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To Reiterate, Just In Case You Missed It: No Elevated Ketone Levels in the Inuit

Sorry Low Carb dieters: the Inuit just aren’t that into you

Since this post the other day and subsequent exchanging of some emails and comments here & there with those I’d generally consider advocates of very low carb dieting—to include those advocating near perpetual states of ketosis—I’ve been met with surprise bordering on disbelief that indeed no, the Inuit are no more a “ketogenic society” than anyone else across the planet Earth.

And if not, then there is literally not a shred of any basis that chronic ketosis is a healthy state to be in (and so sorry, but I’m just guessing it’s not “nutritional,” either).

Let’s dive into the three old papers cited in that other post: 1928, 1936, and 1972, all with identical findings.

STUDIES ON THE METABOLISM OF ESKIMOS. Peter Heinbecker. Departments of Biological Chemistry and Physiology, Washington University School of Medicine, St. Louis. July 9, 1928.

The main objects of the experiments were to learn whether detectable ketosis exists among Eskimos under natural dietary conditions; the extent to which ketosis develops in fasting and the rate at which it disappears on glucose ingestion; the “carbohydrate tolerance” as indicated by blood sugar curves; and to determine the respiratory metabolism during and after a ketosis-producing fast. […]

It may be said at once that the Eskimo on his usual dietary shows no ketosis and has high tolerance to ingested glucose. […]

Eskimos show a remarkable power to oxidize fats completely, as evidenced by the small amount of acetone bodies excreted in the urine in fasting.

[emphasis added; note also that “acetone bodies” and/or acetoacetic acid are what are commonly referred to today as “ketone bodies.”]

The paper explains why they’re not in ketosis. Two reasons.

  1. Very high protein intake (av. 280 grams/day; fat only 135 grams)
  2. Low carbohydrate, but not very low carbohydrate (“54 gm. of carbohydrate of which the bulk is derived from the glycogen of the meat eaten.”)

Accordingly, with super sufficient protein to make glucose from dietary protein, combined with the meat carbs (liver and muscle glycogen) they get from eating raw, fresh kills, they maintain good glucose tolerance and insulin sensitivity.

Screen Shot 2014 03 31 at 8 27 24 AM
Normal glucose tolerance with adults receiving about 120 grams 12 hrs after last meal

In order to produce deep ketosis, which the paper explains they were very resistant to, they fasted the subjects for 82 hours. Guess what happened to their glucose tolerance? Shot to hell would be an understatement! This should be a sobering picture for anyone experimenting with prolonged ketosis (starvation).

Screen Shot 2014 03 31 at 8 28 16 AM
280-300, and over 220 for three hours after the same 120 gram dose of glucose

Wow, they must be DEB3ATEEZ! No, they were put into starvation, and in order to spare essential glucose for the brain, the metabolism no longer gave a runny shit about cellular sensitivity to insulin. Yea, really healthy and “nutritional,” that chronic ketosis thing.

Now, tell me again how “there’s no such thing as an essential carbohydrate.”

Now I understand exactly what happened when months ago, thinking ‘hmm, maybe there’s something to this,’ I began eating 4-6 oz. portions of protein rather than 8, 12, 16 or more. Upped the fat, stayed lowish carb, and then when I did have a carby meal, glucose tolerance was shot to hell and I’d see 160-180, even 194 once. I also now understand perfectly why upping my carbs to 100-200 of starch daily restored my tolerance to normal human.

Moving on.

A STUDY OF THE BLOOD LIPOIDS AND BLOOD PROTEIN IN CANADIAN EASTERN ARCTIC ESKIMOS. Arthur Curtis Corcoran and Israel Mordecai Rabinowitch. Department of Metabolism, The Montreal General Hospital, Montreal. December 13, 1936.

Both lived at Dundas Harbour, on Devon Island (lat. 74deg 35′), and had had practically no carbohydrate food other than the glycogen of animals for about 10 months before the tests. In each case, the test was commenced in the fasting state and the concentrations of the different plasma lipoids were determined before and again 1, 2 and 3 hours after administration of the oil. […]

Also suggestive of an unusual mechanism for the utilization of fat is the absence of ketosis in these natives, whereas the urines of both of Tolstoi’s subjects contained acetone. The explanation of this absence of ketosis is not entirely clear. As shown previously [Rabinowitch & Smith, 1936], though the small amount of carbohydrates in the diets may be more than balanced by the potential sugar production from the large amount of protein to keep the ratio of fatty acid to glucose below the generally accepted level of ketogenesis, the respiratory quotient data suggest another mechanism also. That the Eskimo possesses a very active fat metabolism is suggested from some of the data. [emphasis added]

I can hear the VLC/Keto “nutritionists” now: “SEE, LC MAKES UZ A FATZ BUR3RZ!” Yea, but they’re not in [“nutritional”] ketosis. They’re eating their meat fresh and raw, lots and lots of it (high protein), getting glycogen from it, and it’s also plenty enough to ensure robust gluconeogenesis from dietary intake.

They are not putting themselves into a “nutritional” state of starvation by restricting protein along with carbohydrate, in order to consume more micronutrient bankrupt fat, without even resistant, fermentable fibers to ensure vitamin-synthesis by gut microbes—just to ensure keto-hocus-pocus long term. The Inuit are not doing anything like it, have never done anything like it, and would avoid it like the plague if they had ever even conceived of such a harebrained idea.

A final note on this one, because some are surely going to purposely misread the study so they can lie. First of all, as the paper makes clear, this was a study about blood lipids and the differences between different populations, i.e., those eating a “civilized diet,” vs. those further north eating predominately their natural diet, except for at most 2 months of the year (remember that number).

In order to determine the efects, if any, of the dietary habits of these natives, the data, as stated, were divided into two groups, namely, (a) those obtained in Hudson Bay and Strait amongst natives who live, to an appreciable extent, upon mixed diets, and (b) those obtained in Baffin and Devon Islands amongst natives whose diets, except for about 2 months in the year, consist of the natural foods of their environment (seal, whale, narwhal, walrus, etc.). A summary of this division of the data is recorded in Table III in which are also recorded, for comparative purposes, the average values found with the same technique amongst civilized peoples. It will be noted that the average concentrations of total lipoids, neutral fat, total fatty acids and phospholipins and the average ratio of phospholipins to total cholesterol were higher amongst the meat-eaters than amongst those whose diets, in addition to meats, consisted also of appreciable quantities of carbohydrates (flour etc.). [emphasis added]

Now, recall what I quoted above:

Both lived at Dundas Harbour, on Devon Island (lat. 740deg 35′), and had had practically no carbohydrate food other than the glycogen of animals for about 10 months before the tests. […]

…the absence of ketosis in these natives. [emphasis added; plus, 10 + 2 = 12]

…Just so you can keep your liars straight.

ALASKAN ARCTIC ESKIMO: RESPONSES TO A CUSTOMARY HIGH FAT DIET. Kang-Jey Ho, M.D., Ph.D., Belma Mikkelson, B.S., Lena A. Lewis, Ph.D., Sheldon A. Feldman, M.D., and C. Bruce Taylor, M.D. The American Journal of Clinical Nutrition. August 25, 1972.

Grain products and simple carbohydrates are virtually absent from the diet, as they must be imported from a great distance at considerable cost.

The marine mammals and the herds of caribou, upon which the Eskimos depend, tend to be migratory, and famines occur occasionally, especially during the long dark winters (5, 6). In the summertime, their diet is usually plethoric. In general, they have no fixed time for meals and eat as they please, but they usually do have one good meal toward the end of each day. Much of their food is eaten uncooked, partly from preference and especially from necessity, because fuel is scarce. […]

Average total daily caloric intake was approximately 3,000 kcal per person, ranging from 2,300 to 4,500 kcal. Approximately 50% of the calories were derived from fat and 30 to 35% from protein [260 grams on average]. Carbohydrate accounted for only 15 to 20% of their calories, largely in the form of glycogen from the meat they consumed. Grain products were scarce and although sucrose was not unknown, the average adult ingested less than 3 g/day, primarily for sweetening tea or coffee.

Are you noticing a pattern here in the composition of diet in all three studies, and that the the VLC, ketogenic and Zero Carb folks have it conveniently wrong? How many times have you heard over the years that “Atkins is not a high protein diet, it’s a high fat diet?” Well, Atkins may indeed be high fat, low to moderate protein, but it certainly doesn’t have the Inuit as a healthful population as an example, to justify such tomfoolery—as its proponents seem to do endlessly; nor does it have any other population I’m aware of, either. Moreover, much of that protein was fresh and raw, thus providing significant glycogen (carbohydrate) from meat, another aspect that in no way supports a VLC, Ketogenic, or ZC diet. The entire very low carb phenomenon is in part a charade when it uses these Inuit and other populations to justify doing something so unnatural, so unprecedented!

And sorry, but in all cases in all three studies, protein is 250 grams and upward, on average. Ever tried to ingest that much protein without drinking it? Well, I have: 280g on workout days and 230g on rest days, while doing LeanGains for months. It’s high protein. Trust me. I hated that part the most, especially when it had to be combined with lower fat on the workout days, in order to accommodate far higher carbohydrate and stay within total caloric bounds because for Martin Berkhan, it’s count calories or go home. So this is another thing Atkins and other VLCers get wrong if in any way thinking they are modeling some natural, proven healthy diet by claiming it’s not and should not be very high protein. It’s not even close. And by the way, Atkins isn’t even a ketogenic diet beyond induction and as I recall, one was supposed to find the level of carbohydrate that would keep him out of ketosis. So, this whole “nutritional ketosis”” (an enormous contradiction in terms, incidentally) thing is even a vast departure from Atkins, all the while Atkins is likely too low in protein for many practitioners. What a mess.

Well, no need to delay further, you already know the punchline.

Each Eskimo’s serum was tested for the presence of ketone bodies by the strip paper technique (18), which is sensitive to concentrations of 1 mg/ 100 ml or greater and all serums were negative. This does not preclude an increase in ketone body production during this time; usually these substances do not attain noxious concentrations until after fasting periods longer than 50 hr. [emphasis added]

So there you have it. Three studies separated by 44 years, from the West of Alaska to the Hudson Bay, all on Inuit with just about the same high protein dietary ratios, all on their natural diets, and not a single subject in ketosis, ever; and it was more difficult to get them into ketosis than for normal subjects, requiring them to be starved for more than two days straight.

So, what are the lies of commission and omission by advocates of very low carb, ketogenic and zero carb diets we’ve exposed so far, over the last few weeks?

  1. The poster child Inuit do indeed get carbohydrate, above 50g per day on average, from “meat sugar” (liver and muscle glycogen that’s only available in appreciable amounts when fresh and raw). See more here.
  2. The poster child Inuit do indeed get fiber, from meat (glycans in the raw blood, raw meat, raw grisly bits and raw connective tissues that resist enzymatic digestion and the gut microbes take over). See more here. Here too.
  3. The poster child Inuit are never in ketosis unless in a severely fasted state.
  4. The poster child Inuit indeed eat as high protein as possible, in oder to have adequate glucose available, both from the aforementioned glycogen, as well as in sufficient quantity for gluconeogenesis without wasting lean tissue.

In other words, I can’t think of a single thing I can recall from VLCers, ketosis fans, or Zero-Carb zealots about the Inuit that’s true and accurate—at least in the context of what their diet actually is and how their metabolism responds to it.

Do you believe this is all an innocent mistake? After all, even the oldest paper, from 1928, seemed to take it as an matter of course that carbs from meat (glycogen) was obvious and well known, and all three papers mention that matter-of-factly.

Accordingly, I think you’ve been conveniently lied to by some people. Why, would be up to you to form an opinion.

