Learn more about Peter Attia’s digital program
This week I had dinner at a great steakhouse in New York with a very good friend. Like any two “normal” guys after a long day, all we could talk about was science, and on this particular night the topic du jour was NAFLD (non-alcoholic fatty liver disease for the non-cognoscenti). We ate, we drank, and we shook our heads in disbelief at the thought of 7 million children in the United States being afflicted with NAFLD. In the next few years NAFLD will become the number one indication for liver transplantation (not a typo).
After dinner, my friend, who I dine with almost every time I’m in NYC, made a comment about how many vegetables and how much fruit I consumed.
I had the following: a chopped salad, tuna tartare, a 12 oz filet; and we split an order of sautéed onions, brussels sprouts, and a bowl of berries.
He asked, “How are you able to stay in ketosis with all of those carbs?” I responded, basically, that for the past few months I have not been consistently in ketosis, and when I am it’s only following a long bike ride where my BHB levels may get back into the 2-3 mM range. Most days, however, I live in the 0.3 to 0.8 mM range, depending on the time of day. (In my mind, to reap the benefits of nutritional ketosis, one probably needs to consistently be in the 1-3 mM range, and for some “applications” 3-4 mM is probably ideal.)
So what gives, you may be thinking. Is Peter Attia not Mr. Ketosis? Well, my friend suggested it might be time for another one of the dreaded what-do-I-eat posts.
Anyone who knows me or who has read this blog for a while will appreciate the fact that I loathe talking about what I eat. Why? Because, it unfortunately gets interpreted by many as what they should eat. It’s like asking me what exercises I do, and inferring you should do the same. It doesn’t make sense. I have specific genetic factors, epigenetic alterations, and goals. These factors coalesce to shape my behavior – how I exercise, what I eat, what I supplement.
A little backstory first
In September of last year, for my wife’s birthday, we went to our favorite restaurant in San Diego, where we live. The day before I emailed the owner and general manager, both friends, and asked for them to have one of our favorite off-menu items on hand (the best sushi in San Diego). They happily obliged and asked which of their desserts my wife would most like. I said something to the effect of: well, they are all great, so you pick.
The next evening, after eating more sushi and sashimi than I could imagine (I ate 3 platters myself), they brought out a platter with a full size serving of each of their signature SIX desserts, each with a lit candle. We sang Happy Birthday, blew out the candles, and my daughter and wife, themselves already stuffed, proceeded to have a small forkful of each of the six desserts. My daughter said, “Daddy, these are so yummy! Why don’t you have a bite?” To which my wife echoed, “Yea, they really are ridiculous…”
And in that instant, I made a decision. I did something I had not done in 4 years (to the month, actually). The decision was this: about 3 or 4 times a year (I opted for my wife’s and daughter’s birthdays, Thanksgiving, and maybe something else), I would – for one meal – eat whatever the hell I wanted.
In the next 15 minutes I devoured the remaining 4/5-ths of EACH of the six culinary masterpieces in front of me. From cheesecake, to carrot cake, to decadent ice cream, and stuff I didn’t even recognize, I ate it. In an instant I felt both wonderful and horrible. The look on my wife’s and daughter’s faces – alone – was worth it. Their jaws on the table the whole time. The taste was beyond what I remembered (actually, much sweeter than I remembered, probably because when you don’t eat sugar for 4 years, well, you know).
I could barely get up from the table. That night, when we got home, I had a horrible headache. 1,000 mg of Tylenol and 2 glasses of water later, I still couldn’t sleep. I eventually got a few winks of sleep. The next day I felt hung over – a feeling I had not experienced since my 26th birthday. My fasting glucose was 126 mg/dL and BHB was 0.2 mM. Clearly I was out of ketosis.
I decided to go out for a glycogen-depleting workout (multiple sets of 3 min all out intervals on the bike) and about 36 hours later, after resuming my normal diet, I was right back into ketosis and felt just fine. I told my wife I was going to repeat this experience on Thanksgiving. As such, and despite how far in advance this was, I asked her to plan to make an extra bowl of my favorite Thanksgiving dish – candied sweet potatoes – baked sweet potatoes coated in melted marshmallows.
