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 ?

156 Comments.

  1. I am not sure if you answer question about juicing, I am new here can you share your opinion on green juice and green smoothie( vegetable juice and vegetable smoothie with one fruit) Thanks a lot for that

  2. Hi Sam,

    I generally favor eating foods as foods, but if you prefer juicing that’s fine too.

  3. Good to know about the similar effects of glucose on pain.

    And Stabby did indeed include a part about fructose altering ethanol metabolism in his article, although recommended fruit, and didn’t say to use it unless one was feeling a bit too drunk, for fear that it might kill the buzz.

    Cheers.

  4. Ahhh, the debate continues. Good stuff Paul. I like the direction these debates are heading. I truly feel that malnourishment is a prime environmental stressor that perhaps trumps macronutrient ratios. I do feel there is credence to some moderation principles. If “sugars” do increase the metabolic rate, then it would make sense that it would increase the turnover of some health-promoting vitamins and minerals. This can be problematic in subjects who may be unable to acquire the most nourishing food, which can be an issue with any macronutrient, can it not? I personally think fruits offer a dynamism that cannot be considered equivalent to sucrose supplementation alone. Of course this is just one aspect of nutrition that I will not belabor. Nevertheless, isn’t it quality we are after when it comes to the years we live?

  5. Paul, Sam, JRAC,
    on this point; ”We recommend not counting carb calories from vegetables, as it costs nearly as many to digest them as you get, so they make very little net contribution to glucose balance.” Paul Jaminet

    I must admit, i have always took the vegetables referred to in the phrase as Leaf Vegetables (aka greens) http://en.wikipedia.org/wiki/Leaf_vegetable.

    & i have always counted Root Vegetables http://en.wikipedia.org/wiki/Root_vegetable. ie. all forms of potatoes, yams, cassava, carrot, turnip etc

    so i guess i have been counting the “bulky/big” items. & ignoring the leafy stuff. & then there is pumpkin which i would call a “bulky/big” item, but i think its more of a fruit than a vegetable.

    may be i’ve been getting it all wrong?

  6. Hi Darrin,

    It takes about 40 calories of glucose to digest a pound of vegetables. Leaf vegetables have less than that and so are negative contributors to glucose balance. But most squashes, root vegetables, etc have more than that, often around 80 calories per pound. Carrots are around 200 calories per pound, beets even higher. Potatoes closer to 400.

    So, a simple way would be to subtract 40 calories per pound from everything. Another way is just to ignore most vegetables that are not “safe starches,” tubers, corms, sugary vegetables, fruits, or berries.

  7. So just make clear when I put to fitday.com I should not put veggies(leafy greens carrots, onion, tomato,) to calculate my carb intake? Cause when I calculate with them it was about 75grams of carbs (when I do not eat sweet potato) So know I should count carbs only from root (yams sweet potato etc)??
    Thanks a lot

  8. Pure genius post Paul and thanks for putting it all in one spot to absorb.I notice so many things of what you say here like a quick aging when I try to up carbs by huge amount and also a stronger effect when I up sugar but with a greater sense of manliness and power.I also notice that sugar pushers age rather quickly and if you check out videos you will see that in two short years the effect is noticeable.Yes we age but it should not happen that noticeably IMO.

    Another thing is when I go VLC I also get the reduced thryoid effect.Its like a week or two in and I swear my eyebrow edges start to thin.I keep thinking its in my head but I notice it more and more and when I add back in carbs I notice it less and less.

    My father once told me that life is balanced and you wanna stay right in the middle area to live right.Makes sense in alot of ways and in nutrition maybe we should just be balanced.I mean we hav 3 macronutrients so why should we NOT eat equally from the 3?

  9. sam,
    Paul sums it up by suggesting 2 options for counting carbohydrate calories in veggies & fruits. I have slightly re-worded that hopefully makes it clearer;
    Either;

    1. subtract 40 calories (or 10 grams) per pound (450 grams) from everything.

    OR,

    2. ignore vegetables that are NOT tubers, corms, sugary vegetables, fruits, berries or safe-starches.

    So in your examples, you can ignore leafy greens. But count Carrot (sugary vegetable) & count Tomato (fruit). Onions look to have similar sugar & cals to carrots (sugary vegetable), so you can probably count them as well if you eat a lot.
    & of course count the yams (tuber) & potatoes (tuber).

