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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:
- What is my inherent level of insulin resistance?
- 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 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.
- 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.
Regular supplements I consume every day
*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:
- I go to great lengths to avoid sugar which, unfortunately, shows up in virtually every highly processed food.
- I eat zero starch (e.g., bread, cereal, rice, crackers, pasta).
- 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).
- 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.
- 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).
- 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
I’ve been seeing a lot of questions from people newly interested in restricting carbohydrates who are vegetarians or even vegans and wanting to know what they can eat. I’ve tried looking up vegan and vegetarian low carb, but they all seem to rely heavily on tofu and seitan for protein. Do you have any other ideas? Because I’d hate to see people decide that low-carb isn’t for them because there isn’t anything they can (or will) eat on it besides leaves and coconut oil. And some people don’t like coconut!
Definitely a great point. I think vegetarian versus vegan is a big difference in challenge, the former being a bigger challenge. But both are absolutely possible, especially if not aspiring for full-blow nutritional ketosis. Simply eliminating all sucrose and HFCS, and only taking in fructose in the form of fruits and vegetables would give a huge benefit.
I’ve been trying to up my fat intake and this weekend I made Jello sugar free instant pudding with heavy whipping cream instead of skim milk. Wow was it good! It was pudding you could cut into wedges. Super rich, super filling. Crazy-good dessert. Am I killing myself though with the cornstarch they use as a thickener. Does all that fat outweigh all that carbohydrate? Each serving (not including the cream) was 8g of carbohydrate (0g sugar), which I assume came from cornstarch. It threw me out of ketosis but I thought it was such a good weekend treat I didn’t care.
So what kinds of foods have the omega-6 polyunsaturated fat that you avoid? I did some googling, but quickly got bogged down in minutiae. I’m guessing you have a top five at the ready.
Let’s address this when I write more about PUFA in the future. My views on omega-6 are slowly in the midst of a change right now.
Medstudent, FYI, Omega-6 PUFA’s are basically found in seeds, nuts, and grains. Sources rich in Omega 6’s therefore are seed-based oils (safflower, sunflower, corn, canola, etc.) and the margarines made from them, and things fried in them (e.g., french fries); most nuts; and things that eat grain (grain fed cows).
If you’re looking to avoid PUFA’s an option is to use monunsaturated fats (olive, avocado, macadamia); real butter; grass fed beef instead of grain fed; and macadamias as the best nut.
Should also add, coconut oil (nearly all saturated fat and therefore not an O-6 PUFA) is not only another option, it’s now my fave, Good Lord — Nutiva, you can spoon that stuff out of the jar for dessert it’s so good.
grass fed instead of grain fed! that’s a new one. tastes way better anyway.
Looking at the nutritional data on coconut oil, it looks very high in Omega-6, as below, and highly inflammatory,
https://nutritiondata.self.com/facts/fats-and-oils/508/2
unless this is not actually coconut oil, but a blend perhaps?
Makes sense though as coco”nut” would probably suggest it has O6’s in as other nuts do, i.e. sunflower, safflower etc.
Great blog by the way, totally changed my way on thinking about food, keep up the great work.
Might be a blend. The stuff I use is almost all SFA. Small fraction of MUFA.
Hi Peter,
wanted to clarify something – hopefully it’s not old ground. I’ve been cutting up bouillon cubes into about 2g squares and drinking them every morning as your table suggests. However, based on the package, that’s not going to give 2g of sodium. So does the 2g recommendation apply to bouillon cubes or sodium?
thx,
Eric
PS bought Volek/Phinney on your recommendation. Great read – very technical. Reminds me of you and Taubes 🙂
See previous responses to this question in various comment threads.
Peter, I have been strugglng to get into full blown ketosis. I have the blood meter recommend but only have a high reading of 0.4 for ketones. I started weighing everything this weekend and deteremined my problem is too much protein. My problem is how to get enough fat for satiety without getting too much protein. I am going to try and make home made Cool Whip with Xylitol. What do you eat to get fat without carbs or protein? I am going to retest my ketones after a few days of keeping protein below 150 gram and see where I’m at. Thanks, Dave
Dave –
Sauteed mushrooms in butter and olive oil, heavy cream in coffee, spinach salad with olive oil based dressing and macadamia nuts are good go-to sources for fat calories without all of the protein.
