August 23, 2012

Nutritional biochemistry

Hey Peter, what does your daughter eat?

Read Time 7 minutes

If there’s one question I get asked often, it’s this one.  And I understand why.  Anyone who knows me, and knows how obsessed I am with everything I do, knows there is one thing on earth I cherish more than anything else – my daughter.

Any of you reading this post who are parents know exactly what I’m talking about.  My daughter, and I know the same is true for Gary with his boys, is one of the greatest driving forces behind us founding NuSI.  Why?

Picture the United States as a cruise ship.  Overall, it’s a wonderful place to be.  We have so many things to be thankful for (as do many folks outside of the U.S.).  But, there are icebergs out there.  If we continue the course we’re on, our fate will be similar to that of the Titanic.  Unlike the Titanic, though, we actually have several icebergs in our path.  That is, there are many different forces in the world today that – if left unchecked – could easily disrupt our way of living.  I won’t go into detail about what I think the list of potential threats to our economic and social freedoms are – pension overhead, national security, energy security, structural problems with education – but I’ll assert my opinion on the first problem we need to get a handle on.  If we don’t figure out a way to curb the twin epidemics of obesity and diabetes, our healthcare spending alone will bankrupt us.  No one can pinpoint the day this will happen, but if not in my lifetime, I’d bet anything it will be in my daughter’s lifetime.  In other words, of all the icebergs we need to skirt past, this one is the closest to our vessel.

So, back to the question.  While we wait a decade or so for NuSI to fund the type of science that will unambiguously resolve the jugular question — What should people eat to maximize their chances for greatest health? — what do we do?  If you’ve been reading this blog, you’ll certainly have a great idea for what I do, based on my interpretation of the data currently at our fingertips.  But ambiguity remains, especially when asking an even more important question than what do I eat.  Since my daughter (and presumably your children, for those of you with children) is infinitely more important to me than anything else, including myself, how do I interpret current data around what she should eat?

Principle 1: Excess sugar is not conducive to good health for anyone

I don’t think I need to spend any additional time reviewing the harm of sugar (e.g., sucrose, high fructose corn syrup, beet sugar, cane sugar, brown sugar).  If you do want a quick refresher on this, you can read this post. If you can only make one intervention in the dietary pattern of your child, make it this one.  Based on our experience and the experience I’ve had with clients, friends, and family, a trend has emerged.  It seems the longer you wait to make changes in this area, the more difficult it can be.  Not always, but often.  Sugar is very habit forming, and from a neurochemical standpoint an addiction to sugar is not unlike an addiction to gambling, alcohol, or heroin.  Yes, they all have nuanced differences, but each of these addictive patterns or behaviors results in stimulation of the dopaminergic pathways of the brain.

How do we translate this intent into practice?  The easiest thing to do is to minimize the amount of sugar brought into the house.  This means we don’t have soda, cookies, candies, cakes, cupcakes, and other similar nutritional weapons of mass destruction lying around.  This doesn’t mean we never have them lying around.  Invariably, a grandparent or neighbor will bring over a lollipop or some cookies, but this is an exception, not a rule.

Furthermore, we don’t have any juice in our house.  Our daughter (who is 4) drinks whole milk and water.  That’s it.  Amazingly, she no longer finds sweet beverages enjoyable.  Recently, at a birthday party, she was given one of those Capri Sun sugar-syrup drinks.  She took one sip and asked for a bottle of water.  It was actually too sweet for her.

As I explain below, she still gets some sugar in her diet, but it’s probably about 20% of what the average kid her age is consuming.  And she gets plenty of fructose in the form of fruit.  But when she eats fruit, it’s usually lower fructose fruits (e.g., raspberries, blueberries, strawberries) rather than higher fructose fruits (e.g., watermelon, banana).

