Tuesday, June 7, 2011

Fat balance versus energy balance

When losing “weight,” you want a selective process.  You want to lose fat, not essential lean mass, which includes essential water (i.e. not water of edema), muscle, organs, and glycogen.

When a person adopts a low carbohydrate diet, the body continues for several days to draw down glycogen stores to fuel the brain and muscles.  Glycogen stores typically amount to about 300 to 400 g in the average subject, 100 g of which can reside in the liver. The body stores glycogen in combination with water in a ratio of about 3 g water for each 1 g of glycogen.  Thus, on a low carbohydrate diet, initial depletion of glycogen can alone account for up to 1.2 to 1.5 kg, creating an illusion of rapid change in body composition.

As noted by Flatt,  “The body ignores that 1 g of fat contains more than twice the energy present in 1 g of carbohydrate, an element of information needed to determine the energy balance.”(1) The body does not regulate energy balance; it regulates the balances of carbohydrate, protein, and fat, each of which has its own economy.

Ingested carbohydrate, protein, and fat differ markedly in their potential fates:
Utilization in structures of glycomolecules
Utilization for repair and maintenance of tissues
Utilization for repair and maintenance of cells
Oxidation to support body functions
Conversion to glucose; oxidation to support body functions (only in a carbohydrate deficient system)
Oxidation to support body functions
Oxidation to produce heat
Conversion to glucose; oxidation to produce heat (only in a carbohydrate deficient system)
Storage as body fat
Storage as glycogen (500 to 600 g)
Conversion to glucose; storage as glycogen (only in a carbohydrate deficient system)

Conversion to body fat
Conversion to body fat

Numerous studies have shown that the concept of energy balance does not strictly apply to human metabolism because of the different ways the body manages the separate economies of  fat, protein, and carbohydrate.  

As an example, Miller and Mumford did three experiments involving overfeeding humans with a supplement of 1300-1500 kcal per day, either high in protein (~15%) or low in protein (~2.7%). [2 full text]   Fat content of high- and low- protein diets was held constant, so high protein diets were reduced in carbohydrate, and vice versa. 

Their data showed large deviations from predictions of the energy balance hypothesis.  Subjects overfed a low-protein, high-carbohydrate diet consistently gained less weight than predicted by the increased kcaloric intake; in fact, some subjects on low protein diets lost weight despite consuming an excess of 8-10,000 kcal in a week. 

In one experiment, subjects on low protein diets overconsumed an average of 35, 230 kcal but gained only 0.9 kg, compared to the energy balance prediction of  5.9 kg. In contrast, subjects getting the excess kcalories from higher protein foods gained an average of 3.7 kg, two-thirds of the amount predicted by the energy balance equation.  Miller and Mumford ruled out significant loss of lean mass by multiple methods of estimating body composition, including whole body potassium, skinfold, nitrogen balance, and urinary creatinine, none of which indicated significant change in lean body mass in these subjects.

These data indicated that, given the same excess “energy” intake,  higher protein intake increases body weight gain compared to higher carbohydrate intake. These data clearly contradict the energy balance idea as well as the idea that high protein diets have a metabolic advantage over high carbohydrate diets; on the contrary, they suggest that high carbohydrate diets have the metabolic advantage. 

Prewitt et al [3 full text] found that women (black, Hispanic, white, and Asian) assigned to a 60% carbohydrate, 20% fat diet required 14-28% (average 19%) higher caloric intake to maintain weight than when assigned to a 44% carbohydrate, 37% fat diet (protein intake was constant at ~19%).  Despite efforts to maintain stable body weight on the lower fat intake by increasing carbohydrate intake,  the subjects lost an average of 11% of body fat (2.5 kg) over 24 weeks. 

Grams, Not Calories

In the nutritional biochemistry literature, research along these lines has led to the realization that the body deals with substrate balances, not energy balance.   That means, the body has a fat balance, protein balance, and carbohydrate balance, the latter two of which it appears to regulate. 

Since the body processes each nutrient (protein, fat, carbohydrate) differently, we can’t reduce them to hypothetically equivalent kcalories with equivalent fates.  Ironically, this has become the battle cry of advocates of low carbohydrate diets, when the data (some of which I cited above, some below) overwhelmingly supports the conclusion that high carbohydrate diets have the “metabolic advantage” over low carbohydrate diets.

To lose body fat, you must create a metabolic situation in which the body oxidizes more fat than it deposits in stores, which we can call ‘negative fat balance.’  This could occur through increased oxidation of fat relative to deposition, or decreased deposition relative to oxidation, or both. 
Hill et al tested nutrient balance in humans using diets high and low in carbohydrate or fat. [5] Figure 2 shows the nutrient oxidation rates for protein, fat, and carbohydrate at baseline, and three different experimental diets.  The high fat diet supplied 20 percent of calories from each protein and carbohydrate, and 60 percent from fat.  The high carb diet supplied 20 percent of calories from each protein and fat, and 60 percent from carbohydrate.  The mixed diet supplied 20 percent of calories as protein, 35 percent as carbohydrate, and 45 percent as fat. 

Click for larger version

As shown, on the high fat and “mixed” diets, the subjects oxidized (“burned”) more fat than either carbohydrate or protein, and on the high carbohydrate diet, they oxidized more carbohydrate than either fat or protein.  Notice that protein oxidation was essentially the same regardless of diet, because all diets had equivalent proportion of protein.  This confirmed the long-known fact that carbohydrate spares fat oxidation.  From this figure, you might naturally conclude that eating a low carbohydrate diet will lead to fat loss by increasing fat oxidation.

The next figure shows the balance (intake minus oxidation) of protein, fat, and carbohydrate on each of the diets.

Click for larger version

On the 60% fat diet, the subjects were in slight negative fat balance (burning more fat than consumed) on day three, but by day seven, they were in positive fat balance (burning less fat than consumed)--hence, on day seven they were storing dietary fat in adipose.  This happened despite the fact that they had increased fat oxidation.  Decreasing dietary carbohydrate forced the body to burn more fat, but because they were consuming a high fat diet, they were consuming more fat than they could burn in a day, resulting in a positive fat balance....increasing adipose.

In contrast, the subjects on the 45% fat and 20% fat diets were in negative fat balance—burning more fat than consumed—on all measured days, with those on the 20% fat diets in the greatest negative fat balance—losing body fat at the greatest rate.

Note that this means that on the same kcaloric intake, when the subjects ate a 60% fat diet, they were accumulating body fat, but when they ate a 45% or 20% fat diet,  they were losing body fat...and they lost fat faster on the 20% fat diet than on the 45% fat diet.

Notice also that when the subjects were on the 60% carbohydrate diet they had positive protein balance at both measured days, but when on either the 60% or 45% fat diets, by day seven they were in slight negative protein balance—burning more protein than consumed.  That means they were burning up lean mass, despite a high (20% of calories) protein, kcalorically adequate diet.  This happened because carbohydrate is protein-sparing.  In other words, eating adequate carbohydrate prevents the use of body protein to produce glucose or glycogen; eating too little carbohydrate leads to the body breaking down lean mass to generate carbohydrate.   This is why many people find it difficult to maintain and especially to build lean mass on a low carbohydrate diet.

What about carbohydrate?  All diets showed positive carbohydrate balance.  This means they were storing carbohydrate, in the form of glycogen, at time of measurement.  Humans are continuosly oxidizing carbohydrate, but intermittently feeding on carbohydrate.  Given adequate dietary carbohydrate, our body's will maintain a positive carbohydrate balance during the day, because we don’t eat at night. This carbohydrate gets burned at night during sleep, when not eating.   Hill et al comment:

As noted above, the body does not regulate energy balance, it regulates balance of nutrients.   The body has different ways of handling each nutrient, in general it avoids converting glucose into fat since it needs glucose and can store it as glycogen.

In the case of carbohydrate, we know that when carbohydrate intake increases, the body increases carbohydrate usage and converts some (about 10%) to heat (thermogenesis), and it stores any excess carbohydrate as glycogen.  It appears that the body regulates carbohydrate stores (glycogen) by increasing carbohydrate oxidation when carbohydrate is abundant and reduces glucose oxidation when dietary carbohydrate is scarce (to conserve glycogen).  Experiments involving overfeeding 500 grams of carbohydrate daily have shown that the body converts very little of this to fat, and only after prolonged overfeeding; after seven days of such overfeeding people produce only about 5-10 g of fat via conversion of glucose.[6 , 7]  Furthermore, conversion of glucose to fatty acids consumes about 25% of the energy in the glucose.  

In the case of dietary fat, when you eat more grams of fat than you burn, you will store those grams of fat in fat stores; the body has no other way to store them, and most research shows most fats do not have a thermogenic action.  The high prevalence of obesity shows that the body does not regulate fat storage effectively.  Since it avidly stores fat without regulation, this suggests that evolutionary diets did not have much fat (avid storage would evolve as a response to scarcity).

So, if you consume 10 g excess fat daily, you will directly store those grams of fat in fat stores.  Over a month, those 10 g of fat add up to 300 g, or about  three quarters of a pound.  The body does not calculate the kcaloric value of those grams of fat; the kcaloric value is simply irrelevant to the body.  I repeat, energy balance is irrelevant.  The body has no means of regulating "energy," a theoretical entity; it only shuffles grams of substances like fat, carbohydrate, and protein.

When you eat fewer grams of fat than you burn, you will release fat from fat stores.  Eat 10 g less fat daily than you burn, and you will lose 300 g of fat per month; to lose one pound of fat weekly, you need to create a fat deficit of about 65 g daily (i.e. consume 65 g less fat than you burn).   

You might be able to achieve this on a low carbohydrate diet, and you might not.  If eating a low carb diet allows you to eat less fat than you burn daily, you will lose fat, and if it doesn’t you will not.  On the other hand, regardless of theoretical "energy" intake, if eating a low carbohydrate diet results in your consuming more fat than your body burns daily, you will increase your body fat day by day. 

In my experience, many people increase fat intake well beyond fat oxidation when eating low carbohydrate diets, in spite of reduced kcalorie intake.

The body does not store "energy," it stores fat or carbohydrate, gram by gram.  A gram of fat is a gram of fat; if you don’t burn it, you will store it.   


rosenfeltc said...

Great post, this has been my experience as well.

Alan said...

The allegation that the body has 3 separate economies for protein, carbs, and fat is interesting - did I overlook your citations probative that such is true?

One is reminded of the fact that the only places where one sees stories of "rabbit sickness" is in pop diet blogs - not in medical Grand Round citations.

This allegation (3 separate economies) should be tested.

We can also test for the existence of carbohydrate deficiency. It might take some work to produce a sufficiently sensitive test; that level of effort might not, or it may be, at a higher level of rigor than an average non-physics/chemistry investigator is used to holding himself.

Stephan Guyenet said...

Hi Don,

I'm not sure what you're referring to as the "energy balance hypothesis". The idea of energy balance is that the amount of energy inside the body equals the amount entering it minus the amount leaving. I haven't seen an experiment yet that disproves that! Carbohydrate overfeeding causes more thermogenesis than fat overfeeding in some people, which explains the lower fat gain, however that doesn't seem to apply when a person is in energy balance.

The reason people typically refer to fat tissue when they're talking about energy balance is that fat represents the largest and most plastic form of energy storage in the body. The amount of energy available in fat tissue is much larger than the amount in muscle tissue (partially because you can only eat up so much muscle before you die), and much, much larger than what's available in glycogen stores. Muscle is not an energy storage organ-- although muscle mass will increase a little during overfeeding, you can't get buff by eating more. But you can get fat.

Also, the body only breaks down muscle for energy when it's in dire straits. That means that fluctuations in energy balance are reflected mostly in fat mass, which is why fat mass is typically equated with energy balance.

Karn said...

I found it interesting that not one person in the study was over 160 pounds. Ah, times have changed.