Thanksgiving came and went, and I repeated the same act of debauchery during the big feast. Sure enough, by the Sunday morning of Thanksgiving weekend, I felt back to my baseline. I haven’t gone on a bender like that since, but I’m probably due for one.
I’m sure at least some of you are asking, “Does Peter still think sugar is metabolically deranging?” The answer is absolutely, at the levels it is consumed by most Americans. If you want a refresher on my point of view on sugar, definitely give this post a re-read.
So what did I take away from this?
Somewhere between “every day” and “never” there is a tolerance I have developed to consume massive amounts of carbohydrates, and specifically sugar. Now, there are two components to this: a purely physiologic one and a behavioral one (which I suspect is heavily influenced by my physiology).
Focusing just on the physiology, I would guess I could probably “tolerate” a binge like that every few weeks with little measurable or discernable adverse effect. I won’t even attempt to argue whether it’s every 7 days, every 14 days, or every 30 days. But, it’s probably somewhere in that vicinity.
What about the behavioral side? Well, I suspect there exists a different “frequency distribution function” that describes how often I could binge like this without resuming unhealthy eating habits in the long run. If I had to guess, I think the threshold for recidivism is higher from the behavioral tipping point than it is for the physiologic one. In other words, habits matter. I can probably tolerate – physiologically – more sugar today than I can tolerate behaviorally.
One last point I’d be remiss to leave out. You should keep in mind that for a period of 4 years, my consumption of sugar (sucrose, HFCS, liquid fructose in the form of any beverage, etc.) has been less than about 5 grams per day. The average American, depending on which stats you believe (I think they are all pretty weak), consumes somewhere in the neighborhood of 100 to 120 grams per day of sugar, NOT including the liquid fructose in juice!
So, I have to at least entertain the hypothesis that 4 years of avoiding sugar has been a sufficient enough period of time to offer me some sort of “metabolic reset.” Now, I have no intention of testing this. If I was once susceptible to insulin resistance, I’m pretty sure I will always be. But, an interesting Gedankenexperiment would have me going back to one of several different dietary patterns – vegan, but with no sugar; standard American diet with lots of sugar; modestly higher carb, but still sugar-restricted – all could offer insights into the physiology of adiposity and fuel partitioning in my metabolically reset condition.
How has this shaped my current eating behavior?
Sometime early in the New Year, I started really craving more vegetables. I’ve always loved them. Even in ketosis I still ate one or two salads each day most days, but I was pretty restrictive about the quantity of vegetables that had much carbohydrate in them (e.g., tomatoes, carrots). But now, I wanted even more. Big heaping bowls of curry stir-fry. (I have to toot my horn on this one thing. I make a really good, creamy, spicy curry stir-fry.) I realized this would probably knock me out of ketosis, especially with the large amount of tofu I mix with it and the yogurt I use to make the sauce.
My lunchtime salads were getting bigger and bigger, and I was piling more and more “stuff” into them. Almost laughable by the standards of those around me.
And I noticed I was eating less meat. Not at all by “design,” but somehow by seemingly craving less. It seemed an average week would have maybe 2 servings of red meat. When a great steak is placed in front of me, believe me, I enjoy every bite, but I found I just wanted it less. I also started craving a bit more fruit, especially berries and even apples, the former I consumed in modest amounts in ketosis, the latter I did not at all. (Because I know someone will ask – do I think red meat is harmful? – the answer is no, I do not believe so. Certainly not based on evidence I’ve seen to date, including the recent story about protein. For those looking to brush up on the state of evidence implicating red meat, I’d recommend three posts – one I wrote many moons ago in response to one of the dozen epidemiology stories, one written by Chris Masterjohn in response to the TMAO data, and one recently by Zoe Harcombe in response to the protein epidemiology).
I don’t know what to make of this, of course, and it may be nothing at all, other than an evolution of preference. I’ve checked mineral levels in my body in search of a clue (none showed up). Maybe I’m over- or under-saturated in some key nutrient?
Now, since everyone seems to care how much carbohydrate I consume, here is my current framework. I put carbohydrates into 5 essentially MECE categories:
- Those I consume daily – mostly salad stuff and other vegetables; about twice a week I make a curry stir fry with tofu, for example.
