A Conclusion to the ‘Safe Starch’ Debate by Answering Four Questions

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the truth arthur schopenhauer dr. Rosedale A Conclusion to the Safe Starch Debate by Answering Four Questions

“All truth passes through three stages: First, it is ridiculed; Second, it is violently opposed; and Third, it is accepted as self-evident.” 
— Arthur Schopenhauer

A shorter summary is first, followed by a more complete version with additional comments about Kitavans, thyroid, nature, and more…

Short Summary…

Even in a state of starvation blood glucose is maintained right up until death. What this really shows is that even if you are starving, and eating no carbohydrates, or fat, or protein, there is no such thing as “glucose deficiency”.  The body can easily make what it needs.

Question #1;

Is it better to eat the requisite glucose, or let the body make it?

The ‘safe starch’ debate boils down to whether it is better to eat the requisite glucose, or let the body make it when necessary.  I believe strongly in the latter.  We can never know exactly how much and when we will need extra glucose depending on environmental circumstances.

When you eat the glucose, there are different effects than if your liver makes it, namely it circulates for hours and leads to a spike in insulin and leptin, that circulates for hours, that over time will contribute to insulin and leptin resistance…that ultimately contributes to metabolic chaos resulting in chronic diseases of aging including obesity, diabetes, cardiovascular disease, osteoporosis, autoimmune disease, cancer, and others.

I have long summarized health by the ability to burn fat… or not.

Eating glucose i.e. “safe starches” will spike insulin and will, at least temporarily, prevent one from burning fat… in anyone… a worm, a mouse or any human.  It will raise leptin that will prevent one from changing to the healthy calorie restriction phenotype (see below).

Glucose, like all parts, must be orchestrated; where, when, how it is used is what will determine health and life.  When we talk about significance of starches, safe or otherwise, the most important factor is their effect on hormones and other biochemical pathways that affect the harmony of 15 trillion cells needing to act as one for life and health.  And all starches raise insulin and leptin levels… a lot… having a long term adverse effect of insulin and leptin resistance; cells not being able to properly hear their life-giving messages.

Paul Jaminet and all the other safe starch advocates concentrate on blood glucose… and though it is unwise, to say the least, to eat glucose when one is trying to keep blood glucose down, diabetes is not a disease of blood glucose, but of insulin, and more importantly, leptin resistance.  It is the effect of eating “safe starches” on insulin and leptin resistance that must be acknowledged and stressed.

Disease is not as much from the parts but much more from the misinformation given them.

It is not an excess of cholesterol that causes heart disease.

It is not a lack of calcium that causes osteoporosis.

Disease is not due to glucose, excess or deficiency, but the communication that tells it what to do…and sugars, more than most anything, by non-enzymatic glycation and insulin and leptin resistance, messes up that communication.

Question #2;

If the body can make all the glucose it needs from other biochemicals, called gluconeogenesis, are there potential adverse effects from this?

Any potential adverse effect of gluconeogenesis would be determined from the initial substrate; whether one is using amino acids to manufacture glucose or other precursors that are extremely benign such as from ketones, the glycerol backbone of fats, or from lactate and pyruvate recycling. Those latter sources of glucose substrates separate from amino acids, under adapted carbohydrate and protein restricted conditions, can virtually make up the entirety of precursors for whatever glucose might be necessary.

Most people on my diet actually gain lean mass without increasing exercise, via protein sparing and increased sensitivity to insulin. Therefore, one can’t be burning much of their lean mass/protein, if any.  They are deriving their fuel from ketones, glycerol, recycled lactate and pyruvate.  This is perfectly healthy, more so than burning glucose.

Fat is a great fuel, the best fuel, furnishing fatty acids, ketones, and glycerol (that can turn into glucose if necessary), to burn.  However, one needs at least two weeks to adapt to properly burning fat, more if older or overtly metabolically challenged.  I will maintain that the symptoms that people are experiencing occasionally and calling glucose deficiency are nothing but inadequate adaptation to properly burning fat by either consuming too much carbohydrate or eating excess protein.

Gluconeogenesis from protein requires deamination, and the nitrogen molecule is then used to manufacture ammonia and urea that are both poisonous. This is why urine is called urine.  Burning protein is not healthy, but if you can’t burn fatty acids or ketones and you are limiting carbohydrates you will have no choice but to make glucose from protein, either from what you eat, or from your muscles, bone, or other protein sources.  The trick then is to not eat more sugar, but adapt to burning ketones and fats…by eating less sugar, not eating too much protein, and eating fat if hungry.  You learn to ski by skiing.  You learn to burn fat by burning fat.

Question #3;

Is it that important to eat less than 100 gm starch?

Answer; Yes; that is where the deeper benefits lie. That is when one gets into ketone burning and when one can get into the calorie restriction, longevity phenotype.

The worst diet to be on is high fat along with moderate and sometimes even “low” (as opposed to very low) carb.  If you are going to eat fat, you have to be able to burn it, and as little as 100 gm non-fiber carb/day can prevent one from adequately burning fat.

According to George Cahill, perhaps the world’s foremost expert on the metabolism of ketones and starvation, 100 gms/day of sugar forming carbohydrates i.e. starches, is all it takes to prevent one from burning and therefore adapting to burning, ketones.

As one follows my diet more closely, meaning as little non fiber carbs as possible and avoiding excess protein (above 1 gm/day/kg lean mass for most), the beneficial returns not only increase, but accelerate.

Question #4;

Is the VLC diet only better for “sick” people?

What I said 20 years ago is just as true today; Carbohydrates should be defined as fiber or not fiber. Any carb that is not a fiber will turn to sugar and will cause harm…for any and everyone, males, females, monkeys and worms. The only difference among the sugars and non-fiber carbs is how fast and how much harm will be caused.  ‘Safe starches’ is an oxymoron.

One should not discuss effects of starch only on blood glucose. What about intracellular glucose?  If you eat that sugar and it’s not in the circulation, where is it?  Much gets pushed inside cells causing intracellular glycation and cellular harm.  Lots will turn into liver fat. It has to go somewhere, and wherever it goes it will do damage.

EVERYONE who eats starch will raise their glucose and/or insulin.  Keeping glucose down by raising insulin is doing one no favors; just trading one evil, elevated glucose, by an even worse evil, high insulin.  (See “Insulin and its Metabolic Effects“).  This was shown clearly by the ACCORD study.

If diabetes were properly diagnosed as improper metabolic signals, especially from insulin and perhaps even more importantly from leptin, then we all have diabetes to one degree or another..

Life’s commonalities are much more critical to life than the differences, since life can’t live without them.  (See my next blog, an essay I had written a few years back called “The Transcendence of Commonality Amongst Individuality”)

The basics of metabolism are true for all people, in fact virtually all life.  This is why worm studies are important to us.  Human insulin and glucose will work in a worm just as it does in a human, causing damage and shortening lifespan when elevated.

The major benefit of a very low carbohydrate, moderate protein, high-fat diet, and what will get you to the next level of health, is the adaptation to constantly burning fat and ketones and thus requiring less glucose. By forcing the intake of 100 gm or more/day of glucose into the body you would prevent that adaptation.

The lowering of free T3 is a sign of that adaptation, and, according to Paul Jaminet, when you follow his diet you prevent the lowering of free T3.  That is powerful indication that following a “safe starch” diet is preventing one from changing into a calorie restriction phenotype and preventing the genetic expression and adaptation to deeper maintenance and repair that equates to health and longevity that a very low carbohydrate, high-fat diet would otherwise allow the opportunity for.

 A Conclusion to the ‘Safe Starch’ Debate

Ron Rosedale M.D.

A more complete version with additional comments about Kitavans, thyroid, nature, and more…

I understand where Paul Jaminet, Chris Kresser and other ‘safe starch’ advocates are coming from, sort of; that if we have to maintain a certain level of blood glucose anyway, then why not eat it?  I don’t need to hear more arguments that say that glucose is necessary for mucus; glucose is necessary for protein, etc.  I could even add that glucose is needed much more importantly for self-recognition to help prevent autoimmunity (and I believe non-enzymatic glycation can mess that self recognition up), and many other purposes.  I agree.  I repeat; I agree that glucose is a necessary component of life.  Few, I believe, deny that.  However, this does not imply that glucose is an essential dietary nutrient or that we must, or even should, eat it.  Being a necessary component of life and being a dietary necessity are far from the same.  Cortisol is necessary for human life yet you don’t need to eat it, and rarely should.  As with so many biomolecules, it’s far preferable to let the body adjust the levels depending on needs.

Paul Jaminet correctly states, as an example of glucose’s importance, that even in a state of starvation blood glucose is maintained right up until death.  However, what this really shows is that even if you are starving, and eating no carbohydrates, or fat, or protein, there is no such thing as “glucose deficiency” (unless insulin toxic or relatively rare conditions where glucose cannot be made sufficiently, such as cortisol deficiency, but the ‘safe starch’ advocates are not referring to this).  The body can easily make what it needs.