Principle 2: The less processed the food is, the better the food probably is

As an extension of the first principle, if you always make trade-offs in favor of cooking your food, rather than pulling it out of a box or jar, you’ll win many of these day-to-day battles.  At least half the week our daughter asks for cereal for breakfast (instead of bacon and eggs).  Rather than dump her a bowl of sugar-laden cereal, my wife or I will make her steel-cut oatmeal, to which she’ll add milk and a few raisins and walnuts.  Sure, it’s more carbs in one meal than I eat in 3 days, but it doesn’t contain sugar (beyond the fructose in the raisins).

When she wants spaghetti for dinner, we make her real sauce out of real tomatoes and garlic.  No added sugar, of course.

This requires extra work, as you can imagine. It’s much easier to dump cereal out of a box or pasta sauce out of a jar.  But if I need to sleep 15 minutes less or my wife needs to cut her run short 15 minutes to make it happen, is it worth it?  For us, the answer is yes. But, it is a choice – of both time and money – every parent needs to make.

Principle 3: Insulin and insulin-like-growth-factor (IGF) are important for childhood development

This topic is highly complex.  For anyone who has studied IGF-1, GH, IGF-BP3, STATb5, or any of the hundred other molecules involved in the highly regulated pathways of growth, don’t be offended.  It would take another series the lengths of the cholesterol series to give this topic its fair shake.  However, a few key points are worth noting.  There is sufficient evidence, for me at least, that a growing child needs a modest dose of insulin to capture their genetic (vertical) growth potential.  In fact, stunted growth is one of the documented side-effects of children on ketogenic diets, though there may be several factors accounting for that beyond the role of insulin and IGF (e.g., protein deficiency, caloric deficiency).

Ketogenic diets are a medically accepted treatment for recalcitrant seizures.  About half the children whose seizures don’t respond to any medications almost immediately stop seizure activity once they are in ketosis. Some investigators, including Dr. Elizabeth Thiele, Director of the pediatric epilepsy program at Harvard’s Mass General Hospital, are investigating this approach in adults.  I had breakfast with Dr. Thiele recently and had an amazing opportunity to learn from someone with enormous experience treating children with ketogenic diets (over bacon and eggs, of course).  According to Dr. Thiele, who described some really amazing in vivo and in vitro research, the reason for the effectiveness is not entirely clear.  That is, it’s not clear if the seizure activity is ameliorated by the presence of B-OHB (beta-hydroxyburyrate) or the stark reduction in glucose or the insulin, or some combination of these, or even something altogether different.

Of course, having too much insulin-like-growth factor is even worse.  There are numerous medical reports that describe the opposite “growth” scenario – too much IGF-1, for example, being associated with increased childhood malignancy.

Everyone wants to know if my (non-epileptic) daughter is on a ketogenic diet.  The answer is no.  If I had to guess, she probably gets 40% of total calories in the form of carbohydrates, and very few of them are sugar.  That said, she’s so used to seeing her daddy give himself “boo-boos” on his finger every day to check his ketone levels that I think she’s getting curious…but that will have to wait a long while.

Principle 4: Fat is fine

As much as you’ve heard me espouse the benefits of fat intake in adults, it’s equally or even more true in children.  As the Harvard anthropologist Daniel Lieberman points out, as we evolved from chimps to homo erectus about 1.5 million years ago, and to homo sapien about 200,000 years ago, we required an increase in our storage of body fat (from about 4-5% to 7-8% to 12-14%).  Why?  Most likely to support the requirements of our rapidly growing and developing brains.  At no point in our development is this more necessary than as children.

My daughter certainly consumes less fat than I do, but she still gets about 35-40% of her total caloric intake via fats – saturated, monounsaturated, and polyunsaturated.  Perhaps her favorite breakfast of all is bacon and eggs with cream cheese.  She likes to wrap a piece of cream cheese and scrambled eggs with a strip of bacon which she calls a “cooc-a-mooc.”  Don’t ask me how she thought of that, but she loves them.  She drinks whole milk (it’s always struck me as strange that the American College of Pediatrics recommends children switch from whole milk to skim milk abruptly at the age of 2), avocado by the truckload, and a wide variety of quality meats.

