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7 Things Everyone Should Know about Low-Carb Diets

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Laura Schoenfeld wrote a guest post for my blog called “Is a Low-Carb Diet Ruining Your Health.” Perhaps not surprisingly, it caused quite a stir. For reasons I don’t fully understand, some people identify so strongly with how many carbohydrates they eat that they take offense when a suggestion is made that low-carb diets may not be appropriate for everyone, in all circumstances

In these circles low-carb diets have become dogma (i.e. a principle or set of principles laid down by an authority as incontrovertibly true). Followers of this strange religious sect insist that everyone should be on low-carb or even ketogenic diets; that all carbohydrates, regardless of their source, are “toxic”; that most traditional hunter-gatherer (e.g. Paleolithic) societies followed a low-carb diet; and, similarly, that nutritional ketosis—which is only achievable with a very high-fat, low-carb, and low-protein diet—is our default and optimal physiological state. 

Cut through the confusion and hype and learn what research can tell us about low-carb diets. #lowcarbdiets #myths #truths

On the other hand, I’ve also observed somewhat of a backlash against low-carb diets occurring in the blogosphere of late. While I agree with many of the potential issues that have been raised about low-carb diets, and think it’s important to discuss them, I also feel it’s important not to lose sight of the fact that low-carb diets can be very effective therapeutic tools for certain conditions and in certain situations. 

With this in mind, here are 7 things I think everyone should know about low-carb diets.

#1: Paleo Does Not Equal Low-Carb, and Very Low-Carb/Ketogenic Diets Are Not Our “Default” Nutritional State, as Some Have Claimed.

Some low-carb advocates have claimed that most traditional hunter-gatherer societies consumed diets that were very low in carbohydrates. I’ve even seem some suggestions that nutritional ketosis was “the norm” for these cultures.

These claims are false.

The majority of studies have shown that traditional hunter-gatherer (HG) societies typically consume between 30–40% of their total calories from carbohydrate, though the range can vary between 3–50% depending on the population studied and the latitude at which they live. (2, 3) The only HG societies observed to eat fewer than 20% of calories as carbohydrate were those living at latitudes quite distant from the equator, often in marginalized environments where fruits, vegetables, starches, and honey were not readily available.

Yet even these cultures—such as the traditional Inuit—often made an effort to obtain carbohydrates from berries, corms, nuts, seaweed, and tubers whenever they could, as Richard Nikoley has recently detailed on his blogWhat’s more, contrary to popular claims, studies have shown that it’s unlikely the Inuit spent much time—if any—in nutritional ketosis. Their high protein intake would have prevented ketosis from occurring. (5)

So, while ancestral diets were certainly lower in carbohydrate than the diet currently recommended by the USDA (45–65% of calories), they were not typically “very low” in carbohydrate (<15% of calories). With virtually no historical examples of human beings following ketogenic diets for any significant length of time, and few examples of very low-carb diets, it’s difficult to imagine how these diets could be considered our “default” nutritional state or the optimal approach for most people.

#2: Low-Carb Diets Are Incredibly Effective in Certain Situations

Lest low-carb advocates think that I am anti-low-carb, I’d like to reiterate that both the research and my clinical experience suggest that low-carb diets can be incredibly effective therapeutic tools for certain conditions.

These conditions include (but aren’t limited to):

  • Overweight and obesity
  • High blood sugar, metabolic syndrome, diabetes (both type 1 & type 2)
  • Traumatic brain injury
  • Epilepsy
  • Parkinson’s disease
  • Alzheimer’s disease
  • Other neurological conditions
  • PCOS

I have personally witnessed some remarkable transformations using ketogenic diets therapeutically in my practice. I recall an 84 year-old woman who came to see me complaining of dementia and early-onset Alzheimer’s. She was losing her memory and cognitive abilities at an alarming rate. After just two weeks on a ketogenic diet, this progression not only halted, it reversed: her memory returned, her mind was sharper, and she was far less confused and disoriented. Her family (and her doctor) were stunned, and could hardly believe the changes they were seeing.

Yet as impressive as very low-carb (VLC) and ketogenic diets can be in certain situations, that does not mean that these diets may not have some undesirable side effects over the long term—some of which we’re only beginning to understand. For example, as I discussed with Jeff Leach from the American Gut project in a recent podcast, some preliminary research suggests that long-term ketogenic/VLC diets may cause adverse changes to the gut microbiota. (6) In addition, a new paper soon to be published in the journal Cell by two Stanford microbiologists indicates that diets low in “microbiota-accessible carbohydrates (MACs)” contribute to modern, inflammatory disease. (7)

The phrase “microbiota-accessible carbohydrates” refers to the various fibers found in fruits, vegetables, starchy plants, nuts, seeds, legumes, and other foods that are poorly absorbed by us, but can be utilized as a food source by our intestinal bacteria. It’s worth noting that many of these fibers are found in foods with moderate to high carbohydrate content—foods that would typically be excluded on very low-carb diets. 

