The 3-Step Process to Determining Your Ideal Carbohydrate Intake
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The 3-Step Process to Determining Your Ideal Carbohydrate Intake

by Chris Kresser

Last updated on

Cathy Yeulet/Hemera/Thinkstock

This is a guest post written by staff nutritionist Kelsey Marksteiner, RD. Click here to read her blog or join her newsletter!

There’s been a lot of talk about the right amount of carbohydrates to eat lately. Laura Schoenfeld started us off with her article about the possible detriments of eating a low-carbohydrate diet for too long, and Chris Kresser followed this up with his discussion of the common misconceptions people tend to have about low-carb diets. They’ve done the heavy lifting here and provided lots of scientific evidence to back up cases where a higher or lower carbohydrate diet might be beneficial.

What I want to get into today is the practical aspect: how do you determine the amount of carbohydrates that’s right for you?

To do this, I’ll walk you through the step-by-step process that I take with clients so you can start to think about it for yourself. While many people find it easier to work with a professional on this, I think it can also be done on your own.  The important thing to remember is that there’s no one-size-fits-all approach.

When most people start a Paleo diet, they typically start a low- (and sometimes very low) carbohydrate diet. They get in the habit of not including starchy tubers and fruits. Some people will thrive on a diet like this, which is fantastic. Others might feel great for a while, but then slowly start to feel more fatigued, have more difficulty during workouts (and even more problems recovering), and overall just don’t feel so great. Guess which clients I’m going to be seeing?

I see the clients who don’t thrive on low-carbohydrate diets. They come to me wondering what they’ve done wrong and why they’re feeling sick when all they’ve done is followed the Paleo diet to a T – and that’s why this conversation is so important to have. We need to make sure that folks starting the Paleo diet understand that there’s a range of carbohydrate levels that can be consumed, and that everyone will feel best at a different level. I can’t tell you how many of my clients have come to me legitimately scared to eat carbohydrates of any kind. I don’t think any diet should cause people to be afraid of an entire macronutrient. All of us here at believe in personalization, and that’s exactly what I’ll be teaching you about today.

Let’s go through the 3-step process I use to help clients determine their ideal carbohydrate intake.

Step 1: Consider Underlying Diseases/Conditions

This is critical. If you have diabetes, you’re likely going to do better on a lower carbohydrate diet (though check out some of the comments under Laura’s article – even diabetics don’t all thrive on low-carb). If you have small intestinal bacterial overgrowth, you’ll probably want to limit your carbohydrate consumption while you treat the SIBO. Note the emphasis there: for someone with a gut dysbiosis issue, a low-carbohydrate diet is used as a therapeutic intervention and isn’t meant to be continued for life. I see so many clients who started a low-carb diet because they wanted to use it therapeutically, only to never try reintroducing those foods again.

If you have adrenal fatigue, you’ll likely feel better on a more moderate carbohydrate diet along with eating snacks to keep your blood sugar stable. Breastfeeding? You’ll definitely want some carbs, too. The point here is that there are many conditions that affect how your body deals with carbohydrates, so you need to take these into consideration when thinking about how much carbohydrate you might do well with.

Chris discusses the different levels of carbohydrates that work best for a variety of conditions in his book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014). I’ve listed them in the chart below:

Carbbohydrate Intake Chart

Step 2: Get Started!

If you are an overall healthy person (and you either don’t exercise or exercise moderately), I suggest starting on a moderate carbohydrate diet and experimenting from there. When I first start working with a client who has no underlying health issues and wants to find their ideal carbohydrate intake, I often have them begin by implementing what I like to call “The Rule of Thirds”. That is, their plate should be ⅓ protein, ⅓ starchy tubers, and ⅓ non-starchy vegetables. It ends up being a moderate carbohydrate diet (though it depends on their calorie intake of course) – not astronomically high like the Standard American Diet, and nowhere near a ketogenic diet. Eating three meals a day like this also means they’re less likely to skimp on calories (and I’ll work with them to make sure this is the case).

If you do have a condition that would affect your carbohydrate intake (diabetes, hypoglycemia, thyroid disease, adrenal fatigue, etc) and/or you exercise a lot, refer to the chart in Step 1 to know what carbohydrate level you should begin with.

If you have multiple conditions that place you in seemingly opposite carbohydrate levels, I suggest working with a practitioner to help you craft a diet that will suit you best.

Step 3: Experiment! (And Take Notes)

From there, we experiment. Sometimes the carbohydrate intake will feel too high. It might trigger cravings for sweets, or perhaps increase their blood sugar too much.

I’ll have my client track their meals and take notes along the way with how they’re feeling so we can really see what’s going on. This is a crucial (and often overlooked) part of the process. If you’re not taking notes and keeping track of your meals, the experimentation phase can feel downright overwhelming. Being able to look back and track how your symptoms change with a concurrent change in carbohydrate intake is vital to figuring out the right level for you. If there’s a disease we’re dealing with (i.e. diabetes or adrenal fatigue), we focus on tracking those symptoms (blood sugar and fatigue, respectively) to see how they change. I have my clients use an app called Meal Logger for this task, where they can take pictures of their meals and keep notes on their symptoms.

If the carbohydrate level seems to be a bit high for the client, we bring it down. If it feels too low (perhaps they’re still feeling sluggish and are having trouble with their workouts), we’ll try bringing it up and monitoring their reaction. Eventually, we settle on the sweet spot.

So there you have it – my step-by-step process for determining your ideal carbohydrate intake. I hope seeing this helps you start this experiment for yourself and find what’s right for you. Don’t feel like you need to put yourself in a low-carb or high-carb camp – you just need to do what works for you! There’s a huge spectrum of carbohydrate intake; it’s just a matter of finding where you should lie on it. This is something I help clients with all the time, so if you’re having any trouble, don’t hesitate to reach out.

Now I want to hear from you. Have you found your ideal carbohydrate intake? What’s the process you used?

kelseyrd03This is a guest post written by Kelsey Marksteiner MS, RD. Kelsey is a Registered Dietitian with a Bachelors degree in Nutrition from NYU and a Master’s in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. She is a firm believer that everyone is different, and she tailors her plan for each and every individual. Through her work, she aims to meld the dietary wisdom of traditional cultures with the latest science in integrative and functional medicine to create plans for her clients that work in the modern world. You can learn more about Kelsey on her staff bio page, or by visiting her private practice website. Join her newsletter here!


Join the conversation

  1. What do you do when you fit three out of the four categories? I feel schizophrenic! Adrenal issues, trying to gain muscle (hardgainer), SIBO, not so great one hour postprandial numbers.

  2. Hi
    I am a 28 year old woman and am 152 cm. Who is on 1300 cals 105 carbs 130 protein and 45 fat and while I gained muscle on this plan I have been struggling to lose the visceral fat and am always tired and foggy headed so decided to try something else. I have decided to change my macros to 1430 cals with 40% carbs (143grams) 35% protein (125grams) and 25% far (40 grams) Are these macros healthy and am I on the right track? I don’t want to gain more fat or lose the muscle I have worked hard to gain but am also scared to make a change from my routine or be on the wrong plan for me

  3. Hi,

    I currently am training at the gym 40-60 minutes 4 days a week weight training, and 2 days a week 30 minute cardio HIIT preferably. However, ive not lost any body fat as of yet, and i have been doing it for 5 weeks. I am 54kg 24 year old female.

    I have not been working out this week due to flu, and i am currently on 1,200 calories 40% Protein (130G), 30% Carbs (90G) and 30% fat (45G).

    while i am not active at all is this percentage range ok?

    also what range do you recommend for weight training and cardio fat loss not muscle loss.

  4. Howdy

    The article advises carbs amounts depending on lifestyle/conditions.

    However it doesn’t detail the split between main category of carbs: safe starches, fruits, sweet veggies [carrots, corn, beets,etc..] and carbs from non-sweet/non-starchy veggies.

    I guess it matters? 200g of carbs from fruit would have a different impact than 200g of carbs from potatoes?


    • I found when I went low carb I needed to dramatically increase my fat intake.

      Breakfast scramble egg in butter and sautéed spinach in butter

      Snack-6 almonds

      Lunch handful of shredded chicken half an avocado over a salad with olive oil and red apple cider vinegar (home meade with ITALIAN seasonings

      Snack peanut butter filled celery sticks

      Dinner, filet mignon, Brussels sprouts sautéed in butter, salad.

      Lost 28 lbs in 70 days and kept it off with same diet.

  5. After trying to implement diets to accomodate my numerous medical conditions, it seems there is no solution. Autoimmune hepatitis with periportal duct damage, type 2 diabetes, hashimotos with an isthmus nodule that exceeds acceptable limits, hypertension, venous insufficiency and osteoporosis/ osteopenia are taking their toll.

    Several years ago I tried a LCHP diet and the toxins overwhelmed my body causing venous insufficiency. The Paleo diet resulted in little weight loss and 135 lbs on this 5’5″ frame is unacceptable. Visceral fat is impossible to lose and prescribed steroids have caused my arms and legs to decrease in size and bruise easily.

