An Easy On-Ramp to the Keto Diet with Dr. Josh Axe

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Do you want to start feeling better?

Yes, Where Do I Start?

An Easy On-Ramp to the Keto Diet with Dr. Josh Axe

The ketogenic (or keto) diet emphasizes high fat, low carbohydrates, and medium protein intake. In some studies, the keto diet has been shown to benefit sufferers of epilepsy, insulin regulation, polycystic ovary syndrome (PCOS), infertility, glioblastoma, and more. One common misconception is that you must be on the diet forever for it to be valuable. Beginners to the diet may want to start slow, replacing some of their carb intake with healthy fats. Ayurvedic and Chinese medicine have lessons to offer about the value of herbs, synergistic effects, and the overall body environment. On any diet, whether paleo, keto, Mediterranean, or another type, it’s important to emphasize high-quality whole foods.

Dr. R’s Fast Facts Summary

Benefits of keto

  • Insulin balancing
  • PCOS, infertility
  • Brain health
  • Diabetes and weight gain

Long term application

  • Try 30-90 days then transition to a paleo diet
  • Great diet to cycle in and out of as needed

How does intermittent fasting tie in?

  • Can be used synergistically with keto

Food quality

  • Incorporate good quality foods like avocado, coconut oil, almond butter etc. vs processed cheese and bacon

Common Problems & Helpful Supplements

  • Get a lot of electrolytes in your system
    • Celery Juice
  • Eat more veggies ⅓ of your plate
  • Take more herbs and spices
    • Take adaptogenic herbs
    • CBD oil
  • Practice lowering stress hormones
    • Go for walks
    • Take baths
    • Deep breathing/Yoga
  • Get moving
    • Walking is great
  • Don’t go overboard on oils
    • Eat foods with natural oils like avocado, almonds, olives

In This Episode

Episode Intro … 00:00:40
Benefits of Keto Diet … 00:05:34
Is the Keto Diet a Forever Diet? … 00:10:58
How to Start the Keto Habit … 00:19:28
The Importance of Whole Foods … 00:22:03
Lessons of Ayurvedic & Chinese Medicine … 00:24:36
Keto Diet for Beginners … 00:31:31
What to Eat on a Keto Diet … 00:37:41
Episode Wrap Up … 00:41:04

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Episode Intro

Dr. Michael Ruscio, DC: Hey everyone, welcome to Dr. Ruscio Radio. This is Dr. Ruscio. Today I am here with Dr. Josh Axe. We initially met about two or three years ago at a Paleo f(x) conference, and had a chance to sit in a panel together and chat.

You have a new book coming out, and you pinged me and wanted to come on and talk about it. So we’re going to be talking about your new book and your keto approach. We were just chatting off air about how you incorporate some traditional Chinese medicine into your approach, which I thought was very interesting. I’m looking forward to digging into that and all things keto. So, Josh, welcome to the show.

Dr. Josh Axe: Hey, Michael. Thanks for having me. Appreciate it.

DrMR: Yeah, it’s good to have you here. Tell people just really briefly about you and your background for anyone who hasn’t come across your name before.

Keto Diet

DrJA: Sure. So I got into the natural health industry through a health crisis in my own family. Right now, I run It’s a large natural health website, and I am also the co-founder of a nutrition company called Ancient Nutrition where we focus on creating products that are based on traditional Chinese herbalism, Ayurveda, and other ancient superfoods like bone broth and herbs like turmeric. Anyway, that’s a big focus today. But I got into the natural health industry originally through, again, a health crisis. My family growing up, Dr. Michael, was really into fitness, but not really into health or nutrition. So at 40 years old, my mom was diagnosed with cancer, and we didn’t know any better and didn’t know there were alternatives.

She went through all the conventional medical treatment. She had a mastectomy and went through chemotherapy. And I remember just how sick she got, her almost dying and her losing her hair. At the time, I was just a kid in junior high, thinking, there’s got to be a better way here for somebody to heal. So my mom went through those treatments and eventually she was diagnosed as being cancer-free. But after, she actually seemed sicker than ever. She was diagnosed with hypothyroidism, chronic fatigue syndrome, digestive issues. She got put on several medications, including antidepressant drugs. The biggest memory of my mom was she was sick and tired all the time.