Principle 5: They are, after all, still children

My wife and I agreed a long time ago that we were not going to restrict our daughter’s eating when she was at birthday parties, on Easter egg hunts, out for Halloween, or on other “special” occasions.  A few weeks ago we took her to Disneyland for her 4th birthday.  (Anyone want to guess what it’s like for an ISTJ to spend 2 days at Disneyland?  Were it not for the look on her face, I’m not sure I could have survived.)  We decided, for these 2 days, she could eat whatever she wanted.  The day started with a bag of cotton candy larger than her head.  I couldn’t resist looking at the package to see that it contained 90 gm of sugar.  I did the quick math on converting that dose of sugar from her weight (35 pounds) to mine (165 pounds) and realized it was like me eating 450 gm of pure sugar in 20 minutes – the length of time it took her to inhale it!  That’s about 12 cans of soda.  She went on to have pretzles and cookies for lunch and, of course, a cake for dessert after dinner.

The entire time I was watching her mainline sugar – more in one day than I consume in a year – I couldn’t help but chuckle.  I sent pictures to my friends all day long.  In the end, she was pretty sick of all the junk she consumed and welcomed her usual meals. But, for a couple of days she ate just like most any other 4-year-old would on her birthday.

Principle 6: No two kids are the same

As you’re reading this keep in mind, this is an anecdotal account of my life and my child.  Yours will be different.  What works for our child may not work for your child or children.  Don’t worry about it!  In the end you’ll be the best judge of what the optimal zone is.  I really believe my daughter will live a healthier life because of the way she eats growing up.  One day, of course, she’ll have to make her own choices.  Will she completely rebel against everything we’ve tried to teach her?  Perhaps, but I don’t think so.  I really believe that kids are the product of the example set by their parents.

I used to always wonder where my tendencies came from. Not surprisingly, much of who I am today is the result of the behaviors I observed in my parents.  It’s my belief that if my daughter grows up in an environment where an emphasis is placed on eating well, it will become a natural extension of her behavior, too.


Photo by Foodie Factor on Unsplash

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  1. My wife and I have been Paleo/Primal for about 14 months, and have gotten increasingly stricter with it for ourselves in the past few months (we’re currently doing a Whole30).

    Starting about 8 months ago, give or take, we cut the grains and sugar out of our daughter’s diet (she’s currently just over 2 years old.) She is a great eater and her diet currently consists of some whole milk dairy (milk, cheese, cottage cheese), eggs, a wide variety of vegetables and tubers (sweet potatoes, peas, green beans, lima beans, spinach, mushrooms, onions, peppers. tomatoes, artichokes, carrots, avocado), nuts, meat, fish, and fowl, and fruit (blueberries are her favorite). We give her the bare minimum of processed food (as little as possible, organic and no-added-sugar when in a pinch). Basically, she eats like we do (although we, the adults, are now dairy-free). We try to have as many meals together as possible, so she sees what we eat, and always wants to eat off our plates. Since we don’t eat grains, sugars, or processed junk, she never asks for it.

    We’re bracing ourselves for what will happen as she gets older and out into the world, but for the time being, this is all going great.

    And I have a personal theory regarding kids and veggies (based on really not much buy my own thinking about it): I think that if more palatable foods (highly processed, highly sugared, etc.) are in a kid’s diet, those become distracting from more whole foods. This is why I think you see kids get away from veggies as they get older – they’ve been exposed to more things like pancakes and cookies and so on. As the sweeter stuff comes into play, and the grainy stuff, the veggies become less appealing. If you don’t introduce the “distracting” stuff, they stay with the healthy stuff.

