Long Term Very Low Carb and Ketogenic Diets = Bad News

Via Spanish Caravan, a frequent commenter with let’s just say a “medical background.”


Physiological Insulin Resistatnce (PIR) results from glucose deficiency the same way mucin deficiency induces dry eyes, nostrils, colon and anemia like symptoms. They’re both ways of preserving glucose for your brain.

When you VLC, your muscles become insulin resistant to preserve your glucose for the brain. So while your muscles are running on fatty acids, they become insulin resistant. This leaves glucose for your brain but the net result is your BG going up as you’re “physiologically” insulin resistant. There doesn’t really seem to a problem with this state, as there is with mucin deficiency; it’s not known to induce diabetes or make prediabetics diabetic. At least not according to those who advocate VLCing. I have a feeling however, that this is a disease-prone state.

Dietary carbohydrates and insulin action in humans

The effects of low carbohydrate diets on insulin sensitivity depend on what is used to replace the dietary carbohydrate, and the nature of the subjects studied. Dietary carbohydrates may affect insulin action, at least in part, via alterations in plasma free fatty acids. In normal subjects a high-carbohydrate/low-GI breakfast meal reduced free fatty acids by reducing the undershoot of plasma glucose, whereas low-carbohydrate breakfasts increased postprandial free fatty acids.

Why is it disease-prone? Because high serum free fatty acids are implicated in various disease states, especially immune related (and also diabetes in some cases). High serum FFA and very low trigs that we see among those who VLC are associated with nascent autoimmunity, especially rheumatic autoimmunity.

See: Low fasting serum triglyceride level as a precocious marker of autoimmune disorders.

We’re talking about triglycerides as low as 10-20 in some of these guys who are in long-term ketosis; you can only attain those levels in long-term ketosis or in starvation. And starvation is ipso facto ketogenic, a point which most people miss. That’s why the immune related problems that people who undergo starvation apply directly to those who’re in long-term ketosis.

Why do you think antibody-positive hypothyroidism is rampant in those who VLC? I used to think these people were hypothyroid to begin with but began VLCing to relieve their symptoms. The opposite is happening: healthy people are developing hypothyroidism (either euthyroid or later Hashimoto’s) upon going on ketosis or undertaking autoimmune protocols. Why? That’s because antithyroid antibodies like TG and TPO are markers for abnormal T-lymphocyte function. T-lymphocyte dysfunction, as I’ve mentioned elsewhere, can be induced in long-term VLCing through either thymus atrophy or starvation-like immunodeficiency. There is a correlation of something like 70% between thyroid antibodies and rheumatic autoimmunity; that’s why most people develop RA or other diseases after contracting Hashimoto’s or vice versa.

Jaminet made a connection between mucin and stomach cancer; he should have made a larger connection between mucin, secretory igA, which is immunoglobulin A found as secretions in tears, saliva, and secretions from the gastrointestinal tract and other epithelium layers. IgA plays an important immune function and could be behind many of the immune problems being encountered by those VLC, along with obviously gut dysbiosis which eviscerates immune-aiding microbes:

Secretory IgA’s complex roles in immunity and mucosal homeostasis in the gut

Secretory IgA (SIgA) serves as the first line of defense in protecting the intestinal epithelium from enteric toxins and pathogenic microorganisms. Through a process known as immune exclusion, SIgA promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking their access to epithelial receptors, entrapping them in mucus, and facilitating their removal by peristaltic and mucociliary activities. In addition, SIgA functions in mucosal immunity and intestinal homeostasis through mechanisms that have only recently been revealed. In just the past several years, SIgA has been identified as having the capacity to directly quench bacterial virulence factors, influence composition of the intestinal microbiota by Fab-dependent and Fab-independent mechanisms, promote retro-transport of antigens across the intestinal epithelium to dendritic cell subsets in gut-associated lymphoid tissue, and, finally, to downregulate proinflammatory responses normally associated with the uptake of highly pathogenic bacteria and potentially allergenic antigens. This review summarizes the intrinsic biological activities now associated with SIgA and their relationships with immunity and intestinal homeostasis.

We keep triangulating this thing: long-term ketosis and VLCing => glucose deficiency symptoms like dry eyes, constipation, anemia symptoms, PIR + immunodeficient symptoms like unexplained food allergies, allergic rhinitis, sinusitis, respiratory infections, runny nose ==> disease state for T lymphocyte dysfunction and low immunoglobulins ==> pathogenesis of immunodeficiency + autoimmunity ==> then, and this is the reason why it’s hard to connect the dots, years down the road, clinical immunodeficiency and autoimmunity. Some people never get diagnosed because these are crypto disease states that are normally referred to specialists only when symptoms become severe. You’ll never suspect you have selectively immunodeficiency; your only symptom might be a mildly runny nose, especially if you supplement with Vit D.


Hopefully the notion that maintaining very low levels of carbohydrate and persisting in a state of ketosis long term will soon be a thing of the past.

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More


  1. Edward Hutchinson on February 9, 2014 at 14:39

    However we have to remember that those who are using resistant starch may be benefiting from intestinal gluconeogenesis.
    Nutrition: Short-chain fatty acids regulate intestinal gluconeogenesis.

    Microbiota-Generated Metabolites Promote Metabolic Benefits via Gut-Brain Neural Circuits
    Microbiota-Generated Metabolites Promote Metabolic Benefits via Gut-Brain Neural Circuits

    “Soluble dietary fibers promote metabolic benefits on body weight and glucose control, but underlying mechanisms are poorly understood. Recent evidence indicates that intestinal gluconeogenesis (IGN) has beneficial effects on glucose and energy homeostasis. Here, we show that the short-chain fatty acids (SCFAs) propionate and butyrate, which are generated by fermentation of soluble fiber by the gut microbiota, activate IGN via complementary mechanisms. Butyrate activates IGN gene expression through a cAMP-dependent mechanism, while propionate, itself a substrate of IGN, activates IGN gene expression via a gut-brain neural circuit involving the fatty acid receptor FFAR3. The metabolic benefits on body weight and glucose control induced by SCFAs or dietary fiber in normal mice are absent in mice deficient for IGN, despite similar modifications in gut microbiota composition. Thus, the regulation of IGN is necessary for the metabolic benefits associated with SCFAs and soluble fiber.”

  2. John on February 9, 2014 at 13:02

    I’ve been saying it all along: The low-carbers are going to have their arteries clogged from all that fat.

    • Sinvanor on June 17, 2014 at 09:26

      That’s not even close to what he said. Way to want to think you’re right based on really old and wrong evidence. There is such a think as good for you fats and bad fats. Don’t like being misinformed then have it change, do ya?

      Also this is NOT ketosis, this is ketoacidosis which produces these symptoms including the insulin resistance. You prevent this by eating 20-50 grams of carbs a day and drinking LOTS of water.

      There is NO SUCH THING as true ketosis. If you’re producing ketones (no matter the level) then you’re in ketosis and burning fat for fuel. If you have too many excess ketones you can get ketoacidosis. You are not for instance with the urine sticks supposed to be in purple like some people seem to think. That can lead to ketoacidosis.
      Keto is not supposed to be about starving yourself. You’re supposed to drink lots of water, eat good for you fats (IE not just bacon and cream, get in avocado, coconut oil and olive oil) moderate protein (too much will cause the body to turn it into glycogen anyway) and low carb. NOT NO CARB.

      Why does no one look into ketoacidosis vs ketosis then attack ketosis with out knowing the difference?

    • Aton on June 29, 2014 at 07:50

      ketoacidosis is higher state this here we can name like in diabetes (pre-diabetes) they have the same pathology abnormal keton body levels. Low carb 20-50 is good for some condition but in healhty people can mess with brain and body. The biggest myth is that ancestors eat low carbs.

    • Brett on August 13, 2014 at 10:22

      This is all anecdotal hogwash. Popular opinion is anti-fat/cholesterol, even though there is no evidence to support it. People will believe what they wish.

      I’ve been on a keto diet for years, and I have no health issues, quite the opposite in fact. My health has substantially improved. My cholesterol levels are better than perfect. My BMI is ideal. I have not eaten anything that has fiber in it in years. Meat/dairy are my only sources of sustenance. The only plants I consume is in the form of coffee.

      I used to have horrible cholesterol, horrible excess body fat, horrible water retention, and chronic inflation.

      I don’t have any arthritis, constipation, dehydration, or immune issues. I have not once been sick in any way for years, this includes never having allergies.

      The notion that eating low carb contributes to insulin resistance is ludicrous, as nothing a person in ketosis consumes has any insulin changes. There are no spikes, my blood sugar has been perfect without a single spike in years.

      Every meal a person who eats plants will have an insulin spike post meal, this cannot happen to a person in ketosis unless they eat a higher proportion of protein than fat in their meal.

      Please don’t peddle misinformation about something you don’t have a clue about.

    • Richard Nikoley on August 13, 2014 at 11:02


      Just know you don’t have the Inuit to fall back on. Nor any population ever observed. You and others are conducting an experiment with little basis in observing healthy populations practicing long-term, chronic ketosis.

      The way to exercise metabolic flexibility is how it’s always been done naturally: periodic, intermittent fasting.

    • Richard Nikoley on August 13, 2014 at 13:42

      “This is all anecdotal hogwash.”

      And in the very next paragraph:

      “I’ve been on a keto diet for years, and I have no health issues, quite the opposite in fact. My health has substantially improved. My cholesterol levels are better than perfect. My BMI is ideal.”

      So, the only anecdotes that are valid are his and similar.

      This email I got yesterday, and the thousands of comments on this blog (and thousands more in Paul Jaminet’s comments and forum) are “hogwash.”

      “Hi Richard,

      “So, I happened upon you by way of Paul Jaminet’s forum. I have been researching the implications of a vlc diet. I liked your article on Long Term Very Low Carb and Ketogenic Diets = Bad News.

      “Here’s some background on me. Female, early 40’s. 5’3, 105 lbs. SAD up until the past few years and then I switched to VLC. Let’s say practically no carb. Healthy before switching to vlc. Last year I started getting very cold toes, sore finger joints and a runny nose. Went to several Reumy’s and after testing, a Scleroderma marker came back positive, however I am ana negative. The rheumy’s have said I may never progress to an actual disease. With that said, I am still trying to make sure I don’t progress and maybe even turn things around.

      “I have since added back carrots, potatoes and rice…trying to up my carb intake and stave off what may be coming down the pike. I wonder if there is anything else I should reintroduce or supplement? I appreciate that you must be busy but would love to hear any opinion or advice you may have. Love Free the animal.”

    • K. on August 14, 2014 at 15:25

      Hi Richard,

      I am the one that sent you the email you copied and pasted here. I would greatly appreciate any thoughts on how I could at least make an attempt to turn things around. Like I stated in my email to you, I have added back 2 cups of rice a day as well as carrots and potatoes. I will be taking morning basal temps to see if my core heats up after reintroducing carbs. Temp today at waking was 96.0. Keep you posted. Any foods or supplements?

      Keep up the good fight.

    • K. on August 14, 2014 at 18:01

      Also if this is just the start of a disease process is it even possible to turn it around/reverse it?


    • Richard Nikoley on August 15, 2014 at 08:33

      Have you looked at the posts on RS and Probiotics? Lots of people reported body temp increased after years of chronic low once they added raw potato starch to their diet.

      As far as Scleroderma, I know nothing about it.

    • Brad Baker on August 15, 2014 at 09:11

      It’s been rumored that body temp increases when one gets off their ass and moves. I’ve even heard some with the gall to suggest it improves your health!

      Sorry, but I find it hard to keep my trap shut when see people anal-ize minutia like body temp, blood glucose levels, insulin, etc., etc. when all you need is a mirror. Go lift something heavy! Lose fat while adding muscle (the body’s largest endocrine organ). The whore-moans will work themselves out.

      AHS 2014: The Underappreciated Role of Muscle in Health and Disease

    • Brad Baker on August 15, 2014 at 09:17

      I realize some people have a “broken” metabolism in some way, that perhaps need medical help? But still, you’d be surprised how many problems can be improved if not solved by a change in activity – to high intensity strength training.

    • K. on August 16, 2014 at 07:32

      I have looked into RS as a way of upping my temp. I have Tatertot to thank for that. Would this have to be added indefinitely in order to maintain the normalized temp?


    • LaFrite on August 16, 2014 at 09:28

      Ideally, once you are used to raw PS, you should think about eating real foods rich in prebiotic fibers and RS. These foods should be come your staple foods.

    • K. on August 16, 2014 at 09:45

      Thanks LF.

      Potatoes, rice, carrots sound good?


    • LaFrite on August 16, 2014 at 12:47

      Very much. Add beans and lentils as well!

    • laury on September 17, 2014 at 19:40

      Very interested in your diet of just protein and dairy, can you tell me your meal plans.

    • 132213 on March 31, 2015 at 03:15

      Bullshit. Your meals are meat and dairy products? All day every day? Bullshit. I’d love to see the logistics, cost, and meal planning breakdown of that.

      I wonder how many of these idiots proclaiming this garbage are industry shills? I’ll black bag every last one of you assholes and throw you in a meat grinder.

    • F. Fishaman on April 8, 2015 at 11:47

      While I have nothing against keto, I achieved the same effect as you just by eating low calorie/high protein and weight lifting. I agree that long term keto is fine though.

    • Richard Nikoley on April 8, 2015 at 12:37

      Seems good to me, and Leangain-ish, which fucking works. Caloric restriction combined with hyper protein, toss in 18 hours of daily fast (I prefer 2x per week of 30 hour fasts), and heavy lifting.

      It fucking works. I can’t imagine how it wouldn’t for everyone, but it’s a tough program to follow.

    • Corey on July 16, 2015 at 19:14

      So right with that keto acidosis. The only bad fat is trams fats which unfortunately is in all mainstream production that my friends is why kills. Even saturated fats are okay.

    • Jarrod on January 9, 2017 at 17:08

      Very interesting seeing as the most up to date research is showing global inflammation reduction across animals and humans and they have gone so far as to advise that a lot of this is due to genetic down regulation that happens based on Beta Hydroxy-Buterate effect on Histones and other genetic switching mechanisms. If any diet is done without deep knowledge then you get bad results. your success is directly proportional to your effort to understand the subject and apply it. So histamine increases are very doubtful, though it may increase depending on food choices, one must also understand that histamine has less of an effect if other inflammation contributors are lower so, Histamine by it self is not a quality indicator, breathing air effects histamine levels for example.

    • Pepper on January 8, 2018 at 18:12

      I have scleroderma, a diseased thyroid, and a positive ANA.

      My doctor has *just* put me on a ketogenic diet. I’m to not go nuts with the protein. Eat lots of cooked veggies. (I cannot handle raw veg because of my gut issues) Drink LOTS of water. When I pee on the stick, if it’s purple, then I need to drink water immediately. The goal is to keep me in ketosis – not have high levels of ketones.

      He’s also told me to try intermittent fasting. (Skip breakfast)

      He told me that all of this would have the effect of reducing inflammation.

      When I began this diet a week ago I was ankle to wrist blisters. Incredible itching. Joints swollen and hot. Had been this way (to varying degrees) for two years.

      I’m now a week in and the itching has stopped. The blisters are in the process of healing. The ‘hot spots’ finally went away two days ago. Joint pain has reduced significantly and the swelling is already down.

      This is my personal experience and it’s very short-term. But I cannot see how this diet can possibly make my situation worse than it was. If I stay where I am and don’t improve one little bit more, I win.

      This is the first thing that’s actually helped me since my body went to hell.

  3. EatLessMoveMoore on February 9, 2014 at 13:37

    Jimmy Moore’s latest total cholesterol: 392. This is (of course) nothing to be concerned about.

  4. Mister Ian on February 9, 2014 at 13:39

    I hope I have not missed this in previous posts of yours, but as we talk about these things, what is your definition of VLC and LC? Is it consistent in the literature? Is it in total grams of carbohydrates or sugars only and how many per day. I guess resistant starch doesn’t count towards the total. Perlmutter in Grain Brain talks to do less than 80 g per day of total carbs, which I assume by your definition is VLC?

    I’ve been doing some playing around with blood ketone measurements to put numbers to it. The online buzz is about being in ketosis, but in fact it is very hard to get the blood ketones up to the so called true ketosis threshold of 1 mmol/L. The highest I’ve gone is 0.6 and that’s with chugging MCT oil and almost no carbs, which certainly isn’t paleo! So in fact it makes me think that going into full blown ketosis just isn’t meant to be.

    • Richard Nikoley on February 9, 2014 at 15:13

      I don’t know that VLC is defined. It’s one of those you know it when you see it. I’d say any level of LC that causes phisiological insulin resistance would be a good measure.

      If you want to be in deep Ketosis, tack on a good 300 kcal deficit to your VLCing. As we found on the potato hack, even people eating 90% carbs were peeing pink, but it’s because they were in a big caloric deficit because it’s hard to eat enough potato.

    • Mister Ian on February 9, 2014 at 19:58

      Thanks, good point, the body would want a deficit to kick into deep ketosis,which for me means, I think, a lot less protein. Again, is it necessary I wonder. If I, as they say: look, feel and perform well at 51 years of age now why go more extreme unless it is a sure thing to stave off Alzheimers and other aging issues forty or more years from now. But the jury is still out on this.

    • La Frite on February 10, 2014 at 02:00

      Mister Ian,
      I don’t think you need to be in ketosis. I would in fact say that using ketosis as a preventive measure against Alzheimer, etc, is a little extreme. Just ditch the grains, eat only 2 meals or less / day (maximize inter-prandial time) and make sure you eat also for a good gut flora. Exercise some for fun and for keeping metabolic flexibility. Ketosis is a great survival mechanism if you get stranded somewhere without easy access to foods, but I guess, you are not in survival mode, are you ? 😀

    • John on February 10, 2014 at 06:29

      Mister Ian,

      Just because a ketogenic diet might be a good theraputic measure for Alzheimers, that doesn’t mean that it would prevent it in the first place. The fact that there are many long term complications with VLC diets would argue against it. If Alzheimers is a concern, I would look into other things like reducing bodily iron stores, which basically means donating blood. Blood donation is much safer than a long term ketogenic diet, and worst case scenario, you simply help out another human being in need.

    • Mister Ian on February 10, 2014 at 08:03

      La Frite, what you say is almost exactly what I’m doing. 🙂

      The question which I continue to ponder is as John says is a ketogenic diet a therapeutic measure or a long term goal for brain health.

      And what does it actually mean “ketogenic diet”? That’s why I decided to do the finger pokes and test the blood ketone levels.

      Our dietary quantity and type of carbohydrates, protein and fats is only part of the equation. Exercise, overall health, age, gender and individual variability will affect our results. But does a ketogenic diet mean that the blood ketones have to be elevated or only that there is low carbohydrate consumption? Certainly we did not evolve metabolically to need a carb fix every two hours and we also didn’t evolve with such concentrated readily available carbohydrates — except when we raided the bee hives 🙂

  5. GTR on February 9, 2014 at 14:01

    Question arises: out of all possible variations of VLC diets and additional helpers – eg. supplements, excercise, hormones, drugs, whatever – is there any one that’s working? Or is carbohydrate an “essential” substance, that needs to be consumed from the outside, like let’s say vitamin C?

    What I see in Spanish Caravan is reliance on observational studies that check the state of the subject on some example VLC diet, as practiced. Are these “optimal”, the best VLC diets available – including in combination of vitamins, supplements etc.? Now, maybe there’s no such thing as a better VLC diet, than ones that are practiced today? How would we know that?

    Overall I’d be reluctant to reject the whole category of VLC diets (including future ones) based on studies obeserving the results of only some of them. But of course the conclusions about this particular subset that was tested can be made, and potential new or not ones have to be quality-tested in those areas that Spanish Caravan mentioned, before being used.

    • GTR on February 9, 2014 at 14:23

      Some example for what I said – Masai eat lots of fat, but supplement with herbs, that lower the negative effects of consuming a lot of fat. Or for recipies with sugar that add cinammon to lower sugar negative effects. You can even eat some MSG and supplement with oxaloacetate to lower the negative effects of the former. Or perhaps some drug can do such thing – drugs are quite effective at blocking or enhancing various biological pathways.