When you eat starch it is digested into glucose and before it goes anywhere it first enters the bloodstream.  All you will accomplish then by eating starch is to raise the blood glucose further. Therefore, one cannot correctly talk about a glucose deficiency from not eating enough.

One needs to rephrase the question from, “Are ‘safe starches’ necessary to eat or even beneficial?” to…

Question #1;

Is it better to eat the requisite glucose, or let the body make it?

The ‘safe starch’ debate boils down to whether it is better to eat the requisite glucose, or let the body make it when necessary.  I believe strongly in the latter.  We can never know exactly how much and when we will need extra glucose depending on environmental circumstances.  

Furthermore, when you eat the glucose, there are different effects than if your liver made it, namely it circulates for hours and leads to a spike in insulin and leptin, that circulates for hours, that over time will contribute to insulin and leptin resistance…that ultimately contributes to metabolic chaos and resulting chronic diseases of aging including obesity, diabetes, cardiovascular disease, osteoporosis, autoimmune disease, cancer, and others.

I have long summarized health by the ability to burn fat… or not. 

Eating glucose i.e. “safe starches” will spike insulin and will, at least temporarily, prevent one from burning fat…anyone.. a worm, a mouse or any human. It will raise leptin and will remove one from the healthy calorie restriction phenotype (see below).

Glucose, like all parts, must be orchestrated; where, when, how it is used is what will determine health and life.  The use of glucose, just like cholesterol and all biochemicals in our body, must be orchestrated.  Let’s not mess that orchestration up by forcing that glucose on us at a time, place, or purpose that is likely not in tune with what the body, or brain, wants or needs.  Let’s not mess with the orchestra unless we are absolutely sure that we totally know the score.

When we talk about significance of starches, safe or otherwise, the most important factor is their effect on hormones and other biochemical pathways that affect the harmony of 15 trillion cells needing to act as one for life and health.  And all starches raise insulin and leptin levels…a lot…having a long term adverse effect of insulin and leptin resistance; cells not being able to properly hear their life-giving messages.

Paul Jaminet and all the other safe starch advocates concentrate on blood sugar…and though it is unwise, to say the least, to eat glucose when one is trying to keep blood glucose down, diabetes is not a disease of BS, but of insulin, and more importantly, leptin resistance.  It is the effect of eating “safe starches” on insulin and leptin resistance that must be acknowledged and stressed.

Disease is not as much from the parts but much more from the misinformation given them.

Life is in the instructions, not the parts. It is not a lack of substrates, parts, that is generally the problem, but the instructions of what to do with the part; the effect on hormones that tell the part what it needs to be doing to maintain the health of the republic of parts and cells..

It is not an excess of cholesterol that causes heart disease.

It is not a lack of calcium that causes osteoporosis.

Disease is not due to glucose, excess or deficiency, but the communication that tells it what to do…and sugars, more than most anything, by non-enzymatic glycation and insulin and leptin resistance, messes up that communication.

Question #2;

If the body can make all the glucose it needs from other biochemicals, called gluconeogenesis, are there potential adverse effects from this?

This is a whole different story than talking about glucose deficiency. Furthermore, any potential adverse effect of gluconeogenesis would be determined from the initial precursor; whether one is using amino acids to manufacture glucose or other substrates that are extremely benign such as from ketones, the glycerol backbone of fats, or from lactate recycling. Those latter sources of glucose substrates separate from amino acids, under adapted carbohydrate and protein restricted conditions, can virtually make up the entirety of precursors for whatever glucose might be necessary.

Most people on my diet actually gain lean mass without increasing exercise, via protein sparing and increased sensitivity to insulin. Therefore, one can’t be burning much of their lean mass/protein, if any.  They are deriving their fuel from ketones, glycerol, recycled lactate and pyruvate.  This is perfectly healthy, more so than burning glucose.

Fat is a great fuel, the best fuel, furnishing fatty acids, ketones, and glycerol (that can turn into glucose if necessary), to burn.  I encourage you to see the fine summary of the great advantages of burning ketones at AHS 2012 by Nora Gedgaudas.  However, one needs at least two weeks to adapt to properly burning fat, more if older or overtly metabolically challenged.  I maintain that the symptoms that people are experiencing occasionally and calling glucose deficiency are nothing but inadequate adaptation to properly burn fat by either consuming too much carbohydrate or eating excess protein. 

Gluconeogenesis from protein requires deamination (cutting off the nitrogen), and the nitrogen molecule is then used to manufacture ammonia and urea that are both poisonous. This is why urine is called urine.  Burning protein is not healthy, but if you can’t burn fatty acids or ketones and you are limiting carbohydrates you will have no choice but to make glucose from protein, either from what you eat, or from your muscles, bone, or other protein sources.  You will not be too happy.  The trick then is to not eat more sugar/starch, but to adapt to burning ketones and fats…by eating less sugar, not eating too much protein, and eating fat if hungry.  You learn to ski by skiing.  You learn to burn fat by burning fat.

Question #3;

Is it that important to eat less than 100 gm starch?

Answer; Yes; that is where the deeper benefits lie. That is when one gets into ketone burning and when one can get into the calorie restriction, longevity phenotype. 

The worst diet to be on is high fat along with moderate and sometimes even low (as opposed to very low) carb.  If you are going to eat fat, you have to be able to burn it, and as little as 100 gm non-fiber carb/day can prevent one from adequately burning fat and ketones.  If one is going to properly follow my high fat diet, one must go all the way; very low sugar forming carbohydrates, and no more than adequate protein.

According to George Cahill, perhaps the world’s foremost expert on the metabolism of ketones and starvation, 100 gms/day of sugar forming carbohydrates i.e. starches is all it takes to prevent one from burning and therefore adapting to burning, ketones.

The best diet allows for maximal burning of fat and ketones.  This is also a high fat diet, but where non-fiber carbs are kept very low and protein is not consumed in excess.  (For most, this is between 50-70 gm protein/day depending on lean mass, exercise, growth and pregnancy.) There is a tipping point where a high fat diet goes from not so good to great as non-fiber carbs and protein are further lowered.

As one follows my diet more closely, meaning as little non fiber carbs as possible and avoiding excess protein (above 1 gm/day/kg lean mass for most), the beneficial returns not only increase, but accelerate.

In a diabetic, as one lowers their sugar intake, one will generally lower their blood glucose, at least to some extent.  But don’t get fooled into believing that the greatest results possible have been obtained.  Do not confuse better with best or even good.  It is easy to do better.  The typical diet is so bad that most any change will lead to improvement.

You won’t see the really deep benefits of actually lowering the “glucostat” and reversing hormone signaling resistance in the hypothalamus and morphing into a longevity phenotype until you get into what the brain and body thinks is not necessarily starvation in general but glucose starvation, whereby genetic expression will be totally shifted towards maintenance, repair, and longevity that would relate to both disease prevention and reversal. This metabolic adaptation to nutritional availability was set during extremely ancient times shortly after life began around 4 billion years ago and long before fat was used as a fuel, long before paleolithic man, when glucose dominated the oceans and was what to eat.

Question #4;

Is the VLC diet only better for “sick” people?

What I said 20 years ago is just as true today; Carbohydrates should be defined as fiber or not fiber.  Any carb that is not a fiber will turn to sugar and will cause harm…for any and everyone, males, females, monkeys and worms.  The only difference among the sugars and non-fiber carbs is how fast and how much harm will be caused.

In everyone, when one eats starches it quickly turns to sugar, glucose, fructose, galactose, etc. that will circulate and glycate the collagen that lines the arteries causing inflammation and cardiovascular disease and all of the other adverse effects of glycation.  This causes inflammation secondary to the AGE-RAGE reaction. Raising glucose raises insulin increasing risk of cancer. This is not safe and should not be called a safe starch.   ‘Safe starches’ is an oxymoron.

One should not discuss effects of starch only on blood glucose. What about intracellular glucose?  If you eat that sugar and it’s not in the circulation, where is it?  Much gets pushed inside cells causing intracellular glycation and cellular harm.  Lots will turn into liver fat. It has to go somewhere, and wherever it goes it will do damage. This is why it is better to talk about glycemic load than glycemic index. All sugar eaten will cause damage.

EVERYONE who eats starch will raise their glucose and/or insulin…a lot. Keeping glucose down by raising insulin is doing one no favors; just trading one evil, elevated glucose, by an even worse evil, high insulin.  (See “Insulin and its Metabolic Effects“). This was shown clearly by the ACCORD study.

.

