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Season 1, Episode 12: Keto Diet and Brain Health with Anna Cabeca, DO

By Jodi Cohen

Podcast episode highlight: essential alchemy – discussing keto diet and brain health with jodi cohen, ntp, and special guest anna cabeca, do.

With Anna Cabeca, DO, you’ll learn how not all keto diets are created equal, the powerful role social connection plays in the parasympathetic state, and the importance of intermittent fasting for overall health.

  • Not all keto diets are created equal
  • Powerful role social connection plays in the parasympathetic state
  • Importance of intermittent fasting for overall health”

About Anna Cabeca

Dr. Anna educates and highlights her unique keto-green diet and lifestyle as a safe and natural approach to relieving the nine worst menopause symptoms (brain fog, bladder problems, fatigue, weight gain, loss of intimacy, hormonal imbalance, vaginal dryness, and sleep disturbances). Board certified in gynecology, integrative, and anti-aging medicine, she’s designed a novel system for beating back the menopause blues and feeling youthful again.

If you’re enjoying the Essential Alchemy podcast, please leave Jodi a review on iTunes.

Jodi: Hi, I’m Jodi Cohen, your host, and I’m so excited to be joined today by my friend Dr. Anna, who is a board-certified gynecologist working in integrative and anti-aging medicine. She has designed a novel system for beating back the menopausal blues and feeling useful again with her unique Keto-Green diet.

And I’m so excited, Anna, that you’re here to talk to us about the connection between the Keto-Alkaline diet and your brain health, especially because, I think, it almost feels inaccessible in some ways. And so if you could just lay the groundwork by explaining what a Keto diet is and how it really helps our health.

Dr. Anna: I always say there’s many ways to see Keto or to do Keto, there’s Keto-Dirty, and there’s Keto-Clean, which is Keto-Green. So we see Keto everywhere. You can think bacon, and butter, and drink diet cokes, and be doing Keto, and get into ketosis, but that’s not the healthy way so, and especially, in the menopause and beyond because our hormones are shifting and add in a healthy dose of stress, and your reproductive hormones are bottomed out. And that creates a lot more havoc and stress on your body. And we don’t want to do that.

So, and the goal here is to get in to ketosis, but with a healthy balance through lifestyle practices and our plant-based superfoods. So all those dark green leafy and cruciferous vegetables that work to balance our hormones, to feed our gut microbiome, those are an essential part of what I talk about in my Keto-Green plans and my Keto-Green programs. And it’s always more than about what we eat.

So just in nuts and bolts, a Keto diet is a high-fat, moderate protein, very lowcarbohydrate diet. It can look like bacon and hotdogs or it can look like sliced smoked salmon with some avocado, some sprouts on a bed of arugula, add some capers, and drizzle it with olive oil. Both are Keto plates.

Jodi: and you do an amazing job in your book explaining how changing your diet shifts your insulin and how your body burns energy. Can you get into that a little bit?

Dr. Anna: Yeah. And this is what’s really critical because as we’re getting older, it’s harder and harder to burn fat. As we’re getting older, our progesterone hormone, estrogen, testosterone, DHEA, all start to decline. And insulin and cortisol go up. And these are hormones that age us. These are hormones that keep us youthful. So reproductive hormones keep us youthful, insulin, cortisol age us.

And we can see, even in a short time period of stress, like over the last few months, quarantine and concerns about the Corona Virus, how that can age us so rapidly, fine lines, and wrinkles, grey hair, difficulty sleeping, and all of that contributes to inflamm aging, inflammation and aging at the same time.

But the key thing with getting Keto-Green, we worked to balance these two key hormones, insulin and cortisol, and empower, empower the most important hormone of our body, of our lives. And that’s the hormone of love bonding and connection—oxytocin—the hormone that connects us to other people. That’s how we’re connected. And the hormone of laughter, of shared experiences, of intimacy, of connection, of joy, of pleasure, and giving, this is that hormone, and that we want more at the end of our lives than ever. We want to look and say, “Okay, these are all the people I’ve loved and have loved me versus these are all the things I’ve done or have been done for me.”

Jodi: That ties in to the parasympathetic state, that feeling of safety and connection, which is so critical as we’re navigating this uncertainty. And it’s so amazing. I would love to hear more about how the Keto diet helps put our body in that healing safe space.

