Very Low Carbing: Let’s Just Kill This Beast

The identity of this formerly Low Carb Doc will forever be safe with me short of State torture—as will be the identities of the Low Carb Docs who have seen worse, not better, in their patients.

Spanish Caravan” (edited for style, not content)


Paleophil, the legal issue here is an example I cite because it harkens back to SAD and conventional medicine. We’ve been told that the medical establishment will never admit that they were wrong about fat, especially saturated fat, since that will open a floodgate of lawsuits. So those who’ve harmed themselves, become obese, and developed CVD by avoiding fat and eating processed carbs instead, might have a case if they can prove the nature of the harm—and especially if the medical establishment comes out and admits that they’ve been wrong all along about SaFA.

They’ll never do that. That’s an exposure to legal liability that I can’t risk. That’s how corporations behave. Any medical practitioner—or even those who’re not medical doctors, but diet gurus—could be exposed too. Notice how Dr. Perlmutter always prefaces his answers to questions with “you’re not under my care and I don’t have your blood labs, so this is my general take on your question without knowing anything about you or your background.”

If a low-carb doc ever came out and admitted that, “Look I’ve been wrong: VLCing actually lowers WBCs, jeopardizes immunity, facilitates autoimmune pathogenesis, triggers Raynaud’s” …he better have some good liability insurance. He’ll deny, if he wants to survive. It will be like Lance Armstrong coming out and expecting to hold onto his records and endorsements. …Penn State only became liable to the victims of Jerry Sandusky after it fessed up and fired Paterno and the administration.

I actually know a few low-carb doctors who are no longer touting VLCing, now have developed serious reservations about it, but are never publicly warning about the dangers or side effects for such reasons—for any hint of legal admission of guilt or culpability.

I also know a very prominent guru whose patient population have an autoimmunity rate of 1000%; that’s 100%. He’s said that 90% of his patients have Raynaud’s, and 90% are hypothyroid (low T3). He prescribes cytomel and T3 medication freely. But do you know the other side of the coin? About 1/3 of his patients have a serious immune condition called CVID (Common variable immunodeficiency). Another 1/2 have a singular immunoglobulin deficiency which makes flu and pneumonia shots pretty much ineffective. Sudden food allergies, unexplained allergies to airborne particles, dust mites, and indoor materials are features of some of these conditions. These allergies show up all of a sudden and you start sniffling around constantly.

You may treat all these as anecdotal. I actually know these guys and the doc himself is currently on immunoglobulin injections to stay alive. Most CVID patients will die from lymphoma, and he had a biopsy a year ago, and so do many of his patients. I know what he thinks. But he’ll never admit that he became sick or jeopardized the immunity of patients through long-term VLCing. Doing so would be tantamount to what Lance Armstrong did.

When you have skin in the game, you cannot be objective. It’s very naïve to think that any party will roll over in this diet war. You have to use your power of observation and observe patterns. As far as VLCing goes, I’ve seen enough evidence to convince me that’s it’s not matter of love it or leave it.


The plot will thicken. I guarantee it.

Update: In the interest of clarity I want to point out that I’m not saying LC is never appropriate, but I now see it as an INTERVENTION (like a drug), and especially VLC and ketogenic. Probably best under medical supervision to address some issue with the possible exception of obesity where it seems to be fine for a while, like initial weight loss. Just by my “feel” for it over the years, my experience, those of family and blog readers, the problems crop up down the road, when that stall happens and the answer is always: LESS CARBS!

This is also not advocating high carbs. It’s advocating sane amounts of carbohydrate, 30-40% perhaps, from safe sources like potatoes, white rice, fruit and legumes properly prepared. Or, an LC styled diet with regular carb refeeds of several hundred grams weekly or twice per week (anabolic diet).

I fully agree that, just like a drug, VLC or ketogenic has therapeutic applications as I’ve mentioned a number of times but in such cases, there ought be a cost-benefit accounting, just as in the side effects of many drugs.

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  1. AF on January 31, 2014 at 12:40

    well, it also depends if the patients of this doctor are all coming for his help because they suffer from the same condition… this can effect your observation.
    Low Carb is not for everybody, but it helped me to control my type 1 diabetes and in my case also made my other autoimmune related stuff to disappear (eczema and atopic dermatitis)

    • Richard Nikoley on January 31, 2014 at 13:26


      I have been saying for some time now: LC is an effective INTERVENTION therapy. That means: upsides outweigh the side effects.

      In short, VLC is tantamount to a drug and ought to probably come with all the same warnings.

    • J. B. Rainsberger on January 31, 2014 at 15:41

      Very well. How much we know about when to suggest moving away from strict LC eating? What indicators? It’s all very well to say “Only do LC for a while”, but it’s mostly useful advice without some working definition of “a while”. Do you have an opinion on this?

    • Richard Nikoley on January 31, 2014 at 16:10

      Well, since it’s an alternative therapy and not a drug where a limit of dosage might be prescribed (such as antibiotics), everyone is on their own.

      I’ve blogged much about when the sheen of LC wears off. Did for me. Can pinpoint it at 175 pounds, about 10 from ideal. Gained back 10-20 and felt WAY better. But, I did that just eating more of LCish. So, still had cold hands & feet. I’m pretty high energy so all the lethargy reports really go over my own head.

      I say that it’s a great intervention for big overweight or obesity, but just let it do its job and hopefully you’ve learned something, like when you add carbs, make it taters, rice, legumes….not Hot Pockets and Pop Tarts.

      And of course, Keto is proven INTERVENTION THEREPY in other stuff like neuro and cancer.

      It’s a drug. Treat it as such.

    • Spanish Caravan on February 2, 2014 at 11:42

      JB, there is one symptom you should not dismiss. Cold fingers. It could be Raynaud’s or the low T3 euthyroid state or both. I tend to think they’re comorbid. As I commented elsewhere, those cold fingers, if Raynaud’s, is a sign of immune problems. At that point, you’re in the beginning stage of compromised immunity. Where you progress after that depends on whether you continue to VLC and the heartiness of your constitution (genes). You don’t want Secondary Raunaud’s, which means you have a serious autoimmune condition.

      The problem is we don’t have ready biomarkers to test for Raynaud’s or incipient autoimmunity. Autoimmunity is usually only detected after you develop symptoms; then you check for antibodies. Because of the fault rate with ANA, most doctors will ignore seropositivity. But only after antibody attacks have continue for some time will there be tissue damage. If you have an alert doc who found that you may be seropositive at a low level, for example, for one of the Lupus antibodies (let’s say anti-chromatin, which normally progress to the double S DNA, if conditions do not change), then you can reverse that by going gluten- and dairy-free and adopting a healthy diet. But not VLCing! That will facilitate the progression!

      The tragedy here is that most people do not test and such tests belong to the realm of highly-qualified rheumatologists and immunologists. Even then, it’s a crapshoot. Heck, a dozen new antibodies get introduced each year. But many of these antibodies lack specificity, so most doctors have adopted a “wait and see” attitude, i.e., wait until there are overt symptoms. But by then, it might be too late. You can’t really reverse a systemic lupus condition that has infiltrated your lungs or kidneys.

      Most doctors know precious little about the nature of antibodies or how they precedes symptoms. The “lagtime” here also makes it difficult to pin it to any diet you may have been on. So I can understand people failing to connect the dots; but this also gives the VLCers of denying the phenomenon of immune dysfunction.

      You can go two ways here: autoimmunity or deficiency. We’re just learning about the gut microbes and how they play an important role in propping up the immune function, and how they can turn over so quickly on a diet deprived of vegetables and starches.

      Here’s what Wiki says about Primary Raynaud’s:

      “Raynaud’s disease, or “Primary Raynaud’s”, is diagnosed if the symptoms are idiopathic, that is, if they occur by themselves and not in association with other diseases. Some refer to Primary Raynaud’s disease as “being allergic to coldness.”

      But here’s the second phase, if you let it continue. When will it become secondary? Could be years, as long as 20 years.

      “Raynaud’s syndrome, or “Secondary Raynaud’s,” occurs secondary to a wide variety of other conditions. Secondary Raynaud’s has a number of associations:

      Connective tissue disorders:
      systemic lupus erythematosus
      rheumatoid arthritis
      Sjögren’s syndrome
      mixed connective tissue disease
      cold agglutinin disease
      Ehlers-Danlos Syndrome
      … [let’s skip some here]
      Lyme Disease
      Chronic Fatigue Syndrome
      reflex sympathetic dystrophy
      carpal tunnel syndrome
      Magnesium Deficiency
      Multiple Sclerosis

      It is important to realize that Raynaud’s can herald these diseases by periods of more than twenty years in some cases, making it effectively their first presenting symptom. This may be the case in the CREST syndrome, of which Raynaud’s is a part. Patients with Secondary Raynaud’s can also have symptoms related to their underlying diseases. Raynaud’s phenomenon is the initial symptom that presents for 70% of patients with scleroderma, a skin and joint disease.”

      I’m not saying if you have Raynaud’s you’ll reach the 2nd stage and may have to contend with Scleroderma; you’ll increase your susceptibility to it, especially if you’re vulnerable genetically. But notice the lagtime. You’ll never pin it to VLCing.

    • Charles on February 2, 2014 at 12:10

      Thanks, Spanish. This scared the heck out of me because a very close friend started having Reynaud’s symptoms a couple of years ago. She’s not a fundamentalist VLC person, but kind of naturally eats a LC diet. I read an earlier post or two on here, maybe from you, about Reynaud’s, and that motivated me to try to motivate her to try PS, and to add more starches to her diet. Luckily, she’s a smart cookie, and has started in on the program. So you’ve done a mitzvah, as they say. It’s going to start the usual dietary religious war, but I’ve been around long enough to have seen a lot of those, and usually no one dies and a few people do actually get it. Good on ya, mate.

  2. golooraam on January 31, 2014 at 12:41

    wow Richard – didn’t know all this
    now I’m really glad I still introduce carbs here and there
    thanks to you I’m slowly shifting away from junk food to enjoying cooking real food
    like the pinto and smoked ham bone I’m throwing into the crockpot tonight for my breakfast tomorrow

  3. Terence on January 31, 2014 at 12:49

    Thanks for the post, Richard. I am a long time reader, but this is my first time commenting. As a pretty healthy 25-year-old with about 10 pounds to lose, I followed Mark Sisson’s Primal Blueprint diet for about a year and had tremendous results. However, I had a carb-phobia and was consuming less than 100 carbs a day. After reading Paul Jaminet’s Perfect Health Diet about a year ago, I incorporated more carbs into my diet by increasing by fruit intake and potato intake (I probably consume about 200 carbs a day). I’ve never felt better and have continued to notice improvements in my health and, less importantly, my physique. I don’t want to sound too preachy, but taking the focus off of avoiding carbs and continuing to avoid processed junk really changed my entire outlook on diet and nutrition. I feel like any extreme (VLC, low-fat, low-protein) isn’t the answer for most people. Thanks for continuing to debunk carb-phobia.

  4. Alec on January 31, 2014 at 12:59

    Potato starch can be a good thickener… of plots. Da-dum-chish.

    Does this necessarily disagree with cyclic ketogenic/LC/VLC? It seems like somewhere the twain may meet, given some person’s existing conditions and goals.

    • Richard Nikoley on January 31, 2014 at 13:29

      I’m a big fan of ZC meals. Give a a plate of ribs and the 1TBS of molasses in my sauce for about a pint is a wash.

      It’s just not an everyday lifestyle.

  5. rob on January 31, 2014 at 13:17

    The real ass-kicker would be the parents who kept their kids VLC during their rapid growth stage, damages are always a lot higher when kids are involved because the damages play out over decades.

    I still think it’s a nifty diet but somehow it turned into a lifestyle. I was never under the illusion that I was improving my health through VLC, I was just improving my appearance.

    • bornagain on January 31, 2014 at 13:37

      Speaking of parenting, I see it is now the law in the United Arab Emirates for mothers to breastfeed for the first two years of the babies life. See Richard. Not all laws are bad. This is obviously a good law. We should have more laws like this.

    • Michelle on January 31, 2014 at 14:47

      More laws are never a solution for ANYTHING.

    • gabriella kadar on January 31, 2014 at 15:36

      The problem with that is the vitamin D blood levels of those ladies is something like 3 ng/ml. I did some reading about this and if they are forced to breastfeed and don’t supplement with formula, you’ll have a bunch of children with rickets. Not to mention vitamin K deficiency: haemorrhagic disease of the newborn.

      For some reason babies in the U.K. are dying of rickets now. I’m entirely gobsmacked. This is a disease that was eliminated though public health interventions decades ago and it’s back.

    • Richard Nikoley on January 31, 2014 at 16:57


      With every comment, you affirm my initial assessment of you. There’s that.

    • EatLessMoveMoore on January 31, 2014 at 18:18

      And how, exactly, did it turn into a lifestyle? Not by accident, I can assure you. It’s time to start calling out the guilty parties (mainly singular – are you listening, Jimmy Moore?).

    • bornagain on January 31, 2014 at 20:02

      I’ve always seen you as a fairly good judge of character so I place a fair amount of weight on “that”.

    • Richard Nikoley on January 31, 2014 at 21:37

      Then let me make it explicit for you. I may tolerate someone who believes it ok to bring main initiatory force against others to see to certain values they may like but if ever forced, I will have to admit that I had no respect.

      I simply do not believe in forcing anyone to do anything. Ever. Zero exceptions ever. That includes feeding their babies. If they don’t do that on their own with enthusiasm, that particular relationship wasn’t meant to be. And so be it.

    • PhilT on February 1, 2014 at 01:13

      The UK isn’t blessed with a lot of sunlight, being further north than the USA, and nonsense about sunscreen hasn’t helped either. Add to that the fear of paedophiles on every corner (the ones who aren’t hosting TV shows) and the kidz don’t get da sun much at all. Fat phobia reducing dairy consumption may be a factor too.

      We also have a lot of immigrants, so a UK rickets death may be a recently arrived Zimbabwean, Pole or whatever. “A five-month-old baby has died from rickets after his parents insisted on following a strict eating regime as part of their religion.” was a recent headline – 7th day adventist, immigrant mother.

      I got a Vit-D test done, was found to be “insufficient” and supplement with a 4000 IU spray daily. Nobody beleives that we have inadequate sunlight to meet VitD requirements for half the year. Newborns do receive Vit-K injections in the UK.

    • GTR on February 1, 2014 at 08:04

      @bornagain – don’t you think that such law is there to prevent women from working, to satisfy their patriarchal religion?

    • Jennifer on February 1, 2014 at 09:00

      Could NOT agree with you more!!!!

  6. charles grashow on January 31, 2014 at 13:24

    “When you have skin in the game, you cannot be objective.”

    Truer words were never spoken

  7. Bob on January 31, 2014 at 13:35

    Regarding liability, the same thing applies to organizations like the Canadian Diabetes Association, which invites Pepsi representatives to run sessions, etc:

    They will never change their policies, for the exact same reason.

