Note to readers: This post was written in September of 2012.  PLEASE do not ask me why I eat ‘this’ or why I don’t eat ‘that’ — as what is shown here does not necessarily reflect what or how I eat today (or more importantly, how you should eat).  My diet evolves constantly, due to my constant tweaking and self-experimentation. Over time, I’ll share it here and there, but what I eat is not at all the focus of this blog.  I ask that you refrains for asking questions about what I eat your comments.

 

For reasons I don’t fully understand the most read post on this blog is one I wrote very quickly and with very little thought.  I wrote it in response to a question I’m asked all the time, “What do you actually eat?”  The post, aptly titled, What I actually eat, has more than twice the traffic of the next three most read posts combined. Go figure.

After a full year in “strict” (i.e., no “cheat” days) nutritional ketosis I wanted to experiment with other eating patterns.  I had been reading about intermittent fasting (IF), and had a few discussions and exchanges with Mark Sisson and Robb Wolf about it.  Though I don’t know Brad Pilon or Martin Berkhan personally, I’d also read a few interesting things they had written.

Why the change?

My curiosity was sufficiently piqued to break a golden rule – if it ain’t broke, don’t fix it.

I was very happy after a year of nutritional ketosis, but I did wonder if I could improve on a few things.  For starters, as my cycling season was about to ramp up, I wondered what it would be like to weigh 75 kg (165 pounds) instead of my steady-state weight of about 78 kg (172 pounds).  I know 3 kg does not sound like a lot, but it can make a huge difference when riding up Mount Palomar, assuming one can preserve power output. I also liked the idea of not spending so much time eating.  As you probably know, I’m pretty obsessive about how I utilize the 168 hours in each week and resent anything that takes me away from my family, my work, and my training.  (This includes sleep, which I wish I could figure out a way to thrive without.)

In the end, I think Mark Sisson finally just egged me on enough to agree to at least give it try – even just one day per week.  And with that, I embarked on the next phase of my nutritional odyssey.

I decided, in early May, to start with the following protocol: one meal per 24 hours, twice a week.  On the other 5 days I consumed my usual keto-diet.  On the two IF days I would just eat one meal at around dinner time.  I still consumed normal amounts of liquids (water, coffee, tea) and supplements (see list below), with one exception – on fasting days I doubled the amount of sodium I supplemented via bouillon from 2 gm per day to 4 gm per day.

Like all nutritional changes, this one took some getting used to.  Because I exercise in the mornings, on fasting days I would get pretty hungry by about 10 or 11 am.  Interestingly, though, by about 2 pm, as my blood glucose levels would be between 60 and 70 mg/dL, I would start to feel completely fine.  In fact, by about 5 or 6 pm, just before eating my meal, I found I wasn’t really hungry.  This may have been due to the fact that my B-OHB levels were usually above 3 mM by this time of day.

Why do I call it “IFIK?”

Not surprisingly, after eating 100 gm of protein and 40 gm of carbohydrates in one sitting, my B-OHB levels would fall, often below 0.5 mM, the practical threshold of nutritional ketosis.  Usually within 24 hours I’d be back to my normal levels, generally between about 1 and 2 mM. But, the cycling in and out of ketosis was new to me, hence the phrase “intermittent fasting, intermittent ketosis,” or “IFIK.”  I guess you can see why I didn’t end up in marketing – “if-ik” doesn’t really have a nice ring to it.

The purpose of this post is not to provide a detailed overview of IF or ketosis, but rather to address the following common questions I often get asked in response to the original post on what I ate:

  1. Question: Peter, why do you eat so much dairy?  Answer: I don’t.  That was a year ago.  I did eat a lot of dairy, and seemed to tolerate it quite well. I realize that’s not true for everyone. Regardless, I seem to eat much less today.
  2. Question: Peter, is ketosis for everyone? Answer: Of course not.  Besides oxygen and water, few things are.
  3. Question: Peter, why do you eat so much meat? Answer: I don’t.  In fact, some days I don’t eat any.  Other days I do. I obviously don’t think there is anything harmful with eating meat (read this post for a refresher), but I’m quite happy eating lots of non-meat items, too.
  4. Question: Peter, how can anyone possibly do anything athletic without carb loading? Answer: It’s easy.  Anyone can do it, if they are just patient and let their body adapt.
  5. Question: Peter, you eat like a freak (ok, not really a question!) Response: And your point is?

What happened after several months of IFIK?

Interestingly, I did lose weight.  After briefly hitting 163 to 164 pounds, I settled out at where I am right now, about 165 to 166 pounds, right at my 75 kg target.  I have not yet repeated a DEXA scan to confirm, but I suspect I lost a bit of muscle, along with more fat, probably at about a 1:2 ratio.  My last DEXA measured a body fat of about 9%, and I suspect I’m about the same, though my waist is half an inch smaller than when I started, so I may be closer to 8%.

Why do I think this happened?

In the IF community there are really two (maybe more) theories on why I lost weight.  I won’t describe them here in any detail, but will do so in subsequent posts.  One hypothesis is that I’m simply consuming fewer of the same high quality calories than I did before.  The other hypothesis is that the physiologic response to IF (rather than the response to prolonged fasting) is to increase my REE during the period of IF, possibly through the up- and or down-regulation of various hormones.  Of course, it could be a combination of these, or something entirely different, too.

