Obesity has become an epidemic and in this article we’ll discuss the popular Keto Diet Plan and weight loss for men.
Men and women have different hormones with men having much more testosterone and a little estrogen. Recent research has shown obesity linked to low testosterone in men and while testosterone therapy can help with weight loss we’ve noticed that diet is often a barrier to optimal results.
Diet Controversies and Extreme Weight Loss
You may have heard of the HCG diet, which is basically a super low calorie diet (500 Calories per day) that includes some injections of human chorionic gonadotropin (HCG).
Certainly, if you starve yourself you’re likely to lose some weight but often men lose more muscle and less fat and some say that the use of HCG will help you lose the excess body fat and less muscle.
Due to its extreme calorie restriction and off label use of HCG the HCG diet has become somewhat of a controversy with FDA approved HCG packaging from retail pharmacies warning:
HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.
HCG can help increase your testicular function and potentially help increase testosterone production while you are starving on the HCG diet. This article isn’t about HCG but we wanted to point out that even the Keto Diet Plan may not work if your testosterone levels are low.
In fact, testosterone therapy has been shown to help men lose weight and increase muscle mass. Men with low testosterone often have a hard time building muscle despite exercising regularly.
Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: observational data from two registry studies. F Saad et al. International Journal of Obesity (2016) 40, 162–170.
Testosterone is an important hormone for helping you maintain and building muscle mass as well as control your blood sugar. Many men with metabolic syndrome, pre-diabetes, and low testosterone can significantly improve their blood sugar control by improving their testosterone levels.
Fatigue is a hallmark symptom of low testosterone. Many men with low testosterone struggle finding the energy and motivation to hit the gym and often find the couch is “calling their name” from the second they walk in the door after work.
Testosterone therapy appears to be an effective approach to achieve sustained WL in obese hypogonadal men irrespective of severity of obesity. Based on these findings we suggest that T therapy offers safe and effective treatment strategy of obesity in hypogonadal men.
HCG has a similar effect as LH produced in the brain to increase the signal from the brain to the testicles and help increase natural testosterone production. It is FDA approved for use in men with a deficiency of the LH signal.
People promoting the HCG diet may advertise you can lose up to a pound per day. There are of course risks with extreme weight loss and in the case of the HCG diet there is a high risk of having a gallbladder attack which can be life threatening and require surgery to correct.
Gallbladder attacks are related to very low fat diets like the HCG diet but the Keto Diet Plan is generally high or higher fat and, thus, has less risk of causing a gallbladder attack.
Some say that the Keto Diet, also known as the Ketogenic Diet, is a new twist on extreme weight weight loss that can get you quick results. And, of course, some experts say it is an unhealthy way to lose weight that can be dangerous.
Proteins, Fats, and CarbsThe Keto Diet
You probably learned about the food pyramid while you were growing up going to school in the United States. The original food pyramid had grains and breads as the foundation of the pyramid.
In 2005, the USDA released a new food pyramid with no foundation but it does show oils at the bottom, saying “Oils are not a food group, but you need some for good health. Get your oils from fish, nuts, and liquid oils such as corn oil, soybean oil, and canola oil.”
The USDA Food Pyramid was updated in 2005 and no longer has grains as the foundation of the pyramid.
The irony is that corn oil, soybean oil, and canola oil, known as long chain triglycerides (LCT), are more likely to cause weight gain compared medium chain triglycerides (MCT), such as coconut oil and butter. This is in part because MCTs are more likely to be used for immediate energy.
It can be concluded that substitution of MCT for LCT in a targeted energy balance diet may prevent long-term weight gain via increased [energy expenditure].
Medium- versus long-chain triglycerides for 27 days increases fat oxidation and energy expenditure without resulting in changes in body composition in overweight women. St-Onge MP et al. Int J Obes Relat Metab Disord. 2003;27(1):95-102.
Bulletproof® coffee has become popular in recent years and last time I checked they are even making it in the Whole Foods® coffee shop. Bulletproof® coffee is basically coffee and some form of MCT combined, either butter or coconut oil. The following video has had over 2 million views.