      So is there some saving grace for VLC diets? I’d agree that it may not have a sense economically to buy expansive drugs/supplements/hormones rather than just increasing cheap carbs by some grams, but anyway I’m not convinced that we have enough evidence to throw out the entire category “VLC Diets”, rather just a subset “VLC Diets as practiced today”.

    • GTR on February 9, 2014 at 14:49

      By the way, I googled a citation that Spanish Caravan provided “These side effects are consistent with carbohydrate deficiency, because the brain and muscle do not get enough sugar from carbohydrates to maintain their normal function, Astrup said”

      The surprise part of what showed up was… the date. It’s from Q3 2004! So the promoters of VLC had over 9 years to solve the problems mentioned with such articles with their diet (perhaps with the types of methods I mentioned earlier), but there seems to be some silence there? On the other hand VLC is not what get the most government grants, so maybe a reason is being underfunded?

    • La Frite on February 10, 2014 at 02:05

      VLC is a great way to lose weight without giving up pleasurable foods. Apart from that, unless you have brain seizures or other weird conditions, I am not sure I get the point of being in ketosis all the time. Isn’t it stressful at some level ? It is also hard to keep a good gut flora unless you supplement some RS “artificially ” (raw PS powder, etc).

    • John on February 10, 2014 at 06:35

      The Masai never ate a VLC diet. They drank a lot of milk, getting about 100 grams of carbs a day.

    • GTR on February 10, 2014 at 12:02

      @John – the Masai example was not as mach abut VLC, as about a certain framework, where you have some diet that has some downsides, but you compensate these with something else, like Masai compensating their diet negative results with protective supplemental herbs; same with carbs + cinnamon, or even carbs + lots of fiber like in Chinese cusine (high-GI rice + vegetables). Another example may be Ray Peat, who wen eating red meat consumes tea, in order to prevent iron overload, as tea decreases iron absorption. Again – a known disadvantage of a certain food being compensated by something.

      So perhaps for VLC there’s some magic potion that eliminates its downsides? VLC promoters don’t seem offer such stuff, preferring to ignore disadvantages of their approach, which makes it even harder to determine if such thing consists.

    • GTR on February 10, 2014 at 12:08

      @La Frite – the criteria that you propose is reasonableness, sense etc. – these are different that the topic of this blog post, which is that the VLC diet is harmful to your health. I don’t think being unreasonable makes a good reason to “kill” a diet that is one of Richard’s stated goas – as written in a previous post. For example a diet that is based on eating only very expansive products might be unreasonable, but that doesn’t necessairly make it harmful.

  6. Paleophil on February 9, 2014 at 14:20

    Lovely, I had been hoping that Spanish Caravan would give his take on Physiological Insulin Resistance (PIR). Unfortunately, I think many people will not take it seriously as a negative indicator until more serious damage is apparent, even though I’ve yet to see a single report of its existence as a norm in a healthy population.

    Ray Peat wrote something similar, albeit focused on PUFAs: “There is a growing recognition that a persistent increase of free fatty acids in the serum, which is seen in shock, heart failure, and aging, indicates a bad prognosis, but there is no generally recognized explanation for the fact that free fatty acids are harmful. I want to mention some evidence showing that it is the accumulation of polyunsaturated fats in the body that makes them harmful.”

    Is this one thing that Peat got right, at least partly, and could it help explain why so many VLCers report improvements upon trying a Peatarian approach (if their glucose tolerance isn’t too badly shot to tolerate the high fruit intake Peat recommends)?

  7. VW on February 9, 2014 at 14:46

    Art Ayers recently commented that a person can survive well on meat alone as long as the gut flora is adapted. (I would provide a link but I’m on a tablet and have no idea how to copy and paste)

  8. Jojo on February 9, 2014 at 19:22

    Can the problems of long term VLC be avoided by cyclical ketogenic diet (e.g. carb nite, i.e. one heavy-carb meal a week)?

    • GTR on February 10, 2014 at 12:33

      @Ripken, about Dave Asprey’s diet, the breakfast part. One of the problems of VLC diets that Richard and Spanish Caravan covered were cold hands and feet. Dave Asprey’s breakfast seems to be the premium way to get these. It’s not only low-carb, but also contains caffeine – a known blood vessel constrictor, as well as saturated fat – a blood coagulator.

      Example information:

      But it is also possible that Dave Asprey himself doesn’t have such effects, as he does a lot of additional things that either prevent it from happening, or mitigate the effects. For example one of the methods of caffeine restricting blood flow to the extermities as described in the links above is causing fight or flight reaction. Dave doesn’t have these because of extensive use of biofeedback devices – eef neurofeedbac, hrv biofeedback, heg biofeedback etc. which allow you to minimize and even consciously control your fight or flight reactions. Notice that this is a conscious intervention by Dave, which he recommends for everyone, and even – surprise! – offers the necessary equipment on his site.

      And when it comes to the direct ways both fat and coffeine worsen blood flow, then it may be that he is protected by side effect of some substances that he uses. Like Provigil which has some vascular relaxation effect, or a family of Racetams that act as blood thinners. Or even vanilla, that he also sells an expansive version of, that again helps blood vessels. His blood flow is also helped by a definitive avoidance of mycotoxins which are known to restrict blood flow.

      So it may be that his lifestyle has to be practiced as a complete package, as the diet itself has some flaws that are mitigated by other parts of the lifestyle.

    • Richard Nikoley on February 9, 2014 at 22:30


      I’d say if you make it a carb heavy day or two you’d be better off.

    • BrazilBrad on February 10, 2014 at 06:59

      @Richard, I think I remember you posted something on FB about “met-flex” (Metabolic Flexibility). I would love to see you expand on this subject some time in the future, as it relates directly to the fat/carb macro-war thing. I have a suspicion that what is good about carb cycling, and more generally cycling all macros… carbs, fat, protein, and even calories and all food via IF, as well as you varying of potato starch supplementation, all boils down to keeping one’s metabolism energy substrate flexible. Obviously there is a correlation between obesity and low met-flex since “metabolic syndrome” is, almost by definition, really poor met-flex.

    • Richard Nikoley on February 10, 2014 at 07:11

      That was a post by J Stanton covering his AHS13 talk. Top of now.

    • Ripken Holt on February 10, 2014 at 08:16

      I know that Dave Asprey over at bulletproof recommends carb refeeds once or twice a week. What do you think of his diet recommendations?

    • Pagan Cossack on February 10, 2014 at 09:40

      @Richard Why, for improved insulin sensitivity earlier during the day? In general I’d appreciate an inquiry into this hack (John Kiefer & Dave Asprey’s recommendations) as thorough as your much-appreciated expose of the dangers of standard VLCing. Thanks.

    • Richard Nikoley on February 10, 2014 at 09:49


      I like Dave. I’ve been on his podcast (search the archives), I’ve met him a few times, had dinner with him and watched him take his block of Kerrygold out of his pocket, and was a co-speaker at a conference.

      I don’t really know that much about his actual prescriptions beyond BP coffee, butter on everything, and his insatiable biohacking. I’m devoted to mainstream plain folk, and with limited time, can’t spend much time looking into what Dave is doing.

      I trust him to be reasonable, though.

    • Richard Nikoley on February 10, 2014 at 10:23


      I am only cautioning about VLC/Keto as a long term lifestyle. I fully recognize it in an intermittent setting, just like fasting 1-2 times per week for 24-30 hours.

    • DuckDodgers on February 10, 2014 at 12:23

      I know that Dave Asprey over at bulletproof recommends carb refeeds once or twice a week. What do you think of his diet recommendations?

      There isn’t enough evidence for anyone to know — it’s all highly experimental. Dave’s recommendations are mainly for brain/performance hacking, while optimizing one’s overall/peripheral health (thyroid, immunity, ability to combat fungal infections, etc) is considered to be of lower priority. But, of course, that’s why they make bullet-proof supplements 😉

  9. Bobert on February 9, 2014 at 19:24

    Clearly ignoring one third of your tongue does not make sense.

  10. tatertot on February 9, 2014 at 21:40

    Interesting on the very low triglycerides.

    Back in the day, my trigs were over 2000. I took Gemfibrozil for years and kept trigs at 200 while developing fatty liver disease. When I went VLC, trigs dropped to 30 or so. I kept them low as a badge of honor and loved bragging about how low they were.

    When I started PHD, they jumped to 100 or so, I freaked, but now I think that is more a normal level than 30. I had them checked last fall after 6 mo of high RS diet and they are around 120.

    I’ll bet too low is just as bad as too high when it comes to trigs.

    • Kate on February 10, 2014 at 09:02

      Yes, I imagine understanding the significance of various blood lipid markers still has a long ways to go. My pattern has been different then yours. About 10 years ago, after eating high carb low fat for years, my trigs were 50 something. LDL 58, HDL 88. “perfect” according to the medical profession even though I felt anything but. Did a 180 diet thing about 6 or 7 years ago, starting with low carb then segued into PHD three years ago. Trigs went down to 30 something and stayed there even on PHD. LDL and HDL kept inching up to 100 and 114 respectively. Doctors think that is okay, but who really knows? Haven’t had a measurement in over a year, and have been on rs for over 8 months. I’m curious as to what the numbers will be.

    • BrazilBrad on February 10, 2014 at 09:29

      I read a while back on Dr. Peter Attia’s site (eatingacademy) a long multi-part post entitled “The Straight Dope on Cholesterol”… where he seemed to me to be indicating that ApoB ( may be the better marker for CV risk.

    • Spanish Caravan on February 10, 2014 at 23:18

      Kate, the only thing we know is that there is a J curve for all biomarkers. It’s not the lower the better for trigs, as Jimmy Moore says in his cholesterol book. Remember, cholesterol plays an immune function, and I suspect triglycerides, from which we estimate VLDL, do, too.

      “Plasma lipoproteins (VLDL, LDL, Lp[a] and HDL) function primarily in lipid transport among tissues and organs. However, cumulative evidence suggests that lipoproteins may also prevent bacterial, viral and parasitic infections and are therefore a component of innate immunity. ”

      If LDL can be too low, then trigs probably can be too low. The same with HDL: it can be too high when your WBCs, CRP/ESR, and trigs are high. It’s simply an immune response. Again, credit goes to PHD for the J-curve analogy.

      There is a sweet spot for everything and that includes carbs, as well.

    • Mike on February 10, 2014 at 23:44

      What are possible issues with very low triglycerides? Mine were 27

  11. David on February 10, 2014 at 05:24

    Clarify please…I don’t understand the connection.

    “You’ll never suspect you have selectively immunodeficiency; your only symptom might be a mildly runny nose, especially if you supplement with Vit D.”

    • Grace/Dr.BG on February 10, 2014 at 16:48


      Of course I’m right 😉 and thanks for being so CHARMING. Have you considered being an affiliate for Rx Assist, see below?


      I get my PRESCRIPT ASSIST straight from the producer Judy and Jarod in Northern Cal Bay Area. I used to do Crossfit at the same box with them (though it nearly killed my adrenals when I was VLC and ill). Also I find their edible earth awesome for keeping the sibo buggars away………

    • Ellen on February 10, 2014 at 17:40


      Read the posts on hand eczema here

    • Spanish Caravan on February 10, 2014 at 10:37

      Easy, David. It’s a “crypto disease state,” like I said. You won’t know what’s wrong with you until it progresses to the point of severe immune deficiency. For example, I developed IgM deficiency, igg subclass deficiency and hypocomplementemia after, let’s see hardcore 12 months(?) of ketosis. What symptoms do I have? None except a chronic runny nose that’s only midly bothersome. My Vit D is at 80 and I don’t take flu shots and I don’t have respiratory infections. But the low-grade runny nose is constant all seasons. Plus I react to airborne particles and have umpteen food allergies. That’s why I keep saying, you really don’t know how you’re jeopardizing your health. Just because it feels good doesn’t mean you’re healthy. That’s why the carbs ad libitum argument is flawed. You might be on top of the world VLCing but you have no idea what it’s doing to your immune system.

      Autoimmunity and immunodeficiency are stealthy and creepy disease states; you’ll only be made of its encroachment through specialized blood tests and the appearance of mild and vague symptoms, which in many cases you won’t be able to connect to VLCing. Think of it as a frog being boiled alive on your stovetop.

    • Janet on February 10, 2014 at 11:27

      This info about VLC and LC is interesting, if just a bit scary. I have been LC Paleo and probably VLC for 2 years. (65 YO woman–no major health issues and felt super, at least the first 1 and 3/4 years.) Lately, tho, I feel so stiff and sore, and I have eczema or what it looks like it is on my hand and leg. I have a VERY angry patch on my hand right now. I have never, ever had rashes all my life. I sleep well and don’t have any major energy issues. I am small boned and my appetite is not that great. I often skip my bacon and eggs in the am and just have a little protein/fat at lunch and have my major meal at night. Meat-big salad with oil dressing, another kind of veg with butter and cheese. I feel done after that. For quite a long time I had no starchy carbs but have been adding potatoes, sweet potatoes and rice almost nightly for about 2 weeks. I just felt I didn’t really need to be so low carb. My weight is fine–if my fat index is a bit high. I started working out at a fitness gym–machines and treadmill for bone density and strength help. (Osteopenia). I have to admit, I don’t feel or look that improved since that started in October. I have put some weight on again around my waist. Bummer since I don’t think I eat that much. I started potato starch about a month ago. Not noticing much except gas and a really bloated feeling, some dreams. (now at 3 TBL a day).
      I suppose the exercise may contribute to the soreness since I ain’t 30 anymore, but I always did something to move around. I read somewhere that skin problems can be related to the immune-peptide thing (not sure what that is!). Any ideas? LC getting to me? I will continue to add some good carbs tho. I have no desire to go on any “autoimmune protocol” diets–to hell with it. I ate these things all my life and nothin’ happened to me.

    • Richard Nikoley on February 10, 2014 at 14:23

      Janet, given the age, you may need the damn fucking probioticcs Grace recommends and I’ll HATE HER FOR EVER FOR THIS BUT SHE MAY HAVE BEEN RIGHT (that Caps lock was totally accidental)

      Proscript Assist
      AOR Probiotic 3
      Primal Assist

      Taking all three, so confounded. Crazy amazement in 4-5 days.

      Expensive, and I hope it persists when I get done with the bottles, but HOLY FUCK!

      I’ll soon, hatefully, outline it in a blog post.

    • Janet on February 10, 2014 at 14:51

      LOL. Thought you would say that. Given the age, I will probably totter over to Walgreens or online (no tottering required) and give these things a try. Damn. I was trying to hold my budget down to a dull roar. But this rash is a monster on my hand and I work the desk at a library –I hate it when they look up and ask what’s wrong with THAT? Point, point as they back up. I usually tell them getting over a bad burn from all the AWESOME cooking I do now. Thanks Really enjoying the blog.

    • The Natural on February 10, 2014 at 14:53

      Richard, eagerly waiting for your report on these probiotics.

      I have sent out my poop for GI Effects testing last week. Now that I have established a semi-baseline (because I had been on PS for about 3 months and stopped for 4 weeks before sending my samples out. So I know that my baseline results are not going to be truly accurate) of sorts, I want to – suggested and approved by Dr. Grace- start supplementing with the SBOs.

      Very curious to see what you have to report.


    • Richard Nikoley on February 10, 2014 at 16:41

      Janet, have you thought about just scratching off your rash with your teeth, swallowing it, and recycling the bacteria and fungus, see what happens?

      That is actually something I would seriously consider. What do animals do?

    • Richard Nikoley on February 10, 2014 at 19:01


      Demure fail. 🙂

    • K. on August 14, 2014 at 18:42

      Spanish Caravan,

      What have you done differently to get things back on a good track for yourself. My comments are further down re: my possible pending autoimmunity. RN posted my original e mail to him on this page. My history is there if you’d like to see it. Curious to hear what you’ve been doing.


  12. Eve on February 10, 2014 at 10:12

    Totally unrelated, but anyone else getting nauseous on potato starch? I tried some dehydrated plantain chips with the same effect. I get headaches too. Could this all be detox? Didn’t think I was that imbalanced 🙁 Any suggestions?

    • Richard Nikoley on February 10, 2014 at 10:49


      First report of nausea I’ve seen in thousands. Headaches, while not common, have been reported a few times. What helped at least some was a round of SBO probiotics:

      Prescrit Assist
      AOR Probiotic 3 (Dr BGs fav)
      Primal Assist

      1 and 2 you can get via Amazon, the one in the middle via iHerb. I’ve been on all three for a week and man do I have a story to tell. Coming up in a blog post near you.

    • Ann on February 10, 2014 at 10:56

      I’ve been getting the headaches as well. I think it’s the good bugs overcoming some bad stuff, and their die-off causes symptoms of toxicity. Lay off the RS for a day or two and see if your symptoms go away. Then you will know. In any case, once the gut biome is in balance again, you should have a lot less of that. I see it as the same kind of detox I went through with systemic yeast. Every time I would treat the yeast with anti-fungal herbs, the symptoms of having yeast would get a lot worse as they died off, leaving my bodies detox symptoms overloaded with toxins and with a huge job to do. With the yeast, they release hundreds of toxic chemicals into the system as they die and decompose, and some of them are the same chemicals present in alcohol intoxication, so I’ve suffered confusion, anxiety, clumsiness, dullness, fatigue and flu-like symptoms. What I’m experiencing with RS is much less severe than that.

      I can’t do the potato starch – I have leaky gut and potatoes are one of the foods that exacerbates my IBS, but I’ve had no problem with the plantains. I ground mine into flour and mix a tablespoon with my own homemade yogurt.

    • Eve on February 10, 2014 at 11:23

      Of course I’d be the 1 in a thousand. HA!

      Thank you for your response! Did you take those SBO’s with food or in-between meals? Will definitely boost my intake. I was taking 2 Prescript Assist a day but will add in the others.

      Look forward to hearing your experience!

    • Eve on February 10, 2014 at 11:26

      Thanks Ann. I think you’re right about the headaches. Just didn’t realize I had so many bad bugs! I went off PS today and will see if the nausea goes away by tomorrow.

      To add to all of this, I’m nursing a young baby right now so maybe need to hold off on all of this stuff. I started taking activated charcoal at night and a little clay trying to absorb this stuff. Just don’t want it in my breast milk!

    • Kate Berger on February 10, 2014 at 12:38

      I have yet to start my potato starch experiment, but this new mention of headaches makes me more hesitant. I am finding out that what I thought was alcohol, is actually sugars giving me migraines in a particular area of my head. What;s the likelihood of starch doing the same as sugar?

    • Richard Nikoley on February 10, 2014 at 14:11

      I always take on an empty stomach. I’ll chase with PS, food or both, but not before 2 hours. My own thingy. Want to give the the best chance of survival I can think of.

    • Richard Nikoley on February 10, 2014 at 15:43


      What would be interesting, dear lab rat, is for you to take one for the team. but order the three probiotics and wait for them to show up.

      Prescrpit Assist
      AOR Probiotic 3
      Primal Defense

      Take one for the Team, Kate luv. Tell us all about it. Week or two on only PS, then all the probiotics. I recommend on an empty stomach first in AM with water, wait to chase it 2 hours with PS or food, or both.

      Have fun. Become a self experimenter and contribute. Not going to hurt you.

    • Kate Berger on February 10, 2014 at 16:24

      Waiting for all these goodies to arrive. If I die, send in the dogs….

    • Grace/Dr.BG on February 10, 2014 at 16:43

      Do you have problems with histamine or other food induced headaches? The gut is likely missing the histamine-degrading bugs. The SBO probiotics, dirt, and gardening are all excellent ways to re-introduce these bugs. Hope you feel better soon!

      Have you read this?

    • gabriella kadar on February 10, 2014 at 18:17

      Grace, headaches can also be caused by low blood pressure. low bp/low glucose. Potato starch can lower blood glucose. Up and down with SNS. These appear to be young women. I would try 500ml coconut water with a pinch of salt. See how that works. Dehydration increases pain. A lot of women are not hydrated enough. And water doesn’t do it. Caffeine helps with headache as well. Increases blood pressure.