Good news in the NY Times as one food writer Peter Kaminsky seems to have figured out the LCHF lifestyle for himself.
https://www.nytimes.com/2012/05/09/dining/the-author-peter-kaminsky-on-how-to-eat-wisely.html
Interesting. Mr. Kaminsky talks of things that have flavor and are satisfying, but what he’s really doing is avoiding things that spike blood sugar and cause hormonal-induced hunger. (Mozzarella and prosciutto with a few olives and oil is one of my typical lunches now — maybe 3 or 4 ounces of food and it’s a satisfying lunch). He could skip the lentils and spelt and embrace the sausage and bacon a bit more, but he’s halfway there.
Another great example of the common fallacy: I added more X to my diet (X can be anything from antioxidants to seaweed to snakeoil to kitten paws)…I also removed Y from my diet (Y is typically sugar, grains, refined carbohydrates). Conclusion: Look at how amazing X is!
Do you have either a recommended or preferred sweetener. Many new ones are out there. Do sugar alcohols cause you digestive distress? Does your wife use a sugar substitute for baking? Do you use any wheat flour substitute? Any you would recommend? A lot of them have soy in them. I guess you can see why Gary Taubes found it impossible to keep up with the blogs.
I personally use xylitol when I use anything at all, which is quite rare. Only in homemade ice cream and a few other things. Everyone needs to figure out what works for them with respect to fat metabolism, GI distress, etc. If you can do without, do without.
Have you seen any connection between this type of diet and stomach ulcers?
Nope.
Johngdc – It’s been known for some time that the vast majority of peptic ulcers are caused by the bacterium Helicobacter pylori, a discovery made in 1982 by Barry Marshall and Robin Warren and for which they were awarded the 2005 Nobel prize.
https://en.wikipedia.org/wiki/Helicobacter_pylori
“Some skepticism” doesn’t really begin to describe the way their hypothesis was received at first and Marshall ended up drinking a beaker of cultured H. pylori to make his point. (He became quite ill with gastritis but recovered.) Antibiotics are now the standard treatment.
actually, the physicians in my family all agree that that literature is outdated and they’ve cited to studies that show otherwise.
my blood panel will be back soon, so we’ll see.
Pancreatitis?
Only if there is other pathology underlying it.
Interesting. Well, my blood panel will be back soon so we’ll see. Logic (not medicine) seems to me that increased fat intake could lead to complications with the pancreas and/or gall bladder.
I’m as big of an advocate of no carb diet as there is around me, ketotic now for a while. But this health concern is, well, a concern.
I’ll need ammo to fight my traditional physician and physicians in my own family if the blood panel shows any link to my diet and whatever condition i’m suffering from.
Hi Peter,
I am on a crusade to balance my omega 3 and 6 right now and I have been excited and confused by the sea of information and ideas available. I have found two interesting sites with oil profile ratios: https://efaeducation.nih.gov/sig/esstable.html and https://fanaticcook.blogspot.ca/2009/04/omega-6-and-omega-3-in-foods.html
It seems to me that Olive oil is not the best oil in terms of omega 3,6 balance despite its low Polyunsaturated and high monounsaturated fats content. Even canola oil has a better oil ratio than olive oil. As a result, I think olive oil, if used in excess, could be a disaster for omega 3,6 balance (coconut oil seems to be moderate and butter is a clear winner).
I don’t understand why do people care about amount of Saturated fat and monounsaturated fat regarding omega 3,6 balance? Should we care only about omega 3,6 ratio and quantity and apply moderation when consuming food with high omega 6:3 ratio, such as olive oil,grass-fed beef or avocado? Since the more we consume oil with high 6:3 ratio, the less impact the fish oil supplement is going to have in terms of 6:3 balance. That is, my omega 6:3 ratio is 10:1 if I consume 10 tablespoon of olive oil or 2 tablespoon, but my ratio is going to be a lot better if I take fish oil supplement while consuming only 2 tablespoon olive oil.
The reason I try to investigate is because I have a body that is prone to inflammation and since I started a diet (around 2-3 weeks) that is heavy on nuts, olive oil and avocado, I recently have experienced some moderate inflammation reaction with no change in other aspect of my life. I have ordered fish oil from Carlson lab(BTW, thanks for the link)but I wonder whether such 6:3 imbalance would be harmful even for people who are less prone to inflammation.