Drumroll….

Before getting to the part that folks who are still reading probably care about, let me point out a few differences between what I eat today and what I ate a year ago.

  1. I consume, on average, fewer calories per day.  I am also lighter, and we know TEE varies with body mass, so it’s not surprising that most days I am not eating over 4,000 kcal, as I used to. Of course, one might argue my body has become more metabolically efficient at utilizing substrate, and so my REE is lower than it was a year ago.  Finally, I do exercise less than last year.  Hence, there are many explanations for this difference.
  2. I consume less dairy. Don’t read too much into this.  There is nothing deliberate about it, just an observation of my behavior.
  3. I consume less meat of all varieties.  Again, don’t read too much into this.  I have no explanation except that I seem to crave it in lower amounts and less frequently.
  4. I consume more overall carbohydrates, though still virtually zero sugar or refined carbohydrates. Most of this additional carbohydrate is in the form of nuts and SuperStarch.
  5. I consume virtually zero sugar substitutes, except for the little bit in my SuperStarch and protein powder (sucralose).  I also drink, at most, about one diet soda per month.
  6. I spend less money on food.
  7. I spend less time eating.
  8. Currently I only eat three meals per day about once a week. I eat two meals per day probably 4 times per week, and one meal per day twice per week.

To calculate the nutritional content of my intake I use a piece of software called Nutritionist Pro, which is not for the faint of heart. It’s one step removed from a DOS prompt. In addition to costing about $600 a year, it’s not exactly user-friendly.  I’d probably describe it as “user-hostile,” actually.  But, it’s really accurate and has a database that is unrivaled.  The reports, once you learn how to generate them, are very good, also.

Three consecutive days of representative eating

Keep in mind, I don’t count my calories or weigh my food normally.  I do it periodically, such as at this time, when I’m curious as to what I’m actually eating.  I believe I’m able to do so without eliciting the Hawthorne Effect, but obviously one can never be positive.

Tuesday

  • 7 am — morning workout – flat intervals on bike (75 minutes).
  • 1 pm – Nicoise salad:2 cup butterhead lettuce, 1 tomato, 10 black olives, 8 oz tuna steak, 1 hard boiled egg, 0.5 cup red onion, 2 oz lemon juice, 4 tbsp olive oil, 1 tbsp mustard.
  • 7 pm – Chicken salad with nuts:2 cup romaine lettuce, 1 tomato, 0.5 cup cucumber, 2 oz cashews, 2 oz walnuts, 8 oz chicken breast, 6 tbsp olive oil, 2 tbsp balsamic vinegar.

Daily totals:

Carbohydrate – 89 gm

Protein – 131 gm

Fat – 218 gm (about 15% SFA, 70% MUFA, 15% PUFA)

Calories – 2,900

Wednesday

  • 6 am — morning workout – high intensity dry land (90 minutes).
  • 3 pm – The “Peter Kaufman shake” (named after my good friend, Peter Kaufman at Generation UCAN, who hooked me up with the recipe):
    4 oz heavy cream, 8 oz zero-sugar almond milk, 1 pack chocolate protein SuperStarch, 2 tablespoons almond butter, 8 gm additional glutamine, 1 tray of ice cubes (blended to smoothie consistency).
  • 7 pm – Chicken-nut omelet:
    4 eggs, 0.5 avocado, 3.5 oz cheddar, 3 oz red onion, 2 oz walnuts, 2 oz cashews, 4.5 oz chicken thigh, 2 tbsp butter

Daily totals:

Carbohydrate – 60 gm (30 gm of which is SuperStarch)

Protein – 151 gm

Fat – 226 gm (about 40% SFA, 35% MUFA, 25% PUFA)

Calories – 2,800

Thursday

  • 7 am — morning workout – hill intervals on bike (75 minutes).
  • 5 pm – Attia super salad:
    1.5 cup romaine lettuce, 0.5 cup cucumber, 0.25 cup mushroom, 1 tomato, 3 oz sliced T-bone steak, 2 oz cashews, 2 oz peanuts, 2 oz macadamia nuts, 8 tbsp olive oil, 2 tbsp balsamic vinegar.
  • Between 6 and 8 pm – after-dinner snack consisting of:
    3 oz cashews, 1 oz almonds, 2 oz peanuts, 1 oz macadamia nuts, 2 cups of coffee with a total of 6 tbsp heavy cream.

Daily totals:

Carbohydrate – 94 gm

Protein – 93 gm

Fat – 369 gm (about 20% SFA, 65% MUFA, 15% PUFA)

Calories – 3,800

My daily supplements

Note: I am only listing the products I use, and not trying to convince you that my brand of vitamin D is superior to another.  If I feel strongly about a product, I note it. But this is not a product pitch. I don’t make one penny off you buying any of these products.

Fish oil

1 tablespoon of Carlson’s Very Finest Fish Oil, providing 2,400 mg EPA and 1,500 mg DHA.  I do feel this is a superior product and I’ve had detailed toxicology analytics conducted on the product to confirm the absence of lead, arsenic, mercury, and other toxins.