    As for low carbers, I am one. On a good day, I am probably below 50 grams. I have a 290 lb+ weight loss, workout 5 days a week for about an hour or more a day. My lifts are continually improving. I have about 20 lbs more to lose, but who knows with all the skin hanging off of me. I can fit in a 36 inch pants when I started with 66 inch pants.

    Am I a disciple for low-carb living? No, it works for me. When it stops to work, I will do something different. When people ask what I have been doing, I tell them. I also tell them to start by eating real foods, and see how it works. Take what you want, leave the rest.

  8. Jared on January 31, 2014 at 13:37

    What are your feelings about John Kiefer and his carb-backloading. I’ve pretty much stopped the low carb thing since I was definitely feeling some of the detrimental affects of it. Cold hands and feet, poor body temp regulation. Just wondering if this could be the best of both worlds sort of thing. Condense your carbs into a designated eating window. Thoughts?

  9. Kira on January 31, 2014 at 13:54

    People with AI disorders have been helped, sometimes dramatically so, by healing their guts. Perhaps if those who have damaged themselves with a VLC diet would take the appropriate steps to repair their gut biomes, some of the damage would reverse itself.

  10. Danny Grayson on January 31, 2014 at 14:02

    I rocks with it, man. I think a lot of this involves humility, being willing to question oneself/not being devoted to any blogger/guru, and accepting that it’s okay to be wrong.

    Hell, three weeks ago I thought all grains, lentils, and beans were gonna kill me. Same with sugar (even the sugar from fruit!!). Can’t forget gluten too. Fell into the whole insulin hypothesis too.

    This is a weird food alarmist/extremism culture we live in, sir.

    May one day beans, lentils, and rice be welcome with liver and butter. & don’t forget the whey and potato starch :D

  11. Spencer on January 31, 2014 at 14:03

    Seriously, I wish someone had talked to me before I went balls to wall VLC. It works good to help you go to fat burning. Awesome. You can do the same thing just by increasing the amount of fat your eating and fasting every once in a while. This is from a guy who now is experiencing medical problems very similar to what is described as CVID. Keep mind I went VLC 2 years ago, and I just now starting to deal with problems. I haven’t been able to figure it out even with a doctors help. Thank you. Thanks for screwing me over.

    • Spanish Caravan on February 4, 2014 at 21:08

      Spencer, what makes you think you have CVID? Most people who think they have it, don’t. If you think you have immune problems, you need to go see an allergist (immunologist). But you might not even be referred unless you show some symptoms.

      My feeling is that you probably need hard-core 2 years of VLCing to screw up your immune system permanently. Sooner if you’re genetically vulnerable. Also, a lot sooner if you’re wrecked due to SAD and hopped on the VLC bandwagon to lose weight and got yourself into a prolonged leptin deficient state. And you pushing through even after encountering symptoms like cold fingers, cold toes, low body temperature, dry eyes, dry mouth, dry colon & constipation, dry digestive tract and esophagus, and false hypoglycemia (i.e., symptomatic anemia). Multiple glucose deficiency symptoms, if you tolerate them long enough, will manifest as immune dysfunction.

      But most people don’t persist. They become intermittently ketogenic or stay above it. There are, however, 2 groups of people who do persist. (1) the morbidly obese, because they’re seduced by metabolic improvements and weight loss. (2) diabetics, who’ve been brainwashed by the blood sugar mafia that BG readings above 130 are hyperglycemic.

      These are usually the ones who push through and end up with irreversible autoimmunity and/or immune deficiency. No sane person will tolerate these symptoms Up to a point, yes, but not for 2 years.

  12. AB on January 31, 2014 at 14:32

    Is that commenter implying that VLC caused those patients to develop CVID and Ig deficiencies? That’s total BS. CVID is a set of conditions that are, by definition, *primary* (i.e. not acquired). They are genetic defects. Not caused by lack of dietary carbohydrate. Raynaud and hypothyroidism, sure, maybe. But it seems a bit hyperbolic to say VLC basically gives you AIDS.

    • Spencer on January 31, 2014 at 15:26

      “Environmental factors can influence expression of type 1. For identical twins, when one twin had type 1 diabetes, the other twin only had it 30%–50% of the time. Despite having exactly the same genome, one twin had the disease, whereas the other did not; this suggests environmental factors, in addition to genetic factors, can influence the disease’s prevalence.”

    • Spencer on January 31, 2014 at 15:35

      To follow this up, large amounts of people may have a predisposition to CVID and just like certain environmental factors influence the development of type 1 diabetes, the same could be the case for CVID.

    • Spanish Caravan on February 4, 2014 at 22:35

      AB, CVID is not solely genetically determined. Its etiology is largely unknown and the cause is multifactorial. It’s a really term for multiple immune deficiencies that each have different features. It’s like saying, “CVD”, when CVD could mean atherosclerosis, hypertension, thrombosis, myocardial infarction, FH, etc. It spans a dozen disease patterns. Genetic mutations are linked to it but they account for a small minority. Plus, genetic defects and child-onset CVID can be distinguished from adult-onset and event-driven CVID; it is also thought that you could get CVID from certain drugs, just like drug-induced lupus. It’s pretty much idiopathic:

      “Most cases of CVID are classified as sporadic and occur in people with no apparent history of the disorder in their family. Although the cause of these cases is unclear, sporadic cases probably result from a complex interaction of environmental and genetic factors.”

      Like autoimmune diseases with susceptible genes (HLA B27), they’re not specific enough. About 1 in 4 have a relative with a similar immunodeficiency but not CVID, usually singular igg subclass or immunoglobulin deficiency, which is much more common and not surprising. In fact, you might slowly progress to CVID after the onset of such selective deficiency; that might be the pattern of progression for those who VLC long-term. That’s my hunch. It’s not the same as AIDS or HIV.

    • adina on March 7, 2017 at 16:14

      just to jump in– 3 years later– i was diagnosed with a low subclass IgG and IgE about ten years ago. not CVID but almost. up until that point, i had been a vegan and vegetarian with a very high carb diet. my doctors wanted me to start IVIG therapy, but i opted out. since that time, i’ve controlled my deficiency to the point to becoming asymptomatic by eating low carb and VLC. i’m not sure what this means for you, but thought i’d give you a personal anecdote.

  13. bornagain on January 31, 2014 at 15:34

    When you launch your book, do it big this time. Get on morning TV, Dr Oz and Oprah’s recommended reading list and promote the living shit out of it. Make this thing a best seller dude. Don’t end up with book sales like Art Devany’s.

  14. Paleophil on January 31, 2014 at 17:04

    Richard, Thanks for the explanatory background on Spanish Caravan, and thanks to Spanish Caravan for trying to expose the gritty underbelly of VLC. I was impressed by SC’s answers to my questions. I knew there were problems, but things are apparently worse than I thought. Quite eye opening.

  15. GTR on February 1, 2014 at 13:29

    One of the things that everyone in “ancestral health” movement seems to be unaware of, is an evolutionary process that can be called Survival of The Richest. It turns out that most of people descendend from relatively rich (meaning upper-middle class, there were too few of royalty to make them ancestors of eveyrone), with poor peoples linegas dying off. This may be critical to determine if our ancestors were “low anything”.

    This simply means that our ancestors didn’t eat low-X (where X is like calories, fat, protein, carbs etc.), they were rich people who could afford food they wanted. There were certainly temporary depravation, both artificial – eg. religious fasting, or caused by governments like wars, that caused famines, seasonality for sure (no refrigerators to keep fruit available in the winter) but overall, long-term – no low-X for this subset of past populations that were our ancestors.

    It also means that studies based on what a typical person in the particular point in the past ate may not represent what our ancestors ate – as to check what our ancestors ate you’d first need to determine the richest dozen percent or so, and only based on this group determine what their diet was.

    Perhaps this important information is not “interesting” for some because the current evidence about survival of the rich points to the neolithic, to the advent of agriculture, which first divided people according to the wealth, then allowed almost exclusively only the rich lineages to survive long-term.

    “The evidence that best points to the answer, I think, lies in the difference between early agricultural villages and their pre-agricultural counterparts–the presence not just of grain but of granaries and, more tellingly, of just a few houses significantly larger and more ornate than all the others attached to those granaries. Agriculture was not so much about food as it was about the accumulation of wealth. It benefited some humans, and those people have been in charge ever since.”

    I’d argue that it is likely that for the purpose of diet alone there had been a lighter “survival of the richest” even before the agriculture. For the purpose of diet alone we could use “good food provider” as a proxy for rich in pre-agricultural societies, and thus survival of the richest (diet-wise) is both because of more food provided, as well as a sexual selection – a desire of females for the good hunters. So even here, despite what the average state of the population was (even if poor on average), when searching for our ancestors you’d find a chain of well-fed hunters and gatherers. With possible temporary (intermittent) fastring due to some climatic conditions like droughts, or fires, or as a result of tribal wars, but overall being well-fed long-term.

    So very low carb, very low calorie, very low fat are unlikely to be the diets of our ancestors, even if the general populations at that time was poor or starving.

    • GTR on February 2, 2014 at 04:19

      I don’t have that much information for super-comprehensive post, what’s here can add to the previous ones:

      From what I know the “survival of the richest” made some limited rounds around, but not much. In a modern sense “rich” is limited to neolithic where the real accumulation of property was possible. So earlier only a “good forager/hunter”, perhaps also “good toolmaker” – especially in colder climates could be the closest substitutes – with some of these talents being inherited in genes.

      For example among tested modern hunter gatherers the strongest preference among women is “good forager” at something like 55% of tested, that trumps things like looks – at about 40% tested and intelligence at 25%. Strangely their men don’t value intelligence in women much, it’s women who value intelligence in men.


      So it seems that good hunters – a substitute for rich – have it much better on the mating market, thus we can expect better reproduction. It’s not only about attractivness, but is even more important later because although men bring only 43% of calories during normal times, their share increases to 65% of calories when women have young infants. This would suggest that good hunters had reproductive success compared to bad ones, and thus that we can trace our ancestry in those part of hunter-gahterer tribe that was well-fed, rather than in the poor, bad forager part of the tribe.

      But this all seems to be trumped by Neolithic, where the real economic classes appeared. We know about the unusual fertility of the Eastern super-rich with their harems etc (it was more about middle-class, rather than aristocracy in Europe).

      Matt Ridley – the Red Queen
      “Without exception, that vast accumulation of power was always translated into prodigious sexual productivity. The Babylonian king Hammurabi had thousands of slave “wives” at his command. The Egyptian pharaoh Akhenaten procured 317 concubines and “droves” of consorts. The Aztec ruler Montezuma enjoyed 4.000 concubines. The Indian emperor Udayama preserved sixteen thousand consorts
      Measures to enhance the fertility of the harem were common. Wet nurses. who allow women to resume ovulation by cutting short their breast-feeding periods, date from at least the code of Hammurabi in the eighteenth century B.C.; they were sung about in Sumerian lullabies. The Tang Dynasty emperors of China kept careful records of dates of menstruation and conception in the harem so as to be sure to copulate only with the most fertile concubines. Chinese emperors were also taught to conserve their semen so as to keep up their quota of two women a day, and some even complained of their onerous sexual duties. These harems could hardly have been more carefully designed as breeding machines, dedicated to the spread of emperors’ genes.”

      How about the lowest class – the slaves. The info about fertility of slaves is scarce, as few were interested in writing about them, but what is available shows below-replacement levels at least for men slaves, as they had limited acces to women, while lots of births among female slaves can be attributed to the owners or supervisors.

      There was also clearly a downward movement from the overreproducing higher classes to the slave class, as well a a short life expectancy, including the possibility to be killed by masters in the West, or being castrated in the East. Upwards mobility was there – freeing the slaves, but in lower numbers than slaves made from unwanted children sold to slavery or abandoned and captured by slave traders (main source of slaves if there had been no conquests for some preceding years).

      “The Roman slave supply”

      “Ancient sources convey the impression that the enslavement of exposed babies was an unexceptional event. While impossible to quantify, this practice may conceivably have been the leading domestic source of free-born slaves in the mature Empire. Its numerical significance
      depends in part on the overall incidence of child exposure, a rather intractable issue that cannot be discussed here. Suffice it to say that the latter is consistently portrayed as a widespread custom,and that ethnic groups that raised all their children were considered exceptional.”

      “It is both true and untrue that the relative importance of different sources of Roman slaves ‘cannot be gauged from ancient texts’.lO’ Enough is known, however, to establish the improbability of the Self-Replacement-Hypothesis in the terms in which Scheidel has stated it, and to rehabilitate the importance of importation, and more particularly of self-sale and the enslavement of foundlings.”

      What really distinguishes Gregory Clark’s work – a book is called A Farewell to Alms – is the quality and reliability of the input data. He used English wills from the Medieval Times, that apparently are still available, preserved in the churches. So the data is a real data. It shows that basically every woman gave birth to 5 children, but the survivability varied based on the economic status – in the range from the 4 surviving offspring for the rich, to the 1,7 (below the replacement rate) for the poor. The end result being something like 90% of people at the eve of the Industrial Revolution come from 10% of the population (the reach people) at the beginning of his study – somewhere around 1200 AD. The process was that the children of the rich moved downwards – taking over jobs of the extinct poor people. This he claims was positive overall, as the rich farmers had certain genetic traits that made them better people than the poor – tendency to use trade negotiations rather than violence to solve conflicts, as well as were better at planning for the future (low time preference), compared to the poor who were living the moment.

      Also more people come from villages (rich farmers), as death rate in cities was higher – up to 1/3 of the entire generation, because of the dieseases. As for the averages – the society he describes was Malthusian in the sense that the average per-person wealth was close to the die-off treshold, even if the total wealth grew, then reproduction caused the per-person wealth not to grow. The real revolution, that freed humankind from this Malthusian trap was the Industrial Revolution – only after it the average per-person wealth began to grow. This also means that Robb Wolf is wrong! It was not the agriculture – as he wrote in his book, but the Industrial Revolution that is the most important change in the human condition.

      So basically when we look at oru ancestry backwards in time, from us today, to some hominids in the past, what we see is a chain of individuals who are mostly rich – with some perhaps temporary downward moments, followed by upwards one, who thus didn’t suffer from the starvation, but ate a reasonable diet, with enough calories (although in medieval times rich ate less protein than hunter gatherers, same calories according to G. Clark work) even when the average in the population were starving at the Malthusian limits.

      It also means that if we want to blame some change for the obesity epidemic, then it should be the Industrial Revolution – because only after it the wealth per person increased enough that that the calories became available enough to make obesity popular. It was also evil in the sense of reversing this Clark-Unz process that gave rise to it – right now poor reproduce well, thanks to the overall high wealth (government redistribution itself couldn’t work if there were no resources to distribute, like in the Malthusian limits).

