Dangers of Zero-Carb Diets, I: Can There Be a Carbohydrate Deficiency?

It’s frequently said in the Paleo blogosphere that carbs are unnecessary. Here’s an example from Don Matesz, an outstanding blogger who eats a diet extremely close to ours:

Protein is essential, carbs are not…. You can only cut protein so much, but you can cut carbs dramatically.

Dr. Michael Eades has mocked the idea of a carbohydrate deficiency disease:

Are there carbohydrate deficiency diseases, Mr. Harper, that you know about that the rest of the nutritional world doesn’t?  I’ll clue you in: there aren’t.  But there are both fat and protein deficiency diseases written about in every internal medicine textbook.

Such statements made an impression on me when I first started eating Paleo five years ago. But several years and health problems later, I realized that this view was mistaken.

Why Aren’t Carbohydrate Deficiency Diseases Known?

How do doctors discover the existence of a nutrient deficiency disease?

It’s not as easy as you might think. For example, the existence of essential fatty acid deficiency diseases in humans was in doubt right up into the 1950s, even though omega-6 deficiency disease had been discovered and characterized in rats in the 1920s. [1] The reason is that omega-6 and omega-3 deficiencies can occur only on unnatural diets. It was infants fed fat-free formula in the 1940s and 1950s who ended up proving the existence of omega-6 deficiency disease in humans.

Two difficulties have made it challenging for science to recognize a carbohydrate deficiency syndrome:

  1. Lack of an animal model.
  2. The rarity of zero-carb diets among humans.

Until recently, few people save the Inuit ate very low-carb diets, and the Inuit didn’t leave good medical records. As a result, few or no humans developed recorded carbohydrate deficiency syndromes.

This wouldn’t be a problem if it were possible to induce carbohydrate deficiency in animals. However, it isn’t.

Animals don’t get carbohydrate deficiency diseases because they have small brains, meaning low glucose needs, and big livers, meaning high glucose manufacturing capacity. Animals can generate all the glucose they need from protein or from volatile acids like propionate produced by bacterial fermentation in their digestive tracts.

But, as we note in the book, humans are more fragile. We have small livers and big brains, and so the possibility of glucose deficiency is real.

Here is a comparison of brain, liver, and gut sizes in humans and other primates [2]:

Organ % body weight, humans % body weight, other primates
Brain 2.0 0.7
Liver 2.2 2.5
Gut 1.7 2.9

The brain is the biggest determinant of glucose needs.  While other primates need only about 7% of energy as glucose or ketones, humans need about 20%.

Compared to other primates, humans have a 12% smaller liver. This means we can’t manufacture as much glucose from protein as animals can. Humans also have a 40% smaller gut. This means we can’t manufacture many short-chain fatty acids, which supply ketones or glucogenic substrates, from plant fiber.

So, while animals can meet their tiny glucose needs (5% of calories) in their big livers, humans may not be able to meet our big glucose needs (20-30% of calories) from our small livers.

So any carbohydrate deficiency disease will strike humans only, not animals.

How Should We Look for a Carbohydrate Deficiency Disease?

To find a carbohydrate deficiency syndrome in humans, we should look at populations that eat very low-carb diets, such as:

  • The Inuit on their traditional hunting diet.
  • Epilepsy patients being treated with a ketogenic diet.
  • Optimal Dieters in Poland, who have been following a very low-carb diet for more than 20 years.
  • Very low-carb dieters in other countries, who took up low-carb dieting in the last 10 years as the Paleo movement gathered steam.

We should also have an idea what kind of symptoms we should be looking for. Major glucose-consuming parts of the body are:

  • Brain and nerves.
  • Immune system.
  • Gut.

The body goes to great lengths to assure that the brain and nerves receive sufficient energy, so shortfalls in glucose are most likely to show up in immune and gut function.

So, we’ve mapped our project. Over the coming week, or however long it takes before we get tired, we’ll investigate the evidence for carbohydrate deficiency conditions in humans.

Related Posts

Other posts in this series:

  1. Dangers of Zero-Carb Diets, II: Mucus Deficiency and Gastrointestinal Cancers A Nov 15, 2010.
  2. Danger of Zero-Carb Diets III: Scurvy Nov 20, 2010.
  3. Dangers of Zero-Carb Diets, IV: Kidney Stones Nov 23, 2010.


[1] Holman RT. The slow discovery of the importance of omega 3 essential fatty acids in human health. J Nutr. 1998 Feb;128(2 Suppl):427S-433S. http://pmid.us/9478042

[2] Aiello LC, Wheeler P. The expensive tissue hypothesis: the brain and the digestive system in human and primate evolution. Current Anthropology 1995(Apr); 36(2):199-211.

Leave a comment ?


  1. An interesting topic. I’m not convinced that carbohydrate deficiency can occur in the context of a healthy population through low carb dieting. Perhaps a good population to look at might be those with glycogen storage disease’s (Von Gierke’s, McArdles etc.). I’d like to see more research that examines glycogen storage during the period of adaptation to a low carb diet, whether it remains depleted or eventually ‘refills’ through gluconeogenesis. Many studies use low carb to produce glycogen depletion but I’m willing to bet that in each case the participants were previously eating a moderate to high carb diet. I’d be inclined to assume that as long as there is no problem with glycogen storage, insulin sensitivity in both the liver and peripheral musculature is good and a low carb diet is maintained, then unless performing ridiculous volumes of intense activity there will probably always be plenty of glycogen to breakdown and to be refilled with either minimal exogenous or endogenous glucose.

  2. Hi James – Those are good research topics. Thanks. However I think the bottleneck is the rate of gluconeogenesis, not glycogenesis (i.e. conversion of protein to glucose-6-phosphate, not glucose-6-phosphate to glycogen).