  10. Thanks a lot I am not native english speaker I live in europe so just sometimes need to make sure with my english sorry for that. Thank you to make me clear with that counting

  11. I would bet that girl is hyper not from the sugar, but from the red 40 in that Peep. A rogue Dum Dum lollypop taught us that our then-five-year-old is extremely sensitive to red 40 – he becomes not only hyper, but a bit violent.

    And they insist on putting it in so many foods, and kids’ medicines. Ugh, ugh, ugh. I can avoid the foods, but finding a dye-free ibuprophren, or grtting a pharmacy to prepare an antibiotic that is not pink can be a challenge.

    On topic, count as a hypothyroid who does better on more starch. Thank you, potato!

  12. Hm…I meant “count me as a hypothyroid…”. I hate typing on an iPad, sorry!

  13. Thanks, Steph. Good to know about the red 40!

  14. Hi Paul — I hope you can answer this question. I am going to increase my starches in order to hopefully make my Armour dosage more adequate for my body’s needs. However, I am wondering about the effect on thyroid antibodies (mine are quite high, both kinds). Do you think increasing starches is helpful for lowering antibodies?

  15. Hi Kathy,

    I’m not aware of evidence that starches will lower antibodies. I would think eating a fairly neutral amount of carbs, ~30% or a bit more or less, should be a good strategy however, as long as they don’t feed a gut dysbiosis.

  16. I would like to know your opinion on post workout fuel, is it better to have date(rich in glucose) or some banana or other fruit (mostly fructose). I know the best would be sweet potato, but I do not always have acces to them after workout. Thanks for advice

  17. Hi Misa,

    Fruits are as good as sweet potato. Bananas are just about perfect, they’re 2/3 glucose 1/3 fructose. Dates are closer to 50-50. So I would go for a banana, plus some protein — maybe a boiled egg or two.

  18. Thank you so much, do you have any links where I can find glucose/fructose content in fruits? I do have one but I am not sure if the good, one cause in that is for example apple very high in fructose even more than banana.

  19. Hi Misa,

    http://nutritiondata.com.

    If you go to the “Carbohydrate” area, they’ll list sugars as sucrose, glucose, fructose, and a few others, eg maltose. Sucrose is 50% glucose 50% fructose. Maltose is all glucose. So you can work out the glucose:fructose ratio with a bit of arithmetic.

  20. Thanks alot I appreciate your help, loves bananas after workout:-)

  21. Hi Dr. Jaminet, last Sunday I went to a super Bowl party with the best intentions of adhering to the PFH.

    Unfortunately, I got caught up in the excitement of the game/party, resulting in downing numerous bruskies, whiskeys, burgers, hot dogs, chips, sweets, ice cream etc.

    My victory celebration carried over into Monday.

    Should I go into a 2-3 day fast to make for the previous two days excesses, or should I just resume PHC?

    As of this post, I haven’t had anything to eat today.

    Thanks!

  22. Hi All,

    very interesting posts. I have a question (actually, lots of questions but would be very grateful to get this one answered). Is it possible to work for both longevity or athletic performance? I am concerned about bringing my protein intake below 70 g per day because I want to maintain (not gain) my muscles and be stronger. I also do intermittent fasting, mostly in the 16/8 hour protocol. Does this everyday fasting give any of the benefits of protein restriction? How low can one get protein intake and still stay athletic and lean? I am also wondering if taking creatine and alternating higher protein / carb days can help (like going down to 50 grams of one and up to 100 grams of the other, then change it after a couple days). Currently I’m eating about 80-90 grams per day of each macro (fat, protein and carbs).
    If you have any suggestions I will be most grateful! Thank you.

  23. Johnny, do whatever you like. Just resuming PHD is fine, but if you feel like fasting that’s fine too.

    Hi Reka,

    Yes, certainly you can be an athlete and work for longevity.

    While higher carb and protein eating may be essential to top-level Olympic performance, you can be an excellent athlete with low carb and protein.

