Comparing low-carb lifestyles
November 22, 2010 7:31 PM   Subscribe

What's the degree of difference, for fat loss or general health, between ketosis and being, say, 10g of carbs above your ketosis threshold? Trying to make sense of ketogenic diets, non-ketogenic low carb diets, paleo, and carb cycling of all types. Any and all related resources appreciated, especially unbiased scholarly research or personal experience.

Also, what personal factors make a person better suited for one option over another, aside from psychological stuff like motivation or compliance?
posted by acidic to Health & Fitness (10 answers total) 28 users marked this as a favorite
Whether you're strictly in ketosis or not, most people will see best results in terms of fat loss/leaning out if they stay under 100g per day (typically less than 50g is ketosis territory). The results tend to be faster in real ketosis, but the side effects are also more pronounced.

Personally, if I were significantly overweight, I would do a ketogenic diet. However, if you're looking for something for long term health or you just want to lean out a little, I'd stay in the 50-100g/day sweet spot. I'm not entirely convinced that ketosis forever is the best thing for the human body, but I think the evidence is there for a "fat adapted", low-ish carb diet. Check out Robb Wolf for harder science on this.
posted by telegraph at 7:48 PM on November 22, 2010

Many paleo-fans see it as a low-carb diet, but it's not necessarily so.

Plenty of cultures around the world consume a lot of carbs, but do just fine in terms of health. A survey by Loren Cordain over various hunter-gatherer populations estimated that on average, HGs consume roughly equal amounts of carbs, protein, and fat - with slightly more carbs and less protein.

It seems that people who want to lose weight quicker or have glucose intolerance/diabetes will do better with a low-carb diet, but beyond that it is largely personal preference and your individual body's response. Just eliminate vegetable oils, refined sugar, and gluten grains and you should do well. The body can be trusted on food choices, as long as you don't give it things that we aren't adapted to!
posted by Earl the Polliwog at 8:25 PM on November 22, 2010

I'm not entirely convinced that ketosis forever is the best thing for the human body,

I think the trouble would be that ketosis is a razor's edge thing. Once you get down to a fairly low bodyfat, you would have to rely completely on consumed food to fuel your body. If that runs out, or you just have a bad day, you have zero reserves and the body starts to go into ketoacidosis, literally consuming itself from the inside.

Re: hunter gatherer diet and carbs. Science has shown that being in slight calorie deficit extends life. Presumably, through better health. Those societies never really have an excess of food. So it matters less. I think the problem is that if the body is going to be fed excess calories over a long period of time, excess carbs is the least healthful.
posted by gjc at 8:38 PM on November 22, 2010

It was my impression that most members of hunter-gatherer societies only work at finding food about 10-20 hours per week, which would give the impression that food is not all that scarce on the whole.

Intermittent fasting gives much of the longevity benefits of caloric restriction in rats, but I do not believe that either has been shown to have much of an effect in humans.
posted by Earl the Polliwog at 9:25 PM on November 22, 2010

I have a long history of health problems that have been almost entirely resolved via a low-carb diet. I'm not a doctor or a scientist, but here's how I would answer your question:

what personal factors make a person better suited for one option over another, aside from psychological stuff like motivation or compliance?

It's my opinion that genetics play a large role in determining what type of diet suits one best. Are your ancestors from an agrarian culture? Or a nomadic one? A good chunk of my ethnic background is from the Caucasus Mountains, where agriculture is pretty limited - traditionally people ate lamb (or pork, for cultures that didn't prohibit it) and lamb's milk products with a few veggies or berries as seasonally available. There weren't a lot of grain products available there until recently. Years ago a study was done, The Long-Living of Soviet Georgia, that addressed the paradox of these people surviving mainly on meat products and saturated fat but living long, healthy lives (at the time, one of the highest life expectancies worldwide).

With the introduction of American-style fast food and convenience products, the ethnic Georgian age of mortality has dropped. Heart disease and Type 2 diabetes are now common. In my case, after a good period of following the low-fat, high carb dogma prevalent in the 1980s, I became diabetic and developed hypertension and high cholesterol. A shift to a low-carb way of eating - after learning I had food intolerances to dairy, grains, and fructose - reversed all of that.

As far as knowing whether a particular low-carb, paleo, or ketogenic diet works for you - it's all about experimentation. Following something like Atkins is an easy way to start, because everything is broken down into lists and tips for navigating the real world. Low-carb non-paleo foods and convenience foods are sometimes included. If you're averse to processed foods of all kinds - I am - then you may lean more toward paleo/primal. As mentioned above, paleo might allow some high carb foods - tapioca starch and yams are a couple that come to mind - for people who have a higher carb threshold, but even so, most paleo foods are low-carb when compared to the standard American diet.

As for resources - if you aren't already reading Mark's Daily Apple, and Hold the Toast, start now. Both sites have a ton of useful links that you can get lost in for days.
posted by chez shoes at 11:33 PM on November 22, 2010

Great posts so far. Still interested in carb cycling. I have been contemplating alternating a ketogenic diet with a more reasonable diet (including rice, millet, and fruit but no gluten and very little sugar) that's a low calorie version of a realistic maintenance diet. Something like 3 weeks ketogenic, 2 weeks normal. Thoughts?
posted by acidic at 1:31 AM on November 23, 2010

Look, the 10g of carbs or whatever is just a rule of thumb. Different people will enter ketogenesis at different levels. Some people enter it at less than 100g of carbs, others eat an apple and they pop out. If you're eating low-carb (like 10-15% of your calories are less are coming from carbs) you're likely going to lose weight whether or not your Ketostix are purple. Rate of weight loss in relation to carb intake is also highly-dependent on insulin sensitivity. The more overweight you are and the higher your body fat percentage, the more likely carbs are to affect you badly. If you are very active (as in hard physical training over four times a week) you also get more leeway in your carb intake.

