Keys To Making The Ketogenic Diet Work In The Real World w/ Franziska Spritzler | The Metabolic Link

This week’s episode of The Metabolic Link features an illuminating conversation between our host Dominic D'Agostino, PhD, and Franziska Spritzler, RD, CDE.
Franziska is a registered dietitian and certified diabetes educator who specializes in low-carb and ketogenic diets. She has been following a low-carb approach for over a decade.
In this episode, we cover:
💡 The essential tools Franziska uses when helping clients adhere to low-carb diets
💡 Managing and interpreting changes in blood work on low-carb diets
💡 Tips for navigating low-carb and ketogenic diets when traveling or eating out
💡 Franziska's stance on incorporating non-nutritive sweeteners and allulose
💡 Getting the whole family on board with dietary changes
💡 Franziska's excitement about the growth of metabolic health and her future plans
Be sure to register for MHS 2024 in Clearwater Beach, Florida as Franziska will be joining us as a speaker! You can join us in-person or virtually but spots are selling fast! Visit metabolichealthsummit.com to claim yours.
In every episode of The Metabolic Link, we’ll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
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*Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

[@gloriagiorgi1026]

The most difficult thing I believe is convincing a child or your partner to eat like you, this is the challenge for a family.

[@peterbeyer5755]

Steve from Serious Keto discusses this, I’ve lost 20 kg on keto and kept it of. My friends are aghast when I tell them I eat a high fat moderate frothing and no carb meals Eve; though they can see my weight loss.

[@marthatettenborn-ketocance3391]

As a low-carb/keto dietitian myself, I LOVED hearing you talking about the application of the "art" of the metabolic lifestyle. So many of Franziska's comments and recommendations were exactly what I say to my clients as well - so reassuring to see consistent messaging. And so great to hear you both discussing how you can be flexible and resilient around your dietary choices. The world needs to hear that you can survive and thrive without being a "militant" or "hardcore" keto. I reached out to Franziska back in 2016 when I was setting up my own practice and she was so generous with sharing her knowledge and her reference list with me. Congrats, Franziska, on your work with Diet Doctor and with Metabolic Mind!

[@franziskaspritzler-LCD]

Thanks very much for the nice feedback, support, and kind words!

[@gloriagiorgi1026]

May I ask where you are located Martha?

[@faylouise8169]

excellent interview!

[@robyn3349]

Thank you!

[@lhenkle13]

Where can I give this 2 thumbs up ❤

[@annfuller9044]

Nice info thank you. Very helpful. I'm hoping to attend the event in Jan at Clearwater. So excited for the healthcare CE too. That is call responsive to professionals needs. Kudos

[@franziskaspritzler-LCD]

Thank you so much! Hope to see you at the Metabolic Health Summit in January.

[@fractalbeans9513]

Thank you very much for this informative and inspiring discussion! Some questions: 1 - do we need to talk about calories in the context of ketogenic diets? Calories made sense for the CICO paradigm; the validity of calories as a useful tool has been debunked, hasn't it? 2 - I have been on a strictly zero carb diet for health reasons for about 5 months; monitor BS and ketones. Basically, doing strict carnivore except I also take MCT oil. I am doing it out of desperation so compliance is not an issue but I wonder how you can ensure compliance in outpatients? 3 - loved the part about lab work but I just can't afford it; the NHS (UK) health check, even if you are lucky to get an appointment, includes checking your blood sugar and, if you really insist, cholesterol test. Going private is impossible. 4 - Regulating appetite: I am not sure framing it as "appetite suppression" is not sending the wrong message. One of the great benefits since going zero carb keto has been the normalisation of appetite after the keto-adaptation phase. I am not suppressing it and I don't get cravings; the body is coping with that without my interference.

[@ScienceAppliedForGood]

Regarding question #1, I'd say there is no point in talking about calories at all, especially in the context of ketogenic diets. One who talks about calories is till under influence of the Energy Balance Model of obesity which is false, unlike the Carbohydrate-Insulin Model which provides good explanations for causes of obesity. More details, can be found in the following paper: Ludwig DS. Carbohydrate-insulin model: does the conventional view of obesity reverse cause and effect? Philos Trans R Soc Lond B Biol Sci. 2023 Oct 23;378(1888):20220211. doi: 10.1098/rstb.2022.0211. Epub 2023 Sep 4. PMID: 37661740; PMCID: PMC10475871.

[@lynnwilliams5432]

I like to know bone density effects.

[@JazzfromOz]

I reversed Osteopenia on this diet I think because it is rich in Collagen which binds calcium to the bone

[@andreadamascceno2139]

I believe that density will be affected, not only by diet, but also through exercise.

[@faylouise8169]

I just wanted to pass on the importance of cholecalciferol as a substrate that all other metabolites of vitamin d (umbrella term use) are dependent on its availability in physiologic levels, (apprx 24hr halflife, so one can be cholecalciferol deficient and be calcidiol sufficient which is a great misunderstanding in medical education, to only look at 25OHD as a 'nutrient' repletion lab assay, that would be false, as 25OHD calcidiol has a halflife of about 3 weeks or longer, and is tightly regulated by the renal feedback loops, and, circulating calcitriol 1,25OH2D plays very little in the body's need and use for immune modulation as well as all other autocrine/paracrine fnxs. Preferentially those cells will want cholecalciferol and in innate fnx there will be use of 25OHD. Keep in mind all further metabolites of cholecalciferol vitamin d the nutrient, (proper use of the term vitamin d), are all dependent on cholecalciferol. As such, the better way to use 25OHD as a nutrient status lab assay is only if one builds and maintains that level into physiologic range best above 50ng/ml by mostly daily intake of vitamin d cholecaliferol. Though vitamin d (umbrella term use) is considered steroidal family, it is different than all other steroidal hormones in its origin, and indeed calcitriol is an active hormone, all cells have the cellular apparatus to convert from either cholecalciferol, and or calcidiol for their own use, not dependent on megalin and cubilin as found in tissues of kidney for example in endocrine use. In fact most of the activity that vitamin d (umbrella term use) is found in autocrine/paracrine, with much less so in endocrine, though that canonical paradigm lays stuck there sadly. if you want to read research a great place to start is with The Role of the Parent Compound Vitamin D with Respect to Metabolism and Function: Why Clinical Dose Intervals Can Affect Clinical Outcomes: Hollis and Wagner: www.ncbi.nlm.nih.gov/pmc/articles/PMC3849670/ and please read on to their updated New insights into the vitamin D requirements during pregnancy: www.ncbi.nlm.nih.gov/pmc/articles/PMC5573964/ both these articles explain nicely the different metabolites, please note the addition of endothelial cells in the updated graph/map.

[@plaetzchennuss6548]

Thank you for the article links, it's a really important info.

[@H4KnSL4K]

I've heard a lot about getting sufficient protein. What if you really want autophagy? e.g. If you're using keto to fight cancer? Would it not make sense to have 'less than sufficient' protein, since that's what triggers your body to do this cleanup process that will remove and recycle broken cancer cells?

[@peterbeyer5755]

4 chicken drumsticks supply approx 100 grams of protein, I found that in Melbourne Australia this is the cheapest source of animal protein.