      The problem with all these reports is confounders. We don’t have enough information.

    • Mike on February 11, 2014 at 02:43

      could headaches have something to do with the sulfites in ps depleting thiamin/b1?

    • Frisha on February 11, 2014 at 04:09

      Or an allergic response to the sulfites. Headache is one of the symptoms of sulfite allergy, and allergy to sulfites from food is not uncommon. If potato starch contains sulfites, then it really should be listed on the label.

    • Pone on February 12, 2014 at 21:08

      Ann, if potato starch is ingested raw, none of it should be entering your system through your gut. The whole point is that the body does NOT metabolize it at all. The starch gets eaten by bacteria, which produce short chained fatty acids, which then heal the gut and feed the liver to create ketones.

      The problem you have with potatoes would apply to the flour, the whole potato, and the potato skin. Are you sure you were ingesting raw starch?

  13. Carl on February 10, 2014 at 12:00

    Carb restriction is a scam. What’s important is avoiding transfats and HCFS.

    Doing that alone helped me recover my health.

    • La Frite on February 11, 2014 at 04:37

      For me, it was
      – refined sugar
      – wheat and grains in general
      – polyunsat seed oils

      I kept eating a lot of starch from good sources and still dropped the bad weight and improved my energy. 2/3 of what I was eating was already OK, being French and happy to be in a kitchen 🙂 But my excess wheat, sugar and omg-6 PUFA consumption was just not right.

  14. AndrewS on February 10, 2014 at 12:22

    “Implicated’? I need better than that.

    Let me note that I am willing to entertain the notion that the human body runs better on a bit of the right carbs vs. VLC.

    Given molecular mimicry and a leaky gut as probable causes for autoimmune diseases, including RA and Hashimoto’s, it makes sense that one “leads to” the other, although the causal factor is neither disease but someone else (that being the leaky gut).

    A more probable pathway that I see is a VLC individual having a slower metabolism. The body be all like “aint enough energy for you to go chasing a deer, how bout you sit down and take a nap instead?”. That would look like hypothyroidism, and could be from a broken metabolism caused by years of wheat-eating, which could manifest as nascent RA and Hashis.

    In other words: I don’t believe that VLC causes RA. The line of evidence that you presented does not convince me.

    • Richard Nikoley on February 10, 2014 at 15:17

      “I am willing to entertain the notion that the human body runs better on a bit of the right carbs vs. VLC.”


  15. DuckDodgers on February 10, 2014 at 13:23

    Truthfully, I don’t understand how “Paleo” was ever theorized to be “low carb”. Any survivalist who has hands-on experience fending for themselves in the outdoors knows that you make a b-line for “energy positive” plants. You don’t mess around with low carb plants for energy.

    From Finding Caloric Staples — Eat The Weed

    The creatures we eat are usually nutritionally dense. This does not hold true for plants. While plants can provide important minerals, vitamins, antioxidants and necessary trace elements most of them don’t pack a caloric punch. Many if not most plants take more energy to collect, prepare and consume than we get back in calories. Dandelion greens could be a classic example.

    We have to find the dandelion greens, pick them, clean them, and in a true survival situation find the fuel to cook them, something to cook them in and good water to cook them in. That takes a lot of energy and time. For that dandelion leaves offer us little, and while the root is edible it is quite bitter. Conversely, a starchy root that is edible raw, such as sea kale, Crambe maritime, would be a prime edible. It has a large root, particularly at the end of the growing season and is edible raw. It’s easy to find, easy to dig up. That’s energy positive. It’s a caloric staple…

    …In a survival situation (frankly life in general) if you are not taking in more calories then you are expending to get food you are inching towards starvation. This is why we don’t climb a pine tree to get a teaspoon of pine nuts tasty and edible as they are. When one needs to forage caloric staples become the prime food focus right after animals.

    • La Frite on February 11, 2014 at 04:43


      I think the “low carb” paleo notion might have come from the fact that our ancestors experienced long ice-ages, forcing people to rely on animal foods a lot of the time.

    • DuckDodgers on February 11, 2014 at 11:47

      Not sure what you mean by “long ice-ages”. In evolutionary terms most glaciation periods were quite brief and interspersed with glacial retreats.

      From Wikipedia:

      A glacial period (or alternatively glacial or glaciation) is an interval of time (thousands of years) within an ice age that is marked by colder temperatures and glacier advances. Interglacials, on the other hand, are periods of warmer climate between glacial periods.

      The overwhelming majority of our evolution was done during those “interglacial” periods of warmer temperatures. I suppose that’s why we all don’t look like Yetis.

      Anyway, it’s a myth that there were no plants available during glacial advances. If that were true, then the plant and grass-eating herbivores that all the carnivores were eating would have all gone extinct during the first few months of any glacial advance — and then every animal would have starved. But, that’s not what happened. In fact, grass-eating horses and camels migrated over the ice bridge from North America to Eurasia.

      It’s actually well known that grasses and sedges were available to those herbivores on the ice bridges. And guess what grows under grasses and sedges? starchy and Nutrient-dense roots and tubers. But, up until last year, researchers had no idea how even early hominids in Africa were able to survive off of all the grasses that left the C4 isotopes found in their fossilized bones. It was a mystery and they literally assumed that these hominids were munching on reeds of grass that were void of nutrition, up until last month. But, a new theory hypothesizes that early hominids were likely eating the extremely nutrient-dense tubers that grew these grasses and sedges. So, with one paper, the energy positive starchy tubers were back on the map as a nutrient-dense C4 staple.

      And literally, just the other day, a new DNA-based study was published in Nature that shows that nearly 50,000 years ago during the ice age, the landscape was not a barren landscape as once thought. Researchers already knew that the grasses and sedges existed — which means starchy tubers and roots existed too.

      From: Fifty thousand years of Arctic vegetation and megafaunal diet

      Although it is generally agreed that the Arctic flora is among the youngest and least diverse on Earth, the processes that shaped it are poorly understood. Here we present 50 thousand years (kyr) of Arctic vegetation history, derived from the first large-scale ancient DNA metabarcoding study of circumpolar plant diversity. For this interval we also explore nematode diversity as a proxy for modelling vegetation cover and soil quality, and diets of herbivorous megafaunal mammals, many of which became extinct around 10 kyr BP (before present). For much of the period investigated, Arctic vegetation consisted of dry steppe-tundra dominated by forbs (non-graminoid herbaceous vascular plants). During the Last Glacial Maximum (25–15 kyr BP), diversity declined markedly, although forbs remained dominant. Much changed after 10 kyr BP, with the appearance of moist tundra dominated by woody plants and graminoids. Our analyses indicate that both graminoids and forbs would have featured in megafaunal diets. As such, our findings question the predominance of a Late Quaternary graminoid-dominated Arctic mammoth steppe.

      So, what this study tells us that the once-thought barren landscape of the ice age was actually dominated by forbs (colorful wildflowers) and graminoids (grasses).

      “Forbs” include Typhaceae, which includes Cattails that have a starchy root and and starchy pollen that happen to be rich in Resistant Starch.

      And “Graminoids” happen to include Cyperaceae, which includes extremely starchy and nutrient-dense tiger nuts.

      In other words, families of plants known to be rich in starches and Resistant Starch dominated the landscape even during the “ice age”.

      So, the wooly mammoths, woolly rhinos, reindeers, bison megafauna were living off of these plants and there is no reason why Paleo ancestors wouldn’t have eaten them as well. Why wouldn’t they? They plants had “energy positive” properties.

      In fact, last year it was confirmed that shortly after the glaciers retreated there were Paleo-Indians who were harvesting starchy and nutrient-dense cattails and tiger nuts in North America 9,000 years ago. Based on the recent evidence published in Nature, my guess is that those Paleo-Indians had been eating those plants all along.

    • La Frite on February 11, 2014 at 13:14

      mmmm, that’s not what this graph shows:

      Colder phases lasted longer than warmer ones.
      But again, I was not opposing what you said, I was just trying to give an explanation (or a hint) as to why the myth of “paleo” low carb could ever be.

    • DuckDodgers on February 11, 2014 at 13:33

      Good catch. You’re right! The cold phases were longer. I had it backwards. Still, the ice age itself is a minority of our evolution and starches and carny sedges and forbs appear to have been available the whole time.

    • Richard Nikoley on February 11, 2014 at 13:39

    • DuckDodgers on February 11, 2014 at 14:38

      Thanks, Richard….

      To my mind, the ice age was a minority of our evolution as hominids. But, La Frite pointed out that I had the glacial retreats and advances backwards.

      So, can you just remove the part about glacial advances/retreats and our evolution being in-between those glacial/interglacial periods? That part of my comment was incorrect.

    • DuckDodgers on February 11, 2014 at 15:49

      Richard, if it’s easier for you, I fixed the error (and added back in my original paragraph breaks):


    • Richard Nikoley on February 11, 2014 at 16:04


  16. Grace/Dr.BG on February 10, 2014 at 22:31


    Have you heard of low net carb? I think (true) Paleo is rather low net carb. However for those carb adapted and those with the genetics their ancestors likely tolerated high GI foods without difficulty and in fact thrive on them (like Asians who move around). Spanish has talked eloquently about being insulin sensitive — this determines whether one can thrive on high GI foods or not. If you’re VLC for extended periods, then it becomes harder IMHO to be carb sensitive due to the rebound IR from VLC and subsequent wonky cortisol states. Plus the gut starts breaking…….extinction of the beneficial microbiota that are fed by fiber and RS fiber!!


    • DuckDodgers on February 11, 2014 at 12:06

      I think (true) Paleo is rather low net carb.

      There were certainly low starch cultures — as evidenced by low copies of AMY1a genes in those cultures. But the perception that the majority of our evolution was rather low net carb seems to be mostly based on outdated and obsolete evidence. The more I dig into this, the more I’m finding evidence of energy positive tubers, corms, bulbs and rhizomes (and now “forbs”) being available in virtually every environment that our species evolved in including the ice age.

      From the PaleoResearch Institute:

      Many plants produce several different types of starches in a single organ, meaning that one must learn to identify populations of starches, rather than relying on single starches. At PaleoResearch Institute, we have documented starches in human tooth calculus, groundstone washes, ceramic washes, washes of Poverty Point objects, floor samples, other sediment samples, and in nearly every type of provenience that we have examined for evidence of food processing.

      Almost every month, more and more advanced research is being published that shows the potential for greater starch consumption that what was previously believed.

    • DuckDodgers on February 11, 2014 at 13:26

      G, sorry, I think I know what you are saying. Carbs but high fiber, right?

    • Ellen on February 13, 2014 at 06:53

      “Modern Africans still get 40-60 grams RS daily on the form of maize porridge”

      Well this makes me very excited about the polenta I made from the nal-tel corn my husband grew for our chickens. It was delicious and easy to make using the double boiler with lots leftover in a loaf pan in the fridge for frying.

    • Grace/Dr.BG on February 12, 2014 at 20:49


      Please rant anytime (same with you too Spanish Caravan). I like to just sit back and observe and learn!


      Yes I totally concur. Tiger nuts must be low GI like wholegrains — millet, buckwheat, sorghum which have GIs of 30-50, fiber 10-15%. Carbs are slightly higher 60-70% (grams per 100g) but let’s say these are eaten room temp or cooled then reheated (since electric devices didn’t exist in the late Paleolithic). More of the ‘starch’ would retrograde and be ‘fiber’ for the friends in the gut, not BG impacting carbohydrates, no?

      Tiger nuts have even lower GI when dried because then the fiber% goes up to 20%. If they are dug up after -12 months, they’re still edible but lower in Vitamin C and other nutrients. Still wonderful nuggets of nutrition and fiber.

      We keep forgetting the food that feeds and fuels our massive microbiota and why we try to emulate with white powder, aka PS.

      If our paleoancestors were eating tiger nuts (and we know they did), then whole grains perhaps are just as ‘paleo’ as tiger nuts. Modern Africans still get 40-60 grams RS daily in the form of maize porridge. I find that outrageously cool for their gut.

      Unfortunately in the States we have GMO Bt tampered corn which is fed to our children and unsuspecting livestock and chickens. Look at figure 6 — Bt enterotoxin ingested by weevils and pests which then kill them by FUCKING AND BREAKING THEIR GUT, spilling new toxic Bt spores into the ecosystem.
      Fig. 6. An illustration of the known pathogenic life cycles of B. anthracis and B. thuringiensis. Reproduced from Jensen et al. (2003), with permission from publisher and authors.

      Bt Herbicide found in blood of 93% healthy pregnant women, 80% fetuses (Bt is a lectin and enterotoxin that causes intestinal/gut permeability)

    • Grace/Dr.BG on February 13, 2014 at 14:07

      MMMMmmmhhhh… Ellen, that sounds delicious! Maize was one of the superfoods of the Incans and Mayans (besides chocolate).

    • DuckDodgers on February 13, 2014 at 18:16

      If our paleoancestors were eating tiger nuts (and we know they did), then whole grains perhaps are just as ‘paleo’ as tiger nuts.

      Grace, you always impress me. I have to say I had a similar thought. I think it really comes down to low toxin grains, which is pretty much everything except wheat, right?

    • Richard Nikoley on February 13, 2014 at 23:11

      I doubt it. Goes back to digging up starchy tubers vs collecting grass seeds. Think about it.

    • Grace/Dr.BG on February 14, 2014 at 02:02

      oh DUCK…

      I’m breaking the CODE OF SCIENTIFIC SILENCE… you make me open my mouth!

      What do you think of the Vikings?? Do you think they were too busy conquering, pillaging and taking over the earth and forgot/failed to soak their grains which lead to mutations on HFE to upregulate iron?

      Other populations soaked/fermented grains and legumes and likly avoided the toxins. (Or like Asians, shucked the anti-nutrient hulls off and used IRON WOKS TO COOK)

      Guess what? When there is plenty of fiber (eg non-starch polysaccharides and RS = food and fuel microbial populations that perhaps breakdown phytates or counter they anti-nutrient mineral effects), there is no phytate ‘damage’. And this is even more notable if protein and iron are present. SORRY VEGANS!

      So tiger nuts meet this requirement, whether it has much anti-nutrients or not (I don’t think it does). Fermented horchata (eg all horchata) has B subtilis and other SBOs. Guess what? This is nature’s gift of synbiotics to humans (like all ancestrally derived foods = SUPERFOOD FOR THE GUT). ahaha LOL.

      J Nutr. 1998 Jul;128(7):1192-8.
      Intestinal fermentation lessens the inhibitory effects of phytic acid on mineral utilization in rats.

      Br J Nutr. 2001 Oct;86(4):443-51.
      Ingestion of insoluble dietary fibre increased zinc and iron absorption and restored growth rate and zinc absorption suppressed by dietary phytate in rats.

    • Bernhard on February 14, 2014 at 05:55

      Grace and Ellen.

      As to superfoods. Again we appear to have forgotten all and everything about proper
      food and it’s proper preparation:
      “Nixtamalization typically refers to a process for the preparation of maize (corn), or other grain, in which the grain is soaked and cooked in an alkaline solution, usually limewater, and hulled.”

    • DuckDodgers on February 14, 2014 at 06:53


      Interestingly, the unpeeled tiger nuts — even if I soak them — are too fibrous for my stomach right now. I probably just don’t have the Prevotella to break them down. And frankly, I’ve been doing so well without those gut bugs I’m really not sure if I care that much to get them. Anyway, I agree that many cultures thrived on grains if they had the right gut bugs and the grains were prepared properly. And clearly P. boisei had better fiber-munching gut bugs than I do.

      What do you think of the Vikings?? Do you think they were too busy conquering, pillaging and taking over the earth and forgot/failed to soak their grains which lead to mutations on HFE to upregulate iron?

      The vikings likely did a much better job of preparing grains than modern bakers do. All of the old world recipes involved ferments and double-ferments and inadvertent soaking whether people realized what they were doing or not. I know it would seem silly for vikings to worry about “soaking their grains,” but what really happened is that the cooks would start making the breakfasts before heading to bed, and they would leave the porridges in the embers overnight so that the grains would be quick to cook in the morning and wouldn’t delay them. That’s how most traditional grain-based puddings were made (slightly in advance). That kind of pre-soaking just came about naturally and since they didn’t have supplements to back them up, their cooking tended to follow practices that didn’t do much harm.

      But that’s a terrific find about fermentation lessening the effects of phytates! I suspected that, but it’s nice to see evidence!

    • DuckDodgers on February 14, 2014 at 07:07


      Check this old-school n=1 out…

      Deacon John Whitman of East Bridgewater, Massachusetts — died in 1842, at the age of 107 of no apparent disease.

      The Christian patriarch: A memoir of Deacon John Whitman; who died at East Bridgewater, Mass., July, MDCCCXLII, at the advanced age of one hundred and seven years and three months

      His food was of the coarsest kind. Boiled salt beef and pork for dinner, the liquid, in which it was boiled, thickened with a little Indian meal, or a few beans, for supper and breakfast, was his bill of fare, sometimes for nearly three months in the winter. But he did not complain…In regard to his food and drink, Deacon Whitman thought less, probably, than most persons. He was generally blessed with a good appetite, and ate freely, though moderately, of what was placed before him, provided it was wholesome. He was never heard to express, beforehand, his anxiety as to what the next meal might be, or to speak with interest of any particular dish, as better than another. Nor, was he ever heard to speak in praise of any particular kind of food, that might be before him, or of which he had just partaken. He ever seemed to feel that the bounties of Providence were better and more abundant than he deserved. He desired to partake of them in gratitude, and to devote the strength sustained by them to the faithful and diligent discharge of duty. He partook of animal food, simply cooked, in moderate quantities. He was never particular to have animal food for breakfast; and yet, if placed before him, he did not pass it by, but ate with a good relish. At dinner it was his custom to have animal food, and yet, if the table was spread with hasty pudding and milk, he could make his dinner. He usually salted-down in the fall his barrel of beef, and another of pork, which were consumed during the winter. At other seasons, he would kill a lamb or a chicken, and have them boiled, and broth made of the liquid in which they were cooked. But in all cases, his food was simply cooked, without those heating spices and health destroying condiments now so common. If there was any one article of food of which he ever seemed more fond than of another, it was milk. He often made his meal of this, either in its natural state, or boiled or made into milk porridge. There was a period of his life, between the ages of ninetyfive and one hundred, when he almost entirely gave up animal food and confined himself to a milk diet. But he thought that he experienced a clogging effect from his milk, and he returned to the common diet of the family, eating animal food in moderate quantities.

      In regard to his drinks, he never abjured tea and coffee. It is true, that, from his straitened circumstances, coffee was very seldom placed upon his table. The beverage, which passed under the name of coffee, was prepared from rye, or the crusts of bread burned and pounded fine and prepared in all other respects as coffee is usually prepared. On some special occasions, when strangers were present, or perhaps on the morning of the Annual Thanksgiving, a cup of coffee properly so called was allowed. But even then, it was made somewhat weak, and well supplied with cream and sugar, so that it was little else than cream and sugar, warmed and colored with a slight infusion of coffee. He always drank weak black tea at night. At other times, he drank water, molasses and water, burnt crust and water, or small beer, but always in moderate quantities. These were his common articles of drink. He did occasionally drink a tumbler of cider, but he was never in the habit of drinking it regularly, as was then the custom of most of his neighbors. He was fearful that cider drinking might end in drunkenness. He thought that the children of some of his neighbors, who had extensive orchards and made large quantities of cider, were laying the foundation of habits, which would prove their ruin. This operated on his mind to such a degree, that it was one of the strongest reasons why he did not set out a large orchard himself. He was fond of apples and regarded them as wholesome fruit, but he feared the free use of cider. He did sometimes provide a small quantity in the fall. And on very cold days, or when he had been in the woods, he would drink a little. But cider was never a common drink either with himself or family.

