Is a Low-Carb Diet Ruining Your Health?
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Is a Low-Carb Diet Ruining Your Health?

by Chris Kresser

Last updated on

This is a guest post by Laura Schoenfeld, a Registered Dietitian with a Master’s degree in Public Health, and staff nutritionist and content manager for You can learn more about Laura by checking out her popular blog or visiting her on Facebook.

Carbohydrates, and the role they play in a healthy diet, are one of the most hotly contested nutritional debates in the world, both in conventional and ancestral health circles.

One one side, you’ve got folks who say that carbohydrates are nonessential and increase your risk for diseases such as diabetes, cancer, and neurological disorders. On the other side, some say that carbohydrates are crucial for good health and should make up the majority of your calories.

It’s no wonder I have so many clients who come to me completely confused about carbs and whether or not they should eat more or less of them.

While some people do incredibly well following a low carb Paleo diet, there are many people who crash and burn on this type of dietary plan. So, how can you tell if you’re the type of person who shouldn’t be eating a low carb diet, and how do you figure out how many carbs you should be eating? I plan to teach you just that in this article.

Is your low-carb diet doing you more harm than good? Find out how many carbs YOU should be eating.


I recently discussed the role of carbohydrates during pregnancy in an episode of The Ancestral RDs Podcast. The most important reason why women need adequate carbohydrates during pregnancy is to ensure adequate fetal brain development and growth. Another reason is because a high protein diet can be dangerous during pregnancy, and when you cut out carbohydrate as a major macronutrient, you usually can’t help but increase protein as a percentage of calories. Protein intake greater than 25% of calories during pregnancy may lead to decreased mass at birth and increased perinatal morbidity and mortality for the baby.

The Institute of Medicine recommends a minimum of 175 grams of carbohydrates per day during pregnancy, which is 29% of calories on a 2400 calorie diet. Paul Jaminet advises pregnant mothers to restrict protein to about 15% of calories and to obtain 30% of calories as carbohydrates. Chris recommends a moderate carb approach for most pregnant women (except those with any type of diabetes) in his book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014).

Like these other experts, I generally recommend 30% of calories from carbohydrates for my pregnant clients, and also for those who are struggling with fertility. Unless you have diabetes or a serious neurological condition that requires carbohydrate restriction, it’s not worth the risk playing around with a low carb diet when you’re pregnant, and these diets aren’t conducive to fertility for many women either. (If you’re interested in more reasons why carbohydrates can affect fertility, read this great post by Stefani Ruper.)


If you’re a professional or recreational athlete who trains hard 4, 5, or even 6 days per week (I hope you’re not doing 7 days per week!) and trying to maintain this level of activity on a low carb diet, you may be doing more harm than good to your health and fitness.

While there are athletes who thrive on a well-planned low carb approach (LeBron James most recently!), there are many others who do not. Each athlete is completely unique in their ability to perform well on a low carb diet, and there’s nothing wrong with testing out the diet to see how it affects your athletic ability.

But if you’ve been trying a low carb diet for months now and your workouts are suffering, your weight isn’t budging (or maybe you’ve even gained weight!), and your recovery time is increasing, you’re probably not the type of person who can handle a low carb diet combined with regular intense physical activity.

I’ve had many clients come to me on a low carb diet who, after switching to a more moderate carb approach, found that their energy and endurance significantly increased, and they were able to make quicker strength gains than before. Many also were able to shed some of the stubborn body fat that they’d been retaining despite eating a low carb diet and training hard, which was a result they didn’t expect!

For my athletic clients, I usually recommend a minimum of 20% of calories from carbohydrate, and depending on the person’s health goals, training schedule, and current issues, I may actually recommend more like 40-50% of calories from carbs.

Again, each athlete is an individual and what works for one person, or even a thousand people, may not work for you. So don’t be afraid to experiment and pay attention to how your diet makes you look, feel, and perform! And don’t hesitate to get help if you need it!

Hypothyroidism and HPA Axis Dysregulation (Adrenal Fatigue)

Hypothyroidism is one of the most commonly cited medical reasons for needing to eat a moderate carb diet. The main reason why carbs affect thyroid function so directly is because insulin is needed for the conversion of the inactive T4 hormone into the active T3 hormone, and insulin is generally quite low on very low carbohydrate diets.

So if you’ve suddenly started developing hypothyroid symptoms on your low carb diet, it’s a pretty good sign that you’d be better off upping the carbs (and getting your thyroid tested if you haven’t already!) For more about how low carb dieting affects your thyroid, listen to this great interview with Chris by Jimmy Moore.

HPA axis dysregulation, also known as adrenal fatigue, is another condition where a moderate carb intake is important for general health. Kelsey and I talked about adrenal fatigue on our first Ask the RD podcast, so listen to it if you’re unfamiliar with this condition. The main hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to increase on a low carb diet. This means that a low carb diet is a potential adrenal stressor in susceptible individuals. Combine that with a stressful job, inadequate sleep, and overexercise, and you’ve got yourself a recipe for adrenal burnout.

So if you have adrenal fatigue, or if your current lifestyle is already high stress in a few different areas, you may want to increase your carb intake until you can get those additional stressors under control, as you may drive yourself into adrenal fatigue by having a chronically elevated cortisol output. Lara Briden has written a great article on the benefits of whole food carbohydrates in lowering cortisol and raising GABA, a calming hormone that is often low in adrenal fatigue patients.

If you’re experiencing symptoms of hypothyroidism or adrenal fatigue, you may be worsening them with a well-intentioned low carb Paleo diet. I recommend working with someone to help you figure out if your diet is indeed making these symptoms worse, and how to change what you eat to better support your thyroid and adrenal health.

Gut Health

One of the less discussed downsides of a very low carbohydrate diet over the long run is the potential for alteration of the gut flora. Chris recently covered this issue in a podcast with Jeff Leach, where they discussed evidence that a very low carb diet can lead to gut dysbiosis and a reduction in the diversity of the gut flora. A lot of the information on this topic is new and not fully understood, but it’s reasonable to believe that when you avoid carbs, you’re also avoiding important prebiotics (i.e. food for your gut flora) like soluble fiber and resistant starch.

These prebiotics are essential for promoting the growth of beneficial gut flora. Without them, your beneficial flora can’t produce as much gut-healing substances like butyrate and other short chain fatty acids, and your microbiome composition may even shift in an undesirable direction. And as Chris would say, you’re only as healthy as your gut is: an unhealthy gut contributes to everything from obesity and diabetes, to digestive illness, to autoimmune disease, to skin disorders.

Those who are doing very low carbohydrate diets, and who simply can’t increase their starch intake for whatever reason, should use prebiotic supplements such as resistant starch-rich unmodified potato starch or FOS powder. However, these products must be incorporated slowly into your supplement regimen, as you can experience severe gas and bloating if too many prebiotics are taken all at once, or if there is existing gut dysbiosis or bacterial overgrowth. In this case, it would be wise to work with someone who can help you get the prebiotics you need while on a very low carbohydrate or ketogenic diet to protect the health of your gut microbiota.

How Many Carbs Do I Need?

To determine how many carbs my clients need to eat in a day to reach their health goals, first I decide what percentage of calories from carbs they’d possibly do best with. As an example from above, a woman struggling with fertility issues may benefit from a carb intake around 30% of calories. I then determine her caloric needs using a calculator like this one. If we determine that her daily needs are roughly 2000 calories per day, 30% of calories from carbs is 600 calories. As there are 4 calories in a gram of carbohydrate, this works out to be 150 grams of carbs per day.

Usually I give my clients a target range to hit depending on their activity levels, and we use these targets to re-evaluate their food diaries and see if they’re hitting their goals. Most of my clients are surprised to learn how much carb-rich Paleo foods they have to eat to get up to 150-200 grams per day! But once they start making a real effort to hit those targets, the health benefits are immediate.

These benefits include weight loss, elevated mood, skin improvements, increased energy, normal menstrual function, more satisfying sleep, and more. It’s so exciting to see what a couple of starchy tubers and pieces of fruit can do for a person’s health when they simply need to eat more carbs!

Wondering what foods have carbs in them, and what portion sizes you need to eat of each type to get the carbs you need? Click here for a handy list you can print out!

Final Thoughts

The purpose of this article was not to bash low carb diets. I truly believe that there are many people out there who get amazing health results from a low carb plan, and there are dozens of health conditions that benefit from a very low carb or ketogenic diet, especially severe neurological conditions. Paul Jaminet has written some great posts explaining when a ketogenic diet may be useful and necessary, so I strongly suggest reading those posts if you’re still on the fence about where you stand with carbohydrates and your health needs.

My hope is that by reading this article, you’ll be able to understand the many factors that play into how a person handles a low carbohydrate diet, and whether or not their health will improve on such a plan. Everyone is different in their ability to thrive on a low carbohydrate diet. If you’ve found yourself identifying with any of the issues I’ve written about in this post, you may be in need of a macronutrient adjustment in your diet.

Helping people optimize their carb intake is a challenge I truly enjoy. As a dietitian, I love to help people evaluate their diet to determine if they’re meeting their health needs with the food they’re eating. If you think you could benefit from a Paleo diet makeover, I’d love to chat with you about where you’re at and where you want to go with your health.

Your carb intake shouldn’t be the major factor that’s preventing you from reaching your health goals. I hope you use the information I’ve shared today to evaluate your own nutritional needs and make the changes that make sense to you.

Now I want to hear your story. Have you experienced health benefits from increasing your carb intake? Share what you’ve learned in the comments below!

Laura Schoenfeld MPH RDAbout Laura: Laura uses her knowledge of traditional and biologically appropriate diets to improve her clients’ health. Growing up with a family that practices Weston A. Price principles of nutrition, she understands the foods and cooking practices that make up a nutrient dense diet.

With her strong educational background in biochemistry, clinical nutrition, and research translation, she blends current scientific evidence with traditional food practices to help her clients determine their ideal diet.

You can find her at, on Facebook, and Twitter!


Join the conversation

  1. Thank you so much for your contribution to this topic! I’m a 35 year old female and I’ve been Euthyroid Hashimoto’s since 1997. After a period of severe stress last fall, I went into adrenal fatigue, vitamin D deficiency (17) had a surge in thyroid antibodies (tested 2/1/17) which led my functional medicine doctor to start me on AIP for 60 days, adrenal support supplements and 50,000 IU of Vitamin D for 30 days beginning 3/25/17. I’ve seen an increase in energy and emotional stability, and have lost 7 lbs (I’m 5’8 and was only 108 lbs to begin with so we’re watching it closely) I’ve been able to successfully reintroduce eggs, almonds, coffee, brown rice and ghee.

    I just received my 2nd set of lab results from 6/13 and was shocked to see my TSH enter hypo territory for the first time in 20 years (6.68 on 6/13 compared to 3.32 on 2/11) My antibodies have decreased negligibly. My Vitamin D has jumped to 105 after the thirty days of D3.

    It’s hard not to think my protocol over the past 80 days doesn’t have something to do with the TSH, so I began searching and found your explanation of the potential effects of low carbohydrates and hypo/adrenal fatigue.

    I’d be so grateful for your input on my situation. My instinct at this point is to reintroduce other non-gluten grains to increase my carbohydrate intake. Any other suggestions?

  2. My energy crashed badly after going into ketosis, with exhausted adrenals and thyroid meds not working with the efficacy that they did and experiencing terrible hypoglycemia. Low carb is not for me.

    Thank you for this article, it’s helped me understand why my body cannot function on no carbs.

    Back to the carbs……yum! 🙂

  3. Thanks for the article, it illustrates very wll my experience, which is 100% as you describe, since keto-enthousiasm on the web can make you miss the point that everyone is different and continue to make wrong. After 1 year of low carb (50-80gr/day) which combined with a lot of exercise made me lose 20kg (and gain some muscle), I started to feel exhausted. So increased protein even with supplements I had not used before, but it got worse. I added some carbs but they probably were not enough and not the right ones for my body (beans for instance, they don’t make me feel energized, basmati rice or potatoes do), I hit a plateu so convinced my self to go full ketosis. It was quite easy at beginning, my body was accustomed to low carb but nevertheless the first week with low veggy and <30gr/day was quite hard, then second and third was ok and even nice (no hunger), but after that it was a progressive crash down up to 4 months of keto adaptation (measured). Energy went down, I could make just a bit of exercise probably thanks to the fitness I had accomplished before but it was like a car using the last fuel, it got worse day by day. Then some bad things happened: cold body temperature (even 35°), panic and insomnia, even lower energy and feeling sick even if I used to eat lot of good fats (avocado, coconut, olive olil etc). I added grey salt and magnesium, followed all the tips by keto-gurus (!), my body got exhausted, fasting blood glucose increased from 70 to 90, colesterol increased (LDL too), body pressure was (is still) quite low. I think I messed with my thyroid. I started reintroduce carbs I tolerate well, such as basmati rice and potatoes and they made the magic. For instance after a carb meal my body temperature increases upt to the norm (36,6°C) but not if I don't eat carbs. Must add that I follow an intermittent fasting every day, which I had to interrupt during the pure keto diet (4 months, no recharges). It seems that only if I eat some carbs at the evening than feel energized the morning after and have no wish for food. It results as a natural aproach to fast if I eat some carbs, otherwise I need to always eat. I just think my body can't do it without a bit of carbs, and if I don't the consequences are quite hard. I felt like crap and almost got to the hospital, so no more keto for me, at least not without (many) carb-up days

    • Wow. I have been eating clean and exercising, in my opinion, moderately for 10 weeks now (about 4-5 this mes a week). The last couple of weeks my muscles really suffered more than usual. It became intolerable finally so much that I I decided to take time off from exercising. Originally it was going on o be a few days but ended up one week. I did feel the inflammation going down significantly in my legs but the exhaustion was terrible. All I want d to do was sleep. And then I had a small toast plate of spaghetti with meat sauce. Within minutes quite literally, I felt like I drank copious amounts of energy drinks. It has remained that way the rest of the day. I feel like I was starving myself of carbs. I felt my fatigue and brain fog lift after I ate the glorious toast plate of spaghetti. Anyone else ever feel this way?

  4. I can´t tolerate carbs anymore and have them cut out for longer than 6 months. I have substituted this through eating a smoothie with 1 cup of blueberries and 2 bananas in the morning, and one in the evening. But now i begin to have a intolerance against fructose, and i don´t know what to do anymore. Im from Germany and don´t have the money to go to a Functional Neurologist.

    • Use an app like my fitness pal to see how many carbs are in what you eat. Sayying you are eating a low carb diet, but you are having 4 bananas a day doesnt add up. 1 banana has 29g of carbs and 4 fiber = 25 net carbs each toal of 100g of carbs = 400 calories. And on a 2500 cal diet you are at 16% carbs just from the bananas.

  5. A proper low-carb diet always means you get a lot more energy from natural fat.So there is question that how much fat should you eat? As much as you need to feel satisfied and great. Eat when you are hungry. Stop when you are satisfied. Then repeat. It’s that simple.

  6. I went on the Paleo diet when I found out I had cancer, but my coach wanted me to try ketogetic. The problem is I have leaky gut and nothing I’ve tried seems to help

  7. I don’t really fit your categories above, but I was already thin when I dropped the carbs and have been losing too much weight . I have a high metabolism and burn food quickly. I need the extra calories so I’ve added more fat and protein but they are not putting on the fat for me. I have decided to add carbs back into my diet. Good idea?

  8. This information is 100% true as I am now in the middle of it and trying to recover via carb reintroduction and some back loading. I am A type, work out 6 days a week the past 6 months, ketosis diet 30 grams and IF on top of that! I also am 50 years old and use to have pre-diabities and had a heart event MI in 2011. Lost all the weight via low carb and exercise as I have always been akin to fitness, but moved to keto and lost some stubborn weight, then it all hit. Could not sleep, could not say asleep even with an ambien, neck and traps hurting etc. Another sure symptom that I found and verified as true with low T3/4, is low fluctuating body temperatures, mine went from 95.5 at the worst to 97.1 if lucky. The last 3 days I added back loading (am a Kiefer fan too) to introduce carbs but at the right time, but still get them up (ate pasta and meatballs with garlic bread last night, what a treat) and a cherry turnover before bed. I am still a bit sore, However last night was a better sleep. Body temperatures are coming back up already. I am still going to see the endocrinologist and get test done since the damage was done and I do take a topical test cream, and I read that that can cause issues with aromatase (estrogen) long term, and the keto high fat diet can make the T3 receptors on the cell less responsive?? Anyway, this is a good topic and area for all keto/low carbers to be aware of, and perhaps is accelerated based on age, ie: older athletes pushing protocols too hard and too fast, beware.

  9. Interesting, every time a attempt a ketogenic diet, I lose weight extremely fast, and I really need to loose weight but my sleep apnea worsens at the same time. I use the cpap machine and instead of an AHI reading of .6 to 1.9 episodes per hour, I get readings of 2.0 -3.5 episodes per hour. I have read that sleep apnea may be associated with cytokine dysregulation.

  10. Your article only talks about adrenal fatigue & HPA dysregulation in terms of high cortisol levels. What about if you have chronically low cortisol/low DHEA? Does the same advice apply?

  11. So this explains why I can’t tolerate low carb & have to eat moderate amounts. Funny, it was the physician I went to for Hashimoto’s & adrenal problems who was angry that I could not do it.

    So, what do you do if you have blood sugar issues, too? I can’t keep my insulin levels both lower and higher at the same time.

  12. I lift 4 days a week and I walk 2 miles about 3-4 days a week. How many carbohydrates would you recommend I consume for the above stated activity?

  13. Hi I would like your opinion.. I have suffered IBSC for 2 years and I recently decided to try the LowCarb, ModProtien, HighFat diet. Although it didn’t help my constipation at all, my energy levels sky rocketed and my anxiety/brain fog completely vanished. I was the calmest and most productive I had ever been. Then from no where I started experiencing seizures. My doctors couldn’t find anything that was causing them except low thyroid levels with a really high TSH of 28.7 and TPO antibodies. I was diagnosed Hashimotos and put on Armour. My problem is that I can not put on weight, I am so skinny compared to before, I am literally fading away. I don’t know what to do and I am wondering if my diet started all my thyroid issues! I desperately want to gain weight but now I am finding out with hashi’s I have to be on an A.I.P diet which means I have had to exclude even more foods, no dairy, no soy, no gluten, no nuts, no grains, no legumes, no nightshades, no coffee… the list goes on. How I am supposed to gain weight when all I can eat is meat/veg/fruit.. where can I get more carbs from.. please help

    • Plantains are your friend. I make flatbread this way: 400g green plantain (peeled), 1/3 cup oil/butter, 1/2 tsp sea salt blended til smooth in a Vitamix. Pour on a baking sheet lined with parchment paper and bake at 350 for 20 minutes or until just browned around the edges – experiment until you find how you like it best. For fluffy bread, I blend the above, then pour in a bowl & use a handmixer to add in 1/2 tsp cream of tartar & 1/4 teaspoon of baking soda. Today, I tried it as cinnamon raisin bread – I added 1 tbs cinnamon, 1/2 tsp vanilla, 1/2 tsp molasses & stevia to taste (optional), then the leavening & a handful of raisins I folded in. Baked the same way. Delicious. (I use butter, but you can use coconut oil for AIP – I am allergic to almost everything you must eliminate on AIP + shellfish, coconut, tapioca & arrowroot, so I feel your pain!). Best of luck! If I needed to gain weight, I would do a lot of hearty stews with sweet potatoes, yucca, beets, carrots & a side of this bread or plain ole tostones. Trust me, that should do it!

      • Hi Michele, Great advice.. I am only sorry I didn’t see it sooner. I have the a.i.p Paleo cookbook and a lot of the recipes use plantain’s so I am really going to get serious about them now. I am also going to try the stews you mentioned! I increased my carbs over the past months and I am not eating potato and rice again. Been gluten free 5 months. I managed to gain weight and I now look healthier however my mood disorder / anxiety is back. The ketogenic diet cured my mood disorder but ruined my health and weight. It’s very annoying because now I am considering medication for the moods when I know that keto can cure it but I am scared to drop all the weight and get sick again. Anyway thanks for the great advice, I will try Paleo instead of keto with healthy carbs like sweet potato’s so I don’t drop to much weight! 🙂

        • I’m sorry to hear about your situation – that is a very tough choice to make! My son has neurological abnormalities that cause him to have Bipolar 2; he has also had a couple very mild seizures. For him, neurofeedback helped immensely. He was cycling ultra-rapidly; sometimes as many mood swings as 3 dozen per day. Neurofeedback helped bring him down to 1-3 per week, which was amazing. He has maintained the benefits 2 years after stopping treatment. Anyway, it might be something to look into before medication; usually they try ketogenic diets for people with his brain condition who end up with seizures, and the neurofeedback stopped those, as well.

          It seems like you tried different amounts of carbs already to see if you could maintain the mood benefits at a middle ground level? Have you tried/been able to try achieving ketosis by exercising, while being able to eat more carbs?

          I hope you can find a way that works for you!

        • For the mood disorders I would try doing intermittent fasting with the diet that is working for you. Do not eat less, just shrink your eating windows. You actually may need to eat more this way if you notice weight loss on the same amount of calories. Your metabolism works more efficiently when your body has a time out from constant digestion. A keto diet tricks your body to thinking it’s in a fasted state. Possible it’s the reasons for the mood benefits. Don’t quote me, I’m sure a little Google research will give you some clearer answers. I’m hypo thyroid and ketosis made me I’ll within days. I still do the IF, love it. I’m not religious about it, I listen to my body, if I need to (or want to for whatever reason) skip a day or break the fast early, I do it. Good luck.

    • When you went low carb did you use sweeteners? I had a terrible reaction to Xylitol and it caused me to have 20 plus episodes (TLE) in one day after not having any for YEARS. I check all labels now.

  14. Here’s my story. I’m hypothyroid, have been since age 25. After my daughter was born six years ago at age 35 , my thyroid levels went crazy and I gained 40 pounds despite regular exercise and healthy eating (no joke). I’m now getting back to normal thyroid levels and weight is coming off slowly (as it should) with healthy eating and exercise. My new endocrinologist is awesome but has a nutritionist on staff who recommended a low carb diet with a food journal. I tried low carbs for a week and felt like crap. I told the nutritionist and she said to stick with it. Then the end of second week, I still felt horrible and another problem surfaced. Backstory: I had an eating disorder in my teens and early 20s and this carb counting started making me obsess over what I ate. For example, I started feeling guilty for wanting an extra bite of fish or fruit. I went back in my food journal and questioning if I ate too much at a given time. I got scared, my husband got concerned, and I stopped carb counting and threw out my journal. I purposely started skipping appointments with her, (about two weeks worth), which I decided today that I’m going to make the next appointment so she will leave me alone or start a new approach that won’t play into my obsessive tendencies. I eat really healthy thanks to food sensitivities and not being able to eat much processed foods, and stick with healthy carbs, but I can’t figure out why this nutritionist wants me to count carbs knowing my obsessive tendencies. Is it because it’s textbook? I refuse to be the food obsessed person I used to be.

    • I have run into similar problems, although I have been lucky enough never to have had to deal with an eating disorder. It sounds like this nutritionist, like most physicians I have run into, is more interested in forcing a round peg into a square hole to justify her favorite food fad than in helping patients.

  15. The problem with people is our tendency to go to extremes. To say that this is better or that is better, when if you look across the expanse of human-history, it’s really not an either-or.

    Like right or left, liberal or conservative, idiot or genius.

    The reality is, and has always been, that the answer is dynamic. Sometimes this is better. Sometimes the opposite is better. Sometimes both must be mixed. It’s dynamic thing, not a progressive thing. We sometimes go this way, and then times call for going back, and then this way again, and then back again.

    In human diet throughout the ages, it would seem that carbs and meat and fat and sugars, all of it in ample amounts is ideal.

    And we can see that it’s ideal because ideal is the most efficient at making us all fat. And what is fat if not the definitive indication of more than enough.

    All of our health-problems isn’t because we eat certain foods . . . well except those laced with unnatural additives that have cumulative affects. However, we’re talking just normal sustenance food here.

    Our problems come from a consistent excess of those foods, not the periodic feast at Thanksgiving, Christmas, and birthdays, but the consistent feast of every single day. Eating till you’re stuffed, or being in a perpetual state of full/suffed is not natural. For herbivores, this might be natural as they tend to eat all day long, but not for omnivores nor carnivores. And look through the world, most omnivorous animals are more carnivorous than herbivorous with the exception of a few, and when they’re small, and when they eat seeds. I think when they’re small and eat seeds, they tend to eat more plant than animal.

    Our bodies, like most of macro-animal life, are designed to go without or less-than-adequate for short periods time.

    That IS what a diet IS, fundamentally speaking. It’s designed to simulate what would naturally occur if humans did not live in abundance.

    When we have a keto-diet, or vegan diet or one of the bazillions of all-food diets, it’s really just to simulate the natural struggle of survival at those times where food is more scarce and harder to come-by.

    The reason the keto-diet is so effective, so utterly effective for those disciplined to stick to it is because it more naturally simulates what humans actually went through in times of scarcity where the largest amount of their diets came from what they could find and kill and by chance happen upon growing, probably while out hunting.

    If you haven’t noticed, when on a keto-diet, even just beginning one, once those ketones are really in there, you never feel as weak when you haven’t eaten for a while. I remember, I get shaky when I haven’t eaten in 5 to 6 hours. Sometimes, I get shaky after eating a large amount of cereal within 3 hours. That never happens on a keto-diet.

    Your mind feels a bit sharper. Maybe not dramatically, but it feels a bit sharper.

    You feel less energy to do things at first, but that eventually goes away. And it’s not the less energy that makes you just want to eat, but the less energy where you just don’t feel as energetic.

    You feel more potential energy. Like for me, I feel like I could run much more than I actually could. I feel healthier. I feel less sluggish and run-down, even when I haven’t eaten in more than 6 hours.

    At any rate, it seems to me that what I’m feeling is more in-line with what would make me more capable of hunting down my own food in a time of scarcity. Having the patience to focus instead of just wanting to eat, the bit sharper mind to focus, the ability to go hours without feeling some dramatic increase in sluggishness that just thinks food, food, food, and it doesn’t make me feel like I just need to sit and do nothing.

    Carbs makes you feel all of those things, especially when you don’t have any to eat.

    I mean, you still feel those things in the keto-diet too if you don’t eat anything, which happens to me because I’ve just never had a palate for meat and fat by itself. It gets annoying to me to eat meat every day all of the time. It starts to feel bland, and the taste starts to wear on me.

    But, even though you feel that way, it’s a less sharp feeling. It’s never as bad as the way I feel when I’m going hungry from a diet that is full of carbs.

    If you’re on a carb diet, you’re hungry all of the time. It’s ridiculous. It’s just constant gnawing making you crave whatever you can find to eat. Constant growling 1.5 to 2 hours after eating that never stops. Gas like crazy. It’s relatively mild in its stink compared to meat-diets, or even processed-food, but still, it constantly builds up whenever I’m hungry.

    That doesn’t happen to me on the keto-diet. I can literally feel weak due to not eating anything for hours and hours, and desiring to eat anything, and it’s still not nearly as bad as when I’m going hungry from a carb-based diet.

  16. I ran across your article and was greatly encouraged to change my VLC induction diet. I have hypoglycemic episodes, on the VLC diet I had them every day,; gained weight and had brain fog ALL the time. I can not do grains or gluten. Please tell me how to slowly include some carbs, too many and I have episodes of drop in blood sugar. Thank you!

      • Me, too. I got panic attacks on low carb, although normally I do not have hypoglycemia. I tried to tell my physician, but he was too busy yelling at me that I had no self control, to care about my symptoms. It seems I am not alone.

    • To Ruth — or anyone with her question — grains are not the only source of carbs! If you want to “up” your carbs, eat some fruit every day. It full of nutrients and rich in carbs. Make a salad from apples, oranges, berries, grapefruit, pineapple. Eat a half cup of it. Have a glass or raw milk or kefir. There are hundreds of foods you can eat that are rich in carbs (if that’s your goal) without eating wheat, gluten or grains.

  17. I’m 25 years old, and I am delving into the world of nutrition. Since my older brother’s background is a Paleo and Ketogenic based, I decided two weeks ago to start a low-carb, high-fat ketogenic diet that consists of intermittent fasting from dawn through noon. I consume two “fatty” coffees through my fasting period followed by a high fat/protein based meals. I am struggling, as I stride into my third week. My sleep cycle, for one, is not consistent. I wake up a few times throughout the night, but I am able to fall asleep easily after each time I wake. Moreover, I suffer from low energy, mood swings, and high stress life with work/school, cravings, sleep interruptions, cognitive issues, and some bowel issues that I have yet to discover.

    I am a novice in the world of paleo nutrition, and I am asking for help. Please help guide me towards a healthier lifestyle.

  18. I also have researched ketogenic diets and would recommend the very low carb diets for people with certain medical conditions that haven’t responded well to higher carb intakes. I also think it’s important to get enough protein regardless of which low-carb diet you’re on, which seems to be missing in these very low carb/high fat ketogenic diets.

  19. Started low carb dieting no starchy vegetables and feel tired the person I am seeing said to drop carb intake to 70-80g in order for them to see me in a fat burning state as I have done a test to see which fuel I am burning. This test showed I was burning mostly glucose.

  20. I started low carb about 6 days ago and Ive been in a fog. People on support groups keep telling me to stick with it but it seems to make me feel bad. I have increased anxiety at night and not able to sleep. It’s 3 am before I fall asleep. I have subclinical hypothyroidism. I recently took a test for adrenal problems and havent gotten the results back yet. How do I find out how many carbs I truly need for a day? I dont think extremely low carb is for me……

        • Slowly drop your carbs. 150-200 seems to be a decent starting point. Do that for awhile and when you’re ready taper down, or drop down. Whatever works for you.

          I’m week 6 over here and I dropped way to quick but I’m in too far to stop. So, do the realistic thing.

    • My dad had great success with a diet of 2 low carb meals and a one hour reward meal begun with a salad as part of the Carbohydrate Addict’s Diet. I haven’t tried this approach, but I have reduced my carb intake to less than 20 grams per meal, and let me tell you, I felt horrible!!! I don’t know how anyone can sustain this. I feel almost like I have the flu or a major sickness, I’m so lethargic, when I do low-carb. I can hardly do anything, and I feel crappy and irritable. A couple of days ago, I tried it again for weight loss reasons, but it wasn’t worth the loss of productivity and how bad I felt. It took a whole day of eating moderate carbs to feel human again. Low carb is not for me!

      • Doing low carb, under 20 gr
        is NOT something you want to do off and on. You will perpetually be miserable. I have found eating enough protein to be key to my low carb lifestyle. So many people fear protein in the low carb world! Once adapted life and eating is a dream life. I feel fantastic, energy to burn, can workout fasted, can fast and feast with ease. Blood markers are fantastic, hormones greatly improved, etc. Going on two years now. It took some tweaking and the way, but is amazing now. Such freedom from food. Love it. Optimal protein, moderate fat and low carbs is working for this 49 year old mama to nine. ?

      • You will feel crap to start with. Your body is getting used to a new way of eating. You probably need to give it time. If after a month you still feel crap then it’s maybe not for you.

        • Christy,
          Most likely your electrolytes were off. One must learn about a diet before jumping in. Sounds as if you were half in to ketosis when you bailed out.

  21. What A refreshing, responsible, balanced article – if only I had read it sooner. I have been literally killing myself trying to recover from anorexia whilst sticking to a low carb diet. I had read so much about the Paleo Diet and read The Grain Brain and, in my vulnerable state, believed that by taking in carbs I would be doing myself, body and brain, more harm than good – actually, omitting carbs was doing exactly that. I have been suffering extreme insomnia, burning at the back of my throat, severe stomach and digestion problems, chronic fatigue – I could go on. I have suffered from anorexia for 22 years and in all my time I have never felt so unwell as this time and I truly believe it was partly due to lack of carbs. I am sure that the low carb diet suits many, but I wish article praising it would be a little more balanced/responsible. People preach it like it is a religion and make the foods they advocate avoiding sound like poison. That is why this article is so good, it is balanced and doesn’t insist either diet is right or wrong – it merely points out the pitfalls. Thank you for writing this, you have helped me beyond belief – in fact, I have just had my first bowl of buckwheat porridge!

    • Hi Natalie,
      Have you looked into the relationship between eating and your microbiome? There is a free course on it with Coursera. Rob Night and his crew are most interesting.
      I believe as you say that everyone needs different things and that ingredients that might be poison to one may not affect the next person adversely. I suppose the blood type diet that Mercolla talks about is something I should take a closer look at for myself to make the connections personally.. The thing is……….there are so many fuzzy lines. I mean I was recently convinced to up my carbs in order to relieve dry eyes. (I’m talking- opening my lids at night was beginning to feel like ripping off a band aid……lol) and while increasing my carbs with white rice (turns out brown is not as safe a choice for me) and potatoes did help, I am beginning to think it was actually the sodium increase that made the most difference. While searching for answers, I came across a Dr. Steven Phinney who talked about lack of sodium causing problems in the diet. I thought I was taking in more than enough because my husband is heavy with the shaker when he cooks (to the point of needing to rinse it off). Even though my taste buds were rejecting the heavy hits of salt, I think I may have been low in an overall sense. I was eating a little too many apples, avocado, bananas berries, and plain raw vegetables with no salt etc………..and no processed foods.
      Even though I wasn’t craving bread, cereal or pasta which I used to live on, I was still craving potato chips in a big way. I couldn’t understand this obsession until reading what Dr. Phinney had said. Now I wonder if upping the carbs in the form of potatoes and such is merely helping the electrical and chemical activity in my body because of the sodium increase and resulting electrolytes. It’s worth checking into…………. I almost didn’t.
      Note. Since my increased intake of “safe” starches has not caused me any adverse neurological effects, I’m moving forward with the Perfect Health Diet (with less rice).

      • Too many confounding variables. You increased your salt, but also started eating several other things.

        And just FWIW: Salt makes my dry eyes worse.

  22. There is an interesting new theory that not only explains why Europeans are much slimmer without low carb diets, and why Mississippi and southern states were the first and hardest hit with the obesity epidemic in the US.

    Iron Enrichment of food appears to be the culprit.

    Iron overload has been linked to nearly every major chronic disease, including heart disease, cancer, diabetes, Parkinson’s and Alzheimer’s. However, new studies are now linking iron overload, and/or disturbed iron homeostasis, to obesity.

