51: High-Fat, High-Carb Dangers, HRT, TOFI, What Happens To Dietary Fat Not Used, Sperm Production

51: High-Fat, High-Carb Dangers, HRT, TOFI, What Happens To Dietary Fat Not Used, Sperm Production


If you are interested in the low-carb, moderate protein, high-fat, ketogenic diet, then this is the podcast for you. We zero in exclusively on all the questions people have about how being in a state of nutritional ketosis and the effects it has on your health. There are a lot of myths about keto floating around out there and our two amazing cohosts are shooting them down one at a time. Keto Talk is cohosted by 10-year veteran health podcaster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona osteopath and certified bariatric physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday. We love hearing from our fabulous Ketonian listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes and listened to the past episodes, then you can do that and leave a review HERE. Listen in today as Jimmy and Adam battle myths and share Ketonian wisdom in Episode 51.


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KEY QUOTE:  “The bigger the fat cells become, the fat cell can become sicker. When those fat cells become sick, they amplify inflammation and cause more and more weight gain.”  – Dr. Adam Nally

Here’s what Jimmy and Adam talked about in Episode 51:

Hey Jimmy and the Doc,
Thank you for this awesome podcast. I have learned so much from you guys. I read Keto Clarity a year ago and have been learning everything I can about ketosis ever since. My fasting blood glucose is always in the 70’s and 80’s, but my weight seems to go too low for my comfort. I’m 6’1” tall and weigh 178 pounds. I have heard you talk about how eating high-fat and high-carb at the same time is a really bad idea. I don’t necessarily want to go too high-carb, but will it cause me problems to stay high-fat but add a lot more real food sources of carbohydrates such as potatoes, berries, fruit, etc. to keep my weight over 180 where I’m most comfortable. My father had his first heart attack at 50 years old and even though my blood work is excellent, besides high LDL-C, this concerns me. Can you please clarify the dangers of high-fat, higher carb eating?
Thanks for all you do,

HEADLINE: Can breakfast help keep us thin?


1. Can hormone replacement therapy have a negative impact on blood ketone and blood sugar levels that would halt weight loss?
Hi Jimmy and Adam,
I love your Keto Talk podcast. I had a question about being on hormone replacement therapy while eating keto. I had surgical menopause when I was 26 and I’m currently on hormone replacement therapy (HRT). I’ve also been on keto for the past few years and I’ve always struggled with my weight. I’ve noticed that when I’m not on my estrogen therapy, I have no issues with losing weight. But the moment I start on HRT, I can’t seem to lose the weight. On HRT, my blood ketones are only 0.4 mmol and my blood sugar is in the 90’s. When I’m off HRT, blood ketones reach 1.2 mmol and blood sugar is in the 60’s. My endocrinologist has a fit when I’m not my hormone replacement. So despite being on a low-dose of estrogen (3mg), could the HRT be negatively impacting my weight loss and my overall ability to stay in optimal therapeutic levels of nutritional ketosis?
Thanks for your help with this!
2. Why don’t TOFI people gain weight eating low-fat? Would a ketogenic diet help them without weight loss?
Hi guys,
I look forward to your podcast every week.  It has helped keep me informed and motivated me in my keto journey since I began 9 months ago. I’ve lost 38 pounds so far with ease with no hunger or cravings. You guys rock!
I’m very interested in the biological mechanisms of ketosis and I know how much Dr. Nally loves geeking out on this kinda stuff. Regarding the Carbohydrate-Insulin Theory, can you explain how TOFI (thin outside, fat inside) people don’t put on visible weight when they consume a high-carb, low-fat diet? Is it just genetics? And can you explain how a high-carb, low-fat diet creates inflammation in the body with or without the weight gain? Finally, how would a low-carb, high-fat, ketogenic diet help someone with TOFI?
Thanks so much,
Katy from Liverpool, England 
3. If you don’t burn up fat you consume, then what happens to it in a ketogenic state?
I intermittently fast for 16 to 20 hours each day in addition to being on a ketogenic diet. I’m about 3 weeks in, and so far so good. If you are fully keto-adapted, then what happens to the fat that you consume and do not burn off for energy? If your insulin levels are low, that fat can’t possibly be stored, right? If that is true, then what happens to it?
I appreciate your input. THANKS!