    I thought it was rather uncontroversial that there are bottlenecks in gluconeogenesis during fasting, thus the ketosis adaptation, but I guess that has to be documented.

  3. Leonie’s comment reminds me of this post on hyperlipid:


    Regarding that old corn oil vs olive oil vs standard diet study of MI survivors in Britain in the 1960s. The results – corn oil drops your cholesterol and kills you, but in addition, both in the corn oil and olive oil groups, one person developed diabetes after adding 500-600 calories of fat to their diets daily. There are OLETF rats who develop diabetes from fat – perhaps due to issues at the mitochondrial level. Well, Peter explains it better than I could!

  4. Thanks, Emily, it’s good to have smart readers!

    Especially smart readers with working memories. I commented on Peter’s post and it figures heavily in the upcoming series, but I totally forgot that it mentioned several cases like Leonie’s.

    A few jigsaw puzzle pieces may be clicking together … Looks like I have some extra posts to work up!

  5. You know – I think I first saw your name posting on a hyperlipid comment regarding micronutrients. I’m a collage-thinker – I don’t necessarily come up with original ideas but most facts go into certain nooks and crannies and can be pulled out when I need them. I dont know of that is “smart” but may be more a relic of my day job as a psychiatrist remembering everyone’s life details!

    But I’ve also been thinking about my own experience with Paleolithic diets – I have not experienced low carb flu with low carb weeks, had no difficulty losing weight on various carb levels (though never over 150 carbs a day) as long as the carbs were starchy/paleo. I don’t often count, I go by hunger. I gained the weight only during pregnancy in a different hormonal environment, and I have no health issues (actually, I used to get a tiny bit of excema under my wedding ring during the summer, but this past paleo summer – not a touch of excema). I’m wondering if my experience is one of a relatively healthy metabolism (granted it was broken enough to gain the excess weight during pregnancy) and relatively healthy gut. It is possible I am in a certain percentage of the population that is more resistant to wheat damage. But the problems others experience always interest me. What is going on physiologically? Would a hunter gatherer experience low carb flu going from tuber rich fall to a leaner winter? That wouldn’t be particularly adaptive.

  6. Interesting topic.

    I followed a strict low carb diet with around 50g of carb per day for over 1 year and I think I have developed hypothiroidism and a prediabetic state
    Regarding my energy it wasn’t too much at beginning but then it rise to a pretty normal level.

    Here’s my last blood results:

    Glucose 94 (70-105)
    HbA1c 5.1 [non diabetic 4.6-6.5]
    Cholesterol 214 (140-220)
    Insulin 2.9 (5-25)
    C-peptide 0.75 (0.5-4.0)
    PCR 3 mg per liter

    TSH 3.4 (0.3-4.0)
    FT3 2.2 (2.1-4.9)
    FT4 11.4 (6.8-18.0)

    What you think about them?
    Do you think I’m experiencing carbohydrate deficiency?

  7. After re-reading Peters article I wonder if it would be worthwhile to trial significantly lowering the fat in my diet to see what effect this has.

    Although Jenny in her comments does not give much credit to rat studies in correlation to humans. I was interested to read that according to Bernstein people with PCOS cannot lower insulin to normal levels even with a low carb diet. I have PCOS but my last fasting insulin levels were not all that elevated.

    I also have a goiter with nodules & thyroid antibodies.

    Any one have thoughts on whether a low fat diet is worth the effort for me to trial?

  8. Hi Kratos,

    Your numbers look good except for the hypothyroidism. I don’t see evidence of carb deficiency. If the 50 g refers to glucose content (i.e. 200 calories), not amount of plant food, then you’re getting enough carbs (we believe).

    For the hypothyroidism, are you supplementing selenium and iodine?

  9. Hi Leonie,

    I don’t believe that a low fat diet would help you.

    Have you read our latest post? That suggests nutrient deficiencies as a possible cause for the Rose Corn Oil diabetes cases.

    From what you’ve just said, it sounds like food toxins / autoimmunity are a more likely cause in your case. Some auto-antibodies attack the beta cells of the pancreas. It’s likely the same thing that has caused your thyroid issues may also have caused your diabetes.

    So the key could be removing all toxic foods.

  10. Copy/Paste from my email to you (there’s no preview here so I hope the links work):-

    From What limits the liver’s capacity to convert amino acids to glucose? , it appears that the liver can produce up to 400g of glucose/day from amino acids alone. The liver can also produce glucose from glycerol, lactate & pyruvate. Kidneys can also produce glucose from amino acids, glycerol, lactate & pyruvate, (see Liver and Kidneys Synthesize Glucose. ), therefore total hepatic & renal glucose production could be >450g/day.

    In the absence of insulin, lipolysis greatly increases, which greatly increases serum free fatty acids & glycerol. Hepatic ketone production also greatly increases (see Diabetes; metabolism in the absence of insulin. ) Free fatty acids compete with glucose, reducing glucose uptake by muscles. Ketones compete with glucose, reducing glucose uptake by muscles and brain.

    The above suggest that there is sufficient hepatic & renal glucose production long-term to maintain hyperglycaemia in the absence of dietary carbohydrate.

    Resistance training/anaerobic exercise reduces serum glucose by increasing glucose uptake by muscles. Whether that can result in hypoglycaemia, I don’t know.

  11. Thanks, Nigel. I’m planning to discuss it in a post, since it’s so fundamental to the issue of zero-carb dangers, but it’s good that you’ve contributed it to the comments.

  12. I’m struck by the chart at the bottom of Nigel’s first link that shows blood ketones rising steeply until day ten of a fast and then continuing to climb until day 40.

