My favorite part about writing columns is to see what kind of reaction people will have to what I’ve written. Nothing is more boring than the same old BLAH BLAH BLAH you read everywhere else, so I like to mix it up a bit every once in a while by writing about topics you may not elsewhere. And just because I write about a subject doesn’t necessarily mean I fully embrace it as a concept myself. Unfortunately, there are some people who think if I write about it, then it MUST be a part of my core beliefs.
The latest example is this blog post I wrote asking the question “Is A Zero-Carb Or Even A Low-Carb Diet Healthy For A Pregnant Woman?” It was merely a question of curiosity that was worthy of discussion within the context of what I write about on a daily basis. You’ll notice in that column that I took great pains to leave my personal opinion about zero-carb diets out of it and I simply reported what people like Dr. Barry Groves, Dr. James Carlson, and others had to say about the subject. It was a fascinating concept that hopefully got people to think. However, it did more than that.
As you can see from the more than 70-something comments left on my Examiner.com reprint of this column, this one really fired people up! And that’s fabulous because my job is to present information in an engaging manner so the brain juices will start to flow and a conversation about that particular topic will ensue. However, something rather odd happened as this particular column was being discussed–some made the leap of faith that because I wrote about zero-carb and pregnancy that I somehow believe this is healthy.
I’m not sure where this came from because never once did I ever express what I believe about zero-carb diets in that particular post. Sure, I’ve interviewed a zero-carb advocate this year to have him articulate his views about it, but does that mean I personally support such a nutritional approach? Well, I thought I made the answer to that question pretty clear in this previous column distinguishing the difference between “low-carb” and “no carb.” When you’ve written as much as I have, then I suppose some of these posts get lost in the shuffle and people miss them. It’s one of the reasons I link to previous posts so much to get people up to speed about what I’ve already blogged about.
What’s really funny is this newfound uproar over the zero-carb diet like it’s something new within the realm of discussion. It is not. These people who support zero-carb have been out there for YEARS touting this as their diet of choice and I first blogged about them in this May 2006 article. The “Zero Carb Path” as the supporters describe it is something that is completely relevant to talk about since oftentimes the low-carb lifestyle is interpreted by the media and so-called health “experts” as eating zero carbs. You and I both know that is simply untrue which is why there is a distinction between the kind of diet that Dr. Atkins promoted, for example, and this “meat and water only” diet.
Quite frankly, I’m surprised by the kind of hysteria that was unleashed following my column about being on zero-carb diet while pregnant the other day. I was merely asking a question that I’m sure was on the minds of other people, too, and that’s really all I did–ask the question publicly. That doesn’t mean I endorsed one side or the other or expressed my opinions about it. I merely reported the story and let people come to whatever conclusions they wanted about it.
With that said, because there have been some misconceptions about where I stand on zero-carb diets, let me be crystal clear today. I do NOT support a long-term zero-carb diet for health or weight loss. My personal belief is that you cannot possibly get all the nutrients your body needs eating meat that you purchase from your local grocery store. There are great advantages to adding nutrient-dense foods like eggs, nuts, green leafy veggies, berries, and more that people who follow a zero-carb diet are missing out on. Plus, there’s the sustainability factor. Can you live a completely carb-free diet for the rest of your life? If people think low-carb is “restrictive,” then think about how bad a zero-carb diet would be to follow forever and ever amen. YIKES! Not me and I wouldn’t recommend it as a preferred method for weight or health management.
So, for the record, let me repeat: I do NOT support a long-term zero-carb diet for health or weight loss. Any questions?
But it’s not just me who disagrees with zero-carb. I went out into the low-carb community to get a sampling of familiar names to express their thoughts and reactions to what some would describe as a rather extreme version of the healthy low-carb lifestyle that so many of us enjoy. You’ll notice many of the responses explain that a zero-carb diet in modern society is vastly different from what a zero-carb diet from primitive groups like the Inuit consumed and that there really is no such thing as a truly carbohydrate-free diet.