Chris said...

you have got me officially confused now Don.

vizeet srivastava said...

Hi Don,

I have difficulty agreeing with some of the points you made here.
1. The high prevalence of obesity shows that the body does not regulate fat storage effectively.
I think it is quite well regulated with leptin reception. Most of us have screwed up our leptin reception.
2. it avidly stores fat without regulation, this suggests that evolutionary diets did not have much fat
I think fat regulation is not something that evolved in humans.

Another point:
High amount of subcutaneous fat does not pose any health risk and does not effect ones power or stamina so nature is a bit casual in regulating it.

Theo said...

I think this is an oversimplification -- taking how the body responds to fat on an energy level and thinking that that is the whole picture. If leptin signalling is good and you are not eating addicting foods, it is very difficult to gain weight with added fat. If the glycogen stores are full and the adipose tissue is signalling that it's at a good level then you shouldn't be hungry. At least that has been my experience. If I overfeed on fat for a few days I completely lose my appetite and have difficulty eating more than a moderate amount of food.

Gretchen said...

"eating too little carbohydrate leads to the body breaking down lean mass to generate carbohydrate."

Not if you're also eating sufficient protein. Then the body uses the ingested protein, which is reduced mostly to amino acids during digestion, rather than going to the extra work of breaking down your muscles.

Mert Guney said...

Definitely very, very interesting, Don.

ryn said...

this hasn't taken activity into account at all. if people were walking 6-9 miles a day, their energy requirements and usages would be quite different. you cannot "control" for activity levels by keeping all study subjects at the sedentary baseline of modernity. that only produces a picture of dietary effects in damaged and deficient people. if your thesis is that sedentary people should structure their diets differently, you need to be explicit about that, but this does not illuminate the ancestral hunter-gatherer's needs and habits.

Sanjeev said...

Thanks for this Don.

years ago I bought into the "as long as you are zero carb you canNOT gain fat mass" from a pair of MDs, science writer who wrote several books on physics with (apparently) an axe to grind.

I lost weight at first and when the weight came back that initial easy loss just held some kind of spell over me.

I got to my highest obesity ever following this advice. My mind is such a sorry tool sometimes.

if the body monitors and controls each individual energy input/use/output stream, then the overall "mass/energy balance" is automatically under control.

The aggregate of the streams is not regulated, but the regulation of each stream aggregates to overall control.

don wrote:
>When you eat fewer grams of fat than
>you burn, you will release fat from
>fat stores

My understanding is that on low carb adipocytes will be releasing fatty acids and taking them up again, regardless of the amount eaten. So if one eats a ton of zero-carb fat, the adipocytes do not stop dumping fat into the blood.

Adipocytes taking up fat and storing it without insulin is one of the things that Taubes fessed up to based on Hall and Chow's work, and apparently they convinced him using this recycling argument.

He still apparently thinks ASP plus small amounts of insulin (like any normal person has almost all the time) does nothing, since T1's can't get fat without insulin.

Don said...


The data I cited clearly shows that we have three separate economies, that the body manages carbohydrate balance, protein balance, and fat. We even have separate compartments: glycogen stores, muscle and organ tissue, and adipose, each dominated by carbohydrate, protein, or fat respectively. I laid out the separate fates of each nutrient. For more, just read the article in Obesity by Flatt. As for testing, the research I cited by Hill et al, and many others similar, have established these three economies in operation.

Don said...


I agree that at least in hypothesis we can "explain" the large discrepancy between the predicted and actual gain from CHO overfeeding in the Mumford and Miller study by thermogenesis, but to my knowledge no one has actually measured the heat release, we only assume that it was lost to heat (an assumption made to uphold the energy balance hypothesis). Correct me if wrong.

In the Hill et al study, they clearly showed that people were in negative protein balance despite not being in "dire straits," unless carbohydrate insufficiency (leading to difficulty maintaining glycogen stores) counts as dire straits.

The Hill et al study clearly shows that fat balance can be positive despite calculated energy balance being neutral. This is why I said energy balance is irrelevant to gain of fat mass. Deposition of adipose represents a gain of fat mass, the energy value of the gram of fat is irrelevant to the body mass (it would store the excess gram of fat as a gram of fat regardless of its theoretical energy value, i.e. it would not matter whether the gram of fat had a theoretical energy value of 1 kcal or 1000 kcal or any other number of kcals). IMO to understand why people gain fat mass we have to look at fat as mass, not as energy.

Put otherwise, people aren't trying to lose energy, they are trying to lose mass; so the goal is to have a negative mass balance, not a negative energy balance.

Don said...


The body does not burn off excess dietary fat in thermogenesis, and it does not automatically burn more fat to draw down excessive fat stores, ergo it does not regulate fat stores, it allows them to grow unchecked year after year after year until someone grows obese. This is just the opposite of carbohydrate. Where are the people with unchecked growth of glycogen stores? If any exist they are rare indeed. The body has mechanisms for regulating glycogen at both ends, namely burning less glucose when dietary glucose is low, and burning more glucose when glycogen stores are high. That's regulation. There is no comparable system for regulating fat stores. Ergo, fat stores are unregulated and people grow fat easily by eating more grams of fat than they can burn in a day.

Don said...


You say:

"I think this is an oversimplification -- taking how the body responds to fat on an energy level and thinking that that is the whole picture."

If everything works as simply as you suggest, why do people get so overfat in our society. Even if you say that their leptin signaling is screwed up, you are admitting that the body does not have a good system for regulating fat stores.

Again, where are the people who keep endlessly storing glycogen? Why don't people keep growing endless stores of glycogen? Simple, the body regulates glycogen by conserving it when dietary glucose is low, and spending it when glycogen stores are high. It simply does not do this with fat under any circumstances. That is why people get excess fat, but not excess glycogen.

Don said...


There is a limit to the amount of protein a human can consume, and it is extremely inefficient to use protein to fill glycogen. Why use protein to create glucose, which exposes your body to excessive ammonia and urea and sulfuric acid resulting from deaminating and metabolizing protein? Why not simply fill glycogen with less toxic glucose?

Protein is a toxic fuel source compared to carbohydrate. This is why the body chose to use glucose, not amino acids, as a fuel. Why not follow the wisdom of the body?

Don said...




???? All I need say is this: Sports nutrition research clearly shows that people perform better at both high and low intensities when fed high carbohydrate diets. Thus, in evolutionary times, the winner would have been the one eating more carbs, not the one eating more fat.

mario_encinias said...

Could our evolutionary ancestors have eaten a high fat diet? NOT LIKELY...

Foraging economies redically limit the amount of available animal fat as does compulsory meat sharing, which is a common trait among many foraging groups. If we are to take human evolutionary history seriously as a metatheoretical source for speculating on a species-appropriate-diet for humans, then we must consider that SCARCITY was the prevailing dilema for our human ancestors just as it is for modern hunters and gatherers. A high-fat diet would not have been a practical possibility for the vast majority of our evolutionary past. The high fat "cave man" diet is more often based on sterotypes than on a careful study of the ethnographic and archeological records. Kudos Don...I have really been enjoying this line of arguement.

vizeet srivastava said...

In the end I may agree with you Don. It still a difficult post for me to accept.
But seems what you mentioned is possibly right. I am doing the same thing eating lot of rice with meat and vegetables but not gaining weight.

Gretchen said...

". . . it is extremely inefficient to use protein to fill glycogen. Why use protein to create glucose. . ."

Of course it's inefficient and the body doesn't use gluconeogenesis when glucose is available.

But as far as I know, people who are dieting don't want efficient use of macronutrients. The least efficient the better.

And people on LC diets aren't eating many carbs, so the body adapts and gets what glucose it needs from protein.

If you're not eating enough protein, it will break down muscles, as in starvation or untreated type 1 diabetes. Eskimos on traditional diets eat mostly protein and fat and aren't listless and weak from muscle loss.

Humans are omnivores, and the body adapts to the food that is available.

Eric said...

I'm enjoying this "series" Don, as well as all the comments... One flaw in the argument you commented on later though jumped at me.

Where you asked: "Where are the people with unchecked growth of glycogen stores? If any exist they are rare indeed. The body has mechanisms for regulating glycogen at both ends, namely burning less glucose when dietary glucose is low, and burning more glucose when glycogen stores are high. That's regulation. There is no comparable system for regulating fat stores."

The glucose regulating mechanism you talk of is due, on one part, to the fact that glucose is so precious and therefore, if glycogen stores are low, the body will do what it can to spare it before having to resort to gluconeogenesis. The reason, however, why glycogen stores can not grow unchecked is simple: the body can only store a finite amount (compared to fat stores) and the body has also put in place a system where, once glycogen stores are full, it will convert the glucose to triglycerides/fat. So, you can store energy almost infinitely in the form of fat but, the same is obviously not true for glycogen.

This certainly doesn't make eating more carbs than one's level of activity dictates or glycogen stores can handle, the way to go, wouldn't you say?

Don said...


Last night, in my quick response, I realized that I may not have made it clear that when I said "energy balance hypothesis" I meant the hypothesis that body weight is regulated via regulation of energy balance, and that reduction of body fat should therefore be approached by regulating energy balance, rather than regulation of fat mass intake/oxidation.


First, why are glycogen stores finite? Because the body regulates those stores, burning off excess glucose when glycogen is high, and yes, in very extreme cases, converting glucose to fat. It is not because there is no room for glycogen; theoretically, every muscle and liver cell is a potential depot for glycogen. The cells could expand to the limits of their elasticity to accomodate glycogen storage, just as skin stretches to accomodate storage of adipose. But this never happens (to my knowledge) because glycogen storage is regulated.

In other words, glycogen stores are limited because they are regulated, and fat stores are virtually unlimited because they are virtually unregulated.

BTW, the conversion of glucose to fat due to topping off glycogen is exceedingly rare and probably practically impossible on a diet of whole foods. As I noted, Flatt and others have shown the one must consume an EXCESS of 500 g of glucose for more than 5 days in a row to induce this pathway. This means eating your normal eucaloric diet, and adding about 10 cups of rice or twenty 4-ounce potatoes on top of that, for five consecutive days, a heroic food consumption feat. So, evidence for this pathway is derived only from feeding liquid glucose solutions, something unavailable to our ancestors. Moreover, at the end of seven days, consuming 500 g/2000 kcal of excess glucose daily results in only 5-10 g/45-90 kcal worth of de novo lipids daily...so still, more than 1900 kcal of carbohydrate is stored in glycogen or by hypothesis converted to heat.

Finally, the fact that glucose storage is regulated within limits but lipid storage is not suggests that ancestral diets had abundant carbohydrate but limited fats. To thrive, the organism needed a method to prevent accumulation of glycogen beyond certain limits, but it did not need a method to prevent accumulation of excess body fat.

Don said...


One more thing: no one gets to decide how to store excess fat, e.g. subcutaneous or visceral. This is decided by the body, not our preference. So no one can say, well, I decided I'm only going to store this excess dietary fat under my skin, because that's harmless.

Don said...


Several studies I have seen indicate that Eskimos on traditional diets consume 250-400 g protein per day. This amount will spare muscle loss by providing enough dietary protein for glycogen production, but the wastes from this appear to contribute to the Eskimos having the highest rate of osteoporosis of any ethnic group, and the bone loss occurs early in life and in isolated Eskimos (see my series on Eskimo Osteoporosis).

Mostly nature drives organisms toward efficiency in use of resources. Who wants to spend 100 units of energy on a task if it can be done with 10? Inefficiency leads to low energy levels by route of waste.

But if it works for you, keep doing it until it doesn't.

Sanjeev said...

there's a condition where the liver can grow to unlimited size.

In these people glycogen storage can be infinite - the liver just grows every time they store a little more glycogen.

So It's not 100% clear to me that glycogen storage is "controlled". It runs up against the hard limits (muscle and liver) and then stops.

