159 | Navigating Your Unique Carb Threshold: Personalized Diets for Optimal Health and Inflammation Control

Ever feel like navigating the dietary world is akin to charting a course through the Bermuda Triangle? Fear not! In our latest episode, we're your compass to understanding low-carb diets and how they meld with our individual health odysseys. Join me as I reveal why nutrition is far from a one-size-fits-all affair, exploring the nuances of plans from paleo to Mediterranean-keto and shedding light on managing conditions like IBS and SIBO through diet. With a focus on personalized approaches, we tackle the often misunderstood realm of anti-nutrients such as lectins and phytic acid, their impact on health, and the significance of prep methods to lessen their effects. 

Hitting a wall with your health goals can be disheartening, but could the culprit be your carb intake? We delve into the importance of metabolic flexibility and discovering your body's unique carb threshold. This session breaks down the spectrum of low-carb diets, from the modest reduction to the more extreme carnivore approach, and how to incrementally adjust your carb consumption to achieve optimal health without sacrificing energy or mental clarity. Plus, I share a strategy to utilize electrolytes, smoothing out the transition to fewer carbs, so you can maintain both hydration and nutrient balance.

As the episode wraps, remember that your journey through the landscape of nutrition is deeply personal and ever-evolving. I invite you to subscribe and stay tuned for more episodes that answer your pressing questions and provide the insights you need to navigate inflammation and diet. Whether you're a dietary novice or a seasoned expert looking to fine-tune your regime, there's always more to learn and we're here to illuminate the path. Tune in, take notes, and transform your approach to health—one meal at a time.

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Transcript

Speaker 1 0:01

One of the greatest obstacles to crafting health and wellness is identifying and controlling inflammation. It's at the core of all complex and chronic diseases and is the driving mechanism that underlies the most common symptoms that people like you struggle to overcome. Join us as we explore cutting-edge science and research to give you the information and tools you need to create the quality of life you want and deserve. And now here is the host of Inflammation Nation, dr Steven Noseworthy.

Speaker 2 0:29

Hey guys, welcome back to the podcast. Today we're going to be talking about low carbohydrate diets and choosing among let's call it the spectrum of options that we see in the low-carb diet area, and it's a question I deal with fairly frequently frequently enough that it's top of mind and I decided, hey, let's talk about this in the podcast. Just a word of warning I may break down into a coughing fit every once in a while. I picked up a little bit of a tickle in my throat, courtesy of my one-year-old grandson. Thank you, benjamin. I appreciate that. So please forgive me, I'll try to edit it out if I can, but otherwise I may pause and just cough every once in a while. So one of the hardest things to do when you're trying to handle health issues on your own is to navigate what has become a very confusing world of diets. There are literally hundreds of diet books published each year, and it seems like every few years there's a new kid on the block that gets all of the attention, and it seems to be the thing to do. At least, that's certainly how it's presented in the social media space, and one of the things that you should know is that, ever since the internet came to be. Diets tend to cycle in and out of the limelight. In the last few years has been dominated by the ketogenic diet, intermittent fasting strategies. Now we're starting to see a resurgence of the Mediterranean diet, which first was promoted back in 1975, but it really kind of became very popular in the 1990s. But now it's back and people are starting to blend these together and so you'll hear people now talking about a ketogenic Mediterranean style where you're combining keto and Mediterranean, which is kind of more of a content prescription. But the thing to remember is that there's no single diet approach that's going to be right for every individual person. Even when we see research studies that do a deep dive into one diet type or that compare different diet types together, whatever results come out of that are averages of very large numbers of people within which that group. There's a lot of variation. Right, and assuming that the study is well designed to begin with and the researchers don't have any undisclosed conflicts of interest or personal biases that drive their conclusions, when we see these large scale studies on diet and nutrition, the conclusions are generalizations that, again, are generally true but may not be true for you, and I don't say that to convince you to not pay attention to nutritional research, but to make sure that you look at everything with a critical eye so that you can make good quality decisions for yourself.