KEY QUOTE: “I believe breakfast is the most important meal of the day, I just don’t believe you have to have it at 7 or 8 a.m.” – Jimmy Moore

Hi Jimmy and The Doc! Love the show, I have a long drive to work everyday and you guys make it fly by!
My question is about the impact of a ketogenic diet on sperm production? You talk about it boosting testosterone but does it actually boost sperm production?
Thanks guys!
Danielle in Sydney, Australia
BONUS: I’m a little surprised that The Doc is okay with aspartame as I have read that over 40 degrees Celsius it converts to formaldehyde. Why do you like it?


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– Isn’t the problem with weight loss woe on keto too many calories?

Hi Jimmy and The Doc! You guys are the best! I love all the work you do to spread information and support for keto. But I do have a tiny bone to pick with you guys if you wouldn’t mind hearing me out!

I am a certified holistic health coach who has specialized in the ketogenic diet for many years now. I love it with my whole heart because the benefits are outrageous and undeniable! However, I have noticed some do not find weight loss success when attempting keto because of one MAJOR issue in my opinion. I see it time and time again. It’s the calories.

I’m not talking about a person mistakenly eating too many carbs for individual tolerance nor am I talking about accidentally eating too much protein. These are people who are fully keto-adapted with adequate blood ketone readings who are working out and sleeping great, managing stress well, and yet they are not losing weight. Why? It’s because they are eating too many calories to give their body a reason to need to tap into body fat stores.

This is one of the things I have heard you guys repeatedly tell people often on Keto Talk—“calories don’t matter, as long as it’s coming from fat and as long as they are eaten to satiety.” But this doesn’t actually work in real life for most people and it also doesn’t make any logical sense. After all, if it were indeed sound and true, people would not be able to maintain weight in ketosis. Health coaches like me who have been in ketosis for years would just forever keep losing fat until we keeled over. But this isn’t happening because if a person is maintaining ketosis, they are eating enough calories from fat that the body doesn’t have to convert body fat into ketones and homeostasis is achieved.

I hear you guys say it’s hard or darn near impossible to eat too much fat because you get full. But, most people coming into this have leptin resistance, binge eating disorder, and other issues that bypass satiety completely. Without proper coaching and calorie accountability they get totally out of control on keto just like any other plan. Now, I’m not saying health isn’t still improving on keto even with excessive calories. Healing will indeed still happen. But not weight loss for most people. I can confidently say that after years of consulting that this is unfortunately the rule and not the exception.

Most people eat way past satiety after the first month or so of keto. It seems that at first they have such great appetite suppression from ketones and are able to stop before consuming calories in excess. But then that satiety dwindles and they start snacking on fat bombs, macadamia nuts, olives, cheese, and other non-protein or carb containing drinks or shakes with tons of cream. It’s an overload of fat calories. They are still having 1 to 2.5 blood ketone readings but they just keep packing in the calories from fat and stop losing weight. Every now and then even gain a little. It’s not water weight either, it’s body fat.

Then, they totally believe all the myths that keto doesn’t work and you only lose water weight in the beginning and that consuming fat ultimately makes you fat. I HATE those myths. We know ketosis is da bomb diggity and will absolutely shift every metabolic marker in the right direction. And in my opinion weight loss is the least important. But not to my clients! And not to the average person interested in health and wellness. I get clients who have tried various high-fat programs and they end up at me after they get frustrated gaining weight and feeling cruddy.

I wholeheartedly believe this weight gain is completely unnecessary if keto-adaptation happened as a result of using the fat on our bodies preferentially over the fat on our plates. What are your thoughts on this? Thank you so much for addressing my little pet peeve and I hope I didn’t come across as a jerk! I want to see this movement succeed and thrive and this is one topic that we need to get right to communicate the best information to the masses.

You guys are my heroes so thank you for doing what you do!


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Jimmy Moore from “Livin’ La Vida Low-Carb”
Dr. Adam Nally, DO from DocMuscles.com
– TODAY.COM article: Is The Ketogenic Diet Right For You?

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