If diabetes were properly diagnosed as improper metabolic signals, especially from insulin and perhaps even more importantly from leptin, then we all have diabetes to one degree or another..

Paul Jaminet and Chris Kresser have stated that maybe a very low carb diet is better for those who are sick with metabolic diseases, but not for ‘healthy’ people.  However, we all are in various stages of metabolic disease.  We all have some degree of insulin and leptin resistance.  Most wake up recovering from their dietary insults and are the most insulin sensitive they will be the whole day.  In other words, we all have some degree of diabetes, if it were diagnosed properly.

When you eat a so-called ‘safe starch’ meal, many people’s blood glucose, if not most, will go above 126 mg/dl, meaning that if they were fasting, they would by definition be called a diabetic.  The fact that they were not fasting does not mean that the glucose does not do the same harm as if they were fasted.  Eating several such meals/day would mean that the supposed ‘healthy’ person was ‘diabetic’ most of the day and perhaps only upon awakening was the BS at a healthier range…and this is saying nothing about insulin and leptin levels and resistance, where the underlying disease actually resides.

Life’s commonalities are much more critical to life than the differences, since life can’t live without them. (See my next blog, an essay I had written a few years back called “The Transcendence of Commonality Amongst Individuality”.)

The basics of metabolism are true for all people, in fact virtually all life. This is why worm studies are important to us.  Human insulin and glucose will work in a worm just as it does in a human, causing damage and shortening lifespan when elevated.

Starches, “safe” or otherwise turn quickly to glucose in any animal that can digest them and all will get the same side effects; it will cause glycation, AGEs, raise insulin, leptin, whether you have blue eyes, brown eyes, are a mouse or a worm… This is the advantage of getting further down, closer to the roots of disease; differences fade away and the commonalities are left to see…and treat.

Yes people are different, but the basics that we are talking about here are not only true for all people but transcends humans and are true for virtually all animal life. It is worth repeating; if you eat a non-fiber carbohydrate (sugar or starch), it will raise your blood sugar, as it would your neighbor’s blood sugar, and it will raise virtually every person’s blood sugar in the world…and every dog’s, and every worm’s blood sugar… In turn, raising glucose raises insulin and leptin and accelerates the rate of aging, and the symptoms of aging, including cardiovascular disease, diabetes, obesity, osteoporosis, and cancer.

OTHER POINTS

Kitavans and Okinawans are poor examples to use in defense of carbohydrates.

I have consistently heard those in the Paleo, higher carbohydrate camp refer to the Kitavans as an example of a population eating a high carbohydrate diet and supposedly being much healthier, and the conclusion often made is that their high carbohydrate diet is causing the improved health of Kitavans.

It’s interesting to look at small subpopulations such as the Kitavans, but not more. Basing dietary recommendations on that is fraught with error. They are a very small, isolated group of people that easily could have certain genetic anomalies that might allow for longevity (even though they don’t particularly live a long life).  Kitavans also mostly eat one major meal a day and that offers benefits in spite of any starches since most of the day they are calorie and protein restricting.  Both are highly correlated with longevity in many animal studies.  Partly because of this they’re much smaller than the average Western population, the average male being 5’4″ tall and female being 5’1″.  It is known that smaller members of a species such as dogs live longer, and there is evidence that this may also apply to humans.  This is likely related to lower IGF-I levels, a well studied longevity factor in animals. Was this measured in the Kitavans?  How about mTOR, also associated with lower protein intake and strongly associated with longevity?

Little mentioned of the Kitavans is their high intake of coconut oil.  This is very high in medium chain triglycerides that have been shown to have numerous and powerful metabolic advantages. That is the trouble with population studies. It is impossible to control all of the variables in diet and lifestyle.

But do Kitavans have extended longevity?  That’s quite debatable. They do not have a higher number than average of centenarians (if any) and do not apparently have higher than (even post 50 year old to account for high infant death rate) average lifespans.

A serious mistake so frequently made in health and medical studies is confusing correlation with causation. This is well illustrated with virtually all of the studies that correlate cholesterol with heart disease.  But even here, in the Kitavan study, the most one can say is that their health and longevity, if indeed they have increased longevity, is correlated with a diet and not caused by it. It could be that the diet is an innocent bystander and that the real cause of their enhanced health is from their short stature and the possibly related low IGF-1 and mTOR.  They may even be healthier in spite of their diet.

Being short and thin, with likely low IGF-1 levels, eating a somewhat protein restricted diet high in MCT’s, the Kitavans have several known reasons to live long, healthy lives. Even so, they do not have remarkably long lifespans. It is this that needs to be explained. Why not? Perhaps because they are eating high amounts of starches. In other words, rather than the notion that is being perpetuated by starch proponents that Kitavans live a long, healthy life secondary to eating starches, it could be that whatever health benefits that are being experienced by Kitavans are in spite of the starches rather than because of them. It is very possible, in fact probable, that they would live even longer and healthier lives if they ate a high-fat, very low carbohydrate diet in addition to their other advantages, thus keeping glucose and insulin lower to go along with their likely lower IGF and mTOR.

All one can say is that Kitavans, with their diet of far less junk food, higher (cellulose) vegetables, high MCTs, lower protein, that may help result in short and lean stature likely secondary to lower IGF-1and mTOR (known longevity factors in animals), with their less stressed lifestyle gives them low rates of heart disease and diabetes but with only an average lifespan with few centenarians, that may likely be despite eating starches than because of it.  And this is the best example that ‘safe starch’ advocates can come up with??

As far as the Okinawans; simple. They are calorie restricted, eating a diet higher in fish and vegetables, and lower in rice than their mainland counterparts.  In the most comprehensive study pertaining to the Okinawan diet and longevity, the following was found;

“Findings include low caloric intake and negative energy balance at younger ages, little weight gain with age, life-long low BMI…and survival patterns consistent with extended mean and maximum life span.”

The study concluded…

“This study lends epidemiologic support for phenotypic benefits of CR in humans and is consistent with the well-known literature on animals with regard to CR phenotypes and healthy aging.”

I have not seen a breakdown of the calories eaten, but since they eat more fish and fibrous vegetables than their mainland counterparts and lower calories, simple logic could conclude that they eat fewer non-fiber carbohydrates, which, along with reduced stress, may account for their increased average lifespan.

Caloric Restriction, the Traditional Okinawan Diet, and Healthy Aging,  Annals of the New York Academy of Sciences, Volume 1114, Healthy Aging and Longevity: 3rd International Conference, p 434–455, October 2007

We must understand the limited information allowed by laboratory tests to interpret them properly.

Lowering thyroid (or raising rT3) is not hypothyroidism.

Lowering WBC does not mean impaired immunity, but perhaps less stress on the immune system, or stronger WBCs as far as phagocytic activity, therefore requiring fewer of them. Lowering insulin does not necessarily mean T1 diabetes.

Centenarians and CR (calorie restricted) animals including humans have lower free T3.

I don’t doubt that Paul’s diet is a good one.  There lots of good diets and virtually any diet that is different than the typical American diet will be better.  But we are not just talking about better. We’re not talking about improving diabetes but reversing diabetes, heart disease, and slowing down the aging process itself.  The major benefit of a very low carbohydrate, moderate protein, high-fat diet, and what will get you to the next level of health, is the adaptation to constantly burning fat and ketones and thus requiring less glucose. By forcing the intake of 100 gm or more of glucose into the body you would prevent that adaptation (according to George Cahill) and would prevent experiencing the truly deep benefits of a very low carbohydrate, high-fat diet.

The lowering of free T3 is a sign of that deep adaptation, and, according to Paul, when you follow his diet you prevent the lowering of free T3. That is powerful indication that following a “safe starch” diet is preventing one from changing into a calorie restriction phenotype and preventing the genetic expression and adaptation to deeper maintenance and repair that equates to health and longevity that a very low carbohydrate, high-fat diet would otherwise allow the opportunity for.

Age and Ageing 2010; 39: 723–727

Down-regulation of thyroid hormones, due to either genetic predisposition or resetting of thyroid function favours longevity.” [emphasis mine]

It is important to understand nature, and to understand what its primary directive is…and its primary directive is not longevity, and certainly not post reproductive health and longevity.  For that we have no footsteps to follow. As far as I know, no other species is purposely trying to live a long, healthy post reproductive lifespan.  For that we only have the best science go by.

What, or even whom, is evolution selecting for? Evolution does not select for (somatic) longevity.  However it wants to keep the genome immortal.  If one looks at an individual human or any animal or any life, it can be broken down into the soma, the body, and the germline.  The soma is there to take care of the germline and see it through to the next generation. The soma is taking the chromosomal baton that had been handed to it and passing it to the next soma to take care of that chromosomal information so that it too can do the same to the next generation. As such, our germline has stayed immortal since the beginning of life.  The soma becomes expendable and takes the environmental hits, the oxidation and glycation and other insults.  It is the shield that protects your genetic information from that damage.  It is why we even age.  Therefore, the only longevity that can be talked about is the immortal longevity of our germline and the “expendableness” of our soma. The longevity of the soma becomes, at least for nature, irrelevant outside of that.

