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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
Recipe for curry stir fry would be greatly appreciated!
Hi Peter, thanks for the interesting post. It sure must have been funny to see your wife and daughter’s reaction when you ate those cakes! I don’t think my hubby or daughters would bat an eyelash. Maybe that’s the litmus 🙂
My question is: Are you now more insulin sensitive than you were 4 years ago? If so, how do you know that? Recently, one of my colleagues, a respected endocrinologist, told me that insulin sensitivity does not change and that those of us with lower innate insulin sensitivity just become symptomatic as we age due to age related islet loss. He said some other stuff which seemed kinda wrong to me. He treats his “pre-diabetics” aggressively with metformin and calorie restriction. He believes in “calories” because as long as you are making insulin you are not going to metabolize fat. When I asked him what would happen if you just ate fat, he was kind of stumped. Not my intention, but I enjoyed that.
I am, actually. In fact, I’ve been thinking of doing a post on exactly this topic: How do I measure and quantify insulin sensitivity? Maybe, if enough folks are interested, I could do this as part of series I’d like to write about the “science” of measuring things pertaining to metabolism.
If you’re taking votes, I just submitted mine.
YES! YES! YES!, would love to see this.
Noted.
@Miriam:
“Recently, one of my colleagues, a respected endocrinologist, told me that insulin sensitivity does not change and that those of us with lower innate insulin sensitivity just become symptomatic as we age due to age related islet loss.”
Dr. Eric Westman, for one, would largely agree that this is correct, unless you have, as Peter notes, certain genetic factors. There are a very few people who can become insulin sensitive again – most cannot.
Reading this comment stream makes me so sad – filled with people who long to use Peter’s experience to cheat, to return to stuffing themselves with cake, to drinking. . .unless, like Peter you exercise an enormous amount (and while it’s less than he used to, it’s still way more than most people in this thread do), you’ll gain all your weight and health problems back.
Why would you want to do this? To return – as even Peter admits – to feeling hungry, to brain fog & mental slowness, to less-than-stellar blood markers, to those extra 5 pounds of water. Why? After fighting so hard to progress, why throw it all away?
To each their own. 😀 Best wishes.
I too am interested, as another vote!
Hello Peter…yes please….that post would be appreciated. I’m also looking forward to the thyroid post. Thanks as usual, Michele
The votes are adding up!
Yes! Upvote for post re: insulin sensitivity. Perhaps you could also speak to the other related topics in Miriam’s post a bit more, too, e.g. innate/hereditary sensitivity, aging effects, etc.
Unrelatedly, I just came across your blog, Peter, recently, and I have been absolutely devouring it, not calorie restricting myself at all, when it comes to your posts. I really appreciate how much work and thought you put into these topics, and especially how you encourage readers to consider the science and fully understanding the proper interpretations of experiments & data, etc. Honestly, this is the best blog I’ve seen for a layperson (perhaps a somewhat in-the-know-or-attempting-to-be-educated layperson, but a layperson nonetheless) trying to improve his understanding of what we actually know about the science of eating.
Ha ha, glad you’re not taking an IF or CR approach to the content!
Peter,
” Maybe, if enough folks are interested, I could do this as part of series I’d like to write about the “science” of measuring things pertaining to metabolism.”
I think the level of interest would be enormous.
Ok, I guess this is sufficient feedback to plan the next post around this topic.
Yes, would love to see a post on it as well. The question i have wondered about is this: Are the traditional markers of IR- BG, waist cirucm, weight and BP NMR score, A1c, low HDL( i think that is it?) sufficient to say a person is IR or not?
Based on the foregoing I am not IR, but produce tons of LDLP whether on a carb restricted diet or not.
I have no intention of emulating your diet, but enjoy your general thoughts. I have yogurt or Kefir with berries or an apple in the am if I do not go to the gym, and a baked or sweet potato for dinner. Eat a qsquare or two of 90-1–% dark chocolate most days. Never any junk like you, and never have any food cravings of any kind.
Question: Do you no longer eat dark chocolate
Thanks for your time and effort. Greatly appreciated by this 60+ year old reader.
Glad it’s helpful, Steve.
