September 30, 2012

Nutritional Biochemistry

What I actually eat, part II – “IFIK” (circa Q3 2012)

Read Time 8 minutes

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.

 

Photo by Dan Gold on Unsplash

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

569 Comments

  1. That’s pretty interesting, i discover Martin Berkhan thanks to you, and his point on IF and low carb, keto and the alternative hypothesis.
    You probably know that he’s strongly against it, his article “low carb talibans” was interesting but he gave the impression to misunderstood, insulin resistance and insulin sensitivity. i gone through the 256 comments and some times i thought he gave arguments against his own faith and couldn’t counter others, do you have a thought about him and did you read the article?

  2. Hey Peter,

    Great articles man. I’m an 18 year old headed to college with a big weight loss story, over 55 lbs lost since February. My mother and I are big into the “ketosis” thing right now and we’re trying to eat fat like it’s going out of style. I find it hard to get my fat in without eating high-fat meats, which skyrockets my protein quickly. I see you eat a lot of eggs, are there any other high-fat products that are good for meals that aren’t loaded with protein? Also, we use a lot of real mayo at our house. No carbs, high in fat, tastes good – I haven’t found where you’ve eaten any at all. Is there a particular reason or do you just not like it?

    • I’m not a big mayo guy, but never have been, even when I was a carbivore. I just find the taste of vegetable oils unappealing. You can try making scrambled eggs without the whites (and fluff them with whole cream) to increase fat content relative to protein.

  3. Peter,

    Can I achieve the ability to mainly burn fat for fuel without ever going to full on ketosis?
    Will the body adapt to mainly burning fat if I am eating only leafy greens, nuts and occasional berries for carbs?

    I would be aiming for an intake of say 75 g – 100g a day from only natural fibrous carbs. No sugars, perhaps an occasional diet soda (which I think the body treats as sugar).

    I would like to retain lean mass and lose about 35 pounds+ of body fat. I will have a Dexa scan done soon, so I can track future progress. I do high intensity resistance training once weekly and also mountain bike (medium pace) and walk/hike.

    Mike

    • Well to start with, that product has 3 billion bacteria per capsule vs. 30 billion. So that makes it 90 cents vs. $1.11 for the same amount of bacteria.

      Second, only one strain of perhaps a less important species. Mark’s product, on the surface at least, looks like a better value if you think about it rationally.

  4. Maybe you should consider opening up a discussion forum as a companion to your blog? You have enough high-quality users to justify that and it would keep unrelated discussions outside of each blog post. It would also give a place to grow a discussion around particular topics over time, instead of people accidentally discovering those within an article discussion. A very good one is hosted by Invision: https://www.invisionpower.com/

    • It’s a great point, Will. Maybe I should consider it. My fear, I guess, is that it turns into a forum for a few nasty people to run amok.

    • I believe Invision has anti-spammer technology that catches some of that. But the rest you can just moderate out. Probably there is still an option to not post anything new until it has been moderated.

  5. I tried out MCT Oil recently (2 tablespoons with lunch and 2 tablespoons with dinner) and I noticed a very unpleasant side effect that it dramatically increased my heart rate. I could literally feel my heart beating strongly, and it wasn’t a pleasant experience. I repeat this result on different days, and it stops if I do not take the MCT Oil. Since a known effect of this oil is its thermogenic property and ability to increase metabolism, that seems somewhat consistent with my result. I do wonder about the safety of this oil if it is increasing heart rate or intensity beyond baseline. Has it been studied for that?

    • GI side effects are far and away the most common, but your thesis for tachycardia does make sense and at least seem plausible if your liver is rapidly converting MCT to ATP and the only disposal is heat.

  6. Hi Peter,

    Great post. I have lost almost 100 lbs (most fat, some muscle) over the last year thanks to the ketosis diet. My doctor finally become supportive to what I eat after so many blood tests.

    I am on a daily cardio,3 workouts per week schedule and feels amazing as long as I get enough sleep. Interestingly enough, I have noticed the similar patterns with what you described: my dairy and meat consumption went down quite a lot a couple months after my weight has stabilized and I no longer restrict my carb intake to strictly below 50g per day and enjoy eating more nuts.