Until we understand that nature cares little for us living a long and healthy life and until we go beyond what is typically “natural”, we will continue to do what is very natural, and it is inevitably natural to get sick and die soon after our children can stand on their own two legs, as it were.

Any discussion of health and medicine should at least take into account the biology of aging.

Life is a constant battle between damage and repair. It is repair that we have the most control over, and is therefore the most important.

As far as damage; there are at least 2 major sources.  We have only limited control over oxidation. This, by definition is from oxygen. However, you shouldn’t stop breathing.

Glycation.  Don’t eat glucose.  Any excursion increases glycation.

Repair; The biology of aging convincingly shows nutrient sensors including insulin for glucose and mTOR for protein, control a genetic pathway that is almost universally conserved among all animal life from single celled yeast onward to humans.  Science also is showing that leptin controls the healthy phenotype imparted by calorie restriction in so-called higher organisms that use fat as a primary fuel. 

It appears that nature has all sorts of tricks up her sleeve to allow the members of the species to live as long as necessary to impart a reasonable chance of reproductive success. Tricks such as intracellular antioxidant up regulation, DNA repair, increased autophagy (cellular garbage collection), are all enhanced when nature believes this is necessary, including times of hardship such as perceived famine. Those nutrient sensors are controlled by the amount of macronutrients in each meal, sugars and proteins raising all of them…but not fat.  When these nutrient pathways are raised, cells are told to multiply and repair is diminished, accelerating aging and increasing risk of cancer in complex multi-celled people.

Paul Jaminet and the other ‘safe starch’ advocates seem to be concentrating only on the on potential damage, or lack thereof, secondary to glucose, including mitochondrial damage.  I, along with many biology of aging experts, believe strongly that glucose is a major cause of molecular damage in all life and that it contributes to aging.  However, the “accumulated damage” school of aging, especially as it pertains to reactive oxygen species is really quite archaic today.  Being ignored is the effect of eating glucose on the above extremely important nutrient sensing pathways that help regulate the genetic expression of extremely powerful repair mechanisms.  To dig into this ancient health-promoting pathway, one must simulate glucose deprivation and eat far less glucose forming carbs than recommended by ‘safe starch’ advocates.

Controlling intake of protein is very important.  I believe that I was the first low carb advocate to disavow high protein and instead recommend higher fat.  I was then and am now extremely confident that I am right.  I had plenty of friendly disagreements with the Eades about protein when we worked together, as they believed high was good as did almost all low carb advocates.  My public talk/debate with the Eades at ASBP (American Society of Bariatric Physicians) in 2006 that is posted on my site – Protein: The Good, The Bad and The Ugly and several others, where I introduced the science of mTOR and the relationship between protein, cancer, and aging changed a lot of minds about high protein including apparently Jeff Volek and Steve Phinney who are now embracing the lower protein and higher fat diet in their books.

A quote by Oscar Wilde that is very apt, “Everything popular is wrong”quote everything popular is wrong1 A Conclusion to the Safe Starch Debate by Answering Four Questions

A low fat diet to lose weight and treat diabetes and even that diabetes is a disease of blood sugar…

Take calcium to strengthen bones…

Cholesterol causes heart disease…

Even low carb advocates pushing high protein…

I have long said these were all wrong, and I have argued against them all for 2 decades…and I will be shown ultimately to be correct on all counts…

I have used my diet to save many lives. I have been fighting for my VLC, high fat and no more than adequate protein diet and the importance of insulin, leptin and mTOR to be accepted, since I am certain this can save millions more.  No offense, but comparatively ‘safe starches’ is just a speed bump.

 

© Copyright 2012 Ron Rosedale, M.D.

 

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62 Comments

  1. Dana
    Posted August 18, 2012 at 3:24 pm | Permalink

    I think the Kitavans are getting away with the starch in their diets (1) because they are still eating plenty of protective animal foods and (2) because they are getting a lot of sunshine. Get into Stephanie Seneff’s thought processes about sulfated cholesterol and sulfated vitamin D to see why (2) probably matters.

    Those of us not living in an equatorial or tropical region are going to have to adapt to having less of that UVB sunlight. That includes not eating all those carbs that the UVB allows us to adapt to, under Seneff’s model. Which is going to be most people worldwide, by now, and particularly people in the United States and Europe and northern Asia.

    I can think of one population that “needs” to eat glucose-forming foods, and this is from personal experience: I found while I was nursing that if I ate too little glucose, I made less milk and was in danger of my milk supply drying up. (You can tell by feel, if you’ve done it for long enough.) Glucose cascades to galactose which cascades to lactose, and human milk is high in lactose. But there is still a case to be made here for nursing mothers to monitor themselves closely and strike that balance between good milk production and good blood sugar control. So this probably explains why women seem to crave carbs more than men. Still, if you’re not lactating, you can live without it.

    • Jonathan Swaringen
      Posted August 19, 2012 at 10:03 am | Permalink

      What were your glucose levels like when your supply was drying up? Were you eating less than 50 g carbohydrate less than 100? I’m curious as to whats required. There is a difference between requiring 20 g and 100 g so it might be good for people to know.

    • Janknitz
      Posted August 20, 2012 at 6:50 pm | Permalink

      BTW, it sounds like you and Dr. Cate Shanahan took a lot of undeserved flak at AHS for daring to suggest the Okinawan diet is not starch-based when newly minted PhD doctor Chris Kresser was citing an old study from 1949. As you point out, it makes no sense to think that the primary source of calories in the diet of a people living on a tropical island surrounded by waters teeming with seafood and sea vegetables and well known for their proclivity for pork could be considered “starch based”.

      I grew up on the island, and rice was served at every meal, but I don’t even remember seeing much sweet potato. Meat and or fish were staples at every meal, along with an abundance of vegetables. Pork was a major source of fat and protein. I laugh when I see googling around that someone has even concluded that the Okinawan diet is vegan. Clearly someone who has never been there!

      Chris Kresser relied heavily on a questionable retrospective study written at a time the island was still recovering not only from the devastation of WWII (I’ve heard accounts that claim that not a tree was left standing on the island after the war, the beaches were full of unexploded ordinance), but oppressive occupation before the war. People who lived in that time told us stories of being too poor to buy a pair of rubber zorries (flip flops) once a year.

      Starvation was widespread on the island immediately before and during WWII. It’s that starvation–a.k.a. calorie restriction–that is most likely a factor in the longevity of Okinawans along with their relatively healthy omnivorous diet, NOT the starch they eat.

      • Dr. Ron Rosedale
        Posted August 22, 2012 at 1:47 am | Permalink

        thanks for your points..

  2. js290
    Posted August 18, 2012 at 7:49 pm | Permalink

    It’s a logical fallacy to claim that VLC is good for sick people but not for healthy people. Something cannot be A (healthy) and ~A (unhealthy) at the same time.

    I’ve often wondered if the people claiming to have thyroid (typically low energy) problems on a VLC simply are not eating enough? That is, the claim is that by adding back carbs into the diet, they miraculously solved their low energy/thyroid problems. Perhaps all that really happened was they ate more, which happened to have been carbs. My guess is they would have experienced the same effect by eating more fat.

    This is really a very fundamental concept that anyone who’s gone through a differential equations class should pick up very quickly: the concept of a coupled system. That is, energy input and energy output are coupled in the mathematical sense; therefore, they cannot be treated independently. Changing one affects the other, probably in very non-linear ways. So, if one understands coupled systems, then one can immediately reject the notion of “eating less and moving more.” Because eating less may cause one to move less. And, in order to move more, it may absolutely require eating more.

    As an unqualified skeptic, that’s my guess on the supposed “thyroid problems” that people claim to experience. They either aren’t fully keto-adapted, they aren’t eating enough, or both.

    • Jonathan Swaringen
      Posted August 19, 2012 at 10:01 am | Permalink

      Some of this may be not enough Sodium as I have read in The Art and Science of Low Carbohydrate Living/Performance that Keto diets or diets with lower amounts of carbohydrates cause sodium dumping so sodium needs may be higher. I think this might have been temporary…not sure.

      Sadly I still have low energy ….and I think I’m eating enough fat…could be many things though. Good article though.

      • Elenor
        Posted August 26, 2012 at 1:08 pm | Permalink

        Interesting, because one of the suggestions provided in the hypo-thyroid/adrenal fatigue “world” is drinking a TBL or so of sea salt every day. (Some drink it in orange juice (YUCK!) or, as I did, in plain water.) It helped. Was it because a somewhat LC diet was shorting me on salt? {shrug} Dunno, I ended up taking physiological (i.e., not “treatment”) doses of hydocortisone that, over a couple of years, ameliorated my adrenal fatigue symptoms pretty amazingly.

