December 19, 2011

Nutritional biochemistry

What I actually eat (circa Q4 2011)

Read Time 7 minutes

Note to readers: This post was written in December of 2011.  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 pursuing questions about what I eat in the comment section.

 

Once people start to “get it” with respect to why carbohydrate reduction, or all-out restriction, leads to good things, the inevitable question I’m asked is, “So….what exactly do you eat?”  I’m always a bit hesitant to get into this.  It’s sort of like asking a pilot, “So…how do you fly this plane?”  It’s a great question, but probably the wrong first question.

For many people it’s so overwhelming to contrast what they currently eat – probably a typical American diet of 500-600 daily grams of carbohydrates (200 grams of which are sugar) – with a diet of less than 50 daily grams of carbohydrate, which is what I consume.  Remember, what I’m showing you here is what I have been eating for about the last 7 months.  For the first 20 months of my nutritional transformation, I was gradually reducing carbohydrate intake from about 600 daily grams to 300 daily grams to 150 daily grams.

It’s really important to understand that carbohydrate reduction is a continuum. There is no “right” amount of carbohydrate to eat.   Let me illustrate this with the following “2 by 2” matrix, below (sorry, once a consultant, always a consultant).  When asking the question, “How much should I reduce my intake of carbohydrates?” it’s a good idea to start with two broader questions:

  1. What is my inherent level of insulin resistance?
  2. What are my goals?


There are technical ways to quantify the answer to the first question, which I will detail in future posts.  However, the simple version of determining your inherent amount of insulin resistance is checking how many criteria of metabolic syndrome are present.  In other words, are you overweight?  Is your waist large?  Is your blood pressure high?  Do you have elevated blood glucose or triglycerides (these are determined from a standard blood test)?  Do you have low HDL cholesterol?  For the purpose of this question, even responding “yes” to one of these questions means you are predisposed to being insulin resistant.  I was a “yes” to 3 of these questions.

Consider this matrix, and let’s use me as an example.

How much should I reduce carbs?

 

  1. How predisposed am I to insulin resistance?  One look at a picture of me in my non-lean state, coupled with an understanding of my family history, and it’s clear I didn’t hit the genetic lottery with respect to insulin resistance.  Hence, I am towards the right of graph.
  2. What am I optimizing for?  Some folks want to lose 15 pounds.  Others want to have fewer swings in daily energy level, or stop taking their blood pressure medicine.  In my case, I want to maximize as many variables as possible: I want to be as lean as I can; I want to cure my insulin resistance; I want to be sure I never have a single symptom of metabolic syndrome; I want to do everything I can to avoid cancer and Alzheimer’s disease; I want to be metabolically flexible. Hence, I am towards the top of the graph.

As you can see, based on my poor genes and lofty goals, I find myself in the upper right square, which means I need to adopt the greatest amount of carbohydrate restriction. My wife, in contrast, has good genes, coupled with high goals, placing her in the upper left box.  As a result of this combination, she does not need to restrict carbs as much as I do.  If her goals were even more modest, she could get away with very little reduction in carbohydrates – probably just reducing sugar without much reduction in starch.    

Below is a picture of a few of the foods you’ll typically find in my refrigerator.  Note that on average I consume about 4,000 to 4,500 calories per day.  I get this from approximately 400-425 grams of fat, 120-140 grams of protein, and 30-50 grams of carbs.  In addition, there are a number of supplements I consume daily, which I describe in the table below.  In future blog posts I will go into greater detail as to why I consume each of these supplements, but for now I’ll give a very quick explanation.

Finally, note that under no circumstance do I ever count calories (for the sake of limiting them).  When I was first transitioning into ketosis I did need to count how much carbohydrate and protein I was consuming – anything over about 50 grams of carbs and 150 grams of protein makes it difficult to generate sufficient ketones – but I do not ever count calories for the sake of restricting them. I eat when I’m hungry.  I don’t eat when I’m not hungry.

 

Foods I typically eat

Regular supplements I consume every day

 

my list of supplements

*I will be writing a great deal about the role of omega-6 and omega-3 fatty acids in our diet in subsequent posts.  However, if you want a quick (albeit high-level and not overly nuanced) overview of the topic, take a look at what Dr. Andrew Weil and Livestrong have to say about it.

One last point on supplements – I do not take a multivitamin at this time, but I am looking into it a bit more closely.   My concern is that 1) they may not be necessary when you remove glucose from your diet (I’ll write about why in the future), and 2) they may actually do direct harm, as a result of contaminants.

