Pardon the delay in posting and responding to comments. I was on Dauphin Island off the coast of Alabama for a wedding last week. I couldn’t ask The Older Brother to sit in, since it was his Middle Son getting married.

Anyway … in my last post, I commented briefly on a video presentation of a study that, in some people’s minds, nailed the coffin-lid shut on the Carb-Insulin hypothesis. I replied that I don’t believe the hypothesis is dead, but needs some revising. Based on personal experience, lots of reading and listening to podcasts, conversations with other people and so forth, I’ve been slowly revising it my own head for years. So let me reach up there between my ears and pluck out some thoughts, then see if I can work them into a coherent post.

More Carbohydrates => Higher Insulin => Fat Storage

That’s the Carbohydrate-Insulin hypothesis in a nutshell. The more carbohydrates you eat, the more insulin you produce, and the more insulin you produce, the fatter you become. Or to express it in reverse for those trying to lose weight: the fewer carbohydrates you eat, the less insulin you produce, and the less insulin you produce, the leaner you become.

Simple is certainly appealing. But I happen to know the linear equation of more carbs = more body fat isn’t true in my case.

But wait … didn’t you finally lose weight after going low-carb?!

Why, yes, I did. And it was easy. Unlike when I tried low-fat/low-calorie diets based on cereals, pasta, bread and rice, I dropped the pounds fairly quickly and wasn’t hungry. Like a lot of people, I figured if low is good, lower is better.  So I stayed on a very-low-carb diet for a long time.

But after reading The Perfect Health Diet, I put real-food starches like potatoes and squashes back into my diet. After listening to Jimmy Moore’s podcast with the guys who designed the Carb Nite protocol, I started enjoying a high-carb Saturday night (but with a Mexican dinner, not donuts). After reading about the gut microbiome, I started eating tiger nuts for the fiber and resistant starch. After reading a book called Natural Hormone Enhancement, I decided to mix things up even more. Some days my diet resembles The Perfect Health Diet. Some days it resembles an Atkins induction diet, all meats and eggs and green vegetables. Some days I skip breakfast. Some days I fast until dinner. Saturday is still the high-carb night.

I average more carbs per day now than I did a few years ago, but haven’t gotten any fatter. So more carbs = more body fat clearly isn’t true for me, at least not as a linear relationship.

Does that mean insulin doesn’t drive fat accumulation? Nope, not at all. I don’t think we’ve seen the final word on the research, but let’s just say I’ll be stunned if turns out insulin has little to do with gaining weight.

Insulin inhibits lipolysis — the breakdown and release of fat from fat cells. Any book on metabolism will tell you so. That’s one of insulin’s many jobs, and it’s a crucial one. When you eat a meal that raises your blood sugar, insulin brings the blood sugar down partly by storing fat and keeping it stored. That way your cells burn the glucose first.

Take a look at this graph from a study by Dr. Jeff Volek. It shows the relationship between the concentration of insulin in our blood and the ability to release fat.

Here’s a quote from text accompanying the graph in the Volek paper:

Adipose tissue lipolysis is exquisitely sensitive to changes in insulin within the physiological range of concentrations. Small to moderate decreases in insulin can increase lipolysis several-fold, the response being virtually immediate. Insulin also stimulates lipogenesis [creating new body fat] by increasing glucose uptake and activating lipogenic and glycolytic enzymes. Small reductions in insulin levels, such as that easily achieved with dietary carbohydrate restriction, remove the normal inhibition on fat breakdown.

I’ve seen several studies in which giving diabetics higher concentrations of insulin made them fatter. In a study of the effects of obesity on rats, the researchers stated matter-of-factly that they made the rats obese by pumping them full of insulin. When they stopped pumping the rats full of insulin, the rats returned to their normal weights. So yes, high insulin levels encourage fat accumulation and inhibit fat breakdown. And yes, your body releases insulin when you eat carbs.

But it’s not the temporary spike in insulin after a meal that makes you fat. That’s when insulin is doing exactly what it’s supposed to do: partitioning nutrients, shuttling glucose into cells, storing fat so glucose is burned first when glucose is high, etc. Later, insulin is supposed to drop and allow fat to flow from the fat cells.  Lower insulin also allows glycogen to be converted to glucose.  It’s all about keeping glucose within a safe range.

In a lecture I watched online, a biochemist described insulin rising as the building/storing phase and insulin dropping as the burning/using phase. Both phases are necessary for good health. The problem is that for metabolically damaged people, insulin stays high when it ought to be low. They spend too much time in the building/storing phase, and not enough time in the burning/using phase.

During his presentation on hyperinsulinemia on the cruise, Dr. Ted Naiman showed a chart of the insulin responses of normal vs. obese/insulin-resistant people to the same meal. The obese people not only had a much higher initial insulin spike, their insulin levels stayed higher for several hours. Take another look at Dr. Volek’s graph. It doesn’t take much extra insulin to inhibit lipolysis rather dramatically.

But those are metabolically damaged people. (We’ll get to what I believe causes the damage shortly.) For metabolically healthy people, a high-carb meal will certainly raise insulin temporarily — as it should — but that doesn’t necessarily mean insulin will stay high. When I first started hearing from paleo types that tubers have been part of the human diet for eons and are perfectly fine foods, they usually pointed to the Kitavans – native people who live on a high-carb diet (mostly sweet potatoes), but aren’t fat or diabetic.

So I looked up some articles and a study of the Kitavans. Yup, they eat a lot of sweet potatoes and they’re not fat or diabetic. But here’s the interesting part: their average insulin level is 24 pmol/L. If you check Volek’s chart, you’ll see that’s down in the range where fat breakdown occurs. (By contrast, one study puts the average insulin level for American adults at around 60 pmol/L.)  So for the Kitavans at least, a high-carb diet of whole unprocessed foods doesn’t lead to high insulin levels throughout the day. In other words, they don’t become insulin resistant. I’m sure we could find plenty of other paleo people who ate natural starches without becoming fat and diabetic. Quite a few Native Americans, for example, grew squashes and beans.

No doubt the potatoes and other starches I eat now temporarily spike my insulin. So why haven’t I gotten any fatter? Well, I don’t have any way of checking my fasting insulin level at home, but I’d wager a large sum it’s no higher now than it was a few years ago, when I rarely ate starch. I’d also wager a large sum that when I was living on low-fat cereals, low-fat pasta, whole-wheat bread with margarine and other vegetarian delights, my fasting insulin was much higher.