    Though my bloodwork has improved greatly, the AST/ALT fluctuates constantly and is rarely in the low – normal range. I believe insulin resistance is driving inflammation throughout my body. Fasting readings are usually below 110 and A1C is below 6, but daily blood glucose readings are often high.

    Genetics along with Southern cuisine throughout previous years have exacerabated my conditions, but an elimination diet helped me identify many inflammatory triggers. My beloved fried foods, legumes along with other staple carbs, and extreme desserts are but a memory. Gluten is out, as is dairy, peaunuts, soy, sugar, and MSG. With the number of supplements I take, one would think food shouldn’t even be necessary. However, the fire still rages and I need assistance.

    If you can direct me toward a diet to improve my health, you will be my hero. Thanks!

    • Really suggest you look into candida overload as well as other parasitic issues. Getting probiotics in the billions as well as cleansing the bowels from candida and parasites will be extremely helpful for these conditions.
      Also consider that having a large amount of probiotics maintained in the body will help tremendously with inflammation issues. Adding more roots to your diet will also go a long way in supporting, rebuilding and maintaining organ health. Ginseng, turmeric, ginger are a few extremely valuable roots to use on a daily basis. There are also specific organ cleanses that can be done to help the digestive organs rebuild themselves.
      A heavy metal detox is one of the first steps in this overhaul, as well as looking deeply into the spiritual, emotional metaphysical aspects of these conditions. Look at Dr. Jon Barron’s Metal Magic tincture.
      I’ve been working with people all over the world for about two decades, and have had great success in this type of approach to disease.
      It is my experience that once we look at the emotional energies that lie beneath the physical body, such as is done with biofield technology, great healing occurs within the physical, especially when we restore bowel health, as microbiology dysfunction affects all of the organs.
      Look up Hanna Kroeger, as her work has become a standard for herbalists world wide when looking at working with any disease.

  6. Thank you so much for this article. I love the table and how it puts the most important information in an easy to read format. This has helped me a lot.

  7. Great article! Would love your ideas for adrenal fatigue, hypothyroidism, and unfortunately now candida overgrowth. For three weeks I’ve stopped all sugar, including all fruits and sweet potatoes. The last couple of days I’ve gotten really anxious with other symptoms from the anxiety. Somehow I need to up my carb counts without feeding the candida. I may go ahead with sweet potatoes. Any help would be appreciated!

    • Probiotics, one or two a day, one hour before my meal took care of my candida overgrowth and I had horrible anxiety/panic attacks that was due to vitamin D deficiency. I take two 2000 mg vit D3 a day and it has helped tremendously! Hope this help you too

  8. Carbs only give 1/3rd picture 🙂
    It would be great if you can also suggest what the rest of the calories should like. i.e. fat and protein ratio as well. not just carbs.

  9. I an wanting some advice at this point anything helps. Heres a little about me… I found out I had hypothyroid a few months after my last (third) child was born as I was working out but unable to lose weight. I tried weight loss pills, portion control, watching what I ate, and no progress. I have a very high stress life kids, work, school, relationship issues that have only gotten worse because of my lack of self esteem. I also have had depression for many years and always felt fat whether i was 130 or what not. I was then diagnosed with fibromyalgia and two years later have almost non existent vitamin d deficiency, and iron deficiency. I am trying to correct those but its hard and takes a long time. My endocrinologist who i see for my thyroid issues says its stress and thats why I cant lose weight but I dont believe that. My levels with my thyroid are not stabalized and also are a work in progress. She also told me that I could see the best trainers, and dieticians in the world and wouldn’t lose weight because Im too stresses out. My symptoms from it all are intense and there are many including hair loss, weight gain, chronic pain, anxiety, brain fog, headaches etc. I tried a keto diet & lchf but found it hard to eat fooda higher in fat as i had trained myself not to for so many years. I dont enjoy those foods and they make me feel sick as I prefer lean meats or steak occasionally. I was doing 105protein grams daily, under 20 g carbs daily, fat intake around 75-90g daily. I lost almost 30 pounds in 3 months and thats with having cheat days almost every Saturday and sometimes sundays too. More of my hair fell out because of it so I now have extensions as it became so thin. It caused my cholesterol to go up which i never had an issue with before and i blame on the bacon and higher fat foods. I dont want to eat the same 5 things only the rest of my life and want to find something that will work as a permanent life change and help me lose weight. I would like to lose 75/80 pounds.

    • If you were having cheat days once and twice a week, that’s most likely the reason your cholesterol went up. If you were following a keto diet consistently, it would have gone down. The thing about a keto diet is you have to be committed to it. There are lots of great keto recipes and a variety of foods you can eat. Obviously if you lost 30 pounds in three months doing the diet in a sort of halfway fashion, if you follow it all the time you should get phenomenal results. Good luck on your journey!

    • Try Thyroid Support herbal supplements from Gaia Herbs. They have been really helping me. I also cut out all gluten.

  10. I read “The Metabolic Typing Diet” by William Walcott, the knowledge in there saved my life. I started with a low carbohydrate ketogenic approach at 25 grams carbohydrate. The book recommends starting low carb .. not necessarily ketogenic but I felt amazing on lower carb high fat. I felt so good going even lower in carbohydrate that I actually decreased my carbohydrate from 25 grams down to 10 grams and Voila !!!!!! All my life long symptoms vanished !!! I increased my carbohydrate in 5 gram increments weekly until my symptoms reappeared and then titrated down. I always knew I didn’t feel healthy but I actually didn’t know I had any health problems at all until I started eating a ketogenic low carb diet. I then went to the doctor and had blood tests and stool samples taken to see what was going on .. and was diagnosed with polycystic ovary syndrome, a relentless parasite called blastocystis hominis and a candida overgrowth in the gut. All which required a low carbohydrate diet to treat. The body’s intuition is unsurpassable.

    • Hi I was just curious to why you would move up your carbohydrates 5 grams a week if you felt great at 10? My doctor had told me that I should start a low-carb diet eating only meats and vegetables to lose weight but then he mentioned something about moving up my carbs and I couldn’t understand why you would do that? So maybe you can help me out there.

  11. Great points to consider! I find many of my clients that are younger woman were having issues with low carb intake. Especially coming off birth control and trying to regulate their cycles. I have seen incredible changes when they go from low to moderate carb intake on their energy, and fertility.

  12. I am hypothyroid and believe I also have adrenal fatigue. So I think your 75 – 150% carb recommendation sounds good to experiment with. I don’t eat grains, I love fruit, but need to moderate. I am trying to include sweet potatoes every day, and am eating squash and beets as well as leafy greens. I eat flaxseed, coconut, nuts, I think they have some carbohydrate content too?

    I really want to increase T4 and T3 levels. And heal adrenals

  13. I have been on paleo for several years now and after reading this article am really thinking I need more carbs. I usually eat a high protein breakfast for lunch 3-4 egg omelet and just meat and veggies for both lunch and dinner. I try to limit fruit. The prob is I have reactive hypoglycemia so Im worried about adding in carbs. What carbs should I avoid if I have this? I have struggled with energy and anxiety for some time now and Im wondering if this is why! Also, the paleo diet (even with lots of ghee and coconut oil) does not help my hypoglycemia at all. I have to still eat every 2 hours. Could low carb be adding into this? Ive read that if your thyroid is too low in T3 it can cause hypoglycemia….and that also too little carbs adds to this problem with the T3. Have you heard of this? Thanks!

  14. So, you’re saying that any diet above 30% carbs is a high carb diet and that a person eating such a diet will gain muscle or weight. What if they’re restricting not their carbs but their calories? Will they gain weight even so?

  15. Hi Kelsey,
    I’ve been dealing with carb issues the past few years. I was doing competitive crossfit when I decided to try a ketogenic diet which was a disaster. Ever since since trying to cut out carbs I developed insomnia and anxiety. I was following a very paleo/zone diet for years while crossfiting, and then tried to foolishly “lean out” by cutting carbs…Within 3 days I had developed severe insomnia and anxiety that have stuck with me. I did reintroduce carbs but it’s been 3 years, and I still suffer with insomnia when I do any sort of high intensity training, or don’t seem to eat enough in a day. I stopped crossfit all together, and try to keep my exercise mellow, since anything too intense will cause anxiety and insomnia that just won’t seem to go away.. Right now I will eat a oatmeal and have a sweet potato or rice at dinner, but it feels like I’ve permanetly broken my system. Is there anything I can do ?
    Any help is appreciated,

    • Hello Mandy.
      I used to suffer from almost the same (only difference is that I used to be an athlete and was working HIIT) What I did (and have been doing) is doing yoga and walking regularly, and it actually works! To be honest, I was underestimating yoga and those light exercises, but, they make one a lot of good! Do not believe in my word, you should give them a try.
      I suppose, your cortisol levels may have increased due to intense exercise routine and eating habits. The result is usually anxiety, burning muscle and fat gain, unstable mood, problems with sleeping and so on. So, I recommend you to include oatmeals (as you already do) to your diet. Plus Rhodiola (a herbal supplement) will help. You can also get more omega 3. I hope it helps. All the best

    • Sounds like you have hypoglycemia, which I also have. I believe it was the low carb diet and other factors that caused it in my case. Low carb diets can negatively impact the hormonal balance over time. I now see Dr. Diana Schwarzbein in Santa Barbara who is an endocrinologist and has a few books that discuss the importance of balancing protein and carbs. Our society went from too many carbs to too few carbs. Add overexercising to the equation and other lifestyle choices and the problem is compounded. Good luck finding the answers!