  2. Hi Peter,
    It’s very good to see that there is no clash between what you believe, practice and preach about diet, and what you are feeding your daughter: integrity and honesty is highly important.
    I am very happy to report that my now-almost-14-year-old son eats almost exactly as we do, my wife and I. And this means close to zero insulin-stimulating carbs, and he is already almost 6 feet tall, strong, muscular, a fast runner with great endurance for his age, handsome with nice skin and exceptionally good digestion, and only gets colds when he doesn’t sleep enough for several days in a row, which happens maybe once per year.
    Here ( is a diet analysis poster he did for math class, (he got the best grade; I helped a bit), where he was looking specifically at protein requirements and intake, but all the info about the other macronutrients is there. We used a very typical day in the winter. His total calorie intake was 3063, and I am very happy to report that 61% (207 g) was from fat, 13.5% (103 g) from protein, and 24% (182 g) from carbs, but almost all fibrous and thus not insulin-stimulating. This was a while ago, and we are eating even more fat now!
    But there is something that I haven’t noticed you mentioning (maybe you haven’t at all), and this is the importance of keeping the body alkaline to avoid chronic acidosis from excess uric acid, either from production or insufficient excretion. This is of great importance for health, both from the purely theoretical physiological perspective, as well as from the very real experience of perception of health through our performance in day to day activities. Any thoughts on that?

    • I forgot to mention that he did the poster two years ago, and we’ve all been eating an organic/local, mostly raw, vegetarian version of LCHFMP for almost 5 years now, fine tuning as we go along. And we all feel better and better with every month.
      Most exceptional is that my wife who suffered from asthma rather seriously since she was a kid, that’s about 40 years, is almost completely free of it. My guess is that within another couple of years, asthma and the continual stress it brings about, especially during the spring and summer, but really throughout the year, (because it takes a couple of months to recover from the spring/summer, and then the cold air is really bad for the chronically inflamed lung tissues, and then every cold used to take her a couple couple of months to completely purge the mucus), will all just be bad memories of a past life.
      I have to say that although there were remarkable improvements that came about from the elimination of simple and starchy carbs, the two most recently added elements that have made a marked difference in her getting better over that last year, are: 1) a lot more water—always on an empty stomach—together with more salt (unrefined), and 2) the excretion of accumulated acid by the alkalisation of body tissues through green drinks and an alkaline diet. These two have brought about an enormous improvement.

  3. It really is nice to read what other parents are doing in regards to LCHF approaches in there own lives (especially an MD that gets LCHF) and how they implement it in their kid’s lives. I wrote a post about how I approach food choices and health with my 8 year old daughter – I’m “just a stay-at-home-mom” with a passion to understand health (thank God for Gary Taubes, Tom Naughton and Jimmy Moore or I would still be 233 lbs instead of 5’10” and 140) and why the SAD diet failed me. I wondered what your thoughts are on wheat? We try to limit it as much as possible but she eats fermented wheat and ancient wheat on limited occassions. I have been learning about Dr. Davis research. Our approach is very similar to yours. Sugar is totally limited but we follow a whole, real food approach of traditional nutrient-dense foods with the principles of Weston A Price for het even though I am LCHF and strive for Ketogenic for both my husband and myself.

    • Re Wheat you may be interested in this interview:

      Fasano researches gluten. My lay understanding of what he said is that eating gluten, even in a normal healthy person, causes tight junctions in the intestine to open (briefly) and allow things to pass through that should not. The immune system will respond. The point was not really followed up with regard to any negative consequences, but left me wondering that in some, there may be effects we do not yet understand/appreciate.

      We have basically cut wheat out, but may have a hamburger bun or pita eating out once a month and our 3 yo will also.

      After going low carb (and later more paleo/grain free except for the cheats) I had some minor aches and pains go away which I attributed to being in my 40s but could be attributable to what Fasano terms as gluten sensivity.

    • I suspect you are correct regarding a higher level of carbohydrates for children. Vilhjalmur Stefansson in his studies and time spent with the Inuit noticed that the young were given the prime cut of their raw Primal fair, the fish heads, sweet meets and other organ foods. It might not have been candy floss :), but it was the closest they had. I wonder if the Inuit would have been taller had there been a little more carbs for the diets of their children.

      I did a search for the oldest human remains (homo sapiens sapiens-us), larger than thumb bones and the such, and the two oldest were from the same area in Iran. One was 34000 years ago and the later 27000 years. The average height of the adult males in the earlier site was six foot seven inches and from the second site, five foot seven inches. Either they were from two diverse groups or their diet was different. I speculated that the tall group may have been heavier meat and fat eaters but also partook of local figs and other carbohydrates and the shorter ones may have had to rely more on the available carbs. Just speculating.