      Wine he never kept in the house, except what, as an officer in the church, he provided for sacramental occasions. And he was never in the habit of either offering or taking himself, a glass of wine, even on special occasions. If it was ordered by the physician, as a medicine in sickness, it was obtained and used as any other medicine would have been. But the family never knew what it was to drink wine as a matter of pleasure, or as an indulgence of luxury. The writer does not remember ever taking a glass of wine under his father’s roof, or seeing any one else do it.

      Lunch was called “Dinner” and was typically the large meal of the day; What we know as Dinner was called “Supper”, which was traditionally just a few bites of leftovers (often pre-made grains from the pot left in the embers). The Deacon followed a typical New England diet of porridge for breakfast and occasionally lunch (left cooking/soaking in a pot left in the embers overnight), lots of raw whole pastured milk, traditional bone broths, beans/grains (soaked, I’m sure), traditional hasty puddings (grain based), moderate portions of animal foods on a regular basis and a diet of little to no sugar.

      I’m sure he also led a very low-stress life (meditative praying, forgiveness, etc).

      He looked pretty good at 99! Anyway, it shows that you can live a very long life with the right gut bugs, properly-prepared nourishing foods and a low-stress life.

      The best part is that he never even paid attention to what he ate. He just lived his life.

  17. Pone on February 11, 2014 at 03:21

    Many low carbers wear their insulin resistance as a badge of honor, claiming that this is an advantaged chemical state that allows them to conserve glucose. What I don’t see explained is that many low carbers have fasting glucose over 110, which is prediabetic, and it is dangerous.

    Fasting glucose over 110 – regardless of the reason for it – means your body is continuously producing glycation products with proteins and these are dangerous. High persistent glucose levels over 100 is associated with neuropathy, risk of cancer, heart disease, etc.

    I don’t understand how you can be philosophically or intellectually consistent in saying that you want to avoid glucose or starch as a food source, but you are willing to tolerate your body creating very high levels of glucose internally. Surely glucose is worse if it is part of a high fasting glucose than it is bad as a dietary input?

    • Pone on February 11, 2014 at 14:23

      A good layman’s summary of A1c is here:

      If impatient, jump to section named “How High is Too High?” where they summarize some study findings.

      I think most people don’t understand that there are huge health impacts between an A1C that corresponds to average glucose of 100 and one that corresponds to 115. For retinopathy alone, I have seen studies (NHANES) that show retinopathy taking off like a rocket right around average glucose of 110.

    • Spanish Caravan on February 11, 2014 at 11:25

      Pone, the problem really isn’t the elevated FBG of 110. There really isn’t much literature that says 110 itself is dangerous, except for the claim that beta cells begin losing functionality when BG breaches 110, courtesy of Jenny Ruhl.

      The larger problem is what PIR represents. It shows that there is such a thing as glucose deficiency, which the VLC community pooh poohs. Why would the brain make your muscles insulin resistant and make your FBG go up when you VLC? The same reason why glucose deficiency symptoms manifest as dry eyes, colon, mouth, etc. The whole digestive tract dries out when you VLC long term, since your brain pulls glucose for its own use. The crux is what this apparent diversion of glucose from the mucous membranes. The entire theme of Richard’s blog and Tatertot’s posts has been gut dysbiosis, how a proper balance of gut microbes seems to preserve immunity, that is, intestinal homeostasis. When you VLC, you potentially compromise “mucosal immunity” by adversely affecting mucins, secretory IgA, gut microbes and gut flora, and gut lumen that seem to play such a role.

      And this compromised mucosal immunity could spearhead intestinal permeability and other pathogenic activity; or it may be accompanied by immunodeficiency by being associated with leptin deficiency resulting from a stressed out thymus. All these may show up as health problems down the road. Cold fingers and toes, especially if they happen to be Primary Raynaud’s, which often anticipates full-blown autoimmunity later, is another such manifestation.

      Buttressing this observation is the fact that some of the biomarkers begin gravitating toward one direction which only manifests in states of starvation or extreme stress (low trigs, WBCs, FT3, immunoglobulins, IgGs, complements, T/B/NK cell counts). Incidentally, the buzzword used in starvation literature is mucosal immunity, as starvation in the form of either protein-calories or caloric deficiency leads to lowered immunity, lapses in cell-mediated immune responses, mucosal damage and pathogenesis of whatever you’re in the hook for — whether that’s of the autoimmune or immunodeficient variety.

      PIR, like the above glucose deficiency symptoms, seems to be a diversion of glucose from its properly designed role in direct response to a deliberate exclusion of a singular macronutrient. That’s why it’s disturbing.

    • Richard Nikoley on February 11, 2014 at 16:25


      A Portland, OR area MD is asking after Dr. Bernstein’s folks having autoimmune issues and could swear I saw you mention that somewhere.

      I’ll search comments too.

    • BrazilBrad on February 14, 2014 at 13:57

      @Pone, yeah, and many low carbers have fasting BG of 80. Please explain.

    • Pone on February 14, 2014 at 16:47

      BrazilBrad, there is a lot of individual variability on this. That’s why it’s important to test your glucose and observe how the real body (n=1) responds to actual food inputs.

      I don’t have good summary statistics for low carb dieters. Could you post a few references that might show what kind of fasting glucose numbers low carbers have, and how those compare against other diets? I am less interested in the average numbers than the standard deviations, because I suspect that low carb has a wider range of fasting glucose numbers.

      The two cases for low carb diets that I am familiar with:

      1) Obese patients with very high fasting glucose numbers usually benefit from low carb. I don’t know why, but I have to speculate that rapid weight loss simply improves their type 2 diabetes. It’s simply about less fat means less insulin resistance. I’m not obese, so I don’t have n=1 data to share here.

      2) People who are not obese appear to end up with a high fasting glucose. This was me. My fasting glucose on Paleo low-carb went to 115. My speculation here is that the body may be seeing no meaningful dietary intake of glucose as starvation. In a starvation state the liver goes into overdrive creating glucose from protein and glycogen. And the body isn’t regulating this kind of glucose effectively.

      I would love to see summary statistics for fasting glucose and A1C numbers for various types of diets. I always wince at these kinds of studies, because the ugly truth is that likely none of the groups adhere to these diets very well. Unless you can put people into a hospital setting and force their nutrient intake into a particular profile, it is hard to guarantee success.

      When I found out I had wheat intolerance, it took me THREE YEARS to get wheat out of my diet. You can understand a thing in some general way, but the actual implementation of that can be incredibly difficult because of how processed foods are made and labeled. I think it is a similar thing with a low carb diet. It’s easy to explain the concept to a person, but the subtleties of what is a starch versus a sugar versus a low-carb vegetable is difficult to implement without a wide base of experience and knowledge.

    • BrazilBrad on February 15, 2014 at 04:07

      I don’t have any data for large populations. You may be correct the population of VLC eaters in general, I don’t know. I just know of various exceptions. The most recent is a Brazilian doctor who has a popular low-carb Paleo blog. He reportedly eats a ketogenic diet and has a fasting BG level around 80. I recently bought a BG test kit, but I don’t eat VLC. Anyway, the kit came minus the needles. Fucking stupid. I need to return it and buy a (complete) kit.

  18. Pone on February 11, 2014 at 13:26

    Spanish, I don’t disagree (or have much knowledge of) gut issues associated with high fasting glucose. But the first part of what you say is wrong. There is a very strong and well established set of risks associated with high A1C levels. High fasting glucose = high average glucose = high A1C. High A1C puts you at many times higher risks of certain cancers (nasty ones including pancreatic and liver), heart disease, subtle neuropathies, etc. So I don’t care by what method you end up with high fasting glucose. High fasting glucose is a bad end target by itself, for any reason, and by itself carries enormous disease risks.

    High A1C levels are also correlated with high advanced glycation end products (AGE). High AGE is correlated to heart disease, neuropathy, and aging itself.

    To me, accepting a high A1C / fasting glucose value is like a person walking around on the freeway. And your response almost sounds like saying the main risk is that the air quality on the freeway isn’t very good. If you are walking around on a freeway, you have much bigger risks to worry about than the air quality. P.S., yeah, the air quality isn’t great either. 🙂

    Vascular inflammation, heart disease, cancer: those are the big risks associated with high fasting glucose.

  19. Sarabeth Matilsky on February 11, 2014 at 15:49

    Okay, so I am thinking about this stuff a LOT, and soon I hope to be able to contribute some n=1 from my family’s experience…

    I ate a high-carb/low-fat vegetarian diet from birth until I was thirty, at which point my then-six-year-old son was so sick (autism spectrum symptoms and severe anorexia) that we had to realize that Something Wasn’t Working. Basically, I had to give up my RegligionEtarian Habits. We switched overnight to a GAPS/SCD-type diet, which has been the basis for much of our dietary experiments for the past four years. I am really interested in pushing the envelope, and in keeping my mind open enough so that I can understand when it’s time to change things even now. You might say that I am obsessed with cooking for my family, but it’s also my scientific calling!

    My son was so ill (and so anorexic) at the beginning of all this that he craved only fruit/starch, and got diarrhea from _everything_. All along, he has been extremely sensitive, especially to carbs (squash couldn’t be eaten until sometime last year without diarrhea). Lately, when I began thinking it was time to add in more carbs (we have all along eaten tons of cooked and fermented vegetables, but no other sources of sugar/starch except for very limited amounts of fruit starting two years ago), I realized that a body is possibly truly compromised when it needs glucose _and_ can’t digest/absorb the foods that can provide it.

    Healing the gut when it is in a Really Bad Way is so fascinating to me (although…it’s one of the biggest and most challenging things I’ve tried to do for my child, way more so than birthing him!).

    Dr. Natasha, developer of the “Gut and Psychology Syndrome” protocol, has always maintained that GAPS is _not_ a low-carb diet, but that removing certain carbohydrates from the diet _for a time_ can be necessary in order to heal. I continue to wonder how long that is…and how many carbs are ideal…and how to optimize things. It is very clear to me that it was a necessary approach for my son, at least with current available knowledge/protocols, and when he was in his formerly compromised state.

    When you’re talking about “low carb,” are you meaning “grain-free/starchy-vegetable-free,” or do you have a specific range in mind? I did a personal American Gut sample back in November, before I added starchy tubers and PS to my daily diet, and when my diet was very similar to my son’s. I had been eating this way for 3.5 years at the time, and my food diary showed a carb consumption of about 20%, from greens/squash/other vegetables. I got interested when I read the PHD, and Jaminet discussed functional glucose deficiency…and how he was lacking “carbs” even though he was eating carbs.

    I’m planning to do another American Gut sample soon. 🙂 And I wish I’d done one for my son 4 years ago, and could do one now, and then later, when we’ve Healed Him Up even more. But actually, the fact that he eats food and doesn’t tantrum for three hours per day is probably reward enough. I’m starting to think that soon he’ll even be able to eat more starches again – the PS is agreeing with him. 🙂

    I think it’s so interesting the contemplate the _therapeutic_ potential of all sorts of diets, which isn’t the same as them being healthful on a long-term basis for an already-healthy person.

    Thank you very much for this blog!

    • Pone on February 11, 2014 at 17:21

      Sarabeth, for me the biggest revelation of Jaminet’s Perfect Health Diet was that my Paleo “low-carb” diet was actually more like a zero carb diet. Because vegetables take as much energy to digest as they give back. Eat them for nutrition. Don’t count them for carbs. To me that is a critical insight.

      Adding three to four cups of starchy white rice into my diet has made a huge difference for me. My fasting glucose came down from 115 to 85, and my post-meal glucose after one hour rarely goes above 110 now.

      I think there are a lot of Paleo dieters who believe they are on a “low carb” diet who are actually ketogenic and simply don’t understand how to count carb calories. I think Jaminet’s guidelines of minimum 50 carb grams / 200 carb calories from starchy sources, and up to 30% of total caloric intake from those same sources, is spot on advice.

    • gabriella kadar on February 11, 2014 at 17:51

      Sarabeth, have you got your American Gut results yet? Care to share?

    • Sarabeth Matilsky on February 11, 2014 at 18:12

      No, I’m still waiting. But I ordered another kit for later. Will definitely be interested to see. 🙂

    • Sarabeth Matilsky on February 11, 2014 at 18:17

      I always said, “We aren’t on a low-carb diet!” But like you say, now I’m not so sure. Sometimes lately I wonder, “Maybe it was the _wrong_ choice to try to heal my son’s gut this way!” Except…especially with the anorexia piece, it certainly seemed important to steer away from the overgrowth-feeding carbs for a long while…

      I also wonder if, at some point in dealing with severe health issues, there really is no perfect/great solution – it’s a case of do the best you can, and Get Through The Hellish Times. I also guess it’s a brave new world for a person who, like my son, seems to have had a compromised gut since birth – not just a downhill slide starting at age twenty-five or so. I am much more optimistic in recent weeks, though, partly due to information I am gleaning from this blog. 🙂

      Off to ferment some fresh turmeric with EM cultures…phototropic yeasts should be a good addition to our probiotic dosing, I think! 🙂

    • Pone on February 12, 2014 at 22:18

      Ann, be careful with words like “resistant starch”. If the starch feeds bacteria and doesn’t metabolize as glucose, you shouldn’t count it as carbs. When Jaminet says eat 200 to 600 calories of carbs per day, he is referring only to carbs that metabolize as net glucose. He isn’t counting any resistant component or resistant starches. He’s only counting the part of the resistant starch that metabolizes to glucose.

      I don’t know much about Chinese cello noodles, but the spec sheet looks like they are very starchy, so we can count those in your daily carb totals:

      But isn’t plantain starch supposed to be a mostly non digestible starch, similar to potato starch? If yes, you wouldn’t count any of those carbs at all in your dietary carb allocation. Because your body won’t metabolize those as glucose. The resistant starch is for the benefit of the bacteria, not for you to convert to sugar.

      Based on that, 1.5 cups of cello noodle have about 180 grams of carbs, roughly 720 calories!! Was that your intention to have so many carb calories in a single meal? That would send my own glucose level to the moon.

      So the diet you are describing here is effectively a zero carb diet, followed by a glucose challenge test for dinner!! Your poor body wouldn’t know what is up or down eating like that. There is no pattern to the glucose consumption.

      What worked for me: I eat four meals a day. Between breakfast and lunch I have a huge salad. After each of those meals (I typically wait about an hour), I have one cup of starchy white rice. Some days I only have three cups, but if I see I am losing too much weight and feel like I am not holding glycogen after exercise, I kick it up to four cups.

      Each of those single cups of rice give about 160 calories of carbs that metabolize directly to usable glucose. I’m not overwhelming my system. But I’m challenging my body at regular intervals with small but meaningful doses of glucose. That – together with avoiding the fats that cause me insulin resistance issues – brought my fasting glucose way down and seems to be keeping my glucose one hour after eating under 110.

      One thing I have to say is you might benefit from getting some simplicity into your diet. You have so many different issues, each which feeds on the other. In your position I would implement Jaminet’s recommendation using only the exact starches he lists as safe. Avoid completely any other starch, at least for a while until you get your problems under better control. The cello noodles for example appear to be made from mung beans. And Jaminet is claming that most legumes have toxins that cannot be soaked or cooked out. Why deal with the complexity of toxins and immune responses to foods on top of your other issues? Simple and safe carbohydrates, in very well measured and well tolerated quantities, spread evenly throughout the day, ought to go a long way in helping you to fine tune your diet.

    • Ann on February 12, 2014 at 08:05

      Pone, I am IR, and have been VLC for a couple of years, but hardcore since October, and have managed to reduce very high insulin levels to 25% of what they were. I’m now adding in RS via mung bean noodles, rice, and plantain flour over the past week. So far have drastically reduced anxiety levels, which I LOVE, and just feeling much happier overall. Would love to continue doing this.

      Feeling good, but noticing a couple of bothersome things. First, even with good BG readings, I’m feeling hungry ALL THE TIME. This makes me think that somehow all this RS is stimulating insulin. Is it possible that the blood sugar is staying low but that the starch could still be stimulating more insulin output? When I was dx with IR initially, my BG scores were always low, but the high insulin was what was keeping it low. If my BG numbers never rise much after eating, is this a pretty certain sign that insulin is not being stimulated?

      Secondly, I’m so bloated! I realize the body retains more water with carb metabolism, and I’m not concerned with my vanity, but I do have concerns about blood pressure increasing if I’m retaining more water. Lowered blood pressure was another benefit for me with VLC. I went from average BP of 125-130/75-85 to being more like 110/68 on VLC, and that was very comfortable for me. I realize that from a functional medicine standpoint my BP wasn’t really high, but lowering it told me that my heart wasn’t having to work as hard and I felt pretty good about that.

      Also experiencing some tingling and numbness in hands, although I feel considerably warmer and more comfortable everywhere else.

      Did you experience any of these, or any other things that you considered transitional effects, when you added in more carbs/RS?


    • Richard Nikoley on February 12, 2014 at 08:27


      Just n=1, but I experience this bloating feeling, as well as water retention since doing PS. Not all the time, but sometimes. So, it would be a few days of retaining water, then dumping it with a million trips to the john, even at night.

      Eventually went way and since adding the SBO probiotics a week or so ago, I’m often sleeping through the night without a single leakage event. Thirst greatly diminished as well, such that I’m far less inclined to quench anytime before bedtime.

    • Pone on February 12, 2014 at 16:31

      Ann, how did they ever diagnose you with insulin resistance if your blood glucose numbers were always low? That’s a puzzling diagnosis for that symptom!!

      To me the greatest frustration in controlling blood glucose is that we have no instrument to measure insulin levels at home. The disease we are fighting is *INSULIN* resistance. Blood glucose levels are one symptom of that but the primary thing we should be concerned about is insulin and how it responds to diet, food, etc. Unfortunately, we don’t have that instrument, so it’s next to impossible to answer some of your questions.

      In going through the literature, my jaw dropped when I saw some graphs that show after a dairy fat meal insulin skyrockets, but glucose doesn’t behave abnormally (insulin resistance, because glucose is not responding to very elevated insulin). It would surely be useful to each of us to understand which foods have such effects on us.

      Your feeling hungry all the time could be related to total caloric intake, but usually that kind of hunger is due to hypoglycemic swings after eating a carb meal. Have you plotted your glucose after a starchy carb meal? What is baseline, 1 hour, 2 hour, 4 hour readings? Are you going very low glucose at any point in that timeline and is your hunger feeling corresponding to those dips?

      I think most people don’t understand that the first month of weight loss on a low carb diet is all glycogen, not fat! And glycogen (glucose in the muscle) binds four to one with water. Water is HEAVY. So you take off 10 pounds and put back 10 pounds like nothing, simply by eating carbs. Personally, I cannot live without glycogen in my muscle. When I deplete it, I get a feeling of horrible exhaustion, and I simply cannot exercise hard without it.

      In terms of fine tuning your diet, again I would say RUN do not walk and buy Paul Jaminet’s Perfect Health Diet. Calibrate against that, and after you have been on that diet a month come back and report results. I think it is very very hard to improve on those guidelines.

      My problems are mainly around food absorption. At first I thought it was just wheat. Now I’m finding that many people who form antibodies to wheat also cross react with dairy, yeast, oats, and other foods. It’s common for such people to also malabsorb one or more of the five FODMAP sugars. After living with the wheat problem many years, I’m only now discovering all of these other issues, and I’m up to my behind in alligators trying to get it all diagnosed and my diet cleaned.

      For me, I think high blood glucose was a side-effect of an effectively zero-carb diet, which is what strict Paleo really is (even though it is in denial about that). When in stress on zero carbs, the liver goes crazy and overproduces glucose. That combined with dairy fat (I was chugging down dairy cream like crazy) created insulin resistance. Just reducing the dairy fats and carefully controlling carbs while re-introducing starch has completely turned that around.

    • Richard Nikoley on February 12, 2014 at 17:59

      “I’m up to my behind in alligators”


      My blog has gone mainstream. Commenters don’t even feel A-OK to say “I’m up to my ass in alligators.”