Speaker 2 3:29

So how can it be that there isn't a single diet that works for all people, right? So if you listen to vegans, for example, they're convinced that everybody should eat nothing but plant-based foods, both for health as well as for moral reasons. On the opposite end of the spectrum, you have carnivores, who generally are not making moral arguments, but they present carnivore diet as a viable solution for a wide variety of health issues. And then you have fruitarians. I remember watching this girl on YouTube a few years ago. She was a fruitarian. She literally ate 30 bananas a day, which kind of signs bananas in and of itself, doesn't it? So diet proponents like to argue the value of their diet, but what gets lost in the arguing and the finger pointing is you as an individual. Now, I know that there are healthy vegans out there, but I also know that there are healthy carnivores and there are healthy omnivores who eat a little bit of everything, and so the only rational solution and answer is that, while there are some generalizations that we can make about diet and they tend to apply to all people.

Speaker 2 4:48

When you're trying to fix a health problem using diet as a tool and you should you need to ask the question well, which diet and which diet related strategies are best for you right now? And I say right now because you might need to adopt a specific diet strategy for a short period of time that maybe is not really going to work for you long term, or maybe you don't want to do that for long term. A classic example would be, say, a low FODMAP diet to solve IBS issues or small intestinal bacterial overgrowth. Many people can do low FODMAP for a few months and then slowly introduce foods back with great success. Others actually need to stay on a SIBO diet or a low FODMAP diet for much longer. To be honest, there are some people a smaller fraction who are probably going to have to adopt that as a way of life. It's their long term solution.

Speaker 2 5:45

So you need to think of your diet as a tool and as a pivotal part of your lifestyle. It's one of the biggest levers that you can pull to affect change in your body chemistry and your health, and you've heard me say before that I think most people and let me emphasize most most people will do well if they start with a paleo style diet which is a content prescription and then make modifications from there that are unique and specific to them. So, again, what I thought I would do is talk about the paleo diet but focus on the carbohydrate content of that, so we can sort out what low carb, very low carb and ketogenic diets can do for you and how to decide which one of those is right for you. Now, on the other end of the spectrum, I'm not a fan of high carbohydrate diets like not even close. But let me clarify that. I'm not a fan of high carb diets for people with health issues.

Speaker 2 6:42

As a general rule again, emphasize, general rule if you're already healthy and if you have sufficient muscle mass to store a ton of glycogen, which is glucose in its storage form, and if you use your muscles in ways that require glucose for fuel typically anaerobic type stuff then you can get away with eating more carbohydrates than the average person. But if that's not you, then you need to find the sweet spot for carbohydrates so that you eat the least amount of carbs that you can function on. So the paleo diet is sometimes described as a plant-based diet with moderate protein and healthy fat. But to call it a plant-based diet is a little bit of misdirection. But the paleo diet is as much defined as what you eat, as it is defined by what you avoid.

Impact of Lectins on Carbohydrate Intake

Speaker 2 7:32

In general, the paleo diet eliminates grains. That's perhaps its most defining characteristic, and by avoiding grains you avoid a whole bunch of other things too, things which may be fine for one person and not so much for others, things like dietary lectins or FODMAPS or things called anti-nutrients. And so, very quickly, lectins are sugar binding or carbohydrate binding proteins that are found in all types of foods, but they're found mostly, certainly in high concentrations, in beans and legumes and certain vegetables that fall mostly within the nightshade family, and there are different types of lectins that have different protein structures, and for some people these lectins can trigger immune responses, meaning drives inflammation, and in some people it can also flare up autoimmunity through a couple of different mechanisms. But some lectins are helpful, while others, like the one that most people probably have heard of called ricin, it's downright poisonous. It will kill you in a certain amount, and so, like pretty much everything in life, lectins are neither all bad nor all good. It just really depends, and it depends on the specific lectin, the specific person, perhaps the amount that you're consuming. So here are a few pointers.