    I have stopped my bacon and salami routine after reading this newly published article:
    https://www.biomedcentral.com/1741-7015/11/63 but my I still consume plenty read meat and butter. Looking back, I think the most valuable thing I have gained from Ketosis and this site is the ability to differentiate physiological hunger and psychological ones, think critically, and establish my own program and evaluate it.

    Thanks again for your time and this awesome site.

    • Charlie, I think the study you quote has a few flaws that don’t allow me to draw the same conclusion the authors do, but if it’s working, don’t change it. Keep up the good work.

  7. Hi Peter,
    I’ve switched to paleo/low carb high fat diet about a month ago from a raw vegan diet (mostly high carb) aiming to lose some excess lower belly fat and cellulite. Since then, I noticed higher energy levels, mental clarity, gained more muscle and overall feel stronger. However, I gained some weight and cellulite on my abdominal area while my legs became bigger (I can barely fit into my old pants), more muscular and stronger ( I kept the same exercise routine-I jog 5 times a week, do squats). My diet consisted mostly of fats (plenty of olive oil and coconut oil, ghee, butter, vegetables/ salads (raw), chicken, plenty of eggs & animal skin, as well as chicken and bone broths. At most times I keep my carbs as low as possible (50g day mostly, but occasionally it gets below 100g). Eventhough I try to cut all fruits out, on some days I do indulge a piece of fruit and on some days I do green vegetable juice (celery, few cucumbers, parsley, spinach/kale) as a meal replacement, but I was still within that 50-70g carb range, so I really don’t get what I did wrong?! In the beginning I did some raw unpasteurized dairy (plenty of heavy cream, some kefir), but later associated it with the cellulite gain so I quit. Seems like I fall into a category of really insulin resistant people, at least that’s what I concluded from all this…Now I am trying to get as close to nutritional ketosis state, but am wondering can I still do that if I keep my green vegetable juice as a breakfast replacement and do plenty of fats and protein for my 2nd and 3rd meal a day? I really wanna lose the weight I just gained and go back into how I was before paleo…Also, do you have any experience with women getting rid of reducing cellulite? Thank you for you time! 🙂
    Best wishes,
    Dorina 🙂

    • Very hard to say without knowing so much more. You may be hyper-responding to the massive increase in saturated fat. I would definitely continue to eat things like salad by the truckload, but maybe consider reducing sat fat (e.g., dairy). Ketosis might be a big leap to start.

  8. Peter,

    I did a page search for “spinach” on this page and only 2 results came up.

    Am I right in inferring from your posts and diet, that you’re getting same nutritional values from your diet as you could be getting from spinach, if you ate it? Isn’t spinach and kale super efficient foods in terms of nutrients/gram?

    Do you not eat them b/c of oxalic acid concerns (which are mine) or are you getting same value somewhere else? I am just thinking, not that you “should eat vegetables,” but, wouldn’t it make more sense to eat foods with higher nutr value/g?

    Thank you for your effort with NuSi!

    • I have no idea if spinach or kale are “super foods,” but I’m pretty sure there is no such thing. I love them both, but don’t see how they replace my diet.

    • Sorry! I wrote that super early.

      I was just wondering if it were possible (and easy) to get enough vitamins/nutrients in your diet to be able to avoid taking spinach, kale etc. I guess other people on LCHF usually do kale/spinach shakes in the morning to max vitamin intake etc. So, seeing that you quantified everything, I was hoping to find out whether the sample diet outlined could effectively replace spinach/kale type foods (b/c of the oxalic acid concerns.)

      Thanks.

      • I eat one to three salads per day, so if vegetables are “essential” (they may be, but I’m not sure), I get plenty. I would actually guess that I eat more vegetables than 90% of Americans, though that bar isn’t high, I suspect.

  9. I’m wondering if you’ve heard of or considered Barlean’s Omega Swirl (emulsified fish oil) as an omega-3 supplement. It is supposed to have 9 times better absorption than fish oil capsules; I was hoping you could comment on that. Thanks!