It’s important to note, however, that the beneficial bacteria-starving effects of ketogenic/VLC diets can be at least partially offset by consuming non-digestible, fermentable fibers like resistant starch and non-starch polysaccharides that don’t count toward daily carbohydrate intake. This is something I recommend to all of my patients following low-carb diets)

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#3: The Fact That Ketogenic/Vlc Diets Work Therapeutically for Certain Conditions Does Not Make Them Appropriate in All Circumstances, for All People

This assumption is a basic failure of logic, but it’s remarkable to see how often it happens. A person has a life-changing experience with a VLC diet, so they assume that their friend will have a similar experience. Or a clinician that works primarily with people suffering from neurological conditions has great success with ketogenic diets, and then makes the assumption that all people (regardless of their health complaints) will benefit from them. 

This is akin to saying that since people with hemochromatosis (a genetic condition that causes iron overload) need to limit their iron intake, everyone should consume foods that are low in iron. 

The belief that “everyone” will benefit from one particular dietary approach—no matter what it is—ignores the important differences that determine what is optimal for each person. These include variations in genes, gene expression, the microbiome, health status, activity levels, geography (e.g. latitude and climate), and more.

When it comes to diet, there is no one-size-fits-all approach

#4: Some People Do Better with Low-Carb Diets Than Others

If you understand #3 above, then this should not come as a surprise. 

Some people may thrive on a long-term, low-carb diet. I have patients and even a family member in this category. And maybe you’re one of them too. But that doesn’t mean everyone will have this experience. If you talk to practicing clinicians who work with patients on a daily basis, or spend any amount of time in internet forums or the comments sections of nutrition blogs, you’ll find numerous reports from people who either experienced no benefit from or were even harmed by following a low-carb diet.

What blows my mind is that the “low-carb zealots” seem completely incapable of accepting these reports at face value. Instead, they’ll argue that anyone who doesn’t succeed with low-carb is either doing it wrong, cheating, or somehow imagining their symptoms.

What’s the more likely explanation here? That everyone who gets worse with a low-carb diet is either incapable of following directions, weak-willed, or delusional? Or that a low-carb diet simply does not work for everyone? You be the judge. 

#5: If a Low-Carb Diet Works as a Therapy in a Given Condition, That Doesn’t Mean Too Many Carbs Caused That Condition in the First Place

This is another error of logic that is often made. Here’s an example:

“A low-carb diet is effective for treating type 2 diabetes. Therefore, eating too many carbohydrates led to this condition in the first place.”

This is like saying:

  • Restricting iron is helpful in hemochromatosis patients. Therefore, consuming too much iron is what caused hemochromatosis in the first place.
  • A low-FODMAP diet helps patients with Irritable Bowel Syndrome (IBS). Therefore, eating FODMAPs caused IBS in the first place.
  • A low-histamine diet alleviates the symptoms of histamine intolerance. Therefore, histamine intolerance is caused by eating too many histamine containing foods.

Or, more ridiculously, since wearing a cast on your arm will help the broken bone heal, the reason you broke your arm in the first place is because you weren’t wearing a cast. 

It’s true that VLC/ketogenic diets are effective for improving the metabolic markers associated with type 2 diabetes. But that doesn’t mean that eating too many carbohydrates led to the condition in the first place. It is certainly possible (and indeed likely) that eating too many refined and processed carbohydrates, in the form of flour and sugar, contributes to diabetes. But I have not seen a single study suggesting that eating whole-food carbohydrates (e.g. fruit or starchy plants) leads to diabetes or other metabolic problems. On the contrary, reviews of prospective studies looking at the relationship between fruit intake and diabetes have found that those with the highest intake of fruit had the lowest incidence of diabetes. (8, 9)

It is also worth pointing out that virtually all studies performed so far showing benefits of the Paleo diet in conditions like type 2 diabetes and obesity have used moderate carbohydrate (not low or very-low carb) versions of the Paleo diet.

#6: If a Low-Carb Diet Is an Effective Therapy for a Condition, That Doesn’t Mean It’s the Only Therapy for That Condition

There’s little doubt, as I said above in #2, that low-carb diets can be remarkably effective in certain situations. For example, there are numerous studies showing that low-carb and ketogenic diets can help with weight loss and metabolic problems. (10

However, that doesn’t mean it’s not possible to lose weight and reset your metabolism through other means. Studies have also shown that calorie-restricted diets, protein-sparing modified fasts, and even low-fat diets can also be effective treatments. (11, 12, 13)  

This means that it’s not necessarily true, for example, that everyone with type 2 diabetes should be on a low-carb diet. They may be able to reverse their condition by following a high-protein, moderate-carbohydrate, moderate-fat diet (such as the Paleo diet with 32% of calories from carbohydrate in this study), or any of the methods I just mentioned. 