    Iron supplementation has also been linked to increased mortality and studies have also shown that iron-fortified flour increases inflammation and is not safe for non-anemic men. Non-celiac gluten sensitivity was also rare before the 1950s. It should also be noted that most free-radical injury is iron related.

    States and countries with the highest iron intakes (food enrichment, meat, etc.) appear to have the highest obesity rates. Mississippi—the most obese US state—was one of the first states to make fortification mandatory for flour, bread, cornmeal and corn grits during the 1940s—they and other southern states were using it to fight pellagra. The state made it practically illegal to take a bite of food that wasn’t high in iron (i.e. flour, bread, grits, pasta, rice, meat).

    Although enriched flour was widely available by 1950 thanks to “War Order Number 1” enacted for WWII , some states went a step further and enacted the Newfoundland Law, requiring enrichment in flour, bread, rice, pasta and corn grits. Notice the similarities of states that had the most obesity in 1994? (1994 was the first year CDC data was available from all states).

    In 1954 Canada unified and adopted the Newfoundland Law requiring enrichment of flours and breads across the country. Newfoundland is currently the most obese province in Canada.

    In 1983, the FDA mandated that all white flours, pastas, rice and corn grits produced in the US be fortified and the FDA also raised the minimum level of iron significantly in 1983. Canada, the US and UK are the only developed nations to fortify their foods with iron.

    Like many EU countries, France has never allowed their flour to be enriched. Some European countries, like Denmark, have even banned fortification of foods. Low carb diets are not as popular in unfortified countries—they have very few problems eating breads and pastries.

    For more on this theory, see: Iron, Food Enrichment and The Theory of Everything

    Here in the United States, people lose weight fast when they avoid refined and fortified carbohydrates. According to FAOSTAT, the French consume 40% more (unfortified) wheat than Americans do, but have 1/3 the obesity rate.

    If obesity is an inflammatory disease, then it stands to reason that supplemented iron, through fortification, may be counterproductive for those who are inflamed. At the very least, obesity researchers need to make attempts to distinguish between diets that are fortified with iron and those that are not, going forward.

    If the theory is true, carbohydrates may indeed be safe for most people, provided they are not fortified with inflammatory iron supplements. If nothing else, the theory appears to explain virtually all dietary paradoxes.


    • So interesting, about the iron-fortification theory! Which I’ve begun to hear about elsewhere. Doesn’t iron feed certain gut microbes as well? And aren’t mixed-up gut microbes implicated in obesity?? It is truly a tricky place we industrialized humans have found ourselves in…

  23. I in no way know what the ones who have struggled with low carb and their health ate for protein while they were low carb, but it has been my experience with people I work with, mostly women, that they have usually fallen for the HIGH FAT camp and their protein is way too low. High fat, low protein is essentially starvation and starving (hypo caloric) seems to be what is behind thyroid-adrenal, keto related problems. We see so many people coming from too low of protein with energy problems, hair falling out, depression, etc.

    I once was in this camp, lost hair, my energy and lots of lean body mass! For the past year I have been keto with optimal protein and am feeling fantastic! I am losing again (thanks to some IF and keto), my insulin numbers are down and ALL of my blood work is fabulous and has much improved in one year.

    Again, I know there are many factors to the struggles with low carb diets and no one diet is perfect for everyone, but I think it important to look at the other macros as well. =

    This is a great article by Steve Phinney, a well known keto expert.

  24. WHy is every keto dieter suddenly Gluten free? Keto was the easiest diet ever. Now suddenly all this nonsense is being added to the fray. THIS is when something good gets a the tinges of cult and BS. It is no longer that pure low carb diet – NO, now it’s a whole wad of supplements and …sorry but if you’re low-carbing WHY are you even on gluten free anything.Starting to be really irritated with this new look diet and stop calling it BAnting since Banting promoted rusks and sherry in the afternoons. We can never just get something pure and simple. SOMEONE has to come and fiddle with it.

    • Maguerita,

      “Gluten-free” just means you don’t eat gluten. It doesn’t mean you eat gluten-free processed foods.

      • Yes! We so need to come up with a term that implies “free of gluten” without the long explanation…………FOG doesn’t cut it but I may have to to start using it lol.

  25. I’ve only been doing Atkins for a week now (<20g Carbs/day), so am obviously NOT an expert, but just wanted to share an observation.

    I've read a lot of the posts here and all of them reference only their carb intake. That's just part of the picture. What is your fat and protein intake? Doesn't this make a difference?

    Again, NOT an expert just asking.

    • It depends on the person.

      If you’re upping carbs, the person order I would drop with is;
      1) drop a little protein and carbs
      2) drop some fat
      If you’re deeper in, you can probably drop protein and keep the fat.
      Whatever works for you.

  26. Once dreaded for having high levels of cholesterol, whole eggs are regaining their relevance as a food for weight loss. New studies now indicate they do not affect blood cholesterol adversely and neither cause heart attacks. Whole eggs offer an easy diet to lose weight. They are high in healthy fats and protein and can make aperson feel full while having taken just low amounts of calories for Weight Loss Diet. Eggs are known to have high density of nutrients and can supply all the required content of nutrition for someone taking a calorie-restricted diet. Nearly all the necessary nutrients are contained in yolks.

  27. Flat out wrong across the board – low carbs only induce hypothyroidism if you are missing the following nutrients from your diet. Selenium, Iodine, Iron, Magnesium, Zinc, and DHA.
    . Poorly educated and a very understanding of neural biochem.

    • Hi Asad, what do you mean by it can induce hypothyroidism ? I have been eating LCHF now for 2 years (see my post below)
      I have leg jitters that magnesium supplements are making worse and giving me a terrible headache. I am not losing weight anymore even though I eat below 20 gm carbs a day and have done for a long time now.Somedays I feel great and others I feel terrible but cannot up my carbs as I bloat up like a balloon. I know I am lacking in something or have done something to my body through eating this way but do not know what to do about it. My legs are twitching terribly as I am writing this and I have already taken 2 tabs of 300 mg magnesium today which nearly sent me off the hyper scale and gave me a terrible headache. Any suggestions ??

      • went to the doctors about 3 weeks ago and had blood tests for everything as told him I ate LCHF for nearly 2 years. He prescribed me Quinine Sulphate tablets as all the blood tests came back negative. So far been cramp free for 3 weeks now and still eating LCHF. You can only take these for a month then you have to have a break, so I will see what happens when I stop taking them. Back to my old energetic self now and still 8.7 stone.

        • how is your salt and potassium intake ? and have you measured your blood ketones ?

          Instead of the high magnesium tablets you could try to eat some avocados with sea salt instead.

          I had severe leg twitching and cramps the first weeks i was on keto. I am now testing out a zero carb, no vegetables, and are not experiencing twitching and cramps anymore. My main problems are still mostly there though (hypothyroidism, adrenal fatigue, IBS, tiredness, depression).

  28. So how does one go about figuring out just what is causing them to feel sick from a VLC diet? I did low carb 7 years ago, lost 40 lbs over 12 months and had no problems. Gained all the weight back over the past 2 years with a desk job and too many carbs. Started VLC mid-April and it seemed all was going as before. I track my macros, take the necessary supplements (like magnesium), upped my water intake and added more sodium. Then all of a sudden, last week I just crashed. I feel super sick, body aches like the flu, I have a migraine type headache that will not go away even with medication, I have nausea, some abdominal pain, feel thirsty despite water intake, have high anxiety/mood swings, and I am exhausted.
    I figured it was due to my diet, so after some research (here and elsewhere) decided to up my carbs. I have not taken in more than 75g though and I am really feeling horrible. Went to doc and vitals check out ok. Blood pressure is fine, heart sounds fine, etc. and no indications of some other health issue causing this, so pretty convinced I just hit a brick wall with the VLC.
    But I am confused with what I have read. It seems like it could be hypoglycemia, but the symptoms relate to too much cortisol as well. I understand they are related, but how can I pinpoint what is triggering me? Should I get tested for cortisol? Should I monitor my glucose? Or could I have messed up my thyroid and need to have it tested? Or all of the above??
    And once someone doing VLC has thrown their system out-of-wack, how long does it take to start feeling better? As I said, I increased my carbs 2 days ago but no relief yet. Some recommend doing a 200-300g intake of carbs, but I don’t want to do that if it will just trigger some other issue I might be having. Just trying to figure out how to better manage my diet and not feel like death warmed over. I think my age could have an effect on why the VLC is causing problems this time around. I was 39 last time, now I am 46. I figure hormone changes and different dietary needs are playing a role here. Any thoughts on this would be great 🙂

    • Dear Friend,

      I can relate with your problem. Like you I am also on a quest to health but somehow it is always easier to help others then yourself :P. When reading your post the first thing that popped up was this:
      – Are you measuring your blood ketone levels ?
      – And what about blood glucose ?

      If you have not done this prior then I highly advice you to do so. I use this measuring device which can both measure ketonines and glucose levels.

      Also, how is your electrolyte intake ? Usually when one experiences your symptoms on a ketogenic diet its either too little elektrolytes (adrenal and thyroid problems increase cortisol, which decreases elektrolytes in the blood) or its is too little fat. Im in the same camp really. It is really hard to find a suitable range to be in but once you found your ratio then its a great find and support.

      Ask me any questions and I try to help.

  29. I did Keto and I lost weight, but I looked and felt like a dead person and it just is not for me. I don’t think I could eat another scrap of meat or high fat food for a while. It upset my stomach and I just slept forever. My work performance suffered greatly too. Glad I’m not the only one who felt like a steaming bag of dog poo on Keto.

    • sounds to me you were going trough “keto flu” and were lacking severe magnesium,potassium, salt. I wouldn’t count keto out yet and rather find a suitable coach or mentor who could aid you in your journey.

  30. I have been eating LCHF for 2 years now. The first year was great and I went from 135 lbs down to 99 lbs. I was obviously too thin at this weight (I am 5ft 4ins ) so while on holiday last Christmas put on a few lbs. Now though, even though I am eating the same foods I have eaten for 2 years I am putting weight back on and am now 126 lbs. I also gave up smoking in Feb this year but still smoke e cigarettes so wondered if this had anything to do with it. I feel constantly tired and worn out whereas for the first year I had an abundance of energy. I rarely get a whole nights sleep and on lying down get jitters in my arms and legs and palpitations. I do not feel good anymore but cannot introduce any more carbs back into my diet as I know I will put weight on. The only place it seems to go is my belly. It is 12 years since my menopause so it is not that. I was reading your comments and wondered if my metabolism is out of sync and could it be hypothyroidism and what can I do about it. I cannot see any light at the end of my tunnel and feel that I am going to go into old age (I am 58) as a fattie. i have always looked after my body and prided myself on having a good figure with no fat, but all of that is un ravelling before my eyes. Help

    • Hi Shelly, You may want to look at this video

      I have a similar situation. I went paleo and began issues with dry eyes after a time. When I eat safe starches my eyes feel lubricated, but I put on weight. (I am very happy with my weight now I was too thin the first year as well). I feel like I must choose between the weight and my site!
      The shooting pain in my toes, jitters, twitching limbs and pins and needles in limbs that are not twisted bent or otherwise compromised as far as circulation and anxiety is all from vitamin B12 deficiency. I went through this 3 yrs ago. My doctor wouldn’t agree that I was deficient and finally he sent me to a sleep specialist for insomnia (life long). The specialist looked at the same numbers and told me I was B12 deficient. I went on a B complex for quite a while and changed my diet over completely to now grains. Improvement in everything was excellent including migraines, bloating etc……. and I slept! I recently purchased an entire book on B12 (I’m rather intense ha ha ha). The bottom line is, if you have a blood test you should be over 400 mg. Anything lower is a red flag, especially if you are supplementing. Most sites I trust suggest maintaining a level between 700 and 800. The book said maintain at 1000. My doctor had been telling me I was fine if I’m over 133.

      Eventually though, I began getting dizzy spells……….which lead to my looking into MTHFR. I stopped taking the B vitamins and the dizzy spells stopped, so to confirm, I went on line and ordered a DNA test………spit in a bottle……… postage paid………got the results very quickly. It turns out I have the MTHFR mutation (no surprise 60% of us do) During that time a neighbour called me for a ride home from the walk in clinic at our hospital since they wouldn’t let her walk home. She had gone because she was experiencing dizzy spells and they couldn’t help her. I told her about MTHFR and it turns out she has it too. She was able to switch the B vitamin she was taking to one without folic acid and she is fine now.
      So, you could be B12 deficient even though you are eating large amounts of meat for many reasons, but regular B supplements with folic acid may not be a good solution to the problem if you are. I make it a point to talk to pharmacists whenever I’m shopping. They have all been wonderful but none are familiar with any of the information I have been reading on B12 or MTHFR.

      • Hi Jackie thanks for your comments. My legs are still jittering , in fact they have been now for 2 whole days. I think a visit to the dotor may be in order or a change over from LCHF to Paleo as having read about this way of eating there seems to be more good carbs and fruit involved. I will let you know how I get on either way and thank you again for the video and advice

        • You’re welcome. Is the “jitters” that you describe Restless Leg syndrome?.
          I get RLS in a big way if I eat something with MSG. MSG
          I have also noticed RLS when I take calcium. My doctor told me there should b no reason for this years ago, but I am taking a MOOC on physiology presently and they describe how calcium plays a major role in muscle activation, so not sure why he would say this. Could be I’m confused.
          If you are interested in finding out whether you have lots of B12 but it’s not getting to your cells.

        • Shelly your potassium is probably low which is causing your leg jitters and cramps. It’s near impossible to get enough from foods unless you eat high carb. Get some Nosalt and use liberally of get k lute supplement from your pharmacist. If your levels are less that 4.5 you need it, as most foods that contain it are high carb like potatoes bananas fruits etc. We need rda minimum 4700 mgs a day. Bet you’re not even half that on a diet like yours. Since I went on meq 8 potassium I no longer get freezing cold hands and feet no tingling or cramps.

          • Hi Neeters, yes I do believe you are right. Even though I have been taking quinine sulphate as prescribed by my doctor (crmps now gone) I still get tingling and jitters in my legs so I ate a banana for the first time in god knows how long and it calmed them within hours. I cover my food with low salt but that doesnt seem to do anything really. I think I shall just carry on perhaps eating a banana once a week or so and see how I get on. Thanks or the info all the same

              • Yes, but I’ve ruined that by blending them with honey and cinnamon to make an amazing pudding. When I think avocado now, I get cravings for pudding.

                • LOL Jackie! Just swap out the honey for some natural stevia, only need a teeny tiny bit and you will be good to go! 😉 I actually add cocoa powder to mine, I will have to try cinnamon.

                • I had to give up the cocoa powder in my avocado pudding because it was clearly standing in the way of my getting more than 2 1/2 hrs sleep……..sigh. I’m going to try the stevia. I have it, and I haven’t heard anything bad about it. I guess honey sounded natural and unprocessed. Thank you very much. I feel like I’m running out of things to eat.

          • My hands and feet have not been cold this last while because it’s been unbearably hot this summer and I’ve been active outside. The rest of the year I suffer cold hands and feet even if the rest of me is warm. I often have a banana for breakfast, so I’m going to see if maybe things are worse during periods when I switch to something else. Thank you for mentioning the relationship Neeters.

  31. A low-carb has benefitted our whole family. We all have much more regulated energy levels and have lost some weight. Most importantly, it has eliminated some major side effects from the psychiatric medications that our son takes. His cholesterol, triglycerides, and blood sugar are now completely normal and we have a goal to slowly reduce and eventually eliminate these meds. Since he has lost weight, he is able to participate in more physical activity In all the years that we worked with experts and sought various treatments, not once were we suggested to try a low-carb paleo diet. We started off strict in the first few months and now we are able to engage in occasional treats, but stick to hight carb paleo options as much as possible.

  32. Thank you so much for taking the time and energy to share this!! Suffered from PTSD for several years before diagnosed, with six months of therapy and my MD suggested then that I go vegan for cholesterol reasons. I did for 18 months, eating organic and clean with lots of carbs. Felt great emotionally and slept well!! Husband is type 2 Diabetic and more recently same doc told him to eat very low carb diet. I opted to switch to a pescatarian paleo type diet with very low carbs for myself and have had more anxiety and panic attacks in two weeks than I did in two years! I believed for years I have had adrenal fatigue and after ready your article and the link to the article on this subject it fits me perfectly! I have spent countless hours trying to find the right lifestyle diet solution to feel good and it is extremely stressful with all the contradiction out there. This was a blessing for me and I thank you both!!!!

    • Hi Phyllis,
      Have you tried “The Perfect Health Diet”? A scientist and his scientist wife developed it. It is free of grain, but incorporates a higher level of carbs. I haven’t purchased their book yet, but the website gives a great deal of information.

  33. Adrenal fatigue is a complex condition characterized by dysregulation of the adrenal output of cortisol which is regulated by the Circadian rhythm throughout a 24-hr day. To imply that high cortisol is the only effect of adrenal fatigue is incorrect. The reality is one can have too high or too low cortisol for any given point in the 24-hr cycle. And because cortisol is a glucocorticoid, one of whose main functions is to regulate blood sugar, especially in response to a flight or flight trigger, it is vital to pay attention to how carbohydrates in the diet affect blood sugar and cortisol’s ability to maintain homeostasis. In my clinical experience, in late stage adrenal dysfunction where a patient’s cortisol levels and adrenal reserve are chronically depleted, a temporarily lower carbohydrate diet is very helpful because it relieves the fatigued adrenals from having to produce cortisol.

    • very interesting post Leslie. Do you have some additional information or sources ?

      I am adrenal fatigued and have a low functioning thyroid (and most likely liver). Since some months I have done keto and it has been hard for me to spot the advantages.

      Since a few days im doing zero carb keto, meaning that I cut out all plants to avoid ” Salicylates “. I doubt this is doing me good but i will keep testing.

      I AM very interested in Histamines though. Adrenal dysfunction could well be a response of chronic histamine reactions that stimulate adrenal and cortisol from the adrenals.

  34. What if my workouts are fine and I am feeling good and strong, but my mood and energy outside of workouts are low/fluctuating? Would I benefit from upping my carbs?

  35. Unfortunately, I think good old fashioned trial and error, for most of us, is the only way to figure out how carbs affect one’s individual body. And, too, patience. When I was on VLC and felt like crap, I was terrified to add any carbs to my diet, even a little carrot, because I was in such a hurry to lose weight. As I wrote below, I *may* have damaged my thyroid because of it.

    Also — and REALLY unfortunately — age helps and trying to recall patterns about what works via weight loss and, importantly, how you feel. I think I finally figured out how bad I was feeling because I could compare it to other periods in my life when I felt good, or “normal.”

    Now, I am overweight, yes, but also too old to care so much. I am a middle-aged woman in her 40s; there’s only so much I can do! So, that has helped me be more patient and not afraid of carbs like I used to be – just wary of what kinds make me feel bad.

    I can also report that generally non-grain/wheat source of carbs (i.e. fruit or veggie) does not make me feel bad nor gain weight if #1. I eat it in moderation and #2. It’s not the first thing I eat or if I eat it on an empty stomach. That just sets me up for a sugar crash.

    p.s. rice with coconut oil sounds delicious!

  36. I’ll admit I am a bit wishy washy, but when reading the comments here, I am influenced to eat more carbs and less carbs at the same time (still haven’t read the actual article) because the postings are well written by intelligent people and important details are left out of the equation. I would love to see a place (forum I guess) where people can go and have all the information that is offered by others sorted out for them. I guess this would be a situation where you would have a list of question that would narrow things down for you and you could mess with the system a little. If you began by clicking yes to female and no to thyroid complications for instance, you would be able to read the responses that related to this. If you were to change your mind and decide that indicating female was limiting the responses you received, you could click ‘either’ for this and so on. This process could be very helpful for people who aren’t considering important factors, as well as for the easily swayed who have decided to disregard them.

  37. I am impressed that Chris has these articles and wonderful discussion forums. I thought that he would have a low carb focus and not devote so much attention to people having issues with this. He has an excellent site.

  38. Happy to report that low carbing did not ruin my health – although I was fearful for a while. In a nutshell: I ate an ultra-low carb diet (less than 40gms/day) for about thirteen years, and felt great the whole time. For the past few years, my fasting blood glucose was always slightly over 100, with a normal A1c. When my A1c came back elevated to 6.3 on my annual exam this year, I got concerned. NO DOCTOR was able to explain to me what had happened to my body. Were my beta cells asleep or dead? Were my peripheral cells now refusing to let in the glucose my body was making? Independently, I chose to try reversing the trend, adding back in some healthy carbs – mostly starches, no refined sugars., and supplementing with Gymnema. I stopped counting carbs, but I know I’m still eating relatively low. In four months, my A1c was back to 5.6, and my fasting blood glucose is always in the 80’s or low 90’s. More carbs . . . lower A1c. Go figure . . .

    • More carbs means mire insulin release therefore lower bg A1c. uts when you chronically overeat carbs and gain weight that your numbers go up and also if you Undereat carbs you get a type of “reactionary ” insulin resistance which is your body’s adapted state of carb starvation. Low carb and diets are all wrong. Anything in moderation is ok. Plain and simple. VLC stole 5 years of my life. I now eat everything i like and was able to get off thyroid meds and hormones and only supplement with a liquid mineral solution that is copper free and has selenium and 200 mcgs iodine plus Magnesium Chromium and a few other things in it and i take a B complex that is the methyl type by Thorne. I do eat some grains but not wheat. I am 56 and finally feeling better thanks to discovering the real source of my thyroid and chronic fatigue. ..not eating enough carbs and a sleep disorder. Cpap therapy within 6 months fixed almost everything. Adding in potatoes and orange juice daily has made me feel way better. And i eat grits with my eggs a couple times a week. I also eat a lot of beans and chick peas. Half my pkate is always greens or salad. Im still overweight as i gained 70 lbs at menopause from severe hormone imbalance. but im getting better.

  39. i had a short flirt with ketosis (6weeks) had a constant headache , i raised my sodium level this did nothing. so i came out of ketosis to around 50-60g carbs a day and that cured it. i feel great on this level of carbs, i hike every day, lift weights and run occasionally. i find low carbing an excellent tool for maintaining my weight loss. i’ve been around 130lbs for nearly 12 months and i find it easy to keep at a stable weight. we eat a Real Food diet (Primal with dairy) which is high in green leafy veggies and lean meats.

    • May I ask what carbs you eat? I hate weighing out my food. I tried it a couple of years ago and the ‘My fitness Pal’ ap I was using kept warning me that I was going too low carb. My nerves were shot at that time. I was heading for MS I was sure, so these warning were scaring the hell out of me………lol. I didn’t know what keto was, so when they said I was entering ketosis, they might just as well have said rigamortis. I have planned to try again many times, and I really should because I’m never sure what amounts I should be taking in. I’m the same weight and felt good on extremely low carbs, but my eyes became very dry and I keep finding eyelashes lately. I have not done well on a lot of safe starches…….tired or headache. Plantain was wonderful because you can make so many things with it, but I’m forever clearing my throat after eating it and Post Nasal Drip suggests allergy.

  40. I loved this post……finally had some concrete explanation why I was getting very depressed and exhausted on the low carb mildly keto diet after 3-4 weeks…..I was following roughly the wahls protocol, verging towards her paleo plus version…..I was eating some yams every week, but not every day…..

    After reading this article, I ate a whole cup of white rice with coconut oil guilt free last night, and today I feel a whole lot better…..I wish I could be one of those people who see god when they achieve “keto clarity” but clearly for me it is more like “keto hell”…..

    Thank you Laura, for explaining to us outliers that it is not our willpower but our genetics as always….

    • I think there are a lot of people who don’t respond well to a very low carb diet. I’m a little concerned with the fear of carbs that is developing. We see how the fear of fat worked for us! I too don’t function well on VLC and enjoy reading articles that back up the fact that it isn’t for everyone! Too many out there think it’s the ONLY way.

    • very low carb was terrible for me. weight gain, low thyroid, periods went, enormous amount of tummy fat gained. no energy to lift. raised to 70ish grams/day, no fruit but added squash and sweet potato. i am a new person. will never do VLC again. and this is with PCOS/IR taking metformin.

  41. How to get back to normal after low carb diet,now I can’t eat carbs, I’m feel bad after carbs please help me be a normal again.

  42. I started low carb in 2011 and lost 25lbs. I went back to carbs a few months after and gained it all back. Then I tried LC again and couldn’t lose any. I had blood work done and found out I was hypothyroid. I continued on LC and for a long time with meds, tried to get my thyroid levels back to normal. I struggled with it for years, all the while doing low carb on and off but mostly 90% on. This past January I had blood work done with once again high levels. I decided to end the low carb and just eat normal. After 2 months I went back for blood work and my levels are completely normal. For me I believe low carb greatly affects my thyroid. Since eating “normal” again I look better, feel better and my mood has greatly increased. I know everyone is different but I thought I would share my story to help anyone else who may be in a similar situation.

  43. My own recent experiences seem to back this up.

    I have diagnosed moderate hypothyroidism for which I am on medication, and found this article by googling “low-carb and hypothyroid” because I am beginning to suspect my condition was brought on from following a very low carb diet for about a year and a half (8 mos. strictly on/more cheats as time went on, but mostly vlc.) prior to and during the diagnosis.

    I lost 60 lbs. in about 5 mos. by keeping under 20 total (not net!) carbs per day. To put it bluntly: while my body looked better, my face did not. Folks would kindly tell me how “old” I looked (I was 38-40.) but I figured it was because I *was* getting old. We all do, right? I wasn’t careful in the sun and, too, didn’t have the puffy pudgy face anymore.

    But, I could really see that in addition to regular aging, on low carbs I just didn’t look like myself; I was sallow with odd-looking features, even. It’s hard to describe. But, when I would “cheat” with carbs, however, my face appeared brighter, I would wake up not with a food hangover but with renewed energy and vigor. My hair, which was falling out due to the hypothyroidism, came back a little (It’s all back now since I am on meds!). Since I have binge eating issues, though, I always went back to low carb as that’s the only thing that helped me stay structured because the food choices had more satiating fat and flavor and helped to prevent me best from overdoing it.

    After what can only be called a 5 month food and booze binge, I am now back on the bulletproof plan, which doesn’t have to be very low carb, but I am doing it that way for reasons I mention above. While I am now back to being 60lbs overweight, during my binge, I “looked like myself” again and, despite weight gain, felt better overall in terms of having a healthy glow, skin, etc. normal features. Now, a week back into low-carb (and 12 lbs. down) obviously getting rid of water, I look like hell again.

    In sum, I think I need more carbs and am really going to explore the issues here so that I can find a way to incorporate them into my diet, experimenting a little. I am not saying that low-carb “caused” my condition, just that perhaps it’s not the ultimate way for me to go, even though I experienced rapid weight loss. Yet again, it could have caused it! I am looking into St. John’s book “No-Fail Fat Loss for Women” to see if more frequent “re-feeding” with what she calls “safe carbs” (i.e. white rice, sweet potatoes, etc.) might help.

    Anyway, thank you for posting this article so all of us general google dieters can see it and begin on the way to figuring out own best relationship with carbs!

    • I feel great while low carb, My mind is sharper and my weight is ideal. However my skin and eyes dry out. Also I am losing eyelashes and eye brows. My thyroid tests are always fine according to my MD, but they are outside of okay for American guidelines. When I eat rice potatoes or sweet potatoes I feel brain fog. When I eat plantain I get post nasal drip (having to clear my throat all the time). I feel like I’m between a rock and a hard place.

  44. Well written. I appreciate the points made in this article, because though folks love to believe in whatever type of eating protocol helped them, the overarching truth is that it really all just depends. As other people eluded to, it depends on gut bacteria, physical activity, insulin sensitivity currently, thyroid function, stress, sleep, movement, and probably a whole host of other factors.

    I’ve been on both sides of the table. I went super low carb for a pretty long time. The first six months? I was like God, flying on a golden carpet, dominating the world. But eventually (like tons of other VLC or -50G a day low carbers), my body broke.

    Didn’t sleep a full night in a year. Frequent urination. Dizziness, energy issues, massive stress, the whole nine.

    Then, suddenly I was in the other camp, promoting carbohydrates for health, because of the deep deep trouble I landed myself in restricting them. Imagine that? I was that guy posting studies defending low carbohydrate diets, nebulously referencing inuit diets, and otherwise going on and on with as much dietary dogma as I could find and validate on the internet. Then, when low carb broke my metabolism, and a whole host of other things, I wised up and started looking at the bigger picture.

    Which is to find what really works for you, and keep in mind that it’s metabolism and sleep that you really want to work toward optimizing, rather than restricting particular macronutrients (generally speaking). For some people, a low carbohydrate eating protocol will ruin their health for a while, and they’ll have to eat 300-400G of carbs a day for a year, to get back to normal sleep, normal saliva production, and normal energy regulation and metabolism. For others, under 100G of carbs a day will be spectacular for the rest of their existence! Great for them.

    But my take, as a former United States Army combat soldier, and a now 5 year entrepreneur with a successful company, that’s been on both ends of the spectrum is: IT DEPENDS.

    And anyone who ruthlessly claims otherwise, just doesn’t have as much information as they need, and is temporarily unbudgable, locked in the grips of dietary dogma. A place I TOO, fell into and crawled out of.

    • Hi Ryan , great post, I have been low carbing since October to help me utilize fat while running ultra distances, but at the minute I have no energy or motivation to train . You have made me see the light and instead of getting more tired and stressed I’ll up the carbs ! cheers Leanne

    • That is very helpful to me, what you said. Is it the case that some people need to go high carb to get out of the situation they created from low carb? I read the comments and put the cart before the horse here. It sounds like I need to go back and read the whole article because it was very helpful to a lot of people. Thank you for posting your comment as well.

    • I was like you too. Trapped in the low carb dogma for about 18 months, thinking my ridiculously skinny, sinewey, aged face and body was just the healthiest and my concerned friends were all just jealous. It was like a mental illness and I could NOT see what was happening to myself mentally. I was right, everyone else was wrong. I couldn’t see that I was manic, in everyone’s face, aggressive, hyperactive, never slept or relaxed, drove away friends and thought everyone else had the problem. I went literally crazy. I also suffered physical degeneration. Split ridged fingernails, cold to the bones. Blue hands and feet. Gum disease, I lost all my teeth.

      Since I began eating carbs at each meal again, I slowly regained my mental health. Carbs put the “fire” in my brain out. I went from frenzied and manic to calm and rational within days. My weight has crept back up a little but really, what’s the price of sanity. Or false teeth?

      • I was definitely caught up in the joy of Paleo eating… and as you said, I did have friends trying the diet because they wanted to look as you say “skinny”. I never thought of them as jealous, but I suppose there is an element of envy since the idea of becoming thin seemed to far outweigh the idea of alleviating health issues. My skin improved greatly and then after the long term, I began to notice dryness which probably does lead to wrinkles.
        The mental health problems went away when I went on the low Carb High Fat diet though, not the other way around. I went on a GAPs diet first, and I found that I was able to suddenly see the big picture. I stopped running around like a chicken with it’s head cut off starting projects here and there, forgetting what I had begun and then opening up another can of worms in the next room. Always anxious, always jumpy sleeping less than 3 hrs a night at the end. I did more than 30 years of insomnia (not counting my childhood) and Paleo brought an end to all of it. The problem is that I was not eating enough safe starches. I got too low for too long. I do have cold hands and feet all the time, but this is something I have always experienced (I mean bone aching cold) and I have noticed that my nails were getting brittle.
        I think the bottom line is that grains are not safe for me to eat if I don’t want to experience mental illness, but I had better keep my safe starches up if I don’t want to look old before my time…………and I suppose as well I should add more exercise to my regime so I don’t become as someone said a “fatty”.
        Probably my B12 deficiency was corrected more quickly with the switch to HFLC. This would explain why my mental health improved so much. When you remove the grains that keep you from digesting properly, things improve. I’m defiantly getting low now as I eat less meat and more safe starch (no B supplement) while waiting for my hydroxocobalamin.

    • Wow! I couldn´t say it better. I have been there too and thank God I found this article, I just wanted too much for me to work a VLC diet, that I left out of sight what my body was telling me. I now add more berries and an apple a day to my diet and I can sleep now and have energy to do exercise, and I don´t feel like a zombie all day. Like you said: “it all depends”.

  45. I have explored articles on nutrition for about 3-4 years now. I am 22 and since junior year of high school I started having more signs of hormonal imbalance. I’ve always had symptoms unknowingly of pcos but kept it in check with exercise and unfortunately LOW calorie eating (typical teenage girls, sadly). Well that eventually stopped working and I came across low carb eating. It created a constant conscious worry everytime I ate carbs but my weight fell off and I felt good…..for a little. My hair thickened, less acne, all was great. Until I got worse symptoms (hypothyroid symptoms) and pcos-like symptoms reappeared. I’m currently upping my carbs, but some days 200 doesn’t even seem to be enough! I wanted to share this because even for people with diseases or symptoms that improve with low carb might eventually need higher carbs. And it’s ok! Listen to your body, women get out of balance so easily, don’t be afraid to switch it up. Weight used to be an issue for me but now it’s not. I eat 2,000 cal. Do weight lifting 1-2 times a week( not insane or real heavy whatsoever) I don’t feel deprived of food or overworked with my exercise.

  46. Hello,I`d like your opinion on something.
    I have diabetes type 1, 5 months ago I cut out most carbohydrates,I now only consume around 7-8 cups of vegetables per day and occassionaly some nuts.Moderate amounts of animal protein and lots of fat. My A1c is 5.2. But :
    I have a “heavy sensation“ on my throat,where my thyroid gland is, I `m tired all the time, sometimes I do exercise but I`m usually fatigued dnd I have great difficulty in any type of mental work.I can`t concentrate.Mental tireness and tension. My TSH was slightly above the maximum limit.Do you think I should go back eating more carbs to support my thyroid-in the expense of my blood sugar control?
    Thank you.

  47. See Dr. Broda Barnes research from 1906. Even he explained a high fat, moderate protein, low carb diet (Keto) was most effective in maintaining weight in Hypo and Hashi patients. We process carbs the same way a diabetic does and grains are endocrine distruptors. This article is horrible and would leave me bed ridden if I followed its advice. Please dig deep into the research, people. These doctors from over a hundred years ago had the answers and remedy for Hypothyroidism. Cut the grains and use T3 along with T4 therapy. NDT’s are the proven method and it doesn’t cause weak bones like Synthroid does.

