My book, The No Grain Diet
, was published in 2003 and my clinical recommendation included eliminating gluten as a first line intervention before I would fine tune a patient’s diet.
It’s taken well over a decade, but the Gluten-Free, Low-Carb Paleo (GFLCP), which is essentially the same kind of high-fat, moderate-protein, low-carb diet I’ve been promoting, is now hitting the mainstream. Gluten-free diets are also becoming widely recognized.
For those with celiac disease, avoiding gluten is vital, but physicians are also starting to recognize that many have some sort of gluten intolerance, and fare better on a gluten-free diet.
Now, the US Food Administration (FDA) will start to crack down on food manufacturers misusing the gluten-free label, which is good news for those trying to avoid gluten.
Four years ago, I warned that many food products bearing the gluten-free label were in fact contaminated with sometimes high amounts of gluten. In one study, even naturally gluten-free products tested positive to gluten, courtesy of cross-contamination during processing.
New Gluten-Free Labeling Standard Is Now in Force
In August 2013, the FDA issued a standard for gluten-free labeling, requiring any product bearing the label to contain less than 20 parts per million (ppm) of gluten. As reported by CNN1 at the time:
“The new regulation is targeted to help the estimated 3 million Americans who have celiac disease, a chronic inflammatory auto-immune disorder that can affect the lining of the small intestine when gluten is consumed. Gluten is a protein composite found in wheat, rye, barley and crossbreeds of these grassy grains.
‘Adherence to a gluten-free diet is the key to treating celiac disease...’ said FDA Commissioner Margaret A. Hamburg... ‘The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.’"
According to the rule, in order for a food to bear the label “gluten-free” it must be:
Any gluten-containing grains must have been refined in such a way to remove the gluten. The final product may not contain more than 20 parts per million of gluten
Naturally gluten-free grains include rice, corn (just make sure it’s non-GMO), quinoa, sorghum, soy (which I don't recommend eating for other reasons), flax, and amaranth seed. The following foods may NOT use the gluten-free label:
Foods containing whole gluten-containing grains
Foods made with gluten-containing grains (such as wheat, rye, barley, or any their derivatives) that are refined but still contain gluten
Foods that contain 20 parts per million of gluten or more as a result of cross-contact with gluten containing grainsMost People Can Benefit from Avoiding Grains
The deadline for compliance was August 5, 2014.2, 3 You may still find some products manufactured before the deadline that may not conform to this standard, however.
The gluten-free labeling standard should make it much easier to comply with a gluten-free diet, whether you’re suffering from celiac disease or gluten sensitivity or not.
Celiac disease is really just one of several autoimmune disorders that can be significantly improved by avoiding grains. The autoimmune thyroid disease known as Hashimoto’s is another disorder where gluten avoidance is very important.
There’s also compelling evidence that high-grain diets fuel Alzheimer’s disease, and that avoiding gluten can help prevent and treat this devastating brain disorder. Neurologist Dr. David Perlmutter’s book Grain Brain goes into this in detail.
Similarly, if you want to avoid heart disease, high cholesterol, type 2 diabetes, or even cancer, you'd also want to severely limit your grain consumption, or avoid grains entirely. The reason for this is because grains and sugars are inherently pro-inflammatory and will worsen any condition that has chronic inflammation at its root.
In my experience, about 75-80 percent of ALL people benefit from avoiding grains, even whole sprouted grains, whether you have a gluten intolerance or not. The ONLY carbohydrates your body really needs are vegetable carbs. All sugar/fructose and all grains, including the "healthful" ones, will tend to raise your insulin levels, which is a detriment to your health.Low-Carb Paleo and Ketogenic Diets Embraced by Athletes
I’m quite pleased to see that the high-fat, moderate protein, low-carb diet I’ve been recommending is now being embraced by a number of athletes. This eating plan is in stark contrast to traditional carb- and protein-loading.
The idea behind carb-loading is to saturate yourself with carbs so your muscles will have plenty of glycogen to go on while you exercise. This can work well for really fit athletes that have an intense workout regimen.
