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This New, Weird Diet Might Be The Best Thing For Gut Health & Weight Loss. Here's Why — And Exactly What To Do

Vincent M. Pedre, M.D.
Board-Certified Internist
By Vincent M. Pedre, M.D.
Board-Certified Internist
Dr. Vincent M. Pedre is a board-certified internist in private practice in New York City since 2004. He serves as medical director of Pedre Integrative Health, president of Dr. Pedre Wellness, and is the author of Happy Gut.
Photo by Nataša Mandić
July 11, 2018

It's 2018, and ketogenic (or keto) diets and intermittent fasting are not only buzzy, they're practically mainstream. At this point, I've answered nearly every question about how both plans fare in terms of gut health, weight loss, and so much more, and I know how effective both plans can be. As a medical doctor who specializes in gut health, I’ve used both independently with patients and have seen great results.

But I also know that these plans don't work for everyone.

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If you prefer not eating massive amounts of dietary fat (up to 90 percent by some estimations), going keto could feel cumbersome. Ketogenic diets can also become very calorie-dense, and eating too many calories from any food can stall weight loss or cause weight gain. For other patients, going long periods without eating can feel like purgatory. "Nearly every minute I’m fasting, I start thinking about food," one patient confessed when I put her on a 14-hour daily fast.

The benefits of combining fasting with ketosis

With these and other considerations in mind, I created a hybrid plan that combines a modified form of ketogenic eating with intermittent fasting. I’ve called it The Cyclitarian Plan because you cycle fasting with a higher-fat, plant-based diet to minimize or eliminate the drawbacks of both plans while amplifying their benefits. Among these benefits are optimized gut health, hormone balance, improved insulin sensitivity and blood sugar control, increased energy, better brain power, long-lasting stamina, and lasting fat loss. When you're Cyclitarian, you turn yourself into a fat-burning machine by using your own body's fat as fuel while you're fasting, and then using the fat you eat as fuel while you're in ketosis.

And I'm not the only person to witness the benefits of combining keto with intermittent fasting. As Jason Fung, M.D., wrote in his best-selling book The Complete Guide to Fasting, "Being in ketosis teaches your body to burn fat for fuel rather than sugar, and since that’s what your body has to do during fasting, if you’re already in ketosis, your body is already using fuel the way it’s supposed to."

Far from the latest diet fad, people have used fasting as a powerful healing modality for centuries. Recent research has elucidated those fasting benefits, including lowering inflammation and reducing your risk of disease. The Cyclitarian Plan also is the ideal way to heal your gut. Just like your body has its own internal clock, your gut flora maintain their own circadian rhythm.

Giving your gut a break and eating keto-friendly, gut-healing foods becomes the best way to optimize that circadian rhythm to support immune health, weight loss, and all the other benefits of a healthy microbiome. The key is staying consistent with what you eat (and don’t eat) every day. With The Cyclitarian Plan, I’ve tweaked both strategies to optimize a program that works to help you heal your gut, lose weight, reduce disease risk, and hit the reset button on your overall health. I've also added in a mix of potent gut-healing foods to supercharge the plan.

What does a Cyclitarian diet look like?

1. You eat largely plant-based, with gut-healing foods mixed in.

Contrary to what you might believe, ketogenic diets are not an all-the-bacon-you-can-eat plan or about throwing big slabs of butter into your coffee. My plan incorporates plenty of fiber-rich plant foods, prebiotic-rich fibers like dandelion greens, and fermented/ cultured foods and drinks like kimchi, sauerkraut, and coconut kefir. You can incorporate many of these foods for very few carbs and stay in ketosis. Gut health is an often-overlooked but crucial aspect of losing weight and cultivating overall health. Among its many benefits, research shows that balancing your gut microbiota could play a role in helping you lose weight and prevent obesity or type 2 diabetes. The Cyclitarian Plan centers on gut-healing foods, including plenty of gut-healing caprylic acid and immune-boosting lauric acid (in coconut oil), along with anti-inflammatory foods like wild-caught salmon, walnuts, flaxseeds, and chia seeds.

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2. You fast in a way that fits your body, starting small.