Vitamin D

5,000 IU D3 in gel capsule, by NOW.

Magnesium

400 mg magnesium oxide by Nature Made.

Sodium

2,000 mg in the form of bouillon, typically by Knorr.

MCT oil

Either 2 or 3 tablespoons, depending on activity level, by NOW.

Probiotic

2 capsules of Mark Sisson’s Primal Flora, providing 60 billion CFU.  The reason I use Mark’s product is because I know and trust him, and I know how much homework he did in formulating this product.

One of the topics I’m currently getting steeped in is gut biota, and I’m hanging out a lot with a San Diego expert on the topic, UCSD Professor Larry Smarr, who has repeatedly sequenced his entire gut biome, with the help of Craig Venter at Synthetic Genomics and others at MIT.  As Larry points out, the challenge of “moving the needle” with probiotics is that they only provide the aerobic bacteria while, of course, most of our gut biome is anaerobic.  Stay tuned for much more on this topic.

Closing thoughts

  1. My performance, especially in light of my reduced training volume (or maybe because of it!) has not deteriorated.  In fact, this week I had 3 best times in 3 of the activities I do weekly (tire flipping/sledge hammer/plyometic routine (1:04); short sprint up 15-18% grade (0:39), and long sprint up 8% grade (3:29)).  It’s possible the added carbohydrate, relative to my constantly ketotic state, has facilitated this, despite consuming about 15% of the carbohydrate I used to consume on my “standard American diet” circa 2008.
  2. I will discuss the impact on my biomarkers in a separate post.
  3. The only drawback I’ve noticed of IFIK so far is that I’ve inadvertently turned my daughter off nuts.  About 4 months ago, after having three consecutive identical dinners (chicken-nut-salad), she called my wife into her room as she woke up and said, “Mommy…we need to talk.  We need to have something different for dinner tonight.  We can have steak…we can have sausage…we can even have regular salad without nuts…but I can’t have nuts in my salad anymore!”  Poor girl… So now I have to make my salads separately.

 

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569 Comments

  1. Chris says:

    Hi Peter, this question doesn’t exactly relate to the above post, which I really enjoyed reading. My question regards the effects of anti-psychotic medications on insulin resistance and weight gain.

    The first 20 years of my life I was relatively lean and well-muscled, though I always had a small layer of extra adipose tissue. Around my 20th birthday I was put on Zyprexa and Depakote and promptly gained 20 pounds in one month. Over the next several years my weight slowly crept up until I began eating low carb. But even then it was a struggle.

    I’m wondering if my metabolism was permanently altered due to the effects of the Zyprexa, or if it just exacerbated a latent problem that would have inevitably emerged on its own. I’ve read studies regarding anti-psychotics and their effect on insulin sensitivity, and just wanted to hear your take on it.

    Thanks much!

    Chris

    1. Peter Attia says:

      Hmmm, good question, Chris, but I don’t know the answer. I have heard others comment on this, but I don’t know enough to comment meaningfully. Perhaps others know?

    2. RJ says:

      Chris, I took high doses of Seroquel for 5 years. i later tried Abilify, Risperdal, and Zyprexa ODT. I feel that the drugs have permanently affected my metabolism. I currently take lithium (dx is Bipolar-NOS and PTSD). I feel that he most important things are:
      1.) daily exercise. Try to get high-intensity interval training at least 3-4 days per week. This is important on multiple levels for staying well.
      2.) vegetables and focusing on your gut flora. I try to eat 5 servings of vegetables per day, OR MORE, plus probiotic-enhancing foods like a couple forkfuls of sauerkraut per day. This is very hard for me due to the taste/smell side effects of the lithium, but at least i don’t wake up destroying a jar of peanut butter in the middle of the night, like I used to do on Seroquel.
      3.) long-acting therapy modalities that will ensure long-term success, such as DBT and/or ACT (mindfulness is key)
      The most important thing is to continue treatment and commit to raising your standards for physical fitness and nutrition, as well as treatment using DBT or ACT.

  2. Matt says:

    Peter, have you tried any of your workouts without the superstarch since you have discovered it? If so, what were the major differences in how you felt?

    1. Peter Attia says:

      I only use SS during workouts that last longer than about 3 hours, which I only do 1x per week. Otherwise, I’m using SS to replete glycogen (as I’m showing on these 3 days).

  3. Brian says:

    Peter, I had my first blood test with my doctor yesterday. It was very interesting trying to explain my diet to him. Needless to say I did not convince him, but he did walk away knowing I’ve done my homework and wasn’t just a nutcase who didn’t care what I eat. Believe it or not, he runs an NMR test standard so I’ll get to see my LDL-P count which I was surprised and very relieved to find out. He is excited to see the results. One thing that was interesting was that when I told him I expected my HDL to go up, Triglycerides to go down, and LDL-P to be in a healthy range, he agreed with me…. so I’m not sure what the issue was. He got a little defensive at one point and tried to tell me that fat is stored in arteries! He was grasping for straws of course and he quickly admitted he was wrong. Anyway, I should have the results by early next week.