10 years later, I was in school just trying to learn, and studying to become a doctor. I got a call from my mom the year before I graduated, and she said, “I’ve got bad news. I’m just been diagnosed with cancer, and they want to go in and do surgery and radiation. What do I do?”

Keto Diet

And I said, “Mom, I’ll be home.” I flew from Florida, where I was in school, back to Ohio, where I grew up. And we just felt led to take care of her all naturally. I spent some time online, talking to mentors, and also researching. In my researching on diets for cancer, I came across a study on the keto diet. I started reading about how cancer cells may feed off of sugar and a form of fermentation, and that you can starve cancer cells. So part of my mom’s protocol was going keto, removing all carbs and sugar, aside from a few berries, beets, and carrots.

Then I came across another study, or an article, referencing vegetable juicing and something called Gerson Therapy. So we incorporated juicing in there, and also started reading studies on different types of Chinese herbs and mushrooms like reishi mushroom. So I put together a sort of anti-cancer protocol that included the keto diet with lots of vegetable juicing, green vegetable juices, and certain Chinese herbs and treatments. My mom followed this protocol for about four months. She went back to her oncologist’s read of the CT scan. The next day they called us and her oncologist said, “This is highly unusual. We don’t typically see this, but your tumors have shrunk in half.” They said, “We want to see you again in nine months.” She went back nine months later. She was in complete remission.

Today, it’s been 13 years. My mom’s in the best shape of her life. In fact, my mom’s turning 67 this year and says she feels better now than she did in her 30s. When I opened my practice, I had more of a functional medicine practice. We did chiropractic, diet therapy, physical therapy. But we took care of the whole person. That led me into what I do today, which is running my health website and newsletter, and also our supplement company.

DrMR: So did she have cancer twice? Was it once when you were in junior high and once when you were near graduating?

DrJA: She did, yeah. The first time we went conventional, and the second time we went completely natural.

DrMR: Gotcha. And was it breast cancer both times?

DrJA: No, it was breast and then actually lung.

DrMR: Gotcha. Wow. Poor mom. But glad to hear she’s doing better.

Benefits of Keto Diet

DrMR: So there’s definitely some research, to my knowledge, about the anti-carcinogenic effects of ketogenic diet. And I think it’s mostly well-studied in glioblastomas. I’m pretty far from that literature, so I don’t want to speak too far out of my area of expertise. But certainly there’s been some documentation that ketogenic diets can be helpful with cancer. Neurological is another area that comes to mind, also metabolic. What are some of the benefits from keto dieting, if people haven’t heard of these before?

DrJA: Yeah, and it’s one of the things that I do reference in my new book. By the way, we quote a lot of medical literature, but I break it down. It’s super easy to understand and it’s a easy read.

So you’re right on glioblastoma, there were a couple of studies. There’s another study going through that it may help with colon cancer, breast cancer, prostate, and some others. So it’s newer research, but that came up more recently. I think one of the big reasons, Michael, why it can be so effective, is its ability to balance out insulin very quickly, and also getting you in a state of ketosis. But insulin is one of those hormones that affects many other hormones in the body, and there are a lot of conditions that are affected by insulin.

Keto Diet

For instance, there are studies showing that keto diet can benefit PCOS (polycystic ovarian syndrome), and also infertility issues. PCOS is primarily an insulin issue. If insulin is imbalanced, that affects ovarian cysts and different hormones in the body. Alzheimer’s disease is sometimes referred to as type 3 diabetes, and is very connected to insulin, as is of course diabetes and weight gain. So I think one of the top ways the keto diet can benefit the body is, it is probably the quickest way to start balancing out insulin. And that has a tremendous effect on many organ systems. I think different organ systems have to deal with different macronutrients or other things. But your stomach, your kidneys, and parts of your liver have to deal with protein. Your liver and gallbladder deal with fat.