Speaker 2 8:57

Foods that have the highest lectin count are grains, especially wheat and gluten containing grains, but also beans and legumes, and there are variations. Some beans and legumes have more than others. Again, some nuts and seeds. Some nuts and seeds have more lectins and those lectins are more problematic than other nuts and seeds. And the nightshade vegetables, which is your tomato, potato, eggplant and peppers. Now, we do know that soaking and cooking beans and legumes can reduce the lectin content, but that's reduced and not eliminate. So that's going to work for some people. It's not going to work for others. Again, it all depends on the sensitivity of the person. But as far as carbohydrates go, the first thing to consider eliminating when you have a health challenge is or are all grains, all beans, all legumes, all nuts, all seeds and all nightshade vegetables. And that's specifically not just to maybe contribute to controlling your carbohydrate intake but to get away from these potentially problematic lectins that we see being an issue often enough with people who have auto-immunities, systemic metabolic arrangements, so that we can remove some kind of a fending factor or trigger that causes the immune system to upregulate and that's going to be an issue.

Speaker 2 10:23

And as far as individuals go, the ones who are more likely to have these problems with lectins are the ones with autoimmune disease issues or autoimmune reactivity and or leaky gut. They often go together, but not always, and these lectins can cause issues through a couple of different mechanisms. The first is that as these proteins bind to sugar components of cells, they can alter cell function and they can tend to invoke a general inflammatory immune response. And that's part of how high-lectin foods can at the very least prevent something like a leaky gut from healing and, at the worst, can actually cause it. But the second way that lectins can be a huge problem is in the realm of autoimmunity, and I've shared with you before the basic concepts of molecular mimicry or what we commonly call cross-reactivity. Cross-reactivity or molecular mimicry is where something has a protein structure, like a food has a protein structure which at the molecular level looks enough like the protein structure of your own cells that your immune system attacks both of them.

Speaker 2 11:35

And this is not some fringe theory that you know held by wackadoodle healthcare practitioners on the alternative medicine side. This is legit science and it's fairly well studied. Whether it's well known among practitioners is another issue. The science is certainly there, and so what we know is that some lectins tend to look like specific human tissues, so that we can say with some confidence that, in general, grains, especially the gluten containing ones, certain beans and legumes and certain vegetables tend to be a problem with people who have autoimmunity or who are predisposed to that, and the target in autoimmunity spans a wide range of different tissue types. Lectins can flare up autoimmunity to the thyroid, to the brain, to the gut, to the liver, to skin, to adrenals, and that's not the entire list, but perhaps some of the more common ones that we see in clinical practice and studying and research. And, what's more, these lectins can cause immune targeting of subcomponents of these larger systems, like singling out specific enzymes or certain aspects of neurotransmitter systems, for example certain neurotransmitter receptors. Now I'm going to put a link in the description to an article published by a mentor of mine is a PhD in immunology and he studied this concept over years, just so that you can see I'm not blowing smoke right. There is science behind this. Lectins can be a huge deal for someone, so look for that link in the episode description.

Speaker 2 13:06

And the third way that carbs can be an issue is with their anti-nutrient content. Anti-nutrients are compounds found in grains and, again, some vegetables that inhibit the absorption of vitamins and minerals, and one of the most well-known anti -nutrients is something called phytic acid. You might hear it referred to as phytates, and it just so happens that the foods that are highest in phytates that might interfere with nutrient absorption are the same foods that are high in these unfavorable lectins. And that makes it kind of easy in deciding to reduce or eliminate the consumption of grains again, especially gluten containing ones, or eliminating most beans, legumes and nightshades, nuts and seeds. That can help across more than one decision point because you cover multiple bases. So again, the paleo diet, with a little tweaking, is going to be the best content prescription for most people. So what do I mean by content prescription? Simply the list of things to avoid, which by default leaves you with a list of things that you could eat and they will be generally safe for you.

Speaker 2 14:18

But when you look at diet and trying to sort that out for yourself, diet content is not the only parameter to figure out with your dietary strategy. Quantity is another one. How much do you eat and how do you parse those calories out across calories coming from protein sources or fats or carbohydrates, and since I did a longer series about discovering your personal food code I think it was last year, so I'm not going to repeat everything from that series If you haven't listened to that, highly recommend you go back. It's a distillation of the strategy that I used with all of my personal coaching clients to help them use diet as a tool for optimizing their health. Again, that segment is called Discovering your Personal Food Code. Just search for that wherever you're listening, whether it's Apple or Spotify or even on YouTube. So the part of that that I want to cover now is in the quantity section is the part that applies to how much carbohydrates should be in your diet.