The simple question I asked them was this: “Is a zero-carb diet healthy or not?”
Here’s what they told me:
DR. JONNY BOWDEN
“I think it’s a pretty theoretical question. Even the Inuit living on walrus blubber and seal meat probably got some carbohydrates in their diet, and even a lion living on zebras and hyenas gets some carbs (in the entrails of their prey, who themselves graze on grass). But as a practical matter, I think its not very advisable. There’s too much evidence for the health properties of the plant phenols, polyphenols, flavonoids, vitamins, minerals and fiber found in abundance in vegetables and fruit.
I know there are people who seem to do pretty darn well with minimum amounts of these foods, but I suspect they are genetically or metabolically adapted to these diets more than the rest of us. Personally, I wouldn’t choose a no-carb diet, though I wouldn’t doubt that you could survive on one (which you, by the way, could not do on a zero-fat or zero-protein diet!). I think the good stuff in vegetables and low-sugar fruit is just too good to leave off the menu, and I think you can get all the benefits of low-sugar eating and still include plenty of vegetables and berries.”
KENT ALTENA (BOWULF)
“I actually made a YouTube video on this topic recently and here is a summary of the video: ‘I am pretty convinced that for most people going zero carb is an unnecessary step. Sure there are some very metabolically resistant and/or people suffering with hyperinsulinemia. For the most part, most people should be getting their veggies in and not fearing adding back a reasonable amount of carbs. Trying to discover what the magic number per day can certainly be trying, but your health will appreciate it. Thinking zero carbs is the answer also misses number of things: phytonutrients without getting more chemicals, fiber-rich vegetables, and carbs present in other non-veggie sources, like nuts, eggs, or cheese. Unless you are really hyper sensitive to carbs, enjoy the variety of nature and food selection.’
I think eating zero carb CAN be healthy, but it requires a level of vigilance and dedication to get adequate levels of nutrients that a standard low carber does not have to be as concerned. The meat and other items they eat can have the vitamins within the fat they eat like the Inuit used to get from blubber and organ meats. More than likely though modern zero carbers will need to be vigilant to supplement their diet with other items. Therefore, I would only recommend the diet to only those who are really metabolically resistant. I think you can see that in Dr. Atkins’ reticence in promoting the fat fast.”
JUDY BARNES BAKER
“It should be possible to live entirely without plant foods, since many of our ancestors did and some societies that exist today still do, but that is not the same as living on a diet of nothing but muscle meat from domesticated animals. The Arctic explorer, Vilhjalmur Stefansson, proved in the early 1900s that you could be healthy on a diet of meat, fat, and water. He and a companion had themselves locked into a hospital ward and were fed a diet that consisted of 80% fat and 20% animal protein for one year and suffered no ill effects. However, he believed that you needed to eat some of the meat raw (or at least rare) and include organ meats. He pointed out that during his time living with the Inuit, he had eaten whole fish, including the bones, organs, tails, and heads.
Also, some non-plant foods do have carbs, oysters, scallops, liver, and eggs, for example, so a diet without plants is not necessarily a zero-carb diet. Does this mean some carbs are necessary? Probably not, but some variety might be. I think we all agree that the starch and sugar in plants are not essential for humans. The argument that there are other necessary elements in fruits, vegetables, and grains was refuted by Gary Taubes in Good Calories, Bad Calories. He said that it is the anti-nutrients in grains that cause us to need additional vitamins and minerals.
So, I guess my answer to your question would be that, in my opinion, you could live without plants and be healthy, pregnant or not, IF you had access to a wide variety of fresh, natural, unprocessed meat and fat, fish, and crustaceans and good, clean, mineral-rich water, all hard to come by where I live. Otherwise, including a few berries, nuts, and green vegetables might be prudent.”