  48. If low carb inhibits the conversion from T4 to T3, does craving carbs when having the “hypothyroidism” can’t hardly stay awake episodes indicate there is a problem with conversion?
    My DR has never checked any T3s so just wondering. He says TSH is fine, T4s are fine, A1C 5.8 so it’s a sugar problem. I have Hashimotos and symptoms have never gone away even though Synthroid has my TSH in the normal range.

  49. Hi! My naturopath recommended that I go on a paleo diet with no sweets even no honey or maple because of Candida. I had a very compromised immune system and got sick a lot. I stuck to it for one year and have since then modified it by adding some carbs just recently. Now my bloodwork is showing that my TSH is high up to 635. It was always normal before the diet. I don’t sleep well and I get dizzy when I do eat sweet things like honey or maple syrup. My new Dr. Has put me on 200 mcg Selenium to help. I Eat a lot of chicken some shrimps, other selenium rich foods. Several years ago after an MRI was told I have old MS related lesions on my brain but no new ones for several years. I believe I was starting to get full blown MS before I started the low carb diet and taking probiotics and supplements. I think my thyroid problem is from the diet and no carbs and goitegins in almonds(almond flour) and brocolli and such. I use coconut products a lot too but am considering cutting them out too since my LDLbut was 95 triglicrides 55 which brought total chol. To 207. Dr. Said that’s ok because they ballance out. Now after reading your post I will add some rice to my diet. How much do I add? Otherwise I feel great. Walk most mornings, weights 2-3 times a week. Healthy weight 135 at 5’6″. What kind of diet should I follow now? Help my get back on track! Thanks!

  50. Everybody has a different tolerance level for carbohydrates, before they start causing health problems. For example for me this level is quite low, and I try to keep carbs under 40 grams/day. I’m also very picky when it comes to carb sources avoiding bread, pasta, rice, potatoes, and most fruits.

    At the end everybody is unique and they have different dietary requirements, that’s why no diets works well for everybody.

  51. Wow, this sounds a lot like me! I was diagnosed with adrenal fatigue in June 2012 by an ND after the birth of my second child. I was tandem nursing both children and running marathons on a regular basis. I got campylobacter in March 2011 and it destroyed my gut. It was never the same again. I had crazy gut dysbosis from it and the strong antibiotics they put me on to kill it. After dealing with the ill effects of that for over a year, I started having major blood sugar crashes and couldn’t sleep at night. I would wake up ravenously hungry and couldn’t sleep without getting up and eating some high protein/fat food like peanut butter. I finally got sick of this and went to the ND who diagnosed me. He’s the one who suggested paleo and getting off grains and sugar. I did and felt way better initially, after going through the three week withdraw from bread and sugar. I kept going to the ND for three months but he didn’t take insurance and I simply didn’t have enough money to keep going and spending $250 a month on supplements he prescribed. I felt great and lost all the baby weight and then some. I was as thin as I was in high school. After a year of this, I started gaining weight and the blood sugar crashes increased. I have major crashes in the afternoon where I can’t do anything and can’t sleep at night unless I eat three boiled eggs before bed. I had no idea I needed more carbs. I’ve started adding them back and it’s helped a lot. I’m also going to see an integrative doctor who’s running tons of labs. I think in the past two years I’ve gone from AF to full on hypothyroidism and possibly Hashimotos. I think I made my situation so much worse by eliminating carbs and all forms of sugar for so long.

  52. When I read the article, it just made me wonder to see how those Canadian inuits, or any other society where carbs were not even on the table survived for so many years. To me, the idea of a low carb-life makes perfect sense. The only point I am struggling with this ketogenic diet is to see how it can be sustained as a vegeterian. I tried loading myself with all the fat and egg/butter but didnt feel good, because I have never been so much loaded with animal protein and fat before. So, I wonder if vegeterian eating and ketogenic diet matches.

    • I think you must be confused about what the research actually says. The Inuit are not an example of a ketogenic culture.

      See: Lies, Damned Lies, and The Inuit Diet

      With more than 20 studies spanning over 150 years, there is zero evidence that the Inuit were ever in ketosis while eating their traditional diet.

      To remain ketogenic, a person must restrict protein and consume high level of fat. But, what we see from the literature is that the Inuit were consuming way too much protein and not nearly enough fat. Rather, the large amount of blubber they collected was too valuable to eat, since they needed to burn it in their oil lamps for heat and light during the long dark winters.

      Excess protein is converted to carbohydrates in the body and the Inuit were said to have had abnormally large livers to assist them with this process.

      Every culture went out of their way to obtain carbohydrates wherever they could find them. Even the Inuit.


      • I lived in Alaska for several years, and yes, the Inuit eat blubber, lots of it (whale tastes really good too, like beef). No, they don’t consider the little oil lamps they use the most ideal use of what is a valuable food (especially with kerosene and battery powered lights now easily available). No they do not eat anywhere near as much protein as they do fat, which they prize highly as a food. Yes, I’ve eaten their diet and managed to light up a keto stick consistently, besides losing a ton of fat off my waist (granted I went more toward the fresh salmon and other wild game than the frozen fish dipped in oil). A caveat: very few Inuit eat the traditional diet anymore. This is just my observations and experience, but I’m sick of reading nonsense written by people who get their info second or third hand.

        • Graachus:

          While I’m sure many will be delighted to take your single MODERN observation over a few years of a few Alaskans as gospel that THE INUIT ARE HIGH FAT KETOGENIC.

          The problem is, people should actually go with the 150 years of research on the Inuit, research which contradicts virtually every of your statements (at least of a few decades ago). What Inuit currently eat has little relevance to the myth that has been propagated.

          All the research is detailed in these 17 posts and 1,500 total comments:

          BTW, I lived in Japan for 5 years and France for 2. Can’t imagine using that experience to assert “The Japanese eat…,” or “The French eat….” Hell, I can’t even say “The Americans eat….”

  53. Thank you for this article. I tried Atkin’s diet many years ago and within a week I felt so sick with a myriad of weird symptoms that I felt it necessary to stop, though I didn’t know why. Fast forward 5 years and I decide to give it a go again, this time with South Beach diet. I followed phase 1 plan almost to the tee. By day 4 I was feeling really sick again. Many strange symptoms. I kept going because people told me it was must my body in ketosis and I needed to adjust. Within another week I was still sick and I noticed lumps in my neck. They seemed to grow overnight. Went to my doctor and she ran a thyroid test and found my TSH was 76+ and my FT4 was almost non-existent. She called me right away to tell me she had never seen numbers like this in her 30 years in medicine. She then sent me for scans and more bloodwork. My thyroid antibodies were sky high and I had tumors on both sides of thyroid. That is when I was diagnosed with Hashimoto’s thyroiditis. I ended up taking thyroid meds for about a year and re-vamped my diet ( I have to include healthy carbs or else I crash and burn.)

    • It’s probably a good thing you went low carb, otherwise the thyroid issues might not have shown up until you were very ill.

      I doubt the diet caused it – it happened way too quickly, but it may well have made it a lot more obvious….

  54. I have been tending toward low carbs for weight management but also because I have reactions to specific types of carbs which seemed to have caused increase inflammation. I have Hashimotos, had adrenal fatigue previously, early hormonal disturbances in my 40’s (now 52), had severe small intestinal problems – very sensitive, lactose, fructose, polyol intolerant although ok on other FodMap and diagnosed with SIBO. My sensitivity to carbs comes from grains, sugar and I think also pseudo grains eg buckwheat. I would be curious to know if anyone else gets hot, sore and prickly skin (but no visible problems), fluid retention, indigestion, and inability to shift weight. I have been working with nutritionist, but its been a long journey. I want to know how long I have to be really strict to be able to have a more varied diet. I also want to be able to do intense exercise (long and hilly bike rides) but I fear running out of energy for lack of carbs to support the exercise. I have been on restricted plans for years, and my sensitivities don’t seem to be getting progressively better. Is anyone else experiencing this level of problem?

    • i get intensely hot when i eat dates, figs, dried fruit, fodmap fruit and veg and rice (and all grains) give me horrific instant abdominal retention to where my clothes don’t fit for days after. i have tests for sibo coming up. Have you tried l-glutamine?

  55. I’m very thankful to come across this article. I’ve been low-carb for a while because I think I either have SIBO or candida problems, so I’ve been going very low-FODMAP. In return, my mood has plummeted, my hair is falling out in clumps, and I haven’t laughed in a while.

    I’m going to try upping my carb intake (the low-FODMAP ones), while still trying to stay true to the Autoimmune Paleo Protocol and see where that gets me. I’m very happy to see that not everyone bashes carbs — I was starting to get worried!

    • Catie, I had similar issues. This past week I increased carbs from 50 grams to 150 within AIP guidelines and I have never felt better. I also sleep so sound!!!

  56. I think it’s nonsense and destructive to discuss “low-carb” without dealing with what you do with the other two macro-nutrients – not to mention total energy intake and micro-nutrients.

    I don’t eat “low-carb”. I eat low-glucose. That means restricting BOTH carbs and protein. I started it for diabetes and will continue for life for that and lots of other health reasons.

    I think its completely proven that glucose (from diet) is not an essential nutrient. We can make what we need from protein and other things. That shouldn’t even be an issue of debate at this point.

    BUT, replacing carbs with protein is often not a positive move. The excess mostly become glucose, so little has changes. It also stimulates glucagon and that may cause additional problems.

    Now, for low-carb/HIGH-FAT which is what we should be discussing here, a problem could occur for someone with impaired fat absorption or fat metabolism. In that case, maybe what’s broken is what should be looked at (fat metabolism). Or, if high-carb is not harmful to them, they can just stick with that.

    I can’t see that high-protein is EVER a good idea above what is needed for tissue growth and repair. It seems that the vast majority of bad experiences on “low-carb” come back to this – excessive protein and not enough fat (or, if the fat is Omega-6 PUFA, that’s just about as bad or maybe worse then lots of glucose in terms of AGEs, inflammation, etc.)

    • Salim Morgan makes a really excellent point. There is not a lot of study data, but low-carb high-fat is probably better and more sustainable than low-carb high-protein.

      I think a lot of people fall into excessive protein intake partly because the fear of fat is so deeply ingrained in us after a lifetime of listening to the government and the American Heart Association tell us, without any scientific basis, that fat would “clog our arteries.” As it turns out it was the carbs and trans fats clogging our arteries and creating the inflammation that causes heart attacks.

      • “I can’t see that high-protein is EVER a good idea above what is needed for tissue growth and repair. It seems that the vast majority of bad experiences on “low-carb” come back to this – excessive protein and not enough fat”

        Funny you should say that. The Inuit were overwhelmingly documented, in the scientific literature, to have been high protein, low carb. They had to conserve their fat as it was their lamp and heating fuel.

        Studies on The Metabolism of Eskimos, by Peter Heinbecker (1928)

        “According to [Krogh & Krogh’s] analysis the metabolism of the food contained in the Eskimo dietary would not be expected to cause ketosis, because the calculated antiketogenic effect of the large amount of protein ingestion was somewhat more than enough to offset the ketogenic effect of fat plus protein…Average daily food partition is about 280 gm. of protein, 135 gm. of fat, and 54 gm. of carbohydrate of which the bulk is derived from the glycogen of the meat eaten.”
        Clinical and Other Observations On Canadian Eskimos In The Eastern Arctic, By I.M. Rabinowitch (1936):

        “Eskimo catches a walrus he immediately opens the stomach and eats all of the clams, which have some glycogen. He also relishes the skin on the whale and narwhal, both of which are rich in glycogen, and he eats enormous quantities of meat. The Eskimos eat the livers of practically all animals, except that of the white bear. These are rich in glycogen. As stated above, when food is abundant a healthy adult will eat 5 to 10 or more pounds of meat a day, and, only when in need does he consume very large quantities of fat. Blubber is not regarded as a delicacy. It is also of interest to note that though whale, walrus and seal have enormous layers of blubber, the accumulations of fat in the musculature seen in some land animals are practically unknown; the meat is, therefore, lean. When consideration is given to these facts and to the additional fact that about 58 percent of protein is convertible into sugar, it is obvious that the ratio of fatty-acid to glucose is well below the generally accepted level of ketogenesis. I estimate that when food is abundant, the average daily diet of the adult Eskimo consists approximately of 30 to 40 grams of carbohydrate (which includes glycogen), 250 to 300 grams of protein, and about 150 grams of fat (FA/G=1.2). These amounts of meat are apparently not heroic, for it has been alleged that the Yakuts, on the Low Steppe, east of the Lena, eat as much as 25 and 30 pounds of meat a day.”
        The Diet of Canadian Indians and Eskimos, by H. M. Sinclair (1953)

        “The skin (mattak) is greatly relished and tastes like hazel-nuts ; it is eaten raw and contains considerable amounts of glycogen and ascorbic acid…There is in fact nothing unusual about the total intake of aliments ; it is the very high protein, very low carbohydrate and high fat intakes that have excited interest. It is, however, worth noting that according to the customary convention (Woodyatt, 1921 ; Shaffer, 1921) this [Inuit] diet is not ketogenic since the ratio of ketogenic(FA) to ketolytic (G) aliments is 1.09. Indeed, the content of fat would have to be exactly doubled (324 g daily) to make the diet ketogenic (FA/G>1.5).”
        Basal Metabolism of The Eskimo, by Kaare Rodahl (1952)

        “It is well known that considerably higher amounts of pro tein are regularly consumed by the Eskimos (DuBois, ’28), who generally speaking, prefer a diet where approximately 50% of the calories come from protein and the greater part of the remaining 50% are derived from fat. August and Marie Krogh (’13) report that the normal diet of the West Greenland Eskimos contained an excessive amount of animal protein—280gm daily—and they noted that there seemed to be a considerable delay in the metabolism of protein and excretion of nitrogen, only 60% of the nitrogen being excreted during the first 24 hours after eating large meals rich in protein. In East Greenland the Eskimos consume an average of 300 gm of protein daily (Höygaard, ’41). In Alaska a daily protein consumption of more than 300 gm has been observed among the most primitive Eskimos.”
        Carbohydrate and lipid metabolism in the Alaskan Arctic Eskimo, by Feldman et al. (1975)

        “Such an isolated people presents an opportunity to identify genetic and/pr induced adaptive phenomena to this diet which is characterized, in comparison to the general American cuisine, as being of a relatively low carbohydrate, low confection, moderate fat and high protein composition.”

        It appears that the only population eating LCHF are modern ketogenic dieters. Perhaps LCHF is highly beneficial, but we’ll never know since it’s never been observed or tested long term in any human population.

    • Exactly what I was thinking! Most of the objections to a low carb diet are based on the assumption that the carbs are being replaced with protein. In a LCHF diet that is not the case at all. The other common objections is that you can’t be eating fruit or veggies either. There are lots of low carbs veggies and fruits that you can fill up on; broccoli, cauliflower, spinach, kale, green apples, berries, lemons, limes, oranges and I am sure many more.

  57. I totally agree with @Nils at top of conversation and think the point was lost in the whole grain vs seed debate.

    You can incorporate more carbs through a lot of different ways – yams/carrots etc and don’t have to rely on grains. I thought it was interesting to consider @Ken’s Healthy Living comment regarding eating foods raw as well – especially his position that beans were bad – haven’t heard this before any comments on this?


  58. Hey Laura!

    Great article, I really appreciate your work! Just wanted to let you know I was listening to the Jillian Michael’s podcast (shameful, i know!) and she had a segment on her podcast about low carb diets and pretty much took your blog post word for word in some parts. Im not sure if you were aware, since I dont think she gave any credit to anyone. It’s the one titled “Jillian Gets Chickens” The segment starts around 30:00. Just wanted to let you know!

  59. As much as people condemn the Atkins diet for being this horrible no-carbs cheese-and-bacon diet, it’s clear to me such people never read the book, because it *provides tools* for figuring out how much carbohydrate you personally can handle in your diet. Instead of jumping all over the place with different carb intakes, you start out low and gradually reintroduce.

    When someone works hard to give you a tool for good health and you just spit in their face, it’s no wonder you continue to struggle. (I mean “you” here in the general sense.)
    Meanwhile, I’ve heard of people whose hypothyroid symptoms *improved* on a low-carb diet, and there have been people who’ve seen leptin and cortisol do better as well. And I wonder how many of the athletes who “can’t perform” on low carb were failing to increase their fat intake. That is not an unheard-of error for people to make. Dietary quality matters too. Just more stuff to think about.

    That said, not only can carbs help in pregnancy (*don’t* overdo it, nobody needs to have a nine-pound baby), but they can also be important in lactation. You don’t need to go overboard and gorge yourself, but if you’re breastfeeding you will learn how it feels when you’ve got proper milk production going on, so eat just enough carbohydrate to keep that going. Reason: Starch breaks down into glucose which your body converts first to galactose and then to lactose. You make some glucose but your native production is meant to support those tissues with an absolute glucose requirement; it’s not meant to feed a baby too.

    • Let’s not be dramatic. I’m not sure anyone who observes scores of their clinical patients failing miserably on low carb diets — and shares those observations — is “spitting” in anyone’s face. Atkins was not a deity. To suggest that those who failed on a low carb diet were somehow ‘doing it wrong’ is pure dogma. This article was specifically written to challenge those attitudes.

      We all have different flora and pathogens in us that respond to different levels of macronutrient intakes. Most people will do just fine with a moderate whole foods carb intake. Low carb diets certainly have their place, for those who need it, and no one is challenging that. But for those who feel worse on a low carb diet, it’s a breath of fresh air to have a clear and concise resource that people can access.

      • Not true! For me the low carbohydrate diet was just perfect! Bad comment thank you

        I guess my point should be clear.

        P.S. so far 100% of people I’ve met with “low-carb didn’t work for me” -issue were doing it wrong. And I’m not talking about 1 or 2 people here. I’m not saying this is ALWAYS the case but it has been the case 20+ times in my experience…

        • Well, then meet one of the exceptions. I did Atkins the first time in late 1994 or early ’95 WITH the original book borrowed from the library (don’t think the “new” one was out yet…) and dropped all the weight I needed at the time during induction (about 11 or more, and mostly fat because at a higher weight I fit into my old smaller clothes). However, the moment I increased the carbs I began to gain again, and after that it seemed it was easier for me to gain weight than before. Three years later I tried again, with the new book, hoping for another dramatic loss but it was disappointing. The 3rd time maybe a couple of years later I even tried the pork rind/cream cheese no-carb “fast” when I began to stall but I think I just gained some weight back so I had to quit. I was diagnosed with hypothyroidism probably within a year and ever since, every time I try low-carb, even for 2-3 days, Iike just this past week, I stop losing, feel colder than normal and my body temperature drops significantly. Conversely, I remember a time when I was able to lose on a moderate carb diet, which is what I’m going to have to try from now on.

          So, the real point is that we’re all DIFFERENT, and there is no “one size fits all”. When I was skinny and didn’t gain easily (until I had my first child at age 30) I believed people who said they didn’t lose while on a diet were all lying, then many years later I had to go through it myself to believe it, in fact, last year I gained 2 lbs. while on a week of low-carbs.

          Just thank your “lucky stars” that low-carb works well for you, but don’t park yourself in an inflexible belief system or else life will teach you a lesson for being judgemental, many of us have done the diet right (I defended Atkins for years…) but our bodies don’t cooperate. Listen to this podcast with KK and hear what he had to say about it:

          • As I said before, we all have unique pathogens and unique microbiomes. Metabolic syndrome is almost certainly due to a disruption of our microbiomes, rather than a specific ratio of whole food macronutrients.

            High carbohydrate indigenous populations (and there are many examples), who ate ridiculous quantities of honey and starches, do not develop metabolic syndrome. Yet, Westerners do.

            Dr. Ayers explains a theory that makes more sense:

            Obesity is a Symptom of Antibiotic Damage to Gut Microbiome

            We may enjoy a fat marbled steak, but the corn and antibiotics used to produce that mouth-watering plate of satiety, is not so healthy. Corn and antibiotics make that meat on the hoof fit for human consumption, but the cattle are quickly dying and the fat marbling is a symptom of cattle metabolic syndrome. The corn and antibiotics disrupt the bovine gut microbiota and alter energy flow. The result is prime beef.

            As It Is with Cattle, so It Is with Middle Americans

            General descriptions of Americans with metabolic syndrome and steers ready for the abattoir are similar. That should not be surprising, because both are caused by damaged gut microbiota and consequences of metabolic syndrome. Americans routinely damage their gut microbiota with antibiotics (processed food, etc.) and the major symptoms of the resulting gut dysbiosis are chronic inflammation, depression, autoimmune diseases, obesity and metabolic syndrome. Repairing gut microbiota reverses all of these symptoms.”

            In other words, if you damage your microbiome—whether it be from antibiotics or junk food (or both)—you may develop an inability to properly metabolize carbohydrates.

            That does not mean that carbohydrates cause metabolic syndrome. No, it just means that you’ve damaged your ability to properly metabolize carbohydrates (i.e. metabolic syndrome). Luckily, this damage can be repaired in many people.

  60. Thanks for taking the time to reply to my comment Tom. I’m actually adding carbs back in at the moment as I’m pregnant and keep hearing dire warnings about being too low carb in pregnancy. It’s a complete disaster: I’m hungry all the time, craving the wrong foods as in ready to open a bag of Doritos, my nasal congestion has come back and my IBS is flaring. It makes it difficult to know what to eat.

  61. I feel many of you brilliant people are overcomplicating the issue of carbs. The questions we should all be asking are what are the optimal sources for healthy carbs and what is the daily amount we should be consuming based on your personal lifestyle? I came up with a few food questions to help make my choices. They are hardcore and don’t take into consideration the nutritional benefits found in happy cross breeding accidents aquired from soaked nuts or sprouted seeds.
    Here they are, your feedback is welcome as I am constantly refining these food questions:

    If the food is toxic in its raw state, you were not meant to consume it. Cooking and soaking removes most of the anti-nutrients (along with the nutrients) much of the toxicity but not all. It is wise to consume more than 51% of your plate raw.


    Gas, Allergies and Bloating is your body’s way of telling you that you ate the wrong thing. If it makes you, scratchy, cough, wheeze, runny, cramp, swell, creates excessive mucus or gives you gas then give it pass and remove them from your diet.


    While it is often said that feeling a bit tired after a meal is normal. I disagree, food should be energizing not depleting in nature. When you consume some of the wrong foods, they convert into sugar rapidly, causing damaging spikes in blood glucose followed immediately by a drop. The result is low energy levels and feeling sleepy.

    Furthermore to metabolize the sugar, minerals including magnesium, manganese, chromium, cobalt, copper and zinc are removed from the body tissue where they are stored. This depletes the body of minerals that are essential to health and disturbs critical mineral relationships.

    Feeling sleepy after a meal can also be related to health conditions such as Allergies, Food Intolerances, Nutrient Deficiencies and Insulin Problems.


    This indicates that you do not have the right digestive enzymes to break them down or have a digestive disorder; Corn, Seeds and Grain are good examples. They are the plant’s reproductive material, intended in nature to produce new plants. You and your Paleo ancestors were meant to transport some of them, then fertilize them when you poop them out. Which brings us to the next question …


    The primary purpose of seeds,grains and beans is to produce new plants, It is unwise to consume excessive plant reproductive material. due to their varied protectionisms. In fact there are some that may kill you.

    Plant’s reproductive material has evolved natural protectionisms namely anti-nutrients (enzyme inhibitors and lectin) to suede off predators. Lectins are toxic to us. Soaking and cooking can remove some of the anti-nutrients but not all.

    • Great questions! Though I never made a list, these have guided my food choices for a long time. I seem to do better listening to my body, rather than defining a diet and attempting to stick to it. My needs vary, season to season, and sometimes even day to day. One thing I can say that seems to be true for me in general, is that when I’ve been very low carb for a long spurt, I will have some carb cravings attack me! I’m learning to listen for earlier signs that my body is needing some carbohydrates. Also, in general, “moderation in all things” can be a very helpful M.O.!

  62. I eat very low carb: 10-50g most days with carb refeeds once every week or two. My health has improved dramatically: IBS has gone, period pains have gone, mood is better, more energy, joint pains have gone, better quality sleep, I don’t become crippled by hunger to the point that I can’t do anything until I get food, I have plenty of energy even after a vigorous exercise. My lipid profile is good, blood pressure is normal, thyroid and female hormones are all normal. So while I appear to be in the pinnacle of health and I feel great right now, this article implies that if I don’t start eating more carbs then I will get sick? But if I start eating more carbs then the IBS comes back, my nose gets blocked up and I get terrible hunger again. The way I feel right now I’d rather take my chances with adrenal fatigue and hypothyroidism than go back to the way I feel when I eat more carbs.

    • Aurora, I’ve been low-carb for years and my health is good. I too probably do 20-40 grams a day, and I fall off the wagon usually every weekend with a little wine, chocolate, wild rice, pizza etc.

      Low carb is definitely sustainable over the long term. In fact it makes the most sense as a permanent change. Chris’s comments are well worth reading. There are side effects and complications in some people. If you feel good and your blood workups are good, that is probably important information.

      The Atkins approach — which is scientifically very mainstream and very well tested — is for each person to figure out their own tolerance for carbs. For some people it’s 150 grams a day, in some people it’s more like 30.

      A lot of the posts on this board I’d be wary of because they’re coming from people who have an axe to grind. Low carb has well organized and powerful enemies. The vegans and animal rights groups are very committed to their cause and they feel no guilt at all about spreading scare stories about meat and low-carb eating. The grain industry and industrial bakeries are paying people to post anti-low-carb messages to forums like this one.

      It’s silly. Cutting carbs is a completely simple logical response to health conditions (mainly, obesity and metabolic disorder, or some forms of ibs) that result from eating too much carb food. A little like, if you’re coughing too much, cut down on the cigarettes. Another 20 years and we will be wondering why this was ever the least bit controversial.

      • Tom said: “The vegans and animal rights groups are very committed to their cause and they feel no guilt at all about spreading scare stories about meat and low-carb eating.”

        Tom, I’m not sure where you get this idea from. No one here is advocating for cutting out meat. Quite the opposite actually. Just about anyone who reads this blog knows that meat is essential to health. And up to a pound of meat per day can be quite healthy in a balanced diet.

        Tom said: “The grain industry and industrial bakeries are paying people to post anti-low-carb messages to forums like this one.”

        No one here is recommending grains or baked goods. If anything, the only carbs people are recommending here are a balanced diet that includes tubers, rice, and legumes. Very simply, eating like an average HG culture does, with everything in moderation. That’s hardly the conspiracy you make it out to be.

      • Tx Tom,
        For having more patience in this convo than me. And, for again, highlighting the primary health issues for Americans & that low carb can be of significant benefit.

        While I too have been low carb for over 5 yrs, (50-75grams w/ lots of healthy animal fats) and am significantly the better for it… I just want to toss in re: the importance of essential nutrient intake & as Ken, below mentions – anti nutrients, & the complex symbiosis in our ecosystem that is required for all of us (bacteria, bugs, plants, animals, humans, etc) to survive. Aint it all truly GRAND! Vive Vida!

  63. I’m from the U.S. married and living in Mexico over 11 years. As you may know, one of the staple foods of the Mexican diet are beans (black beans in Veracruz where my wife is from and white beans [“Peruvian” beans] in the northwest-central region where we are currently living in Guadalajara). In March we removed from our diet corn products (tortillas), potatoes, wheat products (Pasta, bread..), soy products and rice along with all products containing corn or potato starch, soy and flour… I may have skipped something. But, being fair to my wife (and since I’ve been somewhat of a “beaner” all my life, to me too to a certain extent), I haven’t removed from our diet black beans, pink beans or white beans… Also, living in Mexico with such abundance of fruit, I haven’t removed from our diet guavas, passionfruit, prickly pair cactus fruit or papaya… I don’t eat bananas since March. Part of the reason for not removing guavas and papaya is that they are the #1 and #2 fruits/vegetables in vitamin C in the world. Vitamin C deficiency is linked to high blood pressure (which I have living 11 years 4,000-8,000 feet above sea level after my first 33 years living near sea level)… Passion fruit is also well known for lowering BP… As for prickly pear cactus fruit (Tunas), they are considered extremely high in anti-inflamatories and anti-oxidants (especially betalans)… All that said, since March I’ve dropped at least 34 pounds, and found that my physical endurance has increased astronomically; two years earlier I could bearly make it to 5kms running. In June I was running very near 10kms (6 miles) 5 days per week… My pant-waist size was 38-40 in the beginning of March. Today it is between 34-36. However, there is a strange fatigue I experience after the run or the day after… I’m in the process of finishing Gary Taubes’ monumentally inspirational book, “Good Calories-Bad Calories” and in the middle of Udo Erasmus’ very informative book “Fats that Kill, Fats that Cure”…, consume between 2 and 6 teaspoons of sugar (in coffee or lime-flaxseed water)–8 to 24 grams/32 to 96 calories per day, ignoring the sugar content of the 2+ guavas, tunas, or apples I may eat in a day (it’s either one or the other; I don’t have that much of a tendency towards eating fruit, not all of the above) and am surprised that, although I find my weight and waistline decreasing, I don’t have that sense of excess energy that Gary Taubes describes… And I eat all the animal fat and coconut oil and animal protein I desire. I don’t believe much in calorie curbing, especially seeing the effects over the past 6 months… that it “a calorie isn’t a calorie…” etc… But, it is interesting reading this piece… And maybe my daily consumption of beans is the equivalent of a carbohydrate increase in those who experience certain aspects of fatigue with exercise on a very low carbohydrate diet… And, with the beans and the sugar and the fruit in my diet, it IS a very low carbohydrate diet compared with the amount of carbs I was consuming through February 2014…

    • HI Ross,
      Something to strongly consider – your salt (sodium) intake.
      I, too, had varying issues w/ fatigue & malaise w/ exercise, along w/ feeling really great, most of the time. However, having lower leg cramps & spasms that shot me out of bed led me to do some more research on electrolyte balance. One of the issues in low carb diets, particularly if you are achieving ketosis (even intermittently), is a decrease in insulin levels. Research in IR & diabetes has shown that insulin is a “strong enhancer of sodium reabsorption”[ ] …. As insulin decreases, more sodium (+magnesium & potassium) is excreted. This can be quite acute & variable depending on how you cycle the carbs in your diet & how much exercise/sweating/electrolyte excretion is occurring. Symptoms of low sodium (hyponatremia) include: morning headaches, constipation, nausea, lethargy, fatigue, short term memory loss, confusion, muscle cramps/spasms, low blood pressure, etc. [ ]
      Many of the low carb diet instructions include using “bouillon cubes” to offset these symptoms…. However, reality is that as we maintain a low carb lifestyle, our insulin will remain low and, we simply need to increase sodium in our diet as the norm. While I consciously eat a high sodium diet (& occa. supplement magnesium & potassium)…. depending on increased ex. Intensity & electrolyte loss from sweating – I will drink mild salt water solutions to maintain sodium balance. I’ve had clients, on low carb, who were acutely fatigue while exercising – drinking 6oz oz. of H2O + 1/2tsp of salt immediately resolved the issue. I find that a cup of salty water or salty green tea is a great “pick me up” in the afternoons. One of the FAQs I get is “how much salt?”…. like drinking water – stop when you don’t want anymore (and adjust the salinity to taste). That’s how my horses & cattle do it . Sally Fallon Morell has been a great advocate for increasing our salt consumption & highlights the critical importance in overall health in this article [ ].

      I hope this might be helpful. Viva Vida!

      • Hi Carmen, what I don’t mention when I write about myself in these groups and conversations is one of the reasons I stumbled across Chris Kresser in the first place and probably why he or his aids won’t respond to something I write because it is well outside their realm of understanding, is that I don’t have a large intestine or a rectum. What is logical for most people becomes illogical for me. I have what is called a J-Pouch; the Ileal part of the small intestine constructed into a semi-artificial rectum, although 100% Ileum. from my father I inherited Familial Adenomatous Poliposis/Gardners Syndrome that led to the removal of my colon at the age of 13 in 1982 and the removal of my rectum just after 9/11. I lose a lot of water in my feces. But, I also drink a lot of water. In blood tests, my sodium level is normal, as is my potassium level and my iron levels hover near deficiency… could be due to problems in the small intestine related to Gardners Syndrome or due to Duodenitis diagnosed 9 years ago. It could also be that the Duodenitis went away with the removal of wheat products (I don’t believe I have Celiac and I don’t believe that only people with Celiac experience life-threatening problems related to the consumption of wheat products. And I don’t believe that it is only Gluten in wheat that is the issue, just as lactose isn’t the only problem with dairy products). I was trying to drink electrolyte drinks before and after the runs. But, it seems that my body (mouth, throat) don’t accept them. And when I have that type of reaction, I tend to take heed of it as if my body is saying, “this isn’t something good for you”. Granted, I don’t have problems with gatorade. But, I doubt gatorade is actually what one truly needs to drink when they have concerns with electrolytes. All this said, since that seems to be my style of communication, you are probably correct about the issue of electrolytes and exercise and I should check my blood tests for when they analyzed my potassium levels last. While I’ve removed potatoes from my diet (there are 30+ fruits and vegetables higher in potassium than potatoes anyway), I do eat a sufficient amount of tomatoes. And now I should stop giving you a headache and read what you wrote 😉

        • I probably should have read through first before writing the above. I’ve been reading a lot lately. Not all of what I read is on the Paleo reading list or mentioned by the Paleo experts such as Chris Kresser and Mark Sisson. Although maybe they believe Udo Erasmus’ perspective is out dated or in conflict with what they believe, I find it interesting what Erasmus says about gaining Omega 3 from Flaxseeds and have researched about what it would take for you to increase your HDL cholesterol with Flaxseeds instead of with Salmon. But, I live in Mexico. Salmon wherever you live is very expensive. But, in Mexico it is of very questionable quality and not all Salmon is the same… It would be easier and cheaper to gain more Omega 3 from Mackerel than from Salmon. But, there is the same question of where the Mackerel comes from. So, back to flaxseeds: Calculated for what Chris and even Udo says about how much of the Omega 3 in Flaxseeds is not metabolized by the body, I can still obtain the adequate amounts by consuming the equivalent of 5 tablespoons per day (if I were suffering a degenerative disease). You may be wondering what this has to do with what you wrote… Magnesium. In order for you to turn Omega 3 from Flaxseeds into DHA for your health, you must also procure that your body has enough Magnesium (Pumpkin Seeds), Vitamin E (Sunflower Seeds), Vitamin C (Guavas #1 in the world and very low glycemin index due to their soluable fiber), Zinc (Sesame Seeds), Vitamins B3 (Chicken) and B6 (Beef). But, speaking about Magnesium, Pumpkin Seeds are #1 and I eat a lot of them ground and placed in what I’ve cooked… But, that doesn’t mean that I absorb any of this, due to not having the Ileal part of the small intestine. Granted, no one in the world actually explains if the Ileum turned into J-Pouch actual stops functioning although it is alive… In April, my Vitamin B1 was borderline deficient: 8 where normal is considered between 8 and 30. And my Vitamin B2 was low: 11.4 where normal is considered between 6.2 and 39. And when you read about the small intestine and where the nutrients are absorbed, it is mentioned that the Ileum absorbs B12, but it doesn’t mention where B1 and B2 are absorbed. As for B1, I eat organ meats semi-regularly and I haven’t removed legumes from my diet, as I mentioned about beans. As for B2 I eat a lot of chicken, normal amount of mushrooms, legumes, alot of almonds and cheese…

          As for constipation… I was experiencing it for the first time in my almost 13 year J-Pouch life between December and May… It has since disappeared, thank god.