    • Thanks for the quick response. I’m curious about the bioavailability/absorption in general, particularly when considering omega-6 to omega-3 ratios and how much to omega-3 to supplement. I know you’re planning on writing a post about omega-6 and omega-3 fatty acids and hope you’ll touch on this. Thanks again!

  10. Hi Peter. I have been struggling with being overweight for a long time and I have to admit that I have done a lot of research (although not being medically trained on this topic). I have seen your eating plan and your weight loss principles, but I have found that there is research to the contrary.

    I have been for genetic testing and this testing indicates that a low carb, higher fat (the fats and proteins that you also use) is not an ideal diet for my genetic makeup. The scientists that did the testing claim that their findings are based on 20 years worth of research into people with my specific genetic variations.

    On the other hand there is tons of literature about the diet that you typically follow, also based on years of research that basically proclaim the contrary to what my genetic testing finds (a low GI diet). With all this conflicting information and having tried and failed at all of these various diets, how does one know what is right for you and what not?

    Do you know anything about the research behind the DNA diet (which is what this genetic testing is called) and whether it is sound? I could provide you with the full report if you so wish.

    I would appreciate any guidance you can provide.

    Thanks

    Rian

  11. Hi Peter,

    I’m very interested in Super Starch as part of my soccer training/competition regimen but live in the UK and shipping is a little costly. What natural foods or supplements would you recommend pre & post training/games to ensure I can maximise my performance? Sometimes I feel a little lethargic in games……

    By the way, I really admire your work and the level of detail you go into. Whilst the UK doesn’t have the level of obesity America has it is on the same track. I’ve been referring people to your site whenever they’ve been curious about why I eat what I eat.

    Thanks,

    Mike (UK)

    • I actually think nuts are a pretty darn good alternative, depending on the amount of glycogen replenishment needed (e.g., cashews — high; almonds/walnuts — less high).

  12. Hi Peter, I feel like I might be your twin sister. At 38, I started working out, doing tennis and weight lifting, lost a ton of weight. Then I found karate and I fell in love. So for the last three year, I am an amateur bareknuckle fighter and a trainer, I work out 3 to 4 hours a day, sometime 5. I eat ‘healthy’ but I am still 200 pounds. I am 5’6″ and I have a lot of muscle so I don’t put any weight to the ‘obese’ label the BMI puts on me. My doctors say that I am awesomely healthy but I am not happy with the way I look. I want to be around 160 to 165. I already move like I could concur the world, but I am tired of looking like a frumpy housewife.

    I have been trying to stay wicked low carbs and failing. when I try to stay below 20, food is all I can think about and I get cranky and obsessed and then feel like a failure if I go over my goal, which sometimes spirals into a binge. Do you have any tips?

    • Sorry to hear about your struggle, Patty. I really do know how you feel. Weight aside, hopefully you’re not IR as I was. Tweaking the weight is tough, and not something I can offer meaningful insight on without a lot more info.

  13. Dr. Attia,

    Good Evening,

    I am a former family physician who left primary care because I could not stand watching my patients die such horrible deaths from diabetes and the complications of metabolic syndrome. I, too, had periods where I blamed my patients for their disease. All the while, I was struggling with my weight. I stumbled upon an intermittent fasting style of eating by accident after I discovered I was developing insulin resistance. I was not nearly as diligent with exercise but my thoughts led me to consider how we evolved as a species. It occurred to me that our ancestors were hunter gatherers for all but the last 100 years. We did not have an abundance of food stuffs around so our ancestors probably ate only one large meal a day. So I set about eating one meal at night time. If I got really hungry during the day I would eat nuts. My weight stabilized. This lasted until I hit the mid aged struggle of peri-menopause. I slipped back into old eating habits and am back in a similar situation with weight and suspect my insulin levels are climbing again because I cannot get the weight off eating traditional food sources multiple times a day.