    This reminds me of Thomas Seyfried’s recommendation to fast for 7 to 10 days in order to starve cancer cells. Hans S discussed this in comments back in September at the following link and it’s footnoted in Paul and Shou-Ching’s book.


    Sorry for going off topic here. I’m particularly interested in this at the moment because I’m on day eight of a fast to see if it will improve my migraines more than a ketogenic diet does.

  13. Hi Robert,

    Very good, please let us know if the fast helps!

    I’ve been thinking of doing a long fast myself to see what happens.

  14. I will Paul.

    Do you have any thoughts about gut flora dying during a long fast? I’m worried about this and wishing I had saved a hefty stool sample in the fridge to reinoculate myself afterward.

    I’ve been reading books about fasts by people in the natural hygiene movement. Their theories aren’t much use but some of them seem to be trustworthy empirical observers. Two of them describe the expulsion of a lot of black putrid material on day 13 and 14 of fasts and I’m guessing that’s dead flora.

  15. Hi Robert,

    Well, I wouldn’t worry too much about it. Some probiotic species can live on human mucus, which has a high sugar content. Many bacteria can survive in a dormant state, with very little activity and no food, for many weeks. You only need a small number of each species to survive to repopulate the gut.

    Pathogenic species would be more likely to die off than commensal species.

    So I would think a long fast could be therapeutic for gut diseases.

  16. A very low-carbohydrate diet may mean a lack of dietary fiber.

    A low-fiber diet may mean constipation.

    I wonder why Atkins dieters talk so much about laxatives?

  17. Here’s a link to the abstract of that study Paul

    I thought I had the full article, but no such luck. Some number crunching demonstrates that just over a third of the children were below the 10th percentile in height before, while over 80% were in that category on their last recorded visit.

  18. Fascinating information on dry eyes! I’m a long term gluten-free low-carber (8 years) and experienced many health improvements in the first 6-12 months of adopting this way of eating. Great health followed over the next several years along with effortless weight maintenance. But – over the last 2 years or so I have developed mild acne rosacea, anterior blepharitis, dry flaking skin (I used to be a walking oil slick) and a skin hypersensitivity (tingling and feelings of things crawling on me – mainly concentrated in my face and scalp). It has literally been driving me mad. The only thing I’ve been able to establish so far with the help of my natural-health-oriented doctor is my phase-2 liver function is not working optimally. I’m currently taking a range of supplements to try and improve this condition. I was also thinking it might be an issue with peri-menopause and hormones (47 years old and I’ve grown some of that peach fuzz facial hair that you often see on older women) causing the hypersensitivity feeling on my face. I might try upping my carb intake and see what happens. I’ve added your book to me Amazon cart for my next order.

  19. Hi GeeBee,

    Interesting. Did you have a course of antibiotics? Or did antibiotics make your condition worse?

    One thing I have noticed is that while bacterial infections are most likely on a high-carb diets, fungal infections seem to flourish on low-carb diets. I associate rosacea with fungal infections, in part because it often begins with antibiotics which clear the gut of commensal bacteria.

    Blepharitis is sometimes due to fungal infections, e.g. http://www.ncbi.nlm.nih.gov/pubmed/19957565. In a sample in this paper, http://www.ncbi.nlm.nih.gov/pubmed/20952834, bacteria were found in about 60% of eye infections and fungi in 10%, but I suspect those percentages might be reversed if low-carb dieters were sampled.

    It’s just a thought, but the possibility of fungal infections is often overlooked and you might raise it with your doctors.

    The hypersensitivity suggests immune activity but doesn’t tell us what’s causing it. Are you taking vitamin D?

  20. I haven’t had a course of antibiotics but was given a prescription for Rozex Gel (metronidazole) that I use twice a day.
    Last time I had my Vit D levels checked (1 year ago) I was near the top of the range. I do controlled sunbathing in the summer and supplement in the winter. I do have a brother who is a celiac so I’m very conscious of my increased risk of developing an auto-immune condition.

  21. With regards to ‘low carb flu’ I came across this only in a certain percentage of clients when I first started teaching Zone diet principles (30:40:30, PCF, reduced calorie).
    Barry Sears has a different take on it. He said it was a release of Arachidonic Acid from fat cells due to the previous diet of high omega 6 and refined carbs causing a buildup of AA in fat cells where it gets sequestered to deal with it. With an outpouring of AA, more of the inflammatory prostaglandins / eicosanoids are made. What is interesting is that during this period – usually lasting around 3 weeks, various issues that each person tends to get flare badly like eczema or asthma.
    The antidote is taking a lot of fish oil, as it balances the AA. Indeed this works when I’ve tried it. Alternatively add carbs back in and decrease more slowly, to slow AA release.
    My experience is that about 25% of people get this, and usually the more metabolically unwell.

  22. I’ve been thinking about the “carbohydrate deficiency” problem since reading this blog, and the book. On page 28 of the book, you write, “A fasting person’s daily glucose production has been measured at…120 to 160 grams.” The source for this is a paper by Nair et al., studying metabolism after three days of fasting. The trouble with this is that we know that as fasting, or carbohydrate deprivation, continues, the body adapts to the use of ketones instead of glucose, glucose production is much less, with only 15-20 g coming from protein (http://books.google.com/books?id=rXSO9YLr72YC&pg=PA246). It appears that we are well capable of producing enough glucose for mucin and for the cells that can’t use ketones, but it takes a while to get to that point.

    It’s possible that some people experience the deficiency syndrome because their carb restriction is intermittent, not lasting long enough for full ketone-adaptation.

  23. Hi Ubizmo,

    Yes, ketones can replace glucose. However, they don’t conserve protein (if they are manufactured from it), and they may not prevent a glucose/mucin deficiency.

    I’m going to address this more in a future blog post, starting with the topic Nigel raised above (see http://perfecthealthdiet.com/?p=1032#comment-7079).