LAURA DOLSON
“Zero-carb is not a good idea, and in fact is almost impossible for very long, as the number of foods that contain no carbohydrate at all is quite small. I’ve spent quite a lot of time designing low-carb menus that have all the essential nutrients in them. Although it is possible at 20 grams of net carbs, it is not at all easy. Just adding 10 or 15 more grams makes it much more attainable. If you want to make it easy, go to 40-50 grams per day, which means you can also get a wider variety of phytonutrients as well. I realize that there are some people who are extremely sensitive to carbohydrate and cannot tolerate this much, but in my experience most people can, especially if most of the carbohydrate comes from non-starchy vegetables. (For example, spinach and other greens have carbs, but they are so wrapped up in fiber that most people will not experience a blood glucose impact at normal amounts.) To eat zero carbs is to seriously restrict the range of nutrients you can eat, and not a good idea.”
DR. MARY C. VERNON
“First, of course, nothing I say should be taken as medical advice for any one person. That is a complex matter and requires individual consultation. That said, I believe there is quite a bit of historical information regarding very low carb diets. Meat has some glycogen, so even it is not completely zero carb. The Inuit were able to prosper in extremely tough climatic conditions eating very low carb diets. They were able to have children and breast feed them.
However, their zero carb diet might not translate to the Western world, because they ate things that are not favorite items in our culture and they ate at least some of these things without cooking them. So, we have historical information that this very low carb diet can be done, if done in the way the Inuit developed and practiced it. The European explorers who followed the Inuit example did fine. Those explorers who did not follow the Inuit way but ate as they were accustomed were not as successful.
The person who has studied this in great detail is Dr. Steve Phinney. I learned most of what I know about this from him.”
DR. JEFF VOLEK
“With normal foods it would be very difficult to achieve zero carbs. Even meat, eggs, cheese have some albeit few carbs. Sure you could survive, gluconeogenesis is more than adequate to maintain obligatory glucose needs. Although I’m a hardcore omnivore, meat at every meal with absolutely no other nutrition sounds incredibly monotonous and I suspect not optimal for health.”
DR. RICHARD FEINMAN
“This question is actually of some interest because, as you write, people get the idea that, because there is no biological requirement for dietary carbohydrate, zero carbohydrate diets are recommended. In fact, I don’t know anybody who recommends a zero carbohydrate diet but the question points up some of the confusion in the whole field. What you really want to know about a diet is the immediate effect on the plasma distribution of macronutrients. So a zero carbohydrate diet, of course, does not mean zero glucose in the blood.
Obviously, in the absence of diseases, you can survive for a long time with zero carbohydrate. That’s what you do when you’re starving. As far as we know, most of the undesirable effects of starvation reside in the absence of protein, total amount and availability of essential amino acids and, to a lesser extent, essential fatty acids. The other side of the coin is high and low fat where, if carbohydrate is low a high fat diet may have lower total fat in the plasma than a low-fat. The point is the limitations of ‘you are what you eat’ and it is not obvious, in terms of blood glucose that zero carbs is so different from low carbs. In general, more information is needed than the level of one nutrient to predict the effect of a diet.
A side issue is that it is probably impossible to get a zero-carb diet with normal food. Even meat has some carbohydrate in glycogen and cell material. When you brown meat in frying, the brown part is a reaction between the carbohydrate and protein in the meat. The browning reaction is called the Maillard reaction and is chemically similar to the reaction of glucose with proteins, under conditions where there is high blood glucose, to produce so-called advanced glycation products (AGEs), the best known of which is hemoglobin A1c.”
GARY TAUBES
“It does seem a bit extreme going to consume meat and water only, and as Dr. Carlson points out, muscle meat might not be sufficient to provide all the vitamins needed, if that’s all that’s being consumed. So, yes, why limit it to store bought meat and nothing else, other than to set up a hypothetical situation for discussion? Finally, one minor point: even a diet of meat and water is not zero carb. There will be a few percent carbohydrates from glycogen stored in the muscle.”