Apparently, butter, which has been sustaining humans for thousands of years, is not one of the preferred oils on the USDA food pyramid. Rather, GMO rapeseed oil, also known as Canola® oil, is somehow a healthy choice.
There is zero discussion about trans fats and rancid fats on the food pyramid. Butter rarely goes rancid and contains zero trans fats but Canola® oil can easily become rancid and hydrogenated Canola® oils can contain high amounts of trans fats.
In fact, it’s rancid fats that start the process of cholesterol accumulation in your arteries and, furthermore, cholesterol is essential to human life as cholesterol is what our bodies use to make testosterone.
When we measure someone’s cholesterol we measure it fasting so that we are measuring the cholesterol your body makes, not the cholesterol you eat.
Even more ironic in the food pyramid, they are including beans with meat as if beans are somehow a substitute for meat as a protein source. A 3 oz. serving of beef provides about 25 grams of protein and this is a complete protein. Beans do not provide all of the essential amino acids nor do they provide an important mineral, iron.
Not all foods contain the same type of protein. Meat, eggs and dairy products are considered complete high-quality sources of protein that provide the full package of essential amino acids needed to stimulate muscle growth and improve weight management.
Plant proteins such as grains, legumes, nuts and seeds are incomplete proteins in that they do not provide sufficient amounts of essential amino acids. In fact, research indicates that increasing consumption of high-quality complete proteins may optimize muscle strength and metabolism, and ultimately improve overall health.
The food pyramid misleads children that beans and meat are equal. With recent books like, “Skinny Bitch Bun in the Oven: A Gutsy Guide to Becoming One Hot (and Healthy) Mother!”, by Rory Freedman and Kim Barnouin, no-meat diets like veganism are being sold to mothers and their children will be potentially effected by these choices for the rest of their lives.
It is baffling to me how Rory Freedman and Kim Barnouin seem to be ignorant of the important differences between animal protein sources and non-animal protein sources. Again, from beefitswhatsfordinner.com:
Lean meats contain heme iron, which is much more easily absorbed by the body than nonheme iron found in plant foods. Heme iron is an important dietary component for promoting cognitive health, including memory, ability to learn and reasoning.
Heme iron is particularly beneficial for growing children because research indicates that some toddlers are at higher risk for iron deficiency, and childhood iron-deficiency anemia is associated with behavioral and cognitive delays.
What is the Keto Diet?
The Keto Diet is a low carbohydrate (carb) diet. Carbohydrates are found in many foods and are essential to human life. The three main components to foods are proteins, fats, and carbohydrates. Foods also contain vitamins, minerals, and fiber.
We are told the reason grains make us fat is because we aren’t eating whole grains. The truth is that a carb is a carb is a carb. Or rather, carbohydrates (carbs) in general tend to cause weight gain regardless of the type of carbohydrate.
Whole grain and body weight changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies. Pol K et al.. Am J Clin Nutr. 2013 Oct;98(4):872-84. doi: 10.3945/ajcn.113.064659.
This is because the body doesn’t like a lot of sugar floating around so insulin increases to push the sugar into storage like body fat but also into your muscles (more on this later). If you constantly overload your system with carbs, eventually, your body builds up resistance in the form of insulin resistance, and your ability to control your blood sugar levels falls apart and diabetes sets in.
The idea of whole grains is that it slows down the sugar from entering your system. This is in part true but if you eat excessive amounts your body will have a difficult time utilizing all the energy from the carbs and much will be put into storage (fat).
While fiber from whole grans may have some beneficial effects in terms of helping to control your blood sugar levels, vegetables are a much lower carb option with plenty of fiber. Some vegetables have more carbs, such as potatoes so not all vegetables low carb.
Low carb vegetables include:
And many more
Carbs can also be broken down into simple and complex carbs. Simple carbs would be things like white sugar, high fructose corn syrup, sports drinks, maltodextrin, white bread, white rice, pretzels, candy, and dextrose. Simple carbs get into your system fast and cause a spike in your insulin levels.
Complex carbs are usually whole grain foods with high fiber content like whole grain bread, oatmeal, brown rice, popcorn, and corn tortillas. Due to their fiber content they are more likely to cause a slower rise in your blood sugar level and less spike in your insulin.