      There are some interesting followups from others; eg. about the sorry state of the groups that didn’t participate in the Clark model, but didn’t go extinct, just become a minority, but still kept their high-violence, high-time-preference, inability to do monotonous jobs behavior from hunter-gatherers time.
      “In pre-modern Japanese society, the Burakumin specialized in jobs that required contact with dead flesh, e.g., butchery, leather making, and preparation of corpses for burial. They were and still are socially stigmatized, and marriage with them was forbidden. Because of their endogamy and their reserved occupations, they may have thus escaped the process of demographic replacement that Gregory Clark (2007) described for English society, i.e., they were not gradually replaced by downwardly moving members of the middle class. As such, they might provide a glimpse into the genetic predispositions that characterized the Japanese several centuries ago”

      You could probably add Australian Aboriginals to such groups, that collided with the industrial civilization without the additional necessary evolution – with bad results. In all fairness though Amazonian Indians do quite well in South American conditions after moving from the jungle to the civilization, on the other hand South America is at lower standards than the one in Japan or Korea.

      What is kind of puzzling is a role of totalitarian regimes of 20-th centaury, which seemed to try to reverse the evolution that Clark described. Especially Communism killed rich farmers – so called kulaks – by millions, as well as killing capitalists, while trying to promote the poor.

    • Stan on February 1, 2014 at 14:28

      Explains why so many people suffer from foie gras deficiency.

    • Richard Nikoley on February 1, 2014 at 16:46


      That’s pretty interesting. Did you not put up a comment like this recently? I’m kinda wanting to toss this out there. Are you willing to toss everything together into a blog post?

      Just let me know here, or in email, put it all in one sack and and I can pop it up in the next week or so and everyone can chew on it themselves.

    • gabriella kadar on February 2, 2014 at 16:34

      GTR, the industrial revolution was really primarily a British phenomenon, or English. Since it was run on coal and there was/is lots of coal in the British Isles (not Ireland). Industry began in Europe later and never took on the grand scale as it did in England. This is partly because the materials came from the colonies. So even though the family size and birth rate in England spike during the 19th century, the quality of life for people living in England’s colonies certainly did not improve.

      If you check the situation in Europe, food harvests were oftentimes inadequate to feed the population. I can’t remember the ratio of years right now (it’s been a while since I read all of this) but if you look at cemetery records, it’s disturbing to find how many graves were filled by paupers who starved to death. For example, the French always had trouble with food. Nature compensated because people were short and smaller bodies require less calories to do work.

      If you want to read a really excellent book on the subject, try ‘The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700’ by Roderick Floud, Robert W. Fogel, Bernard Harris, and Sok Chul Hong. Published by Cambridge University Press and National Bureau of Economic Research. 2011. It is part of the New Approaches to Economic and Social History.

      Various bits of it as working papers are available on the NBER website. Actually, if you are interested in all this stuff that you are writing about above, you’ll have some fun reading a number of papers on NBER.

    • GTR on February 3, 2014 at 02:46

      If you listen to Gregory Clark’s presentation you’d understand why the Industrial Revolution was a real breakthrough in the entire human existance – it’s the first time the wealth PER CAPITA persistently increased. In previous times – including hunter gatherer times – the per capita wealth was within tight bounds, because even though there was a slow economic growth, the population always was trying to outgrow it.

      So for example after Black Death the per-capita welath and wages increased – sipmly because there were so few people left. But soon it returned to the previous low levels because the population grew in size faster than the economy. Only after the Industrial Revolution the economy was able to grow faster than the population.

      This type of behavior – reproduction despite the lack of resources is a characteristics of animals too. Herbivores are known to do “overshoot and collapse” when not checked by predators – they reproduce to such large numbers that this new large population destroys the environment they live in (eg. overgrazing creating a dessert). This was studied eg. on herbivores left on islands without predators.

      The predators on the other hand have their population in check first by the natural limits on the numer of prey, but also they limit their numbers by violent means – lot’s of fights (eg. hyenas vs. lions), infanticide (eg. male lions killing the cubs of previous pack leader) etc.

      During paleolithic humans behaved like predators, limiting their population via violence, including lots of tribal wars and even cannibalism. Thus the diet of an average person was reasonable – the overall wealth was low, lower than during the agriculture – but since there were these population lowering mechanisms via violence then the per-capita wealth was reasonable. But this was a Malthusian socjety too – per capita wealth was more or less constant.

      In agricultural societies the per-capita violence decreased – people started to behave more and more like herbivores, the summary economy was very slowly growing. But the population growth (remember – 5 kids born per women) was faster than the economic growth. Less violence meant less effective population control via violence, while still not having an economy large enough to feed all those that were born! It also means that if all people were treated equally – then almost all would starve do death (a classic overshoot and collapse of herbivores).

      The solution turned out to be not to fight overshoot with violence, not divide wealth equally (which as I mentioned would lead to almost everybody starving), but simply to divide population into groups – every group would overshoot (5 children per woman), but only few groups – so called poor – would collapse! And all done without much violence – by starvation (1500 kcal/day for the poor). A designated group called rich would not – thus ensuring a stable population even if the average per-capita wealth was below human sustainence level. In case the poor collapsed too much – which would lead to too few people for the economy to function optimally – the excess chidren of the rich would take the niches previously occupied by the poor (so called downward mobility).

      There was no third option – violence was out, good contraception not available, sharing equally would mean everybody would collapse, the economy before the Industrial Revolution was too weak to feed everyboty etc. Some group just had to be designated to survive, and some too die after overshoot.

      Strangely it worked out well! It turned out that in order to be rich, and stay rich people had to have certain features – like futrue orientation (low time preference), ability to concentrate on monotonous jobs, and – in case of England – use non-violent ways to solve conflicts. Which meant that the group that survived causet the average of the society to be better. While the poor who died off were more likely to be violent, live the moment rather than care for the future, and could not work efficiently in monotonous jobs, thus the population got rid of people that were problematic.

      It also means that even if we are descendants of the recent poor, then our more distant ancestors were likely rich anyway, just with someone on the way loosing wealth in some way.

      Back to the Industrial Revolution – it took off in England first, but then moved to other countries, even those that didn’t have much colonies, or large natural resources (eg Germany). In fact in Russia the most industrialized region was the western part – which was a colony itself, consisting of occupied currently: Poland, Lithuania, Ukraine, Belarus etc. – rather than the mainland. In fact it could be the French inventing the industry had the English not speed things up.

      What is important according to the Gregory Clark is that it was the Industrial Revolution that was the pivotal of escaping the Malthusian trap. For the first time in the human history the per-capita wealth was increasing well above any previous level – whether historical, or stone age.

    • GTR on February 8, 2014 at 17:30

      @gabriella, @richard – when it comes to the history and prehistory of the economy, up to the beginning of the Industrial Revolution then Gregory Clark has a series of 26 videos – these are his lectures from the university – UCDavis

      UCDavis – World Economic History before the Industrial Revolution
      “This course details the nature and development of economies from pre-history to the Industrial Revolution. It explains how this was dramatically different from modern economies. Finally it considers what caused the Industrial Revolution, why it was in Europe, and why it was delayed till 1800.”

    • Richard Nikoley on February 26, 2014 at 08:14


      Just to follow up, I finally got all your stuff on Survival of the Richest into a blog draft so I’ll be polishing things up and it’ll probably hit the top of the blog next week sometime.


  16. rs711 on February 1, 2014 at 04:32

    Can someone point me to information showing that the decreased levels of T3 (fT3? rT? just T3? or other thyroid hormones) in VLC dieters are pathological? And not just a ‘change’ unaccompanied by overt pathology?


  17. Paleophil on February 1, 2014 at 05:40

    Here’s a start: ” In the intensive care unit, the prevalence of abnormal thyroid function tests is remarkably high. More than 70% of patients show low T3 and around 50% have low T4.

    Many of these studies have indicated a direct relationship between Low T3 Syndrome the severity and both short- and long-term outcome of disease. The lower the T3 level in critically ill patients, the worse the outcome tends to be.”

    I haven’t dug into the studies, so maybe you’ll be able to find some nits to pick in them, but no human population in history has ever gone out of their way to intentionally stay in chronic ketosis or passed up carby foods when they were available. Shouldn’t the burden of proof rest with the ones advocating this novel approach that makes guinea pigs of human beings? There are claims that it’s more like how our ancestors used to eat, but if you dig into the research on the diets of Stone Age peoples and modern hunter gatherers, you’ll find they include fruits, roots, tubers, legumes (such as legume tubers, legume fruits and groundnuts) and even honey (gasp) wherever they are available.

    Even Eskimos praise wild potatoes that are often called “Eskimo potatoes” (Webster’s calls it “a starchy edible tuberous root,” – and there is more than one species that’s called “Eskimo potato”) as one of their healthiest traditional foods. If starchy and carby foods were so harmful, why on earth would they do that? Even Vilhjalmur Stefansson ate (domesticated) potatoes. The very existence of the words “Eskimo potato” alone should be enough to make one question the notion that there are no safe starches or that chronic ketosis by avoiding carbs makes sense. The amazing benefits that many folks are reporting from potato starch, plantains and such is another strong clue.

    • GTR on February 1, 2014 at 08:44

      @DuckDodgers – you gave link about Paranthropus boisei – why do you suggest that Paranthropus boisei was in any way our ancestor? It looks like a separate, unsuccessful lineage, that went extinct. There’s nothing special about this species either – massive jaws, but brain size/size ration is not good.

      Our direct ancestor seems to be homo habilis, that was more of a bone marrow eater – more delicate, gracile, but with good brain/size ratio.

    • DuckDodgers on February 1, 2014 at 11:51

      Btw, here’s an excellent summary of the mystery surrounding all the evidence of the shift to C4 plants by our Paleolithic ancestors — it was written last year, before this latest Oxford hypothesis to solve the riddle:

      A Grassy Trend in Human Ancestors’ Diets

      The article is fantastic, and covers all the C3/C4 isotope research that narrows in on the mystery of Paleo man shifting to C4 grasses and how it relates with the evolution of larger brained Homo sapiens. A must read.

      At the end of the article it summarizes previous findings on C3/C4 and how it all fits into the timeline of evolution:

      The Findings: A Dietary History of Human Ancestors and Relatives

      – Previous research showed that 4.4 million years ago in Ethiopia, early human relative Ardipithecus ramidus (“Ardi”) ate mostly C3 leaves and fruits.

      – About 4.2 million to 4 million years ago on the Kenyan side of the Turkana Basin, one of Cerling’s new studies shows that human ancestor Australopithecus anamensis ate at least 90 percent leaves and fruits – the same diet as modern chimps.

      – By 3.4 million years ago in northeast Ethiopia’s Awash Basin, according to Wynn’s study, Australopithecus afarensis was eating significant amounts of C4 grasses and sedges: 22 percent on average, but with a wide range among individuals of anywhere from 0 percent to 69 percent grasses and sedges. The species also ate some succulent plants. Wynn says that switch “documents a transformational stage in our ecological history.” Many scientists previously believed A. afarensis had an ape-like C3 diet. It remains a mystery why A. afarensis expanded its menu to C4 grasses when its likely ancestor, A. anamensis, did not, although both inhabited savanna habitats, Wynn writes.

      – Also by 3.4 million years ago in Turkana, human relative Kenyanthropus platyops had switched to a highly varied diet of both C3 trees and shrubs and C4 grasses and sedges. The average was 40 percent grasses and sedges, but individuals varied widely, eating anywhere from 5 percent to 65 percent, Cerling says.

      – About 2.7 million to 2.1 million years ago in southern Africa, hominins Australopithecus africanus and Paranthropus robustus ate tree and shrub foods, but also ate grasses and sedges and perhaps grazing animals. A africanus averaged 50 percent C4 grass-sedge-based foods, but individuals ranged from none to 80 percent. P. robustus averaged 30 percent grasses-sedges, but ranged from 20 percent to 50 percent.

      – By 2 million to 1.7 million years ago in Turkana, early humans, Homo, ate a 35 percent grass-and-sedge diet – some possibly from meat of grazing animals – while another hominin, Paranthropus boisei, was eating 75 percent grass – more than any hominin, according to a 2011 study by Cerling. Paranthropus likely was vegetarian. Homo had a mixed diet that likely included meat or insects that had eaten grasses. Wynn says a drier climate may have made Homo and Paranthropus more reliant on C4 grasses.

      – By 1.4 million years ago in Turkana, Homo had increased the proportion of grass-based food to 55 percent.

      – Some 10,000 years ago in Turkana, Homo sapiens‘ teeth reveal a diet split 50-50 between C3 trees and shrubs and C4 plants and likely meat – almost identical to the ratio in modern North Americans, Cerling says.

      Humans: The Only Surviving Primates with a C4 Grass Diet

      Cerling’s second new study shows that while human ancestors ate more grasses and other apes stuck with trees and shrubs, two extinct Kenyan baboons represent the only primate genus that ate primarily grasses and perhaps sedges throughout its history.

      Theropithecus brumpti ate a 65 percent tropical grass-and-sedge diet when the baboons lived between 4 million and 2.5 million years ago, contradicting previous claims that they ate forest foods. Later, Theropithecus oswaldi ate a 75 percent grass diet by 2 million years ago and a 100 percent grass diet by 1 million years ago. Both species went extinct, perhaps due to competition from hooved grazing animals. Modern Theropithecus gelada baboons live in Ethiopia’s highlands, where they eat only C3 cool-season grasses.

      Cerling notes that primate tropical grass-eaters – Theropithecus baboons and Paranthropus human relatives – went extinct while human ancestors ate an increasingly grass-based diet. Why is an open question.

    • GTR on February 1, 2014 at 16:15

      @Duck Dodgers – how much all this is just an economy, rather than the optimal diet? The major difference between C4 and C3 plants is the way they use CO2 – C4 plants are more advanced by having an active CO2 pumping system (rather than passive one as C3 have), that allows them to thrive in low CO2 concentrations. C4 are like turbocharged engines.

      The CO2 pumping system as exemplified by corn:

      Optimal CO2 concentrations:

      “It is well known that a CO2 level in the garden’s air between 700 and 900 ppm improves crop development and yield. Most plants grown for their beautiful flowers or foliage optimally develop at about 800 ppm. Roses are distinctive as they require about 1200 ppm in carbon dioxide concentration for best results. For many fruits and vegetables, the ideal CO2 level in the garden should be at least between 1000 and 1200 ppm.”

      Basically C4 can live at diminutive CO2 levels and thrives at 300+, while C3 plants thrive only at 800-1200 ppm of CO2 (at which their productivity is higher than C4 plants maximum!), have problems at low CO2 levels that we have now, and start going ectinct at around 150 ppm.

      Generally CO2 concentrations have a persistent lowering trend, on the Earth as a lot of CO2 is trapped in limestone, and doesn’t return to the biosphere. Around 500 million years from now the lowering CO2 concentrations are supposed to kill plant life on Earth.

