The Keto.Fast.Flex plan is one that can appeal and accommodate anyone. The big question on everyone’s mind, and one of the most hotly debated topics, is on what we should eat. What is seemingly an innocuous question seems to be the most controversial of them all. You can’t create a comprehensive diet program that will work for everyone, because many of the diet programs (let alone the research studies) that are out there don’t keep in mind that the gut microbiome is central to health (and disease). The things that all the good eating plans have in common are that they take out all the junk and try to put in more of the good stuff.
Understanding the Basics
By now, we should all know that processed foods, packaged foods, sugars, fast foods, junk foods, sugar sweetened beverages, and hydrogenated fats are bad for you. For many, just stopping the intake of these unhealthy foods can make a big difference. That may only get you so far, however. The reason is because we need to understand how food works and what it can do for us.
It is important to remember that real diets for your longevity are more like lifestyle plans; they stay with you for life. The Keto.Fast.Flex plan is one that can appeal and accommodate anyone. Before you start getting out the pitch forks, thinking that I’m advocating a high meat diet, you should know that a vegan can be keto also.
What is KetoFLEX?
KetoFLEX is a high-fat, mildly ketogenic diet that involves eating highly nutritious whole foods, including many plant-based foods. The standard keto diet was initially developed to treat epileptic children who didn’t respond to medication. Keto diets focus on eating lots of fats and eliminating carbohydrates almost entirely to maintain blood ketone levels, which is hard to do.
KetoFLEX differs from the standard keto diet. With KetoFLEX, you’ll eat slightly more carbohydrates than you would on a traditional keto diet. The KetoFLEX diet is also different because it incorporates intermittent fasting, which has neuroprotective benefits.
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The Principles of the Keto.Fast.Flex Plan
I don’t like the word “diet” because it implies that you start something for a purpose and then you will probably be done at some point. That’s not how life and health works. So, how do you figure out a plan that will be able to stay with you for life?
The ketogenic diet has been around for a long time. It is a high fat, low carbohydrate diet and it has been used for almost 100 years in the treatment of epilepsy. It’s not for everyone, though. It has a purpose. Just think of it like this: our body has two main sources of fuel-sugar and ketones. Sugars come from carbs and ketones come from fats. Our default mode is to run on sugars but our brains and our whole body actually runs quite nicely on ketones as well. When you restrict carbohydrates you are running off the fat and revving up your body to burn more fat. Thus, the whole “fat for fuel” phrase that everyone has been chanting these days. (Side note: you have to make sure the quality of the food is high because all fat is not created equally; also, you are allowed to eat vegetables!). So, this may not be something to keep doing forever in all situations.
In certain settings like neurologic conditions, cognitive disorders, seizure disorders, obesity, and metabolic syndrome, the ketogenic diet makes sense, at least for a period of time. Think of it as a turbo booster, a jump starter. There are certain situations where you shouldn’t really be doing a ketogenic style diet (eg, children without epilepsy, severe weight loss, eating disorders, pregnancy, metabolic disorders) and this is why it is important to talk to your doctor before making any big changes in your lifestyle and have them monitor you while you are on this diet as well.
There is also a lot of data out there about intermittent fasting and its benefits. When we fast we convert the white fat cells (which store all the calories) to the beige fat cells (which burn energy). It’s nothing new that a ketogenic diet can help you grab the bull by the horns and regain control over your metabolism and weight. In some cases, it may be just fine to continue it for the long run. However, in many other cases, it may not be possible, necessary, or safe. Nonetheless, the first stop at trying to regain control over your health and weight loss could be found in the ketogenic diet, which is Phase 1 of the Keto.Fast.Flex Plan.
Personalizing the Plan
As I was developing this plan, I found that for me, I found benefit in doing Keto for about 3 months and after the first month, when things seem to be settled, I introduced fasting. I started with a basic fast and then tighten up the eating window. Then periodically I would practice fasting mimicking style eating. If anyone has a desire, need, or indication to cycle off the ketogenic style of eating, I still continue to suggest including fasting. But, then what next? Well, that’s the fun part.
