Is Starch Good or Bad for You? You Be the Judge. | Chris Kresser
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Is Starch a Beneficial Nutrient or a Toxin? You Be the Judge.

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sweet potatoes
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As many of you know, I’m currently at the Ancestral Health Symposium at Harvard University. Yesterday I participated on a panel organized and moderated by Jimmy Moore called “Safe Starches: Are They Essential on an Ancestral Diet?” The panelists were myself and Paul Jaminet on the “pro-starch” side, and Dr. Ron Rosedale and Dr. Cate Shanahan on the “anti-starch” side (though Cate’s position is not quite as cut-and-dry as Ron’s).

I’m giving my talk on iron overload today, so I don’t have a lot of time, but I wanted to at least summarize the “anti-starch” side’s arguments and then list some bullet points of my arguments in favor of starch for those of you who aren’t here. I’m not sure if the panels will be made available after the fact (the talks will be).

Ron and Cate believe that glucose is toxic in any concentration, and it’s just a matter of scale. In fact, Ron is fond of saying that “everyone is diabetic”. Since starch breaks down into glucose, then by definition starch is toxic and should be avoided – by everyone. I’m a little less clear on Cate’s position, but she seemed to argue that glucose raises insulin, and insulin causes problems, so everyone should be on a low-carb diet ranging from 20 – 70 grams of carbohydrate a day, starch included.

My arguments in favor of starch

  • Let’s define the terms: are we debating whether starch is “safe” in healthy people or people with particular health conditions like diabetes or small-intestine bacterial overgrowth? These are very different conversations. People with hereditary hemochromatosis (a disorder that causes iron overload) should not eat iron-rich foods like liver and mussels; does that mean everyone should avoid these foods? Even if starch/glucose is “toxic” for diabetics, should everyone avoid starch/glucose?
  • If the argument is that starch is not safe for healthy people, I would say there’s little to no scientific or anthropological evidence to support that idea, and overwhelming evidence opposing it.
  • There are literally billions of people eating high-starch diets worldwide, and you can find many examples of cultures that consume a large percentage of calories from starch where obesity, metabolic problems and modern, inflammatory disease are rare or nonexistent. These include the Kitava in the Pacific Islands, Tukisenta in the Papa New Guinea Highlands and Okinawans in Japan among others. The Kitavan diet is 69% carb, 21% fat, and 10% protein. The Okinawan diet is even more carb-heavy, at 85% carb, 9% protein and 6% fat. The Tukisenta diet is astonishingly high in carbohydrate: 94.6% according to extensive studies in the 60s and 70s. All of these cultures are fit and lean with low and practically non-existent rates of heart disease and other modern chronic disease.
  • Amylase is thought to have played a key role in human evolution in allowing humans an alternative to fruit and protein. Compared with primates, humans have many more copies of a gene (AMY1) essential for breaking down calorie-rich starches. The ability to digest starch, along with the discovery of fire and cooking, gave humans a new food source that allowed us to thrive even in marginal environments. Some scientists have even argued that consumption of starch, along with meat, was primarily responsible for the increase in our brain size.
  • Dr. Rosedale argues that evolution is optimized for fertility, not longevity, and that starch consumption decreases longevity. The evidence he cites from this come from studies of roundworm, C. Elegans. However, I am not aware of any evidence in humans showing that starch consumption decreases longevity, and some of the longest lived cultures in the world consume large amounts of starch. Okinawans over the age of 65 (who grew up eating a traditional diet) are a prime example. According to a study of the traditional Okinawan diet in 1949, they obtained 85% of calories from starch, mostly from sweet potato. Life expectancy was 86 years for women and 77.6 years for men. Life expectancy at age 65 is the highest in the world, at 24.1 years for females and 18.5 years for males. Finally, the Okinawan population has the highest prevalence of centenarians in the world. This is especially remarkable when you consider that Okinawans did not have access to modern medical care during the 40s & 50s and and higher rates of death due to infections like tuberculosis as a result. If glucose is toxic and promotes short lifespan, how do the Okinawans live so long?
  • There is no one-size-fits-all approach. The amount of starch (and carbohydrate in general) will depend upon genetic/epigenetic factors (like amylase production), existing health conditions and the volume and intensity of activity – among others.
  • If the argument is that starch isn’t safe for those with impaired glucose tolerance, I concede that may be true in many cases. However, I’d like to point out that there’s some evidence that suggests starch may be safe in this population as well. For example, low-fat diets also cause fat loss (even without deliberate calorie restriction), though to a lesser extent than low-carb diets. And there are documented cases of people losing significant amounts of weight and improving metabolic parameters by eating nothing but potatoes. For example, Chris Voigt lost 21 pounds over the course of two months by eating only potatoes and not deliberately restricting calories. Furthermore, his fasting glucose decreased by 10 mg/dL (104 to 94 mg/dL), his serum triglycerides dropped by nearly 50%, his HDL cholesterol increased slightly, and his calculated LDL cholesterol dropped by a stunning 41% (142 to 84 mg/dL).

There’s more, but I don’t think it’s necessary to go further. If Drs. Rosedale and Shanahan are going to advise us to avoid an entire class of food that has been eaten for a couple of million years by humans, the burden of proof is on them to tell us why that food isn’t safe. Evidence from roundworm experiments and biochemical/mechanistic speculation is not enough in the face of overwhelming evidence that starch and glucose are safe in the absence of certain existing health conditions.

Now I’d like to hear from you. Which side of this debate are you on?

355 Comments

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  1. There are no safe starches for me as a type 2 diabetic so I stick with protein, low carb veg, salad, some berries. I must eat to my meter… So the poster above who said “for whom” is right on the mark;)
    My lipids etc drop drastically too when I low carb.
    I have concern when I know my kids have genes for type 2, and see them eating way too many carbs, will they be in my shoes in their 60’s?:):)

  2. As someone who avoided starches for many years, I’ve changed my stance on this. After developing thyroid issues/symptoms, I’ve found that adding rice, potato, sweet potato to my diet has really helped my energy levels, with no adverse effects.

    Like you said, who are these starches ‘safe’ for? Some people may not tolerate them well, others may tolerate them just fine. Given that many cultures consume them with no ill effects, why paint them all with the same ‘unsafe’ brush?

    • Its a myth that the Okinawan diet is starch-based. There was ALWAYS an ample supply of fish, seafood, and sea vegetables (it’s a tiny island in what was some of the most pristine waters–though perhaps no longer). Except when they were starved by conquerors they ate a lot of pork and all the fat with it.

      1949 is not the best time to judge the diet of the island. Okinawans were starved before and during WWII when it may not have been safe to hunt pig and fish. Sweet potatoes were perhaps a subsistence food but not the major source of calories in the diet except in extreme times. In 1949, agriculture and fishery were probably still in recovery phase on the island–as late as the 1960’s there was still so much unexplored ammunition that some places were STILL unsafe. The island was nearly bombed out if existence during the war–every tree gone.

      I grew up on the island in the 1960’s. While most Americans were isolated from the Okinawans on military bases and “civilian enclaves”, my mom was the original locavore so we ate where Okinawans ate and shopped in their tiny storefronts. We had Okinawan Friends and ate in their homes, attended their family celebrations, etc. I NEVER ever even saw a purple “Okinawan sweet potato” until 40 years later in Hawaii, when they suddenly became trendy.

      The diet is very similar to native Japan with plenty of short grain sticky rice but always substantial servings of meat, fish, eggs and seafood, and a variety of vegetables along with a mouth puckering green tea. . Fat is not skimped on.

      There is certainly starch in the diet (mostly rice is what I experienced) but its far from a “starch based” diet.

      I know there are studies that show life prolongation from very low calorie intake/starvation, and my guess is that has more to do with Okinawan longevity, combined with their healthy omnivorous diet in good times. Its ridiculous to credit sweet potatoes as a factor in their longevity!

      • Hear, hear!