So the first revision of the “alternative hypothesis” I carried around in my head looked something like this:

Damaging Diet => Chronically High Insulin (Insulin Resistance) => Fat Storage.

What is or isn’t a damaging diet certainly varies among individuals. Back in this post, I recounted a section from Denise Minger’s excellent book Death By Food Pyramid in which she wrote about the huge variations in how much amylase we produce. People who produce little amylase experience much more dramatic blood-sugar surges when they consume starch than people who produce a lot of amylase. The low-amylase producers are also eight times as likely to become obese.

I doubt that’s a coincidence. Excess glucose damages cells. It makes sense that cells would protect themselves against high-glucose assaults by developing resistance to the insulin that’s trying to shove glucose through the door. So perhaps for some people, it really is as simple as too many carbs => insulin resistance.

But having said that, I doubt many type II diabetics got that way by eating potatoes and fruit. I think it’s much more likely that the carb culprit was processed carbs. It isn’t just that they spike blood sugar (although they certainly do). These “acellular” carbohydrates also produce inflammation – and inflammation is a likely driver of insulin resistance.

Which brings us to a major non-carb culprit: the crap oils that have been displacing natural fats in our diets for decades. We didn’t just start eating more breads and cereals after the Food Pyramid came around. We also started replacing butter and lard with soybean oil, cottonseed oil and other industrial horrors that drive inflammation. If inflammation in turn drives insulin resistance, then the “heart healthy” diets people started adopting in the 1980s were a double whammy: too many processed carbs, combined with industrial oils. Pass the (ahem) “whole wheat” toast with margarine, please, because I’m being good to my heart.

The second revision of the “alternative hypothesis” I carry around in my head took it from this:

Damaging Diet => Chronically High Insulin (Insulin Resistance) => Fat Storage.

To this:

Damaging Diet => Hormonal Disruption => Fat Storage.

Yes, insulin resistance is a form of hormonal disruption, and yes, I believe chronically high insulin drives fat accumulation. But other hormonal disruptions can make us fat too. I’ve mentioned seeing a documentary called The Science of Obesity that featured a woman who’d been lean her entire life, then started blowing up. She cut her calories to 1500 per day and still got fatter. Doctor after doctor accused her of lying about her diet.

But finally an endocrinologist ran some tests and found she had a small tumor on her brain. The tumor was preventing her brain from sensing the hormone leptin. Since leptin tells the brain how big our fat stores are, her brain concluded that she had no fat stores and needed to build them up. Fat stores are, after all, a crucial part of our fuel system. So each time she restricted her calories more, her body responded by slowing her metabolism more.

Few obese people have a brain tumor, but once again, a bad diet can lead to leptin resistance. Inflammation may cause leptin resistance directly, and chronically high insulin can block the leptin signal from reaching the brain. So we’re back to the same likely suspects: processed carbs and crap oils.

A baked potato with butter contains neither, which is one reason I now eat the occasional baked potato with butter. I may have surprised a few people on the low-carb cruise by eating the potato that came with my dinner on several nights. Then again, I saw others in our group doing likewise. Like I said, the low-carb movement is becoming more of a real-food movement, at least among the people I know.

But I don’t just eat the potato because I think I can get away with it. I eat the potato because I believe I’m better off with it than without it. Yup, you just heard me say that … er, write that.

Once again, the reason has to do with hormones. Going down to near-zero on the carbs and staying there can cause hormonal disruptions in some people. In the Natural Hormone Enhancement book I mentioned above, author Rob Faigin praised low-carb diets as a way to jump-start weight loss, but cautioned that going very-low-carb permanently can reduce testosterone and raise cortisol in men. He cited several studies to back up the point. Here’s one I just dug up.

He also cited evidence that going permanently low-carb can lead to a slower thyroid. I know Dr. Ron Rosedale insists the change in thyroid hormones is a healthy adaptation, but come on … if you’re trying to lose weight, do you really want a “healthy” slower thyroid?

Faigin’s solution is to mix it up: a VLC diet five days per week to promote weight loss, then high-carb (but not processed carbs) with reduced fat two days per week to prevent hormonal disruptions. The Carb Nite protocol is based on a similar idea. Paul Jaminet’s solution, of course, is to eat some “safe starches” daily while still keeping carbs on the lowish side overall. I can’t say if one solution is better than the other. It probably depends on the individual. Like I said, I mix things up and go with different diets on different days.

Having said all that, I would never encourage type II diabetics to run out and eat potatoes. During a Q & A session on a previous low-carb cruise, Denise Minger put it something like this: a low-carb diet is an effective treatment for type II diabetes, but that doesn’t mean metabolically healthy people have to give up fruit and potatoes to avoid diabetes. In other words, just because someone with a broken leg needs crutches, it doesn’t mean we must all use crutches to avoid breaking our legs. On the other hand, just because people can eat potatoes and fruit without becoming diabetic, it doesn’t mean diabetics should eat potatoes and fruit. In other words, just because walking without crutches won’t break your leg, it doesn’t mean people with broken legs don’t need crutches.

So to wrap up a very long post:

I don’t believe obesity is as simple as the more carbs we eat, the higher the insulin, and the higher the insulin, the more fat accumulation. Losing weight also isn’t as simple as the fewer carbs we eat, the lower the insulin, and the lower the insulin, the leaner we become. Cutting carbs can certainly promote weight loss (as it did for me), but when most of us go low-carb, we not only cut out the acellular processed carbs completely, we also embrace real fats and give up the crap oils. We eat bacon and fry our eggs in real butter. So I suspect the benefits are partly the result of reducing inflammation, which in turn reduces insulin resistance and perhaps leptin resistance.

To keep the benefits coming, it’s not necessary (or even advisable for many people) to stay at near-zero-carb levels permanently. For non-diabetics, I believe it’s better for overall hormonal health to mix it up, adding in some real-food starches, or cycling VLC days with higher-carb days.

To me, the golden nugget of the “alternative hypothesis” is that getting fat isn’t about calories; it’s about hormones. When our government told everyone to eat plenty of grains and cut the arterycloggingsaturatedfat!, following that advice created hormonal disruptions for many, many people. The cure is to 1) eat real, unprocessed food and 2) reduce the carbs to a level appropriate for your metabolism.