It's just that the human body never developed a way to store near infinite glycogen (unlike fat)

Gretchen said...

"Who wants to spend 100 units of energy on a task if it can be done with 10?"

I think people who have very efficient metabolisms so they can store fat on 1o00-calorie-a-day food intake would like this.

Also, apparently people with metabolic sydrome have more de novo lipogenesis than others.

I also used to think it was rare, but since then I've seen studies showing it's not.

I think the key factor here is insulin sensitivity. People without insulin resistance, especially those who exercise a lot, may do better with a lot of carbs and less fat. People with IR, especially those who can't exercise, may do better with fewer carbs.

We all have to find what works for us.

Anonymous said...

i think many miss the big picture...it is about total fat storage in regards to overfeeding with fat versus carbs(why btw are we trying to overeat???)...not the hiearchy of oxidation rates...

carbs have preferential oxidation over fat...the body prefers to burn carbs first as there is a limited storage site for them...

if you don't eat carbs...will you burn fat faster? yes!... but, you are also eating more fat by default, so you have much more fat to burn... but then you run into the slowed metabolic rate and SLOW glucose clearance b/c making glucose form protein is time consuming and body consuming so a body adjusted to making glucose from protein is going to have slow clearance rates b/c carbs are not supplied causing more work.

Now does this general concept apply to everyone? I don't know...maybe there is something in someone's individual genetics that makes it impossible for them to lose fat while eating carbs....There are a lot of things that science does not know yet....

mostly it is about leptin crossing the BBB to signal energy. however someone can make that happen and work properly will equate to a healthy body

Sanjeev said...

Another factoid for your consideration ... the body does do a lot in response to overall calories.

Specifically, low calorie diets, irrespective of how calories are lowered will produce lowered metabolism and a host of related hormonal effects.

Some of the hormonal effects are greater with high fat - I believe the thyroid falls quicker and the catecholamines rise quicker. The bulk of the changes are the same though - high protein & high carbohydrate also squash thyroid, it's just faster with high fat.

I conclude from that whether there is a direct measurement or not, the body behaves as if it is measuring fat calories coming in.

Anonymous said...

>suggests that evolutionary diets did not have much fat

This is patently false. Anyone who has spent any time outdoors knows the easiest foods to obtain are: vegetables, tubers, insects, fruit, nuts. Vegetables and insects are low in calories and fruit is only available seasonally in most parts of the world, and can only be stored where sun-drying is possible (hot and dry climates). That leaves tubers and nuts as the likely staples for most of humanity throughout most of history, other than a few situations where humans were unable to exhaust the game animals or fish and hence could obtain most of their calories from hunting/fishing.

The above theory is backed up by evidence. There are numerous primitive peoples who currently or in the past obtained most of their calories from nuts: bushmen and mongongo nuts, pacific islanders and coconuts, native americans of the Great Basin and pine nuts, various europeans and acorns or chestnuts or hazelnuts.

I have some experience of my own with a primal lifestyle and high nut consumption. Namely, I just got back from 6 weeks on the Pacific Crest trail, eating about 500g/day of instant rice, 400g/day of unsalted dry-roasted peanuts, plus daily multivitamin as my trail diet. According to USDA, this diet provides 4240 kcal, broken down as 49% carbs, 40% fat, 11% protein. This is enough for me (180cm/5'11" 77kg/170lb male) that I don't lose weight rapidly and don't suffer from protein cravings, both of which were problems on other trail diets I have used in the past. (Undesired loss of body fat is a problem for most long-distance hikers and protein cravings are also common. Fruit cravings are common for those who don't take a multivitamin or who are short on potassium, which is plentiful in peanuts.) I supplemented this diet with binges on ice-cream and cookies (to restore lost body fat) and animal foods (to top up protein stores) during town stops.

What I have noticed is that, even though I really like peanuts, my body starts to feel a bit wary of them when I eat 400g/day for days on end. I suspect there are toxins in the peanuts and my body is warning me that I will be punished by nausea if I eat more peanuts that the minimum necessary to avoid weight loss or protein/vitamin/mineral deficiency.

I suspect this is the same reason primitive peoples don't gain weight even when high-fat nuts are readily available. Namely, the nuts contain toxins. The body allows eating nuts as necessary, but as soon as needs are met, the body will cause nausea if more nuts are eaten. Compare with cod-liver oil: no one in the 19th century got fat overeating cod-liver oil.

Eric said...
This comment has been removed by the author.
Anonymous said...

Reference 6 isn't working?

R. K. said...

The weight gain by the High Protein group in the Miller and Mumsford "Gluttony" experiment can be explained by Seth Roberts' flavor-calorie association. The excess calories to the HP group were served as more of the same stuff they were already eating, thus binding the calories with those flavors. The Low Protein group had their excess calories presented with a variety of foods, which leads me to believe that they perceived a variety of flavors while consuming extra calories, and thus there was not enough time to build the associations. From the "Gluttony" article about how the LP diets were enhanced: "In view of the unusual nature of the low-protein diet we give here a list of foods used most frequently: Double cream, sugar, corn oil, butter, wine, jam, honey, marmalade, fruit squash concentrate, boiled sweets (i.e. 87% sugar and flavoring) and low-protein bread. Tinned fruits and soft drinks in season to serve as vehicles for sugar and cream. Limited quantities of breakfast cereals, rice, spaghetti, sago, corn-flour (cornstarch), and potatoes and other root vegetables. Lettuce, salad vegetables, aubergines (eggplant), marrows, and mushrooms to increase palatability and serve as vehicles for fat."

Avishek said...

Not true that eating excess fat will always store as fat. Let's go back to functions of fat in the body: synthesizehormones, protaglandins, you probably know more than I do. Not all dietary fat eaten has to be burned off.

This is why those on a hypercaloric ketogenic diet can continue to lose weight. Ketogenesis may change things up a bit, because in this case we are dealing with a nutrient that is never even stored in the body, ketone bodies.

Since on any low carbohydrate diet the amount of ketone bodies beign oxidized is greater, you could perhaps SUBTRACT the grams of fat ingested being burned as ketones from the total Fat balance ot calculate whether or not you would get fat... assuming that the ingested fat calories being burned as monoglycerdies would actually store as fat as you mention...follow?

Sanjeev said...

Avishek wrote:
This is why those on a hypercaloric ketogenic diet can continue to lose weight.
Losing significant ketone in the urine is temporary.

People who have kept careful records report continually declining ketonuria. See Lex Rooker's blog for instance.

Aside from that, lots of people have reported that even if they stick on the very low carb diet for a long time, its effectiveness declines. Faster for some than others.

Even Dr. Eades appears to have modified his stance, now claiming that ketosis amounts to, at absolute best, 100kcal per day, and usually less.

Many who have reviewed the literature Dr. Eades relies on (Lyle McDonald, Anthony Colpo (who was once an Eades acolyte)) report even that number is exaggerated - there is minimal to no metabolic advantage.

Gary Taubes has also modified his stance, now claiming "g3p is not rate limiting". In my very humble opinion he's trying to be too smart by half.

I followed the Eades/Colpo exchange, reading the references - by that time though my enthusiasm for low carb had already been waning (along with the results). On balance it looks like metabolic advantage is a bust. In the longer term low carb, high fat does not look optimal for a large fraction of people.

It does however seem to help some folk control their hunger better than a high carb diet, so it may be appropriate for a lot of people, but IMHO it should be sold as an aid, not a magic metabolic advantage pill.

Don said...


Most research indicates that high fat intake promotes insulin resistance, not high carbohydrate intake if accompanied by high fiber; and low fat High carb high fiber diets reliably reverse metabolic syndrome and NIDDM and reduce insulin requirements in IDDM.


Don said...


Its very clear that the body controls glycogen storage, by increasing glucose oxidation when glycogen levels are high (to limit glycogen storage) and decreasing glucose oxidation when glycogen storage is low (to conserve glycogen). So the body metabolically maintains glycogen stores between upper and lower limits. This is not at all controversial among nutritional biochemists who study glucose economy.

Also, low calorie diets are low substrate diets...i.e. less grams of carbohydrate, fat, protein, are coming in. The body responds to the deficit of substrates (i.e. carbohydrate deficiency) not deficit of energy. This is clear because it does different things when we lower fat only than if we lower carb only...it is responding to the lack of a substance it needs, not just to a deficit of a non-descript "energy."

Don said...


How do you know that the diets of recent tribes are the same as evolutionary diets? Were you there?

And, how do you know that nuts available to humans 2 million years ago were of the same nutritional composition as the nuts eaten by modern tribes? What if the nuts available then were more like chestnuts, high in starch and low in fat?

Look, the body has specific metabolic adaptations. It does not have an efficient way of regulating excessive dietary fat, i.e. of keeping down stores within limits. This clearly implies that it did not need to control fat storage in the evolutionary time period.

Your comment about fruits ignores that humans evolved in a tropical region. Fruits are available all year round in the tropics, and wild fruits have more glucose and less fructose than cultivated fruits.

Really, take a look at the whole of nature. Just how abundant is fat compared to carbohydrate?

Don said...


BTW, your reported diet is higher in carbohydrate than in fat, and you yourself report the difficulties in living on large amounts of nuts. So any intelligent human ancestor would have looked for a less toxic staple food, like tubers.

Gretchen said...

Don, I have diabetes and I'm familiar with the research that purports to show that high-carb, high-fiber diets "reverse" diabetes. They don't.

See Karin O'Dea's research comparing four diets in type 2 diabetes. The high-carb, high-fiber people did better on an oral glucose tolerance test (OGTT) afterward, but the people on the low-carb high-protein diet had much much lower blood glucose levels while on their allotted diet.

So as long as you're not planning to take an OGTT (or "cheat" by eating carbs), you're better off on low carb.

I think we're coming from different places. You're interested in best diet for healthy people able to get a lot of exercise. My interests are in keeping blood sugar normal.

Don said...

Hunger on a high carb diet:

Why is everyone afraid of hunger? Because they believe they should eat less (calories) to lose weight. Wrong, just eat less fat and have at the potatoes, rice, etc.

If you are hungry, just eat more...that's why hunger exists, to tell you to eat more, just as thirst exists to tell you to drink more. But no one ever got the message that thirst is "bad" and "overdrinking" will make you retain water.

Its not how much you eat that leads to fat accumulation, it is what you eat...these and many other studies show that fat contributes to fat stores and carbohydrate does not...

This comes from experience. I have eaten very low fat diets. To get adequate calories on low fat intakes, you have to eat a lot. To get 1800 kcalories, you have to eat 18-20 4-ounce potatoes or sweet potatoes--six potatoes per meal, three meals each day. Alternatively, about 9 cups of rice. When most people go on "low fat" diets they completely miss this and expect to be satisfied eating typical portions they would eat on a high fat diet. So they feel hungry and blame it on the diet...when they should just eat more low fat foods. But they don't because they erroneously think they have to eat less to lose weight.

Just as thirst is a reliable guide to how much to drink so long as you are drinking the right stuff (water), hunger is a reliable guide to how much to eat so long as you eat the right stuff.

Gretchen said...

Don, I forgot. Anderson was an early proponent of the high-carbohydrate-and-fiber diet for diabetics. I read a chapter in a book he'd written in which he admitted that his diet resulted in very high postprandial blood sugar levels, but he said there was no evidence they were harmful.

That was a long time ago. New research has shown that they *are* harmful.

Brandon Berg said...

Maybe I'm not following correctly, but wouldn't an inability to convert carbohydrates to fat efficiently be extremely maladaptive in times of uncertain food supplies? That doesn't mean it's not true, but it does raise questions.

Furthermore, isn't this largely irrelevant when it comes to weight loss? You can waste all the glucose you want, but if you don't push your fat and fructose intake all the way to zero, you're going to end up storing at least that much fat. Which means that in practice you still gain weight as long as you use fewer calories than you take in.