Nobody can give you your perfect diet plan. You have to experiment with carb and calorie levels as well as types of food you intake to find something that gives you a reasonable rate of weight loss and you can maintain for a long period of time. The best idea is to take a generic base plan, run with it for a couple of weeks, and see how it works for you. If it does, great, go with it. If it doesn't, switch it up. If you're stalling and can't figure out why then you can start getting nit-picky--and that way you can also tell people what you've been doing up to that point so they can give you ideas on what to change.

In my opinion, I'd cut the "normal" eating to a week, and if you're very overweight cut it out entirely. But like I said, you've got to try things and see what works for you.
posted by schroedinger at 6:47 AM on November 23, 2010

I started eating paleo a number of months ago. I was very overweight and I have health issues. I've followed Robb Wolf to some extent, but I did my first kick at this through Whole 30 (I did version 2). I found it difficult for the first couple of weeks (although I was eliminating caffeine and alcohol as well). My concern with your idea of cycling, is that you'd never get past the tough parts because you'd be adding back in the carbs. This is purely anecdotal speculation, however. If you try it and you don't get past the cravings and feelings of deprivation while cycling, then you might try cutting it out completely to see if that changes.

Generally, my thoughts are that you should try them out and see what feels good. The Whole 30 approach is about going strict paleo for 30 days. Going on paleo (with no food amount restrictions) for me has really changed my life. My medical issues have improved drastically, I have more energy, I feel good, and I've lost around 60 lbs. (with light activity only). I don't see any advantages for me at this time to changing the way I eat now.
posted by kch at 8:42 AM on November 23, 2010 [1 favorite]

My concern with your idea of cycling, is that you'd never get past the tough parts because you'd be adding back in the carbs.

Seconding this. I think it would be much easier to just follow a moderate (non-ketogenic) low-carb diet without calorie restrictions. I've done this for the last year and am extremely happy with the results. The body undergoes a radical change when you switch from high-carb to low-carb. I used to crave carbs and was hungry literally all. the. time. I had a very "healthy" and varied diet - I cooked almost everything myself from fresh ingredients-, but it was also very high in carbs. I had issues with blood sugar and hormones, couldn't sleep, had mood swings, and was low in energy. 3 weeks after the switch (which was unpleasant!), I was done with carbs. I do not even like the taste of chocolate anymore. Rice, bread, fries taste like cardboard. I've done moderate low carb for one year now and have no desire to increase my carbs. I am happy and healthy, I love the food I eat (I started loving fruit and vegetables! I crave brussel sprouts now - imagine that!). I'm rarely hungry. I don't have to restrict or control anything, I just stay away form grains, sugar and potatoes. That's it, no counting or measuring. I think if I would do cycling, I'd have to deal with cravings for 2 weeks out of 4. Why on earth would I do that??? What's "reasonable" about eating grains? My body doesn't need them!

Cycling also sounds like a pain in the ass for social/logistical purposes (e.g. it is easy to explain to friends that no, you don't eat carbs at all, and they get used to it and are not cross with you if you refuse to try their homemade bagels. But if you say "Well, I can eat them next week but not this week" they will think you're a nutjob.) This may seem like an irrelevant point, but the acceptance of your social environment is a crucial factor for sticking with your diet in the long term. Could you do a high-maintenance diet like "carb cycling" if you had a live-in partner/young children/while traveling/when you're in the hospital? I know I couldn't...

You ask for personal factors - the one I can think of is exercise. If you do strenuous exercise, it will be hard (in my experience) to do a ketogenic or very low carb diet. You'd do better on a moderate low-carb regime. I can't even begin to imagine how I would do exercise on a carb cycling regime - I assume I'd have wild swings in my fitness level from week to week, as the body would never adjust to an even level of carb intake. I'd be afraid of very low blood sugar levels. But maybe I'm wrong.

Concerning weight loss: I wasn't even that interested in weight loss because I wasn't overweight, but still went from a size 8 to a size 2 within 9 months. I never did a "real" (very strict) induction phase. I think I only went into ketosis for very short amounts of time, by accident, so to speak. In retrospect, the switching process might have been easier if I had gone into ketosis for one or two weeks and followed one of the "programs" out there. But I wouldn't consider doing ketosis for anything but induction. Once you're over the hump, it's not necessary anymore.

All in all:
- Pick a diet that you can imagine sticking with for the rest of your life. Moderate Low Carb is just that.
- IMHO, diets that require calorie counting/restrictions are pure torture and do not work. If you still have cravings, reduce your carbs. And from time to time, eating like a pig is perfectly OK and healthy ;)
- everything else (Atkins, Paleo, South Beach...) is a matter of personal preference and your body's setup. Some people don't do well with dairy products, others feel bad after eating meat - try to find out what makes you feel good.
posted by The Toad at 10:21 AM on November 23, 2010 [2 favorites]

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