      Shit. That means everyone working hard—assholes and elbows—is probably going down soon too. 🙁

    • Sarabeth Matilsky on February 12, 2014 at 20:01

      Hi Pone,

      Meant to say: thanks for your thoughts! Here’s something that’s been confusing me about Jaminet’s ideas, because his descriptions of calorie ratios and quantities just don’t seem to add up. 200 carb calories can be obtained, if I’m counting correctly, from just _one_ cup of cooked white rice. Three to four cups just seems like so much, especially coming from my background of all-the-grains-I-could-eat as the basis for my diet. I don’t really want to swing the pendulum back too far in that direction!

      I’m kinda nitpicking…but I am definitely interested in figuring out optimal amounts, and Jaminet’s descriptions seem like an impossible amount of food to fit into the average person’s gut!

      What do you think?

    • Ann on February 12, 2014 at 20:14

      Pone – Actually, blood sugar and insulin issues were not even on my radar when I was diagnosed. My periods had stopped, then I accidentally got pregnant after being told I was likely infertile and didn’t ovulate. That birth was a c-section, and the surgeons found cysts on my ovaries. Sixteen months later, when I weaned my son and expected a cycle to start, again nothing. Another ultrasound, more cysts, and an endocrinologist that tested insulin. I asked him why I would have high insulin when I don’t have high blood sugar (had been tested for gestational diabetes with both pregnancies) and he explained that the high insulin had kept my blood sugar low. I probably would never have known except for the accidental discovery of the cysts. Stupid allopathic Gynecologists just assume everything can be fixed by putting women on the pill and forcing a period, and that would have been my fate as well, I’m sure. I’d probably be a full-blown diabetic by now if they hadn’t found those cysts.

      When I had my adrenals tested, they also looked at my insulin – but based on MY food reporting, which I tried to be exacting about, but it’s never as accurate as the blood test.

      Is there any way to know, time-wise, about how quickly insulin brings down blood glucose levels?

      It seems like the blood glucose would have to spike first, for the insulin to respond wouldn’t it? I mean, it makes sense from a logical view, but I know that we are all different. I just know how hard I’ve worked to get my insulin down to levels where I’m not hypoglycemic all the time. That was not great. It caused BG drops that left me sweating and shaking and panicky. I had to eat every few hours, which was difficult with my IBS and food sensitivities. I was one sick puppy for a few months. I certainly don’t want to be eating a lot of carbs and find out that it’s driving my insulin out of control again.

      I have the PHD book – bought it last weekend and read it in two nights. Fascinating and I loved every minute, but again, the IF worries me because now that I’m eating more carbs I feel even hungrier between meals. Hard to know what to do. When Richard said that we should think more Asian food, and cut the fat because of the increased carb calories, I got very nervous, because the increased fat in my diet has made it possible for me to NOT be eating all the time. And I am well aware of the ticking time bomb that fat + carbs can be for the heart and arteries.

      I have a monitor, and have been testing at rising in the morning, and before, 1 hour after, and 2 hours after meals. I will throw in a 4-hour reading as well. My out-of-bed levels have been high, over 100 two mornings now, which is unusual for me.

      I’m finding that I’m much higher after even 24 hour cultured dairy, so I’m switching to coconut milk for making my yogurt. It’s a nice base for the plantain starch.

      I’ve had malabsorption issues as well. I think I have SIBO, or possibly a bacterial infection of some type – I get the results from my MM GI Effects test any day now. Hopefully that will tell something. My unmentionables have been picture perfect and stellar the past couple of days for the first time in months – but still float, so some fat absorption issues clearly. For a very long time now, the only time I have had formed BMs was if I used charcoal or bentonite.

      My food issues were so bad in December, and I became so immune-compromised, that my Itegrated Med Doc told sent me for an ultrasound to see if my liver and gallbladder had issues. Nothing there, and she actually told me it was a good thing I didn’t have gallstones or some other need for surgery because at the time I was too immune-compromised to recommend surgery. That scared the shit out of me-

      Part of my gut issue has also been candida, or some other fungal thing, as I had thrush in December, and antifungal herbs cause a horrid die-off, but I think I’m actually past the worst of that after being so strict with my sugar and carb intake over the past few months. I was a hot-mess for most of December and January, bedridden and unable to eat. I’ve come a long way with experimentation and self-treatment. Mega doses of vitamins A and C, and quite a few b-vitamins as well, milk-thistle and dandelion for my liver and gallbladder, digestive enzymes, and lots of elimination of trigger foods.

      All of this gut dysbiosis has caused an ongoing IBS and increasing food sensitivities, so my diet has been increasingly limited. I wonder about fodmaps, but don’t really think a lot of the foods bother me that much. I don’t eat fruit right now, primarily because of insulin and candida, and also because I just don’t think we need the sugar in the form of fructose. Just my opinion. Right now the worst foods for me, and absolute no-nos, are uncultured dairy, gluten and most grains, potatoes, and weirdly, onions. I know the potato thing is not a nightshade thing, as I eat tomatoes and peppers just fine. I’m disappointed about the potatoes, too. I was doing the potato starch in December, which caused that particular bout of IBS and sent me to bed, which is too bad, because in the weeks before my gut tanked, I was feeling better than I had in many, many months.

      I’m convinced this is the right plan for gut dysbiosis, IBS, fungal control, etc., but I’m not totally convinced on the BG/Insulin issue.

      I’m starting the Primal Defense Ultra on Friday, despite my reservations. My story sounds almost exacly like Dr. Grace’s, including the adrenal issues, and when she says she didn’t really start on the road to amazing recovery until she started the SBOs, that hit home. I have been hesitant to start on SBOs, as I wonder about all those spores. No long-term studies, and I don’t feel that I can afford to chance making things any worse. I am overcoming my reservations, however, and trusting Dr. Grace, Richard, and others who’ve reported improvement. I’m **over** this, and improvement sounds very nice.

      One other really weird symptom I have right now that I cannot explain, and doesn’t seem dependent on any particular food, time of day, activity, or anything, and has only really been happening for the past few months with the Adrenal, SIBO, yeast, and my being so low-carb, has been a shortness of breath, and inability to “catch” my breath when I try to breathe deeply. Strangely, I also have an inability to complete a yawn. I don’t have asthma that I know of, or at least I never have before. Very frustrating, and at times scary.

    • gabriella kadar on February 12, 2014 at 20:29

      Possibly if you can’t take a full deep breath (which you’d need to do to fully yawn), then the diaphragm is not depressing as it should. It could be anxiety. Wouldn’t be surprising at all given everything you’ve been through. Lie down and breathe with your stomach not with your shoulders. See how that feels if you can do it. Some people are so tense and anxious they can’t. Need teaching.

    • Pone on February 12, 2014 at 20:41

      Sarabeth, you are not nit picking. The ability to do calculations of different foods by weight, and then break out the carb grams, is a very important skill to have if you want to eat (lower) carb.

      One cup of rice is 158 grams *BY WEIGHT*. This is approximately 41 grams of carbohydrate:

      41 grams of carbohydrates is 164 calories. So four cups of white rice each day give you about 656 calories, roughly 25% of a 2600 calorie diet.

      I am still trying to figure out how many calories I eat each day and will probably defer that to a dietitian once I find one. I’m guessing I am somewhere around 2400 to 2800 but may get a surprise.

    • Pone on February 12, 2014 at 20:59

      The classical pattern is that you ingest starch, which converts to glucose, which causes insulin to go up, which causes glucose to go down. In the real world it is complicated and the biofeedback can break down. If you are eating a specific type of fat that creates high insulin and insulin resistance, your glucose might never go very high, and you would never have a clue that this moment existed.

      Really we need to look at glucose and insulin together to unravel a lot of the mystery. There isn’t a practical way to do that currently.

      How many carb grams from starchy foods or sugars do you think you eat each day, and how did you calculate that?

    • Ann on February 12, 2014 at 21:22

      Pone, I have been trying to eat mostly starches that are RS. So I’m trying to get the 30 grams of RS that’s been recommended. Today, for instance, I had two tablespoons of plantain flour in 1 cup of 24 hour cultured coconut milk yogurt. Then at dinner, about a cup and a half of cold cello noodles with chicken and fish sauce. So, about 50 grams in plantain flour, if my calculations are correct, and about 100 grams for the cello noodles so far today. The Coconut yogurt is negligible for carbs, as it’s been cultured so long. I actually have to add a tablespoon of honey to the coconut milk so that the yogurt cultures have enough to eat over 24 hours. It doesn’t have quite the sugars milk does.

      Too much? Too little? Breakfast was three eggs, three slices bacon, and a small zucchini sauteed. Lunch was the yogurt with the plantain flour, and dinner was 1 cup chopped rotisserie chicken with the cello noodles. I may shoot some water with 2 tbsp plantain starch before bed with my probiotics.

      Confusing about the fats causing high glucose, as classical science teaches that fat doesn’t stimulate insulin.

    • Pone on February 12, 2014 at 21:43

      If you want to blow your mind up, check out this study on dairy fats versus monounsaturated:

      and pay attention to the graph:

      Look at graph D the black round dot, which is the dairy fat meal. The insulin explodes for that meal, and the corresponding glucose in graph C doesn’t respond in kind. That’s what insulin resistance looks like.

      Graphs like that are why I’m eating a lot more macadamia oil and passing up on the butter and the dairy cream.

    • Ann on February 12, 2014 at 22:14

      Well, I’m definitely anxious right now, but a lot of it seems to be physical symptoms. When my gut feels good, I feel good – calm, patient, couldn’t care less. That’s one reason I’m trying to get all these different factors – insulin, yeast, bacteria – in order. They’ve all caused physical symptoms of anxiety. I’ve been a mess. I do meditate, use hypnosis, and some yoga, but on days when my physical symptoms are present, there’s not much I can do for the anxiety. In other words, it’s not just a psych symptom, although when I’m not feeling well, that figures in as well.

      I’m also wondering how much of the anxiety over the past few months has been die-off from bacteria, yeast, parasites, whatever. I’ve done anti-fungal herbs, which I know caused die-off of yeast, but even changing to the RS, which Dr. Grace says changes gut ph and makes the gut inhospitable for pathogens would cause some bacterial die-off for a lot of us. I wonder about this when people, including myself, complain of the headaches when starting RS. If we’re this messed up to begin with, these kinds of changes are going to cause some negative physical symptoms when those toxins clear. I know my anxiety SKYROCKETED when I was using anti-fungal herbs for the yeast. It was like the yeast symptoms, but MUCH worse. It’s hard to feel like you’re getting better during a healing crisis!

    • Ann on February 12, 2014 at 22:15

      Pone Wow – that’s horrifying. Out with the ghee starting tomorrow morning. Coconut oil doesn’t turn me on, but I’m willing to do anything. I’ve made so many food changes already, this will just be one more…

    • Pone on February 12, 2014 at 22:24

      I don’t know that ghee will cause the same issues – maybe yes and maybe no. I do know I am really frustrated that I cannot *test* that because I have no way to measure insulin!!! So I don’t blame you for being conservative.

      Try Macadamia oil. It’s much healthier monunsaturated fat than olive oil. It has the lowest omega-6 content of all monunsaturated oils. Olive oil carries about 10% of its fats as Omega-6. Macadamia is 1%. Perfect fat!!!

      If you want a saturated fat, you might try MCT Oil as well, which is basically just the Lauric acid part of coconut oil. But coconut oil shoots up the LDL cholesterol. That’s the next problem I need to solve once I get done body slamming the glucose and food intolerance issues. I feel that Jaminet’s diet has me on a roll in a positive direction, so eventually I’m going to get this all well controlled.

    • Pone on February 12, 2014 at 22:34

      Ann, I understand some of this frustration, because I don’t digest quite a large number of foods well. That’s all the more reason to run to simplicity. Get a minimal amount of starches from foods that you are *SURE* are both safe (on Jaminet’s safe starch list) as well as tolerated well by you. Just having that safe place I can run to get glucose without worrying about complicated side effects – the four small white rice meals each day – gives me a platform from which I can practice switching out other foods in my diet. If you are mixing up the starches too much then you have to deal with too many variables. You end up with no carbs in morning, too many at night, and some of those starches (wheat, corn, fruits, oats, beans) can up being the source of toxins that either cause or make worse your other issues. Create a simple base of starchy meals that everything else can build on.

      Resistant starch is a completely different thing: that is about fiber for bacteria in your gut. It’s important, but if you go without it for a day your body won’t be in a panic.

    • la Frite on February 13, 2014 at 01:12

      The study you are referring to has focused on men with very high fasting triglycerides from the start.


      That is quite a condition in itself and if you are low in trigs, your markers might not exhibit the same trend at all.

    • BrazilBrad on February 13, 2014 at 08:51

      You’d have to be an idiot to make dietary choices based on that study.

    • La Frite on February 14, 2014 at 01:44



      Do I detect some kind of hostility in your response to my remark ? I was just mentioning that the people selected for the study exhibit some very specific issue (high fasting trigs) which may not be the case for normal / healthy people. So this is already a confounding factor. You cited that study, and as a careful reader, I will look into it. If you want to just focus on your own blood sugar readings, then be my guest but don’t cite a study with at least one obvious confounding factor.

      For the rest, you may want to read what some people have to say about this study. I think the best answer came from Chris Masterjohn (bottom of the post):

      From Chris M:

      ” You can see that all the mathematical indices of insuling sensitivity and beta-cell function are driven by the difference shown in this table. The fatty acids had no effect on blood glucose, but they increased insulin levels, more so with saturated fats. I can’t find anything definitively showing whether oleate (monounsautrated) or palmitate (saturated) are more easily oxidized to generate ATP than the other. The main regulator of insulin release from the pancreas is the ATP/ADP ratio. So when the pancreatic cell is in a high-energy state, it will release insulin.

      It makes sense as a very simple explanation to me that palmitate was most effective at providing easily oxidized energy to the cells. Therefore, pancreatic cells were in a higher-energy state and secreted more insulin. This did not lead to a significant reduction in blood glucose because the fat also provided energy to the muscle cells. Being in a high-energy state, they reduced their cell-surface expression of insulin receptors so as not to overdose on unneeded energy.

      However, this study does not clarify the mechanism, so this cannot be said for sure.

      The problem with the interpretation fo the study is that it is studying an acute meal effect and trying to draw conclusions about a chronic disease-producing effect. The appropriate study design for this type of interpretation would be to feed high-fat meals of different fatty acid compositions for several weeks or however long it is believed would be needed to have a measurable effect, and then to perform a glucose tolerance test. Instead, they are testing the effect of a single meal of different composition.

      This dubiously assumes that the amount of insulin appropriate to a given meal or given carbohydrate load does not depend on the composition of the fats or other components of the meal. What if it is normal and healthy to have a higher insulin response to a meal rich in saturated fats? They are assuming that because diabetes is associated with higher fasting insulin and impaired glucose tolerance that they can use mathematical models designed to test fasting insulin and glucose tolerance to test the acute effect of meals of different composition. This is a logical leap.”

      Interesting, isn’t it ?

    • Pone on February 13, 2014 at 12:53

      La Frite:

      1) So please find us the study where dairy fat is not insulinemic for a normal population?

      2) Why should we care that the subjects were high in fasting triglycerides? The point was not to study their overall metabolism. The point was to see how one specific type of fat caused a very pronounced kind of insulin resistance.

      I’m NOT high tryglycerides at all, yet literally within days of stopping dairy fat my fasting glucose was down 15 points. So for *me* the study seems to have some relevant observations. I am quite sure there is individual variation and some people won’t see the same effect.

      Of course what should be really clear is that any person could determine the truth for their own case simply by measuring insulin before and after a test starchy meal that is combined with different types of fat. It’s amazing to me that people will spend their lives online arguing about studies and never take any initiative to actually test with real data.

      In my own case, the decision to start using a glucometer was life changing. That steered me very clearly towards correct sizing and timing of carbohydrate starches. I was able to keep my blood glucose low while at the same time ingesting enough starch to meet my daily carb intake targets. Yet I get onto boards where people will argue right and left about studies reporting glucose metabolism after certain types of meals, and 90% of those people have never used a glucometer and could never be talked into trying to use one.

    • Pone on February 13, 2014 at 12:54

      Brazil, be constructive. What do you object to?

      A study like that simply gives you the basis for a personal hypothesis. You then have to test that and measure the result. In my own case, stopping dairy fats lowered my fasting blood glucose 15 points within two days.

    • BrazilBrad on February 13, 2014 at 16:58

      @Pone… really?… “Why should we care that the subjects were high in fasting triglycerides?”. Maybe because of the various possible confounders that can cause high trigs? This study says zip about what happens with normal, healthy people. And anyway there is no correlation between mortality and dairy consumption, so why should we care about what dairy does to our BG/Insulin? Besides, high quality dairy foods are very nutrient dense and healthy.

      I don’t see what you will gain by spending your life pricking your fingers and dwelling on BG readings (assuming you’re hormonally normal/healthy).

    • Sarabeth Matilsky on February 13, 2014 at 18:18

      Oh yeah, I always forget, darn it! Weight of food does not equal weight of calories…

      Okay, I dug up the results of my weeklong-food-diary that I calculated online using the calorie counter software. This was back in November when the starchiest food I was eating was butternut squash, with a small amount of honey/fruit but all other carbs coming from vegetables.

      According to this, I was eating an average of 2676 calories per day, comprised of 61.1% fat (185g, of which 84g was sat. fat), 18.9% protein (129g.), 19.8% carb (135g.). So yes, I’m sure my _net_ carbs were way less than 135 g. (I am 5’7″, slim, about 130lbs – I’ve weighed the same during my vegetarian days, my pre- and post-pregnancy days, and now – weight is not my “thing”. Mood/hormone/blood-sugar-issues are!)

      So then I read the Perfect Health Diet, and was greatly interested by Jaminet’s ideas concerning the possibility of being in ketosis (to address “neurological issues,” which my main symptoms definitely seem to be) while _also_ eating enough starchy carbs to avoid glucose deficiency (a concept I hadn’t really considered before).

      Jaminet’s recommendations, if I’m interpreting correctly, are:

      [lower range for ketogenic] 200-600 starch calories (1-3 heaping cups cooked sweet potato, OR .5-1.5 c. tapioca flour, OR 1-3 cups rice); 400-600 protein calories (3.5-5 hamburgers, a whole lot of dairy or eggs); plus fats [plus as many ketogenic short chain fats as you can give].

      Anyway… I’m still thinking things through, but assuming two meals per day, it seems like “enough” starch for me might only be 1/2-1 cup per meal. Or am I missing something, proportionally speaking?

    • Pone on February 13, 2014 at 19:52

      Brad, again, we aren’t trying to make conclusions about metabolism of people with high triglycerides. I’m observing an anomolous behavior when eating one specific type of saturated fat. Look at the literature, and there are many other studies that show very similar effects on many types of patients.

      Can you find any study that shows insulin and glucose curves for dairy fat against monounsaturated fat when simultaneously eating starchy carbs? Show me the study.

      High average blood glucose – recorded by A1C – correlates very strongly to mortality from heart disease, cancer, and is correlated strongly with serious conditions such as retinopathy and neuropathy. As average blood glucose travels above 110, the conditions rapidly escalate.

      In any case, if you actually believe that blood glucose levels don’t correlate to mortality, probably I don’t want to talk to you further. I guess there are people who still believe in creationism over evolution too, and I don’t talk to them either.

    • Pone on February 13, 2014 at 19:57

      Sarabeth, I think your math is right. 1/2 to 1 cup starchy white rice per meal should give about 20 to 40 carb grams per meal, for a total of 80 to 160 carb grams = 320 to 640 carb calories per day.

      What nutrition software are you using? I gave up on finding a good one since I wanted to track things like amounts of omega-6, and I’m using unusual oils like Macadamia that most software doesn’t track well.

    • BrazilBrad on February 14, 2014 at 07:26

      I thought “ketogenic” was around 50g carbs or lower? That would be 200 starch calories. I don’t see how 600 could be ketogenic…. though maybe if you are highly active and burning off much of that? I do better (better body comp with slight ab definition) with around the amount of carbs that are “enough” for you versus what PHD recommends… or at the low end of what PHD recommends which (I think) is around 80-100g starchy carbs? (It’s been a while since I read the book). Still, it’s kinda tough to say since I can’t be bothered to weigh my food.

