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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
I have been following your website for less than a year and wanted to put to test being in ketosis, I am Canadian so nice to talk to another Canadian and I am in my menopausal years, always keen to learn new methods to reduce body fat. I cut back all complex carbs and added coconut fats, my sugar levels were between 90-95 and my ketones were .1 upon my first measurement. I was at least 4 weeks on this diet before I tried to test my ketones. I was a little disapointed that I could not achieve better numbers, I thought perhaps it was my fruit intake which included oranges. After 6 or 8 weeks of the diet I gained body fat in my legs and abdomen……………not the results I was looking for, I have since removed myself from this diet and am going through some Medical detox and medical food to address my metabolic syndrome issues. Perhaps when I loose the weight that I gained I’ll rethink your method. Concerns are age and menopause hormone, any suggestions for the next go round
Louise
Lots of possibilities, but glad you’ve abandoned if not get results you were looking for. Impossible to troubleshoot via blog, though.
I thought i would contribute this podcast in the overwhelming mix of information out there. Peter if you hear this or have heard this could you comment on it. It largely speaks to saturated fats in the diet based on a meta analysis. I know that a meta analysis is not an experimental design however I found that the majority of the experts on the show used correlation to infer causation citing other studies they knew of. They seem to bash butter quite hard, implying that there is a fatty acid (palmetic acid steric acid) in butter that is “known” to be bad for the heart. I appreciate and try my best to understand the science, but the back and forth of the science and “experts” out there make it difficult to choose a best course of action for my own diet.
https://onpoint.wbur.org/2014/03/31/saturated-fat-healthy-diet-fat
If you really want to understand why low-carb diets are, in general, healthier than low-fat ones, read “The Art and Science of Low Carbohydrate Living” by Volek and Phinney. They don’t use epidemiological studies to fool you.
Hi Peter,
Thank you very much for your answer.
I will give get the free – prick your finger – cholesterol test at the chemist, see the number before I get my proper triglycerides test, just to be on the safe side.
In the UK, statins are now pushed on patients deemed at 10% risk of heart attack, 10 years ago it was 30%. Last time checked, my risk level was 2%. It’s crazy.
I belong to a big NHS GP practice in the UK with a few doctors. My endocrinologist is private. My GP is not overly worried but my high cholesterol flags on the computer whenever I see any doctor. So, with a non-diabetic-sugar level, an ideal blood pressure, fit and physically active, an ok thyroid, eating more than my 5 a day, not drinking or smoking, rarely sick, I am still not being responsible with my health! Even treatment for a severe allergic reaction to exotic gnat bites got me a lecture on the power of statins and the wonders of a low fat diet, but strangely not on the nefarious effect of sugar on the body.
Kind regards
D
Dear Peter,
I am a 56 year old women, extremely obese, have Graves/Hyperthyroidism, a combo of Osteo/Rhum arthritis in my knees and most joints of my body. I am on disability now and am feeling quite helpless. I have taken med’s for my arthritis for over 20 years and I just gain more weight every time I put another medication in my body. I went off all med’s 4 years ago and lost about 80 pounds. Then I got Graves and the side effects I have had with this and med’s is horrible. So much so that I can not swim anymore and that was the only exercise my doctor would let me do. Subsequently, I have gained back All and More! I don’t even know where to start…. my doctor was useless and I am looking for another doctor but they are very hard to find now. Most aren’t taking new patients or they have gone to the States to work now. I do not know where to start now. I use a walker to get around but not much anymore. I want to turn this around. Do you have any words of wisdom in regards to starting this? I really need to change my life.
I’m sorry to hear about your condition. The most important thing is really to get the hyperthyroidism condition under control, which of course requires an excellent endocrinologist. Maybe consider finding a functional expert in thyroid disease (but understand most specialize in hypothyroidism).
