My thoughts on Low Carb and Paleo Episode 3: A New Hope

Yes, I know A New Hope was episode 4, but I could not think of a catchy but Germaine line that sounds like “Revenge of The Sith”, and this thing was only supposed to be two parts as it is! Call it artistic license I guess.

If you missed part 1 and part 2 make sure to check those out.

I want to look at some of the specific claims, misconceptions, and actual benefits surrounding low carb. I think I’ve said this a few times now, but I’ll make the point again: I see many important uses for LC/ketogenic diets. I had more than a few comment that Keto was the “only” way they could control their autoimmune condition. Bully for them, and this is precisely why we need to not only research LC, but be willing to pull it out of the tool box and give it a whirl. While we are doing that though, let’s remember we have other tools, and situations in which LC simply is not going to be appropriate. No need to get poopy pants over all that, better to just learn and grow.

Is ketosis the “natural” state for humans?

I must throw myself under the bus on this one. I do not think it’d be tough to do some google searching and find some circa 2003-2004 era comments on my part stating ketosis was THE natural metabolic state for humans.  I based this off the observation that ketosis was effective for a host of ills and might hold some promise for an extended lifespan (I’ll get to that mistake in a bit).  Something I had not considered in all this was that the efficacy of ketosis had nothing to do with it being the natural metabolic state for humans, and everything to do with limiting the ingestion of too many calories and reducing pro-inflammatory gut irritants. When I started looking at the animal models of ketosis, it was interesting that we were not seeing therapeutic benefit of ketosis Vs. the animals natural diet, but rather a protective effect of not feeding critters diets that were KNOWN to cause metabolic problems. I talked at length about that in my post “Of Mice and Morons.”  Said another way: We do not see metabolic problems in free-living animals such as mice, nor do we see these issues in contemporarily studied hunter gatherers. And, with the exception of the Inuit, none of these humans or critters are consistently in ketosis.

That LC can be used as a powerful therapeutic tool is without a doubt, but it has tricked more than just me into mistaking the effect of a therapeutic intervention for a cause. For more than 100 years medical practitioners recommended a LC approach for weight loss, but for the reasons related to specific individual insulin resistance AND satiety. Some folks do well on higher carb, some better on lower. We can do theory and internet flame wars all day and never get to a point that helps people. Or, we can take general guidelines, encourage folks to tinker, and actually see some results for our efforts.

One of the best explanations I have seen to date on both the important role of dietary carbohydrate in human health, and a credible mechanistic explanation of the pathogenesis of insulin resistance, is encapsulated in Chris Masterjohn’s talk at AHS 2012. I have seen similar proposed mechanisms of insulin resistance and fat gain being an adaptation to reduce oxidative stress since perhaps 2008, but Chris nails this.

Please watch the entire video and ponder upon it’s implications a bit, especially if you are leaning towards the Insulin hypothesis crowd.

Chris Masterjohn — Oxidative Stress & Carbohydrate Intolerance: An Ancestral Perspective from Ancestral Health Society on Vimeo.

We have a mechanism whereby excess calories can be either pushed through the mitochondria, causing severe oxidative stress, or we have fat gain and insulin resistance occurring in an effort to “lock up” excess calories and glucose, which can both pose significant metabolic problems. Let me say this again, as it’s important that folks get this: Insulin resistance is likely an effort to prevent cellular death due to free-radical production. This is facilitated by pushing substrates (primarily fat and carbs) into adipose tissue, which is RELATIVELY inert (aside from the hormonal messengers that adipose tissue produces). We also see elevated lipoproteins, triglycerides, and blood glucose as the body is trying to put nutrients ANYWHERE other than through the mitochondria. I’m working on a future post that will look at instances of insulin resistance not related to a caloric excess. What we see is another example of the body responding to stress. Stay tuned for that.

We can actually see a nice pharmaceutically induced version of this mitochondrial substrate overload from the drug 2.4-dinitrophenol (DNP). DNP causes uncoupling proteins to essentially “leak” electrons/protons out of the electron transport system. The effect is a lot of heat, and a lot of waste. The electron transport chain is designed to create a potential energy cascade to be utilized to build molecules like ATP and it’s intermediaries. If we are cold, we see these uncoupling proteins become more active in an attempt to boost our temperature. If we are eating an antioxidant rich paleo diet, not too much to worry about in all this. If we are nutrient deficient, this can be problematic due to the reactive oxygen species (ROS) which damage everything from proteins to organelles to DNA. This is what we see in the case of DNP, as many people have died from using the drug due to multiple organ failures as a result of ROS  overwhelming the bodies ability to buffer this oxidative activity. An individual who overeats tends to be ‘warm.” This is a mild level of uncoupling protein activity attempting to “burn off” the excess cals. The body knows that too much of this will kill it immediately, so substrates are pushed into adipose tissue where it will kill one a bit more slowly.

That was a bit of an important side-road, let’s get back to Chris’ talk: This adaptation to excess calories fits the data much better than the insulin hypothesis, but again, does not diminish the therapeutic benefit of LC for specific populations. In his talk, Chris also discusses the gene frequency of amylase in both humans and primates. Even the least “carb adapted” humans have several more copies of the amylase gene than do chimpanzees, which implies a significant selection pressure to both maintain and propagate this selective advantage. Amylase is the enzyme used to digest STARCH.

If you follow the work of Richard Wrangham, you will understand that cooking is an important feature in all this, as amylase activity is best on starch which has been gelatinized via cooking. You can wrap the Expensive Tissue hypothesis right into this…humans started cooking both meat and starch, gut got smaller, brains got bigger. We appear to have strongly selected for the genes to assist in starch digestion. This wraps back around to the question of whether or not ketosis is the default metabolic state for humans. It seems a stretch when you consider the significant genetic and digestive machinery that has been allocated to dealing with starch. What I found particularly interesting in the talk is that we do not only see improved starch digestion with increasing numbers of these genes, but a lock-step improvement in insulin signaling  Those people with the best ability to digest starch also have the best ability to handle the associated glycemic load.

One final point in this line: ketosis is the metabolic state of starvation OR significant carbohydrate restriction+ moderate to low protein intake. There are many good primers on the specifics of ketosis, including specific substrates produced, as well as the protein sparing effects of ketosis during starvation. I’m not going to reinvent the wheel on that, so if you want some specifics on ketosis, exercise your Google-Fu.  What is intriguing to me is that if one consumes just a few too many carbs, or protein, one is bounced OUT of ketosis. I could easily imagine a system in which excess carbs or  protein would be shuttled to storage activities, leaving ketosis humming along…as the “natural metabolic state.” Interestingly however, we see the exact opposite, the body seems to leap out of ketosis at any opportunity. I’d wager the default metabolic state is actually one of “metabolic plasticity.” We see pathology when folks can metabolize limited amounts of any of the macronutrients, with associated pathology and decreased health and longevity. Diabetes is a prime example in which folks lose the ability to properly handle carbs. One of my all time favorite papers, Secrets of the Lac-Operon  describes exactly this. Aging cells are those which lose the ability to use fat as a fuel source due to mitochondrial damage. INTERESTINGLY however, transient carb exposure (cyclic low carb?) seems to offer both the metabolic flexibility of maintaining mitochondrial fat utilization, but also the hormetic stress response associated with transient elevated glucose levels. What this means in practical terms is cells show a more youthful profile while we also have systemic mechanisms which help to reduce the advanced glycation end products (AGE’s) which are inevitable with circulating blood glucose. If you are a fan of Art Devany, fractals, and punctuated equilibrium, this is in that wheelhouse.

Sorry about the diversion into uncoupling proteins, it just seemed to “fit” there. Hopefully this gave you some gristle to chew on regarding the claim that ketosis is the “natural” state for humans. The “natural” state for healthy humans is clearly not a static location but is typified by metabolic plasticity. We see pathology at those margins where ANY substrate starts creating problems. We see this in a host of genetic diseases, like various fatty acid metabolism diseases in which certain chain length fats cannot be metabolized (and can build up and kill the person). We see this with amino acid metabolism issues in the form of phenylketonuria  (PKU) (the amino acid phenylalanine is not well metabolized, and can again, build up in the system and cause problems). We also see this in garden variety diabetes in which blood glucose is not easily disposed, and can subsequently wreak havoc via advanced glycation end-products. This fuel-storage/excess model is compelling to me due to the mechanistic robustness…it’s just kind of bad ass, but it also offers up an evolutionary survival story in that this process has been conserved due to it’s survival potential. Something I’m going to do is look at the proposed evolutionary advantage of various metabolic diseases such as PKU. It might be interesting to know WHY these diseases have stuck with the population.

What about longevity?

I was likely one of the most vocal advocates of LC for anti-aging purposes, and I do think the concept has merit…but within constraints. I know intermittent fasting is quite popular these days. I do not toot my own horn too often, but I’ll take credit for a big chunk of that, as I wrote about it back in 2005, and had been talking about it on the CrossFit message board as early as 2003. Studies, looking at mice to fruit flies to macaques, seemed to indicate ketosis, as associated with calorie restriction or intermittent fasting, could dramatically extend life. The data on the short-lived critters was crystal clear: one could expect an almost doubling of average lifespan from intermittent fasting or CRAN (calorie restriction adequate nutrition). Early work in primates looked promising. I thought we had a method that might dramatically improve health and lifespan. Well, unfortunately, humans are not fruit fly’s, nor rodents. In humans the genetic reaction norms are such that we do not allocate significant amounts of energy rearing our young RELATIVE to many other species.

This is a long but outstanding piece on genetic reaction norms. If you want to comment on the POTENTIAL of CRAN/IF/ketosis to extend human life, you need to be articulate in this material. I’m always game to entertain questions. I know I’m going to get some peanut gallery commentary on this, even if it is simply directed to other folks sites or inboxes. Instead of running around asking folks what their “opinion” is on this stuff, dig in and get comfortable with the material, and you will have a better chance of understanding it for yourself.

Evolutionary pressures dictate how a species may deal with scarcity. In certain cases, like mice or laying eggs for fruit flies, the energy input for offspring is significant enough that if calories are too limited, the organism will go into a state of dramatically slowed aging in the hopes of making it through the lean times, and then making babies like crazy. Humans, do not operate this way. We do experience decreased fertility when under caloric stress, but we do not see the longevity effects. One could live barely above starvation level, and the max increase in lifespan is estimated to be about 6-7 years, not several decades. Here are two papers from longevity expert Michael Rose, talking about all of this.