129 Responses to “Carbs, Keto, Insulin And The Alternative Hypothesis, Part Two”
  1. Johan says:

    Great post!
    Now (with your modification) the hypothesis is much more believable (or at least could be taken seriosly).

    I believe insulin is very missunderstood, James Krieger explains it very well in his 5 part series:

    “Cutting carbs can certainly promote weight loss (as it did for me), but when most of us go low-carb, we not only cut out the acellular processed carbs completely, we also embrace real fats and give up the crap oils….”

    It could be the drop in carbs (i do not believe that) or it could be that when people drop the carbs most will up their protein intake (thats what worked for me personally).


    • Tom Naughton says:

      I disagree rather strongly with Krieger. He thinks insulin has nothing to do with it. In fact, he keeps insisting that insulin is a fabulous appetite suppressant. Riiiiight. So researchers pump rats full of the “appetite suppressant,” and they become obese as a result. Diabetics up their dose of the “appetite suppressant,” and they get fatter. People go on diets that reduce production of the fabulous “appetite suppressant,” and yet they spontaneously eat less and lose weight. It makes no sense.

      I think high insulin has a lot to do with getting fatter. The revised part of the equation is that fasting insulin levels aren’t a linear function of how many carbs we eat.

  2. gollum says:

    1 So you don’t need insulin to “use energy”, au contraire. Peter @high-fat-nutrition already explained that nicely with the liver listening to insulin, but very nicely put. –

    2 Why should our body listen to carb signaling only, with insulin? What about the fats? Well, fats do induce cephalic phase response. But there might be a “fat insulin”, I mused for some time. Well, maybe there is. Reading up on glitazones, I found this gem:

    “The endogenous ligands for these receptors are free fatty acids (FFAs) and

    PPAR receptors. Take-up-fat. The impact on metabolism would depend on the cell type (liver, adipose, grunt).

    Eicosanoids are made from [O6] fats.

    Now if this plays any significant role in vivo we have at least two corollaries: a – it might sabotage Highfat diets, b – if these receptors are somehow befuddled, the fat staying in the bloodstream may “cause” metabolic syndrome because fats and carbs downregulate each other. This would supposedly cause hyperinsulinism to keep glucose down.
    One cause of befuddlement that comes to mind would be fatty liver.

    3 Insulin is downgraded by the kidneys. It is known that DM2 with weak kidneys have to dose less insulin for the same effect. Which led me to the hypothesis that the age66-onset DM2 (Altersdiabetes) could be perhaps caused by slow kidney. Of course at first it drops blood glucose, but long term?.. It does not help that high blood glucose damages the kidneys. Cue low fat quack..

  3. Onlooker says:

    Yep, I’ve always suspected a larger part for the industrial seed oils in this whole thing. See also Dr. Eades’ recent article mentioning another mechanism. These things are just bad news.

    Another aspect to this whole thing is also the likely epigenetic component. I think it’s just about indisputable that this thing is getting worse with each generation (ala Pottenger’s cats, etc.). If things don’t get turned around real soon I hate to see what the generation getting born right now (and ten years from now) looks like.

    Eat real food folks! That’s the real answer. (I know it’s harder to get today’s eater to understand what that means.) With the fortification hypothesis/theory added to this industrial oils thing (and who knows how many other factors) it really is apparent that it’s “processed foods” that are killing us. (And now they want to produce meats grown in a vat; because we really understand everything about the nutrition we get from meat and can grow that in a test tube. Ugh.)

    • Tom Naughton says:

      That’s the message we’re pounding home in the book for kids. It’s not a low-carb book for kids; it’s a real-food book for kids. Of course if kids on a crap western diet switch to real food, their carb consumption plummets anyway.

    • Walter Bushell says:

      Oh, yes and the meat will have “healthy” “vegetable” oils in place of the saturated animal fat with its fat soluble vitamins and sugar probably so it will sell.

  4. Dave Sill says:

    Good stuff, Tom. Thanks. Have you tried monitoring your blood sugar after meals including “safe” carbs? You’re obviously not having weight gain issues, but I’d be concerned about glycation.

    • Tom Naughton says:

      Yup, I found that my glucose goes up after eating a meal with starch (exactly as expected), but then comes down to normal soon after. This morning I had about 3/4 of a sweet potato fried up with eggs and topped with cheese. I just checked my glucose when I read your comment. It’s at 84.

      • BobM says:

        That’s a really low value. I’ve just gotten a meter, so I haven’t tested much. However, the lowest I’ve gotten so far is 109, and that’s at about 12:30 after not eating since dinner the day before. I’m going to test morning and night, and before and after selected meals, just to see what happens. After dinner last night (forgot to take beforehand), I got 152 about 45 minutes after a single (1) home-made sourdough roll (made with Einkorn wheat), and all low carb stuff otherwise (hamburgers with cheese and home-made mayo, a few small slices of tomato, and onion; salad with anchovies and oil and vinegar). Basically, one piece of bread shoots my blood sugar up. I haven’t tested with potatoes yet (sweet or otherwise).

        I have gotten much lower on official tests, but that was after 4.5 days of fasting (63, 74).

        • Tom Naughton says:

          I found that supplementing with some resistant starch before bed leads to lower BG in the morning. It’s worth trying.

  5. tw says:

    Excellent post and analysis. I too found Jaminets book very helpful (particularly when I was approaching chemotherapy 2 years ago). I never did measure my cho intake but sweet potatoes were eaten daily throughout the period. Did it help? I think it did.

    I would add one book: The Obesity Code by Dr. Jason Fung in TO. This takes your explanations and adds some color. I think this book is a must read for anyone interested in nutrition. It explains for example why people become insulin resistant as they get older (eating too frequently) and the role that hormones play. ……and how to reset them: fasting. I think this is conjunction with all of the other resources you mention is a game changer.

    • Tom Naughton says:

      I’ll give it a look, thanks.

    • Curtis says:

      I just finished the Obesity Code. I agree, it goes in the ‘good’ pile of books worth recommending.

      I’ve also enjoyed the Dr. Jason Fung videos on YouTube.

      His comparison of type I and type II diabetes was an eye opener for me. Type I diabetics suffer from too little insulin and type II diabetics suffer from too much insulin. Giving type II’s insulin injections may force their blood-sugar down, but it’s NOT addressing the real problem…which is insulin resistance! And that’s a dietary problem. Which should be treated with diet, exerciser and fasting.