The Keto Diet Plan is a reduced carb diet and some may try to eliminate carbs completely from their diets. There are several problems with eliminating carbs completely from your diet but those with obesity may see significant weight loss with the keto diet.
A 2004 study showed that those with obesity may benefit from the keto diet plan with minimal risk:
Long term effects of ketogenic diet in obese subjects with high cholesterol level. Dashti H.M. et al. Mol. Cell. Biochem. 2006;286:1–9.
The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol.
Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.
In this study, 83 obese patients (39 men and 44 women) with high glucose and cholesterol levels were included. Their body weight, body mass index (BMI), total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the Keto Diet.
The patients were assessed after eight, 16 and 24 weeks of treatment with the Keto Diet. Patients lost on average about 30 lbs over the 24 weeks. Also, bad cholesterol (LDL) levels decreased and good cholesterol (HDL) levels increased.
Blood sugar levels also tended to improve as did triglyceride levels. Finally, there were no negative changes in kidney function noted.
In this study, patients consumed 20-30 grams of carbs per day for the first 3 months and then increased that to 40 to 50 grams of carbs per day. Their diet also included 80 to 100 grams of animal protein (meat, fish, cheese, eggs) and fats – 20% saturated fat, and 80% polyunsaturated and monounsaturated fat.
Summary of Keto Diet Study
This study had patients eating 30-50 grams carbs and 80-100 grams protein with healthy fats and obese patients lost an average of about 30 lbs over 6 months.
In general, men not trying to lose weight need at least 100 grams of carbs per day. If you live a very active lifestyle you likely need closer to 400 grams of carbohydrates per day.
Ketosis Can Be Dangerous
If you have diabetes and allow your blood sugar to go too low or forget to take your insulin your body will respond by producing ketones. If ketone levels get too high it becomes ketoacidosis and causes the blood to become too acidic. This can cause extreme vomiting and dehydration and may become life threatening.
Know Your Carb IntakeHow To Calculate Your Daily Carb Intake
Serving sizes for some carbohydrate foods (each has about 15 grams of carbs)
You can see from the list above that if you combine any two items you are now at 30 grams of carbs. The good news is that even restaurants like Five Guys® offer burgers wrapped in lettuce instead of buns.
Also, for breakfast you can have a large omelette or protein shake. I prefer stevia as a zero calorie sweetener to artificial sweeteners.
Avoid bagels and skim milk. Bagels have a very high glycemic index and skim milk is used to fatten hogs (very easily).
Avoid sugar and fruit. If you’re trying to lose weight its a waste of space in your tummy and will waste your allowed carbs.
And, obviously avoid cake and other desserts. After you’ve lost the weight you’ll deserve some cake. Until then…
Artifical Sweeteners Cause Weight Gain?
Recent studies have shown that not only do artificial sweeteners not help with weight loss, they actually contribute to weight gain. Artificial sweeteners have been shown to increase your risk of diabetes as well as stroke and heart attack. Beware the zero calorie sodas!
Not so Sweet Revenge: Unanticipated Consequences of High-Intensity Sweeteners. Swithers SE. Behav Anal. 2015 Mar 12;38(1):1-17. doi: 10.1007/s40614-015-0028-3.
Protein shake ingredients suggestion
Yogurt or Kiefer
Frozen wild blueberries
Coconut oil or MCT
1-2 egg yolks
Pure whey protein powder
Remember, it’s not about what you eat once in a while it’s about what you’re eating everyday. If you slip up on the diet, just try to learn from what triggered the slip up and get back on track.
Often, we start craving junk food when we are missing other things in our diet like fiber from vegetables and protein. Try having a low carb snack between meals like some cheese.
Sample Keto Diet Menu Plan For the Busy Man
The Keto Diet Plan
Always talk to your primary care doctor before starting a new diet plan.
Low carb protein shake with 1 cup whole milk yogurt (unsweetened), 1/2 cup wild blueberries, 1 tablespoon coconut oil, and a scoop of pure whey protein powder. Sweeten with stevia.
20 grams carbs
50 grams protein
20 grams fat
Hamburger (1/4 lb) with lettuce wrap instead of bun or steak (4oz) and cooked vegetables. You may prefer 2 hamburger patties (1/2 lb) or an 8 oz steak. Avoid starchy veggies and potatoes.