    Peter Attia has been doing a series on the effects of his very low carb ketogenic diet, and though it’s reduced his top end power it’s improved his aerobic performance: http://waroninsulin.com/how-a-low-carb-diet-affected-my-athletic-performance.

    Why do you want to bring protein below 70 g/day? That’s an excellent level, but it’s in the bottom half of our recommended range; lower protein intake might impair longevity. I wouldn’t go below that, especially if you’re athletic.

    Yes, intermittent fasting brings a number of benefits for longevity.

    Carb and protein cycling is a great idea. Non-workout days should have total carb+protein of 600 calories / 150 g, workout days try 1000 calories / 250 g. Split them up between carb and protein to your own taste.

    Best, Paul

  24. Great, thank you very much indeed!

  25. @Darius

    Interesting thoughts. I know for me the cyclical style dieting of Lyle Mcdonald and Martin Berkhan has really worked. By worked I mean I have leaned out, made strength gains, etc. I eat a substantial (for me) amount of carbs on workout days and then mostly protein and fat on rest days. I think I will try and up my carbs further to about 300 grams on workout days to see if it has any further benefits.

    As for the sun worshipping human.. that is interesting food for thought. I know that everything about me does better when there is ample sun.. my skin glows, my mood is through the roof and I couldn’t be happier. Someone tell me again why I live in Wisconsin?

  26. In this study on rats comparing 58% sucrose vs 58% starch or 68% glucose, the sucrose rats had the lowest corticosterone levels http://jn.nutrition.org/content/107/6/1068.short

  27. Hi Lindsay,

    Because you like cheddar cheese?

    Hi flare,

    Thanks for the link. If all you did was look at the numbers in Table 3, the saturated fat (actually Crisco) line would look the best. Which goes to show how little you can trust hormone levels on a short-term diet study.

    As far as the sucrose diet goes, I don’t know of any reason to think lower corticosterone is better in this context.

  28. @lindsay

    what ethnic background are you? my father was spanish & puerto-rican and i grew up in connecticut. BAD IDEA. i was healthiest while traveling in desert places such as reno, nevada & sydney, australia in the summer. now i live in SF and it’s still a bit less than ideal but i like the lifestyle.

    as for the cycling carbs diets, what is your metric for figuring out your carbs on workout and non-workout days?

  29. @Lindsay,

    I ran across Martin Berkhan’s site, and while I don’t think he eats PHD-approved at all times (esp in that he eats a ton of protein), the effects of the lean gains routine are nothing short of amazing for one’s physique. I try to do the PHD with a little bit of lean gains, with protein intake around 150g.

  30. Wondering if anyone has read “Minding My Mitochondria 2nd Edition: How I overcame secondary progressive multiple sclerosis (MS) and got out of my wheelchair.” by Dr Terry Wahls. There seems to be a lot of similarity with the Perfect Health Diet, other than the potatoes and rice. Any thoughts?

  31. @Thomas, @Lindsay

    After ‘standard’ PHD (maybe too low carb PHD) for about six months I’ve been doing Leangains-style for the past 3-4, and I too have better success than before.

    (Success = weight loss without significant muscle loss.)

    In my case I lift once a week (Body By Science-style), and on that day I drive carbs above 200g. I do 60-90g carbs on off days. Protein is consistent at 130-150g per day, which I know is too high for PHD but I tell myself it’s only temporal.

    All days are 16/8 IF.

    By watching calories (1600 off day, 2000 workout) I’ve (slowly) lost around 15 lbs over 6 months, but maintained or increased my strength (as measured by weight and/or time-under-load).

    So I am a fan of LG + PHD. The big question is what happens when I stop watching those calories? My entire life to date it’s meant a slow creep up back to ~my starting weight. I’m hoping this time will be different; I’ve been lighter before, but never had this little fat mass. We’ll see.

  32. @john d.

    the numbers you listed are out of context unless we know your height and bodyweight. 1600 calories is very hypocaloric, what is that? 15% less than maintenance calories? 25% less? unless you are maybe a 5’8″ 160lb male?
    i’m just guessing here, as my maintenance calories are 2600 at 185lb and 6 feet tall. unless i did the math wrong.