Hold your horses a bit. I’m not so sure any more this is important. I’m going to write about this in the future, but in the interim, spend more time worrying about getting lots of omega-3, and less time worrying out less omega-6 or even the ratio.
Xiaolei — well, while we’re waiting for Dr. Attia to give us the full authoritative scoop on PUFA’s — I’ll just point out that IMHO there are two issues here: 1) you’re hung up on the RATIOS and not paying enough attention to the sheer quantity of Omega-6’s involved; and 2) the Omega-3 in Canola or any of these vegetable oils is the ALA type, which is usually seen as far less useful to you than the EPA/DHA found in fish — hence (possibly) you can’t really count on the Omega-3 in vegetable oil to do you much good. (Peter set me straight on that point a while back).
So the trick with vegetable oil is to minimize the Omega-6 load. The ratio that is most useful at a glance is the Mono:PUFA, not the O3:O6.
People like olive oil NOT because it has a great ratio of 3:6 (it doesn’t), but because it has little of either, since it has relatively little PUFA content, and is hence benign. Therefore you can use olive oil and not ingest too much Omega-6, which in turn means the Omega 3 fish oil supplements you’d take are not being wasted. A bit of canola oil on the other hand, you’ll be swamped with Omega-6.
If you look at the sources you link to, notice that a tablespoon of olive oil has far fewer milligrams Omega-6 in it just about than any of the other mono or PUFA vegetable oils — despite whatever the ratio is. (An exception is the > 70% oleic sunflower, which is interesting).
But, once Peter tells us some more no doubt I’ll have to restock my pantry. I heartily endorse coconut oil though.
Hi Peter,
Thanks for responding; cannot wait for your article but do take your time. Wish you the best.
Hi Kevin,
Thanks for your reply. My post is driven by my concern over quantity rather than ratio. I was trying to say that there should be some factor that separates canola oil from olive oil. If not, 3 table spoon of olive oil is just as bad as 1 table spoon of canola oil in terms of amount of Omega 6. I agree with you that it is the quantity that matters, but following that logic and the assumption that there is no other variables at play, olive oil and avocado would be pretty bad choices if consumed without moderation.
I suspect there might be other variables/pathways that affect inflammation process and I am anxiously waiting Peter to share his knowledge on it. In the meanwhile, I will go buy some salmon from Costco.
Cheers,
Xiaolei
Hey, Doc Peter.
I’ve got gallstones and it turns out I’m gonna have to get my gallbladder yanked out in a couple of weeks. I’ve been in ketosis for over two months now, and I’m adapting really well to my training. Obviously, this is going to set the training back a little, but I would rather not have to re-adapt to ketosis.
All of what I’ve read says foods to avoid post surgery are the very foods I would need to eat to stay in ketosis. Is eating fats that much of a problem after getting one’s gallbladder removed? Also, is this way of eating a problem for those without a gallbladder?
Peter,
First off. Thanks for putting together this amazing resource. I’ve only scratched the surface in reading your blog so far, there’s so much to “meat to digest”, I feel like I have to take long breaks so I don’t eat more than 150g of protein a day. 🙂
Quick background on me: Fat kid, turned fat adult, never exercised a day in my life, ate some junk and some healthy food most of my life, but mostly I ate too much of what ever I was eating… ended up 5’4″ and well over 200lbs, 40% body fat, clinically obese by age 34. Then one day partly inspired by a doc telling me “I shouldn’t gain any more weight” and partly inspired by a bet I made with my wife that I WOULD go to the gym if we were just members of a 24 hour gym… I started on a quest to get healthy. I lost 50lbs in 3 months, by eating a VLC diet (~1200cals/day) and exercising at 1-2hours a day-7days/week. After losing the weight, I decided to see what my new body could do… I started cycling, and did my first double century ride a year later. Since then I’ve kept the weight off, and even lost another 15lbs, and now have completed 6 Ironman races, 7 one-day double centuries, 1 double-double century, 30+ marathons including 2 years in a row of running 4 marathons in 4 days, two 50 mile ultras, a several 50kms.