2-20 grams carbs
20-50 grams protein
20-30 grams fat
Steak salad w/ avocado & avocado oil/vinegar dressing. If you cook a few pieces of steak and keep them refrigerated this meal is pretty easy. Avoid store bought dressings and make your own.
2-10 grams carbs
20-40 grams protein
10-30 grams fat
Ketosis vs KetoacidosisA Little Ketosis Is The Goal
Ketosis is basically a milder form of ketoacidosis. Ketogenesis is the production of ketones. Ketones are produced from fats.
Fats are not soluble in water so your body will convert them to ketones which can float freely in your blood. To get your body to start producing ketones you must restrict carbohydrate intake.
If ketones build up too much in your body ketoacidosis occurs and this can cause you blood to become too acidic and vomiting and dehydration ensue. Ketoacidosis occurs most frequently in people in with diabetes type 1 or type 2.
Ketoacidosis can also happen in some people with low blood sugar, called hypoglycemic ketoacidosis. If you are considering the Keto Diet you should do it under the supervision a doctor.
Revive Low T Clinic is not a weight loss clinic but we do have experience helping men with diet and exercise. Men suffering form obesity should see a doctor focused on weight loss as there are additional lab tests that are not standard at our clinic.
For example, if you are obese and have diabetes type 2 you are at increased risk for ketoacidosis on the Keto Diet Plan and, therefore, you should seek a clinic or doctor more focused on weight loss.
Men trying to lose weight may benefit from testosterone therapy as low testosterone is a risk factor for obesity. Furthermore, the Keto Diet may cause changes in adrenal, thyroid, and other hormones, including testosterone.
Check Your Testosterone Levels
Revive Low T Clinic accepts most insurance and cash patients only pay $150 for your first visit including your lab test.
Men on the Keto Diet may tend to have higher cortisol levels which could suppress thyroid function and contribute to muscle loss and more difficulty losing body fat. There is a fair amount of glucose stored in your muscles and muscles have a high demand for oxygen and glucose in high intensity exercise.
Also, the Keto Diet may cause more brain-fog and fatigue than is tolerable for some. The brain seems to need carbs for optimal function and cannot rely on ketones. Thus, if you use your brain a lot the Keto Diet may not be the best option.
It is puzzling that hydrogen-rich fatty acids are used only poorly as fuel in the brain.
Why does brain metabolism not favor burning of fatty acids to provide energy? - Reflections on disadvantages of the use of free fatty acids as fuel for brain.
Peter Schönfeld et al. J Cereb Blood Flow Metab. 2013 Oct; 33(10): 1493–1499.
Children need plenty of carbs from health sources and if you have children and are looking for a good cookbook I highly recommend, “Nourishing Traditions,” by Sally Fallon. I was a vegan for a very short time and felt like I was starving to death. Reading this book changes my life and potentially saved it as well.
In an animal study, rats on the Keto Diet, “had significantly impaired brain growth and visual–spatial memory.”
Ketogenic Diet Decreases Circulating Concentrations of Neuroactive Steroids of Female Rats. Rhodes, Madeline E. et al. Epilepsy & behavior : E&B 7.2 (2005): 231–239. PMC. Web. 24 Apr. 2017.
The Keto Diet and Bodybuilder Carb TimingTime Your Carb Intake For Maximum Results In The Gym
If you are exercising regularly you should avoid the Keto Diet. You’ll be much more easily fatigued if you are avoiding carbs. Many bodybuilders are timing their carb intake to get maximum benefit.
Eating a large amount of carbs (or meals in general) right before workouts should be avoided. Digestion actually takes a lot of energy. Men who weight about 180 lbs should generally eat about 45-90 grams of carbs 4-5 hours before weight training. You should also eat about 50-100 grams of protein with your meal and 20-40 grams of healthy fats such as butter or coconut oil.
If you have to eat closer to your work out consider a doing a protein shake like the ones discussed in this article. If you eat too much fiber right before working out you will likely still be digesting while you’re trying to train and feel the drag.