So, what are my closing thoughts, suggestions? It’s simple. In order to do LC healthfully, based upon the lowest carbohydrate intake of any population we know about, you:

  1. Get that protein high, and unless I’m not mistaken, this has always been Dr. Mike “Protein Power” Eades’ take on LC. Good for him.
  2. Unless you’re a hunter out eating your kills fresh and raw, including the offal, then you need to get at least 50g of carbohydrate daily. I’d suggest safe starches (rice, potatoes, traditionally prepared legumes).
  3. Get over the notion that fat is particularly healthful or nutritious. 50% of calories ought to be about the upper limit.
  4. Scroll up and look at the 2nd chart again and get over the notion that a state of prolonged ketosis (starvation) is in any way healthful and does anything but mess up your glucose tolerance and insulin sensitivity royally. Inuit have excellent glucose tolerance when eating their natural diet. You don’t, if you’re keeping yourself in ketosis.
  5. Get over the notion that when in ketosis, eat a piece of birthday cake, and see your BG spike to 200 that “you can’t tolerate any carbohydrate.” No, you’re just confirming a bias based on bullshit information. You’ve fucked up your tolerance and insulin sensitivity by following shitty, wrong advice. Your fault. Your metabolism is probably fine if you follow the above steps. Expect to have high readings for a few days until you adjust. Toss your meter for a while, so you don’t freak yourself out.
  6. Exercise ketosis intermittently. It’s called a fast. 1-2 days, once every while. Likely healthful in terms of hormesis and autophagy.
  7. Get resistant fermentable fibers like resistant starch in your diet so that your gut bugs have the substrates by which to synthesize vitamin nutrients. And in order to ensure that you’re not feeding empty cages, such as after lifelong occasional rounds of carpet bombing antibiotics, or years of VLC dieting that has starved some of them to extinction, get on some rounds of soil-based probiotics.
  8. Stop being such idiots about all of this.

Alright then. Does that about cover it?

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

153 Comments

  1. DuckDodgers on March 31, 2014 at 13:45

    Nice post.

    But, I would add that likely every single bite the Inuit consumed contained “animal fibers”. It wasn’t just the “grisly bits”. In a freshly killed animal, glycans are everywhere in the animal. And these glycans tend to be indigestible carbohydrate compounds that make up “animal fiber”. These glycans are found in the muscles, in the blood, in the skin, etc. These ingestible glycosylated carbs are everywhere and constitute various forms of animal fiber.

    So, for instance, drinking the fresh raw blood tapped from the side of a cow — as the Masai do — is chock full of glycans. In fact, blood has about 150 different kinds of glycans in it!

    http://www.ncbi.nlm.nih.gov/pubmed/16052617

    That means fresh blood is likely an extremely prebiotic drink.

    I think people are getting the idea that “animal fiber” is just in the connective tissues and “hard” pieces. But that’s not true. The glycans are in every single bite of a freshly killed raw animal. Every bite the Inuit ate was full of animal fiber.

    Really any piece of fresh/raw animal should be full of prebiotic glycans. Sushi included.

    • DuckDodgers on March 31, 2014 at 13:47

      And, yes, cooking and time degrades most of these animal fiber glycans. The only glycans that really survive over time and heat tend to be the dry/hard pieces. Better than nothing, but probably not much compared to what the Inuit and Masai consume when they eat/drink fresh and raw animal products.



    • Richard Nikoley on March 31, 2014 at 13:58

      Thanks Duck. Edited accordingly.



    • Borofergie on April 3, 2014 at 01:02

      A raw meat diet you say?

      Take a look at this picture:
      http://i.imgur.com/4R6QisK.jpg



    • La Frite on April 3, 2014 at 02:59

      Wow, cool picture! It actually made me feel like eating some! Primal instinct is waking up in the middle of the IT office where I am sitting on ass programming some BS …



    • Borofergie on April 3, 2014 at 03:21

      You should come to one of my BBQs. Once you get past the burnt on the outside bit, it looks exactly like that in the middle.



    • La Frite on April 3, 2014 at 03:27

      Yeah, I like the meat rare. My wife hates it … since I am the home cook, I have to prolong the cooking time for her. I tried to convince her that the longer is not necessarily the better but quasi raw-meat is repelling to her … sigh … (and if you could her face when she sees me eating raw pieces of liver in the kitchen … I have to hide from her … )



    • Regina on July 21, 2014 at 20:56

      Fantastic post Richard!! Thank you.
      As well, it is great to read DuckDodgers research insights.
      It’s sinking into my narrow brain pipe little by little. I wish I had the cojones to eat raw fresh kills. :o) Though I could eat sushi all day long.
      I really want to do right by my dog. I think I failed my beloved Woody who died of prostate cancer last year. I fed him a very good quality raw ration of nose to tail cow. But I didn’t know anything about animal fiber and “glycans”, etc…. With our surviving dog, I am adding some larch arabinogalactan, a prescript assist OR an AOR Pro3 OR a Prima Defense, a sprinkle of pysilium, a little white rice or potato. Now, his raw meat source is from local pastured ruminants (lamb, goats, cows – ground pancreas, spleens, hearts, livers, kidneys, tripe) and I’ll throw him a marrow or knuckle bone 1x wkly. Does the slaughtered, freshly ground and then frozen organs still have enough carbs? Is this balanced with the fiber hack I’m adding?
      Dreaming of seal skin (sorry PETA)….

      Amazing info here. It takes me a while to wrap my head around it but I think I get it. Had my first black beans in a while tonight. Let them bubble a bit on the counter and then slow cooked. Yay!



    • Duck Dodgers on July 21, 2014 at 22:02

      Regina,

      It appears that dogs evolved, over the past few thousand years, eating our starchy leftovers. This is evidenced by the fact that domesticated dogs developed genes to break down starch:

      The Scientist: Dogs Adapted to Agriculture

      It’s very difficult to get freshly killed meat for a dog. And it’s not like humans have been eating much freshly killed meat once agriculture came to be (agri-meat is traditionally hung for tenderization). So, in the spirit of human/dog tradition, I’ll just give my dog a few scraps of starchy leftovers with their raw meat. Sometimes I’ll just give my dog a little spoonful of raw honey.

      Oh, and I’ve also started giving my dog an Honest Kitchen base mix, which has a good amount of raw natural plant fibers. Her stool is a bit bulkier, but I think she’s fermenting more SCFAs now.

      I knew something was amiss when I took my dog to the farmer’s market one day and she started whining and pulling me towards the pile of sweet potatoes — wagging excitedly.



    • Ellen Ussery on July 23, 2014 at 04:17

      I have had great success feeding my 16 year old cairn raw organs (local, pastured, etc!!) mixed with a bit of fish, some minced carrot and greens and a berry or two, a bit of yogurt mixed with some powdered kelp and alfalfa. That is dinner, breakfast is a vew raw chicken necks.

      As for probiotic I have been using Proviable, which seems much more effective than the other dog probiotic i was using. i am not sure it is a good idea to use human probiotics.



  2. DuckDodgers on March 31, 2014 at 14:14

    It’s also important to understand that by eating raw meats and raw fats the Inuit were also consuming raw enzymes. Their bodies didn’t need to create their own enzymes so their energy needs would have been lower than someone who consumes a cooked meat diet.

    For instance, if you eat raw fat, you also consume lipase. Normally we need to create our own lipase to digest fat, but the Inuit were getting a free ride. Their food was basically digesting itself! This frees up a lot of energy for the Inuit and they needed that extra energy to make their foods more energy positive and keep themselves warm!

    • DuckDodgers on March 31, 2014 at 14:20

      As Edward Howell put it:

      From: Enzyme Nutrition: The Food Enzyme Concept By Edward Howell

      The secret of the good health of the carnivorous Eskimo is not that he eats meat, but that he forbids his personal enzymes to digest all of it.



  3. Bill Lagakos on March 31, 2014 at 14:16

    I guess the “fresh & raw” aspect is rather important here. Stefansson and Andersen developed ketosis at various periods during their 1 year of a meat-only diet, although for the most part they were eating: “ordinary, refrigerated, butchers’ meat. The meat was usually boiled or stewed, the inside being left rare…”
    Fresh & raw =/= rare.
    http://jama.jamanetwork.com/article.aspx?articleid=267994
    http://www.jbc.org/content/87/3/651.full.pdf

    • DuckDodgers on March 31, 2014 at 14:25

      Great find, Bill! That seems to be the difference. Interestingly, Arctic explorers who cooked the same meats that the Inuit were eating raw tended to feel sluggish and had difficulty staying warm. You can see why when you put the puzzle pieces together. Raw enzymes, raw prebiotics, etc. The Inuit didn’t need to expend as much energy digesting raw meat/fat.



    • LeonRover on April 1, 2014 at 00:13

      And Steff developed “rabbit starvation” during his first couple of days on overly lean meat.



  4. Paul Doherty on March 31, 2014 at 14:40

    Your closing thoughts are a nice summary. Covers it very well. Thanks!

  5. Justin Wisor on March 31, 2014 at 16:06

    So should I go make a potato now and end my proposed 2 month cyclic keto experiment…? So much to think about >.<

    • Richard Nikoley on March 31, 2014 at 16:36

      Justin:

      Depends on how cyclic. For my money, If I wanted to emulate the Inuit, I’d go with keto from December through Feb, maybe, and the rest of the year get 50-150g carbs per day.

      I’m sure there’s many ways to do this sensibly, and I do see the hormetic and autophagic value of intermittent ketosis. But constant, year round, chronic ketosis, until proven otherwise (and there are now ZERO cultures to use as example—and when they put them into ketosis artificially, meta goes to shit) is the realm of serious guinea pig.

      Or, in FTA vernacular: fucktard.



    • DuckDodgers on March 31, 2014 at 18:13

      The Inuit likely weren’t in ketosis much during the Winter either. Hydrolyzed “cached” meats broke down into sugars. The prebiotics in kelp were boiled down into sugars. They ate a lot of “mouse food” during that time of year, which was rather carby. Mussels were rich in glycogen that time of year and were collected in daring, life-risking harvests under the ice. And their raw meats were so easily digested (rich in enzymes) that they weren’t burning any calories digesting food like we do — thus their glucose needs were probably reduced.



    • Jim on April 5, 2014 at 18:14

      I don’t see why the inuit would be in ketosis mid winter. I’m currently at the north end of Baffin Island 500km north of the arctic circle. Very cold and dark for a few months but a few of the hardy locals have been successfully hunting caribou this whole time. They also still fish and hunt seals. More success as the sun has come back up but they weren’t totally without fresh food. Haven’t managed to do the raw meat myself though.



    • gabriella kadar on April 5, 2014 at 19:01

      Snowmobiles help a lot. They’re not using sled dogs to transport caribou are they? Too bad you haven’t gone for the raw meat. Looks quite good. Then you would be able to let us know how the fresh seal and caribou meat are.

      I have a feeling I’d do better on them than beans. There’s just something satisfying about chewing on raw meat.

      Hope your house is dry. Too much mould up north in those houses. One of my colleagues has been on a ventilator now for 3 months because he got a fungal infection in the lungs. He was regularly going up north to provide treatment but ignored the signs of the infection until it was almost too late to save his life. He CAN blink. Nothing quite like an IV diet: he’s lost 60 pounds. Dangerous places.



  6. gabriella kadar on March 31, 2014 at 17:28

    Excellent, Richard. (I put the comma in there.. but excellent Richard is probably appropo as well.)

    Not 100% sure here but I’ve been reading up on Chondroitin sulphate and Glucosamine. You know how people take this shit to improve their arthritic symptoms? Like resistant starch and Inuit food: reduces gut inflammation and reduces general body inflammation thereby reducing arthritic joint inflammation.

    I’m a total ‘duh’ here but I never checked up on this stuff and people claim it helps them. I used to think, it’s a freaking protein (but it’s not, thanks Duckie) and it’s digested (it’s not, thanks Richard and Duckie). All those people consuming gelatin? Hm, what really happens to gelatin?

    Maybe Duckie can PubMed this better.

    If I’m entirely ‘out of it’, just delete my comment.