Paper 1 “Why Dietary restriction substantially increases longevity in animal models but won’t in humans”


Paper 2 “Caloric restriction does not enhance longevity in all species and is unlikely to do so in humans”


I mention this as some folks in the LC camp point to ketosis as mimicking the effects of CRAN or IF. That is completely true AND almost pointless as an argument for improving longevity when we consider genetic reaction norms and the work of Michael Rose. We are mimicking a metabolic state which is now understood to be ineffective at increasing longevity in humans to any significant degree. Six years appears to be the estimated increased lifespan of severe calorie restriction and/or intermittent fasting (eating one week, not eating the next).  Prof. Thomas Seyfried has done work indicating if we want to see a solid therapeutic benefit from ketosis/CRAN/IF, we need to do them in a very severe manner. Likely worth it to battle cancer, not sure that it is worth it to gain an extra 6 years of life, especially when one considers how dramatically a calorie restricted ketogenic protocol, or eat one week, skip the next week, would impact our quality of life. This all seems really dubious when we overlay the fact exercise seems to increase lifespan by about three years. We get 50% of the benefit of the most severe CRAN/ketogenic protocol, yet can be jacked, and have a life.

When I first started reading the literature on IF, I had an idea that perhaps an alternate day fasting protocol could give one a nice boost in longevity, while maintaining good performance and quality of life. This was back in 2002 when the only data we had was in small animals. As data has come in regarding larger primates, the benefit of these protocols is simply not there. The genetic reaction norms of mice and men are too different to see these same benefits in any type of a livable protocol.

So, Low Carb is bad, right?

As sure as the night follows day, some folks will read this and the take-away will be that LC is bad. DESPITE my description of LC as a valuable therapeutic tool for a variety of conditions. Folks just want a black/white world. If your takeaway from this post is that I think LC is bad I will pray that you are circumcised by 1,000 desert fleas.  (I wrote this piece BEFORE all the gnashing of teeth that led to my Part 2 scree. Prescient, I’d say!)

So, what Are some situations in which LC is valuable?

1-Insulin resistance/diabetes both type 1 and 2.

Lowering glycemic load can be incredibly powerful in reducing inflammation and metabolic derangement. One could likely get as much benefit from a moderate LC approach (75-100g/day) as a strict ketogenic approach. The study by Staffan Lindeberg looking at a paleo diet in Type 2 diabetic heart patients had carb levels even higher, and folks saw remarkable improvement in insulin sensitivity. In addition to our knowledge that overeating is likely the impetus for insulin resistance, Mat Lalonde has made the point that nutrient deficiencies are also a big factor in all this. If we have inadequate substrates for antioxidant production, ROS species increase inflammation, which itself deranges metabolism and insulin sensitivity, regardless of calorie intake.

2-Neurodegenerative diseases. Parkinson’s, Alzheimer’s and other conditions seem to really respond to a very LC/ketogenic approach. It looks like we might actually get some studies in this area, which is good considering the growth of these conditions. Ketosis seems to stabilize calcium homeostasis in the brain (important for mitigating oxidative stress), and provide an alternate fuel source for glycation damaged neurons. We have seen some reports of simply adding a ketogenic dose of MCT oil in the form of coconut products, without carb restriction, actually improving some of these conditions.  We have great data indicating a ketone-ringers solution  could greatly benefit traumatic brain injuries (TBI), likely for the reasons mentioned above: stabilizing calcium homeostasis and providing an alternative fuel to glucose.

3-Certain cancers.

Breast, colon, prostate, and certain brain tumors appear to respond very favorably to a ketogenic diet due to limiting glucose for these tissues. Unfortunately not all cancers respond favorably to ketosis, some in fact become more aggressive as the cancer is “stressed” and appears to start shuffling it’s genetics to become more adaptable. Again, an important area of research that hopefully gets more attention. AND I’ll make the point that if we want research in these areas (certainly makes sense), LC proponents might consider not acting like religious zealots, conducting personal attacks, etc.

4-Hormetic stress

I do not think that prolonged ketosis/CRAN/IF is going to dramatically extend human life. I DO think that dropping into ketosis (via a cyclic low carb diet) or occasional 16-18 hour fasting is a great way to maintain metabolic flexibility and perhaps forestall some cellular aging. My problem in saying this however, is the people who should do it (reasonably sedentary desk-jockeys with low stress) will not be the folks doing this. It will be the 2 a day Crossfit games people, or SEALS who are so type-A they cannot see the forest for the trees. If you have a high demand training schedule, you are getting all the hormetic stress you need via exercise. You are likely training at a level that is already beyond the genetic norms for health and longevity. LC, fasting, etc is NOT a smart addition to your game plan unless tanked adrenals are a personal goal.

What are Some wanker moves with regards to LC?

1- CrossFit or very hard training while LC or ketogenic. Crossfit burns through glycogen like nothing else I can imagine. If you are going to do it, you need carbs, quite a few of them. If you are trying to be competitive I’d get at least 1.5-2.5g/lb of BW most days. Obviously with the normal caveats of trying to get those carbs mainly in the PWO when/if possible. I know most folks know Peter Attia, and have likely followed his ketogenic training program. Peter is a good friend and about 15x smarter than I am. He is tinkering and experimenting, but even he has noticed he must supplement with carbs or he has no “low gear “ (glycolysis). Tinker if you want to, but my gut sense is that we will not find a magical fuel source in LC unless your activity is ultra running, or similar very long but low intensity activities. If you do MMA, CrossFit, etc, I do not think LC will work. If you are a strength athlete, I think CLC is the bee’s knees. If I was not doing BJJ and just lifting and doing gymnastics, I’d be all over this.  (I wrote all this prior to part 2. It’s a bit redundant at this point, but hey, electrons are cheap.)

2-Not realizing LC is a tool. This should have actually been #1. Please, don’t shit the bed on this.

What about ME!? What about MY needs? Or the Unique Snowflake Section

A couple months back we did a series of flow charts to help folks navigate specific issues like fat loss, muscle gain and optimizing athletic performance. You can grab those here, you just need to sign up for the newsletter. Those flow-charts actually are short hand for this entire series in that they will help you dial in your macros for your given goals. In reading the comment of Pat (from part 1) however, I see folks making some consistent mistakes with regards to FAT loss. They are focusing on the scale and not on measurements and performance goals. I talk about that here  and here. Read, ponder! The Truth is Out There.

Even though I cover damn near every contingency in the flow charts and two posts I linked to, I’ll cover some specific macro considerations here:

1-Regardless of your goal, shooting for ~1g of protein per Lb of bodyweight is a solid place to be. If your goal is fat loss you will find this very satiating and anabolic enough to prevent most muscle loss under calorie restriction, especially if you are doing resistance training (you better be!)

2-Carbs: if you are insulin resistant (TG/HDL >1.0), doughy through the mid-section, under severe sleep debt, you should keep a handle on your carbs IMO. 50-110g per day should be plenty, try to get this from low-ish glycemic load sources such as onions and carrots (just suggestions, use whatever you like).

If you are training hard and insulin sensitive (not carrying fat at the midsection, no wacky blood work with skewed triglyceride/HDL ratio, you should be doing anywhere from 1-3g of carbs/lb of BW. Obviously the 3g is for folks who are training at a very high level, we want this to be “paleo” carbs more often than not. White rice is likely fine but it sucks compared to sweet potatoes. Just saying. I’m doing grappling 3-4 days per week, 2-3 days per week of lifting and I’m likely getting 250-300g of carbs per day and I weigh about 175lbs. Some days less, occasionally perhaps even more. I tend to only have  a bit of carbs with breakfast, then I hammer down at my post jits meal, same at dinner time. If I travel, get sick, or miss training, I just dial the carbs down a bit.

3-Fat: I mainly use it for flavor at this point. Most sweet potatoes get a healthy slab of grass fed butter, and I use grass fed cream in my coffee. Given my very glycolyticly demanding sport however, I consume less of my cals as fat than when I was just lifting and doing gymnastics. This is where the tinkering comes in…If you are not recovering you likely need more carbs (and to look at periodization, intensity, and sleep!); if you are porking out, perhaps you need to dial all the cals back, while trying to maintain protein levels.

What about Calories?

Jamie Scott (That Paleo Guy) did a great 2 part series:  Calorie Rants and Ketosis Part 1  and Part 2.  Give those a read, they are very good.  Jamie takes me to task on an important point. In Part 1 of this series, I made a statement to the effect “Calories matter.” Jamie is/was concerned that the focus on good old calories would push some people into calorie COUNTING instead of focusing on whole, unprocessed foods. They will avoid meat and nuts entirely for fear of the calorie costs of these food, missing entirely the satiating properties, to say nothing of the superior nutrient densities. I wish I could just sweep this under the rug and say “Ah, that won’t happen, people are generally smart…” but I’d be fooling myself, and ignoring the obvious lack of reading comprehension in part 1. Some people WILL read what I said and take that in the entirely wrong direction. I try to mitigate this by relying on VERY general guidelines (you see this in my book, the Quick Start guide, and the recommendations I’ve made above). As a coach I like basic food logs, especially if they are nothing more than a photo of each meal. With a quick look at a meal photo I can tell a person to “dial back” or “add some more” and we can get remarkably good results form this. No magic 40/30/30 numerology or food scales necessary. Which is why a comment in Part 1 of my piece AND in Jamies part 1 is troubling for me:

 “I agree, there must be a limit somewhere. I think the only way to really answer it is by experiment.

The other thing that seems to be conflated in this discussion (not you, just in general) is whether that limit would ever be reached by a person eating ad libitum, but under the constraint that they have to stay ketogenic (not just what they think is ketogenic, but what is measureably so). It is one thing to say you can eat endless amounts of fat, and quite another to say that there is no amount of fat that you will want to eat that would make you fat. It’s possible that the latter is true even if the former is not.”

What I take from this is “If one TRULY stays in ketosis, is it IMPOSSIBLE to over eat?” My gut instinct is to say “No, I can find you people who can over eat, even in “nutritional ketosis.” But this is an opinion, I have no RCT to back this up. What I find intriguing from the simple interface of coaching/helping people is: How is this ANY easier/better than the basic eyeball method I have outlined in, again, my book, quick start guides etc. How much DETAIL will be necessary to guarantee we remain in nutritional ketosis? I hear the food scale getting pulled out, right along with the measuring cups. This seems neither easier nor better, and as I’ve said elsewhere, food neurosis REALLY kicks in when folks start scrutinizing their food as is typical in the CrossFit world of the Zone, or in what would be necessary to fit the standards here of ensuring nutritional ketosis. This feels vaguely of trying to make some kind of religious ritual produce a measurably beneficial effect in the real world…perhaps I’m missing something, but this line of inquiry seems to be valiantly trying to find a way to make ketosis magic.

I hope this helps clear up some of the drama around LC and Paleo. I see the evolutionary template as a means of making informed decisions about how we eat and live to optimize performance, health, and longevity. I see LC as a tool to be used for specific situations, and to achieve specific goals. Hopefully, a day will come when NONE of this is controversial or still adhered to with religious dogmatism. Someday ketone-ringer solution will be the go-to IV for folks with TBI. Ketogenic diets will be used in conjunction with standard chemo and radiation to not only fight cancer, but protect normal tissue from the damage these blunt force tools offer. Primary care physicians will recognize the therapeutic value of LC for insulin resistance. World champion athletes will still, for the most part, be carb fueled.