Peter,
I want to take a moment to thank you for being so perfectly you! Your TED talk brought me to tears; as a nurse I have had the same experience you shared with some of my patients. I’ve also had those thoughts about myself- the gradual weight increase despite a “healthy diet” and exercise lead to feelings of inadequacy, hopelessness, doubt and anger. I felt like I had no discipline or will power. With diabetes, Alzheimer’s and hypertension in family, I know that it’s only a matter of time before I find myself on the same cocktail of medications and list of specialists monitoring and managing my diseases. As a result of your TED talk, I found your blog, Gary Taubes books and several other experts via Youtube discussing LCHF. With Gary’s prodding (“You don’t have to believe a word I say, just do it for 30 days and see what happens!”) I’ve been LCHF for 9 weeks now. Your blog and both of his books as well as the Youtube lectures have guided me, encouraged me and supported me the entire time. I feel like a different person in every way- my thinking, joint mobility, digestion, appetite, body aches, skin, body awareness, mood stabilization, etc. have all changed. As a result of these changes, I’m seeing everything in my life very differently. Your courage in putting yourself “out here” has helped me tremendously. I appreciate your integrity, your clear communication and your boundaries- I’m learning just as much from the simple and steadfast approach in your comments as I am from your blog posts. Thank you for sharing yourself; it is giving me the confidence to do the same and the belief that it can make a difference. I look forward to seeing what comes out of NuSI. I have great faith in it’s mission and the methods you are using to study this complex topic. Blessings to you in your life and your work!
Lisa, I’m so glad you shared this with me. And I’m even more delighted to hear that you’re feeling so much better. Weight, of course, is just the tip of the iceberg. Sounds like you’re reaping many benefits of improving your diet. And you will be a much better nurse for your patients, also.
Hi Peter,
For me it makes sense that most of the people will not respond well to carbs after being on very low carb for a long period of time but how to interpret this phenomenon? Is this good thing or bad thing? How does adding carbs and becoming tolerant to them after a while should be taken (like some people add starches back and lose weight and their fasting blood glucose improves):
1. My metabolism is working well as I can tolerate carbs without gaining weight?
2. Although I’m tolerating carbs but what would be the long term effects in terms of my insulin sensitivity and other factors? ( for example carbs tend to increase LDL-P and frequent spikes in insulin over the years can make one insulin resistant).
3. By adding carbs if one gets better glucose tolerance, how it can be good if it is achieved by secreting more insulin?
As an analogy, if you add back nicotine and caffeine they affect the body more but then regular use of them makes you tolerant towards them and now you need more of them to get the same effect which is no good, how far does this apply to adding carbs back?
I’m not sure this is true. The mechanisms of nicotine and caffeine are very different than glucose.
Dear Peter,
I really enjoy reading your blog. After reading your latest post above I accidentally read about Norm Robillard’s Fast Tract Digestion diet. Basically some kind of low carb diet to treat and prevent acid reflux.
Are you familiar with this diet and waht do you think about it?
Kind regards, Stefan
No knowledge of it.
Hi Peter,
First of all, thank you for your dedication and generosity in sharing your knowledge and experience on the web.
I would like to have your opinion on some rather interesting (in my opinion) findings of an experiment I conducted on myself (with two more friends). Being healthy and fit (training 12-15hrs weekly, around 10% body fat for the past 2yrs) with a normally balanced diet rich in non-processed foods, I tried a 5-day “detox diet” of raw-vegan juices only (just for the fun of it), that the company was marketing “for athletes”. Among other data, I took my lipid particle profile (spectracell) before and after the diet. The data I would like your opinion on (all data are in my blog if you have time and interest), are my LDL-C, LDL-P, LDL-IV, HDL-C and HDL-P. Firstly, my LDL-IV before the diet was 162 nmol/L. I understood from your posts (hope I’m right here…) that it is not relevant considering my low LDL-C (78mg/dL) and LDL-P (653nmol/L) and their concordance, but was still surprised why it was so high… Would you suggest any idea? After the 5-day diet, I saw a reduction in pretty much every value (LDL-C to 55, LDL-P to 547 and LDL-IV to a still high 158). Would that (maybe, possibly, just a single 5-day case study on a healthy subject does not make science) suggest that a short period on a similar program might help controlling blood lipids? As it is almost the opposite approach of the LCHF diet, how would you explain so similar body adaptations? Interestingly, also my HDL-C went from 104 to 101 mg/dL and my HDL-P from 9558 to 8064 nmol/L…
I would really like to know your thoughts (also on the short-timed changes) and if that was something you would expect. And in case you want to read the whole experiment and see the result, I would be immensely honored.
Again, thank you for your posts and attention,
Not sure anything can be inferred from such a short test. I’ve checked lipids as many as 9 times in 3 days and seen 10-20% variation, even with NMR.
U said you take probiotic and other supplements as well. There is so much talk when it comes to vitamins… I wanted to ask if you had any input on supplements when someone is on a ketogenic diet.
Thank you
Dr Peter Attia,
Love you work very much I’m confident this change will be massive for my coming year of sport 25yrs old ( Rugby Player) i can’t seem to find very much on side effects. I have been paleo for a year and just switching to Ketosis I’m having liquid bowels terribly for over 2 weeks. Do you have a post or any comment on trying to diagnose or process of illumination for this issue. Thank you. Ketosis feel so good quitting is not an option.