    2 things i think are important: i think that phd recommendations for protein may be too low. if i go less that 1g per lb of bodyweight i feel “off”. weak, cold and un-satieted.
    i also think that long term caloric restriction may increase longevity but at the expense of everything enjoyable about life. hypo-thyroid, no libido, no performance. i think if you are only going hypercaloric one day a week, essentially you are only anabolic one day per week. which means the other 6 days you are catabolic. i think this ratio is out of whack.
    what do you think would happen if you had more days in a calorie surplus, more days per week in an anabolic state…

  33. @John D,

    I’m doing quite similar things but I do not watch calories. No unwanted fat gains.
    But I exercise 2-3x week (HIT/HD) and I don’t do any carbing up on those days. It’s absolutely without value for me (I tried).
    I don’t really control my carbs either and just go by feel but when checking they seem to fall always in the 70-140g range. In the summer more in the upper percentile of that range (due to more fruits/ice cream and less starches – seems to be my form of natural seasonal fluctuation).

  34. @darius:

    I am 5’10”, (now) 165. I am -20%/0% off day / workout based on simple calculator. I can’t argue with the results from either the amounts or the frequency. Unsure about adding more hypercaloric days — I’m not lifting those days so it feels off. What do you think benefit would be?

    (incidentally my first 6w I was 1800/2400 and didn’t budge weight wise. Since then I am a couple pounds a month. I started at ~180. I am probably still 15%BF. also FWIW I got to 180 unintentionally from 170 eating PHD — but few carbs and maybe only 80-100g protein, so I am with you on the increased intake there.)

    @Franco, I love me my carb days. I feel great that day and for the first time while losing weight I don’t think I’m losing muscle. Also Rice Krispies + sweet potatoes + gluten-free English muffins in one meal!

    But I am 80g the other days, so we even out…

  35. @john, if you always feel awesome, pumped, relaxed and alert i’d say that’s optimal. but i’m just thinking that with you basically always being in a catabolic, hypocaloric state that you may be chronically stressed and “not know it” as it’s a relative comparison.

    (maybe a lot of us have chronically malnourished ourselves, causing the body to conserve energy and gain fat for survival under perceived stress)

    as long as food choices are non-allergenic for you (no ibs symptoms, etc), you could try increasing your “anabolic” days and just see what happens to your mood and physiology (body temp, pulse, sleep quality, etc)

    the leangains school of thought is only overeat on training days, while tom venuto treats cyclic over-carbing on a x:y ratio, perhaps undereating for 3 days, then overeating for 2 days, then repeat, regardless of when the training days fall. with tom’s idea you are still mostly undereating to lose fat and stay lean, but it may be less stressful than your 6 under:1 over cycle.

    however all this is moot if you are still “overweight”, or over 25% bodyfat. sounds to me like you are pretty lean at 15%. getting into that sub 10% bodyfat may require you having a lot more lean muscle first, or it may not. but the body holds onto that fat until it’s certain you won’t die, or it has the systemic resources to detoxify whatever the fat is holding onto.

    i think robb wolf said that the only way he got rid of his small love handles was basically starvation while on the I, Caveman show. forcing his body to eat those fat reserves. i’m not sure if that situation can be replicated in our urban lives, even if we did starve ourselves, considering robb was outdoors and doing evolutionarily natural activities.

  36. I do have two question on you. 1)When I want to do IF can I drink vegetable juice(only leafy greens and lemon) or to have blended spinach with some berries. I workout in the morning and feel hungry very hungry till noon,but I really want to try IF. Do you suggest only water till noon or is it OK as I wrote to drink juice(smoothie)

    Another qustion 2)my dad does not have gallbladder, can he eat PHD with high fat ratio? Or he should lower his fat intake to 50% or so.

    Thanks a lot for answer.

  37. Hi Misa,

    Yes, it’s fine to drink vegetable juice, or eat vegetables and some berries, during a fast. The other thing you can try to assuage hunger is a spoon of coconut oil – that’s what I recommend to people fasting on weight loss diets.

    Your dad will probably be more comfortable eating more carbs. Probably 45% carbs 15% protein 40% fat would be a good calorie ratio. He might also consider bile supplements with fatty meals.

    Best, Paul

  38. But I do not want to loose weight I just want to do IF for health longevity reason, still you suggest spoon of coconut oil?