Remember, hammers are just as important and valuable as screw drivers. It just depends on what the project is and what we are trying to do.




Categories: Paleo/Low Carb


Robb Wolf’s 30 Day Paleo Transformation

Have you heard about the Paleo diet and were curious about how to get started? Or maybe you’ve been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? Then Robb Wolf’s 30 Day Paleo Transformation is for you.


  1. Frank says


    Awesome article and thank you for your tremendous work. Quick question.

    You mention that prostate cancer appears to respond favorably to a ketogenic diet. In Dr. Eugene Fine’s AHS12 presentation, he suggested that prostate cancer is not so dependent on glycolysis and is less likely to respond to a ketogenic diet.
    (See here at about 6:10 mark:

    I have an interest in this issue as my dad was diagnosed with recurrent prostate cancer last week. I’m going to advocate he cleans up his diet either way, but I’d like to have a clear eyed understanding of whether I should expect ketosis to be therapeutic in his case. I’ve already started my own research, but if you can point me to any research/resources that you may have handy, with regard to ketogenic diets and prostate cancer specifically, I’d appreciate it.

    • says

      Frank- I will check that out and for me there are a few pieces to this when considering if ketosis would be of benefit:
      1- Does the specific cancer respond favorably to ketosis? Breast, colon, prostate, astrocyte and glioblastoma brian tumors are all derived from the same embryonic tissue and seem to respond favorably to ketosis. I’d be inclined to consider ketosis so long as wee do not have something like melanoma which seems to be emboldened by ketosis.

      2-so long as we are not goign to make the situation worse with ketosis, even if the ketogenic approach is not that powerful on the cancer itself, it can be very helpful in mitigating normal tissue damage, and the likelihood of collateral cancers form the radiation and chemo. I have heard good things about the laser ablative surgery out of UCI I believe…I’d def look into that.

  2. says

    Great post. I agree that metabolic flexibility is the key, that’s what indicates a healthy metabolism.

    Folks have been studying this. I think this study puts it best:

    “Thus, metabolically healthy skeletal muscle is characterized by the ability to switch easily between glucose and fat oxidation in response to homeostatic signals.”

    “Skeletal muscle fat oxidation: timing and flexibility are everything”

    Phil Maffetone was using this concept of developing metabolic as a training methodology decades ago, to great success. He’s got a good summary of it here:

    In listening to your podcasts and reading your site, I think this is one aspect that’s been missing from your approach.

      • Joshua Naterman says

        ” The authors found that in vivo insulin sensitivity was related to a higher in vitro capacity for fat oxidation. These findings support the concept that the capacity of skeletal muscle to oxidize fat under appropriate physiological conditions is related to leanness, aerobic fitness, and insulin sensitivity.”

        A direct quote from

        This means that the more insulin-sensitive you are, the more fat you will burn. The diabetic research you quoted showed that more carbs led to better insulin sensitivity, and the vast majority of research done on physically active people, shows that as you get up to ~55% carbs as total caloric intake your insulin sensitivity increases and fasting insulin levels drop.

        This, along with all the other research out there, is in agreement that, to a fairly large degree, the more you switch from high fat to higher carb (without caloric excess) the better your insulin sensitivity becomes. This is especially true with exercise, and we all know that if you aren’t exercising you are literally living wrong (from a health perspective. Obviously this statement excludes clinical populations who cannot exercise for medical reasons).

        Holding all that to be true, which I think is impossible to refute, I would like to know why you think that low carb dieting is good for people with insulin resistance.

        from Part 1, in bold:

        “LC is fantastic for the insulin resistant individual, as it addresses both glycemic load and satiety. But if one manages to bypass normal satiety mechanisms, or if one can find some combinations of highly palatable, but low-carb foods, it’s still a ticket to Fat Camp.”

        You appear to be completely contradicting yourself, and appear to be missing the point that even in type II diabetics, who are the most insulin resistant population, this concept of “getting more carbs leads to better insulin sensitivity” holds true.

        Your recent comment in this series where you recognized that even in diabetes research, carb levels above what you are recommending show even more promising results. This is in direct contradiction to your bolded statement regarding low carb diets for insulin resistant people.

        Despite talking about multiple mechanisms for insulin resistance, this lack of a clear message seems to indicate that you are having trouble nailing down how this stuff works.

        It sounds like you’re still figuring a lot of this stuff out, and sending a lot of mixed signals in the process.

        You have a lot of sick people who depend on you for accurate information, and I would like to know what your message is. I am sure they would like to know as well.

        • says

          Felling pretty hoity, toity?

          In a sick, metabolically broken person, GLUCOSE DISPOSAL is dramatically impacted. It’de be nice to provide an intervention which does not further exacerbate AGE’s and out of control blood glucose, yes? LC will do this. As I also mentioned, some people have damaged pancreatic beta cells to a degree they will NEVER do well on a higher carb approach, this form Dr. Tom Dayspring of the National Lipid assoc, you can check out his material for that. ALSO, we have the benefit in LC of reducing the foods commonly thought to cause SIBO and the associated systemic inflammatory effects of LPS. Fix all this (iron overload must be adressed due to it;s effects on systemic inflammation…) and yes, we can and likely should ratchet up carb intake to a level which shows no untoward lipid or systemic inflammatory changes.

          Josh, you are holding insulin sensitivity up as the holy grail, and yes it is important. But insulin sensitivity will go down on a LC protocol as the body is shifting to using fat as a fuel, sparing glucose for the brain. This is NOT bad and in the context of the situations I described above, this is a very beneficial adaptation. I am working on a piece looking at that myriad of of ways insulin resistance can be caused, many of which have nothing to do with carb intake.

          Direct question for you:
          Would you recommend an insulin resistant shift worker consume a hight carb diet? Do you have data to support your position.

          My message is crystal clear on this topic, your understanding of the material is not. I’ll help you with that though.

  3. says

    I reached this same point on IF/CRAN and longevity as well. I started telling people that the real benefit was in PERCEIVED lifespan. Let’s be honest, a lifetime of cold, starving, shivering, sexless existence will FEEL like it lasts much much longer. 😉

    Kidding aside, I’m loving the new posts! Sure, I listen to your podcasts as well, but there is a different style of learning and absorption that comes from a well written post like this. Thank you so much for taking the time to create these and without undue pressure I am looking forward to more in the future

    • says

      Thanks Bill! I wish I could spin out the written word at the rate we do the podcasts. I probably have 25+ hrs of writing and researching in this series.

  4. says

    HOLY CATS, Robb.

    Awesome stuff. I’ve learned so very much from these posts. I seem to have followed your thought patterns and evolved my own beliefs over time: starting with thinking low-carb was the end-all be-all for everyone. And of course, as we learn more about epigenetics, individual metabolic needs, and the effects of exercise & other lifestyle factors, we realize that advocating LC across the board no matter what, is just as irresponsible and short-sighted as the AMA/ADA recommending low fat and lots of grains across the board for every man, woman, and child regardless.

    Couple of specific points to highlight what a freaking rock star you are and why your work continues be one of the best go-to places for no-BS information on this stuff:

    1. “Insulin resistance is likely an effort to prevent cellular death due to free-radical production…We also see elevated lipoproteins, triglycerides, and blood glucose as the body is trying to put nutrients ANYWHERE other than through the mitochondria.” YES!! I did my master’s thesis on Alzheimer’s as “Type 3 diabetes,” (and the therapeutic role of ketogenic diets) and one big theory is that the brain is so damaged from oxidative stress & glycation (after years of SAD dietary abuse) that as a *protective mechanism,* it shuts down glycolysis. It doesn’t *want* any CHO coming in, because that would only make things worse. The problems of dementia result when axons & dendrites recede (causing loss of synapses) or neurons overtly die, because of a lack of *some other substrate,* like ketones. The brain stops metabolizing glucose well, but because peripheral insulin levels are still high, ketones aren’t generated to any appreciable degree —> brain cells starve. This article is GREAT:

    2. Regarding strict keto/CRAN: “Likely worth it to battle cancer, not sure that it is worth it to gain an extra 6 years of life, especially when one considers how dramatically a calorie restricted ketogenic protocol, or eat one week, skip the next week, would impact our quality of life.” YEP! I know Mark Sisson is more of a big picture guy and doesn’t wear a white lab coat to work, but I think he’s spot on with his philosophy about doing the minimum amount of work with the minimum amount of deprivation, toil, or whatever you want to call it, in order to get the maximum benefit. And you’re right about finding a balance: who cares if you live another 7 years if the 80 years that preceded those extra few were filled with feeling hungry, being cranky, and being completely socially isolated because and not enjoying a meal with friends or tossing back a glass of wine now and then? Doesn’t seem like longevity should be an end unto itself if most of those years are full of semi-misery and living like a hermit.

    3. Ketones as therapy for Alzheimer’s, Parkinson’s, etc: “We have seen some reports of simply adding a ketogenic dose of MCT oil in the form of coconut products, without carb restriction, actually improving some of these conditions.” I’ve read some of the research, and this is true. But I also think simply giving exogenous ketones without low-carb & high-antioxidant dietary intervention is like bailing water out of a leaky boat without stopping to patch the hole — you merely manage the symptoms while the underlying cause(s) continue to wreak havoc.

    4. Ketosis & the potential for unlimited fat/calorie consumption: I dunno on this one. If people were more machine-like, either on or off, I’d say it makes sense that you literally could not gain body fat on a keto diet. The thing is, people eat for a ton of reasons that have nothing to do with satiety. (Boredom, sadness, peer-pressure, addiction.) So even if one’s actual food appetite was satisfied (i.e. they weren’t physically *hungry*), lord knows people keep on eating anyway.

    Your scientific integrity is true, Robb. Keep putting information out there, keep being honest, and you will continue to transform people and save lives. THANK YOU!

    • says

      thanks for the kind words AND the kick-ass paper! You are right, Mark’s suggestions are (IMO) right in the sweat spot of the ROI story. Do a little smart stuff, get a LOT in return.

  5. Jamie says

    Thanks for all the research.
    What are your thoughts on kid’s nutritional requirements?
    We have three boys (4,6,8 y.o.) with nearly insatiable appetites; right now they’re mostly allowed to eat as much healthy paleo foods as they want, although it seems they’re hungrier when they get more carbs (sweet potatoes, fruit, occasional rice or white potatoes). While they’re growing it seems wrong to consider their carb needs the same as a “healthy” adult. We had been teaching them, “there are no essential carbs” as your body can get the fuel it needs from fats and protein, but it seems we might need to modify that a bit.

    • says

      Yea, so long as the carbs are good quality, I’d let them at it. the caveat with that might be if theey show obvious signs of carb crash later (cranky, tired etc).