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#7: Whole-Food Carbohydrates Do Not Affect the Body in the Same Way as Processed and Refined Carbohydrates

This should be obvious to anyone with a basic understanding of nutrition and human physiology, so I’m amazed at how often I see experts talk about all carbohydrates as if they’re the same. 

In #1 above, I referenced studies indicating that most hunter-gatherer societies consumed about 30–40% of calories from carbohydrate. These carbohydrates came from starchy tubers and plants, whole fruit, and in some cases, honey. We also have evidence of specific ancestral populations—such as the Kitava, traditional Okinawans, and Tukisenta—that consumed between 70–95% of calories from whole-food carbohydrate. (14

Yet despite this liberal consumption of carbohydrates, these people were remarkably lean, fit, and free of chronic, inflammatory diseases like diabetes, cardiovascular disease, and neurological conditions. (15) If carbohydrates cause these conditions, regardless of their source, why don’t we see such conditions in these groups?

What we do see is that these cultures acquire modern disease when they adopt a modern diet and lifestyle, complete with the highly processed and refined foods that characterize it. 

When it comes to macronutrients, quality is much more important than quantity for most people. 

Final Thoughts

I hope this helps to clarify some of the confusion that has surrounded this issue. Low-carb diets are an effective therapeutic tool in certain situations and one that I (and many other clinicians) use in my clinical practice. That said, it’s equally true that low-carb—and especially VLC and ketogenic—diets are not appropriate in all circumstances, and they are certainly not our “default” or optimal nutritional state. 

Sadly, it doesn’t seem to matter how much scientific evidence, clinical experience, and common sense is brought to bear on this question: those who preach and follow low-carb dogma will not be swayed. Ah, well. As they say: “You can’t fight faith with facts.”

455 Comments

Join the conversation

  1. I wanted VLC or at least low carb to work for me because the mental clarity and energy level can’t be beat. But I cannot sleep enough on it. I’ve tweaked and tweaked and nothing works, but the moment I bring my carbs up near the 125-150 grams range, I sleep better than I ever have. There is just nothing else that works.
    So while I lose just a bit of the mental clarity and high energy, the trade off is worth it. I had to accept that I also, without intending too, became a little dogmatic about it. Otherwise, how could a simple tweak bother me so much?
    I came to paleo through the work of scientist who study hunter gathers and ancient humans. I never heard of keto until I started reading about dietary strategies. Chris is right here that the assumption that early humans were all or even mostly VLC is wrong. So if this is your logic for following a VLC diet than it is about as true as vegan being the original human diet. Only small groups ever did either and never full time.
    But, absolutely follow the diet that truly works for your body. Just be willing to change it if your idea of what that should be doesn’t quite work out!

    • If you had more mental clarity then why sacrifice that for a number? Or were you tired. I get less sleep because I don’t need it, but that’s me. Seems to me that the hours of sleep required are based on mainly eating SAD and trying to cure a sick body and mind.

  2. I am currently cyclical Ketogenic for autoimmune thyroid, mthfr, ebv, t2d. I am finishing up at 16 weeks. I have run blood at the 12 week mark and will continue every 3 months to monitor progress. I currently jump carbs every 3 days to 50-80 net carbs (usually involves a piece of fruit prior to am work out, and a 1/2 sweet potato with evening meal) While my gut function is immensely improved, absorption is much better which helps in the overall picture, iron stores and estrogen dominence have been hit. Hair loss in women is very common and usually there is a misguided approach “oh hey, you must not be getting enough protein, increase your fat, maybe you need zinc” when really if a blood test was run, given that eggs, coffee, exercise, magnesium…all pull on iron…they might be surprised. For women who are already struggling with hormonal imbalances particularly estrogen dominence, burning fat as fuel releases more estrogen so DIIM maybe a necessary tool. Menstrual cycles are another issue very common to this diet, and carbs are needed to produce the cycle

    • Hair Loss in women should not be common. Women and men now undereat severely on a day in and day out basis for years on top of years. That right there alone will cause issues with hormones. You must evaluate your past to make improvements for your future. Keeping your calories above your maintenance threshold of what your body needs daily is key. Other main points, stop over-exercising (do only 2-3 days a week), eat quality whole foods, eat 2 lbs of veggies and get a balance of fats, proteins, and carbs in your diet daily. Days you workout, lower the protein and increase your carbs and fats to have your body use the protein effectively, repair faster, and avoid adrenal fatigue/thyroid issues