      When it comes to shortest time frames, then unfortunately for C3 plants since the onset of Pleistocene ice age, som the concentrations of CO2 are very low evolution-wise. The record was actually at the last interglacial, where CO2 reached 180 ppm low record, very close to C3 extinction beginning at 150 ppm. Even at hot interglacial periods it was like 300 ppm, suboptimal for C3 plants, but at which C4 thrives. Compare this to let’s say Jurasic, when CO2 concentrations were between 1000 to 3000 ppm. A climate in which C3 plants evolved and to which they are accustomed to was much higher in CO2.

      So maybe this shift to C4 plants was related to economics – the C4 availability/C3 availability was growing, so C4 were a bigger percent of hominids diet. Chimps chose constant diet of C3 a the expanse of lowering population – semi-extinction instead of adaptation to what’s available. If so then this should change now – with rising CO2 levels C3 are in better shape now.

    • gabriella kadar on February 1, 2014 at 07:21

      Paleophil, a year ago my office manager’s father underwent repair surgery for an aortic dissecting aneurysm. I did some reading about thyroid function changes as a consequence of severe acute illness or surgery (ICU material) because he told me a couple of months later that he just didn’t have the energy but the surgery was 100% successful. The thyroid levels go down for sure. It can take a few months to kick in again. But when ICU docs tried to give these patients thyroxin, outcomes were very bad. Same goes for giving insulin when sugars are very high. It appears the body has to do what it does in order to survive.

      It is possible that someone with low fT3 to begin with is more liable to succumbing to some sort of serious illness. It indicates that something isn’t going very well. But whatever gets the patient into ICU also has an acute effect on thyroid function as well.

    • Gene on February 1, 2014 at 07:26

      Some hunter gatherers in Europe just 7000 years ago lacked salivary amylase genes: No Eskimo tubers for them.

    • DuckDodgers on February 1, 2014 at 07:28

      No human population in history has ever gone out of their way to intentionally stay in chronic ketosis or passed up carby foods when they were available. Shouldn’t the burden of proof rest with the ones advocating this novel approach that makes guinea pigs of human beings? There are claims that it’s more like how our ancestors used to eat, but if you dig into the research on the diets of Stone Age peoples and modern hunter gatherers, you’ll find they include fruits, roots, tubers, legumes (such as legume tubers, legume fruits and groundnuts) and even honey (gasp) wherever they are available.

      + 100,000,000,000

      Well said.

      Here’s the thing about “Low Carb Paleo” that nobody really talks about outside this blog — there is virtually zero historical or anthropological evidence to back VLC up. The real anthropological evidence that is being published these days is pointing towards far more C4 starches and carb consumption than what VLC proponents would have you believe.

      It’s actually pathetic to see evidence like that published and no one else in the so-called “Paleo Diet” world even notice or lift a finger to investigate. It either shows complete ignorance or a lack of intellectual curiosity on the part of other members of the ancestral health community. Or perhaps some people are aware but no one wants to recant their low carb hypotheses at this point to consider the role of RS.

    • Gene on February 1, 2014 at 07:55

      Duck, the two skeletons in the link I posted above show an inability to digest starch. I.e. no “tubers, legumes” etc. They didn’t have the digestive machinery to break it down.

      Moreover, your second link isn’t a HUMAN. It’s a human ancestor or, perhaps a species competing with our early ancestors. And you say VLCers are twisting evidence?

    • DuckDodgers on February 1, 2014 at 08:10

      Some hunter gatherers in Europe just 7000 years ago lacked salivary amylase genes

      The La Braña man had 5 AMY genes, which indicates a population of low starch consumption — not necessarily no starch consumption.

      From: Anatomical & Physiological Adaptations To Cooked Dietary Starch In Ancestral Humans

      …While on average, high starch consuming populations have just under seven AMY1 gene copies, low starch consuming populations have over 5 gene copies. This general similarity in the proximity of average gene copies between high and low-starch populations indicates that this genetic mutation occurred far before the advent of modern settlements, and more than likely on the African savannah. Thus, the drastic difference in the number of AMY1 copies may suggest a clear divide in our evolutionary history with all other apes, directing evidence toward and highlighting the importance of the consumption of starch-rich [(Underground Storage Organs)] USOs (Perry et al., 2007)…

      …In contrast, arctic populations, who consume extremely high proportions of, if not exclusively, animal foods, do not have any genetic adaptations to aid in the processing of such a diet, making it highly unlikely that humans evolved consuming a diet high, animal-based diet (Milton, 2000).

      The Hadza are in serious competition with mole rats for deep tubers, and mole rat C3/C4 ratios overlap with both Australopithecines and Homo erectus (Laden and Wrangham, 2005; Marlowe and Berbesque, 2009). From 6.0-1.5mya, mole rats consistently appear in the fossil record with hominids, suggesting that they all shared not only the same habitat, but also had similar diets, including significant tuber consumption (Laden and Wrangham, 2005). Other than mole rats (and warthogs) (Marlowe and Berbesque, 2009), there were likely hardly any other animals competing to eat USOs, making them a trustworthy food source (Wrangham et al., 1999).

      In any case, we all have more AMY1 genes than La Braña man did, so it would be baffling why anyone would choose to ignore those genes in this day and age. The point is that each of us was designed to digest plentiful amounts of starch.

    • DuckDodgers on February 1, 2014 at 08:14

      Duck, the two skeletons in the link I posted above show an inability to digest starch. I.e. no “tubers, legumes” etc. They didn’t have the digestive machinery to break it down.

      Not so. He had 5 AMY1 genes, which simply indicates a low starch population. They say it right in the report:

    • Paleophil on February 1, 2014 at 10:14

      Gene, Doesn’t it strike you as at all strange that to support a VLC diet, chronic ketosis and the notion of no safe starches/carbs, one has to reach for more and more extreme examples as each of the past ones gets debunked? The Eskimos and Vilhjalmur Stefansson didn’t cut it so now we have to look to a single human from 7k years ago who may not even have had any descendants that survived to the present?

    • DuckDodgers on February 1, 2014 at 11:46

      why do you suggest that Paranthropus boisei was in any way our ancestor?

      Well, first of all, it wasn’t my suggestion. I was simply quoting the Oxford researcher, Dr. Gabriele A. Macho, who said, “I believe that the theory—that “Nutcracker Man” lived on large amounts of tiger nuts—helps settle the debate about what our early human ancestor ate.”

      Secondly, Paranthropus boisei was a hominid, of the family Hominidae, which includes humans, gorillas, chimpanzees and orangutans. So, what’s important is that we have evidence of an early hominid digging up and eating raw starchy tubers, which is a pretty big deal.

      Thirdly, the research shows that Paranthropus boisei ate a lot of “C4” plants, based on the isotopes in his bones. C4 plants are grasses and sedges (pretty inedible), and many ancestors that we are actually descended from have high C4 isotopes in their bones. So, it was a riddle that eluded researchers until recently. Researchers couldn’t figure out how our ancestors could have survived on grasses.

      It is possible to obtain C4 isotopes by eating a C4-eating animal — and no one is suggesting that our homo ancestors didn’t eat meat — but hunting tools were not around 2 million years ago and that means plants and meat scavenging were the main sources of food. If our direct ancestors did eat plants (which seems very likely) a good portion of those plants appear to have come from C4 desert grasses and sedges, which most likely means nutrient-dense bulbs/corms/tubers from those grasses.

      So, the evidence from Paranthropus boisei simply gives us clues as to what C4 plant sources were eaten by early hominids that could have given them the fat/carbs/protein they needed to survive.

    • Charles on February 1, 2014 at 12:12

      Actually, that doesn’t imply at all that they didn’t eat tubers, only that they may have eaten them, but the starch went right to their intestines and nourished their bacteria.

    • Paleophil on February 1, 2014 at 14:06

      @DuckDodgers: What about the butchery evidence at Bouri and Gona that dates back 2.5-2.6 million years? A more controversial claim was even made for 3.4 mya.

      It wouldn’t be surprising, since chimps are known to hunt bushbabies with small stick-spears as well as using tools to obtain termites and crack nuts:

      Seems plausible that wooden spears were used by hominids even earlier than stone tipped spears and stone knives.

    • gabriella kadar on February 1, 2014 at 16:48

      Thank you GTR! I’ve watched a video about how with increased CO2 levels, crop plants grow better, produce more and require less water. Phosphorus for fertilizer is another matter altogether. The largest phosphorus source on the planet is in Morocco. (this article is old, but the situation has not changed. Because of the global economic situation, sales of phosphates are down, this despite the fact that populations developing countries are growing and people need to eat.) It’s all about balance.

    • DuckDodgers on February 1, 2014 at 17:59

      Actually, that doesn’t imply at all that they didn’t eat tubers, only that they may have eaten them, but the starch went right to their intestines and nourished their bacteria.

      Not sure what you mean. Just because starch is raw does not mean that it’s resistant starch. Only a portion of tiger nut tubers are RS and —gram for gram — tiger nuts have twice the starch as potatoes. Most of the starch from tiger nuts are easily digestible and could be used for energy (that’s what made them an ideal energy source).

    • DuckDodgers on February 1, 2014 at 18:08

      What about the butchery evidence at Bouri and Gona that dates back 2.5-2.6 million years? A more controversial claim was even made for 3.4 mya.

      Well, as you say, it’s controversial. Nobody really knows for sure.

      But, I think it’s pretty clear that we are omnivores. If we got all our food from meat, I think our jaws would look far more carnivorous. And if we are omnivores, I think all the high levels of C4 isotopes is suggesting a shift to tubers/corms.

    • DuckDodgers on February 1, 2014 at 18:17

      So maybe this shift to C4 plants was related to economics – the C4 availability/C3 availability was growing, so C4 were a bigger percent of hominids diet

      Okay, but if that’s what we adapted to over the last 2 million, then that’s what we’ve adapted to.

    • Charles on February 1, 2014 at 18:40

      @DuckDodgers: I wasn’t speaking to Tiger Nuts, only to the comment quite a ways above that certain humans didn’t have the genes/enzymes to digest starch, implying by that, I thought, that they didn’t eat anything starchy.

    • DuckDodgers on February 1, 2014 at 18:59

      @Charles. Got it.

      I’m still learning about AMY1 as well, and while that’s what I would think too, there are studies that low amylase activity can be related to high blood sugar surges after eating starches.

      But, as with anything, it’s probably more complex than any one study can cover. For instance, you would think that good amounts of RS would counteract such surges. :)

      I think low AMY1 copies just means low starch consumption. Truthfully is we all knew our AMY1 copy number, we’d probably have an easier time figuring out what level of starch was right for our own bodies.

    • DuckDodgers on February 2, 2014 at 17:49

      It looks like Homo Erectus, that was the main human species between 1.8 mln to 800k years, declining afterwards (african version also known as a Homo Ergaster) is the first certain fully omnivorous hominin, with a very variable diet.

      Precisely. But, the groundbreaking research right now is on the C3/C4 isotopes. And even homo had a good amount of C4 food, likely coming from grassy sources (tubers, corms, etc.). In addition to all those variable sources you referenced, either homo was eating massive amounts of grass-grazing animals (unlikely), or more likely he was scavenging some meat and filling up on nutrient-dense C4 tubers/corms/bulbs:

      From: A Grassy Trend in Human Ancestors’ Diets

      – By 1.4 million years ago in Turkana, Homo had increased the proportion of grass-based food to 55 percent.

      – Some 10,000 years ago in Turkana, Homo sapiens‘ teeth reveal a diet split 50-50 between C3 trees and shrubs and C4 plants and likely meat – almost identical to the ratio in modern North Americans, Cerling says.

      No matter how we slice it, it’s hard to avoid the evidence that homo seems to have eaten a lot of C4 foods. Since P. boisei had a diet of almost entirely C4 sources, it was uniquely useful in giving us clues as to what those C4 sources probably were (nutrient-dense tubers/corms). And since a high meat consumption for homo is unlikely, it’s not a stretch to suggest that homo relied heavily on C4 tubers, corms, bulbs, etc.

    • GTR on February 2, 2014 at 10:03

      It looks like Homo Erectus, that was the main human species between 1.8 mln to 800k years, declining afterwards (african version also known as a Homo Ergaster) is the first certain fully omnivorous hominin, with a very variable diet:

      “Toothwear analyses suggest that across their range, H. erectus engaged in a diverse and broad diet (Ungar et al. 2006). The food an organism ingests can also produce subtle changes in the chemistry of body tissues (you actually are what you eat), including the dentin and enamel that make up the crown of a tooth. Using this information, investigations of the stable isotope chemistry of H. erectus teeth also support the idea of a flexible and diverse diet (Ungar & Sponheimer 2011). Whatever the flora and fauna H. erectus ate at the varied geographic localities where H. erectus fossils are found, their tooth and jaw anatomy reveal that their diet did not require the same robust masticatory adaptations seen in earlier hominins.”

      An interesting thing that such time distance means that if Homo Erectus reapearred we could still have fully functional, fertile offspring with them (by the way – in the zoos, despite few millions years of separate evolution, and definite size difference camels can mate with lamas to create so called camas). The only dificulty being in smaller hips of their ladies, which would require cesarean sections for sapiens man + erectus woman pregnancies. No such difficulty for the hybrids of sapiens women and erectus man.

    • Paleophil on February 2, 2014 at 10:47

      I meant that only the 3.4 mya ago figures is controversial. I don’t know of anyone who disputes the 2.5 mya figure, and that’s just the oldest clear stone finding. Wooden tools likely predated stone and didn’t leave remains.

      Since even chimps use stick-spears, it’s plausible that those of our ancestors with the same or more intelligence did.

      Yes, omnivore seems to be the best term, however imperfect or vague. My main concern is that people don’t swing too far in the other direction from VLC/ZC over to strict vegan. Out of the frying pan, into the fire.

    • DuckDodgers on February 2, 2014 at 18:02

      I should be clear. Early homo were likely scavengers, but later homo was definitely a hunter and consumed a good amount of meat. Still, I think it’s unlikely that all of their C4 levels came from meat. With all of the evidence for grass consumption by other hominids, there’s no reason why any hominid who was evolving AMY1 starch genes would avoid tubers/corms.

    • BrazilBrad on February 3, 2014 at 02:23

      @Duck, why is a high meat diet unlikely? What is the evidence that supports this hypothesis?

    • Polaris on February 3, 2014 at 02:30

      Actually all primates appear to have at least 2 AMY1 gene copies as far as I know and so an ability to digest some starch more or less present in most food of plant origin.

      Even our closest relatives, namely chimps and bonobos, have actually only 2 copies and obviously experiment definitely shows that they nevertheless don’t have to bother and exclude any starch from their diets and adopt the VLC fad.