        • Jonathan Swaringen
          Posted August 26, 2012 at 2:28 pm | Permalink

          The salt thing is talked about in The Art and Science of Low Carbohydrate Living/Performance

          Apparently when you hit a certain low point of carbohydrates the body dumps salt. They advise extra sodium of about 5000 mg instead of 2300 mg recommendation. Either from using home made bone broth or good bouillon cubes. Another option would be to liberally use unrefined sea salt of your choice.

          • Dr. Ron Rosedale
            Posted August 26, 2012 at 3:25 pm | Permalink

            If insulin was high to begin with, it will significantly reduce on my diet. This allows the excretion of extra retained sodium and fluid in the urine. This has the effect of greatly reducing retained fluid, and helps to lower blood pressure if initially high. However, it is quite imperative that electrolytes, especially potassium and magnesium, be replenished for the first month of following the program. Sodium replenishment would depend on how much, if any, excess sodium the person had to begin with. This is very easily measured in the blood since most sodium is extracellular, compared to potassium and magnesium that is mostly intracellular and much harder to measure.

            It should also be noted that if one is “adrenal fatigued” and cortisol levels are low, this will also lower blood pressure, such that going on the diet might make one feel poorly. As such, taking salt would raise the blood pressure and make one feel somewhat better, though the underlying problem of adrenal insufficiency is what really has to be dealt with.

            I appreciate your excellent comment.

    • Posted August 20, 2012 at 7:00 pm | Permalink

      Your calorie explanation sounds plausible, but untrue in my case. I think one of the problems with many of the theories and chatter about this effect is that it is very difficult for people who have few problems transitioning to the diet to understand or even believe that the issue exists.
      The problem with the explanation by many low carb experts is that it oftentimes does not adequately address that transition phase. I know in my own case, had I not backed into a lower carb diet accidentally, I would never have stuck with it. Returning to the “safety” of a high carb diet can really make a difference to people who are on the edge hormonally, at least adrenally.
      It doesn’t help much when people continue to insist that we are all doing it wrong. I followed a number of plans religiously. Now that I know how it feels on the other side, I have no problem going through a bit of hell to get back into a fat-burning state if I get out it for some reason. I have developed short cuts. Before I did Kruse’s leptin reset with CT, re-entry meant certain loss in weight, but also loss of sleep ability, libido, energy, and feeling constantly cold.
      I do not think it is wise for the low carb community to ignore such data. There are plenty of people in the high-carb community who are more than ready to bash us for their perception of the failings of our diet. Let’s not give them any more ammo by not dealing with it. Instead of sweeping such data points under the rug, it would serve us well to stir them up, take a look, and make the diet more workable and successful for everyone.

  3. Posted August 19, 2012 at 1:32 am | Permalink

    Thanks för this very enlightening post. I took the liberty to linkt to it and write about it on our Swedish lchf.se blogg since I think a lot of the LCHF (Low Carb High Fat) community in Sweden needs to read it.

    • Dr. Ron Rosedale
      Posted August 19, 2012 at 2:41 am | Permalink

      Thank you, would love to see your blog. Sweden is really leading by example on the VLCHF, would love to visit.

  4. Pam
    Posted August 19, 2012 at 8:36 am | Permalink

    Dr. Rosedale, thank you. As always, an informative voice of reason amongst the noise.

    I saw you speak at PaleoFX in Austin and am now re-watching you on the DVD’s.

    Please keep getting your message out! As a 50 year-old woman, the ONLY diet that has worked to help me lose weight, lower my FBG from the low 100′s to…82! yesterday, improve my skin, blahblahblah…I could go on for days…is VLC, high fat (1/4-1/2 coconut oil daily!), adequate high-quality protein (fish, fish, meat with sat-fat, more fish).

    • Dr. Ron Rosedale
      Posted August 19, 2012 at 7:58 pm | Permalink

      When you do it right, as clearly you are doing the results will always speak for themselves. Great job and thank you for posting your experience and success.

  5. Posted August 19, 2012 at 11:12 am | Permalink

    I had an interesting exchange of comments with Dr. Jaminet here:

    http://wp.me/p25oah-7l

    Also, an evolutionary perspective on T3 levels and dietary carbohydrate:

    http://www.medical-hypotheses.com/article/S0306-9877(04)00169-0/abstract

  6. Posted August 19, 2012 at 11:53 am | Permalink

    Man, have I got some stuff to say about THIS! First, thanks Dr. R. for your insights, your diet must work since only proper brain chemistry could enable such clarity of thought. “The scientists of today think deeply instead of clearly. One must be sane to think clearly, but one can think deeply and be quite insane.” — Nikola Tesla

    When one considers the entirety of the evidence against it, the whole ‘safe starches’ concept comes dangerously close to comprising a boatload of insanity. It’s proponents appear to be over thinking the issue in an attempt to dazzle everyone with their brilliance, or maybe their brains are swimming in glucose from eating too many ‘safe starches’. I’ll take clear & common sense reasoning and simple truths any day over complex & convoluted arguments and reading contrived ‘studies’ ad infinitum.

    Here’s another clear thinker, MD nutritionist Natasha Campbell-McBride, “majority of starches are undigested, & besides feeding beneficial bacteria they also feed the intestinal pathogens”, so advocates no starches, 26:00 minute mark here: http://goo.gl/2KGrS

    Also, from Wikipedia re Sorbitol, the Polyol Pathway and Aldose Reductase: “While most cells require the action of insulin for glucose to gain entry into the cell, the cells of the retina, kidney, and nervous tissues are insulin-INdependent, so glucose moves freely across the cell membrane, regardless of the action of insulin. The cells will use glucose for energy as normal, but **ANY glucose not used for energy will enter the polyol pathway**. Aldose reductase is the first enzyme in the sorbitol-aldose reductase (polyol) pathway[12] responsible for the reduction of glucose to sorbitol, as well as the reduction of galactose to galactitol. When blood glucose is normal (about 100 mg/dl or 5.5 mmol/l), this interchange causes no problems, as aldose reductase has a low affinity for glucose at normal concentrations.
    In a hyperglycemic state, the affinity of aldose reductase for glucose rises, causing much sorbitol to accumulate. Too much sorbitol trapped in retinal cells, the cells of the lens, and the Schwann cells that myelinate peripheral nerves can damage these cells, leading to retinopathy, cataracts and peripheral neuropathy, respectively.
    Aldose reductase inhibitors, which are substances that prevent or slow the action of aldose reductase, are currently being investigated as a way to prevent or delay these complications, which frequently occur in the setting of long-term hyperglycemia that accompanies poorly-controlled diabetes. It is thought that these agents may help to prevent the accumulation of intracellular sorbitol that leads to cellular damage in diabetics.[13]”

    Great! Just what the world needs, more pharmaceutical drugs melting peoples livers & kidneys and leading them down the false primrose path of, and reinforcing, the treatment of symptoms rather than avoiding and eliminating the dietary causes of disease, including the much loved ‘safe starches’.

    And that’s just sorbitol, don’t even get me started on how high serum serotonin from eating high serotonin carb foods causes coronary fibrosis, atrial & ventricular fibrillation and electrophysiology disruptions that’s killing the carb loading extreme performance athletes.

    There’s too much freely available information just within Wikipedia to quote or cut & paste here, or to justify such a high level of scientific ignorance. I’m going into the bumper sticker business, my first one being THINK CLEARLY, NOT DEEPLY. Problem is that to think clearly you gotta go VLC-MP-HF and drop the ‘safe starches’ too.

    • Dr. Ron Rosedale
      Posted August 20, 2012 at 11:23 pm | Permalink

      You make some great points.. Thanks much for your comment.

  7. Ironmoon
    Posted August 19, 2012 at 12:05 pm | Permalink

    What about athletes on HF diet and protein recommendation for them?

  8. darrin
    Posted August 19, 2012 at 7:42 pm | Permalink

    Hi Dr. Rosedale, thx for the Post.
    I have a query if i may regarding thyroid blood tests and lab ranges.
    I have read that the ‘normal’ ranges specified in lab results are usually too wide, so a normal value (within range) may not be necessarily be an optimal value.
    So to my query, if you were to refer to blood tests (in addition to symptoms), could you give me your optimal range numbers for the flowing please,
    TSH, fT3, fT4, rT3.
    I specified freeT3 & freeT4 (instead of T3 & T4) because that it was the labs use in my part of the world.
    If you do have a chance to respond, could you please specify the units as well, as i know these vary from Country to Country (tho i think TSH is pretty consistently mIU/L). Where I am we use pmol/L for fT3, fT4 & rT3, but i can easily convert what ever you specify.

