Optimizing Carbohydrate Intake for Your Body-Part 1 of 3

July 17, 2012 in Categories: by

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I am devoting this week of posts to an important topic that I talked about with Jimmy Moore on his Livin’ La Vida Low Carb Showpodcast, specifically the very individual nature of carbohydrate requirements.  I want to use the written medium of my blog posts as an opportunity to expand on this topic in a more succinct fashion, and to open a discussion with you should you have any questions.  When Jimmy asked me what I thought about safe starches and ketogenic diets (two extremes of paleo diet carbohydrate consumption), I answered that I believe there is a fairly large variability from person to person on how many carbohydrates (and what types) each person needs for optimal health.  I encourage self-experimentation to determine what carbohydrate range is optimal for each individual.

Carbohydrate consumption recommendations vary from eating as much non-starchy vegetables and fruit as you want (The Paleo Answer) to eating almost no fruit but consuming lots of “safe starches” (Perfect Health Diet, Mat Lalonde, Chris Kresser) to limiting both fruit and starchy vegetables and sticking fairly low-carbohydrate (The Paleo Solution, It Starts With Food).  One of the reasons why people come to such different conclusions as to how many carbohydrates should be included in our diet is because historically studied hunter-gatherer populations consumed dramatically variable macronutrient ratios from the Eskimos, whose diet consisted of approximately 90% animal protein and fat and only 10% carbohydrates, to the other extreme of the Kitavans, whose diet contained only about 10% protein but 70% carbohydrates, mainly from starchy tubers.  Just about everything in between exists, although 10-30% of calories from carbohydrates seems like a fairly common occurrence in hunter-gatherer populations (see analysis in Perfect Health Diet, this post by Drs. Jaminet and the referenced paper 1).  Okinawans, who are currently the longest-lived humans, consume about 50% of their diet as carbohydrates, typically from starchy tubers (and eat lots of fish and pastured pork) 2The takeaway message here is that humans can adapt to a wide range of carbohydrate intake if they are avoiding foods that cause inflammation and irritate the gut and if they are eating a balanced omega-3 to omega-6 fatty acid ratio.

I love low-carb diets for weight loss (it’s been absolutely essential for my own weight loss).  I lost most of my weight while consuming between 30g and 50g of carbohydrates per day.  However, I find that I need more carbohydrates these days (somewhere between 75g and 100g per day works well for me).  If my carbohydrates dip too low, my cortisol increases too high and I start to gain weight and have trouble sleeping.  Chris Kresser reports (here) that some of his patients who have come to him on low or zero carbohydrate diets experience increased weight loss when they increase their carbohydrates a little.  This seems to have been true for me, although 100g of carbohydrates per day is still quite low, especially compared to the typical carbohydrate consumption of the Standard American Diet which is in excess of 300g per day.  Many people thrive on low to moderate carbohydrate diets as a maintenance diet (anywhere from 50g per day to 150g per day).  On the other end of the spectrum, some other people thrive on ketogenic diets (very low carbohydrate and moderate protein) and these diets can be extremely powerful in addressing some specific health conditions (more on this in a future post) and for propelling weight loss.  You’ve probably noticed a contradiction here already.  Some people find ketogenic diets propel their weight loss while others find that ketogenic diets stall their weight loss.  The difference is likely due to regulation of a variety of hormones, but probably most importantly, cortisol management.  Ketogenic and very low carbohydrate diets necessarily increase cortisol expression in order to create glucose for the few cells in the body that cannot run on ketone bodies.  In the absence of adequate sleep, adequate stress management, adequate sun exposure, and any other factors that may affect cortisol management, ketosis can lead to complete derailment of cortisol expression.  I believe that cortisol management (because my kids still get me up several times per night most nights) is why my body is doing better on more carbohydrates these days (I also think it’s why my body refuses to lose the last 10 pounds that I want to lose).  Independent of cortisol issues, there are also other people who simply need more carbohydrates (kids, endurance sport enthusiasts, athletes, older people).  What type of carbohydrates you consume is fairly individual as well (if you have SIBO, you’ll want to avoid starchy veggies; if you have a history of metabolic derangement, you’ll want to be mindful of your fructose intake; if you’re an athlete you’ll want to consume more starchy vegetables).

So, how exactly do you figure out what is the best carbohydrate intake for your body?  The easiest way is to try a few different levels of carbohydrate consumption as well as types of carbohydrate (non-starchy vegetables versus starchy vegetables versus fruit) and time of day of carbohydrate consumption.  See how you feel.  Change and see if you feel better or worse.  Change again and see how you feel.  Go back to the first carbohydrate level and see if it’s how you remembered it.  (I am assuming here that you are relatively healthy.  If you are dealing with disease, then I think figuring out what foods you need to eat to heal is more important than figuring out your optimal level of carbohydrates.)  It may take several months to narrow in on your perfect carbohydrate intake range.  And if you are challenged with certain health issues or are actively losing weight, it might be a moving target.  I suggest keeping written records of what you are trying, how you feel, and anything else you might think is relevant.  In my next two posts I will provide details to guide you through this self-experimentation strategy for determining your optimal carbohydrate intake.  There are two questions to be answered here.  What level of carbohydrates does your body need to run optimally?  This might include anything from performance at the gym, sleeping well, losing weight efficiently, managing stress easily, having energy and feeling happy.  Then there’s the level of carbohydrates that your body tolerates.  How low can you go before you start to see adverse effects?  How high can you go before you start to see adverse effect? 