  16. I crossfit 3x’s a week and I eat what I would consider high carb. I don’t consume anything with actual sugar including honey/etc., but my carbs come from whole fruits, organic corn tortillas, some gluten free bread, and once or twice a week fries (yum!) at my local grill but bunless burger. This has worked very well for me for 2 years. I do have adrenal fatigue and have been taking a physiologic dose of cortisol (20mg daily, spread throughout the day) for the past year. I have had no problem maintaining my weight with this combination at about 16-17% bodyfat. I once tried to go low carb but felt like utter CRAP at crossfit after a few days, so went back to what feels good! I do intermittent fast 1-2 days a week for 18-24 hours (non crossfit days only) and I usually don’t eat anything before noon-2pm daily so my meals are more like 2 larger meals a day, and later evening snacks.

    • I’m pretty sure crossfit and intermittent fasting are both contraindicated for adrenal fatigue—I would focus more on rest and relaxation, and strengthening your circadian rhythms. But keep doing what makes you feel good! The main issues with fries, though, are degraded oils with trans fats and acrylamide, which can increase your health risks over the long term even if you feel fine eating them.

  17. What is a good carb amount for someone with candida problems/fungal infection susceptibility? Would this fall under the “digestive problems” category?

    • For anti-candida, Paul Jaminet advocates his standard Perfect Health Diet, which recommends 30% of total calories as carbs per day from safe starches. For someone eating 2,000 calories, that works out to 150g of carbs as safe starches. Personally, I responded very well to it.

      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 150g of carbs as “safe starches” would translate to about a pound of potatoes per day. So, for some people, they may find themselves increasing carb consumption to combat candida. I ate a banana per day (as Paul recommends some of the carbs to be fructose) and was fine.

      Basically the goal is to turn candida into a benign yeast with some glucose and fermentation from RS-rich foods and then hit it with anti-fungals, bio-film disruptors and anti-candida enzymes.

      The traditional low/no-carb diet for combating candida appears to be an over-simplistic reaction to candida’s glucose metabolism and is actually not well-supported by the scientific literature. See this comment for links to relevant studies as well as a link to a well-researched moderate-carb anti-candida/biofilm protocol.

        • I should refine that statement a bit. If you have an overgrowth of candida, you need to trim that overgrowth. It’s not really possible to fully eliminate candida—and nor would you want to, as benign candida apparently offers us some benefits as a symbiont.

          That well-researched protocol that I referred to involves enzymes that digest the excess candida. It works pretty well, actually.

          Those enzymes are advertised to diminish candida in the body fairly quickly (in 30 days or less). But I suspect that might be a bit too rapid for someone with a severe candida infection. As the candida goes away, the die-off toxins can be very taxing on the liver (as the post explains). So, it helps to go slow and help your body deal with the process using the recommendations. Some say going too fast can damage the liver, so you have to listen to your body for aches and pains along the way and use those reactions as a guide. It’s a marathon, not a sprint.

          Most people say that it takes 6 months to a year to combat candida successfully. I think the enzymes can offer rapid success, but I would go try to go slow depending on the severity of the overgrowth and keep in mind the understanding that you are modulating an ecosystem and not just killing candida.

          The goal of an acidic gut really just switches the hyphal candida off and the goal is to keep it switched off (i.e. benign) so that it doesn’t easily grow back. But, simply switching it off when the overgrowth is present doesn’t fully diminish the overgrowth.

          So, even if it’s benign, and you feel much better with an acidic gut, the remaining overgrowth will probably still present a load on your system and be waiting for the right conditions to pounce. That’s trimming back the candida with enzymatic therapy is a good thing to incorporate into a protocol.

          Sorry for the confusion.

  18. I have been doing a poll on how the carbs are counted. Paul Jaminet says not to count the leafy greens at all, Jimmy Moore says to count them all, Dave Asprey seems to go along more with the thinking of Jaminet. Several others say ‘net’ carbs are about half the carbs in veg, due to the fiber being used by the gut bacteria and turned into SCFA. Makes a BIG difference for me, as almost all my carbs are from non-starchy veg. Often wonder if I am getting enough to produce mucus. Would love to know where you weight in on how to count them.

    • Chris does not recommend counting carbs from leafy greens. You can hear his detailed explanation on this podcast.

      The goal in eating starchy carbs is to obtain exogenous glucose—so your body doesn’t have to chronically produce all of its glucose. When you obtain carbs from greens, you end up burning more glucose digesting them than you can extract from them. So, you don’t obtain net glucose from greens.

      While SCFAs do contribute to intestinal gluconeogenesis, the amount of SCFAs produced by most leafy greens tends to be scant. The predominant fibers in leafy greens tends to be cellulose and a significant quantity of the cellulose that humans consume is not metabolized by gut microbes.

      From: 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)”

      And even if you did harbor such cellulose-degrading microbes, the amount of potential SCFAs that can be generated from cellulose is still relatively paltry compared to other more fermentable fibers (such as resistant starch). Cellulose is still important, but mainly for stool bulking/transit times and the phytonutrients that come with those plants.

      • Thanks Duck – I somehow missed that Podcast.
        I think this point (what carbs are we counting) needs clarifying in the Paleo/low carb community. I eat 75 ish carb grams per day, but almost all are from leafy veg. I think I will add some berries and maybe even some sweet potato. Perhaps I’ve been too low carb now for awhile.

        • “I think this point (what carbs are we counting) needs clarifying in the Paleo/low carb community”

          Well, I wouldn’t expect clarification. The community is well-populated with people who seem to have a fear of eating carbs. They’re never going to agree. I would keep in mind that Asprey and Moore are not clinicians — they don’t see hundreds of patients. They are just guys with gut/metabolic derangements who blog/podcast about it.

          The phrase “Paleo/low carb” is really an oxymoron. I have yet to come across an indigenous culture that didn’t go out of its way to consume glycemic carbs wherever they could find them.

          • “The phrase “Paleo/low carb” is really an oxymoron. I have yet to come across an indigenous culture that didn’t go out of its way to consume glycemic carbs wherever they could find them.”

            THANK YOU for saying this!!! U have been silently wondering about this prominent point regarding indigenous diets for awhile now, with no one I felt safe asking! This makes soooo much more sense to me!

            I usually start out feeling amazing on a keto diet (like the first week) and then about week three I end up blacking out or having intense recurrent dizzy spells. (I do 3-5 30-45 minute HIIT cardiovascular sessions weekly and have a very fast-paced job).

            • I also have very low non-fasted blood sugar, even when i am getting moderate carb intake, but my doctor keeps telling me it’s unremarkable and I’m frustrated about that … any suggestions? I live in a small town so I can’t just switch GPs

  19. Well, you are very right. Everyone is different, but the problem, real problem is most people, like me, have been so wrong on health and diet for years that we don’t even know what “feeling good” is.

    I started off with Dr. Gundry’s Diet Evolution, on my Dr.s suggestion, and did very well for about 4 mod. Lost 36 lbs. was feeling pretty great, energized. While starting the Dr. Gundry’s Diet Evolution, I also went to a local nutritionist and did blood work. Many small problems, but the two that stood out was Adrenal Fatigue and very high iron in blood.

    Now, after two years of not loosing any more weight, need to loose at least another 30 lbs., and really not feeling any more energized or for that matter better, I am sadly unmotivated.

    Yes, I mildly exercise. I’m 61, 5′ 4″ and weigh 166. No energy, not sleeping (my average hourly sleep at night for over 30 yrs. is about 4). Sometimes it is easy to get to sleep to only wake up at 2pm and never get back to sleep. Sometimes it takes forever to get to sleep and then I toss/turn all night in wakeful sleep.

    I’ve tried for months with Mark’s Daily Apple routine, Robb Wolf, and Chris Kresser information. Nada.

    Frustrated, tired, unmotivated,

  20. Kelsey or Chris, just one question: I work on my feet for 8 hours a day. Does that alone justify a higher carb intake? My goal is weight-loss, but it’s hard for me to to stay asleep if my carb intake is low. I just don’t know which group I’m in here.