    Actually my dad does not feel any digestion problem with high fat diet ratio we were just wonder if it is ok since he does not have gallbladder. So he will change the ratio as you suggested
    Thanks a lot

  39. Hi Misa,

    I think it’s generally best not to be hungry, so I think it’s good to find the minimal amount of food you need to relieve hugner. If vegetable juice works, that’s great. You could also try a small bit of protein, eg 1 egg, or a spoon of coconut oil.

    If your dad has no problem digesting the fat then it’s OK to eat higher fat. But there’s nothing wrong with a slightly higher carb intake.

  40. Thank you so much I appreciate a lot your help

  41. Another great post Paul!

    In terms of sporting performance, i used to do competitive powerlifting, and i tried a number of low carb high fat diets (The Anabolic / Metabolic Diet, the Natural hormonal Enhancement diet), each for about 8 months interspersed with a few months of moderate-high carb dieting, to see what effects they had on my body comp and performance. In each case, initial weight and fat loss came pretty quick (inadvertent caloric restriction due to satiety of such diets), but then plateau’d after about 2 months, at which point calorie counting and thus fat intake reduction became necessary. Aesthetically, i always looked better on more carbs because muscle’s appear much fuller and more defined.

    With regards to performance, my strength and capacity for lifting volume (i.e number of sets and reps) dropped off gradually, and frequent carb-ups were necessary to stop performance deteriorating excessively. Performance for me was ALWAYS better on higher carb diets.

  42. I know this is different topic, but I have just started to read your book and you suggest to take probiotic supplement. I take one in the morning on empty stomach and eat about 1 cup of fermented veggies each day. Do you think that I need to take supplement too?, I mean if it could be enough that 1 cup of fermented veggies and may be some miso soup.

  43. Dr. Paul, I listen to you this morning February 09, 2012 at CJBK in London, Ontario and I am very interested in what you had to say to Andy Oudman. I will purchase your book “if it will help my diabetes, I have my blood sugar under control through exercise and Metformin. Would your diet help me in a better way than where I am now?

  44. Dr. I had sent you an email asking your advice regarding me being a diabetic and would your diet allow me to follow your Perfect Health Diet. I am on medication (Metformin)and blood pressure pill and a cholesterol pill and a small dosage aspirn.

  45. Hi Rick,

    At the bottom of this post: http://perfecthealthdiet.com/?p=5027 there’s a section “What About Diabetics?” which recounts the story of Newell Wright, a diabetic eating our diet.

    I do think our diet and micronutrient/supplement recommendations are very good for diabetics. Every diabetic is a little bit different so you will have to experiment with different macronutrient ratios a bit to find what works best for you. But in general, I think our diet is excellent for diabetics and should control the disease and in a few cases may enable a cure.

    Usually blood pressure is one of the first things to get fixed, so I think you can hope for fairly rapid improvements there.

    Best, Paul

  46. @ Paul:
    >”As far as the sucrose diet goes, I don’t know of any reason to think lower corticosterone is better in this context.”
    Doesn’t low corticosterone in rats suggest low stress levels?

    What do you think of these studies, where rats on 45% to 67% sucrose + nutritious diets are reported as fine (in contrast to modern rodents which are fed deficient/purified diets)?
    http://jn.nutrition.org/content/3/1/61.full.pdf+html
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1275514/pdf/biochemj00921-0130.pdf

    Isn’t stress generally supposed to increase glucose levels? Why then does fructose improve glucose levels, HbA1c and insulin?
    http://www.ncbi.nlm.nih.gov/pubmed/19064538
    http://jn.nutrition.org/content/139/6/1246S.full.pdf
    http://www.ncbi.nlm.nih.gov/pubmed/2527132
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844681/
    http://www.ncbi.nlm.nih.gov/pubmed/11134101
    http://www.ncbi.nlm.nih.gov/pubmed/3516605

  47. Why I Ditched Low Carb | CHEESESLAVE - pingback on February 10, 2012 at 11:31 am
  48. not sure if anyone mentioned this, best phrased by peat himself: ” I encourage people to eat sweet fruits, rather than starches, if they want to increase their production of cholesterol, since fructose has that effect. ”

    Assuming thyroid function is fine, fructose might actually be good?

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