Your pancreas is the primary organ when it comes to breaking down carbohydrates. It just has to do a lot. I think it’s important to remember: none of these herbs heal you. Your body heals itself. So when you remove carbs on a keto diet, your pancreas is not having to do work. So it finally has a chance to regenerate itself. I think of all of the macronutrients, carbs are the most heavily over-consumed, especially in processed forms like high fructose corn syrup, processed sugar, and everything else. So it’s probably, in many people, the organ that needs the most support and regeneration.

All that being said, I think the biggest benefits of keto, one, are insulin and hormones. Number two is your brain and nervous system. Your brain loves using ketones for fuel. I think it’s great for quick weight loss and metabolism, in regards to things like diabetes, and, in some cases, gut health. There’s an animal study done on autistic spectrum disorders, and keto was shown to be supportive of lowering candida and improving behavioral outcomes and that sort of thing with the way it balanced gut bacteria. Overall, insulin issues, brain issues, metabolism, those are the biggest benefits.

Keto Diet

DrMR: It’s interesting you say that there’s a study showing benefit for colon cancer. In my book, I reviewed a number of studies that found that you don’t have to eat a high carb, high prebiotic, high fiber diet in order to have a healthy colon. It’s not to say that those things would be a bad idea. But one of the biggest things I’ve been confronted with as someone who focuses on gut health is, geez, is it bad for my gut if I eat low carb? Because low carb diets tend to be lower in fiber and prebiotics.

And there are always outliers, but the general trend seems to show that you can do just as well from the gut health perspective, if not better—especially if you have a sensitive gut—on a lower carb diet. So that doesn’t surprise me, that finding for colon cancer. Now again, I don’t think either one of us are advocating that if someone has colon cancer, they blow off all the recommendations and just go keto.

DrJA: Exactly. Right.

DrMR: But it’s an interesting data point to consider. Another thing you said I think is really interesting to touch on is that carbohydrate overconsumption is likely the main macronutrient that’s most skewed. We recently spoke with Christopher Gardner over at Stanford about his DIETFITS Trial. He put people on a healthily constructed low-carb diet, compared to a heavily constructed low-fat diet. Even the people going on the low-fat diet (which is going to be by definition fairly high carb), when compared to their baseline diets, ended up decreasing their carb intake. So it does seem that overindulgence in carbs is probably the one macronutrient that can be attended to the best, in terms of the three macronutrients: protein, carbs, and fats. I think that makes the keto approach timely.

Is the Keto Diet a Forever Diet?

There’s something else that you said (before we started the recording) that I think is important to touch on, which is: the keto diet isn’t necessarily something that people have to do forever. I think it’s important just to lay that foundation. I see in my area, when it comes to elimination diets of various stripes—whether it’s a paleo diet or a low-FODMAP diet—people think they do it forever.

And really, the goal tends to be that you eliminate problematic foods and then eventually reintroduce them. It sounds like you’re advocating that same approach for a keto diet, but can you expound upon how you see this in more of a longer-term application?

DrJA: Yeah. So, you know, it’s a great question. I think one of the things to remember is the keto diet was rediscovered. So again, people have followed this diet before this. But in the 1920s at John Hopkins University, they were having children with epileptic seizures fast. They found that when the kids started fasting (eating nothing or just water or something very simple), their seizures went completely away in most of the kids. What they decided was, we need to find a diet that mimics fasting to help these kids. So they tried some different things, and found when they put these kids on a keto diet—high fat, low to moderate protein and very low carb—the epileptic seizures also stayed away. When you’re fasting, your body gets into a state of ketosis. It starts burning your own body fat as its source of fuel, breaking down that body fat using ketone bodies as your source of energy.

Keto Diet

The keto diet is the only other diet, aside from fasting, where your body does that. That being said, I believe the keto diet should be done in a similar way to long-term fasting. It’s great for our body to get in a state of ketosis. It’s great to run like a hybrid car where your body can burn both fat and carbohydrates for energy. I would say a low-carb Crossfitter is probably dipping into ketosis fairly frequently. And I think a lot of times too, Michael, people think that ketosis is black or white. You’re either in it or you’re not that. It’s a spectrum. Ketosis is a spectrum, so you can be in heavy ketosis, you can be in a light state of ketosis. You could dip in and out of ketosis over time.