    • Paleophil on February 3, 2014 at 04:18

      Since chimps, baboons, lorids and tarsiers hunt small vertebrates, not to mention insects, and since chimps use small spears, I find it hard to believe that early homo never hunted. It’s more likely that all hominids both scavenged and hunted to varying degrees. Successful species usually have multiple ways of surviving. If you think about it, we don’t need scientists to find and date stone tools and that’s almost irrelevant (other than to try to guess when the use of stone versions of tools begin), as it’s obvious that since chimps can hunt, all hominids were likely able to.

    • Paleophil on February 3, 2014 at 04:19

      PS and that’s something that vegans and vegetarians will never tell you, which is another good reason to ignore them, except where they criticize VLC/ketogenic diets. That’s their biggest service to humanity.

  18. Richard on February 1, 2014 at 05:46

    As an MD, of who/what/where/when/why not mattering since other MD’s in this blog are hiding their credentials, I call BS! There I said it, now who are you going to believe, me or the other MD? We’ve both given you opposing opinions, with absolutely NOTHING to back it up!

    Dick, MD

    • Richard Nikoley on February 1, 2014 at 07:18

      I can’t dispute that, Richard.

      Everyone simply has to decide for themselves. SC didn’t just pop in here. He’s been posting comments and demonstrating his deep medical knowledge. 260 comments, to be exact.

      I’m assuming for most, it will just confirm biases either way. Perhaps for a few, it might be the thing that gets them to add reasonable amounts of safe carbs back into their diets on a regular basis or at least do regular carb refeeds.

  19. Mario on February 1, 2014 at 07:17

    Bullshit alert!

    Someone is ramping up their book publicity campaign… So sad!

    And he has Jimmy Moore helping him with a few tweets here and there… Oh, look who else is working on a new book… Assholes! Not just you two, but a whole lot of other foodie-healthnut-fuckers! The whole bunch of you are just trying to cash in on our, me included, stupidity – sadly you have, and will continue to succeed.

    Peace! lol

    Btw, I do use about 10g/d of RPS, it does help and study’s support it, along with other prebiotics like FOS and GOS.

    • Richard Nikoley on February 1, 2014 at 07:20

      Hey Mario, my Lamborghini is on order. I went with the burnt orange.

    • Mario on February 1, 2014 at 07:45

      I didn’t say you’d get rich!

      But putting a book out, here or there, and other income from this sort of thing can add up to a comfy income or even just a supp income for someone who’s already worked and saved a nest egg…

      Let’s be honest, blogging, book writing, writing, basically not really working – is a nice way to live!

    • Richard Nikoley on February 1, 2014 at 07:57

      Blogging is certainly very cool and yea, I’d love to make more than pocket change from the stuff on the sidebar, but I can’t be too much of a whore about it. For instance, I had affiliate links to a few paleo treat like companies but didn’t feel right about it and took them down.

      I’d rather have penis enlargement ads, laf.

      Happy to have US Wellness but I think in all the months it’s been up, it’s maybe generated $60.

      Book writing, on the other hand, sucks big time. It’s real no-shit work and if you don’t believe me, try it.

    • Mario on February 1, 2014 at 08:43

      I’ve done a bit of technical writing, and yeah, it does suck in its own way! But it’s certainly easier and a more enjoyable thing to do in the comfort of a nice coffee shop, if push comes to shove a starbucks (lol) or the comfort of one’s home, as opposed to working a 9 to 5’r type thing…

      Bottom line for me is that I KNOW money makes people do a lot of fucked up things! Itsa FACT! Some things are more so fucked up than others… So I find it very hard to trust people who can benefit financially from saying and/or doing certain things.

    • gabriella kadar on February 1, 2014 at 09:56

      Mario, when a person writes a blog and continues to produce a new entry at least once per day for years and years, that’s a job. First try it. Then judge. Make sure it is interesting enough so that people are actually reading it and commenting and generating all sorts of really interesting contributions. Good luck with that.

    • Mario on February 1, 2014 at 10:44

      GK, I would need more than luck as I am not interesting and have nothing interesting to say, take it from me, I know!

      I was serious up there! But, I did do something like that in my past life, and I agree with you 100%, but even on the worst of days, it’s still better than a 9 to 5’r or simply working for someone else…

    • Charles on February 1, 2014 at 12:19

      Writing a book is (generally) hell. I’ve never done it, but know a number of authors, some big-time names, and no one says it’s anything but one hell of a lot of work, over a long period of time, mostly by yourself.

      Passion for the subject makes it tolerable-to-fulfilling at times, but don’t knock it, or call it “not work,” until you’ve tried it. That’s just ignorance.

    • Mario on February 1, 2014 at 13:38

      Well, I know an author, actually three, and a screenwriter and a few other writer types… Yeah it’s, work, but come on, who writes a book about something they know nothing about or are not passionate about it!? What publisher in their right mind would pay someone, possibly with some sort of an advance, to write about something that they couldn’t give a shit about!?

      My line of work is exactly as you’ve described the book writing process to be. And my work is something I am very passionate about! I’ve also worked 9-5’rs directly under others, and I can tell you, this method of working as it relates to writing a book or my line of work is way better!

      My bottom line when it comes to food and health and all this shit is if someone is making money offa something, especially directly, proceed with caution…

      Now let’s get back to Richards orange Lomborghini…

    • Richard Nikoley on February 1, 2014 at 17:07

      “So I find it very hard to trust people who can benefit financially”

      And yet, you didn’t drop over dead writing in Starbucks over an untrustworthy coffee.

      Thanks, Mario. It’s fortuitous that perhaps a young, dumb, fulla’cum reader will see your comment and resolve to not look like such an ignorant moron when their opportunity comes to masturbate in public.

    • Charles on February 1, 2014 at 17:40

      And I often find it hard to trust someone without skin in the game. Everyone’s selling something, whether it’s a product or their reputation.

  20. Richard Nikoley on February 1, 2014 at 08:11

    Thanks V

    While Wooo believes me obsessed with her and I do enjoy giving her shit (see the comment thread at prague stepchild, Jan 24 post) now & then, I actually only see a bit of what she puts up. Actually didn’t know about the FB page, just Twitter. Anyway, just checked both. Quite amusing.

    One wonders if her going on an on like that kinda substantiates the point of this post.

    There’s like 2 dozen tweets or more and on FB, like 108 comments, 80 by Wooo and the rest by only 3-4 others. Quite an echo chamber.

    But what does it matter? What she thinks of me is none of my business.

  21. GTR on February 1, 2014 at 08:14

    I don’t think it’s impossible to get away from a certain types of diets as their promoter without legal problems. All you need is some pretext (officially called – reason) as let’s say some new study showing up, that supports your new direction. Your official version would be that what you were doing before was OK, while the new thing you are doing now is just better – as proven by this new evidence. Thus you harmed noone, just made your approach more optimal now than the past one – a normal way the progress works.

    What you probably can’t do is just to admit that your old way was wrong, harmful etc., and especially you shouldn’t feel guilty about it or admitt your guilt. You have to pretend what you were doing was reasonable, and good for the patient (you surly have some positive cases, where VLC turned out to be very helpful), compatible with some science of that time etc. The fact that recommendations are contrary to the new ones doesn’t matter – claim both are good, the new ones are just better. Humas are omnivores after all.

    • Richard Nikoley on February 1, 2014 at 08:27


      Some have already expressed to me offline that the liability issue is a bit hyped. Here’s what people don’t get and since I have been deeply involved with layers for years, the general consensus is prudence.

      You see, the issue is not so much will they win. The issue is can they contrive enough of a case to motivate the insurance company to settle and not take the risk. Just getting sued automatically means an insurance provider is already in for $20k plus in just legal fees and I assure you that the attorneys will get what they think is the “minimum worth” on the thing. You won’t believe how opposing attorneys will shoot the shit or argue minutiae in order to drive up the bill and if the plaintiff is on contingency, no problem, all the better, even. The defendant attorney will just shower with paperwork and justify it to his client that it’s good strategy and will motivate settlement negotiations because the other side has to spend time they can’t bill for.

      But what it all means is that getting sued, even for doubtful claims = higher insurance premiums AND an inability or difficult time switching providers if you think you’re getting gouged.

  22. Richard Nikoley on February 1, 2014 at 08:51

    Just added to the post:

    Update: In the interest of clarity I want to point out that I’m not saying LC is never appropriate, but I now see it as an INTERVENTION (like a drug), and especially VLC and ketogenic. Probably best under medical supervision to address some issue with the possible exception of obesity where it seems to be fine for a while, like initial weight loss. Just by my “feel” for it over the years, my experience, those of family and blog readers, the problems crop up down the road, when that stall happens and the answer is always: LESS CARBS!

    This is also not advocating high carbs. It’s advocating sane amounts of carbohydrate, 30-40% perhaps, from safe sources like potatoes, white rice, fruit and legumes properly prepared. Or, an LC styled diet with regular carb refeeds of several hundred grams weekly or twice per week (anabolic diet).

    I fully agree that, just like a drug, VLC or ketogenic has therapeutic applications as I’ve mentioned a number of times but in such cases, there ought be a cost benefit accounting, just as in the side effects of many drugs.

    • Mario on February 1, 2014 at 09:02

      Very good update!

      My uneducated opinion is that people should just eat whole, unprocessed foods, and not over do it on one specific thing, especially all the time. And be practical and realistic, and don’t pig the fuck out!

      It’s not that hard!

      P.S. Richard, thanks for not deleting my comments, a LOT of other bloggers would have and/or would NOT allow free-thinking, right or wrong, comments… Cheers!

    • jo on February 1, 2014 at 10:19

      Yes! Thank you for that addition. Im a regular reader of this blog. I take responsibility for my own choices, but i must say, getting a little tired of being referred to as an idiot because i low carb to correct for medical challenges i havent been able to correct y e t.

  23. rs711 on February 1, 2014 at 09:28


    I’m happy to talk about whether what carb levels are optimal – but that wasn’t my question. I’d simply like to review the evidence/literature demonstrating how reduced dietary carbohydrates are intrinsically causal factors in pathological decreases in T3.

    The study linked in the article you posted from Chris Kresser’s website is an epidemiological one (fantastic for generating hypothesis, woefully inadequate for testing them). It concludes that: “As long as there is no clear evidence of benefit from thyroid hormone replacement and until well-designed studies confirm its efficacy, thyroxine supplementation should not be recommended for the treatment of NTIS”.
    [I haven’t gone through the study] but it seems too far removed from my question to make it relevant.

    Again, Spanish Caravan may be 100% correct in *guessing* that low-carb is potentially quite dangerous, unsustainable and better alternatives exist: big claims require a lot of evidence – all I did was ask for a tiny piece of it; the claim regarding T3 (as it’s of interest to myself and others in the blogosphere).

    Science is about resolving contradictory evidence, not focusing one the comfortable perfect fits. I suggest actively trying to prove oneself wrong ASAP because sooner or later, someone will do that for you.

    • Paleophil on February 1, 2014 at 17:07

      Plus, if any of the tiny minority of people on this earth who think along the lines that long-term VLC with chronic ketosis and very low intakes of RS makes sense and is low risk, even for people who aren’t obese, a diet that even the favorite examples of LCers (such as the Eskimos and Masai) would find strange, want to convince the rest of the world, they’re going to need a lot of evidence. Asking the rest of the world to instead provide the evidence will seem odd, whether that’s logical or fair or not. Absence of evidence of serious long-term harm from low T3 and the other unusual and more clearly negative symptoms commonly reported by VLCers is not evidence of absence.

      On the other hand, where is the evidence of long-term harm to Atkins dieters of the last three decades? Granted, it doesn’t require a lot of restriction after induction, but wouldn’t there be some VLCers among them and shouldn’t we have seen some of the more serious things that people are reporting recently among Paleo folks, like Raynaud’s, hypogammaglobulinemia, leukopenia and autoimmune disease, instead of just more minor things like constipation, headache and rashes (and the occasional controversial claim of increased kidney stone risk, which I am not seeing in these recent warnings about VLC Paleo) that I’ve seen reported?

      Is the evidence of serious long-term harm from Atkins out there and I’m just missing it?

    • Paleophil on February 1, 2014 at 11:06

      @rs711, Don’t worry, I am actively trying to prove myself wrong (and coincidentally just did that in another of Richard’s comment threads) and you even thanked me for doing so here –

      I’m looking forward to your future efforts in that regard. I haven’t yet noticed your answer to my question about whether you’ve experimented with RS.

      I didn’t ask you what carb levels are optimal, just wondered why the burden of proof re: T3 shouldn’t rest with the ones advocating a novel approach, especially one that seems to be contradicted by so much of what people have been reporting in this blog. Shouldn’t we question that too if we’re going to avoid confirmation bias?

    • GTR on February 1, 2014 at 13:57

      @Paleophil – there’s always this question of burden of proof. Since proving something is costly – who should be responsible for providing proof?

      There are various ideas to answer that question. One is that the burden of proof is on the claimant. This one is frequent in formal debates, and it has a nice property of minimizing the amount of unsubstatiated claims made.

      But “the burden of proof is on the claimant” seems totally wrong when it comes to normal life, and even normal econimic activity. If the claimants were obliged to provide proof, then the amount of useful and beneficial information we get would diminish, simply because providers of true information don’t have time or willingness to deal with providing proof.

      Example 1 – you advise someone “Don’t eat this mushroom – it’s poisonous”, and he demands “peer-reviewed scientific evidence” for this from you, then just end the conversation with such pretensional person, and leave him with his mushrooms.
      Example 2. if someone asks you how to improve his diet you could give an answer “Consume resistant starch”. If then this person asks you “You have to provide evidence for this claim” then you can, but are not obliged to do it if you don’t sell RS or don’t profit from it otherwise. Say to such person – “You are the one to benefit from RS – so search for evidence yourself!”.

      Thus we have a rule of who has the burden of proof – it’s on the beneficiary. In case of people who sell VLC books, or offer VLC treatments for patients the burden of proof that their diets DON’T cause T3 hormone-related thyroid problems lies on them.

    • Spanish Caravan on February 2, 2014 at 00:10

      Paleophil, the answer lies right here: most people with enough sense stop VLCing when they encounter continuing constipation, anemia-like symptoms (bka the low-carb flu), dry eyes, dry nostrils, cold fingers and cold body temperature. There is sane person who will continue when you’re hobbled by these side effects. What they usually do is up the carbs, usually above the ketogenic level of 50-80, depending on your weight, or up your protein; that will ease you out of ketosis and VLC side effects. However, there is one group of people for whom VLCing seems mandatory, even with such side effects. Because you swallow the VLC dogma that BG > 110 kills off beta cells and BG=13=hyperglycemia, you’ll do everything you can to control BG. Even with such symptoms. It’s those who really have been bearing the brunt of the VLC underside. They VLC because they think they have no other choice. You’ll hear more about this in the future.

      Most people wise up and leave VLCing. These are the fortunate ones. It’s those who stick to it long-term. They’re the ones who end up with immune dysfunction. If you want evidence, I’ll provide evidence. But there are no double-blind, placebo and nocebo controlled clinical trials that show that long-term VLCing leads to immune dysfunction. There is no financing for such studies or is anyone ever remotely interested in such a study.