I’m the healthiest person anyone of my friends know. (Which is, IMO, more of a sad commentary on the state of our nations health, than it is a commentary on my fitness.)
However, I was recently diagnosed with osteoporosis (which was discovered accidentally thanks to me taking a DEXA scan to determine my body fat more accurately as I prep for my 7th Ironman). The current conclusion is that this likely resulted from several rounds of Acutane I was prescribed as a young teenager.
I also recently discovered Bob Seebohar’s MET program, and for the last couple months have been working in his nutritional philosophy into my diet.
At 61kg, my typical daily intake these days is: ~50g Fat (.83g/kg); ~150g Carbs (2.4g/kg); ~150g Protein (2.4g/kg) – ~1,650 cals/day
As an Ironman triathlete, I exercise about 700hrs/yr or ~2hrs/day. (Although I’m including in that low effort practices like stretching and strength training.)
One last bit of background: I don’t eat dairy or gluten, because I have found that when I consume these, I get a great deal of congestion and mucus build up.
So… here are my questions….
Getting to Seboohar’s MET 1:1 Carb:Protein was pretty easy, since I don’t eat gluten, it was actually pretty easy to just say “no more grains”. But I do like/LOVE my GREEN LEAFY vegetables!!! I really love them. I always have. And especially now with my diagnosis of Osteoporosis, I am eating more of them than before. A typical breakfast for me is to sauté up 3 cups of kale in olive oil toss in 2 eggs and/or a couple ounces of chicken.
I can see myself eliminating fruits, starchy vegetables, and even beans… but I think I’d have a really hard time eliminating leafy greens. It looks like you still maintain leafy greens in your diet, so I guess that’s the path that worked for you.
Q1: If I’m eliminating “sugars” — should I also be trying to eliminate any leafy green vegetable that has “sugar” in it. Examples: Swiss Chard, Broccoli, etc.
Q2: I have picked up from your various articles that I should also be reducing my protein intake. You seem to suggest that there’s a magic number around 120g. I wonder, was that based on a g/kg ratio? What ratio are you shooting for? I think you mentioned 1.5g/kg elsewhere… but it seems like that would be an even lower amount of protein for you. What is the preferred g/kg ratio of protein.
Q3: 50g Carbs + 120g Protein = 680 cals… so I guess that leaves only fat to make up the fuel we need. From what I can tell, you’re basically setting these Carb/Protein limits based on the metabolic conditions most conducive to stimulating and maintaining ketosis… and then you’re filling in the remainder of your caloric needs with fat. Do I have that right?
Q4: Finally — do you know any nutritionists in the Seattle area that work with endurance athletes and believe in the concept of nutritional ketosis?
Thanks
-Brad
Brad, congratulations on an absolutely remarkable turnaround. Very inspiring. To your questions:
1. The amount of sugar (i.e., fructose) in those veggies is really minor. Should not be an issue.
2. This is only an issue if you’re trying to be in ketosis, if not, don’t sweat the extra protein. Your carb intake is well over ketosis, so protein is not an issue.
3. Based on being in ketosis. If you’re going for a low-carb, but non-ketotic diet, these constraints disappear.
4. I do not.
Thanks for the quick reply. I apologize if these next couple questions are answered elsewhere, I searched the site and didn’t quickly find answers to these.
First of all, when I first read Bob Seebohar’s stuff I was immediately convinced that keeping insulin response down would be a massive advantage to me in my endurance racing. Which is why I jumped on the MET bandwagon without hesitation. Nutritional Ketosis sounds like a very logical extension to this exact same philosophy. So I’m equally intrigued by it. But I’ll admit, MET doesn’t sound nearly as extreme… and so I have some concerns about the “unknown” potential health risks of nutritional ketosis.
Q1: If I chose to continue to move down the “low carb” spectrum… and decided to taking on nutritional ketosis what are the contraindications to be aware of before moving toward nutritional ketosis? Are these things I can get tests on without a MD’s prescription? What markers should I be tracking to make sure I’m not doing some other damage to my systems by being in ketosis?
Q2: You mention ‘being in ketosis’ in your reply and in many of your posts. How do I determine if I am “in ketosis”? Is this something I can self-test without a MD’s prescription?
