are two main reasons behind sleep deprivation. Either you have a sleep hygiene issue (trouble falling asleep or staying asleep), or you have a scheduling issue, in that your lifestyle is interfering with adequate sleep.
For sleep hygiene issues, the typical recommendations always merit consideration: limiting caffeine, avoiding blue light before bed, creating a cool and dark environment, etc. But, when you have a scheduling challenge, getting adequate sleep requires some lifestyle restructuring. It’s worth the time to re-engineer your schedule to slowly go to bed earlier or rise later to increase your sleep time. But in the meantime, can you catch up on sleep on the weekends?
Weekend catch-up sleep: Is it a real thing?Of course, you can get extra sleep on the weekend. But can it potentially reverse your Monday-Friday sleep deprivation? Perhaps. In a study of over 2,000 people participants, those who slept longer on the weekends, nearly two hours longer on average, had a significantly lower body mass index (BMI) than those who didn’t. Further, it appears that the sleep:BMI relationship was dose-dependent in that every extra hour of weekend catch-up sleep was associated with a significantly lower body mass.8 So catch-up sleep can indeed be a good strategy. That is, if your overall average sleep for the week puts you out of the red and into the black, as in you’ve paid back your sleep debt.
Sleep more. Weigh less. Not convinced? Sleep on it…
When following a ketogenic diet, it is not uncommon for people to neglect eating quality sources of fiber in an effort to avoid any carbohydrate intake. There is a chance this can lead to constipation, poor digestion, and a lack of certain vitamins and minerals.
What is fiber?Dietary fiber is the indigestible plant material that passes through our digestive system either completely undigested, or broken down via microbial fermentation, in the large intestine.1 Fiber aids in the removal of waste via the colon and is important for maintaining healthy digestion. Fiber is categorized as either soluble or insoluble, and each is digested differently.
Soluble fiber: Soluble fiber dissolves in liquids and becomes gel-like in the digestive tract.1 It slows digestion, increases satiety, and when consumed with carbohydrates can slow intestinal absorption and can help minimize increases in postprandial blood glucose.2
Soluble fiber is predominantly found in fruits and legumes, which are not advised on a ketogenic diet, and small amounts are found in vegetables.3 Soluble fiber ingredients are also commonly found in low-carb packaged foods, such as isomalto-olidosaccharides (IMOs) and soluble corn fiber.
Insoluble fiber: Insoluble fiber does not dissolve like soluble fiber does. This type of fiber stays intact and is responsible for what people refer to as “roughage” when speaking of fiber. This type of fiber aids in digestion and promotes elimination of waste by the colon.4
Insoluble fiber is the predominant type of fiber found in vegetables, especially the low-carb, non-starchy options that are fitting for a ketogenic diet.
Taking in fiber on a ketogenic dietFollowing a ketogenic diet is easy when you stick to fatty meats, eggs, oils, and full-fat dairy. However, by a strict intake of these foods, there is very little consumption of whole-food fiber in addition to a lack of micro nutrient intake. Moreover, low-carb, “keto-friendly” packaged foods, although providing ease of entry into a ketogenic lifestyle, are typically filled with soluble fibers. These soluble fibers contribute toward the majority of the daily carbohydrate count and lead to a lack of insoluble fiber in the diet. Consequently, due to the attempt to meet daily macronutrient ratios, there is a tendency to neglect all vegetables, even low-carb options, and thus losing out on insoluble fiber intake. A well-formulated ketogenic diet should not be void of fiber; some may even argue it provides more fiber than other diets. This is because a well-formulated ketogenic diet includes regular amounts of low-carb vegetables on a daily basis, along with quality sources of fats and protein.