 

Ok, at long last, here is a list of what I ate over the past 5 days (excluding water, still and sparkling, which I consume about a gallon of each day)

Wednesday

Breakfast: “Fat shake” (In a blender: 8 oz heavy whipping cream, 8 oz sugar-free almond milk; 25 gm sugar-free hydrolyzed whey protein, 2-3 frozen strawberries)

Lunch: About 4 or 5 oz of assorted cheese (Gouda, Swiss, Manchego), 2 or 3 oz olives, about 4 oz of particularly fat salami and pepperoni

Late afternoon:  About 2 oz of mixed nuts (almonds, walnuts, peanuts), large latte (latte made with heavy fat cream instead of milk) at Peet’s

Dinner: Garden salad with olive oil (lots of extra oil) and balsamic vinegar dressing, about 6 oz grilled salmon with a lot of butter and lemon juice

 

Thursday

Breakfast: Scrambled eggs (6 yolks, 3 whites**, with added heavy fat cream) cooked in coconut oil, 3 or 4 sausage patties (be sure to look for brands not cured in sugar).

Coffee with homemade whip cream (heavy fat cream hand whipped)

Lunch: Half chicken (thigh, breast, wings) with lots of skin; about 2 oz of Gouda and aged-cheddar

Dinner: Wedge blue cheese salad with bacon; 12 oz prime rib with lots of butter; 5 or 6 pieces of asparagus coated in butter

Coffee with half and half cream, 2 cups (the restaurant did not have heavy cream, so I had to settle for half-and-half)

**The reason I typically minimize egg whites, at least when making my own eggs, is to ensure I keep protein intake under about 125 grams per day.   Ketosis is pretty easy to attain if one is eating, say, 2500 calories per day.  However, given my caloric demands – and the requirement that I keep protein intake limited – I really need to go out of my way to ensure I’m not eating too much protein.  I will be writing about this in much greater detail in a future post.

 

Friday

Breakfast: Whole fat latte at Starbucks (made same as above), scrambled eggs (about 4 eggs), bacon (high fat pieces), slice of Swiss and slice of cheddar (since I was eating in the airport, the scrambled eggs were made “normally,” not with the additional fat I use when making my own)

Lunch: About 4 oz of especially fat salami and pepperoni, about 2 oz Parmesan cheese

Dinner: Ground beef sautéed with heavy cream, onions, broccoli, and melted cheese

2 large cups of decaf coffee with homemade whip cream (heavy cream whipped with a touch of xylitol)

 

Saturday

Breakfast: Scrambled eggs (6 yolks, 3 whites, with added heavy fat cream) cooked in coconut oil, 3 or 4 pieces of especially fat bacon (not cured in sugar), about 3 oz of cream cheese

2 cups of coffee with heavy cream

Lunch: Tomatoes with basil and mozzarella and balsamic vinegar and olive oil, about 2 oz raspberries with homemade whip cream

Dinner: Leftover ground beef sautéed from previous night, salad with homemade cream dressing (whole fat Greek yogurt, olive oil, basil, blue cheese, garlic)

1 cup of decaf coffee with homemade whip cream

 

Sunday

Breakfast: Omelet (6 yolks, 3 whites, coconut milk, sautéed onions) cooked in coconut oil, 4 or 5 pieces of the fattest bacon I can find

2 cups of coffee with heavy cream

Lunch: Plate of assorted cheeses (aged Gouda, Swiss loaf, aged Parmesan – about 3 oz), about 2 oz salami, about 1 oz olives

Dinner: Cream of mushroom bacon soup (heavy cream, chicken broth, shredded Parmesan cheese, mushrooms, chopped bacon, garlic, butter, chopped  papers, various spices), leg of lamb (baked in sauce made of red wine, balsamic vinegar, diced tomatoes, garlic, and a lot of spices)

2 cups decaf coffee with homemade whip cream (as above)

 

So there you have it — 5 days in the eating life of Peter Attia.  This may look a bit strange, relative to what you may be eating now, but remember, I’m at the far end of the spectrum – i.e., nutritional ketosis.  You may just be starting your own journey of reducing carbohydrates, but I hope this gives you an idea of what I eat.  In particular, what probably stands out is:

  1. I go to great lengths to avoid sugar which, unfortunately, shows up in virtually every highly processed food.
  2. I eat zero starch (e.g., bread, cereal, rice, crackers, pasta).
  3. I consume only modest amounts of fruit (one serving per day, at most, and only in the form of berries, which contain the least amount of fructose).
  4. I eat vegetables, but primarily because they are a great way to get more fat (e.g., high-fat salad dressings, butter), not because I “need” them.
  5. I go out of my way to eat as much fat as possible, especially monounsaturated and saturated fat (the only fat I avoid is omega-6 polyunsaturated fat).
  6. I have a few “go to” meals that I eat several times per week.  I do this because I really like them and it’s quick and easy make them. Yours need not be the same!