Q3: A little bit of googling led me to some references that seem to suggest that “increased bone demineralization” is a potential side effect of ketogenic diet. Needless to say, with my recent diagnosis of Osteoporosis that would be baaaaad. Is bone demineralization indeed a contraindication of the ketogenic diet? OR… is this bone demineralization only linked to “high protein diets”?
Q4: Am I confusing ketogenic diet with being in ketosis? Are these the same things?
Q5: I’ve done the New Leaf metabolic tests and in my Zone 1/Zone 2, I’m pretty metabolically efficient at ~95% (running) and ~80% (cycling). I’m working on my Zone 2 work to help push those numbers up… And I believe that going MET has helped… and I’m also convinced that nutritional ketosis would help more… but…. I’m struggling to figure out the math on keeping Carbs under 50g for a long hard training or race effort. How are you still achieving carbs of <50g on days when you do long hard training efforts (3-4hrs)? Even using MET with 1:1 ratio I'm still getting much more carbs than that. I can't think of any "portable" nutrition that you could carry with you that can supply your needs. What are you using for your long/hard training efforts?
Q6: You mention Generation UCAN. I've never tried it, but heard great things about it, and I'm planning on getting some to use during my long hard training efforts. But like Q5, I'm wondering how you keep your Carbs under 50g if you're using UCAN? One serving of UCAN has 28-30g of Carbs. I get that these are "good carbs" and even better than good carbs they're super carbs… but are you simply excluding these from your carb counts?
Thanks again!
-Brad
Brad, you may be overwhelming the poor guy with so many questions.
Some easy ones —
Ketosis is the process in which the body creates ketone bodies to utilize fat as a source of energy, rather than relying entirely on blood sugar. Your body truly burns fat for energy, in other words. There is always some of this going on at a low level, but being “in ketosis” means that it’s happening at a high rate througout the day. Peter has said that you’re in ketosis if a blood meter gives you a ketone reading (beta-hydroxybutyrate levels) of between about 0.5 and 3.0 mM.
See Peter’s Ketosis post, which also speaks to health concerns (or lack thereof)…
https://eatingacademy.com/nutrition/is-ketosis-dangerous
Yes you can determine if you are in ketosis youself. Peter indicates that he uses a blood glucose & ketone meter, like diabetics use, wherein you prick youself in the finger and analyze the drop of blood for either glucose or ketones (there are also urine sticks such as Ketostix, but they are said not to be as reliable).
If you look at Peter’s Books and Tools tab:
https://eatingacademy.com/books-and-tools
…scroll through that, and you see a bullet point about a ketone/glucose meter he uses, the Abbott Precision Xtra. In the comments someone also mentions a similar product, Novamax Plus. You can find these on Amazon, etc. (Very cheap).
“Ketogenic” refers to the type of diet that enables you to enter into and stay in ketosis. Someone in ketosis is necessarily eating a ketogenic diet, or they wouldn’t be in ketosis. Kind of hard to do, you must severely restrict carbs (some say less than 50g a day, likely even less than that), and the tricky thing is you must ALSO limit protein, as too much protein also prevents ketosis. You necessarily get the majority of calories from fat.
Peter, love your site. Much like you, I’ve been eating very low carb for quite a while now. I’m concerned that this is inducing some level of hypothyroidism, as my free T3 values have been quite low over the last year and a half. My concern is that as a result of this, my LDL and total cholesterol values have gone up quite a bit (I do know all about the different types of lipoproteins, tests, etc., just simplifying here). I take the same amount of fish oil as you. And last year, while I was taking niacin, my HDL got up to 95; but I stopped the niacin for a while, and my profile worsened.
So I guess the question is, is the low carb eating negatively impacting my thyroid/cholesterol profile, or could it be that my ratio of protein to fat is too high? Any opinion?
Too much going on here for me to guess or speculate without knowing a lot more.
Your diet is not for people who react to salt is it? I’m sure you know a lot of about health and far more than I, but I would bloat up badly on cheese and salami and would look and feel horrible. I notice with the comments here if there is “too much going on” you decline to comment. therefore your personal diet is of little value to anyone else.
Really? All this work just for me, huh? Too bad I’m the only one who can benefit from this. Sorry for the sarcasm, but if this is what you think, you’ve missed the boat. Who said you need to eat cheese and salami just because I did during a week when I happened to record what I ate for readers?