      However, I have also read that strict vegan and vegetarian children are smaller in stature than their more carnivorous classmates.

  4. Peter,
    Did you noticed any change in behavior after the Disney Binge? I have a 4 yo son, had a major meltdown after eating a small blueberry bagel. We eliminated most wheat several months ago, someone my husband works with stuck that bagel in his lunch bag to be funny ( they give him a terrible time about his wife’s packed lunches and think we are lunatics for the way we eat). Anyway, do you think the loss of mental and emotional capacity after a bagel is more likely related to carb load or wheat? Thanks a ton!

    • Funny you should ask. Gary asked me the exact same thing. As much as I want to say it turned her into a hell-child…it didn’t. She continued to be her usual, profoundly sweet self. And believe, she ate pretty poorly for 2 straight days. I do recall on Easter, though, after she inhaled a lot of chocolate eggs, she was a bit out of sorts.

  5. I chuckle thinking back to when my daughter was 2. She would grab the butter stick off the butter plate and chow down. We would grab it out of her hand because we thought at the time that that was unhealthy. If we had to do it again, we would let her dig in. She has always drunk whole milk, eaten our home cooked food with plenty of butter, and had very few sweets. She is 11 now and doesn’t care much for sweets. We try to make sure she gets plenty of sleep. She’s extremely healthy, smart, and fun. What more could a parent want?

  6. I am becoming more concerned about the kids around me – especially the rapidly ballooning children of close friends and relatives. I’ve begun to seriously consider going for a certification program in nutrition so that their parents will at least give me a hearing. People will believe something if it comes from someone with the title “nutritionist.” Last week, the CSA (Community Supported Agriculture) farm we have a share in, sent out their weekly newsletter with this gem in it, written by a nutritionist (it was the week potatoes were going to be in the share):

    “Carbohydrates are sugars and are all converted into Glucose in our system. Glucose is the preferred energy source of the brain and for our muscles. If we do not get adequate glucose/carbohydrates, our body starts to break down proteins from our muscles and organs to convert to glucose. ”

    My husband is convinced that I could never get certification unless I’m prepared to grit my teeth and toe the party line until the end – but I really don’t know if that’s the case. I know it would be nearly impossible for me not to challenge things that I know are not true.

    (BTW, I sent a reply to the CSA citing Volek and Westman: “We recently used dual-energy x-ray absorptiometry to examine the change in body composition in subjects who switched from their habitual diet (48% carbohydrate, 32% fat) to a very-low-carbohydrate diet (8% carbohydrate, 61% fat) for 6 weeks. Surprisingly, fat mass decreased significantly (–3.3 kg) and lean body mass increased significantly (+1.1 kg), despite no change in physical activity. There were no significant changes in the control group. These results suggest that a very-low-carbohydrate diet favors loss of fat. Water may account for some of the initial rapid weight loss, but it appears that fat loss accelerates and lean tissue is preserved over longer periods, ” but never got a response.)

    • It’s tough to hear these things without wanting to respond. I used to be on various nutritionist discussion boards, but I had to quit. Too painful to read and I’d much rather focus my energy on other things, like trying to advance the science.

    • I took this from the other thread where Dr. Cahill’s obituary was quoted:

      “A crucial finding was that in the first few days without food, the liver starts breaking down protein to make glucose to feed the brain. But using protein as fuel can be perilous, because it is the stuff of vital organs and muscle.”

      The current state of nutritional “expertise” is like a game of Whisper-Down-the-Lane. Dr. Cahill makes a crucial discovery about the body’s response to starvation, and 50 years later nutritionists like Ms. CSAconsultant are saying it’s a response to a lack of whole grain bagels…

  7. Thanks for sharing this personal story and pictures. It is so nice to see this very personal side of the scientist you are. 🙂
    My daughter (who is 15 and a swimmer) will be reading it as she is contemplating a ketogenic diet (currently at about 80grams carbs/day).
    I did have one question. After reading William Davis’ book “Wheatbelly” and learning that wheat will raise insulin levels much more than sugar, not to mention the other toxic effects, what type of pasta do you serve your daughter with the homemade spaghetti sauce? Are there some grains you avoid completely? Why or why not?