However, I believe it is totally inappropriate for the vast majority of non-athletes that exercise casually. There’s also compelling reasons for professional athletes to rethink carb-loading, for the fact that high-fat, low-carb diets provide more long-lasting fuel and has an overall better impact on metabolism.
Athletic superstars like NBA players LeBron James and Ray Allen claim to have switched to a low-carb diet with beneficial results.4
Other athletes jumping onto the high-fat, low-carb diet include Ironman triathlete Nell Stephenson, pro cyclist Dave Zabriskie, and ultra-marathoner Timothy Olson. Former Ironman triathlete Ben Greenfield is said to have followed a ketogenic diet while training for the 2013 Ironman World Championships.
“After switching to a ketogenic diet, Ben experienced improved stamina, stable blood sugar, better sleep, and less brain fog,” the featured article5 states.
“Greenfield, author of Beyond Training, no longer follows the ketogenic diet, but advocates consuming plenty of healthy fats.”
Ironman Triathlete: High-Fat, Low-Carb Diet with High Intensity Training Is a Winning Combination
Former Ironman triathlete Mark Sisson is another tremendously fit athlete who has reportedly improved his athletic performance, body composition, and energy levels after ditching carb-loading for a high-fat, low-carb, Paleo style diet. He subsequently went on to write the popular book, The Primal Blueprint.
Even more interesting, he reports getting fitter on this diet while simultaneously exercising less. As I’ve discussed on many occasions, high intensity interval training can cut your workout routine down from an hour to about 20 minutes, three times a week, without any reduction in efficacy. On the contrary, you can reap better fitness results by exercising this way, and that’s exactly what Sisson experienced as well.High-Fat, Low-Carb Diet Benefits Pediatric Epilepsy and Cancer Recovery
High-fat, low-carb ketogenic diets are also well-recognized in certain fields of medicine. For example, children with epilepsy are frequently prescribed a ketogenic diet to control their seizures when medications are ineffective.6 The ketogenic diet benefits your brain by making your brain cells burn ketones (which are byproducts of fat burning) instead of sugar. According to epileptologist Ahsan Moosa Naduvil Valappil, MD:7
“[The ketogenic diet is] based on a ratio of fat to carbohydrates and proteins. A normal diet contains a 0.3:1 fat-to-carb and protein ratio, but the classical ketogenic diet is based on a 3 or 4:1 ratio… This means that the diet includes 3-4 grams of fat per 1 gram of protein and carbohydrate... Research has shown that more than 50 percent of the children with epilepsy who eat this diet can have their number of seizures cut in half. About 10-15 percent of children will stop having seizures... Fats like butter, heavy whipping cream and olive oil are recommended. Carbohydrates are strictly limited.”8
Ketogenic diets may also be key for cancer recovery. All of your body's cells are fueled by glucose. This includes cancer cells. However, cancer cells have one built-in fatal flaw – they do not have the metabolic flexibility of your regular cells and cannot adapt to use ketone bodies for fuel as all your other cells can. So, when you alter your diet and become what's known as "fat-adapted," your body starts using fat for fuel rather than carbs. When you switch out the carbs for healthy fats, you starve the cancer out, as you're no longer supplying the necessary fuel – glucose – for their growth.The Benefits of Mimicking the Life of Our Ancient Ancestors
During the Paleolithic period many thousands of years ago, people ate primarily vegetables, fruit, nuts, roots, and meat. These foods form the basis of the Paleo diet, although there are slight variations of it. Unfortunately, many Paleo diets recommend switching the carbs for protein rather than fat, which can have detrimental consequences. I’ll discuss this more below. Today, these staple foods have been largely replaced with refined sugar, high fructose corn syrup, cereal, bread, potatoes, and pasteurized milk products. This processed food diet has promoted the rise of a wide array of chronic and debilitating diseases, including obesity, diabetes, heart disease, and cancer.
Going back to basics and refocusing your diet on fresh, whole, unprocessed, "real" food is foundational for optimizing your health and addressing just about any health condition. You can easily mold your diet around the principles of Paleo eating by following my nutrition plan. Episodes of intermittent fasting may also be important, as our ancestors clearly did not have access to food on a 24/7 basis like we do today. I believe it to be one of the most profound interventions for the 21st century. While my nutrition plan goes into many details, as a general rule I advocate eating a diet that is:
High in healthy fats. Many will benefit from 50-85 percent of their daily calories in the form of healthy fat from avocados, organic grass-fed butter, pastured egg yolks, coconut oil, and raw nuts such as macadamia, pecans, and pine nuts
Moderate amounts of high-quality protein from organically raised, grass-fed or pastured animals. Most will likely not need more than 40 to 70 grams of protein per day, for the reasons I’ll discuss below Unrestricted amounts of fresh vegetables, ideally organic Are You Eating Too Much Protein?
Your body needs protein for bone and muscle maintenance and for the creation of hormones, among other things. However, you do need to be careful to not consume too much. The average American consumes anywhere from three to five times as much protein as they need for optimal health. I believe very few people will need more than one-half gram of protein per pound of lean body mass. Those that are aggressively exercising or competing and pregnant women should have about 25 percent more, but most people rarely need more than 40-70 grams of protein a day.
To determine your lean body mass, find out your percent body fat and subtract from 100. This means that if you have 20 percent body fat, you have 80 percent lean body mass. Just multiply that by your current weight to get your lean body mass in pounds or kilos.
The rationale behind limiting your protein is this: when you consume protein in levels higher than recommended above, you tend to activate the mTOR (mammalian target of rapamycin) pathway, which can help you get large muscles but may also increase your risk of cancer. There is research suggesting that the "mTOR gene" is a significant regulator of the aging process, and suppressing this gene may be linked to longer life. Generally speaking, as far as eating for optimal health goes, most people are simply consuming a combination of too much low-quality protein and carbohydrates, and not enough healthy fat.
It is particularly important though to make sure you increase your protein intake by 25 percent when you are working out with strength training. Your body will need the additional amino acids to build muscle tissue. Translating Ideal Protein Requirements Into Foods
To determine whether you’re getting too much protein, simply calculate your lean body mass as described above, then write down everything you’re eating for a few days, and calculate the amount of daily protein from all sources. Substantial amounts of protein can be found in meat, fish, eggs, dairy products, legumes, and nuts.
Again, you’re aiming for one-half gram of protein per pound of lean body mass, which would place most people in the range of 40 to 70 grams of protein per day. If you’re currently averaging a lot more than that, adjust downward accordingly. You could use the chart below or simply Google the food you want to know and you will quickly find the grams of protein in the food.
They provide countless critical nutrients, while being sparse on calories. Next comes high-quality proteins, followed by a moderate amount of fruits, and lastly, at the very top, you’ll find grains and sugars. This last top tier of sugars and grains can be eliminated entirely. Another tremendous benefit is that once your body has successfully switched over from burning carbs to burning fat as its primary fuel, carb cravings tend to disappear as if by magic. To summarize, there are two primary ways to achieve this metabolic switch, and these strategies support each other when combined:
- A high-fat, moderate-protein, low-carb diet: This type of diet, in which you replace carbs with low to moderate amounts of high-quality protein and high amounts of beneficial fat, is what I recommend for everyone. This kind of diet is very helpful for normalizing weight and resolving insulin/leptin resistance.
- Intermittent fasting: There are many reasons to intermittently fast. In my view, it’s one of the most effective ways to normalize your insulin and leptin sensitivity and shed excess weight, which is foundational for optimal health and disease prevention. You can boost your results further by exercising in a fasted state.
- Besides turning you into an efficient fat burner, intermittent fasting can also boost your level of human growth hormone (aka the “fitness hormone”). High intensity interval training will do this as well. Intermittent fasting can also improve your brain function by boosting production of the protein BDNF, which activates brain stem cells to convert into new neurons and triggers other chemicals that promote neural health. This protein also protects your brain cells from changes associated with Alzheimer’s and Parkinson’s disease, and helps protect your neuro-muscular system from degradation.