Authors: Chris Kresser
Tags: #Health & Fitness / Diet & Nutrition / Diets, #Health & Fitness / Diet & Nutrition / Weight Loss
Now that you’ve developed your Personal Paleo Code through beneficial changes to your diet and lifestyle, let’s focus on five areas where you can fine-tune your code even further. You feel great now, but you’ll feel (and look) even better once you zero in on personalized answers to these questions:
•
Macronutrient ratios:
How much carbohydrate, fat, and protein should you eat?
•
Calorie intake and meal frequency, timing, and size:
How often, and how much, should you eat?
•
High activity level:
What changes should athletes and highly active people make?
•
Superfoods:
Which foods are highest in essential nutrients? How can you further optimize your health and prevent disease?
•
Supplementation:
Which supplements should you take, and which should you avoid?
Macronutrients—protein, carbohydrate, and fat—are the nutrients that humans consume in the largest quantity and that make up the bulk of
our caloric intake. In Step 1 we discussed macronutrient quality: which
types
of fat, protein, and carbohydrate are optimal for human health. In this section, we’re going to discuss macronutrient ratios:
how much
protein, fat, and carbohydrate you should eat and in what proportion.
Despite various recommendations from mainstream health organizations, nutrition experts, and diet gurus advising you to go low-fat, low-carb, or high-protein (or some magic combination of all three), the truth is there’s no one-size-fits-all approach when it comes to macronutrient ratios. We share a lot in common as human beings, but we’re not robots; we have different genes, lifestyles, health issues, activity levels, and goals, and all of these factors will influence what an optimal macronutrient ratio is. And since these factors can change over time (for example, if you develop a chronic illness, significantly reduce your activity because of an injury, move to a new climate, or start training for an athletic competition), your ideal macronutrient ratio can also change over time—and even seasonally throughout the year. Learn how to listen to your own body and determine what it needs; don’t just jump from one fashionable diet trend to the next.
For most people, the
quality
of macronutrients has a much more significant impact on health and well-being than the
quantity
or
ratio
. The fact that hunter-gatherers thrived on a variety of diets and macronutrient ratios supports this idea.
If the low-fat-diet gurus are correct, then you would expect the Inuit, Eskimos, and Masai, with their extremely high-fat diets (the Inuit get up to 90 percent of their calories from fat), to be obese and dropping dead left and right of heart attacks. If the low-carb gurus are correct, then you’d expect to see a lot of overweight and metabolically dysfunctional Tukisentans and Kitavans, whose diets are, on average, about 70 to 90 percent carbohydrates, or even higher! In fact, we see neither. All of these populations are virtually free of the modern diseases, like obesity, diabetes, heart disease, and autoimmune disorders, that are killing Americans every year. They also tend to be lean and muscular, and without having to spend hours on the StairMaster at the local gym.
Humans can thrive on a wide range of macronutrient ratios; let’s take a closer look at the factors that determine what specific mix of fat, carbohydrate, and protein is right for you:
•
Constitution (genetics, physiology, biology).
Modern studies have shown that some people have genes that predispose them to problems metabolizing glucose (sugar), while others have genes that make it more likely they will have problems burning fat. There is still much we don’t understand about the contribution of genetics to diet and the relationship between genes and environmental factors.
•
Season.
During the summer, your body will naturally crave different foods than it does during the winter. It’s true that our ancestors had access to certain foods only at certain times of the year. If they lived in Northern Europe, they weren’t eating mangoes from Thailand in the winter.
•
Geography/climate.
If you’ve been to the tropics, you probably found yourself craving lighter foods with higher water content, like fruits and vegetables, more than you did at home. Likewise, in cold climates, you probably gravitate toward eating more protein-and fat-rich foods, like meat stews. There’s a reason for this.
•
Health status.
Have you ever noticed that you crave different foods when you’re coming down with a cold or the flu? The body has different needs in different physiological states. Women often crave more carbohydrates during pregnancy because the developing fetus has a need for glucose, and women naturally become somewhat insulin resistant as a result. People with thyroid problems may suffer on very low-carb diets, because insulin is required for proper thyroid-hormone conversion. As people age and become less active, they often find that they need less food, or perhaps less of a particular macronutrient, than they did when they were younger.
