Dr. Fung has released a new book Diabetes Code; exceptional book with great info to hand to your doctor if he/she doesn’t get Keto!
All the science and studies in one place, diabetes, high blood pressure, fatty liver et al, all written in classic Dr. Jason Fung easy to understand style.
Great news! The more well-presented materials published out there the better for community education and public health reform.
Is there any new info in the new book for those who already practice keto & IF, if you’ve already read Dr. Fung’s 2 previous books, “The Obesity Code” & “Guide to Fasting”?
He talks about the new book in his blog post:
https://idmprogram.com/the-diabetes-code/
With some detail on what to expect.
I quote:
‘One question some people have asked is “What new information is in The Diabetes Code that isn’t in The Obesity Code or The Complete Guide to Fasting?” Well, almost everything. People get confused because they’ve read the same stuff on my blog and then complain that there’s no new material in the book. That’s the point. I don’t hold any information back that may help you, the reader, simply to sell a few books. The information is already all out there, free but it’s written better.’
“There’s not a lot of editing, other than occasionally deleting the profanities, and sometimes adding them in.“
Love it
I just started reading it last night. So far so good. I like it and I think it would be a good resource to give to type 2 diabetic friends and family members. It’s direct and to the point specifically about T2D to get them introduced to keto/IF.
Much of what he has in Obesity Code, but even more user friendly; it’s a great book to give to friends and doctors who don’t get it!
I am a lover of all thing Dr. Fung, because his teaching and writing has completely changed my life by applying the simple things he teaches!
If you like Obesity Code, you will refresh what you learned and extend understanding in Diabetes Code, and if you haven’t read the book he co-authored with Jimmy Moore, the Complete Guide to Fasting, that should also be on your must read list! Excellent helpful info from doc and a guy who lost 180 lobs. on Keto and has kept it off for 15+ years!
I also LOVE dietdoctor.com for the high quality information it provides and also LOVE Dr. Sarah Hallberg https://www.youtube.com/watch?v=ESL3_7sdCwU&t=14s there are six chapters in this new set of videos. She is a leader in the field as well!
There are LOTS of bad keto “experts” out there, but the above are all medically sound and wise in the approach they offer.
One last thing…yes, I am over the top with all things keto because I have completely cured my T2D and am reversing long term insulin resistance plus losing weight and improving all my lipids without ever being hungry, not to mention losing 67 lbs so far!
There is a ratio that nobody talks about much to help you determine how to compute your macros for effective, slow and steady change that I learned from my Keto Nutritionist, Randall Evans who is in the Integrative Med Dept. at KU Medical Center.
Here is the formula he gave me and which has kept me healthy and healing (yes there are options, but this is good sound medical keto ratios-more exercise will alter this, but this is a great starting place):
A helpful FYI personalized formula from my Keto Nutritionist is a 1:1 ratio (or more on the fat side)
Protein grams + Net Carb grams : Fat grams (1:1)
To accurately figure your keto macros ratios you need to know your lean body mass index and then it is multiplied by activity level (.5 sedentary to 1.0 active) to determine total protein. That is your protein macro.
Use 20 carbs for strict keto macro. And then to figure fat macro, add together your protein number and carb to get a total; that number is
your fat macro.
Simplified Example:
Lean body mass is 100 lbs
Activity/Exercise level is multiplied by .5 (sedentary) to 1.0 (active and athletic)
100 x .5 (sedentary) = 50 grams protein daily
Net Carbs = 20 net carbs for strict Keto
Formula says to add 50 g Protein + 20 g Net Carbs = 70
Match the 70 to get the 1:1 ratio to create 70 g total Fat
Fat can go higher to keep hunger at bay so the ratio can increase fats for hunger and you will still lose so long as you don’t get crazy with excess overeating.
Obviously this can be adjusted if more active and depending on carb sensitivity - keto MUST be personalized to you for it work continuously and to feel good.
Don’t forget to readjust macros as you lose weight!
I just finished it tonight. It’s quite good. My only beef with it is a small one.
A few times in the book he gives lists of “healthy fats” and fats to avoid. He doesn’t mention animal fats from meats in either of the lists, good or bad. The closest he got is listing butter as a healthy fat.
I’m not sure if it was on purpose or not, but by not addressing it, it’s going to leave some confusion to readers who are new to keto and IF, which I’m assuming it’s the target audience. He also calls LCHF Low Carb Healthy Fat, not Low Carb High Fat. He is relying on the reader’s knowledge about whether or not animal fats are healthy, and someone unfamiliar with the concept of fats being healthy for you is going to assume that animal fats are bad fats because that is the conventional wisdom of today that everyone believes. I didn’t feel that he properly addressed it, so if you recommend this book to a T2D friend, you may have to explain that bacon and steak is good for you.
While this is interesting it is probably not even close to enough food for most people.
Sounds like you are talking about a short to average size woman (I am 5’6 and try to eat about 60 grams of protein based on 120 lbs of LBM and no activity). Since protein and carbs have 4 calories per gram and fat has 9, 70 grams of non fats would be 280 calories and 70 grams of fat would be 630 calories of fat, so 910 calories total. I do not count calories or grams of anything but I think as a guideline it seems restrictive. I did see your second part about adding fat but if you are told to eat 70 grams a fat, most people would not feel comfortable adding another 80 grams of fat on top of it if they are told that 70 is ideal (which I do not believe it is for this person). If it is working great but I could not manage
The example I gave was for round numbers and not an exact description of what to eat. I also said that fat can go higher so long as a person isn’t truly over-eating, and we all know what that looks and feels like. AND, activity level drives this model, the more active you are the more you need and the more you eat. I never said this was ideal, I said it was the STARTING POINT to move into Ketogenic eating.