Always good to read you posts as I’m basically you (insulin resistant) but with more hair (just kidding). Question, I ave been doing the LCHF for about two and 1/2 months right now. Lost about 16 lbs, feel great, tons of energy but my latest blood test cam eback and although my TG were ok (146) and my HDL was good (47), my LDL-C was elevated (225). I had them do an ApoB test and that came back high at 150. I’m less concerned about LDL-C as i agree it’s the particle size that matters most, but with ApoB being elevated, I was curios to see what your thought were on this being on a LCHF diet. Not looking for medical advice just your thoughts. BTW, my BP is now 105/55. It used to be 125/80. I’m meeting with a Lipid Specialist in May to get a better breakdown of my numbers.
Sorry, “moderation” should be “motivation” 🙂
Peter, that’s a great idea. I and I’m sure many others would DEFINITELY be interested in a series relating to measuring insulin sensitivity and other parameters pertaining to metabolism
Regards
Ok, I’ll bump it in the queue.
My white knight has fallen off his horse. I’m so disappointed in you, Peter. Ah well, I continue to feel like a million bucks in continual ketosis and have energy to burn, so to speak, at age 61. I can do a century ride basically fasting (a mug of bullet-proof coffee before) and not have any hunger or need to eat en route. I have no cravings or desires to “binge” and find it hard to believe that the horrible after-effects are worth the brief moment of “mouth pleasure.” (Although to me the taste of sweet is is now unpleasant). I am inclined to agree with those that find your veering away from healthy eating to be akin to an addictive response. Just my humble opinion for what it’s worth.
Ah, yet another reminder why I rue the day I decided to do this. Hopefully I’ll exercise better judgment in the future and refrain from discussing what I eat ever again. That said, I’m happy you’re feeling well.
The majority of the people here, I think greatly benefit from and enjoy/appreciate reading about your (Peter’s) personal experience and dietary tweaks/status whether it be full blown keto, low-carb with (4/365)% debauchery, or a third or fourth or fifth way of eating.
I hope the sense of excitement in these comments continues to far outweigh the disappointment, and you continue to share your personal experiences with us.
Peggy, have you read Peter’s post on his experiments in the metabolic chamber? Do you have any doubts that he knows very precisely what is best for his health and performance and that he is able to control his diet and every other aspect of his life to the smallest detail? We all know how he would be eating if top performance in endurance sports was his number one priority. And perhaps it is not at the moment, not a problem to me 🙂
Peter,
You are definitely NOT a disappointment, nor have you fallen or failed. You are a treasure for two reasons:
1) You are one of the rare few who is actually qualified to speak on this topic
2) In spite of being inclined toward introversion, you have put yourself on display for all to see (and judge)
What others think matters very little. I know that you know this. Unfortunately some people treat this topic like religious doctrine and are quick to attack (usually subtly) anyone who blazes their own trail.
Please know that most of us are only excited and happy for you.
Sean
Sean, can I hire you to be my personal coach? A constant reminder of all things sane? I may print this comment for future reminder. Thank you.
You’re welcome. I am actually a counsellor by trade, but no, I’m not trolling for business 🙂 Feel free to PM me if you need another dose (out of the spotlight).
Thank you, Sean.
How to create an argument on the net?
Step 1: Express an opinion
Step 2: Wait
Peter, Had I not read your blog in late 2012, I would almost certainly have had diebeties right now and would’ve been at high risk of a heart attack or worse in the future. With the amount of dis-information out there, mainly from government sources, it is blogs like this that educate people. I know of at least 2 other people that have gone LCHF since I referred them to your blog and have last massive amounts of weight. So don’t you dare stop writing about your experiences. 🙂 As much as you don’t like the limelight, you are saving people lives!
I appreciate that, David. It’s hard to blog when you’re not a “blogger” (because you don’t want to be).
Just wanted to echo Sean’s comments and add that it’s nice to know that Peter is human and does like to indulge in sushi etc. once in a while. I am just finishing up reading Good Calories, Bad Calories and am thinking about transitioning into a more LCHF diet – but I *know* I am going to be breaking the ‘rules’…
Maybe a silly question Peter, do you feel hungry often? I’m guessing that if you’re not eating breakfast and exercising in a fasted state, then yes, but you’re somewhat used to it?