Intriguingly, the fermentation process of insoluble fiber during digestion can also contribute to ketogenesis (i.e. the production of ketones). Fiber is broken down by the gut microbiome into short-chain fatty acids, such as butyrate,5 a molecule that is very structurally similar to the ketone body, beta-hydroxybutyrate. Subsequently, butyrate can be converted to beta-hydroxybutyrate and has been shown to increase blood ketone levels in humans.6
Fiber sources on a well-formulated ketogenic dietLow-carbohydrate fibrous whole foods, such as those listed below, are recommended as part of a well-formulated ketogenic diet to allow for entering and/or sustaining nutritional ketosis (defined as an elevation of beta-hydroxybutyrate (BHB) above 0.5 mmol/L). Consider adding these examples to your diet:†
Tips for consuming more fiber on a ketogenic diet:SaladsThis may be an obvious solution to a lack of insoluble fiber in the diet, and you may even be experiencing flashbacks from traumatic dieting memories you just can’t shake. However, a ketogenic salad should be an exception to this bias. If you have ever had a good salad, you know salads are underrated; they only become boring when you take away the fat—not an issue on a ketogenic diet. Gone are the days when you ask for “dressing on the side.” When you find a high-fat dressing you enjoy, you will begin to enjoy your salads!
Recommended ingredients: leafy greens (all types), avocado, hemp seeds, boiled eggs, fatty cuts of beef, chicken thighs, fatty fish, olives, nuts & seeds, artichoke hearts, high-quality oils, high-fat dressings (see below)
Sautéed & roasted vegetablesWhile from a glycemic standpoint there is an advantage to eating vegetables raw (due harder access to carbohydrates stored inside plant cells), sometimes eating cooked vegetables can bring a sense of comfort, and could translate to better compliance to a ketogenic diet. The best oils for cooking that can handle heat contain saturated and monounsaturated fats such as butter, ghee, avocado oil, extra-virgin olive oil, MCT oil, and coconut oil. Use of fresh or dried herbs and spices such as garlic, parsley, cumin, chili, oregano, paprika, rosemary, coriander, etc. will add additional flavors.
Recommended ingredients for sautéing: spinach, onion, mushrooms, kale, zucchini, cabbage, Bok choy
Recommended ingredients for roasting: Brussels sprouts, broccoli, cauliflower, onion, mushrooms, celery (don’t knock it ’til you try it!)
Chia puddingYes, pudding! Ketogenic chia puddings are extremely easy, cheap, and convenient to make and, most importantly, are full of fiber. The carbohydrate content of chia seeds is primarily fiber, 86% to be exact, and most of it is insoluble fiber! When chia seeds are soaked overnight, they absorb the liquid and take on a pudding-like consistency. Spruce up the chia puddings with some of the recommended ingredients below to avoid a flavorless gel and make sure to include healthy fats!
Recommended ingredients: chia seeds, flax seeds, hemp seeds, low-carb nuts/nut butters, sugar-free chocolate chips, cocoa powder, cinnamon, vanilla extract, MCT oil/powder, full-fat coconut cream, coconut butter, shredded coconut, unsweetened nut-milks, coconut oil, sea salt, sugar-free/low-carb protein powders
Dressings & dips Dressings and dips are like smoothies in that you can easily sneak ingredients into them. Adding fiber into dressings and dips makes food taste better, as well as being an easy way to get in those healthy fats! Use a blender to make these, and include dressings and dips with any savory snack or meal!
Recommended ingredients: spinach, kale, steamed cauliflower, raw or steamed zucchini, high-quality oils, tahini, herbs & spices, garlic, lemon juice, apple cider vinegar, full-fat yogurt (or dairy-free alternative), MCT oil/powder, avocado oil- or olive oil-based mayonnaise
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If you have ever walked down a grocery or health food store aisle containing protein powders, you’ve likely found that the sheer volume and varieties of protein supplements can be overwhelming and confusing. How do you choose the right supplement? How much should you consume? Will you be able to absorb and tolerate it properly?
Let’s take a closer look at the importance and requirements of protein and best available sources of protein supplements.
How Much Do You Need?
Proteins are the building blocks of life. They are a class of molecules that are a key structural component of all cells in the body. Protein is needed for growth and repair of the body and maintenance of good health. Additionally, protein is required for energy metabolism, muscle synthesis, cell signalling, immune responses, and enzymatic reactions.