  21. I think when we talk about low carbohydrate diets everyone is talking about something completely different .
    For example
    Some term a low carbohydrate diet as not eating bread, rice pasta, starchy vegetables and have little idea how much carbohydrate is in other foods.
    Research states that a low carbohydrate diet is anything less than 40%E as carbohydrate So on a 2000Kcal/d this is 200gm carbohydrate . Yet you term this as a high carbohydrate diet?
    To meet your minimum nutritional daily intake of 2 servings fruit, 5 servings of vegetable , 2-3 servings of dairy products, without considering any other foods with carbohydrate in them , your diet with less than 75gm/carb would mean you could not achieve this, unless you severely restricted an enormous number of different kinds of fruit and vegetables. Certainly you couldn’t include beans, legumes and lentils.

  22. I really appreciate this series on carbs, and especially the ongoing discussion of the therapeutic uses of various diets.

    Specifically in regards to gut-healing, it would be awesome to hear further discussion of the Tough Cases – those patients who are extremely carb-intolerant, very sick, and who still – after a round of a GAPS-type, probiotic-rich experimentation, still can’t seem to find a sweet spot. In other words: how else can one target gut dysbiosis besides varying macronutrients in an otherwise Clean diet?

    Thanks again,

    • Have you tried resistant starch? Low-FODMAPs? When I could barely tolerate any plant foods at all and was having increasing problems due to eating VLC for too long, I found the Fast Tract Digestion series by Dr. Norman Robillard, and was able to introduce jasmine rice to get some glucose without feeding my SIBO. Getting enough calories and carbs this way allowed my metabolism to improve, which helped my body beat the SIBO. Over time I was able to increase the variety of starches and other low-FODMAP fruits and vegetables to help feed the good bugs and probiotics I was taking/eating.

  23. Thankyou for this information. I am a 39 year old male, I think I’m generally healthy, pretty active physically and been low carb Paleo for the last couple of months. I’m 178cm and weigh 62kg. I was lean before Paleo and now I’m even leaner but I’ve lost a couple of kgs and have noticed drops in energy levels and I think it might be lack of carbs. So as of now I’ll start getting more sweet potatoes into me and see how it goes. Cheers again.

  24. Although not paleo, Dr. Richard Bernstein who wrote “Diabetes Solution” has been treating his patient and himself with a very low carb diet to control diabetes and reverse and stop complications of diabetes for many years. He says that a person with diabetes deserves truly normal blood sugars. He recommends eating 30g carbs/day – 6 for breakfast and 12 each for lunch and dinner. He also uses medications to cover anything the diet does not cover. His dietary recommendations can easily be made into a paleo template.

    As a person with diabetes, the only way I know how many carbs I can eat and how I react to foods is to use a glucometer before and after eating. This cannot be done by just looking at symptoms or by noting how one feels.

    In you rule of thirds, where is the fat? All you mentioned was protein, tubers and veggies.

    I agree that there is no one perfect diet, but making sure blood sugars are truly normal is of utmost importance.

    • For the rule of thirds, the fats are included (or added) to meats, veggies etc. I’m just trying to keep it simple with the easy explanation. If you check out my blog post on my site about it, I mention where the fat comes from.

  25. I am pretty well convinced of having SIBO and just newly pregnant. I recentlyl tried upping starchy veggies to help with energy and the pregnancy, but that aggravated IBS symptoms. I’d rather be miserable with IBS and have a healthy baby to show for it than otherwise, but is it doing the baby more harm than good if I aggravate SIBO/IBS?
    If there’s someone you recommend I see in the Minneapolis area, that would also be helpful. Thanks!

  26. I realize most people here know this already, but for any newbies it’s worth mentioning that for those who are targeting a moderate level of carbs (150g), while *also* avoiding grains, it can be very easy to under eat carbs.

    Unlike refined grains, which are very carb-dense, most whole food carbs tend to be mostly water, making them rather carb-sparse.

    It shocks many people, but 150g of carbs is actually a pound of potatoes. It’s a bit of a paradox that a pound of potatoes a day is technically “moderate carb”, and I think it really demonstrates how many carbs people eat as refined carbs on a high-carb SAD diet.

    I personally found it to be a bit confusing when I first started trying to target a moderate level of carbs. A good resource is, where you can enter in foods/weights into the tool and instantly see how many grams of carbs each one has based on various weights or volume. After just a few days, you learn pretty quickly and can begin to eyeball it.

    Another way to ballpark carbs in a meal is to just ask WolframAlpha, like this. As you can see, a 1/4 cup of mashed potatoes only has 9.2 grams of carbohydrates. (Which means that you need to eat a lot more than that to get to 150g of carbs/day.)

    So, that’s the “easy” way to ballpark it.

    To put the amount of carbs in perspective. To get to a moderate target of 150g of carbs (for an average 2000 calorie consumption) you would need to consume:

    1.5 cups of mashed potatoes = 55g of carbs
    1 cup of cooked rice = 55g of carbs
    1 medium beet = 8g of carbs
    1 large banana = 31g of carbs
    TOTAL CARBS = 149g carbs

    So, as you can see, it’s more than most people probably realize once grains are removed from the equation. Personally, I find it a challenge to overeat whole food carbs and I usually have to make sure I’m eating enough whole food carbs in a day.

    Hope that’s helpful to those who are new to this.

    • Now this gets me wondering how resistant starch carbs would be counted. Say your banana is under-ripe, and your rice or potatoes are cooled. If those do not count the same as other regular, non-RS carbs, then would a person’s carb intake be even lower?

      • Yes, it’s impossible to metabolize/digest starch and feed your gut flora at the same time. However, the bacteria in your gut can eat resistant starch and contribute to intestinal gluconeogenesis. In other words, in a way, feeding our gut bugs can reward us with energy.

        But, I wouldn’t worry about it. One way or the other, you or your gut bugs are going to extract the energy from that sweet potato!

        Additionally, many people might be surprised to learn that the carbs in the USDA nutrition database aren’t intended to be precise. Since carbs are actually difficult and expensive to accurately measure and the weights of polysaccharides and monosaccharides do not necessarily equal their glycemic potential, most government databases just focus on measuring a general level of fiber and not the precise amount of carbs or glycemic impact.

        The international bodies call this standardized estimation the “subtraction method” or the “by difference method” and what they do is measure all the components of the food and whatever the remaining weight is is considered to be a carb. It sounds totally dumb (and in some ways it is) but this provides an acceptable estimation of fiber content, and it creates a less confusing nutrition label for the masses.

        For instance, there are scientific protocols to only measure glycemic carbs in a food, but the measurement is typically expressed in “monosaccharide equivalents” and includes free sugars plus dextrin, starch and even glycogen. But this expression can lead to a confusing nutrition label.

        For example, 100g starch expressed in monosaccharide equivalent weights 110g, and therefore it’s entirely possible to have a starchy food whose glycemic carbs weigh more than the food itself. That can be very confusing. So, most people (and most governments) prefer the dumbed-down nutrition label because of the neat and tidy measurements and the focus on fiber. The food industry prefers it this way too, and the analysis is less expensive this way.

        But, this can introduce all sorts of errors, as further discussed in this article.

        So, the international standard for measuring carbs in most government databases is to simply estimate the carbs. They are by no means intended to be precise.

        Therefore, I’d say it’s probably not worth your time worrying about the precise amount of carbs in a sweet potato or any other carb because there are too many variables to consider (gut bugs, cooking times, estimated glycemic values, species variations, etc.). The best we can do is to estimate our carb intake and the official government databases are generally an adequate ballpark.

        So, now that we can see that even the official databases are just a fudge, we can see that the point of eating isn’t to be weighing every single morsel that goes in your mouth. The idea is to get used to conceptualizing a rough daily intake of food — perhaps just weighing your carbs until you can visualize an ideal *estimate* of your target carb intake.

        Hope that helps!

        • DuckDodgers – Had to comment and say thank-you for so generously answering so many questions for people! You’re so helpful and have clarified lots of things for me too. Thanks again!

    • That is very helpful, thank you!

      It makes me realise that, while I would call my diet moderate carb because I’m not actively avoiding carbs, it is probably actually low carb. I’m really only have rice and sweet potato as carb sources and not having large quantities of those. Occasionally potatoes or quinoa or a bit of fruit.

      I have an issue where eating any significant amount of carbs for lunch causes me to be incredibly tired all afternoon. Whereas at breakfast or lunch I can tolerate it fine. I’ve just bought a blood glucose meter to try to work out if it is being caused by blood sugar swings.

      • Kelly,

        I can only tell you my experience. I used to have the same problem. It happened after going VLC and then transitioning back to whole food carbs. Eating certain carbs would put me right to sleep after lunch. It felt like I was drugged. I also bought a glucose meter and my blood glucose was fine. No spikes, no dips.

        I soon realized that only certain carbs caused the intensity of the sleepiness. Long grain rice knocked me out, but short grain rice (sushi rice) didn’t give me any problems.

        After a bit of research, I learned that different species of carbs, such as rice, have different starch structures and can feed different species of bacteria and with different quantities of fiber. For me, certain species of rice would metabolized into compounds that made me incredibly sleepy. There was no blood sugar issue.

        So, some people (in reality it’s their gut biomes) are sensitive to specific types of starch, for instance specific branching structures that only appear in certain foods.