    Briefly, what I believe is:
    1. The body has two imperatives during starvation — supplying glucose (or ketones) to the brain and preserving muscle / lean tissue.
    2. It conserves protein by downregulating glucose use (e.g. by downregulating mucus production).
    3. The relative usage of ketones vs glucose is determined in part by the available amino acid supply which provides ketogenic as well as glucogenic amino acids to meet energy needs.

    In starvation the downregulation of mucus production is severe. In zero-carb dieting it seems to be severe if protein and coconut oil are restricted. If substantial protein is eaten, then it’s likely that mucus production is not downregulated so much. That seems to be the $64,000 question at this point.

    Best, Paul

  24. Are there any blood tests to determine choline deficiency? My wife has PCOS and fatty liver and I guess we could start supplementing choline and see if that improves things, but I’d like it better if there was a direct test so we’re not just shooting in the dark.

  25. Hi Albert,

    Not that I’m aware of. But choline is one of the most abundant organic molecules in the body. It’s very safe to supplement choline and/or to eat egg yolks, so that you needn’t fear supplementation.

    Re fatty liver, check out yesterday’s post, be sure to keep down omega-6 fats and sugars!

    Best, Paul

  26. Perfect Health Diet » Danger of Zero-Carb Diets III: Scurvy - pingback on February 1, 2011 at 6:26 pm
  27. Ratios between protein, fat and carbohydrates I established in late 1960 at the then low consumption of meat in Poland and in stores where purchased mainly zbuki, not eggs.
    Therefore, the main source of protein had to be cheese, which is 90% casein protein and which is not the best. By necessity we had to increase the supply of protein, about 56% of which is converted in carbohydrates. So with 100 g of protein is formed in addition, 56 g carbohydrate. Therefore, the proportion of protein, fat and carbohydrates I determined as follows: 1: 2.5 – 3.5: 0.5.
    Today is the possibility of using proteins with the highest biological value, and the body needs much less. That is why I accepted to be the best supply of approximately 0.8 g carbohydrate per kilogram of body weight – the weight owed. A man weighing 50 kg, therefore, needs about 40 grams of carbohydrates, and weighing 100 kg (weight and we predicted) – I need about 80 grams if its height is about 2 meters Fats highest biological value will automatically reduce the body’s demand for protein. When consuming unsaturated fats that demand is increasing.
    The demand for carbohydrates may be different in different people. One of just 0.5 g per 1 kg body weight, another 1 g. You need to eat enough carbohydrates to the urine ketone bodies appear. Trace of ketones in the urine in a healthy person can be.

    Every body is different and everyone has different needs for energy, protein, fats and carbohydrates, but everything should be within the recommended proportions.


    The Optimal Nutrition per 1 gram of protein should account for 2.5-4.0 0.5-0.6 grams of fat and grams of carbohydrates. When a protein is the highest-quality body needs it to about half the time for a gram of protein you should consume approximately 1 gram of carbohydrate

    It can be assumed that the board may look like
    At 1 g Protein will account
    2.5-4g fat
    0.8 g carbohydrates + / – 0.2 g

    No body is not able to secure such an ideal chemical composition of the food you eat that all the tissue cells always receive only what is best for them, that is the best and the best nutrients for energy, and in such amount, in which the body is needed. Therefore, human nutrition is a compromise between what is and what it should be. The idea is that “what is “, it was as close as possible to the “what ought to be. “

  28. Dear Dr Kwasniewski (I assume you are Dr K?),


    Thank you very much for that explanation, it’s very helpful in understanding the Optimal Diet. I wish I could read your site in Polish to understand it better, but am glad to have your explanation.

    We agree on most points:

    I agree that ketogenic diets can be healthy, and indeed can be the best therapies for neurological ailments and many diseases of aging.

    I agree that for those on a ketogenic diet, achieving a low level of ketones on a urine stick should be optimal – not so many ketones as to feed infections, but a slight excreted excess so that you know tissues are not starved.

    I agree that the optimal carb and protein intake varies between persons, due to many factors including body weight. As people age they become more metabolically efficient and need fewer calories. Often changes occur suddenly, e.g. at menopause.

    I agree with your formulation of the optimal diet. We should get all the nutrients that benefit us in the amount that delivers all the benefits and none of the toxicity. (Perhaps a slight disagreement would be that for most nutrients, like carb and protein, I think this still leaves us with a healthy range, not a single amount.)

    My points of disagreement are:

    1) I think it is healthier to induce ketosis with ketogenic short-chain fats (as in coconut oil) rather than by minimizing carb and protein consumption. This avoids invoking the body’s starvation response. Ketones become a disposal pathway for the short-chain fats, rather than a starvation response with potentially damaging adaptations.

    2) I think it is generally sufficient for good health to invoke ketosis part of the day, for example through a daily 16-hour fast aided by coconut milk/oil consumption, rather than all day; or intermittently through occasional fasts.

    3) I think there are potentially significant health risks from insufficient carb+protein consumption, and we may not know what these are — they may take decades to play out, as in cancers of the GI tract.

    4) I think ketogenic diets can be potentially harmful in people who have chronic infections with eukaryotic pathogens like Candida, Toxoplasma, etc. So such diets are not for everyone.

    So, in short, I think the benefits of Optimal Dieting can be achieved with fewer risks with some modest alterations to the diet such as coconut oil consumption with higher carb+protein intake.

    Thank you very much for coming, and I would love to continue the discussion. Questions I would ask you:

    What would be your summary of the clinical experience of people on the Optimal Diet? You have so many decades of experience with so many thousands of people. Do you think the rate of GI cancers is elevated? Which diseases have elevated incidence on the Optimal Diet, and which diseases have decreased in incidence the most? Have you found any nutritional supplements particularly useful for Optimal Dieters?

