My (Failed) High Fat Low Carb Diet Experiment

There I was in my general physician’s examination room trying to explain why I was eating copious amount of bacon, cheese, and avocado and wanting a more a more advanced cholesterol test to show that it wasn’t really doing me harm. It wasn’t going well to say the least. I think the word “moderation” make more appearances that standing ovations at a State of the Union address.   How did I get here I thought to myself?

A couple months ago I wrote that I had switched to a high fat low carbohydrate (HFLC) diet for a number of reasons.  I wanted to share my experience, both good and bad about the HFLC.  Briefly, the genesis of this was multi-faceted, but stemmed in a large part from the writing of Peter Attia and the performances of Zack Bitter.  So be sure to check out their blogs for more insights.

The Diet

First, let me explain what exactly a high fat, low carbohydrate diet looks like in actual numbers and in practical terms.  The goal really is to minimize carbohydrate intake to less than 50g/day, keep a moderate level of protein (max 2g/kg), and the rest is fat, pure fat.  After an adaptation period of a few weeks the science shows that you can dramatically increase the energy coming from fat and fat derived ketones.  So what did a typical HFLC day for me looked like?

Yeah thats a lot of fat

Yeah thats a lot of fat

For breakfast it was bacon and eggs, sometimes with avocado or with cheese. Coffee is a must for me and being on a HFLC diet I substituted my traditional cup with coffee, 1-2 tablespoons of coconut oil, and 1-2 tablespoons of butter that is mixed in a small blender. It tastes almost like a latte.  Lunch was a salad with plenty of olive oil and normally some sort of meat (bacon, salami, leftover salmon or steak).  Dinner was a piece of meat (fish, chicken, steak) and a veggie side. Veggies were always of the low carbohydrate variety, mushrooms, limited tomatoes, greens, onions, broccoli, brussels sprouts, or green beans but NO root vegetables like potatoes, yams, carrots, etc.  Typical garnishes are sour cream, cream cheese, or just plain butter.  If I did need to snack it’s nuts or nut butter.  Alcohol is limited to a glass of dry red wine and if I am feeling frisky some hard alcohol (bourbon or scotch) straight up.  Dessert could be diet soda with whipping cream (yum like a cream sisal) and very dark chocolate (>85% cocoa) or some mixture of nut butter, coconut/almond flour, and egg baked as a cookie.  And that’s the HFLC day.  Everyday.

Except it wasn’t.  I knew that this diet was unsustainable (for me).  I just like pizza, beer, and pastries too much. So I took an idea from Tim Ferris’s diet in the 4-hour body, I introduced a “cheat day” where I could gorge on anything that I wanted, be it pizza or beer or the worst candy imaginable for 1 day, each week. It was glorious, but the problem is that I had no idea what this did to the long-term effects of the diet.  How long did this cheat day set me back from my nutritional fat adapted state?  I didn’t know, so I had to measure it.

Measuring Nutritional Ketosis

Of course thats not really surprising that I measured my ketones, I mean as a scientist I could not just believe that I was fat adapted and in ketosis.  Show me the data!  So every couple of days I pricked a finger and measured my blood ketone levels (see Figure 1).  Nutritional ketosis is the state in which you are adapted to using fat and ketones rather than carbohydrate and corresponds to a level of blood ketones above 0.5mM. This procedure can be expensive ($2/stick) and is for certain an uncomfortable conversation starter around friends. “You are eating what? You are making yourself bleed because why? Because you want to eat bacon and eggs everday?” Ha, joke was on them though, I was in nutritional ketosis and pretty consistently at that.  After my occasional cheat days it would drop back to near 0 and would take a couple of days of HFLC to rebound.  The diet was working, and I was confident I was on my way to super human fat burning capacities and amazing lipid values. So what happened?

Stars indicate

Stars indicate “cheat” days…or my reason for living

The Good

One of the major goals of nutritional ketosis was trying to steady out my energy levels during the day and avoid the highs and lows that come with carbohydrate driven fluctuations in insulin level.  In this regard, the diet worked.  I did not have those afternoon lows in which all I wanted to do was nap.  I didn’t feel like I was starving between meals and was looking for my next fix.  I could focus throughout the day and just generally felt very good.

The Bad

Prophetically I said that the one thing I knew for sure was that this diet would improve my lipid biomarkers.  Massive studies had shown this, anecdotal evidence from other ultra runners suggested this.  Regardless of changes in performance my lipids were going to get better, right?  Well of course I would drop $30 to have them tested.  (Note: I’ve written about nuance before and perhaps I should have followed that advice more carefully here.)

My first blood test 3 days into the diet showed my cholesterol breaking down this way:

HDL :69 (very good!)

LDL :161(kind of bad)

Triglycerides: 71(good)

I wasn’t overly concerned or impressed with these numbers, sure I would have liked to see the LDLs lower as the last time I had them measured they were 120, but that had been 4 years ago.  So I was disinterested until I could again.