Don said...


Thanks for telling me what I am interested in, but you are wrong. I am interested in keeping blood sugars normal and in treating disease with diet, since I am a health care provider.

As I said, keep doing what you are doing as long as it works. Just make sure you have a good sense and awareness of the subtle signs that something isn't working. For a large number of heart disease patients, the first sign they notice of their disease is a heart attack, sometimes death. I know that these people had earlier warning signs but they didn't notice or know how to interpret them to self-correct.

Avishek said...

Hm Sanjeev I accidentally hinted I was referring to long-term weight loss. It seems like people do regain a lot of lost weight in the long term.

What I am saying though is that the argument here is not taking ketone metabolism into account, making a drastic oversimplification that eating more fat = storing more fat.

Ketones are burned in the morning during the fast, probably during sleep?, after weight-bearing exercise, and of course during low carbohydrate diets. You'd have to subtract the energy derived from ketones to your equation to assess how much fat you are consuming is storing as fat.

Judging by the amount of raw milk I've drank recently, this is not true at all.

I hae gianed fat on a very high fat low carb diet though. I think a moderate approach is better than a high carb approach for myself and is what I most likely follow

Sanjeev said...

Don wrote:
Why is everyone afraid of hunger?
heh ... i've asked myself this too.

I've tried using the sensation of hunger as a target for concentration practices.

It's impossible; the sensation is not steady enough. It's OK for noting, impermanence and no-self practices but useless for practices that require perception of steadiness / continuity.

Thanks for the ongoing education, especially showing where I'm wrong.

sandra said...

"Hunger on a high carb diet:

Why is everyone afraid of hunger?"

Hi Don,
I'm not trying to lose weight so do not care about calories- I do not seem to gain no matter what I eat. I still worry about hunger as I am afraid it might indicate lack of good glucose control.

When I ate more carbs I had to eat much more frequently (3 meals plus 3 snacks). I would often eat a bedtime snack a few hours after a big dinner. Snack was usually high carb (lowfat yogurt w/fruit or cheerios w/lowfat milk or toast). I would still wake up not just hungry, but famished.

With higher fat/low carb I can eat 3 meals only w/o hunger and also have breakfast much later in the am.

My fasting glucose was 95 before lowering carbs/upping fat and went down to 85 after changing my diet...

What you have been writing makes sense, but yes I am afraid of hunger and what it might mean is going on with glucose/insulin.

It is very difficult for a non-scientist to decipher all this!

Sanjeev said...

Avishek wrote:
Ketones are burned in the morning during the fast, probably during sleep?
for me the maximum ketonuria used to be one hour after a long bicycle ride (5 hours or so), regardless of time of day, and lasting 2 or 3 days.

The sticks would turn pink immediately after the ride, I assume that during the ride the muscles were using all the ketones produced, leaving none to be spilled in the urine.

The sticks got deeper and deeper over the next hour and stayed deep purple for 2 days, as long as I stayed low carb. I could not tell the time of the absolute maximum, because beyond that last deep purple reading they had no more gradations.

After about a year they rarely got deep purple, regardless of how much I exercised.

vizeet srivastava said...


There has to be a mechanism by which body decides when to store visceral fat and when to store it under the skin. I assume it is due to problems in leptin signalling that one end up in high visceral fat (There may be some other factors). The reason I believe this is:
1. my own experience (I am not consuming grains (except rice) and sugar) and now I don't get belly fat.
2. Farmed animals accumulate large quantities of visceral fat.
It will be really good for many of us (who are following your blog) if you can write an article on visceral and subcutaneous fat.
I feel totally confused now.

Anonymous said...

>This clearly implies that it did not need to control fat storage in the evolutionary time period.

Actually, there is some agreement between us. I believe nuts are widely available in much of the world and always have been, and thus most humans long ago evolved the capability of living on nuts (as well as tubers) as a backup food when game was not available, which was frequently. However, nuts are somewhat toxic. Thus even though the fat is there from nuts, humans won't overeat nuts (at least as they are available in nature or as primitive peoples might have prepared them). Thus no need for the body to develop a separate feedback system (other than nausea from overeating toxins) for dealing with an overload of fat from nuts.

As for fat from animals, the only place fatty animals are widely available currently is the Arctic, and there are all sorts of mechanisms to ensure the people living there don't overeat. In particular, an active primitive hunter weighing 77kg in the arctic will burn something like 8000 kcal a day, and eating that amounts of calories is going to be difficult, even if most of the calories are from animal fat. Again, the body doesn't need to deal with excess fat because other mechanisms provide the limitation. In the Ice Age, fatty animals were available elsewhere than in the arctic, but the same situation prevailed. Anyone living in Europe in the ice age was likely burning phenomenal amounts of calories, so that overeating fat was quite difficult due to the small size of the human stomach.

So I think we are in agreement that the body didn't need to evolve a mechanism to cope with excess fat. But I think it is obvious that there were and are many occasions where primitive peoples ate high fat diets (plant fat in the temperate and tropical areas, animal fat in the arctic or during the ice ages). High fat is NOT unnatural.

FWIW I detest high-fat diets myself. Like most people my preference is for a balanced diet, with fat intake somewhere between 20% and 50% of calories.

Alan said...

> Why not simply fill glycogen with less toxic glucose?

Because glucose has close to zero satiating power. Protein has satiating power.

Don: I'm holding a $175 money order which i will remit to you the first time you show us proof that any epidemic of morbidity has been pinned on excess consumption of protein.

Richard said...

Hi Don,

Are you still in favour of intermittent fasting (8 hour eating window for example)? Does increased carbohydrate intake alter eating frequency for fatloss?

Great post,

Helen said...

Theo said:

"If leptin signalling is good and you are not eating addicting foods, it is very difficult to gain weight with added fat."

Speaking only for myself, I've found the opposite. I've found it exceptionally difficult to put on, or even maintain, my weight on a lowish-fat diet. (I don't count grams, just no longer add fat or eat cream or bacon.)

I am beginning to wonder how so many people have gained weight on a low-fat diet. My theories are that their carbs were refined and/or in the form of bready things - which I think I could overeat, but I simply don't eat them - and they put a lot of sugar on top.

If your carbs are not made into bread and are consumed with the fiber nature put in them, and you don't fry them or slather them in cheese or butter, I predict you have a good chance of losing weight on a low-fat diet. My satiety is fine, by the way.

It also so happens that this diet is not incredibly "rewarding." That fits in with Stephan's hypothesis at Whole Health Source.

Cliff said...

"Because glucose has close to zero satiating power. Protein has satiating power."

According to studies potatoes are one of the most satiating foods, stephan has a blog post about this.


Your probably right for the most part but you could probably gain lean mass as long as your protein was high enough.

Brandon Berg said...

"Humans are continuosly oxidizing carbohydrate, but intermittently feeding on carbohydrate. Given adequate dietary carbohydrate, our body's will maintain a positive carbohydrate balance during the day, because we don’t eat at night."

This doesn't explain the positive carbohydrate balance. This was net change in carbohydrate balance during a 24-hour period in a room calorimeter.

The actual reason, I think, is that energy requirements were calculated according to expenditures while confined to the calorimeter, so the subjects were likely in negative energy balance on the non-calorimeter days. So their glycogen stores were running low prior to going into the calorimeters, and were replenished during those days.

But this means that the study doesn't show what you think it shows. What happened is that the subjects preferentially used glucose to replenish glycogen stores and burned fat for energy. That didn't get the HF group very far, but the HC group was essentially able to trade fat stores for glycogen stores.

That's all well and good, but it's not a viable long-term plan for weight loss, as the effects stop as soon as glycogen stores are topped off.

What about the metabolic advantage of a low-fat diet? Apparently there's no such thing. From the abstract of the same study: "Diet cornposition did not affect total daily energy expenditure but did
affect daily nutrient oxidation by rapidly shifting substrate oxidation to more closely reflect the composition ofthe diet."

From another study: "There was no significant difference in fat balance during controlled overfeeding with fat, fructose, glucose, or sucrose."

The problem with Prewitt et al, which ostensibly demonstrated a metabolic advantage, is that it started with the high-fat diet in January and then put them on the low-fat diet from late winter through the end of spring. It appears to reflect seasonal variations in energy expenditure rather than a metabolic advantage.

The authors raise this possibility and dismiss it, but it's the most plausible explanation for the fact that energy requirements continued to increase for the five-month duration of the low-fat portion of the study.

So we have two calorimeter-based studies showing no metabolic advantage for low-fat diets, and a poorly-designed outpatient study showing a metabolic advantage that magically grows and grows as the weather gets nicer.

Eric said...

So, other than their complete fear of saturated fats and animal products, the likes of McDougall (others like Ornish, Fuhrman, Barnard wouldn't be reliant enough on starches) aren't that far off then? OK, we might need to also reduce/eliminate legumes - or at least ensure proper preparation, and reduce reliance on grains - or, again, ensure proper preparation.

But, if I'm following your argument correctly these days Don, you are advocating for a diet rich in healthy, low in anti-nutrient starches, unlimited veggies, ample amounts of fruits with a few nuts and enough healthy animal products (meat, fish/seafood, eggs, dairy) to supply protein and the right amount of good fats; does that sound about right, without getting into too many details on macronutrient ratios or anything else?

Gretchen said...

Don, I have no interest in debating any more on your list, as it's not a
diabetes list. I'd be happy to debate privately. You can reach me through my
Web site, www.gretchenbecker.com.

I thought Primal people ate meat and fat. Maybe I should just leave the

Malena said...


There's a Swedish fruitarian forum following the 80/10/10, that is, 80% carbs, 10% fat, 10% protein (energy percentages) where one of the members has diabetes 1. After a year with huge amounts of glucose and fructose (approx 2500 kcal/day) her diabetes has improved to her doctor's astonishment.

According to the 80/10/10 philosophy, fat in the blood prevents your cells from absorbing glucose, leading to a higher blood sugar. Skip the fats and you have no problem. I don't know if this is theoretically correct, however IRL it works.

Actually, i think these 80/10/10 people are interesting. They eat primarily fruit (dates and bananas) and they have to eat and eat in order not to be super thin and lose more weight...so that's how fattening fruits and carbs are. The HFLC followers are afraid >20g carbs/day make them fat and then there are people eating >1000g carbs/day and still loosing weight.

Another thing I find interesting. Staffan Lindeberg, the Swedish paleo researcher follows a diet with 70% carbs. If you look him up on Youtube you will find a Portuguese program where you can see how he looks like after following his diet for years and years - extremely think. Then you can check up Loren Cordain on Youtube. He has also been interviewed recently on this Portuguese program. What does he look like after years of a high fat paleo diet. Well, not like the old photos where he looks slim. Now he actually has a little bit of a belly hanging over his belt. So, who do you trust? The fat diet guru or the slim one? I would go for the slim.

Eric said...


I've also followed these 80/10/10 people for quite some time. I certainly don't agree with everything they claim but, one can obviously not disregard the fact, as you pointed out, even with the immense amount of carbs they consume, weight/fat gain certainly does not appear to be an issue...

I'd be wary however of using pictures or videos to judge whether or not one's system works or not. Anything outside of their diets might be the cause (busy, stressful schedule, sleep, exercise, etc.). Not saying that Cordain's approach is optimal or at fault, or better or worst than Lindeberg's, but not certain how valid these observations really are. Worth noting too: Cordain's approach is certainly not high-fat. Not low-fat either, but certainly not within the high-fat paleo end of the spectrum...

Gretchen said...

Malena, with all due respect, you can't understand the problem if you haven't been there.

Malena said...

Hi Eric,

Yes I agree the 80/10/10 is not the way to go, too much vital nutrients missing but nevertheless interesting because of the non-fattening aspects of fruit.