  3. I came to this site after visiting the Intensive Dietary Management site looking for answers as to why I’ve been waking up at 2:30-3:00am most mornings since adopting a WOE that is VLCHF and doing IF (23:1; 7xper week) to lose weight and avoid T2D. I felt that these 2 sites would give me some understanding as to what may be going on with my ‘sudden’ and long lasting lack of sleep. I wouldn’t mind so much if I felt rested and rejuvenated after 4-4.5 hrs of sleep, but I don’t. I need 6.5-7hrs most nights to feel well.
    I found a comment that gave me some good food for thought regarding sleep, but felt compelled to read through the other comments, as well. I’m so glad I did. I was hell bent on spending the rest of my life striving to eat as low carb as possible. In fact, some commenters on other sites almost had me convinced to try Zero Carb. I still feel that VLC and Zero Carb have their place for many and see no reason why they are not sound plans for different reasons; but in light of my sleep deprivation of late, I will be adding a modest amount of complex carbs in the form of some extra veg to my diet to see if that will work to increase the duration of sleep.
    But before leaving Chris’s site, I wanted to thank certain commenters for opening my eyes to other possibilities in the area of carb consumption. My goal is to be as healthy and disease free as possible while maintaining a healthy weight. This is the same goal as it is for the majority of people who visit these sites. As most know, however, the opinions, blended with ‘facts’ and wonderful anecdotal evidence, are legion. It is mind boggling how diverse the experiences and beliefs are of those who refuse to simply toe the line and eat the SAD diet (as many special interests would have us do).
    I can’t start reciting the names of those whose comments struck me as incredibly intelligent, balanced and reasonable, because I would surely leave someone out and that would be worse than not thanking each person individually. I think you know who you are and I just want to thank you for your thoughtful and reasoned responses. This site and any books on the subject could just as easily be yours and they have meant as much to me as the great resources that we’ve all been lucky enough to read. I’m very tired and hope I didn’t ramble too long or sound too disoriented, but I want to thank you from the bottom of my heart for taking the time to give of your vast knowledge and insights.

    • Chris is right here, the notion of one size fits all is illogical .
      The China Study which is the most comprehensive nutritional study ever done really sent a strong message home that meat & cheese is not the answer to good health. Breast cancer is sometimes called the “rich woman’s disease” because only women who can afford to eat a western diet high in red meat and dairy get breast cancer. When I first read that I wondered if that was true. The best diet one is where you get all the things the body needs. Such as minerals that are now depleted from our soil, so we need a mineral supplement where are grandparent generation did with flaxseed oil and CoQ10 these combined provide all the vitamins, minerals, omega’s and probiotics I need . We alkalize twice a day, our basis are covered. We take our health seriously our doctor is specialized in longevity and health . He is slim looks 25, but looks like he is in his forties he is healthy vegetarian glowing with health. My doctor thinks, inadequate sleep and having high level stress and bad diet is the killer

      • The China study is riddles with problems. If you love reading about diet research, I recommend you look into it. Many conclusions from that study have been shown to be weak and often misleading.

      • The China study has been debunked as manipulated and cherry picked data. Additional Co-enzyme 10 can also have adverse effects.

      • The China Study made the giant assumption that a diet of meat and dairy is the same as those eating casein, milk protein, most people eating a paleo diet would be avoiding this almost completely as they avoid dairy except butter fat (Ghee) and eggs. Correlating meat in this study just seems a downright failure, Check out the 6 countries study too which put forth the idea of low saturated fat, the research was pulled from 20 countries which only showed that trend when 14 were removed. This type of bad science lead to people throwing out healthy fats for refined carbohydrates. Having eaten vegan i suspect you could actually eat really healthy if you added some wild meat, animal organs, and genuinely replaced the huge amount of meat with vegetables rather than processed vegan meat like products. Personally, i found myself eating a lot of tofu, seitan, and the like as I enjoy cooking and just don’t enjoy a life of not being able to cook and

  4. hmm, so using your logic it is always true: if you reduce the stress and you start feeling better, the stress did not cause you to feel bad in the first place? So, if reversing poor diet helps a condition, it does not mean that that kind of a diet cause it in the first place???
    I this the broken bone analogy is fine, but carbs and food analogy used in the same way is misleading.
    I don’t think all carbs are bad, but it is obvious that eating certain types of carbs CAN cause a condition and some people are just better off not eating carbs, especially if their level of activity does not support their utilization in the appropriate manner. When you are physically active you use even good carbs differently. So, if diabetic
    So, I think your article provides a backwards sweeping statement.