- Those I consume often – nuts, berries, almond butter (which I just spoon out of the jar), super starch (both as a meal replacement and post-workout drink).
- Those I consume intermittently – a couple spoons of rice here and there, especially when I make Indian food or when we have sushi; a piece of baked potato when it looks particularly appetizing. If my daughter “makes” spaghetti, which she loves, I’ll usually have a forkful to remind her that her dad is not a complete freak.
- Those I consume only on very special occasions – exceptional desserts, for example – about 2 or 3 times a year, like the ones I consumed on my wife’s birthday, or the candied yams. (NB: One thing I decided in an instant – if I’m going on a bender, it’s not going to be for “average” dessert like some lame birthday cake; it’s got to be best in class.)
- Those I still completely refrain from – I call these the “cheap” carbs – basically all else (including cookies, potato chips, cereals, and the candy bars they keep handing me on this flight as I type this), including any liquid form of fructose, such as juice or sports drinks.
Below is a “typical” 5 days of eating over the past few months. Keep in mind, I virtually never consume breakfast, maybe once a month (e.g., if I have a breakfast meeting). Essentially, I do all of my exercise (current routine, below) in a fasted state only consuming the BioSteel’s high performance sports drink (HPSD), which contains virtually no calories – maybe 8 kcal of BCAA per serving. So, despite the dietary changes I’ve made, and the fact that I’m not in ketosis most of the time, I remain seemingly well fat adapted, though RQ is a bit higher than before.
I should point out that I spend much less time exercising than I have historically, due to time constraints. But, I still aim for the following schedule, which is interrupted by travel during at least 2 or 3 weeks each month. The schedule below amounts to about 14 to 16 hours per week of training.
Monday – high intensity lift, followed by swim
Tuesday – ride (tempo)
Wednesday – swim
Thursday – ride (TT practice or threshold)
Friday – high intensity lift
Saturday – ride (VO2 max intervals), followed by swim
Sunday – group ride or solo TT practice
I can’t believe I’m about to do this…I just have this horrible feeling someone is going to attempt to replicate this, bite-for-bite, for no good reason. Please refrain. Remember, this is what I eat because of how my body works.
Wednesday
Lunch – huge salad (bowl larger than my head) with romaine lettuce, kale, carrots, tomatoes, cucumbers, olives, mushrooms, chicken breast, 2 tbsp olive oil, 3 tbsp lemon juice, 1 tbsp white vinegar, 1 cup of almond slivers
Snack – a cup of macadamia nuts
Dinner – Another large salad, but no chicken or nuts in this one; 1 pound of salmon; bowl of berries to follow
Thursday
Lunch – huge salad (bowl larger than my head) with romaine lettuce, kale, carrots, tomatoes, cucumbers, olives, mushrooms, can of tuna, 2 tbsp olive oil, 3 tbsp lemon juice, 1 tbsp white vinegar, 1 cup of walnuts
Snack – 2 or 3 tbsp of almond butter (a zero sugar variety)
Dinner – Omelet made from 6 eggs (white + yellow), shredded cheddar, lots of other veggies; side of steamed broccoli in butter; 2 more spoons of almond butter after dinner
Friday
Lunch – same as Wednesday (I basically rotate salad back and forth about 3:1 in favor of chicken over tuna)
Snack – none
Dinner – Curry stir-fry containing tofu, carrots, broccoli, bell peppers, mushrooms, zucchini, and squash, in a sauce made from curry paste and Greek yogurt. I typically consume two heaping plates of this.
Saturday (post ride and swim)
Lunch – 7 hardboiled eggs, an avocado, 2 oz of cheese
Snack – a Fuji apple covered in almond butter
Dinner – 8 oz of steak (fillet, rib-eye, or tri-tip), 8 oz of salmon, large salad (sans meat and nuts, which I only do with lunch salads).
Sunday (post longer ride)
Lunch – The “Peter Kaufman” super starch shake (heavy cream, zero-sugar almond milk, a package of chocolate super starch, 2 tbsp of almond butter, an extra 20 g of Biosteel whey protein, frozen strawberries, ice – blend to a thick shake); I’ll drink 2 liters of this. Literally.