Regarding Cordain I actually think that if you are promoting the "ideal diet", having followed it for years, you actually should look healthy and not carry 20 pounds extra load. I work with skincare and I make sure my skin agrees with what I eat. I don't follow any diet slavishly, and eat too much sweets, however, periods when I ate more fat and protein had a very negative effect on my skin. It look reddish, irritated with dark under eye circles. I can't promote I know how to keep your skin looking great if my own skin looks irritated. If I would go to a PT I expect that person to be very fit. If consulting a diet expert, I expect that person to have a healthy body weight and no belly. My philosophy is that I am myself my best argument for the (minimalistic) approach to skincare that I promote and I expect experts in other fields to be the same.

Eric said...

I WHOLEHEARTEDLY agree Malena. Physios should not be needing hip surgeries in their 40s (colleagues of mine and my wife are sad examples of this) and MDs or dietitians should be able to take their shirt off without shame (as crazy Paul Chek advocates). However, it's a far cry from reality and, possibly, not the best way of judging one's approach. On that concept alone, no one would have gone to Charlie Francis for sprinting advice, or Greg Glassman for fitness tips (not saying you should, either, but...). Bad publicity, no doubt, but nothing else...

Malena said...

Hi Gretchen,

I never said I know how it is like to have diabetes, therefore I exemplified with someone who has.

In my opinion, you have to be open to new ideas and solutions. My sister healed herself from ulcerative colitis and has written a book on it (in Swedish) for free download on the internet (we have actually translated it into English but not published it yet). Her approach was working on diet and emotions. She/we have been contacted by hundreds of people by now and those open to try new strategies (instead of ingesting drugs/toxins year after year) have had immense changes in their health, outlook on life and many healing completely, which is more than any of their doctors have managed.

We have noticed there are two types of people. The proactive ones, testing new strategies and checking around until they find something that works. These people will come out of the chronic illness vicious circle leading to premature retirement and death. Then there are the victims and unfortunately they have identified with being victims. Their case is sooo special, no one knows how it is to be them, they have tried "everything" (which they haven't of course) etc etc etc.

Regarding diabetes I don't know much of course. I have a friend with diabetes 1. I don't know any other person eating so much sweets and junk food than she does. Then, a former colleague of mine has diabetes 2. He is a foodie. Now, I don't say everyone that has diabetes has any of these habits but I suppose the majority have. Then it is more of a psychological problem, and with food addiction, than whether fat or carbs are the villain.

Thomas said...

From what you are saying, do you think it’s possible that someone can eat 1000 calories per day and still gain weight, based on the macronutrients they are eating? I hear people say this all of the time, but do not see how this can possibly happen (if there BMR is over 1000 calories per day), unless there is a severe pathology, like hypothyroid (lowering their BMR).

Gretchen said...

Malena, high carb, low fat with no processed foods and abundant low-carb vegetables is not a new idea or solution to me. I bought into it in early days. It didn't work for me.

So I experiment and found something that worked for me.

The implication that people who don't agree with some prescription are helpless victims is offensive. So is the implication that people with a primarily genetic disease scarf up sweets.

I know a couple of people who eat only junk food and are thin. Does that mean eating junk food causes thinness? I don't think so.

I haven't eaten a piece of cake, pie, candy or even bread in 15 years except for a few slices of bread to test some things. I never ate fast food except when on a trip and it was the only thing available.

Helen said...

@ Malena,

Gretchen has a blog. You should check it out. Talk about someone pro-active and informed! Gretchen is one.

It seems like the examples of diabetics with unhealthy habits stick in people's minds. There are plenty who take care of themselves. You might not be aware of them, because they might not "look" like they have diabetes.

To me it's a great myth promulgated on the blogs I tend to visit (paleo, traditional diets), as well as in the mainstream, that diabetics have done something uniquely unhealthy and that's why they have diabetes.

Rather, diabetics represent the range of food behaviors of the general population. They are uniquely vulnerable to the effects of insulin resistance (which does not equal diabetes) and other outcomes of the SAD diet. They are also just uniquely vulnerable. I have diabetes and I've been a normo-weight health nut all my life. Maybe it's stress. I don't know. I think it's genes.

I get tired of people in the blogosphere solving diabetes who haven't had it and don't have expertise in it. In genetically susceptible people, it can be triggered by obesity and fatty liver, but it's not the equivalent of those things. Let's stick to talking about those things on these blogs. Believe me, if experimenting, hard work, and the just-right diet could cure diabetes, neither Gretchen nor I would have it anymore.

Malena said...

@Gretchen and Helen,

I think you both misunderstood. Apparently you both belong to the proactive persons and you are probably both better off because of that than my junk eating friend. You are not satisfied with medication, you try to find your own solutions beyond doctors.

Then, as i mentioned, my sister got well because of changing food and working on emotions. My belief is that will all "serious" illnesses, there is always some sort of emotional crisis starting it all. You might have a predisposition for something, however, you might be all fine (and eat junk) if your life situation is ok. If, on the other hand, you experience emotional problems (stress at work, divorce, family crisis, problems with children, unjustifiable accusations, all depending on your own subjective experience of course) then that might be the trigger for illness. This is something me and my sister have seen many times. One very young man was fooled to believe he had become a father. Another person was falsely accused of fraud, one had a bad divorce etc etc. Although Ryke Geerd Hamer is very controversial, I find his connections between cancer-emptional crisis 100% correct in all cases I have seen in people around me. The problem is, it is very hard to deal with emotions. So, to help the body heal, improving the diet is always at hand. Though it might not solve everything.

As diet is a tool ready to be used by anyone facing health problems it makes me sad seeing people I care about not using it. My junk eating friend has got an insulin pump so she doesn't have to inject insulin. Only those with good eating habits are allowed to get those in Sweden, you have to have some sort of control. This makes me even sadder. If my friend belongs to one of those who are considered having ok habits, then I wonder how the others eat. She is low in iron and low in b12 but is a vegetarian...I don't understand this and I have tried to make her change but obviously as I don't have diabetes I have no say in these matters.

Then, I have also have contact with people who have tried all kinds of diet things (correctly) with no or only little improvement. For them, other things are the cause but I don't believe, as allopathic medicine does, that it is some sort of hocus pokus from other space no explanation perhaps the genes (the modern devil) autoimmune thing that you can do nothing about. The trick is to find out what you actually can do about it.

So, I'm sorry if it sounded I accused diabetics in general, perhaps I am a bit fed up with the society (allopathic medicine) transforming patients into victims.

Anonymous said...

Is it just me or is reference [6] not working?

Brandon Berg said...

"These data indicated that, given the same excess 'energy' intake, higher protein intake increases body weight gain compared to higher carbohydrate intake."

Yes, but as you yourself noted, neither of the diets produced any detectable changes in body composition. So it's likely that most of the weight gain in the high-protein group was due to an increase in lean body mass.

It's also worth noting that both diets were relatively high in fat, averaging about 45%.

Gretchen said...

Telling people with a disease that it's because of their emotions is a form of blaming the patient. As is telling someone their disease is because they didn't "eat healthy."

I think both attitudes are understandable. They're a form of self-protection:

"My friend Joe got lung cancer and he smoked. I don't smoke, so I won't get cancer."

"My friend Miriam got diabetes and she loved cheeseburgers. I don't eat cheeseburgers so I won't get diabetes."

The fact is, various behaviors can increase your risk. But they don't guarantee you'll get a disease, and conversely, not doing them doesn't guarantee that you won't.

Genetics is often the key. What helps one might harm another.

Anonymous said...

i would personally appreciate a post explaining why you so heavily changed your dietary views, what provoked them, how and wy you thought they should change.

we will never get back to paleo times so maybe explain to us why you lived such a long time on a VLC high fat diet, and then bombard with posts advocating high carb.

also, you cant compare SFA to try and show consequences of excess omega6- two different things, 2 different results.

i remember you were doing one workout a week, is that still so even with a high carb low fat diet?

also, what physical changes have you experienced which lead you to conclude low fat is better?

Sanjeev said...

malpaz wrote ...
why you so heavily changed your
IMHO there has not been a big change.

Don was one of the only paleo bloggers I kept following because he was recommending starches in the form of tubers a long time ago.

Don was recommending potato at the same time that others were vying for the title

"king of fat"

or seemed to be competing for an audience on the basis of

"I can stuff more fat into my diet than you can dream of"

I don't agree with much of what Mr. Matesz writes, but he has not changed his stance as much as many think.

sandra said...

Starchy tubers were not frowned upon -true... but neither was fat (check out the "my meals" series)

Don, and (I think) Stephan are now recomending low fat for health. I think this is a huge change.

Alan said...

One could take Don's presented evidences, and propose the following: we evolved mechanisms for making glucose from protein and from fat; & we evolved mechanisms for making fat from protein and glucose. But we never evolved any capacity for de novo protein-genesis. This indicates that the ancestral diet was replete with protein, but experienced shortages of fat and of carbs.

I'm NOT proposing this: I'm offering a devil's-advocacy against - well, i'm not sure against what.

Back in the day, Dr Kurt Harris noted that carnivores are seldom fat. They didn't evolve any dependency on STORAGE as their advantage-mechanis; they evolved better predatory tools.

Within the same commentator-ship, we see paleo posts which sometimes state that we evolved in a condition of plentiful food; sometimes the same indivdual posts that we evolved to deal with frequent famines. Can't have it both ways, methinks.

My own experience of wildlife is that they are never obese, but also, seldom in starvation. I don't think famines occur frequently in foraging/hunting hominids. Famines only start when people move into agricultural settlements; it gets worse when they build cities. Can anyone show evidence to the contrary?

Malena said...

I think we also have to look beyond macronutrient percentages. For many years I have skipped all kinds of milk products, grains containing gluten, yeast, glutamate and soy. A friend's mother, having rheumatism, also tried this. Changes took some time but after half a year her condition was improved. And, she had dropped 1-2 sizes but weighing the same. Her body composition changed without any other changes than exchanging bread and pasta for rice, tubers, quinoa etc and using e.g. coconut oil, olive oil, rice milk and more eggs instead of milk products.

If I eat any of the allergens above I get stressed up. I get cranky and depressed. My pulse increases. What impact will that have on my health long term? If people eat inflammatory, stressing, pulse increasing, cortisol increasing food, what will happen to their weight? And if we lead a stressing, pulse increasing, cortisol increasing life, what happens? It is well known type A personalities are more prone to heart attacks (an emotional cause - not genes), but what about the rest of us?

Cliff said...

I think people like stephan and don recommend a low fat diet for health and longetivty now because they stopped living in paleo fantasy land.

Last time I checked every culture who was revered for its health and longetivy was a starch based society.

There is absolutely zero evidence of any culture living on a high fat diet and having outstanding longevity.

Malena said...


I don't belong to those thriving from fat and protein, however, I remember my sister telling me something interesting she had noted when reading Herodotus.

As you know, Herodotus traveled the antique world, documenting peoples and cultures. According to his scriptures, people in Egypt, ancient agriculturalists, were proud to become old, on average an Egyptian could expect to become 80 years (I suppose this regards those surviving childhood). However, the king of the nearby hunter tribe claimed Egyptians died so young (at 80) instead of 120, as the people of his tribe, because they ate dung (grains) and if it wasn't because of their exquisite wine, they wouldn't even become 80 years old. The tribe had what the king called the "table of the sun" where all kinds of meat were served each day.

Regarding age this reminds me of another thing. As Mark Twain said, there are lies, damned lies and statistics. A 60 year old Swedish person today can expect to live 10 years longer than a 60 year old in the 1600s. So much for our healthcare system. 99% of the extra 10 years can probably be explained by no starvation, no malnourishment and better hygiene. Lucky for the pharmaceutical industry there are some very creative statistics you can use to support whatever toxins you are selling.

Ken Matesz said...