    Best, Paul

  29. I’ll have to disappoint you, I am not Dr Kwa?niewski, the only person using this diet.

    “I think there are potentially significant health risks from insufficient carb+protein consumption, and we may not know what these are — they may take decades to play out, as in cancers of the GI tract. ”

    Minerals perform a variety of different functions in the body are the other components of the enzyme. Demand for minerals and their use in the body is the greater, the body gets the protein in the diet worse and worse fuel. The lower the biological value of protein intake and a lower value of bio-fuels, the more difficult to be metabolism, the more there must be a chemical reaction to obtain a similar result, the more your body needs to synthesize enzymes, consume more minerals and vitamins as components of these enzymes, This eventually has more to lose energy unnecessarily so. fundamental transformation.

    In rats a protein-fat diet with 75% of energy in fats, 20% protein and 5% carbohydrate – led to a decrease in demand for protein by 35% energy by 34% of minerals by 68% and in addition to more favorable results in all parameters studied decreased heart weight by 35%. The proposal, when it comes to the heart, is simple:

    The better the energy is replaced by the heart (mainly phosphorus compounds), it is smaller.

    Rats fed the highest quality protein (eggs, cheese) and the highest value of fats (butter, lard) – they need much less energy, protein and minerals in their bodies because the metabolism is much more efficient, and that the consumption of less energy , proteins and minerals. The same is true in humans.

    Not enough to be of the opinion, and you need to know. The liver does not like too much protein, because it must be processed for urea, which is costly, and wherein the hydrogen is lost, which could be burned for the benefit of the body. In a nitrogen atom body loses two hydrogen atoms, where it is excreted in the form of urea, three hydrogen atoms, where it excretes ammonia and 4 hydrogen atoms, where it excretes ammonium ion, which has the chemical formula NH4 +. In order not to lose too much hydrogen, you need to eat enough protein as possible. And need it less, where this protein is biologically more valuable

    Protein a carbohydrate can be treated interchangeably, but the higher the biological value of protein (determined mainly by the amount of acids exogenous), the more you should consume carbohydrates (more complex than simple) or proteins predominantly composed of amino acids glikogenne.

    Fat is the higher biological value, and its addition to the food faster and more” replace “an excess of available amino acids, aliphatic, and EDNO egzoheksoz, trioz, pyruvate, acetate and cytozolowego acetyl-CoA for cholesterol or (and) fat”

    A normal healthy person needs only to egg yolk (organic phosphorus, the body active, trace elements, vitamins, etc) – not protein. Protein is usually reached with offal, but not casein, or other biologically worthless zooglobulin (including meat).

    Easy experience:
    Three egg in half cup butter and skwarkach – gratify any healthy, while maintaining it in health.
    The same, but with a slice of bread – it will cause a feeling of “hungry”. Without more health effects.
    The same, but with two slices of bread – will wish to continue eating. If you commute – the beginning of the fattening!.
    This is the same, but the bread to the full – will fattening, atherosclerosis, diabetes type II – or start the “morbid genes” metabolic syndrome – as in fattening houses prwaie Mc Donald. Simple?.

    A simplified explanation of a simple biochemical experiments:
    1. we have a macro and in perfect proportion mikroelemnety – the building blocks of protein, fat for energy,
    2. “And too little vitamin B copleks – the building blocks of protein, fat for energy, carbohydrates for energy pathway heksozowy (LDL – even in the standard)
    3. we have a macro, too few B and Mg compleks – borderline – the building blocks of protein, fat for energy, carbohydrates heksozowy trail, the excess carbohydrates in the pathway pentozowy – NADPH production, production of cholesterol niebudulcowego. (LDL – high)
    4. we have a macro elements B compleks not enough, not enough Mg excess energy from carbohydrate-protein building blocks, fat for energy, carbohydrates heksozowy trail (as far as stocks permit Mg), the rest of the pathway to produce NADPH pentozowy. Hepatic energy economy!, Excess acetyl-CoA derived from carbohydrate, crashes are the mitochondrial matrix to the cytosol and begins to ride – that is, on the whole fattening!
    Deficiencies of micronutrients, especially magnesium! causes the production of NADPH in the pathway missing pentozowym and replace the excess and the malonyl-CoA-CoA and further to ketone bodies or fat or cholesterol. This results in a drastic change in serum lipids, atherosclerosis but still does not have to grow. Excess fat (from carbohydrates) is converted into triacylglycerols and then transported to the adipose tissue. This occurs when the percentage ratio of energy around BTW
    But it’s very rough out

    When purchasing products zdatnych humans to eat, but the proportion BTW, you can follow the addition of cellulose, cholesterol, and (or) phosphorus in the product. The principle is quite simple: the more cholesterol and (or) phosphorus, and less cellulose, the higher the biological value of food.

    “Ketones become a disposal pathway for the short-chain fats, rather than a starvation response with potentially damaging adaptations”

    Because only the biological value of fat that matters, not how many and what acid is.
    I’ve included a biological value of fats: egg yolk fat, bone marrow, butter, cream, fat goose fat (fat and mesentery oko?onarz?dowe), bacon, lard, … i.t.d. And at the end ceres (not to be confused with Demeter, or asteroid), and other vegetable fats with highly carcinogenic substance – margarine.
    On what basis is fixed biological value of fat and more – please look at the http://www.dr-kwasniewski.pl – is in many places are!.
    Olive oil, canola oil and other vegetable oils are as good as mineral oils – for diesel engines commonly called “diesel”

    And what would have been left unsaid was not: if someone thinks that nonsense I wrote out in my last post – has a serious problem.
    But I will give my definition of the biological value of fat, which would also not be left unsaid:
    “Fat is the higher biological value, and its addition to the food faster and more” replace “an excess of available amino acids, aliphatic, and EDNO egzoheksoz, trioz, pyruvate, acetate and cytozolowego acetyl-CoA for cholesterol or (and) fat”

    Coconut oil
    On the contrary, oils by their biochemical composition, although the value of energy, are nutritionally worthless! . Just like beet sugar, alcohol, vinegar, egg white protein, protein, peeled, seeds of cereals, gelatin, potato starch, and many other products. It is easy to know them, because they do not spoil at room temperature.