    • DuckDodgers on February 14, 2014 at 08:18


      The low end of the PHD, for diabetics, is now ~100g of carbs for a 2000 calorie individual. If you click on Jaminet’s own link, above, he’s saying “20% to 30% carbs” for diabetics — and for everyone else it would be ~30% carbs which would be more like 150g of carbs.

    • Sarabeth Matilsky on February 14, 2014 at 10:08

      Well, assuming only *two* meals a day, then it’s actually less than that – and I would only need to eat the equivalent of 1 c. of rice in an entire DAY in order to meet Jaminet’s minimum… Except that now I’m reading on his website that he’s upping his recommendations in general, so maybe I’m going on old info.

      In any case: is free, and the learning curve was steep and frustrating until I’d entered my own recipes manually (is kinda annoying to enter 25 different ingredients, but then you can select “one serving” of beef stew and be done with it). It’s so interesting to find out whether my guesstimations are accurate (as accurate as one can be, with this sort of thing).

    • Sarabeth Matilsky on February 14, 2014 at 10:09

      I forgot to say: the calorie count website is what the American Gut folks recommended.

    • BrazilBrad on February 14, 2014 at 13:45

      @Pone, you seem to be trying to make the claim that eating dairy is unhealthy in a roundabout way by the effect of creating “high average blood glucose”. Why don’t you just state it plainly – as eating dairy is not healthy? Then we can at least debate what it is you are claiming. If that’s the case, I remain un-convinced. I’ve read lots of articles and studies claiming otherwise. Have a look at the numerous articles on where Chris Masterjohn and others claim the apposite, that quality dairy, especially grass fed is very healthy.

      Btw, I never made any claim or inference about steady-state (fasting) blood glucose levels. What I highly doubt is that BG *swings* related to healthy eating correlates with mortality…. well unless you are constantly eating. Me, I eat twice a day at most, so I could give a rats ass what my BG does for 4-8 hours when the other 16-20 I’m fasting.

      What raised my hair is your inference that eating dairy is unhealthy and I can’t let that slide past without challenging it.

    • BrazilBrad on February 14, 2014 at 14:12

      @Pone, I had not seen @LaFrite’s post above where Masterjohn lays out the flaws in that study. Most importantly I think, he concludes with…

      “They are assuming that because diabetes is associated with higher fasting insulin and impaired glucose tolerance that they can use mathematical models designed to test fasting insulin and glucose tolerance to test the acute effect of meals of different composition. This is a logical leap.”

    • Ann on February 14, 2014 at 14:20

      Brazil Brad – Pone was discussing that with me, as we both come from a place of Insulin Resistance. Did you read all the posts relevant to this? For some of us, dairy is only unhealthy if it spikes insulin. Pone’s point was that there is really no way to know if this is the case because the study showed that blood sugar did NOT spike commensurately. That means it COULD be happening, and we would have no way to know this. For me, since I’ve spent the past six months working very hard to reduce my high insulin levels, I’m not willing to take that chance, and I believe Pone’s approach reflects that as well.

      If you have reason to believe that you eat dairy safely, then by all means do so. I don’t need to know the facts, as I can get everything dairy can give me from other sources.

      Weston A. Price is a fabulous organization, but they also are assuming for healthy individuals. Anyone outside of metabolic “normal” needs to take many issues into consideration, and Masterjohn will be the first to admit this.

      Keep in mind as well, that this particular subject reflects research and experimentation into gut health. You do realize, don’t you, that milk proteins are some of the hardest to digest, even raw – unpasteurized and unhomogenized – and create autoimmune responses in many individuals, many of whom are here for gut-related issues. So for many of us no, milk is NOT a perfectly healthy food, no matter what WAPF says! At least not at this point in our healing.

    • Pone on February 14, 2014 at 17:43

      La Frite, thanks for reference to the article where Masterjohn was quoted.

      One thing I will say is that people usually object to studies that show fats causing insulin resistance by complaining that “…but they gave them carbs with their fats!” Well, of course they gave them carbs. The interesting research question is what happens to glucose in the real world when you eat some carbs with different kinds of fats.

      I understand the low carb folks want to go to a restaurant, open the free butter plate, and sprinkle on some salt and have a butter meal with no carbs. 🙂 Okay, but that is kind of freakish, and it isn’t a very interesting meal to study for 95% of the population.

      Without taking any specific position about one fat against another, I was simply trying to make people aware of the fact that there is this very interesting research that – in more than one study – shows that fats can create very different insulin levels when ingested together with carbs. And – by whatever mechanism – this is creating insulin resistance because insulin keeps rising dramatically but blood glucose doesn’t come down appropriately. So if you are in the 95% of the population who eats a non-trivial amount of starchy carbs with your fats, you should want to know about this effect.

      If you accept that an average blood glucose (A1C) corresponding of to about 90 mg/dL is a whole lot healthier than an A1C corresponding to average glucose of 115 mg/dL, it’s a very reasonable thing for the individual to simply play with different types of fat in their diet, and to observe what if any effect does this have on fasting glucose. That is a self-experiment worth performing.

      And – repeating myself – what is most frustrating to me is that this *should be* a trivial experiment to conduct on yourself. But it is not, and the reason for that is we have no home-based test for insulin! Therefore, as you do these experiments you have no idea if your insulin is low or high. You have only glucose to measure, and that by itself is a very incomplete data point. You need to see how insulin responds to food inputs – together with glucose – and it is the two values together that gives you some idea of what is happening.

    • Pone on February 14, 2014 at 18:08

      BrazilBrad, I may not have given my timeline clearly. I started out on low carb Paleo, which in restrospect was probably about a 20 to 30 carb gram per day ketogenic diet. I lost weight I cannot afford to lose, and it left me feeling weak. It raised my fasting glucose, and my LDL particle counts soared.

      I converted from that Paleo diet to Jaminet’s Perfect Health Diet. I also substituted dairy fat for monounsaturated fat. That stabilized my fasting glucose quickly. I still have many problems, and I think those are probably related to my wheat intolerance. I suspect I cross react with other kinds of foods and may have FODMAP sugar absorption issues.

      In spite of eating about 450 to 600 calories of starchy carbs a day, I still have a feeling like I have no glycogen in my muscle. I still remain pretty weak.

    • Pone on February 14, 2014 at 18:18


      I don’t know if dairy is good or bad. It’s too broad a statement to be interesting here.

      I simply observed that many studies show that carbs + different kinds of fats give remarkably different results on insulin levels and insulin resistance. If you have a fasting glucose problem, that is worth observing and testing. Maybe you make a dietary adjustment if you prove that a certain type of fat causes you to have a glucose problem.

      When you say that you don’t care what your blood sugar does for four to eight hours because you fast the rest of the time, you are making assumptions that may or may not be true. Your assumption is that your body has low fasting glucose during your fast, and that this offsets high glucose during your meals. In fact, many people see high fasting glucose during their fasts and their glucose goes off the charts one or two hours after their meals. Until you start measuring, you really have no idea where you are. Until you measure, you cannot fine tune your carb load at each meal to affect your glucose levels after meals. Maybe you are fine. Maybe your glucose is a mess. You really don’t know if you don’t measure.

      I’m very interested in your ideas on daily fasting. Are you just following Jaminet’s guidelines for this?

    • BrazilBrad on February 15, 2014 at 02:42

      I don’t think the majority of readers here are unhealthy. As such it would be good for people to be more explicit about what they are claiming esp wrt cited studies. We shouldn’t have to go back and read ALL the posts in a thread to figure it out, since one single sentence or a few extra words can set it straight. In absence of such a statement it would be common for people to assume that the claim/inference is about the majority of people, not metabolically imbalanced ones.

    • BrazilBrad on February 15, 2014 at 03:53

      @Pone, No, not following Jaminet’s guideline, I don’t know what they are.
      I do (more or less) what they call a daily 16/8 IF as outlined (first?) on – It’s basically a 16 hour fast with an 8 hour “feed window” which for me is usually one or two large meals. I also do high-ish intensity weight lifting and sprint intervals when my hamstrings permit it.

      Yes, I do not know what my fasting BG levels are. But I also think that high BG numbers *may* not be a sign of health problems in *all* cases. This goes back to a few of my most recent posts on this thread where dudes much smarter than me explain how complicated this process is. How fat intake can affect BG and insulin levels.

  20. Patricia on February 12, 2014 at 10:29

    It’s not so much taste but the texture that keeps me away from natto. Just … no. (shudders)

  21. Ann on February 12, 2014 at 21:24

    And if I need to lower carbs, is it okay to JUST use the plantain flour twice a day? Is that an adequate source of carbs when adding them back in after VLC?

    • Pone on February 12, 2014 at 22:45

      Ann, someone else here needs to tell us:

      1) Is plantain starch different than plantain flour? Remember, for potatoes those are very different things. Raw potato starch won’t become glucose in your body. You can’t count those carbs.

      2) Does raw plantain starch metabolize to glucose?

      Honestly I couldn’t find the information easily on Google. We know raw plantains have low glycemic index, but a lot of that food does become glucose in the body (mainly through fructose conversion in the liver, which may not be all that healthy anyway). But what about the plantain “starch”? I have no idea how it is created, is it even sold as a product, and does it metabolize the way the entire plantain would.

      When I searched for a product, all I could find was plantain flour.

      For your carb meals that you want to metabolize as glucose, I would go for some whole foods. Starchy white rice is perfect.

    • tatertot on February 13, 2014 at 10:35

      I’ve never seen plantain or banana starch for sale anywhere, although I have seen it used in studies. All I’ve seen for sale is banana or plantain flour, which are presumably the same thing. They are just dried and ground up green bananas or plantains. I’ve seen many papers that measured all kinds of banana/plantain flours and they fall in the 40-50%RS by weight range.

      The Wedo banana flour guys are doing a bunch of tests on their stuff and hopefully will have some reports for us soon, if you are looking to buy some, their $70 for 5 pounds + some swag isn’t a bad deal and will help get them established:

      Grace has been in touch with an Australian producer of banana flour (Mt. Uncle’s) and they also are doing some testing of raw flour and also finsihed products. Preliminarily, what we are hearing is that even when banana flour is used in baking, there is still a lot of RS that remains, so it should be a good selling point on the gluten-free front.

      The only problem with banana flour, it’s harder to mix than potato starch, but on the other hand, has more natural fibers, vitamins, and minerals than potato starch.

    • Ann on February 13, 2014 at 11:28

      Pone – I’m just dehydrating very green plantains and grinding them up via the Vitamix. They don’t taste good, but using it it similar to using the PS in how it mixes and goes down.

      With my adrenal fatigue, I also have something called “reactive hypoglycemia”, although that’s lessened since I lowered my insulin in the past few months. I’m actually wondering if the RS in the plantain flour is lowering my blood sugar too quickly, like quicker than the first reading I’m taking at 1 hour post-meal, and if that’s causing my adrenals to raise my blood sugar quickly in response, which insulin would then rise to compensate. That was happening all the time last fall. I would wake in the night with low bs panic attacks – heart palps, difficulty breathing, confusion – the whole package. Thought I was having a heart attack the first few times…

      I’m starting to think the anxiety over the past few days is really more caused by some IBS that the mung beans are giving me. I suspect you’re right about the toxins and the difficulty digesting them. I suspect this because after reading your post on distributing the rice over several meals, I ate 1/2 cup white rice this morning with my eggs, bacon, and vegetables, and my out-of-bed glucose was 100 (after all those mung bean noodles last night!), but only 124 1 hour post-meal, and 111 2 hours post-meal. That seems really reasonable to me. So I suspect it’s not the insulin causing the anxiety, but some gut disturbance either from the cello noodles I’ve been eating this week, or the plantain flour. I’m cutting the noodles first.

      So, considering what you’ve said about small rice portions over the course of the day, I’ll add another 1/2 cup to both lunch and dinner for a while and see how that goes. So far today, I can’t say I feel too bad, even with the tummy trouble, and after checking my numbers this morning, much more willing to go on with the experiment.

      Thanks for all the information, and all of your kind words and willingness to respond. I love that we are all learning so much from eachother.

    • Lauren on February 13, 2014 at 13:29

      I take the Mt Uncle’s banana flour. To drink it in water, you need to stir, stir, stir and drink quick! I have also baked with it. Unlike PS, it has an obvious flavour that you may or may not like.

    • gabriella kadar on February 14, 2014 at 16:07

      Ann, if you have sleep apnea, that would also result in high morning blood glucose levels. During apneic episodes, adrenaline is released which, being part of the fight/flight mechanism, results in glucose being dumped into the bloodstream from the liver. Since the body is doing nothing much except struggling for breath, the glucose does not get used up and hangs out in the circulation for a long time. Insulin release is not stimulated by endogenously produced glucose. The beta cells primarily respond to signalling from the gut. This makes sense, because the brain needs lots of glucose in dangerous situations. So do the eyes.

      Adrenalin release will also result in rapid heart rate and if the apneic person wakes up as a result of an apnea, there is anxiety. This also depends on stage of sleep. During REM sleep, apneics often report nightmares of being trapped, rooms shrinking, doors not opening… etc.

    • Pone on February 14, 2014 at 16:34

      Gabriella, I never knew that the body doesn’t release insulin from endogenously produced glucose. What a critical point if that is true. Do you have any references for that?

      That would partly explain why so many low carb dieters are seeing such high fasting glucose numbers. Lack of dietary glucose means the liver has to produce it all from protein or glycogen, and the body has no regulation mechanism for that. How strange this seems to me. How could the body not be trying to regulate glucose levels in all cases?

    • Ann on February 14, 2014 at 19:09

      Gabriella, I was told those nighttime panic attacks were my adrenals responding to nighttime low bs due to reactive hypoglycemia.

      Is that what you mean? So you think a sleep study might be helpful?

      I don’t have them anymore, since I started treating my adrenals with ACE, working to lower my insulin, and started working to clear up my candida problem, and now my adrenals really seem to be speed-healing.

      I’ve had sleep issues for years, but no apnea that I’m aware of. My son, sixteen, is profoundly disabled and doesn’t sleep well, so neither do I. For many years I’ve sometimes been up multiple times in the night with his needs. I am assuming this has had a great deal to do with my adrenals dumping on me. The past six months, trying to heal the adrenals, I’ve had caregivers spending the night, and I’ve made some pharmaceutical concessions – one of them being Trazodone for sleep, until I can get a few months of solid sleep to try to heal my adrenals. I think it’s working. It will be a hurdle getting off of the Trazodone, but I’ve done it before and survived, and hopefully I’ll be in a better place with my health when that time comes. Too many issues to try to deal with all at once. I just needed sleep help, as the sleep deprivation made everything so much worse. Other symptoms still there – foof allergies, irregularity, some depression and anxiety, but with 8 or nine hours of adequate, restful sleep all of the other health concerns seem much less drastic and scary.

      For a while I was having to eat right before I went to bed to get through the night without waking up with anxiety and hypoglycemia, but with lowering the insulin I don’t have to eat as often anymore.

    • gabriella kadar on February 14, 2014 at 19:13

      I am not applying any of this to low carbers. Just those with sleep apnea. Most people with moderate to severe apnea have some metabolic derangement because most of them are overweight in all the wrong places.

      Sympathetic nervous system up regulation due to sleep apnea is not the same as low carb. When fight/flight happens, the glucose released into the blood stream is supposed to go into the muscles and the brain. The whole point of ‘fight/flight’ to get moving. If the muscles aren’t doing anything, it just floats around. Sure, eventually, insulin will be produced but you’ll see a delay and blood glucose will go down a couple of hours after waking up if fasting.

    • Ann on February 14, 2014 at 19:29

      I realize what you’re saying. I used to snore a lot, but my husband says he doesn’t hear me snoring since I changed my diet three years ago. Back then I cut all processed food, wheat/gluten, and started sourcing grass-fed and pastured meats. I used to go head to head with him on the snoring, from what I’m told. Now he doesn’t notice me snoring at all. Also, I’ve lost 32 pounds since December with all this gut trouble, so while I’m still technically overweight, I don’t have issues with HBP. I’ve been having an asthma kind of thing lately, having a hard time catching my breath, but this week I stopped eating nuts, and finally cut cow yogurt and kefir and went to homemade coconut yogurt, and I’m breathing better. Nuts were clearly a problem. Probably the casein, too, although since I was culturing the milk yogurt 24 hours, there were probably only negligible traces of lactose left, if any. I just don’t think I can do dairy anymore, for a variety of reasons.

      I really liked that article though, and will talk with my doc about it when I go in next week to get the results of my MM GI Effects stool test. She is pretty proactive, and will probably recommend a sleep study for me if I ask. I had honestly never considered that as a potential problem for me, but I will now.

    • gabriella kadar on February 14, 2014 at 19:51

      Funny thing can happen: snoring means a person’s airway is partially blocked. Snoring stops when breathing does. So a person’s spouse may be happy that there’s no more snoring but there can be apnea.

      It’s one of those scary things I’m concerned about with my patients when I provide them with an appliance. The wife reports the snoring stops. That may or may not be great. I need feedback that the breathing is still going on.

      The thing that pisses me off with the sleep study analyses is the following: hypopnea (which is partial airway blockage): the person does not get enough stage 3 sleep. The brain, detecting the lower O2 levels will not get into the most relaxed stage of sleep because it doesn’t want to experience even lower O2 levels. People with hypopnea therefore get mostly stage 1 and 2. This results in feeling very tired in the morning as though there was very little or no sleep at all. Which is in some ways accurate. Stage 1 and 2 are not deep. People are easily roused from these stages.

      But nothing is done about hypopnea. People with hypopnea can benefit from an oral appliance. Which one depends on anatomy. They can even benefit from using an APAP. There’s all this stupidity about “I’m not sleeping with a machine.” Sure, but if it makes such a huge difference in quality of life, I’d do it in a heartbeat. It’s just the intelligent thing to do.

      There are things like hypothyroidism which also cause airway problems. As does having a small lower jaw (moms don’t let your kids suck their thumbs). There are any number of reasons why someone would be having reduced airflow during sleep. Tonsils. Adenoids. Chronic nasal inflammation/allergies.

      I’m not going to write a book here. People need to either figure it out for themselves or have someone figure it out for them. Then do something about it.

      The biggest problem is when sleep apnea is severe. Like 35 apneas per hour each lasting 55 seconds. Yup, half the time, no breathing at all. People like that are so disabled from not getting restorative sleep they are disabled and overwhelmed by normal life and someone should be able to have power of attorney so they get a sleep study done. We have not yet recognized how debilitating it is on the decision making ability of people in this condition and have to leave it up to them to decide what is best for them. We can’t imprison them in a sleep lab.

    • Richard Nikoley on February 14, 2014 at 20:32


      Glucose can also produced in the gut.

      Google intestinal gluconeogenesis, read up.

    • Pone on February 14, 2014 at 20:54

      Richard, interesting, but what would be relevant in this subthread is does the body produce *insulin* in response to intestinal gluconeogenesis? Gabriella’s claim that the body does not produce insulin in response to endogenous glucose was what I was responding to, and I am assuming that she meant glucose from the liver.

      It would be interesting – but pretty strange – if the body produced insulin from dietary sugars and starch broken down in the gut, but then failed to produce insulin from intestinal gluconeogenesis from non-carbohydrate sources? You would think at some point both processes produce glucose in the gut that then gets absorbed, and something in that process then triggers the insulin release?

      I’m learning here.

    • Ann on February 14, 2014 at 21:08

      Gabriella, so what I think I’m hearing you say is that sleep apnea is a huge problem for a lot of folks, but that sleep studies are only partially helpful for some people. Just like all medicine, eh?

      What, then, would your suggestion be for how someone like me, who may or may not have a problem, should seek the help they need? I’m feeling ambivalent about your confidence in sleep studies to actually provide any help!

      I do have small jaw – did suck thumb – had every dentist I’ve ever had complain about how small my mouth is.