I didn’t do as good of a job of explaining that this is the starting point for the 1:1 ratio; if you stick to the ratio of protein and carbs on one side of the ratio, you can go to 2:1 or 3:1 and not affect insulin. Eating more fat is not a problem since fat doesn’t impact insulin much at all.
All Keto should be a MINIMUM of a 1:1 ratio with fats going higher to increase calories to curb hunger. And ALL of this needs to be personalized to your body. But as a starting place the formula works. As always with Keto, don’t eat when you’re not hungry and eat when you are, and if you want to stay Keto, push up the fats to keep insulin under control.
I am overweight and 5’6" and had metabolic syndrome. I do IF daily and extended fasting to keep moving blood work and weight. I have lost 67 lbs in eight months and am off all meds except for a little blood pressure medication. My blood sugars are fabulous but my insulin is still quite high.
Daily, I eat 15-20 net carbs (no more than 30 total carbs ever because i heave learned that I gain weight or stall on more carbs), I eat between 60-70 grams of protein and 100-125 grams of fat. I typically eat about 1500-1800 calories per day and I’m very rarely hungry. Eating these macros puts my ratio at about 1 (carbs + protein) to 1.5 (fat).
If I finally get motivated to move more and get some exercise, obviously I will be able to increase food, but the key to the model is activity drives what you burn, and how much protein and carbs your body truly needs. I am essentially still mostly sedentary, that’s why my numbers are what they are.
Finally, I didn’t make up the ratio, it is the medical model used by integrative medicine practitioners as the starting place to give people and idea of where to begin, and then it is fine tuned to the person.
Some people can get away with more than I can because their underlying metabolism is healthier.
Dr. Fung routinely talks about saturated fats (meat/animal protein fats) in a positive way in all he writes and speaks. While he technically doesn’t say it is good fat, and maybe this would be helpful for him to say it, he has tons of research citing the protective impact of saturated fats on cardiovascular health.
I did a quick search and found tons of stuff on his IDM (Intensive Dietary Management) site which is his program clinical site. https://idmprogram.com/tag/saturated-fat/
I agree. I’m just saying I would have liked to see it a little more clearly in the book.
I would say the book had a good amount of new information compared to the obesity code. There was alot of repeat information as well. I found that almost all the information in the book is linked back towards diabetes, or hyperinsulinemia.
There’a nothing wrong with the ratio per se. It works to define keto macros due to nothing more than infant school maths, 1:1 in grams is 4:9 in calories or 1:2.25 or 31:69% fat. The problem comes in the multipliers which don’t really work at all.
Protein is an entirely moveable feast. For someone with 100lbs of LBM (45kg), the safe range of protein ranges from 27 to 150g so basing your multipliers on that +20g makes it difficult to get a realistic set of macros. As your example shows, 50g of protein, an entirely reasonable 1.1g/kg of LBM means you are massively under-eating (910kcal for a 140lb+ person). If you a binging on protein (still safe), say 100g (2.2g/kg), then you’re at 1300kcal, far more reasonable calorie intake but still low AND a very high protein level and higher insulin load. If you adhere to where many subscribe, the lower end of the protein spectrum, then you starve (650kcal). Therefore 1:1 is basically inadvisable in almost ANY case for one reason or another. It doesn’t get any better with a heavier example even if total calories are not linearly related to bodyweight.
Like you said, you couldn’t make 1:1 work with those multipliers and I doubt anyone but an already healthy protein fiend could. The ratio idea is a lagging not leading indicator of what you should eat so isn’t really much use in trying to do calculations. You eat what you need to and then you’ll find what ratio you end up with (for whatever that’s worth). As you really have done, so should others - build from the ground up… 20 net carbs, a comfortable protein level (worked out via trial and error based on the basic protein science e.g. start at 1g/kg LBM) and fat to satiety. Your TDEE should give you an idea of where satiety might be so you can calculate your likely fat amount. I know your clinic came up with this but it’s not helpful and smacks of trying to create some (faulty) proprietary methodology that they can claim as theirs. IMO this ratio based model is just not useful as any form of dietary planning tool.
Given how much “free” stuff he’s given the world, I didn’t feel bad about buying the book.
Also, this way, I can share the knowledge with others and reinforce that which I have learned.
This passage, though:
Actually, there is nothing proprietary about this model, and without some guidance most of us tend to overeat protein for satiety. In reading Fung, he actually advocates, based on human study evidence that we actually need far less protein than we typically eat. Satiety is driven by more than what we actually need; satiety can be met differently depending on status of sleep, stress, variety in the diet that hits the satiety flavor notes et al. AND, extended fasting actually decreases protein needs according to research.
https://idmprogram.com/how-much-protein-is-excessive/
People like me who are Fung devotees need guidance to correct serious health issues, thus the focus in insulin.
I am attempting to follow the guidance of medical professionals who have studied, and applied current research and have clinical experience with patients vs just reading about Keto. My nutritionist is one of these people having worked for 15 years in a clinical Keto setting with cancer patients, T2D and epileptic patients and works with patients daily. He is one of the most selfless people I have ever met and his guidance has allowed me to reverse my T2D and that of numerous others including friends of mine who have applied this formula in a personalized way.
I’m sure they are all great people and I believe Dr Fung implicitly based on his vast experience. I’m just saying the 1:1 idea has no value for non-clinical ketonians especially when there are better (if less over simplified) models for setting your dietary patterns. It fails much harder when you eat less protein (which I generally agree with) since it flexes fat and calories on that value. It’s just bass-ackwards.
When you are prescribing keto for a specific therapy, you sometimes restrict calories for a specific effect so you may get away with it but that doesn’t make the logic good to be applied to mainstream keto advice for non-cancer, non-epilepsy regimes.
