Higher Carb Dieting: Pros and Cons

Last week’s post (Is It Good to Eat Sugar?, Jan 25, 2012) addressed what I see as the most problematic part of the thought of the health writer Ray Peat – his support for sugar consumption.

Apart from this difference, “an extreme amount of overlap is evident,” Danny Roddy notes, in our views and Peat’s. Both perspectives oppose omega-6 fats, support saturated fats, favor eating sufficient carbs to normalize metabolism, support eating nourishing foods like bone broth, and oppose eating toxic foods like wheat.

If there is another difference between our ideas and Peat’s, it’s that “Peat-atarians” often eat more carbs. Danny puts it:

Paul and Peat have similar recommendations for carbohydrate consumption. Paul’s recommendations hover around 150 grams while Peat usually recommends 180-250 grams, but he himself eats closer to ~400 grams.

So I thought it might be worth looking at the issue of overall carb consumption.

Carbs for Hypothyroidism

In Is There a Perfect Human Diet? (Jan 18, 2012) we noted that diseases can change the optimal diet. In some diseases it’s better to lower carb consumption, but in others it’s better to increase carb consumption. The example we gave is hepatitis; hepatitis B and C viruses can exploit the process of gluconeogenesis to promote their own replication, so high-carb diets which avoid gluconeogenesis tend to slow down disease progression.

Another disorder that might benefit from more carb consumption is hypothyroidism. A number of people with hypothyroidism have benefited from Peat-style carb consumption. Here is ET commenting on last week’s post:

As someone following the PHD with a good dash of Peat, I really enjoy this post and the comments. Thank you Paul….

Paul says that “I’m not persuaded that it’s a desirable thing to keep liver glycogen filled at all times, but for some health conditions it may be good to tend that way, like hypothyroidism.” Well, according to Chris Kresser, 13 of the top 50 selling US drugs are either directly or indirectly related to hypothyroidism. If going by either the low body temperature/low pulse diagnostic, and/or some kind of pattern on the serum tests (Anti-TG, TPO, TSH, free T-3, free T4, total T3, total T4), we are talking a significant proportion of the population, especially women, being hypothyroid in some form….

Many with low T3 have a conversion problem from T4 in the liver (80% of T3 is converted from T4 in the liver and kidneys – only a small portion is coming from the thyroid gland).

Is it a good idea to NOT try to fill the liver glycogen in such a pattern? For those who have lived with the consequences of low T3 (adrenaline rush, waking up in the middle of the night, fatigue, tendency to orange-yellowish color i the face etc.), and had improvements on a more Peat like diet, I do not think so.

The way to fill liver glycogen, of course, is by eating more carbs.

I’ve previously noted that increased carb consumption upregulates the levels of T3 thyroid hormone (Carbohydrates and the Thyroid, Aug 24, 2011):

T3, the most active thyroid hormone, has a strong effect on glucose utilization. T3 stimulates glucose transport into cells, and transport is the limiting factor in glucose utilization in many cell types. In hyperthyroidism, a condition of too much T3, there are very high levels of glucose utilization. Administration of T3 causes elevated rates of glycolysis regardless of insulin levels.

The body can reduce T3 levels by converting T4 into an inactive form called reverse T3 (rT3) rather than active T3. High rT3 levels with low T3 levels lead to reduced glucose transport into cells and reduced glucose utilization throughout the body.

This means that eating more carbs raises T3 levels, and eating fewer carbs lowers T3 levels.

For a hypothyroid person, then, eating more carbs is an alternative tactic for increasing thyroid hormone activity. It may provide symptomatic relief similar to that achieved by supplementing thyroid hormone directly.

Perhaps the two are complementary tactics that should be done together. Taking thyroid hormone pills will increase glucose utilization, creating a need to eat more carbs. A mix of the two tactics may be optimal.

UPDATE: Mario points out that most cases of hypothyroidism in advanced countries are due to Hashimoto’s, an autoimmune disease probably triggered by infections or gut dysbiosis, and eating more carbs will tend to flare any gut dysbiosis and thus aggravate the thyroiditis. Meanwhile, supplemental thyroid hormone tends to reduce antibody activity.