6 weeks later:

HDL: 74(very, very good)

LDL: 200 (very, very bad)

Triglycerides: 71(good)

I’ll be honest, that LDL number of 200, freaked me out. It’s what foolishly caused me to schedule an appointment with my physician.  A total cholesterol of 200 is a stated goal, so seeing an LDL cholesterol value that high was just scary and confusing.  As nuance will have it, some people respond poorly to the HFLC diet.  Still, always the skeptic and optimistic I knew that the thing about traditional cholesterol numbers is that they are actually pretty useless. There are much better markers to track the risk of for cardiovascular disease.  If you want to learn more about this phenomenon I recommend the series on cholesterol that Peter Attia wrote about.  Inspired by Peter’s posts about cholesterol and my own reading about the complexity of it I went to see my primary care physician to order a VAP Cholesterol test, which rather than measuring total concentration of cholesterol, it measures the size of the lipid particles that carry the cholesterol and Apolipoprotein B, which is a better marker of cardiovascular disease.  Well turns out I had the favorable lipoprotein particle size phenotype and apolipoprotein B levels well within the normal range despite my ultra high LDL (which had already decreased to 136 mg/mL in 3 weeks!).  So perhaps I over-reacted.  Still we all know that the real reason I wanted to go HFLC was to get faster, so how was that going?

The Inconclusive – Training Benefits

First off, it’s hard to know whether something is improving your fitness when you can’t even train normally.  Originally I was hoping that now I would be ramping up my training, my hamstring would be on the mend and I would be training at near normal levels.  But that stubborn hamstring is just not cooperating, so I am still at about 50% of the volume and severely limited in my hard efforts.  It’s better than nothing, but not good enough to get fit to race given the standard of people that I race with.  Still I could tell a difference in training on the HFLC diet.  I felt horrible.  Everything was hard.

Every. Single. Run.

Every. Single. Run.

It should not be surprising that a carb adapted athlete might struggle on HFLC, but I was running nearly a minute/mile slower than my normal easy pace.  Fast and hilly running, when I occasionally attempted them, were near impossible.  Now you might think that is just because I was out of shape from taking nearly 6 months off, and that certainly played a role, but I was also supplementing carbs and running hard on my cheat days.  Those runs felt normal and much easier.  It was night and day. Still I am not going to withhold judgment here. For some people, some events, it might be ideal. I’m just not sure if I’m one of those persons racing one of those events.

The Aftermath

So I fell off the wagon. Maybe it was the holidays, maybe the running, maybe the lipid numbers, maybe that I just enjoyed food a lot less when I had to worry about everything I ate and I seemed to have lost my interest in cooking? All these reasons together made my future diet plans clear, drink beer and eat pizza.  Well maybe not that exactly, but at least carbs more than once a week was definitely in my plans.

You often hear the phrase, “live high, train low” in terms of altitude training.  I think similar principles are applicable to diet, with “high” being full of glycogen using carbohydrate for energy and “low” being glycogen depleted using fat for energy.  To me the HFLC shifted the paradigm from live high, train low, to live low, train high.  At times I could introduce carbs to high intensity workouts, so I didn’t feel awful and I could push hard.  Before I was doing specific workouts, or combinations of workouts to enhance my fat burning capabilities.  For me, I think I prefer the latter strategy, for others clearly the former works.  In the end the diet that you eat should be highly individualized and designed for you to reach your goal….and the one that you follow.

I can follow this diet

I can follow this diet

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60 thoughts on “My (Failed) High Fat Low Carb Diet Experiment

  1. Wow, you really were serious about tracking this diet. Good for you for experimenting. Sometimes we get stuck on our normal and are too afraid to try something new. The only way to get better is to fail until you succeed

  2. Eat what makes you feel good! When you’re happy, you’re better, and that might outweigh the science benefits of a diet?? who knows

    • In my case if I feel that I am miserable. So eating whatever I want wouldn’t be worth it. There’s a saying that goes “Nothing tastes as good as thin feels” and in my case that’s the truth.

  3. Hi Matt,
    We met in Boston after your phenomenal 2014 race. I just love your blog – thanks!

    Was wondering if you have tried PRP yet for the high hamstring tendinopathy. I just got the procedure done and am curious about prospects for success.

    Best,
    Bill

    • Hey Bill thats the race that gave my injury. I cant really afford the PRP and have heard mixed things, ~40% efficacy(?). That being said there is a very low chance it will make it worse. Let me know how it works, and keep up with the stretching and strengthening in addition to PRP, I’m curious at to how it turns out for you.