Usually people complain, initially at least, about the opposite. If you’re ingesting MCT I would stop. If I had to guess, you have steatorrhea. Even if not consuming straight MCT, you may have too much MCT in your diet (or even other SFA).
Frankly you should not be surprised when some of your readers attempt to replicate your diet. You call your blog the eating academy, and you teach about diet and health. Naturally some will follow the lead of a mentor., and why not. Everyone must find their own way, and your guidance may be helpful to some.
Hi Peter,
Do you think caffeine can affect cholesterol levels in a low carb environement? If quitting coffee with cream just for two weeks reduces total cholesterol by 40mg/dl, what is more likely: coffee or cream (10 grams saturated fat per day) or both?
Assuming measurement error is not issue, could be both for different reasons.
I’ve recently started the Ketogenic diet a week ago and lost about 10 lbs, I keep my calories under 2000 I’m 5″10″ 230lbs. Can anyone give me the ideal numbers or percentage for each…Carbs? Fat? Protein?
This is my opinion based on my own experience… It might or might not work for you. I don’t count calories or rather, I don’t limit my calories. There is no point. When I’m in proper NK, I tend to be under 40g/day of carbs… that’s what works for me.. some ppl need to be under 20g some can manage it at higher levels. I try to eat 80/15/5 as fat/protein/carbs and limit protein to 1-1.5g a day per kg of lean body mass. I generally eat about 3500-4000 calories/day and I feel that to limit yourself to 2000 calories will probably mean you have to limit your fat intake which would be detrimental to staying in NK… In fact, when my weight loss stalled, I figured out that this was because my calorie intake had dropped and I wasn’t eating enough fat. As soon as I upped my fat intake, I started losing weight again.
Again, just my opinion, but it worked for me.
Do you find after a heavy carb binge that your face feels puffy and itchy for a couple of days?
No, but I do get a bit bloated.
I just found your site and I love it! Thank you. I spent some time searching, but couldn’t find some info on my issue. I have been on very low carbs for 16 days. I have periods of rapid heartrate w/o exercise. I am wondering if it is low sodium or dehydration (?) Any thoughts? Thank you!
Are vivid dreams on low carb diets due to cortisol or lack of glucose to the brain?
I’m not sure.
Resistant starch a new magic bullet?
https://www.fathead-movie.com/index.php/2014/04/14/revisiting-resistant-starch-part-one/
Peter,
First off, thank you for all the information, both public and personal that you have written on this site. I’d hate to see that go as it’s invaluable to someone like me, who like you, wants the best from their body.
I’m a bit conflicted as to the ‘eat all the fats you want’ statement most keto-advocates advocate, yet cannot ignore the laws of thermodynamics.. It seems almost stupid to ask but, despite eating a low carb diet and feeling keto-adapted, will I still store fat?
I can’t help feel like a bit of a dunce, but that’s why you’re the doctor and I’m not!
Many thanks
Henry, the post I did a while back on “fat flux” addresses this point exactly.
Hi Henry,
I would say “eat all the fats you want until you are not hungry any more”. Nobody says you have to eat like a lion even if you are not hungry.
You say we “cannot ignore the laws of thermodynamics”. You cannot “ignore” the law of gravity either, but it doesn’t mean that gravity is important when talking about health and weight. To focus on the amount of calories you eat is a mistake. Not all the calories are the same: when I ate carbs my liver was warning me (NAFLD) and I was fat. Now I eat low-carb and I am healthier. What says the first law of thermodynamics about that?
You ask about storing fat when being keto-adapted. I don’t know if I am in ketosis (I just eat low-carb and I don’t measure my ketone levels), but my body fat is under 10% (I can’t believe it). If I store fat I must be burning the same amount (give or take) of stored fat for energy.
@Vicente,
10%bf is very impressive. Congratulations.
Would you mind sharing what %bf you were at before ketosis, and how many months of being in ketosis it took to get to 10%bf? What is your current macro split and calorie intake approximately.
Thanks.
Hi N,
I don’t know if I am in ketosis. I eat low-carb but I don’t measure my ketone levels.
I don’t know either what my body fat percentage (BF%) was before low-carbing. I didn’t have a caliper back then as I wasn’t thinking about making a before-after comparison. I don’t even know how much waist I have lost (I could have a hint if I compared my trousers from before with my trousers after). If someone thinks the skin caliper is not accurate, I really don’t care if it is not: I can clearly see my muscles in legs and arms and I can see I barely have any fat. I don’t care if my BF% is really 11% or 7% instead of the measured 9%.