Snack – none
Dinner – Family sushi night! I’ll have a seaweed salad or two, huge platter of sashimi, California roll, and another specialty roll.
Lastly, because I know someone will ask, the few times I now take to measure, record, and tabulate exactly what I consume, it works out to about 3,500 kcal per day. But some days, especially when I travel, it can be as low as 2,000 kcal when I only consume one meal per day (dinner). Other days it can be as high as 5,000 kcal. But, 3,300 to 3,600 kcal per day is the typical range.
So, there you have it – the most irrelevant information you’re likely to find on this blog (except for what’s below… this is actually valuable stuff!)
Fashion tip of the month
While in NYC I realized – about 15 minutes before leaving my hotel for a very important meeting – that I had forgotten to bring cufflinks. My heart sank. I’ve never made this mistake before. I immediately realized why. While packing, and just about as I was going to grab a set, my phone rang and I was distracted. But that was neither here nor there. What was I going to do? I didn’t have time to buy a new set, and the hotel concierge didn’t have a set to lend me, so I grabbed some dental floss and tied the cuffs of my shirt together using precise surgical knots. I was pretty self-conscious that someone would notice and ask or comment, especially on a day stacked with so many back-to-back important meetings. Amazingly, no one said anything, though I could see some people looking at them and doing the double-take. Over that lovely steak dinner I alluded to at the top of this post, I told this story to my friend (who snapped the picture, below). His response? “Yea, I noticed it right away. I thought it was a new style. Very cool, actually. Kind of European.” So there you have it. Don’t say I never shared anything of value on this blog.
Photo by Toa Heftiba on Unsplash
I am not trying to be on a ketogenic diet and do not want to go into ketosis. I went on low carb and gave up wheat -sugar-milk and doing this got rid of gut issues, sinus infection, and lost 13 pounds–3 pounds more than I would have liked due to lack of hunger. I am searching all over to find out what I am doing wrong that I can only sleep 3-4 hours a night which is running me down. But am curious to know if a urinalysis Sieman’s I had in March where it listed Ketones – Moderate (40) means that I was in ketosis?
Hello Peter,
Have been following your blog now, limited commenting, for at least 3 years now. I follow a carb restricted diet, off and on for the past 15 years, mostly off recently due to family issues. The last 4 months I have been back on a very low carb diet, probably too much protein, however. Couldn’t get ketosticks to register anything, so that is my guess.
This past weekend I decided to try a 3 day fast to see if that could kick start me off of this weight plateau.
Days 1 and 2 were pretty good, energy enough to do my yearly trail clearing (cutting, hauling and grinding wood on my property) pretty intense.
Day 3, however found me totally fagged out! I measured my blood sugar at various times during the day and it was down to 43 with one reading. I did NOT want to give up on the last day, so I just lay on the couch reading, drinking lots of water
Day 4, woke up exhausted blood glucose on waking is 39.
1 hour after breakfast 52
1 hour after lunch 56
2 hours after dinner 83 – pretty normal for me, I stay below 100 most of the time. Energy levels seem fine now.
My question: Is that reading of 39 dangerously low during a fast? I felt clear headed, just physically beat up. Keto-strips showed very high ketone levels (urine).
I could not find any information on the web concerning glucose levels I should expect on a 3 day fast, but figured if you had done something like that, you would have measured everything 3 ways from Sunday.
If you don’t have time for this, I will understand. I may stick to 18 hour fasts, once a week or every two weeks!!
Love the blog, and especially the videos. There is a sea change coming in diet, and you and Gary have really lead the vanguard. Thanks so much!
Cap’n Jan
Did you have BHB measurements along side the glucose measurements?
