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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. 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. 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. 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.
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). I go to great lengths to avoid sugar which, unfortunately, shows up in virtually every highly processed food. 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 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.
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.). 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. 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. The second type, however, is much more subtle: you go for the chocolate cupboard without actually knowing why.
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. Starving the pathogenic flora with intermittent fasting is another good technique that helped me a lot.
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.
The whole story of plant vs animal ingestion is complex and far beyond the realm or reason of proponents on either side. And if humans are naturally carnivores (or omnivores) for perfect health, should we be deprived of our needs? In reply to Scott C Irwin – probably no longer relevant to you since your post is over a year old. I was under the impression that the brain, bone marrow, and liver can oxidize carbs only for the production of ATP? 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. I just wanted to thank you for making the two much needed items clear (fat and sodium) in your post above. 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!)? There are several layers to this and, frankly, there are some things we can’t fully explain – I’ll always acknowledge this. Take a look again at the figure below, which shows you how many calories folks are consuming on each diet and, more importantly, where those calories come from.
You’ll note that people on these diets, including the strictest low-fat high-carb diets, significantly reduce their total amount of carbohydrates (therefore reducing the amount of insulin they secrete). The reason, I believe, most of these diets have some efficacy – at least in the short-term – is that they all reduce sugar and highly refined carbohydrate intake, either explicitly or implicitly. Someone made a great point in response to my post on why fruits and vegetables are not actually necessary for good health.
I know a lot of people who eat this way and, I’ve got to say, these folks do not eat a lot of sugar or a lot of highly refined carbohydrates. While I do plan to write an entire post on this topic of what one can and cannot conclude from an experiment, I do want to at least make the point here: The biggest single problem with nutrition “science” is that cause and effect are rarely linked correctly. I am, to be clear, not implying this is the case for this trial, but I want you to understand why it’s important to read papers fully.
This trial, The Lifestyle Heart Trial, prospectively randomized a group of not-so-healthy patients into two treatment groups: the control group and the experimental group (or what we’d call the “treatment” or “intervention” group). First off, and perhaps most importantly from the standpoint of drawing conclusions, compliance was reported to be excellent and the differences between the groups were statistically significant on every metric, except total average caloric intake. Take a moment to look over the rest of the table (or just skip reading it since I’m going to keep talking about it anyway).
Though not shown in this table, the experimental group also reported less chest pain severity (though chest pain frequency and duration were not statistically different). Let’s take a leap of faith and hypothesize that the dietary intervention (rather than, say, the social support) had the greatest impact on the measured parameters in the subjects.  It’s certainly the most likely factor in my mind.  But what, exactly, can I conclude?
People don’t like to be hungry, and if they are reducing their caloric intake by reducing fat intake, they seldom find themselves satiated. Semi-starvation reduces basal metabolic rate, so your body actually adjusts to the “new” norm and slows down its rate of mobilizing internal fat stores. I argue that reduction of fat intake has nothing to do with it and that the reduction of total calories has a transient effect. It’s *really* tough to study this stuff properly, especially compared to studying things blood pressure lowering pills, which are complex in their own right, but MUCH easier to control in a study.
A nutrition department of a university accepts funds from a company that makes confectionery. Do you think the Academy’s supporters want to hear that if you eliminate their products you will no longer need to rely on the products provided by the biggest supporters of the Diabetic Association? Pretty much solely because of their report, Suzuki was forced to eventually withdraw the Samurai from production in the US although they later won the lawsuit that was filed as a result of the forged report by showing videos from the actual testing of the car conducted by CR.
Ironically, the fact that CR had to admit it was faked somehow wasn’t plastered all over their magazines and the front pages of a bunch of newspapers. At that point, everything they publish became suspect and may as well line a birdcage somewhere.
Peter, I have a coworker who has recently lost 80lbs over the course of a year on weight watchers. Looking forward to your next post, and of course people's comments for the current one!


I will discuss all of this in great detail, hopefully in the coming month, when I do a post on PUFA (polyunsaturated fatty acids).
Anyway, it’s nice to discover someone who takes the Taubes viewpoint on things, and also takes the time to actually post online about it with some frequency, so thanks! Oh absolutely, I was mostly referring to the fact that most of the excess carbs we eat are converted to palmitic acid, which is a SFA. There was an (1) average protein, low fat group (65% CHO), (2) High protein, low fat group , (3) Average protein, high fat, and (4) high protein, high fat (35% CHO).