It depends on my eating regimen. These days I’m back to 1 or 2 meals per day. On 1 meal per day, I get hungry midday, but the hunger is actually gone by about 20-23 hours into “fast.”
I think you should be commended for your honesty and openness in sharing your experiences with us, particularly this one. I think for many people you really are/were “Mr. Ketosis”. Someone that many looked up to in terms of what can be achieved with this diet and in the state of ketosis. One thing that I think some of us are wondering is whether you have made this change purely because you want to be more flexible with your eating habits and/or because you don’t really see significant benefits of being in full NK at this point in your life now that you don’t have metabolic syndrome.
I am personally interested in this because I am very fit but have recently started the ketogenic diet because I am continually trying to optimize my mind and body. However, as you know, the diet is quite strict and I do love pastas and breads and fruits. Of course each person is different in terms of goals and biology, but I am wondering for someone like me, that is in pretty good physical and mental condition, whether this strict approach is worth it ?
Rob, the answer is a bit longer than what I address now, but it comes down to many things, not the least of which being the way I want to teach my daughter about food. This does not mean I won’t be back in NK at some point — I’m sure I will — but for this moment in time, I’m very happy consuming something off that path.
Peter,…the last post you did about what your daughter eats was wonderful….actually ALL your posts are wonderful. I know you have close to ZERO time but I would love to know how you teach your daughter about food if that is something you would like to share….even just bullet points would be great. I apologize for making requests with so little to give back!
Yes, maybe another post one day about how I teach my daughter about food.
Peter,
The early qualifiers in this post – you didn’t really want to do another what-I-eat post; people, I’m tellin’ ya, don’t eat like me – made me think you were being overly cautious. But holy yikes, I see what you meant now! I’ve followed your blog since the very beginning and have advanced my knowledge so much because of the excellence of your mind, and your unbelievable generosity to share the journey.
I’ve never considered you the keto-guy or the _____________(name of dietary regimen) guy. IIRC, I don’t think you even lost the majority of your weight while technically in ketosis, and if people read carefully they’ll see that your diet has evolved constantly since you first began treating your IR. I see you firstly as a physician-scientist attempting to understand disease and healing; and secondly, a wonderful example of what the journey of adaptation looks like. Diet, exercise, aging, health, time management, relationships – life – it’s all a process of serial re-engineering and experimentation.
I loved it when you said in your TED talk that we really don’t know what the perfect human diet is (paraphrasing). There are so many things that contribute to our health, some of which we can’t even measure, and our happiness is a big one. Sometimes we get happy by doing something a little outrageous, like making our family members drop jaws on table in fancy restaurant. Awesome. And as awesome is the demonstration of principle proposed by Volek and others that an improved insulin sensitivity allows for some CHO wiggle room. You bounce back, maintain a high exercise output, are in fact, Dr. Shredded. As you are a fanatic measurer, I’m sure your various numbers will continue to guide your dietary evolution.
Anybody who expects you to be – or stay – any particular way doesn’t understand the concept of n=1. Nothing you can do about that. I really appreciate the insights gleaned from your personal journey.
JB, I definitely appreciate how much of the nuance you’re catching. Thanks for paraphrasing it nicely.
Peter, I would like to see the “here is what I eat in a week” presented so we can see how much of your diet consists of each food instead of presenting it as meals. Would it be possible to list what percent of calories you consume (over a week’s worth of meals, not individual days) from each food category? Namely grouping foods as something like: vegetables, meats, nuts, eggs, fruits, “pure fats/oils/butter”, and other ingredients.
The educational value would be much higher because the body doesn’t enormously care how that food is distributed into meals, and it’s hard to tell at a glance how those day to day variations smooth out. A percent figure also lets the reader account for what is (for most) a comparatively greater caloric intake.
Sorry, Ein, what you see is what you get. I have a job and such.
Peter, or anyone else who could help. I have been following the LCHF lifestyle for about 6 weeks and have already lost 4 kilos which is a lot and faster than I had imagined.