I am 175cm tall and my weight was 95Kg (209 pounds) last summer. Today my weight has been 70Kg (154 pounds).
It took me 6 months to lose those 25Kg. My weight has been more or less stable for the last 4 months.
I don’t have a six-pack (I wish I had one) but my belly is completely flat. I love my body now. May be a side effect of this way of eating is that you become a little gay, watching your body and loving it (it’s a joke but also a little truth).
Hi N,
sorry, I forgot to answer your question about macro-split and calorie intake. I don’t count calories any more. I did while losing weight (I was controlling carb intake) but I stopped a couple of months ago. I eat avocado, salmon, meat, eggs, bacon, cheese, sobrasada (spanish kind of sausage), all kinds of nuts, salad vegetables, yogur, butter, flax seeds, 85% chocolate (once a week may be), etc. May be one piece of fruit per day (some days none). I also drink coffee and kefir but no milk (no special reason for that as I like both). I don’t eat wheat, not even in small quantities, grains, bread, pasta, sugar, potatoes, rice, etc.
Thanks for sharing, Vicente. That’s excellent, happy to hear how well it has worked out for you.
I think I’m right around 15% bf (Visual estimate) and am using low carb methods to get to 10%. My eating is pretty similar to yours. I don’t count calories or measure macros either anymore but suspect my caloric intake is around 2500 kcal. I am 6 ft. tall, weigh 175 lbs. and resistance train 4 days a week and could possibly do with a few more calories.
Gracias,
N
Vicente,
While you might not be in nutritional ketosis, I am guessing your daily carb intake isn’t more than 100 grams or so. Do you ever find yourself suffering from the low-carb flu?
If one is not in NK but still doing low-carb, I wonder how many grams of carbs per day one would need to ensure the brain has sufficient glucose in the absence of ketones.
Currently, I too am hanging out in this purgatory. No breakfast, Big Ass Salad for lunch (with lots of olive oil, boiled eggs, sositch), a fat-shake post-workout, and dinner is a no-carb hot meal (fat + animal protein) + ~60 grams of carbs from either white rice or sweet potato. I am curious if dropping the rice/sweet potato will throw me into the low-carb flu zone.
Hi Naren,
I believe I eat less than 100g carbs/day. I am quite sure about that: 1/2 liter kefir, salad, a few nuts, and eventually a piece of fruit or a yogur doesn’ t seem enough to reach 100g. But I will track my carb intake for a week so I can tell you for sure.
I also had the same doubt: what will my body do if I don’t eat a lot of carbs but I don’t have enough ketones either? No problem so far:
1) my brain works ok (at least I think it does). I am not sure I believe your brain is going to have problems because of the diet (pure speculation).
2) now I can play a 2 hour tennis game without signs of tiredness. Before low-carbing I could only play for more than 20min because of deep exhaustion. No joke there: it is just like that. Friends of mine say it is because I am 25Kg lighter now but I always replay: “true, I am lighter, but now I play for hours with no carbs at all: something has changed”.
Just one day I had terrible cramps in my legs. Since that unpleasant experience happened I try to have more sodium (drinking broth) regularly.
You eat potato and rice. When I started low-carbing I wasn’t only fat: I was taking medication for my GERD (I was diagnosed a hiatal hernia) and I had NAFLD. Now my liver is perfect (or at least my liver transaminases are) and my GERD has disappeared. Moreover, my brother was diabetic until his kidney failed and he received a new pancreas and a new kidney. When I watch the big picture, I can’t see carbs in my diet. I have no choice.
Vicente,
As always, thanks for sharing. I am delighted every time I hear how well low-carb has worked for you.
Out of curiosity, in a person who might consume alcohol with some regularity and also be insulin resistant, how is it determined if the fatty liver is NAFLD or Alcohol related, do you know?
Also, I looked up Plain Kefir available in America and it contains 12 grams of carbs/sugar per 240 ml. Is the sugar content similar in the kefir available in Spain? And I wonder if like yogurt, Kefir too is less insulinogenic compared to 12 gms of sugar from say fruit juice or ice cream. Do you consume it for its probiotic properties?
While I am currently young (32) and physically active, I have insulin resistance in my genes and wouldn’t mind getting an early start avoiding rice, potatoes, etc. My reason for including them was because I started noticing some low thyroid like symptoms while in NK (not verified through TSH, T3 blood tests though so I could be wrong in my “how I felt”-based assessment). Although including them hasn’t necessarily caused a complete 180 on those symptoms, and has introduced some bloating/water retention.