Thanks very much, Bob, both for the kind comments and for sharing the other data with folks. We’ve heard from a lot of you that your goal for the year of 2014, is to adopt a 100% plant based diet, part vegan, or just truly focus on including more veggies in your daily meals.
Nikki and I made a plethora of mistakes on our journey to living a plant based lifestyle and our goal is to guide and help you thrive and make things a little smoother by sharing what we have learned. Fortunately, there’s an easy trick to increasing nonheme iron absorbency: consume it with vitamin C. Primarily, I’d say beans and lentils – black beans, chickpeas, pinto beans, kidney beans, you name it.
Kale and mushrooms can also be good sources of iron, as can whole-wheat flour, oats, rye flour, and everyone’s favorite quinoa. Get more actionable steps for living a healthy plant-based lifestyle straight to your inbox:Signup now and receive an email once I publish new content. Good science, bad interpretationGravity and insulin: the dynamic duoIf low carb eating is so effective, why are people still overweight? I have a lot of diabetes in my family, in fact my sister died at the age of 15 due to ketoacidosis. Have you thought about the ecological impacts of this dietary shift and what they might be if large numbers of people took this up? Low carb allows you to recover the liver, pancreas, adipocytes, mitochondria, etc, and this takes a few weeks to kick in and stabilize completely. Feed animals need lesser lands, scrub lands that they brows from and help enrich naturally- think bison (buffalo) on the prairies. Our ancient brethren with population success ran through the wild species in their lands, and agriculture had to come about for their survival.
Logic taken to extreme would then suggest we also condemn wild carnivores for their behaviour. 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?
Thank you so much for documenting your experiences and taking the time to answer questions! That said, many of the successes (at least weight-wise, though hopefully by now you realize there is much more to health than just body composition) of popular diets can be explained by a few simple observations.
You can argue that those who are overweight probably consume an even greater amount of carbohydrates. Even the Ornish diet, which is the most restrictive diet with respect to fat and most liberal with respect to carbohydrates, still reduces carbohydrate intake by about 40% from what people were likely eating pre-diet. No one on the Ornish Diet or Jenny Craig Diet is eating candy bars and potato chips, at least not if they are adhering to it. The point was, essentially, that telling people to eat 5-6 servings per day of fruits and vegetables can hopefully drive a beneficial substitution effect. I have no intention of engaging in a battle with proponents of plant-based eating or no-saturated-fat diets. Stated another way, it’s one thing to observe an outcome, but it’s quite another to conclude the actual cause of that outcome.
In other words, for every intended difference between the groups a difference existed, except that on average they ate the same number of calories (though obviously from very different sources), which was not intended to be different as both groups were permitted to eat ad libitum – meaning as much as they wanted.
Ornish’s study?  I think the reduction in sugar and simple carbohydrates played the largest single role in the improvements experienced by the experimental group, but I can’t prove it from this study any more than one can prove a low-fat vegetarian diet is the “best” diet.  We can only conclude that it’s better than eating Twinkies and potato chips which, admittedly, is a good thing to know. And, the majority of the benefit folks receive comes from the reduction of sugars and highly refined carbohydrates. Case in point…they recently reported that olive oil is not good for you because it does not contain omega 6. 3, has a good point about some plans (including WW) having the advantage of group support, which I think is a very major confounder. It is wonderful to watch these people glow once they have found some sort of solution to their weight problem. One of my favorite things to say to people who are scared of saturated fat is that even on an entirely plant based diet, (ala Ornish Diet), if they are restricting their caloric intake, their bodies will be running on the saturated (animal) fat that they have stored on themselves.
For example the degree of unsaturated fatty acids in our membrane bilayer probably plays a role in our insulin sensitivity, just as one example. With that said there are several nutrients that meat eaters get in abundance that vegans and vegetarians need to be more mindful of. The body absorbs heme, which comes from meat, better than nonheme, which comes from vegetable sources.
Conversely, try to avoid tea with your iron sources because the tannins can inhibit absorption. Soybeans are particularly high in iron, but they also contain amino acids that inhibit its absorption. Although people often associate spinach with iron, it’s actually not a great choice because it contains oxalic acid, which limits iron absorption. His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things. 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? 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. In the meantime you will suffer from hiperinsulinism which will prompt hypoglycemia attacks. This happened to me (and still happens once in a while) long after the metabolic problems were resolved.
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.