About 2 weeks into the diet I approached my Dr and got a full lipid blood profile done. The LDL/HDL/TG I understand and am going to compare in about 6 months. My question is that I noticed that my liver Bilirubin level was at the maximum level of “normal” as was my Albumin. Do you think that this is due to my rapid weight loss putting stress on my liver? Or is there any evidence that producing ketones in a state of NK adds stress to the liver and therefore can lead to raised Bilirubin levels?
Cheers and love the site.
You may have something called Gilbert’s syndrome (about 1 in 20 people have it), and it results in increase bili, but not to very high levels.
Peter, I wonder if you noticed any changes in appetite control. Whenever I try to relax my ketogenic way of earing (have followed it for over 2 years now) I cannot control my appetite and start to overeat. It could be just me, though. I am also very physically active, but at my age of 38, the exercise cannot outweigh excessive eating, something I easily managed when I was younger even on a crappy high carb diet. For me appetite control along with energy levels is a proxy for a good diet.
The only food that seems to have a “strange” effect on appetite is fruit. Even a large amount of fruit seems to provide little satiation (but lots of enjoyment). I’m pretty sure I know why, and I definitely plan to write a post on appetite, perhaps one of my favorite topics, though something I have written virtually nothing about on the blog.
Wasn’t the short version of this that fructose just sits in the liver, triggers nothing and goes nowhere? I thought you or someone you referenced mentioned it.
Peter, that’s interesting. Reminds me of an experience I had last summer when my way of eating was somewhat carb-restricted. I mainly had huge salads with copious amounts of avocados, meat and vegetables etc.
No sugary stuff. Not much fruit, except some semi-ripe bananas here and there. After some time of that, I was getting a bit bored of those kind of meals so I thought I’d branch-out to include some other foods.
Then one day I bought some oranges as well as tangerines and thought they tasted simply amazing (like of an addictive quality). For the next week most of meals were mountains worth of oranges with yogurt on the side, and also otherwise I was eating less fat than what was usual for me. Gradually it came to a point were the oranges still tasted “good” and “sweet” but my desire for them had diminished (same thing went for other fruits like apples, or other things that contained sugar such as dark chocolate). So, then I noticed that I hadn’t had any avocados for a while and got the idea to eat some, after the first bite I remember thinking to myself: “Oh my god, this is the most creamy, delicious thing ever. I could just eat avocados for the rest of my life.”
Weird experience. Since then I’ve stuck with more moderate, not-so-out-of-the-ordinary eating habits (as in not particularly excluding any food group) and haven’t felt that kind of a compulsively rewarding response to eating any food.
Haha, people seem to focus on your dental-floss trick! Really good one doc!
Sorry to have lost you on the darker side of carbs! 😛
I shall now walk the lonely path on my keto journey.
Peter,
Love your blogs and your videos, thanks for what you’re doing. I’m a chiropractor who strongly advocates the low “cheap” carb lifestyle and your writings prompted me to crack open my physiology text (Guyton 8th Ed., page 858) where I read: “Especially dramatic is the long-term effect of insulin lack in causing extreme atherosclerosis, often leading to heart attacks, cerebral strokes, and other vascular accidents.” I’ll assume this is from release of large amounts of fatty acids into circulation, but I will also assume this situation is pathological only in the presence of insulin “lack” which I suppose is defined as no insulin at all or levels well below what would be present in a keto-adapted person. Just checking. Thanks again. By the way, have you checked out Standard Process for your supplement needs? (not a plug)
Hmm, that’s an interesting reference. I’m curious as to the source. What does it reference for that assertion?