Having read most of these comments as well as the original blog, I have only one comment myself. This relates to gleaning evidence of what humans ate in ages past. Some in this post have hypothesized that fruits, nuts, berries, tubers and other vegetables were plentiful and therefore these were probably the basis of ancestral meals. Someone else said that these kinds of things were the easiest foods to obtain.

But I disagree with this analysis because I think it is based on how a modern man looks at his environment. To a modern man, hunting and acquiring meat seems challenging and more of a gamble. The fruit tree does not run away. The tuber likewise has no legs.

In addition, some say that the old hunter/gatherers likely would have over-harvested animals in their area and thus had to depend on these starches.

But I remind myself that 10,000 years ago the entire human population over the whole Earth was probably less than 1 million people. What do you suppose the population of deer, elk, buffalo, gazelles, fish, rabbits, squirrels, and so on was 10,000 years ago. Was it less than today or more?

While a modern man thinks hunting means going into a tree blind and hoping a deer walks within gunshot range, hunters of old did not find hunting difficult or challenging or up to chance. If they wanted meat, they got it. And there was plenty of it.

Rudolf said...


"hunters of old did not find hunting difficult or challenging or up to chance. If they wanted meat, they got it. And there was plenty of it"

1. Why would they want so much meat if they had lots of tubers around with much less effort?

2. How do you now how hard was it for a man in Africa between 2-0,1 mya to hunt? They did not even have bow and arrow. So, what made for them hunting so easy as you suggest? How did they do it?

David Isaak said...

"Again, where are the people who keep endlessly storing glycogen? Why don't people keep growing endless stores of glycogen? Simple, the body regulates glycogen by conserving it when dietary glucose is low, and spending it when glycogen stores are high. It simply does not do this with fat under any circumstances. That is why people get excess fat, but not excess glycogen."

The body's capacity to store glycogen is quite limited, and most Americans are walking around with their glycogen storage quite full--especially those who are inactive. (Muscle glycogen cannot be drawn upon for the general energy needs of the body--it is only used by exercising the muscle in question.

The body is quite good at converting carbs to fat and storing them that way, however. And that is why people in America are so fat. The consumption of fat has been falling steadily, while the consumption of carbs has been skyrocketing. People are not fat from overconsumption of fat; the are fat from overeating carbs and converting them to fat.

Thomas said...

"The body is quite good at converting carbs to fat and storing them that way, however. And that is why people in America are so fat. The consumption of fat has been falling steadily, while the consumption of carbs has been skyrocketing. People are not fat from over consumption of fat; the are fat from overeating carbs and converting them to fat."

I've heard otherwise-that denovo lipogenesis from carbohydrate is NOT a significant pathway for creating fat. Maybe it is in people who chronically and massively over-consume carbs but this is not most Americans. Most Americans over consume everything-and this leads to storage and retainment of ingested fat. This carbohydrate centric view of obesity is simply incorrect-a fad that comes and goes and has come again. It's recently found favor with the paleo crowd for some reason, although restricting carbs is not why paleo works for many people.

Alan said...

>> . How do you now how hard was it for a man in Africa between 2-0,1 mya to hunt? They did not even have bow and arrow. So, what made for them hunting so easy as you suggest? How did they do it?

Because they were eating lots insects; and because larger prey was extremely plentiful.

Alan said...

>> The body's capacity to store glycogen is quite limited, and most Americans are walking around with their glycogen storage quite full--especially those who are inactive. (Muscle glycogen cannot be drawn upon for the general energy needs of the body--it is only used by exercising the muscle in question

very good point. If Don's premise (that fat-regulation is underdeveloped whereas carb regulation is well-evolved) were correct, in-active humans would not feel much appetite for carbs. Well, gosh, it's the couch potatos amongst us who are most likely to be gorging on Pringles.

owever comma; I myself have cut back tremendously on fat, JUST IN CASE. I substitute more protein.

Colldén said...


You could look at the research of Marie Francoise Rolland-Cachera who studies the epidemiology of childhood obesity. She believes excess protein is an important factor in children becoming obese.


Colldén said...

This is off-topic, but I was reading through some recent posts and comment threads and noticed there is still a prevalent belief that sucrose is a health hazard in the long-term, I am wondering what good evidence there really is to support this?

I only know of one good really long-term animal study that compared the effects of diets high in either sucrose, starch and fat, and it didn't show any particular harmful effects on mice eating a 60% sucrose diet for 55 weeks. In fact they had the lowest fasting glucose and insulin of all groups.


MM said...


I think it's funny, because I also used to think something like Pringles was "high carb". However, over 60% of the calories in Original Pringles are fat. http://caloriecount.about.com/calories-pringles-original-i106605

These are really a high fat food. (If they can be called a food. :) ) Most "high carb" junk food is this way. I've been reading labels and most cookies, pie, chips, etc. are at least 50% fat by calories unless you get something that says "low fat" on the label.

Avishek said...

Good point about snack foods

Also most of the fat inthose types of foods is polyunsaturated, although sometimes it is saturated from palm oil I believe. PUFA lower metabolism and causes you to store more fat, SFA increases metabolism.

Animals that want to hibernate load up on PUFA.

M & M said...

"That means they were burning up lean mass, despite a high (20% of calories) protein, kcalorically adequate diet."

Does such an option comes into play.
In the phase of adaptation to dietary fat the body burns protein enzymes responsible for producing energy from carbohydrates (12 protein-enzyme glycolysis)-oxidation of protein?

To break down the fatty acid particles into particles of two coal need only one enzyme protein, and a carbon molecules, called alpha-oxidation, is also just one enzyme.
In total two

Brandon Berg said...

She believes excess protein is an important factor in children becoming obese.

Specifically, her research suggests that the substitution of protein for fat in the diet of infants, and the resulting reduction in total calories, may contribute to childhood adiposity.

This is not implausible, as the protein content of human milk is quite low (about 6% of calories), but it doesn't have any real implications for adult nutrition.

Interventional studies of increased protein intake relative to baseline in adults have fairly consistently shown beneficial results.

Cliff said...


Tooth decay isn't a negative??

Don said...


Let's say someone eats 1000 kcal per day, only meat and fat, and 50 g protein (RDA level) which supplies 200 kcal. That means 800 kcal from fat, or about 90 g fat. S/he will be burning up muscle to get adequate carbohydrate, constantly reducing his/her ability to burn fat. If s/he burns only 80 g fat daily, s/he will gain 10 g fat daily, 300 g fat per month. Also, very low carbing reduces the production of oxaloacetic acid, which reduces the rate at which one can burn fat. So, yes, I think it is possible, although probably rare, that people can gain on only 1000 kcal daily.

Don said...


Wrong about the lean mass. There was an increase in fat mass in the high protein group, not an increase in lean mass. I worded it wrong. I meant there was no change in lean mass.

Don said...


I fixed link #6.

Don said...


Fasting glucose of 95 is not pathological. Some evidence suggests it may protect against certain types of infections, and some people have such FG on low carb.

You would not have to eat so frequently on low fat high carb if you simply ate more at each meal. For example, take the snacks and add them to the meals. If you were still "famished" it means you weren't getting enough food...eat more. Typical rural Chinese person eats at least 1 pound of dry rice daily, plus noodles, potatoes, yams, sweet potatoes.

BTW, hunger would suggest low blood sugar, not high blood sugar...unless you have diabetes (losing sugar in urine).

Don said...


You are almost correct. The correct interpretation is that ancestral diets almost always supplied adequate protein/amino acids, so there was never a need to make protein from scratch.

This doesn't mean that the ancestral diet was "high" in protein, only that it was almost always protein adequate, which would mean it almost always provided about 0.8 g/kg. When it did not, the body had mechanisms for reducing protein loss.

Also, to make protein from scratch, the body would have to have a mechanism for extracting nitrogen from the environment without eating food. To my knowledge, no animal has this capacity, it is the province of leguminous plants (which fix nitrogen from the atmosphere into soil). Otherwise non-leguminous plants absorb nitrogen from the soils.

Don said...


Such a post on the way.

Don said...


Animals evolve defense mechanisms against predation. Those with ineffective defenses die, those with effective defenses pass on more of their genes. The longer a prey animal is subjected to a predator, the more the prey population becomes resistant to predation. Besides the fact that the mass of predators must always be smaller than the mass of prey (due to loss of energy in the food chain) this is why over time the ratio of mass of predators to mass of prey will decline. Not so with plants, especially when the predator (humans) knows how to remove toxins from the prey. It is simply impossible to support millions of people on herds of animals...just as it is impossible for African herds to support millions of lions and tigers.

Don said...

Couple of comments:

1) I don't believe anyone has proven that sugar causes tooth decay. Acids may do this, but not sugar.

2) Muscles use glycogen daily in normal activities, though not at the rate when exercising.

3) liver glycogen is depleted constantly by the nervous system.

4)Appetite/hunger is regulated by the brain, and the brain uses....glucose. Whether on the couch or not, the brain is sucking down glucose. This is why even couch potatoes want glucose rich foods, but when they eat fat-coated glucose rich foods it slows the process of getting glucose to the brain.

People on low carb diets typically crave sweets more than people on high carb diets. They might substitute noncaloric sweets, or they come up with "primal" cookies having more fat and calories than a conventional cookie, or they drink alcohol, or they eat lots of protein (which their bodies convert to glucose). More on that in an upcoming post.

But if depriving your brain of its natural fuel works for you, keep doing it until it doesn't work.

Gretchen said...

I've been on a LC diet for 15 years and I don't crave sweets. In fact, a piece of chocolate cake looks rather disgusting to me.

Generalizations are dangerous.

themondays said...

Hi Don,

I have a question. I am interested in trying this idea of making sweet potatoes the base of my meals, because although I am no scientist, I see the logic behind it. However, when I went "primal" about 2 years ago, I gave up all grains, legumes, and potatoes, and my diet became low carb/high fat by default. So yesterday, before trying the sweet potato idea, I bought a blood glucose monitor and tested myself. My fasting glucose was 95. My 1 hour post meal was 105, 2 hour was 79, and 3 hour was 92. Today, on "sweet potato" day, my fasting measurement upon waking was 81, but my post sweet potato meal (about 1.5 cups sweet potatoes with 2 oz. of liver) was 292 after 1 hour, 292 after 2 hours, and 147 after 3 hours. So, my question is, will my testing results improve over time, and if so, how long should I expect it to take? Are my results with the sweet potato so high because my body's ability to deal with the glucose have atrophied? I would like to give the tuber idea a chance. I have no health complaints other than some cramping in my calves at night. I take no medications, have good blood pressure, have a healthy weight, and I get about an hour of exercise (varying in type) per day. Help! :) Thanks for your time and input.

Anonymous said...

What macro nutrient ratio do you now suggest for fat loss Don?

Brandon Berg said...

The Miller/Mumford study does suggest, inconclusively due to the state of the art at the time, greater lean mass gains in the high-protein group.

Specifically, the high-protein group had a net positive nitrogen balance of 3.6g per day, or 100g over the course of a week. That suggests significant lean mass gain--up to 3kg, I believe. The low-protein group had a very slightly negative nitrogen balance.

The HP group gained an average of 5.6g potassium vs. a 4.8g loss for the LP group over the course of the study, relative to a baseline of 120g per person.

No significant differences were noted in urinary creatinine.

Skinfold tests showed either moderately (2.3mm vs. 1.5mm) or slightly (2.0mm vs. 1.8mm) greater increases in subcutaneous fat for the HP group, depending on the method used. I have no idea what that implies in terms of total fat mass gains.

Regarding nitrogen fixation, there actually are some animals (termites, shipworms), that can do this. Technically, the ability is specific to certain types of bacteria, and nitrogen-fixing eukaryotes depend on symbiotic bacteria to perform this function.

Don said...


Glucose has more immediate satiating power than protein. The brain monitors glucose and insulin levels of blood, probably because glucose is its main fuel. Evidence in a forthcoming post. But all you need to do is test it yourself. After a fast, eat 500 kcal of pure protein (whey protein, for example) one time, and measure your satiety over the next 4 hours. Then, on another occasion, eat 500 kcal of pure glucose. Make the same measurements.