I don’t believe in one-size-fits-all programs; I think it's always important to take your individual needs into account. Especially if you formerly ate a high-carbohydrate diet, I recommend following a plant-rich ketogenic diet first, and then transitioning into fasting. Once your body has become keto-adapted (using fat as its fuel) and you stabilize blood sugar levels, fasting usually becomes easier. With fasting, I encourage patients to start small and gradually increase their intervals. You might start with a 12-hour window between dinner and breakfast and increase that window to 14, 16, or more hours daily over time. You can also vary it day by day—the key is making it work for you.

Life happens, and you shouldn’t feel absolutely confined to any diet. Especially on days when you work out, you can break ketosis with higher-carbohydrate gut-supporting foods, like root vegetables (sweet potato, turnips, and carrots). Intermittent fasting also allows some flexibility. During weekends, for instance, my patients might have breakfast with their kids rather than strictly adhere to their workweek no-breakfast regimen. The intermittent piece of the plan allows for day-to-day variability, keeping the diet non-monotonous and exciting.

3. You should eat fat—but not obsess over it.

Ketogenic plans usually contain around 70 percent or more dietary fat. You needn’t become that obsessive about ordering, say, the highest-fat steak or dousing your meat with coconut oil. Instead, aim for a variety of healthy, higher-fat foods, including avocados, nuts, and olives, without worrying about macro ratios. The centerpiece of the plan is still fiber-rich vegetables, which are the foundation of a healthy gut microbiome.

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4. You can still eat carbs!

Researchers estimate you should eat fewer than 50 grams of carbohydrate daily to get and stay in ketosis. That’s easily doable as a Cyclitarian. You can fit in tons of leafy and cruciferous vegetables along with some low-sugar fruit (berries are awesome) on this plan, plus fasting allows you some additional leeway. That doesn’t mean you can eat a doughnut and lose weight, but you can be a little more carb-lenient on this plan.

Here's what a day on The Cyclitarian Plan looks like.

While I custom-design The Cyclitarian Plan for every patient in my practice, this typical day from a middle-age male provides a good example of the diet in action:

7 a.m.: Black coffee or green tea (my preference). On mornings he felt especially hungry, we added MCT oil and grass-fed ghee (better for people who may be dairy-sensitive) into his morning beverage to keep him in ketosis.

Noon: A big salad topped with high-fat foods like grass-fed beef, walnuts, olives, and extra-virgin olive oil.

Afternoon snack: Macadamia nuts, sprouted almonds, or olives.

7 p.m.: Wild-caught salmon, spinach sautéed in coconut oil, side of herb greens dressed with olive oil and lemon juice, then berries for dessert. (Many patients find even with a ketogenic diet, they can fit a glass or two of very dry red wine into two to three dinners per week while staying in ketosis. On nights before big workouts, we allowed a serving of an energy-dense, complex carb, like sweet potato or butternut squash, to build muscle glycogen stores to help power his workouts.)

Under that schedule, he stopped eating at 8 p.m. for the evening. If he felt like having something later in the evening, he stuck to unsweetened herbal hot teas. Like many patients, he stayed full and focused throughout the day, avoiding the energy-robbing spikes and crashes high-carbohydrate diets can create, including that post-lunch energy slump. He didn’t dwell on food as much, and he enjoyed it when he ate.

With some minor tweaks, The Cyclitarian Plan can work for a wide range of people. What I believe proves most practical about this hybrid plan is its flexibility. You could mix up your fasting schedule and you can stay in ketosis five days a week while incorporating higher-carbohydrate "cheat" foods the other two days (like on the weekends). Of course, always talk to your doctor before starting a new diet program of any sort to make sure its suited for your individual makeup!

Want to know more about the benefits of intermittent fasting? Here's the scoop.

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Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D.

Vincent M. Pedre, M.D., medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. He completed his bachelor’s degree in Biology at Cornell University before attending the University of Miami School of Medicine and completed his residency in Internal Medicine at the Mount Sinai School of Medicine. He has appeared on the Martha Stewart Show and ABC and is the author of Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy, and Eliminate Pain. Dr. Pedre is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture.

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