Peter:
I want to add that my partner and I are doing amazingly well on a ketogenic diet – he is 70 and I am 59 and we can bike rings around much younger cyclists. As I said in my other post, my diet is very much like yours in smaller quantities. I just had brunch (after a 1.5 hour bike ride with no breakfast except for a cup of coffee with heavy cream) of 1 piece of bacon, 2 eggs fried in the bacon fat with a pat of butter and some cheddar, and a cup of homemade beef broth. I won’t eat again until dinner which will be porterhouse steaks, asparagus in olive oil, and a salad with homemade dressing. I am never hungry and have amazing health and energy for someone with a horrendous family history of insulin-resistance and metabolic syndrome-related health problems.
Wonderful to hear.
Peter:
If you happen to get this comment/question:
My daily diet is much like yours (though many fewer calories). I am a 59-year-old female who has been eating this way for 12 years. The past 5 years, I have been cycling, increasing my miles and speed each season. I am registered for a 6-day ride across my state and I’m really concerned about how finding appropriate food out in the rural areas of this state. This is an organized ride with communities providing the meals, and I fear that high-carb food will be the norm. Our luggage (limited to 2 40-pound bags max) is transported in large trucks and the weather will be very hot, so bringing food along is problematic. Any ideas on what I can take along that is non-perishable and easily portable for emergencies? I don’t ever eat during a ride, so that isn’t an issue. I just want to have something along in case the meal options aren’t suitable.
I corresponded with Steve Phinney about this last summer, and he had some ideas that didn’t work all that well so I’m asking you in case you have better ideas.
Thanks.
Hmmm. In such situations, I carry some of my own food (e.g., pre-packaged cream cheese, nuts, oils, super starch), and just rely on being very picky about what I eat from what is being provided. If you can at least get some eggs for breakfast, you should be ok.
Will the cream cheese do OK unrefrigerated in a hot truck for 6 days?
Not sure about that…I would try an experiment before the trip with the same conditions and see if it lasts. For me, it easily lasts a few days at room temp, but I’ve never subjected it to those conditions. Another option to buy some really high quality pemmican, carry your own coconut oil, coconut butter, nuts, etc. All of that stuff will easily be preserved.
You might try making pemmican. It is mostly fat and keeps very well.
Great article. What kind of salami? Applegate? Trying to find passtured salami.
thanks
I generally go with an organic variant from whole foods. Mostly just looking to avoid the added sugar and abx.
Thanks!
Peter, I believe you said that you had to keep your protein consumption at around 150 grams per day or below in order to stay in ketosis. How does protein interfere with the development or maintenance of ketosis? Is it metabolized to glycogen or something?
Correct, gluconeogensis.
OK let me sneak in a question here that’s been bothering me. I’ve read that ingestion of protein stimulates insulin release – just not to the degree & with the glycemic impact that carbs do. (Though I believe i recall in Reaven’s ‘Syndrome X’ book that he summarily dismissed dietary protein because it stimulates insulin).
Question: does protein itself *directly* cause insulin release, or is it only when excess protein is converted into glucose that the body reacts to the glucose with insulin release? Thanks!
Both. In the case of the latter, it take place as hepatic glycogen is converted to glucose and exported.
What about those of us that are lactose intolerant?
What are some alternatives?
To butt in with anecdotal stuff Jeff, have you gone very-low-carb yet and made sure you’re still lactose intolerant? I’d thought I was increasingly lactose intolerant for nigh on 15 years. Spent a fortune on Lactaid. Then when I went low-carb/high-fat I almost immediately realized that, whatever else had been going on, I wasn’t lactose intolerant. In the relative absence of carbs, I can eat cheese, whipping cream, sour cream, butter, yogurt, and there is nothing like lactose intolerance in my life. I even drank a glass of regular milk to check this.
To requote something I saw from another low-carber, I never even fart anymore…
Is there some way you could show what your wife eats on this diet? I am a highly active marathon woman and would like to see what a woman would eat like on this if possible? Would it still be 4000 calories like you? I run 20 miles on weekends and about 10 miles a day.
Yes, I’ll do that at some point. She eats less than me, both in absolute quantities and in fat intake.