    Thanks

    • Dr. Ron Rosedale
      Posted August 19, 2012 at 7:51 pm | Permalink

      I prefer fT3 between 2.2 – 2.5 and TSH anywhere between the normal range of that lab, and the others are relatively irrelevant.

      • darrin
        Posted August 19, 2012 at 8:07 pm | Permalink

        thx for the quick reply.

        Is the fT3 of 2.2 – 2.5 in pmol/L?

        • Dr. Ron Rosedale
          Posted August 19, 2012 at 8:16 pm | Permalink

          pg/ml

        • darrin
          Posted August 19, 2012 at 8:43 pm | Permalink

          for anyone interested in the alternative fT3 units,
          fT3 2.2 – 2.5 pg/ml (0.22 – 0.25 ng/dl) = 3.38 – 3.84 pmol/L

      • Sharon
        Posted May 11, 2013 at 9:04 pm | Permalink

        So what if your TSH is 5.08 and your Free T3 is 2.1?
        What are we to do to keep from going into Hashi’s?
        I actually took the antibody test . TPO was 7, the AB was <20.
        I am going to test again at the end of May and I'm hoping that I don't have a problem. I feel ok, good energy. I keep hearing that there are over 300 symptoms for HypoT and Hashis and if you have only 3 symptoms, you have it.
        I don't want to throw hormones at this problem. I think we need to get to the root cause and fix it. Any suggestions?

        • Jonathan
          Posted May 27, 2013 at 10:20 am | Permalink

          You should read The Iodine Crisis by Lynn Farrow, Iodine by David Brownstein, and Stop the Thyroid Madness website and book by Janie Bowthorpe.

          There is a free to join Yahoo Group for Iodine and an Iodine OT group. You have to request access to the Iodine group, but it doesn’t take too long to go through.

          http://www.stopthethyroidmadness.com/how-to-find-a-good-doc/

          The Iodine practitioners link would be a good idea if you can find one of those.

          http://goo.gl/XaIo4

          tinyurl.com/iodine-references

          Two different Iodine supplementation guides. There is a good chance with Thyroid problems that you are Iodine deficient and/or you have problems with the Iodine symporters which uptake Iodine into the areas where its needed.

          This is the Iodine I buy. The second one is a a bulk bottle to refill the smaller ones.

          http://goo.gl/ibgA5

          http://goo.gl/extv2

          Good luck hope this helps you out. Keep us posted.

  9. steve
    Posted August 19, 2012 at 7:52 pm | Permalink

    Dr Rosedale:
    You suggest nuts as an improtant part of your program. What would you suggest for those who cannot eat nuts of any kind due to allergy? Seems to be an important part of your diet for both fat and some protein which you otherwise want limited.
    Also, can you cite any long lived, healthy populations that eat any diet near yours?
    Thanks,

    • Dr. Ron Rosedale
      Posted August 19, 2012 at 8:10 pm | Permalink

      You do not have to eat nuts, it is just a handy food to have if you are on the road a lot. There are many ‘studies’ on many animals based on the science of the biology of aging that have been published. Also here is a published study on people which was based on my diet. http://drrosedale.com/resources/pdf/Clinical%20Experience%20of%20a%20Diet%20Designed%20to%20Reduce%20Aging,%20JARCET-3.pdf You would have to wait for another 40 years in order to get the long term studies that you are talking about. Most scientific studies are very expensive and mostly funded by pharma, the Rosedale Diet takes people off their drugs so not a great candidate for large funding possibilities. The Rosedale Team

  10. Janknitz
    Posted August 19, 2012 at 11:52 pm | Permalink

    Am I correctly understanding you to mean that T3 normally goes down and TSH up on a VLC diet and it’s a metabolically normal process?

    My TSH was up to 5.49 and I was told I needed to be on thryroid hormones. I have an HMO that refuses to test T3, and the endo adamantly denies that diet can have anything to do with thyroid levels. While I was waiting for the endo referral I upped my fat and calories (I was eating too few calories) and my TSH came down to 3.2 But I was told that I was still hypothyroid, that my change in diet had nothing to do with it, and I needed to be on a synthetic T4 med.

    I don’t FEEL hypothyroid. My basal body temp is low, but I feel plenty of energy and warm despite the low BBT. I am vary wary of taking this med–I don’t think it’s necessary.

    I’m also concerned that the limited testing done doesn’t tell the entire picture.

    OTOH, my weight loss is extremely slow and often stalled, despite being low carb (20 to 30 grams/day), grain free, starch free, and lately I’ve reduced dairy. I eat plenty of fat and adequate protein. I’ve managed to lose 52 lbs to date, but it’s been agonizingly slow (13+ months). I’d love to have a boost from thyroid hormone to help me lose weight faster, but I’m not convinced I need it or it’s a good thing for my body.

    • Dr. Ron Rosedale
      Posted August 20, 2012 at 5:34 pm | Permalink

      I think you had a slight misunderstanding; TSH normally does not go up; usually it remains unchanged or in fact even goes down a little bit indicating that hypothyroidism is not being caused by a VLC diet.

      Furthermore, the fact that your thyroid function improved on a VLC, high-fat, adequate protein diet is usual and it could very well be that you are not hyporthyroid even though your TSH was initially high. What remains to be known is if you have auto-antibodies that are attacking your thyroid (easily measured in the blood). If you do not, then you do not have hypothyroidism currently, and following my diet will make it far less likely that you would get it in the future. Thanks for the question and comment.

      • Janknitz
        Posted August 20, 2012 at 6:46 pm | Permalink

        Thanks, I can’t get the HMO to test auto-immunity either, because they claim it won’t change the treatment plan. And the HMO endo has warned me that independent testing is innacurate, meaning that even if I bring independent results indicating auto-immunity they will be discredited.

        • Dr. Ron Rosedale
          Posted August 20, 2012 at 11:26 pm | Permalink

          That is too bad about your medical care but not surprising. Actually it is the only way to diagnose whether you have a problem or not and would change the treatment completely, i.e. whether it might be beneficial to rest your own thyroid by taking some thyroid or not. At this point, I would not.

      • Sharon
        Posted May 11, 2013 at 9:12 pm | Permalink

        Dr. Rosedale, what is the ceiling for antibodies in the blood for Hashis?
        I mentioned in another post that I tested TPOin November, 2012 and I had 7. Is the presence of any AB an issue. My AB test was <20.
        Keeping in mind that the test before that read 5 and jumped to 7 concerned me.
        Is there a range and am I in the safe range?

  11. Ameer
    Posted August 20, 2012 at 4:11 am | Permalink

    I commend you Dr Rosedale on this excellent post. From reading your work, Pauls, Chris etc…. I have not yet stumbled around the simple fact of seasonal eating? Is it not natural in the purist sense that we follow a seasonal pattern? Restricting Carbs in the summer may in the long run have a negative impact on our Gut flora. I just find it, the two camps fight over such a ” Black and white subject ” When in reality like you pointed out, many human have different polymorphism. We need not worry about finite details of how many grams of Carbs, I think as a species we should concentrate more on Quality of food, and location of food.

    I myself am a proponent of a High fat Keto diet in the winter, due to the fact in nature that’s all I had, but in the summer I indulged in fruits, veggies and tubers. Seasonal eating, combined with quality food, will increase the Gut Flora of any individual. This is just my two cents .

    Thank you.

    Ameer

    • Dr. Ron Rosedale
      Posted August 22, 2012 at 1:44 am | Permalink

      thanks for your thoughts.

  12. Shaun
    Posted August 20, 2012 at 4:05 pm | Permalink

    Protein spikes insulin too. Should we stop eating protein?

    • Dr. Ron Rosedale
      Posted August 20, 2012 at 5:28 pm | Permalink

      Protein is an essential nutrient; we must eat it to live. We don’t have to eat any glucose forming foods at all; it is a non-essential nutrient, so why harm your body with it? Though protein does spike insulin, it does so to a far lesser degree than glucose. Even so, I have made many comments and points that stress that excess protein is not good either. What should comprise most of our diet is fat and this hardly spikes insulin and perhaps even more importantly, leptin, at all. Thanks for the comment.

      • Posted June 5, 2013 at 6:26 am | Permalink

        Hi Dr. Rosedale –

        How much protein do you reccommend if you are trying to build as much muscle as your genetics will allow?