Carbs for Mood

Another interesting comment came from Jim Jozwiak:

Paul, this discussion gets to the crux of what I do not understand about the Perfect Health Diet. You are speaking as if refilling liver glycogen is a good thing, and it undoubtedly is, because mood is so much better when there is sufficient liver glycogen because then the brain is confident of its power supply. Also, you acknowledge that safe starch would eventually replenish liver glycogen after muscle glycogen is topped off. So why not eat enough starch to replenish liver glycogen? It is not so difficult to figure out how much that would be. Have some sugar, feel what replenished liver glycogen is like, then titrate safe starch gradually meal-by-meal to get the same effect. When I do it, and I am not an athlete, I get 260 grams of non-fiber carb per day, which is considerably more than you usually recommend. Have you tried this experiment and found the result unsatisfactory in some way?

Jim has experimented to find the amount of carbs that optimize his mood, and found it to be 260 g (1040 calories). On a 2400 calorie diet, typical for men, this would be 43% carbs.

If Peat typically recommends 180 to 250 g carbs, as Danny says, then on a 2000 calorie reference diet that would be 36% to 50% carbs.

Those numbers are strikingly similar to another statistic: The amount of carbs people actually eat in every country of the world.

Here is a scatter plot of carb consumption vs per capita income by country. Dietary data comes from the FAO, income is represented by GDP per capita from the IMF:

At low incomes people eat mainly carbs, because the agricultural staples like wheat, rice, corn, and sorghum provide the cheapest calories.

As incomes rise, carb consumption falls, but it seems to approach an asymptote slightly below 50% carbs. The lowest carb consumption was France at 45%, followed by Spain, Australia, Samoa, Switzerland, Iceland, Italy, Austria, Belgium, and Netherlands.

We can guess that if money were no object, and people could eat whatever they liked, most people would select a carb intake between 40% and 50%.

This is precisely the range which Jim found optimized his mood.

The Longevity vs Fertility and Athleticism Trade-off

I won’t enumerate studies here, but animal studies indicate that higher carb and protein intakes promote fertility and athleticism, while restriction of carbohydrate and protein promotes longevity.

In our book, we calculate the daily glucose requirements of the human body at around 600 to 800 calories, or 30% to 40% of energy on a 2000-calorie diet.

So a 30-40% carb diet is a neutral diet, which probably places minimal stress on the body.

A 40-50% diet is a carb-overfed diet, which probably promotes fertility and athleticism.

A 20-30% diet is a mildly carb-restricted diet, which probably promotes longevity.

Do we see diminished longevity with higher carb consumption in human epidemiological data? I think so.

It’s useful to compare European countries, since they are genetically and culturally similar. There is a correlation between carbohydrate intake and longevity. Here is a list of life expectancy among 46 European countries. Neglecting little countries like Monaco, San Marino, and Andorra, that are not in my carb database, the countries with the longest life expectancy are also the ones with the lowest carb consumption: Italy first, France second, Spain third, Switzerland fourth, and Iceland sixth are all countries with carb intake below 50%. Sweden, at 50.8% carbs, placed fifth in longevity.

Did Evolution Hardwire a Preference for Carbs?

We know that the brain has an innate food reward system which tries to get people to eat a certain diet. What carbohydrate intake is it likely to select for?

Experiments on the food preferences of insects and rodents give us clues. The paper “Macronutrient balance and lifespan,” by Simpson and Raubenheimer, cited some time ago by Dennis Mangan, summarizes evidence from animals for the influence of macronutrients on lifespan. A good example is the fruit fly; protein has the dominant effect on lifespan, with low protein favoring longevity and high protein favoring fertility. The flies eat so as to maximize fertility:

The response surface for lifetime egg production peaked at a higher protein content than supported maximal lifespan (1:4 P:C, Figure 1A). This demonstrates that the flies could not maximize both lifespan and egg production rate on a single diet, and raises the interesting question of what the flies themselves prioritized – extending lifespan or maximizing lifetime egg production. Lee et al. [3] answered this by offering one of 9 complementary food choices in the form of separate yeast and sugar solutions differing in concentration. The flies mixed a diet such that they converged upon a nutrient intake trajectory of 1:4 P:C, thereby maximizing lifetime egg production and paying the price of a diminished lifespan.