    • Bernhard on February 15, 2014 at 15:16

      Gab Kad
      Mind watching some short videos? Had CPAP here for half a year, best compliance, did not do a thing to the better. Because it could not fix the problems root. Tried it on myself, it really is not a good experience, doubt my compliance could be achieved.
      But I believe we found something better – please watch the videos.
      Apnea – snoring Dr. Moses:

      Pax. And P.S. Believe Weston Price, with his direct observation abilities and research was 100 years ahead of his time, unfortunately to this very day is so.

    • BrazilBrad on February 15, 2014 at 03:15

      @Pone, you said “Lack of dietary glucose means the liver has to produce it all from protein or glycogen, and the body has no regulation mechanism for that. ”

      The body also makes glucose from fatty acids, especially when one is eating low carb. There is a wealth of info and great (bolded) quotes in this article with many supported references and studies…

      “Thus, when insulin levels fall and ketone levels rise, as occurs when our carbohydrate intake is low, our cells increase their supply of CYP2E1 and thereby activate the conversion of fatty acids to glucose.”

      “when this pathway is activated, we not only convert fatty acids to glucose, but methylglyoxal concentrations rise and inhibit the breakdown of glucose. Thus, when glucose runs low and we begin subsisting primarily on fatty acids for fuel, we have a coordinated effort to both spare glucose and to make more of it.”

    • BrazilBrad on February 15, 2014 at 03:22

      A related study. I didn’t have the time to read/grok the whole thing…

      Effect of fatty acids on glucose production and utilization in man:

    • BrazilBrad on February 15, 2014 at 03:41

      So @Pone, going back to your claim. It seems yes, the liver produces glucose, but can use body fat and/or protein to do it.

      I think the complexity and difficulty in understanding the relationship/effect between BG/insulin/dietary-fat comes from the many different effects that Insulin has. It’s over-simplifying to say that insulin merely controls blood sugar…

      “In fat catabolism, triglycerides are hydrolyzed to break them into fatty acids and glycerol. In the liver the glycerol can be converted into glucose via dihydroxyacetone phosphate and glyceraldehyde-3-phosphate by way of gluconeogenesis”…

      “If we really do make glucose from fatty acids when times are tight as all of this evidence so strongly suggests, there should be a way for our bodies to regulate this process so that it only kicks in when we are in need of glucose. Indeed, such a mechanism exists.”

      Insulin Regulates Gluconeogenesis From Fatty Acids

  22. Grace/Dr.BG on February 13, 2014 at 14:14


    Do you know the best way to make extinct the beneficial flora? I’m sure you thought of this! And then microbes and their fermentive products (butyrate etc) affect inflammation pathways, GPR41, PPAR, cholesterol modulation, assimilation and bile acid metabolism.

    Appl Microbiol Biotechnol. 2013 Sep;97(18):8273-81.
    Cholesterol-lowering probiotics: in vitro selection and in vivo testing of bifidobacteria.

    Duncan et al (2007) AEM 73; 1073-1078
    A study was done examining the shift in gut populations with Atkins in obese patients. The best way to extinguish our worker beehive symbionts was a fiber/RS-less diet (eg Cordain’s Paleo, VLC, Atkins, Bernstein, Phinney, Volek, Eastman, GCBC).

    See slides 10-14.

    4 very significant anti-inflammatory, longevity associated and butyrate-producing subpopulations were DECIMATED by the fiber/RS-deficient diet.
    –F prausnitzii

    Do these populations ever return? Is it like a single course of antibiotics where they never re-establish even after 2 years?

    Though he blasts potatoes, even Cordain has published that early hominins consumed ~25% of their diet from underground storage organs (starchy, fiber and RS-rich tubers).

    This is the case for 2 million years of our ancestors evolution!

  23. Ann on February 13, 2014 at 14:25

    I”m pretty sure this must be what happened to me. I started having my problems after starting “Wheat Belly” in late 2011, and then going grain-free and VLC. I lost a lot of weight, but developed IBS and a host of other complaints.

    Dr. Grace, how far along were you in your progress of eliminating Candida before you started SBOs?

    • Grace/Dr.BG on February 13, 2014 at 16:50


      For me the low carb thing didn’t really control the candida that was induced by a Tetanus shot and titanium dental implant. Only fluconazole worked and it was by luck that resistance didn’t develop during the 18 mons that I had to rely on it. After some oral chelation and titanium/amalgam removal, then Trinity Natren and FloraMend (by Thorne) controlled the candida. Eating sauerkraut at every meal brought it from symptomatic reliant on probiotics to 3+/no probiotics.

      Since I’ve had regimens to eradicate the bacterial and parasitic overgrowth (which everyone has), I’ve only needed diet, fermented foods, SBOs, and fiber. The botanicals can wipe out some commensals, so seeding the gut with fermented foods and SBOs are still vital. I wish it were easier to be bulletproof though after the severe damage. After late nights or clubbing, my gut gets into trouble UGGH.

      I’ve been moderate carb since living in Shanghai for the last 2.5 years (whole soaked grains, heirloom tubers). This turned out to be the turning point for my gut and adrenal health. Actually I did the whole PS (white powder) but it made no difference because my sleep/brain/adrenals were already corrected I think.

    • Ann on February 13, 2014 at 17:11

      Thank you Dr. Grace – my doc told me I developed thrush in December because I was immune compromised. But you are saying the SBOs helped the yeast. Elsewhere on your blog you state that one should not take probiotics if one is immune-compromised. I have no idea what to do. I have Primal Defense coming on Friday, as I got very excited when you and Tim said that you both turned the corner on this gut thing very quickly once you started the probiotics. Now I don’t know what to do.

      I am awaiting the results to my MM GI Effects Stool test, but it’s been the seventeen days, and it’s not back yet. Should I wait for the test results before I take the Primal Defense?

      Also, I have read with great interest your seven steps to curing SIBO, and it all makes great sense, except I believe I’m intolerant of a lot of the sources of RS at this time. PS is out, as are white potatoes. I can eat rice, but seem to have a problem with beans. I’ve been trying the plaintain flour, and I haven’t yet determined if it’s causing some IBS at this point or not. Sometimes it takes my gut so long to react to stuff, and it takes equally as long to get past the issue. If I can’t use RS to the degree you recommend, how should I proceed with that step of the program?

      Can you also be more specific what you mean by the term “courses” when you talk about bentonite and charcoal?

    • Grace/Dr.BG on February 14, 2014 at 01:40

      By immune compromised I specifically mean post-chemo (which breaks the gut and also lowers the WBC, white immune cells) or if the WBC is suboptimal or not within normal ranges.

      For me bentonite and charcoal can be taken anytime for little issues (like probiotics) or a ‘course’ like therapeutically dosed 2 Tbs or 3-5 caps with each meal for 3-7 days, respectively.

      From your symptoms it sounds like the microvilli are broken and the enzymes to digest are missing. Perhaps gastric acid is screwed too. Does taking a 20min walk after meals make you feel better, digest better, less indigestion?

      The SBOs grow around roots — root veggies, trees, plants, etc. They degrade organic matter and prevent molds and pathogenic overgrowths to the plants that they symbiotically support. Makes epic sense, no? Evidence from medical literature is that SBOs secrete neat antifungals. They don’t work alone but once the ecosystem is set up and self sustaining, I think, everything is happy including the host.

    • Ann on February 14, 2014 at 21:25

      Gabriella, What kind of doc are you? I just love the variety of readers on this blog! I also really love the spirit of kindness and concern from folks like you that give so freely and generously of your information and expertise! It’s very refreshing for someone like me that’s become so saddened and disillusioned by my experiences with allopathic medicine.

      One question I’ve never had answered about my thrush – does having thrush mean that I have systemic candida? I guess I have been thinking that I had some systemic thing that just overgrew from my gut up into my mouth when I was under a lot of stress. Like it had been somewhat contained, but got out of control when my immune system was unable to contain it.

      Are you saying someone can have thrush without the entire body being completely riddled with yeast?

      I have wondered because I’ve never even had one yeast infection in any other area that some other women have issues with. At least nothing that’s ever shown itself. Although I do believe yeast overgrowth has something, maybe a lot, to do with my gut problems. I believe this because since treating a bit for my candida, I have started to feel better in some ways.

      I just ordered Caproyl and a psyllium seed/husk combination that is to be used with a liquid bentonite clay to try to work on my candida. My tongue just always has a slight white bloom to it these days, and it just can’t be healthy.

      I ordered the products from a website called “Whole Approach”. Whole Approach is based on a candida cleanse protocol pioneered by a nurse and acupuncturist S. Colet Lahoz. Pretty interesting stuff with a high success rate of clearing the yeast. Theyapply herbal anti-fungals in three-month cycles, and combine them with a psyllium husk and bentonite colon cleanse to push the capryol through the digestive system so that it is not immediately taken up by the liver. Pretty clever, and a lot of folks have very good results on this program. Like Tim says here, the psyllium husk and bentonite are supposed to ease the symptoms of die-off.

      S. Colet Lahoz’s book about the protocol

    • gabriella kadar on February 14, 2014 at 19:56

      Ann, thrush can happen from the acid burns on the soft tissue of the throat and palate….. It’s not always some sort of immune deficiency. When the mucous tissues are burned, the oxygen levels on their surfaces reduces and Candida loves low oxygen levels.

      The other thing that Candida loves is anemia. For the same reason: low oxygen levels in the tissues.

  24. Gordon on February 13, 2014 at 15:43

    This quote is really interesting in light of the reaction I’ve been having to PS:

    “SIgA promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking their access to epithelial receptors, entrapping them in mucus, and facilitating their removal by peristaltic and mucociliary activities”

    TMI: Been trying the RS foods and 4 tbs of PS per day for a couple of months and I often have days where I have many (5 or more) bowel movements produced with much peristaltic vigor. These movements produce well-formed poop, often tiny, as well as sometimes, uh, mucilary materials alone, sometimes with bubbles (sorry!).

    I’ve been telling myself that the far end of my system has never had the butyrate etc it needed since I was breastfeeding or whenever, so maybe it is going through a reboot or some kind. But maybe it’s the renewed immunological activity that is producing the heightened peristaltic activity.

    Perhaps this has been discussed already but the RS posts and discussions have become too voluminous to keep up with. But anyway just another n=1. I’ll keep on with the RS because the symptoms are not actually very bothersome.

    Also have the headache problems and allergies but those go back several years. RS so far has not affected them. Damn mysterious wish I had more time to research that more.

    • Richard Nikoley on February 13, 2014 at 16:54


      The SBOs, Prescript Assist, AOR Probiotic-3 and Primal Defense have resolved to 80-90% in about 10 days nagging sinus shit I’ve had forever. So nice to wake up to a clear sinus and easy breathing through the nose.

    • Gordon on February 13, 2014 at 17:34

      No way! Sinuses have been killing me for the last few years. Still haven’t figured out whether it is immunological or neurological (migraine). No paleo-related experiment I’ve done has had any effect on them. Look forward to the upcoming post.

    • gabriella kadar on February 14, 2014 at 16:28

      Acid reflux during sleep will also result in sinus congestion. Acid reflux results in swelling and inflammation of the throat and pharynx. Acid can also enter the nose with predictable results.

      Some foods in particular, consumed in the later parts of the evening can result in acid reflux during sleep. Obviously huge meals prior to sleep are a no-no. But some foods combined with alcohol (which slows down gastric emptying but won’t prevent reflux because it also relaxes the cardiac sphincter) will cause reflux.

      We’ve teased out evening apple consumption as the cause of acid reflux for one of my patients. The acidic fibrous fruits will sit in the stomach for a lot longer than, let’s say, an orange. This can annoy the stomach. As the apple clears out of the stomach (going down to the duodenum), the acid comes up. She also has chronic sinus congestion. When she didn’t eat her evening apple, she didn’t reflux. Then she decided to tempt the devil, and sure enough, proved it to herself that apples are not a good thing to eat in the evening. This includes blueberries, strawberries, blackberries. Probably pineapple.

      Less acidic fruits such as mango are fine. Less fibrous but acidic fruit is fine: clementine.

  25. Ron on February 13, 2014 at 17:02

    Been a while since I’ve commented. Interesting info about insulin resistance while VLC/Keto. I’ve been LC-VLC for 3 1/2 years… started faithfully taking resistant starch last April/May, & I figured both my FBC & HbA1C would be rather stellar. I had blood drawn in early January, which revealed some decent #s… HDL-109, LDL-101, VLDL-8, trigs-40 & CRP-0.4 Then I looked at my FBG (95) and HbA1C (5.5), & was rather shocked. OK, lesson learned… I’m now loading up on more potatoes, white rice & beans.

    • Pone on February 13, 2014 at 19:46

      Ron, those cardio numbers are phenomenal.

    • Joseh on January 28, 2015 at 10:13


      Were you able to get your FBG #s back to normal? How long did it take? I’m 3 weeks in with no movement on my 110 FBG and getting concerned.


    • pone on January 28, 2015 at 13:51

      Potato starch raised my fasting and postprandial glucose numbers higher. Interestingly, I made a significant dent in my glucose by not eating any starches or disaccharides (such as sucrose). Get the book on the Specific Carbohydrate Diet and try that out and see if you get a similar result. I get a reasonable carb load now from fruits, mostly berries, and I eat a lot of low glycemic vegetables, but no starchy carbs at all.

  26. Ann on February 13, 2014 at 18:09

    Maria Emmerch, from the blog Maria Mind Body Health just posted this article today on kids thriving on ketogenic diets. In light of recent posts here, I thought some here might find this interesting….

  27. Kati on February 13, 2014 at 20:42

    I am sad to say that the past few days PS has tasted like cat piss smells to me. So I’m going to have to find different ways to get in my RS. Question for you smarter than me: if I cook with green plantains, is the resistant starch still present in final cooked product? I know that beans still have resistant starch after they are cooked, so was wondering if it was the same deal. Thank you,

    • tatertot on February 13, 2014 at 21:25

      Kati – No idea about RS that remains in cooked plantains. Sorry, just nothing out there. The answer is ‘probably’ but I would be very hesitant to give you a number or amount you’d need to eat to make a difference.

      Could you try putting a half a green plantain in a blender with some water or milk and drinking it like a smoothy? Add some cocoa powder and sweetener or berries. A half a plantain should have close to 20g RS.

      I’m surprised you react that way to PS. Lots of people put off by the texture, but not the taste or smell.

  28. Kati on February 13, 2014 at 21:31

    Oh a smoothie! Lol. I didn’t think of that. I’ll try it in the AM with some of green plantains I have on my counter. Maybe I can sneak some PS in there. I have liked or tolerated the PS from the beginning of all this up until the past few days, so I’m willing to try other things for the RS.

    • Kati on February 13, 2014 at 21:32

      Oh and thank you, TaterTot!

    • tatertot on February 13, 2014 at 21:39

      kati – here’s my take. Try to get RS2 (raw starch granules) and RS3 (cooked and cooled) most every day. The cooked and cooled can be the bulk of your RS if you eat several servings of rice, potatoes, beans, or some other starches that have been pre-cooked, cooled (or frozen) and reheated. Yes, it takes some planning and home cooking, but it is very easy and increases the RS substantially. Then, also, try to get some RS2 by eating a green banana, a plantain smoothy, or even a spoonful of PS in a glass of water.

      If you have issues you are trying to work through and feel a higher dose of RS is needed, that’s where mega-dosing the PS can come in handy. If you are healthy and just want to stay or get healthier, try the real-food + some raw starches without really worrying about an exact dosage or even schedule.

      I usually eat a cooked/cooled/reheated starch every night and then take 2-4TBS of potato starch near bed or else eat some dried plantains I keep on hand. I’m kind of just doing it as a long term experiment, but I think most people will benefit from some type of schedule like this, even if it isn’t all that obvious what the benefits are, if that makes sense.

    • Pone on February 13, 2014 at 21:58

      tatertot, where I am still confused is which kinds of resistant starches are feeding bacteria in the small intestine, and which ones are feeding bacteria in the colon?

      I gather potato starch is primarily targeting colon bacteria. If any particular starch was targeted by small intestinal bacteria, there wouldn’t be much – if any – left by the time it got to the colon.

  29. tatertot on February 13, 2014 at 22:16

    Pone – In a normal, healthy person there should be minimal, if any, fermentation of RS in the small intestine. It was long thought the small intestine was devoid of bacteria, but that has been recently disproved. There are quite a few bacteria in the small intestine of healthy people, but still, there should not be much feeding going on. It’s possible in a healthy person, the feeding gets started, but then quickly pushed on to the large intestine where it is completed. Remember, it takes several species to fully digest RS.

    In a person with translocated bacteria, aka SIBO, overgrowths of bacteria or even yeasts or fungus, could presumably use the RS as a food source causing bloating and gas resulting in GERD like symptoms. This is Norm R’s theory and why he uses a near zero fermentable fiber diet to starve these overgowths with great success.

    You are correct, in a severely dysfunctional gut where fermentation/digestion of RS is taking place in the small intestine, the RS may not get to the colon. In this case, the overgrowths need to be dealth with.

    Grace takes a bit different tack than Norm, in her 7 steps to curing SIBO, she wants to bust up biofilms in the small intestine, plant new microbes, and feed them well so they grow like crazy in the colon and make a gut like it’s supposed to be…she refers to this as Weed-Seed-Feed, just like you’d do with a garden.

    In Norm’s plan, you can get relief from GERD or heartburn, but you may be stuck in endless ‘weed’ mode. Simply starving the bugs that want to grow in your small intestine. As counter-intuitive as this seems, he has had good success with it, and it is probably the best route for people who can’t get relief any way else. Grace’s plan attempts to take Norm’s approach a few steps further, but relies on some pretty advanced testing to ensure that the pathogens are accounted for and follow-up to ensure they stay gone.

    Hope that answers your question.

    Norm’s Plan –

    Grace’s Plan – url-removed/2013/11/how-to-cure-sibo-small-intestinal-bowel.html

  30. Pone on February 13, 2014 at 23:53

    That was very helpful and thanks. You should turn that into a reference article on this site.

    I’m feeling like potato starch is the first time I have ever actually succeeded in feeding something to the bacteria in the colon. I have tried a lot of soluble fibers – most heavily grapefruit pectin – and I just don’t see much result to suggest bacteria are processing those fibers heavily. With potato starch, there are pretty profound and immediate effects on stool volume and consistency that make me think the bacteria are just going to town and growing orders of magnitudes faster than with any other starch or fiber I have used.

    I wonder if it has something to do with the fact that potato starch in uncooked form is not forming any kind of viscous gel. The starch loosely diluted in water might just be presenting a much greater surface area for bacteria to feed in. So the amount of calories that the bacteria can metabolize might just be much much higher for potato starch than other resistant starches or soluble fibers?

  31. Michael Roll on February 15, 2014 at 14:52

    Any insight on long term VLC with a diet high in FFA, such as coconut oil?

    • Richard Nikoley on February 15, 2014 at 16:15


      Addressed way back when LCers in typical fashion said ‘huck huck I eat butter for butyrate,’ exposing their ignorance. Now, ignorance is fine, everybody has it, but it’s always funny when they strut it around. The butter and CC oil is fine, I suppose, but none of those fats make it to your colon in the way needed for colon health. For health promoting SFCAs in the colon, you need fermentable fiber, and the bugs make it for you. RS is the best of the fermentable fibers in our view, though it should be a mix.

  32. ChocoTaco369 on February 17, 2014 at 10:13

    Richard, I am cracking up right now. Why? Because this is the summary of the entire body of work by Ray Peat, Danny Roddy, Andrew Kim and the like-minded crowd. Modern disease is primarily an autoimmune condition brought on by increased FFA’s in the bloodstream. And what causes elevated FFA’s? Not just longterm low-carbing, but too much omega 6. Omega 6 suppresses the body’s ability to oxidize glucose, so even if you are eating ample carbohydrate, if you’re eating too much omega 6, you can’t oxidize said carbohydrate efficiently. Hmm…a diet with too much omega 6 even though carbs are ample? The SAD! Hmm…a diet with not enough carbs and too much FFA’s in general? Classic paleo!

    You sound like a Peatard, Richard.