Note that I only suggest that you embark on this process of self-experimentation if you are fairly healthy (it’s okay if you have weight to lose), if you are not consuming gallons of coffee to get through your day, if you are sleeping at least fairly well, and if you can keep your food intake relatively consistent from day to day.  The goal is to figure out the range of carbohydrates that you can consume and be healthy.  Then as you practice eating your optimal level of carbohydrates, you can learn how to shape your meals so that you don’t have to count carbohydrates or really think about it anymore.  By the end of this process of self-experimentation, you should be able to intuitively eat the right number of carbohydrates for you!

 

1 Kaplan HS, Hill KR, Lancaster JB, Hurtado AM. A Theory of Human Life History Evolution: Diet, Intelligence, and Longevity. Evolutionary Anthropology 9:156-185, 2000.

2 Sho H. History and characteristics of Okinawan longevity food.  Asia Pac J Clin Nutr. 2001;10(2):159-64.

Comments

I like to think of ketosis as a large reset button. It can be very powerful for a variety of health issues (regulating hormones, correcting metabolic problems, etc.). However, there’s mixed information about the long term safety of ketogenic diets (and whether the short term benefits continue). I’m in the process of researching all of this to try and put together a comprehensive post (or two) on the pros and cons of ketosis. Also,I am enjoying seeing the increase in number of high level athletes that eat paleo and/or low carb. It’s a very powerful challenge to the conventional wisdom about exercise nutrition!

I’m curious about those of us that are naturally slim. I’m about to embark on the whole 30 but I’m a bit nervous as I hear so much about people losing a lot of weight on the paleo diet. I’m curious if I will just need more starchey vegetables?

Yes, probably you will want to consume more carbs (and more fat) whether from fruit or from starchy vegetables (although it might not be that much more than someone who wants to lose weight, depending on how active you are). The idea here is to find what works for you and your goals, not to just lose weight. :)

@Jay, if all other systems are in order, a diet appropriate to you will move you to your body’s healthiest fat/lean mass ratio, whether that’s higher, lower or the same as where you started.

Hello Sarah:

Thank you very much for writing your blog and sharing it with the world. My wife and I have just posted a blog entry on http://ketotic.org in which we take a quote from this blog entry of yours as an example of a common mistake. If you have time, please check it out and let us know what you think:

http://www.ketotic.org/2012/07/ketogenic-diets-and-stress-part-i.html

Thanks again for your contribution to the our collective understanding of nutrition and health by sharing your knowledge on your blog.

Regards,

Zooko

Sarah,
When you talk about carb levels, are you talking about net carbs or total carbs? There’s a big difference between the two.

Thanks!

Good question! I’m really taking about total carbs here, although it doesn’t make that much of a difference to this process as long as you pick one definition and stick with it. One of the things that I ask the self-experimenter to do is to choose how many servings of fruit and starchy vegetables they will have each day which will make the ratio of net carbs to total carbs fairly consistent and also gets me out of having to explain the difference. Plus, I find that net carbs can be very misleading the way it is used in so many low-carb prepackaged foods that tend to have lots of not very healthy ingredients.

I’m dealing with thyroid issues and a low/high mix of cortisol levels (low in the morning, very low and at noon, very high in the evening). Before I found out about either issue, I had gained 40 pounds within a year. (ugh!) I’m now on thyroid meds, and with supplementation of adaptogens (herbs) I’ve managed to start getting a decent night’s sleep. I’ve been dieting for nearly 3 weeks using Isagenix (protein shakes 2x day) and one moderate meal (heavy on the protein), and have lost 10 pounds. I have drastically cut back on carbs and am avoiding bread, pasta, sugar, starchy veg, and even gluten. However, I don’t want to cut back so much that I aggravate my cortisol levels further. I also would like to start waking up more easily and having better energy to get me through the workday. -I’m usually wide awake around 4-5 due to my cortisol being high. Would I perhaps be better off eating a few more carbs for breakfast & lunch?

I’m not familiar with isagenix, so I don’t know what protein is in it, how much and what kind of fat is in it, how many carbs, etc. so it’s hard to make a solid recommendation. I’m not a huge fan of liquid meals because it can mess with your digestive enzyme secretion and whatever carbs are in it are typically absorbed quite quickly compared to eating whole foods. Are you still sleeping better now that you’ve switched to this way of eating? If you think this is working for you for right now, you could give it another few weeks and see if your sleep improves. Otherwise, adding some veggies on the side of your shakes (or reverting to a protein and veggies meal three times per day with a little bit of fruit) is probably a good thing to try.