Speaker 2 15:20

Sugar and carbohydrates account for the largest percentage of the calorie intake of most North Americans, and it's gone way up since about the 1980s. The 1980s was the advent of the low fat, high carb diet, which experts at the time claimed would solve heart disease because you're reducing fat, particularly saturated fats, and in fact, the experts back then predicted the eradication of heart disease as a result of reducing dietary fat, replacing it with carbohydrates, and of course, that did not happen. But what did happen as North Americans shifted their diets to more carbohydrates and reducing fat, there was a drastic increase in the rates of obesity. All you have to do is go to Google. Google the phrase obesity rates by decade, and you'll find a series of websites that show graphs that basically show obesity starting to skyrocket somewhere between the 1980s and the early 2000s and after about 2000, it starts to level off to the point where we get to our current high rates, which are the highest rates of obesity that we've ever seen.

Speaker 2 16:33

And I'm not saying that carbohydrates alone are solely responsible for the obesity epidemic, but consuming more carbohydrates than your body can handle is a major player in that. And that idea that Everyone has a personal carbohydrate tolerance threshold is the basis for you and that's the thing that you need to know to find your own personal carbohydrate sweet spot. How much can you handle without causing issues? So remember that high carb intake is really only reasonable or necessary. With well muscled athletes doing anaerobic or what we call glycolytic type exercise, these are activities that require a quick surge of high energy and high power over short distances or short periods of time. Think about sprinting, you know, from here to the end of a parking lot. That's a blood sugar or a glucose based activity. So if the goal is the lowest carb intake that you can handle, what number is that? Is it 120 grams of carbs? Is it 22? Is it 87?

Speaker 2 17:37

A lot of nutritionists and healthcare practitioners will express carbohydrate content of diet in terms of a percentage of your calories for the day, so they might define low carbohydrates, as you know, where carbs make up 20% of your calories for the day, and I honestly I don't like this approach because I think of the carbohydrate threshold as a hard number of a number of grams per day, not a percentage of total calories. And by fixing the carbohydrate intake as a number of grams, it won't change if your calorie intake goes up or down. Like if I tell you that you need to eat 20% of calories from carbs and you go from eating, say, 800 calories a day, if you're under consuming food and you need to double that to make maybe 1600 calories per day, you're doubling the amount of calories. But if you express your carbohydrate intake as a percentage, you're going to end up doubling your carbohydrates. That's the math. I mean, it's just simple math and that in most cases is going to be the wrong thing to do. But if I tell you that you still need to double your calories but you keep your carbohydrates capped at a specific number of grams per day, then we can control the impact of carbohydrates on your metabolism and then we just draw extra calories from protein and healthy fats and fill in whatever gap it is that we need to fill in and, believe me, that will help you control your metabolic state much more easily.

Speaker 2 19:11

So what is low carb and how is that different from very low carb or even keto? Well, in general, low carb is defined as any carbohydrate intake less than about 125 to 130 grams per day. And just so you know, the average carbon intake of someone eating a standard North American diet is over 250 grams of carbs. So low carb is half of what most North Americans are consuming, and that's you know this. Eating more than a couple of 100 grams of carbs per day when you're not a well muscled, power type athlete, that's devastating metabolically for most people and, again, it's at least twice as much as what they should be consuming.

Speaker 2 19:54

So when you look at the spectrum of low carb, it goes from, let's say, 130 grams per day on the high end to zero on the low end, which is the carnivore diet, and some people can flip back and forth between the two high carb or not high carb but they can be at the high end of low carb at around 130. They can be somewhere in the middle. They can go keto, which is a much lower carbohydrate. They can flip back and forth and it can be perfectly fine they can. They can engage in intermittent strategies, like fasting strategies for 16 hours, one, two, three days at a time where you're going zero carb because you're not eating any food, and these things are advantageous. Like you should be able to do that right, and this is, you know, one of the big impact points of the protein-sparing modified FAS that we talked about when I interviewed Maria Emmerich a few months ago. Being able to eat and tolerate carbs is advantageous, but so too is being able to eat and handle very low carb or keto or even carnivore.