      I’ve done four 24 hour fasts in the last week and I’ve been walking a couple miles every other day. After reading the Perfect Health Diet a couple years ago, I’ve pretty much been doing the 16 hour fasts ever since then. So extending the fast to 24 hours wasn’t much harder.

  6. Perry says:

    Yes! And I will add that a good working hormone profile leads to a naturally higher metabolism even in the case of the organism consuming the same (or higher) number of calories.

    Good hormonal profile >>> high metabolism >>> lean body

    This would be the Ray Peat approach.

    • Tom Naughton says:

      Agreed. Switching from a crap-laden western diet to a low-carb diet provides a quick and easy improvement in hormonal balance. But ultimately, I think the key is switching to real foods. To swallow 300+ carbs per day, you almost have to eat the processed stuff.

  7. BitterCelery says:

    If only there was a home insulin meter available that would make measuring insulin response and levels as easy as it is to measure blood glucose…

  8. Josh says:

    I have been suspicious of many of the manufactured oils for a while. My question is…..

    What constitutes an acceptable oil? For example, if I squeeze the heck out of an avocado I get oil. Is that a good oil? It strikes me as being the same as olive oil. In other words, if the process to make the oil is simple and understandable by the layperson, it’s probably a good oil. OTOH, if I need a complex chemistry flows-chart to understand what to mix in at what temperature with what catalyst, then it is probably not a good oil.


    • Tom Naughton says:

      Yeah, that’s pretty much it. What I call “industrial oils” are the oils that only exist because of chemical processing and industrial machinery. Interestingly, they were first developed as lubricants for industrial machinery.

      • Onlooker says:

        And they were labeled “vegetable” oils;a brilliant marketing move. Ugh

      • Walter Bushell says:

        Well they are good lubricants and diesel fuels, but have no earthly purpose aside from those that I know about.

        But then they are good for business for doctors and morticians, big pharma and big farma.

        It’s an ill wind that blows nobody good.

        • Sky King says:

          Coconut and Red Palm oils are some of the best oils for consuming, but there isn’t any money to made in this country selling such oils since we don’t have the climate to grow a gazillion coconut and palm trees. Hence a reason why Big Farma had to come up with a way to convince the American Public that seed oils from corn, safflower, canola, sunflower, soybean, etc. was better for them!

          That’s called the Greasing, the Oiling, and the Screwing of America!

          • Namu says:

            For shame, the USA could be the world leader in high quality butter.

            Reading the good Peter D. it seems the omega-3 are as problematic as the omega-6 beyond a few grams a day.

        • Galina L. says:

          During some period of my life I was working recommending lubricants for different machines. The worst case scenario happened when somebody oiled a mechanical joint with a handy seed oil – it gunked the joint up quickly.

          • Namu says:

            The seed oils make fine lacquer / veneers though I’m told, as they polymerize nicely in air and under UV.

        • Cindy C says:

          I have used linseed oil when doing oil painting. We never thought about using it for cooking. Back then, I did not know that further deodorizing and refining would turn it into an oil people used for cooking.

          Some on the history of such oils.

      • Curtis says:

        One thing that sticks in my mind from reading The Big Fat Surprise is; we never consumed any of those vegetable oils, rapeseed oils, cottonseed oils, industrial oils, etc., prior to 1910. But we’ll demonize foods that we’ve eaten for hundreds of thousands of years. Chalk another one up for common sense 🙁

  9. Jennifer Snow says:

    This is basically what I’ve been learning myself. I’ve been finding that avoiding the bad oils is much harder than merely avoiding carbs. They’re in EVERYTHING!!!!

  10. Bonnie says:

    Thank you for making the distinction between t2 diabetics & metabolically healthy people. Maybe I just notice it more, but it does seem that many low-carbers don’t understand the differences. I’ve been reading The Obesity Code & understanding so much more about insulin. I’ve started thinking of my vlc diet as medication for my diabetes – & it isn’t something a non-diabetic needs.

  11. Dianne says:

    Andras Eenfeldt interviews Dr. Fung:

  12. Maria J says:

    Just adding another nod to The Obesity Code. Not only extremely informative but he has a great sense of humor. And very educational presentations on YouTube as well. Good to have you back.

    • Tom Naughton says:

      Good to be back.

    • Sky King says:

      Another nod here to Fung’s new book. I read it not because I have diabetes (I don’t), but because I wanted to see what he had to say on the subject of Fasting, which I’ve been a BIG fan of and a practitioner since the year 2000.

      I understand Dr. Fung and Jimmy Moore are collaborating on a new book called, A Complete Guide to Fasting, which I believe will be released later this year in November.

      • Tom Naughton says:

        I suspect I’ll receive a copy.

        • Dianne says:

          Well, if Dr. Fung has Jimmy Moore’s stamp of approval, that’s all I need to know.

          • Curtis says:

            The first text you see under the price of the Obesity Code on Amazon says…

            “Fung zeroes in on why insulin resistance has become so prevalent and offers specific outside-the-box solutions that have emerged as the key to maximizing health.
            —Jimmy Moore, author, Keto Clarity and Cholesterol Clarity”

            How’s that for a stamp of approval?

            • Bob says:

              Jimmy Moore has to write these glowing reviews for Fung as Fung is JM’s meal ticket with the new book that just came out.

              • Tom Naughton says:

                Your ability to read Jimmy’s mind is stunning. Tell me, does being omniscient ever become boring?

  13. Erik says:

    Great post! I think the phrase/concept of “damaged metabolism” needs to be more prevalent in any mention of weight-loss.

    Maybe then the skinny people will finally understand why their advice doesn’t work. They have never been as hungry as I have, even after eating.

    • Tom Naughton says:

      Some skinny people will never understand. They were born on the finish line and think they won a race because of their superior character and discipline.

  14. Stealth says:

    “Cutting carbs can certainly promote weight loss (as it did for me), but when most of us go low-carb, we not only cut out the acellular processed carbs completely, we also embrace real fats and give up the crap oils….”

    Most of the people who read your blog perhaps, but did you ever look at some of the popular low carb forums? One not-so-friendly low carb forum in particular has thousands of members who mostly thrive on frankenfoods and crap oils. OMG what some people eat while thinking it’s OK because it’s low carb! The site owners ban anyone who says a word about these food choices, since they also own a large online store to supply said frankenfoods and crap oils to the masses. They still manage to lose weight on the LCFF (Low Carb/Franken Food) diet.