Several years ago I was diagnosed with high Reverse T3 and adrenal fatigue (along with fibromyalgia and chronic fatigue), and my (then) doctor prescribed bio identical hormones. I am currently taking T3 (50mcg) and Hydrocortisone (7.5 mg) (both sustained release).

April 1 of this year I began eating Paleo/sometimes Primal, and I have noticed improvements in my sleep quality and daytime energy levels. I have also lost pounds and inches to the point where I actually do not want to lose more.

I really would like to get off of the hydrocortisone if possible. Reading this post has me wondering if I will need to adjust my carb intake in one way or another to keep myself stabilized throughout what I assume will need to be a gradual process. Do you have any suggestions about all of this? I’ll be seeing my new doctor soon, and I would love to have some things to ask her.

I don’t blame you for wanting to get off hydrocortisone! That stuff has some seriously horrible side effects (I was one of those people who got Every Single Side Effect on the package). I’m not sure that a focus purely on carbohydrates is the right way to go though. Fibromyalgia is often seen in conjunction with autoimmune disease and Chronic Fatigue is believed to be autoimmune in nature. Have you considered giving the Autoimmune Protocol a try? http://www.thepaleomom.com/2012/05/modifying-paleo-for-autoimmune.html You’ll want to make sure you are getting enough dietary iodine to support thyroid function too (good sources are seaweed and fish). The AIP is naturally moderately low carb. If you feel the need to adjust up and down, you can try some starchy vegetables (since you don’t have digestive symptoms?) and/or fruit.

I also think that addressing your adrenal fatigue (which may be causing the reverse T3 and the chronic fatigue symptoms) is really important (and will probably make the most noticeable difference, at least initially). I know that it’s important to rest, relax, avoid strenuous exercise, avoid caffeine, get lots of sleep etc. with adrenal fatigue. I’m not sure what kind of supplements might be helpful (might be a good question for your doctor).

Good luck!

Thanks so much for these suggestions :) When I first started Paleo I did 3 weeks without eggs, nightshades (including spices), or nuts & seeds. As I added those back in I didn’t notice any huge symptoms right away (within ~72 hours), but I think I may need to try the AIP in full.

I DO have digestive symptoms now, and they started a week or so after I had finished adding back those categories. Even when I stay off fruit entirely my GI system can be pretty “fast-paced.” I started noticing that symptoms seemed to follow salad consumption (and I usually eat tomatoes in my salads).

I sense that this is going to be a process. And not necessarily a quick and easy one. But I’m very hopeful that I may be able to get off of prescription meds someday (thankfully I do not notice any bad side effects [but maybe I’m just oblivious!] from the cortisone).

I deeply appreciate your blog and your personal response to my query.

Many thanks!

I think anyone dealing with health issues has a long process to figure out what they can eat and what they can’t (in part because this list changes over time!). Definitely sounds like nightshades at the very least would be good to omit. i think you would see some improvement with the AIP.

Hello there! This is kind of off topic but I need some help from an established blog.
Is it very difficult to set up your own blog?
I’m not very techincal but I can figure things out pretty quick. I’m thinking about setting up my own but I’m not sure where to start. Do you have any tips or suggestions? Thank you

Hello Paleo Mom,

I’ve been at Paleo now for 52 days. I’ve been consuming a bit too much beta carotene and my family have pointed out an orange hue. What low beta carotene, paleo friendly starchy high carbs are out there?

Thanks very much

Have you talked to a doctor about why you’re not processing beta carotene? Other options are plantains (green are very starchy), taro, lotus root, and parsnips. You could also try yuca, but it should be chopped and soaked for 24 hours before cooking to remove cyanogenic glucosides.

Thanks for the suggestions! No I haven’t. This was only pointed out to me a few days ago and from a quick internet search thought it may have been only an aesthetic issue. Is this usually indicative of other problems?

Hey!
I have fibromyalgia and have been following the AIP for about 2 months (its been helping a lot!). I asked you about my carb levels awhile back. As you suggested I added in more starchy veggies and do feel much better (energy and sleeping wise) when I’m higher carb (around 150grams). However, the downside to the energy and sleep is that I’ve been having more stomach issues. You suggest trying to keep fructose below 20g a day for the AIP. I’m wondering if/ and how it is possible to get around 150 carbs without as many or any starchy veggies (I’m suspecting SIBO) and more fruits while still being under 20g of fructose a day. Any thoughts are helpful!
Thanks so much for all your work, it’s very inspiring!
Megann

Sarah, Just had a thought: In you Paleo Approach Book, you have the fabulous food charts with the breakdown of the vitamins and minerals, within. Maybe in your next edition of the book, add the carb content of the foods to these charts, also. Do you actually have Carb charts on your web site? Thanks :-)

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