    Oh and one more thing. I told him if he is smart and wants to stay a relevant doctor, he should check out NuSI right away. He wrote it down so hopefully he does the right thing and starts living in the now.

    Thanks for all you do!

    Brian

    1. Peter Attia says:

      Great. Will be interesting to see.

    2. khan says:

      I was curious to know about your blood test results, kindly post them. I am curious to know what is the effect of low carb and high fat diet

  4. lorraine says:

    What are your ketone levels on the higher carb days (over 60)? Aware of the slight insanity of referring to high carb as being higher than 60…….

    Glad your wife and daughter keep you a bit reigned in.

    1. Peter Attia says:

      I’d be nowhere without them… It really depends on too many things to really give an accurate answer. Type of carb (e.g., SS has little effect on B-OHB), timing, amount of aerobic exercise, glycogen deficit…all seem to play a role. Of course, starting level of B-OHB matters too.

  5. John says:

    Peter excellent article as always. I have been living off a Keto diet for about 4 months. I think it’s interesting you bring up this article because I find myself eating the same way coincidently. I will be consistent through much of the week and in days I have long classes I usually eat 2 high fat low carb meals. The first couple months fat loss was effortless, but now it seems my body is starting to preserve fat stores. I think these 2 meal days sort of make my body tap a little further into stored adipose, because without a doubt my body has become an efficient fat utilizing machine. Just my 2 cents, keep up the great work.

    1. Peter Attia says:

      Could be…I sure would like to see a few cleverly designed experiments address this question.

  6. David Nelsen says:

    Peter, glad to see you back posting! I’ve been stuck at my current weight for a while and might give IFIK a try to get over the hump. I think I can already see from you food logs that I’m eating a bit too much. I have a BBQ smoker/grill and make a lot of really tasty meat dishes that the whole family enjoys (I add hardwood smoke flavoring to the meat). What I use is like a Big Green Egg if you heard of that. I’ve been afraid of IF since I can’t remember ever skipping a meal in my life, but I think I’ll give it a try on an upcoming weekend. On the Gut Flora, what are you trying to accomplish? I have some gut issues and have to take Metamucil every night or there’s trouble the next day. This is the case even if I have a large salad for lunch and dinner. I never have indigestion or any other stomach issues, but I’m curious about the Gut Flora supplement. As far as your daughter is concerned you need to mix up your play (kind of like in Poker) – they go through phases and don’t want the same thing all the time. Then again, my daughters have eaten Nutella sandwiches for breakfast for more years than I want to count. Cheers, Dave

    1. Peter Attia says:

      My interest in gut biota is pretty broad. I’ll definitely write about this in detail in the coming months, but it goes beyond regularity.

    2. Vasco Névoa says:

      “One of the topics I’m currently getting steeped in is gut biota” – hooray!! 😀
      This, Peter, is promising to be a lot greater in magnitude and importance than your cholesterol series. And quite interrelated, too.
      My personal situation of high LDL-c can be traced, I believe, to an exaggerated gut permeability, which in turn is definitely caused by a mutated/overgrown gut microbiota. So, in my view, it is probable that many SIBO sufferers will also suffer from high LDL counts as a consequence. I’m trying to verify this through N=1 experimentation.
      I’ve been trying a restricted FODMAP diet to kill down the critters while watching the lipid profile, but progress has been stalled by an overconsumption of heavy cream (apparently 2% lactose is still enough for stomach and small intestine bacteria to thrive, especially when we gulp down a pint of cream every day). So now cream is out, coconut milk is in. Now I just fear that such an extreme low-FODMAP/ketogenic diet will trigger mycotic overgrowth… Candida time? Hope not.
      I’ve come to consider the gut biota as possibly THE main force in body composition and metabolism… they control a LOT of what’s going on in us, whether through FIAF or neurotransmitters or immune modulation or who knows what else, and it is our chronic food habits that in the end dictate what kind of biota we maintain.
      It is also, I believe, a source of fundamental differences between individuals (why does that guy eat whatever he wants and not gain any weight?), being a mid-term “state” store of the body – can someone with a carb-specialized biota change their food habits and not feel like s**t for a looong time?
      Anyways… great to see this extremely important field come into your analytical attention. I’m looking forward to reading your thoughts and experiments, and learning more about it. Glad to be joining your input to the ones from Lucas Tafur and Art Ayers – one step closer to reaching critical mass on the subject.
      Cheers

  7. Richard Hanks says:

    Peter, great post! Am I reading this correctly that you are still in Ketosis most of the time (aside from short fluctuations after a post-fasting meal) even with carbohydrate intake in excess of 50g/day? Thanks!

    1. Peter Attia says:

      Tough to say, Richard, because it would require me checking hourly for a few days and then doing an “area under the curve” analysis, which I have not done. I have done a few days of 5-6 checks per day, and my guess is on days with ~60 gm/day of carb (virtually all from nuts and SS), I’d be in ketosis about a third of the time. Even on days when my total is ~30 gm/day, if consumed in one sitting (along with ~100 gm of protein), I invariably fall “out” of ketosis for at least a few hours.

