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  1. I am very glad I met you yesterday. I misspoke about my son telling me to drink a protein shake when I wake up. He said I should exercise for 30-40 to kick start me for the day. Is this correct?

    1. It was a pleasure to meet you also. Thanks for a great question. There is absolutely no doubt that exercise is good for you and I strongly encourage it in everyone. Exercise, however has little to nothing to do with weight loss. In people with diabetes or prediabetes, just like in healthy people, the body just increases the appetite so you eat the calories you burned and since as I have told you, counting or limiting calories is totally counterproductive for people that want to lose weight and get healthy, there are several traps for people who thing that beginning an exercise program is going to help them lose weight.
      Trap-1: People can sometimes give themselves permission to cheat on their diet and slip carbs and sugar in as a reward for being so good and exercising. This will stop weight loss in its tracks and sometimes reverse it.
      Trap-2: People will exercise too much and get so burned out with it that they give up not only exercise but a healthy diet as well.
      Trap-3: People exercise beyond their capacity and injure themselves.
      Here’s what I recommend. Don’t even think about exercise for 4-6 weeks after you begin a ketogenic diet. When you start feeling the urge to move, which will come naturally as your insulin goes down and the energy trapped in your fat cells becomes available, your body will naturally want to be more and more active. Take that momentum and create a great exercise program for yourself. I recommend getting the book, “Body By Science” by Doug McGuff MD. You can read about Doug and his program at http://www.drmcguff.com/

    2. I tell people not to worry about exercise for the first 2-3 months they are on a low carb diet. As your metabolic system heals and allows free flow of fat in and out of fat cells to be used as energy and the mitochondria, the tiny furnaces producing energy for the body will switch to preferring fat as fuel to carbs and you will naturally gain energy and stamina. It will make you want to move and be more active. I’m a big fan of exercise but it can be overdone. The older you get the more time between exercise sessions you need. This is called the recovery period so in my opinion people over 30 should go to every other day for heavy exercises and over 50 probably every 3rd day. You could do walking or light jogging every day if you liked. But the exercise that gives the biggest bang for the buck is resistance training (weight lifting). Also something called high intensity interval training (HIIT) where you exercise for only 15-30 minutes but you alternate between exercising as vigorously as your body is capable of interspersed with brief intervals of light exercise. I use a tape that is 22 minutes long with 9 sections of very fast music that are a minute and a half long and there are 1 minute segments of slow music between each fast section where I rest. The book that I recommend for anyone who want to exercise is “Body by Science” by Dr. Doug McGuff. Remember 50 grams of carbohydrate a day is a red line, cheating over the line will in most cases sabotage weight loss though will still get some benefit.

    3. I personally am a fan of once a week resistance training to exhaustion, twice a week High Intensity Interval Training for 20 minutes and 2-3 times a week flexibility training like yoga or other stretching and balance exercises. I think low intensity prolonged exercises like jogging, biking or swimming are hard on the joints and gives less benefit than high intensity interval training. I think we evolved to hunt during the middle of the day when our ability to cool ourselves by having 10 time the sweat glands of most animals, no fur and the energy saving 2 legged gait gave us an advantage in the heat. It’s important to exercise so if mornings fit your schedule better, go for it. I am a fan of Dr. Doug McGuff when it comes to exercise and I recommend his book, “Body by Science” as a good exercise guide.

  2. Hello, Doctor. I am a 67 year old woman, 5’6″, 174 (most days!), in very good health, OK to do the diet per my doctor. My question is about supplements and vitamins. I currently take Folate, B1, B12, P5P, C, K2, D3, Evening Primrose Oil (for arthritis – works wonders), Hydrochloric Acid 325 mg with Pepsin 82 mg with some meals. Do you know any reason why these would be incompatible with this diet? Thank you very much for this and your work.

    1. i don’t recommend taking Hydrochloric acid or pepsin. They will not cause a problem with a low carb or any other diet but your body naturally senses and produces just the right amount of both of these substances. If you supplement them your body will eventually atrophy the glands in the stomach that produces it and once you stop supplementing it can take weeks for them to be able to produce the normal amount again and you will suffer indigestion the whole time. B vitamins including folate, and vitamin C are water soluble and any extra will just get excreted in the urine quickly. PSP appears to be a mix of plant anti-oxidants. When you eat a ketogenic diet the production of free radicals is so low that exogenous antioxidants are unnecessary. Oil of Primrose sounds like a reasonable thing to take for arthritis. Arthritis often mostly goes away on a ketogenic diet.

      1. Thank you very much. I appreciate your getting back to me so quickly. I will implement the information you have given me. Thank you again for your time and your work, Doctor Mabry.

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