    • Tom Naughton says:

      Well, I suppose a crap diet devoid of sugars and processed starches is better than a crap diet that includes them. But I’d still prefer a real-food diet.

    • Firebird says:

      I was banned by Wheat Belly’s Facebook page and have been blocked on his Twitter account because I ask questions about why ditching grains and going low carb has not worked for me. Rather than address that in detail, he’d prefer to just shut out those of us who it is not working for while pushing the success stories as if every story is a successful one.

    • Curtis says:

      “Low-carb is like a box of chocolates, you never know what you’re gonna get”.

      That’s why I like “Paleo” better. It has specific guidelines; sugar-free, grain-free, legume-free, etc. Since paleo is all about “REAL” food, it makes looking for healthy recipes a lot easier. I mean, Amazon has about a million paleo cookbooks (slight exaggeration)… and a google search for “paleo recipes” will bring up another bazillion options (maybe a slight exaggeration).

      • Tom Naughton says:

        My issue with some “paleo” diets is the frequent servings of maple syrup and honey. Yes, they’re natural, but they’re still sugars. And I doubt paleo man fought off the bees often enough to eat honey more than once in awhile.

        • Namu says:

          Man ate honey often enough to drive the selection of specific behaviors in 17 species of honeyguide birds, though.

        • Curtis says:

          But, but, but, but…maple syrup and honey are all natural!!! That’s right Virginia, and so is snake venom. But that doesn’t mean it’s good for you.

          You and BobM (in the post below), make a good point. I guess as a T2 diabetic I’ve conditioned myself to ignore sweeteners.

          A friend of mine was raving about these new cigarettes he gets that are all natural and made with organic tobacco etc., etc., etc. I couldn’t help myself, I had to laugh! 🙂

    • BobM says:

      I think this happens with a lot of different diets. For instance, we have friends who were on a “paleo” diet and who cooked and ate tons of sugar (as paleo for some reason thinks maple syrup and other sugars are OK) and fake desserts. I know that some desserts set me off (though the longer I’m on low carb, the less these set me off), so I avoid anything sweet as much as I can. If we go on vacation, I’ll have some pizza, some sandwiches, a little ice cream, some chocolate. Otherwise, I try to keep all sugar intake (including fake sugars) as low as possible. I will eat some 70% chocolate every once in a while.

      I’ve also realized that insulin is a major problem. And all of that — including fake sugars — cause an insulin response. So, if I go on vacation, when I going there and coming home, I fast. I also fast for several days after getting back, which puts me into ketosis and I’m up and running again on low carb.

  15. tali says:

    Tom, I eat carbs and maintain a 23 BMI. I’ve read many diet/health gurus recommend a keto diet (50 or less carbs a day) to prevent or use as adjunct therapy for cancer.

    I’m a triple cancer survivor, currently cancer free. Would it make sense to adopt a keto diet as a preventive measure?

    • Tom Naughton says:

      If it were me, I’d avoid all junk carbs and stick to stuff like tubers and squashes. A keto diet has been shown to put cancer in remission, but only for some cancers and only for some patients.

  16. Jim Jozwiak says:

    If diabetes were defined as abnormal insulin secretion after a carb challenge, then many more people would need to adjust their diet in some manner to avoid the problem. But you can’t just blame carbs. For instance, you can make yourself hyperinsulinemic just by overeating and gaining weight, or even by taking enough chromium to raise insulin levels. My theory is that people mostly gain weight because they feel euphoria from hyperinsulinemia so long as it is accompanied by a suitable level of insulin resistance. If they make a mistake and do something to increase their insulin sensitivity while maintaining their hyperinsulinemia, of course, they will get very anxious. And unfortunately, if they get so hepatically insulin resistant that gluconeogenesis takes off and fasting blood sugar rises, they will get very depressed.

  17. Jennie says:

    Hi Tom. Thank you for this very thought-provoking article. I am wondering if you have a hormonal explanation for why a totally breast fed 5 month old baby would be very chubby (my granddaughter). I’m wondering why some babies are like this but many others are not?

    • Tom Naughton says:

      I wouldn’t worry about a chubby five-month-old. My daughter Alana was a fat baby with a round face and dark hair. Now she’s a skinny blonde who enjoys gymnastics and did more pushups during a recent fitness test than any girl in her class. In fact, only a couple of the boys could do more pushups than she did.

  18. Mark says:

    Check out Free the Animal about his fortification of grains articles. Fascinating, and once again shows unadulterated foodstuffs seems to be the best for humans.

  19. Firebird says:

    This came at the perfect time for me. I read Faigin’s book back in 2002 and it echoed what Vince Gironda and bodybuilders of the 40s-60s use to do…meat only diets to get lean but add ONE carb meal every 72-96 hours to restore glycogen. Only recently have I begun to follow that advice.

    For me, my cortisol is through the roof and that is where my nutritionist friend says the problem lies. I’ve only read recently that leptin levels may be corrupted by being too low in carbs. Some bodybuilders are suggesting that every 10-12 days I go very high carb — 200+ grams per day to regulate leptin.

    I’ve added some fruit and potatoes back into the diet along with oatmeal. I’m not sure how that will work. I feel fatter than I did a week ago, I can tell you that.

    I may incorporate a carb night to see what happens. I tried it before but I stopped because I was forcing myself to eat foods (like pizza) that I just did not have a desire to eat anymore.

    • Tom Naughton says:

      I do the carb nite thing, but avoid junk carbs like wheat and sugar. My Mexican meal usually includes refried beans, rice and some corn tortillas.

      I believe the message from Faigin, Jaminet, etc., is that there’s an ideal range for all nutrients — protein, vitamin D, whatever. The ideal range for carbohydrates sure as shootin’ isn’t 300+ gram per day for most of us, but it’s not less than 40.

      • Firebird says:

        Dr. Greg Ellis told me a while ago that, although he stated that there was no such thing as an essential carbohydrate, he didn’t feel zero was the ideal range. He suggested 50-100 gms per day.

        • Tom Naughton says:

          That seems to be the range where a lot of us end up. I was eating around 100 per day during my fast-food diet, and still managed to lose weight, so zero clearly isn’t necessary for me.

          • Firebird says:

            Back then, Ellis didn’t mind what kind of carbs you consumed. I’d take a small bag of Smartfood popcorn to work with me. He said that as long as I came in under my daily range, it was okay.