  4. Why Are your blood results in the “bad” section? It seems that you later found out that the size of the lipid particles that carry the cholesterol were the “good” size. That seems to be consistent with the literature on this subject: that HDL (the good cholesterol) goes up, and that size matters with the lipids. In this regard, I’d venture that your blood work was a success, no? It would be expensive, but personally, I’d like to see more testing. With regard to the sustainability of this diet, I’ve found that feeling good definitely makes it more sustainable. I’ve managed many consecutive sub 40 carbs (net carbs) days… now that I’ve been doing it for a while, the “cheat days” (or in my case, cheat meals) make me feel awful! I also noticed the same things as you did: At the beginning, I could not keep up on short, fast rides with this diet (but after a couple months, that is much better). Also, I was able to do a 13 hour run eating only 8oz of nuts (and felt great the whole time!) That never would have happened before. I strongly believe that this diet needs more study, with frequent blood tests for lipids and markers for heart disease! If I weren’t worried about all the fat / cholesterol I’m eating (and the potential increase in heart / kidney / gall bladder problems), I’d certainly adopt it for the long haul because I feel so much better!

    • Thanks for the thoughtful response Brian.

      Very fair point. Probably should be more in the inconclusive part. Much of the literature also shows a decrease in LDL though, which is probably why I was so surprised, and slightly concerned. 40g/d, I am not sure how many of those I was able to manage. Did you measure you blood ketones at all?

      I also agree with the cheat day assessment. I did not always feel great eating all that junk food, which makes me think I had adapted to that feeling before. I really hate those insulin/glucose swings.

      • No, I did not measure ketones, blood sugar, or have lipids tested. This is mostly due to the expense. This is why I’ve been interested in reading the literature… and more pertinent to my situation your results, those of Peter Attia, and Zack Bitter.

        It’s ironic in a way: during the transition period from Western Diet to Keto Adapted (~2-3 days) you really don’t feel good going either direction. But what I noticed is that adding a few cookies while Keto Adapted really made me feel crappy, whereas adding bacon or cheese or eggs while adapted to the Standard Western Diet didn’t make me feel bad at all.

        To me, the difference in glucose swings is like night and day. As an aside, I’ve also noted that the caffeine crash from coffee is completely eliminated while on this diet (anecdotally, from my friends, their crashes aren’t as bad as mine were). Again, this difference is night and day for me: coffee is MUCH more enjoyable now with coconut oil + butter + minimal carbs.

        I wonder if you will try it again… though I agree with what I think you’re suggesting in your beginning statements about “moderation.” According to myfitnesspal, I had come from a diet that contained MORE carbs than even your “typical western diet” pie chart shows! It’s likely the best bet for the long haul is something like the “carbohydrate reduction” pie chart you show in the middle!

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  6. Thanks for documenting it, Matt. But the early warning sign was that food stopped being an enjoyable part of your life – not something that’s likely to be sustainable even if it helps your running.

    • I would take the other side of this argument. As human’s, food is meant to fuel us. It is primarily our western culture that has made food into a social experience and believing that we must enjoy it. Worse, much of that enjoyment is from sugar lighting up pleasure centers in our brain like cocaine. I get satisfaction out of knowing that the food I am eating is good for me and my body feels good. If I cheat, I get a short-term satisfaction only to feel like crap hours later. And, I really don’t find eating a clean/Paleo/LCHF diet all that limiting. There are tons of good tasting foods. The trade-off is the effort you must invest in making your own food. There are plenty of options if you are willing to put in the time. And, a big thank you to my wife for helping me with that part 🙂

      • ” It is primarily our western culture that has made food into a social experience and believing that we must enjoy it. ”

        Ever seen a communal meal in Africa or been to Asia? Food is a social experience in pretty much all cultures. Not sure where you got this ignorant view.

  7. Have you read Phinney & Volek’s books? http://www.amazon.com/Art-Science-Low-Carbohydrate-Performance/dp/0983490716

    I think the thrust of it is that they advocate a generally low-carb diet, but with the addition of carbs around intense workouts.

    I think a good middle ground is to get the bulk of your carbs from non-refined source, so fruits, vegetables, tubers and limiting the sweet stuff, floury things, rice and beer to post-run indulgences. I know Pam Smith wrote about using “carb back-loading” where she consumed the bulk of her carbohydrates in the evening. Might be worth investigating?

    I still think eggs and bacon are a great way to start the day, but I usually have some fruit mid-morning.

    • Yes, I read the Phinney and Volek book about sports performance before embarking on the diet. It was really helpful and interesting.

      Part of the reason I tried this diet was because I don’t trust my self control to avoid those sweet carb things. The HFLC diet eliminated the choice. Maybe a stricter rule for myself would be good? I don’t really think of myself as a type A ultra runner.