Dr. Anna: Yeah. And so there are a few things why it’s even more important when we’re under stress or when we’re in menopause and beyond. It’s because, as I said, these reproductive hormones are declining. And progesterone is a neuroprotective hormone. It’s a hormone that we know that helps support our memory, and our mood, and a good night sleep. And it helps with the neurotransmitter GABA, which is the hormone of the neurotransmitter of relaxation. I always say to remember what the hormone GABA does, to experience it, think of the rock group ABBA. Watch the musical Mamma Mia. So true.

Jodi: Go GABA!

Dr. Anna: Yes, yes. So that feel-good hormone, that’s the neurotransmitter GABA.

Jodi: The dancing queen hormone.

Dr. Anna: Ah, totally, totally. And that’s so good. That makes the difference in how we feel. Now, as that declines, and estrogen and testosterone are produced from downstream from progesterone, there’s several metabolites down there, and we produce our estrogen and testosterone. What we know is that Alzheimer’s is over two times as prevalent in women as in men. Over two times is prevalent. So what is that? Why?

We think it has something to do with estrogen. And lo and behold…And I really believe it has more to do with progesterone. When we look at the graphs and follow the curves that the brain’s ability to use glucose for fuel rapidly declines between 35 and 55, this is a period of neuroendocrine vulnerability, and when we may be feeling anxious, mood swings, irritable, brain fog–

Jodi: Forgetful.

Dr. Anna: memory loss–

Jodi: “Where did I put my keys?”

Dr. Anna: We call it Sometimers. Going into a room and not having any recollection. And there’s a reason for this because, our brain, we use glucose for fuel or ketones, vitally important ketones for fuel. But the use of glucose for fuel in the brain appears to be estrogen dependent. So what that means is as our hormones are declining, and I believe progesterone, more so, as our hormones are declining, our brain’s basically starving for fuel.

Jodi: That is a really important point. And I really want to cover and land on it. So just so people understand, glucose comes from carbohydrates, right?

Dr. Anna: Yes.

Jodi: And that is the body’s preferred fuel. But what it sounds like you’re saying is if your estrogen levels are dropping, even if you have the raw material, it can’t be utilized?

Dr. Anna: Right, right, right, exactly. Yeah, it’s basically struggling. It’s suffocating for fuel. And I always say that glucose is to gasoline, as ketones are to jet fuel. So that’s a huge difference. And that’s a really important awareness that when we shift to getting into ketosis, we have more mental clarity.

Now I experienced this. And then I needed to understand why was I experiencing this as I shifted my diet from Keto, the Ketogenic diet, to KetoGreen or Keto-Alkaline, as I called it, because I started checking urine pH. And I want those pH strips to be seven when I wake up in the morning and when I go to bed at night. And if not, I figure out why? Is it too much stress? Is it too little micronutrients? What’s the reason there? Because acidic urine, over time, is associated with increased risk of hypertension, cardiovascular disease, stroke, cancer, bone loss, you name it. So we don’t want that. So everything we can do, as we implement plans, diet, nutrition, etcetera to help us, we need to test, not guess.

And what I recognized is cortisol, our stress hormone, is a very acidifying hormone. So you can have a stressful situation go from alkaline to acidic on your urine pH. And the opposite is true for oxytocin, which is the most alkalizing hormone. You could have a fun time out with friends, laughing, listening to music, whatever gives you joy, and then you’re going to be more alkaline no matter what you ate that evening.

Jodi: That’s an amazing point.

Dr. Anna: So that’s huge.

Jodi: Right, because what you’re really saying is—and greens are good for the liver, which helps detoxify hormones. There are so many powerful reasons to integrate them into your diet—but what you’re saying is that it offsets the negatives of stress because stress makes you more acidic and plants make you more alkaline so it evens you out.

Dr. Anna: Yeah, absolutely. And, I think, that’s a big wow factor. That is huge. And this is why we say in the research, 93% of diets fail. And number one, some of them aren’t sustainable. And number two is that, it’s not just about what you eat, it’s not just about what you eat. So our Keto-Green way is a lifestyle practice. So in my book, Keto-Green 16, I talk about 16-hour intermittent fasting, 16 key foods, a 16-day plan to really get you there and see results in a meaningful way.