          As for sweating… I was sweating well during the runs in May and June. But, disappointingly, I’ve found that I don’t visibly sweat since then, not enough for it to visibly show on my shirt after running. But, I do sweat, since I feel that horrible discomfort of suffocating skin hours later if I haven’t yet showered… like now… The bathroom is full of mosquitos and I’m not in the mood to wage war butt naked…

          Ok. I got to the end of your very interesting comment. Thanks Carmen!

          I’ll check out the links you placed in your comment and the saline water, especially with green tea.

          I hope I didn’t give you a migraine.


  64. I’m not opposed to the theories about gut flora — quite the contrary. I’m only saying that the field is so new, we don’t have enough data to make recommendations one way or another.

    Geez, the whole field of microbiome has only begun to get traction in the last 6-8 years. It will be a decade at least and probably two decades before we have a decent base of research.

    I’m saying there is no scientific basis to say to an obese person: Well, yes cutting the carbs will help you lose weight and reduce your risk factors for diabetes, heart attacks and cancer — but DON’T DO IT BECAUSE YOU MIGHT HURT YOUR GUT FLORA.

    The people who have political or personal reasons to fight the low-carb movement (vegans and and the grain industry, prominently) have used every trick in the book.

    They have tried to scare people by intentionally confusing ketosis with ketoacidosis. They have trumpeted all kinds of sketchy and sometimes outright false claims that meat and dairy will give you cancer. And now these people have glommed on to this gut flora thing.

    It’s the latest scare tactic — don’t stop eating Rice Krispies and banana nut muffins because your GUT FLORA WILL GO HUNGRY.

    My take on this as a non-scientist is that I can maintain gut flora just fine eating low-carb vegetables, salads, low-carb nuts, and occasional grains and starches. But I’m not going to pretend to cloak my choice with scientific authority because that would be dishonest.

    • “It will be a decade at least and probably two decades before we have a decent base of research.”

      Not true at all. There’s already at least 40 years of solid research on our gut bugs. Did you think scientists just discovered gut bacteria a few years ago? That would be a pretty silly assumption to make.

      “My take on this as a non-scientist is that I can maintain gut flora just fine eating low-carb vegetables, salads, low-carb nuts, and occasional grains and starches.”

      Well, Tom. That’s your prerogative and your own hypothesis. But you should know that there is plenty of data that points in the other direction. As I said, there is over 4 decades worth of data now, that you are apparently unaware of.

      Here’s one 2010 paper about cellulose, which is the most common fiber found on the planet and is most typically found in low carb leafy greens.

      The cellulose-degrading microbial community of the human gut varies according to the presence or absence of methanogens

      “Attempts to elucidate the cellulose-degrading microbial community have only been partially successful as only a restricted number of individuals appear to harbour such cellulose-degrading organisms (Bétian et al., 1977; Montgomery, 1988; Wedekind et al., 1988).”

      Take a moment to notice the years of the studies referenced in that sentence: 1977, 1988, 1988. This research has been going on for a very, very long time. But, it’s only recently that people have started talking about it.

      In layman’s terms, that quote above, tells us that few humans have the gut bugs to metabolize cellulose. So, that big low carb salad you eat every day, Well, if you’re like most people, virtually none of it is fermented by your gut bugs into beneficial compounds, like short chain fatty acids. It mostly just bulks your stool — which I won’t deny is beneficial. It is.

      However, it’s well understood that a key goal with fiber diversity is to get your gut bugs to ferment beneficial short chain fatty acids in your colon from the fibers you eat. And a big leafy salad just doesn’t do that according to the research. Even if you did have the right gut bugs, cellulose is well known to have very little ability to ferment into SCFAs compared to other fibers.

      This is what I’m talking about here. You seem to imagine that this is all something that’s been dreamed up over the last few months. Nothing could be further from the truth. The data has been there for a very, very long time.

      For instance, here’s a paper published in the British Medical Journal, from 1975, on fermenting short chain fatty acids in your colon.

      BMJ: Short chain fatty acids in the human colon

      That paper was a call to investigate these SCFAs more closely. Now, 40 years later, there’s a huge body of evidence that shows how important these SCFAs produced by gut bugs really are to our health (look it up).

      The only thing is, you don’t seem interested in learning about it. Oh well. Not much I can do about that.

      PS — The Inuit were apparently not as healthy as we were led to believe. It appears to have just been wishful thinking. A review of the scientific data now shows that the Inuit have a similar prevalence of coronary artery disease as non-Inuit populations and they have excessive mortality due to cerebrovascular strokes. [1][2]

      So, there’s that.

      • The Inuit tended to develop anthracosis from inhaling soot from their seal oil lamps, which certainly causes atherosclerosis. They also had a very high O3 intake.

        Seth Roberts was actually reversing his heart disease according to his heart scans. He attributed it to butter. But he also supplemented with mega doses of O3. If I had to guess, I’d say he died of a hemorrhagic stroke rather than a heart attack.

      • Duck, re the Inuit, I was referring to observational accounts from people who visited Inuit populations 60-80 years ago before Western food arrived.

        The significance of those accounts (as well as observational accounts of the Masai in the 50s and plains Indian populations in the late 19th century is that they had virtually no carbs in their diet and they thrived — and presumably had been thriving for many generations.

        The point isn’t that the Inuit diet is some kind of model for the rest of us (though high fat may in fact turn out to be a good way to go). To me these studies are useful just to illustrate that carbohydrates are not essential to human survival as so many lay people and even some medical professionals think they are.

        As for gut bugs, I’m not saying there isn’t a body of research on gut bugs. I’m saying the research is not NEARLY far enough advanced to tell us how to manage the gut bug populations — what to eat, how to eat.

        There is no question that gut flora is important and can be critical to nutrition and health. But I would be highly skeptical of anybody who claims to know what you should eat to feed your bug populations. The whole field of “probiotics” is full of charlatans and snake oil salesmen — and I say that as someone who has tried such products and believe they can probably be helpful in some cases.

        BTW your remarks about fiber I generally agree with. Fiber is a good example of something that is beneficial to some people in some cases but has been way oversold in order to market a lot of foods that are probably not good for you.

        Pretty much if you see a box of something with the “heart healthy” seal of the American Heart Association, you should not only avoid buying it, you should probably escape that aisle of the grocery store.

        • Tom,

          The Masai have always consumed large quantities of raw milk and honey. Honey is extremely important to the Masai. In fact, this — as well as their weekly habit of trading their meats for carbohydrates with neighboring tribes — was well documented even in 1895.

          Secondly, the published scientific literature on the Inuit shows that they were obtaining sufficient carbohydrates from the glycogen in the raw meat they consumed (Heinbecker, 1928, Ho 1972),

          Heinbecker wrote: “…Average daily food partition is about 280 gm. of protein, 135 gm. of fat, and 54 gm. of carbohydrate of which the bulk is derived from the glycogen of the meat eaten.”

          Ho (1972) wrote: “Carbohydrate accounted for only 15% to 20% of their calories, largely in the form of glycogen.”

          Yiu H. Hui, Ph. D. (1985) wrote: “Eskimos actually consume more carbohydrates than most nutritionists have assumed. Because Eskimos frequently eat their meat raw and frozen, they take in more glycogen than a person purchasing meat with a lower glycogen content in a grocery store. The Eskimo practice of preserving a whole seal or bird carcass under an intact whole skin with a thick layer of blubber also permits some proteins to ferment into carbohydrates.” (Principles and issues in nutrition: Yiu H. Hui, Ph. D., p.91 (1985))

          The Inuit ate 8 to 10 pounds of raw meat per day (Sinclair 1953), and raw meat has relatively small amounts of glycogen (animal starch) in it. Diving marine mammals have significant glycogen stores to assist them on their extended dives. And even if their meat only contained the conservatively low levels of glycogen found in Western beef, at 8-10 pounds of meat per day, they were consuming 48 to 60 grams of glycogen per day. Of course they also loved the glycogen-rich muktuk and livers too. High levels of glycogen in muktuk were discovered as far back as 1912 (JAMA: Volume 57, 1912).

          Interestingly, Heinbecker (1928) showed that the Inuit exhibited normal glucose tolerance when fed their traditional diet. But, when Stefansson and Anderson did their year of Western-style meats, Tolstoi (1929) found that they failed their glucose tolerance tests. This suggests that Stefansson and Anderson were unable to replicate the Inuit diet at Bellevue.

          I should also point out that the Masai also preferred their meat raw and fresh. They even drank blood raw and fresh from the leg of their cattle. My guess is that most Western VLCers do not eat this way.

          As the literature shows us, both the Masai and the Inuit consumed sufficient levels of carbohydrate and the Western VLC diet is nothing like what these cultures were doing.

          • So, the Inuit weren’t low enough in carbs and protein to be in ketosis so they died of cardiovascular disease. Therefore, ketosis is bad.

            • “So, the Inuit weren’t low enough in carbs and protein to be in ketosis so they died of cardiovascular disease. Therefore, ketosis is bad.”

              Nope. The Inuit consumed sufficient carbs and apparently died of cardiovascular disease from the anthracosis caused by inhaling too much soot from their oil lamps — as you so brilliantly demonstrated. 🙂

              The point is that every indigenous culture made an effort to consume sufficient carbs. Chronic ketogenic diets are a modern invention, which may be beneficial, but haven’t been tested by any indigenous populations.

    • I maitain my gut flora on nuts, greens, non-starchy veggies, gristle and raw potatoes. Potatoes won’t knock you out of ketosis if they’re raw as they’re mostly RS.

  65. To Duck, if what you’re saying is that it is incorrect to equate “paleo” with “carnivore,” I agree. It is equally incorrect to equate it with herbivore.

    It is abundantly clear that different human populations around the world have eaten (and still to some degree eat) the food that is available from their local environment, be it animal, vegetable or both.

    As has been pointed out ad nauseum, “paleo” diet is not really a scientific notion because we can’t really duplicate the food that was available to our ancestors. (Otherwise we could travel to Bar Harbor beach and grab 8-pound lobsters out of the surf, too bad…)

    However I do think paleo is useful as a way of thinking about food and understanding why modern industrially produced food, for example high-yield grain and high-sugar fruit products, is going to cause health problems in many people. These are foods that were not available to ANY human population when our digestive systems evolved.

    Paleo does not belong to carnivorers or vegans, but I do think eating Paleo will naturally cause people to eat less refined “modern” carbohydrates, and that seems to be a good thing that nearly everyone can agree on.

    If you’re trying to “eat paleo”, whether you are a carnivore, omnivore or vegan, you are probably going to have a lower carbohydrate load than if you are eating from the middle aisles of the supermarket. And that simple thing will mean less obesity, diabetes, heart disease and cancer down the line.

    • 100% correct, Tom.

      And believe me, Tom, I’m no herbivore. In particular, I just think we need to start investing the role of microbiota-accessible carbohydrates and how they impact human health. No longer can we call all carbs the same going forward.

      Specifically, here’s the paper from “Cell” that Chris mentioned, in another article:

      Cell Metabolism :: Starving our Microbial Self: The Deleterious Consequences of a Diet Deficient in Microbiota-Accessible Carbohydrates

      I think the impact of our food on the microbiota is the next frontier in human health.

      • The whole world of biome science is so new, it’s too early to draw broad conclusions.

        Yes, we know that C diff can be brought under control with stool transplants. There is a lot of well founded theory about the notion that a healthy, diverse microbiota helps to prevent overgrowth of things (candida) that make us sick.

        But I don’t think we can say that a low-carb diet will hurt a person by starving the biome. There are really well documented observational studies from recent times of aboriginal populations who lived almost entirely without carbohydrates (the Masai and the Inuit) and seemed to be incredibly healthy. If their microbiota were sucking wind, there’s no evidence this was doing the people any harm.

        My theory is the whole “starved biome” theory is another one of those things circulated in vegan circles by people who are fighting low-carb tooth and nail because they are worried low-carb equals eating more meat.

        Rather than circulate half-baked theories as fact, I wish vegans would accept that reduced carb (not necessary very low carb but reduced carbs vs. the typical American diet or a low-fat diet) has been proven scientifically.

        Rather than try to fight the very valid science about carbohydrate consumption, I wish vegans would emphasize that it is very possible — I wouldn’t say easy, but eminently doable — to eat low-carb without meat, dairy, eggs or fish.

        Frankly, they’re going to lose the scientific debate anyway if they’re trying to persuade people that it’s healthy for everyone to get their calories from starch and sugar.

        • Tom,

          The argument for dietary fibers (MACs) is not a vegan issue. I’m no vegan. I eat a 1/2 pound to 1 pound of meat every day. The idea of feeding your microbiome was recently discussed by Chris on his podcast with Jeff Leach of the Human Food Project. It’s a terrific episode, and I encourage you to listen to it.

          RHR: You Are What Your Bacteria Eat: The Importance of Feeding Your Microbiome – With Jeff Leach

          In the episode— and I hope you take the time to listen to it—Jeff Leach explains why a low carb diet tends to drop fiber intake and lower fermentation to shift the colon to a more alkaline state, which tends to breed pathogenic infections. He’s also written about it here.

          Jeff Leach eats plenty of meat, mind you. He’s no vegan. He even ate nothing but meat for days on end to test his biome and report on the effects. I assure you this is not a vegan conspiracy. You may dispute Leach’s hypotheses — that’s your prerogative, but I suspect the results are not as simple as you imagine.

          PS — The Masai were pastoralists (not hunter-gatherers) who consumed lots of raw milk and tons of honey. They traded their meat weekly for sweet potatoes and bananas. These kinds of misconceptions is what I’m talking about. VLC advocates conveniently forgot to mention (or never investigated) the finer details of what these cultures actually did.

        • Tom,

          you said:

          “But I don’t think we can say that a low-carb diet will hurt a person by starving the biome. ”

          there are many people genetically predisposed to low or no expressions of certain glycans in their mucosa or innate immune proteins, with serious implication on their immunity. Their bodies do not manage to fight the pathogens alone.

          For instance due to FUT2 deficiencies (so called non-secretors – up to 20% of the whole population) or MBL (mannose binding lectin) – also a very high proportion of people.

          Not everybody is genetically lucky.

          It needs the right gut flora provided with the right food, to help to body overcome these deficiencies.

          If these people keep their gut biome in low diversity and starved, they are on the road to hell.

  66. When I saw the headline I braced myself for the same old misinformation, but this is actually a thoughtful and reasonable post. 30 percent of calories or 150-175 grams of carbs a day is not a bad approach to try if you’re afraid to do very low carb. That will still be much better for people than what they’re eating now — often 400 grams.

    If overweight Americans reduced their carbs to 30 percent of calories, and avoided sugar and refined starches, most would lose weight.

    More strict low-carb regimens are undoubtedly helpful for some people, obese or wtih pre-diabetes or bad blood lipid markers.

    The whole gut dysbiosis thing is more theory than scientific finding at this point. Clearly there are human populations that lived almost entirely on fat and protein and thrived, so we know gut dysbiosis is not an inevitable thing; still, a relatively tiny amount of starch is all that should be necessary to keep the gut flora healthy, and 99 percent of low-carb and paleo eaters will get that from the vegetables and nuts that they eat.

    Schoenfeld seems to be coming from a reasonable and honest place. She is not spouting the pro-grain dogma of the American Heart Association/USDA; she is not pushing the disinformation of the vegan doctors. And she is acknowledging what the research of the last 20 years (and really the last 200 years) has made clear, which is that major reductions in carbohydrate intake and modest increases in dietary fat should be the public health goal for the vast majority of people. That would set us on the path toward beginning to control the obesity epidemic.

  67. We really enjoyed this article Dr Chris. I (Aimee) was doing low carb last year thinking it was the next step in Paleo for me in order to lose weight and balance hormones. I wasn’t feeling good and started an eating plan from a guy who was helping heal my mum’s thyroid through food alone. He had us eating loads of food, mostly veggies, some fruit, a bit of meat and fat, plus gelatin and bone broth. He explained that the low carb thing for people with hormone issues isn’t safe long term and I was so glad I’d found him so I could stop ruining my health on low carb! I’m feeling much better now, I eat stacks of awesome food (jelly for brekkie, yay!) and I’m noticing improvements with my hormones in just a few months of doing the eating plan properly.

    My partner Clint feels better on low-carb but I know he needs more veggies, otherwise he’s missing out on so many nutrients. I think it’s effecting him mentally. So I’m cooking similarly for him as I need to eat and hopefully it’ll help him also.

    It’s just so nice to see some info from someone as well known as you on the topic. People don’t necessarily listen when I try and explain the harmful effects low carb can have on some people, so to direct them to this page is really helpful! And everyone is different, we need to eat right for our individual situations but as with any health craze, paleo or not, people often jump on the bandwagon without knowing the pros and cons, and pay for it later. Thank you for your great info!!

    Aimee 🙂

  68. Laura – thanks for the sane article on what rather too often seems to become an intolerant argument.

    For me the takeaway point is that there is no right diet for everyone and we should be seeking our own personalised solution. I have some intractable health issues right now that might be carb related and have been researching this whole macro-nutrient issue. What a minefield! But here’s what seems a practical way out…

    I recently came across Phil Maffetone’s 2 Week Carb Intolerance Test.

    Phil is an MD and a legendary endurance coach. He is also consistently ahead of the game, experimenting with carb intolerance, minimal footwear and primal exercise well before the current trends.

    The 2 Week Test is a protocol he’s refined over 40 years of practice. It’s a time-limited exclusion diet that should establish pretty definitively if carbs are causing you health or performance issues. If you do have carb issues, he then explains how to experiment and find the type and quantity of carbs you can tolerate, without any dogma about the “one best way” to eat. If you don’t have carb issues, your choices are open.

    As Chris points out, there is nothing ancestral about low carb, so the only reason I can see to eat that way is if it’s causing some kind of specific issue. In fact recent work at Cambridge University has found that flaws in the standard technique have substantially over-estimated the consumption of animal products in early humans, so the role of tubers, nuts, fruits etc is probably larger than we have been thinking.

    It seems to me that this simple, practical and time-tested self-experiment could quickly resolve the issue for each of us much more effectively that wading though thousands of pages of claim and counter claim from the various entrenched camps. Hope someone finds this useful. Personally, I’m getting myself organised to give it a go…

  69. What an informative article, and some really interesting answers. Before I go off to read the half a dozen links I clicked on, I just want to say – thank you!

    I have long wondered why things like potatoes have been vilified by the low carb community. My food philosophy is that if nature provides it, it really can’t be that bad for us. In moderation, as with all things.

    Anyway, the reason I actually came to this article is because I have recently been diagnosed with cancer. A rare one. (Would rather have won the lottery!). Although my feeling on that is that maybe it is not so rare as underdiagnosed. The symptoms tend to be ignored by medical practitioners, and it was only thanks to my naturopath that I kept going in and demanding they deal with the issue.

    Now, I have heard that a keto diet may be good for this issue. There seems to be some very well informed commenters on here, and I was hoping someone had some good links on this issue, either keto related or something I may not have heard of.

    Thanks in advance.

  70. The vitriol, bias, and polarized thinking surrounding this issue never ceases to amaze me. Especially because the following conclusions are, according to research, clinical experience, and common sense, fairly straightforward:

    1. Few, if any, traditional cultures regularly consumed a ketogenic/VLC diet. It is not our “default nutritional state” as many have claimed.

    2. Ketogenic/VLC diets are effective therapeutically in certain situations, such as metabolic syndrome/obesity and neurological conditions such as epilepsy and Alzheimer’s. However, even in these cases there may be side effects (such as adverse changes to the gut microbiota) when these diets are followed long-term—some of which we’re only beginning to understand.

    3. The fact that ketogenic and VLC diets work well therapeutically for certain conditions does not make them appropriate in all circumstances. People with hemochromatosis need to limit their iron intake, but that doesn’t mean everyone does.

    4. Some people obviously do better with ketogenic/VLC diets than others. Should this really come as a surprise to anyone, given differences in individual genetics, epigetnics, biochemistry, health status, microbiome, lifestyle, and goals? Such people may thrive, even long-term, with a VLC diet—but that does not mean that everyone will.

    5. Even if ketogenic/VLC diet is therapeutic for a particular condition, that does not mean that 1) it’s the only effective therapy for that condition, or 2) that the condition itself was originally caused by eating too many carbohydrates. Both assumptions are logical fallacies. VLC diets have been shown to be effective for improving metabolic markers in T2DM, but so have restricted calorie diets, protein-sparing modified fasts, and even low-fat, high-carb diets. And just because restricting carbs can be effective in T2DM, it does not follow that too many carbs caused the condition originally, and that healthy people without metabolic problems should restrict whole-food carbs. Again, people with hemochromatosis need to eat less iron, but eating too much iron didn’t cause the problem in the first place.

    6. Whole food carbohydrates, e.g. from starchy plants like sweet potatoes and whole fruit, do not affect the body in the same way as carbs from refined and processed sources, such as flour and sugar. Anyone with even a basic understanding of nutrition and physiology should understand this, but it’s remarkable how often this fact is overlooked in the “low-carb” discussion. I see so many people extrapolating the results from studies which look at the detrimental effect of processed/refined carbs to mean that we should avoid or restrict *all* carbs. That is a leap that cannot be made.

    I support what Laura has written in this article, and my experience working with patients is similar to hers working with clients.

    In the end, I have no problem with someone following a VLC diet over the long-term if 1) it improves their health, 2) it doesn’t cause adverse effects over time that could worsen their health. And I do have patients that fit into this category.

    However, I have quite a few patients—probably more—that do not. And given points 1-6 above, why would I (or anyone else) suggest that they persist in doing something that could harm themselves?

    That’s what blows me away about this “debate”. There’s really nothing to debate. The fact is, some people don’t do well with VLC. Why do people on VLC diets feel so threatened by that? Perhaps because, in some circles at least, VLC has become dogma: “a principle or set of principles laid down by an authority as incontrovertibly true.” And as the saying goes, you can’t fight faith with facts.

    • Chris,

      I’m in complete agreement with your six points and would be interested in your take on the Newcastle diabetes study and Dr. Roy Taylor’s conclusion that type 2 diabetes is caused by too much fat in the liver and pancreas. His theory is that everyone has their own personal threshold for how much fat they can tolerate..

      This is why many Asians are prone to T2D at lower BMIs than Europeans and why some severely obese people never develop diabetes and why Pima Indians have the highest diabetes rates in the world.

      The key to reversing diabetes according to Dr. Taylor is to lose weight and exercise by whatever means possible to reduce fat in the liver and pancreas.

      It’s why Dr. Bernstein’s low carb high fat diet works and why Dr. Gabriel Cousin’s low carb, raw vegan diet works and why Seventh Day Adventists have had good success. Even John McDougal claims success with his “Starch Solution.”.

      I imagine that even a high carb, low fat diet would work for some people if they managed to loose enough weight and exercised hard enough although you would get an argument from Dr. Bernstein on just how many people would actually benefit from this approach.

      Even Dr. Joel Furhman says diabetics need to follow a low carb diet to reverse diabetes which is where he differs from Dr. Neil Barnard.

      What all these Doctors have in common is they all advocate eliminating most processed foods and sugar and eating a whole foods diet. There is no confusion there.

      For some people, just these changes may be enough. My own view is since I had diabetes and numerous self testings after higher carbohydrate meals showed they raised my blood sugars, I try to avoid overeating carbohydrates even though now that I am very lean and fit I can and do eat more carbohydrates than when I was diabetic.

    • Chris – I was at the Low Carb Down Under event at the weekend and Tim Noakes presented this slide which indicates that your specific response to carbohydrate load depends on your past history of Insulin Resistance. Someone with elevated IR in the past will gain more fat for a given carbohydrate load.
      I asked Tim if this effect reduces over time on a low-carb diet and he said “No, never.”

      This would suggest then that while our predecessors may have successfully integrated carbs into their diet without negative complications, the same cannot be said for most folks (anyone?) coming from a modern, mid-life SAD diet. The damage has already been done, the body tissues are already in an Insulin Resistant state.

      Of course the best plan is to avoid IR in the first place – protect the children! But for the rest of us, your comments are too simplistic.

  71. It appears a major mechanism here is insulin intolerance. In addition to a low carb diet and exercise, it appears metformin would also help. The latest drug is Cycloset which is a dopamine agonist and somehow resets they hypothalamus. I’d be interested if anyone has any feed back on that.

  72. Tricki, I have exactly the same issues. Severe dry eyes, nose and throat, osteoarthritis, and carbs make me gain weight instantly. Paul Jaminet insists dry eyes are caused by a very low carb diet, and that safe starches and Vit C will reverse that. For me, the addition of potatoes made my eyes much worse and I gained 5 or 6 pounds in a couple of days. I’m working with bone broth now. Gosh, I hope someone figures this out soon. Good luck!

    • Barrbra,

      not claiming here that my questions could help you personaly but can you answer?

      How much probiotic / fermented foods / SBO do you regularly (= daily) eat/supplement?

      How much inulin rich foods (onions, garlic, leech, asparagus) do you regularly eat?

      How often do you eat lectin rich foods (for instance legumes e.g.: various beans, chickpeas, lentils)?

  73. All this dis. course. sigh.

    I don’t want to hate Gary Taubes or Jimmy Moore or anyone else. I don’t care if this pathway is correct or that enzyme isn’t properly absorbed or that macro should be at this exact percentage. I’m tired of the arguing and measuring and study study study.

    I want to be well again. Functional again. Happy again.

    I watched Chris Kresser on video (Why Paleo is Taking the World by Storm), talking about how sick he was, how he couldn’t work, how he was broke and tired and at-the-end-of-his rope afraid.

    I know exactly how that feels. I am right there. I, too, went to NDs and nutritionists, and hypnotherapists, and doctors, and diet gurus of all stripes. I, too, have a small fortune’s worth of ineffective supplements in my cupboard. I, too, have lost my livelihood and my passion for life.

    The difference is that I have been off grains and trans fats and sugar for a dozen years and mostly paleo for at least four; I have tried all the things that supposedly cured him. And that I’m a Type 2 with a very nasty autoimmune condition that makes my life a living hell. And that I’m now 70 lbs overweight, female, and post-menopausal.

    So where does one go from here? Is there anyone out there who can help me where it really matters? In my health and happiness and passion for life?

    • Hi Beedee,
      I wish it were so simple as Paleo, low carb, safe carb, etc …. but it really is getting the balance of essential nutrients in AND being able to absorb them. And, one’s current health issues affect nutrient uptake. See my comments on this blog from Aug 28th to get a bit more of an idea about me or visit If you want to discuss possibilities, contact me.
      Vive Vida!

  74. I would be interested in your opinion on the impact that low carb diet can have on proteoglycans, specifically how they can impact mucosal tissues – dry eyes, gastrointestinal lining, synovial fluid and cartilage health.
    I had the opportunity to ask both Prof Tim Noakes and Dr Steve Phinney face to face about this yesterday. Prof Noakes said it had little effect; Dr Phinney said dry eyes can be resolved by adding in a couple of grams of salt or by consuming a little bone broth.
    I appear to respond by gaining fat quickly if I re-introduce carbs in any significant quantity (Prof Noakes suggests this means I’m dealing with a degree of insulin resistance, and this shall remain so life-long) but I also am dealing with osteoarthritis in the hips. So I really want to figure out if the low carb approach, while helping with weight control, is negatively impact my joint health. I would appreciate your thoughts.

  75. Laura, can you explain why you would calculate a recommended carb intake in terms of percentage of total calories rather than a simple measure of carb calories or grams of carbs? Why the added step? Isn’t it the absolute amount that matters rather than a percentage? Or is there something fundamental that I am not understanding?

    • The short answer is because people’s carbohydrate needs vary based on their caloric needs. A mildly active woman who needs 1800 calories per day to meet her daily requirements should do just fine on 120-150 grams of carbs per day, whereas a professional male athlete who needs 6,000 calories per day to meet his caloric needs would probably not do well at that 150 grams per day mark, since he’d probably be burning it up pretty quickly during training sessions. He’d be better off doing a VLC approach at that point to ensure adequate ketone production. But if he were doing a moderate carb diet for athletes, he might need more like 400-500 grams of carbs to sustain his activity.

      Of course these are just rough estimates and the individual may tweak up or down depending on personal response to the diet and health goals. But the amount of carbs you’d want to eat depends significantly on the amount of calories you need to sustain your activity levels… obviously the woman eating 1800 calories per day wouldn’t want to eat 400 grams of carbohydrate!

      • Adding on, looking first at macronutrient percentages and then at grams sets up a different kind of perspective. Looking at percentages requires you to “stand back” further in your viewing to get a broader and more comprehensive view. Helps with systems thinking, and that in turn can be extrapolated into other areas.

      • Laura, which kind of carbs shall I count to the intake of carb calories? Dr. Jaminet only counts the safe starches of potatoes, rice and winter squash and some roots, and doesn´t count the carbs of vegetables.
        Do you count the carbs the same way as Dr. Jaminet, or do you also count the carb cal of berries, honey and vegetables?

  76. Talking calories misses the whole point. Calories is a number that we calculate for the energy content of the food. Biochemically it is a meaningless number, because it tells us nothing about how the energy from that food source is metabolically partitioned in the body through the TCA cycle.. Calories from fructose is partitioned completely differently to calories from starch or digestible fibre. It is not the calorie intake that is causing the damage, it is the way they are metabolised. Unfortunately there is an attempt to divert the conversation from the obvious fact that some carbohydrates (in particular fructose) are causing metabolic chaos. Sugar sells!! We can balance diets for animals quite easily (it is simple math)..we could do the same for humans except that we have free choice and a sweet tooth. What we eat is determined by marketing, not by nutrition.

  77. K…. So maybe you can shed some light on this then: If the consensus now seems to be that VLC/ketogenic diets are unnecessary and perhaps even harmful, then why are most members of the ancestral eating community STILL loathe to actually call out Jimmy Moore on his bullshit? I see Paleo blogger after Paleo blogger either changing their position vis a vis carbs outright or “modifying” it to non-recognition – but still skirt around the elephant in the room that is Jimmy Moore? What is everyone so afraid of? Could it have something to do with his podcast empire – and all the free promotion they might lose? Ya think? At any rate, he and most members of this community owe me an apology – for being right and daring to say it, that is.

    • Evelyn

      I think the better question is to ask why your approach by means of calling out names in literally every post was I effectual, rather than simply dealing with facts of matters.

      I don’t want to destroy Jimmy Moore and I wish him well. I want to burry Nutritional Ketosis alive.

      I’m far more effective than you for that simple reason.

    • This kind of exchange is what frustrates those of us who just want to get healthy. It seems that some in the blogosphere have lost focus…it has become more about being “right” vs. helping people and is distracting.

      Medicine (and nutrition) is complex and always evolving, based on research, clinical experience, etc. If Chris and others have changed their messaging based on this, I don’t think they owe you or anyone an apology.

      I can’t speak about Jimmy Moore… I follow blogs of people who have real-world clinical experience. To me, this is the best resource of information.

  78. I totally disagree with this amount of carbs as a person with diabetes as well as a health care provider in the field.
    If you have diabetes, or even pre-diabetes, I highly rec. a book by Dr. Richard Bernstein “The Diabetes Solution.”
    Yes, the first week you switch to low carb you will feel tired… but your body will adjust and you;ll be able to keep your blood sugar down to non-diabetic levels to avoid blindness, stroke, amputation etc.

  79. Thanks for the informative article. The link between low carb diet and cortisol helps answer a medical puzzle for me.
    After going on a low carb diet a few years ago, I developed PVC heart arrhythmia. Not just an occasional skipped beat, but 20 minute stretches where my heart would “skip” every 5 to 10 beats, occurring multiple times a day. After the PVC diagnosis I was assured that it wasn’t dangerous — but it’s still disconcerting to have your heart flop around like that! After going through periods when my carb intake fluctuated, I realized that every time I reduced my carb intake, the PVCs would start up again. I’ve increased my carb intake and now experience PVCs rarely, and never for extended periods of time. Interestingly, when I received a cortisone shot for hip pain, I had rampant PVCs for 2 weeks even while eating more carbs. This strongly indicates to me that it’s connected to cortisol levels. I’m sure I’m not the only one who has experienced this, but I could not find a “reason” for it until I read this article. I guess I should be grateful that my body gave me a clear signal that I needed to eat more carbs.

  80. This article, and the recommended one on gentle carbs by Laura Briden, has absolutely made my day. I spent 2 years on a low carb GAPS/ SCD/ Paleo diet and went from severe stomach symptoms and fatigue to even worse stomach symptoms (unable to tolerate ANY food), HPA dysregulation and now diagnosed hypothyroidism. I have only recently added safe carbs back into my diet (when I accidentally upped my carb intake and realised that it was beneficial) and the difference is immense – better sleep, better blood sugar regulation, decrease in fatigue etc. I had been feeling guilty that I had to add rice, potatoes and small amounts of oats into my diet because I have become such a staunch follower of the Paleo lifestyle and buy into it on a nutirutional level as well as political level (food production issues etc), so reading these articles that confirm that the carbs are required by certain people for health alleviates my guilt completely!! Thank you all for continuing to write, research and spread the word about this health knowledge. It is literally saving lives!

  81. I don’t know where you and Stefani Ruper the idea that low carb diets aren’t good for fertility issues. There’s plenty of evidence to the contrary, notably the Nurses Health Study and many others.

    How do you imagine our hunter gatherer ancestors consistently found 30% of their calories from carbs in the winter months to conceive and carry on healthy pregnancies?

    Personally the only time I ever ovulated without drugs is when I followed a very low carb diet, and I got pregnant on it, too.

    • “How do you imagine our hunter gatherer ancestors consistently found 30% of their calories from carbs in the winter months to conceive and carry on healthy pregnancies?”