      I do like the idea of “back-loading” and maintaining a low carb diet in the morning into the afternoon depending on that days workout. Thanks for the insights, and yes bacon and eggs all the time 🙂

      • Personally I think trying to maintain a state of true ketosis is just too much effort. No beer! No pizza. You call that living? I think a better goal is to try to achieve a level of metabolic flexibility where one is equally adept at tapping into fat and glycogen for fuel. I suspect (but have no data) that doing long runs without breakfast or fuel on the run could help with this. Whether or not you want to do the glycogen-depleting run the evening before, however…

  8. Thanks for sharing your experience. I am a proponent of this diet, but I totally agree that each individual should follow a diet they can live with. My logic for doing it is primarily for long-term health benefits — the research really points to diabetes and triglycerides as the things to be worried about. Tim Noakes has some great stuff on this, and he even said they predict now that 30% of people that try the diet will experience their LDL going up, but most people will have the opposite effect.

    I started this diet in March of 2014 and running was miserable for a month or so. Then, I quit trying for ketosis and settled for “fat adaption” — the amount of fat I am burning while running. As an ultrarunner, that is my end goal, burn enough fat to have minimal fuel demands during a race. These days I eat 50-125g of carbs per day and I can do just about any kind of workout I want. I had a breakthrough 50-mile race (1+ hour PR) 4 months after switching to the LCHF diet. Most of the studies you see and much of what is published is pushing people toward ketosis. But, I think the “middle ground” of just limiting carbs to a sensible level offers many athletes great benefits. I went from eating 300-400 kcals an hour during ultras to 150-200 during races with no stomach or GI distress. My cholesterol, blood pressure, triglycerides, and blood glucose are all way down. And, I recover from hard workouts and races much faster.

    • Thanks for the comments Andrew! This is brilliant and exactly where I am striving to go. Live, highish, train, low. Its actually the approach that I have tried to adopt in the past. I guess it seems to have worked well, my RR100 debut was not so bad. Still, that performance was an unknown and we always think about ways to push ourselves even further. Good luck with the training, racing, and diet.

  9. I wonder if your cheat days messed up your ketoadaptation. Your ketone levels remained high, but I wonder if there were some other effects. It’s interesting to me that your ketone levels were higher post run – mine were always lower. I had a similar problem with performance – my HR was higher than it should be for a given pace (effective running economy reduced). Thanks for sharing!

    • Its a valid point…and concern. I just don’t think we have the data to really know the full effects of the diet, health or performance.. Odd that your ketone levels were lower post run, all the data suggests the other way. Were they short runs, really intense runs? Best of luck with your running.

  10. Thanks for sharing. I noticed similar effects, I ran about 2 min slower on a 10 mile time trial (62min) and bonked hard in a half marathon while following the diet, and I didn’t include cheat days. I wasn’t able to get my ketone values as high as yours though.

    • Its weird that you “bonked”. If you were only using fat to fuel then there should not be a bonk in the traditional sense of running out of glycogen. Perhaps you had a little bit of muscle glycogen present, just enough to feel good at the beginning, which then became more “bonk-like” as you progressed.

      Interesting, stuff. I also would be curious as to how long you had been HFLC before racing.

  11. Thanks for spending the time and effort to post this. I lost 115 lbs eating a essentially exactly what you described. Well except for butter in my coffee, I have yet to try that in the 9 years since starting.

    Losing the weight required me keeping my net carb intake (total carbs – total fiber) around 20. However, once I started training for Ironman I found that on heavy training days there was some introduction of carbs before, during and after. I always thought of it like adding NO2 to an already pretty efficient system. I had very specific guidelines to follow and as long as I did not deviate I rarely ever had issues.

    Sustainability is really the biggest challenge. Post Ironman, I found that cutting back on workouts was much easier than giving up the occasional slice of pizza and beer. That meant putting on 40 lbs over a couple of years. So now I am back to basics and down 10 with 30 to go.

    On On

    • Brian – I am not sure how you kept your carbs that low. Insane.

      What guidelines did you use for the supplementing with carbs during heavy training days?

      Good luck keeping up on the diet. Be thankful you have found something that works as so many people never figure that part of dieting out.

  12. You went into this knowing that that this is not for you since you like pizza, beer and pastries too much. You supplemented your diet with cheat days so you never gave your body a chance to switch. Your experiment, failed, as predicted. Now you are happily back to drinking beer and eating pizza. Thank you for wasting my time reading this….

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  14. IMHO a couple of things would need to be changed for it to be a real (but personal) test. First, give it longer without the carbs, the body takes longer than 6-7 weeks to fully adapt to LC performance, and your time off wouldn’t help. Secondly, the “cheat” days were definitely not helping and should be cut out. If that’s not what you want, fine. I’ve been LCHF two years now and can’t see myself going back to running/cycling with carbs unless it’s a very short race (5k run or similar).

  15. The LDL values you mention are NOT measured Low Density Lipoprotein concentrations (which are always in nmol/L) but cholesterol values, in mg/dL, and they were NOT measured from your blood.
    They were guessed at, by the lab, using the Friedewald formula; look it up.
    These calculated values, though long promoted by the NIH.gov & medical disease industry for lower cost, have never correlated well with actual human caardiovascular disease outcome trials, unless extremely high.