JACKIE EBERSTEIN
“There were only two circumstances when Dr. Atkins used a diet below 20 grams of carbs. One was the fat fast for limited periods used while attempting to break a plateau. The other was 0 carbs for 3 days before a patient visited the office to measure ketones on our breathe analyzer. The purpose was to determine how ketone-resistant a person was. In both of these circumstances patients were following their supplement program to avoid a lack of nutrients.
Dr. Atkins did not believe there was any benefit to less than 20 grams. Since he considered the program a permanent lifestyle the idea of avoiding all vegetables and the other foods that make up the 20 grams on Induction simply does not make sense in the long run. He wanted the plan to have as much variety, palatability, texture and phytonutrient content as possible and still get the job done.
It is vitally important to remember that weight, blood sugar and insulin balance as well as the nutrient intake of a woman in the months before pregnancy has an impact on the baby. I discussed some of this in this column I wrote. There is no reason why a pregnant woman can’t have a healthy and successful pregnancy as our patients did with an individualized low carb plan under appropriate supervision.”
MARK SISSON
“Interesting question. Lots of variables to consider. As you know, I am not of the zero carb camp. I am a low-carbber. My optimum maintenance range is 100-150 grams a day. My weight loss recommended range is 50-100 and my ‘aggressive, short-term, hit the weight-loss hard’ range is under 50. It’s almost impossible to be zero carb if you are eating healthy fats (including nuts, seeds) and all manner of animal flesh. It’s clear that we CAN live without directly eating carbs.
The question is whether a pregnant woman raised her whole prior life on carbs can gestate a healthy baby without any. I wouldn’t recommend it (not that it can’t be done) given the types of protein/fat-only foods normally available. Veggies need to be included at some level to provide vitamins and minerals that can’t all be obtained from 99% of availble protein sources. Even Inuit eat plants in summer and animal stomach-contents otherwise.
While gestational diabetes is a possible problem at typical carb intakes, I don’t think it’s an issue in an exercising mother at 150g/day. My main goal in suggesting that some carbs are advisable would be simply to promote insulin sensitivity during development. The idea is that unless the child were to continue on with a life of zero carb, it might be less-than-optimum to set him up that way (that’s just intuitively).”
FRED HAHN
“We know that a low carb diet is healthful. Study after study and client after client has shown that this is so. Jimmy brings up a good question–can a ZERO carb diet be healthy or does it lack essential nutrients for ‘optimal’ human health? Well we know what Dean Ornish, Gary Null and others of their ilk would say. They’d say you’d be dead in a year from heart disease. Of course the Inuit peoples would prove this wrong. And you can’t say ‘Waitaminnut! The Eskimos had generations to adapt to this kind of diet.’ Why? When the British arctic explorers (Amundsen and crew) in the early part of the previous century ate what the Inuit ate for years they experienced robust health. Only when they switched back to eating to their local fare upon return to England did their health begin to suffer. So we know that going Eskimo does not kill us and can in fact improve our health.
But will going really low-carb to the point of zero carbs make us loco? Will it rob us of essential nutrients? The answer is tricky and it depends. If we are eating organ meats, bone marrow, etc. along with the rest of the common cuts of an animal there are few micronutrients we are not getting. But we usually don’t. So getting some of the micronutirents like vitamin C from a orange or green peppers might be a wise idea. Personally I eat an extremely low carb diet and enjoy robust health.”
NINA PLANCK
“Interesting debate. I don’t see the merits of zero-carb for pregnant women in part because steady blood sugar is so important and carbohydrates can be part of that. There are times when pregnant women will not be in the mood for protein, fat, and salt–vital as these nutrients are. Nothing wrong with a peach or a sweet potato because there’s a lot of good in them. But the ideal quantity of white flour and white sugar is undoubtedly zero, so if you can curb your addiction to carbage your baby will be much better off, and so will you.”