Photo by Glen Carrie on Unsplash

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1,115 Comments

    • You talk about the benefits of ketosis but what about the draw backs? I have a lot of diabetes in my family, in fact my sister died at the age of 15 due to ketoacidosis. I have been on my own journey trying to achieve where you’re at. Nutritional ketosis. My question is, since I do not have diabetes and am trying to prevent diabetes, will entering into ketosis help or harm me? Also, what is the quickest and safest way to induce ketosis? I am also been dabbling in IF(intermittent fasting) to help achieve higher ketosis but read somewhere that it could be harmful for women to fast. What is your stance on this? I also have PCOS, do you think achieve a nutritional state of ketosis will help this? I currently measure my ketones with a keto-stix, what are some standards that i would have to meet to say that I am in a state of”nutritional ketosis”?? Thanks for your time

  1. This may be a stupid question, but why do you need 4000-4500 calories per day? That seems like a lot. Do you exercise multiple hours a day… or does the [calories in (food)] – [calories out (basal metabolism + exercise)] model of weight gain not apply when you consume mostly fats?

    • Both. I do exercise quite a bit (though only about half what I used to), but more importantly, my body partitions “fuel” differently now, so my basal metabolic rate (i.e., the rate at which I expend energy when I’m doing nothing) is higher than it was previously.

    • I don’t see how your food listings above add up anywhere NEAR 4-4500 calories. Are those ostrich eggs you’re eating?

  2. Fascinating stuff here. The nutritional ketosis approach makes some sense to me, from the perspective of human evolution (I’m an anthropologist, and even though evolutionary anthro isn’t my specialty, I’m somewhat familiar with research on human evolution and diet). I have a couple questions for you:

    1. Do you plan to continue with this low-carb, low-protein, high-fat diet indefinitely? It seems from your discussion of the performance outcomes of the diet, you do. Would adapting this approach so that nutritional ketosis is used to achieve the basic goals of reducing indicators for metabolic syndrome, and a modified version (still high fat, low carb, low protein) used for long-term maintenance?

    2. Have you thought about the ecological impacts of this dietary shift and what they might be if large numbers of people took this up? To nuance that a bit, leaving aside an animal rights rationale, there are persuasive arguments that producing and consuming animal-based foods is energy and resource inefficient, in comparison with vegetable-based foods, even when it’s produced locally through organic methods. Some of your fats are coming from plant-based oils and other plant-based foods, but it looks like the majority still comes from meat, dairy, and eggs. I’m all for optimizing individual health, but want to do that in a socially and ecologically responsible way.

    Thanks for taking up this experiment and writing about it!

    • When I started my “experiment” with nutritional ketosis, my intent was to only carry it out for 12 weeks. Four weeks into it, I felt so bad, I regretted the day I was born. Were it not for the fact that I had committed (to myself) completing the experiment, I would have stopped. After all, I had already achieved great results with gradual carb reduction, and I couldn’t imagine this final, seemingly extreme, step was worth it. It turned out – and I will write about this in great detail later on – I was making a few critical errors in my application. Once I corrected these errors, within 3 days, I felt incredible. This experience gave me great insight into how lousy one can feel when you eliminate carbs without addressing a few things. Seven months later, I’m still in ketosis and having a hard time remembering what I was like to not be in ketosis. I can’t really say if I’ll stay here forever (versus, say, highly carb reduced but not ketotic). For now, though, I’m really excited about the results. To date, the “cost” of ketosis (e.g., less sprint speed) is more than offset by the benefits (e.g., near infinite capacity to burn fat across all ranges of activity).

      To your second question, I think it’s an important questions, but one I don’t know enough about (yet) to comment on. I’m currently reading a book Lierre Keith, “The Vegetarian Myth,” which actually addresses this issue. The book, coupled with my own understanding of the impacts of indirect land use change (see Tim Searchinger’s article in Science), has me hesitant to jump to any quick conclusions about how unsustainable my high-fat diet may or may not be. More for me to learn about…

    • Hi Peter,

      In response to the other Scott who posted on Dec. 28, you wrote:

      “When I started my “experiment” with nutritional ketosis, my intent was to only carry it out for 12 weeks. Four weeks into it, I felt so bad, I regretted the day I was born. Were it not for the fact that I had committed (to myself) completing the experiment, I would have stopped. After all, I had already achieved great results with gradual carb reduction, and I couldn’t imagine this final, seemingly extreme, step was worth it. It turned out – and I will write about this in great detail later on – I was making a few critical errors in my application.”

      My question is have you posted about this “in great detail later on” yet? If so where can I find it on your site? Thanks very much.