            I asked him once about pasta and which was better, rice, corn or spinach and he told me it was all the same, just eat the regular (if you’re going to have it at all). I believe he revised that a few years ago and recommended no grains at all.

            • Tom Naughton says:

              We live and learn and change our minds. Back when my program was to just limit carbs to under 100 per day, I didn’t care if they came from potatoes or hamburger buns.

              • Firebird says:

                And it’s been 14-15 years since I had a bag of Smartfood, though I DID indulge in some popcorn when I saw “Jersey Boys” when it was in theatres 2 years ago.

                • Tom Naughton says:

                  I go to the movie theater so rarely, I’ll happily eat popcorn when I do.

                  • Tom says:

                    Remember when movie theater popcorn was going to kill us because it had coconut oil in it, so we changed over to canola and fake butter?

                    I’m pretty sure that push came from your pals at CSPI.

                    • Tom Naughton says:

                      Yup, that was them. They wanted the theaters to switch to partially hydrogenated vegetable oils — a.k.a. trans fats.

  20. PhilT says:

    Good job expanding and fine-tuning the message of the insulin hypothesis.

    Clearly fat loss in the presence of elevated insulin is going to be difficult, but we don’t see much data on 24h insulin levels to be able to easily relate to that. Even high carb calorie restrictors see a reduction in insulin levels.

    The part of the hypothesis that needs most work IMHO is the “getting fat” part, rather than the losing weight aspect. Eating carbs leads you to burn carbs while storing fats and inhibiting the release of fats on account of the insulin, but the evidence base for the idea that this makes you eat more in order to maintain “available energy” isn’t as good – or I haven’t seen it yet.

  21. Josh says:

    FWIW, if a person wants to lower their carb intake but takes a more moderate approach on carbs than those who must eat almost none of the things, I recommend the book “Always Hungry”.

    Essentially, the doctor who wrote the book recommends a lower-carb diet. Warning: The first half of the book is mostly discussion of studies that justify his approach.

    Most of the foods he recommends are real foods, made at home, so it is a lot of work. But, the recipes are very tasty to say the least.

    He does allow some carbs in the last two phases of the diet, including many fruits and some whole grains (and by that he means whole, as in CHUNKS of grain, not pulverized flour). The whole idea is to reduce the insulin levels. He calls insulin Fat Fertilizer. Sugar, as you might imagine, is severely limited but one can add a bit of honey or maple syrup to some recipes in the later stages.

    So, if you are not up to limiting your carb intake to less than 50g a day and have time to cook, Always Hungry is worth looking into. As usual, YMMV. Good luck.

  22. BobM says:

    That’s similar to what Dr. Jason Fung believes in his book The Obesity Code. He’s all about insulin.

    I think it is very complex, and likely there are different people who will get different results from the same diet. I have been adding potatoes periodically to my diet. I’ve made a potato gratin dish from Julia Child’s recipe a few times, and I cook it one day, cool it, then reheat it to get more resistant starch. I’ve also been eating some other carbs, periodically, even sourdough bread using Einkorn wheat. However, these all set my wife off, and she wants to eat more. For me, they don’t do that. And I still only have them once a month or so, although some potatoes I’ll have if breakfast or other meals come with them.

    About those Kitavans: I’m not sure how much I trust this data. They have a high rate of smoking, yet appear to be impervious to that. I’ve also seen estimates that they eat high amounts of coconut, yet that doesn’t seem to factor into their high carb content. Also, this kind of data is always sketchy, although Dr. Fung insists it’s their low insulin that’s likely allowed to happen through various means.

    I’ve also spent several months upping my resistant starch (potato starch, green plantains, other prebiotics) and probiotics (started with fermented food and added pills after a while). I’ve since backed off of that and now do not use resistant starch foods/supplements but still use vegetables and fermented food. The only benefit to resistant starch/fermented food that I can quantify is slightly more dreaming. Otherwise, the detriments (gas, abdominal issues) seemed to outweigh the benefit for me.

    In fact, I had such poor results with resistant starch, that I’m going to go on an all meat diet for a month to see what happens. Here’s a site that discusses this:

    This may be because I have a tendency towards IBS/FODMAP, so all of that resistant starch and fermented food could be bad for me. I’ll see what happens after a month of meat and animal fat.

    Also, for potatoes especially eating out, I try to avoid these not because of the potatoes but because of how they’re prepared. I agree with you that seed oils are bad (and there’s not a lot of evidence in my opinion that olive oil or avocado oil are good; if anything, they’re neutral). I get concerned about potatoes that come with breakfast, for instance: are they fried in oil? The same for meat: has it been seared in oil? When I cook at home I use animal fat (lard, tallow, duck fat, bacon fat, goose fat), so I don’t mind eating potatoes and meat, but ordering out can be tricky. And, as stated above, seed oils are in everything. My wife makes mayo for me (with olive oil or avacodo oil), as you can’t find mayo without canola or soybean oil.

    • Tom Naughton says:

      That’s exactly the point about the Kitavans: they have low fasting insulin, probably because of the all-natural diet. I wouldn’t recommend that diet for people who have already become insulin resistant.

      When we go out for steaks, we take a little tub of Kerrygold butter with us, then ask for the baked potato without butter.

      • Dianne says:

        Regarding mayonnaise, I recently bought a very tasty product called Coconaise from Amazon. It’s expensive, but I mainly use mayonnaise to make devilled eggs or to put it on asparagus, so it takes me a long time to go through a jar. The ingredients in order listed are: Coconut oil, MCT oil (from sustainably-produced palm oil), organic eggs and organic yolks, organic high oleic sunflower oil, vinegar, yellow mustard (white vinegar, water, mustard seed, salt, turmeric, paprika), concentrated lemon juice, salt, evaporated cane juice [do they really think people don’t know that’s sugar?], natural vitamin E (mixed tocopherols), phytate (an antioxidant from rice bran), natural lemon flavor.

        I don’t know where sunflower oil ranks in the list of healthy/unhealthy oils, but it’s the 4th ingredient down the list and as I say, I don’t use a lot of mayonnaise, so if it isn’t actually poisonous, it shouldn’t be a problem.