Don said...


I still fast ~16 hours on most days, and my diet is low in fat (~20%) and high in CHO now.


Positive carbohydrate balance means storage of CHO as glycogen, and the purpose is to satisfy the continuous oxidation of glucose despite intermittent feeding. Multiple studies show that fat balance is negative with high carb low fat EUCALORIC diets. The study you cited is on a HYPOCALORIC diet (overfeeding), Hill et al discussed in this post was EUCALORIC. Of course overfeeding CHO will create a positive fat balance by reducing fat oxidation. Further, that study you cited used a 50/42/8 C/f/p diet for the high carb arm, i.e. it was high in carb and high in fat, whereas the Hill study was low in fat (~20%) which is key to producing a negative fat balance (you have to be consuming fewer GRAMS of fat than you burn). In other words, the McDevitt et al study was rigged to produce a positive fat balance regardless of dietary treatment arm.

Don said...


Actually, some researchers would agree with the 80/10/10 people that dietary fat impairs insulin signaling and thus that it is the fat in diets that causes metabolic syndrome, not the carbohydrate. Few people will go that low in fat to find out if it will improve their diabetes, because it costs them in food reward.

Don said...


You are pretty close to the catching my drift.

Don said...


So far as I know, no one has shown significant MUSCLE mass gains simply by overfeeding protein. If it did happen, most Americans would be quite muscular specimens simply because they over eat protein (averaging about double the RDA) and calories. Overfeeding typically produces a 75/25 fat/lean gain, but you are suggesting that of the 3.7 kg gained, 3.0 kg or 80% was lean, never replicated in any other study to my knowledge without resistance exercise. If you could gain 7 pounds of lean mass simply by overeating protein over a few weeks, you would actually be producing BETTER results than most resistance training studies show.

As Brad Pilon accurately notes in his e-book How Much Protein:"If you read through all the research on resistance training and muscle growth,
you would find the average amount of muscle mass that is typically gained by a
healthy adult man or woman through resistance training is about 2 to 5
pounds over the course of 8-16 weeks"

Thus it would be incredible that simply by overeating protein, without resistance training, you could gain 6.6 pounds of functional lean mass in 4 weeks. Half the time and twice the lean mass gain without even creating a demand for it via training.

Further, I have repeatedly in my life tried to gain lean mass by overeating calories and protein, without this level of success, despite also including intense resistance training. Even top genetically gifted bodybuilders fail to gain more than 10 pounds of lean mass per year despite large intakes of protein and calories and intense training. So I reject the possibility that Miller and Mumford recorded a gain of lean mass in the protein overfeeding study. The increase in skinfold measurements shows an increase in fat mass and the minimal increase in whole body potassium indicates minimal change in lean mass...as they noted it was within the margins of error of the measuring instruments and thus probably meaningless.

Don said...


The consumption of fat has NOT been falling steadily, especially not among people gaining fat. Percent of calories from fat has declined but absolute amount of fat consumed has increased on a population basis (average), but that doesn't tell us anything. To find out what is making people gain fat, you have to look at the diets of people gaining fat, not the population as a whole; and data there points to higher fat consumption and lower carb consumption among people growing or grown obese. You are confusing population statistics with what individuals do.

Don said...


So I forgot that some microbes also fix nitrogen, thanks for reminding me. Now show me that some mammal does it, without aid of microbes.

Don said...


I said people on low carb diets TYPICALLY crave sweets more than those not on low carb diets. That leaves room for the ATYPICAL in which group you apparently belong. I made my generalization based on my own experience with low carbing, as well as watching others low carb. But some don't crave sweets, instead they crave alcohol, or coffee, or more and more protein, all predictable responses to a low carb approach (from a Chinese medical perspective) and some are ATYPICAL and don't do any of these things. Generalizations are only 'dangerous' if you don't keep in mind that they are generalizations, not universally true.

Don said...


It is normal and expected to have high blood sugar after a meal high in carbohydrate. This is not pathological. High fasting sugar is pathological. But, if you haven't been eating many carbs for a long time, your body will take some time to adjust insulin output to carb intake. Insulin output per meal is adjusted to your habitual diet; when you change your diet, your insulin output will lag behind. so after a period of time your body will adjust, become more insulin sensitive, be able to store glycogen more quickly, and have lower postprandial blood sugar. But postprandial blood sugar will always be higher on a high carb than on a low carb diet.

Don said...

For fat loss, I recommend not more than 20% of energy as fat.

Adam said...
This comment has been removed by the author.
Adam said...

> Gretchen said...
> I've been on a LC diet for 15 years and I don't crave sweets.
> In fact, a piece of chocolate cake looks rather disgusting to me.

The low carbers I've known LOVE their coffee. Gretchen, do you have 0 caffeine intake? And 0 intake of other stimulants to "get you moving" during the day? I doubt it!

Also, maybe you don't crave sweets because you have no room for anything else? Your picture doesn't show you to be in any calorie deficit. If you're constantly overfeeding on fat and protein, I can see how someone could get by on minimizing carbohydrates. Even then, I'd bet sweet flavors make their way into meals just about every day. People are notoriously bad at self reporting.

Thomas said...

@Adam-a bit of a low blow on Gretchen I think. Having said that, finding chocolate cake (I'm assuming she actually means most sweets) disgusting isn't what I would consider a bragging point. I think it's kinda sad.

@Don-thanks for the 1000 cal/day weight gain explanation. I think it's likely VERY rare too, although I hear quite a few people claiming it. Adam is right about people being notoriously bad(overweight tend to under report, underweight tend to over report) about reporting food intake.

sandra said...


Thank you for your response...

I guess I will continue to experiment w/more carbs. I felt hungry at first but after checking on fitday I was indeed low in calories.

I do not think this was the case before going low carb though...I can't be sure as I wasn't keeping track, but I was constantly shocking (and irritating) people by eating as much as I did w/o gaining weight... but I was eating some sugar, processed wheat products, and plenty of PUFA, so perhaps that is the differrence.

I look forward to reading what you have to say about the relationship between (saturated?) fat and cancer...

sandra said...

Thomas/Adam: I agree w/Gretchen... I do not crave/eat sugar (nor do I drink coffee) on low carb. Most cakes/sweets are cloyingly sweet and unappealing: you just taste sugar, no real flavor. Not sure why this is "sad"??

BTW, I also did not eat/crave sugar as a vegan on a high carb diet...I knew many high carbing vegans that binged on sweets though!

I did crave sugar when I had it as a regular part of my diet...

Dr. Gee said...

craving sweet is a typical result of LC from TCM perspective? interesting. that is new to me.

my craving for sweets has largely disappeared on "moderate carb" (20-40%)
yam/sweet potato & fruits now taste plenty sweet & good. why is it sad?


Malena said...

Theories are one thing, the interesting thing is to see them in action.

Here in Sweden there's a controversial blogger called Katrin. When pregnant last year she gained 60 pounds. I suppose you do that if you eat a B&J every night. To get rid of them, for some reason, she didn't just resume her normal eating before she got pregnant but decided to go on a LCHF diet. After 9 months she was back to her normal weight, I think the main reason is no B&J, very small portions and exercise. And, of course that the baby + extra water, blood etc weight counted for 20 of those 60 pounds…

Back to her normal weight, she says she is more flabby than before and claims this is due to some sort of after-pregnancy thing – the body changes after a pregnancy. But I’m thinking, with much more exercise than before, a personal trainer twice a week, with strict diet and yet a flabby body. What?

Another thing that the readers heard about every month were her extreme PMS depressions. She tried everything, different pills, a therapist, actually it was all quite sad to hear about. Now she doesn’t write that much about her PMS. I suspect now, when she isn’t that strict about her diet any longer, her hellish PMS has improved.

There has been a lot of coffee. And wine – yes you can have some wine in a LCHF diet it contains only x amount of carbs… Isn’t that the Sisson diet as well? Lots of coffee and wine – because you deserve it when you have eaten no carbs all day and are so fatigued you need to drink a Celcius (Katrin) before every training session to get you moving.

Malena said...

@Dr. Gee,

20-40% carbs isn't that low, isn't the typical LCHF diet <20% carbs?

@Sandra and everyone not craving sweets after changing diet:
I haven't eaten milk products, soy or wheat for ten years due to food allergies. The first weeks, when I changed my diet, I had cravings for those foods. But they quickly disappeared. It is often hard to change a habit. However, afterwards you have founded a new habit. An your body, mind, appetite will have positive feelings for your new type of eating.

I have started my breakfast with yoghurt for 28 years. Now just the thought of eating yoghurt turns my stomach. I have no cravings for bread. Or typical Christmas cakes and sweets. Just as I have no cravings for béarnaise or cheese.

However, there are now other things I love. Dark chocolate (used to dislike it), a really good espresso once in a while (always had milk in my coffee before), sweet potato (didn't like it first time I tried it).

So, my conclusion, change of taste has not much to do with carbs. Or fat. Or protein. Its a change of habit.

Cliff said...


While I don't think you can say its proven without a doubt if you look at the data you will see its pretty indisputable that sugar causes tooth decay.

Acids do cause tooth decay but where do they come from? Sugar changes the Ph of your mouth to slightly acid which increases bacteria which in turn eat the sugar and produce lactic acid.

After being influenced by ray peat I went on a big sugar experiment and my teeth declined pretty rapidly. I was getting all vits/minerals and supplementing A,D,K so it was definitely influenced by the sugar.

I was convinced going into the experiment that sugar wasn't the real cause of tooth decay but after that experiment I actually really looked hard at the research data and it directly matches up with my personal experience that sugar does in fact cause decay.

I have absolutely no teeth problems eating copious amounts of potatoes, whole milk and wheat though.

Gretchen said...

Don and Adam,

You say not eating carbs causes "cravings" for other foods. In my experience, most human beings eat every day. If eating protein and fat and vegetables instead of carbs when you're hungry means you're craving them, then I agree with you.

Maybe I'm on the wrong list. I thought this was the list where someone was posting photos of his meals, which I liked because it sometimes gave me ideas for food combinations I hadn't thought of. I seem to remember gobs of bacon grease.

But maybe that was another list.

Also, going over 200 after a meal is not normal. It suggests diabetes. However, not eating carbs for a long time can cause you to test diabetic when you're not. This is called "starvation diabetes," as starvation is the ultimate LC diet. That's why they tell you to load up on carbs for 3 days before a glucose tolerance test.

So don't panic. Keep eating carbs and then retest in a week or so.

Colldén said...

Cliff, your Peat experiment lasted how long? How did you measure tooth decay?

I've been eating close to Peats guidelines for almost 4 months now, and my teeth are far less sensitive now than they've ever been. For my entire life I always got severe shooting tooth pain whenever I ate or drank anything cold. Then two months ago I noticed while eating ice cream that my teeth no longer hurt. I can now chomp down directly on a mouthful of ice cream with my front teeth without the slightest bit of pain.

Mind you I've never had any real tooth decay so I wouldn't know how to identify it, but teeth becoming less sensitive seems like a good sign to me.

Don said...


I don't see anywhere that anyone said that postprandial blood sugar of over 200 is normal. I only said that it is normal on a high carb diet to have higher postprandial blood sugar than on a low carb diet. And I also explained the period of adjustment when transitioning from low to high carb. When you make any change there is always a period of adjustment. People often assume that symptoms that arise during this period of adjustment mean that the change is "wrong". That's like assuming that because your muscles get sore after your first exercise session done after a long sedentary period, exercise is 'bad.'

Alan said...