Hi Peter,
No, I haven’t been to a doc’s for any blood tests (but probably, at some point should do this), as I have not found a single ‘low-carb’ doc in the area that doesn’t have his/her own brand of ‘supplements/diet’ that you have to buy. My experience is that asking for ANYTHING from an M.D. is met with stalwart resistance. (You are a doc, you don’t have this problem us ‘mortals’ have ;->)
(Quick detour on why I am reluctant to go to docs: I worked for a Big Multinational. They had a health day and everyone had to go. When they measured my body mass (weight/height on a chart, sheesh!) I was overweight. (My caliper measurement was a consistent 17% at the gym- not bad for a female, but I was also a serious weight trainer, heavy weights, no froo-froo girl weights.) It was put in my personnel file that I was ‘uncooperative’ with the health professionals when I refused dietary counseling. Every doc I have had to go to in the last few years has given me the same song and dance. YOU are an anomaly in the profession. I note you are no longer in the profession ;-> )
So, no I have no idea what the BHB measurements are. Just the measurements I took with my home test glucometer. I also test with ketostrips, (definitely in ketosis! even after starting to eat again after 3 day fast). Fasting blood glucose this morning was 83, which as I said, is pretty much average for me. I don’t seem to have any blood-glucose regulation problems while eating low-carb. It doesn’t swing hard in any direction, pretty much goes up to 110 or lower if I ‘pork out’ a bit, then back down to the 80’s.
I might have been feeling some eurphoria from GHB production, but I didn’t feel all happy-face, more than usual (My husband says I can have fun in a paper bag), not more talkative than usual either.
I WISH that the labs would get off their kiesters and do some lobbying so that they, too, can do tests and send results to patients without the intermediary. They would probably make a bundle on that.
The other issue I have is we are on a (very) high deductible medical plan, currently between jobs, so funds are somewhat limited and I don’t want to experiment with docs and keep wasting money on dogmatists, if you see what I mean. We have looked hard for someone who understands very low carb dieting, to no avail. Austin, TX area. If you know someone that would be deluxe.
Normally I wouldn’t post here, Peter, I know you are up to your neck in work. But I thought I’d give it a try. The 39 glucose reading was kind of scary (that low, I read, can cause convulsions and other really not fun things). I just wonder if I was in trouble, or if this is not uncommon when someone fasts from the platform of a very low carbohydrate diet. It would seem likely that blood sugar would drop, but that surprised me!
Hi Peter-
Very basic question- I see a lot of discussion of macro caloric percentages allocated to “fat”. Detail on specific proportions of fat consumed seems lacking (%’s of fat allocated to Saturated, MUFA, PUFA). Understanding dietary choices and results are individual and no one answer is correct, do you have an opinion on a starting point for healthy fat percentages on a low carb diet? Could you advise on the fat percentages used on your NuSi “high fat” diet experiments? The percentages you average given your current diet? Thx for any insight!
Thanks Peter – Your work has totally changed the way I eat, and train, and live – thank you. One thing I’ve never been able to work out from your writing is: when you talk about carbohydrate intake, do you include fibre? A 150 gram serve of broccoli will have about 11 grams of total carbohydrate but nearly half of that is fibre, so I’m wondering if it counts as 6 grams of carbs, or as 11… I’m just wondering which part of the label I should be reading to try and work out what I’m actually eating. (and yes, I thought about spelling ‘fiber’, but I’m an Australian, and I just… can’t)
…And then I read more of the comments on https://eatingacademy.com/nutrition/how-did-we-come-to-believe-saturated-fat-and-cholesterol-are-bad-for-us and found it. Total Carbohydrates it is.
Love your blog. Thank you again for all your work. Wondering if you have reviewed the new research paper “Long-term ketogenic diet causes glucose intolerance and reduced ?- and ?-cell mass but no weight loss in mice” https://ajpendo.physiology.org/content/306/5/E552.abstract . Well aware the vast difference between research using mice and humans (additionally, the study used a high Omega 6 ratio – not good). Nevertheless, becoming increasingly insulin resistant in the long run after most people have such spectacular short term results using a KD might be worth noting. Any thoughts on the implied rebound effect?
Have not read.
Hi Peter.