DR. NATHAN ELIASON
“It is probably just fine to have the mild ketosis associated with a very low carbohydrate diet during pregnancy. As you are aware, you can have a fairly low carbohydrate diet in which you are not in ketosis which almost surely is fine during pregnancy. On the other hand, a high carbohydrate diet likely will lead to complications which we see more and more frequently (macrosomia, neonatal hypoglycemia, gestational diabetes). The complications of having a baby which is too large are very real. However, we will surely never know for sure if a ketotic low carbohydrate diet is safe, and probably never know if a relatively low carbohydrate diet is safe because of the very real legal risk that obstetricians run. Unfortunately, it is far safer for them to recommend the ‘standard’ high-carb, low-fat diet than to allow for anything outside of the standard.”
DANA CARPENDER
“Is a zero-carb diet healthy? For what values of ‘healthy?’ We have reason to believe that the Inuit (Eskimo) lived on a nearly carb-free diet during the winter, and they apparently didn’t suffer scurvy or other nutritional deficiency diseases. This is evidence that given the proper balance of animal foods, carbohydrate foods are inessential. On the other hand, the Inuit were eating a VERY different diet from your modern low carber. They ate game and wild-caught fish, not animal foods from domesticated animals that had been raised on a commercial diet. They ate a diet so high in fat many of us would find it unappealing. They ate parts of the animal many modern Americans won’t touch–liver, brains, kidneys, marrow, all of the organ meats (some of which, I might add, do contain a bit of carbs–liver especially.) And they ate much of their meat, fish, and blubber raw–and aged it well first. It is impossible to extrapolate from the effects of such a diet that a diet consisting solely of the animal foods available in your local grocery store, and familiar to modern American palates, is healthful, much less ideal.” (Read more of Dana’s thoughts on this subject by clicking here)
As you can see from just this cross-section of the low-carb universe, most of us are very skeptical that anyone trying to follow a zero-carb diet in modern-day life is probably missing out on key nutrients in their diet because zero-carb today isn’t the same as it was thousands of years ago. With that said and in light of what I’ve written about here today, I have an announcement to make. If you are a regular reader of my “Livin’ La Vida Low-Carb Discussion” forum, then this may affect you so listen up!
Effective Friday, October 31, 2008, we will no longer be discussing, mentioning, or allowing the subject of zero-carb diets to appear on the forum. On that date, all current threads and posts that talk about zero-carb will be permanently removed and deleted. This includes not just the “Meat And Water Only” thread and other associated zero-carb threads that have been created. It also will impact any personal journals or other areas of the forum where “zero-carb” is mentioned.
The original purpose of my forum was for a place to talk about “low-carb” living and how it can positively impact your weight and health. Unfortunately, what has happened is the zero-carb message has become so dominant there that you can’t tell that we actually talk about low-carb diets, too. So with this decision to remove the content by the end of the month, that will take care of the issue and return the forum back to the low-carb focus that I wanted it to be. If you have questions about Atkins, Protein Power, or any of the other established low-carb diets and want to talk about them, then this is the forum for you.
So what about the zero-carb followers? Am I gonna leave them high and dry to go elsewhere. The answer is no. I’ve discussed this issue at length with my zero-carb moderator Charles Washington and he has agreed to start his own forum dedicated specifically to the zero-carb lifestyle for anyone who chooses to follow that path themselves. Charles is working on building this forum as we speak and will begin moving the relevant content from the current forum to the new zero-carb forum over the next few weeks. We’ll let you know when the site is ready for people to sign up there and that will be announced soon. Charles is dedicated to continuing what he started at my forum at his very own zero-carb forum.
Let me publicly thank everyone who has expressed their support for the work I am doing here at my blog and forum because your encouragement is always like a cool glass of water on a hot summer day to me. There will always be people who will express hate and anger me for one reason or another–although I have never fully understood that since I’m merely trying to encourage, educate, and inspire others to live healthy with all that I do. The fact that you come here often tells me you indeed care about yourself enough to learn, be stimulated by conversations, and hopefully becoming that healthy person you were always meant to be. THANK YOU for all you are doing to spread the positive message of livin’ la vida low-carb.