    Looking forward to reading more from you about nutrition in children.


  8. Hello, Peter!

    Congratulations on raising such a happy, healthy child!

    We are hoping to have children soon, so I was very interested to read this post today. I’ve given a lot of thought to how I might handle the carb situation, if my partner and I should be lucky enough to have kids. He and I are both prone to insulin resistance and have been since we were little, so we’re keen to avoid the same fate for our kids. I’ve been thinking that I will do for my children what I wish my parents had known to do for me–recognize excessive hunger as a signal that there are too many carbs in the diet.

    When I was little (5 or 6 onwards), I started to get chubby, and would constantly ask my naturally thin parents for snacks, etc. They didn’t believe me that I felt hungry, and would say things like, “You just THINK you’re hungry! You just like the way it tastes!” They did their best to keep me on a “healthy” diet–one dessert per week, whole grains, no saturated fat, tofu instead of red meat, no soda, only fruit for snacks, no fast food or junk food–but of course it didn’t work. I turned into a fat grownup, and I always tried to ignore my hunger and follow the food pyramid guidelines! In my mid-20’s I finally figured out for myself what was going on when I was sent for a diabetes test as part of a medical clearance for some work in a remote location. I’d eaten my usual “healthy” breakfast at 8:30, which was steel-cut oatmeal made with water, a stewed apple (no sugar) and a handful of slivered almonds. By 10:00, I was starting to feel the typical hunger that I always tried to resist until lunch, because I “couldn’t be” hungry yet! At 10:30 I had the blood glucose test and my results showed a blood glucose of 80 (units?). The nurse asked me if I’d had breakfast, and when I said yes, replied incredulously, “Was it a donut?? Because you look like you’re having a sugar crash!” That’s the first time I made the link between low blood sugar and that constant plaguing hunger, and of course that’s gone away now that I keep my daily carbs below 20g. I just wish my parents had known that that’s what I was feeling when I was little and constantly complaining of hunger, and could have responded in a way that would have helped me not get so fat!

    So, when I have kids, knowing that their bodies will be different than their parents’, I don’t want to keep them on as strict a low-carb diet as myself or my partner, but I will try to keep my eye out for excessive / non-stop hunger as a sign that they might be getting too many carbs.

    One more thing, Peter–given that you’re planning to write on the topic of low carb pregnancies at some point… Here in the UK they have started treating overweight pregnant women with meteor in, even if they don’t have gestational diabetes, to prevent the fetus from experiencing high blood sugar and thus becoming predisposed towards obesity later in life. I’ve been wondering if there is any evidence surrounding the effects of ketosis vs. metformin

  9. @Zak Hendsch: “Very similar physically and raised in a similar environment. . .” I once remarked in a casual conversation that two siblings were brought up in the same environment. A psychologist among us said, no they weren’t brought up in the same environment; they had different siblings. 🙂

  10. Peter

    What is your view on bacon? In particular, it being processed,the nitrites and nitrates, etc.


    • I had looked into this. Apparently ALL bacon contains nitrates and nitrites – the better ones just don’t contain “added” nitrates and nitrites. From the Applegate website:

      “Q: Do Applegate Products Contain Nitrites or Nitrates?

      A: The short answer is yes, but with another longer story. Nothing is ever simple, is it?

      All animal proteins are made up of amino acids that contain naturally occurring nitrites and nitrates. And so Applegate products made with animal protein will have levels of naturally occurring nitrites and nitrates.
      In addition, the celery juice and sea salt used to cure our meats also contain naturally occurring nitrates.
      For these reasons, the USDA does not allow animal protein products to state “nitrate/nitrite free” on their labels. So, being law-abiding citizens, we don’t state that.
      Packages for our products are required to say “no added nitrites” since they contain the naturally occurring variety, but were cured without the addition of chemical sodium nitrate.”