Speaker 2 21:02

And the question you have to grapple with is how low is low enough to accomplish your goals? Are your goals fat loss? Is it brain health? Is it reduction of joint and muscle pain? Is it your gut? Is it something else, or is it a combination of all of those things? And what you might find is that some people, regardless of their complaints, will drop out a small amount of carbs and do really, really well even though they still have carbs in their diet, while others will have to drop out more carbs and go even lower to get the same benefits. Some people might have to go all the way down to keto. Some people have to go full-on carnivore.

Speaker 2 21:40

So how do you separate the low carb approaches by numbers? Well, let me give you a quick rundown of the amount of carbs that are associated with different low carb levels, and these are ballpark numbers and this is the way I look at things. So this is not like an official from the ivory tower. Someone else has defined this. This is, although I will say that in general, there's some pretty good consensus that low carb is anything less than about 130 grams per day. So let's start there Right.

Speaker 2 22:11

Low carb is a category anything less than 125, 130 grams of carbs per day, and if you don't know what that looks like, like I'm throwing out numbers, I'm not just assuming. Well, you know what that looks like, but it's perhaps best to think of carbohydrates in roughly 20 to 25 gram increments, and you know, roughly 20, 25 grams. Depending on the size that would be an apple, or perhaps a banana, or half a cup of white rice, it could be a medium-sized potato. That's roughly 20 to 25 grams of carbs. Again, everything's going to be depending on the size. So, using that as kind of your mental calibrator, if I say to you you know, hey, maybe you should consider eating 50 grams of carbs per day which I'm not saying to you as a prescription, I'm just, you know, speaking out loud. If I said to you 50 grams of carbs per day, you're like well, that's an apple and a banana. Now you know in your head how much that is, without actually having to get out a scale and weighing and measuring your food, although that is not a bad thing to do. My wife and I do that all the time. So we have low carb, which is anything under about 125. We'll use 125 because it's an even increment of 25 grams.

Speaker 2 23:27

Very low carb, then, is generally anything less than 50 grams of carbs per day. Now that again is somewhere around an apple and a banana, or an apple and a small baked potato, or it's a baked potato and a half a cup of rice, something like that. And again, I'm not saying you should be eating these foods because maybe they're okay for you, maybe they're not, I don't know. Again, just trying to give you a mental picture. So we have low carb, which is anything less than, say, 125. We have very low carb, which is generally anything less than 50. And then we have ketogenic, which is very low carb and, roughly speaking, most people are going to have to eat less than 30 or 35 grams of carbs per day to be in ketosis. That's going to vary depending on their physiology and their activity levels. And so if I said to you, hey, let's start eating 30 grams of carbs per day, what does that look like? Well, maybe it's an apple, and maybe it's a cup and a half or so of berries and a protein shake, and that's it. You're done, doesn't take much.

Speaker 2 24:38

And this is one of the reasons why North Americans and the Standard American Diet are eating so many carbohydrates is because it's so easy to find them. It's not just that. I mean, there's the whole science behind. Foods now are engineered for taste and palatability, I would say even addictions. We get hooked on foods that taste good. We love the texture and have studies that show that certain foods and combinations of different flavors actually stimulate the addiction centers in our brain, like that. Again, that science, I'm not making stuff up.

Speaker 2 25:14

So, to reiterate, we have low carb, we have very low carb, we have ketogenic and then, of course, we have carnivore, which requires no carbohydrates at all, and so these carbohydrate levels are like Russian nesting dolls, right? Carnivore and keto are both very low carbohydrate diets, which is a version of a low carbohydrate diet, just a more extreme version. So, in other words, low carb includes very low carb, keto and carnivore. Very low carb includes keto and carnivore, and keto is very close to, but not exactly the same as, carnivore, because carnivore has zero carbs. So for you, like, how do you need to go? Of course, the answer is I don't know, because I don't know you, I don't know your history, I don't know your labs, I don't know what your goals are.