        The pro-safe starch group accuse the anti-safe starch group of using weak, unscientific arguments and generalisations and then we get this from the pro-safe starch group!

        I’ve also read first-hand accounts of the traditional Okinawan diet, written by native Okinawans, and the emphasis on starch is conspicuously absent!

      • I read recently an amusing article stating some of these so-called centenarians were actually dead and their children were enjoying their old-age pensions. I think the article said there was to be an overhaul of the departmental computer systems after that.

      • I never made it to Okinawa in the 13 years I lived in Japan, but what you say resonates with what I’ve heard about Okinawa, that pork was/is the preferred meat and lard is used widely. I think the omnivorous diet, with lots of plants and herbs as well as meats and fats, has something to do with their longevity, as well as close-knit families and intact culture, despite Japanese and American imperialism. Just my impression.

        Similarly, I want to roll my eyes when people go on about the supposedly low-fat, high-soy Japanese diet. Some favorite foods there include tonkatsu, very fatty pork chops, dipped in egg, then panko, and deep-fried; tori-age, or bits of chicken (fat and skin intact) rolled in cornstarch then fried; and toro, the fatty, rich, pink underbelly of tuna and the most prized sushi/sashimi. When I used to pull the skin off such fried chicken, a Japanese friend exclaimed, that’s the best part! Which was a novel concept to me at the time.

        The traditional Japanese diet, like the Okinawan, includes foods from the sea, the mountains (fiddlehead ferns and all sorts of greens), and everywhere in between. People call it a “rice-based” culture, but that should not be taken to mean that rice accounts for the bulk of calories consumed. Rather, it’s the default starch, but by no means the only one, and is eaten frequently but in moderate quantities, accompanied by smallish portions of meats, vegetables, fermented pickles, and miso soup. Many flavors and types of tastes (not just sweet and salty, but sour, bitter, and umami — savory — as well). The SAD tends to lack sour and bitter flavors, and may be deficient in various micronutrients provided by such foods. Of course, with the spread of western fast food chains in Japan has come the spread of obesity and poorer health in those who consume that diet.

      • I’m sorry, but you’ll have to show proof of this in a published, peer-reviewed study. The analysis I referred to was based on the 1949 diet in Okinawa, and the lifespan data is based on the population that was eating that diet. http://www.ncbi.nlm.nih.gov/pubmed/17986602 Personal accounts are not on par with peer-reviewed evidence.

        You have also misinterpreted my argument. I never claimed that starch was responsible for their longevity. I said that it’s highly unlikely that a population could live to be so long if their diet is 85% “toxin” (glucose), barring some unbelievably protective factor. This is especially true when you consider that the Okinawan population I am referring to did not have access to modern medical care and had high rates of mortality due to infection.

        • According to the study you cite:
          “Therefore, we investigated six decades of archived population data.”

          How does this source of information give a more accurate picture of the traditional Okinawan diet than the testimony of a native Okinawan or someone who has lived among them?

          Unfortunately I cannot access the full text without paying – so I don’t know what this ‘archived population data’ consisted of that so accurately spells out the traditional Okinawan diet. Is it in any way similar to food frequency questionnaires of 24-hour recall?

          • It might be interesting to mention opinion about Okinawan diet from recent review article published in Nutr Metab. 2012; 2012: 569486.
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335253/?tool=pubmed

            Okinawan Diet – excerpt.
            Equally notable is the wide variation in other aspects of healthy diets such as macronutrient intake, represented most notably by the healthy Okinawan diet, which is LOW IN FAT and HIGH IN CARBOHYDRATES (mostly from vegetable sources). This suggests that low-energy, nutrient-dense diets with high-quality carbohydrates may be beneficial for reducing the risk of CVD among many chronic diseases.
            The cardioprotective benefit of Okinawan diet is ascribed, in part, to the LOW CONSUMPTION OF SATURATED FAT. Other possible mechanisms, such as the high contents of phytochemicals, high antioxidant intake, and low glycemic load in this diet, are also likely to be contributing to decreased risk for CVD and some cancers through multiple mechanisms, including reduced oxidative stress.
            A comparison of the nutrient profiles of the previous dietary patterns shows that the traditional Okinawan diet is the LOWEST IN FAT INTAKE, particularly in terms of saturated fat, and HIGHEST IN CARBOHYDRATE INTAKE, in keeping with the very high intake of antioxidant-rich yet calorie-poor orange-yellow root vegetables, such as sweet potatoes, and green leafy vegetables. The longevity of Okinawan populations suggests that such a diet may even help to slow the aging process itself.
            My comment: The authors failed to mention the role of : 1. Coral calcium, 2. Pork, 3. Soy (even unfermented – tofu), 4. See food including algae
            http://www.facebook.com/MichalPijakMDPersonalizedPaleoNutrition

            • Not blowing my skirt up!

              The first reference given in the Okinawan diet section is the same one Chris has already cited. The other two references given are by the same team of researchers and no doubt mined from the same archived data as the first study.

              Is this cream of ‘peer-reviewed and published scientific support’ for this position vis-a-vis the Okinanwan diet and safe starches? One study and a couple of permutations thereof by the same authors? Jesus wept!

              How do you get a high carbohydrate diet from green vegetables anyway? As a percentage of those ‘restricted calories’, maybe, but in absolute (mass) amounts?

          • “How does this source of information give a more accurate picture of the traditional Okinawan diet than the testimony of a native Okinawan or someone who has lived among them?”

            God, you’re not serious, are you? How does a scientific study gave better data than personal impressions?!

      • The Okinawans and Kitavans are useful to make a dramatic point, but not necessary to disprove the low carbers claim that starch is unhealthy for those of us without metabolic issues. Hundreds of groups all over the world consumed starch as a staple **prior** to the onset of the diseases of modern civilization. That is, before DIABETES EXISTED. This reality immediately falsifies the position that “carbs” in and of themselves are **causing** modern metabolic disease. The burden of proof is on Rosedale and others to defend their extremely radical position.

        I was quite shocked at AHS12 as to the degree to which (very) low carb is still entrenched in the paleo community. Chris, you did a great job on the panel standing your ground, especially given that fact that Jimmy was anything but an impartial moderator and Paul was so passive.

      • i also think the diet in 1949 was not representative of the traditional Okinawan diet.

        my dad grew up in rural China; his family was poor. so they ate mostly veg + rice. didn’t have a lot of meat (probably cooked in lard). so it may have been 60% – 80 %calories from starch.

        but for middle class family a typical meal includes rice, veg, meat/fish/egg (including organ) & soup , fruits as dessert. i doubt the starch calories is that high.

        (due to the overdose of veg @ childhood, of my dad, he hates veg & all he wants now is fatty cuts of meat, meat, meat, meat + some rice.)

        • “but for middle class family a typical meal includes rice, veg, meat/fish/egg (including organ) & soup , fruits as dessert. i doubt the starch calories is that high.”

          Yes, but 95% of the population was poor!

      • Finally! Someone who really knows what the real Okinawan diet is. No! Nobody in Japan would ever eat in the way that Dr John McDougall thinks that they eat. I lived on the mainland in Tokyo and never met a single vegetarian or vegan except for one fat angry Aussie vegan female and her pasty faced skeletal timid Tasmanian flatmate. Fish, pork and chickens everywhere in meals. Not very red meaty I agree but that has more to do with the climate and landscape of Japan.

    • Tracey. Love it!! I’ve been diagnosed with hypothyroidism and adrenal fatigue. I do not do well on high protein low carb. I do well on more carbs/starches.

  3. Chris, great points, but to me a glaring point is of course individuality and then what population, if generalising, is this geared towards. Fat and glucose are primary human fuels, to say glucose is toxic in even a moderate amount is short sited, especially as many people following a healthy lifestyle exercise, and If someone told me I couldn’t have a plate of potatoes and steak after I played rugby Id laugh at them, id be in bits the next day. Indeed there are some who this would apply, but I cannot see the negatives of consuming safe starches. If this is the their stance in the paleo world then they really are down to eating meat and berries!