•
Activity level.
A construction worker doing manual labor for eight hours a day or a high-level athlete in training will have different dietary and macronutrient needs than someone who works at a desk. This should go without saying, but, amazingly, it is often ignored in the discussion about macronutrients.
•
Goals.
If you’re training for the next Mr. Olympia competition, you will very likely eat different foods than an obese person trying to lose weight.
Before we move on, keep these numbers in mind:
•
1 gram of carbohydrate has 4 calories.
•
1 gram of protein has 4 calories.
•
1 gram of fat has 9 calories.
You’ll use these numbers to do some quick math as you calculate your own ratios.
In the United States, the average person gets about 45 to 60 percent of total calories from carbohydrates. For a moderately active man eating 2,600 calories a day, this works out to between 290 and 420 grams a day (using the numbers in the box above, that’s approximately 1,200 to 1,700 calories from carbohydrates). For a moderately active woman eating 2,000 calories a day, it’s about 225 to 325 grams a day (around 900 to 1,300 calories from carbohydrates). On a typical Personal Paleo diet that includes starchy vegetables, fruit, some dairy products, and perhaps white rice (if tolerated), carbohydrate intake tends to range between 15 and 30 percent of total calories a day. A low-carbohydrate Paleo diet ranges between 10 and 15 percent of total calories as carbohydrates, and a very low-carbohydrate Paleo diet would be anything lower than 10 percent. On a high-carbohydrate Paleo diet, carbohydrate intake would be somewhere between 30 and 45 percent (or higher) of total calories.
Paleo Diet
: Very low-carb
Carbohydrates (% of Total Calories)
: <10
Paleo Diet
: Low-carb
Carbohydrates (% of Total Calories)
: 10–15
Paleo Diet
: Moderate-carb
Carbohydrates (% of Total Calories)
: 15–30
Paleo Diet
: High-carb
Carbohydrates (% of Total Calories)
: 30–45+
While many health experts include nonstarchy vegetables (such as green vegetables, carrots, peppers, and so on) when counting carbohydrates, I do not. Though these foods do contain carbohydrates (primarily glucose), they are difficult to break down, and our bodies actually expend glucose in the process of digesting these foods. Therefore, I count only carbohydrates from starchy plants (sweet potatoes, potatoes, taro, yuca, plantains, white rice, buckwheat, and so on), fruit, dairy products, and sweeteners.
Ultimately, the only way to determine your optimal macronutrient ratio is to experiment. Most of my patients do best with a standard, moderate-carbohydrate Paleo approach, with between 15 and 30 percent of total calories from carbohydrates per day, which I’ll explain in a moment. First, however, here are some situations that may call for a carbohydrate intake that is either lower or higher than standard:
•
Those who need to lose weight and have not tried low-carb before
•
Anyone with metabolic problems, such as insulin or leptin resistance
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Those with high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia, often seen as reactive hypoglycemia, which occurs after meals)
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Those with mood disturbances (though mood disturbances can sometimes be helped with higher carbohydrate intake, especially if sleep problems are involved)
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Those who have significant amounts of weight to lose or metabolic issues and whose blood sugar responds very poorly to dietary carbohydrates
•
Those with neurological or cognitive problems
•
Those who have tried a low-carbohydrate diet with some success (who may find added benefit from trying a very low-carbohydrate diet)
•
Those who are highly active or training hard
•
Those who are lean and have trouble maintaining their weight on low-carb diets
If none of the above applies to you,
begin with a moderate-carbohydrate Paleo diet
(that is, 15 to 30 percent of calories from carbohydrates). This amounts to roughly 100 to 200 grams per day on a 2,600-calorie diet (400 to 800 carbohydrate calories) or 75 to 150 grams per day on a 2,000-calorie diet (300 to 600 carbohydrate calories). (See the section below called “High Activity Level” for information on how many calories a day you should aim for if you’re exercising regularly.)