        After a few months of figuring out which carbs to focus on, and focussing on various fibers including resistant starch, my gut biome normalized and I no longer have those afternoon issues with sleepiness.

        Of course, in your case it could be any number of issues, and Chris has talked about more than a few of them on this blog and in podcasts. But at least try experimenting with different kinds of foods to see if it’s at all related to that.

        • Thanks so much for your reply Duck, that is really good information for me. It sounds like I am having the same thing, because I was VLC a few years ago and it’s probably been happening since then. And yes, feeling drugged is exactly how I would describe it.
          Interestingly, sushi rice is definitely a bad one for me. I will experiment with various carbs as you suggest. I’ve also started on resistant starch and Prescript Assist recently. The more I read, the more it seems it all comes back to the gut microbiome. I’m hoping once I get that sorted out it will help with my fatigue issues also.
          Thanks again, it’s one more piece of the jigsaw to put in place.

    • This is where I get confused how to calculate carb consumption.

      So one sweet potato that weighs 150 grams means you have consumed 150 grams of carbs as per Kelsey’s chart? Is that right?

      Or do I need to do another calculation to determine the actual carbs in that potato?

      • A sweet potato isn’t 100% carbohydrate – there are other things in it like water, fiber, etc that add to its weight. 1 5″ long sweet potato that weighs 120 g only has 26 g of actual carbohydrate. You can look up the carbohydrate content of different foods online. Hope that helps!

          • This is what I’m talking about! People are often confused by this. I’ll bet a lot of people make this mistake. You guys should really think about doing a post on how to guestimate carb intake.

            • Duck

              How did you test your veggies–if you eat them. I know you handle some rice but how did you establish your veggie tolerances?


              • Well, I just experimented. It turned out I only really had trouble with long grain rice and the occasional ingestion of refined sugar (which I try to avoid anyhow).

                But, I have no problem eating a big heap of short grain rice as part of a meal. So, I could tell it was species-related.

                By the way, I should mention that I completely agree with Chris and Kelsey’s view on non-starchy carbs. I don’t count them towards my carb intake because non-starchy carbs tend to not be a *net* carb.

                In other words, if a vegetable like a carrot or broccoli has more fiber than sugars, it often takes more energy to digest that vegetable than you can extract from it. So, it doesn’t really give you any net energy and shouldn’t be counted as a “carb”. You eat those vegetables for the fiber and phytonutrients — not for energy.

                So, this all shows you have to eat a lot of starches to get to your carb target. The key is to just find starches you can tolerate. If you can’t tolerate any carbs, it may be a sign that the gut biome needs tending to.

          • @Chris Lines, Also keep in mind that 150g is adjusted for a 2,000 calorie diet. Many adult men require more than 2,000 calories per day, so you may infact prefer to target more than 150g of carbs.

            I’m amazed at the paradox. Many people would struggle to consume more than 150g of whole food carbs in a day if they knew what it really entailed. And I think that shows just that the volume of carb intake can be very deceiving.

      • I was interested in learning how you’re defining carbs. I typically include nuts and seeds in this category, which I didn’t see mentioned. Also, because I treat clients with prediabetes and type 2 diabetes, I don’t recommend high-sugar fruit like dates or high-starchy vegetables like plaintains or yucca, which can spike their glucose levels.

        Interested in your thoughts.

        • Christine, I believe they’re using the standard definition of carbs, which is not a category of foods, but a macronutrient found in foods (measured in grams, and not including fiber).

          While cooked ripe plantains are high-GI, green plantains and yucca are low-GI and among Chris’s recommended starches. Dates are also low-GI, but as with most dried fruits, they can be easy to overeat.

          • Actually, from other comments I see that Chris doesn’t count carbs from green leafy vegetables because they’re burned during digestion—and perhaps even all non-starchy vegetables, although that seems a bit simplistic to me considering things like cooked beets and carrots.

    • Many thanks for this post, DuckDodgers! That clears up a lot of confusion about the weight of the food vs. carb content.

  27. I did Mark Hyman’s beta Detox a couple of years ago and found that the best marker for me if I am eating too many carbs is my fasting blood sugar. My daughter is type 1 so we have numerous glucometers around the house. I like to be in the sweet spot (for me) of 82 – 87. I know it could be lower, but I’m 51 years old and that’s where I feel best. So, that means low fruit (berries mostly), lots of veggies, some dark chocolate, protein, and once or twice a week I can indulge in gluten free grains, or even a pale almond muffin (actually do well with those) and a big sweaty workout if I do have carbs and then I don’t go high. Eating tubers, rice, etc..runs my fasting blood sugar in the low 90’s.

  28. Does the chart above include carbs from non-starchy veggies? I recall it the book it only said to count starchy veggies toward your carb macros.

  29. I started a low carbohydrate diet when I was having some balance issues. When those cleared up, the strict Paleo diet made me jittery as if I was on caffeine. As I started adding carbohydrates back, I became aware that with the ingestion of gluten products, my neurological symptoms came back. So what I did was eliminate gluten grains, added legumes (mostly lentils), increased animal-based fat while decreasing my consumption of muscle meats. I get much better results with modifying carbohydrate intake by tweaking the amount of fruits. Vegetables and tubers have no effect on total carbohydrate load.

  30. Hi!
    I’ve been happily paleo for the past 18 months, and recently was wondering if dips in energy could be due to a deficit in carbs. But I’ve never calculated my carb intake and don’t really know where to start. I have no idea if my current diet is very low, low, or moderate carb.
    What tools would you recommend for calculating my macronutrient intake?

  31. Very helpful! My latest test results had good Beta cell function markers but some of the insulin markers were “in the yellow”. the hydroxybutyrate was red (6.8). Glycemic rates were good. I am a 49 year old female from Europe (living in the US since 2000) and have been on the Primal diet since 2012. My HDL and tryclycerides are in good hsape, but my APO B and CRP are in the red. My (Paleo) doc told me to skip grains completely (I am still eating white rice and quinoa every now and then). This time she told me to lower my carb intake even more. But looking at my intake (between 80-180) I really don’t know how much more I should cut out! I now wonder if there’s a relationship between these insulin resistance rates and my CRP?

  32. Great article Kelsey – thanks.

    In Personal Paleo Code, Chris says he only counts starchy plants, fruit, dairy and sweeteners when measuring carbs.

    He also suggests doing the first 2 weeks of the 30 day reset at one level of carbs, then altering for the second to test difference.

    Being lean, moderately active but feeling generally fatigued, I decided to start my reset at a high carb level.

    Do I just literally just weigh the grams of starchy plants & fruit (no dairy for reset!) I’m eating each day to see what level I’m consuming?

    At the moment I’m regularly between 300-400 grams a day – no problem! I think I would probably faint if I ever tried under 100 grams! As you say, everyone is different.


    • No, you can’t just weigh the starchy foods you’re eating to know how many carbohydrates it contains. For example, a sweet potato is not PURE carbohydrate. It has water, fiber, etc that make up some of its weight. A 120 g sweet potato only has 26 g of actual carbohydrate in it.

  33. I have elevated sdLDL. Reports are that low (not very low) carb diets with saturated fats like coconut oil or animal fats will help. But what carbs to reduce? Wheat? all grains? Does it matter?

    • The most important carbs to reduce are probably high-glycemic ones like refined sugars and flours. Most people in these parts recommend avoiding all grains besides white rice (especially wheat), but the importance of this depends on your individual sensitivity. The approach Chris advocates (and I agree with) is to do a strict paleo “reset” for a month and then see how you tolerate other foods from there, if you wish to.

  34. I am 69 yrs old–from India –in USA 43 years –last two years mostly vegetarian –Type 2 diabetes –just found out about
    LCHF diet and working on it. Same time need to gain
    weight — hard to find high calorie with good fat and protein–without meat.

  35. I am a runner, training 6 days a week and averaging between 280-360 Km per month, depending on the training phase.
    I have never had problems with carbohydrates, but decided to switch to a LC regimen, to see if this could improve my performance. This did not happen, however knowing that ROS generation is much lower on LC and having seen that my performance has not worsened either on LC, I have decided to stay LC (actually LC-vegetiarian).
    At first my mistake was to go VLC (50-100g/day), actually quite ketogenic. That was taxing on my body and training, almost unbearable. I guessed I should have changed training strategy to keep on that diet (more of a polirised training). So I decided to up my carb intake a bit, towards 200g/day on average and that is my sweet spot. At that level I can keep my training regimen unmodified and actually enjoy my workouts. There are day where I stay around 150g, other slightly below 100g, others slightly above 250g, it depends on the workout that awaits me the day after. But in average 200g is the minimum intake of carbohydrates I need to feel well. And this is exactly what your table above lists for persons like me.