    • Pone on February 17, 2014 at 16:41

      Choco, that’s a fair summary of diets, but what is your own point of view? It’s not clear if you are agreeing or disagreeing with your own statements.

      And, by the way, how does anyone avoid being overdosed on Omega-6? Eat a chicken – even a so-called “organic” chicken – and you are probably eating 9% Omega-6 in the fats of that bird. The whole food chain is thoroughly messed up by cheap grains that are then fed to farm animals.

      I audited all chicken farms in my geography and could not find ONE farm that did not feed their chickens at least 50% of caloric intake from grains.

  33. What is the quickest way to get too much sugar out of your system - Page 6 | Mark's Daily Apple Health and Fitness Forum page 6 on February 17, 2014 at 12:41

    […] eaten. It's laughable. Richard Nikoley did a wonderful writeup of this insanity around a week ago: Long Term Very Low Carb and Ketogenic Diets = Bad News | Free The Animal Low carb diets cause direct physiological insulin resistance. The body does it on purpose to […]

    • Pone on February 17, 2014 at 16:56

      I agree with the spirit of your reply, as well as of the post that Richard wrote here.

      Paleo is a trojan horse. Paleo is actually a covert ketogenic diet, which doesn’t seem to actually realize it is ketogenic. People are getting themselves into a serious mess eating eating this way.

      I think Jaminet’s modifications to Paleo in the Perfect Health Diet gets it mostly right. It’s a clear headed view of the critical issue, which is how much starchy carbohydrate should you be taking, as a minimum and a maximum, each day.

  34. BrazilBrad on March 16, 2014 at 12:56

    @SpanishCaravan, … ‘When you VLC, you potentially compromise “mucosal immunity” by adversely affecting mucins’…

    what is the mechanism causing this? Is it reduced amount of gut bugs not stimulating the goblet cells to produce as much mucin or is the reduced glucose ingested from the carbs somehow reducing the goblet cells’ ability to produce mucin?

  35. BrazilBrad on March 16, 2014 at 13:43

    Is it that with VLC’ers gluconeogenesis cannot produce enough glucose for adequate mucin production? Have their been studies that show this?

  36. TravellingBeard on April 21, 2014 at 08:37

    I know this is an older post, so hope my eyes didn’t glaze over the answer, but curious if there are recommendations how long one should be on VLC, IF you approach it as a treatment/intervention rather than a long-term thing? From your research/experience, how long before the mucin issues Paul Jaminet mentioned become an issue that it is recommended to lay off VLC?

    • Richard Nikoley on April 21, 2014 at 09:44

      “but curious if there are recommendations how long one should be on VLC, IF you approach it as a treatment/intervention rather than a long-term thing? From your research/experience, how long before the mucin issues Paul Jaminet mentioned become an issue that it is recommended to lay off VLC?”

      Well, in my view, once your fat loss has “stalled,” that’s the signal that VLC is no longer working for fat loss and that by persisting, like lowering carbs even further is going to bring on metabolic issues.

    • TravellingBeard on April 21, 2014 at 12:16

      Thanks very much…let my body do the talking kind of thing is where it’s at then.

      It also seems the PHD version of the ketogenic diet seems more sustainable because of the starch requirements (200 calories minimum if I recall), as well as MCT Oil (4+ Tbsp/Day).

  37. Bushrat on April 27, 2014 at 05:00

    Can’t believe that I missed this shit when it was first posted. I have an actual immunodeficiency and receive intravenous IgG monthly. I started eating paleo to try and improve my health and eventually went low carb. That was nearly five years ago and so far I have only improved. I didn’t cure my immunodeficiency (since it is not something that can be caused by diet) but did fix a lot of inflammatory issues and possible autoimmune problems. Keeping inflammation as low as possible is the most important thing I have to remember so as long as I stay low carb and particularly avoid sugar and dairy then I kick ass. I work a manual labour job and go like the energiser bunny whilst coincidently having less sick days then almost anyone else.

  38. Bushrat on April 27, 2014 at 05:12

    My point, which I forgot to make, is that if I had not switched to Paleo/LC I would be a skinny fat sickly guy who spends three to six months of the year laid up and has to drag himself out of bed every morning and is buggered by a day of sitting in an office. When I first switched to paleo I went through a massive low carb flu which I suspect was candida die off and every time I go higher carb (Christmas holiday binge – two weeks plus of bad food and alcohol) I start encouraging candida again. Had it not been for that initial LC experiment which I believe killed off my candida overgowth I would not have seen an improvement. Once I saw that improvement and set it as a baseline I could experiment with higher carbs and see they are not for me. I suspect many people’s poor health is in part candida overgrowth coupled with inflammation and they need to do a period of LC to kill off candida and reign in inflammation. At least three months of this and then they can experiment with adding carbs in and see if it negatively effects them. If people suffering from candida and/or systemic inflammation do not go through that LC period of withdrawal symptoms then they are wasting their time. Encouraging them to skip that is doing them a disservice. The point I am trying to make is that maybe your resistant starch idea has merit (hard to find RS in Australia so I haven’t tried it yet) and maybe LC is not good for the long term but people are better off if they go LC for a few months initially before experimenting with higher carbs/RS and finding a post like this informing them that LC has no benefit will force them to skip that important ‘reset’ whereby they rid themselves of candida and reduce their inflammation.

    • Pone on April 27, 2014 at 10:49

      A few tablespoons of potato starch each night contributes very few calories. It has no effect on whether you are low carb or not.

      How did they diagnose your candida? Was that done by a gastroenterologist?

    • PC on June 6, 2014 at 09:05

      I agree. I did VLC for about 5 months and I feel it has given me the “reset” you describe. I have since binged on sugar, dairy and am now experimenting with other carb sources, but I’ve had a lot of inflammation since this binge. What I’ve learnt is that grains are still a no-no (an accidental bite of gluten caused massive inflammation) and quinoa makes me inflamed too. I’m naturally gravitating back towards low carb because that’s honestly when I feel at my best.

  39. Debra on June 3, 2014 at 12:45

    I just recently found out that I have Hashimoto, what is the best eating plan for this condition. I read so many conflicting stories.

  40. rose mcduff on September 4, 2014 at 09:32

    Low carb made me insulin resistant and im desperate to regain my insulin sensitivity. When i eat carbs i have a adrenaline reaction. I suffer from dawn phenomenon unless i drink red wine. Hoe can i regain my insulin sensitivity. Before low carb i had heaps of energy. Any advice would be greatly appreciated. Thankyou , rose

    • Richard Nikoley on September 4, 2014 at 10:07

      Rose, I’m no clinician, but if you never exercise, then do, you’re also going to have an adrenaline reaction, elevated heart rate, etc.

      So, take it easy. How would you commence regular exercise if you had not done any in a ling time?

  41. Kate on September 25, 2014 at 08:36

    I realize this is an older thread, but I do see some newer comments. Wanted to throw out my n=1 exeperience which I think is very similar to that of Spanish Caravan. I’d love to understand what is going on with my body, and this blog seems to be the only thing that is making some sense.

    I’ll try to keep it short. Prior to January of 2013 I had been eating a “healthy” SAD (I know, oxymoron), but made a big life change when I started to do P90X and make fitness a bigger part of my life. I was already working out regularly before that, but I was ready for real change. Started eating lower carb while I did P90X and then in April of 2013 I decided to give keto a try (<30 g net carbs per day). After the initial transition, I was on top of the world… more energy than I had ever had, and no more problems with hypoglycemia that I had in the past. I couldn't imagine ever NOT doing a ketogenic diet, and had intended for it to be permanent lifestyle change.

    Fast forward to December 2013 and I literally thought I was going to die. Came down with severe abdominal pain of unknown origin and couldn't even keep water down… lost 20 lbs from my already small frame. I was in and out of the hospital for a month with zero explanation for my symptoms despite every test known to mankind. The only thing that really was worth noting was that my eosinophils had skyrocketed. Now, I will say that this isn't unusal for me because I have a long history of environment allergies and sinus problems, and there has always been the question of whether I have an autoimmune disease. Really didn't think the two were connected.

    But my eosinophils have remained high, I've developed eosinophilic gastrointestinal disorder (they say this could be due to food allergies… none of which I've ever had before!) and my IgG levels are deficient and dropping! So now there is more talk of autoimmunity and also immunodeficiency.

    What in the heck is going on?!? Did keto cause this? Since I got out of the hospital in January, I've been living in the approx. 100g of carb range, so in theory I'm no longer in ketosis. My diet is more in line with what is recommended with the PHD.

    I'd love to hear some thoughts. Sorry for the novel!

  42. Corey on July 16, 2015 at 19:17

    You know ketosis is awesome, saturated fats are healthy, trans fats are not there very very super minimal amount in animals your favorite Doritos probably have more than meat. Plus it’s based on mono and poly unsaturated fats which help the blood and system. Yeah carbs are tasty but if it’s that and my health I will take fatty foods any day over carbs sorry

  43. Tuba on July 25, 2015 at 12:34

    What pathetic nonsense. It’s all anal-retentive garbage that is as mythological and irrational as the medical old guard. Ketosis is a superior metabolic state FOR LIFE. Fund some other excuse to parade your nescience.

    • Richard Nikoley on July 25, 2015 at 18:35

      So you assert, Tuba. Just assert, and with caps in place of an argument.

  44. siiis on January 17, 2016 at 03:10

    The problem with what you’re saying is that what we live in today, this abundance is not normal humanity.

    The fact is, meat is a huge part of our diets right up until two things start happening in human society, and both have to happen first. One, we become agricultural. Two, most of our food is from our agriculture and meat has become considerably more expensive than plant-based foods.

    Then, the rich get meat, and the rest of us get plant-based foods. Kind of what Democrats are causing to happen in the U.S. right now.

    You see, if you haven’t noticed, there’s been a dramatic drop in the amount of fats and meats that we consume in our foods.

    And there has been a dramatic increase in the amount of diabetes, heart-disease, and all of those health-issues that we are told fats cause.

    Well, fat hasn’t been increasing in our diet. It’s been dropping. Carb-based foods have been increasing to replace those fats and meats that are becoming increasingly prohibitively expensive.

    You may feel it convenient to try and blame the meats and their fats, saying that they are contributing to diabetes, that low-carbs over the long-term contributes to diabetes,

    but we’re not eating less carbs in society. We’re eating substantially more. And diabetes is increasing, not decreasing.

    Also, diabetics, do you realize that when they go on a keto-diet, often, it’s like they’re completely cured of diabetes, though they aren’t, and if they go back to carbs, they’ll exacerbate their diabetes even more.

    However, if they stay on a keto-diet, they tend to have no discernible issues related to their diabetes. Some, it’s medically like they no longer have diabetes. And the only reason they know they do is because if they go back to a carb-diet, their problems return.

    • Richard Nikoley on January 17, 2016 at 06:38

      You are conflating junk food with real food.

      Not interested.

    • Lily on January 14, 2017 at 02:48

      @siiis this is completely true. I reversed my type 2 diabetes since going keto. All of my labs are perfect good/bad cholesterol etc. My doctor was amazed and couldn’t understand how I did it after not staying on the SAD and “exercise.” I’ll never go back to starchy carbs. Keto ain’t for everyone, but people that it don’t work for shouldn’t bash keto or those it works for. Some people can get the SAD and have no health issues. Again, do what works for you, low or high carbs, but don’t knock keto when there’s plenty of evidence from real people that it has helped.

  45. Jemmah on January 13, 2017 at 10:41

    I’ve done the LCHF keto diet, and I felt like absolute shit, no health regime should make you feel like that! And since when is an apple bad??
    After ALOT of research on this diet, I am really angry at myself first and foremost for being so stupid and wasting my time on this fad diet and I am also angry at the lack of information that is provided as to how much the diet can have an adverse effect on your health after a duration. Especially so for the more vulnerable and easily influenced people out there, ie teenagers. Yes it does get rid of fat and water, but only short term. Fat adaptation my foot!! Once you start adding forms of carbs again the weight and water comes back tenfold. But at what expense is this short term result diet worth? Thrombosis? Halitosis?Heart failure? Gout?
    Apart from aiding individuals with type 1 diabetes and epilepsy again short term as it not a cure for diabetes or epilepsy, it’s a lazy persons quick fix diet and it’s bullshit and Dr Atkins has alot to answer for. Who in the right mind would follow a diet from the 70’s? (Me obviously)The decade that bought convienience processed food to its peak? We have moved on people. If evolution meant for humans to only eat fat and protien all our lives we would not have been given the ability to turn carbs into fuel full stop. Not to mentioned the plethora of side effects the diet brings also, who wants bad breath like that? People would be able to smell you before they saw you. Not the most attractive attribute if your in sales and have to meet people face to face.

    I know I won’t change peoples opinions cause they think they know best. But keep it simple stupid, don’t eat refined processed food ALL the time. Treats are OK. When you eat, do more!! There is no mystery or quick fix to weight loss. It’s determination and hardwork. Nobody ever succeeded by sitting around waiting my for a miracle. I know this may sound easier said than done, but it took me 7 years to lose 10 stone and keep it off. No miracle came funnily enough just lots of exercise, vegetables, fruit, protien and low gi carbs. I know people have certain food allergies too and not all people can follow a certain diet. But getting rid of forms carbs in fruit and veg isn’t the answer, it will kill you slowly but surely. Amen

  46. Bret on January 14, 2017 at 06:22

    Nice blast from the past, via FB link.

    It is striking the contrast between the amount of VLC advocacy in the comments three years ago vs. today.

    It does seem like people are coming around and this Atkins epidemic going back into remission.

    BTW, I want to clarify, Brett up there is not the same as me. (Easy to tell by counting the T’s, but I’m constantly shocked by how many people lack that basic attention to detail.) 🙂

  47. Mandi on January 17, 2017 at 07:34

    I was VLC for over 3 years, I’d cheat only at Christmas (life is meaningless without xmas cookies imo). I came to this very same conclusion… I’ll quote you from a previous comment:

    “The way to exercise metabolic flexibility is how it’s always been done naturally: periodic, intermittent fasting.”

    I got to this article because I was looking at why I was having so many more infections lately. I have chronic EBV anyway, and it wasn’t until I started attacking the biofilms with garlic and other similar foods (not supplements, notice) that I recovered. I was on three consecutive courses of antibiotics and still could barely breathe, plus antiviral, plus antifungal. That was this past fall, about 3 months after stopping the keto diet.

    The reason I started it in the first place was that I had daily migraines and the diet stopped them finally. Drugs had a very limited effect on the migraines, probably because back then, I had no idea I had EBV, or that it can lead to encephalopathy. But after a few years I started to get the feeling that “things / bugs / germs” were growing on the fats. It was an intuitive feeling, so I decided to give a more normal diet a try.

    When I did the diet, I wasn’t using the popular books, I was calculating it with chronometer dot com food tracker and being also guided by the medical book “Ketogenic Diets” that is meant for children with epilepsy. I was calculating a 2:1 diet most of the time, but not with use of fat bombs followed by cheating which is what many people do. Every meal was that ratio or it wasn’t eaten.

    Fasting was super simple, but lead to leg pain, so I just didn’t do it much anymore. I never had a “keto flu” not even the first time. If you get the ratio right from the start, and start with a fast, it doesn’t hurt as much. But those tips are not often given in ordinary keto books or articles, instead we have a lot of permissive articles that mess it up so it can be more “mainstream” and “easy.” The opposite is true, stricter is less painful.

    But the upshot ultimately was that my immune system, while not attacking me anymore, was also lowered, and after a while the backlash was worse than if I’d chosen something else like IF or just Atkins regular. I also did not lose any significant weight on the diet, but I do with IF. I think if I did it again, I’d be on the keto diet for about 6-8 months, long enough to reset my immune issues, and then eat better afterwards. It was also a myth that you get no cravings. I craved berries and vegetables every day. I had no craving for rice or such things, but the fresh fruits and veggies just called out to me. I resisted, but I didn’t think that was healthy.

    Thank you for posting this article, it has helped me find some sanity and not feel so alone in my decision to quit a diet that wasn’t helping me. Conforming, even around a good idea, is not freedom and is rarely truth.

  48. Mandi on January 17, 2017 at 08:01

    This quote from the article intrigues me if you wouldn’t mind explaining why Vitamin D would be involved in runny nose and/or immune deficiency: “Some people never get diagnosed because these are crypto disease states that are normally referred to specialists only when symptoms become severe. You’ll never suspect you have selectively immunodeficiency; your only symptom might be a mildly runny nose, especially if you supplement with Vit D.”

    It might be genetic, but my body ignores oral D3, so I am prescribed D2. I also make a homemade skin lotion with tons of D of both kinds in it. It’s the only way for me. The comment above made me wonder if there is some connection with the keto diet I was on or if it indicated something else. I just get parroted the same phrases by doctors “most people… ” yeah, ok, I’m not one of them, so stop there, doc.

    • PaleoPhil on January 28, 2017 at 09:25

      “your only symptom might be a mildly runny nose, especially if you supplement with Vit D.”

      Mandi, Spanish Caravan meant that vit D supplements may mask symptoms that would otherwise show, leaving only seemingly mild symptoms like chronic runny nose or maybe cold extremities, which chronic keto diet believers tend to dismiss.

      He went into more detail in his comment here:

  49. Lili on March 6, 2017 at 05:01

    Dear Richard

    Sorry I didn’t know where to write my post.

    I found your website thanks to Dr Ayes and Darwinian. Dr Ayes has a theory about Celiac+antibiotic being part of the problem for thyroid issues. Do you have info I can read about it? Also he advise to avoid any grain, consume prebiotic fiber and incorporate new bacteria to the gut, any advise how can I do all these 3 things thanks. Greetings from Norway.

  50. Laura on May 3, 2017 at 13:25

    Hi there,

    A quick question. I am a female in my 30’s, prediabetic with major hypoglycemic tendencies. I finally solved the hypoglycemia problem by switching to a ketogenic diet. I can leave the house without a purse full of snacks and glucose tabs, I can keep up with my kids better, etc. Major quality of life improvement, not having to deal with harrowing blood sugar crashes on a semi-regular basis.

    What do you recommend for someone like me, who experiences such a clear and functional benefit from avoiding carbs?


    • Robert on May 4, 2017 at 00:12


      I’m also in my 30’s, and I had similar problems, although not as serious. Hypoglycemia was fairly bad. When I had to eat I had to eat, got angry and desperate. I always needed to be full. I also had higher fasting blood glucose, on the verge of prediabetic definition.

      I then went low carb, and it was like “coming home”. Felt really good on it. But after some time (1.5 yrs) problems started, for example sleep problems. And my wife developed eczema for the first time in her life. I realized something was up, investigation lead me to leaky gut, and that ketogenic diet can cause this, and also sleep problems.

      We then added more carbs to our diet, with the inclusion of resistant starch and other fibers and much veggies. 16:8 intermittent fasting is also our daily routine.

      The result: still no problems with hypoglycemia. Sure, if we fast for really long there will be times when the brain gets sluggish. But going 6-7 hrs even after a meal with much carbs is not a problem. I think fasting and especially resistant starch helps with insulin resistance. A person with healthy insulin system can do great on a mostly carb diet. It’s just us with problems who can’t handle it. Attack the problem, and you will be able to handle more carbs.

      I’m not suggesting huge amount of carbs, but look into the Perfect Health Diet.

    • Jarrod on May 4, 2017 at 23:51

      Keto as a macro ratio doesnt cause IBS or any other gut related issues, what causes the issues, is the choice of foods, and most people tend to think Keto is a narrow set of mostly meat and fat products, but fail to understand that plant fats and high fibre veg like broccoli, celery, chard etc are what needs to be consumed as well. and that not every meal has to have the same ratio. so if you have a salad for lunch you do not need to have fats on it as long as your overall balance is made up for in other meals, also fewer larger meals over all works better with this style of diet due to the food components taking longer to digest.

    • Richard Nikoley on May 5, 2017 at 00:41

      LOL, Jarrod

      People dress there salads in 2-3 tablespoons of fat for a reason.

      On any given day, I blame blue cheese dressing for the obesity epidemic.

      What if nobody ever ate salad? Huge caloric savings.

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