Speaker 2 26:07

But I can suggest to you that if you decide on your own to drop your carbohydrates down again, if you choose to do so of your own accord, you have to watch for signs of blood sugar destabilization, meaning that if you do not have an adequate amount of metabolic flexibility, if your body is not efficient or adept at switching into and out of fat or carbohydrate burning as your primary fuel source, then you eat the lowest amount of carbs that you need to have decent energy, good mood control, good mental focus and no cravings. If you drop your carbs down to any of these low carb levels and you get tired or you have brain fog or you can't concentrate or you've got cravings, it's a sign number one that you are dependent upon carbohydrates, that you are inefficient at burning fat as a fuel source and probably you need to develop that capacity. But pushing the process can backfire. So if the symptoms are mild and you can adapt within a few days, then no big deal. You were close to being metabolically flexible and all it took was just a little push, a little practice to get you there. That's fantastic.

Speaker 2 27:24

If you feel miserable when you drop your carbs down too low and it doesn't clear up after a couple of days on its own, without doing any special tricks or tips, I said, especially if you're using electrolytes, which sometimes can really help stabilize that transition. So if you feel miserable and again it doesn't clear up and electrolytes don't help, then you need to bring some carbs back into your diet healthy ones, obviously in order to stabilize your body, your metabolism, and then spend some time with the lowest carbs that you can handle to be stable and then try again in a couple of weeks. The more time you spend in a lower carb state, the easier it is to transition into full blown metabolic flexibility. So think of the various levels of carbohydrate intake as stepping stones that you descend, causing at any given step, when going down, more destabilizes you. So with the numbers that I gave you, between low, very low carbohydrates and so on, you'll notice that there's a big drop from 125 grams per day at the top end of low carb to 50 grams per day, which is the top of the low carb category. And if you can't make that jump from 125 to 50 and handle that well, then add in a few steps along the way. So maybe you start in 125 grams per day for a few weeks and then you drop by 25 gram increments. You go from 125 to 100 and see how you do. If you're okay, stay there for a couple of weeks, then drop down to 75 grams and then continue on in that stepwise fashion until you get to the point where you're satisfied you're doing the best that you can. So let me summarize here before I close.

Speaker 2 29:19

More than any other macronutrient carbohydrates can present a multitude of challenges to people with health issues, and most people will need to modify the content and quantity of the carbohydrates they eat in order to get better. However, most people are running a carbohydrate dominant metabolism and therefore they are dependent metabolically dependent on carbohydrates, which is not a good place to be. Being metabolically flexible means that you can drop out your carbs, replace them with calories from protein and fats and still maintain functionality and quality of life. If you destabilize which means that you get tired, you get moody, you get foggy you've got cravings for more carbs. In particular, that means that you've gone too far. You need to bring some carbs back in for a period.

Speaker 2 30:12

So consider dropping your carbs in 25 gram increments until you find the lowest amount of carbs that you can eat and remain stable, and no matter what the number is, because the number really doesn't matter. It's the function and quality of life that's important. So, no matter what the number is, you should always be striving to have the capacity to fast or to eat low carbs with grace. Now, whether you do so or not is up to you, but you should have the ability to do that. So ask yourself can you currently do a 16 hour fast and function well throughout that entire period of time. If not, you have some work to do. Ideally, you should be able to handle not just a 16 hour overnight fast, but maybe a one day fast, up to a three day fast. You should be able to handle those with relative ease.

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Speaker 2 31:06

Okay, one final tip before we close. I mentioned this earlier using electrolytes with adequate sodium throughout the day can really help smooth this transition and training period. And here's why and I'll leave you with this Carbohydrates allow your muscles to hold onto water and other nutrients. So when you drop your carbohydrates, you lose water content in your muscles and you start to spill your electrolytes and other nutrients that are needed for basic human metabolism. So again, sometimes simply adding a pinch of salt to your water or using pre-packaged electrolytes can really help you as you stair, step down and find your own carbohydrate sweet spot. All right, guys, we'll leave it there. Hopefully that answered some of your questions. Let me know in the comment section or you can use the website and you can reach out to me directly. Thanks, guys. We'll talk again soon on the inflammation nation podcast.

Speaker 1 32:07

Thanks for listening to inflammation nation. If you enjoyed this episode, make sure you subscribe to our podcast. Be the first to know when a new episode drops so you can stay on top of your game. It also helps others like you find the answers they need. You can use the links in the episode description to check out Dr Nose Release self-learning programs for thyroid detox and gut health, or you can submit a question for the podcast and even reach out to Dr Nose Release directly.