  30. BROMAT. CHEM. TOKSYKOL. – XLIII, 2010, 3, p. 276 – 280

    Isabella Boles?awska, Julius Przys?awski, Adam Szczepanik, Marek Chuchracki, Jasmine ?wirska



    BROMAT. CHEM. TOKSYKOL. – XLII, 2009, 3, p. 615 – 619

    Isabella Boles?awska, Julius Przys?awski, Marian Grzymis?awski


    FOOD. Science. Technology. Quality, 2009, 4 (65), 303 – 311


    Nutrient content of daily food rations of women and men diet TRADITIONAL AND “OPTIMAL” – COMPARATIVE ANALYSIS


    Probl Hig Epidemiol 1992 Profile (1):63-66
    Boles?awska I et al 2011, lipid levels
    Lipid profile, aldehyde dimalonowego and acute phase proteins in patients using the ‘optimal’ model of nutrition.

    Isabella Boles?awska 1 /, Julius Przys?awski 1 / Marek Chuchracki 2 /, Adam Szczepanik


  31. I’ve been selfexperimenting a lot with carbs to control my acid reflux. On VLC first improvement in my overall health was a cure for my horrible acid reflux. Then I started adding some carbs back and the symptons came back eventhough I took betaine HCL with every meal.

    Then I discovered SCD and thought that maybe it was just the complex carbs causing the problem. So I ate carbs but only from fruits. My health was soon worse than in long time with horrible acid reflux.

    Next I decided to try PHD approach and get carbs only from starches. I ate like 100-150g carbs a day from safe starches including potatoes, sweet potatoes, white rice and rice syrup. This time i had no signs of acid reflux and due the higher carb intake I felt overall better than on VLC.

    So the sugars gave me symptons but not starches. I’ve also realized that some dairy products seems to make acid reflux worse. More specifically it’s non or not enough fermented dairy like milk and commercial yoghurt. Butter, some cheeses and kefir does not cause acid reflux. Could the explanation be lactose which is also a sugar and is broken down in fermented dairy?

    Last thing that seems to give me acid reflux is coconut flour. I have no idea how this is related to it but could it be the fiber? Coconut oil and milk does not give me any symptons.

    I would just like to know the mechanism behind the sugars (and maybe high fiber) causing the problems. I’ve read Cris Kresser’s acid reflux series and at least for me there was more than just betaine HCL and low carb to it. Maybe you could write an article about acid reflux? Thanks!

  32. You say that Dr. Kwasniewski’s diet provides too little selenium and iodine. Everyone has a reason and how to understand what you read in books by Dr. Kwasniewski as it is used. The responsibility and independent thinking nobody nobody exempt.
    100g http://nutritiondata.self.com/facts/sausages-and-luncheon-meats/1357/2
    Selenium 58.0mcg 83%

    Choline 682mg
    Selenium 56.0 mcg 80%

    Pork, fresh, variety meats and by-products, liver, raw
    Selenium 52.7 mcg 75%
    Them to different things:
    Brawn, pate, bacon, cold feet, saps protein, blood sausage, egg yolk (preferably daily, in the form of desserts, fried, boiled ect), Swiss Cheese Emmental original, Lust yellow cheeses, cheese white fat, liver, kidneys, neck, shoulder, ribs

    Italians eat enough carbohydrates, vegetables, fruits, and have problems with gastrointestinal cancer

    You may try to contact to obtain scientific information:
    “Patients who are in for a treat Arkadiach are asked to send its observations on the health and well-being before and after their stay. Especially committed to the patients staying on treatment for a refund OSBO, with funds from the 1 percent tax. The database will be owned and for the exclusive use of the Health Committee. It will serve as evidence of optimal nutrition and may be shared with the consent in writing to the Commission, expressed the signatures of three members, only to persons or institutions who will wish to use it strictly for the purposes of scientific research (dissertations, theses, scientific articles) .

    SKYPE: optymalni_jaworzno
    E-mail Office OSBO: biuro@optymalni.org.pl

    Dr. Kwasniewski and his son

    It reminds you Sippy’ego diet for peptic ulcer disease?

    need to eat these “blind” cheese if you have a gut sensations. These are the bacteria that do not result in the gut rot, stink, production of industrial gases and combat missions. Symbiotically tolerate lactose intolerance, allow even the pastoral nourishment eaten, those who eat it should not
    Thanks to them, among other things did not smell like food for the predator, which was crucial at the “exit” from the forest to savannah!

    most of the vegetables makes me separation of hydrogen sulfide in the gastrointestinal tract …

    In this case, should get vaccinated orally suitable culture of bacteria – usually cow’s bacteria, even better goat!. Streptococcus, Lactobacillus, or otherwise eliminates the excessive proliferation of septic bacterial flora in the gastrointestinal tract, occurring eg after oral “cure” of antibiotics.
    How to do it. Eat cheese, but not casein, propionic fermentation, occurring mainly in Poland, a long-ripened cheeses Alpine – are suitable for this purpose the best!. Such a “vaccination” as necessary to carry out preventive action – at least once in m-cu.
    “Scripture,” he says – “pastoral sRAW you eat, you stink flies would not let go” – well, maybe a little shook?

    that the “vaccine” was the most effective, of course, the cheese should be eaten “raw”!, preferably chilled to a temperature of 5-8 C.