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If you want to be able to maintain health and wellness while keeping the gut microbiome and whole health in mind, you have to acknowledge that it is YOU that is following this plan, not the masses. If you have Hashimoto’s Thyroiditis, Crohn’s Disease, Ulcerative Colitis, Bloating, SIBO, Obesity, Fatty Liver, Diabetes, or Heart Disease, there is going to need to be some sort of adjustment. Also, and most importantly, you have to allow for flexibility. Don’t tell me you’re never going on a vacation or doing anything fun with friends because you have to stay on your restrictive diet. We weren’t designed like that. Humans are social animals. Go out there, have fun! Live your life!
If you like the Keto-Fast part and that’s what resonates with you and you have been able to work with someone to tweak particulars of it that fit you best, then that’s great. If you break out of ketosis for a while when you are on vacation or chaperoning your kid’s field trip, who cares! Don’t beat yourself up over it. But, when all the fun is done, you’re probably going to have to give yourself a turbo charge boost again and re-induce the ketogenic stage and even consider a little more regimented fasting plan after things settle…then you can find your way back to Flexing again.
Maybe you also realize that ketogenic diet is not for you…it was nice when you were doing it and you lost some weight, but it’s not practical for you. That may be because, for many it really is not a practical long term plan (and/or there are other factors that need to be optimized as well). It’s ok to Flex to a method of eating that doesn’t keep you in ketosis, but that also doesn’t mean the first stop is the drive through window either! It helps to look at what’s going on in your gut microbiome, life, health, genes, and many other things in order to best optimize the Flex aspect for the long run. I personally like cycling out of ketosis and following a lower carb, balanced eating plan. It gives me the chance to diversity my diet, eat what’s in season, and expose my microbes to different things while building resiliency. If I can do it, you can do it too! Remember, we weren’t built to live regimented strict lives where we can only eat one way, or the way a study was designed for people that have nothing in common with you. Eating clean, whole foods in a ketogenic style can get your metabolism revved up and ready to burn fat. Fasting can help you reset by allowing your body to rest.
The KetoFLEX 12/3 Diet
Through Dr. Bredesen’s work with thousands of participants and now with early results from a successful clinical trial, he has found that the most effective nutrition for support of brain health includes a mildly ketogenic, plant-rich, highly nutritive diet combined with nightly fasting of a minimum of 12 hours with at least 3 before bed. This approach is summarized as the KetoFLEX 12/3 diet (sometimes also called the ReCODE diet) - a heavily plant-based, nutrient-dense, whole foods diet, that emphasizes local, organic, and seasonal non-starchy vegetables from every color of the rainbow, combined with an adequate amount of protein, and generous amounts of healthy fat. The primary side effect is improved health and protection from all chronic diseases.
KetoFLEX 12/3 is a diet (that becomes a lifestyle) to optimize cognition. FLEX refers to metabolic flexibility, the ability to use either glucose or fat as a fuel source. Specialized imaging has demonstrated that a reduction in the brain’s ability to use glucose precedes and accompanies Alzheimer’s disease. Evidence has shown that ketones can be used effectively as an alternative and adjunct fuel.
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It’s very important to first eliminate the inflammatory foods below for several reasons. Most importantly, combining inflammatory foods with a high fat diet (even with healthy fats) can contribute to coronary artery disease. To learn about the benefits of fasting, including autophagy, often referred to as cellular housekeeping, read Cognitive Restoration Through Fasting. Everyone should stop eating at least three hours before bed and extend the fast for at least twelve hours. Those who are ApoE4 positive can work on slowly extending the fast to 16+ hours. This is the level of the pyramid that comprises the foods - non-starchy vegetables and healthy fats - that will make up the majority of your plate. Non-starchy vegetables are those with a low glycemic index that won’t spike your blood glucose or affect your ability to get into ketosis.
Freely enjoy deeply pigmented, organic, seasonal, preferably local, non-starchy vegetables, including leafy greens and cruciferous (some raw and some cooked) with fresh herbs, spices, and teas. Increasing healthy fats, such as high polyphenol extra virgin olive oil (EVOO), avocado, nuts, and seeds, will not only make the nutrients from your vegetables more bioavailable, but it will also help you achieve nutritional ketosis. It’s very important to work on healing underlying chronic GI issues and to promote gut health as you are implementing this new diet. The gut microbiome provides the foundation for healthy function of our nutritional, immune, hormonal, and neurological systems.