I have been doing Dr. Joel Fuhrman’s “Eat to Live” nutritarian diet style and have lost about 64 pounds in a 3-month timeframe. I have plateaued but continued to lose at a slow rate (down from 270 lbs to 206 now). I just wanted to get your opinion about this eating style. It is very low in calories, but high in fiber and micronutrients with most food coming from unrefined whole plant foods (fruits, green vegetables, non-starchy vegetables, beans, nuts/seeds/avocado). Dr. Fuhrman advocates food with a high micronutrient-per-calorie density. I don’t know the exact mechanism for how weight loss occurs on this type of plan, but I would imagine it would be due to 1) a reduction in calories and 2) a stabilization of blood sugar and decreased insulin response at mealtime using low-GI vegetables, fruits, and beans. There is a lot of research to be done though, as it may be possible that the phytochemicals might also play a key role in inducing lipolysis.
Hi, Peter!
I love your blog!
I’m following a ketogenic diet since July 4th and I have noticed that I no longer crave sugar! I have a compulsive relashionship with sugar since early childhood but now I have no desire to eat any kind of sugar. It’s like a miracle! It’s so good!
I have a question: I love cheese. What kind of cheese have a low glycemic index?
Hi.
I am a fellow MD working in Iceland.
Firstly I want to congratulate you on your work, truly amazing and groundbreaking stuff.
Like yourself, I have shedded about 20-25kg by gradually cutting out carbs (your intro in the
video-lecture on RQ could have just as easily been about myself) and for the past year
I have been on an LCHF diet.
I was more into endurance training before but now I’m doing almost exclusively HIIT (cross-fit/boot camp, 1hr training sessions) and sometimes olympic weight lifting.
However, on the low carb diet I have had problems keeping my performance level up, especially the last 15-20min. So I came across John Kiefer’s book about carb backloading and I found his theory very interesting, exploiting the exercise induced translocation of GLUT receptors in muscles and just jam in refined carbohydrates right after exercising. I’ve tried it and certainly find that I feel more energetic when working out and after 3 weeks I haven’t noticed any increase in body fat (his claims are that it is nearly impossible to put on body fat with carbohydrates consumed within the first 1-2 hours after heavy resistance weight training).
However I wonder what your experience is on how many grams of carbohydrates an average person can consume after exercise and still keep optimal/near optimal ketosis, and whether you agree with Kiefer that it is better to have a large but short-lived insulin spike post exercise than a lower, but longer elevation of insulin in your blood stream?
Keep up the good work!
You may find the post on carbs and ketones “co-existing” helpful on this question.
Brilliant! Thank you.
Hi Peter,
I just found your blog via Dr. Jonny Bowden’s site and I’m loving it so far. You mention your reactions from your family about your diet, which is something I am still struggling with as I transition from “eating what ever I want” to eating what I want because I know it’s better for me. I am in the stage of cutting out most sugar all together, most carbs, etc.
When I’m making meals for just myself, I love it and feel great all day. However, I find myself out or even at home with friends and family often that do not share my restraint or even my opinion on eating habits. Do you have any suggestions or advice on how to, or how you, handle that? I know the ideal and possibly even “adult” think to do would be to ignore any negative comments and do what is right for me. But I find my family feeling hurt or calling me rude for turning down meals or baked goods (to name a few) made specially for me. So unfortunately, this is still something to overcome as I evolve my diet to where I want it to be.
Thanks in advance and I look forward to reading and learning more!
Maybe others will have ideas. I’m too selfish to eat something just because it will make someone feel better, with the exception of my daughter.
> … turning down meals or baked goods …
I suspect that if they offer you a cigarette, you have no problem declining that. 🙂
You could get a Cyrex Array 3 test run. Odds are about 40% you’d test positive for wheat-related toxins. Then you’d have a piece of paper to display (and having this can be very useful for dealing with government schools, nursing homes and hospital stays).
We just tell hosts, in advance, that we have a severe wheat reactivity issue in the family, confirmed by inadvertent challenge testing.
If they are politically independent thinkers to the least degree, you can also tell them “You do know that the official government diet advice, the USDA MyPlateOfMetabolicSyndrome, is an utter political disaster, entirely unsupported by science, and very nearly completely the inverse diet of what human beings need to eat?”
I see that you have enough admirers, but here’s one more love letter, so to speak. As a PA student, I am head over heels in love with your blog. Just starting ketogenic “stuff” for my narcolepsy, and I have directed nearly everyone I know here for cholesterol info. Thank you THANK YOU for making a science blog that doesn’t cater to the lowest common denominator. It’s hard to find something for people with a strong science background.