    • Ben: that was my first point. “Let’s define the terms: are we debating whether starch is “safe” in healthy people or people with particular health conditions like diabetes or small-intestine bacterial overgrowth? These are very different conversations.”

  4. I am extremely insulin resistant. A little bit of starch can set me up for a long period of weight gain. My b-i-l is an insulin dependent diabetic and I steer him the Rosedale route. My 21 year old son has the metabolism that is set at light speed – I consistently include good starches in his meals. Had I been raised on a good starch, whole foods diet, I might find the inclusion of starch in my diet to be feasible or beneficial. But like many Americans, I was raised on high sugar, low fat. I am metabolically ruined now and have to stick to the strictest of low sugar, low starch, primal regime in order to not balloon.

    • I was raised of home-cooked meals, eating a lot of veggies, without an excess of sugar, but now at 51 years old I eat a LC diet (since Nov. 2007) because it keeps me at better health and prevents the weight gain. Yes, I lost 30 lb on LC, but I also lost all my seasonal flues, the need in asthma meds, pre-menopause symptoms, leg edema and much more .

  5. I’m not big on eating a lot of starch but, I think there are some logical flaws in a couple of the axiomatic arguments presented by the starch opponents:
    “Dr. Rosedale argues that evolution is optimized for fertility, not longevity”
    This is true for some life-forms but not all. Mammals with long gestation periods and long developmental cycles through to maturity, such as Whales, Elephants, and Humans are, by necessity, optimized for both fertility AND longevity. Our success as a species requires the passing of adequate wisdom to succeed well and in variable environmental situations. Only a longer life can provide that. If evolution had not optimized us for longer life, we probably wouldn’t live as long.
    Second: While I realize that below is not a direct quote from Cate;
    “Glucose raises insulin, and insulin causes problems – so insulin causing things are bad”
    The whole insulin mechanism would not exist to handle starch/glucose so effectively if we were not evolutionarily designed to consume a variety of foods in variable environments and seasonality to succeed and thrive – to fertility and for a long time.
    Humans are not consumption specialists, we are generalists. We are designed to creatively succeed in as many situations as possible. This is how we have come to overrun the planet to a level of being nearly unsustainable.

    • >Dr. Rosedale argues that evolution is optimized for fertility, not longevity.
      I did read somewhere that so-called pigmy populations were optimised for fertility by omitting the pubertal flush growth due to having a low life expectancy, however my partner has just drawn my attention to a study postulating the short stature of 2 ethnic groups (Efe, Biaka) as a consequence of an alteration in thyroid hormone pathways with unique mechanisms for each tribe, in response to living in a tropical forest environment which is low in iodine. The symbiotic Bantu Lese population has a prevalence of goitre at 42.9% compared with 9.4% for the Efe people and offspring with both tribes as parents have an intermediate incidence of goitre . I assume the Lese haven’t adapted because they moved there more recently from iodine-sufficient regions in the direction of the Cameroons.

        • Great point. I’m sticking you and Jaminet at the top of my “list”
          And thanks for the cleanest web site!
          I enjoy /visit Attia, Taubes, Wolf–actually about ten more, but you two are the cream of the crop
          where my reality hits the road.
          There are brands out there to be protected, I respect that. When I decide what to eat, you two are the source.

      • It might be interesting to note that studies in fruit flies showed that certain amino acids such as methionine were vital toward maximizing longevity while not reducing fertility patterns. Including methionine into a calorie limited diet enhanced fertility while maintaining longevity. At the same time, decreasing methionine levels in high caloric diets actually extended life spans. Earlier studies had already displayed that lowered levels of methionine in mice and rats assisted in prolonging life expectancy.

    • Another more fundamental problem of focusing exclusively on longevity is this: without fertility, longevity is meaningless. If a hypothetical intervention increases longevity but decreases fertility, that is not going to help us in the long run.

  6. One can be on a “low carb diet” of under 50-70 grams of carbs, and still have “safe starches.”. The Perfect Health Diet suggests that vegetable carbsare fermented into short chain fatty acids in the gut, which is why they do not count towards the carb requirement.

    I tend to not eat that many sweet potatoes, because I have to count and measure them more specifically, whereas “lower carb” is easier if I stick with vegetables.

    Fruit is a whole other issue, and I would love to see more about that (free fructose vs fruit fructose).

        • Turnip my Love! I meant to say are you more interested in learning more about turnips? Wiki is good for that. Your vegetable totem may well be the turnip, it is worth some meditation. I wouldn’t pick a fight a with you as I strongly sense that your animal totem is a rude grumpy mummy brown bear though. Respect!

  7. I have no clue who is right, so I take the mindset of an investor and implement a hedging strategy. More carbs in the summer and less in the winter.

  8. I believe that eating any single nature food in moderation does no harm to humans since our evolution, during millions of years, involves living nearly in all the regions of the world, and mixing with probably all the possible tribes on earth, therefore having eaten nearly all the existing nature foods in wild, however, that would be great if I could know my specific genetic information, by a single test, about what foods and how much I can eat, depending on the history of foods eaten by specifically my ancestors altogether. However, I think that the problem with the starch is what you eat it with in the same dish. I don’t believe that our ancestors had a big plate full of many different foods collected from all the corners of the globe in the same dish 3 times per day every day. They normally ate what they could get instantly, similarly to the animals – they don’t eat a full plate of mixed foods, but each single type of food one by one. Mixing foods is where starts all the problems, I think. For example, mixing starch with protein in the same dish makes a poor absorption of both. Mixing milk with meat proteins also causes the stomach’s enzyme crash, which results in a poor absorption of both at the end. I believe that this is the only thing our genetics aren’t adapted to – to absorb many different types of foods in the same time, which leads to bad absorption of them all, and there is where starts all the deseases. Eating a single food one by one, even starch, makes it easy for the stomach to absorb its nutrients fully. Like that Cris Voigt who ate only potatoes…probably not mixing them much with other foods. Funny, but our ancestors had a better nutrition by having relatively smaller access to foods than today, when in the abundance of all different kinds of foods, we suffer from a poor absorption of nutrients.

  9. I feel far better having a few starches in my diet than without. I think a lot may have to do with where you are in the spectrum of health. Lower carb/starch seems to work well for those with metabolic derangement but then as one loses weight and insulin levels normalize in the body, it seems like some starch is necessary to feel optimal. I cannot ever eat gluten-based grains and I have found that certain FODMAP foods like onions and sugar alcohols are definitely not well-tolerated, but a little rice with sushi or some white or sweet potatoes from my garden go a long way to making me feel great overall.

  10. If the anti-starch camp – Rosedale, Shanahan, and Gedgaudas, among others, probably including Jimmy Moore – doesn’t offer legitimate, convincing arguments for their position soon, I’ll have to start believing they’re fear mongering and sensationalizing. It’s frustrating to want to respect them as thought leaders but at the same time not be able to find truth in the foundation of what they’re saying. How they can be so convinced of their rightness in the absence of compelling evidence?

    I do have to express my appreciation that Cate Shanahan seems to be genuinely open to moving off her staunch anti-starch position. It seems she has begun to recognize that a low/no starch diet doesn’t actually work well for everyone and that some of us thrive on safe starch consumption. Keep up the good work, Cate, of trying to get to the truth of the matter.

    • the hunter-gatherer ideology hypothesises that man originally didn’t eat starch,thus man isn’t meant to eat starch,so those beholden to this ideology seek after evidence supporting their belief.

      • I’m not sure this is true. I think HGs were digging up roots and wild tubers as part of their foraging routine. Wild roots and tubers of our ancestors’ generation most likely had a very different nutrient density then what we see today. The huge idaho spuds we see today were probably nothing like ancient potato species.