  33. And last
    Here are 10 practical “rules” for start-optimal diet.

    5. Try to eat carbohydrates in the form of starch, ie, the potatoes and vegetables.

    Some people are convinced about the dangers of carbohydrates that they will not eat them at all. It is a mistake. 50 grams of carbs a day you eat. If your body does not get them, must be prepared by himself, mostly from the protein. Thus forcing him to unnecessary, additional work.

    You have to remember that fruits and vegetables contain very little carbohydrates. Table 10 indicates how much you eat a certain weight to bring them together with the body of 50 grams of carbohydrates. These are huge amounts of time ranging in weight.

    If the optimal diet is not recommended for eating large quantities of such products, such as tomatoes, cucumbers, lemon and spinach, it’s not because they make a lot of carbohydrates into the body, but because they include mainly water and fiber. Water is a thousand times cheaper and healthier in its pure form, a person can not digest fiber. Consume it only ruminants, but they are specially designed stomach, which makes this possible. So why burden the indigestible component of the digestive tract?

    Knowing this, you should not buy expensive fruits and nowalijek, because it is simply a waste of money, for which better buy securities.

    The optimal diet allows some amount of simple sugars, such as ice cream and creams, but only its own production, based on egg yolk and cream, because the fat consumed along with them much relieve the absorption of these sugars into the blood. But you always need to keep the right balance in relation to protein and fat .(…)

    Ten Commandments for Optimum Nutrition commencing

    1. Eat much as you want, no more.
    2. Try to eat protein-containing products of the highest biological value, which is most similar to the composition and needs of your body.
    3. Maintain a balance between the main nutrients: protein, fat and carbohydrates – 1:3-5:1 (if ingested proteins are of the highest quality) and 1:3-5:0,5 (where proteins are less valuable.)
    7. Life without motion is not life. You have to move. Greater effort after 1 hour, 3-4 times a week bet is to run or ride a bike (…)

  34. Hi NOOB,

    Thanks for all you’ve written, but I’m afraid you’ve overwhelmed me. It’s going to take me some time to sift through what you’ve written and all the links.

    Hi jnv,

    I am planning an acid reflux blog post or series, but not sure when.

    Mechanisms are hard because there’s such a diversity of possible causes of acid reflux — in my view, anything that severely irritates/inflames the small intestine can do it. Common causes are infections and food allergies.

    In your case, it appears that whatever is causing it likes fructose but not glucose. That suggests a bacterial infection in the small intestine.

    You might try rice syrup or dextrose (fructose-free sugars) as a test. This would help clarify whether it is the fructose or the simple sugars that matter. The simple sugar – starch distinction suggests a positional issue — starches are digested farther down the intestine. Fructose would suggest an infection with a bacterium that, either by biology or location, is particularly favored by fructose.

    Not sure what the issue is with coconut flour.

    You did a great job figuring out your triggers! Congrats on finding a diet that works for you.

    Best, Paul

  35. I was propably a little unclear but I’ve already tested rice syrup with every meal in my desserts. And it doesn’t seem to cause any problems.

    But this confuses me because I hadn’t realized rice syrup was actually a sugar aswell, I had somehow assumed it was a starch. So it wasn’t all sugars causing the problem but most likely fructose as you said.

    But there’s no frcutose in non fermented dairy and coconut flour, wondering what’s the problem with these. Maybe I have several separate mechanisms causing acid reflux?

    Anyway thank you and looking forward to your post!

  36. After reading the Perfect Health Diet I’m convinced that I should be trying to get at least 200 carb calories / day.

    However, I have some health issues that make it difficult to find an appropriate source of carbs. Rice and excessive fructose seem to trigger my acne, while I’ve found that many starchy vegetables seem to trigger irritable bowl symptoms (possibly via pathogens fed by undigested disaccharides in the colon, as outlined by the Specific Carbohydrate Diet?).

    Is it possible to meet carbohydrate needs via SCD-safe vegetables such as winter squash or beets?

    Also, does anyone have any insight as to why cassava seems to trigger my IBS symptoms less than sweet potato, or why rice doesn’t trigger IBS but does trigger acne?

    Many thanks!


  37. Hi Charlie,

    Yes, you can do the squash, beets, and other SCD-recommended vegetables.

    It may take some experimentation to find foods you best tolerate.

    However, be sure to keep trying to re-shape your gut flora toward a better mix with probiotics, fermented foods, and anti-fungal and anti-biofilm foods. I’ll be doing a blog series on anti-fungal foods before the end of this month, and the “Bowel Disease” series (starts here: http://perfecthealthdiet.com/?p=215 ) may give you some ideas.

    It’s really bewildering sometimes why some foods give a person problems and others don’t, and the mix of problem foods is different for everyone. Someday science will figure it out, but for now it’s guesswork.

    One possibility to consider: don’t exclude oral pathogens. Rice digestion starts in the mouth, with salivary enzymes, and it’s possible sugars in the oral cavity trigger acne. I’ve found that alternative toothpastes — I’ve been using turmeric and vinegar lately — can sometimes help change the mouth flora and affect facial skin conditions.

    Best, Paul

  38. Paul, can you elaborate on turmeric and vinegar for teeth cleaning?

  39. I’ll discuss that in a blog post later, but basically, you can use all kinds of things to clean your teeth. What you use should modulate your oral flora in a favorable way, suppressing microbes that cause decay and promoting probiotic microbes.

    I am gradually migrating to the view that a lot of traditional herbs and foodstuffs are actually pretty good at suppressing pathogens and promoting probiotic species. So it occurred to me that they should make good toothpastes.