This seems to be the evolutionary preference in mammals as well as flies. When unlimited food is available, animals tend to overfeed slightly on carb and protein, sacrificing lifespan for increased fertility and athleticism.

Jim reported improved mood on a 43% carb diet. Is it due to the filling of liver glycogen raising metabolism? Due to a sensation of enhanced fertility, libido, and athleticism? Or simply due to greater satisfaction of the brain’s reward system?

Yet another factor may also be involved.

Might Stress Be Mistaken for Enhanced Energy?

Peat favors sucrose as a carb source, which is why Danny Roddy recommended orange juice and Travis Culp soda. I argued in last week’s post that it would be better to eat a starchier diet so that the carb breakdown would be at least 70% glucose, less than 30% fructose and galactose.

Eating a higher-carb diet fills up liver glycogen, removing the most rapid fructose disposal pathway. This makes a high-carb sucrose-based diet rather stressful for the body; it has to dispose of fructose rapidly to avoid toxicity, but has limited ability to do so.

We can see the stressfulness of sucrose by its effects on the “fight-or-flight” stress hormones adrenaline (epinephrine) and noradrenaline (norepinephrine). Here is a study that fed high-fat, high-starch, and high-sucrose diets for 14 days to healthy non-obese subjects, and measured the hormonal response [1; full text]. This paper was discussed by the blog Proline (hat tip: Vladimir Heiskanen). The results:


On high-fat and high-starch diets, adrenaline and noradrenaline levels are low; they are consistently elevated — almost doubled — on the high-sucrose diet.

This makes sense; as Wikipedia notes,

epinephrine and norepinephrine are stress hormones that underly the fight-or-flight response; they increase heart rate, trigger the release of glucose from energy stores, and increase blood flow to skeletal muscle.

These hormones trigger the release of glucose from liver glycogen, thus freeing up room for fructose disposal.

Note that this result contradicts an assertion by Danny Roddy:

I consider the ability to refill glycogen (minimizing adrenaline & cortisol release) to be an important factor in health.

Refilling glycogen is not the same thing as minimizing adrenaline release. The requirement to dispose of fructose may trigger adrenaline release.

The reason I bring this up is not to renew the starch vs sugar discussion; but rather to ask if this “fight-or-flight” response to sugar consumption may not be partially responsible for the perceived mood and energy improvements on a Peat-style diet.

Indeed, one of the peculiar aspects of Ray Peat’s health advice is his recommendation to increase pulse rates well above normal levels. In his article on hypothyroidism, Peat states:

Healthy and intelligent groups of people have been found to have an average resting pulse rate of 85/minute, while less healthy groups average close to 70/minute.

I would have thought 60 beats per minute was normal, and when I was more athletic my pulse was typically 48 beats per minute.

One of the effects of adrenaline and noradrenaline is to speed up the pulse rate. If Peat really does eat 400 g of carbs per day, predominantly from sucrose, then he may be achieving his high pulse rate from an “adrenaline rush” that helps dispose of an excess of fructose.

If, indeed, this is a source of improved sense of well-being on Peat-style diets, it may be a double-edged sword. Chronic stimulation of the “fight-or-flight” hormones to aid in fructose disposal may have long-run negative consequences.

UPDATE: I’m reminded of this video, showing the adrenaline-promoting effects of sucrose consumption:


Starch would not have had the same effect, and would surely be healthier in the long run.

Summary

It is possible that higher carb intake may increase thyroid hormone levels, fertility, and athleticism, and enhance mood in some people. These gains do not come without cost. Notably, they probably involve a sacrifice of longevity.

If the benefits of higher carb intake are sought, it is best to achieve them by eating starches primarily, not sugar.

Conclusion

In our book, we recommend a slightly low-carb diet of 20-30% of calories. If we were re-writing the book now, we would probably be a bit less specific about what carb intake is best. Rather, we would say that a carb intake around 30-40% is neutral and fully meets the body’s actual glucose needs; and discuss the pros and cons of deviating from this neutral carb intake in either direction.