    Also be aware that a single LDL particle typically carries 3,000 to 6,000 lipid (fat) molecules and that how many are cholesterol, vs. triglycerides, vs. phospholipid vs. any of many others varies widely.

    Similarly, the HDL values you mention are also cholesterol values in mg/dL, NOT Measured High Density Lipoprotein concentrations, which are always expressed in μmol/L.

    So be cautious about jumping to unfounded conclusions.

    If you want more reliable data, study: http://www.liposcience.com

    • You are correct, which why I wrote:

      “Still, always the skeptic and optimistic I knew that the thing about traditional cholesterol numbers is that they are actually pretty useless. There are much better markers to track the risk of for cardiovascular disease. If you want to learn more about this phenomomon I recommend the series on cholesterol that Peter Attia wrote about. Inspired by Peter’s posts about cholesterol and my own reading about the complexity of it I went to see my primary care physician to order a VAP Cholesterol test, which rather than measuring total concentration of cholesterol, it measures the size of the lipid particles that carry the cholesterol and Apolipoprotein B, which is a better marker of cardiovascular disease. Well turns out I had the favorable lipoprotein particle size phenotype and apolipoprotein B levels well within the normal range despite my ultra high LDL (which had already decreased to 136 mg/mL in 3 weeks!). So perhaps I over-reacted.”

      I also put the values in mg/mL and was careful to mention the complexity and difference between total cholesterol and particle side. Maybe I didn’t make it clear enough that I know and appreciate difference. It is why I asked for a VAP test in the first place and even said that “perhaps I over-reacted” (ie I WAS CAUTIOUS about making unfounded conclusions). Sure I wish I could have the NMR test done, but honestly I can’t afford it (thus VAP instead).

      I would like to know what data you are talking about when you say “have never correlated well with actual human caardiovascular disease outcome trials, unless extremely high”. What meets the definition of extremely high? Which specific studies are you referencing.

  16. The LDL values you mention are NOT measured Low Density Lipoprotein concentrations (which are always in nmol/L) but cholesterol values, in mg/dL, and they were NOT measured from your blood.
    They were guessed at, by the lab, using the Friedewald formula; look it up.
    These calculated values, though long promoted by the NIH.gov & medical disease industry for lower cost, have never correlated well with actual human cardiovascular disease outcome trials, unless extremely high.

    Also be aware that a single LDL particle typically carries 3,000 to 6,000 lipid (fat) molecules and that how many are cholesterol, vs. triglycerides, vs. phospholipid vs. any of many others varies widely.

    Similarly, the HDL values you mention are also cholesterol values in mg/dL, NOT Measured High Density Lipoprotein concentrations, which are always expressed in μmol/L.

    So be cautious about jumping to unfounded conclusions.

    If you want more reliable data, study: http://www.liposcience.com

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  18. HFLC diet/eating between 1100-1500 everyday for a month caused me to gain 5 pounds and made my pants fit tighter. I never felt healthy eating all that protein either. *Gags*

  19. Excellent article! I tried many times to go HFLC to lose weight, and I was always miserable. The first two weeks I would have killed for an apple. All the fat was literally making feel sluggish and constantly bloated. I was tired all day an in pain, and finally my gall bladder became inflamed which was was the last straw. Now, I’m eating my whole grain toast in the morning again with my eggs, a sandwich and a piece of fruit for lunch. For dinner I eat whatever I want but a small portion. I might have a slice of pizza or Chinese food once a week. I love the new Blake’s pot pies and Mac N’Cheese. They are much lower in fat and carbs than traditional pot pies. I’m losing weight again, i feel like a million, and my lipid and blood sugar results are excellent. If you want to stuff yourself on bacon and eggs and cheese and nuts all day, knock yourself out. But don’t try to sell that BS to me anymore. Keto my BUTT!

  20. I have to tell you that the reason you failed is because you did everything wrong. How on earth could you consume over 4000 kcal a day? Thats insane and yes too much of a good thing is a bad thing. I’ve lost all the weight I wanted to lose and cured all of my ailments by eating low Carb/moderate fat and protein. It works when you do it right. Nothing wrong with the diet. It can also take 6 months to become fully adapted and heal the body from the inside out. It is a huge commitment not a crash diet but a way of living. Your numbers are going to go up in the beginnjng as your body heals and regulates. In time if you would have stuck to kt you would have seen them improve and greatly as a matter of fact. The problem with people is they have no patience or follow through. They want a magjc bullet to solve all their problems but they dont want to do any real work. Please educate yourselves.

    • No magic bullet*

      *except the one you are preaching.

      I recommend learning about gene-environment interactions. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653419/

      Not everyone takes 6 months, not everyone responds the same. 4,000 kcal a day is not a lot if you are running 70 miles a week.

      Oh and good luck with moderate protein. Nothing like protein to ramp up cancer growth. Plenty of evidence** that younger, middle aged whom consume high protein diets die younger from increased cancer death. In every organism we know, restrict protein, increase lifespan. But you are free to continue eating “moderate” protein.