All that being said, for myself and the people I’ve cared for, I don’t typically recommend a keto diet for their life. There are some civilizations, Eskimos, potentially the Hunzas, and some others, who may have lived more in a state of ketosis. But I think for a lot of people, just like fasting, you’re resting a system of your body. You’re allowing your body to adapt and use another source of fuel. So with most people I work with, I say do a keto diet for 30 to 90 days. Let’s reset those insulin levels. Let’s give your pancreas a rest, like doing a cleanse or a fast. Do that for 30, 90 days. And then let’s get on a very clean, anti-inflammatory paleo diet. Or let’s move into keto cycling.

One of the things my wife did for awhile was two keto days and then a carb day, two keto days and a carb day. On her carb days, it was kind of a cross between keto and carb cycling. On her carb day, she’d eat more berries. She might have a sweet potato. So she ate really clean, healthier carbs and not a giant piece of pizza. Somebody can do keto cycling or paleo, and then that’s a great follow up. But for most people the keto diet is like a long-term fast or cleanse. It’s really not a lifetime diet.

DrMR: Yeah, and I’m glad you said that, to help people with the perspective that this can be a tool to kickstart your metabolism, help reshape satiation mechanisms, and what have you. From there you can segue into a more middle-of-the-road diet where you’re not necessarily going super low, and then you can use it periodically. I’m sure most people that use this will notice, “Okay, I’m getting off the rails. I’m eating more chips and snacking more, I’m eating more of these high-carb foods.” They’ll likely feel themselves drift, as I have, into this carb quicksand where they periodically need to do something to help jolt them out of that. The first time I noticed that was actually with intermittent fasting, where I was starting to eat more carbs. Then I did a 24-hour intermittent fast and my carb cravings, when I went back on normal foods after that, were just gone. That’s a good question to segue us to: how does intermittent fasting tie into this?

Keto Diet

DrJA: Yeah. So I’m a huge fan of intermittent fasting. I think it’s this principle I talked about earlier. It’s important to remember there’s not a single food that heals you. Turmeric doesn’t heal you. Coconut oil doesn’t heal you. The body heals itself. Think about this… if you have a cut on your hand, what does it need? It just doesn’t need to get infected. You’ve just got to keep it protected and it will heal itself. But if you have a cut on your hand and every day you’re scraping it, using it, it doesn’t heal or it doesn’t heal as fast.

Think about your organs in the same way in your body. Your digestive system is working and working and working all the time. And it doesn’t get to heal itself. That’s why fasting of all types, including intermittent fasting, where maybe you skip breakfast and you eat your meals in between a four- and eight-hour window, is healing. Maybe you eat at 1:00, you have a snack at 3:30, and then eat again at 7:00. Maybe there was a six-hour window where you weren’t eating. If that’s the case, then your body now has 18 hours to heal and regenerate itself. That’s why, especially for gut issues, doing intermittent fasting or intermittent fasting plus keto is beneficial, especially for gut-related issues and autoimmune disease. Your body really can take time to heal itself.

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Keto Diet

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Keto Diet

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How to Start the Keto Habit

DrMR: Do you find there’s a benefit to on-ramping? Let’s say someone hasn’t been eating the greatest diet, they might be stuck in that carb quicksand that I described earlier. Do you find that starting them off with a short fast helps them better adapt to the keto diet?

DrJA: It’s a great question, Dr. Michael, and I actually cover this in my book Keto Diet. I will do one of a couple of things. One of those things is what I call a “feast period” for a week. Before somebody goes keto, I have them just try to eat more healthy fats and less junky carbs for seven days, prepping their body for that, and then do keto. Or again, doing that combination of intermittent fasting plus keto together is really powerful. But I think doing either/or is great.