For most people, I believe a slightly carb-restricted intake of 20-30% of calories is optimal. Most people are not currently seeking to have children or engaging in athletic competition. There is good reason to believe that mild carb restriction maximizes lifespan, and most people desire long life. As we’ve noted, supercentenarians generally eat low-carb, high-fat diets.

But the spirit of our book is to educate, and let everyone design the diet that is best for them. And there is room for difference of opinion about the optimal carb intake.

References

[1] Raben A et al. Replacement of dietary fat by sucrose or starch: effects on 14 d ad libitum energy intake, energy expenditure and body weight in formerly obese and never-obese subjects. Int J Obes Relat Metab Disord. 1997 Oct;21(10):846-59. http://pmid.us/9347402. Full text: http://www.nature.com/ijo/journal/v21/n10/pdf/0800494a.pdf.

Leave a comment ?

154 Comments.

  1. CrossFit 312 » Blog Archive » 02.14.12 - pingback on February 14, 2012 at 1:00 am
  2. George Henderson

    Here’s the latest “High-fat Hep C Diet” post
    http://hopefulgeranium.blogspot.co.nz/2012/02/do-high-carbohydrate-diets-and-pufa.html

    I think I make the case a bit more clearly here. Still haven’t got the hang of composing Blogger text on this browser, so apologise for presentation issues.
    MySpace is not what it used to be, alas…
    Besides, some of the old MySpace posts referred to the evils of saturated fat, which was the fashion at the time, and I cannot be bothered to change that now.

    The HCV hypothesis ties in nicely with the Amin A. Nanji research into fibrosis/cirrhosis and PUFA Vs. SFA, as well as some recent US clinical work on high-carb diets causing fatty liver, and high-fat diets clearing it (linked at The Daily Lipid recently I think)
    Generating this hypothesis has been like dropping a pebble in a pond, where every ripple has uncovered a confirmation so far. It would be nice to test it with some contradictory data.

  3. George Henderson

    http://rdfeinman.wordpress.com/2011/07/29/wait-a-minute-lustig-the-threat-of-fructophobia-and-the-opportunity/

    Here is a really good discussion of fructose by a biochemist and “hard science” low-carb pioneer.
    Fructose is preferentially turned to glycogen on a low-carb diet.
    Fruit was included in all the pre-Atkins “Eat Fat to Grow Slim” diets (of which there were a few; Mackarness, Barry Groves, Pendleton, Donaldson, just off the top of my head), in limited but useful amounts. Those 1950s thru 1960s diets were effective and popular.
    A plum, for example, contains a mixture of sugars and starch, in a small serving.

  4. George Henderson

    Hepatitis C exploits lipogenesis, hepatic TG synthesis and expression as well as LDL uptake, I think that’s pretty clear. It might use gluconeogenesis as well, as it probably has sugar somewhere in its structure, but the lipid is central to it getting out and about.
    Hep B is different and what you say may well apply to that; hep B doesn’t have the same relationship to cholesterol as HCV. However, other factors such as fatty liver indicate a need to watch carbs with HBV.

    HCV exploits our misunderstandings about cholesterol; this may be why it’s so prevalent at this point in history.
    It may be that different HCV genotypes evolved to exploit certain population weaknesses, so that some benefit more from lipid profiles seen in low-protein malnutrition as in the developing world, others from high-carb low-fat malnutrition as in the west. But they all depend on TG and VLDL, so far as I know.

  5. George Henderson

    About fruit, vit C and fructose: this hypothesis
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917125/?tool=pmcentrez
    has a lot of interesting facts attached.

  6. Last time I counted carbs I averaged 240 g/day, and that was having as little as possible and still feeling good. But you say I only really need 150 g? I weigh 230 lbs. Or is that only if I eat more fat to feed the muscles? Or maybe as Mark Sisson says my fat burning machinery needs practice.

  7. Hi tam,

    If you are an athlete, then 240 g/day may be a minimum; it’s certainly perfectly normal. If you are sedentary, then 150 g/day will be enough for outstanding health, although some people may prefer higher carb.