      **actual scientific studies

      • He’s right though. You did a very poor macro plan and failed to take into account micro nutrition.

        1) No human body has ever relied on that much fat besides epileptic children. You should have tried what this guy is talking about – low carb yes, moderate protein yes, and reasonable fat not nearly 90% and hundreds of grams… The highest population I could think of who go pretty high in terms of grams of fat would be the Maasai (3000kcals, 60% fat so 200grams). If you EAT foods like fat meat/fish/whole eggs and organ and then maybe, maybe cook in the animal fat… not drinking oil/cream/butter by the pint (which I repeat no one has ever done in natural diets)… you will have plenty of nutrients well balanced to fuel your efforts. Your experiment wasn’t long enough anyways. If anything it’s another proof that focusing on macros and calories leads to nowhere if micro nutrition isn’t dialed in. You find nutrients in real foods found in nature, not processed products, as healthy as they might be touted for.

        2) Studies based on correlations are never proving a point. Like me a study on mortality and consumption of X or Y food and I’ll pick dozens of sentences in the Material&Methods or in the Discussion part that will self-debunk said study. Nutrition science is a joke.

        3) If you do recommend gene-environment adaptation, you should understand that 6 months is a very short-term protocol. But it’s certain that your experiment was in no way sustainable. You should have titled it “My failed extreme epileptic children’ ketogenic diet for intense sports”

        A pharmacist.

      • Thanks for the detailed response Benjamin.

        Just to seek some clarity with the caveat that I absolutely agree that my experience in no way is science nor proof of concept that this diet fails or succeeds. My goal was specific though. To see if nutritional ketosis (which is dependent on keeping a relatively low protein intake of <2 g/kg) was sustainable and potentially beneficial for prolonged LOW intensity exercise. Higher protein will of course cause you to fall out of ketosis.

        Which micronutrients are you referring to? My diet consisted of plenty of veggies in the form of spinach, mushrooms, asparagus, bell peppers, etc. Tracking micronutrients is a total pain and likely highly dependent on the source of the food as well. How should micronutrients be "dialed in"?

        Of course, correlation is not causation and hence nutritional science is handicapped tremendously. They only provide a hypothesis from which to test or often something that can disprove a causal relationship. Nutritional science is not a joke, but extremely complex, difficult, and expensive to perform well.

        6 months is short for some interactions, long for others. I wonder where you get 6 months from. There is no arbitrary time frame for how long it takes your genetic makeup to interact with the environment. It is highly dependent upon the phenotype you are examining. Should I have gone longer, potentially, would the outcome have been different. Hard to say.

        Even the proponents of this type of diet readily admit that not everyone responds well to the diet. Many in fact do not normalize their lipids level (was this me? again the data is inconclusive).

        I do appreciate the interest and believe me I in no way think I have proved anything and am merely sharing my experience for what it is worth. I hope that the discourse in the comments and elsewhere on the internet can be informative and help people come to their own conclusions or better yet conduct their own personal experiments.

        Best of luck.

      • The primary issue is reasoning in term of calories and macros. Protein amount seemed sufficient – you can go higher but let’s not debate gluconeogenesis/glucagon/insulin for hours here.

        My point is – thinking that a high intake of fat through abuse of oil/cream is representative of the diet you’re mentioning in the title isn’t correct. Here you relied on foods that lack nutritional interest, no wonders performance didn’t follow suit.

        Harvard’s Lalonde list of nutritional foods is interesting and solid enough. It should be taken into account when talking about a real diet pyramid. Interestingly enough it’s low carb high fat balanced proteins. I’m obviously not tracking micrograms of boron in my patients’ diets. Liver isn’t as nice and sexy as pizza though so there’s that. You might want to check this out. You listed good foods that would pertain to this list if being gentle – make sure you eat kilograms of veggies a day then.

        I believe I read the 6 months value somewhere above my comment. Balancing decades of high fructose / high polyunsaturated (and oxidized) fats and allowing the metabolism to “reset” is quite a long process, especially in an individual who seems to like his junk food!

        Lastly, “normalizing” lipids isn’t relevant since these charts are constantly lowered to adapt to people having constantly worse food habits. The generation preceding this one didn’t go to Starbucks and fast food joints year round. Of course you want to avoid fat oxidation in such a context of general inflammation and hormonal havoc. But if there isn’t said inflammation in the first place you can have “high” LDL – it’s just fat being burnt. Either from too much food being eaten (in your case “food” being drunk) or from bodyfat like in many people who are impatient about these values. Like oil being carried around in steel pipes. When you’re burning fat, what will show up on a blood work? High LDL high Triglycerides, depending on the nature of fatty acids. Context means more than hard numbers. A good cardiologist knows how to interpret fluctuations.

  21. Read a book by Mark Sisson called “Primal Endurance” you will find your answers in there for the reasons your running failed you.