        • I agree; the whole hunter GATHERER thing seems to = men with spears for the vast paleo majority, which doesn’t jive with what we know of subsistence cultures. I blogged about “chauvanism is bad for your health” on exactly that topic.

          • When we consider the recent evidence demonstrating how the digestive system of a carnivore like a dog has actually evolved and adapted over a relatively short time, to the point where they are now able to thrive without meat, we shouldn’t be surprised that it isn’t really possible to look at what man ate thousands of years ago and assume this is what we should now eat.

            Our bodies adapt very quickly to change, so over many generations I’m sure that we could adapt to eating most diets. The Innuits have adapted to eating high fat, low carb and are very healthy, just as other groups eat high carb and are similarly healthy.

            Starch or no starch again is probably dependent on the individual, and personally I believe it is sugar which is the major cause of inflammatory related health issues, along with processing and additives.

            Whether we eat starchy foods, high-carb, low-carb, meat, no meat, saturated fat, no saturated fat, so long as they are unprocessed I believe there isn’t much difference between any approach, so long as a diet cuts out processed foods and excessive sugar.

            Where we are able to observe primitive cultures in the modern world, anything sweet is usually seen as a treat, and I’m sure we’ve all seen the videos of tribesmen in the Amazon climbing trees to get to beehives, and the subsequent gorging on the honey.

            At one time in the west, sweet treats were mainly for special occasions, such as birthday cakes, Christmas pudding, and as a kid I only received sweets as a reward.
            Nowadays babies are weaned straight onto tinned food which is sickly sweet, and as soon as they grow and get spending money it usually ends up being spent on sweets and candy.
            Fast food stores ensure there are plenty of sweet relishes/sauces to add to foods and our addiction to sugar pandered to.

            • I agree with a lot of what you said, but I also don’t think that dogs thrive without meat. I think they survive without meat. I think dogs that eat a plant based diet would do even better on their natural diet of meat and some vegetables.

              There are many stories of people switching their dogs (or cats) to more species specific diets and seeing ‘cures’ to arthritis, digestive disorders, etc.

              • Dogs having a few more copies of the amylase gene just means they can digest starch faster. It could be an adaptation from starting to use starch when it was still scarce; it doesn’t mean they’ll metabolize glucose differently if there’s lots of starch in their diet.
                Digestion and metabolism are two different things.

                Adaptation is driven by natural and sexual selection – that’s a scientific fact.
                Natural and sexual selection are driven by the death and failure of individuals; in medicine (as opposed to pure evolutionary science), those are events which it is unethical to condone. Especially when there’s the alternative adaptation – using our big brains to identify unwholesome foods, and our strong social structures to forbid them.

    • I don’t think that everybody should treat potatoes as a poison, people have different nutritional needs. However, I think many more people could benefit from eating a ketogenic diet or close to ketosis like me. It makes wonders for a mental health, mood problems, PMS, hot flashes, migraines. My son trays to eat a Paleo-style diet, no starch limitation for him, except when he feels he may be getting a flue, or there are some tests, then he is avoiding anything with carbs..

  11. “There is no one-size-fits-all approach. The amount of starch (and carbohydrate in general) will depend upon genetic/epigenetic factors (like amylase production), existing health conditions and the volume and intensity of activity – among others.’

    That sums it all up pretty nicely. Individually, we need to track how we feel, biomarkers, etc to be able to answer the question for ourselves.

  12. My own experience restricting carbohydrate and avoiding things like sweet potatoes and other starchy vegetables was described very succinctly by Stefani Ruper on her blog post about carbs for fertility: http://www.paleoforwomen.com/carbohydrates-for-fertility-and-health/

    “Because low carbohydrate diets are so popular for weight loss, it is common for women trying to lose weight and to ‘look good’ to exercise often, eat very few carbohydrates, fast, and restrict food intake. The more of these restrictions a woman undertakes at once, the more and more her body reads this as living in a starved, stressed state. The results are significant. Her adrenals fire heavily, her liver gets tired from performing so much gluconeogenesis, her insulin sensitivity drops, her body fat levels fluctuate, her leptin signalling gets off, she stops sleeping soundly, and she stops menstruating regularly.”

    Check, check, check, check, check, check and CHECK.

    • Check. How many low carb Paleos plateaued half way through weight loss? Tons literally and figuratively. Why is that? That was one brick wall many Paleos hit. When Dr. K last year talked leptin resistance in a big way a tidal wave response occurred finally someone was talking about it. Isn’t this one of the reasons why the term Paleo Failo started circulating?

      It didn’t fail completely but it did not work completely either. It began a movement to start asking tougher questions about it all.

      I have seen when I do add carbs my body isn’t freaking out and holding onto fat so I make it through when food and carbs become more plentiful.

      But carbs are very problematic for me and I think it may have something to do with fructose being my arch enemy. So a work around for me since all types of potatoes have fructose maybe a bit of rice is my work around. Going to try it.

    • I agree women need carbs, I was too low carb for too long and felt the hormonal impact. My motto is to now eat a little bit of everything, rather than a huge amount of the “right” foods. After eliminating FODMAPs for 3 months the only foods I haven’t reintroduced are garlic, onions and raw dairy because they do not agree with me, others may tolerate them and therefore can enjoy. I think it is important to experiment yourself, it is not just about food, to summarise Chris’s posts it’s about managing sleep, stress and activity for optimal health and it takes hard work. I have returned my metabolism back to it’s pre-teen working order and have never felt or looked better.. As a mother of four teenage/adult daughters I am very passionate about getting the message out there, thank you Chris for helping to make this happen.
      Jodie

    • Check for me as well. My PCOS symptoms had mostly normalized before I decided to experiment with a lower-carb diet (<100g/day) at the time when I was exercising more (Zumba 2-3x/week, plus strength training 2-3x/week). Within weeks I was spotting heavily and erratically and my actual period didn't show up for two weeks past ETA. Reproductive Endocrinologist told me my body was stressed and asked if I had made any changes in my lifestyle. Took a few months to really get back into the rhythm, but increasing carbs (~200/day) normalized my cycles again.

      • I don’t know what’s going on with me. I lost over 100lb on a ketogenic diet. Then my metabolism slowed right down (I got a stomach bug abroad and took antibiotics, which I think really kicked things off). Cold hands and feet, no energy, weight loss stopped. Felt terrible unless I ate some form of sugar. So I started making kefir to rebuild gut flora, and upped my carb intake. The symptoms eased, and I feel “normal” now. However, I can’t lose weight. I can’t lose if I’m keto (in fact that brings on fatigue and cold hands again), and I can’t lose if I add rice and sweet potatoes to my diet. I don’t lose if I’m inactive, and I don’t lose if I lift weights or go jogging. I’ve been fluctuating above and below the same weight by 5lb, for about 3 months now. I’m still a good 40lb overweight for my height.

        To be honest I should be pleased- I’m over 100lb lighter than I have been for a decade, but you know I’d like to get this finished. My aim was never to have a BMI under 25; I was aiming for 27. I can’t even get there. Kinda out of options, and the longer it goes on the harder it is to stay on the straight and narrow, primal-diet-wise. 🙁

        • 100lb! Wow, that’s impressive. I’m no expert, but the weight loss stalling may be from a few things I can think of.

          Ketogenic diet = low insulin and low leptin. But high adipose tissue = high leptin, so you likely had low insulin and high leptin (the winning combo for fat loss). Now that you’ve lost weight, you may have really low leptin if you’re still eating fairly low-carb. But you said you can’t lose weight by adding back carbs, likely because you’re spiking your insulin in the process and storing fat. This leads me to believe you should carb cycle and do some carb refeeds while keeping up the activity.