  8. Jared says:

    Hello Peter,

    Interesting to see you replenishing glycogen stores with Superstarch rather than fat. I assume this would top them off and allow for more explosive power in your land training rather than just relying on fat. Would you say you gained any muscle mass or strength compared to before? Any future thoughts on trying to add muscle mass in the future? I know your love for distance training so this may be counterproductive but just out of curiosity of such an experiment or thoughts on it.

    Thanks

    1. Peter Attia says:

      Fat is a pretty inefficient way to replace glycogen, because each triglyceride only yields 3 carbons (glycerol backbone). Protein is better, but ultimately, nothing is better than a carb. The key, of course, is not overshooting, which is what most folks do.

  9. Mark says:

    Peter:

    I don’t understand the SuperStarch. I checked the nutrition facts and the first ingredient is corn starch. How is the UCAN product any different from the corn starch you’d find in any number of processed soups or baked goods? Seems hard to believe you could modify the properties of corn starch in such a way that it would no longer elicit an insulin response or suppress ketosis.

    1. Peter Attia says:

      Great question, but requires a post of its own. Actually, to be technical, the ingredient is amylopectin, which is plant glycogen. What makes SS “super” is the 40 hour or so hydrothermal processing of amylopectin. More on this later…

  10. Von Packard says:

    Peter – I was happy to see your notes about UCAN – I purchased a small order of the vanilla protien product the other day after seeing you mention it & doing some research on it. It’s in the mail, and I’m excited to experiment. I’ve only seen you allude to it in your posts; could you share any thoughts or links to previous posts you’ve made about it? I’ve read their recommendations, but they aren’t geared towards those with a keto diet. I’ve been doing the insanity workout (1 hr long), and I was wondering if you would recommend using the SS before, during, or after for optimal effect (endurance & recovery). Last question – I’ve been on a keto diet for almost a month now, and combined w/ exercise I’ve gone from 203 to 179, but I still have about 10lb in my stomach that needs to go, and I haven’t changed weight (despite intense workouts!) in two weeks! What can/should I expect as far as change & is there anything specific I can do to target belly fat? Thanks!

    1. Peter Attia says:

      I’ll definitely do a post on SuperStarch. I periodically give a talk on sports nutrition, and spend some time on SS. Maybe I’ll podcast it.

    2. Jeff says:

      I would love to hear that podcast. I used the super starch and found it to be no better or worse than any other high quality drink mix such as endurox or skratchlabs secret drink mix, for competitive cycling, although it cost about twice as much . The vanilla recovery drink did taste pretty good.

    3. Von Packard says:

      I went through my vanilla protein and found it to be not so tasty . . . 🙁 I had a 0 carb BCAA fruit punch mix that I would combine with it to make it palatable. Maybe I’m just too picky. I saw some recommendations for using the chocolate and mixing it with a variety of other things to make it tasty. I’ll try that out – any recommendations from the peanut gallery on favorite flavors of the non-protein flavors?

  11. Aviv says:

    Great post Peter
    Just a point regarding dairy, and it might be VERY important for many guys out there trying to get ketotic and can’t (like I was).
    3-4 weeks ago I stopped ANY dairy and after straggling for months, in a matter of 2 days, boom, I got in – finally!
    I am still experimenting with it and trying to find my sweet spot… didn’t want to say anything until I’ll see results, but hey might have found what stopped me and might be stopping many others!!!
    It is an awful place to be, knowing you doing everything right , yet you gaining wait and feel lousy – I was lost!
    That’s why I decided to write this comment, maybe others out there can learn from me.
    And I was consuming only good quality, highest fat dairy, by the last few months it was goat’s cheese only – yet only after I stopping it altogether I finally got in… seems like dairy getting me a high insulin response – and after learning so much from you and Phinney’s books, it’s one explanation to why I could’n get fully into fat oxidation, and even GAINED weight on a low carb diet! talking about frustration… this is something many low carb books, blogs, experts forget to mention – low carb is not the only thing, food sensitivities and intolerance is VERY important – I’m thanking Nora Gedgadous for teaching me this lesson.
    By the way, I’m too on IF together with being ketotic, I usually don’t eat breakfast and my first meal will be around 1-2 pm. keeping it simple.
    Anyway as I said, still trying to find my “sweet spot”, will drop a comment if I’ll get back to my 165 like last year – than we’ll see who climb these hills faster 😉
    Later

    1. Peter Attia says:

      Absolutely brilliant and critical point, Aviv. Thanks for reiterating. I know I’m made this point in other comments, but it can never be overstated. Some folks have a pretty aggressive insulin response to dairy, while others (like me) don’t seem to at. I can drink a gallon of heavy cream and my B-OHB goes up!

      Whenever I’m working with someone who is “doing it all right” and unable to get into ketosis, step 1 is to visit protein timing/amounts…step 2 is dairy…

    2. Natasha says:

      Aviv,
      When you say dairy – does it include butter? I find myself stuck despite doing everything right, yes. I use heavy cream in my coffee, eat some cheese, sour cream, and a lot of butter. I can see myself giving up the heavy cream, cheese and sour cream. But do I have to give up butter? What is your experience?