    • Thanks for the comment. I will check it out, however if it not founded in scientific evidence I’ll have a hard time thinking of it as anymore than theory and opinion. Theory is great, until it is tested and an overwhelming majority of the data says high fat doesn’t work for elite endurance athletes.

      • “high fat doesn’t work for elite endurance athletes” – Are you an elite endurance athlete? I am not, just at the top 10% of local races, and low-carb/high-fat works like a charm for me. A lot of people try to see what Olympic athletes or Kenyan runners do and think this will be the best for them. Most likely it will not be the best.

      • Thanks for the comment George. Most of the studies that show superior effects of high carb are done in sub-elite pretty fit, but not professional athletes. I am in the top 1-3% of most races, not elite, but certainly trying to get the most out of my body. Timing of nutrients, both fat and carbs, is probably the best approach. One or the other all the time is not optimal just as all intervals or all long slow distance is not an optimal training stimulus. If you are happy at the top 10% and with your diet then more power to you and in the end it is about finding what works for our own expectations/enjoyment etc as it is each of our own goals which determine what we define as “best”. Best of the luck with the continued training.

  22. Hello , I was reading your article and saw you became concerned about LDL of 200, unfortunately that is old thinking, that number is simply measure the number of low density lipid proteins you are producing, it doesn’t tell you the much more important LDL-C , how full of cholesterol is the protein, if your body produces even hire number but the LDL-C is low thats OK, also markers like APO-A and APO-B really matter, Im part of a research study, the old school what is your LDL,HDL,Trig, and Total Chol numbers are almost meaningless in modern cardiovascular world. Read all about it here http://www.bostonheartdiagnostics.com

    Good luck

    • Thanks Kirk – I completely understand that and hence wrote

      “There are much better markers to track the risk of for cardiovascular disease. If you want to learn more about this phenomenon I recommend the series on cholesterol that Peter Attia wrote about. Inspired by Peter’s posts about cholesterol and my own reading about the complexity of it I went to see my primary care physician to order a VAP Cholesterol test, which rather than measuring total concentration of cholesterol, it measures the size of the lipid particles that carry the cholesterol and Apolipoprotein B, which is a better marker of cardiovascular disease. Well turns out I had the favorable lipoprotein particle size phenotype and apolipoprotein B levels well within the normal range despite my ultra high LDL (which had already decreased to 136 mg/mL in 3 weeks!). So perhaps I over-reacted. Still we all know that the real reason I wanted to go HFLC was to get faster, so how was that going?”

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  24. Thank you for this article. I appreciate all the detail you put into it.

    I am on the LCHF diet. When I first started, I didn’t research very well and only knew the basics. 2 months later, (I had dropped 15 pounds) and was in the emergency room because, (stupid me) I thought, “what the Hell, low carb is good, so NO CARB would be even better”, lol. WRONG!!
    I was having heart palpitations, hyperventilating /couldn’t breathe, feeling like I was going to black out, very, very similar to an anxiety attack. My heart was pounding so hard that I thought I was going to have a heart attack, but there wasn’t any pain. Just everything was fading to black and I was on the verge of passing out. I have never had heart issues other than minor skips, and I have never passed out in my entire life. I wasn’t about to pass out then if I could keep from it and was fighting it to the bitter end, because I feel that passing out would be weak and I’M NOT WEAK, by God.

    Anyway, they tested and tested and tested and I neglected to tell them that I was on this diet. They couldn’t figure it out for a long time and I hadn’t thought it mattered. Finally, a specialist came in and asked me specifically if I was on a low-carb diet and I PROUDLY answered ( by then they had me tanked up on ATIVAN, so I was a little bit loopy) “Yes! I’m even doing zero carbs!” he shook his head and looked at me as if to say, ” you poor little dumb ass”, lol. So he explained to me the importance of introducing a level of carbs into my daily diet.

    So anyone reading this needs to be aware of the importance of a certain level of carbs in your diet. I am not a super athletic individual so I do manage to get by on less carbs.

    • I always have a carb refeed meal every 3-4 days . I have an abundance of energy on minus 20g carbs however the approach I take is for bodybuilding inspired by the great Vince gironda

  25. I just started researching the Keto lifestyle “diet” and your graph is a tad off. I have researched quite a bit since and it seems to be right up my alley. The balance is supposed to be approximately 70% fat, 30% protein and 5% carbs.

    That might be why you were having problems. You cannot just eat all the fat you want though it can seem to be that way. I am not familiar with Kcals vs Cals but it seems awfully high from your graph. One should stay around 1500 calories (if counting) and that is the max. Being very active may be different however from what I researched it doesn’t seem that far off, maybe 500 or a little more.

    When I start, I will 25g carbs, 93g protein and 115g fat with 1300 calorie intake. It needs to be tracked very closely the first couple months, so I hear. I’ve seen other blogs where those who are building muscle still stay around the same intake.