  5. I’ve got PCOS and I used to consume far too much sugar.
    I love being on low carb diet, it’s over 2 years now (on and off).
    I lost weight, my menstrual cycles are more regular and other symptoms got better too (like excess hair)! I also use progesterone cream to help regulate my hormones.
    From beginning of 2017 I stop consuming sugar as well. So much better! No more mood-swings, no more cravings, no more hunger 🙂

  6. Congratulations! There are equilibrium in your vision about the facts! I experimented low carb but I discovered that I need carb to my full health.

    • you didn’t discover anything, you just didn’t know how to actually pull it off.

  7. I must be the only person here who sleeps better on a low carb diet. I was eating a lot of sweets before, though, so maybe that explains it. I ate pastries, cookies, candy, etc. and drank a lot of sweet tea. I have dropped 14 pounds in 2 weeks. My goal is 40 pounds.

    • I have been gluten free vegetarian for most of my life . I went to meeting one day and there were some gluten free cookies. I was supposed to head the topic of discussion. Well, I ate three cookies, I felt a little dizzy, disoriented, sick, and tired. … I misplaced my notes, so I just winged it . That got my attention, I suspected a seriously allergy to sugar and now it was shown to be true. I had about 10 pounds I could stand to lose so I went on zero carbs diet. It was so hard since. I dislike the smell and taste of meat, but I forced myself to eat chicken/turkey. Then I left the meat behind and just ate eggs with cheese this was very easy to eat and found a high protein organic zero carb drink that was holistic bent and threw in almond milk and I did that for awhile. Finally, I settled on diet that was the best choice for us since we do yoga, meditation, hiking and are into sustainable living etc… . I settled on Non-GMO organic 80%- 85% raw vegetarian food diet , with two powder products one is for healthy bones and the other products was created by one of my ND’s who is a hormone , anti-aging and longevity expert . She created this amazing organic vitamin packed best tasting powder product ever so I really love drinking that it was so thoughtfully created. I also take a tablespoon of cold pressed of flaxseed daily . I think everyone is different and, what resonates with me on a deeper level was eating food that has a lot of life force, and that is green.

  8. Hi Chris and thank you for this piece of moderation. I am I suppose what many would call a ‘bio hacker’. I have been experimenting with different forms of eating, fasting and exercise now for several years. I came to the VLC after realising the many great benefits of fasting. Intermittent fasting was something I discovered several years ago and has had a hugely positive effect on both my health and lifestyle. Realising that fasting led to low level ketosis I naturally assumed that it was the ketosis that was making me feel so good. This being the case I decided to go on a full blown VLC diet to increase the level of ketones and therefore improve my health even further.
    Well actually no, it didn’t improve, it actually impaired my health. I worked through the ‘induction’ phase in which I expected to feel some of the initial effects of such a radical change. Unfortunately the ‘induction phase’ became my life. I tried changing the foods I was eating, cutting out certain things such a eggs, dairy and nuts, increasing and decreasing levels and types of fats, generally everything I could think of after much research. Ultimately things didn’t improve. I continued to experience the ‘keto rash’, high blood pressure when I have always had great blood pressure previously, brain fog, low energy levels, aching kidneys (I was only eating moderate protein), digestive issues and low mood. The only (known) positive that I gained from the experience was it’s effect on body composition. I was not overweight to begin with but I had always struggled getting those last few pounds off my tummy, with the VLC they just melted off!
    So it would appear that I am one of those people who do not react well to high ketone levels over extended periods. I will continue with intermittent fasting as this has all the benefits but none of the negatives I experienced with full ketosis.

    It’s making me itch just thinking about it haha!

    • I am just curious. How did you figure out it was ketones? Were you measuring your ketone level? Did you increase protein or fat to compensate for the reduced carbohydrates?

      • Hi Don and thanks for your interest. Yes I certainly did measure my ketone levels. I was firstly experimenting with the Ketonix breath analyzer which I backed up by using an On Call blood ketone metre. Just for interest the Ketonix was pretty accurate and over the long term much cheaper to use as it’s a one off purchase as opposed to having to buy expensive test strips regularly. My ketones fluctuated between 1 and 3 mostly. As I said in my post, I maintained a moderate protein intake but no more than 25% of my calorie intake to avoid gluconeogenesis. Fat intake was 70-80% and carbs 5-10%. I had the macros nailed!

    • you think too much and most of it is incorrect, you screwed it up don’t confuse your own useless analysis with being accurate or understanding the body in anyway.

      • You seem so knowledgeable how about you start your own blog and quit intergecting your negativity to this discussion.