    • DuckDodgers on March 31, 2014 at 18:24

      So chondroitin sulfate is an example of a glycosaminoglycan (GAG). Since they are glycans, your body typically shouldn’t be able to digest them. You can find them by eating some weird parts (or supplementing eating gelatin or collagen hydroslylate)

      If the bacteria don’t eat them (not sure if they can or not) my understanding is that glycosaminoglycans (GAGs) can be assimilated directly into the body. Probably depends on the size of the GAGs and other factors, if I had to guess.

      GAGs are found in a lot of places in nature. For instance, when you consume blueberry GAGs, it looks like those GAGs become a part of you:

      http://www.ncbi.nlm.nih.gov/pubmed/21925856

      So, it would stand to reason that by eating a diet rich in GAGs, your body doesn’t need to waste energy making those GAGs. I suspect that the Inuit were able to save energy and reduce their glucose expenditures (and thus, keep themselves warmer) by consuming a diet rich in pre-formed compounds like GAGs.

      Interestingly, GAGs are being used by the cosmetic industry now for some very fancy skin care products. You can smear GAGs right on your skin and they get assimilated into the skin and can reduce wrinkles.

      http://en.wikipedia.org/wiki/Wrinkle#Glycosaminoglycans



  7. Tuck on March 31, 2014 at 18:35

    A couple of thoughts:

    The first two papers tested urine ketones, not serum ketones. The third paper which you quote thus, “Each Eskimo’s serum was tested for the presence of ketone bodies by the strip paper technique (18)” includes a cite, which is, “Examination of the urine. In: Toddy Sanford: Clinical Diagnosis by Laboratory Methods”. Did they use blood serum on urinary strips? Was it a typo? I’d guess the latter, as this paper

    “Development of Paper-strip Test for 3-Hydroxybutyrate…”
    http://care.diabetesjournals.org/content/7/5/481.full.pdf

    Describes developing a paper-strip test *12 years after the Eskimo paper was published.*

    Does testing serum on a urine strip work, if so, why develop a serum-specific test 12 years later?

    At any rate, urine ketone strips aren’t all that accurate, even when you do use them on the spot, not months later. Blood tests are the most accurate gauge of blood ketone levels (which is what matters), and dumping fuel into the urine isn’t a great use of resources, even glucose only gets dumped in pathological states, as the glucose challenge in the fasted state demonstrates.

    What’s really interesting is this quote:

    “The fact that the Eskimos had high serum FFA and low glucose levels (approximately 65mg/100ml) indicated that free fatty acids played a major role in body energy production”

    I suggests that the Eskimos weren’t using ketones for energy because they could use FFA instead, even in the presence of a glucose level that would cause a doctor to label you hypoglycemic.

    So my takeaway from this post (straw-man attacks aside) is that the Eskimos adapt to a low-carb diet by using FFA, and don’t need to resort to ketones except during fasts. Which, in the traditional state, could be months long…

    While I agree with you that chronic ketosis is unneccesary, I don’t think that you’re a guinea pig by attempting it: Johns Hopkins has been had patients on ketogenic diets for decades, with no ill effects.

    • DuckDodgers on March 31, 2014 at 19:52

      It wasn’t a typo. I see that Ketostix strips were considered accurate for testing blood through 1972.

      http://diabetes.diabetesjournals.org/content/17/6/398.full.pdf+html

      However, it was later discovered that there were situations where the Ketostix could be inaccurate.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1788129/pdf/brmedj02206-0029.pdf

      Nevertheless, of all the Inuit tested by various researchers, with the various kinds of tests that were employed, they still never found elevated ketone levels in any of them as far we know.



    • Richard Nikoley on March 31, 2014 at 19:53

      “Johns Hopkins has been had patients on ketogenic diets for decades, with no ill effects.”

      Cool. Let’s use hospital patients as a model for a “‘nutitional’healthyketogeniclifestyle,” now that the Inuit are all tied up.



    • Richard Nikoley on March 31, 2014 at 20:16

      Duck, just as a suggestion; I anticipated this.

      I knew that very quickly, somebody was going to dismiss (or at at least modestly Q, which is what I take this as) everything on the basis of study methods. Fortunately, I spent the most time of all reading over and over, chewing on that.

      And it’s obvious. They knew exactly what they were testing for, and had plenty of control via subjects in their schooling. One cannot read those papers and honestly come away with any other conclusion but that they new what ketosis was, knew how to test and measure it, had tested an measured plenty of subjects in and out of ketosis, and the Inuit were not in ketosis.

      In fact, in the 1928 paper, they went to great lengths to critique their own tests due the time lap between drawing samples and final testing, but they demonstrated controls from other studies in order to assure themselves that their numbers were as accurate as could be had in the day, and in terms of control like that, relative results come into play as well.

      This won’t be the end of it. It is the only thing zealots have left.

      “They were is deep ketosis, they just measured wrong.”

      Just watch. Liars and charlatans always do this.



    • John Lasher on October 23, 2015 at 15:15

      If you calculate based on the Woodyatt formula on the website given the stated levels of macro nutrients they would be just below the minimum level of ketosis around a ratio of 1. Ketosis is ususally present from 1.5 – 2 or above.



    • DuckDodgers on March 31, 2014 at 21:28

      One cannot read those papers and honestly come away with any other conclusion but that they new what ketosis was, knew how to test and measure it, had tested an measured plenty of subjects in and out of ketosis, and the Inuit were not in ketosis.

      Agreed. If they were in ketosis, there would have been evidence of it.



    • Radford McAwesome on April 1, 2014 at 09:29

      In my experience if you are not showing ketosis on ketostix then you are nowhere near ketosis if using an actual blood meter. Not the other way around.



    • Richard Nikoley on April 1, 2014 at 09:49

      What’s really hilarious to me is that ketosis is simply an elevated level of offshoots from fat burning. So, duh, let’s eat 85% fat, 10% protein, maybe 5% carbs just so we can say we’re in ketosis. Well duh, you’re burning dietary fat (gotta burn something) and the ketones show up.

      Back when Jimmy first began his “nutritional ketosis” deal and was all on about how much weight he was losing and still doing his food logs, someone—I forget who—did a before and after analysis, clearly showing a significant reduction of caloric intake.

      So at least be honest. It’s not the magic of ketones in the blood or urine. But if that’s what it takes to reduce the amount of food ON AVERAGE OVER TIME, then that’s why the weight drop.

      I capitalized all that because this LC hocus pocus always reminds me of my grandmother who always told us about the jackpot she hit on the slots (we grew up in NV), but never about how much she feeds them over time. Similarly, the LCers alway tout the day they ate 10,000 calories of fat, never about the days they weren’t very hungry and didn’t eat much.



    • leo delaplante on April 2, 2014 at 06:53

      having done atkins and having been done by atkins ,,i have always viewed it as a low calorie diet



  8. DuckDodgers on April 1, 2014 at 11:31

    The history of the Inuit’s dietary myth is almost as fascinating as the myth itself. Vilhjalmur Stefansson explored the Arctic and returned with fascinating and embellished tales of the Eskimos and their diet. He made his wild claims and underwent the famous Bellevue Experiment to show how the diet could work.

    Stefansson published his book, “Not By Bread Alone” which was a book promoting a cooked, all-animal-food-diet including dairy and eggs. You can read about how he mislead readers here:

    Decades later, Atkins and a host of other low carb authors casually cited Stefansson’s flawed and misleading observations as supposed evidence that there were cultures that supposedly ate no carbs. And then the low carbers took over Paleo telling people to eat lots of cooked carb-less meats despite the fact that no indigenous culture ever did that.

  9. MC on March 31, 2014 at 23:42

    “Get over the notion that fat is particularly healthful or nutritious. 50% of calories ought to be about the upper limit.”

    I agree with most of what you said, except that. Specifically for someone who is stuck in low saturated fat, and high in omega 6 land. Their bodies are probably starving for some good fats, and they haven’t been eating mostly good fats for the entirety of their lives.

    I suspect most VLCers moving to LC or MLC already got their fill of fat, and it would not have much added benefit to go to 70-80% of calories from fat over 50% or less, but I’m guessing it’s a different story for someone who needs some rebuilding.

  10. Fatty Bolger on April 1, 2014 at 02:44

    Stefansson had sugar in his urine after a year of eating the Inuit diet. Isn’t that enough to stop this VLC madness?

    • gabriella kadar on April 2, 2014 at 07:10

      Fatty, could you direct me to the source of this information?



    • Fatty Bolger on April 2, 2014 at 09:09

      Gabriella, I spoke too soon. It was Karsten Anderson, Stefansson’s partner in the all-meat diet trial, who had glycosuria at the end.

      This means he gave himself diabetes as a direct result of eating only meat, since his urine was normal before the study and, funny enough, went back to normal after he reintroduced carbs at the end of the study.

      It’s all in the original study, by Walter S. McClellan and Eugene F. DuBois. The title is “Prolonged Meat Diets with a Study of Kidney Function and Ketosis”, February 13, 1930. The funders of the study were THE INSTITUTE OF AMERICAN MEAT PACKERS. Gee how unsurprising that all of this has been touted as “proof” of the benefits of VLC.

      Here is the PDF:

      http://www.jbc.org/content/87/3/651.full.pdf



    • Duck Dodgers on July 6, 2014 at 21:37

      Finally, it’s worth pointing out that the Bellevue Experiment used fatty Western meats while the Eskimos dealt with much leaner land mammals.

      From: Prolonged Meat Diets With A Study Of Kidney Function And Ketosis. [“The Bellevue Experiment”] By Walter S. McClellan And Eugene F. Du Bois.

      “The meat used included beef, lamb, veal, pork and chicken. The parts used were muscle, liver, kidney, brain, bone arrow, bacon and fat. The carbohydrate content of the meal was very small, consisting solely of the glycogen of the meat…The protein content of the diet ranged from 100 to 140gm., the fat, from 200 to 300gm., and the carbohydrate from 7 to 12 gm.”

      Yes, even the Bellevue Experiment counted the glycogen in Stefansson’s meat.

      At any rate, the Inuit did not have access to such animals that were bred to be fat. No, they ate wild animals that tended to be much leaner. For instance, a caribou is extraordinarily lean — yielding, at most, 50 pounds of back fat and 30 pounds of cavity fat from a well-nourished 1,000 lb carcass!!

      If an average adult male has to eat 8 to 10 pounds of (raw) meat per day to keep warm, there just isn’t enough caribou fat to go around for everyone to stay ketogenic. And as Per Wikholm uncovered, Stefansson’s own writings showed that caribou pemmican was too lean to be ketogenic.

      While overlooking the fact that some fat was used for burning oil lamps, VLC proponents claim that Eskimos discarded lean meats, or fed it to their dogs (who would apparently therefore not be ketogenic). But, as far as I know, they have shown no evidence of this practice beyond a Samuel Hearne quote from “the twenty-second of July” — when carbs were seasonally available — of Northern Canadian Indians who apparently killed many deer solely for “tongues, marrow and fat”. That doesn’t show us much beyond the fact that fat was simply preferred.

      I’m not aware of any cultures that purposefully wasted such enormous quantities of meat on a regular basis. That’s a complete fantasy as far as I can tell.



    • Kyle on July 6, 2014 at 18:29

      If I remember correctly, during those tests, Stefansson mentioned that Anderson preferred his meat cooked medium rare as opposed to Stefansson having his rare. With the glycogen being somewhat a marginal source of carbo, this could have something to do with Anderson’s development of glycosuria?

      Kyle



    • Duck Dodgers on July 6, 2014 at 20:56

      At the conclusion of the “Bellevue Experiment”, another lesser known study was published by Edward Tolstoi, who got to test Stefansson and Anderson with a glucose tolerance test once the year of meat was completed. Anderson’s glycosuria is discussed heavily in the paper. Tolstoi also discusses the Heinbecker study that was referenced by Richard in the article.