        Thanks,
        Fred Hahn

        • Ron Rosedale, M.D.
          Posted October 9, 2013 at 12:24 pm | Permalink

          Hi Fred, Fiona here from the Rosedale Team. I am so sorry your message was not answered sooner. Dr. Ron says to up your protein maybe 10% from what is recommended. There is a fine point though, if you are looking for those beefy pumped up muscles there is a point when it becomes not healthy, and that is a choice an athlete will make. There is a great thread here where two athletes were comparing their own notes and testing. https://drrosedale.tenderapp.com/discussions/questions/2538-rosedale-diet-for-athletes

  13. Shaun
    Posted August 20, 2012 at 4:22 pm | Permalink

    Insoluble fiber causes digestive problems for many people and saturated fat down regulates LDL receptors. Basically, every macro nutrient is bad to some extent.

    • Dr. Ron Rosedale
      Posted August 26, 2012 at 9:59 pm | Permalink

      True, but some macronutrients much worse than others. Thanks

  14. Mario
    Posted August 20, 2012 at 10:06 pm | Permalink

    Dr Rosedale,
    What do you think of the following paleohacks web page? Thank you.
    http://paleohacks.com/questions/108225/the-high-blood-glucose-dilemma-on-low-carb-lc-diets#axzz249Y26D42

    “If you are on a ketogenic or very low carb (VLC) diet (e.g. with 50-100gr carb/day and/or eating ketone producing MCT oils such as coconut oil), you may have a dilemma of having high Blood Glucose (BG) despite eating LC: If you are keto adapted, that is, your body is using ketones and even though you have sufficient insulin (say >5 microU/ml) your body tries to keep your BG higher than necessary, e.g. above 100-110 mg/dl. That is your BG set-point is always high. If you try to lower the set-point to say 80s, by water Intermittent Fasting (IF), then your body starts to convert your muscles into glucose to keep its high BG set-point. So, you may have a slightly lower BG, but you lose some muscle mass. Having a high set-point has many other problems, e.g. if you eat something with a little bit more carb, say a small fruit, your BG shoots up to 130s and stays there for hours.

    “…methylgloxal, which is higher in VLC and ketogenic diets and 20000 times more glycating than glucose…”

    • Dr. Ron Rosedale
      Posted August 27, 2012 at 10:51 pm | Permalink

      It is factually very wrong and misleading. It might be a good topic for a blog post to explain why.

      Thanks for pointing it out.

      • Dave
        Posted August 28, 2012 at 11:15 am | Permalink

        Dr. Rosedale,

        I would very much appreciate a blog post on this, because my personal history seems to lend credence to the premise of the Paleo Hacks post..

        Long story short I was diagnosed w/ T2DM 2 1/2 yrs ago and thank God I didn’t go on the diet and drugs recommended by the endo. I instead went on the Atkin’s Induction diet, and my fasting BG levels dropped into the 80′s for the first month, but subsequently (while remaining faithfully fat dominant VLC with organic paleo food choices) climbed into the 120′s and sometimes 130′s. I should add that during that time I went from 220 to 170 lbs. and am now 12% to 13% bodyfat.

        Subsequently I went from < 30g net carbs per day to between 50 and 100, and now my FBG's are between 100 and 110 typically.

        What's going on if not too few carbs?

        Thanks,

        - Dave

  15. anand srivastava
    Posted August 22, 2012 at 12:46 am | Permalink

    Dr. Rosendale, why did you ignore the first question?

    • Dr. Ron Rosedale
      Posted August 22, 2012 at 1:22 am | Permalink

      The comments are in reverse order. The comment in question was the most recent, not first. Dr. Ron as been quite busy the last day, though he has read them, and is honored that you all have taken the time to write. Also. some answers Dr. Ron can answer quickly, others require longer. He wants to reply in the depth that is required, and he will reply to this as soon as he can. The Rosedale Team.

  16. May
    Posted August 27, 2012 at 2:27 am | Permalink

    Hi Dr Rosedale,

    Thank you for this detailed and informative post – it is greatly appreciated.

    I would be very grateful if you might be able to address 3 issues I am trying to resolve?!

    In the past I have enjoyed drinking vegetable juice made from celery, chard, spinach and a very small amount of lemon juice (approx 12 oz an hour before lunch and dinner). Would this non-fibrous vegetable consumption greatly disengage ketosis?

    I really love big fresh raw vegetable salads (romaine, grated zucchini, red bell peppers) with either avocado or a nut based dressed. Would large salads like this also disrupt ketosis? (I am taking 6-8 T coconut oil per day.)

    I am dealing with a chronic bone infection and would love to hear your thoughts on the benefits of a ketogenic diet in such instances, i.e. when dealing with infections (especially antibiotic resistant ones, mixed strain, incl. fungal and bacteria)?

    Thank you so much for your work and your thoughts!

    PS I bought your book several years ago and look forward to the next!

    • Dr. Ron Rosedale
      Posted August 27, 2012 at 11:03 pm | Permalink

      The foods you mentioned are fine and should not disrupt ketosis. The diet is excellent to strengthen immune function I would also make sure that your gut flora is optimized. Thanks for the compliments.

      • May
        Posted September 23, 2012 at 8:05 pm | Permalink

        Thank you for your reply. It is much appreciated!

  17. Anna K.
    Posted September 3, 2012 at 8:04 am | Permalink

    Hi, thank you very much for the very well thought out article! I have one question about fats. In the paleo world nuts are not very popular because of their omega-6 content, but they are a great food to get your fats in while keeping protein low. I saw you said before: “as one learns to burn fat better, then one will tend to burn the fat that is eaten such that the extra w6 won’t do so much harm”. But you still advocate supplementing with fish oil.

    What do you think about testing omega-6 to omega-3 ratio in the blood to see if it’s within a good level. What level do you recommend?

    thank you.

    • Anna K.
      Posted September 25, 2012 at 6:07 am | Permalink

      If you have the time, can you please comment about nuts and omega-6 to omega-3 ratio? thanks.

  18. Jonathan Swaringen
    Posted September 8, 2012 at 8:49 pm | Permalink

    1imesub
    Why are the Inuit plagued with atherosclerosis, osteoporosis and kidney disease?

    Me
    What time frame are we talking about?  Last I read the Inuit were pretty free from modern disease while eating their hunter gatherer diet with no carbohydrates. Its when they introduced modern foods that they started having problems.

    1imesub
    You couldn’t be further from the truth! Inuit bodies have been discovered from over 1,000 years ago, frozen in the ice; autopsy results: ALL of them have severe atherosclerosis and osteoporosis. Can’t blame carbs for that.

    Urine tests have also been done on the traditional Inuit and shown that kidney disease rates are also very high among the traditional Inuit.

    I recently had a mini debate with a vegan on youtube…I know I’m weird I shouldn’t even try…but I’ve heard this claim before and was wondering if this is a made up vegan rebuttal to the Inuits health? Or there is some other explanation for the supposed unhealthy traditional Inuit including those from along time ago.

  19. Leo Svalberg
    Posted September 28, 2012 at 7:26 pm | Permalink

    Swedish nutritionist Frederick Paúlun claim in his new book “LCHQ” (Low carb, high quality) that it’s not good to have to many ketones, as they are acidic (I guess it has to do with acid/alkaline balance). I never heard of this problem before, if it really is a problem. What is your take on this, doc? Great post btw! :-)

  20. Rachel
    Posted October 3, 2012 at 12:10 am | Permalink

    Dr. Rosedale,

    The doctors in my area admittedly haven’t ever heard of reactive hypoglycemia so I haven’t ever had this question answered. I’ve literally scoured the internet for hours looking for answers but haven’t found anything of substance. I thought, perhaps with your incredible understanding of insulin, leptin, the metabolic system and thus diabetes, you may be able to shed light on this.

    I was advised to go on a low carb diet on the basis of a PCOS diagnosis – I was told I was at a higher risk of diabetes later in life and should cut my carb intake. My doctor also suspected I was beginning to have minor blood sugar issues because I had an unrelenting appetite, and would sometimes wake up in the middle of the night with anxiety. I’ve always been thin and active (if this matters).

    When I cut all grains, but continued to eat fruits and vegetables, I suddenly had violent blood sugar crashes. It was so bad that if I ate a piece of broccoli my blood sugar would plummet into the 40s within 1.5 hours and I’d shake, have difficulty with speech and get severe anxiety. Before cutting carbs I was fine eating cupcakes; I cut carbs and suddenly I can’t even handle a cup of broccoli. I stopped eating any carbs, even the tiniest amounts, but even too much protein would cause these crashes. This continued until a doctor put me on Metformin.

    It would make sense to me that cutting carbs would IMPROVE my reactive hypoglycemia, rather than worsen it quite dramatically. So there’s something happening at a cellular level which I haven’t been able to discover through my own humble research. I’d stopped searching for answers until recently when a friend of mine has found herself in the same situation, and like me, wants to understand why. Can you shed any light on this?

    • Sabine
      Posted October 9, 2013 at 11:41 am | Permalink

      I learned from this myself to not eat any sweet fruits or foods, including artificial and non-sugar sweeteners. You may want to try to keep individual vegetable rations moderate also.