    In my case, I am concerned with Candida and Candida likes alkaline environments and dislikes acids. So vinegar is helpful, baking soda would be bad. Turmeric has an anti-Candidal activity and is a powder. Together they make a usable paste. I’ve been trying this for 3 weeks or so and my mouth feels great – very clean all day.

    It seems to have an anti-rosacea effect too.

    A downside is that the turmeric can mark clothing and towels in yellow.

    I’m not saying this particular combination is uniquely beneficial, I’m sure there are many other combinations that would work. Adding in essential oils or olive oil, maybe some other herbs, might help too.

    I think conventional toothpastes may have a too simplistic anti-bacterial design that kills probiotic flora and allows fungal growth. Oral Candida causes tooth decay, so typical toothpastes and mouthwashes might backfire.

    But this is just my idea.

  40. Have you considered
    The Effect of Xylitol on the Composition of the Oral Flora?

    Zellies also has some research on effects of Xylitol on bacterial flora

    It’s also worth mentioning the beneficial effects of drinking Green Tea on dental health. I don’t think your excellent blog on Green Tea mentioned this potential benefit.

  41. Hi Ted,

    I’ve seen studies on the antimicrobial and antifungal properties of Xylitol, and have bought it and use it as a sweetener from time to time. But it didn’t occur to me to try it as a toothpaste.

    I’m glad you liked our green tea post. Green tea has so many benefits, we confined ourselves to praising its taste!

    Best, Paul

  42. Thanks for the info Paul!

  43. hey Paul!

    found your website several days ago and it gives me some hope again! i’ve been battling chronic, annoying health issues for the last 6 years and would love to get your opinion.

    i was born premature and suffered major allergies and sinus infections growing up, which i took a lot of antibiotics for. i have always been lean and its very difficult to gain weight (obvious gut issues imho). went to college and increased my intake of processed food and booze significantly! nice… haha

    developed pigmented purpura (shamberg’s)on my feet and lower extremeties at end of freshman year. it’s slowly gotten worse and its six years later. on top of that, i have dry facial and scalp skin and am now battling rosacea like symptoms on my face, especially my chin, which i’ve never had before. it’s pretty gross and in constant red/flakey mode.

    this past year i read and followed the paleo diet, which i thought would cure a lot of my symptoms. but then i took an extensive food sensitivity test and found out i am highly sensitive to eggs, dairy, barley, malt, and some others. i have a severe fungal infection (no shock there given my history) and low vit D levels, among a few other things.

    i thought eliminating carbs would help my condition, but it seems to have made it worse. the harder i tried to erradicate it with garlic, ACV, going carb free, fermented foods, probiotics, eating dirty organic veggies, etc. the worse it seemed to get. i saw your comment on hunter-gatherer about his dandruff which caught me by surprise! advocating starches to alleviate what i thought was a fungal problem? what heresy!!! anyways, i would appreciate your opinion immensely if you could suggest a plan for me (yes i know it’s only your opinion and you can’t give medical advice etc etc.)

    how can i simultaneously heal my gut and heal my face? and what is your opinion on the connection to my leaky capillaries in my legs?

    what foods carb/veggie foods should i be focusing on?

    thanks again for any help you can offer. i respect your time and will purchase your book as a token of my gratitude.

  44. Hi Tyler,

    I’ve had a lot of your symptoms. I was premature, had chronic ear and sinus infections which I now think were fungal, but they were treated with antibiotics, tympanotomy and adenoidectomy. I developed rosacea after a course of antibiotics which got worse when I first started Paleo. I had allergies and food sensitivities for several years.

    If you have fungal infections you can’t eliminate carbs. Fungi love ketosis, and anti-fungal immunity consumes a lot of glucose. You need at least 400 calories a day of carbs, 600 would work even better.

    You also need a lot of potassium. Try bananas, tomatoes, potatoes, several pounds a day.

    You also need anti-angiogenic foods for both the purpura and rosacea. Tomatoes are good, so is garlic. Mince the garlic finely and put it in a mug with hot water, drink it like a tea all day, then discard the garlic. The water-soluble parts of the garlic are the good parts, the other parts can irritate and inflame your gut. Turmeric is good.

    Do a search on anti-angiogenic foods for more ideas. 2 weeks ago I presented a video by William Li in the first DHA-angiogenesis post. That lists a bunch of anti-angiogenic foods. Also you have to reduce oxidative stress. See the DHA-angiogenesis series for why. That requires antioxidant minerals and vitamin C. Don’t go overboard on fish oil.

    Salads with an olive oil + vinegar + herb dressing is good for fungal infections. Oregano and thyme are good antifungal herbs.

    I’m going to do a blog series on this when I get time – there are a few angles to research and I have other work I have to finish first.

    Best, Paul

  45. paul!

    dude.. you are the MAN for responding back so quickly. i can’t tell you how much i appreciate that.

    i’ve increased my intake of bananas, potatoes, and rice over the past week. it seems to have helped with the redness on my face. unfortunately, the dryness behind my eyebrows, chin, and side of my right face is still there. it comes and goes, being the worst in the morning and night.

    ive had the flakey skin behind my eyebrows and scalp since 2007, while the rest of the face started in the past 6 months. there was a 8 month period in 2009 when all my symptoms were non-existent. i was eating a LOT of carbs, but seems to have correlated when i started taking turmeric pills and fish oil (in liquid form). what’s up with that? and why are you saying to take it easy on the fish pills now? which i agree with, cause they are not effective anymore. should i decrease my intake of fish as well?

    can you explain the fungal/carb connection? i was under the assumption that carbs and sugar feed the fungus/yeast. and are you saying that to stay fungal free (anti-fungal immunity) requires glucose?

    im having trouble finding the video link you mentioned.

    Paul- thanks again for your time and help!


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