      From: The Effect Of An Exclusive Meat Diet Lasting One Year On The Carbohydrate Tolerance Of Two Normal Men, by Edward Tolstoi (J. Biol. Chem. 1929, 83:747-752)

      “Heinbecker studied the tolerance of Eskimos to carbohydrate. His subjects, by necessity, lived on a practically exclusive meat diet for years, before their carbohydrate tolerance tests were made. In spite of the fact that their diets were low in carbohydrate, the results of the tests indicated that they assimilated carbohydrate well. The blood sugar curves were within the normal range and the urine remained free of sugar. Is it possible that Heinbecker’s subjects derived sutlicient carbohydrate-forming substance from the protein in their diet to keep the insulin producing mechanism sufficiently stimulated to handle large quantities of carbohydrate? His Eskimos consumed about 280 gm. of protein, 135 gm. of fat, and 54 gm. of carbohydrate of which more than half is obtained from the glycogen of the meat.[1] This seems a likely explanation.”

      [1] These figures are acceptable as Heinbecker points out that the statements regarding the Greenland Polar Eskimo, the peoples studied by the Krogh & Krogh (10) and are acceptable as Heinbecker points out that the statements regarding the Greenland Polar Eskimo, the people studied by the Kroghs apply to Baffin Island Eskimos, the group studied by him.

      This supports what Richard also noticed in the Heinbecker study.

      Sinclair (1953) points out that Krogh & Krogh grossly underestimated the caloric requirements of the Eskimos by not factoring in the additional calories needed for surviving the extreme cold weather and internally thawing frozen meat. So, while most research erroneously estimated the Inuits’ caloric intake on Western intakes of ~2,000-2,500 calories per day, Sinclair showed that 2,500 calories was too low for the Inuit who needed to keep warm in Arctic temperatures. Sinclair cites a number of references and accounts of the Eskimos consuming between 8 to 10 pounds of meat per day (which is quite easy to do when raw meat is consumed…it’s cooked meat that is difficult to eat in large quantities).

      Eskimos that consumed 8 to 10 pounds of meat per day would have obtained considerable amounts of glycogen, especially if they consumed marine mammals.

      It all helps explain why Heinbecker observed good glucose tolerance while Eskimos were fed their traditional diet and why Stefansson and Anderson had poor results with their glucose tolerance tests after their year of Western-style meat eating.



    • Duck Dodgers on July 7, 2014 at 15:35

      Correction: A “1,000 carcass” was an overstatement (I had obtained the erroneous figure from this article). A more accurate figure would have been between 330 lbs to 680 lbs for a male caribou.

      From: Wikipedia: Caribou: Subspecies

      The Woodland caribou are the largest and the Peary caribou the smallest. The largest Alaskan male caribou can weigh as much as 310 kilograms (680 lb).

      It’s my understand that the 50 lb slab of back fat that is often mentioned would only be found on the largest caribou, during their peak of nourishment — with smaller caribou having much smaller slabs of fat. We are still talking about a very lean animal.



  11. LeonRover on April 1, 2014 at 03:13

    Ya, know this is the Chinese Year of the Wooden Horse.

    One might name (I almost wrote “christen”) this type of eating

    . paleodoureic

    in honour of our P. Robustus ancestors and current Bonobo cousins.

    Paul & John liked getting the Norwegian kind:

    https://www.youtube.com/watch?v=KkcRZSdc8us

    Sláinte

    • LeonRover on April 1, 2014 at 03:28

      PS Do you wish for megalithic “big standing stones” or for megadoureic .. .. ..

      The choice is yours.



  12. Jane Neish on April 1, 2014 at 04:00

    Thanks this was really interesting.

    This probably doesn’t add anything to the debate but I ended up feeding my dog a raw meat dog food a couple of weeks ago – I bought it by mistake. He started skipping about like a puppy (he’s 17) so he’s been on raw meat since then.

    • Martha on April 2, 2014 at 10:59

      Something else to think about, dogs eat entrails and entrails frequently are full of chewed plants. We had a cow die once over winter in sub zero conditions. By spring, when the cow was found thawed out, almost all the meat and skin was still on the bones, but the entrails were all cleaned out of the inside. By coyotes probably, which are abundant in the area, or possibly bear.



  13. John on April 1, 2014 at 07:22

    Great post. This one really sums it up, shows your level of frustration with stupidity, and conveys the well founded message.

    Even when I was near 0 carb a few years back, I always stayed very high protein. My thought process at the time was something like “well I hear protein still spikes insulin, and I’m probably not keto given the 200+ grams of protein a day but just the thought of going 70% fat makes me feel unsatisfied.”

    Its funny, my best friend started original PaNu style eating around the same time I did. He tried to get his wife on it. She was not fat but wanted to tone up, drop some pregnancy fat, etc. She loved bananas, fruit juice, and carbs generally. She said at the time “I’m not sticking to this high fat stuff, it just makes me feel bad, sort of gross, and like I’m getting fat.”

    At the time I dismissed her feelings as CW influenced perception. Of course, I had gone from high protein/vegetable/fruit feeling “fit and healthy” and sitting well below 10% BF, to gorging on heavy cream, feeling “heavy” after meals, and somehow ignoring the layer of fat appearing on me (probably because my weight stayed the same (and I radically altered my workout so I wasn’t able to track strength changes)).

  14. Tim Maitski on April 1, 2014 at 07:34

    I’m curious if there was any mention of stool volume or regularity in any of those studies.

    That seems to be the biggest change that I am seeing from using potato starch and Prescript Assist.

    If all of those glycans or “animal fibers” are feeding their gut bugs than I would anticipate maybe seeing that being indicated in their stools. I’m seeing a huge difference vs. when I had tried an Atkins type diet. If their stools were large and frequent, that would be another piece of evidence showing a difference between the Inuit and VLC.

    • DuckDodgers on April 1, 2014 at 09:11

      Tim, I believe raw meat dieters tend to have smaller and more compact poos. That’s what happens to my dog on a raw meat diet at least. But, my dog poos like clockwork every morning and if I feed her a plant-based dog food, her stools are abnormally large. I can think of a number of reasons why that might be (lots of cellulose, more water in stools, etc.) Hard to imagine that a diet rich in plant fibers would be digested in the same manner as a diet rich in animal fibers. I think they have different effects in the digestive tract.



  15. Henk on April 1, 2014 at 08:49

    Matt Stone has written about resistent starch cleanse
    http://180degreehealth.com/newsletter-issue-5/

    • Richard Nikoley on April 1, 2014 at 09:26

      Obvious April Fool troll, at least the first para, which is where I stopped reading it. Stone’s schtick is obvious. Against everything anyone else does. He’s not an iconoclast, he just calls attention by finding a way to counter anything and everything.



    • Tim Maitski on April 1, 2014 at 09:43

      I always thought that banana peels are toxic. But I did a quick Google search and found that they are quite edible and healthy. I also found an article where they were successful using banana peels to purify water of lead and copper. Could they be a good heavy metal cleanse? Would probably want to use organic peels.



    • Richard Nikoley on April 1, 2014 at 11:47

      Alright, finally got the chance (just dropped the visiting parents in law off at at the airport after being a bit perturbed earlier by their endless morning knocking and fidgeting around) to read the whole thing.

      I take it all back. Gotta be a good sport about these things and this is simply fuckin’ funny as shit.
      http://180degreehealth.com/newsletter-issue-5/

      Dyin’ and cryin’ here. Good work, Stone.



  16. ChocoTaco369 on April 1, 2014 at 09:33

    Jesus Tap Dancing Christ. This is probably the best post to date on this blog. Nice, Richard.

    • Richard Nikoley on April 1, 2014 at 09:50

      Thanks Choco. By now, I have a pretty good sense of what you’re going to like. 🙂



  17. Dan on April 1, 2014 at 09:43

    Richard, I always think of Mr. Jimmy Moore when I read something like this. Instead of the long-term ketosis thing he’s doing, perhaps he should have pursued a diet something like Paul jaminet’s and Chris kresser’s recommendations, and worked on restoring metabolic and hormonal health, rather than focusing on weight loss. If he had, maybe he would have carried extra pounds longer than he would have liked, but ultimately maybe his overall health would have been restored and the weight would drop when his body was good and ready. Seems to me that if you never eat carbs, your body can never learn to handle them in a healthy way. you may like the number on the scale, but are you healthy? I dunno, any thoughts? I feel sorry for Jimmy, seems he’s kinda painted himself into a LC corner and can’t get out.

    • Richard Nikoley on April 1, 2014 at 10:04

      Right you are, Dan.

      One of the funny things here is that I’ve already seen a place or two: BUT THE INUIT ARE LOW CARB!!!!

      Misses the point. They do low carb right, buy staying out of ketosis and eating HUGE protein. Accordingly, they are getting sufficient glucose and so their insulin sensitivity is tight and glucose tolerance is stellar. Probably, young and dumb people can get away with it, but I’ve seen way too many people 40+ over the years have high fasting numbers and an inability to eat any appreciable amount of carbs without the meter going bonkers.

      This is STOOPID. There is no way in hell that it’s “healthful” or “nutritional” to CAUSE yourself to have crappy glucose tolerance if you truly aren’t diabetic, just suffering from severe physiological insulin resistance, making it fait acompli that you can’t eat carbs.

      On your last point, absolutely. This is my approach and I never look at the scale. I feel great, when I do test BG, it’s fine, getting even better. Body recomp is happening. People get to poke fun at me all they like, and it just demonstrates they have nothing important to pay any attention to.

      Bankrupt.



    • GTR on April 3, 2014 at 01:41

      @Richard – “Probably, young and dumb people can get away with it,”

      There are some theories that organisms are optimized for short term survival, rather than longevity. So when one does something that causes a conflict between the two – short term wins, meaning he doesn’t immediately sees anything wrong at or even some time after doing it. Only in the distant future the bad effects of decision are going to show.

      Example:



  18. Tracy on April 1, 2014 at 10:35

    Sorry if I’ve missed it, but when did fat become not particularly healthful? I’m always adding extra fat to meals.

    • Richard Nikoley on April 1, 2014 at 11:26

      It’s the most energy dense of the macronutrients, but also the least nutrient dense. It’s basically raw energy. Sure, it’s fine, and some of it like grassfed butter and red plam oil, contains some cool stuff, but it simply aint packed with vitamins and minerals as are proteins and good carbs (veggies, fruits, starches). In other words, kicking up from 50% of calories to like 80% comes at a significant tradeoff in terms of vitamins and minerals. Just the facts, ma’am.



    • MC on April 1, 2014 at 13:57

      Yes, but what’s the point in limiting fat? It’s not like you can’t smother your micro-nutrient dense veggies in plenty of fat. You still get the micro-nutrients, while absorbing more of them because you included more fat.

      There’s no trade-off where you have to eat less vegetables, because you added some grassfed butter to your broccoli, if anything, I’d end up eating more broccoli.



    • Richard Nikoley on April 1, 2014 at 16:07

      “Yes, but what’s the point in limiting fat?”

      Calories.



    • MC on April 1, 2014 at 16:31

      Well I guess if you’re trying to lose weight via calorie restriction, but I wouldn’t claim it beneficial for anything other than that, assuming it actually improves weight loss, as some people don’t seem to have any problems losing weight with much higher fat.



  19. LCHF_Graham on April 1, 2014 at 13:05

    So a calorie is just a calorie eh? I’m not buying that. And there’s too much robust science to suggest otherwise.

    As for LCHF and insulin sensitivity many studies with T2 diabetics demonstrate that low carbing very significantly lowers HbA1C scores and improves other metabolic markers. It’s true in my case too. I low carb and now have a high (but within the normal range) HbA1C score (which was off the scale on diagnosis).

    And I have also experienced a massive improvement in my HDL/LDL ratio and overall a lowering of overall cholesterol. All this without any exercise (which I know I should do a little of). Plus significant weight loss (around 6kg in my case).

    Physiological insulin resistance is hardly news to anyone. Peter over at his Hyperlipid blog has written about it. Yes seriously low carb people would ‘fail’ a glucose tolerance test but given two or three days of eating some rice would typically then pass one easily. Hardly ‘screwing up’ in any irreversible sense one’s insulin sensitivity for otherwise healthy people.