      A kids multi a few times per week seems fine.

  6. says

    Robb – good post.

    You say in your free downloadable chart that people looking to build muscle should eat a meal after training that contains 80%-90% carbs. Why? And what research are you basing this on?


  7. Renato Laranja Jr. says

    Robb, I’ve been reading a lot of material by you and guys like Nate Miyaki about determining carb requirements. The articles I read are usually categorized by activity level. Typically there’s a section for the completely sedentary, insulin resistant individual (doughy in the midsection), and another one for the ripped, insulin sensitive athlete. Well what if I really am a unique snowflake? What if I’m doughy through the midsection, but I train consistently like an athlete? Like you, I do BJJ 3-6 times a week. I do a westside-based strength and conditioning program 4 days a week. I also run several times a week. I have considerable muscle mass, but I’m still doughy in the midsection. A lot of high level athletes are in this sort of condition, take Roy Nelson of the UFC for example. He’s obviously spherical, but the man’s got cardio for days so he’s not quite out of shape performance wise. What carb requirements would you prescribe for a Roy Nelson type of athlete?

    • says

      I;d want to know WHY is the person insulin resistant? I’d want some blood work to see fasting insulin, A1C, fibrinogen…the whole ball of wax. Is the person systemically inflamed? bad sleep? Iron overload? If so, we need to fix that. If not…we may just have someone who does not know the mouth/vacum cleaner distinction.

  8. Dinis Correia says

    About time carbs get some love! 😉 I sure hope this is enough to change some minds still stuck in the “but paleo is low carb!” mindset.

    By the way, what are your thoughts on white potatoes? I reintroduced them some months ago and see no negative signs so far (no autoimmune issues here). Matt Lalonde’s talk at AHS12 about their nutritional profile kind of pushed me to eating them more regularly.

  9. Kate says

    The Low Carb Taliban will have a heart attack that we are not supposed to be in full time ketosis.

    Even the Inuit were not, given their heavy protein load from my reading. There are ZERO high fat, low carb cultures that are fit and long lived. If I were a fat armchair warrior, low carb could work. But who wants that?

    Yes, I see many gain weight on Zero Carb and VLC, thinking adding 3 T of butter to half a sweet potato and gaining weight means to blame the carbs!

    Paleo starches for the win!

  10. Vlad says


    Awesome article. What about someone who is training hard but also insulin resistant with belly fat? Training in BJJ/Crossfit? How many carbs then?

    • says

      Get healthy first, then worry about performance. Whish mean syou will get smashed for a while AND you need to figure out what is causing the insulin resistance.

  11. Ben says

    Thanks for the articles Robb. And answering so many questions, thanks for that too.

    What’s your take on the brain’s glucose needs and cyclic low carb diets? It seems to me I do fine with carb loads and then going low carb the following day while retaining mental clarity – but my experience is lacking so far. Any studies, physio/biochem knowledge, or anecdotal evidence?

    What’s the low down on protein to carb conversion? Lyle McDonald says 58% as if its some constant, unaffected by anything. I’d guess a shortage of carbs increases conversion rate and an excess of protein increases conversion rate. Am I right? To what degree, roughly, is the rate increased?

    “So, low carb is bad, right?” haha. “Only the sith deal in absolutes”. Extremely Important Disclaimer – I know Star wars 4,5,6 rock and starwars 1,2,3 are meh.

  12. Stephanie says

    “If you are a fan of Art Devany, fractals, and punctuated equilibrium, this is in that wheelhouse.”

    I’m a fan of fractals but I don’t see the connection here. Can you illuminate me on this all might nerd Robb? Of course I mean nerd in the strictly positive manner.

  13. Shantel says

    Hey Robb,
    Fantastic series!
    Loved every word.
    You mentioned a “ketones ringer solution” for traumatic brain injury and I’m wondering would that include stroke patients? My dad had a massive stroke and some major brain damage back in Nov. I about shit myself while I watched them tube feed him sugar made by Nestlé and kept thinking that craps gonna kill him. I’m no dr but am just curious if LC might do him some good right now.

    P.S. I reached out to you last June with my husband’s gallbladder issue and and I’m happy to report that against dr’s orders he still has his gallbladder and is thriving. Thanks again for your replies and general “give-a-shit-ness”!

    • says

      IMO, yes, a stroke would benefit from a ketogenic intervention. Similar mechanisms with regards to tissue damage. And the paper I told everyone to read covered the stroke issue!

      Glad to hear about your hubby. Amazing what a little dietary tweaking will do!

      • Theresa says

        hello! what paper are you referring to here? My sister also had a massive Ischemic stroke and I am trying to get her on a ketogenic diet in hopes of helping her recovery. I would love your input on this. Also, any studies, papers,or resources I can use to defend the use of the diet to my sisters benefit would be appreciated.


  14. Glen Nagy says

    Ketosis may not be the natural state for humans but do you think that humans that could benefit from ketones would have an advantage over those that couldn’t since almost all people would have produced some ketones. In temperate climate due to the lack of carbs in winter and in tropical climates due to the coconut consumed.

    Very good series. I think even Dr. Atkins would agree, isn’t the last phase of Atkins to slowly add back carbs and Increase them until you stat gaining weight. For some this may be 50g and others 200g. My understanding of Atkins is that everyone has to find the right amount of carbs for them

    • says

      Yea, that’s what’s so ironic about all the yammering around Atkins. He treid to get people to not be in a position to die, then slowly dial up carbs. INSANITY.

      I’m not sure I follow your first questions.

      • Glen Nagy says

        Ya that didn’t make alot of sense, I should have sent it in as a podcast question to see what Greg could do with it. I was talking from an evolutionary perspective most hunter gatherers would have been in at least mild ketosis fairly often due to lack of carbs in winter in temperate regions, coconut consumption in the tropics and an irregular food supply causing IF. Being able to stay out of ketosis is a fairly recent phenomenon for humans. I guess I’m asking if this would cause enough of a selective advantage for humans who could use ketones for mitochondrial repair or other advantages. Over a million years could this result in occasional mild ketosis being health promoting. Constant ketosis is not the natural state for humans but maybe occasional ketosis is???

        Hope that makes more sense. It makes sense in my head but when I put it on paper not so much!!

        • says

          I don’t know that it was even that frequent…perhaps, but again, look at the benefits of exercise. Very similar to ketosis…none of the downside unless taken to extremes. Almost certainly our HG ancestors were more insulin sensitive, but also good at storing intramuscular triglycerides. And we might expect a reward/compensation scenario for the success of staying out of ketosis. Interesting stuff for sure.

  15. SimonM says

    Fantastic again, thanks Robb.

    This “metabolic plasticity” idea is key, methinks.

    One of the few things we know for certain about ancestral eaters (with few exceptions such as the Inuit) is that they ate a humungously larger variety of foods than “we” do. Therefore we have an inbuilt ability to switch our metabolisms to deal with whatever fuel is currently available. (Pictures of aboriginal hunters raiding for honey come to mind.)

    Also, thank you for the observation about how few carbs are needed to get us out of ketosis and how QUICKLY they get us out of ketosis… a Big Clue.

  16. adam says

    fats for flavor, but what about Fats for cooking?
    is the 2 tbs of fats i use to cook meat and veggies for each meal going to add up to tooo much Fat if i am trying to maintain weight?

  17. Lea says

    This statement is merely an observation on myself doing my own personal “experiments” with carbs. My first go to carb of choice was always the wonderful, orange, moist sweet potato. I have a desk job but commit to movement through out the day and get an hour gym time with cardio and weights at least five times a week. After about six months (incorporating 3/days of HIIT) my energy bottomed out. I didn’t know what was going on. I get 8 hours of sleep a day, minimal stress, blah blah. That’s when I went for the rice. It was a totally different carb for me. While yes, nutritionally speaking, it is inferior to the sweet potato, a half cup of rice would keep my energy levels up for close to 5 days!!!! A sweet potato did not come close to that. Not by a long shot. Robb, my question to you is, could that be because the rice is not a sugar-based starch? I’m really curious as to why the sweet potato only helps for carb back loading purposes, but never really “gave” me energy for my body to use.

    • says

      SP’s DO have a fiar amount of fructose…we could make an argument for SIBO, or just not feeling really frisky with too much fructose for you. This is where all the theory goes out the window and the N=1 tinkering wins the day. Now, if we look at the fact you have acces to good quality meat and veggies…is the rice really a problem? Not likely. For folks living on the edge, facing things like Vit-A deficiency (as is common in most neolithic agriculturalists) then we cna see why the kitavans do so much bette ron Sp’s relative to rice.

      good for you for tinkering.

      • Lea says

        I’m a big meat and veggies gal. I eat protein with every meal. I’m pretty sure I don’t have any gut issues, even when I ate SAD. After “tinkering”, I realized I had more energy for the day (and my workout) if I ate a SP before the gym as opposed to post workout. It was litterally like drinking a cup of coffee before a workout for me. Rice a couple times a week is the only thing that truly kept me stable. Of course I only eat it one way, with a homemade bolognese poured over it (*drool*). I’m thinking, my body is just super efficient at utilizing carbohydrates. I’m a pretty high energy person, so long as I fuel accordingly.

  18. says

    This was a phenomenal post, I’m sharing it with everyone at my gym.

    I use the Poliquin approach with most of my clients, specifically those looking to lose bodyfat. A 2 week LC bootcamp to start off lowering inflammation, then slowly ramp up the carb level if they are tolerant. Thoughts? Love the blog and books, you rock!

  19. says

    Really clear, concise and informative post! If people still insist on not “getting” it, know that you have been as pedagogical as is humanly possible and that people, at the end of the day, will have to be responsible for their own reactions.

    Some reflections based on my own “tinkering”: My first foray into paleo was in 2005. I jumped on board to lose a few vanity lbs (I’ve never been in horrible shape) and for overall health. Unlike many paleo adherents, I’m neither a reformed vegan nor someone who’s had a lot of health issues. My introduction to paleo came as a result of being the co-translator for the Swedish version of Loren Cordain’s The Paleo Diet. The whole thing just made sense to me, and coming from a science background I found the whole premise intriguing.

    However, when I first discovered paleo, it had yet (at least as far as I was aware) to start overlapping with the whole LC philosophy. As a result, I focused entirely on nutrient density and eliminating the bad stuff. So, I ended up eating starchy tubers more or less freely (no potatoes though) and quite a bit of fruit on top of that. I lost 25 lbs over a four-month period with little effort (I was tiny by the end of it). When I actually bothered to add up the calories I was eating it was never over 1600-1800 kcal (I’m 5’7” and naturally muscular). I almost started worrying that I wasn’t eating enough. The things was, though, that I was hardly ever hungry. The increased satiety, weight loss and stable blood sugar came despite not specifically aiming to reduce carbohydrates. However, I think it’s important to note is that even a so-called high carb paleo diet will usually be lower in carbs than the standard Western diet. Just eliminating refined sugars and grains might be enough to cull an excessive dose of carbs for people like myself who are generally fairly healthy (i.e. not “metabolically deranged”).