DrMR: Gotcha. One thing that just shot in my mind as we’re talking was, for people who think, “Oh gosh, I could never do keto,” I do think there’s a subset of people that have to be careful with keto. And these are people who are burnt out, not sleeping well, and underweight. But that aside, I’m more speaking to someone who may be saying to themselves, “Well, geez, I really love my carbs, I need my carbs.”

We had a patient just the other day who went onto the paleo diet and she said, “Gosh, I was amazed at how I just don’t crave those foods anymore.” So there’s definitely something really powerful here regarding satiation. If you’re listening to this or reading this and you’re thinking, “Gosh, I don’t think I could cut out my rice or whatever it is,” I think you’d be really shocked once you get off that blood sugar rollercoaster. You can look at a food that used to be heavenly appealing and not have that desire for it anymore (for one of the main reasons that you touched on earlier, Josh, the insulin regulation).

DrJA: Yeah, I’m with you. I had somebody ask me that earlier: “Is this diet harder than other diets?” My answer was I think once it gets out of somebody’s head that “I can’t have carbs,” you stay really full on this diet. In fact, I’m more full on a keto diet than any other diet I’ve ever been on. When you’re eating fat, fiber—at least when you’re doing the keto diet the right way, the way that you and I promote it, you’re eating lots of healthy fats, fiber, and some protein—you stay really, really full.

The Importance of Whole Foods

DrMR: Let’s go into food quality, because that’s a good transition. Atkins was probably the first guy on the scene here. And he had the theory right, I think. But with some of these highly processed fats, I think it’s easy to argue that we need to modify. Atkins actually has been updated to a more modern Atkins program, which looks at healthier fats and also making sure that you don’t forget about things like vegetables. So let’s talk a little bit about food quality, because I think that’s an important thing for people not to get wrong.

Keto Diet

DrJA: Yeah, I’m with you on that. Let me just say this too, Michael, because this happened with Atkins. It’s happened with paleo, it’s happened with vegan, it happens with diets in general. I think people always have to know, you’ve got to eat real food on these diets. I was on Instagram or Pinterest the other day, and I saw a recipe. I’m not kidding you, the recipe was like, one of the ultimate keto meals. I clicked on it, and they took conventional cheese and fried it in butter. Then they put bacon in the middle and they fried another layer and made a crispy cheese topping. It was a keto quesadilla with fried cheese. But that happens on keto, it happens on lots of different diets. I guess macronutrient-wise, it is.

The thing people have to remember is—and this is the way I laid it out in my book, it’s the way you teach people in your book on gut health—you’ve got to eat real food, you’ve got to eat healing foods. So in my keto meal plans and in the book, for breakfast it’s a keto collagen smoothie. It’s coconut milk, it’s avocado, it’s almond butter, it’s collagen, and maybe a half a cup of blueberries. Then it’s wild salmon teriyaki with vegetables that you cover in ghee and coconut oil and then bake in the oven. And we have dark chocolate with almond butter for dessert. So there are a lot of great-tasting recipes, but they’re still made with real food. It’s coconut flour, almond flour, avocados, that sort of stuff. But if fried cheese and pork bacon is the basis of your diet… that’s not good on any diet.

DrMR: Yeah. Fully agreed. You also mentioned earlier when we were talking that you’ve incorporated some tenets of Chinese medicine into the approach. And I’m really curious to hear, what does that look like?

Lessons of Ayurvedic and Chinese Medicine

DrJA: Yeah. So I’m a physician, like you, and I want to see people heal. Some people get on keto because they want to lose weight, and it’s effective for that. But I want to see people heal. I know that Chinese medicine has been around for 3,000 years and they have been very thoughtful in what herbs support what conditions. And I just want to give you an example of this.

Keto Diet

This is more Ayurvedic medicine, but it’s the same principle with Chinese medicine. Eight years ago a study came out that when you consume turmeric or curcumin, you should consume it with black pepper or piperine because black pepper improves the absorption of turmeric. And the medical community was applauding themselves that they had this scientific breakthrough. But the recipe for turmeric golden milk (or turmeric golden tea) which is all over social media is a blend of turmeric and a warming spice blend called Trikatu, which is black pepper, long pepper, and ginger, and then healthy fats like ghee or coconut. That’s the recipe for turmeric golden milk, because they knew in Ayurvedic medicine—without these medical studies—that in order to absorb turmeric, you need warming spices, which open up the capillaries and allow the compounds and turmeric to get in your bloodstream. And then your cells are made up of fat, so fat supports absorption of a lot of herbs and nutrients into your cells and body.