    I’m all for people supplementing with some resistant starch/soluble fiber (I do it myself once or twice week) and a multivitamin, but let’s not throw the low carb baby out with the bathwater and have fries with everything and a 64oz coke on the side!

    • Richard Nikoley on April 1, 2014 at 13:27

      “LCHF”

      We’ll since you actually use your dietary preference in your very name you post under, I’m thinking you’re not worth any more of my time than what I’ve just typed here to tell you why.

      #wasteoftime



    • Richard Nikoley on April 1, 2014 at 14:52

      BTW, LCHF, Peter is where I learned about PIR in the first place and this blog has been linking him up since 2008 or so, and I once sent him a cool evolution book. You’ll find a few links to here from his blog as well, over the span of time.

      In 2010, he sent me long emails about how to help Rotor, who as it turned out, was suffering from an insufficiency in production of pancreatic enzymes. I credit him in part, helping us enjoy three more great years with our buddy.

      He emailed me condolences just last evening.



    • Gina on April 1, 2014 at 20:18

      LCHF_Graham:

      What “robust” science suggests that one can get away with eating more calories if said calories are a particular macronutrient? Real question. The only thing I’ve ever heard this legitimately applying to is nuts because they boost metabolism (e.g. http://jn.nutrition.org/content/138/9/1741S.full.pdf+html). I thought the whole point of NuSI is to test the insulin hypothesis.

      Do you really equate foods like beans and rice with fries and soda? Because, brother, that sounds seriously crazy to people outside the LCHF milieu.



    • John on April 5, 2014 at 16:50

      Typical response from you. You immediately dismiss anyone that disagrees with you.



    • Richard Nikoley on April 5, 2014 at 16:56

      John, I disagree with you, and because of that, you’re dismissed.



  20. paul ralston on April 1, 2014 at 13:15

    so refreshing to read a well thought out post on this topic; ketosis is starting to get really boring. it would be nice if you presented this at this year’s ahs, but i’m sure that’s not happening

    • Richard Nikoley on April 1, 2014 at 13:25

      Paul

      Thanks for that. I’d half love to present. Tim and I heavily weighed putting in for it, and decided against it. Primarily, because we are writing this book for the world generally, not Ancestral, LC, Paleo, WAPF or anyone else—though all support we get from them is appreciated and it will certainly resonate with most of them the most.

      The world has more than enough Paleo books and Sisson and I agreed in our very first conversation about this. Wide as possible.

      Accordingly, we’re keeping out wits about us and acting accordingly for the run up to the book. Of course, once it’s on the shelf, we’ll be happy to talk to specific target markets.

      Make sense?



  21. Arthur on April 1, 2014 at 13:36

    What if I were to still avoid safe starches (coming from a <50g carbs/day diet), but increase veggies and protein intake and supplement with RS…? Would it be as good as, or better than, just adding some safe starches (in terms of nutrient density, ie)?

    And about protein, I once read that eating more than 30% of caloric expenditure as protein per day long term generates ammonia overload. How much protein would be too much? And is it the most nutrient dense macronutrient we have?

    I'm really surprised by your recent posts on Inuit and Maasai carb intake, it seems I was greatly deceived into believing they were almost zero-carb. Thanks for clearing that up, really.

    • Christoph Dollis on April 1, 2014 at 17:08

      What if I were to still avoid safe starches (coming from a <50g carbs/day diet), but increase veggies and protein intake and supplement with RS…? Would it be as good as, or better than, just adding some safe starches (in terms of nutrient density, ie)?

      Good question. And I’d add fruit to the that question.

      I’m really surprised by your recent posts on Inuit and Maasai carb intake, it seems I was greatly deceived into believing they were almost zero-carb. Thanks for clearing that up, really.

      Yep. Ditto.



  22. paul ralston on April 1, 2014 at 14:29

    sounds like a good plan, looking forward to the book
    best,

    paul

  23. Christoph Dollis on April 1, 2014 at 15:36

    While this is very interesting, Richard; paradigm challenging, and makes sense—are there any recent, quality studies that show this?

    • DuckDodgers on April 1, 2014 at 21:31

      No. Most Eskimos are ordering Keebler cookies from Amazon these days. The diet is rarely followed like it used to be.

      One of the most comprehensive summaries of all the original research was compiled in 1952 and published in the British Journal of Nutrition.

      The Diet of Canadian Indians and Eskimos
      By H. M. Sinclair, Laboratory of Human Nutrition, University of Oxford

      If you read it, you’ll see that it supports the studies referenced above.

      A few highlights from Sinclair’s detailed paper:

      The typical dietary is very high in protein. It is high in fat and low in carbohydrate, but would not be expected to be ketogenic.”

      The most important item of food of the Polar Eskimos is the narwhal (Monodon monoceros)..It is hunted almost exclusively from the kayak, and according to Vibe (1950). The whole existence of the Polar Eskimos depends on the catch of this animal, since they get all their necessaries of life from it. The skin (mattak) is greatly relished and tastes like hazel-nuts; it is eaten raw and contains considerable amounts of glycogen and ascorbic acid.

      “There is in fact nothing unusual about the total intake of aliments; it is the very high protein, very low carbohydrate and highfat intakes that have excited interest. It is, however, worth noting that according to the customary convention (Woodyatt, 1921 ; Shaffer, 1921) this diet is not ketogenic since the ratio of ketogenic(FA) to ketolytic (G) aliments is 1.09. Indeed, the content of fat would have to be exactly doubled (324 g daily) to make the diet ketogenic (FA/G>1-5).”

      In 1855 H. Rink, a Danish scientists attempted to make a very rough statistical study of annual food consumption of 6100 Eskimos in Greenland. Interestingly even back then the Eskimos were finding ways to import small amounts of bread, barley, peas and sugar from Europeans. Rink made estimations on the macronutrient levels based on the amount of annual food consumption, including those imports, and if one excludes the imported bread, barley, peas and sugar from the table, he guessed that the Eskimos were getting 33g of carbs/day from their seal and whale flesh alone (the fresh skin in particular was rich in glycogen and they would often consume it quickly as it arrived onshore). And Sinclair points out that the quantities of glycogen-rich mussels and sugars in boiled-down kelp were unknown and therefore ignored in the estimations. In other words, the 1855 estimation and subsequent analyses were using incomplete data. The dietary estimation was unable to assign measurements to the broken down sugars in hydrolyzed meats, the carbs found in carcass guts, as well as commonly harvested plants, like Yupik potatoes and other “mouse food” that were commonly consumed by the Inuit.

      The Sinclair paper documents, in detail, that between 1855 and through the mid-20th century — over 100 years and covering more than a dozen scientific studies — the Inuit consumed a diet very high in protein, high in fat and low in carbohydrates with no detectable ketosis found or expected.



    • DuckDodgers on April 1, 2014 at 21:53

      Oh, and those researchers also never even knew that blubber tends to have “significant levels of carbohydrates” in it. For instance, the posterior, dorsal blubber of a sperm whale is 25% carbohydrates.

      From Body composition of the sperm whale, Physter catodon, with special references to the possible functions of fat depots:

      The largest component of the blubber, regardless of body site, is usually either water or lipid. The water component is higher in the anterior sites, whilst the lipid is often greater in the middle and posterior sites, the maximum content of either component being about 60%. Protein is an important component, and attains up to 35% in the anterior blubber of the head, and rather less elsewhere. Carbohydrate level apears to be very significant throughout most of the body blubber.

      This is why the analyses of low carbers are so disappointing. They never bothered to actually look at the compositions of the raw and fresh components that the Inuit were actually consuming.

      And honestly, it’s a little scary that people missed those kinds of important details.



    • DuckDodgers on April 1, 2014 at 22:35

      More from the 1991 Sperm Whale blubber study:

      From Body composition of the sperm whale, Physter catodon, with special references to the possible functions of fat depots (1991):

      Post-mortem time for the sperm whale carcases averaged 28.4 hr on arrival for flensing at the Icelandic whaling station, and, although carcases were not sufficiently fresh for enzymatic studies, they were adequate for analyses of basic composition. Off Durban, the usual post-mortem time was between 20-25 hrs when flensing commenced…

      The significant levels of carbohydrate, probably mostly in the form of glycogen, in both blubber and muscle, may represent an instant form of energy for diving via anaerobic glycolysis. It is interesting that such a carbohydrate reserve has not previously been reported for sperm whale nor indeed for any other whale nor needed for any other whale so far examined.

      While Dr. Eades is correct that glycogen tends to degrade rather quickly from muscle meat, here we have a study where the average post-mortem time for flensing was 28.4 hrs and the researchers still found that Sperm Whale blubber contained “significant” carbohydrate reserves.

      It’s also worth pointing out that Narwhal skin, muqtuk, was known to be particularly high in glycogen.



    • DuckDodgers on April 2, 2014 at 09:38

      It seems that the “nutrition data” labs measure carbohydrates using the standardized protocols don’t even measure the carbohydrate content in various foods. What they tend to do is “deduce” or “infer” the carbohydrate content in foods. This usually isn’t a bad thing since carbohydrates tend to disappear from meat over time — they are broken down by bacteria during the chilling process. So, it wouldn’t make sense to accurately measure the carbohydrate content of freshly killed meats for mass-market “nutrition data”.

      However when scientists “infer” carbohydrate content, the readings appear give measurements that don’t match up with carbohydrate measurements that are directly assessed.

      For instance, here’s a study that “inferred” the carbohydrate content of whale blubber.

      From:

      Blubber, a component of maktak (a food comprised of the epidermis and underlying blubber), is rarely eaten alone and offers 8% of needed vitamin A, 10% protein and little carbohydrate (<4%),

      Tissues were analyzed…the endpoints include (g/100g) moisture, fat, protein, ash, carbohydrates…Protocol was based on established methodology by the Association of Official Analytical Chemist’s (AOAC) Official Methods of Analysis (AOAC, 2000) and is briefly described herein. Laboratory standards and blanks were used in each method and in accordance with AOAC protocol…

      Total carbohydrate levels were determined from the analytical results of total fat, moisture, ash, and protein; and inferred from the sum difference of these parameters from 100.

      So, when scientists “infer” the carbohydrate content of blubber they don’t find much carbohydrate. But when they actually take the time to measure glycogen and other carbohydrates in blubber, the measurements are very different:

      From Body composition of the sperm whale, Physter catodon, with special references to the possible functions of fat depots (1991):

      Carbohydrate which has been directly assessed (not deduced by subtraction of other components from total weight of sample) is significant in amount, reaching levels in the range 8—30%, except in the anterior dorsal and ventral regions (head) where levels are 6% and <1%, respectively.

      Those scientists carefully measured carbohydrate content over various parts of the sperm whale and found “significant levels” over a wide range.

      What this tells us is that the standardized protocol for “inferring” carbohydrates is likely flawed when it comes to detecting glycogen and other carbohydrates in freshly killed animals. Those standards were designed for mass-market meat sales where carbohydrates should be absent anyway.



    • DuckDodgers on April 2, 2014 at 09:42

      Accidentally omitted the first link to the paper that “inferred” its carbohydrates. Should have been:

      A preliminary assessment of the nutritive value of select tissues from the bowhead whale based on suggested nutrient daily intakes



    • Christoph Dollis on April 2, 2014 at 16:30

      That’s a lot of interesting info. DuckDodgers, you shed some light. Thanks.



    • Christoph Dollis on April 2, 2014 at 16:57

      Reading what you wrote more thoroughly—fascinating! I’d say the long-term VLC is natural hypothesis is busted. The truth is that humanity’s ancestral diet, depending on latitude, etc., probably varied from 50 g CHO/day to several times higher than that.

      Humans vary genetically to in how much they and their ancestral group are adapted to digest starch. For me, I’m thinking a “low-carb” diet is still probably appropriate long term, but I’m tentatively redefining that as 50–200 g (variable) CHO/day.