    I’ve been paleo on and off since then (though I never went back to up a “normal” grain consumption) and have now been solidly “on” for over a year, and intending to stay on for good. This time around I’ve been very influenced by the LC philosophy and have actually found it harder to lose the weight I’m looking to lose than I did back in ’05. As a result, I’ve been considering ditching my efforts to do LC and just focus on nutrient/density and listening to what my body tells me.

    I think where an LC approach is really helpful is when people don’t have a good sense of the difference between a mouth and a vacuum cleaner (as Robb puts it) since eating strictly LC can be extremely satiating and help connect people with a sense of what being full feels like. I do think calories matter to some degree – and have never believed that they don’t – and one thing I see as a very American problem is the portion control issue. I’m a Swede who has lived in the US and can vouch for the fact that American portions (especially in restaurants) are absolutely ridiculous by European standards. This has to influence people’s perceptions of what constitutes a normal portion and can absolutely fuel a tendency overeat, especially when people’s bodies are already bad at reading their own signals of hunger/satiety.

    Just my two cents!

  20. erikJ says

    Great article Robb, All three parts.
    As a former LC enthusiast, it took me some fizzled adrenals and a waaaay slowed metabolism, not to mention months of my own searching, researching and experimenting to realize that carbs aren’t the devil. Though LC initially helped with some insulin/weight issues, it stopped working when performance and muscle development/recovery became the goals.
    I am so appreciative of your work and honesty and in the last few years you have remained a voice of reason and good science in my search for what works(for me). I am currently looking into Nutrition consulting programs so I too can help people in the way that you have helped me and so many others. Keep on fighting the good fight Robb, It is valued!

  21. Jamie Eadie says

    Very good blog series. It’s good to see someone like yourself changing views as you come across new data. The sign of someone with a good attitude towards the philosophy of science and definitely someone worth listening too.

    From my personal experience I tried low carb ketogenic which worked wonders at first due to insulin resistance but after a while it made me feel a bit shitty. So I added the carbs back in every day post training (only do weights) or in the evening carb back loading style and its made me feel loads better. I just eat as many carbs as I can cram down my pie hole and I’m not suffering any insulin resistance with that. As long as it’s cyclic, burn fat/ketones in the morning/afternoon and then carbs in the evening.

    Anyway, agree with all you say but I still have a feeling that it is complicated further in that low carb not only reduces calories but the ability to burn fat and ketones as a fuel source have a significant effect on losing body fat as stand alone items above the reduction of eating less calories on a low-carb diet.

    What I mean by that is that if an overweight person without any insulin resistance would not lose body fat quicker on a low carb inuit diet as compared to doing a kitavin type diet full of paleo carbs and starches if all other variables and calorie intake was equal across both diets?

    Couldn’t be bothered to switch on my computer so I wrote this on my iThingy. Sorry for any typos, just being lazy.

  22. Jeremy says

    Awesome reads! The whole “small” amount of carbs to bump out of ketosis thing makes more sense when you look at the larger picture. Life is choatic and random, therefore we evolved to survive different periods of abundance and scarcity. Focusing on one thing, or the “ideal” thing, is not very different than searching for the fountain of youth or that magic pill to cure everything.

    Different stressors result in different responses and require different tools to address. These tools can change not only between stressors but also people depending on the current state of the person, genetics, etc. Seems logical to me!

    Robb, keep being awesome :)

  23. Joshua says

    Two thumbs up from this “reasonably sedentary desk-jockey with low stress”. Maybe I’ll start calling myself Plastic Man, Metabolic Style. Nah, better not.

  24. Nigel says

    Hi Robb. Wonderful post. It led me to look back at the flow charts you produced, and I was a bit confused by the language in this part, re fat loss

    “Eat per pound of bodyweight
    1.0-1.25g protein
    15-17 calories
    50-100g carbs
    the remainder in fat”

    This can’t mean 50-100 g of carbs per pound of bodyweight can it? Maybe just an issue of how you laid it out, but can you clear this up?

    Also, you say:

    ” If you are a strength athlete, I think CLC is the bee’s knees. If I was not doing BJJ and just lifting and doing gymnastics, I’d be all over this”.

    What’s BJJ? And do you mean Cycling Low Carbs is great for lifting/gymnastics? I’ve been doing that by following the LeanGains protocol, with no increase in fat and more muscle (early days). Those 450 g of carbs on training days have taken me a long way from believing carbs were bad.

    Finally I love to read an American use the term wanker! Here in the UK you’ll never see it written except during an abusive rant. Two Nations divided by a common language.

    • says

      We’ve had several thousand downloads of the charts, you are the first to notice the discrepancy in the prescription!

      BJJ is grappling, very demanding glycolyticly.

      Ha! Yes, i get some things correct in the use of British English, seriously miss on others. In my book I wrote “Your fanny will look great in a bikini.” In the Us, fanny refers to posterior. In the UK…Obviously the anterior. I was almost put in the porn section for that gaffe!

  25. says

    Another great one Robb. Thanks for the hours you put into it. I’ll chime in with Simon and say “metabolic plasticity” was my big take away from part three. I’ll be attending PaleoFX 2013 and it would be great to hear you speak on the subject. Or I’ll wait for you to write a book on it. I’m looking for to chapters like; what is metabolic plasticity, how to recover it, how to optimize it, how to spank it like a bad monkey.

  26. says


    Thank you so much for this article. As a triathlete and Crossfitter, I require more calories, and would see my daily grams of carbs creeping up toward 300g on some days, yet this was less the 40% of overall caloric intake. I was basing my needs on Mark Sisson’s carbohydrate Curve, and therefore thought eating this many carbs was “bad” for me or would make me “fat”. This post, even more than the other 2, really helped clear things up for and thoroughly plan to enjoy my sweet potatoes and other carbs much more fully to complement my training and hope that it come through in my fitness results as well.

    Thanks again!

  27. says

    Hey Robb

    Great post as usual. I’ve increased my carb intake over the last few days, having been ketogenic for some time. The carb cravings and binges seem to have abated since the change, and bodyweight is steady. I have a few pounds of bodyfat still to lose, but feeling good.

    So, for the sake of putting you one the spot, and I know you have already discussed this, but does white potato fit into your eating plan, or are you a squash and sweet potato guy only?

    I certainly think that a mix of starchy tubers is the way to go, I love em boiled, mashed, baked, roasted etc. Could you explain the differences between your view and that of The Jaminets. You don’t seem that far apart these days.

    Also, I understand the whole ketone producing effects of MCT oils, but does just adding this into your diet as a supplement, say mid morning and mid afternoon, really have the same beenficial effects on body composition that a diet inducing real nutritional ketosis would have on body composition.

    It interests me as some company is trying to manufacture some ‘quick weight loss’ product called Raspberry Ketone or something, not for me, but I would be interested on your view of the mechanism they are suggesting.

    Thanks for an amazing blog, you are making a massive difference in so many lives around the world, truly inspirational.

  28. says

    Hey Nitpicker,

    Not meaning to be nitpick myself, but if you are going to call someone out on an error that is most likely a finger slip, then you need to be certain that your post does not contain a punctuation error such as a renegade colon dropped into a sentence.

    Too funny.

  29. Jessie (Alexandria, VA) says

    Great series of posts, Robb!

    Thanks for bringing it all together so succinctly. I’m one of those people who had initial weight loss success on LC but my adrenals were just too fried to maintain any semblance of a normal life (energy levels, brain fog) while staying LC. Much healthier now just focusing on nutrient densities and food quality (with some occasional IF for variety).

    Also, thanks for being honest enough to “course correct” your recommendations as emerging science shows us new insights.

    LOVE your podcasts – yup, BOTH of them! :-)
    Keep the education and the humor coming.

  30. Erik says

    Hey Robb, great series, very informative!
    Am just turning 19, and coming up on one year living a paleo template!
    You discuss the effects of uncoupling proteins, that in the event of excess intake of calories will increase heat produktion in an attempt to burn these off – will this mechanism always be damaging to the body to some extent, or can it merely be a sign of other problems?
    I am asking because i have for the last few months been experimenting with John Keifer’s Carb Back Loading protocol (using mainly paleo foods and have seen great resutls in the gym), and as I understand it, this protocol makes use of this same mechanism – Keifer describes that excess carb intake will be burned off as heat. I have experienced this myself, feeling very warm and sweating during the night following a back load.
    I have always been comfortable in a wide range of temperatures, walking in shorts (and recently vibrams) all year round, living in Denmark. I have always thought this heat production plasticity (to use your terminology?) was a sign of health – i am wondering now, however, if the cost is cellular damage due to oxidative metabolic waste products?
    thanks for all the great info!

  31. Ron says

    Rob, would a high fat diet have any influence on liver enzymes? im 25yoa, work as a police officer and crossfit trainer, and have recently discovered moderately high liver enzymes approx around 40-60 and 150-180 for ast alt. all other lab work is optimal. been an athelete my entire life and have never had this issue before. Gastro doc has ruled out all serious causes.

  32. Caz says

    I’m a type 1 diabetic guy, so really pleased to be reading up about this stuff. It’s easy to think you don’t need to learn anything more after reading so much but still get some surprises after almost 9 years of diabetes! Unfortunately, low-carb is easiest for me (small carbs means small insulin shots means small mistakes) and I don’t do a heap of workouts (I go slow-burn route) so will probably stick with not eating a heap of carbs.

    I’ve been going paleo (after reading Paleo solution) for about 4 months now so still learning heaps. I never knew about gluconeogenesis before reading your book & it was a huge eye-opener (I often had completely unexplained blood sugar rises & this actually explained a lot)

    When you say 1g of protein per lb – you don’t just mean meat do you (e.g. 200g of meat for a 200lb guy daily)? Most meat/offal is about 1/4 protein (from what I’ve looked up on nutrition tables) which would equate to 800g of meat a day – how does anyone eat that much meat?

  33. says

    Great stuff Rob! I know you have mentioned metabolic flexibility in the past on your podcast and I totally agree that this is a big key. The ability to use fat AND carbs at the right TIME is a good marker for health. It is this adaptability that helps people deal with a wide variety of food and helps explains the great range of diets people have historically lived on.

    I am actually working on a noninvasive way to measure metabolic flexibility in the lab as my PhD thesis. If there is anything I can do to help, let me know.

    Keep the good work
    Mike T Nelson PhD(c)

  34. Ian F says


    Great three post on this subject. From reading your book and listening to all the podcasts it seems to me that for folks who are sick, very over weight and or metabolically broken advocating a carb approach is the way to go for a period of time. Then as your activity levels increase and you feel better start to introduce more carbs based on goals. If you are in good shape and have high activity levels and train hard then low carb is not the approach.