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. But for the purpose of simplicity, let’s assume even the folks who go on these diets are consuming the national average of approximately 450 grams of carbohydrate per day (in compliance with governmental recommendations, as a percent of overall intake). If you tell someone who eats Twinkies, potato chips, and candy bars all day to eat more fruit (and they do), you’ve almost guaranteed an improvement in their health if they eat bananas and apples instead of the aforementioned junk food.


I’m reasonably confident that the proponents of these diets are good people who really want to help others and have nothing but the best intentions. Ornish was the principle investigator on a trial published in the journal The Lancet in 1990.
In other words, there were not enough subjects in the study to determine a difference in these “hard” outcomes, so we can’t make a conclusion about such events, only the changes in “soft” outcomes. Eg, the criticism of the Ornish Lifestyle Heart Trial is excellent (and I LOVED the kitten-stroking quip), and really could and should have stood alone.
After short diologue with her on the particulars of her daily intake I quickly realized her consumption of carbohydrate was significantly reduced and eliminated almost all fructose.
With this in mind, I’d like to spend some time looking at these nutrients and how to work them into your animal free diet.
However, if you ferment the beans, the bioavailability goes up, so if you’re feeling soyish, look to tempeh, miso, and natto. Over time, I’ll share it here and there, but what I eat is not at all the focus of this blog. 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? 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 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.
But you’ll be strengthening the good kind of flora and in the process restoring you small and large intestine mucosa.
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). For some reason I am fine with coconut milk contained within foods but not virgin coconut oil. While recommending a LCHF diet, he distinguishes between fat types and limits beef, cheese and heavy cream to 1-2 servings per week.
Popularity, of course, was determined by a number of factors, including compliance with current government recommendations (sorry Atkins), number of people who have tried the diet, and reported success on the diets.
That doesn’t mean bananas and apples are “good for you” – it just means they are less “bad for you.” Here’s the kicker, though. But that doesn’t mean we can or should overlook the errors being made in drawing their conclusions. I’m not discounting soft outcomes, only pointing out the distinction for folks not familiar with them. They never factor in that the chicken was breaded or that when someone ate steak or fish they had a large amount of bread of potatoes along with it. Since the bulk of your iron is stored in red blood cells, women with heavy periods experience significant iron loss, about 30-45mg a month, so they typically want to eat a little more iron during these times. My question is, since I do not have diabetes and am trying to prevent diabetes, will entering into ketosis help or harm me? I’m all for optimizing individual health, but want to do that in a socially and ecologically responsible way.
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.
I'd love your thoughts on both of these topics as your blog posts and diet show you have a differing opinion. We’re led to believe that the reason such folks get leaner and more healthy is because they are eating more fruits or more vegetables or more grains or more [fill-in-the-blank], rather than because they eliminated the most egregious offenders from their diet.
Ornish personally, and I can only assume that he is a profoundly caring physician who has dedicated his life to helping people live better lives. But as always, I STRONGLY encourage folks with access (or folks who are willing to purchase it) to read the paper in its entirety. 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 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. For people who don’t want to read the study completely, or who may not have much experience reading clinical papers, I want to devote some time to digging into this paper.
The end conclusion is the whole thing must be bad and therefore needs to be reduced or outright expunged from the diet.
I recall hearing Gary talking about his discussion with a participant from the Biggest loser on Larry King and the rapant weight gain after the show. 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. It’s hard to tell if this change was statistically significant by inspection, so you glance at the p-value which tells you it was not.
That is one big difference I’ve noticed between studies cited by writers who want to condemn the entire diet consumed by Americans vs those who look at it with a more in depth eye and realize that certain components are the problem not the whole diet across the board. Why did the people in the China Study who ate more plants do better than those who ate more animals (assuming they did)?
Well, for starters, reading abstracts, hearing CNN headlines, or reading about studies in the NY Times doesn’t actually give you enough information to really understand if the results are applicable to you. Parenthetically, if you actually want the answer to this question, beyond my peripheral address, below, please read Denise Minger’s categorically brilliant analysis of the study. Beyond this reason, and let me be uncharacteristically blunt, just because a study is published in a medical journal it does not imply that is worth the paper it is printed on. 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”?? Steve Rosenberg, once told me that a great number of published studies are never again cited (I forget the exact number, but it was staggering, over 50%). Translation: whatever they published was of such little value that no one ever made reference to it again. The thing is, it is possible to eliminate wheat and still eat way too many carbs (can we say ice cream?). I’m now happily in ketosis, and the best part is, I know the WHY of weight loss now, how totally liberating and hope giving.



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