      Some good info here, but the author also thinks saturated fat clogs arteries. GAAAH! Will it ever end???

      Or you could make your own:

      Apparently lamb belly makes a very good bacon, too!

  11. Now that you’ve tackled the youngsters, I’d love to see you address the other end of the age spectrum. I’m turning 60 next year and have essentially been on a low carb diet, at least most of the time, for at least 20 years. When I originally did the Atkins diet I discovered that all my pollen allergies disappeared. Experimentation revealed that eliminating the wheat made the difference. I used to be on two different inhalers but today barely even get a runny nose during the height of the pollen season, which can be brutal here in Tennessee. What I have discovered, however, is that it is increasingly difficult to maintain my weight even at very low carb levels. I eat almost no processed foods. I can go on what might be described as the Atkins induction and my weight will barely budge. However, I plan to stay low carb forever because I believe research is eventually going to show a strong relationship between excess insulin and Alzheimer’s disease. So what might be the ideal diet for many of us nearing Medicare age?

  12. This is really interesting! I am from Sweden were LCHF is huge (as you know) but we live in Australia and has been for 6 years. I have been low carbing for the past 7-8 years or so and of course that has spilled over to our son who turns 13 in a couple of weeks. He is the tallest in his class and his endurance is spectacular, if its running or doing home works-there is no difference.

    Here in Australia we have to provide lunch boxes and it’s gone to the extent where kids in his class offer him money for his lunches…! Which he of course never accept 🙂 The standard lunch for Aussie kids consists of white bread, margarin and vegemite, for recess a lot of kids have donughts and ice coffee, a sports drink or one of those energy drinks.
    My son? He has chicken drumsticks or wings marinated in spice mixes I make myself. It is so easy and you don’t get all the sugars and anti -caking crap. To go with the chicken he’s got home made mayo as well as home made ketchup. That also is very easy and I know exactly what he gets. Another day I just boil some eggs, roll up some ham and cheese slices, cut up cucumber and bell peppers, mayo to go with it. Again so easy and apparently very enviable 🙂

    We are not being fanatic about his diet (even some people would disagree) but as long as I can control what he eats at home I’m happy.
    He feels that they are teaching the kids the wrong things in school when they talk about that margarin is better then butter, cream is bad for you but “here have a processed meat pie, It’s good for you”- kind of talk.

    I recently started to blog about how to cook easy low carb, and my son helps out since he loves to play around in the kitchen and always make his own after -school -snack. Please have look if your interested at

  13. Hey Pete, a couple of off topic questions:

    1.) what do you think of the High fat, low protein, very low carb diets? Jimmy Moore is doing one and is losing weight after 10 years on a LC diet that saw him lose 200 pounds then gain 80 back even though he kept under 20 carbs a day. He goes 85% fat, 12% protein, 3% carbs. When I started reading his blog posts, I immediately thought that he must have been in the ‘Zone of Misery’ you talked about 6 months or so ago (Still patiently waiting on that blog post by the way). Do you think that could have been Jimmy’s problem, too much protein?

    2.) How is life as a first time dad in your mid 30’s? Looks like I’ll be the in the same situation and know no one else who is a first time father at that age. Just curious on your thoughts.

    • 1. Hard to say what’s going on. I’ve learned to stop guessing without a detailed analysis of exactly what someone eats. Too many variables (dairy, protein, artificial sweeteners, others).

      2. Greatest thing in my life. If you think I care about nutrition, you’ve seen one tenth of how much I care about that little girl.