The amount of protein we need is varied and changes throughout our lifetime. The Recommended Dietary Allowance (RDA) for protein is 0.8g/kg of body weight per day for healthy individuals aged 19 and older.1,2 This equates to approximately 55g of protein per day for a person weighing 150 pounds. This is the minimum amount needed to maintain nitrogen balance and prevent protein deficiency.1,2 But recent research indicates that the RDA requirements are not adequate to maintain optimal health, and in fact more protein is needed for women who are pregnant or lactating, older individuals, active people, and athletes.3-5
Animal vs. Plant-Derived Protein is available in a variety of dietary sources. These include foods of both animal and plant origin. Both animal and plant-derived proteins are made up of 20 amino acids.1 Nine of these are not synthesised by humans and are considered essential.1 Therefore, these essential amino acids have to be obtained from the diet.
Proteins from animal sources (eggs, dairy, meat, and poultry) are considered high biological value protein because they contain all nine essential amino acids. Plant-derived proteins (from legumes, nuts, seeds, etc.), on the other hand, typically lack one or more of the essential amino acids and are considered a lower biological value protein.
But when these proteins are combined (e.g.: rice and beans), not only do they provide a complete source of protein, but they also offer a protein profile that is lower in saturated fats and cholesterol.
What Is a PDCASS Score?
Powder supplements offer an easy, convenient, and reliable source of high-quality protein. The most common sources of protein supplements include whey and casein (animal-derived) and soy and pea/rice blend (plant-derived). Depending on the source and purification methods used to manufacture the supplements, a consumer may or may not obtain a high-quality product. The quality and digestibility of a protein is vital considering the nutritional benefits it can provide. It is very important to determine this since the quality of the protein refers to the availability of amino acids that it supplies, whereas the digestibility considers how the protein is best utilised in the body. Therefore, in 1989, the Food and Agriculture Organisation (FAO) along with the World Health Organisation (WHO) in a joint statement recommended utilising the protein digestibility corrected amino acid score (PDCAAS) to determine the quality and digestibility of a protein.6
Anti nutritional factors such as trypsin inhibitors, lectins, and tannins may be present in some protein sources, such as soybean meal, peas, etc., and may cause reduced protein hydrolysis and amino acid absorption.⁶ These factors may be compounded by age, since the ability of the gut to adapt to environmental and dietary insults reduces as we age.6
The PDCAAS score for whey protein is the highest at 1.0 compared to other common protein sources, due to their high content of essential and branched chain amino acids.7 Soy protein isolate is also considered a high-quality protein source (containing all nine essential amino acids) and contains a PDCAAS score of 1.0.7 Pea protein concentrate has a PDCAAS score of 0.89 because it contains lower levels of the sulfur-containing amino acids cysteine and methionine.7
Whey proteins one of the most widely used protein sources for supplementation. Whey protein contains a high amount of the amino acid cysteine. Cysteine has been shown to enhance glutathione levels and has strong antioxidant properties that are capable of helping to prevent damage to important cellular components in the body.6 It also contains a high concentration of branched chain amino acids (BCAA). BCAAs are important for their role in the prevention of muscle breakdown during exercise and tissue maintenance.6
There are different forms of whey protein: Whey Protein Concentrate (WPC) and Whey Protein Isolate (WPI).
WPC is about 80% protein and is created by removing water, lactose, and some minerals. WPI on the other hand contain protein concentrations of 90% or higher since there is significant removal of fat and lactose making it the purest form of protein.6 Unfortunately, the manufacturing process often leads to some proteins breaking down and becoming denatured, reducing the effectiveness of the protein.6 Therefore, even though WPI contains higher protein concentrations than WPC, whey protein concentrate contains more biologically active components. People who are lactose intolerant are able to utilise WPI more readily without experiencing many negative side effects.
Both WPC and WPI can be further hydrolysed. Protein hydrolysates contain di- and tripeptides and therefore can be easily absorbed.
Soy protein contains beneficial phytonutrients such as phytosterols, saponins, and isoflavones. These nutrients have been associated with positive cardiovascular benefits, menopausal symptoms, and osteoporosis.6
Soy protein can also be found in various forms: soy protein concentrate and soy protein isolate. Concentrates have some fat and carbohydrate removed, providing about 70% protein content.6 They have a high digestibility and are usually found in nutrition bars, cereals, and yogurts. Isolates are further refined, lacking dietary fibre but provide 90% protein content.6 They are easily digestible and can be found in protein supplements and infant formulas.