          Carb cycling -> do an intense workout (lift weights, sprint, yadda yadda), then afterwards eat lots of carbs and protein, but keep that fat LOW. I’m talking lean burgers and sweet potatoes aplenty. This way, you should be insulin sensitive from the workout and keep your insulin levels low, but will spike your leptin and thus lower your setpoint = weight loss. Try it out, yah?
          http://www.marksdailyapple.com/carb-refeeding-and-weight-loss/#axzz23MHUjGjk

          There is another possibility, though I’m not quite sure what to do about it if true. Adipose cells either get larger or split into two when they get pretty large. First, when gaining weight, they’ll balloon up. Then they will have enough nutrients/mass to divide into two cells. The issue with being very heavy, then, is that you have a TON more fat cells than a normal person, because these cells don’t really die at an accelerated rate when you’re losing weight, the bunch of cells just get smaller. So you might be hitting this plateau where you emptied most of these fat cells, but you just have a lot of small ones left over. Not sure how to kill ’em beyond keeping at the carb cycling, spot-icing, or surgery. But they may just die off if you work through some carb/activity fluctuations – intermittent fasting would be a nice method to add in as well as training fasted for super fat loss 🙂

        • Hi, Rachel. I feel your pain. I was in the same boat but I didn’t lose ANY weight. Actually I lost about 6 pounds. My story is this. . . I usually hover at 200. I was eating a very high sugar diet for over 5 years (I blame my antidepressant because it was really making me binge). Over the period of a year the AD stopped working and the depression started creeping back in pretty bad. At the beginning of 2012, I couldn’t even get out of bed anymore – I was so tired and so depressed. I knew I had to do something dramatic so I started a Paleo diet with no carbs (well maybe 20 a day). The first few weeks were okay (2 weeks I think). I had a bit more energy. The weight was coming off steadily. I was feeling a little bit better but not a lot. I was proud of myself for turning my diet around so quickly. I was gaining momentum.

          But then one day, two weeks later, everything stopped. The weight loss completely stopped and I believe, looking back, I went into a kindof hibernation zone. I had ZERO energy. I was so depressed. More than before. I could sit on the couch in a daze for HOURS at a time. But I had cut out all carbs and I have eaten a high sugar diet for years, so I was determined to battle through it and not give in. This went on for a month and a half – I could barely work, I didn’t want to leave the house. I was very cold. My husband would leave the house in the morning and I would jack the heat up to 85. Finally one day out of desperation, as an experiment, I ate a sweet potato and within 30 minutes I was up, buzzing around the house, cleaning the kitchen. That was in January-March of this year.
          Have you had your hormones tested? I did and the levels were really low. My progesterone was REALLY low. And I also had an RT3 ratio that was too high (I had read about RT3 for months before getting it checked – I should have listened). As of now I’ve started taking bio-identical hormones and thyroid medication. It has helped maybe 25% I have lost 10 pounds in all (in 8 months). I can come to work everyday and socialize – so I’m better there. But I still have rough mood swings – periods of panic, periods of agression. And I still have zero energy.
          I still don’t know the answer. I found this article http://drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/ but, I will warn you, it will probably frustrate you. It hits on the issue but if you read through all of the comments, it seems her solution didn’t help anyone.

        • I was having trouble losing forty lbs after my first child for five years. Then I did GAPS intro and lost two dress sizes in a month. I am eating the same way I used to eat again and it hasn’t come back yet. I wonder if I had a parasite or fungal infection? Intro was very intense. I had a lot of symptoms that they call die off. I should also say that I have Ulcerative Colitis that came on after I had my baby and received MMR vaccine at hospital. Was vegan for seven years and vegetarian during pregnancy eating crap I hadn’t eaten like doughnuts. Something happened because I was healthy before pregnancy and introducing junk food. Drs so far have said none of those details have any relavence.

          • @Linda,
            I personally have noticed that bacterial infections seem to be extremely common prior to autoimmunity. Then I googled and found many experts talking about this. Was it the bacteria or was it perhaps the antibiotics which are used for treatment? Kind of the chicken and the egg thing. But either way it seems like they both were exposed to the immune system. Perhaps either one messed up the immune system? Did it mess up the gut in the process? We know antibiotics can do that temporarily but maybe it does long term? Maybe with hormonal changes certain genes turned on for you? There are so many maybes for us and not enough good studies to answer them.

            You mention you had the MMR too. Hey that gets the immune system charged. Did you know that those vaccines use saponins to get the immune system to see the vaccine? Those same saponins are ones us autoimmuners are suppose to avoid eating because with our leaky guts they just enter blood stream to jack up immune system most likely. I do think it is not unreasonable to think that hormones does affect how autoimmunity presents it’s self too. I think men who are over weight have have Fibromyalia like symptoms but to a much lesser degree than women. For women it is much more obvious and more painful. I do think their muscle mass seems to help them in some way. That muscles mass also helps them lose weight quicker too it seems.

            Donuts aren’t the only source of really bad lectins. Beans are just the worst too. If you were eating vegan and vegetarian I bet you had a leaky gut to some degree. The older we get the worst autoimmunity gets and the more of them pile on. So many tend to start up with small symptoms and then it just gradually accelerates. Maybe a little indigestion that you assume is normal. Hey I gradually started to use antacids in my 20s. I thought this was normal if I ate spicy food (saponins) and then gradually used them more and more over the years. I have no need to use them now plus they cause intestinal permeability too. The irony. Your old normal may not have been so normal as you recall.

            I never had colitis but my mother did. Genetically autoimmunity seems to show up in families and some times it presents its self the same way or in similar ways. Think back at how you relates health was. My daughter is Celiac but I am gluten sensitive. Gradations of a similar theme.

            I would say that you are the best judge of what is happening to you in many respects and continue to figure out what foods work best for you. Right now genetically docs can not tell you what all your food tolerances and intolerances are. They are all guessing at this point based on some limited science. They won’t be able to do this for decades so your best bet is to do an elimination diet. Pay close attention to any changes and test everything including drugs and supplements and seasonings. Leave no stone unturned. Write it down and track it.

            • I don’t know how I missed your response from two years ago, Turnip. I have come further in discovering what might have gone wrong with me. You are right about the leaky gut with my vegan diet. I also have a history of birth control pills, NSAID and antacid “abuse”, and hormonal imbalance. There is autoimmune and digestive illness in my family which I didn’t know about before. I think non-celiac gluten sensitivity runs in my family. There is heart disease, mental illness, diabetes, rampant tooth decay, and osteoporosis. Things were definitely brewing and then the MMR, I think was the trigger. Dr. Shoenfeld identifies ASIA (autoimmune syndrome induced by adjuvant). Dr. Wakefield’s research found the measles strain used in the MMR infecting the guts of children with ulcerative colitis. I thought I was going to live forever by being vegan. Whoopsy daisy.

  13. I’ve been adding more safe starch in the form of rice (have eaten sweet potatoes for years) ever since I read Jaminet’s book about a year ago and it seems to be very good for me. I, too, am very lean and pretty strong for a 61 year old woman with gut problems (IBS) and autoimmunity (both well enough controlled that I mostly enjoy my life). My safe starch carbs are often over 100.

    I like to ferment my favorite rices; sushi type and basmati, which I do for 3-4 days. I guess this isn’t very common because I don’t get any feedback from people I’ve asked about the possible benefit of this. My husband and I find this preparation especially delicious so that’s a good enough reason for me to do it, benefit or not.

    • Cathryn, I’m actually very curious how you ferment your rice. I recently have been eating a lot of starch after the realization that it seems to upset my stomach much less than fruit and vegetables. The FODMAP diet works very well for me, although I have found that I tolerate fermented FODMAPS (such as homemade sauerkraut and yogurt) very well. In fact, I’m seeing lots of health benefits on these fermented foods and would like to do more fermenting (I recently purchased Wild Fermentation by Sandor Katz to help give me ideas). I’m starting to see some logic to the regular consumption of fermented versions of foods I also eat unfermented in order to supply the gut bacteria needed to digest these foods. Since rice is something I eat a few times per week, I’m curious about how to ferment it.