  14. Thank you for a great blog and blog post, dr. Attia!
    My 2 1/2 year old son was diagnosed type 1 diabetic 1 1/2 months ago, and on top of that we just entered a research project which investigates whether a gluten free diet will benefit his active beta cell count. So naturally we are restricting his carb and gluten intake. His day care is great at handling all this, but they sure do eat lots of bread, so though I prefer he ate other things like veggies and meat, he will problably end up getting his fair share of gluten free bread and the like.
    I myself got interrested in the kegogenic/paleo-sort of eating about three months ago (though I have normal-low BMI), and I think of the diabetes diagnose as a knife-to-the-throat kind of encouragement to eat more low carb and low/no grains. Thank you so much for writing about your take on food and kids!

  15. Another “Thank You” to the long list for your time/effort here. The last pic (at the desk) pretty much screams it’s great to be alive: I hope one day science can up with a blood test measuring the health benefits of being surrounded by people who love us.

    A question for you or your readers. I apologize if it’s been answered already. I bought the blood meter you use. Can I make a correlation between glucose and ketone levels? The ketone strips cost 4x as much as the glucose where I am.

    • I’ve been trying to do so for a year, but the correlation is too weak to justify. Too many factors involved. Ketone strips in Canada are about a third the price (relative to U.S.).

  16. Hi Peter,

    This is on a tangent from the topic, but I wonder if you have an opinion.
    Every now and then I would read articles about how vaccines are bad for your children. I would roll my eyes and think, “duh, why on earth would government do something that would harm our children? “. The CDC are, afterall staffed with doctors and researchers and whotnot, and obviously they know what they are talking about.

    My daughter is almost 5, and have been vaccinated to the nines (we lived in Vanuatu for a while, so hep C was also added to a long list of stuff). My son is 9 months, and he has also been vaccinated according to schedule.

    Since starting eating Primal I have started to wonder if government is pushing something as clearly harmful as grains, why would vaccines be any different.

    I am hesitant to do a google search, as it can be ridiculously difficult to distinguish the proper sites from the crack-pot ones.

    I understand that it is not really the scope of your blog or this post, but having just read another article about it ( , I figured that I need to ask someone.

    Thank you

  17. “That said, she’s so used to seeing her daddy give himself “boo-boos” on his finger every day to check his ketone levels that I think she’s getting curious…but that will have to wait a long while”.

    Hi Peter
    Great post. Can you please elaborate a bit on how you measure your ketone levels?


  18. Hi Dr. Attia,

    I’ve been ketogenic for around 3months now. Always limiting carbs to <50g (more like 30-40g) and never consuming more than 20g of carb in a single meal. I take approximately 1.5g/kg of protein each day.
    However, I noticed that I've lost muscle mass, and have been laying down fat. Before the start I had little body fat around 8-9%, now its more like 14%?
    What could be going on? I do take a casein and a WPI shake from time to time, could it be that?

  19. Peter: A lot off the topic. This afternoon I got talking with a friend of mine and I mentioned a high fat diet. As our conversation continued, I brought up your name. My friend, is Pedro Mendez-Tellez and it turns out you and he know each other well. I even mentioned the book you wrote while at Hopkins, and he pulled out his I Phone to show it to me. It is still used.
    We are running buddies and have run together for years. Pedro mentioned that he had thought of doing a high fat diet, but believed he should have certain test taken prior to taking that step to determine his insulin sensitivity such as a glucose 2 hour test along with tracking insulin. We speculated that would help determine whether a high fat diet would be beneficial. He mentioned, as you have, that your wife is thin. I noted that you have mentioned that she can eat carbs without the negative effects.
    So our questions is what blood tests can we take to determine our insulin sensitivity? Clearly, if we are more like your wife, carbs may be no big deal. If we are more like you, carbs are really a problem.
    I own a running speciality store and before Pedro left he bought some UCAN and said to send his best wishes. Regards, Bobby

    • Wow! PLEASE say hi to Pedro for me. Man, I miss that guy. He was one of my favorite attendings from Hopkins. The gold-standard for determining IR is something called a euglycemic clamp, but it’s not a realistic option, so I opt for 3 other measures: OGTT with HOMA-IR, ratio of TG/HDL-C, and lipid IR score based on NMR. The combination of these tests gives a very good impression of how insulin resistant one is. Please have Pedro email me!

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