Pea/rice protein blend is recommended if you have a milk protein allergy/sensitivity, are avoiding soy products, or consume a vegetarian diet. Including a pea/rice blend protein powder is an alternative to whey protein, has a high PDCAAS score, and provides all nine essential amino acids.
Pea protein also contains a variety of phytonutrients such as polyphenolics, which may have antioxidant activity; saponins; and galactose oligosaccharides, which may demonstrate beneficial prebiotic effects in the large intestine.8
Whether you are using these supplements as a meal enhancer, snack, or a post workout drink, adding a high-quality protein supplement will help meet your daily protein needs. Metagenics provides a variety of protein options; work with your healthcare provider to figure out the amount and type of protein you need for optimal health.
About Nilima Desai
MPH, RD, Metagenics Manager, & Medical Marketing Nilima Desai is a Registered Dietitian who received her undergraduate degree from California State University Long Beach in Nutrition and Dietetics and her Master’s in Public Health Nutrition from Loma Linda University. She has over 14 years of experience providing medical nutrition therapy in diabetes, renal disease, weight management, and vegetarian nutrition. She also served on the board of the Renal Practice Group of the Academy of Nutrition and Dietetics from 2012-2016 as the Membership Chair. Her passion about living and teaching a healthy lifestyle led her to collaborate with a nephrologist on creating the Pocket Dietitian app, which offers the user personalized, easy-to-use dietary prescription on conditions such as diabetes, hypertension, renal disease, weight management, etc. In her free time she runs half marathons and shuttles her two kids to their activities.
Dining out should be relaxing. But if you have a gluten sensitivity, a bit of skepticism should be on the menu. Typical recommendations, such as seeking a gluten-free menu and letting the server know about one’s dietary restrictions, may give the diner a false sense of assurance.
Here’s why—and how—gluten digestive enzymes can improve your dining experience.
Is the Gluten-Free Menu Really Enough?
First, consider economics. While awareness for the concerns of gluten-free customer is growing, the restaurant industry is challenged by slim margins and regular employee turnover. Further, appropriately accommodating these customers requires much more than simply stocking gluten-free breads and pastas. So, if a restaurant invests in the training and infrastructure to adequately support the needs of these customers, it will likely promote its efforts and will welcome questions.
Second, not all restaurants have a gluten-free menu, leaving the diner to navigate the standard menu. Unfortunately, it’s not a good idea to assume anything about the ingredients on any menu, especially those of chain restaurants, often the only option for a traveler.
Discerning gluten-free diners need to ask some very specific questions to determine the risk for gluten exposure from raw ingredients or cross-contamination. But will a well-meaning airport restaurant manager have the answers?
Some Questions to Determine Possible Gluten Exposure
How Can the Right Enzymes Help?
Gluten-sensitive patients will always need to wear their detective hat when dining out. However, medical professionals can support them by recommending targeted support to break down hidden gluten enzymatically. But which gluten enzymes might help the most?
SpectraZyme Gluten Digest is a bacterially derived, clinically researched prolyl endoprotease (AN-PEP). It has many advantages over popular market offerings that feature exoprotease proteolytic enzymes, also known as didpeptidyl peptidase IV (DPP-IV). In short, the AN-PEP is more effective in the low pH environment of the stomach with or without the other enzymes naturally present in the digestive tract.
SpectraZyme Gluten Digest is also a proline-specific endoprotease. This means it can specifically cleave the gluten and gluten peptides after any of the many proline residues, breaking down protein over the entire length of protein and peptide chains, not just at the ends. As a result, the enzyme breaks up the gluten more completely. So less hidden gluten will reach the duodenum
Gluten-sensitive individuals can’t avoid all gluten exposure. But, with SpectraZyme Gluten Digest, they can minimize their risk when dining away from home.
About Maribeth Evezich
Maribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods. as much as she does. She lives in Seattle and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics.