crash diet no carbs

[♪] well, thank you for that introduction. ifeel honored to be here. thank you to the nsca for inviting me toshare with you some, i would imagine, new ideas related to the role ofcarbohydrate for athletes. so i have the challenge of convincing you thatperhaps athletes can perform better and

crash diet no carbs, recover faster without consuming a lotof carbohydrates. and, of course, this is not the conventional wisdom and dogma,and, of course, it goes against a multi-billion dollar sports drinkindustry that's been promoting use of carbohydrates. wow, somebody's having fun. so, i lovethis quote from albert einstein, actually,

make things as simple as possible butnot simpler. and, you know, this is a real challenge in nutrition because thescience is immensely complex. i'm humbled every day about how complexnutrition is for promoting health, and treating disease, in enhancingperformance. so the challenge is always how do we -how do we come up withrecommendations and practical guidance? because i can think of no otherdiscipline where it's demanded that we translate the science, because at the endof the day you need to know what to tell your athletes to eat. people want to knowwhat to eat. so, we have to -we have to try to translate it. so, what am i going to tellyou today? well, i hope in a sort of big

picture i inspire you to think a littlemore carefully about sugars and starches in your diet or in your athletes dietsthat you work with. and, i will would ask you to be a little intellectuallyflexible, and a lot of the group's i talk to are intellectually inflexible because irealize this is new information it's not, for the most part, in textbooks and insome cases it may contradict some of the views and perspectives and biasesthat people tend to have. more specifically, i want to try to convinceyou, in the short time we have, that high carbohydrate intake is not an obligatecomponent of an athlete's diet. and, in fact, if you'll allow an athlete to adapt toa low-carbohydrate diet for a couple

weeks you can reduce carbohydrate to anoptional nutrient, and this may, in fact, help some athletes train harder andrecover faster. so you may be thinking right off the bat, you know, restrictedcarbohydrates is unnatural, its extreme it's unbalanced, it violates theprinciple of moderation, and, you know, that's understandable. and i guessone way i would argue or ask you to think about is from an evolutionaryperspective. i think it's justifiable to defend that most of human history weevolved with very little carbohydrates in the diet. and you can, i think, make astrong case that the introduction of a lot of carbohydrate has led to a lot ofthe common problems we have with obesity,

diabetes today. and, when we study this inthe lab and i put thousands of people on low and high carbohydrate diets what yousee is that as you restrict carbohydrates in an individual you seehim a fairly uniform response in adaptation. suggesting that that's ahighly conserved trait. so we do have the metabolic capacity. we're hardwired torespond favorably to a diet that has very little carbohydrate in it. it's inour genes. in contrast, when you increase carbohydrates in people you getquite widely varying responses. in fact, a lot of people when you takecarbohydrates high enough develop metabolic syndrome and diabetes, and soforth. so it's much more variable and

people exist on a continuum. there's widevariability and how people respond to carbohydrate. and that's really importantbecause that's why we need to individualize carbohydrate intake, bothfor, you know, the lay people as well as athletes and elite athletes. so, this ideathat insulin resistance is a carbohydrate intolerant condition issomething that i've been focused on in my research over the last 15 years, and iwon't spend a lot of time talking about this today, but you can have a profoundeffect on improving insulin resistance with a low-carbohydrate diet. so, ofcourse, type 2 diabetes is the hallmark of insulin resistance, i should say, insulinresistance is the hallmark of type 2

diabetes. we can essentially reverse type2 diabetes with the well-formulated low-carb diet. but the questioni want address today is, you know, on the other end of this continuum, what about the insulin sensitiveindividuals? and as a group, most athletes tend to be more carbtolerant and insulin sensitive. is there a role for low carbohydratein these athletes? so, just a quick review here of endogenous fuelsources. so, for whatever reason, as humans we did not evolve to store muchcarbohydrate in our body. you know, at best we maybe get 2,000 - 3,000 calories at mostprimarily in the form of glycogen, in

skeletal muscle, a little bit in liveras well. and contrast that with adipose stores, which do vary widely depending onbody fat levels, but even the leanest athlete would have ten-twenty foldhigher amounts of energy stored as adipose tissue then carbohydrate. so you've got,you know, a huge fuel tank in fat relative to carbohydrate. and fat isstored very efficiently. has twice the calories. twice the energy per unitweight. it's stored anhydrously, without water. a gram of glycogen takes 2-3 grams ofwater to store with it. so there's extra weight there and it also can bemobilized very quickly. and, so, you know, the paradox here is that when we

discuss fatigue, which is very complex but ina lot of ways fatigue is due to depletion of energy substrates, inparticular, glycogen and low blood sugar. think about hitting the wall in amarathon. this sort of irony there is that that occurs despite the fact thatyou've got tens of thousands of calories still on board. you just can't access it. so that, we'llcredit my colleague peter attia for this analogy, it's like a gas tankerrunning out of gas on the road. it's a bit ironic. so part of this concept oflow-carbohydrate diets is training the

body to be able to access and utilizethat fat more efficiently. and when we talk about fat mobilization and fatutilization it's hard to ignore insulin. i don't want to over simplify the casehere but clearly insulin is the dominant hormone regulating access to our fatstores, and several studies have looked at this relationship between insulin andfat mobilization, and this is what the relationship looks like. it's not linear. it's, in fact, exponential or curvilinearsuch that within this range of insulin levels you see dramatic changes in fatbreakdown. and this is well within the physiologic range.

well within the concentration of insulinthat consuming carbohydrates would modulate. so consuming a sports drinkwith sugar in it is going to elevate insulin enough to have a profound effecton inhibiting fat breakdown compared to consuming water. so insulin levelsare very important regulators of fat metabolism, in addition to, many otherfunctions they have in the body, but we tend to ignore this effect on fatmetabolism. and so, consuming carbohydrate is like a metabolic switch that locksyou into this dependency on having to continually provide carbohydrate forfuel because you're blocking access to your larger fuel tank.

so there's a lot of definitions of low carb.basically, there's no universally accepted definition. people define it invarious ways or operationally define it. i would tend to define it this way, or acouple ways, one is based on a person's tolerance to carbohydrates where acarbohydrate level below which their signs and symptoms of carbohydrate intolerance resolve. this ismore, you know, looking at the clinical situation where you have a person withmetabolic syndrome or type 2 diabetes, and that varies from person to person. or,it could be the level of carbohydrate below which your body fundamentallyswitches over to burning primarily fat,

fatty acids and ketones for fuel. and acouple of key points here is that this is highly variable from person to person.it might take a level of 25 grams of carbs per day for one person to produceketones and switch their metabolism over. where a high-level athlete might be ableto consume a hundred grams or more and still be in this state. so ketones arewidely misunderstood, even among most healthcare professionals. i think primarily because of theirassociation with ketoacidosis, which is a very serious condition that occursprimarily in type 1 diabetics who have insulin insufficiency but this does notoccur in a healthy person. and

the main difference between ketoacidosisand that what i like to call nutritional ketosis is really the level of ketones.most of you, if you've had any carbohydrate this morning, will havelevels of ketones probably 0.1-0.2 millimolar. after an overnight fast, they mightgo up 0.3-0.4. i say nutritional ketosis begins at about 0.5,probably more optimal level of ketones might be between 1 and 2 maybe 3 millimolar,but ketoacidosis is when you're up above 10-20 millimolar. so this is adifference between a torrential downpour that floods the village versus a gentle rain that sort ofnourishes the vegetation, and so forth.

it's apples and oranges. andketones are more than just fuel. ketones, obviously, are an important fuel.especially for the brain and other tissues that rely heavily onglucose, but this was a recent paper, it published in december of lastyear in science that showed ketones acted as epigenetic modulators of geneexpression. and, i think this is a pretty heavy paper to get through but the main point here is that it's showingketones serve as regulators of important metabolic processes for athletes. inparticular, this study showed that ketones within this range of nutritionalketosis had a profound effect on

inhibiting oxidative stress andincreasing expression of a range of antioxidant genes. this was done in ananimal model, but it really i think is very provocative because it's fitting alot of the human data that we're starting to gather in clinicalsituations, as well as athletes. where ketones are antioxidants and they reducethe level of oxidative stress. and just to sort of follow along this, this is sortof a new development as far as my knowledge, but i was exposed to thisabout a year ago. kieran clark, from the uk and richard veech, from bethesda, nih havebeen working quite a long time now, almost a decade, on developing a ketoneester that could be consumed. almost

like another food group. and theyfinally have a ketone ester that does in fact elevate blood levels ofketones within this range of nutritional ketosis, and this is despitethe fact you can be eating carbohydrates in your background diet. and they've done animal studies, safetystudies, and they've now moved into some human studies. and a lot of this wasn'tpublished, but they've started even do some studies in athletes, and this wasone graph that they shared with me in a preliminary study they did in high-levelrollers in the uk that were provided these ketone esters to elevateketones, and showed that it improved power

output in these elite rollers from theuk. so their work's been funded by the military, in particular darpa, to thetune of about 10 million dollars. so the military has a strong interest inlow-carbohydrate diets and ketones, in particular, whether it's deliveredthrough these ketone esters or through low-carbohydrate diets, or acombination of. so what's the evidence that this could work in athletes? well,surprisingly, there hasn't been a lot of work. this is work done by my good friend andcolleague steve phinney, over 30 years ago, where he took a group of very high levelcyclist, these were very competitive cyclist, had very high vo2 max, these guyswere exercising at 65% of

vo2 max and turning out over 900calories, kcals per hour. anyway, he had these athletes who were habituallyconsuming a low-carbohydrate, i'm sorry, a high-carbohydrate diet adapt to a verylow carb ketogenic diet for four weeks and tested their performance and theirmetabolism, and quite to his surprise at the time, and everyone else's surprise,the virtual removal of carbohydrates from the diet did not negativelyimpact their performance. this is a time to exhaustion. you can see,on average, was not different after four weeks of a ketogenic diet. what you see,however, is a dramatic change in their fuel use. so this is respiratory quotient,respiratory exchange ratio, suggesting that

when they did this two and a halfhour time to exhaust test after being adapted, they wereburning almost exclusively fat for fuel. he took biopsies in this study, measuredglycogen. you'll see that glycogen levels were not totally depleted in theseathletes. they were about fifty percent at the start of the endurance run, i'msorry, cycling they were performing, but they ended up in the same place asbefore when they were on the high carb diet. so it dramatically altered utilizationof glycogen here, glycogen sparing. and utilization of fat for fuel. so here'sthe traditional view of fat oxidation during exercise where you get aprogressive increase in the amount of

fat that's burned as you get up to about60-65% of vo2 max, and then it tapers off dramatically. and so,peak fat oxidation rates occur, you know, somewhere between 50-65% vo2 max,depending on training status and, perhaps, some other variables. i want to, justcontrast that to the level of fat oxidation achieved by those cyclists inthe study that dr. phinney performed. so this was -this is the peak fatoxidation rates in 300 people studied in a paper published by venables, and youcan see the average peak fat oxidation was only 28 grams of fat burned per hour,and i give you the range there too. so of all those people, 60 was thehighest, and that was in some very

high-level athletes. this is the datafrom dr. phinney's experiment. so you see a dramatic increase in what i wouldconsider the highest rate of fat oxidation i've ever seen reported in theliterature here, and these were the fat oxidation rates reported in phinney'sstudy. so clearly, humans have a remarkable capacity to burn prodigiousamounts of fat we've done a little bit of work on thelow carb and exercise, more on resistance training. so this is a 12-week resistance training study where we had a group ofhealthy men consume either a low-fat or low-carb diet, without exercise, and thena group that also performed resistance

training for 12 weeks. and this is thechange in body composition, or change in percent body fat from dexa. and, in fact,we see a greater reduction in body fat and percent body fat with low carb andresistance training. and there's no difference in strength gains with lowcarb versus low fat. and there was a wide range of improvements in metabolicparameters as well. so there seems to be an additive effect here of low carb plusresistance training, in that low carbs preferred for burning fat, or losing bodyfat, and the resistance training helps to preserve the lean tissue, and the combinationof the two results in a greater reduction in percent body fat. and thiswas some of the individual changes in 12

weeks in the low-carb resistancetraining group. so pretty remarkable reduction in body fat, but what's evenmore impressive i think is at the same time they're able to gain significantamount of lean body mass. so you can trade fat loss for lean body mass gainwithin an individual. granted i'm cherry picking the best responders here,but this is what's possible in an average college age male who undergoes12 weeks of resistance training and low carbohydrate diet. so am i the onlycrazy person that's thinking about low carb diets for for athletes? i'm oneof a few maybe. but there are seemingly a growing number of researchers andscientists who are interested in this as

well. probably the best examples is tim noakes.and some of you may know he's a very prominent colorful figure in enduranceperformance and for the longest time has endorsed high-carbohydrate diets forathletes. his book lore of running was very famous among endurance athletes,but he's done a complete reversal on his opinion of diet and is endorsing low-carbohydrate dietsand actually apologizing to all the readers of lore of running. and are therereally athletes that are doing this? and i've been somewhat surprised that thereare quite a few athletes, a growing number of athletes that are not onlyadopting a low-carb diet but competing

and winning races, in particular, in theultra-endurance world. i say there's, there are quite a few pockets of lowcarb athletes that are at least anecdotally doing quite well. this is timolsen, who follow some version of a low-carb diet, who recently won thewestern states endurance last year, and also, at that race was zack bitter, and wewere out there collecting data actually in a lot of the low-carb runners andtrying to understand this a little better in the real world, doing fieldwork.but he's an openly an advocate of low-carbohydrate diets and attributedthat to his recent improvements in success. and there are others. i know bobseebohar is recently experimenting with the

ketogenic diets and he's quite wellknown in the endurance world out of colorado springs. and, mike morton whoselegendary in the ultra endurance community has recently switched over tolow-carb and is anecdotally claiming that it's attributing to his recent success insetting a new record in a hundred mile road races. so, one sort of novelhypothesis i want to put forth, because this is something that we've seencontinuously in our clinical work, one of the most consistent responses we seewhen we put a person on a low-carb diet is an increase in a particular fattyacid called arachidonic acid. now i'm going to sort of push to your tolerance ofscience here, but

i think this is really important. on thesurface many people would think this is a bad thing because arachidonic acid isomega-6 fatty acid, it's highly unsaturated, it's the precursor for, at least when it'sacted upon by oxidases, for a lot of the inflammatory components. but that'sonly if it's acted upon by enzymes, oxidases. when it's actually sits in themembrane it's a positive thing. it contributes to insulin sensitivity,improves fluidity of membranes. so we're seeing an increase in arachidonic acidin various membranes, in cheek cells, in different lipid fractions of the blood.and we were wondering why, and we've been studying this now for manyyears, and we have evidence that the

reason it's going up is not becauseyou're producing more, or that you're eating more preformed arachidonic acid,it's because you're destroying less, because of less reactive oxygen speciesthat attack these free radicals. so we have this theory that performingultra-endurance exercise is a huge oxidative stress. just the total amountof oxygen that's consumed to perform triathlons or hundred mile runs is enormous, anda certain amount of that 2-3% is going to escape the metabolic fireand get released as a free radical or reactive oxygen species that's going todamage membranes. so we thought, well, there could be a protection against thislost in our arachidonic acid with exercise

in athletes consuming low-carb diets. andso, we tested this at the western states endurance run, and our initial data herei'm showing, this hasn't been published yet, is that low carb athletes have lessof a decrease in arachidonic acid, and this is the equivalent of arachidonicacid on the omega-3 side dha, also highly unsaturated and prone to attack by thesefree radicals, that we see better preservation of that and better recoveryof that. and we think this has important implications, especially on recovery,because there is this post exercise increase in insulin resistance that occurswith excessive exercise like this. so i'll stop there, but i think there are alot of

implications here that we can talk aboutin the q&a in terms of keto adaptation and its potential role, in not justimproving performance, but i think perhaps the real value might be inpromoting faster recovery through less reactive oxygen species, less inflammation,and so forth. and then there's a whole aspect of what is a well-formulated diet,that are not going to talk about now, but perhaps we can discuss too during the q&a. [applause] okay. it's going to take a second to get mypresentation up. is this yours by any chance? all righty.

escape this for a bit. so i'm looking, okay, here we go. hopefully it's that. no. this one. okay. okay. all right. so i'm actually going to goprobably till very close to the end as my, if i don't go through it too fast,it's pretty crammed with data. all right. so, i'd agreed to debate somebody on low, on matters of low carb, and i was expecting to walk inhere and run over the competition, and had i known it was going tobring out jeff volek and unleash jeff volek here, i would have -i would have thoughttwice about the whole situation, but, you

know, it is what it is and this is myshot. i want to thank brad schoenfeld. iwant to thank pete melanson and marie spano, everybody involved with theadministration of this. this is just such a such a privilege and an honor to be ableto present here. so i'm going to talk about some, you know, go over maybe a little bitof overlap, but you'll see that there's going to be some obvious contrastsin our perception, in our experiences, in our interpretation of theliterature on carbohydrate as it relates to health and body composition andperformance. so i'll look at experimental evidence or review some of theobservational evidence and then go over

some client case studies, at as timepermits, and then we'll have some discussion. so, all right, sothe important concept here, especially within the context of contrasting viewsis r.a. littleton's concept of the bead model of truth. so, basically, thebead model of truth is this, on one end of the continuum, on the zero side you haveabsolute disbelief. and then, on the far end of the bead continuum, youhave the one or absolute certainty. so r.a. littleton proposes that science is notabout trying to achieve closure or assuming certainty. so absolute certainty,he believes, doesn't actual existence, and it shouldn'tnecessarily exist. one of the strengths

of science is that it is tentative. nowthis is coming from a, littleton, was he wasn't a flighty dude. i mean, he wasin the hardcore science. he was a mathematician and then he went on togeophysics and he actually came up with, he put together a mathematicalmodel explaining why we have miscalculated the mass of the planetmercury. so, you know, if littleton doesn't believe in absolute truth, then well, maybewe should reconsider that concept of absolute truth. definitions of low carb. this isalways sort of a sticky, fluid, flexible issue. there's proportionaldefinitions, and then, there's also a

little bit more simplicity, which itend to prefer the absolute definitions. so, generally speaking, low carb dietsrange anywhere from, you know, well, close to zero all the way to up to a hundredfifty, hundred fifty grams. okay, and then you've got some debate overwhether 200 grams crosses over the threshold of being low carb or not.low-carbohydrate ketogenic diets are also called very, very low carbohydrateketogenic diets will range from 20 to 50 grams of carbohydrate per day. so,definition wise, that's what we're going to be focusing on. i'm sure jeff isfamiliar with hession's systematic review and meta-analysiscomparing the conventional high-carb,

low-fat diets with low-carb,high-fat. this was a 2009 meta-analysis that actually found pretty much acrossthe board superiority of the low-carb, high-fat model. weight loss wassignificantly greater. significant improvements in lipid profile. and thereis also even a trend towards improvement blood pressure and the low-carb/high-protein groups. and at six months, a trend towards improvement fasting plasmaglucose. and this was a very interestinglittle tidbit that struck me as interesting, that there's a higherdropout rate in the low-fat, high-carb groups as a whole but more so than thethan the high-fat or high-protein,

low-carb groups. what one of the -one ofmy criticisms of the inclusion criteria of this type of analysis is they don'tnecessarily match protein intakes. and a lot of times they will matchad libitum / free-living type intakes with calorie -with non ad-libintakes. and so, what will happen is when you increase dietary fat and protein youkind of leave that open to eat however much you want, you're going to get more satiety andthat's going to lead to a greater decrease in overall caloric intake, andthose things will sort of dovetail into more weight loss, more fat loss, bettercardiovascular risk profile. and so, you

know, as an ad-lib unplanned thing,a great case can be made for restricting carbohydrate, at leastaccording to this systematic review here. now things can be a little bit differentwhen you control the variables a little bit more closely like, for example,matching protein intake. this bit of research here from johnston andcolleagues, compared a zone type model 40% carbohydrate, 30%protein, 30% fat with an atkins type model. weight loss was notstatistically different, it's not statistically significantly differentbetween the groups. there's a non significantly great weight loss in thenon ketogenic diet -or in the zone

diet. and again, fat loss no statisticallysignificant differences there but in a non-significant better fatloss in the non ketogenic diet. overall, insulin sensitivity, resting energyexpenditure and, you know, this is just the gamma-glutamyltransferase, sortof an index of glucose control. that was -that was decrease in both groups withoutany major differences between the two groups. and kind of the sortof the punchline and the kicker here was that mood was better, perceptions ofvigor were better, in the non ketogenic diet group. now one might argue that, well, youdidn't give them enough time to be on

the diet to get keto adapted, but thiswas a six week diet and, generally speaking, keto adaptation issuppose to take around three or four weeks in order for you to achievethat lower respiratory quotient indicated, indicative of the becomingmore of a fat burning machine, so to speak. so that bit of research kindof raised some eyebrows and challenged the whole low carb is better -low carbis a better paradigm. more experimental evidence, a very recent systematic reviewand meta-analysis with a very large, a very large meta-analysis, and just asa review of research methods, meta-analyses whenever there is a largebody of studies on a given topic like

diets, for example, high carb versus low carb,you know, you can have dozens and dozens of studies, whata good meta-analysis will do is is take -is take the data andquantify it and find common threads and, sort of, make some sense out of it withminimal inclusion and exclusion bias, selection bias and things like that. andso, what meta-analyses do is they give us sort of a bird's-eye view of thecurrent state of science on things. so in this most recent one, a larger one thanhession and colleagues did in 2009, they compared low-fat diets withlow-carbohydrate diets and their inclusion criteria here, they comparedeverything from 4% to

45% carbohydrate diets, inthe low carb end, and they compared it with low-fat diets with the inclusioncriteria being at or less than 30% fat. and so, what they found was, comparedwith low-fat diets, a person on the low-carb ones, they had agreater reduction in total cholesterol, but that's can potentially be neitherhere nor there, because then, you know, good cholesterol can drop as well. low-carb diets had a greater increase in hdl, and this is something that we kind ofsee commonly. reduction in body weight, waist circumference, and other metabolicrisk factors were not significantly different across the continuum of dietsranging all the way from 4%

carbohydrate all the way up to like50-60ish. so this is a very important bullet point. now, as a whole, okay,the take-home of this systematic review was that we humans are extremelyversatile at a -at thriving and doing well, healthwise, on a very wide range ofcarbohydrate proportions within the diet. and i would, you know, i would challengedr. volek in the respect that, well, granted that you have a cut-offof either proportional or net amount of carbs beyond which things start to gowonky, granted we don't disagree on that, i would say that, you know, that the ideathat one-size-fits-all, i'm fundamentally in disagreement with, but i did hear youmention that everybody is different to a

degree. so there indeed is a range ofcarbohydrate that will work with people. i'm just assuming that we may differon what those thresholds are, but in any case. okay, the mediterranean diet has received agood amount of press, of positive press in the scientific literature, and this isanother systematic review and meta-analysis that basically took a lookat the diet paradigms. we got low carbohydrate, low gi and thenmediterranean, and then all the way up to the low-fat, high carb government-issue pyramid typecontrols. so what this meta-analysis found was that the low-carbohydratediets, low gi, mediterranean and

high-protein diets all led to greaterimprovement in a bunch of cardiovascular risk factors including weightloss, glucose control, etc. the low carbohydrate, once again, was mosteffective for raising hdl. and here was something that came to me as a bitof a surprise, the mediterranean diet showed the greatest improvements inglycemic control and weight loss compared to the control diet it wascompared with. what i'm seeing as a common thread is that moderation is goodand moderation has been outperforming extremes in the literature. dr.volek mentioned that insulin sensitivity can weigh into somebody'sability to tolerate carbs and, indeed, in

2005, cornier and colleagues, they comparedthe weight loss of folks who were insulin sensitive vs folks who wereinsulin resistant and they challenge them with either a low-carb or ahigh-carb diet, and the results were very interesting, because the insulinsensitive folks lost 13.5% of their initial body weight. okay. whereas those on the insulinsensitive folks on the low carbohydrate diet lost 6.8%. sojust to kind of reiterate, insulin sensitive folks can actually get betterresults on higher carbohydrate diets than they would on low-carbohydratediets. in contrast, amongst the insulin

resistant folks, those on the low-carb,high-fat diet did better. okay. so insulin resistance folks will dobetter on the low-carb, high-fat. and none of this was explainable withactivity or calories and such, and so they are actually attributingthis to differences in insulin sensitivity. the caveat i want tothrow in with this is this study was never replicated and,unfortunately, they didn't measure body composition. they just measured grossbody weight. all right. dr. volek brought up theseminole phinney study in 1983 and i want to preface that withthe 1981 phinney study where untrained

obese subjects were examined atdifferent intervals, before one week end and then six week end, training at75% vo2 max. now 75% of vo2 max for unfit peopleit's not going to be a very, very gut busting experience. but this is whathappened. all right. pre-exercise muscle glycogen didnot change significantly in the group that consumed roughly 75 grams of carbsper day. in the group that consumed only 1% of their total calories ina low-calorie diet, 830 calories a day. this was obviously aweight lost stint. that group, unsurprisingly, decrease their glycogenstores by about 50% by the end

of the six-week period. now here's the thing, which to me isnot surprising, endurance capacity dropped by 50% in those onalmost zero carb diet. okay. now these are untrained obesefolks? how about athletic folks? this is the exact study that dr. volek wasrelaying with those pretty spectacular results in a physiological adaptationsin elite athletes to low carbohydrate diet. so, you know, a real quick, the the difference between this study andthe one on obese untrain folks was this was not a weight-loss study. thiswas a eucaloric, at balance, no weight

loss study. and so, they put them on aconventional type of high-carbohydrate diet for a week. followed by four weeksof less than 20 grams of carbohydrate daily. the testing parameter was time toexhaustion, so endurance capacity. and if you read - if you read the abstract--thank you. if you read the abstract, it says thatthese results indicate that the aerobic endurance exercise bywell-trained cyclists was not compromised by four weeks of ketosis. okay.now this is the important details and this is why it'simportant to be able to read the full text. one subject out of the five elitecyclists had a three-minute increase in

endurance capacity. two of the subjectsexperienced a 30 minute and 84 minute increase in endurance capacity. so farthe, you know, it certainly looks like they're retainingtheir endurance capacity despite being on a ketogenic diet.all right. two out of the five subjects actually had a significant declinesin time to exhaustion, 48 minutes and 51 minutes. so, although the abstract says,well, these results indicate that aerobic endurance was preserved in a ketogenicdiet, two out of the five guys had significant endurance drops, and one ofthe folks had an incredibly high endurance increase at the 84 minuteincrease. the dip, the mean time to

exhaustion in the groups, for the - atweek one, okay, at the beginning on the conventionaldiet, they had a 147 minute mean time to exhaustion. and afterthe period of ketosis, the four weeks, it was 151. okay. 151minutes to exhaustion at around 62 - 64% of vo2 max. now this differencewas not, i mean, it was minor. it was statistically insignificant and kindof bottom line insignificant. however, that's because one of these guys threwoff the mean like crazy, and it's never mentioned that two out of the five guyshad significant performance decrement. so i think that's

very important point to drive home. in a2004 review by phinney, and this isn't something he mentioned in the text ofthe 1983 study, i'll quote him, he says, the bicyclist subjects of this studynoted a modest decline in their energy level while training -while trainingrides during the first week. okay, understandable. you know, everybody sort ofexperiences kind of a crash and sort of a mood dropping and performancedrop as you're phasing into the low carb, but what he doesn't mention is that, okay,all right, on the first week in your diet after which subjectiveperformance was reasonably restored, except for their sprint capability, whichremained constrained during the period

of carbohydrate restriction. so withsprinting ability remaining constrained during carbohydrate constriction thatpresents a problem. what happens during the final moments of an endurance race? afrantic sprint to the finish. so i would -i would challenge the use of thisresearch by phinney to say that performance indeed was preserved. okay, as we know,the conventional recommendations, even the most recent ones by, for example,the international society of sports nutrition, is for -is forathletes to consume the bulk of their calories from carbohydrate. i mean, evenrecreational general fitness folks the recommendations 3-5 grams per kilogram ofcarbohydrate per day which boils down to

somewhere in the neighborhood of abouttwo grams of carbohydrate, per pound of body weight, and a little bit more thanthat. athletes involved in moderate amounts of intense training, so like,non-endurance strength power type athletes, 2-3 hours a day, 5-6times a week, the recommendation for them is 5-8 grams per kilogram ofbody weight, per day, in carbohydrate. so this is going to translate to, in theneighborhood of, two sometimes even three-ish grams of carbohydrate per poundof body weight. athletes in the endurance and ultra-endurance realms, theyrecommend 8-10 grams of carbohydrate, per kilogram body weight,per day. and this is echoed -- this

recommendation is also echoed by themost recent position paper of the ada. we know they love their carbs, but, i mean,they even hit it lower at 6-10 grams, in general, for athletes, perkilogram of body weight, per day. i want to segue into observationalevidence. so we looked at experimental evidence. all right. the blues on -- this is more of ahealth thing -- and this is something i find very interesting, because one ofthe big positions of low carb proponents is that it's the healthiest way to go. well, if it's the healthiest way to gothen does it mirror, you know, observational research? does it mirrorwhat the healthiest people in the world

are eating? so a guy named dan buettner,he's an explorer and, you know, he's an international man of mystery, i suppose.but, he found five longevity hot spots on the planet. okinawa, japan,everybody knows about that. nicoya (costa rica), (icaria) greece, sardinia - italy, theseventh-day adventists of loma linda and and one of the fifth one, whichis escaping me at this point. pardon? nicoya, costa rica. thank you. largelyplant based diet. no overeating. that's kind of a no-brainer. foods are locallyor homegrown. beans including fava, black, soy, lentils are the cornerstoneof most, most diets of people who reach 100-years old. now, as you know, beans areanywhere from 50-60 plus percent carbohydrate.

three out of the five zones are regularcoffee consumers, that was, i was happy to hear that. happy to hear four ofthe five zones are regular alcohol consumers. all five of the blue zones areregular consumers of grains and legumes and carbohydrate, largely from starch, isthe predominant macronutrient. and then, you know, the kicker, none of the bluezones follow a very low carbohydrate ketogenic diet. now granted, there arepopulations on earth that do consume lower carbohydrate diets inthe blue zones, and do thrive, but my point is that it's not as if the bluezones are doing it wrong. and again,

this is observational research. socorrelation doesn't necessarily equal causation, but what we're seeing is aconvergence of evidence from experimental, control interventions andobservational research showing that carbs are not the bad guy. all right. what-the dominant athletes in endurance sports are the east africans, eastafrican distance runners. how do they eat? and just to be specific, thatruns from kenya and ethiopia. they hold over 90% of the all-timeworld records, and also, the current top 10 positions in the world ranking. sowhile dr. volek can name a few names of folks who have done wellin ultra-endurance,

well, he's probably naming the scantminority of world champions in endurance. the dietary habits ofelite ethiopian distance runs were recently reported, okay, mean total energyintake 3,194 calories. total protein 12%. 76% of which wasplant-based. now i'm not a vegetarian. i'm just reporting the data. 23%-ishper fat. the dominant macro-nutrient, by a large margin, was 64.3% oftotal calories coming from carbohydrate at 9.7 grams, per kilogram,per day. if you recall the issn recommends 5-8 g/kg. so these guys areeven surpassing that. well, for the endurance, 8-10. they're right inthat range, the recommended range of the

conventional larger sports nutritionbodies. so either these guys are unaware of the magic of ketogenic diets and theycould do twice as good on them, or, what they're doing is just fine becausethey're dominating sports. and again, from kenya, the kalenjin, theyproduce 40% of the winners of all the major international, middle andlong distance running competitions, between the decade of 1987-1997. and the dietary habits of the kalenjin, thestaple foods include bread, boiled rice, potatoes, kidney beans, porridge, cabbageand thick corn meal called ugali. they had meat four days a week. mean daily proteinintake 75 grams fat at 48 grams, and then, of

course, the punchline, mean dailycarbohydrate intake was 607 grams. 76.5% of total calories fromcarbohydrate from these world champs. is there something in the water there? isthere something in the air there? or could it be that they're doing it right?here on my clients. some of you may recognize derek fisher, pete sampras andstone cold steve austin. i have not had any of these folks on ketogenic diets.and there's a lot of money and a lot of reputation riding on these athletes.derek fisher, i worked with him during his highest scoring season of hiscareer. if i may stroke my own reputation. and he consumed roughly400 grams of carbohydrate on his training days.

pete sampras, it was during a time wherehe was post superstardom. so we're trying to get him back into shape and hehovered around 200 grams of carbohydrate. kelechi opara, this fabulous dude withthe abs and the pecs, i had 37 days to get themcontest ready. so i gunned it, and i cut his carbs down pretty low because it wasan emergency. okay. we had 37 days for him to just seestriations everywhere. he's a 180 lb --175 lb athlete. i cut his carbs down 240 on training days and 90 on days off. and hetrained about 14-ish, 15-ish hours a week. so special situation. we got kelly davisup there in the upper right. her carbs

were around bodyweight -- grams,per pound. she was 130-ish, high 120s at the time.surprisingly, steve austin, he was not eating a thousand grams of carbs per day.i had his carbs at about 400 grams in the bulking cycles, and down to actually around 200 grams during thecutting cycles. my highest carbohydrate intake guy in this whole thing is brandonstephens at the bottom right. he could not keep weight on with 500-600 grams ofcarbohydrate a day. oh, okay. we're done, my point is there is awide range of carbohydrate rather than just a low-end -- thank you so much folks -- thank you, dr. volek.