This level of the pyramid includes animal protein and fruit, both of which can be very healthful but should be chosen carefully and intake moderated. It’s very important to get an adequate amount of protein but consuming too much impedes autophagy (also fostered by fasting), metabolic health, and even longevity. Healthy people under age 65 should limit protein consumption to 0.8-1.0 grams per kilogram of lean body mass per day. Concurrently implementing a strength training program to avoid frailty is highly recommended.
When consuming animal protein, quality matters. We recommend prioritizing low mercury, wild-caught seafood for the DHA and eggs from pastured hens for the choline. When eating meat, be sure that it’s 100% pastured. Ancestrally, fruit was enjoyed seasonally to fatten up for the winter. Because fruit is now imported from around the globe to be available year-round, many people overconsume and choose varieties that are hybridized to be sweeter and lower in fiber impairing metabolic health. Eat heirloom fruit seasonally. Always balance nutritive value against glycemic concerns. Just as the descriptor indulgences suggests, this is the level of the pyramid where we really start to put on the brakes. If necessary, use limited amounts of approved sweeteners that include pure versions of stevia and monk fruit. Alcohol is a neurotoxin and is best avoided by anyone with dependence issues or at risk of suffering from cognitive decline.
KetoFLEX and Alzheimer's Disease
Alzheimer’s disease is a specific type of cognitive impairment or dementia where beta-amyloid plaques and tau tangles develop inside brain cells (neurons). Another unique characteristic of neurons in a brain with Alzheimer’s is the inability to use glucose for energy. Alzheimer’s neurons are different. Neuroscience has shown Alzheimer’s neurons develop insulin resistance and struggle to take up and utilize blood glucose as a source of energy.
KetoFLEX works by providing the brain with ketones it can use as energy when it can’t use glucose, which can happen in Alzheimer’s disease. The “keto” part of KetoFLEX refers to bringing the body into ketosis. Ketosis happens when you eat very little glucose and the body shifts to producing ketone bodies from fats. If you want to have sustained ketosis, you must eat a high-fat, low-carbohydrate diet. The brain can use both glucose and ketone bodies as a fuel source. Evidence is mounting that ketones can slow down Alzheimer’s as part of a ketogenic diet.
The KetoFLEX diet also incorporates short intermittent fasting windows. Intermittent fasting reduces insulin resistance, one of the hallmark symptoms of Alzheimer’s disease in neurons. One of the ways that KetoFLEX is a vast improvement over the standard keto diet is metabolic flexibility.
Foods to Include and Avoid
The best foods for the Bredesen Protocol are what you might expect of a modified Mediterranean diet. There is a big emphasis on healthy fats, omega-3-rich proteins, and low-glycemic carbohydrates.
Foods to Emphasize:
- Prebiotic foods: Prebiotics help support the healthy microbes in your gut. The balance of your gut microbiome and gut health is directly correlated with Alzheimer’s.
- Foods with lots of resistant starch: These foods help feed your good gut microbes.
Foods to Avoid:
- Simple carbohydrates and high-glycemic foods: For your overall health, it’s wise to avoid high-carbohydrate, high-glycemic foods.
- Gluten and dairy: Both of these may increase inflammation.
Getting Started with KetoFLEX
You can get started on KetoFLEX by talking to a doctor trained in the Bredesen Protocol. It’s certainly worth starting this discussion early if you have a high risk of developing Alzheimer’s. If you fall into one of these categories, or you’re a caregiver of someone who does, don’t put off looking into the Bredesen Protocol.
Don’t be fooled: Bredesen Protocol is more holistic than simply changing your diet. When following the Bredesen Protocol with an expert, you’ll also need to have lab work done and an individualized care plan made.
Rustic Salmon Salad Recipe Concept
One of my favorite KetoFLEX 12/3 go-to meals is a simple, rustic salmon salad (see pic above) with loads of non-starchy vegetables from every color of the rainbow in a creamy aioli. It’s incredibly neuroprotective, loaded with omega-3s, phytonutrients, fiber, polyphenols, healthy fats, and is so easy to put together. From start to finish, it takes about 15 minutes. Feel free to put your personal spin on this idea by using any KetoFLEX 12/3 protein with any combination of non-starchy vegetables, herbs, and spices.