      Laf. Asking everyone else to cure chronic ignorance of actual science.

      At a point, Mother Goose Fairy Tales fall short.

      How about get your Google on?

  82. AAARRRGGGHHH…… diving into all the little details is useful ONCE you’ve fixed the foundation – ie got your nutritional intake at some sort of reasonable, healthy level ie DO YOU KNOW IF YOU ARE GETTING ALL THE ESSENTIAL NUTRIENTS & FROM A BIOAVAILABLE SOURCE?!…… otherwise we’re still taking a palliative approach. We are all H.sapiens with very similar basic essential nutrient needs. Follow this Paleo or that Ketogenic diet may address some problems, for a time but ARE YOU getting your essential nutrients both macro & micro? “Cause if you are not – you will, eventually, “Hit the Wall”. Of course we are all planned obsolescence and will eventually cease to exist on this plane despite the perfect diet. And, please spare me the “moderation” game… either we eat what we need nutritionally or we don’t & specificity is important.

    We can argue the “low carb” issues until the cows come home which is totally ridiculous – NUTRITION is much more complex …. Though I completely agree that safe carbs are an integral part of nutrition for H.sapiens … there’s a lot more factors at play than low carb, safe carb, high fat, no fat, raw food, traditional food and therefore – ALL of the assumptions that are being discussed….

    DISCLAIMER: I’m biased: I really love peaches (especially in heavy raw cream), butter soaked sweet potatoes, sour cream mashed potatoes & chives, gluten free donut holes (deep fried in my beef tallow) & salty Kettle brand potato chips! Gluten based grains cause a variety of unpleasant symptoms. Corn, nixtamalized, in small amounts is usually ok, white rice (thoroughly rinsed 5-6 times) causes no immediately noticeable problems except fluid retention, beer of any type leaves me w/ a fever blister & depending on the alcohol & amount – I’m playing Russian roulette w/ a migrain. My basic premise, for an overall safe macronutrient substrate is 70% fats (the right kind) 20% protein (the right kind) & 10% carb (the right kind). Adjust from there depending on your health status, goals & competence with objectively analyzing your nutritional intake & adjusting accordingly. The biggest problem is we have mostly no experience eating w/ ketogenic based nutrition and the metabolism is different. And, total nutrition is what we really need to address first: that includes macro & micro nutrients.

    Since the blog was rather detailed, I felt compelled to address the key points. Anything less would not suffice for my crazy roommates.

    The problem is – the key variables are not being systematically identified & discussed … low carb – Whaaat!?! High protein or high fat, what kind/quality of fat or of protein?! NO one is openly identifying that fats are the most important key macronutrient (approx. 50-70% of total intake). Nor is it just about the macronutrients…. What about the micronutrients?! The CONFOUNDING variables are significantly HUGE, and even tho we aren’t talking about a scientific experiment – we are assessing data & making conclusions: Let’s not confuse association w/ causation.

    1) Are you sure it’s not about a restrictive diet?! A hypo caloric, restrictive diet (low in carbs or Kcals) will stress the body & affect adrenals/cortisol & thyroid function – many folks on a low carb diet may also be too low calorie. Restrictive diets are very stressful in the long run, hard on the adrenals & thyroid. Restrictive diets are utilized way too frequently due to a focus on fast weight loss – particularly since most have been on high carb diets that cause significant fat deposition, cardiometabolic disorder & consequently follow the misguided belief in “calories in/calories out”. While hypocaloric, restrictive diets will provide some short term benefits: weight loss, lower insulin & decrease cardiometabolic disorder – they are not sustainable if health, over a lifetime is the goal. Starvation does not create a healthy animal. Healthy weight will be achieved, once cardiometabolic order has been corrected & as one follows optimal nutrition over several years. Humans seem to want the quick fix vs the healthy fix.
    2) What about the PROTEIN:
    MOST low carb diets are high in protein – usually muscle proteins that are lean & lower in nutrients…. Which is problematic… Protein metabolism requires appropriate fat levels for assimilation.
    3) What about ALL the ESSENTIAL NUTRIENTS? :
    • Most diets, low carb & high carb – Actually almost all diets of any sorts are nutrient deficient – particularly in the fat soluble & B complex vitamins & minerals. Healing/health cannot be achieved until malnutrition @ the macro AND micronutrient is completely addressed.
    • What about the HUGE issue of micronutrient malabsorption & malnutrition. And, of ALL toxic substances, being eaten, as “food”, which damage the gut, etc.
    • The largest, bestest, bioavailable source of essential nutrients (for H.spaiens) is found in grass fed herbivores & sea food…. BUT only if you eat the WHOLE animal. Liver & kidney are the 2 most nutritious single sources of essential nutrients BUT don’t overeat on these either. AND don’t eat the liver of carnivores – that is deadly. Way too much of a good thing (vit A retinol).
    4) What about the minerals & insulin?
    • On a low carb diet – one is virtually guaranteed to lower insulin which >> increases sodium, potassium & magnesium excretion- this can happen quite precipitously & as these are critical in our most basic metabolic processes – WAHOO – causes quite a bit of distress & significant discomfort: fatigue, malaise, GI upset, stomach digestion problems, headaches, muscle cramps/spasms, poor mentation/memory/mood & glandular function (can we say adrenal & thyroid issues!?). These minerals are essential to daily function & It is imperative to increase one’s intake, immediately & consistently to resume normal metabolic functions.
    • The majority, 70-80% of the population, suffers from some form of cardio metabolic dysfunction …. It is important to get the carbs down so that glucose poisoning/high insulin/insulin resistance is addressed. Once the body recovers – carbs, at a healthy level, can be metabolized normally (no insulin resistance). To treat metabolic disorder in a reasonable time frame – 10% carbs has been the most effective that I’ve found, it’s pretty much the threshold for ketosis to occur.
    5) FATS, the “Gorilla in the Closet”:
    • The “safest”, healthiest macronutrient is animal fats from the natural source: ALL body fat from animals (particularly true herbivores) contains a balance of saturated, monounsaturated & poly unsaturated fatty acids AND fat soluble vitamins. Fats are required for many of our essential nutrients to be assimilated & metabolized.
    • One must be keto adapted (been in ketosis consistently) to have optimal levels of lipid enzymes for healthy metabolism when considering “low carb”. This typically takes up to 6 months or more, IF one maintains a primarily ketogenic substrate.
    • And, too many folks are still focusing on plant oils & fats as primary fat sources, which contributes to inflammation via the arachidonic acid pathway. Along w/ being low to devoid of key fatty acids & fat soluble vitamins.
    • Saturated fats are biochemically, highly stable, they have no double bonds, are anti-oxidative & protect the highly oxidative polyunsaturated fats in the animal tissue. EAT them preferentially.
    6) Are CARBs safe?:
    • Carbs are useful in our diet – they are simple & cheap (in our society) to access & we have been raised on them so we like them. I liken them to “jet fuel”- if your body is burning excess calories – they can be useful but they are highly oxidative.
    • They require insulin which is also oxidative. Though, if you aren’t insulin resistant, you won’t have excessive levels of insulin released.
    • Carbs are convenient, easily stored & our ability to utilize them assists us in inhabiting a wider variety of ecological niches successfully.
    • Don’t assume that because humans in the recent past, 10,0000 yrs have used plant/carb/grain sources that they are “optimal” for us. We are incredibly capable survivors & have a flexible enough metabolism to utilize these “foods” to survive. Long term they are simply A LOT of sugar with minimal nutrients & carry a significant toxic & oxidative capacity.
    • “Safe carbs”- low toxicity, can be a useful addition to a nutritious diet. Prepare them properly & enjoy, but not too much.
    • Grains & beans carry a significant toxic load that contribute to lack of health. Yeah, there are ways of making them safer to eat but with great animal sources & optimal safe carbs/plants, REALLY, Why bother?!
    • 30% carbs? – maybe, if you are not keto adapted, not eating enough healthy fats, not on an optimal macro & micronutrient substrate, and maybe if it’s episodic. Long term?! – the natural & biological indicators point to a higher animal sourced diet.
    • Long term, carb load; consistent, over a life time – 20% carbs… average of 10-30%.
    7) Gut bacteria – unless you’ve been exposed to the full complement of healthy microbes that inhabit our gut & provide them the nutrients they need – No one has healthy gut bacteria.
    • Prebiotics? Hmmm – As far as I can determine, based on biology & the natural environment: Fermented foods are close to essential & have always been a part of most animals’ diet, particularly & including predators. Most predators eat stomach, intestines, organs & all, raw – really nice bacterial source.
    • Hunter-gatherers have always eaten the whole animal. Matter of fact, when hunting is good – they keep the fat & organs & leave the muscle meat. And, they ate a lot of it raw. When’s the last time you ate cooked intestines, let alone raw?!
    • Fermented plants, w/ their fiber already partially digested (pre biotic), is one of the safest/healthiest way for humans to eat high fiber plant products & re-inoculate their gut biome. Ferment foods are, perhaps, even better than cooked b/c bacterial breakdown typically increases nutrients, like vit C & B vitamin content. Modern diets of any sort, rarely contain enough quantity or variety or consistency of fermented foods. Start there before you go w/ FOS powder (hmmm, how many ancient/wild humans had that available?!)
    8) Oh, & what about proper/traditional food prep. & cooking – to reduce toxic load & increase absorption.
    9) Pregnancy – WOW –in addition to the above – this is a really huge issue. .. the body requires an increase in ALL nutrients to develop a healthy baby. Even with decent nutrition during pregnancy, if the mother & father have not had decent nutrition throughout their lives – the baby most likely will be compromised, however so subtly and, lately not so subtly. Most Americans today (70-80%) show significant signs of long term malnutrition & congenital (epigenetic) problems. Epigenetics are bringing much new info to the fore front on this. Vegans are high carb & their babies have significant epigenetic problems – it’s so much more than the carbs. Again, let’s not confuse correlation w/ causation.
    10) ARE YOU eating >>> Organ meats, intestines, stomach, raw meat?!
    • Not usually found in the modern diet but they are the best, most concentrated source of essential nutrients.
    • Or at least -supplementing the key, essential nutrients?! ie. Vit A retinol, vit D, K2, vit C, B complex, Choline, Taurine, all the minerals, trace minerals,etc, etc? Without concentrating on one or the other or both – then any diet is still lacking in essential nutrients & therefore, malnourishing.

    Nutrition is very complex – Yet our ancestors thrived on this planet, successful in almost any & every ecosystem. As with every animal on this planet – we are genetically programmed as to what we need to eat. Yet, very few of us know what to eat to be healthy! Unfortunately, we’ve been raised & taught the wrong things. Changing those habits & thought patterns is a challenging endeavor – particularly when the current diet(s) undermine our brain function & emotional state…. Shifting to healthy nutrition is the most important journey we will ever undertake.
    I am sincerely grateful to Kris, Laura, Paul J., PhD, Ron R., MD, Catherine S., MD., L. Cordain, PhD, Dr.W. Price, M.Enig, PhD, Sally F. & & sooooo many others for sharing their knowledge & daring to go beyond the paradigm…
    AND…. We have to continue to ask the right questions…
    Simple correlations are not enough. GOOD empirical & anecdotal data is not enough. Compare to the basic biological framework of ESSENTIAL NUTRIENTS & their NATURAL SOURCES: what was/is available to “wild” humans living a hunter-gather existence vs. what has become convenient as humans became “civilized”? Assess for congruence. Modern info & concepts are highly biased – influenced by paradigms inured in the very fabric of our society & belief structures. It’s really difficult to “ see our biases”, to call our comfortable, preferred beliefs into question – into real scientific scrutiny. Biology (ie. essential nutrients) is as definitive as Physics (ie gravity) – deny either one to your demise.
    Vive Vida! p.s. pardon my typo errors.

    • Carmen,

      You seem to not be aware that the anthropological data uncovered over the past 5 years has shown a tremendous support for starch consumption in early humans.

      The very fact that most humans evolved lots of AMY1 genes, should be proof enough that starch consumption makes us human.

      But, if that’s not enough for you, recent anthropological evidence from carbon isotopes shows that C4 sedge and grassy tubers were apparently a major component of the early hominid diet. At first this confused researchers, since grass is fairly nutrition-less.

      However, earlier this year, researchers at Oxford finally figured out the missing piece to the puzzle, showing that these high levels of C4 isotopes had to have come from the consumption of tiger nuts — which are actually a grassy sedge tuber that are twice as starchy as a potato and more nutrient-dense than red meat.

      Those starchy, nutrient-dense tubers allowed early hominids to consume 80% of their calories with only 3 hours of foraging. This is rather important as unlike other primates—who forage for up to 8 hours per day—humans require enormous amounts of free time in order to invent and share new technology. Therefore it was essential to consume plants that were rich in nutrients and rich in calories.

      Any survivalist will tell you the same thing — that the key to survival in the wild is to consume energy positive plants (i.e. carbs). It would be utterly moronic to avoid such easy calories coming out of the ground everywhere. Interestingly, tiger nuts taste sweet, like candy — explaining where our penchant for sweets and carbs may have come from.

      Finally, it’s well supported in the scientific literature that wild game is too lean to support ketosis. There just isn’t enough fat in wild game to keep people in a state of chronic ketosis.

      The scientific evidence overwhelmingly suggests that there was significant starch consumption—from starchy tubers, corms, rhizomes, bulbs and even collected pollens—in early humans. Heck, there’s even good evidence of starch consumption at the peak of the ice age!

      • You seem not to be aware that an analysis of the macronutrient content of a diet is insufficient to determine whether or not it produces ketosis.

        Meal timing and frequency, insulin sensitivity, and activity levels also play a role.

        Fasting produces ketosis. Exercise produces ketosis. Fasting while exercising (hunting and gathering, for example) in an individual who is insulin sensitive would produce ketosis to a near certainty.

        The lesson from evolution is that there is nothing more “Paleo” than transient ketosis.

        • Correct. A negative energy balance (i.e. starvation) produces ketosis.

          And are all well aware that our Paleo ancestors had intermittent/transient periods without food. That is not what we are debating here. We evolved that ability for starvational ketosis and we can all reap the benefits from it. But that has nothing to do with low carb diets.

          If you’re going to argue that chronic starvation is an ideal state, be my guest as it’s completely asinine to starve oneself chronically and indefinitely — which is what we are actually discussing here.

          • You missed my point. Probably a waste of time to repeat it, so I’ll just cut to the chase:

            Do you have any evidence that long-term ketosis has any adverse affect? (And by evidence, I mean dietary trials conducted on modern humans.)

            While we’re at it, do have any evidence that a low-carb diet has ever caused candida overgrowth in anyone? (Except Paul Jaminet, for whom a low-carb diet causes every malady known to Man.)

            • “You missed my point. Probably a waste of time to repeat it”

              You’ve got to be kidding me. Perhaps you don’t read your own comments, but you never asked me if long term ketosis had any adverse effect. You just rambled on about the obvious aspects of intermittent fasting and negative energy balance (yawn).

              “Do you have any evidence that long-term ketosis has any adverse affect? (And by evidence, I mean dietary trials conducted on modern humans.)”

              Nope. Nor did I argue that. If you hadn’t noticed, I was simply educating Carmen about the latest anthropological evidence, which shows significant support for starch consumption. Furthermore, there has never been any indigenous culture that has ever been documented to be in chronic ketosis, not even the Inuit. I really don’t care if chronic ketosis is therapeutic or not. Either way, it’s a very modern experiment that has yet to be settled.

              “do have any evidence that a low-carb diet has ever caused candida overgrowth in anyone?”

              Yes. It actually happened to me. I went VLC for about 9 months and candida nearly killed me.

              But, your question is a loaded one. You won’t find very many candida studies on humans because the testing is unreliable, hence why it is mostly dismissed in modern medicine.

              “There is no laboratory test that allows a clear identification of patients affected with this presumed disorder. Actually, “no clear definition of the disease has ever been advanced” [220]. Considering these facts, it is impossible to set criteria to establish and identify patients affected with this supposed disease.”

              So, we are left with the knowledge of candida’s environment and its effects on its dimorphic triggers that I referenced above. Ignore it if you wish. I could care less.

            • And honestly, Sam, it’s just embarrassing that people like Carmen own a business convincing people that our Paleolithic ancestors shunned carbohydrates. That’s got to be one of the most poorly researched hypotheses given the anthropological research that’s been published over the past 5 years.

              I’m quoting from Carmen’s site here. She writes:

              “As hunter-gatherers, for much of our species history – humans survived on an animal based diet, supplemented by certain plant products…Healthy plant foods, low in starches… The [diet] is a low carbohydrate/no grain, high healthy animal fat…moderate high quality protein and vegetable nutritional program. It is direct, simple & effective. It is the most biologically appropriate nutriton for the human species.”

              Except that’s not what the scientific literature says about early hominid diets, by any stretch of the imagination. The scientific literature shows a significant shift in hominid fossil isotopes to C4 grass consumption. And the wear patterns on the teeth of early hominids—who had these C4 isotopes—matches up perfectly with the wear patterns found on baboons who ate C4 tubers, such as tiger nuts. (Starchy tiger nut tubers, by the way, have a macronutrient profile that mimics that of human milk). Meanwhile, Paleo-Indians had starch all over their tools and people were grinding flour at the peak of the last glacial maximum.

              Did people like Carmen get excited over this latest research, which explained how humans ate a fairly balanced diet of carbs, fat and protein? Did they consider modifying their dietary recommendations to reflect all this new data?

              Nope. Nada.

              They just didn’t pay any attention to it. Too busy selling their product, I suppose. People like Carmen have no intellectual curiosity in really looking into the literature of what hominid ancestors actually ate. They just have a business and a false dogma to maintain.

              There’s no curiosity about the overwhelming evidence of starchy underground storage organs (USOs) in indigenous cultures around the world and the AMY1 starch genes that are so prevalent in our species — as well as the prevalent AMY2B starch genes of our own domesticated dogs. There’s no desire to investigate the actual science or have an intelligent discussion about it. It’s embarrassing and borderline inexcusable.

              And all I’ve done is referenced the published scientific data and asked where all of the large quantities of fat could have come from when our ancestors mostly only had access to lean animals.

              Early humans scavenged the fatty marrow from carcasses, with only three or four species (see Figure 4) of “unstressed” African ungulate carcasses yielding marrow of more than 1,500 kCal (with wildebeest marrow being a rare exception yielding 3,000 kCal). That’s not a lot of fat for a family to share and stay in ketosis. If an early, and skilled, hunter was able to obtain the full “unstressed” carcasses, the meat would have been very lean, even with the addition of some caul fat. Where did all this supposed “high fat” diet come from? I’ve never seen a realistic hypothetical answer to that given the lean ungulate conundrum.

              Of course, I wouldn’t expect any of these false ancestral gurus to investigate the scientific literature that closely. If they did, they’d be out of business.

              • Duck, Duck, why is it that folks like you seem to enjoy being so trivially aggressive? Making little slights about my integrity, depth of knowledge – “educating me”? whew – without even having a clue who I am & what I do? Hmmm, cherry picking – my comments & your research & ignoring all the other details I wrote. I’m not an arm chair amateur – in the clinical/health/medical arena nor in biology & nutrition & real whole food. I am a clinician, 35+ yrs. Cardiovascular & diabetes. Physiologist, biologist, botanist, animal husbandry, etc, etc, etc. I raise or hunt most of my own food so I can eat the whole, healthy animal, as much as possible, to maximize my essential nutrients & also indulge in the pleasures of Paleo &Neolithic plant foods that aren’t too toxic. My focus is optimal nutrition. My primary approach is to maximize essential nutrition while reducing cardiometabolic disorder – since that’s a HUGE population based issue- TODAY!

                I think I clearly stated that TOTAL NUTRITION WAS THE MOST IMPORTANT…. Perhaps the real question: “Is a diet LOW IN ESSENTIAL NUTRIENTS ruining your health?”. Key points: 1) it is essential to assess if one’s basic nutrition supplies the essential nutrients (the ones we can’t make or make enough of to survive)…. 2) just discussing “low carb” was rather meaningless. 3) That without better identification of CONFOUNDING variables we were at the level of correlation & that’s not a good place from which to make large, sweeping conclusions. But for the sake of conversation & pointing out that you jump to big conclusions on minimal evidence:

                I’m not about raw “survival”… I know how to stay alive over a short time in the wild, that’s not the point …. I’m relating to “optimal” nutrition for procreation, raising children, healthy brain function & living a long, healthy life. I stated that safe starches have a place in our nutrition – primarily for “calories”(& they are convenient & pleasurable) and properly prepared vegetables (which are tasty & feed the gut bacteria) but most carb/plant based sources lack key essential nutrients . And, 30% carb, all the time maybe problematic – especially if you are one of the majority of Americans suffering from cardiometabolic disorder. If one reviews the essential nutrients for H.sapiens: I’ll pick the easy ones: vit A retinol, D3, K2, B12, heme iron, taurine, EPA, DHA – these are only found from animal sources. Wanna look at a “super food” check out this post: “Liver: Nature’s most potent superfood” : ….Heck even vit C is plentiful in animal tissue.

                Uhhh – I think you need to re-read this article.. Your ref: – with data analysis techniques that even the authors point out as problematic & admit that: [“The isotope method cannot distinguish what parts of grasses and sedges human ancestors ate – leaves, stems, seeds and-or underground storage organs such as roots or rhizomes. The method also can’t determine when human ancestors began getting much of their grass by eating grass-eating insects or meat from grazing animals. Direct evidence of human ancestors scavenging meat doesn’t appear until 2.5 million years ago, and definitive evidence of hunting dates to only about 500,000 years ago.

                – “We don’t know if they were pure herbivores or carnivores,”…. “ If early humans ate grass-eating insects or large grazing animals like zebras, wildebeest and buffalo, it also would appear they ate C4 grasses. If they ate fish that ate algae, it would give a false appearance of grass-eating because of the way algae takes up carbonate from water, Cerling says.”]
                …. So, what conclusions can be drawn from this?!

                Nor can we identify what we should be eating today based on hominids from 2.5-4 million yrs ago. We are descended from herbivorous based primates. NO argument. BUT, something allowed us to diverge & develop the most advanced brain in the animal kingdom. Though, even the best researchers argue about what humans ate only 15,000 yrs ago & debate why the mega fauna of the entire N. American continent became extinct in a very short time… . To jump from what our remote primate ancestors probably ate to identify what modern hominids should eat is simply ridiculous…

                Hunting – do you hunt? Ever dressed a healthy cow elk or doe, very nice fat content (up to 70% of total Kcals, [Cordain], even when totally grass fed) when harvest at the right time? If I’m in a very cool climate (most of the last 100,000yrs)… one healthy kill, large herbivore, supplies a lot more total nutrition & quality calories than a whole marsh of watery tubers or wild rice but these plants definitely filled caloric gaps. Might want to discuss this w/ Robb Wolf, who holds the record for one of the largest elk killed with an atlatl – & he didn’t do it just for fun….. his group of reality show “cave men & women” were starving, trying to “live off the land” for just a couple of weeks – plants just weren’t doing it for them. That elk fed them well & I heard that the raw liver tasted mighty good. (just Google: I, Cave man)

                Do you raise your own meat animals? Do you harvest your own animals? Do you eat organ meats, the whole animal? Do you know how meticulous hunter cultures were/ are about how, what & when they harvest their game? Now why do the Inuit prize all that muktuk?! Really, one article on “reindeer” carcass.?! Reindeer were not the only herbivores on the planet (lessee – wooly mammoth, rhinoceros, bison – . And, hmmm this article (your ref) – staunchly points out the importance of fats. So maybe much of that mega fauna was hunted for its FAT & our ancestors left the lean meat to the jackals? (oh, I think I mentioned that)! And, w/ cold seasons (fall into winter) fat storage is made easier. And, all that trade between inland cultures & coastal peoples (seal, whale, or oulachen fat). I do believe I focused on that key essential, very complex & very misunderstood macronutrient(s) FATs/Fatty acids. Maybe, we aren’t well suited to live inland, you know that “water ape” theory. Oh & hmmm, the Sami have done very well on their seafood & reindeer based diet, ‘course they use the dairy from the reindeer as well. But is Neolithic OK or not in your rules?!


                uhhh – their theory, unproven. Yes the ability to digest starches allowed us a potential selective advantage, able to inhabit larger ecological niches… I did note that.
                [We view starch as a transitional food,” Dominy adds, helping us get from fruit to meat but also important in its own right. What abundant, ubiquitous resource was out there in the environment? “Fruits just don’t do it,” Dominy says. “For one thing, they’re seasonal. Meats are hard to get, and we didn’t have tools or spears yet. So we think that the shift to eating corms, bulbs and tubers gave our ancestors enough sugar resources to develop a large brain.”] Really, this got your attention, based on what REAL evidence?
                This may have worked for lesser hominids, long ago & increased their brain size but for current brain health it’s quite incongruous to the essential nutrients that our healthy “large” H sapiens brain require….

                Ah, the amylase argument….” The very fact that most humans evolved lots of AMY1 genes, should be proof enough that starch consumption makes us human.”
                Uhhhh, dogs have it too, & wolves, though to a lesser extent. Does that make them “human”? Regardless, plant based, starch diets do not contain adequate essential nutrients – for dogs, cats, wolves or humans.

                And I quote from S. Guyenet:[ “Five years ago, I had an interesting conversation with a veterinarian friend about dog food. We were talking about diabetes in one of the dogs she was treating, and I remarked “that’s what happens when you feed a carnivore carbohydrate””.]
                So, cardiometabolic disorder in humans is that much different? How long have you worked clinically, professionally, studying & treating cardiometabolic diseases?

                And I could go on, but I’m getting bored & need to get some sleep so I can do some real work. I could suggest getting some better references though.

                I’m not interested in survival; I’m focused on “optimal”. Cardiometabolic disorder affect a majority of Americans. I have observed cardiovascular disease becoming common in 40-50yr olds, who are fit & thin; when not long ago it was a disease of old age. I’ve been around the block a few years, have observed the ineffectiveness of most “diets”; worked hard at identifying the confounding nutritional variables. Based on the clinical, biological, botanical BIG picture: Grains are playing a big part, as is a carb based diet – plenty of calories with minimal nutrition. Natural selection is always at play…. Biology is definitive. H sapiens can survive on a carb based diet – but does it support- A robust, large brained, well-muscled human? Healthy brain evolution or de-evolution? What was Weston Price looking for – Oh yeah – the “reason for moral degeneration in modern society”.

                Mayhaps your attitude in discussing issues civilly, without ad hominem inuendo is somewhat telling?

                p.s. Oh, and one does NOT need to be in “negative energy balance” to be in ketosis. I have been at 3900 kcals/day (that would be in excess of my daily caloric needs, ie positive caloric balance) and lost body fat….. I weigh, on any given day 118-122# @ 5’4”, Body fat ~18%. Recovered competitive athlete, recovered from clinically significant heart arrhythmia, adrenal exhaustion, fibromyalgia, IBS, pre-diabetes, autoimmune issues,– now a healthy, robust 56 yo [ApoE3/4, (TC 365/HDL 80/TG 82, type A subfraction) fasting insulin 1-2, CRPhs .4] who loves life & still likes to play hard – all on a mostly ketotic nutritional program and still discovering more variables to factor in.
                Vive Vida!

                • I’d be wary of Mr. Duck based on the slanted and almost obsessive nature of his/her posts.

                  Indeed there are people who get too dogmatic about low-carb being good for everybody.

                  But for every one of those, there seem to be two or three like Duck Duck who are throwing everything but the kitchen sink into trying to persuade people that low-carb is dangerous for them.

                  When people get this worked up about something, I get suspicious. Often they turn out to be vegans or on the payroll of some bakery somewhere in the midwest.

                  There is a tremendous amount of bad anti-carb propaganda masquerading as research out there on the web.

                  If you explore the links, you can see a lot of this faux research is generated by vegan organization who are fighting the low-carb and paleo movement with a religious fervor.

                  It’s a little like the Christian conservatives trying to persuade the rest of us that birth control and abortion are dangerous. I understand their motives, but their science is garbage. The health of women takes a back seat to their ideology.

                  Just be cautious and don’t respond unless you want to read more propaganda.

                  There are plenty of good non-biased sources of information about low-carb, benefits and potential problems and side effects — beginning with the Atkins foundation itself which is scientifically mainstream and very sound. (run out of Duke University by a nationally respected doctor, Eric Westman).

                  Another good source is, a blog and set of links run by Dr. Andreas Eenfeldt a Swedish physician who has devoted himself to puncturing the anti-low-carb myths and who has been very influential in changing Swedish health policy. I warn you, if you Google his name, you will see lots of vegan sites ( trying to knock down Eenfeldt — but again, remember where the vegans are coming from.

                • Tom,

                  I do not discount that VLC is therapeutic for some conditions. However, I do discount the anthropological evidence for low carb. It is extremely weak. I am merely interested in looking into the anthropological research. I could care less what you choose to put in your mouth. But, it should come as no surprise that humans are most definitely omnivores.


                  My apologies for the rudeness. But, if our ancestors were truly carnivores, we would have jaws and mandibles that look like a carnivores. If we were truly herbivores, our jaws/mandibles would look like an herbivores. But, we are neither. Humans evolved the jaws/mandibles an omnivore. In other words, you need to look at all the clues, as anthropologists do (wear patterns, isotopic signatures, remaining hunter-gatherer habits, animal compositions, fossilized coprolites, etc). And then you have to form a hypothesis based on all those clues. Over the last few years, the evidence that has come to life has shifted the thinking to greater reliance of Underground Storage Organs (USOs).

                  The overwhelming majority of anthropologists do not believe in a VLC ancestor. And, frankly, to imply otherwise is disingenuous.

                  In fact, the latest issue of National Geographic—you know, the magazine that spends each issue examining the latest research on cultures and ancient anthropology—ridiculed the notion of a highly-carnivorous Paleolithic Diet.


                  National Geographic (Sept 2014): The Evolution of Diet

                  The real Paleolithic diet, though, wasn’t all meat and marrow. It’s true that hunter-gatherers around the world crave meat more than any other food and usually get around 30 percent of their annual calories from animals. But most also endure lean times when they eat less than a handful of meat each week. New studies suggest that more than a reliance on meat in ancient human diets fueled the brain’s expansion.

                  Year-round observations confirm that hunter-gatherers often have dismal success as hunters. The Hadza and Kung bushmen of Africa, for example, fail to get meat more than half the time when they venture forth with bows and arrows. This suggests it was even harder for our ancestors who didn’t have these weapons. “Everybody thinks you wander out into the savanna and there are antelopes everywhere, just waiting for you to bonk them on the head,” says paleoanthropologist Alison Brooks of George Washington University, an expert on the Dobe Kung of Botswana. No one eats meat all that often, except in the Arctic, where Inuit and other groups traditionally got as much as 99 percent of their calories from seals, narwhals, and fish.

                  So how do hunter-gatherers get energy when there’s no meat? It turns out that “man the hunter” is backed up by “woman the forager,” who, with some help from children, provides more calories during difficult times. When meat, fruit, or honey is scarce, foragers depend on “fallback foods,” says Brooks. The Hadza get almost 70 percent of their calories from plants. The Kung traditionally rely on tubers and mongongo nuts, the Aka and Baka Pygmies of the Congo River Basin on yams, the Tsimane and Yanomami Indians of the Amazon on plantains and manioc, the Australian Aboriginals on nut grass and water chestnuts.

                  “There’s been a consistent story about hunting defining us and that meat made us human,” says Amanda Henry, a paleobiologist at the Max Planck Institute for Evolutionary Anthropology in Leipzig. “Frankly, I think that misses half of the story. They want meat, sure. But what they actually live on is plant foods.” What’s more, she found starch granules from plants on fossil teeth and stone tools, which suggests humans may have been eating grains, as well as tubers, for at least 100,000 years—long enough to have evolved the ability to tolerate them.

                  The notion that we stopped evolving in the Paleolithic period simply isn’t true. Our teeth, jaws, and faces have gotten smaller, and our DNA has changed since the invention of agriculture. “Are humans still evolving? Yes!” says geneticist Sarah Tishkoff of the University of Pennsylvania.

                  They call them hunter-”gatherers” for a reason.

                  And while we are quoting Stephan Guyenet here, let me direct you to this particular quote of his:

                  Fat and Carbohydrate: Clarifications and Details

                  It is worth noting that the ancestral African hunter-gatherer diet was probably not high in fat on most days, at least not animal fat. African game is characteristically extremely lean, and the only African hunter-gatherer group I’m aware of that gets a fair amount of fat is the !Kung, and most of that fat comes from mongongo nuts (although the mongongo fruit/nut is mostly carbohydrate by calories, a fact that Staffan Lindeberg recently pointed out to me). Most African game just doesn’t contain much fat, even if you include the brain and marrow, and the primary exceptions, like hippos, are extremely dangerous to hunt with stone-age weapons (9). I have yet to see a single credible account of an African hunter-gatherer group that regularly eats a diet high in animal fat. If you know of one, please cite it in the comments.

                  I’ve come across a lot of arguments that the ancestral human diet was typically high in fat, but these invariably strike me as wishful thinking.

                  I often wondered why the modern version of the Paleo Diet™ is so far off the mark from what the overwhelming majority of anthropologists now theorize. Turns out one reason is that the early interpretations of the Paleo diets cherry picked their data:

                  From: Human Diet: Its Origin and Evolution by Peter S. Ungar, Mark Franklyn Teaford

                  In “The Paleolithic Prescription,” Eaten et al. (1988b) reconstructed a Paleolithic forager diet based on average values from current hunter-gatherer diets available in the literature. The data came from only six groups, mostly living in marginal habitats. One of the studies was on the !Kung, whose diet was recorded for a single month (Lee, 1969), and one was on the Eskimos (Eaten et al., 1988b). Despite these limitations, the diet hypothesized by Eaton et al. (1988b) offers an opportunity to consider how hunter-gatherer nutrition may have changed compared to an ancestral chimpanzee diet.

                  In other words, the first modern iterations of the Paleo Diet™ were based on cherry-picked data for a low carb/high fat diet bias. It probably should have been called the “marginal-habititat” diet, but that wouldn’t have sold as well.

                  And, Tom, I’m simply trying to set the record straight. A lot of people have been misled by the Paleo Diet™ into thinking that our ancestors were mostly carnivorous, but the anthropological research now says otherwise.

        • “The lesson from evolution is that there is nothing more “Paleo” than transient ketosis.”