      • How about giving some examples of what you mean when you tell someone they “screwed it up” or they are “overthinking” something. Sounds like he was simply telling us about his experiences on low carb vs ketosis. Your comments help no one and are merely annoying when you don’t back up anything you say.

      • Asad- If you truly are a doctor and you use this manner to discuss issues with your patients then I feel very bad for them. What a horrible bedside manner if that be the case.

  9. It was fantastic to read your article! I have struggled with multiple digestive disorders, and have gotten virtually no help from the medical community. I am 60 years old, and in the last 3 years I learned that I have celiac disease. I have had severe IBS-D my entire life – which I knew – but for which I had gotten no help. 3 months ago I was diagnosed with Type-2 diabetes. My weight has gone up and up despite any dieting attempts over the years. After being diagnosed with diabetes, I found information online about the ketogenic diet and have been on it since. I am also eating no gluten, no dairy, and low FODMAP. Adding VLC has been difficult, but now that I am used to my limitations, I am doing well. I have lost 24 pounds, and I keep my blood sugar fairly level. (A little high in the morning – around 120 – and falling all day. Weekly averages of all daily testing is under 110.) I feel much better and have much less belly pain than I was used to. I wonder, though, what are the potential effects of being on the ketogenic diet long term? I’m inclined to stick with it since it seems to be working, and also since there’s Alzheimer’s in my family.

  10. Great article. I’ve been eating keto for about 10 months now–I love it so much! I’m down just over 70 lbs (30 more to go!), and I’ve seen improvements in blood pressure and cholesterol panel. I have reversed my pre-diabetes. I will never ever not eat this way. Keto has put my carb/sugar addiction under control for the first time since childhood. No more secret shameful midnight sugar binges! So freeing to no longer be a slave to my cravings.

  11. hello Chris,
    I am wondering how much of the brain and improved insulin markers of the ketone diet have to do with the higher fat and MCT oils without ketones. I have tried the ketogenic diet and my experience was lots of energy (and no sleep) and very clear brain function but unsustainable after three weeks (lack of sleep, adrenal fatigue, sense of starvation – not cravings but lack of adequate nutrition). I have even looking for studies on the paleo diet with added medium and long chain fats, and the difference between that and a ketogenic diet on mitochondrial repair. do you have any information or experience with that?

    • The sleepless nights while on a very low carb diet were my only complain too. And even after 6 months it was still not getting better.

      • Same here. I had to reintroduce carbs to sleep more than 4 hours per night again, but it was the only gripe I had with my keto-VLC of (non-starchy / <10 net carbs) vegetables, meat, fish, old cheese, cream, coconut, yogurt, cream, butter, cocoa powder… felt great! But too little sleep. 🙁

        The honey hack (eating 1 big teaspoon of quality honey at bedtime) kinda worked. But despite the numerous claims to the contrary, I got worried about the fructose.

        What got the job done without the honey, was adding to my meals small portions of semi-starchy vegetables like butternut, pumpkin etc.., and even smaller portions of sweet potato or beet root every other day.

        Carrots (cooked) worked as well, but I have a hard time digesting them personally (a quite rare food intolerance I guess!)

        "Regular" LC (avoiding all sugar, bread, pastry, grains, potatoes, high starch vegetables, legumes)… is IMO probably OK for everyone (with sensible tweaking, that is). From an evolutionary perspective, I find it highly unlikely that LC would *not* be a healthy human diet. It doesn't make any sense. When I read articles bashing LC, the amount of ignorance, prejudice and bamboozling makes me facepalm. It's a witchhunt from angry lipophobes and nutrition bigots who refuse to think differently or listen to contradictory arguments and evidence.

        Keto/VLC, on the other hand, while not downright dangerous, and while very useful as a temporary "fix", is definitly NOT for everyone and can probably be sustained for long periods of time only by a few individuals with a specific metabolic profile. I know a couple of them. I'm not one of them!

      • because you are missing critical nutrients and don’t understand thermoregulation and the role of nnEMF and it ain’t the carbs.

      • It’s due to low serotonin levels because of being low carb (carbs are needed for serotonin in the brain). You can remedy this by taking 5htp and vitamin b6 at night.

        • Perhaps Tryptophan or melatonin or some other disorder that was masked by high carb compensating with high sugar. Could be a bunch of things but if adding back in carbs helped then pretty hard to argue it as long as one doesn’t overdue it and end up diabetic!

  12. Hi, Chris

    I am having a very good experience in a low carb lifestyle. Back in November, 2015 I started with this style, weighing about 264 pounds. After one year I lost about 88 pounds and all my cholesterol levels are now back to normal, with good relation between total cholesterol and HDL and tryglicerides and HDL. LDL is good, also. I was taking medicine for hypertension but now it is no longer needed. I am very happy and soon will start with exercises. At the beginning my main focus was to loose weight.