  36. I was VLC + low fat for about 2 years (I was 16/17 didnt knew anything about paleo and just wanted to lose weight quickly. I lost 14kg in 2 months, went from being a chubby girl to skinny). the problem is I kept eating that way and ended up looking very unhealthy. I was underweight, tired, dizzy and hypoglycemic all the time so just stopped and started eating what I ate prior to begin dieting. which means the SAD. Of course that going through one extreme to the other (I also have hashimoto’s since I was 14) I developed severe Reactive hypoglycemia (which is different than hypoglycemia) my blood sugar would drop to 60. I went to see a doctor she told me to eat carbs every 2h. The outcome – I almost died. ended up in the ER several times my BS would be 35, 40 every hour. I was desperate and about to go crazy. No doctor knew how to help me !! It wasnt until I read about the paleo diet that I got informed. Now I dont’ have hypoglycemia anymore and I am trying to transition to 3 meals a day but I’m starting to
    see a very strange pattern in my numbers. My fasting blood sugar is always 83-85 but if I eat breakfast at 8am only eat lunch at 1h30 my BS will be 130 prior to lunch. the same goes in the afternoon. if I eat lunch at 1h30 and measure my BS at 8pm it will be around 130. I suspect maybe cortisol dysregulation from what ive been reading ? or maybe Its because of hashimotos ? should I be worried since I had a past of severe hypoglycemia ? please help me…

  37. This topic is so relevant to me. I have digestive problems and blood sugar problems, but I’m also an athlete (long distance running). I have been following what is a relatively low carb diet for someone who is active (about 90 g/day, often less) which seems to be *alright* but I feel I could do better. For me I think it’s the type of carbs that I eat that matter. For blood sugar issues I’ve been avoiding grains (1 rice cake and I feel “off”), and I’m also avoiding FODMAPs, legumes, excess fiber and resistant starch to treat acid reflux – I don’t eat strict paleo, because then I would have so few food choices. This seems to keep my symptoms relatively under control, however I do still have some digestive trouble from time to time. Any tips for someone who needs to be careful with carbs – and the specific *types* of carbs – due to digestion and blood sugar, while also needing to maximize carb intake for running? Already tried keto diet which was great for blood sugar, awful for reflux, so I’m sticking to carbs for fuel.

  38. Healthy fit 65 year old woman on VLC for 13 years, feeling great, fasting blood sugar gradually creeping up and this year having an abnormally elevated A1c at 6.1. Been adding in starchy vegetables, rice, quinoa, sweet potatoes (in moderation at every meal) for about two months. Fasting blood sugar now less than 100 every morning for about two weeks, but still completely intolerant of any fruits (even a few berries or melon balls) – 1 hour post prandial BG always greater than 140 and 2 hours greater than 120. Take a brisk two mile walk every day. Is there hope? Should I just keep doing what I’m doing with the occasional fruit challenge as a test? Any suggestion would be greatly appreciated. I can’t be the only one in this boat.

    • I am 58, thin, and have low insulin, but HgA1c of 5.8-5.9 at least for the past year, even on a high fat, low carb diet. My current theory is blood glucose dysregulation due to high ferritin (over 200 ng/mL). (I do not have HH.) I have not been able to convince my doctor that the ferritin is a problem (“It’s not that high”).
      So my suggestion is have your ferritin checked, along with Transferrin Saturation %, Iron, UIBC, and TIBC. Women can store iron starting 10-15 years post-menopause, and the iron can cause all kinds of problems. Phlebotomy results in improved blood glucose control, shown by many studies. I want to give blood, but I weigh under 110 lbs., so need therapeutic phlebotomy.
      I would be very interested if you could post your follow-up, if you try this and have any results.
      Check out Chris Kresser’s presentation “Iron Behaving Badly”.

  39. Great article! Wish I’d seen it a couple of years ago. My process? Over 7 years ago I had some health challenges to heal so I went annoyingly strict Paleo and pretty low carb for about 1 year and resolved most of them. Then my sleep, moods and workouts began to suffer. Being stubborn it took me some time/experimenting to determine what worked best for me. At present I feel great, sleep well and can power through my workouts. For me that means eating about 1 g protein per bodyweight, I keep the carbs anywhere from 100-175 per day coming from vegetables, 1-2 fruits and starchy carbs like white rice, yucca and potatoes on training days. I lift heavy weights and sprint 4 times a week. Eat around 2400 cals a day to maintain 122#. Happy and healthy at age 54

    • The relationship between sleep cycles and low carbohydrate intake has certainly been studied.

      Sleep quality of adolescents worsens with decreased carb intake:

      “…decreased sleep duration was associated with increased consumption of calories from fats and decreased consumption of calories from carbohydrates.” [1]

      People fall asleep faster with carbs 4 hours before bed:

      “We showed that a carbohydrate-based high-GI meal resulted in a significant shortening of [sleep onset latency] SOL in healthy sleepers compared with a low-GI meal and was most effective when consumed 4 h before bedtime” [2]

      Interestingly, a VLC/ketogenic diet (obviously different from just a low carb diet) seems to significantly increase the deep Slow Wave Sleep (SWS) but significantly decreases the dreaming rapid-eye movement (REM) sleep. Perhaps this may help explain part of why ketogenic diets can be therapeutic for some neurological issues. (It might also help explain why increased resistant starch intake is associated with significantly improved dream recall).

      For me, my sleep quality crumbled when I was VLC. I developed insomnia and I actually developed acute anxiety, despite having zero history of either prior to going VLC. It was awful. What I soon realized is that since gut bugs produce the same neurochemicals that our brain needs to function normally—such as GABA, serotonin, norepinephrine, dopamine, acetylcholine and melatonin—reducing my fermentable carbohydrate intake caused a significant reduction in those neurochemicals from being produced by the gut bugs.

      Sure enough, increasing carb and fermentable fiber intake—while simultaneously focussing on replenishing gut buts with fermentable foods and fibers (particularly resistant starch)—completely reversed the insomnia and anxiety issues I had developed from VLC.

      You can buy all those neurochemicals from a pharmacy, and few people know that the corporations will actually use bacteria to synthesize those same neurochemicals. Or you can just get your gut bugs synthesize those neurochemicals for you just by eating the right kinds of fermentable fibers and making sure you have the right gut bugs in place.

  40. Great article, I’ve enjoyed the carb thread over the last couple of weeks and have been introducing back in more carbs and am feeling better. I have stage 3 adrenal fatigue and also SIBO and a parasite (blasto) – Im currently undergoing sublingual hormone therapy as well as a parasite cleanse. What would you say is the priority here? I feel much better eating more carbs so Im guessing thats my answer, but wanted to hear your thoughts on whether I should keep it lower while I clear the SIBO.


  41. Hi Kelsey,

    Thank you very much for your post.

    there is one think about what you mention that puzzles me and I´d like to get your advice.

    You suggest a fixed amount of Carbs in your table (e.g. 100 – 200 g for a man in moderate carb intake). I would like to know why don’t you use a g Carb/ Kg of mass instead or as a % of calories.

    It seems to me that using a fixed amount of carbs ignores very much the differences between individuals.

    Thank you in advance for your answer

    • Actually, I recommend a percentage of calories as carbs in the chart. The examples with specific gram recommendations are based on a 2,000 and 2,600 kcal diet. So if you’re eating a different amount of calories than that, you’ll end up with a different gram amount.

  42. The advice to measure your BG levels is good, irrespective of what diet recommendations you’re following.

    However, it might be helpful to introduce the following caveat that is especially relevant to metabolically deranged individuals:
    insulin levels & patterns may increase & change, respectively, to handle increased dietary levels of absorbable glucose.

    Figuring out whether this is happening when substantially increasing absorbable dietary carbohydrates would be fundamental to correctly managing metabolic syndrome.

    Solely relying on blood sugar is better than doing nothing, but still gives a very incomplete picture if insulin is ignored, unfortunately.

  43. I was marginally hypoglycemic most of my life and have suffered bouts of eczema as well. On adopting the Paleo diet my weight came down and for the first summer is a very long time the eczema has not been a problem.

    I’m familiar with traditional Asian medicine. An ancient admonishment is to “avoid grain.” Not to stop but stay away from as much as possible. It also says to avoid eating animal protein together with carbs as they require opposite pH based enzymes to digest causing a hamburger to pass through the stomach basically undigested resulting in putrefaction in the gut. How would you respond to this notion?

  44. I’m breastfeeding a 4 month old and dealing with Candida. The Candida diet my naturopath recommended is low carb (20-60 grams) but I’m concerned about that affecting my bf baby. At the same time, the Candida reignited my leaky gut/food intolerances which are affecting baby via b.milk so the Candida has to be dealt with. Would you suggest a gentle tapering down of carbs and how low to go?

  45. I have really been struggling of late with this. I have been ketogenic since Feb. (paleo before that) At first I felt amazing, I think from the high fat. With about 40% body fat, and about 40 lbs to lose, I only have lost 10 lbs and it has been painfully slow. A couple of months ago I found the value in eating enough protein, which I think most VLC diets don’t eat enough of and thought I was golden.