          Well, other than eating and F*cking, I suppose. Raising children, perhaps? How about spending time understanding the values of your 30 or so tribe mates, such that you can influence them, as opposed to getting your 1/300 millionth say in a social masturbation chamber equipped with a curtain?

          I apologize. It’s just that the above was my AHS12 presentation at Harvard. Guess who was in the room with me during final preps? Chris, and Denise Minger.

          Transient ketosis ushers autophagy, and cleansing at the cellular level. This ought be well established. But VLC and Ketosis is about being chronic about it, or, too much is not enough.

          Ultimately, it’s probably about selling stuff.

    • Carmen,


      “My basic premise, for an overall safe macronutrient substrate is 70% fats (the right kind) 20% protein (the right kind) & 10% carb (the right kind). ”

      but causes this:

      “white rice (thoroughly rinsed 5-6 times) causes no immediately noticeable problems except fluid retention, beer of any type leaves me w/ a fever blister & depending on the alcohol & amount – I’m playing Russian roulette w/ a migrain. ”

      then you are in trouble.

      It might be good to stop composing long comments and start thinking.

      • Gemma
        Thank you for illustrating the point that I made from my very beginning comment – correlation does not equate to causation. By your statement you appear to have made a classic generalization/over simplification that my macronutrient intake was causal in my symptoms. My lower carb nutritional intake doesn’t cause the symptoms I shared – the foods directly related to the symptoms I reported do – and the metabolic/biochemical pathways are fairly obvious (corroborative supporting data). By identifying & controlling my food “variables” I am able to delineate the causal food(s) & therefore, avoid causing myself a migraine or fever blisters or gaining fluid volume. None-the-less, I still take a risk, now & then, with the migraine thing – I do enjoy a nice mixed drink. Tho, negative reinforcement may eventually win out 🙂

        Now let’s AVOID the next big over simplification – removing toxic substances from ones intake or eating a restrictive diet (that may be beneficial for weight loss) does not equate to getting all our essential nutrients.
        Vive Vida!!

        Vive Vida!!

  83. Recommending more carbs to a diabetic or prediabetic is irresponsible without including the caveat that they should be doing it only if it does not raise their fasting and postprandial blood sugar levels.

    According to the CDC, 70% of all Americans are overweight or obese. There are at least 100 million Americans who are prediabetic or diabetic and 50% of all Americans have at least one risk factor for coronary heart disease,

    I had type 2 diabetes and was completely able to reverse it and loose 100 pounds by going on a Paleo low carb diet and exercising vigorously for 45 minutes, 6 days a week.

    When I got down to 12% body fat and increased my fitness and muscle mass, a funny thing happened. I found I could eat 100 to 150 carbs a day in green leafy vegetables and low glycemic fruit and berries without raising blood sugar above normal levels.

    This would not have happened if I had not given up processed foods, lost weight and become fit.

    Only after losing weight and becoming strong and fit could I eat more than 50 carbs a day without raising my blood sugar levels.

    I have several diabetic friends who have had a similar experience.


    • Blaine

      “Recommending more carbs to a diabetic or prediabetic is irresponsible without including the caveat that they should be doing it only if it does not raise their fasting and postprandial blood sugar levels.”

      Original Sin update. Yep, provide a standard that’s impossible to follow, condemn them all to hell. 2nd oldest trick in the book.

      Hey blain? Ever wondered what the insulin sensitivity and carb tolerance is of Inuit on their natural diets? Well, with a bolus dose of glucose, their blood sugar does raise to perfectly physiological norms (140 mg/dL) and returns to sub-100 normally as well. But how about if they are truly in ketosis (i.e., chronic VLC)?

      And guess what, exact same thing happened to Stefansson; only for him, it was after a year of VLC and not an 80-hr fast as with the Inuit.

      This is all getting pretty really silly. I’m all for T2s correcting their situation and if it requires strict adherence to VLC, fine. I suspect the cure is elsewhere, such as the gut biome, non-processed foods, etc., but that’s a debate for another time.

      There are, in fact, millions of both T1 and T2 diabetics worldwide who control their diabetes just fine. So, perhaps it’s “irresponsible” to advocate more carbs to someone you know won’t follow instructions (while you just assume they’ll follow the VLC instructions), but the well established fact is that people are capable of replacing their pancreas with their mind and doing very well.

      My mom is very tightly controlled, though she does eat LC most of the time. Still needs insulin sometimes, though.

      My father-in-law has been a T2 for over 50 years. He eats beans every day. Potatoes. Typically 2-3 flour tortillas for breakfast with his eggs, beans, potatoes and bacon.

      He’s 86.

      Check out how he looks.

      You have to realize. The Paleo/LC deal is now at the point where there’s a Red Pill / Blue Pill option. So thankfully, Chris is a Red Pill guy.

      • There is a major clinical trial going on right now in the UK on reversing diabetes with a very low cal, low carbohydrate 8 week diet. This is following a pilot trial that reversed type 2 diabetes without medication in over 80% of participants

        The lead doctor on the trial is Roy Taylor MD who has discovered that type 2 diabetes is caused by too much fat in the pancreas and liver which reduces their normal function and that a low carb, low calorie diet allows these organs to return to more normal function if the pancreas has not completely burned out.

        I should have been clear that I was talking about reversing type 2 diabetes without medication of any kind… returning to completely normal blood through diet and exercise alone.

        I was not talking about Inuits who have not burned out their livers and pancreas. I should have been clear I was talking about carbs raising fasting and postprandial blood sugar significantly above normal levels and into diabetic ranges only for diabetics and prediabetics.

        There is no doubt some people can be diabetic and eat beans, tortillas and potatoes for 50 years if they are willing to take medication to counteract the spike in diabetic level blood sugars this will cause.

        Eating a lower carb diet and giving up processed foods is not impossible. Is it difficult? Yes. Is it harder than giving up smoking or a cocaine addiction? Maybe. I don’t know because I have never smoked or taking drugs.

        But I do know I was a sedentary fast food, carb junkie and when I started eating a whole foods, low carb diet and exercising, I got my health and life back. I am not alone. I know many others who have had similar success.

        I’m realistic enough to know that most of the 100 million diabetics and prediabetics in this country will not do what is necessary to reverse what is for most an optional, preventable disease.

        The really sad thing is that there are probably millions of people who would do what is necessary to reverse or avoid diabetes if they knew that while it is difficult, it is possible..

        I do not condemn anyone who can not do it because I know how hard it is to do.

        But I still believe it is irresponsible to talk about increasing carbs in a diet without mentioning that there are 100 million diabetics and prediabetics that this may not be the best strategy for unless they want to be taking diabetes medication for the rest of their lives.

        Most diabetics and prediabetics will find there symptoms become inevitably worse through a higher carb diet unless they have first lost weight, are exercising and closely monitoring the effect that the increased carbs are having on their fasting and postprandial blood sugar levels..

        • Hi Blane.

          “very low cal, low carbohydrate 8 week diet.”

          OK, so what happens when they come out of starvation? LC or HC, the dominant factor there, the one that can’t persist indefinitely is VLC (very low calorie).

          Moreover, raw vegans can reverse diabetes, too. A post from 2008:

          “There is no doubt some people can be diabetic and eat beans, tortillas and potatoes for 50 years if they are willing to take medication to counteract the spike in diabetic level blood sugars this will cause.”

          Your bias and prejudice shows through here. First, I acknowledge that VLC may be the better strategy for people who will not tightly control, won’t give up the junk food, etc.

          But that’s not an argument based in human biochemical, metabolic physiology, but strictly behavioral. Or, as I like to say, it’s an Original Sin argument.

          “willing to take medication”

          Insulin is a human hormone essential to all mammalian life (no idea whether reptiles and others use it too). It’s produced by an organ called a pancreas. When this organ fails, and since we’ve yet to figure out pancreatic transplant, it turns out that we have another organ than can pinch hit.

          It’s called a brain and incidentally, it required upwards of 130g of glucose daily, as an absolute requirement and your evolutionary adaptation will ensure it gets it.

          Along with the tools of a meter, testing strips syringe and a human hormone called insulin, the brain is perfectly capable os taking up the slack of a lazy ass pancreas, and millions upon millions have demonstrated this.

          I’m kinda getting impatient with this notion that the technology that even allows a brain and tools to be a pancreas is somehow sinful, worthy of condemnation, and you’re carbs just aren’t low enough.

          I so salute Chris Kresser for having the courage to open this can of worms.

          • Richard,

            If you are diabetic, eating carbs is like pouring gasoline on a fire and then using diabetes medication as the fire extinguisher to keep it under control.

            Much better not to pour gasoline on the fire in the first place.

            I’m aware raw food vegan diets can reverse diabetes. But if you look into it, you will find they usually start with a water fast, followed by a green drink fast, followed by a very low carb vegan diet that emphasizes green leafy vegetables and low glycemic nuts, fruits and seeds. This is the Gabriel Cousins diet. They did a documentary on it and for the very few people who can follow this diet, it is very successful.

            A low carb vegan diet is even more extreme than the very low calorie diet currently in trial in the UK. When the 8 weeks is over, participants are encouraged to eat a balanced low carb diet with enough calories to maintain their weight loss.

            Both diets are hard to follow they are both better than eating a high carb diet that requires taking diabetes medication to counter spikes in blood sugars that high carbohydrate diets will inevitably cause for almost every diabetic and prediabetic.

            The only exception is a small percentage of people find that once they have lost enough weight and the liver and pancreas return to more normal functions, they may find it possible to eat more carbohydrates. But they also must maintain their weight loss and vigorous exercise or their diabetes symptoms will return.

            There are many, many Seventh Day Adventist diabetics who have had good success following a low carb vegetarian diet and exercising.

            I have never heard of a high carb eating vegetarian who avoided losing weight and didn’t exercise that still managed to successfully reverse diabetes. Dr. Joel Furhman has acknowledged diabetic vegetarians need to eat lower carb diets and exercise.

            I eat about 2600 calories a day and keep my carbs to less than 100 grams following a Paleo based diet. I am not starving. I have been doing it for several years and my blood sugars are completely normal.

            I eat 80 to 100 grams of protein every day. Most of it animal based as it seems to be easier to follow without undue hunger.

            I have zero doubts if i stopped exercising and starting eating a higher carb diet, I would once again find myself developing type 2 diabetes with all the complications that entails.

            Where do you think I’m going wrong here?

            • “If you are diabetic, eating carbs is like pouring gasoline on a fire and then using diabetes medication as the fire extinguisher to keep it under control.”

              I don’t know what I can add to my previous comment. Insulin is hormone replacement, analogous to taking thyroid hormones.

              We have to come to grips with the idea that people are different, not so much physiologically as they are psychologically or behaviorally.

              And this is the precise role of a CLINICIAN with EXPERIENCE like Chris. He’s not sitting at a computer spewing out hypotheses and proclamations like a preacher. He sees INDIVIDUAL patients.

              So, what’s he supposed to do when he finds a patient like my FIL, 50+ years a T2, 86 and in great health because while the man finds Bernstein (yea, he read the book, Sisson’s and mine too) way to complicated, he measures BG tons of times per day, has a very good bead on just how he feels and can keep his BG under good control by using his brain like a pancreas (he’s a retired air traffic controller, so smart and alert).

              So, is Chris supposed to get on his pulpit, condemn the man for his weak sin of liking and eating the foods he likes, such as refried beans, potatoes, tortillas, and instead eat the LC foods he has no experience with and at the cost of quality of life?

              As Chris wrote in his comment that was gold, this is about putting the patient first and I salute Chris for that. A lot.

              • Richard,

                I’m aware insulin is a replacement hormone. There are type 1 diabetics that have won Olympic Gold medals eating high carb diets and using insulin. There is a long list of professional athletes who are type 1 diabetics that would die without insulin. Carbs and enhanced Athletic performance are extremely well documented

                However, there are virtually no active professional athletes who have type 2 diabetes even though the incidence of type 2 in the general population is 10 times greater than type 1. Why is that?

                Could it be that when you are exercising at the level of a professional athlete, it’s almost impossible to develop insulin resistance and the fatty liver and pancreas that leads to type 2 diabetes?

                “We have to come to grips with the idea that people are different, not so much physiologically as they are psychologically or behaviorally.”


                In the last 50 years people have become addicted to fast food, processed foods, supersized sugary drinks and deserts coupled with a more sedentary lifestyle. 70% of the calories of the average American’s diet comes from processed foods, most of which didn’t exist 60 years ago. We spend more time sitting on our buts than at any other time in human history.

                There is now an explosion in obesity, diabetes and heart disease. For the most part, they are all behaviorally induced and can be prevented with a Paleo diet and exercise.

                The answer for type 2 diabetics is not more medication and insulin as a benign hormone replacement therapy. Although in the absence of behavior modification, there may be no other alternative.

                According to the CDC, over 90% of American seniors are taking at least one prescription drug and over 50% are taking five or more drugs with all the risks and negative side effects that entails.

                By some estimates, prescription drugs are the 4th leading cause of death in America.

                In 2012, Glaxo Smith Kline plead guilty to 3 counts of criminal fraud for their diabetes drug Avandia and over 500,000 Avandia users sued GSK for damages.

                If there is a natural way to reverse type 2 diabetes with diet and exercise, isn’t it far preferable to using drugs and insulin to control it?

                The problem is this story is not widely told and many times as with Laura’s post here, little mention is made of the extensive research that shows a low carb, whole foods diet can reverse this disease without resorting to drugs.

                My analogy of carbs raising blood sugar levels in sedentary diabetics and using drugs and insulin as a fire extinguisher to control the disease is directly analogous.

                Will it work for every one, especially those with other endocrine or gut biome issues? I would not argue with direct clinical experience to the contrary.

                I can testify it has worked for me and many people I know.

                Dramatic weight loss, exercise and a low carb diet that excludes processed foods will reverse type 2 diabetes in many people and since the risks associated with this approach are very low, it should be the first option for those willing to try it.

                Read Ben Goldacre’s, Bad Pharma on the high cost of resorting to drugs to treat entirely preventable diseases.

    • blaine,

      I’m buying what you’re selling. When I began LCHF my energy returned and exhaustion disappeared in a few short weeks, it was miraculous, so I jumped at the opportunity to exercise again and my body recovered well, lost 10 lbs, then stopped loosing but probably gained some muscle, net effect was 2 pant sizes. But then after a few months it levelled off and exhaustion and non-recovery crept back in, it kicked my ass. Do you think I should just drive myself through these plateaus, which frankly are life sucking exhaustion events beyond any remote definition of fatigue. Any thoughts ….

      • Greg,

        Body composition and physical fitness is more important than weight. Every Kroger store in the country has a health kiosk next to their pharmacy that will give you your body composition with a bioelectrical impedance test…also blood pressure and weight.

        If you are under 15% body fat, can jog a mile or a mile and a half at a 10 minute mile pace and are still feeling crappy, it is time for a physical and comprehensive blood test.

        Just to be clear, I have eliminated all fast food, all grains, liquid dairy and sodas, (even diet).

        I now eat a ridiculous amount of greens every day. 7 to 9 cups and I limit fruit to one or two small servings.

        I eat eggs, fish, foul, pork, and red meat in moderation.

        Grass fed butter, coconut and olive oil… no manufactured oils. The only sweetener is stevia.

        I lift heavy weights twice a week. I run twice a week and I ride a road bike or mountain bike at least 40 to 50 miles a week.

        After being an overweight couch potato for the last 40 years, I can now pass the army’s physical fitness test for someone half my age.

        Eating right is 80% of the battle but the 20% that is physical fitness will make you bullet proof.

        Good luck.

        PS: Buy a blood glucose monitor at Walmart for $25 and test intensively for a week to rule out diabetes and prediabetes.

        • blaine,

          Your transformation is miraculous, congratulations! Thank you for your insights and experience.

          We are a bit opposite. I was the farthest thing from a coach potato for 42 years to the extent of running ultra marathons and numerous other physical pursuits, managed a gym, and at one point I lead a team of navy divers, I was always fit, then non-recovery and chronic exhaustion hit at 42 and I became a couch potato.

          I’ve had (?) nearly every test the medical system will allow, and a binder full of results. Only thing I can see is boarder line prediabetes or metabolic syndrome. So I bought a blood test kit last month, FBG averages around 110/6.1, the odd reading of 125-150, while on a LC to VLC diet. So taking metformin and green coffee beans now to bring that lower and see how it feels, no change yet. Daytime and post meal glucose is lower so no issue there. I always wake with significant joint and whole body pain and non-restorative sleep is a big issue so perhaps I’m getting a glucose liver dump while sleeping or waking, and that is throwing everything off. Or glucose isn’t the issue and it’s insulin resistance. This is my latest experiment.

          LC brought down my BP from 150/110 to below 140/90. It’s lower now then when I was running ultras. I gained 50 lbs over these 12 years, lost a quick 10 on LCHF, estimate my body fat to be around 25%, was 30% at one point. No longer loosing fat, plateaued.

          If I could exercise more I would. It’s my passion. I’d do it every day twice a day if I could. But the sensations of non-recovery are overwhelming, it’s exhaustion on steroids, and it can last days or weeks. So I walk a fine line between just moving and exercise. Early days on LCHF I was recovering wonderfully, started lifting heavy weights and sprinting, and felt like a million bucks. But for some reason it only lasted a few months, then back to non-recovery and exhaustion. Ugh! Now I just walk.

          This is when I began experimenting with adding back more carbs, but no joy. Like you I eat lots of green veg, although not as much as you, plus seafood and meat, good fats, zero processed or refined anything, no industrial oils. I’m now eating more fish and less meat hoping that might help.

          This debate over more or less or no carbs appears to be ongoing. I’d guess it’s individual and experimentation is key.

          I don’t have Dr support. They regard all my tests as normal. But I do see a GP who allows the tests I request, most of the time, but he adds no value or insight. So I’m relying on my own research to guide me, and insights from others like you. It’s a big witches brew, adding new ingredients, testing theories, doing experiments.

          Bottom line for me is when I hit hard on ketosis something changed dramatically, I felt like I was 20 y/o again, my body and brain lit up like a road flare, it was incredibly transformational. So something good happened, but it didn’t last. Why?

          Maybe it was the change, transition, switch into ketosis. Perhaps it has more to do with the metabolic flexibility involved vs remaining in one steady state or the other. Wish I knew the answer.

          Any/all feedback is welcome. The quest continues…

          • ….also

            I thought it interesting to note my 23andme DNA test displayed my greatest health risk to be diabetes and the medication I’m likely to have the best response to is metformin, go figure. I have no family history, and DNA is not epigenetics, but in combination with everything else, I wonder if this has merit.

            • Greg,

              I’m not a doctor and not qualified to even speculate about your condition. I can tell you though that there is a lot of recent research on “cardiac overuse injury” for people who have engaged in too much exercise or endurance events.

              Mark Sissons who used to be a pro triathlete calls it “chronic cardio.”

              Here is a link to his posting on the subject. I urge you to read it. Perhaps you are still suffering an overuse injury.


              It’s interesting that your blood pressure is lower now than when you were running ultra marathons.

              If you weighed 40 or 50 pounds less now then when you were running marathons, I would think your blood pressure back then should have been lower.

              If it’s a diet issue, Chris Kresser is about the best I’ve read for dealing with endocrine issues and diet. So keep following him.

              If exhaustion after physical exertion is an issue, a cardio CT scan may be in order. They are relatively cheap at less than $200 and would indicate if there is heart issue.

              Here is another article about cardiac overuse injury although the study dealt with overexercising in people who had already had a heart attack.


              good luck.

              • blaine,

                I think you’re right about chronic cardio. I’ve read all Sissons’s stuff and most others in the ancestral/paleo area. There’s a vein of truth that “feels” instinctively right to me. Science and how we interpret it is nothing more than a belief system, but it’s important to believe in something. Truth is relative.

                I’m in Canada so can’t just order a test. It needs to go through a GP who first needs to agree to it and then you have to wait in line. Eg last week my GP suggested a kidney scan, received my letter from the hospital a few days later, appt is in 7 months, what a racquet.

                In regards to heart, I’ve had several tests including, EEG, stress, echo. All fine. But I feel there is something to the whole chronic cardio idea. My last year of running training was difficult, not recovering normally, in spite of more rest. And then my last ultra race put me in emergency. They said it was dehydration, which may have been part of it, drank lots during and after, but I dialled 911 on myself after I got home, it felt like death was immanent. It’s a queer feeling to dial 911 on yourself. That ended exercise as I knew it. But 12 years later and every form of relaxing, recovery, and rest under the sun, you think I’d be recovered by now!?!

                So hello paleo and nutritional ketosis. If FBG of 110 is boarder line or not optimal, could driving it down to 85-90 help me, and if LC or VLC is not budging those numbers, does it make sense to add some pharmacy support like metformin which appears to be risk free from every angle. Could the issue to insulin resistance and/or elevated glucose and it’s toxic effects. Is insulin the key factor in all this? I’m just now reading about Cycloset which has recently been discovered to help with insulin by resetting the hypothalamus. That’s a bit advanced for me but trying to read and understand better. I do have a big problem upon awakening so this makes sense at that level. A reset button would be nice.

                Short intense exercise is manageable at times to I should do that when I can. I was doing short sprints in the pool which felt good but it bores me, so should get back to that. Slow hikes are good and I need to simply eliminate running and probably sprinting from my program, even though sprints felt great in early days of LCHF.

                Keep those tips and ideas coming. It’s frustrating when I try to do everything right and it works for a short time, but then the benefits fade away. I’m truly open to all ideas in this area although I do need to lock myself into some strategies for long enough for them to work.

                So the plan now is no processed carbs, no processed anything, no starch, just veg, meat, seafood, healthy fats, whole foods. Exercise short and intense, rest or walk in between. Take metformin and monitor FBG and try to reduce below 90. Hope for the best.

                • Greg,

                  Sounds like a plan. I’ve found I like biking and can do it longer without as much stress as running. I also swim but do no like it as much.

                  Here is a YouTube video you may find interesting

  84. You bring up some interesting points in this article. Especially with regards to pregnancy, thyroid and athletic demographics, how would one consume 150g+ carbohydrates each day when following a seasonal diet plan? If grains, beans and tubers are out, what may one turn to? Thanks

    • Tubers are definitely not out! Sweet potatoes, white potatoes, yams, taro, yuca, etc. – all these starchy root veggies are great sources of paleo-friendly carbohydrates that most people can do well with.

      Some people include white rice if they can’t tolerate some of these root veggies for whatever reason (i.e. FODMAP intolerance.) Or if they just like it.

      Legumes are unnecessary but some people do fine eating them (when properly prepared), but they really come down to individual tolerance.

  85. I started on a pretty strict low carb diet 2010 – amazingly pain and stiffness disappeared, I started to sleep (instead of waking up every other hour) and I didm´t get tired after lunch or in the afternoon anymore. And my stomach was finally in order. Just happy.
    After about 6 month I started to lose a little bit of the benefits, and overtime it increased. After two years I started to take medication T4, and ever since I have struggled with doctors to get the help I need. Now I have met an specialist and also get T3, so I´m feeling a little better. Just wanted to know if my low card diet might have caused me the growing problem with thyroid? For a year I haven’t been so strict, but always thought I ought to go back to strict low carb to see If I got any better …
    Anyone else like me?

    • If you “haven’t been so strict” for the past year and you are STILL having thyroid problems, is it really fair to blame low carb?

      My personal experience with thyroid and low carb was that when I was eating too few calories I experienced difficulty with my thyroid. As soon as I brought my calories up to a reasonable range, the thyroid issues disappeared. If low carb was implicated, it was implicated only to the extent that the appetite suppression of very low carb permitted me to remain quite comfortable with CALORIES that were too low. I remained VLC with higher calories, and my thyroid function has been fine ever since.

  86. Ugh, so confusing, I’m on my 12th ancestral science related book and it’s getting more confusing, can you help me? I was an ultra adventurer and very fit. Then 12 years ago at 42 became chronically exhausted, unable to recover from anything physical, severe joint pain, non restorative sleep, parathesia. I was a big quality carb eater to that point. 12 years of misery and no diagnosis. 6 months ago discovered LCHF, Paleo, Nutritional Ketosis. Dropped everything carb and processed, ate only whole food, veg, meat, and lots of fat, <50 g carbs, 50% fat. Gains were quick and dramatic, dropped 2 pant sizes, BP normalized, could exercise again and recover, exhaustion gone. But 3 months later it all began to return. I tried adding back some starch, rice and potato, cycle an extra 50-100g carbs on and off, intermittent fast, less exercise, more rest, but no effect. So now I'm back in the ditch again. I did notice my 12 year history of fasting blood glucose in the 108-110 range, and I matched the other criteria for MetSy. So recently I began taking metformin in combination with my LC diet to reduce my FBG. I obviously don't have full blown diabetes but could this level of hyperglycaemia cause all these issues or am I barking up the wrong tree with this experiment? Any other ideas? LCHF did something for a short period, but what, and how do I get it back?

    • Maybe we need to change things around every once in a while, mix it up. If we do anything for too long we can get diminishing returns, or maybe too much of a good thing in terms of gut bacterial populations. Also, there’s a lot to be said for a “novelty effect” whether mental-emotional, or physical.

  87. Hi Laura

    Thanks for this article.
    If you are carb sensitive, then you may want to temporarily eliminate fruits and eat less than 50 grams of carbs per day.Chronic stress can have negative effects on your hormonal environment, making you hungrier and preventing you from losing weight.

  88. My son, who was diagnosed with ulcerative colitis 4 years ago, had the opportunity to participate in a clinical trial studying the effect of fecal transplants on people with active UC. Unfortunately he was told at the conclusion of his treatment that he was one of only a few participants up to that point who did not show some degree of improvement. I’ve come to believe that this was at least in part due to the fact that he was on the Specific Carbohydrate Diet at the time of the trial, and the transplanted bacteria were unable to survive. I recently read (on Dr. Ayers Cooling Inflammation site I think) that fecal transplants have the best chance for success when the donor and recipient eat a similar diet.

  89. “While some people do incredibly well following a low carb Paleo diet, there are many people who crash and burn on this type of dietary plan. ”

    How fast will one see which type one is? I am on a low carb paleo since 4 months (40g carbs / day + 5.5g GOS) and feeling better than ever before. Am I out of the danger of “crash and burn”? Is this time enough for proving that this is safe and good for me?

    • One of Laura’s main points is diversity regarding carb tolerance. Laura or Chris, are there any ideas as of today what biological or even genetical differences are responsible for this?

  90. Hi Laura

    Thanks for this article.

    Chris has mentioned on his podcast a few times the importance of taking a break from technology but to my knowledge has not commented explicitly on the biological effects of EMFs. (Future article please Chris…)

    There is considerable evidence that you may not be aware of that shows that excessive electromagnetic radiation (EMFs from wifi, ‘smart’ phones, ipads, laptops, tablets, TVs etc) causes disruption in cellular signaling that effects our brain glucose metabolism and consequently impacts the desire/need for carbohydrates

    For example in the prestigious Journal of the American Medical Association (JAMA) in 2011 there was an article called “Effects of Cell Phone Radiofrequency Signal Exposure on Brain Glucose Metabolism”, (plus 36 other cites). See

    I would be interested in your thoughts on this as it seems to be in the blind spot of many people. I know from personal experience that if I spend too many hours on the computer I start to crave carbohydrates.

  91. Chris or Laura, if you could please answer this, I’d really appreciate it.

    I am 17 months postpartum (2nd child), no return of menses yet. I am practising ecological breastfeeding, so I nurse during the day and a lot at night, as I co sleep with my son.

    I was 117 lb pre pregnancy, and now I’m at 132. I tried a ketogenic diet 9 months ago,and went back to my pre pregnancy weight within a few weeks. After a while, I started craving lots of carbs, especially at night. I would essentially be low carb during the day, and would binge on a bunch of dates or honey.

    I am exhibiting some symptoms of hypothyroid, got my levels tested and they were a bit low.

    How do I lose my belly fat without going low carb? And what is a good carb intake for a nursing woman who hasn’t gotten her period back yet? Does a nursing woman require as much as a pregnant woman?

    Also, how do you increase carb intake, without messing up insulin levels, so it doesn’t affect the calcium/phosphorus ratio in blood, responsible for healthy tooth remineralization?

    I started taking Bob’s Red Mill unmodified potato start for RS intake. Despite my high intake of refined carbs, my calcium phosphorus ratio has never been better. But is it messing up my metabolism of carbs, and affecting thyroid?

    Please advise.

  92. I am so confused about what I should be doing. I have been on low carb for months with no weight loss and none of the miracle energy I am supposed to have. I feel well in general for a 60 year old obese woman. I keep doing this because I don’t want diabetes and cancer, which sugar feeds. I don’t even know where to turn. I have been to a Naturopath who ran extremely expensive test after another and no real answers and exhausted my funds. I figure if I keep trying things I will stumble on to what works for me. FRUSTRATED!

  93. Hi there,

    Just wondering if arrowroot starch works the same as potato starch in the department of prebiotics.


  94. Ahh the quandary of being both hypothyroid and insulin resistant/prediabetic. If I increase carbs, I gain weight and my blood sugar shoots up. If I keep carbs low, 30 – 50 grams/day, apparently that’s harming my thyroid.

    Oh an that darling little BMR calculator was brought up … It tells me I can maintain my current weight with 1900 calories a day. Hardie har har har. If I am to lose weight, I have to keep calories half that number, and still, I am lucky to lose 2 pounds per month.

  95. Hello, after reading your posts on the cortisol, I too am experiencing a problem with My own cortisol but mine is extremely high early-morning lasting most of the day. I have extreme anxiety and depression with severe shaking and I feel that it’s due to the cortisol being so high. Eight months ago I started the SCD diet due to ulcerative colitis. I also have fibromyalgia. But four months ago all hell seem to break loose and that’s when the depression and then anxiety with panic attacks came into play. Now I am placed on Effexor and Ativan to try to control the anxiety and depression. I take multiple supplements, which are multivitamin, omega-3, Tumeric, D3, digestive Enzymes, and probiotic. I also use GABA to try to avoid taking Ativan when possible. I have recently started HRT therapy two weeks ago hoping to see a change with that.
    I was hoping you could possibly shed some light on why the high cortisol in early-morning and could the diet being no carbohydrates have Any affect on the cortisol and the anxiety. I am a 55-year-old woman going through menopause and trying to regain my life back with hopes that someone could give me some advice.

      • Sheila,

        I don’t think cortisol is causing your problems. More likely the cortisol spike is in response to your adrenals being spent from the low carb diet.

        I had a similar experience with anxiety when going low carb (and I had absolutely no history of anxiety before that). It was awful. Turns out that all of the neurochemicials that your brain needs to be normal are produced in the gut:

        From: American Pshychological Association: That gut feeling

        With a sophisticated neural network transmitting messages from trillions of bacteria, the brain in your gut exerts a powerful influence over the one in your head, new research suggests… Lyte, in a 2011 BioEssays paper, proposed a neurochemical “delivery system” by which gut bacteria, such as probiotics, can send messages to the brain. Gut bacteria both produce and respond to the same neurochemicals—such as GABA, serotonin, norepinephrine, dopamine, acetylcholine and melatonin—that the brain uses to regulate mood and cognition.

        Like yours, my anxiety came from removing carbs from my diet. I had to take GABA and L-Theanine (two very safe amino acids for anxiety) for months, as my gut bugs apparently stopped producing those chemicals. I would have had massive panic attacks without them.

        Eventually, over about 6 months, I was able to rebuild my neurochemical-producing flora by supplementing/eating resistant starch and other fibers while eating a wide range of fermented foods (for the probiotics), which allowed me to wean off of the GABA and L-Theanine.

        When you cut out carbs and fiber, your flora starve and stop producing the chemicals that keep your brain normal. You can either buy these neurochemicals from the pharmacy, or you can get your gut bugs to make them. Either way, they are synthesized by bacteria.

        My recommendation is to follow Chris’s advice in his book, the Personal Paleo Code or look into the Perfect Health Diet. Both offer a relatively similar diet in terms of carb choices, though Chris’s book is more personalized and more recent.

        You may also want to consider eating and supplementing various fibers, such as resistant starch, as soluble fibers can do a very good job of feeding these gut bugs needed to produce the neurochemicals you are currently deficient in. However, you will likely also need to supplement with probiotics (Prescript Assist, L. Plantarum) as they are likely missing/starved from your gut now.

        You may also find Paul Jaminet’s series on bowl disorders (including ulcerative colitis) to be particularly helpful.

        Good luck to you.

  96. Low carb, high fat & grain-free (gluten-free) works great for me. It’s the only way I can successfully lose weight, because I’ve tried every other diet imaginable, and they were massive fails.

  97. Here is my 2 cents. I have been on a low carb/paleo diet for 5 yrs and a gluten free diet for 11 yrs. Currently I am eating about 30-50g carbs a day.

    By going gluten free my health improved in numerous and significant ways but I was on a blood sugar roller coaster. In using a low carb diet I have been able to normalize my blood sugars and no more spikes. Blood sugar stays between 80=110mg/dl all day long. When I first started eating low carb these numbers were about 20 points higher. Before I stopped eating carbs my blood sugar often went over 200 after eating.

    Over the years I have been able to cut my thyroid med in 1/2. I am still slightly low in T3, but if I add T2, I get heart palpatations. Recently I had to drop a blood pressure medication.

    No, I don’t think everyone needs to eat like I do, but I have found that low carb paleo seems to be working well for me.

    The person who probably has been on a low carb diet the longest is Richard K Bernstein, MD who wrote “Diabetes Solution”. He has been doing this for 50 yrs and reversed or stopped his diabetic complications. He is still treating patients. He is not really paleo, but it is easy to make his diet paleo.

    Yes, there are some medical conditions that do much better low carb.

  98. I know I do not do well on carbohydrates and the fewer the better. My biggest change to my understanding has been how little protein I (we) need and what a task it is to convert the excess into glucose.
    Making my own sauerkraut from some red cabbage and then a good variety of vegetables (beets julienne thin is a fav), fruit (whole cut-up pineapple), berries, herbs fresh and dried, seeds, (chia & flax), nuts, probiotic starters (whey, juice from last kraut, Kefir), and fish has done an immense favour to my gut health.
    I occasionally use carbs as my treats or deserts but I favour the simple things I do not add to my Paleo diet: Yam/red potato chips, ice cream (homemade), cream, Asian treats without much sugar and no wheat.
    I figure that as long as my gut health is great, I am doing fine.
    [I know Dr D’Adamo’s blood diet is often discredited but it helped me refine my ‘Atkins’ diet a long time ago. Interestingly, all the foods that were beneficial were already my favs and the avoids I never liked, even as a child, though I ate many of them as they were ‘good for me’. What delight I had tossing Brussels sprout from Sunday & holiday supers.]
    Namaste and care,

  99. I forgot to mention that we strongly suspect a Candida overgrowth because of a lot of antibiotics I have been on. I am trying to kill it, and then repopulate with good bacteria, but something I read in one of the comments confused me about that too. Any advice would be appreciated.