      I am going primal (Sisson) have eliminated almost all sugars and carbs and increasing saturated fats (coconut oil, organic whole whipping cream in my omelets, ghee, grass fed steaks when I can etc.). In the last few days I have been experiencing panic attacks (for lack of a better word). Mabye it’s my blood pressure racing? I don’t fully know. I am wondering if this is the low-carb flu I have read about, or I am doing something wrong to which you allude in your own experience above.

      Right now my gut tells me to go eat starch/grains (in small quantity – or get some 85% dark chocolate or something to comfort myself/treat my body). Is this the bad thinking I should push through or am I moving to fast?

      I have to say these panic attacks for lack of a better word are mildly terrifying (if there can be such a thing!) and seemed to coincide with my attempts to go to a diet that eventually supports nutritional ketosis.

      Any thoughts you have on this or if you did write about your experience and can direct me there – I would be grateful for either.

      Really enjoying the dialogue on your blog. Thank you!

      Scott C. Irwin

      • Scott, I have not (yet) written this post (which will likely be a series, actually). I know it’s important, though, and will certainly get to it. To your question, I have not had experience with this particular symptom. Is it resolving at all? It’s entirely possible this may be transient.

    • @Scott C. Irwin
      As a fellow ex-metabolically sick individual, I can share my experience of carb cravings.
      I think there are 2 distinct mechanisms for the cravings: the lack of metabolic flexibility, and the dominion of the wrong gut flora.

      While the first is relatively easy to resolve with a little education, trial-and-error, and persistence (you just go low carb, don’t ever cheat, and things do get better), the second is not so simple. Low carb allows you to recover the liver, pancreas, adipocytes, mitochondria, etc, and this takes a few weeks to kick in and stabilize completely. In the meantime you will suffer from hiperinsulinism which will prompt hypoglycemia attacks. You recognize them easily (shaking, blurry vision, brain fog, whatever).

      The second type, however, is much more subtle: you go for the chocolate cupboard without actually knowing why. You don’t feel anything specific, except for an eery desire for the brown stuff. This happened to me (and still happens once in a while) long after the metabolic problems were resolved. I had lost all the extra weight, cleansed my liver, and stopped having any hint of hypos long ago, and would still be startled by that sudden need for chocolate after a meal. As I learned the hard way, it all goes away when you have the right kind of gut flora. Bacteria love iron, and chocolate is pretty rich, so that’s one hypothesis. But I’m sure many others can be made.
      It is known that gut bacteria produce neurotransmitters that can hijack the vagus nerve; of course this can only happen if they are living inside your small intestine, because the large intestine (where the gut bacteria should be in very small numbers) is not graced with that nerve. The victims of SIBO (“small intestine bacterial overgrowth”, which by the way, may include also yeasts and fungi in the mix, like Candida Albicans) are usually little more than remote-controlled food cravers, and the gut bacteria have the remote in their hands.

      So… check for the wrong gut flora. Take a lot of diverse probiotics to rebuild it, and persist (it takes a long time). Can’t hurt much, with the lack of sugar and fibre. But you’ll be strengthening the good kind of flora and in the process restoring you small and large intestine mucosa. All great things.

      Starving the pathogenic flora with intermittent fasting is another good technique that helped me a lot. And if all else fails, there’s the fecal transplant. ugh. 🙂 Good luck!

    • Scott, the lands we use to raise grains takes up a lot of space that must be denuded of their natural ecosystems and then demand chemical fertilisers for their success. Feed animals need lesser lands, scrub lands that they brows from and help enrich naturally- think bison (buffalo) on the prairies. The amount of calories one needs from animals may be less than is consumed from todays diet dependent upon plants; unless like Dr Peter one is into extreme fitness- most people are not.

      The whole story of plant vs animal ingestion is complex and far beyond the realm or reason of proponents on either side. Our ancient brethren with population success ran through the wild species in their lands, and agriculture had to come about for their survival. (Modern man has done the same to the oceans. Properly managed, they could have continued to be a healthy source of food for humans.) I would speculate that in a perfect world properly managed lands could allow for animal eating without stress to the lands (and less stress to the animals than what we perpetrate on them today).

      And if humans are naturally carnivores (or omnivores) for perfect health, should we be deprived of our needs? Logic taken to extreme would then suggest we also condemn wild carnivores for their behaviour.

    • In reply to Scott C Irwin – probably no longer relevant to you since your post is over a year old. But I had terrible palpitations/panic attacks when taking coconut oil. I have since stopped. For some reason I am fine with coconut milk contained within foods but not virgin coconut oil. Years ago I blamed the palps on low carb and went vegetarian. Years later, overweight again – I’m going back to low carb, this time without the coconut oil.