  8. Paleo Pepper » Blog Archive » Carbohydrates for fertility - pingback on February 20, 2012 at 4:43 pm
  9. I find it difficult to go from 240g to 150g a day. I think I will have to do it gradually. Check this out. I am the circle on the left. 🙂

    http://drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/

  10. if your preferred sugar of choice is sucrose, it may be worth trying Coconut Palm Sugar.
    Which from what i can tell is 70-79% sucrose, but has a better nutritional profile than good old table sugar.
    http://coconutpalmsugar.com/Nutritional_Information.html

  11. Hi I’ve eaten the SAD diet most of my life, in the past few years doing intermittent fasting. I’ve been feeling unwell the past few months, so I’ve been attempting your diet. I get a shaky feeling, anxiety, sleepiness, depression and dizziness after eating a typical Phd meal, or any meal with carbs in it. I finally realized that I feel a lot better eating close to 0 carbs. What could be causing this? I intend to make a drs appointment, I just want to research some possible ideas before I go. I’ve never eaten such a low carb diet and as I see you don’t recommend it I’m concerned. Thank you in advance for any input. Some extra information: I’ve been on 4 separate weeks of antibiotics these past 2 years. I’ve taken probiotics and made kefir but haven’t noticed improvement.

    • Hi Alex,

      Gut dysbiosis causes it. Gut microbes can only feed on carbs in the oxygen-free environment of the gut. So a zero-carb diet starves them and gets them into a hibernating state which doesn’t generate symptoms.

      Get a stool test to try to see what pathogens you have – eg Metametrix Microbial Ecology profile. Try reading our bowel disease category.

      Best, Paul

      • Thanks for the advice I’ll see if my doctor will order it for me. After I told her how I was feeling a few months ago she just offered anti depressants! And told me to eat 3 square meals
        🙁

        Something strange happened yesterday. I seem to have developed a mildly itchy rash, on my face and inner wrists. I’m not sure if it was from being outside in the heat (if thats even possible?) Or if its related to my extremely low carb diet?

        • Could be oxidative stress depleting arachidonic acid. You might try upping your anti-oxidants, and upping your carbs. Try dextrose or rice syrup, they may be digested upstream of your pathogens and not feed them much. Carbs would do you good.

          • Ok the rash went away thanks Paul. I also have a few other health problems. I have to eat regular meals, if not I get shaky and dizzy but my blood sugar looks ok every time I’ve checked it, I used to be an avid coffee drinker then about a year ago coffee began giving me panic attacks. Also, I tried coconut oil and for the first few days I felt wonderful and could think quicker than usual, then I started getting panic attacks from that as well 🙁 Do you think this is all related to gut dysbiosis? Or caused by something else? My doctor ordered the stool test so hopefully I find out soon what’s going on there.

  12. Also I forgot to add I tried stopping the intermittent fasting and eating three meals I day and I just felt worse, unless they’re extremely low carb meals.

  13. Matt Stone, You’re Blowing My Mind. | Butter Believer - pingback on May 27, 2012 at 7:10 pm
  14. Hi Paul and Shou-Ching,

    Congratulations on the book deal! I can’t wait to get my hands on the book when it’s out.

    I want to thank you for posting information on side effects of low carb diets (hypothyroid, high cholesterol levels and fertility issues). It has helped me immensely. I noticed that other paleo health writers very rarely touch on the subject – aside from Anthony Colpo and Chris Masterjohn.

    I was a fan of Taubes and low-carb paleo for 6 months until it bought me sudden chest pains, shortness of breath and high cholesterol levels. My thyroid levels seemed okay, but I was constantly cold, dizzy, had pounding palpitations and had trouble sleeping – I’m only 26 by the way. Prior to the low carb diet, I’ve never ever had those symptoms before, so when they suddenly showed after a few months on the diet, I thought I was dying. I’ve been to cardiologist, taken numerous blood tests, x-rays, ultrasounds and more, luckily it wasn’t my heart. So the doctors thought I had anxiety, so I went to psychologist and testing showed I was normal and not suffering from anxiety or hypochondria.