    I come from an adrenal fatigue background, but also Insulin resistance. I have been super dizzy lately (and also found out I was taking too much potassium and had low pulse, heart flutters and fatigue) Dr. took me off of it, pulse has bounced back, but fatigue and dizziness remains. My lipids have greatly improved, but I am afraid to increase carbs as I LOVE the lack of cravings, hunger and balanced blood sugar. I could fast for hours and hours without any effect, my blood sugar does not spike and remains level all day, so I suspect I have good blood sugar control on keto??

    I have yet to have someone explain clearly how keto makes adrenals worse?? I have listened to podcasts and read, people say it does, but now how and why? If my blood sugar is level all day is being low carb really hurting my adrenals?

    If I add carbs back in, which I have done this week, I retain water and am bloaty. Like a commenter said above, how on earth will I lose weight if add carbs?? Phinney and Volek tell you to slowly increase your carbs until you stop losing weight, what if you are not losing in the first place?

    Is there a viable option for consistently losing weight?

    Sorry for all the questions, but I feel like I am getting nowhere fast and feeling worse and worse. Desperate for answers.

    • Michelle

      From what I have experienced… Tue next hunger food thought part of keto was great…what happened though is I went longer and longer between meals and my cortisol levels started to make up for the hunger I was not responding to after eating huge pats of butter four hours previous. So after vlc I did lose weight but messed up my cortisol rythem…and not w I’m struggling w weight my adrenals crashed from having too much to do in my body.

      Not sure if that is relevant to you.

      • Thank you for sharing that, it is very relevant to me! My recent saliva test revealed that my rhythm is normal, thank God, but very LOW, like almost off the charts. I had begun lots of IF (I love how it feels) but I suspected it was demanding my already weakened body to do too much so I forced myself back to three meals. Hoping this helps. Thanks for sharing this and confirming what I was thinking. Bless you.

    • Michelle How much protein are you eating? If you have too much this converts to glucose and then stored as fat. You need to balance the PFCs. I eat around 65g protein per day

      • Hi Terri, I have been researching and researching and believe I have a full understanding, finally, of the what really happens and how much protein we need. I did the whole LCHF (what they called moderate protein, was actually way too low) I now believe I am an optimal level for my lbm, at around 88. Steve Phinney himself confirmed this is the minimum amount for me, going over is actually perfectly fine. I was a staunch proponent of lower protein, my kids could all tell you exactly what gluconeogenesis is! LOL

        • I agree. I have to eat 80-90g protein to feel good and not be hungry. I don’t feel well over 65% fat either so I really need the extra protein for the calories if nothing else. I can stay in ketosis with these amounts as long as my carbs are not much more than 20-25g net.

  46. I simply want to lose weight like about 60-70% of the population. As far as I am aware have no other health issues. I have been following a LCHF regime for a couple of weeks based on keto-calculators. I have around 32g carbs, 70 protein and 125g fat. Before then I followed a primal lifestyle for 6 months with no weight loss what so ever, since strictly following LCHF I have lost about 1.8kg (3 pounds). Are the carbs too low according to your chart? I feel if I ate 50g I would never lose weight? Thanks for your help

    • Weight loss is one of the applications of a VLC diet, so if you’re continuing to lose weight and aren’t experiencing side effects related to the low carbohydrate intake, I don’t see a problem with continuing. I imagine Kelsey would agree.

      • Exactly,

        There was a news story last week that obesity levels in the US have hit an all time high. Approximately 7 out of 10 Americans are overweight. Over 100 million people have diabetes or prediabetes.

        Your chart is terrific as far as it goes. It should be noted that the “high” carb diet recommendation threshold on your chart of 200 grams is about two thirds the number of carbs the American Diabetes Association and the USDA recommends and calls “moderate”! So by comparison, your “high” carb threshold is actually a low carb recommendation by ADA and USDA standards.

        The ADA recommends 45% of calories for diabetics should be carbohydrates. For me that translates to about 300 carbs a day which if I actually followed, would guarantee I would be overweight and diabetic which I no longer am on a low carb Paleo diet.

        Here is a link to the ADA calculator that shows what they recommend for diabetics based on age and activity levels. In my opinion their recommendations are insane… the modern equivalent to the old practice of blood letting.

        The best advise I ever received was to buy a blood glucose meter and regularly test myself. You don’t have to be diabetic to do this. Walmart has a meter and 50 test strips that you can buy for about $25. It’s the best investment I ever made to see how many carbs were safe for me to eat.

        Two years ago, I went on a very low carbohydrate Paleo diet. My blood sugar levels returned to normal within a week which is about the same result most diabetic bariatric surgery patients see when they leave the hospital.

        Staying on a low carb Paleo diet, I lost 100 pounds and when I started lifting weights and running, I found I could eat more carbs and still maintain my new lower weight and normal blood sugar levels. Today I try to eat around 100 carbs or less. I rarely go over 150 grams but I don’t think I would be able to eat this much if I hadn’t lost a lot of weight first and become very fit..

        I’ve found testing with my meter, that I can eat a high carbohydrate meal if I immediately follow it with lifting heavy weights or going for a long vigorous bike ride.

        In fact, I discovered my blood sugar levels are usually lower after intense exercise and a high carb meal than after a moderate carb meal with no exercise following it.

        The New York times ran a story last week on a NIH funded study that stated:

        “People who avoid carbohydrates and eat more fat, even saturated fat, lose more body fat and have fewer cardiovascular risks than people who follow the low-fat diet that health authorities have favored for decades, a major new study shows.”

        Works for me.

      • CK, can you point out any well designed trials that show low carb results in weight loss when protein and calories are controlled? People switch to vlc for weight loss, but results are wrongheadedly attributed to carbs.

        Radical approaches such as vlc have a very poor long term track record for weight loss. I know you prefer a balanced approach, but a comment like “Weight loss is one of the applications of a VLC diet, so if you’re continuing to lose weight and aren’t experiencing side effects related to the low carbohydrate intake, I don’t see a problem with continuing” perpetuates the low carb myth.

        FTR, I don’t disagree with your message or recommendation here, just the takeaway that most folks will have – namely less carbs nets weight loss. That is a myth. Those looking to learn more can google Alan Aragon who has brilliantly covered this many times.

        • Tim,

          At the risk of stating something that seems so obvious, loosing weight and keeping it off requires a permanent lifestyle change and refraining from doing those things that made you overweight in the first place.

          Any diet that results in eating fewer calories than the body uses will result in weight loss so there is more than one route to the promised land.

          The real question is since there are many paths to weight loss but 95% of people fail to keep their weight permanently off, which restricted lifestyle is easiest to maintain?

          Here there is quite a bit of research that a diet higher in fat and lower in carbs is more satiating than a high carb, low fat diet.

          Since there has been an explosion in obesity and diabetes rates following the high carb, low fat strategy promoted for years by health professionals, it is understandable that people who have had personal success following an opposite strategy will be quite passionate about it.

          For me, as someone who was an obese type 2 diabetic, I can testify I was addicted to sugar, grains and highly processed foods containing salt, sugar and fat. My addiction is not that different from an alcoholic’s.

          I’ve known some alcoholics that can still have an occasional drink without going off the wagon but for most alcoholics, total restriction works best.

          Here is where carb restriction and the definition of carbs comes in because there is a language problem in differentiating between good and bad carbs.

          For me, I don’t have a choice in eating highly refined carbs because sugar, refined grains and highly processed carbohydrate rich foods trigger sever food cravings and historically raised by blood sugar levels to unacceptable levels.

          I am not strong enough to eat manufactured processed carbs in moderation. I’ve never understood people who can leave a bread basket untouched along with half the food on their plate and then have a one fork taste of piece of pie. I know these people exist but if I was one of them I would never have become an overweight diabetic. I think most of America is more like me or 7 out of 10 of us wouldn’t be overweight.

          For me, a Paleo diet that eliminates sugar and highly processed foods was easier than trying to eat these foods in moderation. For me, total restriction of highly processed manufactured high carbohydrate foods is the only approach that ever worked long term.

          This is not to say I have eliminated all carbs. I am not addicted to fruit, green beans, peas, sweet potatoes, squash, corn and plantains. I can eat these foods in moderation and they do not effect my blood sugar now that I have lost 100 pounds and become fit.

          I wish I could say the same for white rice and mashed potatoes but that’s just me. Other people may have a different experience.

          There should be a different word for whole, complex carbs. Some people have tried with “safe starches” and “low glysemic” foods. Not all carbs are equal and there is evidence, as Chris’s posts report that some whole food, unprocessed carbs even deliver health benefits for people who can tolerate them.

    • The 50 grams of carbs was based on a 2,000 calorie diet. The same ratio of carbs on a 1,500 calorie diet is about 38 grams. I’m doing a pretty similar formula as you are: 30 carbs, 46 protein, 133 fat. It varies a bit every day, but that’s what I shoot for. Good luck!