    3. alan says:

      exactly the same. with dairy on 20 g of daily carbs,and 90/100 g protein i gained weight.

    4. Jessica says:

      Aviv,
      Have you noticed any improvement since taking out dairy? I’m struggling with weight gain when I am so diligent. Do you still use butter?? I’m looking forward to seeing how this turns out for you.
      Thanks!

    5. Aviv says:

      Natasha, Alan and Jessica, just now saw your responds.
      To say I’m frustrated will be an understatement. I do not consume any dairy. There so many things I took off my diet, it’s seams as if nothing will agree with me anymore. I have a feeling dairy doesn’t work for me for other reasons other than weight gain (foot athlete seems to be gone when I stopped consuming dairy, no mucus, etc…)
      The only dairy I’m consuming now is ghee.
      All I know is that nothing seems to work with me. I will gain weight while being ketotic (testing always), my performance went down the drain since I started low carb, to get myself out to do a training ride or anything is close to impossible now (psychologically). Tried intermittent fasting (just got worst), calorie restriction while being ketotic, upped my fat intake, clean paleo, you name it I tried it. Dairy, no dairy, what’s the point, I will gain weight anyway…
      I started my own blog in Hebrew this Summer, since I know ALL the science behind this way of eating, I wanted folks in Israel to learn too. Needless to say, I stopped blogging… I never giving up in life, and I want to understand exactly how things works so I’m reading and trying – just like Dr. Attia did with his journey. Only that with me the story went the other direction – gaining weight and being frustrated. The problem now, after knowing so much, what am I going to do??? go back to low fat calorie restriction diet???
      I have my last 140 (!!!) keto stripes that I ordered from Canada, I’m giving it a last try while being the best I can – the cleanest, paleo, keto food until this supply is over and then I’m done.
      If it’s not working, I’m moving to some deserted place, living of the land by hunting… Any suggestions of a good warm climate place in the states anyone? Had enough from NY… 🙂

    6. Donna says:

      Aviv,
      Before you began this part of your journey from which I glean that you were trying to improve athletic performance were you at your ‘normal’ weight? Did the weight gain begin because you were attempting to go into ketosis? It is possible (without knowing what your diet was before) that going low carb may not be the best answer for you. You may have been eating instinctively what your body needed. It is possible that your body cannot utilize the amount of fat that is consumed on a keto diet.
      What all the tests, all the studies, all the discussion cannot do is tell you exactly how YOUR body will react. You can only experiment with what you have. Take what works for you and discard the rest! Continue to read everything, talk to people about nutrition, take it all in but realize there is no single answer to health and fitness . There are levels of fitness just as there are levels of health. Now that you have experimented one way, experiment another. You’ve discovered dairy is a problem so you eliminated it. Maybe the next is to look at the protein consumed. Maybe enough, maybe not. Perhaps the ratio of types of fat. Does your blood work indicate any other problems such as low vitamin D or magnesium deficiency. Maybe a certain amount of carb needs to be added to your diet that is higher. Maybe you need to eliminate fruit altogether even the low carb variety. Your body like my body and all other bodies are all unique in how the components come together. The building blocks are the same in everyone but the way they come together are unique in every individual.
      What works for one person or even a group of people may not work for another. Does that mean failure. No. It just means you seek the way that gives you what you want.
      The low carb, keto way is a good way. It needs to stop being demonized as unhealthy but at the same time it needs to be understood that it is not the only way to go. As one works with the personal instrument (the body) the discovery is hopefully made about what works best for this instrument and that can only be done by the indvidual. If higher carb is the answer, go for it. If fat restriction is the answer to better health, go for it. If you land somwhere in between go for it. If a plant based diet works best for you, then go for it. In the end it all comes down to what works best for your instrument (body). Science can offer guidance through studies and research but it cannot tell you exactly how YOUR body will react or what it needs. Only YOU can discover that.
      You say you stopped blogging. I thought that was unfortunate. You have this marvelous experience. You can put out there what is happening to you, what you are discovering and you will realize that none of it is a failure. You have not failed. That is not possible. Your insight could be of great benefit to many so I hope you resume your blog if that is what you want to do.

    7. Edward says:

      Hi Aviv,

      If you are truly desperate, try consuming nothing but raw meat for a month, preferably beef. I have been communicating with a gentleman named Lex Rooker over at the Raw Paleo Forum. You can read his story here: https://www.rawpaleodiet.com/testimonials/lex-rooker-usa. He has eaten nothing but raw meat for 8 years now, with one exception, that being the Irish butter that he blends into his morning beef broth. He takes no supplements.

      He mixes high fat ground beef with a so-called primal beef mix, which consists of large amounts of beef organs such as spleen, kidneys, liver, etc, adds ground suet (beef belly fat) to further raise the fat content and consumes around one and a half pounds of the resulting mix each day. He gets all this from his supplier in Texas, Slanker’s Grass Fed Meats,

      Reading about the diets of the Masai, the Samburu, the Inuit and the Sioux who eat no plants other than those they find in the digestive tracts of animals has convinced me that plants are not necessary to us other than our gut biota, and Lex is the n=1 proof. Unfortunately this raw meat diet costs him around $400 per month to feed one person and I can’t afford it. For him it was a matter of life and death, so it represents a real savings as it were.