  35. says

    Hi Rob, great stuff!
    This is the second article that I read the recommendation of white rice. I always thought brown rice was better because it digests slower. I also thought carbs before bed made you fat because you don’t burn them off. I obviously have a lot to learn and take your word as gospel. Please help me understand :-)

    • Amy Kubal says


      Brown rice is not the best choice because it has the ‘whole’ grain intact and the outer shell (the brown part) is where most of the antinutrients and bad stuff is. White rice has the outer part removed and with it goes most of the harmful components of the grain.
      Carbs or food prior to bed doesn’t make you fat UNLESS it is excessive and unhealthy choices are made. Eating at night gets a bad name mostly because what many people choose to eat at night are foods like chips, cookies, ice cream, etc. Be smart about your choices and know what your goals are!

  36. says

    I have been on a keto adapted diet for several weeks now and couldn’t be happier. The mental clarity alone has been worth it, not to mention I am down 5 lbs eating great foods that are satisfying.

    Robb, I hope you and Dr.Peter Attia keep up the great work!

  37. Shelley P says

    Hey Robb,

    Loved this post. I found it very interesting and time appropriate as I am currently using the Carb Nite Solution to jumpstart fat loss and after a few cycles of it will transition into general carb backloading practice (Paleo’d of course) with regular carb intake. I know you had Kiefer on your podcast back around November and I found it very interesting. I was wondering if you feel CNS is a program worth using cyclically on occasion? You seemed to be agreeable with Kiefer, at least, with the backloading aspect of his general practice. Paleofied, of course.

    I’m on day 6 of my 10 VLC stretch and to be honest I feel so good in general I have to question if I’m even in Ketosis. My daily carb intake has been 30 or less. The only “issue” I’ve had thus far was yesterday with some thigh muscle twitching, which subsided in the afternoon. I’ve been able to weight train and maintain my PRs (difficultly though) so far on the program.

    Anywho, just wondering what your feelings are about this program and it’s credibility?

    Thanks again Robb for all you do,


  38. Richard says

    Great series of posts, Robb – thanks a lot for taking the time to put this down.

    I have a question on protein intake – for strength athletes (and I dare say most people) I believe you’re advocating a cyclical ketogenic approach but is the 1g/lb protein recommendation in discord with that, due to the ensuing gluconeogenesis?

    I struggled to get any ketosis going at all when on 1g before pretty much halving that and now happily cycle in and out depending on carb-load (paleo carbs taken PW of course!)

  39. Greg says

    Thanks for part III, Robb — makes so much sense, especially for those of us where ketosis isn’t a favorable solution 24/7.

    Speaking of which, I ran across another blog this morning, talking about overstimulation and desensitization, which expands your thought process on paleo to things like gaming, caffeine, artificial lighting, and drugs. An interesting tangential read IMHO.

    Take care!

  40. Martin says

    Regarding insulin resistance as a mechanism to buffer excess calories in fat tissue: could a person on a hyper caloric, ketogenic very high fat diet (no carbs, low/medium protein) develop insulin resistance?

    • says

      Ketosis it’s self creates peripheral insulin resistance to spare glucose for the brain…the insulin resistance of over feeding is yet another mechanism…stay tuned for a blog looking at various ways we can induce insulin resistance.

  41. Anthony L. Almada, MSc, FISSN says

    Robb: A colleague of mine directed me to this posting today (they marveled at you OSTENSIBLY recanting LC diets). Rather, a provocative read, destined to inspire and inflame zealots on both sides of the carb divide. Bravo for stirring the pot with intelligence rather than inflammatories…

    One population highly germane to this episode, and which comes close to metabolic INflexibility (at least for skeletal muscle) is McArdle disease (McD; no pun intended). McD is a genetic disease (the most common for muscle) defined by an INABILITY to breakdown MUSCLE (but not BRAIN, LIVER, or HEART) glycogen and thus an INABILITY to form lactate or acidify exercising muscle–but they still get the “burn”–a wholly different discussion, mired in lactic acid mythology). McDers still have an ability to use glucose AND fats during exercise, but they hit a ceiling, hard. A person living with McD also experiences a metabolic “epiphany” 5-7 minutes into light intensity exercise–their heart rate FALLS and their work output climbs–dramatically. McD is a brilliant model for understanding the axial role of glycogen in the early stages of exercise, and to enlighten the masses about what still happens in the ABSENCE of lactate and acid accumulation.

    McD is also an intriguing condition to explore LC/keto. If muscle glycogen can’t serve the role it does in us non-mutants then, perhaps, providing additional fuel substrate in the form of fat, through a 36 hour fast, pumping fats into the vein, or a ketogenic diet could offer greater performance in McD. Only lipid-centric case studies have been undertaken over the past 38 years (with the exception of fat infusion–glucose infusion produced greater exercise capacity), while blocking fat availability with niacin (1-2.2 mg/lb body weight–modest doses) BLUNTED exercise performance. Branched chain amino acids and high protein diets (non-keto) do nothing, underscoring the trivial fuel substrate role amino acids have during exercise. The very few cases studies with ketogenic diets (up to 1 mg dietary fat/kg body weight) have revealed REMARKABLE exercise performance improvements, but studies in 1 or 2 persons do not a strong hypothesis validation make. Time for an RCT…

    I have worked with a McD patient off an on for the past several years. He is a former competitive bodybuilder, and was able to achieve a significant physique while LC, and strategic addition of a specific starch extract. His migration to strongman competitor demanded greater amounts of the starch extract, given the longer duration of work being performed (compared to traditional resistance training). He has not had as much success with a true keto diet…

    For the science/evidence junkies:

      • says


        Did you and Anthony (comment above on McArdles) ever do a podcast to expand on the subject that Anthony brought up? I’m assuming if you did it would have been after the date of this blog post but I don’t see anything specific.

        His comment was very informative and seemed to have gotten your curiosity as well. Just wondering, I have a personal desire to learn more about this specific topic myself due to my diagnosis.

        Love your books, podcast and blog. Relatively new to Paleo and fitness in general and I can’t express how much this has all helped me completely change my life over the last 10 months. I’m not just excited about the -110 pds I’ve lost but my fitness levels and health has dramatically changed and I owe it all to the Paleo community and the work of people such as yourself. Forever grateful!

  42. says

    Hi Robb,

    It remains incredibly interesting to read about this subject. BTW, your thoughts now seem to be in line with those of Anthony Colpo, don’t you agree?

    You mention in your piece that prostate cancer appears to respond very favorably to a ketogenic diet. Eugene Fine however imposes during the AHS2012 ( 06m:20s) that 80 percent of prostate cancers are not sugar-dependent. Reason to change your point of view? Regarding this topic, this presentation ( was very interesting too.

    OK, so far some thoughts that arose in you European accomplice.


    Hans Keer

  43. The Idiot. says

    Hmmm, ~1g of protein per lbs of body weight would leave me with approx 260lbs of protein to eat in a day. How the hell does one manage that? I’ve read so many articles – all of them contradicting the other – that I have no fecking clue where to go from here. Looking to lose body fat by doing resistance training (5×5 stronglifts) – someone tell me once and for all which ‘diet path’ would be best! I’m not a lazy SOB looking for other people to do the work for me, it’s just my brain has been scrambled trying to figure it all out!

    • TimA says

      1g protein/lb BW is a common rule of thumb for people of “normal” weight. It’s easy to compute and close enough for government work. However, 1g (or thereabouts) / lb Lean Body Mass is probably more precise. The purpose of the protein is to protect / grow lean body mass. So, if you are significantly overweight, 1g/lb BW is likely more protein than necessary (though it won’t hurt you).

      If that is more than you wish to eat, you should find a good LBM/BF% calulator and determine your LBM. Use the LBM to determine your protein requirements. On lifting days, maybe push a bit higher in protein to be equivalent to the 1g/lb BW. On rest days it won’t matter as much. When your BF% gets below 20% you can go back to 1g/lb BW and be OK.

      Don’t forget, these are just guidelines to make sure you are getting adequate protein. It isn’t really an exact science.

  44. Joe K says

    I’m being a fool, but with a HDL cholesterol of 1.8mmol, and triglycerides of 0.4mmol, does this indicate insulin resistance? I calculate the ratio as 4.5?

    please forgive me, must be that adrenal fatigue brain fog post lunch

  45. Andrew Mckay says

    Hey Robb, this is the first time on your website and these 3 pages have been amazing!

    Anyway what im confused about is when I was reading the paleo solution I read that ‘our physiology is actually wired to exist at a caloric excess’ and ‘one person can overeat several hundred calories a day for years and never gain a kilo’

    How does this tie in to what you said in the first post that calories play a bigger role in weight gain than previously believed compared to the insulin hypotheses?

    Sorry if this is a silly question but im relatively new to the paleo concept and quite frankly my head is mashed overthinking everything I read!

  46. Spar says

    Hi Robb,

    After reading the articles, I have your book as well, have a question.

    Although I am not really sure why you are even mentioning crossfit people or high level athletes since these groups are .0001% of the population that is looking for your advise.

    Considering most people do 30min to 45min of walking or moderate weight lifting 3 times a day.

    So would you say for an average person, not an athlete, stay below 50g of carbs lets say for the first 2 months, this will definitely result in a significant weight loss and then stay around 150g of carbs on daily bases. I guess what I am trying to say why not be around Ketosis until you reach your ideal weight and then should not take more than 6 months.

    As much as I appreciate all the information, I have to say that you are shifting to much towards athletes and these are not the majority of people with insulin resistance.

  47. says

    Love the idea of metabolic plasticity. I’ve been doing my own n=1 experiment with nutritional ketosis, and while being in ketosis for the majority of the past 35 days, I have found it surprisingly easy to jump out of ketosis (verified by blood ketones).

    This made me think that the idea of metabolic plasticity has more validity than being in a constant state of ketosis which completely agrees with your conclusion…

    On the other hand in my experience, and according to Volek and Phinney it takes at minimum 2 weeks to become ketoadapted, to even get the body to a state where it can process ketones…. so if you’re eating a moderate carb diet… can you ever become ketoadapted?

    And if not, then doesn’t that completely eliminate the benefits of metabolic plasticity if you’re still relying on carbohydrates as the primary source of fuel?

  48. shawn says

    “Diabetes is a prime example in which folks loose the ability to properly handle carbs. One of my all time favorite papers, Secrets of the Lac-Operon describes exactly this. Aging cells are those which loose the ability…”

    Both of these should be spelled “lose”

  49. Ivan Sramek says

    Not to get off topic but we are in the process of relocating and are trying to find an honest moving outfit. We were thinking of using this organization, Move4Less 1015 Shary Cir #7 Concord, CA 94518 – 925-808-3139. Is there some sort of movers fraud or review site currently available for checking on them?