      Let’s put the VLC/ketogenic community in perspective. It’s not even 1/100th of the vegetarian community. It’s still the lunatic fringe and it always will be. But it is a passionate community that will provide wrongheaded and deceptive arguments on its behalf to justify its raison d’etre. Given the small size and the extreme nature of their diet, these people can escape mainstream scrutiny indefinitely. The damage the diet causes, even if exposed properly, will hardly attract mainstream attention. These are the flat-earthers, people who believe in UFOs and werewolves, people who believe in channeling and other superstitions.

      There is no smoking and no murder weapon. But like I said before, if you can reason and read between the lines, you should be able to make a rational conclusion about exactly the health hazards of VLCing. There is abundant evidence if you look.

    • Paleophil on February 2, 2014 at 09:47

      @LCers, PLEASE PAY ATTENTION TO WHAT SPANISH CARAVAN SAYS! Don’t just dismiss it – read all his comments and you’ll see that it makes sense and that he is knowledgeable. Don’t wait for absolute proof – your survival could be at stake, especially if you’re extremely low carb or avoiding all resistant starch. No one can possibly prove what he’s saying for years to come (human experiments wouldn’t be ethical, for starters). Ask yourself, doesn’t it makes sense to err on the side of caution? Intentionally staying on chronic ketogenic diets is likely something new in all of human history going back millions of years and losing some weight or keeping acne or other minor issues at bay is not worth risking one’s life.

      @Spanish Caravan, If you haven’t seen this already, I think you’ll be interested:

      The New York Times: Human Microbiome May Be Seeded Before Birth

      It’s looking like the role of bacteria has been underestimated by even the most ardent proponents of the Old Friends Hypothesis and that fetuses may not be completely sterile after all. Some researchers now believe that fetuses have bacteria even before they are inoculated in the birth canal during natural childbirth. The sterile fetus notion apparently comes from an out-of-date assumption in 1900.

      I know you can’t diagnose and treat via the Internet, but can you recommend any basic things I should tell a type 1 diabetic who I know read Bernstein’s book years ago and thus may be doing something close to that?

      I asked about this one in a comment in a past thread you may not have seen: What about a semi-Paleo dieter (he avoids grains and legumes but does eat cooked potatoes, squashes, fruit juices and wine—probably too low overall in RS for some years) in his 70’s with a new onset of idiopathic dermatitis resembling Grover’s Disease that stumped his physicians and improves with UV light therapy? I suggested that he try adding potato starch, increase his potato salad intake and add liver pate, which he’ll do. He won’t eat unusual things like unripe plantains. Now I’m concerned that the skin issue could be just the start of worse autoimmune-type issues. He also has a family history of heart disease and longtime high small-dense-ldl that the semi-Paleo diet didn’t correct.

      Does chronic ketosis stress the body and do you have some idea of how and what parts tend to be most affected? I found thyroid, thymus and adrenal issues specifically mentioned (ex:

      What key things do you think VLCers should be doing now? Presumably carefully adding some “safe” carbs if they can (or something like potato starch if they can’t), and especially some rich in RS. Should anyone who still believes they need to stay VLC be checking their ketone levels to make sure that they are coming out of ketosis at least intermittently? Prebiotics also appear crucial, especially resistant starch, and, if necessary, probiotics.

      What about this from Trundle: “If you’ve been in long-term ketosis, get your immunoglobulins and igg subclasses checked. Chances are, that after 2-3 years, at least one will be deficient,” and we should also watch out for low WBCs and “low lymphs.” Is that low lymphocyte count? Is there anything people can check at home if they won’t see a physician?

      Is some guru recommending that BG never go over 110 mg/dl or so and avoid the foods that cause spikes even that low, or do you mean FBG?

      I strongly suspect that RS is especially important among the prebiotics, because I was experiencing the gradually rising fasting and post-prandial blood glucose and reduced cold tolerance that VLCers are reporting despite getting some carbs from roots (low in starch, like carrots and parsnips), fruits, berries, nuts, raw honey, eggs, liver and cheese (though I didn’t track my carb intakes), and occasionally eating starchier foods like potatoes and rice (because I found that I didn’t tolerate them well, possibly due to my history of antibiotic treatments, which Richard has also posited, and then probably exacerbated in the long term by low RS intake). Thus, maybe Peatarians (followers of Ray Peat) who avoid all starchy foods (despite his qualified approval of potatoes) are also at risk, and also raw vegans and other carb eaters who avoid starchy foods?

      I think this damn macronutrient war is unfortunately obscuring the importance of all this because some people are falling into a war mentality and seeing people like you as just “the other side” to be dismissed and discredited. Now they’ll probably assume that I’m some sort of carb addicted nut or conspirator on the pro-carb side of the war because I believe you. I have already gotten some mildly negative feedback for talking about RS. I hope they’ll notice that I haven’t been personally insulting LCers and that I’m more interesting in learning than winning debating points.

      Thanks again. I hope people pay attention to you, Richard, Tatertot, Dr. BG, Paul Jaminet and Chris Kresser on this crucial issue.

    • BrazilBrad on February 2, 2014 at 10:16

      Again, I think Peter Attia would beg to differ with you on this.

    • GTR on February 2, 2014 at 13:38

      @Paleophil & @Spanish Caravan – you have been talking about chronic (constant) ketosis and chronic (constant) VLC. How about intermittent ones – ketosis and VLC? How long could they last without nasty side effects, or with just temporary side effect that clear themselves when you are out of it?

    • Karen on February 2, 2014 at 20:08

      Except VLC does throw the thyroid into disarray — as I learned to my very great cost. And now I’ve swiftly transitioned out of another round of VLC/HF, after a bunch of different symptoms like anemia, (by all means, call me a slow learner!) and am currently doing a modified potato hack, eating cooked/cooled/reheated spud with some red meat. Easing my way into RS, you might say. The difference after just a couple of days is astonishing. My guts are happier, my jeans are looser, my headaches have stopped, and I exercised again this morning and didn’t want to die.

      Richard, Paleophil, Spanish C and everyone, thanks so much for providing this info and the great conversations. I think the key to keep hammering, for the carb-phobic out there (I consider myself now a recovering carb0-phobic) is that for this to work and not screw with your BG et al, you must be consuming RESISTANT starch. Chowing down on unlimited bagels or pasta or freshly mashed potato without the cooling/reheating is indeed a recipe for disaster.

    • rs711 on February 3, 2014 at 00:48

      No I haven’t yet experimented with tablespoons of Bob Red Mills Unmodified Potato Starch.

      I think the burden of proof lies on diets suggesting something other than omnivory. This leaves quite a lot of margin either way (whether Inuit or Kitavan – if those are the 2 extremes we choose to use).
      There is anatomical, anthropological, biochemical, anecdotal and cultural evidence that humans do very well on very high-fat diets…and on very low-fat diets – although I’d argue that the balance is somewhat swayed towards higher-fat due anatomical and mitochondrial set-up.

      Even if I think the burden of proof is ‘someone else’, that doesn’t mean that if if someone told me people from Tokelau or Kitava had thyroid issues due to their carbohydrate intake, I’d still ask them to substantiate their claims. So, really, it doesn’t matter what I think in the case of scientific claims relating to nutrition – the field has been so poorly researched in the past that nearly everything is ripe for being revisited.

      I think it’s important not to forget that Western medicine has tried disproving ‘high-fat’ for decades and decades with nothing much to show for it (except maybe a lot of dead mice).
      Only in with the recent advent of nutritional movements developing online have we had more of an open debate (fantastic!).
      Nevertheless, we always come back to ‘please show me any kind of data’ that I can mull over myself (unfortunately, anecdotal reports don’t lend themselves to independent scrutiny).

    • Paleophil on February 3, 2014 at 04:16

      I suspect intermittent is better, but I don’t know how much better. I defer to one of the few true experts, Spanish Caravan, on that. It sounds like from his comments that we should stay well out of ketosis most of the time. Read everything that he writes.

    • rs711 on February 3, 2014 at 05:31

      Linking to FoxNews? Really? I think there might have been a collective heart attack :p
      [I’m being a bit cheeky, granted, but….come on]

    • Spanish Caravan on February 3, 2014 at 20:02

      The mainstream media is still trying to figure out VLCing. They’ll always focus on cholesterol and weight loss. But they’ll never “get” VLCing for that. In fact, there is probably nothing better for your CVD health than VLCing and weight loss. I’ve said this before. It’s just that it comes with a big catch.

      They’re still missing the boat but they’re closing in, so to speak. Bad breath = ketosis halitosis. Constipation = glucose deficiency induced by lack of mucin/moisture from the digestive tract, which makes peristalsis painful and abrasive ==> mucin deficiency also affects immunity and leaky gut. Headache & general weakness = due to aserologic but symptomatic anemia, i.e., again, glucose deficiency. Diarrhea: diarrhea isn’t common while VLCing; low stool volume, however, is. Looks like the control group may have had some food poisoning.

      “These side effects are consistent with carbohydrate deficiency, because the brain and muscle do not get enough sugar from carbohydrates to maintain their normal function, Astrup said.”

      This part is correct. So far so good.

      But rashes? What do you think that is? It’s an immune reaction. Probably autoimmune … psoriasis (autoimmune), eczema (comorbid with autoimmunity) and various skin rashes that appear under immune deficiency. They should have tested what those rashes are … fungal, psoriatic, etc.

      “The majority had some of these side effects in the Atkins group. In the control group, almost nothing,” he said.

      Why do you think that’s the case? On a high carb/low fat, you do not squeeze your immune system by inducing leptin deficiency or lowering your T3. The same reason why you almost never see hyperthyroidism, which requires high T3, in those who low-carb, unless it was preexisting.

    • Paleophil on February 4, 2014 at 04:30

      @rs711, Have you noticed how most of the people dismissing the usefulness of potato starch haven’t tried it, despite more and more glowing reports coming in from VLCers who have? Have you tried any RS-rich foods recently like potato salad with apple cider vinegar, par-boiled rice, cooled and re-heated cassoulet l’haricots avec poulet (slow-cooked white bean stew/chili with chicken), or one of Richard’s RS dishes?

      It must be frustrating that Richard, Tatertot, Spanish Caravan, me and more and more people are reporting problems with chronic ketogenic/VLC diets. Wouldn’t you like to disprove us and maybe shut us all up? One good step in doing so would be to get your gut microbiome checked and then show off your results. It would also be good safety precaution, just in case these we are right and there is a risk of serious gut pathology and other illnesses.

    • DuckDodgers on February 4, 2014 at 06:36

      Let’s not forget the increased fungal infections and dysbiosis from VLC:

      From Paul Jaminet:

      Low-carb diets generally improve immunity to bacteria and viruses, but not all is roses and gingerbread.

      Low-carb diets, alas, impair immunity to fungal and protozoal infections. The immune defense against these infections is glucose-dependent (as it relies on production of reactive oxygen species using glucose) and thyroid hormone-dependent (as thyroid hormone drives not only glucose availability, but also the availability of iodine for the myeloperoxidase pathway). Thus, anti-fungal immunity is downregulated on very low-carb diets.

      Moreover, eukaryotic pathogens such as fungi and protozoa can metabolize ketones. Thus, a ketogenic diet promotes growth and systemic invasion of these pathogens.

      As the fungal infection case studies on our “Results” page illustrate, low-carb dieters often develop fungal infections, and these often go away with increased starch consumption.

      Another issue is that mucus is essential for immunity at epithelial surfaces, and glycosylation is essential for the integrity of cellular junctions and tissue barriers such as the intestinal and blood-brain barriers. Thus, reduced production of mucus can impair intestinal immunity and promote gut dysbiosis or systemic infection by pathogens that enter through the gut.

      Finally, a very low-carb diet is not entirely free of risks of gut dysbiosis, and not just from fungal infections. Bacteria can metabolize the amino acid glutamine as well as mucosal sugars, so it is not possible to completely starve gut bacteria with a low-carb diet. Nor is it desirable, as this would eliminate a protective layer against systemic infection by pathogens that enter the body through the gut. As our “Results” page shows, several people who had gut trouble on the very low-carb (and generally excellent) GAPS diet were cured on our diet.

    • Polaris on February 5, 2014 at 03:24

      PP, what’s funny, in France it is considered traditionally that famous popular dishes such as cassoulet or even choucroute garnie (sauerkraut with boiled potatoes and pork) are “best” when re-heated.

  24. Stan on February 1, 2014 at 11:55

    I can’t believe what Adam Kosloff is saying about you
    “Adam Kosloff Should CS and RN’s blathering even be protected as free speech? Imagine if someone set up a blog targeting ex-smokers designed to convince them (via dubious logic and shit-ass “journalism”) that quitting smoking was unhealthy and that they NEEDED to smoke cigarettes to fix their emphysema and cure their lung cancer. Would that blog’s content even be protected by the 1st Amendment?”

    Someone should tell the very reasonable Adele Hite what this goon is saying since she has him on her Healthy Nation Coalition.

    • Richard Nikoley on February 1, 2014 at 13:56


      Did you notice where he said he had never read this blog?

      So, he speaks from high authority.

  25. BrazilBrad on February 1, 2014 at 12:17

    I can see both sides of the LC/VLC argument, but every time I start to agree that it’s *only* good as an intervention thing I remember a few things… like how good I feel when eating low carb, the many CKD diets that body builder use… and then even more how Dr. Attia talks and walks…

    • Charles on February 1, 2014 at 13:34

      I like Peter Attia a lot. He’s also genetically gifted/unique (as are all elite athletes), works out like a fiend, and is still pretty young (41or so). I totally respect his knowledge, and enjoy listening to him. But I would not necessarily generalize his personal experience to more normal human beings.

    • Lauren on February 1, 2014 at 13:46

      Don’t forget… Peter Attia’s got Superstarch in his daily regimen!

    • BrazilBrad on February 1, 2014 at 14:03

      I am 51 years old and my physique is overall (arguably) better than Attia’s – more lean mass though also more %BF. I don’t say that in disrespect. I have no doubt he could blow me away jogging, swimming, or biking. My point is, I am not an elite athlete, I am an ex-athlete of very modest accomplishments (up to Junior college football) and now just dedicated to health/fitness. I think it’s perfectly fine to generalize Attia’s experiences at least with some subset of the population even if not the majority. I don’t think I’m genetically gifted though I have benefitted from the epigenetic effects of playing sports and staying active off and on since I was 10 years old.

    • Charles on February 1, 2014 at 15:05

      @BrazilBrad: I take your point, but your comment, “I have no doubt he could blow me away jogging, swimming, or biking,” illustrates mine. We’re not talking about just physique. Elite athletes have that, often (though not always), but they have a lot more. And that “lot more” can be improved, but in all the years I’ve been around elite athletes, they are born with a unique genetic endowments that most of us just don’t have. And they can perform at high levels on often very weird dietary regimes.