    Thanks again,

  100. Laura,

    I am having trouble with infertility, have adrenal fatigue, low thyroid, fibromyalgia, IBS, etc… When I first started doing paleo I wa told that you can have certain starches like sweet potatoes, but NOT if you were overweight or needed to lose some weight. So I have really stayed away from them for the most part. I basically eat fruits, green leafy veggies, meat, fish, nuts and seeds. Now I can’t believe what I am hearing that I might have caused this or made it worse. 🙁 I looked at the link of ways to get more carbs and don’t know how i could eat enough sweet potatoes and fruit in a day to get up to 150 grams… Could I incorporate some beans and some quinoa? Is quinoa really bad for you like the other grains? Especially if it is organic? That would be an easy way for me to possibly get a few more grams of carbs. I used to make fresh hummus too but thought I wasn’t supposed to have beans, but if I could have some of that it would be nice. My instinct is to add in a bit of beans and quinoa so I don’t have to eat a ton of sweet potatoes every day, but I just don’t want to eat things that supposedly put a strain on my body/digestion to solve another problem. I would have thought things like beans and quinoa would have been better options than white rice, but I honestly don’t know anything about it.

    Thanks for the help!

  101. I follow a cross between the Gut and Psychology diet and the Specific Carbohydrate diet. This has been working well for me. I eat a lot of produce seasonally that is relatively high in carbohydrate such as beets, turnips, carrots, squashes, melons, berries, apples, pears, grapes. I don’t worry about how much as I naturally gravitate towards these foods throughout the day. I don’t eat any grains, potatoes, yams or sweet potatoes. I don’t count calories or measure anything. Is there any reason to be measuring and counting? My weight is perfect. My GERD is gone. And my energy level is about what it was before the dietary change except it is more consistent since I no longer have intermittent bouts of diarrhea that last for days, weeks or months.

  102. I agree with this article. I went on a sort of ketogenic/paleo diet for a while, where my net carbs were always under 20g per day. If I even raised them to 25g per day I’d start gaining weight. So I stayed under 20g per day, losing weight and feeling great. For four months. Then I crashed. Hard. I suddenly felt worse than I ever had, and despite my best efforts, gained 17lbs in less than 3 months. All around the middle. I went to my doctor (conventional doc) who immediately did a thyroid panel, lipid panel and ordered cortisol tests. It turns out I have extremely high cortisol. I eliminated all stressors in my life months before this, so the only thing I could point to was ketosis. I asked a doctor who is a proponent of ketosis for all, and he said it’s common to have these issues, and that I should adopt a “cyclic ketogenic diet and keep my ketones up”. To me that sounded like a bad idea for where I’m currently at, so I need to know where to go from here. Paleo seems to be my best bet because I have issues digesting most grains and all legumes. I also now have glucose intolerance from ketosis too long. So where do I go from here?

    • You may want to have your doctor check you out regarding extremely high cortisol as there may be other causes than just ketosis that may need to be ruled out. If it’s just ketosis, then great.

      Back in the 1960s many people were on low-carb diets, or “the drinking man’s diet.” I was in my mid-teens at the time and a non-drinker. Several adults I knew were on this diet as well. The idea was to keep carbs between 25-60 gr. That was the only guideline. People lost weight on this diet, but found that when they went off the diet later they gained weight rapidly. I knew several people this happened to. I instinctively knew better than to go that route, but I didn’t know why. What I did instead was keep to carbs somewhat low, between 60-100 gr, for 3-5 years later, and then not go crazy with carbs even after that. This allowed the body to *acclimatize* or transition back to more normal carb intake over a period of many years. It was, in effect, a diet with a view to mindfulness and long-term change of lifestyle, not a weight loss diet where one resumed their previous eating pattern or some “normal” eating pattern afterward. Then and now, I’m mindful of what I call “slow acclimatizing” in relation to metabolic changes from diet, which takes much longer than most people ever imagine. Have to take the long view.

      • Thanks. Do you think it makes a difference that I haven’t had a gallbladder for 21 years, or an appendix for 13? On a side note, I’m one of the rare people that, even though I gained a LOT of weight after the gallbladder removal, my liver compensated for it by over-producing bile. So now I have to eat a bunch of fat to counteract the effects of the constant drip. I think that’s why ketogenic made me feel so great for a while- the amount of fat I was eating.
        I’ll talk to my doctor about checking for other causes for the high cortisol. 🙂

  103. There is not a shred of evidence that the lower T3 that accompanies a low carb diet has any adverse effect. It is a pernicious and dangerous myth that has neither theoretical nor empirical support.

    There is, on the other hand, clinical evidence that isocaloric addition of carbohydrate to a diet, while it elevates T3, does not also raise basal metabolism. This suggests that the higher levels of T3 that result from adding carbohydrate to a diet are used primarily, if not exclusively, to metabolize higher levels of blood sugar, making it a particularly harmful practice for anyone with hypothyroidism or borderline thyroid function.

    • Omg. Where’s the evidence? You guys are making all these claims without backing it up with true science? Centenerians (people who live beyond 100 years) most of them show overall low T3 levels, while other thyroid markers are within the normal range.

      You guys are just being delusional. Low T3 is desirable for increased aging while most of you want it to be sky-rocket. This is bro-science. Major BS!

  104. Thanks for the article, Laura. I’m wondering if you’d have a recommendation for a good starting carb level for me. According to the carb calculator, I need about 2000 calories a day. I don’t do too much heavy exercise – 2-3 hours per week of moderate exertion. I do have hypothyroidism, but it seems the opposite to many people – my TSH is high, my T3 is low but I don’t actually feel too bad, just slightly tired.

  105. My approach to analyzing diet is to begin by finding your basal metabolic rate (BMR)
    which is supposed to be the number of calories you need to maintain current weight if you’re doing nothing but laying in bed. In actual practice, most sedentary people can use their BMR number as-is, or possibly add 100-200 calories to it. If more active, add more, but the 2000 calories usually suggested for women is often far too high to be practical. You can play with the calculator tool above to find BMR for a given height/weight at a particular age e.g. 20, 40, 60, 80. You’ll see that BMR goes down slowly with aging. You’ll see that your BMR goes down with weight loss, which explains plateaus encountered in losing a lot of weight. What worked to lose the first 40 lbs may not work to lose the next 40 lbs since BMR has dropped by about 200+ calories. If you want to lose weight, start with current BMR and subtract 100-200 calories, which gives you a daily target and a slow but sane rate of weight loss. When thinking about carbs, I start with my BMR(+) to give current calories needed to maintain weight. Think of these calories as your target, and as a working spectrum.

    Then factor in adequate protein at 0.8 grams per kg of body weight. A working figure is about 60 grams protein for women and 70 grams for taller men, with more for athletes and bodybuilders (however the extreme high amounts of protein that some bodybuilders are smashing down are not necessary nor desirable, and the whey protein so “popular” among bodybuilders is unsuited to many people). 1 gram protein = 4 calories, so 240 – 280 calories protein. Put protein calories on your spectrum. I target to eat about 15-25 grams protein at each meal, for a total of 60-65 grams/day.

    Next, factor in fat. Percentage of fat in the diet can range from 10% on an 80-10-10 type of rawfood diet to 80% on a ketogenic diet, with the average person being somewhere in the middle — a mind-boggling span of variation! After experimenting with fat percentages for two years, my own ideal amount of fat intake is currently about 25%, which is a bit less than average (if I eat more fat than that from any source, I get cystic acne – your mileage may vary). 1 gram fat = 9 calories. 1 level tablespoon of fat = ~100 calories. Find your own fat “sweet spot,” translate it into calories. and put it on your spectrum.

    Add your protein and fat calories, and subtract the sum from your maintenance calories. The result is your carbs in calories. To find carb grams, divide carb calories by 4.
    1 gram carb = 4 calories.

    BMR+ minus (P + F) = C in calories.
    Divide C by 4 to yield carb grams.

    That gives you perspective on your macronutrients.

    So I come at carb grams now in a roundabout way, rather than carbs being first in my thinking (like they are when one does a “low-carb” or a “ketogenic” diet).

    To use myself as an example, BMR=1500 calories.
    Protein=250 calories.
    Fat=375 calories.
    1500 – (250 + 375) = 875 calories in carbs.
    875 divided by 4 = 219 gr carbs.

    Sources of carbs can be personalized to suit your needs. For myself, I like to think of my carbs in terms of non-starchy vegetables, fruits, root vegetables, oats, brown rice, honey. Gluten-free.

    You can add fiber to your considerations, but fiber as such has basically no calories, so it’s good to have in the diet but need not be part of this formula.

    (Ref: F, 63. Blood type O-neg, secretor, Oa. Gatherer-Hunter genotype. 50-80% raw diet, high plant-based, some fish and eggs, gluten-free, dairy-free with exception of kefir.)

    – CBW

  106. Thank you so much for this article! It explained a lot about my own experience. I have been careful with carbs for over a decade because I have reactive hypoglycemia. I always used to monitor the glycemic index of everything I ate. But, I find that GI really doesn’t correlate to my reactions. Sugar and grains of any kind, in any amount, even with fat or protein to slow it down, even properly prepared sourdough will send my blood sugar through the roof and then crashing within a couple of hours. I don’t know how many times I’ve passed out because the tiniest amount of sugar was snuck into something, like a sauce or a salad dressing. But, supposedly high GI foods like bananas or potatoes (white or sweet) don’t have the same effect. I have confirmed this this my glucose meter over and over again. There is definitely more to blood sugar reactions than glycemic index. I tried doing low carb (<60g) Paleo, and within 9 months I was completely free of worrying about my blood sugar, but I was really underweight and stressed out and exhausted. My period disappeared completely. My hair was falling out and my thyroid became enlarged. I added in my safe Paleo carbs up to about 125g/day, and I seemed to have hit my sweet spot. I've been doing well for a couple of years now, no problem.

    However, I'm not sure if the carbs are necessary in and of themselves. It is actually really hard to get all the calories that you are supposed to in a day on a high fat carb restricted diet because your appetite disappears. You just never feel hungry and you forget to eat. Maybe I could have continued low carb if I had force-fed myself a bit, but adding in more carbs hasn't affected me adversely, so there's no need to put myself through that. But, I can easily see how someone who is low carbing, and probably fasting on top of that would really stress their bodies out.

    Also, as far as adrenal fatigue goes, I heard from reading Ray Peat that it is stressful on the body to eat proteins without carbs because proteins are insulingenic, so you have this huge release of insulin with no blood sugar to process, so you get this huge adrenaline response to push stored sugar from your liver into the bloodsteam so that all that insulin has something to process (gluconeogenesis). This feels very dramatic when you are low-carbing, almost like a panic attack. I mean, it basically is a panic attack, It works on the same mechanisms. But, I don't think that means that you need to eat a high carb diet. Just make sure you have a tiny bit with protein. I've tried to go back to higher carb because I was worried that low carb was dangerous after the horrible experience I had, but it really backfired on me. I think the lesson is to watch your carbs, especcially their quality, but not go to extremes. I've heard that other people also find their sweet spot in the same range as mine. I'm not an athlete, but I have a very active lifestyle, and 125g seems like enough. I usually get about 60% of my calories from fat, about 20% from protein and 20% from carbs.

    • Don’t forget that protein provokes an insulin response, but it also provokes a *glucagon* response, which raises the blood glucose in response to insulin lowering it. So protein actually keeps things regulated pretty well. I’m not saying it’s a “bad” idea to eat a little bit of carbs with protein, just that it’s not necessarily *required.*

      Think about it from an evolutionary perspective: Let’s say the tribe just had a nice kill. So there’s lots of protein & fat to be had (from the recently dispatched animal). Would they have chowed down as soon as it was convenient, or would they have said, “Let’s hold off until we gather some sweet potatoes or yucca to have with this antelope…”

      Again, I’m not saying there’s a right or wrong way; I just feel like people focus so much on insulin and very rarely talk about glucagon.

  107. Would you say higher carbs would then also be appropriate for a breastfeeding sleep deprived mom who hasn’t had a decent night of sleep (read averaging 3hr stretches. Sometimes I’m lucky and get 4/5hrs) in the last 13 months?

    I’m just wondering if that is the reason I still have this stubborn bit of belly chub.

    • Don’t worry about “belly chub” you just had a baby. If you continue with breastfeeding and find the nutrition and sleep you need, chances are the belly chub will fall away or you can address it more specifically later when you are feeling well and energetic. Sleep deprivation in itself can lead to belly fat. Plus, many women think their belly is “fat” when it’s just still stretched and soft post-partum.

  108. I appreciate more and more articles like this, discussing the pros and cons of macronutrient ratios sanely – although I also agree with another commenter who noted that titles such as “Is Low Carb Dieting Ruining Your Health?” may be slightly off-putting! 🙂

    When my husband and I began a gut-healing protocol four years ago, to begin recovering our then-six-year-old anorexic and ASD-symptomatic child, we were following a high-carb, high-grain, vegetarian diet.

    For nearly four years, our GAPS-type diet became one that was very low in starch; gradually, over the past nine months, I’ve finally been able to add in more starch, mostly (I think) due to the effects of supplementing “resistant starch” and including more RS-containing foods in our diet.

    I sometimes wish I had tried this approach two years prior. But hindsight is 20/20, and I was struggling with a child who for two years experienced severe digestive and behavioral symptoms just from eating a piece of fruit – so I pardon myself for doubting that he could handle a bowl of rice with much less difficulty! 🙂

    It is interesting to think about “diets” not only in terms of long-term sustainability, but in terms of therapeutic potential. Despite the fact that Natasha Campbell-McBride, who created the GAPS protocol, has always said that GAPS isn’t forever…it took me a long time to believe this. I kind of forgot that along with healing comes…an ability not just to _tolerate_ new/different foods, but also, potentially, to _require_ them. Low-carb may re-jigger gut flora in a GOOD way…but then the same diet continued for much longer may continue the alterations for the worse.

    Such is often the case with starch – difficult or impossible to digest in the acute stages of many gut diseases, but possibly necessary for most healthy or healed-enough people to consume regularly.

    This means that it’s not always low-carb vs. high-carb in the Diet Wars – it’s more like…what diet could help my health NOW? And what about NOW? And what about a year from NOW? The answers may be different each time.

    I’ve written down some of my evolving thoughts, particularly as they are relevant to my son’s healing, here: . I’m so fascinated to hear what others are doing to heal themselves and their children!

    Thanks for your and Chris’ continued attention to topics such as this! 🙂

  109. Hi Laura,

    good article! I would like to ask you: Is it possible to gain weight on a very low carb paleo diet? Everything is always about how to lose weight… I would so so much like to gain a bit. Now, regarding carbs, what I currently do is pretty much what you recommend: I tried out various levels of carbs. What I found was that I feel the very best if I eat as little carbs as 1 avocado or 2 tomatoes or an iceberg-salad for a meal. All the rest is herbs, spices, olive oil and coconut fat. Once daily 200g meat. And, as you mention it, oligosaccharides (1 pouch of Bimuno, that is 5.5g galacto-oligosaccharides). Now, what do you think, is there any trick to gain weight without increasing carbs? Fat and muscle, both needed and welcome. And, regarding oligosaccharides, you mention potato starch and FOS. Would that be good to add them or would that likely be too much together with the GOS I am taking? thanks a lot in advance for any suggestions!

  110. Those of us with impaired glucose tolerance or diabetes have to follow a VLC diet. How can we mitigate the problems this can cause?

  111. Interesting. I’ve done extreme low-carb, high carb, and everything in between. I think moderation is important, especially moderation in how much time and energy we put into thinking about, talking about, planning, and studying what to eat. Obsessing about it isn’t healthy.

    • I am a 19 year old male, and suspect that I have candida overgrowth. I have tried, just as you have, a low-carb and now I am eating a high carb- low fat vegan diet as I have been following the high carb-low fat vegan community and learned how terrible meat is for us. My symptoms are rashes, bloating, low energy..

      The main thing that keeps me on this diet is the fact that I believe that we are able to get all our nutrients from plant based foods, therefore there is no need for meat. Is this true?

    • I follow Dr. John Mcdougall’s “starch solution” as it makes sense to me. Please give me some insight, I am very confused. I am getting into the unhealthy state, as you wrote, of obsessing over what I eat.. But I just want to stop the itching and I don’t know what to do as there is so much contradicting information.

  112. All very informative. I still can’t figure out my % of (quality) carbs to eat. On LC Paleo – i felt great for a while, kept of the weight, adrenal and thryoid issues were resolving themselves…. and then bam! I crashed with no libido or energy. I added back in potatoes and white rice (Jaminet style) and my libido and energy came back but so did the belly fat –SUPER FAST. Ugh. How does one have energy/libido/health on moderate carbs without gaining copious mounts of weight?? This is a serious question I have not been able to answer. I feel confused now on what to eat on Paleo.

  113. Hi Laura,

    Good read there. I notice that I get somewhat tired and bloated after I eat starch (potatoes, rice). At the same time, because I am lean and exercise regularly (4+ days/week), I definitely notice a need for the starch.

    My workaround has been avoiding carbs in the AM and concentrating my intake in the evening hours (6 pm and later). This has helped me stay mentally alert during the day while still providing the benefits of carbs (glycogen replenishment, hormonal balance, easier to sleep).

    Is this a tactic you have used? Do you have any other ideas on this?

    Thanks, Laura.

  114. Wow; I’m so glad that someone is finally saying that maybe ultra low carb isn’t good for everyone. I started low carb (<30g/day) about 5 years ago when I was diagnosed with Type 2 diabetes. Ever since then, besides high blood sugar, I've had problems, on and off, with cortiso, very low T3 (high RT3) leading to fatigue that took me months to climb out of. I never had these problems before. The lower carb I went, the worse the problems (and my blood sugar) got. Under 15 grams of carbs per day had me almost comatose. I eventually figured out (through testing) that I have low insulin production; low carbing lowers insulin more, to the point where my glucagon runs uncountered, my cortisol surges, and my T4 to T3 conversion isn't right.

    Just a few more carbs a day (a sweet potato or serving of beans; maybe up to 50-60 grams total carb/day) stimulates enough insulin to lessen the problems. You won't hear about things like that on most low carb sites.

      • I don’t think I’m really Type 2 (not Type 1, either; tested negative for all the antibodies). I suspect MODY, but can’t afford genetic testing. So I just thrash around, looking for what works.

        • Hi Lynn

          I had a very similar experience. Bit for me my insulin production was to low to raise carbs either.

          Very good chance you are type 1 like me, my antibody test was negative but not all type 1 show positive antibody tests.

          I set up a glucose tolerance test with insulin and cpeptide draws at each glucose draw: fasting 1 hr 2 hr and 3 hr.

          Was cellar from that insulin production was very low!
          I did test positive for thyroid antibodies which for me makes type 1 seem likely along with my physical condition … Athletic and even an 18 inch pizza along with candy and chips could not get me out of ketosis 🙁

          MODY is by percentage far less likely than slow onset type 1, you could get tested for other antibodies there are at least 4 you can be tested for but again not all type 1’s show positive for the antibodies tested.

  115. I’m so confused. So, if I’m training for a half marathon AND I want to get pregnant soon AND I want to be as healthy as possible, what the heck am I supposed to eat? Just rice and potatoes??? I currently IF and eat Primal with RS and other specific supplementation, but the comments to this article made me fear that I was harming my fertility & health! HELP!

  116. Short answer to this question for me is, “Absolutely, yes.Low carbing was ruining my health.” I’ll make the long version s short as possible. Now an extremely active and fit 65 year old, I have been a lacto-vegetarian for 45 years. Added in eggs about ten years ago. About 13 years ago, I dedicated myself to low carb living and have felt great doing so. I’ve been eating VERY low carb (probably less than 40 grams per day), with adequate calories, largely from fats, to maintain my weight ever since. BUT – my fasting blood sugars have been consistently high (103-107 range) for the past several years when I’ve had my annual medical check-up. My A1c has always been OK, so my doc always shrugged her shoulders and we both casually figured it had “something to do with” my weird diet. When my A1c was elevated to 6.1 this year, I became concerned. My doc’s comments were that if anyone simply looked at my blood work, they would assume that I was a diet-controlled diabetic – which clearly I am not. So the clearest explanation I found of what I’ve created in this amazing machine called the human body is physiologic insulin resistance, as explained here: Several other hits on the web allude to this same phenomenon, but the conclusions repeatedly run something like, “This is not a problem, a perfectly normal physiologic response, nothing to worry about AS LONG AS YOUR HGBA1C IS NORMAL” – which sadly now mine no longer is. I’m working on it. Been adding in more carbs over the past few weeks with progressively lower blood glucose measurements, as counter-intuitive as that seems. We’ll see if I can get my metabolism back 🙁

    • That’s a commonly seen paradox- low carb dieters with high fasting blood sugar. I’ve found that adding some carbs in at night in particular can help correct that. I’m not surprised to hear your BG is going down. Good luck and stay positive! 🙂

      • Appreciate the encouragement. Terrible feeling to think that years of conscious eating has actually been counter-productive. Am I likely to start gaining a lot of weight? I’ve re-dedicated myself to regular exercise, initially as an attempt to get my BG down, but now the endorphins feel oh-so-good 🙂

      • I wonder if that would help me? I have insulin resistance and Hashimoto’s and my BG is fine during the day but high in the a.m. I figured it was due to gluconeogenesis, so having some carbs at night should help with this? What kind of carb would be the best?

    • Your experience validates what my daughter, a Type 1 diabetic, has experienced. Ironically, the more fat she eats and the less carb, the MORE INSULIN she needs! Totally backwards to what we’ve been taught. She has recently increased her carbs to 50% and reduced fat to 30% and uses less insulin and has better blood sugar control.

      • “Your experience validates what my daughter, a Type 1 diabetic, has experienced. Ironically, the more fat she eats and the less carb, the MORE INSULIN she needs! Totally backwards to what we’ve been taught. She has recently increased her carbs to 50% and reduced fat to 30% and uses less insulin and has better blood sugar control.“

        Hello Julia, why do you think this happens?I have diabetes type 1 myself.

  117. I suffer from Hashimotos but always with “normal” labs. I’m always tired. What carbs should I eat? I’m so confused now.

    • Without seeing your numbers and reference ranges used for TSH, free T4 and free T3, it’s impossible to comment further.

      As an aside here, there are optimals-within-reference ranges, and for different situations (e.g. the normal healthy person who is not hypothyroid by any standard vs. the medicated hypothyroid patient). These optimals are commonly unknown or overlooked in conventional medicine including and especially by laboratories. That problem would be very easy to fix that with updated education and broad acceptance, laboratories using tighter reference ranges and noting optimals-within-range with further notes if needed, updates that would cost practically nothing as the guidelines could be outlined on one page or screen, but there doesn’t seem to be the will to do so in many or most cases. Many years ago I defined ethics as involving issues of the will and willingness, and that idea could well apply here.

        • Nearly all of the ‘net thyroid patient community have been in agreement about thyroid-related tests, reference ranges, and optimals within range for about 15 years now. You might start with reading Mary Shomon’s books on thyroid (amazon). However, ideas about treatment approaches to any and all hormone issues tend to have wide diversity of viewpoints.

          • OK, well I already know the basic stuff and Shomon’s info is well disseminated. I refer to the site ‘stop the thyroid madness’ but I was hoping there were some newer sites with more recent references, since other people’s anecdotes and rat studies don’t really cut it with my doc (they do have some human studies too, but not enough). Paul from Perfect Health Diet had some interesting info about slightly elevated TSH, totally within range, and increased miscarriages, but their site isn’t geared towards thyroid, so just wondering if anyone else collects the newer studies. But thanks for your help.

  118. You wrote: “…there are many people who crash and burn on this type of dietary plan.”

    What the heck does THAT mean!!!???

    I think that this is BS and you are making this up. I suspect that, IF FOLLOWED CORRECTLY, there are very FEW who do poorly on Paleo.

    And having cravings for doughnuts, bread or birthday cake, I don’t think equates with doing poorly, health-wise.


    • Christopher, could you please clarify. It appears that you are associating the paleo diet with a low carb diet–is that correct? And by paleo diet, do mean the actual (and many versions) of paleo diet or the one that is practiced here in the United States. Thank you very much in advance for helping me understand your comments.

    • Paleo does not equal low-carb. In fact, there are very few traditional Paleolithic cultures that consumed a low-carbohydrate diet. Most of them ate a moderate amount of carbohydrate—between 30–40% of total calories according to most studies (see and for examples). This is most assuredly not a “low-carb” diet.

      The crucial difference between traditional Paleo diets with 30–40% of calories from carb is the quality of the carbs. In Western diets, the carbs are almost exclusively from processed and refined sources (flour and sugar). In traditional diets, they come from starchy tubers, fruit, and occasionally honey.

      I am constantly beating this drum, and I will continue to: it’s not the quantity of macronutrients that matters for most people, it’s the quality.

      • “Paleo cultures”?? I think you mean hunter-gatherer cultures. Paleo people were hunter-gathers but these hunter-gatherer cultures you cite were not Paleolithic. Also these people didn’t have computers, tv, and desk jobs. Of course they could handle more carbs (when they were available). The issue I have with the article is the lack of clear definition of “low carb”. Also, as PCOS is a major cause of female infertility and responds well to LCHF I find the author’s one-sided analysis of LC negatively affecting fertility inaccurate. Finally, the whole article was too one-sided. The average American (pry most) need to significantly curb carb intake and increase healthy fat, the question is usually just how much. The answer: it depends.
        – Tim Noonan, MD

        • “Finally, the whole article was too one-sided. The average American (pry most) need to significantly curb carb intake and increase healthy fat, the question is usually just how much. The answer: it depends.”

          Shorter Tim: I just spent 6 sentences slamming this article, 2 sentences telling you I don’t know the answer.

  119. Please answer me this question I don’t find an answer for! I’ve stopped eating rice and grain, and most sugar except for sugar from whole fruit. I eat a little potato every day. I have low blood sugar (62mg/dl fasting), and I have GERD and possibly SIBO, and gut disbiosis.
    What should I do? I have to reduce sugars to fight bad bacteria and I end up hypoglycemic. Please help!

  120. Thanks for this article, Laura. I’m one of those skinny dudes who looks emaciated when I eat low carb for a stretch of time, but the temptation to do so is there because of the crowd that insists it is for everyone.

    Is there any evidence that carbs should be avoided in the morning, or is that another myth? I’m guessing it’s another thing that’s dependent on the person, but, again, there are those that make skipping breakfast or morning carbs essential to blood sugar regulation for ALL. Thanks again.

    • Well, I’m not Laura, but I’ll chime in anyway. 😉

      The only way to know how your blood sugar does with carbs in the a.m. is to test. One of the reasons people are sometimes cautioned against carbs in the morning is because it might set them up for cravings all day long — and usually not cravings for, say, yucca or sweet potatoes, but for junk carbs & refined sugars. If you find you can do carbs in the morning and *not* set yourself up for inordinate cravings soon afterward (and possibly later too, throughout the day), then I don’t see why you would need to avoid them. Some folks really *are* more “carb tolerant” than others.

    • Well, I wouldn’t say it’s essential for all people. What I’ve read is that people with poor blood glucose control, such as diabetics, found via self-experimentation that they could eat more carbs in the afternoon than the morning, because their blood glucose didn’t spike as much in the afternoon. I believe the explanation that was proposed had to do with the fact that cortisol has a diurnal variation, with high levels in the morning and lower at night. Cortisol increases endogenous glucose production, so if you already have poor glucose control, adding carbs on top of that cortisol-induced glucose will spike your levels too high. I think there are also some studies where they varied breakfast macronutrient composition, and a lower carb/higher protein meal did better in some physiological measures (I’m blanking on what those were) and improved satiety.

    • I say give up on any crowd who insist anything is for everyone 🙂 Join this crowd who respect and understand bio-individuality and then share with us what works for you.

  121. Thanks for this great article – this issue has been on my mind recently as I just got diagnosed with stage 3 adrenal fatigue, SIBO and I also have a parasite causing me lots of issues. I’ve been trying a ketogenic Paleo diet recently as I had read a lot about ‘taking blood sugar out of the equation’ of adrenal health etc, but I’ve been feeling increasingly fatigued and my sleep has gone out the window. i initially felt great being ketogenic but I’m starting to wonder if its doing me more harm than good. My blood sugar is also all over the place but Ive been too scared to eat more carbs for fear of making it worse.
    After reading this article and some of the comments I’m going to give it a go adding back in some carbs and see how I feel. Thank you for tackling this issue and providing some reasoning behind a more moderate approach!

      • Hi Michelle, I wasn’t really tracking my protein grams as I used ketone blood testing strips to see if I was in ketosis or not. I would estimate around 80-100g of protein per day. I definitely had to scale back from the amount of protein I was eating before, and I felt fuller after doing this and replacing the calories with fat. It ended up being about a palm size portion of protein for each meal.

  122. I agree with this article. However, one thing this article doesn’t consider is that 150g of carbohydrates is still low-carb when compared to the Standard American Diet. As a result, many use the term low-carb as a comparison to the SAD. However, 100-150g of carbohydrates is fine for most healthy people and its only necessary to go lower if you’re dealing with health issues like epilepsy. Athletes and pregnant women obviously need more and people who have gut issues should consume more fiber. Low-carb, anywhere from 25-150g CAN be healthy as long as one is aware of their personal needs.

    • Higher than 150 grams per day can be healthy depending on the person. An elite athlete eating 8000-10,000 calories per day (or higher) may end up eating 600-800 grams of carbs per day (or more) and be perfectly healthy due to their high energy demands, along with the many other lifestyle factors that athletes prize such as adequate rest and recovery, stress management, and mobility work to keep them performing at their best.

      There’s no specific gram amount that’s appropriate for everyone, it’s completely dependent on the total amount of caloric intake. That’s why I tend to use percentages rather than grams.

      • My favorite n=1 experimenter, Dr. Peter Attia, even reports that he can stay in ketosis on hundreds of grams of carbohydrates per day–provided he is training heavily. So even if your goal is to mostly stay in ketosis, there is not a one-size-fits all prescription!

  123. Hey Laura,

    Good stuff. I think VLC and/or ketogenic diets can be extremely therapeutic in certain circumstances, but they’re certainly not ideal for everyone, across the board.

    That being said, I have just one (teeny tiny) bone to pick here…

    On your site, you gave this the title, “Do You Need to Eat More Carbs,” and here, it’s “Is a Low Carb Diet Ruining Your Health.” I like the former so much more than the latter. The “ruining your health” part just seems unnecessarily inflammatory. Not sure if you chose the title, or someone else who manages content for this site.

    Like I said — not arguing with the content, because I think you covered it very well and from a lot of different angles. I guess I almost see a “civil war” coming between the ardent low-carbers and the not-so-low-carbers, and this piece brings some much needed logic and calming common sense. Just wish it had a less incendiary title. (And then again, this probably where I go wrong with my own site — too vanilla, not enough “grab you” type headlines.)

      • Do you think there is a distinction to be made between pathogenically lowered thyroid function and lowered thyroid function?

        Would you not expect *some* adjustment in *certain* thyroid values when switching from a predominantly carb to predominantly fat diet?

        If your paradigm is a modern high carb intake, then it is not surprising any deviation from that is considered bad. I’m surprised this is the reasoning that is more and more popular in the paleo sphere?

        I’ve asked for information relating to thyroid issues and ketogenic diets and all I was provided was: anecdotes, rat studies addressing the issue peripherally and some 90s textbook explanation about LC affecting thyroid function who argues in the same breadth that this is linked to hypoglycemia.

        Is there *any* human, controlled experiments that show this? If so, please link to them. I will happily change my mind. Ballantyne’s AHS14 presentation does not provide this kind of evidence. Ramadan fasting is not representative an nutrient dense (e.g. organ meat) well formulated ketogenic diet. Rat fasting study? Not really directly relevant, once again. Scare-mongering of an animal study conflating gestational ketosis with gestational ketoacidosis in humans? That’s a stretch.

        Can increasing carb intake help for a large diversity of issues? Sure! Medicine is full of surprises and complex, so it’d be silly to rule that out. But to just jump to the other end about ketosis being niche and ‘last resort’ kind of thing of simply poor extrapolation from (a lot) of irrelvant science.

        I think it is important you address this. After all, echo chambers are tiresome! 🙂 Shoot me down if you think I’m tooootttaalllyy off base. That’s part of the process too.

        • You may want to read this article, I think it touches on a lot of the points you’re bringing up:

          And I’m not sure why you’re dismissing clinical anecdotal evidence. Just because it’s not in a published paper doesn’t mean it’s not a legitimate way to determine a course of treatment. In many cases, it’s the only evidence we have to work from as practitioners – the collective experience of those who have come before us.

          • I’m familiar with the Jaminet’s views. I’m dismissing clinical anecdotal evidence because it is never seems (so far) to be supported by *controlled* clinical evidence

            Do you think it important to distinguish between a ‘case study’ versus a clinically controlled study? I think it is.

            Also, the critiques applied to Ballantyne’s work is also valid to Jaminet’s. He has been challenged on this and can only point to “in my experience” arguments. Not that they’re worthless, far from it – I find a lot of value in his material. It’s just that when challegend on these points no one is capable of producing evidence everyone can assess – anecdotes are not ‘free game’ for everyone.

            So when you write an article strongly suggesting LC = dangerous…they don’t match up with the available evidence.

            Incredible claims require incredible evidence, that’s all.

    • I agree “Do You Need to Eat More Carbs?” is a much more effective title for many reasons, more inclusive and at the same time, more bio-individuality 🙂

  124. Caution must be taken when using resistant starch (i.e., Bob’s Red Mill unmod. potato starch), as it can raise BG levels in spite of it being “resistant.” My husband is one of those poor souls who can’t use it for this very reason. I use red potatoes (less starch) in 24-hour chilled potato salad, and it does the same thing without the huge rise–I just have to watch portion sizes with him. I alternate between fiber sources: glucomannan, psyllium, or vegetables, so he doesn’t develop a resistance to them.

    Maybe it has something to do with ease or difficulty in digestion, and how much energy it takes to do it? I’m not sure. I just know the Bob’s powder doesn’t work on him.