So I love Chinese medicine, because they follow the principle that food is not just medicine, but meals are medicine. And using certain herbs together and food synergistically can create greater outcomes and benefits within the body. In Ayurvedic medicine in India, they’ll consume dairy, but only with warming spices and bitter food because dairy is dampening and cooling. So they have warming herbs and bitter herbs to help combat those properties of dairy so that they tolerate it better.

All that being said, in my plan, I have a keto cancer plan, which goes through the keto diet, but also incorporates vegetable juicing. It has a list of supplements that you should take in doses, including reishi mushroom, turmeric, astragalus, and other anti-cancer compounds. I’ve got a plan for the keto diet for hormonal health, which includes a certain type of ashwagandha, vitex for younger women, holy basil for women who are postmenopausal.

So I’m based on doing not just the keto diet, but the keto diet combined with the right herbs and other dietary practices that are going to make it the best for that person. Chinese medicine is completely custom. It’s personalized medicine. So there’s not really a single diet for every person. There are dietary principles that everyone should follow, and some of those are seasonal, but there are specific things that help certain people. So I actually have six plans in the book that go through a keto diet that combines Chinese medicine and other things for people.

Keto Diet

There are a lot of herbs used in Chinese medicine that we just don’t use enough today. For instance, dong quai. A lot of women should be using dong quai, it’s a blood builder and hormone balancer. It’s known as female ginseng in China. Especially if a woman is going through her menstrual cycle and losing some blood, dong quai builds your blood like no other. It’s really powerful for women supporting their energy levels and mood when they’re going through PMS. There are herbs like vitex and others that really support fertility. You know, fenugreek and black cumin for digestion. I love Chinese medicine, it’s a big part of what I incorporate in my book.

DrMR: Agreed. Dong quai and vitex are in two of the formulas that I use both in the book and at the clinic for female hormone support. It’s fairly dramatic. The results a woman can see … it could be PMS or it could be hot flashes, depending on their age. It’s just amazing to see the amount of balancing and support that a woman can derive and not have to go on hormones, on birth control, on an antidepressant.

It’s laughable that there are some women who are being offered an antidepressant for premenstrual female rage, for that agitation and emotional lability. I understand that there are physicians probably trying to help them with the tools that they have, but gosh, between an herb or an antidepressant, I’d give someone the herb all day long.

DrJA: Yeah. There’s no doubt about it. You don’t have the side effects. And a lot of them are more effective. They’re treating more of the root of what’s going on. Here’s an example. I know you take care of a lot of the gut issues, you have a lot of people come in with yeast overgrowth. And a lot of doctors just think, “Oh, I need to bomb this thing with antibiotics.” The problem is that yeast, and especially fungal infections, don’t respond well to the antibiotics today.

In Chinese medicine, they would look at that yeast and say there’s an environment in the body that’s off. It’s damp. Just like mold can grow in a damp, dark basement. If you dry it out, dampness goes away. So in Chinese medicine, they’d recommend lots of bitter herbs, because bitters dry up dampness and so do a few other herbs. So you want to do a little bit of warming and a lot of bitter to get rid of that candida. And of course a lot of herbs are bitter, and we don’t get many of those in our diet today. But again, Chinese medicine and Ayurveda have really unique and powerful perspectives.

View Dr. Ruscio’s Additional Resources

Keto Diet for Beginners

DrMR: Now with keto, there’s probably a bit of troubleshooting that people may need. People may have the low-carb flu or may need some support for electrolytes. What are you finding to be some of the most common stumbling blocks when people are trying to start, and do you have some quick fixes or solutions for people who are stumbling?