And I think that lifestyle factor, the intermittent fasting, the no more snacking the creating lifestyle practices to alkalinize us, whether it’s meditation, getting out in nature, positive thinking, not just about how we think and talk to others, most importantly, how we think and talk to ourselves. Now, you and I, both, suffered and grieved through the loss of a child, the loss of our son.

Jodi: Of our little boys.

Dr. Anna: Mmm hmm, yep. And there is just so much with this that persist under the surface. If we can’t get to understand what’s happening to our body, what shifts us from the parasympathetic to the sympathetic state, and we’re in constant sympathetic overdrive, and that constant sympathetic drive depletes your oxytocin, this hormone of connection, and what happens is, cortisol’s up, initially, and then it’s down, oxytocin is down, and you feel that you’re in this state of disconnect, “Like, I know I love my kids, but I don’t feel loved. I know I love my spouse. I don’t feel love for him. I used to love doing this work. I don’t even want to go into the office anymore.” All of these things come up because we’re disconnected. We’re in this cortisol-oxytocin disconnection state. And it feels isolation, depression, and hedonia, no pleasure anywhere.

Jodi: I think that’s happening now during this COVID experience because we’re wearing masks, we’re isolating six-feet apart. I feel that everyone is in that place. And so I’m so grateful that you can share. I want to back up and make sure people really understand Keto, and how you eliminate carbs, but then how you also are able to add vegetables, which most people think of as carbs. Could you land on that for a minute just in case anyone’s confused?

Dr. Anna: Yeah. So the low carbohydrates, so we can have, typically, in Keto, most programs will tell you, you can have around 30, 40 grams of carbohydrates a day really to get into ketosis. I found—for those of us, like me, I’m 54 this month, postmenopausal, I thought I was almost postmenopausal, but I had another period after 12 months of not having one—so in this stage that we really have to look at all the areas that really support our body. Like I find that we only need 30 grams of carbohydrates at this.

And sometimes, we can bump up, once we’re in ketosis, but to get there, we really need to restrict to 30 grams and using low-carbohydrate grains, like the dark-leafy greens, kale, spinach, collards, sprouts, herbs and spices, so medicinal, and the cruciferous vegetables that help with estrogen detoxification, which is really important.

Now, men have ten times as much testosterone as women so the hormonal deficit don’t affect them as much as they do us, but it still does. So they’re able to get in to ketosis faster, they’re able to sustain that longer, too, for the most part. So we really have to be conscious. And I’m a big believer of bumping in and out of ketosis.

Jodi: Interesting.

Dr. Anna: So I think that metabolic flexibility is really beneficial so that we have some carb days. And if you’re cycling, typically, in the luteal phase of your cycle or before your period starts, you’re having those carb cravings, listen to your body. And that may be like a higher carb day.

Jodi: Yeah, and I loved the way you’ve explained it. You were talking about how if glucose is available, that’s what it feeds on, but if you eliminate that for three days, then it goes to the backup fuel which is fat, and you go to ketosis. And that’s like how to shift in to ketosis. I would love for you to talk, also, a little bit about intermittent fasting and how that’s beneficial for the body and the brain.

Dr. Anna: Yes, intermittent fasting is a crucially important part to help your body get in to ketosis, but, also, to get it burning ketones for fuel over glucose to really get you to become more insulin insensitive because, as I said, insulin is one of the hormones that increase when we age that cause more rapid aging, and, also, cause increased levels. As we become more insulin resistant, we have higher circulating levels of glucose, which we know that every point, when we’re looking at glucose levels, over time, every point above 5.3 when we’re looking specifically at our hemoglobin A1c, we’re increasing our risk to get Alzheimer’s or dementia, exponentially.

Jodi: And they call Alzheimer’s a diabetes 3 disease.

Dr. Anna: Type 3 diabetes.

Jodi: Yes. So basically, if your blood sugar’s out of control, if your glucose is too high, which makes your insulin too high, and you might be insulin resistant, you’re setting the state for Alzheimer’s. So the way to unravel that is to switch to burning fat for fuel and intermittent fasting. Can you talk about how giving your body a digestive break really helps allow it to heal?

Dr. Anna: Yeah, definitely, because we need to give our body digestive rest so intermittent fasting and longer fasting. First of all, it takes a while for our body to digest the food. We are conditioned over time to have long periods of fasting.