Then a half hour before your work out you should start hydrating and I recommend adding some whey protein isolate (20 g) with branch chain amino acids to a blender bottle and drinking this while you exercise. Most men should drink about one liter of water while they are weight training to keep hydrated.
The whey protein in your water will help provide some fuel for your workout but the meal you had 4-5 hours earlier that contained carbs will make the most difference. I do not recommend having excessive caffeine prior to your workout as this increases cortisol levels significantly and cortisol is catabolic.
Catabolic vs Anabolic
Catabolic means it breaks things down, like muscle. Cortisol is catabolic and insulin is anabolic. Anabolic means it builds things or increases mass.
You can add a small amount of juice to your protein water for a little extra fuel. Carbs are generally only needed during work-outs if you are over-training.
After exercising for about an hour your cortisol levels will naturally start to increase. This is why I recommend you avoid over-training. Generally, you will see the biggest gains with the least amount of stress on your body by weight training for one hour or less.
At the one hour mark your cortisol levels are starting to cause your body to pull energy from its stores such as from your muscle. To counter this we want to increase insulin modestly and this will help bring down cortisol levels.
Also, your muscles are primed to receive glucose and the insulin will target your muscles. By weight training then carb loading the sugars will be pushed into your muscles and help you bulk up.
After your workout, load some carbs. I suggest eating about 30-50 grams of carbs and potentially more depending on your goals and body type. If you are really trying to bulk up more may be helpful.
And remember to eat protein with your carbs. I like blender bottles and you can easily mix 30 grams of carbs from maltodextrin with 40 grams whey protein and some juice in a blender bottle.
Final Notes About Dieting and Weight LossWork With Your Doctor To Find Your Diet
There are many different diets out there: Paleo, Bulletproof, Zone, Keto, and Atkins. With obesity on the rise we certainly need to take a good look at what is causing this epidemic in the United States.
It is easy to say it is being caused by too much sugar in soda drinks, or too much carbs, or lack of exercise. It is likely a combination of many factors. In fact, there are a number of chemicals called endocrine disruptors, such as bis phenol A (BPA), that cause major issues with our sex hormones, such as testosterone. BPA is in many types of plastic, including plastic bottles.
Many men are able to lose weight simply by exercising regularly and eating less calories but men who cannot despite may have a hormonal issue, such as low testosterone.
While testosterone therapy does not guarantee weight loss, we have seen many of our patients lose excess body fat and build muscle with a holistic approach that includes diet and exercise.
Diet is what you eat and going from fad diet to fad diet can be risky. Starving yourself may lead to weight loss but it can be dangerous and you may end losing mostly muscle. We feel a big part of dieting is a lifestyle change and ruling out other potential causes such as low testosterone and other hormonal issues.
Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: observational data from two registry studies. F Saad et al. International Journal of Obesity (2016) 40, 162–170. ↩
Medium- versus long-chain triglycerides for 27 days increases fat oxidation and energy expenditure without resulting in changes in body composition in overweight women. St-Onge MP et al. Int J Obes Relat Metab Disord. 2003;27(1):95-102. ↩
Whole grain and body weight changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies. Pol K et al.. Am J Clin Nutr. 2013 Oct;98(4):872-84. doi: 10.3945/ajcn.113.064659. ↩
Long term effects of ketogenic diet in obese subjects with high cholesterol level. Dashti H.M. et al. Mol. Cell. Biochem. 2006;286:1–9. ↩
Why does brain metabolism not favor burning of fatty acids to provide energy? - Reflections on disadvantages of the use of free fatty acids as fuel for brain.
Peter Schönfeld et al. J Cereb Blood Flow Metab. 2013 Oct; 33(10): 1493–1499. ↩
Ketogenic Diet Decreases Circulating Concentrations of Neuroactive Steroids of Female Rats. Rhodes, Madeline E. et al. Epilepsy & behavior : E&B 7.2 (2005): 231–239. PMC. Web. 24 Apr. 2017. ↩
Not so Sweet Revenge: Unanticipated Consequences of High-Intensity Sweeteners. Swithers SE. Behav Anal. 2015 Mar 12;38(1):1-17. doi: 10.1007/s40614-015-0028-3. ↩