Keto Diet

DrJA: Yeah, number one is electrolytes. You want to get a lot of fluid and a lot of electrolytes in your system. So what I oftentimes have people do, Dr. Michael, is—and by the way, I had people do this before the celery juice cleanse—I have patients do vegetable juices, especially celery juice (which is awesome as an electrolyte), and then drink water. I typically have people take their body weight, cut that in half and drink at least that amount of ounces of water a day. So I think getting lots of water, and then veggie juices, especially celery, is very good for hydration. I put that high up on the list. After that, just more vegetables. You want to alkalize, you want to get more minerals. A third of your plate, at least, should be vegetables. You can do some raw, but you can bake, do a lot of cooked vegetables as well.

I think number one is veggie juices. Number two is vegetables. And then number three is more herbs and spices, especially adaptogenic herbs. If somebody especially wants to lose weight or heal from anything, I think keeping stress hormones low is really important. When somebody’s done a keto diet and they haven’t responded well, a lot of times I found people have high stress hormones. It might be that people don’t respond to anything well because of high stress hormones. I think it’s important for people to start to practice building peace, whether it be going for walks in nature, moving things out of the schedule in life that are causing emotional turmoil, taking a healing bath at night, using a cup of Epsom salts and lavender oil, deep breathing and doing yoga.

Keto Diet

All of those practices are important, along with things like adaptogenic herbs. I think ashwagandha can be great. And CBD oil. Again, it’s going to be a big craze. I don’t think it’s a cure for everything. I don’t think anything is. But I love the way that CBD oil calms a sympathetic response by your nervous system. So I think using some essential oils like lavender and CBD oil and things like that throughout the day, that calm that response, is good there as well. Building peace, both lifestyle-wise and nutritionally, can be really, really good for a keto diet.

I think people should move. If you’ve got, let’s say, a Crossfitter and they’re jumping in and starting to do a keto diet, the first week, they just need to be sensitive and listening to their blood sugar and not feeling light-headed. Maybe they just take it a little easier those days. People that are exercising or doing moderate exercise, continue to work out. If you’re not exercising, then just get out and walk, because it’s really good for your body. Getting out and walking, I think, is important for those people. Then the electrolytes and getting lots of water.

And then, if somebody has an energy drop, I think it’s fine to get some caffeine. Don’t go overboard and do too much. I tend to not like people to do more than 200 milligrams a day. But I think doing a little bit of matcha green tea, something like that that’s very green and alkalizing, can be good too. I’d say those are some of the biggest things that I recommend.

One other thing: I don’t think people should go overboard on oils. Oils are an extract of food. And let’s say you do a ton of oil, you pour it all over everything, and you’re eating a lot of fat. That’s just a lot for your gallbladder to deal with, versus eating an avocado or eating olives, or eating wild-caught salmon, or almonds. That’s a food that has other things with it that your body naturally is used to breaking down. It’s not so oil-rich.

Again, doing some oils is fine, but I found a few times, Dr. Michael, when people were getting a little nausea on a keto diet, it’s because they were doing three tablespoons of MCT oil, a cup of almond butter, just cooking everything in oil and pouring oil on there. So I’m saying, you should eat oil on a keto diet, but eat a lot of fat-rich foods, and don’t just go crazy on oil. Do you know what I’m saying? That’s another thing.

DrMR: I think that’s a great point. Yeah. Especially if you’re tracking your macros, the fat adds up pretty quickly. So if you’re focusing on healthy food sources of fat, you should be pretty close. But I could easily see someone falling into, “Well, I’ve got to have a lot of fat because I’m doing keto,” and going way too overzealous with the oils they add. That’s a great point that it’s a luxury that we have the ability to concentrate all this fat down into a bottle, where you can easily pour it on a food. But we also have to be tempered with how much we use that.

Keto Diet

DrJA: Yeah, there’s no doubt about it. You want to use some oils, but again, a big thing to remember is eat real food, loads of vegetables too on this diet. I think if people can do that, they’re going to do great.

DrMR: Awesome. Is there anything else that you want to touch on, on this topic of keto or anything else related?