      • Hi Megan,

        I first soak the rice overnight and the next morning stir it well, then rinse til the water is quite clear. Then I cover it again with fresh, filtered water and leave it for a few days. You can put it in a warm spot like a sunny window area and/or add a little hot water to bring up the temp to about warm. Sometimes the rice develops a mild cheesy aroma or smells a little yeasty. Once I found a little white, cottony mold on top that I just lifted off. When ready to cook, drain and rinse and add fresh water.

        Hope this works for you.

          • Hi Turnip,

            It’s not based on any science. It just occurred to me to try it, maybe after I heard someone on a podcast say they did it, I don’t remember. It was just an experiment and I found it very tasty and no problems so it didn’t seem like it compromised the digestibility. At worst it would be the same as eating rice prepared the usual way, is what I figured, but maybe it could be beneficial for those of us with extra sensitive guts. I honestly don’t know.

            • Not based on science, maybe, but there is a long historical precedent for this – the Chinese have been doing it for thousands of years.

              Stephan Guyenet wrote a post about a “new” way to soak rice some time ago (link

              The only difference to what Cathryn is doing, is to save some of the soaking solution, and add it as a “starter” to the next batch, just like doing a sourdough.

              It is interesting to note the emphasis on *not* cooking the rice in the soaking water – it contains water soluble antinutrients/toxins, so is discarded.

              I cheated and used some kefir whey to start my rice “sourdough” and it has worked very well.

              Works even better if you then cook the soaked rice in a bone broth…

              • Thanks, Paul, good to know. I notice Stephen’s post specifies brown rice and I only use white. I have cooked it in the soaking water and it was good, but now I always rinse it and add fresh water. I assume there aren’t as many toxins in white rice. I like the idea of saving some of the soaking liquid as a starter and will try that.

                • They make a “bread” in India by fermenting three parts rice with 1 part red lentils. Soak overnight, pour off the liquid and set aside, then blend them in the blender into a bit of a paste. Add the liquid back, cover and let ferment again, overnight. It should get a little frothy. Add turmeric, cilantro, salt and pepper to taste. Cook like you cook pancakes. They are nice little breads that are great with butter or applesauce, or can be used for sandwiches. Not sure,though, if the cooking destroys all the fermented goodies.

  14. According to the series 9 Steps to Perfect Health – #5: Heal Your Gut, to have a healthy large intestine we need fermentable fibers (starches like sweet potato, yam, yucca, etc.)

    • That is what I read too David. In fact, you can try a new product I saw in the supermarket. It is called Yucca bread. It is made with grated yucca, that has been pressed into a flat bread. The additional water and starch from the yucca have been squeezed, before it is baked.

      Dr. Mercola also makes his own health bar made with yucca, chia seeds, dark chocolate, and other healthy ingredients. The bar is delicious!!! He, (Dr. Mercola), wrote a book about The No grain diet that you might like. I have been able to maintain weight loss from his recommendations, and stave off bad carb cravings, and yes I do consume yucca sometimes.

      Dr. Mercola has articles about yucca – as a healthy starch/carb alternative. Try drmercola.com

      Thanks for sharing David.

      • Lacto fermented dill cucumbers. The Poles call them Ogorki (I think). Get them in brine. Amazingly good for your gut flora & fauna.

          • The trillions of bacteria that every human being carries in their gut. Some of the bacteria do not exist outside the human gut. I point you to the work carried out by Natasha Campbell McBride. She is a Russian/British doctor who has come up with the GAPS (Gut and Psychology Syndrome) diet.

            Some examples (from Wikapedia) of gut flora are –

            Bacteroides fragilis
            Bacteroides melaninogenicus
            Bacteroides oralis
            Lactobacillus
            Clostridium perfringens
            Clostridium septicum
            Clostridium tetani
            Bifidobacterium bifidum
            Staphylococcus aureus
            Enterococcus faecalis
            Escherichia coli
            Salmonella enteritidis
            Klebsiella sp
            Enterobacter sp
            Proteus mirabilis
            Pseudomonas aeruginosa
            Peptostreptococcus sp
            Peptococcus sp

            All these bacteria are important to human health. The one I look to particularly are the lactobacillae. These are bacteria that live in a carbon dioxide environment which is what exists from the small intestine to the colon. They are what absorbs nutrients from your diet and builds faeces to eliminate waste products from your gut.

            Eat lacto fermented vegetables such as sauerkraut, kimchi (I’ve never eaten it) and others, not to feed you but feed your gut flora & fauna.

            It’s a symbiotic relationship. Look after your gut flora & fauna & they will look after you. It’s in their (and your) interest.

            Peace.

            • Just for the record….

              Flora refers to plant life. Fauna refers to animal life

              Bacteria are not animals. Animals, fungi, plants, and protists are eukaryotes, and typically multicellular – and their cells contain membrane bound organelles. Bacteria are prokaryotes, which lack membrane bound organelles and other complex cell structures.

              The bacteria in the gut are primarily the genus Bacteriodes, which are anaerobes, and will die when exposed to an oxygen rich environment. The gut also contains facultative anaerobes that can function in both oxygen rich environments through aerobic respiration and switch to fermentation in an oxygen poor environment.

              In summary: Bacteria in the gut are not animals, most don’t use oxygen.

              Now, about those fungi….
              Fungi were originally classified as plants (flora), but have since been separated out as they are heterotrophs (meaning that they don’t fix their own carbon, but have to use (eat) carbon fixed by other organisms for their metabolism). Since the “intestinal flora” is an old term, we still say that – even though fungi are presently being re-evaluated as organisms. 🙂

              http://answers.yahoo.com/question/index?qid=20070508142520AAkx86j

              • @ kell,
                Is that Kell like in antigen? Ha ha..This is great that you break this all down. So when someone introduces probiotic to gut what happens with the gut bacteria? How do you know which probiotic to introduce and how much? In a healthy gut are there just certain strains that reside there and which ones are there? Does it depend on what you are eating say meat only diet vs VLC? Are there tests you can get that will tell you the strains you have and how efficiently they are working? Can you cite any research about what is optimum gut flora environment etc. ?
                Kell you had me at flora…..

                • All very good questions Turnip!!
                  I’m sorry I don’t have those answers for you – but would love to know also!

                  I can say I recently saw a traditional Chinese Medicine Practitioner who came highly recommended who seemed to think that all I needed to do was take a multitude of ‘pills’!! $400AUD worth and that would cure all of my ills – alongside a no sugar low carb diet of course!!! He gave me prebiotics/probiotics/multivitamins/magnesium/calcium etc etc etc the list is very long and stupidly I ‘fell’ for it and it was only when I got home and started thinking about how much crap he had given me that i felt rather miffed!!!!!!

                • @Kell
                  Well I tracked down an amazing article today that was published in the NY times about two months ago which pretty much tells me this whole probiotic thing is something researches are putting a lot of resources into and the data coming out of it is vast and surprising. How they isolated so called health individuals for this study was quite extensive. You might find this extremely interesting:
                  http://www.nytimes.com/2012/06/14/health/human-microbiome-project-decodes-our-100-trillion-good-bacteria.html?pagewanted=all

              • Denis is actually correct about flora AND fauna. Besides bacteria (flora), there is also some worms (fauna) that we have a mutually beneficial relationships with. You can never be completely worm-free. Even super healthy people have them and actually need them. There is some species (i believe, hookworm) that proved to be beneficial against asthma, for example.

    • There are cultures (herders like Mongols, Masai, also Inuits) who lived healthy lives without fibers in their diet. It doesn’t mean that potatoes are a poison, of course.

    • David, I hope that by fermentable starches you mean those starches that resist small intestinal breakdown and are fermented by the resident bacteria in the large intestine, producing a variety of end products, the most significant of which is the short chain fatty acids(SCFA). These RESISTENT STARCHES were also defined as “Total amount of starch, and the products of starch degradation that resists digestion in the small intestine of healthy people.” SCFA consist primarily of butyrate, propionate and acetate and are the preferred energy source for the colonocytes (cells lining the colon).
      Other benefits of SCFA’s include:
      • Increased colonic blood flow;
      • Beneficially lowers pH in the lumen which may aid mineral
      bioavailability and reduces the growth of pathogenic bacteria;
      • Helps prevent abnormal colonic cell development.