      I’ve been mostly LC for decades (I’m 62–started at 15) so I’m not now, nor have I ever been, anti-LC. But when I look at an elite athlete in their 40s, I do not believe I can generalize their approach to health and/or performance (two different things for sure) to mine, or to many others. I may be able to learn what *might* be possible, and from Peter, I can definitely learn from his lectures and writing. But I do not believe his results necessarily could translate to my body, or to yours.

    • Paleophil on February 1, 2014 at 16:40

      Yeah, a LC guru who thinks a (corn) starch is good he calls it Super! If that doesn’t make VLCers think twice about demonizing all starch, I suppose nothing will.

    • Charles on February 1, 2014 at 17:44

      When you’re young (and 40 is young) and genetically gifted, and work out like a MoFo, you can eat/take a lot of things and feel and look great. And a lot of markers will look fine, too. It’s over time that shit happens. It’s cumulative.

      Not to say anything about Peter. I think he’s a great guy, a good and compassionate person, and really, really smart. And I wish I was him (as does my gf, probably). But I pay more attention to what he says, not what he is. But I think we’ve exhausted this conversation.

    • Richard Nikoley on February 1, 2014 at 19:53


      Peter and I had dinner together in Palo Alto few months back (we exchanged an email yesterday, me trying to see if he’s around for a catchup soon, because our previous meeting was pre RS).

      Anyway, we were talking and got eventually interrupted be the folks at the next table, they were so captivated by the conversation and couldn’t resist, though they did apologize profusely.

      Peter is solid. Let me put it right there.

    • Teresa on February 1, 2014 at 22:26

      “Peter is solid.” — Richard

      Peter is an advocate of LC, or at least he was. I haven’t read his blog in a couple of months, but last time I was there, he was still promoting LC.

    • Richard Nikoley on February 2, 2014 at 07:50

      Peter is open to the science, and in fact, NuSI is designed to have advocates of ALL diets and do studies that are not funded by the food or drug industry.

      He’s also a big fan of “Super Starch.” I can’t recall where, but he basically came to realize that LC was just wrong for any type of athletic performance. Anyway, we’ve phone tagged a couple of days ago. Trying to catch up with him again and compare notes.

    • Charles on February 2, 2014 at 09:15

      Yeah, I think Peter’s a great guy. My only point was that you can’t look at elite athletes and generalize from their diets to a more general population. Elite athletes involved in heavy training can do a lot of stuff that most people couldn’t do and stay healthy. But Peter is definitely a cut above most when it comes to knowledge…and compassion as well. A good person, for sure.

    • rs711 on February 3, 2014 at 05:46

      “SuperStarch is not a sugar or fiber. Chemically it is a complex carbohydrate or starch
      that is completely absorbed […] SuperStarch was originally designed by Scottish researchers in the treatment of a rare genetic disorder called glycogen storage disease […] SuperStarch is an extremely large glucose polymer with a molecular weight between 500,000 and 700,000 g/mol” —> you won’t find this in nature or without high-level processing.

      I don’t see how properties of SuperStarch automatically translate to other forms of sugar, fiber &/or starches.

      PS: Peter Attia is the furthest thing from a guru you’ll find. Also, I strongly doubt he sees himself in any “camp”, LC or other [caveat: I don’t live in his head]

  26. BrazilBrad on February 1, 2014 at 12:20

    Having said that, I personally enjoy periods of LC and HC… cycles. I don’t cower from all good starches and fruit 24/7/365. I have done the potato-hack and know it works. Gotta keep an open mind folks and find what works for you.

  27. Charles on February 1, 2014 at 12:32

    “Don’t worry, I am actively trying to prove myself wrong…” (@Paleophil)

    That’s one of the best aspects of this particular, strange, subculture. Plenty of ego (!), but among the regulars, no intellectual ego about ideas. It’s about experimentation and discovery and throwing thoughts and hypotheses out there and waiting to get them shot down by experience, black swans, or references. And if they do get refuted, people aren’t pissed, they’re interested in the refutation. It’s the best kind of personal science.

  28. Teresa on February 1, 2014 at 17:36

    I’ve been reading about LC diets for many years. I’ve heard all kinds of accusations against it, but this is the first time I’ve heard these issues. Conventional medicine, which advocates a low fat high carb diet, has been trying for years to show that LC diets are somehow dangerous. There have been countless studies trying to prove this. The kinds of things you are saying would have been easily uncovered with blood tests. It’s also the case that millions of people have been on LC diets for decades. If what you claim were true, they would have found some evidence by now, and it would have been all over the news. LC is the outsider, and it gets treated differently than LF, which is the standard recommendation. LF has enjoyed protection from critique for many years now. LC has never had that advantage.

    I don’t know who the LC guru is that you say has 100% “failure” rate when health, or lack thereof, is the measure. or who any of the others are that have private reservations. Without the ability to check out what you are claiming, OF COURSE it will have to remain anecdotal. I do not have the ability to design and run some kind of study. The only thing people like me can to is look at studies other people have done.

    We understand so little about appropriate diet at this point in time. Too many of the people doing the research have agendas or are under-written by organizations with agendas. That makes the truth much more difficult to find.

    • Spanish Caravan on February 1, 2014 at 23:40

      Teresa, here’s what a mainstream Paleo insider said about VLCing in the context of the autoimmune protocol. This is with regard to the long-term VLCing, with which she has become wary.

      “Defnitely I share Paul [Jaminet”s] discomfort with very low carb diets especially over the long-term because when you go very very low carbohydrate, you tend to reduce leptin. And certainly when you start from a place of excessive leptin or leptin resistance, then it’s a good thing. That’s why people see benefits over the short term when they first adopt VLC diets or [Ketogenic Diet] approaches. But over the longterm the reduced leptin causes thymus atrophy and the thymus gland is crucial in the function of adaptive immune system because it’s the gland that matures T lymphocytes, which are huge components of the adaptive immune system.”

      I’m not the one who’s saying this. This is Paleo Mom, Sarah Ballantyne, Ph.D., who participated in the autoimmune panel with Jaminet. I have not checked to see if the claim is legit; but it seems plausible because T lymphocyte dysfunction would make the adaptive immune system go haywire. It could be the underlying force behind the autoimmune pathogenesis and the immunodeficiency that I ascribed in that post. But that’s not all. It would take time to compile the data.

      Some of you’re confused why this hasn’t been told before. They have been told before. It’s just not been broadcast in high decibel for obvious reasons. It’s uncomfortable. It could deflate egos and expose the narcissism of many people and the cluelessness of those who hopped on the bandwagon so soon not knowing what they were getting into.

      Download the thing yourself and check if I’m making up things.

    • Richard Nikoley on February 1, 2014 at 19:36


      Please point me to all the news reports of adverse blood work or autoimmune conditions regarding low fat, vegan, vegetarian, etc.

      Let me give you credit: you’re a geek, as are we all. So, you’re objection is smart thinking, but it ought apply to all. More likely, it’s either that newspeople are too ignorant to understand, or the general public is, or both and that’s where I place my bet.

      At the margins, all geek camps have been touting the bad effects of other extreme dietary camps for years. Perhaps you’ve been sheltered and not looked at anything bad except other extreme camps. Perhaps you have shrugged off self reporting of astronomical cholesterol levels and told yourself it doesn’t matter.

      Whatever the case may be.

      If I’m making any case here, it’s to get sane. There is nothing wrong with a reasonable level of carbohydrate for most people, and I think one can get a great start with Perfect Health Diet. I hate the name, but it is what it is and the info is solid. People are abandoning LC in droves in favor, and living happier lives.

      Go Paul!

    • Teresa on February 1, 2014 at 22:23

      I think you are mistaking the subject. The subject is the claim of some that there are autoimmune issues with LC, not with LF. You are quoting someone who said that 100% of the patients of one doc doing LC had serious health issues. Whether the same develops on LF, vegan, etc. is not relevant to whether or not it happens on LC. I don’t believe any claim was made concerning this LF et alia and don’t see how that could be relevant to my question.

      I try to be objective; I think we all have biases, though, so I try to watch out for that. I have not been looking only at the bad effects of other diets. Indeed, I am open to all theories on this. What I am saying is that I have never seen reports of this before. Your response doesn’t really offer any evidence, just wild conjecture about my own thinking. I’m looking for evidence, not argument. Cheers.

    • Richard Nikoley on February 1, 2014 at 22:36


      I submit as evidence, my comment section over several years. Yea, I know that’s easy, as I can’t really link up every comment easily, nor can you practically go through the 70,000 or so to check which are valid.

      But, the fact is, they are there, and not only here, but in many comment threads and forums all over the place.

      I suppose it comes down to some level of trust and just plain common sense. I lost 60 pounds on Paleo LC. I so wanted to be a fan but cold hands and cold feet all the time except for a summer reprieve of 3 months just didn’t seem right and then I saw so many others with the same issues and more. Women seemed to be the biggest victims and even amenorrhea in young women and such. It even goes way back, but I ignored it for a long time. Probably wouldn’t have with just LC, but it was PALEO LC, how we’re designed to eat! Low & behold, duh, Paleo isn’t LC and should not be unless you’re living at 16,000 feet in Peru, or above the arctic circle.

      The cognitive dissonance is deafening, as they say.

  29. Spanish Caravan on February 1, 2014 at 23:22

    Hey, Richard, I didn’t realize you decided to make my post into a blog post. I haven’t had a chance to really go through the comments. But suffice to say that I think it’s about this we confront this thing head on. I really am tired of the lies being told by these VLC advocates and their stymie dittoheads, who do not even realize that their compromising their health. But the gist of my post above was with regard to why those with something to protect would lie, given our legal system, to escape liability. That’s perfectly understandable. Conventional medicine does it. So does the Big Pharma.

    But the latest example is right here. Tomorrow is the Super Bowl. All of us will be watching it. 4 months ago, the retired NFL players with concussion symptoms reached a settlement through mediation. They are to be compensated in some fashion by the NFL and its insurers. But what does that mean? Does that mean the NFL is admitting that football causes concussion? Heck no. In fact, here’s what the settlement agreement opines:

    “No Admissions of Liability or Weakness of Claims – The settlement does not represent, and cannot be considered, an admission by the NFL of liability, or an admission that plaintiffs’ injuries were caused by football. Nor is it an acknowledgement by the plaintiffs of any deficiency in their case. Instead, it represents a decision by both sides to compromise their claims and defenses, and to devote their resources to benefit retired players and their families, rather than litigate these cases.”

    That’s how things are done when money is at stake. This is really an answer to the prior interlocutor, whom I can’t recall. But it’s very naïve to think anyone will be driven by conscience and fess up or admit your wrongdoing.

    Do you think you’ll hear any low-carb advocate with a practice or interests to protect to come out and admit that in fact those cold fingers and toes may be Primary Raynaud’s and you may be progressing towards Secondary Raynaud’s? They’ll deny and would not even acknowledge that any of their patients every display such symptoms. The same way a conventional MD who prescribes statins will tell his patient who experiences memory problems and muscle cramps, “Really, I never other patients say those things about Crestor? This is the first. Everyone is doing fine on Crestor. Your memory problem is due to stress, not this highly-regarded drug that has gone through double-blind, placebo-controlled clinical trials.”

    But one guy has resorted to an interesting strategy of admitting such VLC side effects but pinning it on something else entirely. I’ll tell you about that what that is. But to do that, I’ll have to drive about 80 miles and get the CDs which I borrowed from my cousin. Sounds weird, huh?

    This will be a never-ending story. It will be met by denials and accusations of lies and misrepresentation. But this is the diet war. It’s been going on since Atkins came on the scene in 1975.

    • charles grashow on February 2, 2014 at 14:50

      @Spanish Caravan

      What do you think of this
      “Fructose is not normally transported in plants or animals, because it is too chemically reactive and toxic. It rapidly bonds and crosslinks proteins and is ten times worse than glucose in forming AGE (advanced glycation end products) such as hemoglobin A1C. If you feed fructose to cattle, it makes their meat tough by cross linking protein fibers and it does the same thing to human skin.

      I can’t understand why fruits, especially juices, are recommended as part of a nutritional diet. At best, fruit should be converted into juice. The juice should be discarded and the pulp eaten as a source of soluble fiber, pectin, to feed gut flora.”

      “Plants clearly don’t like to be eaten and the best that can come of eaten plants is a full belly and a damaged liver. But if you cook or ferment the plants first and bacteria start to digest and dull the chemical arsenal, plants can be safely and perhaps even enjoyably eaten. We need not eat just safe meat. We can also kick back and sip the tea.”

      SO – I eat fruits and veggies – am I up shit’s creek??

    • gabriella kadar on February 2, 2014 at 15:38

      Charles, are you? Do you think you are?

    • GTR on February 2, 2014 at 16:03

      @charles “The juice should be discarded and the pulp eaten as a source of soluble fiber, pectin, to feed gut flora.”

      Some people recommend using superexpansive slow juicers, that discard more fiber – pulp – compared to conventional juicers. To be fair their advantage is that they can juice much larger set of produce.

      “If you’re going to juice high-fiber plants like celery, juice them last! Why? Because the fibers in celery tend to accumulate in the ejection port at the bottom of the juicing auger. If this port becomes clogged, then “pulp overflow” will occur, sending way too much pulp into your juice.
      If you still find too much pulp in your juice, just pour the juice back through the machine again! You’ll find that the second time through, nearly all the pulp is removed.”

    • charles grashow on February 2, 2014 at 16:21

      Not in any way – VLC was SOO bad for me – cold, constipated – I’m in a very good place right now nutritionally speaking – even though I use a STATIN – OMG

  30. gabriella kadar on February 2, 2014 at 04:01

    Spanish, wasn’t Atkin’s inspired by Dr. Wolfgang Lutz of ‘Life without Bread’ fame? Lutz’s dietary recommendation includes 72 grams of carbs per day (yes, even bread). I think he lived to 97, unlike Dr. Atkins.

    What are the grams of carbs in the diet to which you refer? Is it lower than Lutz’s recommendation? Or is 72 grams too low already? Since he was functioning in a less capitalist charged economy, I have some reservations that if this diet was adversely affecting his patients (whom he followed up for decades) he would have made modifications accordingly. How low is too low?

    • Spanish Caravan on February 2, 2014 at 10:58

      Gabriella, I’m not against low-carbing. In fact, I do low-carb. But I don’t go near ketosis. It depends on your weight, activity level and protein consumption, and you count your carbs. But the rule is: if you only eat non-starchy veggies, no grains, and meats, you’re VLCing. You may not go into ketosis but you’re probably teetering on its edge. So get some starchy carbs into your diet. Perhaps not every meal but at least one meal. If you do, I believe you’re safe.

      Like this one guy I know who claims he’s not ketogenic at 30 grams of carbs. He has an insane activity level, weighs 125 lbs., and does not restrict protein in anyway. He’s not in ketosis even without starchy carbs. But is that advisable? Heck, no. More about him later.