Now, over the last hundred years, that really hasn’t happened very much at all, not in our society, certainly not in America. So longer periods of intermittent fasting is really necessary to bring that glucose down, to get our body into autophagy, into this like, I always say this, self-restorative state where we’re killing off the unhealthy cells that are just riding, going along for the ride, and having a field day in our body, which we all have at some point.

So doing fasting and extended fasting can really help us in this instance to become more insulin sensitive, get glucose nice and low, start using our own fat stores, as well as killing off the unhealthy cells that are the weak cells, the unhealthy cells that are in our bodies, so that we can actually boost our immune system. And we know that this is a good way to fortify our immune system. Plus, at least a 72-hour fast is beneficial for gut restoration, for healing the GI tract.

Jodi: I was going to ask that. Like for the people listening, are you saying like don’t eat before 10 a.m. and stop at 6:00? How do you recommend people get into it?

Dr. Anna: Intermittent fasting? First of all, I would say that we want to keep, at least, on a regular basis, 13 hours between dinner and breakfast. So that’s easy, 7 p.m. to 8 a.m. We want to eat by 7 p.m. because any time we eat after 7 p.m. appears to increase our level of insulin for that same food if we ate it at 6 p.m. over 30 to 70% more. So again, contributing to insulin resistant, when we eat late at night, go right into fat storage mode. I don’t know about you, guys, but I don’t want any more fat stored anywhere.

Jodi: Yeah, that’s a great tip. So definitely finish eating by 7 p.m.

Dr. Anna: Finish eating by 7:00, then do at least 13 hours. Start with that because it takes time. I know clients used to struggle with just a 12-hour fast. When they come in for their blood work, “Hey, Dr. Ann, gosh, it was so hard to go 12 hours without eating.” But we say fasting labs at least 12 hours because it takes that long for glucose to get to baseline. So you can imagine the destructive advice of snacking, and what that does to your body over time, we create insulin resistant.

So the research shows that in 2016 in the Journal of the American Medical Association, research was published looking at women with breast cancer. And what it showed was that women with breast cancer who had at least 13 hours between dinner and breakfast had a significantly lower hemoglobin A1c and a significantly reduced risk of recurrent breast cancer. That’s huge! That’s why every woman needs to do that. We need to intermittent fast at least 13 hours.

Now, in Keto-Green 16, I push you to a 16-hour intermittent fast. So say, you finish dinner by 7:00, 6:00 or 7:00 p.m., and you break fast at 10:00 to 11:00 a.m. with a healthy Keto-Green meal—healthy fats, some great greens. You could do a Keto-Green shake. Have a Keto-Green protein mix where you could use like nuts, or seeds, or egg yolks, if you want, or collagen, depending, and add in a handful of microgreens, or kale, or spinach, and throw in some celery, all those fibers are prebiotics to really help support your healthy gut bacteria, and then healthy fats like a half an avocado, quarter to a half of avocado.

You can add in MCT oil or other seed oils like pumpkin seed oil. And you could add those in to your Keto-Green shake so you’re getting healthy fats, good quality protein, and a good amount of fiber from your greens. And then, you will not be hungry and be able to space out to just have two meals a day, one or two meals a day.

Jodi: So I have to ask you because I hear differing opinions. What do you think of coffee?

Dr. Anna: Well, because with creating my recipes, I wore a continuous glucose monitor for over a year. So looking at how everything I did affected like what my blood sugar was doing, from what I was eating, to what I was thinking. High stress increases your blood sugar and cortisol increases glucose secretion.

So when I found out that, and this was very interesting because when I would stop drinking coffee for a week or something, periodically doing a detox, and I’d stop my coffee, I typically lose three to four pounds that week without doing anything really else. Just stopping that coffee when I want to give myself that break in coffee.

And it turns out, when I was using this glucose monitor, what I found is that my glucose, just from drinking that black cup of coffee, would increase 20 to 30 points, would increase 20 to 30 points, so 20 to 30 units. So that was why because I was just bumping up my glucose, causing an increase in insulin, and creating this downward cycle, and plus, I’d be hungrier, and thirstier, and all those things. So yes, coffee’s okay if it’s okay for you. But if it’s not okay for you, then take a break in it, but the only way is to experience what’s going on.

And the other thing, too, like what was interesting, because I always check my urine pH and ketones, like I’d wake up in ketosis, have black coffee. And then I would check later, and I’m like, “I’m not in ketosis anymore. What’s going on, but I’ve only had black coffee.” So that’s where the caffeine and the stress increasing the glucose, and/or just being stressful, thinking about a project, or being late on a deadline, could increase my blood sugar enough to kick me out of ketosis. Isn’t that crazy? Crazy.