I have not noticed any carb flu symptoms in the 100 – 120 gms carb range. I have noticed carb flu symptoms in the <50 gms carb range (NK). I wonder if I could find my carb sweet spot in the following,
-Copious amounts of veggies
-Moderate amount of fermented dairy (yogurt/kefir)
-Berries occasionally
– Glycogen replenishment through SuperStarch, as needed for my athletic needs (hehe vanity more than athletic needs, I gots to look swole afterall!)
And I could keep hormonal issues in check through regular consumption of organ meats. Chicken liver and hearts start to taste good after some time.
May the power of the Universe be with you, mi amigo.
Hi Naren,
no, i don’t know about alcohol-related liver disease. I don’t drink alcohol so in my case there is no doubt. A medical doctor is needed here to answer that question.
My kefir is home-made so it has the carbs of the milk I use: 12g /250ml is right. The bad news is that kefir has an insulinotropic effect that makes the insulin release bigger than that predicted by its carb-count (read “Effects of kefirs on glycemic, insulinemic and satiety responses”). That sounds bad for a low-carber (we all want our insulin levels low, don’t we?). So yes, I drink it because it’s probiotic (and I like it) but may be it is a mistake. I am no nutrition expert so please don’t think I have a good reason to drink kefir. I don’t have it.
I also don’t know what is the best carb-count for me. Is 40g carbs/day better than 75g carbs/day? I don’t know so I don’t count carbs. In your case, if you feel you need more carbs than others, just do it!
Thanks for the good wishes 🙂
Hi Naren,
the days I could weight my food I can tell you I eat a mean of 60g total carbs/day. When I ate out, I can’t tell for sure but I always eat low-carb (no cheating). Of course my numbers are not a valid reference for anybody.
Hi Vicente,
Thanks for sharing that. Do you do any sort of intermittent fasting or just eat high fat, moderate protein, ~60 grams carbs without worrying how many meals it’s spread over?
I am currently working towards getting to ~100 gms of carbs on weight training days and 50-60 gms on non-training days.
The extra 50 gms of carbs on training days come from rice and/or sweet potatoes. I do eat fruit but only berries and in very modest amounts. Have to admit, reintroducing carbs hasn’t been smooth sailing for me. Going from ketosis to 150 gms of carbs (rice/potatoes) gave me the symptoms described in this article, https://robbwolf.com/2014/03/21/carb-reloading/. So a few weeks ago, I dialed it back and am now slowly adding the carbs in until I get to 100 gms on training days. Would like to live in the sweet spot described here. https://i247.photobucket.com/albums/gg158/MDA2008/MDA%202011/Carb_Curve_color.jpg
Hi Naren,
no, I have no experience with intermittent fasting (nor carb reloads). As long as I keep my weight stable (I am already 5 months stable) I don’t see the point of trying. Nevertheless, in the book “Grain Brain” Dr. Perlmutter recommends intermittent fasting as a way of keeping your brain healthy (he also says we should take probiotics).
You are right, I do not care if I do 3 or 5 meals. A few months ago I tried to eat 5 or more meals/day because I thought it was good for my liver. But I really don’t know that for sure so I don’t care any more about how much meals I have. If I am hungry I eat a little.
I want a six-pack like Sarah’s (from the first link you posted)…
Peter, my diet and eating scheduele is pretty similar to yours. I fast for 16 hours, skip breakfast and eat big meals, carbs only post wokout with a goal to quickly replenish glycogen. But lately Ive up my exercise routine as I want to improve both my strength and conditioning and also build muscle. I did some adjustements and increase my calorie intake but often I find myself hungry during the night. Im sure this is because I ate too little during the day, but untill I find out how much my body needs based on trial and error….what would you advise me to do in this cases? When Im hungry during the night (3-5 am)? I usually just have a glass of warm milk.
Slightly unrelated to this post but thought I’d ask anyway. I do quite a bit of cold water swimming. When I started on this journey I had a horrific BFP of 40%… Even with that amount of ‘Bioprene’ I struggled with the cold water. Since I’ve been on a keto diet, I’ve dropped 15% BFP (another 10 to go) but am much more comfortable even in single digit (Celsius) water. Would you say that this is solely due to acclimatisation or is there some part of the fat burning/ketone production that raises your inner core temp beyond what would be normally for those on a high carb diet?
Not sure, but don’t discount acclimation.