    After all that, I was at my wit’s end. I continued the low carb diet for 7 more months, not realising that it was causing me to have high cholesterol. It wasn’t until I stumbled onto your blog (and Anthony Colpo’s) that’s when it all fell into place. Turns out it was low carb that caused me to have borderline hypothyroid symptoms (feeling cold, low libido, high cholesterol), low blood sugar (which caused the dizziness and poor memory), and despite eating more fruits and vegies my heart was having palpitations and chest pains probably caused by mineral excretion (low magnesium/potassium/selenium levels?) The chest pains were bothersome enough that I thought I was having a heart attack – I kept going to emergency!

    I read your post on the hypothyroidism. Although my blood test showed that my thyroid hormones were more elevated than previous years, my doctor wasn’t concerned. Since I started eating more carbs (potatoes, sweet potatoes, taros, rice) I feel SO much better. Even though I ate liver while on low carb, I now eat pate every day, plus Brazil nuts and the chest pains have mostly gone – thanks Paul! I hope the chest pains will completely go away soon.

    Anthony Colpo also mentioned other side effects other paleo dieter’s have had, namely: cramps, lethargy, bad breath, constipation, and menstrual irregularities, cardiomyopathy, panic attacks, nausea/vomiting, bruising, diarrhea, hyponatremia, hepatitis, kidney stones, and severe vitamin and mineral deficiencies. Some studies have showed that ketogenic diets have even caused cardiac fatalities! When I read that, it really really scared me. Thank goodness I caught it early before I continued to damage myself.

    Thank you for writing posts like these and being unbiased about the side effects. I still believe paleo/ancestral diets are awesome, but with higher carbs added is probably safer for most people.

    I noticed a few others who were on low card diets also had dizziness, brain fog and cold body temp when they were on low carb too – it goes away when I make them eat roast potatoes lol.

  15. Paleo For Women | Carbohydrates for Fertility and Health - pingback on May 31, 2012 at 2:37 pm
  16. hi All,
    Anyone know if there are any human studies/research on whether Sucrose consumption lowers ACTH (the main pituitary stress hormone)…or human studies/research on whether Fructose consumption lowers ACTH.
    I found some rats studies on the subject, that seem to show that sucrose consumption lowers ACTH, see here for some info and links;
    http://www.functionalps.com/blog/2011/02/04/sugar-sucrose-restrains-the-stress-hormone-system/
    But no human studies.

    The closest i could find was on Glucose;
    http://www.ncbi.nlm.nih.gov/pubmed/19709691
    which had no effect on ACTH in humans.

  17. So I got my metamatrix lab results back, but it just showed h pylori and a parasite, taxonomy unknown. Some of the good bacteria looks low as well. Thanks for the suggestion Paul, I’m going to try to fix all 3 things 🙂

  18. Hi Paul, and happy Thanksgiving!

    I just read Mario’s update and I want to make sure I understand. I’m still working on getting my temps up (I run 97 degrees usually), but I have Hashimoto’s. Right now I’m at a pound of rice/sweet potatoes daily. Would increasing my carbs help raise my temp, or would it worsen the antibodies and/or produce rT3? Also I usually have 5 T butter daily — would it help if I decreased that? Thanks for your help!

    • Hi Kathy,

      No, I think that’s a good level of carbs to eat.

      Eating more carbs might raise your temperature slightly but I don’t think it will improve your health. You could achieve the same by taking slightly more thyroid hormone (if you are on it).

      5 tbsp a day of butter is a lot. You would probably do better to swap some of it out for more nourishing fat sources like egg yolks. You want to have a normal ratio of phospholipids to triglycerides in your dietary fats and butter is mostly triglycerides.

  19. I’ve noticed that one thing is missing from the discussion on Ray Peat’s carbohydrate intake recommendations and it is an important one that has a bearing on the discussion about carbohydrate’s role in stimulating the undesireable release of adrenaline. Peat advocates orange juice as a source of carbohydrate but he also advocates adding sea salt (1/2 tsp or more) to it to counteract maladaptive stress responses including adrenaline release. I think this is an important distinction — it is entirely plausible that the addition of salt in this manner would produce adrenaline and noradrenaline profiles that look different from the Raben study profiles. He also suggests eating 1oz of cheese as a source of protein in conjunction with the orange juice. I’ve taken my orange juice in this way for years – the salt enhances the flavour.