  47. Thank You!!
    I’ve had CFS for about 12 years(Probably due to diagnosed adrenal fatigue),
    I also have type one diabetes, thyroid issues, AND SIBO!!!!
    What would you say is the priority?
    I’ve always thought it was the diabetes and my adrenal specialist agrees, when I add too many carbs, my BG tends to spike, And often the insulin used to mitigate it can result in an insulin reaction which I know is not good for my adrenals. The thyroid issues seem to have developed over the last year. I tried a little NDT, But felt worse on it. Doctors and I agreed that I need to work on my adrenals, But most adrenal supplements also tend to produce high blood sugar.
    I live in Boston but it seems so hard to find a practitioner that can deal with the complexity. Even though I have good insurance. Help!!!!

    • Suzanne – there are several doctors at Visions Healthcare in Dedham that practice functional medicine. They might be able to help you.

        • I see Dr. Chen. It’s been a long road, but I am getting better. There’s been a lot of supplements. I added acupunture which helps with stress immensly. If you are in the needham area, New England School of acupuncture has discounted rates and the student are great – otherwise, look for community acupuncture (I go to metrowest wholehealth in Medway – they are moving to milford) for super cheap rates. FWIW, I have adrenal fatigue, and as a result, thyroid and other hormonal issues, as well as positive for 1 copy of mthfr. My most helpful supplements are vit. d, massive amounts of various magnesium (cholride & malate pills, magnesium oil), vitamin c, folate, and a emeral labs prenatal (slightly cheaper than phyto-multi, and the goal is to be well enough to be TTC)…It takes time, and a MAJOR slow down of life.

    • Hi, Suzanne.

      Herbalist, and also have adrenal fatigue and other overarching health problems.

      For the adrenals….

      Have you tried adrenal cortex extract, or better yet — nettle seed?

      Nettle seed (with nutritional “calyx” — if you don’t know how to gather it, here’s a post with links as to where to buy them, dried. Also gives you information as to how to gather it, but be careful as to where you gather it from.) seems to help and not induce dependence — you need less over time as you go.

      As with adrenal cortex extract, you shouldn’t use it to tire yourself out more by going “more into debt” with the energy it gives you, but ACE was making me feel more dependent.

      Nettle seed seems to be giving me my energy back.

      Careful not to take too much. 🙂

      Good luck.


      Oh, also, you may want to look into adequate levels of magnesium and boron — from what I understand, chronic stress will deplete magnesium, and it’s been a crucial part of my healing.

      (Although I have a particular health problem that also prevents retention of magnesium, so that may be why it’s been so crucial to get that supplementation right.)

      Epsom salt soaks/baths help a lot with magnesium and sulfate levels, too.

  48. I can completely resonate with Michelle. I have naturally become very low carb in a bid to lose fat, but my health and vitality has steadily deteriorated and my weight is at an all time high. Unfortunately when I up the carb I then seem to get blood sugar swings, I actually suspect some insulin resistance but haven’t gone as far as confirming this yet.

    Am I right in thinking that someone who is metabolically inflexible may benefit more from low carb? or do we need to prioritise the areas that need more carb, such as hypothyroid/adrenal fatigue etc

    Great article but still so confused with my own body!!

    • Hi,
      I do a VLC diet for a major health problem. Going very low carb didn’t work for me until I went very high fat. If you’re going low carb enough to approach ketosis, you’re going to be exhausted and starving until you get your ketones up enough to provide your cells with an energy source other than glucose, and that means eating at least 65% of your calories as fat. I also find that eating more salt than usual often takes care of fatigue problems. The silver lining for me has been major and effortless weight loss. I lost a modest amount in the 18 months I ate regular-carb paleo, but the speed and ease of weight loss for me (a middle age woman with long-standing weight problems) with ketosis has been surprising. Not the reason I eat VLC, but I’m not complaining.

    • Great article!! I have found that looking at the “makeup” of the carbs is really important when trying to overcome specific conditions. Taking into consideration what makes up the grams of carbs such as sugar, fiber, protein can make all the difference when trying to reach your nutrition goals. For example, someone with an autoimmune conditions will have more adrenal issues, weight imbalances related to inflammation or thyroid, imbalanced blood sugars and a leaky gut which may mean more issues tolerating carbs with the protein gluten or sugars such as fructose or even the protein and sugars in dairy. It gets down to how our body sees and reacts to these protein/sugar molecules. I have noticed a lot of the clients I work with have secondary issues tolerating foods that break down into fructose. Those commenting on autoimmune conditions involving adrenal, thyroid, and imbalanced blood sugars, are you truly 100% gluten and dairy free? If so, how long and are you staying away from the processed gluten free options? All thoughts to consider when healing the gut which is 70% of our immune system.

  49. Do you have a recommendation on how many carbs to start with while breastfeeding my 13 month old AND trying to lose weight? I also just recently started exercising. My body just doesn’t seem to want to let go of my baby weight. Was mostly Paleo before and during pregnancy, gained weight after baby was born.

    • I think the simple answer here is you can’t expect to breastfeed AND lose weight/fat. The body’s main priority is feeding that child and it will want to keep a little more fat on us if needed so that if for some reason food is scarce, we can still feed our babies. I hear ya though. I’m currently breastfeeding as well and would love to shed 5-10lbs, but my body does not care about that right now. I’m fine with that and I’ll deal with fully getting my body back when I’m done breastfeeding. I think our hormone profile while breastfeeding will also challenge us when it comes to fat loss.

      • I found with breastfeeding the weight just fell off of me – over 4 stone. In fact I lost too much weight and found sitting down uncomfortable. In the end I was eating chocolate bars to try & stop my weight from falling even further. I should add that at no point was I trying to lose weight it just naturally fell away!

      • I lost 20 lbs the moment I stopped breast feeding. I heard it was evolutionarily stubborn brown fat. I don’t know how true that is, though. Despite the rapid weight loss, It wasn’t all fun and games; I concurrently broke out in male-pattern acne that, 6 years later, has persisted.

          • I would think that it depends on where your fat stores are. For myself I like to keep a lot junk in my trunk so to speak which is sex specific fat that women store for the purpose of gestation and breastfeeding. Your hormones during pregnancy and lactation actually encourage your body to use those fat stores if there is a need for the extra energy. For myself I found that I didn’t loose much weight breastfeeding until my babies were around 1 year old and then it basically fell off. I think because their calorie requirement increased with there size and activity level. Unfortunately for me all the “junk” I lost found its way back and I have no plans for any more babies to help me burn it up.

  50. This is so timely! What would you suggest for someone who has thyroid, gut, and adrenal and needs to lose weight (10 lbs that came on due to adrenal issues from VLC for two years)? I tried upping my carbs ( 5-10 g every few weeks) but just end up even more bloated…

    Thank you!

    • JM, I could have almost written your post! I did VLC for a few years and my blood sugar was great. Then my adrenals crashed in 2012, my gut started having really major problems, and I also started having thyroid problems converting hormones. I’m now on T3 and trying to figure out the diet component. RS seems to be helping my gut issues, but does little for blood sugars.

      If I go even moderately low carb any more, I gain weight like crazy – my body just won’t take it (is this thyroid, adrenals, insulin resistance, or an evil trifecta?). My adrenals are clearly unhappy with low carb.

      At moderate carb levels I feel better and my weight gain is much slower, but my blood sugars start to drift up (into the space between normal and pre-diabetes). I am not sure how to find the sweet spot for adrenals, thyroid, and blood sugar.

      I need to lose about 15#, but anything I do that causes my body stress results in weight gain. It’s incredibly frustrating.

      • Hi,
        I recently did a juice diet to help me with the Step 1 and to transition to a healthier diet and I lost 13lbs. I only gained 4lbs the first two weeks but then I gained 7 more pounds. Every time I lose some weight I gain it all back and I do not know what I’m doing wrong I read Chris Kresser’s articles and try to do what he advices to do. I just started to lower my carb intake and I gained 2lbs this week.

        (I also have gut issues, ulcerative colitis and I tested my thyroid and my TSH, T4, and T3 uptake came back normal)


  51. Thanks for the excellent article. This is exactly why I recommend this website to anyone who asks. I have benefited greatly from all the info posted on this website and have worked long and hard to resolve my digestive issues. I have reintroduced most of the foods I like again, but the one I continue to have difficulty with is legumes. I really like them and want to eat them. I no longer have the digestive problems, brain fog and itching skin I used to with them, but I find the day after I eat them I feel very sluggish and tired. I am very curious as to what is still going on and why this starchy food and no others is causing this continuing problem. Any ideas or referrals to other sources of information? Thanks in advance!

    • Thanks for reading! It’s likely that you’re just sensitive to the legumes themselves, and it’s not necessarily the starch that’s causing the problem. Probably not the answer you were hoping to hear, but it’s the first thing that comes to mind!

    • Tammy, I used to have problems with legumes as well – have you tried soaking them for a fairly long time (I soak them up to 20 hours) and cooking them in a pressure cooker? This has made a big difference for me.

      • Yep. soak the legumes. This is a good idea for everyone as it neutralizes the phytic acid and makes the B vitamins more bioavailable. All native cultures soaked legumes for a reason.

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