      The body also needs some time to adapt, so transitioning during holidays or other slow times may be a good strategy.

      Going very, very low carb, and avoiding ALL sweet tastes helped me. It may be worth trying.
      Also making sure to eat loads of fats, not protein, may be important.

      Another factor may be undernutrition, food allergies, gut dysbiosis, and other stress causing factors. However, all of these can be reduced or eliminated within this diet and the accompanying life-style.

  21. Posted October 26, 2012 at 2:47 am | Permalink

    I think people always resist change and find it hard to accept any new ideas and concepts. It’s important to live with an open mind!

  22. Edward
    Posted March 22, 2013 at 4:31 am | Permalink

    Hi Dr. Rosedale,

    I came across and old study from a VA hospital in the early 1970s where a group of very obese patients were fasted for 60 days to put them into ketosis and then given insulin to drop their blood glucose levels in order to ascertain whether they would experience the side effects of hypoglycemia. They were asymptomatic, which shows in my mind, that glucose is indeed not necessary for adequate brain function.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC332976/pdf/jcinvest00637-0253.pdf

    Regards,

    Edward

  23. Sharon
    Posted March 31, 2013 at 2:06 pm | Permalink

    I too, had a TSH of 5.08 a few months ago and my Free T3 was 2.1.
    I did take the TPO antibody test for Hashis and it came up as 7. Six months prior, it was 5. I also took the Antithyroglobulin test and that was <20.
    What is the "danger zone" number for antibodies?
    I was also told that hypoT can cause high LDL (mine is high) but triglycerides are low and HDL is high.
    Do I have anything to worry about concerning being HypoT? I really don't have any glaring symptoms.

    • Jonathan
      Posted April 1, 2013 at 8:34 am | Permalink

      Two books you might check out are Iodine by David Brownstein and Stop the Thyroid Madness by Janie Bowthorpe. You can find some of the information on the STTM website, but the book has more and its a good read.

      One thing they detail is a temperature test for both the Thyroid and Adrenals. If you measure your temperature with a good thermometer every 3 hours starting 3 hours after you wakeup you can get a good clue on adrenal/thyroid health. If you drink or exercise near one of those time frames your supposed to wait 20 minutes to do it. You do this temp for 5 or 6 days. Average the temps for the day.

      So for example you would take your temp at 9 than 12 and than 3 if you woke up at 6. If the temperatures were 98, 99, and 96 that would be 97.6. If its below 98.6 that can indicate Hypothyroid and if its above Hyper. If these daily temperatures fluctuate more than .2-.3 degrees F or 1 degree C than you need adrenal support.

      They also say a temperature when you first wake up could indicate hypothyroid if its below 97.8. For that temperature you want to take it on first waking up. So you wake up and immediately get the thermometer and test.

      Hope this helps.

      I’ll like to some of the pertinent pages.

      http://www.stopthethyroidmadness.com/temperature/

      http://www.drrind.com/therapies/metabolic-temperature-graph

      http://www.stopthethyroidmadness.com/adrenal-info/

      There is quite a bit more on the website so check it out.

  24. Aimee
    Posted April 18, 2013 at 12:57 pm | Permalink

    Dr. Rosedale,

    If you have already addressed this subject, I apologize. I am wondering what your thoughts are on eating a very low carb diet while pregnant and breastfeeding. This doesn’t seem to be an area where a lot is known or perhaps those that may know are not so willing to comment for fear of liability. I ask this because I am currently exclusively breastfeeding my almost 6 month old and I want to eat low carb. I have had some limited success with low carb eating in the past, limited in that I only did it consistently for 4 months and sporadically after that. I lost quite a bit of weight and had reduced pain, and water retention( which is severe at times).

    While breastfeeding, I have been gaining weight unless I cut my calories to 1700-1800 ( if I go lower it effects milk supply) and I am not a small woman. I am 5′ 9″ and have around 135-140 pounds lean body mass and I’m embarrassed to admit that I weigh around 240 right now. I’ve tried exercising but every time I strength train or even do very low level cardio for 45 min, my inflammation and pain get out of control and I have a hard time functioning. I really feel that I need to get my inflammation under control through my diet first before regular exercise will be possible. In the past I have lived on OTC pain meds(mostly ibuprofen) and pushed through the pain but I don’t want to pass too many meds to my baby so that is not an option right now. A couple of years ago with severe calorie restriction and 1-2 hours of exercise 6 days a week(including strength training p90x style and running- I ran a 5k and 10k) I reached 195pounds. I hurt myself running and had to stop my crazy exercise schedule and gained up to 215. I then did Atkins and dropped down to 183 in a few months with very little exercise. I went through some family struggles(and ate) and pregnancy(and ate) and ballooned up to my current weight of 240. (My highest was 270 about 15 years ago.) Needless to say I have tried a lot of diets. I know that low carb works the best and I feel the best on it.

    I recognize that high fat and low carb is the way to go as it has helped me before and the science behind it is sound. I’m just concerned about the impact that low carb will have on my milk supply and my nursling. I have tried to go low carb for a week at a time and supply does dip some. Would this improve after a few weeks of adapting? Is lactation going to make the adaptation easier or harder or have any impact? Interestingly, my son spits up less when I cut out grains(he normaly spits up A LOT). His needs at this point are absolutely number one but I would really love to help myself too, if possible.

    I was thinking maybe LOTS of olive oil and coconut oil during the transition would help to have that quick energy available for lactation. Also there is all this info that says a woman needs more glucose while pregnant and nursing. If that’s true would it be better to get that through carbs or protein via glucogenesis and how would either affect switching to fat burning during lactation? I do take good quality USANA multivitamins and chelated minerals and their CalMag, carlson’s fish oil, lugol’s iodine and 5,000 to 10,000 iu vitamin D daily. I plan on adding more selenium, to balance the iodine, and more magnesium and potassium(to help with muscle cramping).

    So to recap, my questions are;

    1.Can I do very low carb while breastfeeding?

    2.Will the intial dip in supply pick back up after transitioning to fat burning?

    3.Will eating lots of MCTs help with lactation and or transitioning to a fat burning metabolism? (best sources of MCTs?)

    4.Should I eat additional protein to supply glucose needed for lactation or get it from carbs with the goal of becoming a fat burner during lactation, or would either, or both, prevent that transition to fat burning?

    5.If I do the very low carb diet while breastfeeding and my body does successfully transition to fat burning (without losing my milk) will I lose lean body mass(not what I want to do) to make glucose(lactose) for breastmilk or will my body make the needed glucose from fat? A certain amount of protein is needed for the milk also. From what I’ve gathered it’s about 20 grams of extra protein during lactation, in the context of a high carb diet.

    It has occurred to me that it may be different for different people and I may have to wait until after lactation. I just don’t want to be huge by then or starving to prevent it. Also, I would like to add that I did not have this trouble with weight loss/gain while nursing my first child 18 years ago( I am 37). The weight just came off with no special dieting or exercising and I was eating a very high carb diet at the time.
    If you can advise, Please Help Me! I am so sick of being fat, tired and in pain!

    Thanks for all the great articles.

  25. Ray
    Posted August 9, 2013 at 11:13 pm | Permalink

    Hi Ron ,
    Have been on a low carb diet for many years my fat intake varies between 60 and 70 percent of calories , 10 to 20 carbs and about 20 protein .
    My problem is that i cannot put on weight i am 74 years old 5 ‘ 7 ” and 123 pounds and would like to be about 14 pounds heavier .
    Never taken pharmaceutical drugs or had hospitalisation no aches or pains .

    My wife came on board to a certain extent and has stopped taking her blood pressure pills for the last 12 months as her blood pressure has returned to normal , wish i could get her off of her beer for TD2 .
    Not sure i want to put on weight after writing that i am fit and healthy what more do i want .

    • Ron Rosedale, M.D.
      Posted October 9, 2013 at 12:14 pm | Permalink

      From the Rosedale Team. It is wonderful news that you are doing so great! So, your protein is about 20%? maybe around the 55-60 grams of protein? not in weight but in just protein content. Protein as you know is the one thing Dr. Ron wants you to keep an eye on, too little and your body will take it from your muscle and bone, too much and it will turn into sugar. So for you, at a guess you will be good anywhere between 50-64 grams of protein, higher end if you are active. We love that you want to improve, never stop wanting to improve! You can still raise your fat, avocados, good oils etc. Dr. Ron often says that people would be a lot healthier if they stayed away from doctors! Of course he is referring to the ‘standard of practice’ type docs. I wonder for your wife, if you can tempt her with one of the low carb beers out there instead. Keep us pasted on how thing go, and if you need any help with making sure your protein is right for you.

      Best of Health,
      Fiona from The Rosedale Team

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