The results of my last physical and blood tests suggest that I am pre-diabetic (high triglycerides, high fasting glucose and a glucose tolerance test that says I am not processing sugar fast enough). I came across an interview with you on YouTube and your story compelled me to subscribe to this site. I have enjoyed reading your articles and look forward to the emails.
IMHO: The temptation to “Eat what you eat” or “Do what you do” comes from a lack of understanding of the process involved in deciding what is right for me. I see two paths in most things in life. 1) Acquire what you need/want that is ready-made (do what someone else has already figured out) or 2) Create it for yourself.
I would like to create my own regimen. You are doing a good job of conveying the knowledge, now all I need is the process that tells us how to make adjustments in our diet and exercise. I would like to get my blood tests back in the normal range. Most of us don’t have access to frequent blood tests, so we need to know how to tailor what we eat and what we do that will achieve the desired result.
Thank you so much for this site and your willingness to share what you know and understand.
Richard
I hear you Richard. Though I don’t plan to write any books out there about eating strategies, fortunately others have done a great job. Jenny Ruhl, Jeff Volek, Steve Phinney, Eric Westman, and others.
Peter – I found your blog through the sweet life as I am a T1 Diabetic that has taken on endurance running. I am not sure exactly where this fits in and this looks like as good a place as any. I am just looking for general guidance nothing specific. I have a pending 1/2 marathon (my first) on Sept 20th followed by a full marathon (also my first) on December 6th. As my per run mileage increases it has become obvious to me that on my more conventional diet that my level of consumption of gels, sportsdrink, and other things laced with sugar must increase as well for a number of reasons. I recently had the realization that if I consume the anticipated amount of gel packs during the marathon I will need to bring a backpack along to bring all of my fuel. This, along with the fact that a diabetic ingesting so much sugar seems very counter intuitive, are what lead me to try to find a different way.
My main question and my issue is with the timing of the switch from my current diet to a ketogenic diet. I currently am following many of the ketogenic diet guidelines (no sugar other than when I get when I need “fuel” for running, flour, corn, white rice, grains etc) which was part of a Dr Oz cleanse that I have kept doing for about 8 months. I will have no withdrawal or effects of cutting carbohydrates from my diet because other than a small amount of fruit, considerable vegetables, Greek yogurt and legumes there are none in my diet.
With a 1/2 marathon in less than a month (September 20th), I am concerned about changing over now and messing up my ability to do the final part of my training. I am confident that I can do the switch and would like to convert to the Ketogenic Diet so that I can reap the benefits for the full marathon on December 6th. I am wondering what your thoughts are about the timing of a switch like this. What are the potential issues in the short term. I know the long term benefits and those are what I strive for.
If there are any books or guides that would help me to determine the best course of action, I am open to suggestions, but short of just jumping in I see minimal information about thoughts on these subjects (though I am still searching for the answers). Your thoughts anecdotal or personal on these subjects would be helpful to me in figuring out my best course of action. Thanks in advance.
Richard Bernstein and Jenny Ruhl are very thoughtful on this.
To give you a second less drawn out option if you would prefer.:
Peter,
What are your thoughts on starting a ketogenic program as far as timing goes? I can find no real guide or help in when is a good time to do this switch. I am a diabetic who is training for endurance runs and one is close the other a little further off. I do not want to completely upset the closer race but would love to slip the ketogenic diet in as soon as possible because of the benefits. There is plenty on what it is and how to do it but as far as athletics is concerned, when is a good time to introduce these things. I already eat a very low carb diet with no sugar (other than goo for training), flour, corn…… so there i would be none of that withdrawal. Like I said, I can find no help but will keep looking. Any recommendations for reference material would be great.
How do you feel about diet in regards to women, do you think it could be (or should be) significantly different, especially if it could be different from person to person? I have yet to find a diet that works, I have tried vegan, vegetarian, atkins, paleo – the only thing that has enabled me to lose a significant amount of weight was green juice reboot diet – drinking green juice for 60 days. I lost around 50lbs but it all came back once I resumed eating and developed an insatiable food obsession. I don’t think I would want to do that again. Now I mainly eat fruit, meat and vegetables (in that order) and I do eat the occasional cake/bread/takeaway. I’m still huge and yet I eat nothing like I used to (chocolate everyday, cereal, bread, pasta, cheese).