  3. You mention “the ‘cost’ of ketosis (e.g., less sprint speed)” and Gary Taubes also doesn’t recommend this severe of a no-carb diet for athletes. So how would you modify it if you were recommending dietary changes for athletes who require “sprint speed” as well as high levels of muscular strength? Thanks!

    • This is a great, but fairly complex question. In short, I would say 99.9% of athletes can, in fact, tolerate low-carb (and even ketosis), provided they do it correctly. It took me MONTHS to figure this out…mostly the hard way. If you are like my friend Ed Moses (13-time world record holder in swimming) who needs to give it all for a 1 minute race, there are still huge benefits from reducing carbs – especially the bad ones – but they can not be eliminated completely. I’m going to write about a remarkable product that I’ve been working with personally, and with many folks I coach, in the coming month or so. It’s called Generation UCAN. You can find a link to it under the “books & tools” section of my blog. This technology gives you a time-release glucose, without the insulin spike, so it does not at all hinder beta-oxidation.

  4. I was under the impression that the brain, bone marrow, and liver can oxidize carbs only for the production of ATP? Is 50 grams of carbohydrate enough to meet the needs of these sites?

    • Great question. Contrary to popular belief, though, the brain is not an obligate consumer of glucose. It can not oxidize fat or protein (directly), which leads to this confusion, but it CAN metabolize beta-hydroxybutyrate (a ketone body). In fact, this is one of the greatest benefits of being in nutritional ketosis – my brain gets sufficient energy indirectly from my fat stores (via the conversion of fat to beta-hydroxybutyrate) that I never have the “bonking” problem of my brain getting unhappy when glucose levels get too low. I’ll be writing much more about this later, but a quick overview of ketosis can be found here: http://eatingacademy.com/nutrition/is-ketosis-dangerous

  5. Hi Peter

    When you consume MCT oil, do you just eat coconut oil? Or do you buy MCT oil from a health store like GNC?

    • Great question. As you suggest, coconut (and palm) oil are about 60% medium chain (C6-12) saturated by nature. That said, I consume a “dedicated” (i.e., pure) MCT oil. I take 2 tablespoons (30 mL) every morning, but this is HIGHLY user specific and it takes a while to figure how much to take, and when to take it. Because I take it first thing in the morning, then jump in the pool for a hard swim, I can tolerate a lot of it. A lot of folks who jump right to that level can’t tolerate it (e.g., they get diarrhea).

  6. Hi Peter,

    You write “It turned out – and I will write about this in great detail later on – I was making a few critical errors in my application. Once I corrected these errors, within 3 days, I felt incredible.” I know you mentioned you will write about this later, but I’m wondering if you could briefly share what the errors were and how you corrected them. I’ve been on a VLC diet (<30 grams per day) since October. It took me about 4 weeks to turn the corner, but I still have many days (several per week) where I feel lethargic, weak and just kind of "out of it". I'm so happy with my radical body transformation that I'm just putting up with the tired days, but I always thought I would have to eventually add back in more carbs after achieving my goals and then just worry about regaining weight. I have read so much in the last 3 months that leads me to believe that for optimum health and longevity I should stay on this plan, but in order to do so I need to fix whatever is preventing me from feeling more energetic and clearer-headed as many people eating this way describe.

    I'm also curious if you are familiar with the writings and diet of Dr. Rosedale? He has written specifically about Leptin's role (along with insulin) in determining if you brain will allow your body to burn fat or not. While recommending a LCHF diet, he distinguishes between fat types and limits beef, cheese and heavy cream to 1-2 servings per week. I'd love your thoughts on both of these topics as your blog posts and diet show you have a differing opinion. I have to admit that after even after all I've researched I still have that little voice that warns me about so much saturated fat and I find corroboration even in the LCHF world. There's just become such a glut of information out there that it's easy to find conflicting information even among people all on a Ketogenic diet and I'm wondering how you worked through all of that information to arrive at a point where you are confident with your nutritional profile.

    Lastly, I've probably read 150+ websites, blogs and books dedicated to LC/Paleo and yours is by far one of the most succinct and easy to understand; it will now be the blog that I share with my friends who want to know how I've changed my diet and body! Thank you so much for documenting your experiences and taking the time to answer questions!

    • Katie, Thanks so much for your questions and kind praise. When I transitioned about 8 months ago to full (nutritional) ketosis, I spent the first 6 weeks in pure hell. So weak I couldn’t stand without needing to sit again. It was awful, and were it not for the fact that I told myself I was only going to do it for 12 weeks, I would have quit. Fortunately, I had the help of a couple of experts in the field – Steve Phinney and Jeff Volek (authors of one of the books I recommend). I will write about this in much more detail in the future, but I can say the two biggest mistakes I was making were: 1) I was eating too much protein (north of 200 gm/day), and 2) I was not supplementing enough sodium. There are many other little nuances I’ve learned since, but once I fixed those two, within 3 days I was humming along. I haven’t looked back since. Ironically, it was not the consumption of too many carbs that was hurting me.