  12. Mark says:

    Hey Peter,

    I’ve recently come across your blog and have truely enjoyed reading through all the information you have provided. With regards to the “exactly what do you eat?” post being the one that generates the lost traffic, I suspect that may be people repeatedly visiting that post for reference on their own choices.

    I’m curious what you thoughts are on omega 3 eggs and their stability when heated to high temperatures?

    1. Peter Attia says:

      Great question about the eggs, Mark. I definitely owe the readers a post (or 2 or 3) on the entire omega-3/6 morass. Short answer, the n-3 in eggs is primary ALA, so it’s not really “relevant” for reasons you’ll see when I get around to it. Same for walnuts an other non-marine sources of “high” n-3. The key is EPA and DHA, not ALA.

  13. DavidM says:

    Hi Peter,

    Hopefully you’ve got more time for blogging now! Very interesting results.
    I wonder now if there is really an exercise benefit with ketosis. From what I gauge in the blog post, you are in ketosis fewer times a day compared to previously. And you’re still able to work out just as effectively, if not better.
    Maybe it has more to do with your weight loss? For every 1kg you lose you get 2mmHg decrease in BP. Wonders if anyone knows how much performance you gain for each Kg lost.

    To answer the zyprexa question, most atypical antipsychotics will cause weight gain and is a common side effect. Some less than others, aripripazole maybe have fewer weight gain side effects, but the weight gain is more centrally mediated (other hormones in the brain are also affected such as prolactin) and less to do with any more direct effects on the pancreas and insulin resistance.

    1. Peter Attia says:

      Actually, David, I am busier at this moment that ever before, and don’t see any reprieve for at least 4 to 6 months. Doing what I can, though. Of all the elements of Met Syn, hypertension was never one. My BP has always been about 100-110 over 60-70, and has remained so. I suspect, without the extra sodium, it’s probably lower.

    2. David Ma says:

      Knew it was wishful thinking… 😉

      The HTN comment was just an example of the profound effects of weight loss on different aspects of the metabolic syndrome. My main point was whether there is a stronger link connected with your weight loss and exercise performance, or whether it is a worthwhile confounder in the interpretation of your results. Like you said, I little weight lost on the bike makes a huge difference.

      1. Peter Attia says:

        Certainly is on the bike. I have to lug 40 few pounds up the hills today, even though my absolute power output may be less. The biggest change I’ve noticed, though, is metabolic flexibility. It’s the ability to far better oxidize fat over glycogen for most (all but the most intense) periods of exercise.

    3. David Ma says:

      Re efficiency with fat utilisation: I agree that is an advantage. Particularly as you’re exercising less than before

      Interesting to know about your blood pressure results actually. Not sure how that plays into all of this. Classical teaching was that BThal trait was somewhat protective against high BP. Not sure how applicable any such benefits were in your case considering your ‘disease-burden’ (for a better word) back in the day.

      Wish in the future a panel could be done, that would be able to identify all the significant markers of disease and performance! We’re prob getting closer.

  14. R?za says:

    Hi Peter, to tell the truth, I was a bit surprised seeing Vitamin D in the list of supplements. Based on where you live and your active lifestyle, I though you already had enough to surpass US IOM RDA for vitamin D (600 IU); 5000 IU daily is even higher than the recommended daily intake for people at high risk for vitamin D deficiency (1500-2000 IU), based on the guidelines of IOM and US Endocrine Society. In addition to that, there might be an upper limit for vitamin D intake, as suggest by this study: (https://www.ncbi.nlm.nih.gov/pubmed/22573406). Have you ever measured your serum 25(OH)D levels?

    1. Peter Attia says:

      Yes, measured and consistently low without supplementation. While you might not know it based on my complexion, my dermatologist in San Diego has turned me into a hardcore sunscreen user. I wear a minimum of SFP 30 at all times (just day-to-day) and constantly reapply 50 with all outdoor activity. Years of 8 hour training swims in the oceans have really beat up my skin.

  15. Stuart Williams says:

    A few things…
    1) I believe one of your tags is misspelled ( but biota vs gut biota) on your post
    2) Did your VAP panels show a significant change (good or bad)? What about VO2 max? (closing thoughts 2)
    4) Have you considered replicating your results by going back to baseline (nutritional ketosis) to see if you can replicate your results? (closing thoughts 1)

    Does this indicate then that nutritional ketosis may not be as important on biomarkers/health as Dr. Phinney et al. believe? What effect does IFIK have on insulin and IGF and should science be studying IFIK instead of NK?

    BTW – I have found a potential anecdotal correlation in myself between diet side consumption (ounces) and B-OHB levels. I keep my diet and activity the same and found the amount of diet soda decreases my B-OHB the next day. I have found 2 20 ounce diet mtn dew can drop me from 3 to 1.6. And 20-40 additional ounces can drop me to .5 or below. Roughly each 20 ounce drink seems to decrease my B-OHB by .6 to .7 ( no p values yet).