  20. Paula,

    Ray Peat also suggests eating thyroid pills like after-dinner mints, and does so while on his bizarre diet. A very nice man, but with very strange, and almost absurd dietary advice.

  21. Kelly,
    His point is that through traditional diets humans would have consumed small amounts of thryoid hormone daily through consumption of organ meats and unpasturised dairy so it’s not so strange when viewed from that perspective. He’s also a PHD endocrine physiologist so while you might believe his dietary advice to be strange he has credentials that doubtless you don’t. You may also have assumed I follow a Peatatarian diet – I don’t but I am familiar enough with his recommendations to know that something important has been overlooked – call me a pedant if you wish but he’s clearly cognisant of the fact that carbohydrate can elevate adrenaline and has a strategy via the addition of sea salt to address it which in the context of the discussion above might just be important to recognize.

  22. Hi Paul so you do not recommend low carb diet and high fat for someone who want to get pregnant?
    I am askin cause bulletproof diet suggest high fat diet even for fertility and pregnancy. What is your suggestion?

    Thanks a lot.

    Isn´t ketones diet harmul for baby? Can it cross placenta so baby does not have enough glucose for development?

  23. Hi Paul:

    I read another reader’s comments about how easily she bruised before starting the PhD diet and now was not suffering that problem so much. I had the same problem. If I hit my hands or arms, I would have horrific bruises, like a haemorrhaging under the skin. Very nasty looking. This was happening a lot. I have hit myself quite hard accidentally twice this week and there is not a mark. I am amazed. Something in the diet, or something I have eliminated, has obviously reversed this effect. The longer I continue on the PhD program, the better I feel and obviously lots of things are happening “under the surface!” Thanks again.

  24. 5 Common Paleo Diet Mistakes You Don’t Know You’re Making - pingback on April 28, 2014 at 5:45 pm
  25. Hi Paul, 🙂

    Now that I have taken the time to really read your articles carefully, I think you are excellent. You are far more reasonable and knolwedgeable than “gurus” such as Anthony Colpo, CarbSane etc.

    You are “Feynmanesque” in the care that you give to carefully analyze something.

  26. Still puzzled about how to count my carbs. I use that Cron-o-meter site. It tallies your grams of carbs and draws a pie chart of your day’s calories that shows what percent are from carbs, fat, and protein. But the carbs figure includes fiber, starch, and sugars. I thought you only counted starches so I’ve been excluding the grams of Sugar and Fiber carbs. Someone at the FB page said no, PHD includes carbs from fruits, too.

    So should I add the sugars and starch grams, multiply by 4 to get a carb calorie count, and divide by the day’s total calories to find out what percent carbs I eat?

    It matters to me because I’ve been gaining weight fairly rapidly since late 2012. Nothing that used to work works any more.

    • yep, sugars are included if you are counting carbs. Just exclude fibre.

      Paul does talk about not counting a certain % of the carbs in non-sugary vegetables due to the ‘overhead’ of energy required for consumption. But i would just rely on the carb number you get from cronometer (minus the fibre).
      In reality, there is not many carbs in non-sugary vegetables anyway.

      What could be your confusion is that sugar is Not a safe starch…but it is still a carbohydrate.

      • Yes, that is a confusion. If you had a food/bev with other types of sugar—for example, ice cream or beer—would you exclude those sugar carbs? For the purposes of calculating what percent carbs is in your daily intake?

        • “for example, ice cream or beer—would you exclude those sugar carbs? For the purposes of calculating what percent carbs is in your daily intake?”

          > Do not exclude any carbs (except fibre).
          Basically if you are getting calories form something, it counts.

        • (typo fix)
          …Basically if you are getting calories from something, it counts.