  15. Not starch per se, but its source is important. The global pattern of varying prevalence of diseases of affluence, such as obesity, cardiovascular disease and diabetes, suggests that some environmental factor specific to agrarian societies could initiate these diseases. There is increasing evidence that a cereal-based diet could be such an environmental factor. The global epidemiological pattern suggests that almost all agrarian societies have some prevalence of diseases of affluence. In contrast, diseases of affluence have been virtually absent among many non-agrarian societies in Melanesia, Malaysia, Africa, South America and the Arctic. One such traditional population are the horticultural Trobriand Islanders with a mortality from atherothrombotic circulatory diseases which apparently is close to zero, even though they have access to abundant sources of food, smoke heavily and have a fair share of elderly people. Read more in: http://www.biomedcentral.com/1472-6823/5/10/

  16. Very well reasoned and written.

    For those of us who read about this sort of stuff on a regular basis, it gets tiresome coming across piece after piece, position after position, on what’s “good” and “not good.” As you point out, that analysis is too cut and dry. The real questions are: Good for whom? Not good for whom?

    Here’s an example. Based on your recent post on FODMAPS, I cut down substantially on vegetables and fruits that are high in insoluble fiber – as an experiment. And I’m feeling SO MUCH BETTER. I’m learning that those kinds of foods are Not Good – for me, and for some people. But that doesn’t mean they’re Not Good for everyone.

    Precise thinking and writing like this takes longer than vague generalizing, and it’s harder. So it’s no wonder there’s so little of it around.

    🙂

    • ME TOO, same experience. cut down tremendously on fruits/vegetables like that and my digestion has improved a ton.

    • Susan, good point regarding FODMAP.

      In recent decades, the role of dietary com ponents in inducing IBS symptoms has been explored. There is evidence that certain food components can contribute to symptoms through the effects of malabsorption of carbohydrates, and stimulation of hypersensitivity through food chemical ingestion. Noncoeliac gluten intolerance also exists and may be important in a subgroup of patients with IBS.

      Recent paper summarizes the evidence and application of the most common approaches to managing food intolerance in IBS: the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet, the elimination diet for food chemical sensitivity and others including possible noncoeliac gluten intolerance. (Barrett JS, Gibson PR. Therap Adv Gastroenterol. 2012 Jul;5(4):261-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388522/?tool=pubmed)

      Food intolerance in irritable bowel syndrome (IBS) is increasingly being recognized, with patients convinced that diet plays a role in symptom induction. Evidence is building to implicate fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) in the onset of abdominal pain, bloating, wind and altered bowel habit through their fermentation and osmotic effects. Hypersensitivity to normal levels of luminal distension is known to occur in patients with IBS, with consideration of food chemical intolerance likely to answer many questions about this physiological process.

      There is emerging evidence for the role of food intolerance in the management of IBS symptoms. This does not present a cure, rather suggested dietary modifications to improve symptoms and quality of life. The greatest body of evidence is for the low-FODMAP diet, which improves symptoms in at least 74% of patients with IBS.

      Elimination of food chemicals is more difficult to introduce, more challenging for the dietitian and patient alike, and is largely based on hypothetical constructs rather than high-level evidence. For these reasons, elimination diet techniques should remain a second-line dietary therapy to be instituted only by those trained in the techniques.

      Noncoeliac gluten intolerance appears to exist, but further research is needed to confirm this and to examine the mechanism of action. Caffeine and fats may well play a role in inducing IBS symptoms in some patients, a reduction of which can be trialled to assess response. The considerable evidence supporting the low-FODMAP diet for IBS, and the fact that it is relatively easy to implement without significant nutritional concerns, supports the suggestion that this should be the first dietary manipulation trialled in patients presenting with IBS.

      • After three months of really uncomfortable bowel symptoms which I took to be IBS, (my mother had this), I started a gluten free diet. After only two days without gluten most of the IBS symptoms had dissappeared along with other`problems that I didn’t know were due to gluten intolerance. My migraines are also far fewer now and much less severe than before, though I have not cut down on other foods such as caffeine, fats or FODMAP foods. The removal of the IBS symptoms and the improvement in my migrains has convinced me that food is a very important medicine and a lot less dangerous than most of the pills that doctors would like to prescribe us.

        • Celiac is prevalent in my immediate family. Although I was told I don’t have celiac, I was diagnosed with ulcerative colitis and had acid reflux for about 25 years. When I was diagnosed with u.c. I asked the specialist about eating a gluten free diet. He said “diet doesn’t matter”.
          I quit eating gluten anyway and the acid reflux and the u.c. went away.
          I just recently stopped eating virtually all grains and have lost the “last 10 pounds” that I could never seem to get rid of and my digestion is even better.
          I still eat a lot of fruit because I love it. But, I am also confused on what fruits or vegetables I shouldn’t eat.
          I don’t have health insurance, so getting tests run is pretty much out of the question.

          • @Kathy,
            No doc can tell you which veggies and fruits work for your genetics yet. Yeah they do have some tests but they are so limited in scope. It will take decades before they will be able to do this. In the mean time you can test them out yourself. You can either approach this the long way around and do Paleo and then autoimmune protocol and then find out you are still having problems like many of us. Or, what I have found that seems to work quicker and gets me clearer results is just go meat only and then test one veggie back in at at a time. I would test out Paleo autoimmune friendly veggies first. Then try fruit one at a a time. Do this slowly since sometimes it takes awhile for immune system to react in a way that you can actually see or feel the changes. I would also tell you that fructose may also be causing intestinal permeability too. Maybe test out low fructose veggies and fruit first would be better.

            My mother had colitis but I didn’t. My daughter is a Celiac but I am gluten sensitive. Variations on a similar theme. Also you can get Celiac later in life so you may not have it now but genetically you are a great candidate for getting it. Dr. Fasano also found this out that Celiac can be acquired at any time in your life. Big game changer. All the more reason not to mess with it. Don’t get too swallowed up by the GAPS or FODMAPS either. Just follow your genetics and epigentics and what it tells you.

            No doc can do this for you but they will try and charge a lot for it.

        • I totally agree with your comment about doctors. When I look back now.. I was a very healthy teenager up until I got a job a a bakery at started eating copious amounts of bread.. serious gastritus, constant sinus and candida infections, rashes, chain headaches and then glandular fever followed by 2 years of chronic fatigue (which is not even a diagnosis in my opinion). 9 years… yes 9 whole years later I finally got diagnosed with fructose malabsorption. Since changing my diet.. EVERYTHING has improved, and I don’t have to touch drugs at all. Let just say, I no longer visit the doctor for my health advice.

    • I concur with this. What works for one doesn’t work for another. I have lost 80 pounds over the past few years and *after* that weight loss, I developed diabetes. This is contrary to what all the doctors, and the medical profession on the whole, state should happen. In addition to this, I’m also a celiac and have multiple food allergies/intolerances.

      Jan 1 of this year, both the hubby and I went strict Whole30 paleo. At the same time, I eliminated my diabetes meds (1500mg Metformin daily) and the result at the of March was a rise in A1C from 5.8 to 7.3. (When diagnosed last year, it was 14.1.) It’s taken me most of this year to learn how my system works.

      1. I cannot have grains of starches of any kind. They cause my BGL to skyrocket.

      2. I have to include a “sugar” of some kind. Whether fruits that are higher on the GI or the use of honey, without this, my numbers start to creep up. This has been nice since it’s about 10000 degrees here over the summer – it’s allowed me to enjoy things like sorbets and frozen fruit bars which would typically be off-limits for a diabetic.