    • DuckDodgers on April 3, 2014 at 13:05

      I should clarify something. Turns out that the inference method of assessing carbohydrates was designed to highlight fiber intake and keep things tidy. The fact that it happens to be error-prone (vs the more accurate “direct” measurements of carbohydrates) is just accepted by researchers and in the USDA database. The inference or “subtraction” method (testing other components and assuming the remainder is carbohydrates) is never recommended for testing “available carbohydrates” (i.e. non-fiber carbohydrates) and yet many studies will still use the subtraction method because it is cheaper and it’s the international “standard”, thanks to the push to label dietary fiber.

      And finally, “available carbohydrates” should be adjusted for glucose equivalents. 100g of a starch polysaccharide might be roughly equal to 110g of monosaccharide. But of course, doing that would create some very confusing nutrition labels (imagine a starchy product that contained more carbohydrates than the weight of the product itself). So, to keep things neat the subtraction method is preferred by many researchers, despite the fact that it is error prone.



  24. LeonRover on April 1, 2014 at 22:57

    Richard:

    I think the feedly April Fish link in yr Kissy Kissy comment contains the promo name worthy of La Ketonic Live Show:

    The Ennui Diet™

    Sláinte

    • LeonRover on April 2, 2014 at 06:11

      “Isn’t it SAD” ?

      However:

      “Isn’t it Rich ? Whose in mid-air?”

      Sláinte 🙂 🙂



    • LeonRover on April 1, 2014 at 23:05

      PS I see it’s still April 1 where you are. Here an April 2 shower woke me at 0515 for my 0-0 proof home espresso with 3 tsp of Irish Cream, from the company that brings you KerryGold



    • La Frite on April 2, 2014 at 05:26

      “The Ennui Diet™”

      Isn’t it SAD … 😉



    • LeonRover on April 2, 2014 at 06:21

      PS “Who’s”



    • Richard Nikoley on April 2, 2014 at 14:14

      Leon, that Streisand is every bit as much a visual as audio performance. Stellar. Probably hadn’t even heard it in a decade, much less SEEN her master it like that.



  25. LCHF_Graham on April 2, 2014 at 03:39

    A calorie of fructose and a calorie of Lauric acid are emphatically not the same thing within the human body on a biochemical/physiological level. A calorie is a calorie is a calorie is, I’m afraid, simple minded tosh. And as Richard often points out I’m not doing your homework for you on this one.

    And yes is it really shocking to equate Coke with rice or other carbs. No not really as your body will break both simple and complex carbs into their constituent simple sugars. Mother nature does that not me. It’s a biochemical ‘brute fact’ that carbs are strings of sugars.

    Now the resistant starches Richard is talking about are very different beasts – in their pure form such as potato starch – they are completely indigestible to human beings. However some nice bacteria in our gut love resistant starch. Great.

    The issue I have is two-fold.

    (i) Is it wise to get ones dose of RS via carb loaded foods?

    For me is answer is no. And I’d advice anyone with metabolic health issue to be very cautious with regard to scoffing down cold potatoes etc. Why – well not of the carbs become RS. So it’s better to take a teaspoon or two of pure RS and leave it at that.

    (ii) Related to point one is the issue of ‘carb creep’ – again not as big an issue for those of us that know we cannot afford (health wise) to scoff carbs, ad nauseam so to speak, but is an issue for lots of people. Why? Well the dominant diet/food culture is the world of SAD – a truly unhealthy diet (at the population level). Does anyone really want to be drawn back to SAD by whatever means/rationalisation about how ‘safe’ their particular carbs are? It can be at times awfully tempting to just go with ‘the flow’ food wise.

    I agree that being in ketosis 24/7 is probably not a good idea (or even necessary or possible) for the vast majority of folks (I eat rice once a week for example – I can’t give up my weekly curry but now it’s without massive naan breads etc.). And I eat a fair bit of protein. But low-carb (20g-40g on average per day) has done wonders for me and I’d like others to enjoy the same benefits. I really don’t think people like Dr. Eric Westman are quacks.

    • Gina on April 2, 2014 at 07:14

      “… But low-carb (20g-40g on average per day) has done wonders for me and I’d like others to enjoy the same benefits. I really don’t think people like Dr. Eric Westman are quacks.”

      A vegan diet has done wonders for me and I really don’t think people like Dr. Michael Greger are quacks.

      When it’s down to anecdote and appeals to authority, it’s a wash. 😉



    • Richard Nikoley on April 2, 2014 at 14:50

      “A calorie is a calorie is a calorie is, I’m afraid, simple minded tosh.”

      What’s simple minded is spliting hairs over what you find in a test tube at a point in time, and being such a fucktard that you don’t understand that chronically eating too much over time (i.e. months) puts on fat and chronically eating too little over time (i.e. months) takes off fat.

      All this puflle about being able to eat unlimited, so long as carbs are low hurts people, and I loath you fucktards who keep insisting on doing that.



    • Christoph Dollis on April 2, 2014 at 16:35

      A calorie of fructose and a calorie of Lauric acid are emphatically not the same thing within the human body on a biochemical/physiological level. A calorie is a calorie is a calorie is, I’m afraid, simple minded tosh.

      Look, the one who’s simple minded here is you. You show me where Richard or anyone else said you can eat 3,000 Calories of only sugar daily and that’s just groovy. Or only protein. Or whatever.

      The fact is, we evolved eating a variety of foods. If you eat far too many foods too often, you’ll likely to run into problems. Richard isn’t saying nutrition doesn’t matter—he says it does. He’s also saying it is not optimal for most people to consume less than a minimum amount of carbohydrate daily for long periods of time.

      Therefore, he is saying the exact opposite of your “Calorie is a Calorie” strawman/mantra. He’s saying macronutrients matter, and people should consume some carbohydrate, especially from natural starches.

      Understand it now? I didn’t think so.



    • John on April 5, 2014 at 16:53

      I increased my caloric intake to 2,4000 calories a day from 2,000 and dropped carbs from 200 to 50. I subsequently went from 20% body fat to 13% and lost 30 pounds. Done.



    • Richard Nikoley on April 5, 2014 at 17:01

      “I increased my caloric intake to 2,4000 calories a day from 2,000 and dropped carbs from 200 to 50. I subsequently went from 20% body fat to 13% and lost 30 pounds. Done.”

      Cool.

      So, next thing to do is start a blog and podcast, then tell everyone in the world to do what you did. Make very sure to remind them that if it didn’t work for them, they probably didn’t do it as well as the resigent genius.

      Good luck with that.



  26. LeonRover on April 2, 2014 at 04:22

    Richard:

    No matter what USDA database states now, the McClelland & Du Bois’ paper has this clear sentence:

    “The carbohydrate content of the diet was very small, consisting solely of the glycogen of the meat” and further ” .. .. and the carbohydrate from 7 to 12 gm”

    I note that one of the observing physicians, E F Du Bois, spent 10 days on the diet, but took time to adapt and his appetite was poor.

    The physician could not heal himself.

    Sláinte

    • DuckDodgers on April 4, 2014 at 07:23

      Well, it turns out that the a diving aquatic animal has a LOT of glycogen stores that literally make it a very different animal than the “meat” we consume in the West.

      Sperm whales make routine dives to 400m for 40 minutes and can reach a maximum depth of 2000m. Narwhals make some of the deepest dives recorded for a marine mammal, diving to at least 800 meters (2,600 feet) over 15 times per day, with many dives reaching 1,500 meters. These marine mammals run out of oxygen and switch to their unique glycogen-based energy stores. They store large quantities of glycogen in very odd places, but it typically gets concentrated in the skin and various organs. Seals are the same, but they don’t dive as deep and as long. Nevertheless, a seal has its own glycogen stores (researchers found some near its sinuses) and a seal’s heart and brain have two to three times the glycogen content of land-based animals.

      So, this idea that we can compare glycogen content of a cow or human to that of what the Inuit were eating is entirely misguided. It’s bullshit to use that kind of comparison. We’re talking about marine animals that need large quantities of glycogen to complete their extended deep dives.

      The Inuit had a unique situation where they could find glycogen-rich marine mammals and flash-freeze them by cutting them up into chunks — preserving their glycogen for long periods of time. And then they would often eat those chunks still frozen and drink a little tea to help thaw the ingested pieces. You can’t reproduce that kind diet anywhere else!



    • Richard Nikoley on April 4, 2014 at 08:20

      Duck +1



  27. Markus on April 2, 2014 at 06:18

    Thanks Richard,

    regarding the “absence of ketosis” at the Inuit, I’d like to think one more time about how this was measured in the 1930ies.

    I assume they have used a kind of Keto strip, Ketostix, and those are measuring acetoacetate only by a unique chemical reaction. According to Wikipedia:

    “A strip consists of a thin piece of plastic film slightly larger than a matchstick, with a reagent pad on one end that is either dipped into a urine sample or passed through the stream while the user is voiding. … causes acetoacetate to accept an H+ and become betahydroxybutyrate. Since the nitroprusside reaction on dipstix detects acetoacetate but NOT betahydroxybutyrate, this can be deceptive in very acidotic patients

    http://en.wikipedia.org/wiki/Ketostix

    Now we have acetoacetate, which we can measure. Measure with a Ketostix in the _urine_. And we heave Hydroxybutyrate, another keton body, which cannot be measured by Ketostix. After a while, acetoacetate concentrations are decreasing and more of it is produced from beta-hydroxybutyrate.

    If you are sticking long enough to a ketogenic diet the production of the different types of keton bodies will change: the serum and urine volume of acetoacetate (the only ketone detected by ketostix) is significantly reduced, according to Phinney and Volek, you will have more Hydroxybutyrate in your serum- and thereby in your urine.

    A second point is the excretion rate of your kidneys, after a while they will be able to down-regulate the volume of ketones you excrete into your urin- hey, after all, this is energy that is wasted by your body, so it is a smart way to keep more of it instead of being pissed away!

    So the Ketostix, which are measuring the acetoacetate content in your urine only, will tell you after a while that you are not in a sufficient way of Ketosis anymore- though you may still be in perfect ketosis.

    Sources:
    http://ajcn.nutrition.org/content/76/1/65.full
    Phinney and Volek “The Art and Science of Low Carbohydrate Living”

    There are actually better measurement methods for home (which are pricier) than ketostix but I can only assume what kind of tests were available in the 1930ies and were in use for the studies mentioned. But I’d like to give this hint to think about what the scientists might have measured most probable was the absence of acetoacetate and not of keton bodies per se.

    • Richard Nikoley on April 2, 2014 at 15:12

      “I assume”

      In other words, you didn’t read the studies I linked that explain their testing methods, and now even after the significant time I spent putting the post together, wish for me to waste time trying to debunk your assumptions, that have zero application.

      Thanks, but I’ll pass.

      If you want to critique the actual way they tested (which was different, given the space of 44 years) be my guest.



    • Keith Bell on April 4, 2014 at 12:41

      Markus, that’s a very interesting point. Do you know of any long-term ketogenic diet studies showing increased beta-hydroxybutyrate? You’d think that given all the focus on KD in fields of autism, epilepsy and now cancer there would evidence of raised ketones. I tend to believe success in KD is about flora shift, not ketones. Here’s a study showing KD over time produces an inverse relationship: “Children who were on the ketogenic diet for longer periods of time had a significantly lower fasting breath acetone.” In 2002, study authors had no clear explanation for this “significant inverse association” because they weren’t factoring the well-known reason: microbes make acetone. http://www.nature.com/pr/journal/v52/n3/full/pr2002204a.html

      Researchers for the Modified Atkins Diet called into question the long standing belief that ketosis was responsible for seizure control:
      Quote :
      This study raises important questions on the current use of the traditional ketogenic diet. The first is whether higher ratios with more fat, less protein, and fewer carbohydrates are truly necessary for efficacy. Our results also question whether ketosis is as important as previously reported (10,12). Eighty percent of children with a loss of large urinary ketosis over the study period did not lose seizure control, and the same percentage with trace or zero ketosis at 6 months were still improved. Preliminary efficacy of a low–glycemic index diet with lower levels of ketosis also suggests this may be accurate (13).