    I plan on testing BS and B-OHB levels more rigorously (intra-day & next day) in the coming months.
    I would think as people stay in NK who are extremely IR they would tend to vary their diet and drink sodas, thus kicking them out of Ketosis without realizing by being complacent.

    1. Stuart Williams says:

      Corrections…
      Diet side = diet soda
      BS should be BG Blood Glucose.

    2. Peter Attia says:

      1) good catch!
      2) will detail in subsequent posts.
      3) have not planned on this, but it’s a good idea.
      Your experience with diet soda has been noted in others, too. You may have a cephalic insulin response to the aspartame.

    3. David Ma says:

      Hi Stuart, very interesting you found that effect with diet soda.
      I used to have a diet soda with my meal on Mondays too, and I found that afterwards I would feel sleepy, almost a post-prandial dip type effect. Precisely one of the things I was hoping to avoid with the ketogenic diet.

      Interestestingly, Diet Doctor – Andreas Eenfeldt, MD has recently posted about this topic. Its on the side bar as one of the sites that Peter visits. Its an interesting read.

  16. Bob says:

    If you’re going to throw around terms like B-OHB, REE and TEE could you try to at least once per post let us know what these mean? We don’t all immerse ourselves completely in the culture, for your information (fyi). Thanks. 🙂

    1. Peter Attia says:

      Bob, I’m deliberately doing this! Any post I’ve written on ketosis will address what B-OHB is (start with “the interplay of exercise and ketosis”). For the other stuff — REE, TEF, TEE — check the post titled “good science, bad interpretation.” Fair point, though. I am in a bit of rush trying to get this post out before heading out on the road for the next month. Also, consider using the search feature on the blog. It may help.

    2. Chris says:

      You can’t spare the ten seconds it takes to do a google search?

  17. Jason Williams says:

    I understand where your daughter is coming from. After turning on to ketosis, I started to eat a lot of eggs. If I so much as smell eggs now, I get gag reflex. I think I’ve traumatized myself for life.

    Great post by the way, and very helpful for those of us who struggle to plan our days/diets down to the detail.

    Regarding the sleep issue and psycho-energy, I for one would be thrilled if you were to ever divert a little bit of your time/mental energy from general nutrition towards nootropics (brain hacking). There are scientific-minded communities out there dedicated to mastering how to feed our brains in order to obtain maximum energy levels (full concentration for longer periods of time on less sleep). Ideally, this is done naturally, though there are plenty of artificial ways to do it as well via “smart drugs” such as adderall, modafinil, etc. The science is a bit sketchy though and we could definitely use people like you on the case.

    1. Peter Attia says:

      For me, levels of B-OHB over 2 mM are a pretty amazing “drug” for mental acuity and focus. I’m pretty fascinated by this topic.

    2. Jane says:

      Peter,
      I am fascinated by the notion of increased acuity and focus at B-OHB levels over 2mM.
      Is this a topic covered in more detail in the second Phinney & Volek book about performance?

      Thanks.

      1. Peter Attia says:

        I have not read their 2nd book, but I think it may deal more with physical performance.

  18. Shareef says:

    Hi Dr Pete,
    You said, “This includes sleep, which I wish I could figure out a way to thrive without”
    Were you aware of Dave Asprey’s sleep hacking info over at Bullet Proof Exec? https://www.bulletproofexec.com/improve-your-sleep/

    1. Peter Attia says:

      I do most of these, but my “issue” with sleep is not that I don’t sleep well. I do. It’s just I wish I didn’t need to. I’ve only got 50 years or so left on this earth. I hate the thought of sleeping for 15 or so of them.

    2. Paul N says:

      For a really simple bio-hack on sleep, you might try a period of sleeping on the floor (!) (or on a rug, thin futon etc)

      https://www.paleodietandliving.com/paleo-living/sleep/sleep-which-surface-is-best/

      The common theme seems to be that people slept less but felt better! A Zeo would be able to make some quantitative measurements of this?

      After reading this article (and the linked story within) I gave it a try. Took a me a couple of days to get used to it, but, same thing, my energy upon waking up was noticeably better. Something I had always noticed when camping. I do like the “less tech is better” approach…

      I knew someone years ago whose “bed” was actually a sandbox, and they swore by it!

  19. Nina says:

    Hi Peter,
    Thank for another interesting & informative post – I really enjoyed reading it with my morning coffee & had to laugh out loud at “if-ik,” your user-hostile software, & your little daughter’s anti-nut comment!

  20. Anne says:

    Hi Peter
    Thanks again for another great post.
    I think that you are getting so many hits on this article is because there is not much practical, reliable information out there about day to day living and exercising while in ketosis and/or IF. Obviously there are the Volek and Phinney series and then Mark’s blog pages and books, and others, but I think (I could be wrong but this is just my personal view) that many people are muddling along and trying to string together information from all of the current resources and not finding anything really concrete that might necessarily apply to them.

    What you eat and your reasons for doing so are always interesting and helpful because you describe what and why you are doing it which gives us a few ideas to try things a little differently.

    1. Peter Attia says:

      I just hope folks don’t read too much into what *I* or anyone else eats. The “key,” if there is one, is using the best available evidence out there, and then patiently experimenting till you find what works.