    • gabriella kadar on February 2, 2014 at 11:36

      Spanish, I don’t aim for ketosis. Ketosis causes bad breath.

    • BrazilBrad on February 3, 2014 at 02:46

      You guys do realize that ketosis is not caused only by eating low carb right? Low calorie intake will cause it, even eating an all carb diet like the potato hack. So even if eating keto on a continual basis is unhealthy I very much doubt that cycling in and out of keto is. I think its much more likely that keto cycling is overall beneficial and so one should no more avoid keto than all starch carbs all the time.

    • GTR on February 3, 2014 at 02:55

      @BrazilBrad – about ketosis from low-calorie diet:

    • BrazilBrad on February 3, 2014 at 04:07

      @GTR, what is the point you are trying to make here?

    • BrazilBrad on February 3, 2014 at 04:15

      BTW, many of you guys prob already know that it has been shown that IF affords many of the life extension benefits of long term calorie restriction. And given that ketone generation is a sliding scale (grey, not black and white) then doing regular IF or CKD (cyclical ketogenic diet) would be a beneficial thing. I personally am placing my bet on IF and carb cycling. And it gives me the best body comp and energy levels – I feel better doing it.

    • Richard Nikoley on February 3, 2014 at 07:47

      I’m with BrazilBrad here. Look at the results Brad Pilon (EatStopEat) gets with his folks, and he’s completely dietary agnostic. A therapeutic 24 hour fast once per week for maintenance, twice per week for weight loss and for many folks, seems not to matter what their diet is.

    • Adrienne on February 3, 2014 at 15:38

      @ Gabriella

      Dr. Atkins did not advocate a person staying in ketosis forever. This was a strict intervention to allow for quick “results” and then to be followed by incremental increases (ongoing weightloss phase)in carbohydrate until a person reached their personal carbohydrate tolerance level ( maintenance phase) which he defined as the amount a person could eat without regaining weight. He differs from Lutz mainly in that Lutz emphasized that the cutting back on carbs should be gradual in general and most gradual for those over 40 years of age. I think some of the issues people are finding with sudden dramatic shifts in diet whether it be low carb, low fat, low calorie etc is that as we age, the body does not necessarily react as well to such sudden interventions. I think this is why some of the great rs results reported indicate that some of the so-called “side-effects” — monster farts — subside over time.

      Perhaps we middle-agers and older who try various dietary experiments are confounding results due to age. Also, the pool of overweights may in fact contain a disproportionately high amount of people with subclinical or undiagnosed thyroid or autoimmune issues — also confounding results. People with hypothyroid often have family members with other autoimmune issues like Reynoud’s or diabetes or arthritis etc — so gradual change might be all the more important for some people. Dry eye is also a common complaint as one reaches middle age — again, age is a confounding factor. My hubby who eats a completely mixed diet has Reynoud’s but is muscular, athletic and never been overweight. However, his mother — who he physically resembles — has both Reynoud’s and hypothyroid — so his issue is likely genetically determined and not diet related. I’m not doubting the obvious negative physical results that some are reporting on long-term vlc — but I want to also keep in mind that advancing age and hormonal status (menopause) may be confounding factors. Both my parents and only sibling have diabetes but I do not as far as blood tests show. But I have also low carbed for well over a decade and the normal fasting glucose, fasting insulin and A1C could simply be a result of the diet. I do have hypothyroid but so do so many women on both sides of my family (including mother) and none of them eat a low carb diet by any means. So I have confounding genetic factors. and now with advancing age — confounding hormonal factors.

      For myself, it was the purported paleo concept of no beans/no tubors — not low carb dieting in general that knocked out some important sources of rs from my maintenance level low carb diet. I look forward to learning more about rs and learning from those wonderful experimenters who have been generous enough to post their experiences and results.

    • gabriella kadar on February 3, 2014 at 15:58

      Adrienne, yeah yeah, I read Atkin’s book a long while ago. I know he doesn’t advocate some super low carb diet and all the bullshit in the media was just bullshit. Nowhere does it say in the book that someone can gorge on fatty meats etc.

      I’ve just been trying to figure out where ‘regular carb’ intake and ‘low carb’ differ. Not to mention, there are other confounders in re: physical activity. Heavy duty labour requires more calories. That would mean increasing carbs. It’s not a problem when there’s hours of physical activity to burn the calories ingested. We, not terribly active people, require a nutrient rich diet but not an energy rich diet. If that makes sense. It’s been a long day.

  31. Charles on February 2, 2014 at 11:47

    In case anyone is having trouble finding Bob’s Red Mill Potato Starch, you can go to They have it for $4.58/lb, cheaper than Amazon, but depending on what else you order, there might be shipping costs.

    I have been shopping with them for a decade, and they’re great, customer-service-wise. I’m not putting in a direct link because some asshole would accuse me of trying to make a few pennies. (And I don’t use their affiliate program anyway.)

    • Judy on February 2, 2014 at 17:00

      You can buy BRM potato starch from Vitacost for $3.39/24oz, minimum order of 2, and free shipping on orders over $49. You can buy it directly from BRM for $14.29 for 4-24oz. packages ($3.57/pkg) plus shipping. The last time I bought some from Vitacost, I paid $2.88/24oz. bag because it was on sale (thank you to whoever it was on FTA that posted the sale). This was at the same time the Amazon sellers were jacking up their prices, so it pays to shop around, especially if you are on a limited budget. Not all of the sellers (including the supplier, BRM) have gotten the memo that potato starch is in short supply :)

  32. Dean F on February 3, 2014 at 07:20

    There are so many food fads. It seems like one day “they” are preaching that food “A” is bad and the next they are preaching that your body can’t live without it. I believe in a diet of mostly natural foods. Everything else in moderation. If you listen to your body, see a doctor regularly, eat only when you are hungry, and get plenty of exercise you should be a healthy person :)

  33. PaulKemp on February 3, 2014 at 08:49

    Sorry to be the noob here, but well I’m the noob! I’m looking to see how PS can help with sleep. My work schedule doesn’t allow me time for much for most of the week. I’m up early to take care of my 22 month old daughter. I work nights, and my wife works days. I’ve been paleo/primal/ wtf ever for about 3 years. I have a pretty solid schedule as far as workout and eating goes. My sleep just sucks, and I’m aware of how poopy that is for me.

    So my question is what level of carbs per day are we talking about here? 1oog-150g or higher? I’ve been primal for about 3 years. I have a pretty solid schedule as far as workout and eating goes. My sleep just sucks, and I’m aware of how poopy that is for me.

    Thanks in advance for your time, and you hard work this stuff is awesome! Can’t wait for the book.

    • Richard Nikoley on February 3, 2014 at 10:15


      If you get the right stuff, i.e., Bob’s Red Mill Unmodified Potato Starch (not potato flour) and consume it raw, unheated (stir it up in a beverage) 2-4 TBS per day, you’ll see how it might work for you. Expect nothing, but see how it goes.

      Vivid dreaming and better sleep (either more deep, restful, more time or less time, but more satisfying either way) is ne of the top three reported benefits by hundreds. Very few have reported that it didn’t help and I can’t think of any that reported it hurt.

  34. rs711 on February 3, 2014 at 12:29


    An easy way to determine your carb intake [caveat—> this may change with time]:

    -identify a few areas in your life/health that you would like to see improve
    -‘track’ these for a short easy-to-do period of time (~ 1-2 weeks) to get an idea of where you stand
    -decide whether you wish to start higher or lower carb and go up or down that scale in timely increments, whilst continuously keeping track (according to how your life/knowledge level permits)
    -try to change only that variable (the carbs)…if at all possible

    1. best investment you’ll ever make is a blood glucose meter (whether for you, your kid or other loved ones)
    2. Try focusing on roots, shoots, bulbs, tubers and low GI fruit (some fruit have unfortunately been bred to be unreasonable sugar keggs)
    3. prioritise quality over quantity
    4. don’t count calories
    5. pay attention to your hunger —> eat when hungry; when you’re not, don’t eat (seems obvious but not many people ever get to this point)

    If you need any extra help or advice I’d be happy to correspond with you via email.


  35. marie on February 3, 2014 at 21:37

    Spanish Caravan, here may be a concentrated source of the type of ‘evidence’ that people have been asking for (eg. research citations, plausible mechanisms etc) for detrimental effects of ZC or VLC :
    There are a couple of posts in a series linked to that post, with citations at the end.
    The context was a discussion of Kwasniewki’s Optimal Diet, but since the protein:fat:carb ratios in OD are definitely VLC, I think it applies?

    • Spanish Caravan on February 3, 2014 at 22:24

      I remember PHD getting a lot of flak for saying that. And I thought in the beginning that that didn’t make sense either, since those guys eat lots of processed meats and cold cuts which would have predisposed them to GI cancer anyway. Until you start thinking … in fact, he may not have made the connection between mucin deficiency and mucosal immunity and secretory igA (immunoglob A) until later. You can get stomach/gastrointstinal cancer from such immune deficiencies.

      “The concern is not only cancer in 15 years; a healthy mucosal barrier is also essential to protect the gut and airways against pathogens.”

      The way PHD emphasizes how all diseases start from infections (i.e., pathogens), it does make sense. Especially if you are talking about a deliberate state of leptin deficiency induced by long-term ketosis and VLCing; such a state is a driver of immune dysfunction:

      “First characterized for its effect on metabolism, leptin is now recognized as an important modulator of both the innate and adaptive immune systems . Recently, we and others have observed leptin to be a critical factor in mediating resistance to microbial pathogens.”

      Microbial pathogens: so the gut microbiome may get its finger in the pie, too. No wonder. But the article concludes:

      “Factors other than genetics, such as nutritional status affect leptin levels. Both obesity and malnutrition are pandemics associated with immunodeficiencies that lead to increased susceptibility to infectious disease. Interestingly, both obesity and malnutrition are associated with aberrant leptin levels, obesity causing chronically elevated levels, while malnutrition results in significantly diminished leptin levels. Given the significant impact leptin signaling has on both immune and epithelial cells, the increased rates of infection observed in obese and malnourished individuals suggests that dysregulated leptin signaling may be a critical contributor to the altered immune state in these conditions.”

      “Dysregulated leptin signaling” from both SADding (obesity) and VLCing (malnutrition). The answer lies in the middle, where leptin is neither in excess or deficient, i.e., an omnivorous diet with starchy carbs to bolster the immune system. Thanks, Paleomom.

    • GTR on February 4, 2014 at 03:41

      One of the differences between OD and a VLC based on Paleo is that the former has almost no fiber in it, while the latter has a lot.

  36. John on March 4, 2014 at 07:58

    I had chronically low WBC (2-3) for a long time until I went low carb. Now it’s consistently around 5.

  37. Kaisa on April 8, 2014 at 04:41

    Hi everybody!

    I’m a little desperate about my situation here: my immunoglobulins are low, especially IgM:

    IgG 6.2 g/l (reference range: 6.8 – 15)
    IgM 0.27 g/l (0.47 – 2.84)
    IgA 0.71 g/l (0.52 – 4.02)

    So, only IgA is inside the reference range (and that, too, is quite low).

    Also my WBCs are low: 3.4 (should be 3.4 – 8.2). Last time it was checked it was even lower.

    I have been avoiding all starches because they used to give me bloating and other symptoms and that, I think, is the reason for this bad situation. I also have dysbiosis in my gut, so there’s a connection for sure!

    I would like to know if there’s anything I can do about this. Please tell me I’m not a lost case. Do you think it’s possible to get immunoglobulins back up again? I’m already eating a lot of RS and probiotics. Is there anything else I could do?

    I would appreciate any help!

    Kind regards, Kaisa

    • Paleophil on April 22, 2014 at 21:46

      Get your gut microbiome tested ASAP, and Google search all Spanish Caravan’s comments, to read them all. He was similarly damaged by chronic VLC. Plus, keep your eyes open for when fecal transplants become available.

      Also check out Todd Becker’s tips on hormesis, looking for ways to rejuvinate your immune system and overall health:

      See also Tatertot’s many posts at Mark’s Daily Apple.

      And keep your eye out for more related topics in this blog.

    • Kaisa on April 26, 2014 at 13:49

      Paleophil, thank you for your answer! I found some posts by Spanish Caravan but didn’t find out if he is cured now and if he was able to restore his immunity (and how). Do you know where I can find out more about his process?

      BR, Kaisa

    • Paleophil on April 27, 2014 at 08:10

      You could ask Dr. BG at her blog, and she has a protocol there. It’s labeled as aimed at SIBO, but it might help. url-removed/2013/11/how-to-cure-sibo-small-intestinal-bowel.html She is a pharmacologist who is one of the few people addressing the problem, which most people are unfortunately unaware of or underestimating the seriousness of. More shit will eventually hit the vlc fan. You are unfortunately likely part of the early tip of the iceberg.

      Mr. Heisenbug is another good source:

      Bear in mind, no one has all the answers yet and some things are probably still wrong or getting missed.

  38. Toxoplasmosis elimination | Mark's Daily Apple Health and Fitness Forum page on March 20, 2015 at 04:38

    […] long-term VLCing. Doing so would be tantamount to what Lance Armstrong did. – Spanish Caravan, Very Low Carbing: Let's Just Kill This Beast | Free The Animal Iannello S, Cavaleri A, Milazzo P, Cantarella S, Belfiore F. Low fasting serum triglyceride level […]

  39. Hal on August 4, 2016 at 03:22

    I am another example of a reasonably healthy person being ruined by VLC almost in the exact way that “Spanish Caravan” hypotheses. I am a 31-year-old male, previously extremely fit with no significant health problems and have been reduced to a wreck.

    After a period of approximately 9 months on strict VLC I suddenly developed some disturbing symptoms such as dry mouth, drooling despite minimal saliva, dry eyes (Meibomian gland dysfunction), sweat gland dysfunction, tinnitus, toenail fungus, changes in fingernails, changes in toenails, bloating, constipation, almost complete loss of the feeling of hunger, belching throughout the day and even 24 hours after not eating, SIBO, slight body tremor in time with pulse, muscle twitches, temporary extreme muscle weakness and sudden weight loss.

    These symptoms arose very quickly. By the time I started reintroducing carbs it was too late. There has been an improvement in physical strength but none of my other symptoms have resolved. I feel like I am the frog that boiled himself alive by slowly turning up the temperature.

    Based on my research, my symptoms must be autoimmune in nature and seem to match Sjogren’s Syndrome. Autoimmunity does not always show up on bloodwork. My ANA is negative, CRP and ESR are normal. Abnormalities are borderline total IgG, with a mild IgG1 deficiency, and low Lymphocytes.

    I feel that I am pretty much screwed although there are a few things worth trying starting with improving the gut microbiome, possibly helminthic worm therapy and possibly LDN.

    Be warned. It seems there is a high incidence of relatively rare disorders in people on VLC/ketogenic diets.

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