      And with the coconut oil craze in Alzheimer’s, what if it’s not really about ketones as touted, but really about the antimicrobial aspects of coconut oil? Is AD a fungal brain infection where lauric acid not only uncouples mitochondria, but kills melanin-munching fungi in dopamine neurons? Yet coconut oil is sold as a ketone-raising item to fuel mitochondria which create glutathione to detox the brain of mercury. I can understand why Richard is appalled.

      But I’d like to see more focus on how the Inuit diet affected flora balance, perhaps raising Bacteroides while starving Firmicutes. Or maybe high fat balanced Bacteroides. The point is ketone levels are due to microbial balance. The most basic ketone, acetone, is product of clostridia. Ask Chaim Weizmann who discovered the process using the “Weizmann organism” a clostridium. They made acetone for the war effort using corn fermentation. Weizmann used his royalties to become first president of Israel.

      But more interesting is how microbes interfere with cellular metabolism leading to ketone generation, hence DKA (diabetic ketoacidosis). Are those ketones made with butyrate (beta-hydroxybutyrate), a product of flora? The way this is taught in schools is as a sterile process, as if intracellular microbes don’t exist.



    • Richard Nikoley on April 5, 2014 at 07:47

      “The way this is taught in schools is as a sterile process, as if intracellular microbes don’t exist.”

      Here here.

      This is one thing that’s been completely on my mind in researching and collaborating on this book, how back to the drawing board we are about so many things because almost none of any of it contemplates the microbes in and on us and the impact on health, metabolic, hormonal, mental function, etc.



    • GTR on April 5, 2014 at 17:10

      @Richard – if you want to change the approach people have to bacteria, you have also to reedit encyclopeidas. As of now, whatever page of Wikipedia you open you get a lot of description of DIESEASES bacteria cause, some information about their industrial use, and that’s all. No mention of the beneficial

      Example:
      http://en.wikipedia.org/wiki/Clostridium
      in the introductory section they basically start with giving examples of pathoghens.



    • Richard Nikoley on April 5, 2014 at 17:26

      GTR, in Chapter ONE of the book, this is my WHOLE THEME.

      You’ll see.



    • Richard Nikoley on April 5, 2014 at 17:32

      GTR, Just a tidbit final para from a section in the chapter written some months ago:

      “But the comforting bug metaphor has long since been operative in how we humans generally approach the bacteria in and on us. It’s understandable because after all, our awareness was only raised by the bad ones…the pathogenic, the communicable, the maimers and killers. It was an easy precaution to take: the only good bug is a dead bug. So the bacteria inhabiting humans were dealt with the same way as the bugs invading your home or your bed. It’s unjust to implicate life-saving advances in medical science that at first discovered simple sanitary practices like hand washing, cleaning, doing the laundry, proper disposal of refuse, disposition of the dead, and then later went on to develop antibiotic agents and medicines to combat infections. Hundreds of millions of human lives have been saved by such advances in knowledge and intervention.”



    • Keith Bell on May 2, 2014 at 05:56

      Regulation of myocardial ketone body metabolism by the gut microbiota during nutrient deprivation, 2009
      http://www.pnas.org/content/106/27/11276.full



  28. golooraam on April 2, 2014 at 06:50

    raw liver is full of glycogen? wow – perhaps that should be my next post workout meal
    great news to hear

    • La Frite on April 2, 2014 at 07:02

      Someone can confirm but the glycogen quickly degrades. Unless you eat raw liver from a very fresh kill, I doubt you will ingest much from the one you buy …



  29. leo delaplante on April 2, 2014 at 07:54

    never in the history
    has man purposely not eaten carbs the were available to him

  30. LCHF_Graham on April 2, 2014 at 11:52

    Well I only cited Westman as one ‘low-carb’ doctor actually getting great results with patients – consistent results that constitutes real world evidence. Not an appeal to authority or ideological fantasy (i.e. vegans with their silly and incoherent ‘world-view’). I’d rather low-carb a la Westman and not ‘enjoy’ health whole grains (sic) along with the fun of multiple insulin injections on a daily basis. Call me a ‘fanatic’.

    Yes anyone can be critical of the whole n = 1 thing. But then again to completely discount one’s personal experience might not be totally rational either. Are not most judgements based on some mixture of both personal experience plus the experience/information provided by others? The key to life is the ability to know when those experiences and that information is trustworthy or not – that is to have a self-critical and working bullshit detector.

    Fat equals the dietary evil of all evils but carbohydrates are the ‘essential’ the stuff of life (standard nutritional advice) certainly seems like total bullshit to my eyes and ears (and nose).

    Then again at a certain point people simply talk past each other and no rational dialectic can be entered into. No-one and no evidence imaginable could possibly persuade a closed-minded zealot, such as Durianrider, of their gross errors of logic and evidence and their willful intellectual dishonesty. And he is just the vegan mindset in extremis, yes?

    • Christoph Dollis on April 2, 2014 at 16:41

      Fat equals the dietary evil of all evils but carbohydrates are the ‘essential’ the stuff of life (standard nutritional advice) certainly seems like total bullshit to my eyes and ears (and nose).

      You really, really, really, REALLY like your straw men, don’t you?

      This is probably a hopeless and forlorn gesture on my part, but let me try to toss you a bone. Richard isn’t being black and white here: fats all good, carbohydrate all bad; or, carbohydrate all good, fats all bad.

      He’s being a little more nuanced than this—something which is escaping you.

      Ironically, you go on to talk about zealotry and Durianrider. Sure, he’s a great example, but you could have easily used a mirror.



    • LeonRover on April 2, 2014 at 18:43


    • Gina on April 3, 2014 at 11:03

      “I’d rather low-carb a la Westman and not ‘enjoy’ health whole grains (sic) along with the fun of multiple insulin injections on a daily basis. Call me a ‘fanatic’.”

      The logical fallacies are too numerous to address individually, but this false dichotomy stands out. It turns out those are not the only two options. Just one example: http://www.ncbi.nlm.nih.gov/pubmed/16873779. If you’re interested in that option – and I know you are! – Dr. Barnard has been a guest on the LLVLC show to talk about it.

      I wouldn’t call you a fanatic based on your eschewing of grains, since that doesn’t make you unusual ’round these parts. Also, I don’t call people names. All that starch I eat keeps my serotonin levels high and makes me easy-going. 😉

      “Fat equals the dietary evil of all evils but carbohydrates are the ‘essential’ the stuff of life (standard nutritional advice) certainly seems like total bullshit to my eyes and ears (and nose).”

      Mine too, but I don’t think that’s standard nutritional advice. The current fad is the Mediterranean diet, which emphasizes specific fats. I’ve never read Richard or any of the commenters here demonizing fat. Refusal to demonize carbohydrates is not an automatic demonization of fat. It seems weird to have to point that out.

      “No-one and no evidence imaginable could possibly persuade a closed-minded zealot…”

      Very true, though it might be a touch arrogant to dismiss those of us who remain unimpressed by your arguments as frothing zealots. As for Durianrider, I don’t think he reads this blog. I’m not sure whether to add that to the list under ad hominem or yet another straw man. Perhaps he is the “vegan mindset” (I’ve got to get that on a t-shirt) in extremis, but eating sticks of butter wrapped in bacon all day sounds about as crazy and appealing as eating bananas all day. Maybe I just have a wimpy, moderate vegan mindset. Probably the lack of protein.



    • Richard Nikoley on April 3, 2014 at 12:37

      Gina.

      Wow, you actually even read that, much less struck a comment?

      Blood, sista! In another life, I’d have done the same for you.

      High fat, low fat. What’s really important is what the other 90% of you are up to, but I’ll save that for my next (political post up now, just a bit ago).



  31. LCHF_Graham on April 2, 2014 at 11:56

    Couple of typos in my last post – sorry must be my under-carbed brain failing.

  32. skinnergy on April 2, 2014 at 19:13

    I came across this large document as I was researching other stuff yesterday. It’s a gold mine if you’ve not seen it yet, and it shows reason to think RS may not have much effect on those still on high fat diets regardless of how well they implement RS foods/supplementation:

    ‘Senevirathne et al. (2009), C57Bl/6J mice were fed high fat diet (41% dietary energy),
    moderate fat diet (28% dietary energy) and low fat diet (18% diet energy) supplemented with
    RS for 10 wk. They reported that although the total bacteria population was not affected by
    fat diet, Bifidobacterium /Lactobacillus and Clostridia spp. were only enriched in animals fed
    low and moderate fat diets, but not in high fat diets. (Abstract available only).

    http://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=2638&context=etd

    I know it’s just mice, but my experience aligns well with these results. I’ve been moving away from fat in my meals a bit gradually over the 6-8 weeks. I still get enough to be on what is probably a low-to-moderate fat intake, but I took out about 400-600 calories of it per day so as not to be on specifically a high fat diet and didn’t replace them with other foods. That just means no butter coffee with a straight up fast most days until 1 or 2:00. I’m seeing a nice uptick in BG regulation (85 fasting, followed by 71 at 9o minutes after the meal following that measurement. Was 110-115 FBG) and a nice downtick in the scale weight and (more importantly) the way my clothes fit. It’s not dramatic, but it fits the whole first law of thermoblah we’ve been talking about, and what the tiny human replicas report in the study to which I link.

    More importantly to me, it’s spring in what amounts to a city built over an Appalachian swamp with killer pollen and mold, and I still haven’t had to add back any of the 3 allergy meds I deleted as a result of starting PHD and RS inclusion. I will if I need to, but haven’t yet. That and normal TMI, both firsst in my adult life.

  33. GTR on April 3, 2014 at 00:51

    On the other hand – some culinary traditions we associate with high carb food might actually digest less carbs than simple intake calculations indicate.

    The current Al Sears infomercial newsletter promotes extracts from borlotti beans (also known as roman beans), but also containst information about the beans themselves:

    “The remarkable thing about this particular bean is that it STOPS fattening carbs from breaking down into the sugar your body stores as fat. Instead, it preserves carbs as fiber, which does NOT break down into fat.
    The French eat it in a salad. The Italians in a soup. Both BEFORE a meal.
    […]
    people taking an extract of this bean lost 6 pounds in 30 days… without changing anything else. ”

    So basically some diets thougth to be high-carb actually are moderate-carb, high fiber.

    • GTR on April 3, 2014 at 16:11

      The beans are apparently different, but arent’t they like the same – related to each other as “Phaseolus vulgaris” variety?

      http://italianfood.about.com/od/vegetablesandsidedishes/ig/Frutta-e-Verdura/Borlotti—Cannellini.htm

      Apparently Borlotti are a local Italian version of Cranbery beans, with thicker skin than the “international version”.

      http://en.wikipedia.org/wiki/Cranberry_bean

      You can extract amylase (starch degrading enzyme) inhibitor from Cranbery beans (international).



    • Energy! on April 3, 2014 at 04:47

      Is there any chance he was talking about cannellini beans (white kidney beans)? There are tons of references online that they inhibit carbs but none on borlotti beans that I can find. Just wondering.



  34. Ellen on April 3, 2014 at 15:53

    I mentioned several months ago that the calculus on my teeth seemed to me to have diminished greatly since getting a handle on RS by including some of the recommended probiotic supplements. But I was afraid that it might be some sort of wishful thinking, so I could not wait till my next cleaning for verification.

    That was today. Sure enough my hygienist was greatly impressed with markedly diminished tarter and the overall condition of my mouth

    When I explained what I had been doing, she actually took notes! She also remarked on how good my skin looked. Not many other people see it from such close range, nor have so many others to compare to, so I took her at her word.

    The cleaning was like the old days when I was younger. No digging or scraping. A breeze!

    I am assuming that this because my gut is now producing vitamin K and that this also bodes well for my bones and arteries….

    • Christoph Dollis on April 6, 2014 at 07:42

      My hair feels softer. I noticed that last night.



  35. La Frite on April 3, 2014 at 05:26

    I can only talk about the French: we usually prefer the whiter variety. Don’t ask me why, I don’t know … Flageolets, mogette, etc, have been traditional (as far back as the 16th century I think).