      I don’t know Dr. Rosedale personally, but I have seen his site and read some of his materials. Your particular question, which is excellent, is a bit nuanced and tough to answer in short space. Leptin levels probably do matter, but they matter in a way that is subservient to insulin levels. In other words, insulin levels are the primary driver of fat regulation, not leptin. Insulin may mediate appetite through leptin (and other hormones), but we shouldn’t lose sight of the “master” hormone in fat regulation. Now, the bigger issue, per the second part of your question is the differences between individuals. Some people do actually have a strong insulin response to dairy. Others to not. Some folks even have what is called a cephalic insulin response to artificial sweeteners, while most people don’t. The key – and this is primarily what I try to accomplish with people I work with one-on-one – is customizing “low-carb” eating for an individual. It’s so important to figure out what works for YOU. What works for me is interesting, and likely informative, but what matters more than anything is what will work for you.

      Please stay tuned as I try to articulate these nuances better and better over time.

      • Do you find, then, that you need to always measure what you eat to stay ketonic? One reason Taubes’ approach works for me is that I abhor counting and measuring (even if it’s not calories) because it makes eating too complicated. I can easily say “no” to a category of foods, but I can’t easily say 0.25 protein to 0.75 fat. I just cut out starch and sugar, try to eat more fat (in the way of cheese, half and half, eggs, and the non-lean part of meat) than protein, and balance out with broccoli and other non-starchy vegetables. To be ketonic, I suppose I would need to measure everything to maintain the balance and also measure the level of ketones as well. Is there such a thing a partial ketosis, even if you are above 50 grams of carbs? Lastly, what does 150 grams of protein look like and how easy is it to parse given that a steak, for example, will contain a lot of protein, but also a lot of fat?

        By the way, your responsiveness to all of these questions is extremely helpful.

        • This is actually a bit complex when directed towards me, specifically, because I eat so damn much (4,000 – 5,000 calories per day), AND I’m ketotic. Because I need to cap both carb and protein amounts, I did need to pay attention for a few months until it became automatic, which it is now. So I never count calories, per se, but I did need to pay attention to the amount of carbs and protein. For what’s it’s worth, I eat carbs:protein:fat in about a ration of 1:3:9, but that’s for ME personally. There is no formula for everyone. It’s about your genes and your goals.

    • Hi Peter,

      I just wanted to thank you for making the two much needed items clear (fat and sodium) in your post above. After adding 2 tbsp of MCT oil to each meal and sleeping 8 hours per night, I’ve been able to reverse constipation completely, in the short term, and hopefully also reduce my LDL cholesterol in the long term. I will keep you posted on this last point.

      I’ve found it difficult to reduce my LDL / TC / TG on a high fat, low-carb diet, I believe this is because I am not obese and am not losing weight over the long term. I am hoping I will see a reduction in cholesterol because I added the extra fat + sleep.

      Thanks so much for your blog and your work. If there is a way I can contribute to NUSI I would be interested.

  7. 4000-4500 calories daily is a lot. What is your daily swimming/biking expenditure? I didn’t find any study proving metabolic advantage of keto over carb based diets so I think you’re actualy burning those calories through exercise.

    Re. limited max effort on keto, why dont you try 1-2 days of higher carb to reload glycogen stores (ckd diet approach)?
    I’m also doing lots of biking/running but also lifting/strength training and experienced limited max effort while lifting heavy. After introduction of 1 day high carb/low fat strength is going up and I feel much better overall.

    • My basal rate has, in fact, increased. In my experience, this is the case in about a third of people, but obviously not everyone. In other words, some people, once ketotic eat less, and some about the same (in # of calories), as they did prior. The other thing to keep in mind is that my daily exercise routine has been constant pre- and post-ketosis, so whatever number of calories I was burning then, I’m burning now, +/- a small amount. The real delta (you can test this with a metabolic cart) is in resting energy expenditure. Keep in mind I’m not trying to hit a calorie target; I’ve only documented it to keep track of my carb/protein intake. The real beauty of being in nutritional ketosis is just that! I don’t ever count calories (except to “report” them). I eat when I’m hungry and I don’t when I’m not.

      To your second point, this is a good idea, and I’ve toyed with it. However, right now, I’ve found a remarkable balance between ketosis and the need for a bit of “glycolytic kick” through a technology called “super starch,” which is made by a company called Generation UCAN. I’ll be writing extensively about this technology in the future. I’m also planning a video presentation, specifically focused on optimizing nutrition for peak athletic performance, soon.