  50. Stephen says

    Hey Robb,

    In regards to doing CrossFit and being LC, I read that you said you did not think it would work, what would help me get more lean while doing CrossFit 2x Day. Im 5’8, 165lbs, 12.7% BF.

    Right now I am 21 Blocks on strict Paleo Zone.

  51. Monte W. says

    Could it be as easy as:
    Eat more carbs on the days that you do crossfit or weightlift or whatever exercise
    and eat low (lower) carb on your days off from exercise?
    That way, you are feeding your muscles when they need it and then doing nutritional ketosis the days that you are less active. OR am i off on the timing? Does the body do all the muscle building on the days off? and would on that day need the extra carbs? and the day of the bodybuilding exercises, that day do lower carb??
    There is a trainer that does that (but probably not Paleo) and claimed to have really good results.
    Also, on a side question, when insulin resistance happens, does that mess up the other hormone balance? Lots of women with PCOS have insulin resistance and then that goes hand in hand with estrogen dominance? then the thyroid and adrenal system are also out of balance. And of course the vitamin D levels are low. So all these hormones are out of balance. Can a ketosis paleo diet correct the insulin resistance, which will in turn balance the other hormones?
    Has a body in this state have cells full of oxidized stress, and is there a way to antioxidant all the cells back into a more insulin sensitive state? Are there natural foods and or herbs and supplements that help better than metformin for insulin sensitivity?

  52. Cheryl says

    You recommend getting to the bottom of why I’m insulin resistant before worrying about performance. How do I do that? I have my fasting blood glucose, A1C and fibrinogen numbers, but all I’ve been told is, “they’re still a little high” despite eating paleo and CF for 3 years. I’m frustrated and want to figure it out.

  53. Sam says

    Hi Robb,

    I’m grappling with Mat Lalonde’s results in this post from 2009:

    and what you’re saying about athletic performance in this most recent series of posts. The two don’t mesh especially in reference to time for adaptation vs depression and depleted energy levels. I may be missing something and I do only have a basic understanding of nutrition and LC training, but is there any simple explanation you might be able to provide? Thanks so much. The work you’re doing is incredible.

  54. says

    Wrangham claims that cooking allowed the evolution of human’s larger brain over 2 million years ago. The extra copies of the amylase genes mentioned by C. Masterjohn were added to our gene pool within (!) the last 0.2 million years (Perry 2007). Until than apparently we ate as much (or little rather) starch as chimpanzees which have only two copies, This is exactly why Wrangham’s theory doesn’t make sense. If we cooked 2 million years ago (and there is no evidence whatsoever for that) we haven’t cooked a lot of potatoes. As I have shown here ( ) chimpanzees get only 30% of their calories from glucose + fructose so this amount may be a starting point for a “natural” level of carbs.

  55. Brad says

    Robb, what would be your “tinker” recommendation for someone wanting to do body-recomp on a 3-hour per week gym routine?… the normal M/W/F split one hour per day. Meaning gain/retain lean muscle mass and bring down BF% and lifting performance comes in second on the priority list. If doing intense lifting 3 hours per week and no other exercises then surely not as much carb’s are really needed and being in fat burning mode during the week via CKD can only help, right? I know these are leading questions, but you didn’t really talk about bodybuilding and body re-comp versus Crossfit and performance oriented lifting. Or maybe I missed it and need to go back and re-read? I would have really like to see what your thoughts are on this subject.

    • says

      The main issue is going to be adequate protein, and a cal deficit if the goal is leanness. How you slice and dice that is going to be dictated by your carb tolerance.

  56. says

    Hi Rob,

    Thanks for clarifying the low-carb/ ketosis concept. I have been looking for clarification on MarksDailyApple but couldn’t find any.

    I started eating primal/ lacto-Paleo since mid-November, with VERY bad carb flu in the first 4 weeks, my body is eventually adapting to the new eating style.

    However, the carb ratio has been bugging me as there are days (maybe PMS too) when I go below 100g carbs, I get constant hunger pangs despite a VERY high fat diet – LOTS of nuts, cheese, animal fat, etc, my caloric intake can average 4500kcal on that particular day. White potato also seems to set me up with sugar craving.

    I’m 5’6, 58kg, fitness coach/ recreational runner-triathlete. Weekly training average 10-12 hours, mainly aerobic, am aiming to drop 5% BF from 23%. Since my time in Paleo isn’t long enough, do you reckon the constant hunger pangs a normal initial body reaction to a new eating habit? Or should I increase my carb intake? Thanks for your help.


  57. Jeanmarie says

    Robb, I love your work. I’m addicted to the podcast (someone mentioned two! I didn’t know there were two!).

    One question/comment, I’m 5’10” tall and 150 pounds. If I’m supposed to eat 1 gram of protein per pound of body weight, that’s 150 grams, which I cannot even fathom eating if I were starving. I struggle to get close to half that. I crave protein, but not in huge amounts. Should I be forcing myself to eat more?


  58. Karyn Voltaire says

    There are a couple of websites you can check out. The first is, they have a strong community of reviewers and a number good resources. The second is Ripoff Report. Do a search for the domain of the website like so and see what comes up.

  59. Danny Regan says

    Robb, Wouldnt added carbs for workouts like Crossfit, be more beneficial taken pre workout instead of PWO? If trying to have enough fuel to get through a crossfit workout, i would think the carbs taken pre would be more beneficial. But almost everything i am reading on here says carbs PWO is when you should take them. Just confused

    • says

      It really depends. If you have food in your gut tat you are digesting the wods suck. Where you want the carbs is in the muscle and liver. Pre Wo carbs have only been shown to be beneficial for very long efforts.

  60. Jameson says

    Hey Robb, I am currently trying to do a program developed by a company called Beachbody, you’ve probably heard of them, but anyway, it is a strenght/hypertrophy program called BodyBeast. It has 5-6 days of lifting per week, all using specific sets and rep ranges apparently “aimed at resulting in hypertrophy.” Also, there would be 1 day a week of HIIT (plyometric based) but I recently injured my 3rd metatarsal in my right foot, and I can’t do any impact exercises till it heals. I am very underweight and I want to put on as much muscle with as little fat.. I have also worked out with other Beachbody programs, such as P90x, P90x2 and Insanity, all of which, from what I’ve read in your posts, you would probably classify as workouts which require more carbohydrates, right? I’m sorry for the long comment, but my question really is: I try to eat low carb, meaning under 100 grams on days I don’t workout and under 150 grams(usually under 135 most days) on days I do train… SHOULD I keep doing this? The reason I’m asking is because about a month ago, when I was finishing up a hybrid of several Beachbody programs, I saw my performance start to platuea, and then just degrade and degrade. Additionally, I felt tired, very hungry, and I have had sleeping problems… I want to continue doing these types of programs in order to get me ready to start crossfit at a local Crossfit gym later this year in the winter, but I can’t seem to succeed in any of my goals.. Though I am bulking now, when I do attempt to lean out and lose some more body fat, would eating more carbohydrate in order to fuel these programs make losing fat difficult? (assuming that these programs require more carbs, which was the first part of my question..) I APOLOGIZE FOR THE ESSAY, I am just really confused by what I should do… my workouts aren’t 3x a week heavy lifts with sprints once or twice, and so I didn’t know how my nutrition should be adjusted to them!

    Thanks SO much, your blog and your articles are extremely informative and really interesting. I appreciate all the work you put into them!

    • says

      Hey amigo!
      1- you need something like crossfit football for the mass gain.

      2-you need “way more” carbs. Like double as a conservative start.

      Keep me posted.

      • Jameson says

        In the time that I’m waiting to start Crossfit, and incorporate a real strength training program(like the one you suggested) along with that training, what would be the optimal way for me to structure my macros? In that time I am hoping to try to increase my performance and zig zag my calories/carbs, but When after attempting to become fat-adapted, I am curious about whether or not I will become “un-fat-adapted” by eating more carbs… will this happen?

        • Jameson says

          Oh and again, thank you for taking the time to even talk to me, I realize how busy and hectic your life must be! I greatly appreciate this!

      • Jameson says

        Okay, but I have a few things to say… first off, I’m 17, and I have a bit of a belly I want to get rid of, and despite working really hard doing Beachbody fitness programs and eating low carb, even carb cycling(albeit with still lower carb amounts) I haven’t been able to lose it, and I basically plateaued on things like pullups and weights with certain exercises. Since starting “Body Beast,” I’ve increased my calories, but I attempted to do it low carb, by increasing primarily through my fats. SO I’ve been eating lots of fat and still around 130 or so grams of carbs, 1.5 lbs of protein per lb of bodyweight(I only weigh 118 lbs!!!) What I’ve seen is that I haven’t really gotten much stronger, and I have lost definition in my abs… What do you think is going on? The workouts for Body Beast are only around 35-45 minutes, and they use multiple sets with different repitions, from 8 to 15 reps several times, etc etc. I figured I would be not burning much glycogen doing these workouts as they’re shorter than ones in p90x/p90x2 which were over an hour most days…… could I have been wrong?

        Lastly, will having protein after a workout without carbs benefit me if I attempt to lean out after doing Body Beast? Because I’m really dissapointed that I’ve already gained fat on my abs, which I’ve wanted to get rid of for a long time, and have been trying hard to achieve as well… Well look’y here, I just ranted AGain. I’m very sorry.. a reply would be so helpful, but I understand if you don’t

        Keep posting your hilarious and informative stuff regardless Rob! I love it

  61. Terri says

    I wake, drink coffee, WOD in a fasted stated at 6:00 am, have protein shake PWO, and don’t eat breakfast until 10:30 am. My breakfast and lunch are mainly proteins & fats and the majority of my carbs are eaten at night. Could my meal timing be stalling my fat loss?

  62. says

    I hardly drop comments, however i did a few searching and
    wound up here Is low carb the best way to eat?. And I do have 2 questions for you
    if it’s allright. Is it only me or does it look like a few of these responses come across like they are written by brain dead visitors? 😛 And, if you are writing at additional sites, I’d like to keep up with anything fresh you have to post.
    Could you make a list of all of all your shared pages like your twitter feed,
    Facebook page or linkedin profile?

  63. Claudia says

    What do you think people with hypothyroidism should do, eat low carb or high carb, or moderate carb? I’ve gained a quite bit of weight because of my hypo, and I can’t figure out what to do. I really want to lose these pounds cause I do not feel comfortable not fitting into my old clothing… Thank you so much for everything that you do!

    • says

      Is the person exercising? sleeping well? I honestly like starting on the lower carb side of things, then we just need to tinker and see how it works. AND, shift gears if need be.

  64. says

    Ya know, what’s awesome about this post is the rate of evolution you had on your position on low carb. It helped me to evolve mine.