  13. Grains in the US are heavily treated with glyphosate, especially at harvest time, to dessicate them and make them easier to harvest. Pesticides in produce aren’t great for our gut, and gut dysbiosis may well be related to excess weight issues and poor health, autoimmune issues, etc.

    I think everyone has their own unique tolerance to carbohydrates. I eat grain and legume-free, and very little sugar, which makes me feel better. I eat a limited amount of tubers. I have some weight to lose, but I can’t go very low carb or very low fat because I don’t feel well on those diets.

    If I happen to eat a lot of non-organic veggies, I don’t feel so great from ingesting all the pesticides.

    My husband cannot tolerate low-carb, he loses too much weight. So he eats organic rice and a bit more sugar than I.

    I think that removing processed foods, processed table salt, (replacing it with better salt) and pesticides, especially glyphosate, from our plates can go a long way toward achieving better health.

  14. I am wondering what is the best amount of carbs for a woman trying to get pregnant with PCOS? I am currently eating about 80 – 150 grams from fruits, veggies and some occasional potatoes, nuts or peas. I am sensitive to all grains including rice. In my last lab results my TSH was 4.65 while the range was up to 4. My BMI is 18 so I am not overweight. I am wondering if I should limit the carbs more to help me ovulate and shorten my cycles. Or this can cause more problems with my thyroid hormones.

    • Try fertilaid. It helped me conceive after the first month at 40. It may take a few months but overall it is inexpensive and I still take it even though I am not trying to conceive just to keep my hormones balanced. Good luck children are such a blessing!

    • your TSH is way too high forget what is considered normal, realize that all the lab reference ranges are coming from sample the population who are far from optimal physically, it shows that your panel is far from optimal, Keep reducing carbs, increase your shellfish intake if you aren’t allergic and start cold thermogenesis. Your not gonna like it but its the right thing to do.

  15. Carbohydrate uptake is certainly faster with refined flour compared to an apple so yes, the body reacts differently. Refined carbohydrates, high frucose corn syrup and sugar should be avoided whenever possible.

    The real question is – does the body need to have sugar and starch to survive or thrive? The answer is absolutely not. Carbohydrates only add to fat stores if consumed in excess, which was probably OK for our ancient ancestors but now with ready access to food it’s certainly not necessary.

    It’s not possible to remove carbohydrates entirely and nor should we avoid natural fruits (if there is still such a thing as they are bred and modified to be sweeter and juicier so more like drinking it in some cases rather than eating). We should however restict our sugar and starch as much as possible particularly if weight gain is a noticeable problem and relace it with fats, which satiates and helps to pevemt over eating.

  16. Chris-I appreciate this article. My son and I went on this diet after hearing about a friends’ weight loss. We ordered a few books from those who really seem to be the experts but hadn’t received them, just jumped in with the info we found online. Found many clever recipes and camped out in the kitchen a lot-constantly cooking. On the evening of our 4th day we realized that the insomnia, constipation, moodiness, fatigue, etc. was not worth it. You are so right-it’s not for everyone. We can find a much healthier way to eat for us. A very long 4 days. Thank you so much!

    • anyone who quits after only four days……? even the most basic low carb sites warn of possibly experiencing a few days of whats called low carb flu.! Get a grip…..

    • Seriously??? 4 days???

      I won’t be so rude as to say “get a grip” but I will say that you need to take this a little more seriously.

      And as per the “not for everyone”. The fact is that MOST of humanity (our paleolithic ancestors) DID do very-low-carb seasonally each year, whether they wanted to or not. All it took was either “winter” or “dry season”… no choice.

      I’d say, be a little braver and try it again for longer.

    • The original poster may very well not have been familiar with “low-carb flu.” People who are attempting to make generally healthier choices but may not have all the relevant information could be much better served with straightforward information (“Have you heard about low-carb flu? Sounds like what you may have been experiencing”) than a ridiculing response. I think it’s quite natural for a person who experiences four days of misery on a new eating pattern to question whether that eating pattern is right for them.

      • 4 days? More like 40 days for the body to adapt and transform from being a sugar burner after consuming copious amounts of carbohydrates from processed foods and grain oils for years to a low carbohydrate diet and being a fat burner with lots of nutrient rich vegetables where carbohydrates should come. These changes don’t happen overnight so not sure where you got the idea of 4 days from.