  8. Knowing what you know now about carb restriction and ketosis, would you say that feeling crappy for a period of time at the outset of dropping to <150g protein and 50g carbs/day is unavoidable? Or can this uncomfortable transitional period be eliminated altogether?

    And do you still suggest slowly reducing carbs over a period of months, or do you now recommend just diving in (no swimming-related pun intended!)? I get the impression from Dr. Westman that he has his patients just go for it all at once.

    • The good news: you don’t need to suffer like I did (I was in low-carb hell for 6 weeks when I dropped from 150 to 50 gm/day) if you know what I now know.
      The bad news: I need more time to explain why.
      I promise, I will get to it.

  9. Ok I’m ready to start . How do I start? I’m 40 5’4″ 169 lbs work in produce business I’m up at 5:00 am go to bed at 10:00 pm live under lots of stress tell me how to find out the right amount of fat intake I need?? I saw your dietary intake but, do I Copy it in my daily life? I honestly do not like to excersise . Besides after work have to come home and cook dinner . So I’m ready help me to start!!!!

    • Brenda, congrats on taking the first step! This is very important. Certainly stress (for most people) makes it more difficult. The good news is, while I’m a huge fan of exercise for my “big 4” reasons, you don’t need to do so if weight loss is your primary goal. Take a look at my post called “How can I lose weight.” If you still think you need more help and guidance, send me a personal email. Remember: festina lente!

  10. Hi Peter,
    I am a huge fan of Gary Taubes, as his two books completely changed the way I now think about obesity (especially my own).

    The biggest problem I have is actually being able to stay on the low-carb program, as I have suffered the “dual whammy” of boredom with the food choices and also of losing little-to-no weight after the 2nd week (I was not a happy camper); nevertheless, at 340 lbs, I look and feel awful.

    Ironically, I usually do about 1.5 miles on the treadmill every morning, so it’s not like I do nothing, but the scale never moves. I admit I hate the thought of giving up so many of the foods I love (bread, potatoes, sweets), but I also feel that once I can finally experience seeing actual weight loss, that “pain” will be momentary.

    I look forward to reading/watching what you have to share, as I need to be around people who are experiencing success with this.

    • Mark, thanks very much for sharing your story. It’s hard for me know, exactly, what is as the root of your struggle, but I do wonder if maybe just taking a week to write down and weigh everything you eat to get an accurate assessment of exactly how much sugar and total carbs you’re eating might shed some light? Also, it’s probably a good idea to ask your doctor to check all of your labs to make sure something easily fixable (e.g., low thyroid hormone, low testosterone) isn’t amok. Please stay with it. I’m working on a cookbook to try to address the boredom issue.

      • I look forward to the cookbook. Yes, I’ve gotten several tests and there is no low thyroid or any problem brought to my attention, except for high BP. I am beginning to believe that the reason I didn’t lose much, if any weight on low carb, last time, was because I had too much protein.

        So, starting this morning, I’m going to follow your recommendation of high fat, with much lower protein (and of very low carb, of course).

        It’s kind of scary, in a way, to imagine eating all that fat, but I am willing to do this.

        So, I also gather that I should have sufficient sodium. Any other things you recommend (like taking potassium or multi vitamins, etc?)

        • Yes, it’s a bit “scary” to start eating more fat deliberately, especially for folks like us who grew up brainwashed. The Art and Science of Low Carb Living is a great reference.

  11. Thanks for posting. I read Gary Taubes’s book a couple of months ago and modified my diet accordingly. Since, I have dropped 33 lbs and feel way, way better than I have in a long time. Your list of foods adds to my repertoire.

    A couple of things that I like include 1) coffee with one tablespoon MCT oil or coconut oil and one tablespoon Kerrygold unsalted butter (from “Bulletproof Exec”.); and 2) “Joe’s Special” for dinner (Google it for recipe…it’s great stuff)!

    • Congrats on such fantastic work! I’m actually working on a recipe book, which I hope to have ready in maybe 6 months or so of awesome low carb (*and* ketosis friendly) foods, plus a few other twists. Can’t wait to check out suggestions. Thank you.

      • A low-carb, pro-ketosis cookbook would be great. I would definitely buy it. BTW, just had a Peet’s small latte made with heavy cream — per your notes above. WOW! Terrific! The guy behind the counter said it was a first.

    • Peter
      I am happy to hear you are working on a cookbook. I have been toying with the idea since spending an afternoon sailing with Steve Phinney and Jeff Volek. Would there be interest in thinking about a retail line of specialty foods that are locally sourced (so you don’t have to add preservatives and other ingredients to maintain freshness)? Have you found regions (of the US) where adoption of LCHF is more prevalent? Focused centers where pretotyping some recipes could be beneficial. I would like to help if you are interested. Your message is one to be heard, repeated and acted on. Thanks.