          • My understanding is, that it counts for calories, but not for carbs für glycolysis. Carbs for glycolysis should come frome safe starches (100g daily), the rest to the 150g daily can come from other carb sources. At a daily 2000 cal. basis.

    • Jepps, Thank you so much; that is it, of course. I went back re-read again what Paul has said and thankfully figured out how to “count.” I just can’t use the websites like Cron-o and others to do my PHD math for me.

      st

  27. A Fad Diet - pingback on August 31, 2015 at 12:29 pm
  28. Paul,

    Just out of curiosity, do you have the data for protein and fat intake versus income?

    – Sean

  29. Gotowa do zmian | JOANNA HAŚNIK - pingback on March 29, 2016 at 10:48 am
  30. I just wanted to say that my experience falls in line with the data posted here about adrenaline. I have always used myself as a guinea pig and decided to temporarily switch from the PHD to a Peat-style diet. All of my carbs have been coming from a combination of fruit juice and milk for the last week or so. For the last few days, I have felt extremely edgy and hypoglycemic even though my blood sugar is totally normal. Eating sugar actually makes the feeling worse. I feel like my adrenaline is shooting out 24/7 and have been unable to sleep since embarking on this adventure. I am switching back to the PHD diet tonight to see if my nerves calm down. I feel pretty awful.

    • Hope you feel better soon Brian.

      • Brian Hardaway

        Thanks for responding Paul.

        I decided to give the high-sugar experiment a longer time to see if my body would adjust. Here is my experience after approximately one month on the Ray Peat-inspired diet:

        When all of my carbohydrates come from safe starches, my blood glucose spikes to about 150-160 mg/dl (pre-diabetic levels) and stays there for hours.

        When all of my carbohydrates come from sugar, my blood glucose spikes to maybe 100 mg/dl at most and is back to fasting levels within 45 minutes. My fasting glucose averages about 85 mg/dl on this diet.

        I have a supercharged amount of energy some days. Though, some days I don’t feel as good as I would like to, I feel the best I have felt since I was 18.

        When I was eating the Perfect Health Diet, I had major problems digesting the starch. Even a few bites of white rice or potato and my stomach would be bloated to the point at which I couldn’t fit anymore food in there. I must have a bacterial problem.

        Here is what I am currently eating (I do not do as low-fat as Ray Peat does, I still do whole-fat dairy because I hate skim milk):

        6-8 cups of whole milk
        6-8 cups of juice of some kind (usually orange, blueberry, cranberry, and lemonade are my choices)
        2 eggs for breakfast
        A few ounces of cheese
        12 ounces or so of steak (6 ounces twice per day)
        Fresh shrimp if I feel like it
        Ice cream sometimes (but not always)

        Here are my supplements:
        Vitamin C 4 grams every 4 hours (bowel tolerance)

        2mg of vitamin k2 as MK-4

        1500mg of vitamin b6 (I am autistic and this really helps with my social skills)

        15,000 IU of vitamin D3 (I need more vitamin D than most people to maintain normal levels, maybe because of the autism)

        1,000mg of magnesium (to balance out all the calcium I get)

        Every day I push through with the Peat-inspired way of eating I feel more and more like my younger self from 10-15 years ago.

        This may not work for everyone and I am not here to hate on the Perfect Health Diet. It is just what works for me so far.

  31. Hi Paul ,
    I was wondering , do you count net carb or total carb in the daily 400-600 carb calories ?would that be 100-150g net carb or total?
    Also, for someone who eats 3 meals a day, would you recommend fruit in the morning or afternoon? And lastly , I tried IF,but I really have to have my cup of coffee at 5am when I wake up, usually with a little half and half snd a teaspoon of honey. Then I’ll have breakfast at 8 lunch at 12:30, dinner at 5. Is that still IF or I’m totally blowing it?

    • That is supposed to be net carbs.

    • … Paul has said in the past that carbs are in general better later in the day, so I’d guess fruits are a better snack between lunch and dinner than between breakfast and lunch, but I doubt it makes that much of a difference.

      … I’m not sure about the IF — I don’t think 1 tsp of honey is that much; how much half and half is “a little”? — but I would have black coffee in the morning and nothing else until breakfast if I were you.

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