    The other main bean type the French eat is green beans (haricots verts, fèves, pois).

  36. Edward on April 3, 2014 at 08:31

    Richard, when your looks are going to reflect what you’re advocating here, I’ll start considering believing you. Meanwhile, I’ll just read what the nutcrack Jack Kruse says, as he’s leaner and it appears that he’s been helping many people in the past few years with his work.

    Sincerely, Edward.

    • GTR on April 3, 2014 at 16:17

      @Edward – do big-bang cosmologists have to look like The Expanding Universe due to your rule “your looks are going to reflect what you’re advocating”?



  37. Richard Nikoley on April 3, 2014 at 09:26

    “Sincerely, Edward”

    I love it when people just lie like that.

  38. Rita Weasel on April 3, 2014 at 10:03

    Richard – what do you think about Skinnergy’s comment? Do you find that RS is more effective when fat is kept in moderation?

    • Richard Nikoley on April 3, 2014 at 10:46

      Rita:

      It’s a loaded question because, assuming one must eat to satiation, lowering fat means upping protein or carbs. For most, it’s going to be carbs and if you use safe starches that do have RS, more if cooked and cooled, then it becomes kinda circular and uninteresting for me.

      I do not like ideologically based stuff, like HF v LF. I think we evolved to exploit a huge different environment of what’s available.

      The problem is, one has to be a high fat or a low fat advocate, and I will no longer involve myself in that. What you need to have is a healthy gut biome. My bet is that a healthy gut can handle either. The mix and composition will be different, but the host will be healthy.

      We know this because there have been marvelously successful societies subsisting on both HF and LF.

      You see, the gut biome and its feeding is what unifies it all.

      No longer interested in the silly side taking, either way. You need to be wildly omnivorous. That’s my absolutely firm dietary advice.



    • skinnergy on April 3, 2014 at 12:31

      Richard, I think the question is not whether you advocate an HF or LF, but whether too much of it may get in the way of enriching the gut biome, specifically the butyrate producers that benefit from RS2 specifically.

      Rita, for me (and me only) I did see plenty of benefit (and fartage) from the bionic fiber/RS/probiotic approach before I began reducing fat intake. The fat thing is mostly to obtain the physical appearance of someone that consumes 400-600 less calories per day on average over time. And don’t get me wrong, I benefitted from HF in other ways for sure. Now, I’m not sure if I’m seeing increased benefit from RS because I consume less fat, or if it would have happened anyway from continued use over the weeks and months. The study I linked to suggests this may be the case, but can’t be sure.



    • Rita Weasel on April 3, 2014 at 13:29

      Thank you both for the replies. Truly fascinating.



    • Richard Nikoley on April 3, 2014 at 14:22

      “Richard, I think the question is not whether you advocate an HF or LF, but whether too much of it may get in the way of enriching the gut biome, specifically the butyrate producers that benefit from RS2 specifically.”

      I would agree. It’s no wonder that Paul’s PHD (plus legumes, but he’ll come around to being more right 🙂 seems to be integrating very nicely with very many interested in feeding their gut with some starch and supplemental RS.



  39. Adam on April 3, 2014 at 11:17

    At the risk of oversimplifying and mis-stating, let me try to boil it down:

    – Occasional ketosis is probably fine
    – No evidence to support chronic ketosis is healthy, some evidence to suggest it harms glucose response

    What do you think about a middle ground of following a ketogenic diet for weight loss for several months, or even a year or 18 months? Even if the way it works is by spontaneous caloric restriction, could it still be a good method for weight loss (ease of adherence, simple menu, radical improvement over the subject’s previous diet) for a medium-term time period?

    • Richard Nikoley on April 3, 2014 at 14:26

      “boil it down”

      Nice & pithy.

      “What do you think about a middle ground of following a ketogenic diet for weight loss for several months, or even a year or 18 months?”

      Only if way overweight or obese, and you are continuously losing fat. Once the weight loss stops, time to shift gears.

      This is my story. The 60 pounds were divine and i felt awesome 24/7. Once I “stalled” but persisted, is when probs began and I wasted 3 years trying to figure it out.

      Make sense?



    • Adam on April 3, 2014 at 15:13

      Yep, thanks.



    • Martin on April 28, 2014 at 06:28

      It sounds like story indeed.

      My problem though is: even if my fat loss stalled, my energy level and hunger control are pretty much stable. Whenever I try to up my carbs intake (stafe starches), I get hungry and irritated when not eating for 3+ hours.

      How did you figure it out?



  40. […] note: no matter how you want to slice the blubber, they are not in ketosis, and it takes a long fast to get them there. Inuit are off the table for ketogenic low carbers. […]

  41. […] about the Inuit and how in three studies, 1928, 1936 and 1972, they found no ketosis in the Inuit (To Reiterate, Just In Case You Missed It: No Elevated Ketone Levels in the Inuit), even though they are low carb, about 55g per day on average, mostly from the glycogen in fresh, […]

  42. […] To Reiterate, Just In Case You Missed It: No Elevated Ketone Levels in the Inuit […]

  43. […] In the post I previously linked above dealing with the Inuit and ketosis, I have to pretty much conclude that chronic ketosis is not a good thing. Ketosis is wonderful as a […]

  44. Daniel on April 22, 2014 at 12:38

    We are all different. Different environments, adaptation to environments. There is NO IF ANDS OR BUTs…unless you can refute the previous statement. Yes this is that simple and all people who say there is a one-size-fits-all human diet are idiots.

  45. Mike on April 29, 2014 at 11:14

    Interesting post, but I wonder why nobody told you that urine tests are quite pointless when “diagnosing” ketosis? Of course you can define ketosis as a person having increased ketone levels in the blood – but it’s quite a bit more useful to define it as the body (primarily the brain) deriving most of its energy from ketones, and as it turns out a blood test for beta-hydroxybutyrate is required for that.

    But of course using modern methods would sabotage your argument …

    • Richard Nikoley on May 1, 2014 at 14:12

      Mike

      You obviously didn’t carefully read the studies cited, so you’re dismissed.



  46. I need help with Ketosis meal plan. - Page 3 | Mark's Daily Apple Health and Fitness Forum page 3 on May 20, 2014 at 19:35

    […] in to criticize choco's post as misinformed, you should probably research your own argument first. Last edited by j3nn; Today at 07:07 PM. | My (food) Blog | Follow me on Facebook | Pinterest […]

  47. tina on May 24, 2014 at 15:16

    I love when I can learn and laugh, fucktards is my new favorite word.
    thank you
    Richard

  48. Lady Ermintrude on July 25, 2014 at 06:52

    Hi Richard

    Can I ask a question?

    Would lack of resistant starch lead to yeast infections? I ask because I have had one recently and all I read about it says it is often caused by higher blood sugar. This confused me, although your article may help explain it.

    I have had no grains or sugar or processed food for 5-6 months so I know I do not consume high levels of sugar. However, recently I have lowered carb intake to about 30g a day because Dr Perlmutter’s book says being in mild ketosis is good. I have been very borderline pink tests for a few weeks, sometimes tipping into darker pink/higher ketones. I thought this was a good thing???

    However, it is after this that I got the infection. Could it be that I have elevated my blood sugar levels inadvertently? Could this have led to the yeast infection? Or is it likely that my good/bad bacteria are out of kilter in all areas of my body not just the gut? Or is it both?

    I’ve started drinking a green banana smoothie each day and am hoping this will correct things. Should I be slightly upping my carb level too?

    Thanks!!

    Lady E 🙂

    • Ellen Ussery on July 25, 2014 at 08:01

      According to Paul Jaminet, Ketosis can cause a yeast infection in certain people. This was true for me.

      Ketones feed yeast.

      paul jaminet ketosis feed yeast



    • Ellen Ussery on July 25, 2014 at 08:03

      That last line was my inept Google search. If you use it you will come up with a bunch of references.



    • Lady Ermintrude on July 25, 2014 at 09:06

      Fab thanks 🙂



    • Duck Dodgers on July 25, 2014 at 12:25

      Lady,

      Ellen is correct, but in a nutshell, what seems to happen is that the lack of carbs (and therefore, lack of RS) causes a reduction in SCFA fermentation.

      Human Food Project: Sorry low carbers, your microbiome is just not that into you

      …And, as that article explains, that lack of fermentable fiber causes the pH in your large intestine — particularly the distal end — to shift from slightly acidic (as it should be) to neutral or alkaline.

      What most low carb nutritionists don’t realize is that a neutral to alkaline large intestine causes candida/yeast to morph from a benign yeast to its pathogenic hyphal state.

      See: Alkalinity promotes Candida overgrowth

      Paul Jaminet’s contribution was pointing out that yeasts are Eukaryotes, and Eukaryotes have mitochondria that can rapidly metabolize ketones for energy. This adaptation from sugar to ketones can take a few months — which is why many people don’t make the connection. But once the yeast adapts to ketones, the yeast can get out of control pretty quick.

      When you put the clues together, you can see that the drop in carbs can not only fuels the candida/yeast through ketones, but the drop in fermentable fiber switches on the hyphal growth gene in the yeast and candida, causing it to become pathogenic. It’s a double whammy.

      Incidentally, I believe 15% to 20% of the carbs and starches people eat tends to escape digestion, so even SAD dieters are able to feed some of their gut flora just by being on a high carb diet. But someone eating 30g of carbs a day would already have a disadvantage to a SAD dieter since they would need to eat a lot of other fibers (often mostly in cellulose) just to get into the ballpark of the fiber a SAD dieter is able to consume without even trying.



    • Gemma on July 25, 2014 at 13:36

      @Lady Ermintrude

      As and addendum to Ducks explanation, in short: commensal candida is very useful to the human body when it lives there in a yeast form, and has enough polysaccharides to eat.

      If only ketones are available, it adapts to eating them too, but it makes it very angry, so it starts searching the sugars somewhere else, and starts eating you.



    • Lady Ermintrude on July 25, 2014 at 13:57

      Thanks guys for the really helpful comments. I think in my efforts to cut back the carbs I have maybe gone too far.

      Do you think my green banana/berry/coconut oil drink will be the answer? I also do eat quite a lot of green veggies.

      Btw – my yeast infection is not in the gut (well I don’t think so) it’s in another part of my (female!!) anatomy. But I guess that stems from the same problem??

      Thanks for your help. It’s really useful!!

      Lady E



    • Gemma on July 25, 2014 at 14:32

      @Lady Ermintrude

      “Do you think my green banana/berry/coconut oil drink will be the answer? I also do eat quite a lot of green veggies. ”

      No, it may not be enough, sorry. Google anti-candida diets and treatments. (There is no simple answer).



    • Duck Dodgers on July 25, 2014 at 15:49

      I think in my efforts to cut back the carbs I have maybe gone too far.

      It’s very easy to undershoot carbs if you cut out grains. The reason why is refined carbs are extremely dense. But, a potato, rice, or fruit is mostly water. So, you have to eat a lot of complex carbs just to get to a moderate carb intake.

      A moderate carb intake would be between around 150g of carbs, but believe it or not, that’s a pound of potatoes!

      Do you think my green banana/berry/coconut oil drink will be the answer? I also do eat quite a lot of green veggies.

      Even with a smoothie and lots of green vegetables, it’s extremely difficult to eat more fiber than a SAD dieter if you are only eating 30g of carbs a day. You’d have to actually have tally your fiber to believe it. And then you’d have to consider that green vegetables are typically cellulose, which generally doesn’t ferment as much SCFAs as other fibers do.



  49. keto user on June 10, 2015 at 14:13

    Angry idiot. No amount of carbs will get rid of the hate you cultivate in your mind as an attempt to hide from your guilt.

    • Richard Nikoley on June 10, 2015 at 15:25

      It’s probably lost on you, what an angry idiot you look like writing this comment on a post that’s 14 1/2 months old, there are many subsequent posts on the same topic, and I recently was an overnight guest in the house of the man who was my chief antagonist for what turned out to be a 17 or 18 post series.

      Silly fool.



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