  12. Hi Peter. Superb info here!
    I’m currently on a low carb diet, I have Crohns disease and it significantly helps with that while also obviously having lots of other benefits. I notice from reading your blog that you struggled a bit at first but felt much better when you reduced protein. Is this something you recommend to everyone? I’m currently trying to put quite a bit of muscle mass on (fat loss is not a big deal for me and maybe other sufferers of crohns, but muscle mass loss can be a pain from time to time) and would like to know if there are any reasons not to increase protein if that is a goal? My energy levels are great and I feel pretty good so far.
    Thanks. Steve.

    • Steve, the issue for me (the struggle with too much protein) was the result of my desire to be completely ketotic, coupled with my historic protein-consuming habits. Ever since I was in high school, given my training volume, I had always felt I need about 3 gm/kg of protein per day, which put me at nearly 250 gm/day. The problem is that every gram of protein, over about the first 100, starts to “act” a bit like a carb (though only about 25% as much). Hence, when I was consuming 250 gm/day, it was like adding another 37.5 gm/day of carbs [25% x (250-100)], loosely speaking. In reality, I think you can gain more than enough muscle at 2 gm/kg, provided you eat it at the right times. I should probably add this to my list of future blog posts, too…

  13. Great post. I was amazed you could eat so much fat and keep your protein intake so low. I have a problem right now where I think I eat too much protein in my efforts to eat fat. This will really help me a lot.

    I have been low carb for about 7 months now, I’ve lost 50 lbs with LESS exercise than before. However, my Body Fat % is still about 17%, and I really want to get under 10%. I’m tired of looking flabby!

    It seems like I can learn a few good tricks here. Namely, using heavy whipping cream abundantly. Also eating more egg yolks than whites in my morning eggs. That’s fine by me because the yolk is the best part anyway 😉 I also like the homemade cream dressing idea, and that soup sounds good.

    One thing that worries me, is even though I don’t exercise, I’m consuming more calories than you are in a day. Looking at your intake, I’d eat much more than that normally, I’d be hungry if I didn’t. Maybe if I can up my fat% as high as you I’ll be better off.

    Thanks a TON for all the great info and the fantastic website. I can’t wait to read everything you’ve posted.

    • There are no exact formulas, unfortunately, just general principles. Be flexible, as you are, and constantly search for what works for you. The key is 1. get good starting data, and 2. be consistent in your measurements and eating habits, until you can really figure it out. Keep up the good work.

  14. One other comment I want to make is regarding supplements. I’m currently taking 400 mg of magnesium and putting a lot of salt on my food. The Mg I’m taking is not chelated, does that matter?

    Also, have you looked into taking a vitamin D supplement? There is a great deal of research out there that most Americans are vitamin D deficient and the RDA is much lower than it should be. I’ve been taking 4,000 IU a day and it has basically eliminated my need to take an inhaled corticosteroid to control my asthma.

    • I do take 400 mg of Mg and it’s not chelated. I don’t take Vit D, as I tend to get plenty of sunlight and my levels are fine (I live in SD and swim outside every day). If you are deficient, though, you definitely want to correct it.

  15. Ive already done your steps, except the last one. I’m down from 170 to 139 and would like to get 10 more lbs off. I’m looking for numbers or percentages of calories from fat/protein/carbs. I’ve been tracking calories for months and think it should be easy to tweak things if I just know what I’m shooting for. (5’6, 42yo, hiit workouts & weights 4x week). Thanks!

  16. I see that cured meats like bacon and salami are on the menu. I read that these meats are extraordinarily high in AGEs – this was in that book Wheat Belly. Have you read anything about this and does it concern you? I was really disappointed/anxious when I read it because I had been eating bacon and salami on a regular basis.

    • The biggest toxin in cured meats is probably he sugar contained in most of them. I do go out to my way (even though it means spending a few extra dollars) to buy the highest quality (i.e., least processed) meats. When you minimize the sugar (e.g., dextrose) in cured meats, you’re automatically minimizing the AGE’s.

  17. I guess my question is, “Should I go to 50g carbs and 150g protein and unlimited fat?” Based on being a 140lb female who works out 4x week for 45-95minutes with weights and interval cardio. Or is the 50g carbs and 150g protein for someone who is eating 4000 calories/day. (I’m probably not going to hit 2000).

    • The “magic” 50 gm/day has to do with inhibiting ketosis. It’s actually more nuanced than this, and it depends on the type of carbs (and, as always, genetic factors). For someone like me, eating 4000-5000 calories per day (versus someone only eating 2000 calories per day), it just means a lower overall % of my calories come from carbs. Same “rule” applies for protein intake.

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