    • Good to know! I haven’t heard of anyone experiencing that response to RS so I’m glad you shared your experience. I’m surprised that actually eating whole potatoes has less of an impact on his BG than the isolated potato starch.

  125. Great article, I followed paleo for a good while felt great at the start and lost a fair bit of weight. It all changed though a few months later massive cravings for sweets, gym sessions were lackluster and ended up binging on weekends. I changed it up started to follow Paul Jaminet perfect health diet, the only starch i could really have was basmati rice, if I had any potato I would have cramps terrible wind. So having around 150grams of rice on training days if I go anymore i started putting on weight. The interesting thing that i have tried with the rice is adding a tablespoon of apple cider vinegar, it feels as if it aids me with digestion. Has anyone else tried this at all?

  126. In my personal experience, as I do a desk job, I do better with low carb (around 80g/d, so never really into ketosis), with a 24h fasting day once per week followed by a heavy workout before dinner (well, ketosis is inevitable that day).
    During holidays I tend to move much more, especially low level activities like walking (15-20 Km per day, when visiting a city for example). My body naturally responds with carb cravings, so I enjoy some additional fresh fruits, but also sourdough (the allowed version of the forbidden food 🙂 ). Carbs easily get to 150g/d or even more, however I never stored a single pound of bodyfat, meaning that’s a genuine requirement.
    In my opinion, (and sorry for being obvious) once the appetite regulation is working correctly, just listening to your body will make you do the correct thing. This may not work for everybody, I believe the reason is that the appetite regulation mechanism is still somehow not fully fixed in some people after years of messing up with excess of sugars. It would be interesting to define a way to identify these situations and think of strategies to get them working.

  127. Very informative article Laura, thank you! Can you please clarify whether the carbs in non-starchy veggies should be counted in the total carb count. While they are high in fibre, not all the carbs in non-starchy veggies are fibre! I eat about 90-130g of carbs a day (mostly from non-starchy veggies, plus some carrots, sometimes pumpkin, and snacks made occasional using coconut flour). Those carbs make up about 30-40% of my daily calories. I have developed hypothyroidism, I am hyper-cortisol and have severe chronic gut inflammation and dysbiosis issues. But I think I am getting plenty of carbs (though not much starch). Would appreciate your thoughts?

    • As I mentioned in another comment: “For many green non-starchy vegetables, the body burns more glucose in the digestion of them than it extracts from the vegetable itself! Not to mention the amount that gets digested by the gut bacteria before we even have a chance to absorb it.”

      Most of the nutrition experts I trust agree that leafy greens and most non starchy vegetables don’t count towards your total carbohydrate intake for these reasons. Carrots and pumpkin would contribute some, but you’d be surprised how much you have to eat to get over 100 grams per day. A cup of carrots has 12 grams and a cup of fresh pumpkin has 8 grams. (Canned pumpkin is a bit higher around 18 g per cup.)

      Coconut flour has only 40% digestible carbs, the rest is fiber. So the carb content may not be as high as you think. But it really depends on how much you’re eating of it. It also sounds like you’re not eating a whole lot in general. Based on those numbers it sounds like you might be eating around 1200-1500 calories per day. (Actually 900-1700 based on the math!) So that could be an issue for you as well.

      Hope that helps!

      • Thanks for the reply Laura – most helpful! The main reason I have limited starches in my diet is while I work on getting rid of SIBO and a resistant parasite infection in my gut. Have tried multiple natural based and conventional anti-biotics – but not successful yet. If my current diet it in fact lower carb than I thought and at the lower end of calories, shouldn’t that mean I should be losing weight (which I am not despite training pretty hard)? Thanks again for a such a thought provoking article!

  128. I’m female, and it is what happened to me. I was already Paleo (~100 gr of carbs net daily) for 4 months, and fat-adapted, when I went Paleo-ketogenic (40 gr of net carbs daily). At the time, everyone was talking about ketosis and IF, so I tried Paleo-ketogenic too, since I wasn’t losing much weight on Paleo (I only lost 10 lbs out of 50 I needed to lose).

    All h*ll broke loose 1-2 months later.

    I got weak, I got all the hypothyroid symptoms (e.g. super-cold in the middle of the summer in California!!), and I got dead-tired ALL the time.

    I wish that kind of information was out in 2012 when I wrecked havoc to my body by going Paleo-ketogenic. Two and a half years later and I’m STILL battling adrenal fatigue. I’m of course still Paleo, for life, but now I eat more starches. Still, my body just can’t get into the initial levels of energy as I got when I first went Paleo (the not too low carb version). I wonder if I wrecked it for life. I wonder if there’s a way out of this mess. I eat more DHA now btw.

    • @Eugenia – Same thing happened to me during a time of unremitting stress and LC dieting. It took a long time to overcome but getting LOTS of extra rest really helped. My doc told me to nap at every opportunity and I stopped the LC diet. My energy level is back up to where it should be now. Best of luck!

    • There may be changes you could make that would help your energy that you haven’t discovered yet. You might benefit from working with someone who might have some knowledge that you haven’t come across in your self study yet! But good luck and try not to worry that your health is “wrecked for life” – there’s almost always something that can be done to make improvements.

    • I’d recommend going Weston A Price for life rather than paleo since your results haven’t been going well (I am pretty well convinced WAP will become the final say in the dieting world some day due to it’s flexibility). The CRITICAL difference with WAP is the proper handling of grains/seeds/nuts/legumes which virtually all populations seemed to figure out in the past. Grains cannot be lumped into the same category if one is sprouted and the other is not. The composition changes quite dramatically. The human gut tends to be poorly equipped to handle grains/seeds/nuts/legumes UNLESS they are modified by soaking/sprouting/souring/fermentation. Same with dairy I might add. Paleo is dairy phobic also but WAP found several cultures that thrived on dairy. These populations were not paradoxes. The common theme is that every population found methods that suited them best and the diets varied considerably. The common threads are treatment of plants to make them better suited for human digestion and a lack of refined foods (WAP noted extensively the health decay that occurred within a single generation when populations stopped their traditional eating and began eating white sugar/white flour/industrial oils…here came tooth decay, poorly formed faces, TB, and all sorts of other ailments). Some ancestry clearly favors higher carb consumption than others. Perhaps you are one of them. Try it and see how you feel, but just be sure the traditional techniques are applied to minimize anti-nutrients (phytic acid in particular) and make available the other nutrients.

      • I’m sorry, but no WAPF please. I can’t have grains. I get sick if I eat any other than SOME kinds of rice. The reason why I went Paleo and I stayed with Paleo was health reasons, not weight loss (initially). Since then I have tried to incorporate grains and pseudograins, but I find that they make me sick. With rice, it depends on the cultivar: some types I can handle, others I can’t. I even tried sprouted fermented rice, which I didn’t handle well. It really depends on the cultivar for me.

        I do eat legumes btw. This is one of the starches I added on my diet as I mentioned. I can handle soaked legumes fine most of the time (1 out of 5-6 times I get gas, but usually I don’t). But no grains/pseudograins please.

          • Japanese rice (treated with vinegar), I never have trouble with. California rice is ok most of the times. “Carolina” rice is rather fine too.

            I have trouble with Chinese, Indian Basmati, Thai rice (cooked them myself, no soy).

            Japanese vinegar-treated rice is the least problematic for me.

    • Eugenia, do you have any idea what your protein levels were in grams when you were paleo-ketogenic? I am trying to understand what is going on with my own body. It would help me to know what your protein level was. Thanks so much for your time.

  129. Laura,
    First and foremost: great article on a very HOT and confusing topic. Well done in breaking down some of the issues, especially as it pertains to pregnancy and athletic performance. My wife and I really enjoyed reading it. I would like to add a couple of thoughts to your points.

    Distinction between carbs:
    In my experience, one of the primary reasons why people are confused with carbs is what they hear in the media or read in general blogs. These practices have historically labeled carbs as the evils of nutrition and health because they ALL contribute significant calories. One thing that one has to realize is that carbs are NOT created equal.

    We have the simple carbs (mono or di-saccharides). These are glucose, fructose, lactose, sucrose, etc. They can easily be broken down by salivary and digestive enzymes (Amlyases, etc) and are mostly absorbed in the small intestine, before they make it to the colon. Glucose is the basic sugar that every cell in the body needs to make energy. You can’t avoid it. It’s in (almost) every food we eat.

    Then we have the complex carbs (basically fiber). These are typically the same sugars, but they are attached/linked together in linear, branched (or a combination) fashion such that the same enzymes cannot easily break it down. Some fibers are more fermentable than others. By virtue of being more resistant to enzymatic degradation, they cannot be broken down to basic monomeric or simple sugars and thus do not contribute much to the calorie output as simple sugars do.

    Fiber’s benefits can be generally divided into two components; a) non-fermentable, and b) fermentable. non-fermentable benefits are things such as toxin cleanup, binding and trapping bile salts, lowering of cholesterol, and a slew of others. Fermentable benefits are associated with the breakdown of these fibers in a colon. By remaining undigested, These complex carbs make their way to the colon, where they feed your gut bacteria. This is where the magic happens. These bugs digest fiber into short chain fatty acids (e.g., bytyrate, propionate, acetate, etc), providing you with many benefits. These critters also provide many other direct and indirect benefits which we won’t get into but Chris and team have done a good job outlining in other posts

    This is a topic near and dear to my heart (even though I am not a woman) and an incredibly important one. There’s more and more evidence indicating that when a woman gives birth, she transfers her microbiome to her child. This bacterial community plays a critical role in the development of the child and starts taking shape and changing within the first days, months and years of life. There is even evidence showing that vaginal birth provides an much richer flora to the child compared to caesarian section.

    So, since every parent wants to give their child the best chances of a healthy life, it is important for pregnant women (and their spouses) to ensure that they have a rich and diverse bacterial community in their gut…this means eating plenty of good carbs like fiber.

    This is another interesting but long topic of discussion, which I leave for later.


  130. Nils, I’ve followed Laura’s thoughtful writing and podcasts for the past couple of years. I’m sure she would completely agree. I think what some of the current dialog is saying is the following: Weston A. Price and Paleo are huge leaps forward from the standard American diet. However, everyone is different. You can go beyond a “cookbook” approach to WAP or Paleo by personalizing your diet. If you want to be high fat/low carb that’s great. But rather than dive right in and say well, that means I can’t eat more than 50 grams of carbs a day, perhaps you can experiment by gradually lowering your carb intake and taking measurements (both subjectively and objectively) about how your body is responding to the reduction in carbohydrate intake. Find your optimal HF/LC set point. The same would go for food sensitivities, etc. Maybe you have issues with detoxification, SNPs that require some dietary modification. Nutritionists and functional medicine practitioners can help.

  131. A practice that might benefit some people is just cycling your carb intake rather than keeping it mostly steady-state. What is called a CKD (cyclical ketogenic diet) common with some bodybuilders today and has been around since at least the 60’s. The “Iron Guru” Vince Gironda suggested this way of eating. 3-4 days of low carb eating followed by a carb “re-feed”. This is often done as a weekday low-carb diet followed by a high carb weekend or single “splurge” day or meal. You can find lots of recent books that prescribe some kind of spin on this type of diet, mostly combined with strength training… you are lifting heavy things, right??? If not, that should be the first thing to fix!

    I personally think that cycling carbs, beit X hours per day or Y days per week, is the best way to maintain optimal body composition for the genes you were born with.

  132. I am adding some research gathered from other posts on this site regarding Candida, as I suspect it will help people whose Candida infections are getting worse, or are not improving, while on a low carb diet.

    As Jeff Leach has pointed out, when people switch to very low carb diets their fermentation drops considerably — which means that there is less acid being produced as Short Chain Fatty Acids (SCFAs).

    Candida is a dimorphic fungus, which means that it can be either benign or pathogenic (extending hyphae). Candida is only hyphal when it gut pH is extremely acidic (somewhat rare, but can happen with gut diseases like ulcerative colitis) or too alkaline (which happens from not eating enough resistant starches and fibers).

    Alkalinity promotes Candida overgrowth

    If you read through the half dozen studies in that link, you’ll see that Candida has a number of growth genes that are sensitive to pH. These hyphal growth genes switch on when gut pH is too high or too low.

    In other words, Candida is benign when gut pH is normal. It’s the SCFAs from our fiber and RS fermentation that keep our guts slightly acidic. And it’s no coincidence that acids like acetate or caprylic acid are well known to inactivate candida. Virtually any acid would inactivate candida and it’s the SCFAs from our own gut bugs that do a particularly good job.

    So, people on very low carb diets have guts that aren’t fermenting and are therefore too alkaline, which as we can see from above promotes candida overgrowth. For these people, increasing their safe starch consumption and taking RS will increase SCFA (acid) production, which helps normalize gut pH and switch off the candida growth genes — returning candida to its benign and harmless state. Simultaneously, RS and fibers tends to bloom good bacteria (which also contributes to increased SCFA production), which will crowd out candida. It’s also a good idea to use a candida biofilm disruptor so that good bacteria can move in to candida’s territory.

    Here’s some additional research that shows very low carb diets, and starvation protocols, may make candida worse:

    The following study shows that Candida will stay benign as long as we keep it happy, by feeding it moderate levels of glucose (and keeping the gut pH normalized). If we starve it of glucose, it automatically changes its own pH so that it can become hyphal to search for tissues to feed on.

    The Fungal Pathogen Candida albicans Autoinduces Hyphal Morphogenesis by Raising Extracellular pH

    The next three studies are from a quote on Gestalt’s blog, explaining why conventional low carb anti-candida diets are likely counterproductive:

    From: How to eliminate Candida & biofilms

    It is the conventional belief out there that to get rid of candida one must consume little to no carbs in order to stop their growth. This logically means putting the body into ketosis. What most people don’t know however is that ketones can also fuel candida growth and the fungi themselves use ketones to evade the bodies immune system. The following is the collection of a few days research that completely shifts the conventional paradigm on the various forms of Candida diet out there.

    The following 1st paper shows that the ketone beta-hydroxybutyrate will feed candida, and the 2nd shows that the ketone Aceoacetate is used by Candida to evade the body’s immune system. The 3rd shows that starvation makes candida grow exponentially.

    “The ability to neutrophils from diabetics to kill candida was inhibited by increased concentrations of glucose and beta-hydroxybutyrate, both independently and in combination.

    These data indicate that although phagocytosis occurs at similar levels in diabetics and controls, killing of candida by the diabetic neutrophil is impaired under conditions of hyperglycaemia and ketosis.” (reference)

    “Therefore, prolonged ketosis may be a significant risk factor for candidiasis. This study was undertaken to investigate whether C. albicans itself produces a ketotic metabolite as a virulence factor which can effectively undermine host defense by neutrophils.” (source)

    Starvation of yeast cells induces exponentially grown cells (and usually non-germinative) to germinate. This phenomenon is also observed in cells that are transiently treated with metabolic inhibitors. During each of these treatments (starvation, metabolic inhibition), expression of a growth regulatory gene (CGRI) increases. Candida albicans: adherence, signaling and virulence.” Calderone et al.

    Glucose obviously feeds candida as well however I have not seen evidence that it impairs immunity against candida such as ketones. Glucose therefore appears to be the lesser of two evils in this case when compared to ketones. From a blood point of view it’s impossible to eliminate glucose anyways. Ketogenic diets and many Paleo diets therefore in the long term are counter-productive. Starch and specifically resistant starch is necessary to feed the good guys which are your primary defense against candida.


    For those interested in using RS to combat candida, I highly recommend reading Gestalt’s full article for a protocol including necessary biofilm disruptors:

    How to eliminate Candida & biofilms

    The author of that article was able to inactivate candida in less than 1 month using that approach.

    The research clearly suggests that a diet rich in fermentable fibers and moderate levels of glucose are ideal for keeping Candida in its benign state, where it can more easily be crowded out by commensal bacteria.

    • Wow! Thank you Duck, I think you just saved my life.
      Really do appreciate the effort involved in factually shedding light on Candida and providing all the research links.
      Just such great information

        • It’s possible that some of the successes from ketogenic diets are actually bacterial or viral in nature — and perhaps mistaken as Candida. Just a theory.

          From: Chris Kresser: Episode 15 – Dr. Paul Jaminet on chronic infections, depression & more

          Paul Jaminet: …So pathogens that have mitochondria like fungi and protozoa can metabolize ketones for energy. Bacteria and viruses can’t, and so if you go on a ketogenic diet you’ll starve bacteria and viruses but you’ll feed fungi and protozoa. And so a simple thing to do is go on a ketogenic diet for a while, do your symptoms get worse or better. And that can tell you which class of pathogen you have, one with mitochondria or one that doesn’t have mitochondria. And those kinds of tests can be a big help.

    • Duck, your informations are very essential. Do you have an idea, what is the minimum of glucose/carbs to keep candida under control? If one responds not well to rice and potatoes and sweet potatoes, for fibres one can take potatoe starch, LAG and various fibres for the SCFA´s for gut flora, But is there anything one can do for supporting glycolyse?
      My thought is, that one can again eat enough carbs, when enough SCFA´s were produced.

      • For anti-candida, Paul Jaminet his standard Perfect Health Diet, which recommends 150 grams of carbs per day (for someone eating 2,000 calories. That worked well for me, personally.

        Mark Sisson writes:

        From: A Primal Primer: Candida

        Avoid very low carb.
        Paul Jaminet, who suffered from candida overgrowth, argues that since candida (being eukaryotes) have mitochondria that can feed on both ketones and carbs (as opposed to prokaryote bacteria without mitochondria), going very low carb or ketogenic will only provide more fuel for the overgrowth. Furthermore, since ketones are water-soluble and pass easily through cellular membranes, ketones will actually be a more accessible food source for candida. Don’t go high-carb, since any extra glucose will just be food for the yeast, but don’t go ketogenic, either. Stick to around 100-150 grams of carbs while still limiting sugar. Although other sources do recommend going as low-carb as possible, my money’s on Paul.

        Keep in mind that if you are eating these carbs as “safe starches,” which I highly recommend, that’s a lot of starches — more than most people are probably used to eating. 150g of carbs would translate to about a pound of potatoes per day. I ate a banana per day (as Paul recommends some of the carbs to be fructose) and was fine.

    • The point of Laura’s article is not that low-carb diets aren’t useful in some circumstances (they most certainly are), but that they aren’t a panacea and can even cause problems in certain situations.

    • So… I’m 25, on a Paleo diet for about 2 years now and was pretty high carb for most of the time. I felt fine but had a few more pounds to lose so I thought about trying a ketogenic diet.
      I’ve been on and off a keto-primal diet for the past few months and have been feeling pretty good. It’s only when I try to eat something that has a higher carb content I feel a bit more bloated and gain some weight. I also have more energy on a low carb diet and feel better emotionally (less mood swings) and have less carvings.

      Yet, I agree with Laura about the gut bacteria issue, and that’s why I’m trying to add some resistant starch lately. I also agree that too much protein can be a problem in low carb diets and that it’s important to try to replace the carbs mostly with fat.

      On the other hand my husband is also on a Paleo diet and felt awful on a low carb diet when he tried it. He was weak and had no energy. So his carb intake is high most days and that’s what works for him.

  133. I knew a lot of this already, but what really caught my eye was this line: “The main hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to increase on a low carb diet.”

    So, if a person has LOW cortisol, does this mean a low-carb diet would be a good thing? I have been taking an adaptogen and a glandular for low cortisol (under direction of my functional med practitioner) and have been going back and forth with low carb (which to me is lower than 50g a day…since going Paleo, I rarely eat more than 100g of carbs a day). I had thought since I had a problem with my HPA axis that I should increase carbs, but doc said it wouldn’t matter. What’s your opinion?

    • If you’re already in the stage of adrenal fatigue where cortisol is chronically low, a low carb diet won’t help raise the cortisol. The problem is that the adrenal glands aren’t producing adequate amounts of it anymore regardless of the stimulus.

      Anything that causes constant high cortisol output (inadequate calorie/carb intake, overtraining, emotional stress, job stress, etc.) can put a person at risk for developing an issue with LOW cortisol when the adrenal glands can’t keep up with the demands anymore.

      Make sense?

      Here’s some more info about the condition itself:

      I’d probably do a moderate carb approach (20-30% of calories) since in treating adrenal fatigue we’re trying to minimize the amount of stress from all sources, and VLC diets can be a source of stress for some people. Starchy vegetables and some fruits are ideal, possibly white rice as well as a component of a protein and fat containing meal. Keeping blood sugar stable is key!

      • Thanks! It’s nice to know I’m thinking the right things. 🙂 I’ve also had gut problems all my life (30+ yrs IBS and recently diagnosed SIBO) and know that there is a high correlation between gut issues and low cortisol. It can be so hard to fix these complex issues!

      • HI Laura,

        I have been researching LC diets and adrenal issues. Is there any scientific evidence that you can show me as why/how low carb and ketogenic (VLC) diets do indeed raise cortisol and affect adrenal fatigue? Not at all questioning your opinion, just wondering if you could either lead me to something explaining what actually happens to the cortisol levels/adrenals when eating low carb or explain it to me. Thanks so much. I find this article quite interesting (though my understanding may be lacking a bit) and it is what put me to ease when I was researching it. Any and all thoughts would be greatly appreciated, as I am so curious to learn.

        • Well it’s based on a combination of biochemical understanding of how blood sugar is regulated along with combined clinical experience of dozens of practitioners.

          As Sarah Ballantyne PHD put it: “Ketogenic and very low carbohydrate diets necessarily increase cortisol expression in order to create glucose for the few cells in the body that cannot run on ketone bodies.” This means that when blood sugar drops too low and there are no glycogen stores to bring it back up, the adrenal glands release cortisol to stimulate gluconeogenesis (i.e. the creation of sugar from protein).

          This doesn’t necessarily cause adrenal fatigue, but combine that with other cortisol-raising stressors like overtraining, poor sleep, emotional stress, etc. and you’re at higher risk for it. And if you already have adrenal fatigue, then a very low carb diet can make recovery difficult.

          The article you linked to was making the point that high cortisol doesn’t necessarily cause heart disease, which is true. It’s much like high cholesterol doesn’t cause heart disease. However, both high cortisol and high cholesterol can be symptoms of an underlying issue that can eventually lead to chronic disease, so the levels aren’t irrelevant.

          I hope that makes sense.

          • Yep, that would be a problem on a low carb but not ketogenic diet, or in someone trying to eat a ketogenic diet but with poor adaptation to that fuel substrate.

            Some of us actually do thrive in ketosis though, and see improvements in our gut function, without adrenal overstimulation.

            But if the blood ketones are not getting over 1mmol, then it is tough to get enough energy, and the body will tend to turn on its protein stores in the cortisol driven gluconeogenisis that you are referring to here. Moderating protein is important here, as is eating enough fat and enough salt.

            Thyroid downregulation can be offset quite easily with just an occasional carb feed. But it does not in any case appear to be a problem for many people on well conceived ketogenic protocols.

            I am sure that low carb diets are not for everyone, but sweet tubers everyday likewise are not for everyone. We need to stop acting as if there is a one size fits all (template even). There may even be numerous templates….

          • Laura, you were asked for scientific evidence to support your statements on cortisol and adrenal fatigue yet none were provided.

            I have searched for studies backing up these statements myself … and can find none.

            Do you know of any studies supporting the cortisol and adrenal fatigue statements?


      • Hey, as long as someone with 3 letters next to their name spelling out “PhD”, they must be right!

        How do you reconcile the protein sparing effects of ketosis with this supposed, “necessarily” increased cortisol breaking down protein tissue for converting amino acids into sugar?

        Are you ready to make the jump between rodent studies and humans studies Ballantyne focused on?

        How certain are you about fertility? The study by Zhao & Liu discussed on Suppversity that made the rounds actually says “extra energy intakes successfully restored the ovary function in adult female rats”. They achieved this using carbohydrates. Did they say this was the only macro capable of this? No. They further say “Tomten et al. found calculated energy intake and total energy expenditure were in balance in athletes with regular menstruate, while a statistically significant negative energy balance was found in female athletes with irregular menstrual cycles”. Macro ratios? Nope, total energy.

        The adrenal-ketois straw-man is clearly misunderstood and is becoming a blogosphere meme. CAN you have thyroid or adrenal issues while in ketosis? Of course! Does it have to necessarily be *because* of LC/Ketosis? No!

        Your cholesterol analogy doesn’t work due to differences in age groups – lower overall mortality in the elderly the higher the total cholesterol.

        You are painting a monochromatic picture despite your attempt to carve out a tiny niche of therapeutic utility for the ketogenic diet. It certainly is more than a last resort for the very sick.

        No need to ‘praise’ ketosis obviously – just an absence of a double standard would be nice.

        • Woah easy there! So it’s not ketosis causing adrenal issues no, but your body has a demand for glucose and when it’s not met it goes vampire on the muscles with cortisol fangs. Eating enough protein to “spare” the muscles doesn’t mean that muscle breakdown isn’t happening either. Oversimplification? Absolutely but the recognition of an adrenal/low carb interaction isn’t just dreamed up by “PHD’s” and functional practitioners. It’s a very common issue. Sorry just had to get that out.

      • I’ve had Addison’s disease for years. I had a brief bit of hope that my low carb diet might raise my endogenous cortisol while reading your article. Thanks for clearing that up. Low carb has helped somewhat with weight gain from taking steroid replacement hormones, but nothing will bring back my adrenal glands.

        • The different steroid medications might be tolerated differently – see if your doctor will work with you to find one that doesn’t have quite such bad side effects. Not all steroids have this effect.

        • I take Dexamethasone to treat secondary adrenal insufficiency – Addison’s. I’m also hypothyroid. Adopting the autoimmune paleo diet a year ago turned my health around. Glucocorticoids are notoriously harsh on the gut and open the door to systemic Candida. Gone is the bloating, mind fog, fatigue and other side effects of Dex. Also lost is the weight I gained after starting on it. I can’t tell you how relieved I am, having read numerous posts from people resigning themselves to living with these issues. Eating low carb in this way presents an alternate perspective to the thesis above if the goal is to mitigate the side effects of steroids, because replacement cortisol and thyroid medications already fill the role of maintaining healthy thyroid and cortisol levels. Veggies, yes! Grains? Not with glucocorticoids. Exercise is also key to taming steroidal side effects.

  134. The article makes some interesting points, but the author doesn’t differentiate between carbs and grains (which many people mistakenly equate with carbs).

    Adding healthy carbs like low-glycemic fruit, berries and vegetables is a good idea. But adding in more grains (which tend to be high in gluten, and full of phytates which prevent the body from absorbing minerals) isn’t going to help anyone.

    Paleo dieters who eat a lot of green leafy vegetables, roots, seeds, etc. (all of which our ancestors would have eaten in abundance) are already eating a lot of carbs.

    If people read this article and add more healthy veggies and berries to their diets, that’s great. If they start eating junk like wheat bread again, I can’t imagine that doing them very much good.

    • @nils, last time I checked “grains” are “seeds”, so it doesn’t make sense that you say Paleo eaters should eat seeds but not grains. Weston A Price found that freshly ground grain helped repair teeth, so that goes against your grains hurt mineral absorption claim. Now could be that back in his day it was a healthier variety of grain – perhaps Emmer, Barley, Spelt, etc. not the crap dwarf wheat highly processed white flour we mostly consume today. Sprouted grain breads would be good. Soaked and sprouted lentils/beans too. Undercooked tubers high in resistant starch as well.

      • My research found grains are not seeds. That is why there is a differentiation in the names. Just Google’what is the difference between grains & seeds?”. Grains are mostly carbs, seeds protein & fat (& no gluten).

        • Grains are seeds. They carry the genetic information to grow a new plant. Thus is was defines a “seed” as a “seed”…. Not it’s nutrient breakdown.

          • Dear Barb, a grain is not a seed. Again, it is a type of fruit, like a berry, capsule, or pome. By your definition, an apple or a pear are also seeds, because they contain (within them) genetic information. You are asserting something that is not true. Simply because a grain (or any other fruit) happens to have a seed-like form doesn’t mean it is, in fact, a seed. A seed is a mature plant ovule, a fruit is a mature plant ovary (which contains one or more ovules). Best wishes.

              • Dear Pierson, no, grains are not grass seeds, they are grass fruits. A grain (or caryopsis, as it is technically called) is homologous with an apple. Just as an apple is a fruit that contains seeds, a grain is a fruit that contains a seed. The confusion is coming from the fact that the fruit of a grass happens to morphologically similar to some seeds, but it is not a seed. Best wishes.

                • It is my understanding that grains ARE seeds. They are seeds of monocots – and the term “grain” is a culinary/agricultural name, not a botanical one. While all grains are seeds (of monocots/grass species), not all seeds are grains. e.g. flax, sesame are dicots and thus not grains.

                  That isn’t to say that all seeds of dicots are safe to eat. Some people have cross-reactions to them if they have gluten sensitivity or may have problems with the lectins they contain.

                • Heather,

                  Arthur is actually correct. Do some research on Caryopsis:


                  “The caryopsis is popularly called a grain and is the fruit typical of the family Poaceae (or Gramineae), which includes wheat, rice, and corn.”

                  Arthur knows his stuff. You should read his blog!

                • This is the problem with discussing anything: people will assert various facts, even when they are incorrect, and even when they have been corrected (politely) numerous times.

                  Heather Jacobsen, I have a graduate degree in plant systematics, have written two regional floras, have over 20 botanical publications in peer-reviewed botanical journals, have named new plant species to science, and have taught plant taxonomy for two decades (none of that is to brag, all of that is help you understand I have credentials in this field).

                  One more time:

                  A grain (technically called a caryopsis) is the fruit of members of the Poaceae (the grass family). Fruits are the mature ovaries of angiosperms (flowering plants). There are many kinds of fruits, including achenes, capsules, berries, drupes, siliques, multiples, aggregates, etc., etc. Fruits contain one or more seeds. A grain is a fruit and it contains a seed (surrounded by integuments of the plant ovary).

                  I’m sorry if this does not square with information you have been presented. You need to be open to the fact that the information you have about grains is incorrect. I’m sorry for the abrupt tone, but you are asserting something that is incorrect. Best wishes in your study of botany.

      • Weston price fed his school children in the study you are referring to White Bread with lots of pastured butter. He went on to conclude that it was the fat soluble mineral activators in the butter, not the grain that was responsible for repairing the teeth

      • Brad, a grain is a fruit (technically called a caryopsis), and is the fruit produced by the Poaceae (grass family). It differs from some closely related families (such as the sedge family) by having an adnate pericarp. A seed is found within a fruit (such as the seeds within an apple, the solitary seed found within an avocado, or the seeds you may eat from the fruit of a mustard). Grains have a seed within them. My point is that the words grains and seeds are not synonymous, though they are often confused. For the record, species like quinoa, amaranth, and goosefoot have different kinds of fruits (called an achene or pyxis, depending on the species we are discussing). They are not grains, even though they are frequently called as such. Best wishes.

        • sorry – but I don’t think that is correct. There is no fruit attached to a grain. The grain is the seed of the plant. But not all seeds are grains. Grains are the seeds of monocots/grass species. All grains are seeds but not all seeds are grains. At least that is my understanding of the botany.

          • Wow, Heather, you’re stubborn! In botany, grains are in fact fruits. Grains do contain a seed, though, so perhaps that is confusing to you.

            • No need to be rude, Nick! I wasn’t being stubborn. In fact, I see what you guys are saying. From a botanical standpoint, your point IS correct, and I should have conceded that. But since most people are reading this blog post from a nutritional standpoint, and simply trying to figure out what to eat, I think it confuses people to stick to the botanical nomenclature. We all know the fruit (yes, as it IS called) that surrounds a grain, is not the same, nutritionally speaking as the fruit that surrounds apple seeds or (the no longer existent) banana seeds. This is the problem with nutrition – there is no agreed upon classification system. And I don’t think the botanical system quite applies.

      • Grains and seeds are different. Just look up “pseudo grain”. As for which ones to eat and which to avoid, that really depends on your body! Some people are sensitive to gluten, others are sensitive to. The fructans in wheat, rather than gluten. If you are sensitive to particular carbs, like high FODMAPS, for instance, you really need to stay away from those things (including the prebiotics high in inulin). You have to listen to your body and find out what specific substances work or not for you. Eating more wheat likely doesn’t help anyone. But other grains can be benificial. I agree, however that fruits and veggies and seeds are far more important, full of carbs and fibre.

    • Don’t confuse fibre with carbs, leafy greens have essentially zero carbs as they mostly contain fibre which will be broken down into fat in the colon. Seeds have limited carbs as well… Chris is talking about fruit and high starch veggies like potatoes or sweet potatoes. Paleo is great but there is wayyyy to much carb-phobia. I always appreciate Chris’ reasonable perspective on carbs.

      • For many green non-starchy vegetables, the body burns more glucose in the digestion of them than it extracts from the vegetable itself! Not to mention the amount that gets digested by the gut bacteria before we even have a chance to absorb it.

        • Sorry Laura I didn’t even think about the fact that Chris didn’t write this article! I appreciate yours and Chris’ reasonable approach to carbs!

      • “…..fibre which will be broken down into fat in the colon.” What?
        And how is it that the experts on this page are NOT correcting this info??

          • Some soluble fibers/resistant starches are fermented by the microbiota in the gut, resulting in the formation of SCFA such as butyrate. There are a lot of variables, including the type of “prebiotic” susbtrate and the composition of the microbiome. Insoluble fiber–the hard stuff in celery, for example–mostly passes through the gut unchanged.

    • Dear Nils, you note to make a distinction between carbohydrates in general and grains. Though I understand why you are doing this, you are not representing grains accurately. It is members of the tribe Triticaea that contain gluten (e.g., wheat, rye, barley) and not all fruits of grasses. Further, the phytic acid content is present in modern whole grain foods only because this society (the US) has such a poor understanding of proper food preparation. To provide an example, we harvest our own wild rice (Zizania palustris) from waters here in Maine. This is a gluten grain that we prepare to reduce phytic acid content through traditional practices established by the Anishinaabe. It is also a grain that contains 30% of its lipids as omega-3 fatty acids. The main stream information on grain seems to be almost entirely based on wheat and does not include wild or heirloom grains that can be harvested or purchased. Though I do feel wheat and gluten-containing grains should be restricted (or even eliminated) by many people, historical evidence clearly shows that certain grains can be a part of healthy diets. You might enjoy this article that critiques some of the anti-grain arguments: Best wishes.

    • Amen – My thoughts exactly as I was reading…….. Not everyone can eat grain/wheat types of carbs… She needs to differentiate because most people think of carbs and don’t think fruit/vegetables – they think rice/pasta/bread……

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