Yes Steve. For keto-adapted persons it is a bit different. I’m also reading Guyton’s Medical Physiology….but I do it just to get familiar with our physiologies. Even though it is very good resource, some concepts are a bit behind…it still directly correlates saturated fat with heart disease and it also promotes big amounts of carbohydrate intake
On next page: “In the absence of insulin, all the effects of insulin noted above causing storage of fat are reversed. The most important effect is that the enzyme hormone-sensetive lipase in the fat cells becomes strongly activated. This causes hydrolysis of the stored triglycerides, releasing large quantities of fatty acids and glycerol into the circulating blood. Consequently, the plasma concentration of free fatty acids begins to rise within minutes. This free fatty acid then becomes the main energy substrate used by essentially all tissues of the body besides the brain.” It goes on to discuss how the fatty acid excess also promotes liver conversion of same into phospholipids and cholesterol. All of this, however, is in the presence of excess blood sugar in the diabetic patient. I assume in the non-diabetic individual, the fatty acids are converted in large part to ketones for the brain and this rise in plasma lipids is negated (as has been demonstrated with your own bloodwork as well as countless others on this type of eating regimen). Thoughts?
I explore this is great detail in the fat flux post, Steve.
Hi Peter,
Glad to hear you’re talking with Doug McGuff – I found his book on exercise a very stimulating read. He makes a strong case for the “work out briefer, work out more intensely” philosophy. Alas, I have started and quit Superslow three or four times. The scorching intensity of moving slowly under tremendous load and getting to failure in a relatively short time is not for the faint of heart. I guess I shouldn’t be surprised that you seem to enjoy it 🙂
Best Regards,
-Eric
I’m definitely digging it. And the pain is so upsetting in a way that’s even foreign to me. Quite lovely, actually.
Back in 2005-06, for about 8 months or so, I trained in a way that was close to the Super Slow method. It was Mike & Ray Mentzer/Arthur Jones/Elliott Darden’s HIT method of training. My goals at the time were 1.) Hypertrophy (bodybuilding) and 2.) Strength gains, in that order. I was coming off of about 1 year of doing “bro-splits” with some deadlifts and “quarter-squats” thrown in. Unfortunately, training (mostly) slow negatives with high weights once a week or so just didn’t work for me and my training partner, we lost muscle and some strength. The intense pain during (and DOMs post every workout given how far apart the workouts were) weren’t really translating into gains in size or strength. Since then, I have gone back to a higher frequency doing traditional, “quality work” – mostly compound movements performed with strict form and that has worked best for us.
That said, I would love to hear at some point Peter’s experience with it. Wish Mike Mentzer was around today, and I could learn the nuances of that method outside the basic template, which I probably missed.
All the best, Peter!
Yes, I’m not clear on whether this will produce best results, but I’ve already deduced that one session per week of the “big 5” is not sufficient. I’m doing 2 days a week with a split routine. MUCH more volume than “traditionally” prescribed, but so far I’m pleased. Also, my goals are different. No interest in hypertrophy for strength for the same of that movement. Primary driver is the metabolic effect for strength on bike and in water.
In terms of the insulin sensitivity thing. The hyperinsulinemic/euglycemic clamp comes to mind. When I was an intern, we had a family friend/possibly distant aunt who was an endo attending. I got to spend a week in her lab and did some of these on her subjects. Funny, I never thought I would ever care about that again. There has got to be an easier way.
Ah, yes, we’ll be talking all about my good friend the euglycemic clamp, and his big brother the insulin suppression test!
Do you have any concerns about soy consumption (thyroid function, phytoestrogens)? Is there a particular reason you include tofu besides the fact that you like the taste / texture?
As you note, I just love tofu when I cook it the way I do (I generally don’t when anyone else does). I do have some concern about phytoestorgens, but I take a few steps to mitigate that risk, which may or may not be real.
I’m Italian and so European. And I can assure you I’ve never seen anybody wearing those cufflinks in my continent. It sounds more Japanese style. ;-))
Good to know I’m trend setting!
Got it. Thanks for taking the time to write this blog – it’s been a great resource for me and I’m sure many others.
Hello,
Thank you for all of your hard work.
My wife sent me an article by Dr. Mercola who had posted a link to your video – An Advantaged Metabolic State: Human Performance, Resilience & Health. It was a life changer.
I have since inundated myself with various information on low carb diets and am currently reading Grain Brain by David Perlmutter, MD. I have found it very intuitive as it echoes much of what you have already posted.
You may have written about it, and if you did, I apologize for not doing my homework, but I was curious on your take about Glutten and its adverse effects on the body.
* Gluten, sorry.