There is a documentary on BBC or Discovery science called something like “Did Cooking Make Us Human” where they show an experiment that show that cooked food gives 30%-40% energy so stomach needs less energy to break the food and so the brain has more energy to function..
So eating so much raw food isn’t affecting how much energy the brain gets?
I mean no disrespect, but I’m sure you’re well aware of our propensity to deceive ourselves. What advice would you give to an alcoholic who found that after several years of sobriety, he could drink four times a year without giving in at other times? Thanks for the great web site!
In speaking with real experts on the topic of ‘substance abuse’ I don’t think the term alcoholic is particularly helpful. That said, I’m not sure why I’d be in the position of offering advice to anyone about alcohol.
I believe that he is comparing an alcoholic to a person with who had previously has had issues with carbohydrates. Their ability to stay on the proverbial wagon might be compromised by allowing themselves the ability to fall off every now and then. By doing this someone runs the risk of not being able to get back on it. There is a part of me that agrees with both sides.
You have to ask yourself if you can trust your will enough to let 4 meals out of the almost 1100 you eat annually allow you to be sidetracked then you probably should not do that. Peter does not have a problem with that. I might not have an issue with eating that but I can tell you it would throw my bloodsugar completely out of whack and it would be very difficult for me to deal with.
I apologize. Again, thanks for the great web site.
I was trying to put my thoughts in a way that were not offensive, but after re-reading my post, I seem to come across as a little know it all that is trying to point out the obvious to someone less intelligent than myself. This was not my intention. I am just socially awkward at times. The reason I wrote is because your post brought to mind the times that I have compromised on my intentions and ended up failing at my goal. I guess I felt a sense of empathy, and wanted to help. Again, I apologize if I gave offense.
John, I certainly wasn’t offended at all by your comment. No apology necessary. I just thing the question you ask is very complicated–and a very good one! It is, however, outside of my area of expertise.
I’ve recently started on this journey to weight loss (28 years old, 350lb starting) and am down to 325 in the past couple months. I’ve been reading through your blog and it has been helpful to see your thinking evolve. What I’m curious about is whether you’ve noticed your weight and cholesterol LDL-P (particle count) levels going up with your new, veggie-heavy, diet or if things have stayed the same.
I’m recently unemployed so my variety of vegetables is fairly limited, but I’ve found success by eating salads as often as I can and eating a combination of tofu and chicken for protein. I’ve thought about upping my carbs since steamed potatoes are so cheap (and my food budget right now is about $35/mo) but I’m worried that might hurt my cardiac numbers.
I’m in the camp (not sure the size of said camp) of people who is at their absolute leanest and “best” in terms of biomarkers in strict ketosis. Hence, today, my LDL-P is about 10% higher and my weight about 3-4 pounds heavier and body fat perhaps 1-2% more. That all may be splitting hairs, of course. I’m infinitely healthier than I was on a standard American diet.
I have to say thank you very much for all of the information that you are providing. I am working my way month by month through your posts (from 2012 forward). The comments take more time than the blogs themselves. The one thing that has totally hit home with me is the role that insulin plays. For years as a diabetic I chased my blood sugar reacting to what I had done rather than being proactive and taking control of my diet and insulin. For the last almost 9 months I have been on a carb restrictive diet (not exactly Keto but close) and my insulin usage has dropped considerably. I use a Novolog Pen which was at that time 10-14 days worth of insulin. That equals 21-30 units a day plus lantus. The same pen now lasts about a month which is about 10 units a day. My hemoglobin A1C is much improved and I have lost almost 60 lbs since January. I will be starting the Ketogenic Diet in about 10 days after I run my first Half Marathon. I look forward to the improvements that this will help me to make. Once again thanks for everything. I look forward to reading all of your content. I intend on learning what I can to attempt to prolong my life and improve my quality of life in that time. That is what prompted me to initially change my lifestyle back in late January.
Hi Peter,
What are your thoughts on food tolerance tests?
Thank you