        • Oh, and where did *you* get the 40 days idea? Because it’s very far from my experience, which is indeed around 4 days (max) with most of the people I know (and myself) going low-carb of even full keto. The *psychological* adaptation may take 40 days, or even longer for the most difficult cases, yes (I know this firsthand…). But not the physical adaptation. Think about it: any major nutritional change that would take the body 40 days to adapt to, would be so awfully difficult that it would never be adopted! Except perhaps, for a handful of lunatics. Which is not a good description of low-carbers. Tell me, where did you get this 40 days idea? Any source?

          • My personal experience and that of many others.

            It’s a slow process for the entire body to fully adapt and it doesn’t like abrupt changes. Going from being a sugar burner to efficient fat burner can take several weeks alone.

            In your case perhaps you weren’t getting enough fiber or too much, were dehydrated because of reducing the carbohydrates and then constipated (more probable than diarrhea but possible as well) making you so uncomfortable that you gave up and said it doesn’t work.

            I am just speculating about why 4 days, but if your weight is still a problem then try to cutting down on carbohydrates over a few weeks and see how that goes. Taking a probiotic, magnesium and potassium will also likely help.

            • No offence intended, but my feeling is that you’re sort of randomly throwing woolly thoughts in your posts, without taking the context into account.. From here it doesn’t make much sense.

              > “In your case perhaps you weren’t getting enough fiber or too much, were dehydrated because of reducing the carbohydrates and then constipated (more probable than diarrhea but possible as well) making you so uncomfortable that you gave up and said it doesn’t work. ” <

              Uh? In my case? LOL Where does that even come from? These are wild conjectures, based on almost zero info from my post…

              BTW, you couldn't be further from what I experienced. The psychological adaptation I was talking about was another matter entirely: it was about letting go of old beliefs and habits ("fat is baaaaaaaad, whole grain is heeeeeealthy"..), living in a world where low-carb was seen as a dangerous fad ("you're crazy, you'll have a heart attack from all these "bad" fats you eat"), and coping with brand new everyday cooking habits (bye bye good old pasta and jasmin rice…).

              Jumping to conclusions is not a good habit. ☺

              • Perhaps is just a supposition of what you might have experienced as you didn’t provide any details of your 4 day ordeal so all I could do is suppose as to what tou might have experienced based on what others including myself have experienced, without going on in detail about what happens when transitioning. Transition means these condirions are transitory. Whatever it was you weren’t likely in danger after 4 days due to changing your diet.

                What to take out of this is to perhaps try a different approach whixhis less aggressive in reducing carbohydrates.

          • On more small note. The changes become less dramatic overtime and may not even be noticeable but are still occurring. Dependent on how severe insulin resistance was, level of obesity for example and of course individual cases.

            As mentioned about gradually reducing carbohydrates over a few weeks should help the psychological part as well, particularly if sugar addicted. If a person is so addicted the body goes into physical shock – not pleasant.

        • Don: The ‘4 days’ Felicity refers to was in reference to Val the original poster of these subsequent comments who said her eating low carb was ‘A very long 4 days. ‘ If your ‘speculating’ why F elicits says 4 days as you put it sounds like you weren’t following the thread entirely. Vals shitty symptoms after 4 days made her want to stop she may have said 8,6,10 whatever.

          • I’m not sure what you’re getting at. Val said “On the evening of our 4th day we realized that the insomnia, constipation, moodiness, fatigue, etc. was not worth it. You are so right-it’s not for everyone. We can find a much healthier way to eat for us. A very long 4 days. ”

            My point being that the body continues to experience changes for far more longer than 4 days, so the experts that she was referring to who said 4 days are dead wrong, although the first week or two can be rough depending on how aggressive the change is and how long the person has been insulin resistant / burning sugar and a range of other conditions. Simply stated the body goes into shock.

            As for constipation, I found this website which has some good information. http://www.diagnosisdiet.com/ketosis-and-constipation/

            There is likely no harm in taking an over the counter laxative and stool softener (in case of dehydration) if constipation continues on a LCHF diet to see if there is any relief. If not, then visit your doctor.

    • I’ll just say I felt worse before I felt better. When I felt better, there was no turning back. 4 days is not enough time. It took me 7-10 days to start feeling better.

  17. I agree that there are no panacea’s so a LCHF diet doesn’t work for everyone. If you are insulin resistant it is the best solution in my opinion along with fasting. I don’t know of any experts that group carbohydrates all together. The bad carbs are the refined carbs and that goes for sugar as well. Refer to Glycemic index and load charts. Also, insulin index, since increased insulin sensitivity is what drives weight gain.

    It was mentioned that studies have also shown that calorie-restricted diets, protein-sparing modified fasts, and even low-fat diets can also be effective treatments. Over the long term however this is not the case as Atkins type diets having low carbohydrate intake do the best, whether high protein or high fat.