DrJA: I think the keto diet, like a long-term fast or cleanse, can really benefit a lot of people. If you’re a person out there who wants to lose weight quickly, the keto diet is powerful, because it’s the only diet along with fasting where your body is really burning its own fat for energy. So people will notice big benefits there.

People with neurological diseases and even brain health, I think, can see big benefits. Also somebody who is looking to balance out insulin specifically for supporting diabetes, and people with PCOS or some of those other hormone issues that are insulin-related. And then people sometimes want to just reduce inflammation. If you do it the right way, with lots of omegas and vegetables and herbs, it’s a powerful diet for that as well. Just make sure you have a plan.

What to Eat on Keto Diet

In my book—I’m just going to plug it quickly—I lay out very specific plans. I have a 30-day meal plan. I also have other plans in the book, a 30-day general meal plan for keto, a keto cancer plan, a keto collagen plan, a keto cycling plan. So, there are lots of keto plans. And I have the supplement plans in the book, essential oil recommendations, and we have 80+ recipes, including really healthy keto recipes for great keto breakfast and smoothie options. We have keto pancakes, keto fudge, keto brownies, and it’s all really healthy.

So if you want to check it out, it’s Keto Diet. Just search “Keto Diet Dr. Axe,” and you’ll find it on Amazon or in bookstores nationwide. It’s at Barnes and Noble, Books-A-Million, local bookstores too. And I’m on Instagram a lot and Facebook, so you can always find me there.

But I think just remember, in terms of a practice, that when you’re following any diet, both keto and paleo, eat a lot of food. When you’re making your plate, lots of vegetables there. I also did an interview a few days ago and they asked me, what are the biggest food categories that people need to start getting in their diet right now, that people aren’t getting in general? And to me, it’s broth and herbs and spices.

An Easy On-Ramp to the Keto Diet with Dr. Josh Axe - AdobeStock 79634377 L

One-third of our body’s protein is collagen. So we should be getting collagen every day, whether it’s bone broth or a bone broth protein or collagen protein. Just get collagen or bone broth in your diet or as a supplement every day. And then herbs and spices. I talk about how broccoli is really a great nutrient-dense vegetable. So is kale and so is chard. But cilantro and parsley and turmeric and cinnamon and rosemary, in terms of nutrient density and medicinal compounds… herbs and spices blow vegetables out of the water. If you look at these other countries, if you go to the Middle East today, Asia, India, if you go to their markets, it smells like herbs and spices. If you walk into one of their kitchens, it smells like herbs and spices, and they’re drinking herbal tea.

The herb consumption in Japan is eight times higher than it is in America today. If there’s one thing we’re deficient in, or two things, it’s broth and it’s herbs and spices. So I just encourage people generally to get more herbs and spices, get more collagen. I think those are two things that, whether you’re on paleo or keto or whatever diet, I think everybody can benefit from.

DrMR: Yeah, that’s a great point. I think it was at the 2014 Ancestral Health Symposium, Mat Lalonde did an analysis of nutrient density of foods. He found that, as you’re saying, herbs and spices really were the most nutrient-dense and had the highest nutrient value out of anything (speaking loosely), and he highly encouraged people to make sure that they incorporate more herbs and spices into their diet. So I think it’s worth echoing that because it’s a fairly cheap, fairly easy thing to do that people probably aren’t doing enough of. And it stands to yield them pretty good health benefits.

Episode Wrap-Up

Keto Diet

Awesome. So Keto Diet is the book, and your Instagram and the website are also Thank you for taking the time, Josh. I really appreciate it. Love the work that you’re doing, and hopefully I’ll bump into you at another conference here in the near future. Will you be at IHS in New York?

DrJA: I am, yeah. I’m speaking at IHS. Are you going too?

DrMR: Yeah.

DrJA: Oh great. I’ll see you there. I think I speak on Friday mid-morning at IHS, and then I’m going out to Expo West the next week.

DrMR: Sweet. Then I will see you soon, and thank you again for taking the time and chatting with us.

DrJA: Awesome. Hey, thank you, Dr. Michael. I appreciate it.

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