      My diet now consists of meat, veggies, fruits (mostly berries, grapes, apples and then things like mangos), coconut oil, use of honey here and there. No dairy, soy, corn, grains, legumes, gluten, etc. I would never want to tell someone else that this is the way that they should eat.

      I think we all need to find what works for us and do that. I have read a ton of fabulous info all over the place but not one plan fits what I need. I have to pull a bit from here, a bit from there, and toss in my own ideas. In the end, we’re all responsible for our own health and no one knows better than you what your body does/not need.

      This is what works for me and me alone. I cannot speak for others and would hesitate to advise another diabetic to follow my plan.

      • I am also diabetic and have read that I should include some safe starch in my diet to avoid wear and tear on my liver. I have an A1c of 5.3, and it scares me to experiment. So much conflicting advice! I pretty much eat what Cherie does (minus the honey), plus a few avocados a week. Am I really doing damage?

    • I did the FODMAP diet as well. My diet is about 60 grams each of protein and carbs and the rest is fat. My blood sugar problem and IBS-C are now under control. Fructose, high fiber foods and casein were destroying me.

  17. As someone who is BFing and underweight (5′ 7, 107), I think starches are important. Of course, many who are overweight and carb sensitive probably need to restrict them. Nora Gedgaudas’ argument against safe starches didn’t convince me, either. I’ve tried cutting them out before and going low-carb, but I felt terrible–sometimes they’re the only foods that fill me up.

    • I am currently breastfeeding too. I feel terrible with out carbs- potatoes, lots of fruit, raw milk and rice occasionally. I don’t feel good low carb. But I have a feeling I don’t feel good with higher carbs either. Still trying to figure that out.

    • It´s strange that Kitavans, inspite of very high carb diet are not fat and free of diseases of affluence.

      • They also smoke, which is a much stronger risk factor for CVD than just about anything else.

        • In one of my previous post I mentioned the same: „……………. horticultural Trobriand Islanders …………..SMOKE HEAVILY ……………“ The Trobriands consist of four main islands, the largest being Kiriwina island, and the others being Kaileuna, Vakuta and KITAVA.

      • Kitovans also eat once a day. It looks like IF makes macro-nutrient content of a diet to be less important. Before I started LCarbing, fasting and eating in intervals longer than 3 hours was just impossible because I was too hungry. After I got adapted to LC diet AND fasting, my hunger is not ruling my life any longer. However , I continue eating LC because I like how I feel in ketosis, it also helps controlling my migraines and PMS.

        • If Carbs are so bad, how are Kitavans able to eat only once a day. The problem is not with carbs. The problem is with damaged metabolism. And unless you fix that, you will continue to feel better on low carb. It maybe that your metabolism cannot be fixed. Or it maybe that it has gotten fixed due to the LC diet, you just haven’t checked it out. You do know that you will get a High Carb flu if you start eating carbs suddenly.

          • Carbs are not bad by itself, but different people react on carbs in their diet differently. I think the ability to comfortably tolerate the infrequent eating is the indicator of the appropriate macro-nutrient diet composition for a particular person. I am not comfortable to say that my metabolism is broken because I have been always prone to get too hungry between meals and my appetite has been an issue since I remember myself (until I started LCarbing). I grew up in a different country without any access to a fast food, After moving to US at 35 years old, I continued cooking all my meals. I am not a sedentary person. My be I am secreting too much insulin when eating a “balanced” diet. I have a lady friend who managed to reverse the beginning of middle-age weight-gain by just changing the pattern of her meals to IF – first meal is at 10 am, second and last one at 5 pm, nothing in between. I am now doing pretty much the same but a LC variation. I think my diet is better because I stopped having all seasonal flues and infections since I started my diet 5 years ago(the list of disappearing health conditions is too long to mention), she didn’t. What other people like Kitovans or my friend are doing, or what any expert is saying has nothing to do with my diet choices – only personal observations can give an answer. I think eating excess of carbs is more often an issue for people than eating too little.

            • Might the Kitovans be consuming large quantities of fruit in their diet? Smoking depletes ascorbic acid (vitamin C) from the body, as explained by Dr. Linus Pauling. The Kitovans must replace that vitamin with (probably) fruit. It should be made clear that starches are complex carbohydrates (glucose) and are safer than carbs from table sugar, which contain fructose, without the antioxidants that are in vitamin-containing fruits and vegetables. Thanks, Chris.

      • Magic is in the source of food. Truth is we are wonderfully complex and adaptive. There are heavily processed fats and carbs which have very negative effects but there are quality/natural sourced fats and carbs which are very beneficial to our bodies. I very much enjoy Kresser; what I’ve learned most is that food is primarily individualized. If I were to make blanket statements it would be focus on real food, eat seasonally available food, wild as much as possible, raw and cooked. I’m in the middle of creating my own site/blog. http://www.subjectivesustenance.com
        I’ve been devouring these topics for the last four years. Naturally people in extreme cases with always require specialized circumstances. Just my two sense. Stay healthy my friend;)

    • If you look very closely at overweight humans, chances are the obesity is caused from an over abundance of meat, dairy and too much protein. I doubt very seriously that anyone eating a plant based diet and (that is what a starch based diet is, plants. They are not obese. In contrast they are usually thin and lean and have perfectly working pancrease to handle the extra glucose not used by the brain for fuel.

      Look at Africa…starch based (potatoes) and thin, look at Japan Starch based (rice) thin. US meat and animal protein based, dairy based (obese and chronic illness like Heart Disease and Dibetes)

      • “If you look very closely at overweight humans, chances are the obesity is caused from an over abundance of meat, dairy and too much protein.”

        It’s an abundance of refined sugar, flour, trans-fats etc. in all of the processed foods available here, not too much meat / dairy… That combined with lack of regular exercise / movement.

      • Yeah people say we have been consuming far less fat, not saying fat is bad, but just seems like obese people are eating a lot of fat along with the carbs, inevitably creating a caloric surplus. I think it all just boils down to eating too much as well as the chronic stress environment.

  18. I personally have found I fare much better on a starchier diet, even a much higher fructose diet (I eat a lot of fruit) which I never imagined I’d be saying! Restricting carbs and eating a higher fat/higher protein diet does not feel good for me, it was always a bit of a struggle, and I would end up having crazy fruit binges. At the end of last year I went traveling in Asia and threw the whole high fat/moderate carb thing out the window whilst enjoying loads of fruit, white rice, yams, and small amounts of meat (and daily ice cream!) during my travels. I was well into the “insidious weight gain” parameters as outlined by Mr Sisson 😉 yet I lost 7 kilos, my skin cleared up and I felt amazing. Granted, it was a fun, stress-free period so obviously that played a role as well. Coming home, I tried to revert back to my old ways, limiting the starch and fruit and trying to up the protein and fat again – I ended up feeling sluggish and gaining all the weight back – plus my temps became completely frigid so I suspect that I wasn’t getting enough glucose for proper thyroid function. Now, I’m back on the CHOs again (>250g/day), leaning up slowly (yes, really), warming up my temps and feeling relaxed about my diet again. Sleeping like a baby, too, with all those carbs in my belly – that’s been the best thing!

    • Sucrose increases bad cholesterol build-up in the arteries, yet the vitamins in fruit help to protect the body from this ill effect. Table sugar is the substance to avoid. The starches help us to get a good night’s sleep, especially if consumed with foods that contain tryptophan (for example, low-fat cottage cheese). With the addition of vitamin B6, the tryptophan converts to the sleep-inducing chemical, serotonin.

      • Lovely Christina I so agree. ”Let not thy butt be silent.” He listened and learned, so that’s good.

  19. Awesome. First time posting, but felt it necessary to. All I can say is, I transitioned from a vegan to paleo diet. It was a great starting path. “No/Low” carb worked for a month or two only because my guess was from elevated insulin and glucose levels over the course of 2 years of pounding my body with legumes and grains.

    A couple months into paleo, I started to reintroduce lots of safe starches and have never felt OR looked better. (Super lean, strong, and look vibrant.)

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