      • Mike says:

        When I go out, I almost always eat a salad with dressing. Blue cheese & ranch are good choices for keeping the carbs low. Unfortunately, it’s a near certain bet that they contain seed oils. Sometimes I use prepared salad dressing at home, if I hanker for a salad, and I don’t have any homemade dressing on hand, and I often don’t since it doesn’t keep all that well. For the most part I just live with it and avoid eating out often. I guess at home I could make vinegar & olive oil dressing if I liked it better. In restaurants the oil is usually not olive oil and vinaigrettes usually have a fair amount of sugar.

        When I’m making food and plan to eat a lot of salads, I make mayo out of MCT oil, and make that into blue cheese dressing. The mayo goes nicely on meat too.

        • Tom Naughton says:

          I occasionally go to a deli that has a great salad bar. They have the usual blue cheese and whatnot (almost certainly made with soybean oil), but they also have individual bottles of olive oil and vinegar. So I toss on those along with some crumbled feta cheese.

      • BobM says:

        Good idea about the butter. I also eat more fish (at home) or fish oil to counteract the Omega 6s. (I try not to order fish out, as the portions are too small.)

        I think any data from any location has to be viewed with suspicion. I tried to find the original data from the Kitivans, but cannot. Is this going to be a case where they tested 5 people and then said everyone eats like this? I don’t know.

        It’s also difficult as without a reasonable estimate of exercise and the like, it’s impossible to do a comparison. I ate a very low fat diet with a ton of carbs (pasta, brown rice and beans, whole grain breakfast), and was able to do that while biking 60+ miles a week, walking a ton, playing tennis, etc. As soon as I got hurt, though, and couldn’t do anything, all those carbs want right to my liver and body fat. I started getting depressed, etc.

      • Larry says:

        What diet WOULD you recommend for someone that is already insulin resistant? I agree with you that the issue is more real food than minimal carbs for someone with an undamaged metabolism. But I’m currently damaged from eating years of processed foods when I could get away with it and had a good metabolism. So I planned on doing high quality meat and good fats, with the only vegetables green leafy, asparagus and a little broccoli, plus some raspberries or blueberries now and then in a smoothie with the green leafy. But when would you recommend transitioning from this to the more varied diet with the added tubers and sweet potatoes? Is there any thought on how long is too long for the VLC? Or how long is sufficient to regain insulin and leptin sensitivity?

        • Tom Naughton says:

          If it were me, I’d start adding foods like sweet potatoes and squash back into the diet, then check the glucose meter — but I also wouldn’t panic at the first few readings. If you’ve been VLC for a long time, your body has likely down-regulated its ability to handle glucose, so you may need to re-adjust. I’ve also found that resistant starch helps. If you cook and cool a potato or sweet potato, some of the starch converts to resistant starch. I’ve also found that raw potato starch (high in resistant starch) seems to blunt the glucose respond. I’ll sometimes swallow a couple of tablespoons stirred into water. And as we just learned in comments, vinegar also helps blunt the glucose response.

    • Curtis says:

      Chosen Foods makes a 100% pure avocado oil mayo. My local Costco started carrying it about three months ago.

      “Ingredients: Avocado Oil, Cage-Free Egg Yolks, Filtered Water, Organic Cage-Free Whole Eggs, Organic Distilled White Vinegar, Organic Honey, Organic Mustard (Organic Mustard Seed, Distilled Organic Vinegar, Organic Spices), Salt, Organic Rosemary Extract.”

      Primal Kitchen also makes an avocado oil mayo.

      You can find both of them on Amazon

  23. Tom, this reminds me of the movie Catfish, not so much the plot (which involves false identities via Facebook, etc.) but there is a parable in the movie about how a catfish can keep you on your toes. The parable recounts how when cod was shipped (alive) across the country the cod would arrive in a sub-optimal state, listless, half-dead, etc. until one day a catfish had been shipped in the same container and because it kept nipping at the cod, the cod arrived as fresh and full of life as ever. All to say is that it sounds like if we stick religiously to one diet our bodies might adapt too much and it seems like an interesting idea to more or less wake up our bodies’ abilities to process and digest different foods. Thanks for the post!

    • Tom Naughton says:

      Nassim Nicholas Taleb made a similar point in his book “Antifragile.” Little of the book is about diet, but what’s there is very good. He makes the point that our bodies respond well to mixing things up, as long as we avoid the crap modern foods. He even does a week of a vegan diet now and then.

  24. Nancy P. says:

    Great post! It’s so exciting that you are taking all the information coming your way and formulating new ideas as to how this whole thing works, and sharing it no less! Most impressive is your willingness to accept that you might not have had it 100% right the first time and instead of sticking to your original belief no matter what, you continue to research, learn and share. Thank you-

    • Tom Naughton says:

      Nope, I wasn’t 100 percent right the first time, and I’m almost certainly not 100 percent right now. We have to remain open-minded or become obsolete.

  25. Mike says:


    I think another aspect of this is that potatoes aren’t loaded with fructose. If you eat whole foods, your fructose load will be pretty low unless you gorge of fruit. Loading up on fruit juice, honey, and maple syrup, are pretty much the same as eating table sugar or high fructose corn syrup. Dr. Lustig suggests that many cultures ate a fair amount of carb without bad effects until they started using refined sugar.

    I also suspect that you intervened in your diet relatively early and tolerate starchy carbs better than many of us.

  26. Linda Riddle says:

    Very interesting post and I can see that my reading list is getting longer by the day. And very nice to have you back, Tom!

    After having been mostly housebound for almost two years caring for an ill father, I have just recently decided to venture outside to restaurants. It never occurred to me how risky it could be. I took a friend (new to LCHF) to a popular seafood restaurant. They advertise friendly to low carbers. One of the things on the menu is a seafood dish of shrimp, fish and scallops with a coconut flour batter (didn’t seem low carb to me, but friendly to those of us who really can’t eat wheat.) I decided to throw low-carb out and order this along with baked potato. The potato came with little tubs of “buttery spread” and low-fat sour cream! AND after so long a time of using only bacon fat, lard, coconut oil and olive oil, I could tell immediately that that seafood had been fried in some crappy oil! Ended up picking breading off as much as possible and spending the rest of the day feeling bloated and just not “right.” I think I have to stick with grilled or broiled- the days of any restaurant using something other than crappy oils is probably not in my lifetime! Tom, next time, I’ll follow your cue and take a little tub of real butter! Maybe even sour cream- seems to me “low-fat” sour cream is an oxymoron!

    • Tom Naughton says:

      Chareva and I both noticed that after switching to nothing but real fats at home (butter, lard, bacon grease, olive oil, coconut oil) we can taste the rancid industrial oils in food right away.