    I was stuck on “Ketogenic protocols are God, forever” for a while, until I started waking up in the middle of the night with heart palpitations, doomsday shortness of breath episodes, and the feeling like I was going to straight up kick the bucket several times. Not fun. I also run, and run a company. So, I’m burning energy constantly. — Added some sweet potatoes and bananas back in, boom, panicky, heart throbbing impending death moments went away, and frankly, I have a ton of energy now. Carbs and fat. All whole foods. Little sugar if any. And thriving.

    So – for people out there Googling “low carbs give me panic attacks,” and “heart palpitations and ketogenic diet,” it’s probably not the electrolyte story you’ve been forcefed. Sure, you need more sodium on LC. Sure, you should make sure you’re potassium and magnesium levels are up to speed. But – if your heart is tweaking out, and you’re having borderline or full blown panic attacks, it’s carbs. And they’re not evil. And you need them.


  65. Rick says


    I am 63 years old and have had a long career of public health and toxicology and a degree in microbiology and environmental health during the seventies when it was first invented. I love your very insightful understandings in biochemistry and evolutionary biology. You keep an open mind and are not fearful of the details.

    Thirty years ago after my sister who had schizophrenia committed suicide, I developed a passion in trying to understand the scientific basis of this disease that accounts for 50% of the mental health budget yet only afflicts 1% of the population. Interestingly, schizophrenia has about the same incidence worldwide and throughout modern history except that it peaks a little during times of starvation (e.g. Dutch births of starving parents in WWII) and diminishes a little in some very close knit populations. The riddle to solve is why schizophrenia which is mostly a genetic disease has not disappeared due to evolutionary pressures of fitness. A popular theory now is that its symptoms (hallucinations, voices, erratic actions) actually act as an early warning device to normal populations and therefore are productive to the species as a whole (e.g. Jesus Christ?). Some theorists think that it developed at the time homo sapians developed the pre-frontal cortex around 300,000 years ago. The pre-frontal cortex is the executive function of our brain and makes us able to plan ahead and think in the future and it inhibits our more basic instincts. It is what separates us from the Neaderthals and allows us to have abstract thinking and is why we dominate the earth today. Schizophrenia may have something to do with the linkage of the prefrontal cortex to the rest of our brain.

    What does all this have to do with Paleo/LC and your excellent blog? For 10 years, my wife has been on and off a LCHF diet and I did not believe it had a scientific basis until I last year when I went on it and saw its benefits. Because of my interest in evolutionary biology and background in toxicology and biochemistry, I may have a unique perspective to your discussions.

    My theory… 300,000 years ago with the development of the pre-frontal cortex coinciding with the previous reduction in brain and gut size and the addition of amylase enzymes to break down starch, Homo Sapiens became smart enough to know how to plan for a meal which means they could incorporate more starch into their diet. Starch does not rot and is transportable. Eventually, mass agriculture and civilization was invented (20K years ago) and the rest is history.

    What this tells me is that prior to 300,000 years ago, hominoids for millions of years were mostly fat and meat eating species with occasional forays into carbs during the spring and summers when they ate berries and fruit and put on fat for the winter months (think of bears before they hibernate). As a side note, our personal experiences tells us that carb cravings on ketogenic diets are kept in check as long as you do not bite the apple (the biblical reference was intended). A small amount of carbs on a ketogenic diet then gives intense cravings such as with the first cigarette for the non-smoker or the first drink for an alcoholic. Mother Nature does not want us to eat carbs except in berry and fruit season when we need the fat for the winter. Also, the clear thinking on a ketogenic diet is best for the winter season when you need your wits about you in order to hunt food.

    As I mentioned, when we became Homo Sapiens about 300,000 years ago, our pre-frontal cortex gave us the ability to plan ahead and add more starch to the diet and increase our nutritional plasticity.

    All this conjecture is fine, but what it tells me is this. Due to evolution, modern humans can their long lives with multiple nutritional lifestyles. Excessive eating can shorten our years but what the heck is the difference between living to age ninety versus age eighty? What is more important is mental health and feeling of accomplishment (pre-frontal cortex thing). Being slim and athletic makes us feel better about ourselves. Ketosis is a wonderful thing for mental health (clear thinking) and disease reduction and I predict will become close to the accepted norm thirty years from now when we have all the nutritional and evolutionary research done and assimilated into the broader population.

    Keep up your good work and eventually we get this thing solved.

      • Christopher says

        I’ve always felt that seasonal variations (both temperate — think ‘winter vs summer’ — and tropical — think ‘dry vs wet season’) must have SOMETHING to do with when humans enter ketosis, whether we use our prefrontal cortex in planning or not. Simply, more starches and sugars are available during some parts of the year over others. We often hear carbophiles poo poo the idea that humans may have lived on a ketogenic diet because much of humanity evolved in warmer climes with plenty of carbs available. But they don’t seem to ever take severe dry seasons into account which can be just as detrimental to the availability of carbs as winter in Europe.
        As a result of evolving with SEASONS, I suspect that there may be something to be said for cycling in and out of ketosis as being the healthiest approach to diet. STILL, however, always avoiding the newer, hybridized fruits and starches.

  66. Ian Parkes says

    Robb, I thoroughly enjoyed this series, and your articulate exposition, so I’m a little embarrassed to speak up with a such a finicky comment. I’m new to reading research on low carb or ketogenic diets and so on. The only thing that tripped me up in your otherwise lucid flow were the acronyms. I could work most of them out of course but as I have to mentally translate even LC in my head each time I see it, it interrupts the flow. And IF just looks like a big ‘if’. RCT? Nope. As the rest of your copy is so rich, I reckon using up a few more bytes spelling out the word would be worthwhile for presevering the reading rhythm. I guess ‘HDL’ and ‘LDL’ are probably more familiar than the longish words they represent for anyone who takes an interesting in their own blood work, but personally I’d still spell those out too. Told you it was a quibble.

  67. Jimif says

    Robb, May I ask where you came across the info that melanoma, in contrast to many other malignancies, can be worsened with ketosis? I can’t find any references to this and would really appreciate your help. Thanks.

  68. says

    Hey there Robb. I was just revisiting this post which I loved when you posted it. I recently upped the ante on my hormetic stressors, doing more HIIT and low rep weights. Thought I might need some carbs after being vlc/hf for a while. But damn, my body has other ideas….it seems like the glucose just hangs around even though all my life I have been uber-insulin senstive even throughout hi-carb nasty diet habits of the past. So now 41, still slim and otherwise healthy, ready to get super jilled, I find I have lost some metabolic flexibility toward carbs even as I remain a pretty good fat burner…..weird, it seems like most people have the opposite problem with metabolic inflexibility. What to do?

    The whole culture-war dimension of low-carb vs high-carb in exercise physiology is really tedious, so thankyou for another display of playful, measured ambivalence.

  69. Greg says

    Wholly Kittens,

    You may have just saved my ass. 2 months in ketosis and felt like a superstar, then 2 months not so much. So maybe I dove into the low carb deep end too much. I was <50 g veg only. Exhaustion and brain fog rearing it's ugly head, and the recovery bus has left the station. So this article tells me to reload, regroup, add back a few carbs, and a suggestion of more protein than I was taking. So more fat doesn't solve everything, so much for that idea. I shattered several beliefs to get into this box, and appears that will remain a common theme.

    Glad I read this, more glad you wrote it.


  70. Lisa says


    Unique Snowflake question, though sure many can relate. Developed Stage 3 Adrenal fatigue over the winter, cut out all stimulants (coffee, cardio, had to stop CF) now focussing on traditional bodybuilding bc it’s the only thing that doesn’t leave me bedridden for days.
    My Q is on CHO intake. Some say removing all starch and increasing fat intake is only way to go bc of increases insulin sensitivity (ie 20-50gr cho) but I find after a few days I feel terrible especially with exercise and I feel like I may put my thyroid at risk (which was fine at past blood work). However I’m currently eating only about 60 gr/day and weight isn’t budging so I’m wondering if it’s bc of too low carb causing further cortisol issues on my body? I’ve also read (info paralysis ha) that forcing the body into ketosis puts the body under too much stress for someone with adrenal fatigue.

    • says

      It can be less stressful on the body to provide some dietary carbohydrate instead of it having to make it’s own. For people with more adrenal fatigue issues, usually “balanced” meals with some protein, non starchy veggies, and starchy veggies work well. Try adjusting the amount of carbs you’re eating and see if it helps or not. Here’s a good resource to check out
      Be sure to not overdo it with the exercise, and always leave some in the tank. SLEEP, and sleep well. Do some type of stress management too. I recommend using the Headspace app and even just doing 10 minute meditation sessions once a day. It can help a lot. Also, here are some good supplements

  71. Nick Johnson says

    I just wanted to say thank you
    I am a bodybuilder and I love paleo, but have been trying to do too low carb
    I have been eating more yam/sweet potato and white rice post workout and feel fantastic
    Thank you for all your great information and being so fucking helpful
    I can tell you really love what you do keep it up

  72. Lynne says

    Nice article! This was recommended to me by my cross fit coach.

    I stayed in ketosis for 3 months – typically under 35g carbs per day. The plan was easy in terms of compliance, but I was definitely able to overeat. Initially I shot for <5% carbs, ~10-20% protein, balance fats. I was exhausted and weak. I could also overeat fats like no tomorrow, so my calorie load on average was over 2000. (I was 150 lb female, so this is a problem.) I'm a grappler too, so the weakness was really getting in the way of training. I found that adding in more protein (20-30%) helped with the exhaustion, but the muscle fatigue stayed. After three months, a 10-lb weight gain, and lower gym attendance (I think due to frustration with performance), I gave up and re-introduced carbs. As long as the carbs are clean, I feel great and I'm able to make gains in strength. More important, I'm able to work out hard enough to get an adrenaline rush, which my prime motivator for working out.

    Now I just have to lose that 10 lb and get back on the mat regularly :)

    BTW, The only diet that allowed me to lose weight without tracking food was paleo – but only when I strictly adhered to no salt, no condiments, mostly single-ingredient foods. Unsalted, unsweetened foods (especially proteins) stop tasting good as soon as the hungry to not-quite-hungry threshold is passed.

  73. Lynne says

    Oh and also – I wanted to say that I have MUCH RESPECT for you and everyone who is willing to admit a change of heart/ philosophy.

  74. Christopher says

    I’m going to have to say that you did NOT have to “throw [your]self under the bus” on this one.
    I still believe that ketogenic IS the natural metabolic state for humans SEASONALLY!
    During freezing winters or dry seasons (depending if you are in a temperate climate or an equatorial climate) ketosis is definitely a normal state! The difference is that I think it would have been normal and natural to go in and out of ketosis for up to half a year at a time when healthy vegetation was at a minimum.
    It has been shown that when eating only meat when no vegetation is available, the proper ratio of fat, protein and carbs (glycogen in muscle and liver) is provided for ketosis.

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