    I am not a fan of sweets nor bread. Only for my tacos and a potato of whatever sort. AHHHH they will be missed but I am willing to try. I love hot wings, bacon, eggs, ranch and Caesar dressing, shrimp, salmon, steak, cheese…. Ohhhhhh cheese!!!!! And my new love is good ol’ straight up avocado. The best of the best, in my beginning stages of adapting this new life.

    3 years ago marked my loss of 50lbs (2 years to get there). I worked out and cut out a lot of carbs (no plan, just did it). Maintained another year however I was tired, my back hurt and I was so hungry. I worked out harder and tried to change my workouts and eating plans but I plateaued in a sense that made me I give up. 2 years ago they slowly gained right back. I adapted more to beer, got a desk job, stopped working out and my job feeds us Fried chicken and fries everyday. No wonder I gained the wait back! Keto seems to be the perfect plan for me, if I can say goodbye to my happy hour too 😐 LOL Vodka Soda 0 carbs!!! Which is what I drank when I first lost weight.

    I love that you made the attempt and wrote about it! I actually researched “unnecessful Keto diet reviews” and you were number 3. The other sites were all about the number one diet plans and not an actual review on Keto. I appreciate that you took your time to share your experience. I hope to have a more positive one and good luck to us both on our journey to find the right food for us!

    • First, thanks for the kind words and spending some time reading. I think that as far as the exact numbers go and breakdown of macros it will be highly specific to your goals and your lifestyle. Athletes trying to maintain ketogenic diets maybe able to get away with more protein or even some carbs based on the types of workouts they are doing. Weight loss is a whole different ball game. I don’t really stand behind those graphs beyond the concepts they display.

      Being a scientist I like to track things, but I also know that an n=1 is not a study and bunch of n=1 out there are not necessarily data. Hopefully, some real rigorous science will continue to be done that is useful to many people (it will never work for all). Regardless people should continue to test for themselves as you nicely stated. Good luck.

  26. Very late getting into this discussion – just found your blog. I’ll state up front, I’m a carb lover and am healthy, happy and not overweight. I’m also a dietitian (please don’t hate me 😊 ) My main comment is around the instant link/association of carbs with food like pizza and beer. It creates a reader biase that people love to perpetuate that carbs are unhealthy. What about whole grains, fruit, vegetables, brown rice, beans and other legumes and God forbid potatoes? Look at the blue zones where people live long and productive lives. Commonalities include physical activity, meaningful purpose and simple foods like beans and home grown vegetables. I don’t understand how intelligent people can convince themselves that bacon, cheese etc. are ‘health’ foods. And yet they’re frightened to eat an apple? Sorry, I don’t mean to be inflammatory, I’m just curious about the logic. Finally, I’d also ask you to consider all the work being done on the gut microbiota and how a hflc diet will affect this. We know that proteolytic fermentation produces uremic toxins ( indoxyl sulfate etc.) whereas saccharolytic fermentation in the colon produces healthy products like butyrates. Research in many domains (mental health, obesity, diabetes, renal disease) are finding that a healthy gut micro biome improves many aspects of disease, quality of life etc. I suspect further research in this domain will have significant implications on our knowledge around healthy eating. I would love to know your thoughts now. Kind thanks

    • I agree that perhaps pizza and beer is not the best example, but it is an example of the types of carbs that any nutritional plan should avoid. I’ve had more success with a slow-carb diet, but I don’t agree that cheese and bacon are unhealthy relative to anything with added sugar.

      Fruit has many benefits, but its sweetness is also an issue and fructose clearly can cause insulin to increase. Not all fruits are equal.

      For gut microbiota the research is still so new and any causality link with nutrition seems premature to say.

      Nutrition serves a purpose and if someone wants to lose weight, improve performance, or lower their risk of chronic diseases the approaches will all likely vary. I agree the best diet for most people is “Eat food, mostly plants, not too much”.

    • bacon and cheese is vague. Good quality products are healthy and can be consumed year round. First price bacon and cheese with suspicious additives are junk food just like soda.

      Fruits are not meant to be consumed year round.

      People in the Blue Zones have a totally different lifestyle and their food quality is absolutely premium, seasonal, would put our “organic local healthy+++” products to shame. As a dietitian you understand there are a bunch of factors who make for a longer lifespan. I’d suggest paying attention to the way those Blue Zones people have a social bond and are somewhat active + spend time outside in the sun, even late in life. Diet is a small part of the puzzle.

      If you are active and eat clean, there is a high chance your daily calories intake is good enough so that you stay lean. The macros/micronutrients are barely relevant in that context.

      • Good insights – bacon and cheese vary in quality for sure.

        I’d say diet is a probably a pretty large part of the puzzle if for no other reason than its the thing most people get wrong now. People tend to equate diet and weight which is certainly a false equivalency as you can be healthy and overweight and have a poor diet and be normal weight.

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