> Glucose has more immediate satiating power than protein. The brain monitors glucose and insulin levels of blood, probably because glucose is its main fuel. Evidence in a forthcoming post. But all you need to do is test it yourself. After a fast, eat 500 kcal of pure protein (whey protein, for example) one time, and measure your satiety over the next 4 hours. Then, on another occasion, eat 500 kcal of pure glucose. Make the same measurements.

I simply don't beleive that it is possible to properly measure satiation. The confounding effects of eating-as-socializing, and hedonistic eating, far, far over-ride our actual "hunger".

Helen said...
This comment has been removed by the author.
Helen said...

@ Adam: Don't be such a jerk.

@ sweets: All my life, the more sweets I've eaten, the more I've craved. On low-carb, I didn't crave sweets. I remember looking at a zucchini, however, with hungry eyes, as I would have a piece of cheesecake in former times.

People are talking on these blogs a lot these days about carbs, obesity, and CVD, but what about cancer? Here's a recent study showing a low-carb diet slows cancer growth.

It's hard for me to know what to do with all of this conflicting information, because my glucose readings and energy are better on a moderate-carb (all from whole foods sources, none refined), lowish-fat diet.


@ themondays: That is high. I agree with Gretchen - keep eating carbs and checking. If it's still high in a week, then be concerned.

sashlyk said...


Do you think coconut and MCTs in general are as fattening as the other saturated fats?

Some people, like Ray Peat, go as far as claiming that their consumption contributes to weight loss. This may well be exaggerated, but several (starch and fish eating) tropical peoples eat large amounts of the stuff without apparent harm. Whole coconut is also relatively rich in minerals compared to other fats.

Anonymous said...

While the primal diet would most likely be low fat, it would also most likely be low carb and high protein. Game is lean meat and bones most of the time, and no wild area would provide abundant starch year round(hard to imagine a wild land providing, say, 30 people eating 200g CHO every day - it's not even close). So, most likely, our glucose would primarily come from gluconeogenesis. Lean meat, leaves and whatever additional fat or carbs are available atm. It also makes sense because apes only had access to high carb during fruit season and ate very little complete protein. While starch requires fire to make digestible glucose. It's much more likely that they initially gained year-round glucose via hunting ever larger game. Later, the Homo-species would not have consitant starches in their long travels as well. Only periodically.

Perhaps substituting the huge amount of protein with starch is a nice way to parallel the same mechanism. A more sustainable strategy than constantly going through more animal flesh or own muscles to attain glucose. Unless extremely low activity, the same cannot be said of a high fat low protein approach. Intermittent fasting definitely sticking it's head here.

As far as glycogen storage, we already had the basic machinery in place from the rodent and tree swinging days. Ours isn't much different because there probably wasn't a strict need for such a change.


mario_encinias said...

@ Kirill...unfortunately the ethnographic record does not agree with you...When looking at savannah foragers like the Hadza or Kung (much like those of our ancestral environment)their primary source of starch are the underground tubers, which ARE available throughout the year, and are fairly unaffected by seasonal fluctuations. (they're underground)...but even more equatorial or tropical groups like the Yanomamo or the Papua New Guinians consume starch year round in the form of sago, taro, and yes, yams.

On the issue of meat,these people seem to boast pretty consistent (albeit moderate) access to animal protein regardless of the season. What does seem to fluctuate seasonally, however, is the amount of fat these animals provide. Ruminating animals carry excess fat for only a short period of time just prior to the winter...It is for this reason that I think Don's revisionist revisit to the issues of fat and starch as a nutritional topic in Paleo circles is important here.

psychic24 said...

I'm wishing Dr. Kurt Harris would comment about this post. It seems that everything he says contradicts this low fat approach.

psychic24 said...

Let me rephrase: I am completely and utterly confused with all the contradicted information about nutrition. People like Chris Kresser, Peter from hyperlipid, and Dr. Kurt Harris are all praising high fat diets while more or less condemning carbohydrates (allowing starch in moderation), rationalizing these ideas through lower insulin and less inflammation. Then there is a post like this seemingly discrediting low carb diets and placing carbs back up on a pedestal. Can anyone help make some sense of this and put forth some practical advice for someone who wants to eat a nutritionally sound diet.

p.s. Then again you have Stephan Guyenet lauding the kitavans and making the general statement that many paleo cultures attained their calories predominantly from tubers and such, while Dr. Kurt Harris still suggests the possibility of (and likeliness) the Kitavans having coronary calcium buildup and athersclerosis. To summarize his recent thoughts on the matter, at least in my opinion, it seems this excerpt is most fitting: "If you have the choice, why choose corn or potatoes over meat?"

Cliff said...


I have some pretty nasty decay from my old lifestyle and It starts to get painful if I continuously eat sweets. Especially refined sugar.

I experimented with refined sugar for a month or 2 off and on. Before then I was always doing a moderate amount of fruit. Tooth pain wasn't an issue at first but as I progressed the pain started to get worse. I tried to power through for a little but I had to stop because I could tell shit was getting fucked up.

After that expirement I can now feel on one of my back molars erosion that wasn't there before and I could see in the mirror that a minor cavity I had was progressing. I stopped all sugar including fruit and the problems solved themselves literally overnight.

My brother had the same experience. This also directly correlates with my experience in highschool, I had pretty much perfect teeth and then I started drinking soda and eating candy all the time.

I think if your lucky you can maybe be immune to the teeth decaying effects of sugar. The fact that you have no decay is interesting because I've often wondered that maybe if I had better teeth I could better tolerate the sugar but then again we have thousands of studies showing the direct mechanism of sugar and its effect om tooth decay so I don't really see how anyone could be immune long term without lots of precautions.

I've also come to the realization that sugar is super addictive and causes a false sense of energy(probably adrenaline). This is why people are willing to risk there teeth instead of just eating starch imo

Helen said...

@ Psychic24 -

I dunno. I have two three-year-olds who love them some starch. They would much prefer to eat some unadulterated corn or potatoes over organ meats any day! Or over meat in general. Although they do like meat, it seems to be a more fleeting preference - sometimes they want it, sometimes not, while they always like starch. They also like some surprising things like broccoli and mushrooms. And, like any kids, they love sweet things. Sweet = fresh, nontoxic, and/or ripe, not just in fruit but in starches, vegetables, and meat, so obviously this is adaptive, and obviously, our taste for sweetness is thoroughly warped and exploited by the modern diet.

I've seen so many testimonials on the internet, crowing about completely contradictory diets, about how someone felt like crap on one and was saved by another, sometimes only to become disenchanted with that one and find salvation in a third. It can make your head spin.

Aside from some of Matt Stone's readers, who sometimes advocate a return to junk food, one thing in common with all these seems to be avoiding processed food. Whether grain-based, meat-based, soy-based, or whatever, the modern diet is made up of such denatured, impoverished foods so laden with additives it seems like a switch to nearly anything would bring improvement.

Sometimes I wonder if the problems some people are having with grains, for instance, is not the grains themselves, but highly processed baked products. There have been several articles recently about the aging, CVD-inducing, kidney-compromising effects of phosphates, which are consumed today in increasing quantities in convenience foods and sodas. Maybe Denise Minger's identification of "wheat as murder" (rather than meat) from the China Study data in fact is tracking a fellow-traveler of wheat, such as phosphate in baking soda, or another additive. Niacin causes poor glucose handling, iron increases the risk for heart disease and cancer, and folate may increase colon and other cancers. Yet these were all added because pellagra, anemia, and spina bifida resulting from eating denatured grains as a staple are no picnic, either. Furthermore, there are marked differences in the effect on VLDL, inflammation, and glucose control between refined grains and those retaining their fiber, particularly soluble fiber.

I'm not ready to give wheat a pass, but I think sometimes we forget how unbelievably crappy - in fact, toxic - industrial food is when we try to bend our minds around paleo vs. neolithic foods and various macronutrient ratios. I am not by any means saying these things don't matter, but it might help to step back and look at the big picture a bit.

Anonymous said...

@ mario_encinias

Available, sure. But how much starch does that provide averaged out over a year? And for how many people? I would also not compare a settled culture to paleolithic era hunter gatherers. They were taller, more fit and had bigger brains. While the remaining tribes are remnants that have long adopted their own brand of 'neolith'. They just don't eat the utter garbage that we do.

Brandon Berg said...

Positive carbohydrate balance means storage of CHO as glycogen, and the purpose is to satisfy the continuous oxidation of glucose despite intermittent feeding.

We're talking about the chart labeled "Nutrient Balance," right? This is total change in nutrient balance over a 24-hour period in which the subjects ate, and oxidized, 24 hours' worth of energy.

I understand what you're saying: If we were to look at carbohydrate balance over a 4-hour period after eating a days' worth of calories in a single meal, then we would see a positive change. The subjects would have eaten 24 hours' worth of carbohydrate but consumed only 4 hours' worth. And then in the following 20 hours we'd see a corresponding reduction in carbohydrate balance.

We could repeat this every day, and we'd consistently see the same results, more or less.

But when the measurements are done over a 24-hour period, there's no "other 20 hours" to balance things out. You can't explain the positive carbohydrate by saying that they burned it while sleeping, because the measurement includes the time spent sleeping. In equilibrium, carbohydrate balance will fluctuate during the day, but there will be no significant net change across any given 24-hour period.

This means that the days when the measurements were taken in the calorimeter cannot have been representative. And the reason they weren't representative is likely (as noted in the study) that activity levels were higher on the days when they were not confined to the calorimeter.

Consequently, the subjects entered the calorimeter with depleted glycogen stores, which is why they had positive carbohydrate balance and negative fat balance--their bodies burned fat in order to conserve carbohydrates for glycogen synthesis.

Multiple studies show that fat balance is negative with high carb low fat EUCALORIC diets.

That's not possible. For the diets to be eucaloric, the negative fat balance must be compensated for with positive carbohydrate balance. This can happen for a short period of time, but only until glycogen stores are full, which will buy you less than a pound of fat loss. Once glycogen stores are full, fat loss cannot persist unless the diet is hypocaloric.

So far as I know, no one has shown significant MUSCLE mass gains simply by overfeeding protein.

This study claims a nearly 2kg increase in fat-free mass from four weeks of whey protein supplementation. I don't have a subscription, so I can't assess the methodology.

Note that "lean mass" doesn't necessarily mean muscle. They could have gained other types of lean tissue (bone, hair, nails, etc.

as they noted it was within the margins of error of the measuring instruments and thus probably meaningless.

Fair enough. But that cuts both ways. If the measurement techniques weren't accurate enough to confirm lean mass gain on the high-protein diet, they weren't accurate enough to rule out lean mass loss on the low-protein diet.

And if we're chalking up the nitrogen and potassium balance changes to measurement error, we should throw out the skinfold data, too, as they're not consistent with the weight-gain data. The skinfolds suggest 10-50% greater fat gain for the HP group, but the HP group gained four times as much weight.

I wasn't really going anywhere with the fact that termites and shipworms have symbiotic nitrogen-fixing bacteria. Just thought it was interesting.

Big Tim said...


Man what happened to you...you used to have great info, now you're flipped and touting grains as healthy...Disgusting...Who is paying you to bash the Paleo world you have been in for so long??!!

This will be the last comment to the last post I ever read on your blog.

Don said...

Big Tim,

LMAO! You really think someone would pay me to do this, simply to spread the information readily found in medical and nutrition journals?

Gretchen said...

"This will be the last comment to the last post I ever read on your blog."

I think reading a lot of blogs that simply confirm what you already know is a waste of time. So unsubscribing when someone takes a different course doesn't make sense to me.

However, this comment

"You really think someone would pay me to do this, simply to spread the information readily found in medical and nutrition journals?"

Bothers me. This "readily found" information has been there all along, and was apparently ignored before. Why?

If information was ignored before, how do we know information isn't being ignored now?

There are so many studies out there, one can find a study to support almost any dietary philosophy out there.

I think we need to find what works for us. If low-fat works better for Don, so be it.

groundworkd said...

excellent post.you are correct