There are three main components: the protein + the aioli (which acts as a binder) + the non-starchy vegetables = neuroprotective yum.
Protein: Choose from among the ideas listed below or experiment with any approved KetoFLEX 12/3 protein.
- Salmon: I often use a leftover filet from the night before or canned wild-caught Alaskan Sockeye Salmon from Wild Planet.
- Lump crab: Fresh or from BPA-free cans or pouches.
- Pastured eggs: Cook them so the yolks are still a little soft.
- Pastured poultry: Leftovers are great; just shred with a fork.
- Extra Firm Tofu: No need to cook this vegan option. Just press well to drain and crumble into bite-sized pieces. It will pick up the flavors from the aioli, spices, and herbs.
- Hemp hearts: This is another great vegan option and a fun way to add some crunch.
- Nuts: A sprinkle of shelled pistachios, cashews, or slivered almonds add both flavor and crunch.
- Seeds: Pumpkin, sunflower, or sesame are some of my favorites.
- Legumes: Feel free to add a handful of legumes for a hardier dish.
Aioli: This magic creamy sauce originating from the Mediterranean is similar in texture to mayonnaise. But unlike mayonnaise which is often made from canola oil and eggs, aioli is typically made with olive oil and garlic. I’m going to share a super simple cheater version (that includes an egg) that takes less than 3 minutes to make.
I use high-polyphenol extra virgin olive oil (EVOO) for health benefits. If you’re not familiar with it, you may have to acclimate your tastebuds by using oils with a lower polyphenol count until you grow accustomed to a more bitter taste and the tickle in the back of your throat that accompanies high polyphenol EVOO. Feel free to blend lower and higher polyphenol varieties during this adjustment period.
Start by grinding several cloves of garlic with a mortar and pestle. Once ground, transfer to a tall cylindrical container. Add one cup of EVOO, a fresh pastured egg (wash the shell first), the juice of 1/2 lemon or lime (scant), and a dash of salt. Place your immersion blender all the way to the bottom of the container to ensure access to all ingredients and blend for 30 seconds. Voila! You’ve created a healthful, delicious aioli.
Experiment with adding different fresh herbs and seasonings for variety. Some of my favorites include finely chopped tarragon, parsley, basil, cilantro, dill, mint, rosemary or chives, freshly ground pepper, paprika, citrus zest, Dijon mustard, and even finely chopped Bubbies Kosher Dill pickles to add a probiotic punch. (Rescue Hack: Every once in a while, the aioli inexplicably doesn’t bind. If that happens, never fear! Simply add an additional egg. Blend for another 30 seconds for a perfectly creamy sauce.)
Non-Starchy Vegetables: This is where I go crazy. I really load up on the veggies for both the phytonutrients and fiber. Any non-starchy vegetable is fine to add. Depending upon the vegetable, I sometimes lightly cook them, such as with broccoli florets. If cooking, always be sure to chop your cruciferous vegetables 10-45 minutes before to maximize the antioxidant effect of sulforaphane. Some options include:
- Broccoli: I prefer my broccoli to be lightly cooked; it has an amazing detoxifying effect.
- Carrots: Chopped or julienned is great.
- Peppers: I tend to favor red, orange, or yellow. I always buy organic as these are on the Dirty Dozen list.
- Sweet or red onions: Just a little adds a sweet crunch and makes everything better!
- Scallions: I love the pop of color.
- Celery: I always include the leaves for extra flavor. Celery always needs to be organic.
- Red cabbage: I enjoy this raw; the color, crunch, and detoxifying effect make this a favorite.
- Radishes: I especially like the color and slightly sweeter taste of watermelon radishes when available.
- Tomatoes: Cherry tomatoes, cut in half, work well. These also have to be organic.
- Avocado: Try to get one that isn’t overly ripe; cut into bite-sized chunks.
- Artichoke hearts: I buy them non-marinated, in jars.
- Jicama slices: Who doesn’t need a little extra prebiotic sweet crunch?
- Microgreens: I love a rainbow variety.
The rest is pretty simple. Mix your protein and veggies in a large bowl. Add the desired amount of aioli, favorite spices, and herbs, and gently stir.