    I saw your TED talk and this prompted me to read more about your path. I am humbled by your honesty because I have been there as a physician. Thank you so much for your words. I hope your former patient has heard your apology. I bear the weight of those experiences and hope someday to apologize too.

    I will be following along as you continue to explore this deadly pathologic state of hyperinsulinemia and appreciate your work!

    • Cynthia, your comments mean so much to me. I’m convinced there a lot of Peter’s and Cynthia’s out there who wish they could go back and do it differently. I really hope current doctors can learn from our mistakes. I’m optimistic about tomorrow.

  14. Dr Attia, I am so impressed by your humble TedMed talk. I’m a retired physician assistant who hated trying to manage obese, and consequently mulit- system problem patients, because nothing I said or prescribed worked. Before that I was an ER nurse and did CPR on those enormous bodies or struggled to move them from wheelchairs or stretchers with never enough help, grumbling while risking my back. Before that I was a home health nurse, teaching diabetic care (wrong information) filling insulin syringes and doing wound care for their amputated limbs.
    During your talk I was nodding as you apologized to that obese woman, because I am guilty of a critical attitude myself. Not always, but wish I could say- not ever.
    Now, I’m struggling to lose weight. It’s crept up from a chronic 20 lbs overweight to 50 lbs too heavy. Nothing I did in the past worked except grit my teeth and starve while obsessing about food. I had limited sucess to be sure. Eventually I would relaspe back to eating and resting. Silly me. Of course, I would scold myself for not doing enough exercise, and not eating in ‘moderation’. I’d righteously eat whole grains, lots of beans, and nearly zero fat, but as I got older, even that didn’t work. I joined Weight Watchers and then did South Beach Diet. I was always hungry. Finally, I’d say screw it and eat a Snickers or a big bowl of chocolate ice cream or both. . . with great remorse later.
    How wonderful to now be on a low carb, high fat diet. I’m losing weight and not hungry. I’ve also lost the negative self punishing attitude. (Ric Elias would be happy for me). I’m down 17 lbs. Thank you, thank you, thank you Dr. Attia for working on the science of obesity through nutrition. We need more physicians like you.

    • Jennifer, thanks for sharing your experience. I’m really humbled when others “from the trenches” recount, openly, their personal experiences. If my talk could play even a small role in helping you re-discover the empathy that I would bet anything was once there, I’m grateful and touched. Best of luck as you also pursue your own nutritional journey.

  15. Hi, Pete-

    Congrats on your TEDMED talk. I had the pleasure of meeting Gary on two occasions last year through Tom Dayspring, we really appreciate your work at HDL, please keep it coming. You guys are doing wonderful things for the future of science and nutrition.

    You touch on B-OHB frequently in your posts. Can you please discuss possible mechanisms for the increased production of alpha-Hydroxybutyrate in the insulin resistant state? I was dx with PCOS (BMI 22) last year and interestingly enough my DPMP panel lends itself to primarily skeletal muscle IR. Any insight you have on skeletal muscle vs. adipose tissue IR is much appreciated.

    All my best,
    Lydia Snyder, MS, RD

  16. Dear Peter,
    I was telling my sister about your website. She is vegan and told me that dairy causes cancer because it is full of estrogen type hormones that adults were not meant to ingest. Do you have any thoughts on this?
    Thank you!
    Michelle

    • Michelle, probably worth asking for the experimental and clinical evidence of these claims. It may be possible that some cancers in some individuals are responsive to hormones, but I’m not aware of prospective data that demonstrate this.

  17. Hi Pete,
    Thanks for this valuable resource that I’ve been coming back to for the last year and a half or so! For IF, would “Bullet Proof Coffee,” with butter and MCT, or Coconut Oil, be a good idea in the morning instead of having regular coffee? Just wondering if you’ve experimented with it or believe there is scientific evidence that it would actually work. Also, would you comment on mycotoxins in coffee, especially if someone is drinking decaff. Thanks for your great work! I appreciate your time. Jeff

Facebook icon Twitter icon Instagram icon Pinterest icon Google+ icon YouTube icon LinkedIn icon Contact icon