Try eating at the lower end of the range for two weeks, and then the higher end of the range for the following two weeks. Performing this experiment is valuable, because you’ll get a sense of how changing the
ratio of carbs to fat affects you personally, and you can use that information to fine-tune your macronutrient intake, right down to the daily or even hourly level. For example, I’ve found that eating fewer carbohydrates helps me to focus mentally. By contrast, if I eat low-carb on a regular basis, my energy flags and I don’t sleep well. So I will often eat a relatively low-carb breakfast and lunch, to support mental clarity throughout the day, and a higher-carb dinner, to support sleep and energy levels.
If you have any of the conditions I listed, try the low-carbohydrate or very low-carbohydrate approach as indicated. But remember, some people on low-carbohydrate diets find more benefit from adding carbohydrates back into their diet than from further reducing them. This is where your personal experience should guide you. Pay attention to all of the variables I listed above and adjust your ratios accordingly. As a general rule, as your activity level increases, you will want to increase your carbohydrate intake commensurately. If it’s winter and you’re living in a cold climate, you may find that eating extra fat helps keep you warm (although others get that result from eating more carbohydrates, possibly because of the effects of carbohydrate intake on thyroid hormone). In addition, following very low-carb diets over a long period may adversely affect the gut flora, leading to digestive symptoms like constipation or diarrhea, halitosis (bad breath), gas, bloating, and abdominal pain. If you experience these changes on a very low-carb diet, I’d suggest increasing your intake of fermentable fiber and fermented foods, and/or taking prebiotic and probiotic supplements. See
chapter 10
and the bonus chapter on digestive disorders on my website for more information.
The point is this: You need to experiment. Nobody (including me) can tell you what your ideal ratio is. But by following these basic guidelines and keeping track of your symptoms, you should have no trouble figuring it out.
There’s no doubt that very low-carb diets are beneficial in certain situations. However, in some cases, they may actually be harmful. These include:
•
Hypothyroidism.
Some evidence suggests that very low-carb diets may contribute to poor thyroid function. Insulin is required to convert T4, the inactive form of thyroid hormone, into T3, the active form. Insulin levels are chronically low on a very low-carb diet, which in turn can lead to low levels of T3 and hypothyroid symptoms. This doesn’t happen for everyone on a very low-carb diet, but I’ve seen it often in my practice. If you develop cold hands and feet, fatigue, difficulty concentrating and memory issues, hair loss, and other symptoms of poor thyroid function while on a very low-carb diet, try increasing your carbohydrate intake until the symptoms resolve.
•
Pregnancy.
Carbohydrate needs may be slightly higher during pregnancy due to the growing baby’s need for glucose. I’ve noticed that most pregnant women tend to do better with moderate carbohydrate intake (about 15 to 30 percent of calories) than with low-carb or very low-carb diets. The exception would be women with type 1 or type 2 diabetes, who may need lower-carb approaches to avoid hyperglycemia, which can harm the growing baby.
•
Adrenal fatigue.
I’ve found that most of my patients with adrenal fatigue syndrome (described in more detail in the bonus chapter on this subject on my website) don’t do well on a very low-carb diet.
•
Insomnia.
If you find yourself waking up frequently throughout the night, and you’re on a very low-carb diet, try increasing your carbohydrate intake slightly. In some cases, this single change can resolve the insomnia.
•
High levels of physical activity.
If you’re highly active and training hard, you’re going to be burning a lot more fuel. While
some athletes seem to do well on very low-carb diets, most do better with a significantly higher carbohydrate intake—as high as 50 to 60 percent of calories (roughly 325 to 400 grams per day on a 2,600-calorie diet and 250 to 300 grams on a 2,000-calorie diet) in some cases. See the section below on how to modify your diet if you’re highly active.
As always, you’ll have to experiment to see what works for you. But if you have hypothyroidism, are pregnant, or are training hard, I’d suggest beginning with a more moderate (about 100 to 200 grams per day) intake of carbohydrates.