  27. Bob Niland says:

    re: I average more carbs per day now than I did a few years ago, but haven’t gotten any fatter. … 2) reduce the carbs to a level appropriate for your metabolism.

    Other than the scale, what measures of health do you rely on?

    Some that might be considered…

    BG (blood glucose) is easily measured at home, and the postprandial curve is informative (as is the fasting number). People need to decide what FBG is ideal for them, and what PPBG bump (if any rise at all) is acceptable. Without proposing any numbers, let me just say that consensus targets are too high.

    HbA1c is another that can be run at home (but rarely is). The chart of all-cause mortality vs. A1c is informative (Ivor Cummins, TheFatEmporer, dug one up). People need to decide where they want to be on that, and need to be aware that individual variations in RBC (red blood cell) lifespans can bias the number (so it needs to be reconciled with TG or some BG history). Consensus targets for HbA1c are also too high (the ADA’s keep diabetics diabetic).

    TG (triglycerides) can also be measured at home, but again rarely are (and are informative both as a fasting number and as a postprandial curve out about 6 hours). People need to pick a target for fasting TG at least. They also need to know that consensus medicine lately decided that the lipid panel no longer needs to be done fasting, which seriously screws up TG, one of the two numbers on it that are actually useful. Consensus targets for TG are too high.

    LDL-P numbers (not the fictional LDL-C) are also telling, and this you can’t do at home, and usually have to battle to get your MD to order it. Familial factors can influence responses tremendously. According to a prominent cardiologist we both know, a single indulgence can elevate small LDL-P particle count for a week; and 2 weeks in those with Apo E2 or Lp(a). Almost no one knows what their LDL-P is doing on a routine basis. TG or HbA1c might be a more accessible proxy.

    The bottom line on LDL-P might be a CAC score or cardiac CT scan, which are also not-at-home tests almost never run. No score usually means: what you’re doing is just fine.

    3-Hour Insulin Assay is also quite revealing, and again, almost never done.

    All of which is to get around to that carbs aren’t just about adiposity. There are also serious implications for cardiovascular disease (not to mention cancer), even if you are keeping the scale happy. There are potentially substantial idiosyncratic variations.

    Your point about inflammation is also important. Carbs can provoke it. Adverse fats can also provoke it (a big problem being Omega 6 linoleic acid, pervasive in modern food-like substances and prominently featured in the “vegetable oils” of official deadly diets). A useful test here might be hs-CRP (high sensitivity C-Reactive Protein).

    ω6LA may be an under-appreciated problem in modern diet, and, alas, it’s going to be in almost every dish at most Mexican restaurants. They need to return to using lard.

    • Tom Naughton says:

      I didn’t know that many factors could be tested at home. I check my BG now and then.

      I doubt eating enough starch to provide your body with biologically necessary glucose is any more harmful than forcing your body to provide that glucose by converting protein. In fact, just eating the stuff seems to be less likely to raise cortisol and slow the thyroid. I think Paul Jaminet got it right: eat the glucose you need (because you do need it) and then let fat be your primary fuel.

  28. Nads says:

    I think it is mainly the fructose that is the problem causing insulin resistance and appetite control problems.

    • Tom Naughton says:

      That’s what Dr. Lustig believes, although he’s open to the idea that insulin resistance could have multiple causes.

  29. Jeanne says:

    I go with what works for me: One large meal a day at noon, a small dinner, if at all, and very low carb. I’m guided by my weight and my blood glucose.
    I admit there is a tremendous variation in what works for people, though.

  30. Julie says:

    Ever since I first watched Fat Head back in 2012 (it’s only been four years!?), you’ve continued to open my eyes and change my thinking! I want to thank you for always being honest and keeping an open mind about science, and helping to spread what you find out to others. That’s why you’re my favorite nutrition blogger; you’re not afraid to challenge the status quo, even if it’s low carb.

    I went back to a pretty low carb diet about two months ago. I’d put on some weight recently and thought I could take it off if I cut my carbs down. I had a plan to do a carb meal once a week to keep my metabolism from getting low. But once I started losing weight in ketosis, I got afraid that if I added those carbs back in, I’d hurt my weight loss. Even though I had a strong belief (thanks to your blog) that it would actually help me to add a potato or two a week, I skipped it because the low carb forum I’d joined made me feel like it was all or nothing. I let the dogma win over my better judgement.

    So thanks for this timely post. It’s funny how low carb used to be for those crazy free-thinkers who didn’t follow the rules, and now it has its own set of beliefs that if you don’t stick to, people get furious with you! I see people shouting just as loud about the proper low carb diet as I see vegans shouting about how meat causes cancer.

    Keep writing, Tom. You’re helping a lot of people!

    • Tom Naughton says:

      I guess that’s the danger of becoming a fan of any diet: it’s easy to become dogmatic. I try to avoid that and go with what science and the Wisdom of Crowds tells us.

    • Firebird says:

      That actually happened to me on the Fat Head Facebook page a few years ago. One of the members was so etched in stone that she tried to take me to task because I stated that when all else fails, I will have chili at Wendy’s. I don’t eat fast food…very, very rare. There is nothing inside of me that tells me to pull into the McDonald’s that is three blocks from where I live. When it is all or nothing, I will have fast food.

      I found that of all the meals out here, a $1 serving of Wendy’s chili with a garden salad was a reasonable meal. The last one I had was three years ago. But this woman went on and on about how she would never, EVER put that stuff in her body.

      I disagreed.

      And lived to tell about it. 😉

    • Galina L. says:

      As a low-carber who follows mostly the way how I feel, than rules, I can tell that adding a potato after a week of low-carbing may feel truly awful. If you feel very convinced that you mast add carbs to your weight-loss diet, following Atkins plan for adding carbs could be the safest way. BTW, a weight loss itself after any diet slows metabolism down.

  31. Lori Miller says:

    I eat a bit more carb now (somewhere between Atkins and The Zone) because I get scary palpitations if I go very low carb.

    Have you seen this video? “If Meat Eaters Acted Like Vegans” by AwakenWithJP. Funny stuff!

  32. David says:

    I’d just like to say that it always impresses me how your willing to alter your way of life where ever science seems to lead you. You give up simpler explanations for more complex ones, while still keeping your basic premise. You revise your dietary beliefs based on science. I respect this.

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