Jodi: Well, no. One of the things that I love about you that I really wanted you on the summit is that you’re one of the few people that you’re actually practicing and you’re doing research. So you’re seeing things in the field and then you’re reverse engineering, “Oh, why is that helpful, super helpful?”

Dr. Anna: Yes, we have tens of thousands of clients doing the Keto-Green plan with amazing success. So actually, I know from The Hormone Fix and KetoGreen 16, my books, I’m hearing often how these things have changed the way people think, and how they live, and not just for themselves but for their family, because the realization, “It’s not just about what we eat.” there’s these lifestyle factors that we have to put into place.”

And that was it for me is that understanding the effect of PTSD or Post Traumatic Stress and how that affects your sympathetic nervous system, how it affects your physiology, how it affects your hormone balance. And even though our hormones can be dialed in, it takes more than hormones to fix our hormones.

Jodi: Exactly, exactly. But you know, the thing I’ve noticed, whenever I eat really clean and do more vegetables than protein, I feel calmer, like I just feel happier, and feel more grounded. It’s really, it’s always surprising to me how it affects my mental space, as well as my physical space, too.

Dr. Anna: I think that women are really sensitive to that, too, because just think, we’re more than physical, we’re energetic. And everyone is a little different. And you can see that’s a really good intuitive way to feel what you’re eating. And, I think, that goes even from shopping.

I’m here in Dallas. And there’s a [Halal Market], which is they say the meat is humanely killed. Like the animals are humanely killed to get the meat. So they’re prayed over. They’re humanely killed, and in as a positive a situation as possible. I don’t know exactly how that works, but anyway because—

Jodi: It’s how they kill kosher meat, they’re very gentle, and it doesn’t spark adrenaline from the animal.

Dr. Anna: And that’s important because otherwise, we’re getting that in our food. If the animal’s being raised in a stressed environment, or stressed, and crowded, we’re going to ingest those hormones. So what we ate and how they lived really does matter. And we can take that energy in. We can take those hormones in. And hormones are energetic molecules.

Jodi: Well, that’s like with plants and with essential oils, it really matters to me where its gown, how its grown, same thing.

Dr. Anna: Yes.

Jodi: This was so amazing. Is there anything else that we didn’t touch on that you’d like to add?

Dr. Anna: Well, I think it’s really important that we just recognize that we are works in progress, no matter how old we are, or how much we’ve done, to be able to play with different things over time, it’s really, really powerful. So I continue on this journey right alongside of all my listeners, blogging about my experiences, and listening, taking in what others are experiencing because there’s so much more to our story.

And I love that the scientists are continuing to work and validate some of these areas where women and men are different. But just to let everyone know, this is a marathon, not a sprint, we’re in it for the long haul so no quick fixes. But just be gentle with yourself. Take one step at a time. And the most important promises we make, honestly, are the ones we make to ourselves. So if we promise ourselves that we’re going to do something, let’s stay true to that. And I found that, just that sentence, alone, has helped me so much at this stage in my life.

Jodi: And so many wonderful like strategies and tools to help people take that first step, that first promise. Where can they find out more about you and your resources?

Dr. Anna: Ah, thank you. So my website is DrAnna.com, D-R-A-N-N-A dot com, really easy. So that will take you to my main website, but I’m also, I have my DrAnnaC@DrAnnaC on Facebook, and my Keto-Green community, which is so lively, and interactive, and over ten thousand strong, amazing people, and on Instagram @DrAnnaCabeca. So it’s fun to connect with all of you, guys, there whenever possible.

Jodi: And you must read Keto-Green diet.

Dr. Anna: Yes, the Keto-Green 16 and The Hormone Fix are available everywhere books are sold. And they are essential reading. Absolutely.

Jodi: Well, thank you, you’re always a delight. Thank you for sharing your wisdom.

Dr. Anna: Thank you for having me.

Jodi: Thank you.

About The Author

Jodi Cohen

Jodi Sternoff Cohen is the founder of Vibrant Blue Oils. An author, speaker, nutritional therapist, and a leading international authority on essential oils, Jodi has helped over 50,000 individuals support their health with essential oils.