 Who Tolerates Carbs? The conclusion by ostensible authorities is murky. However, there are clear findings which point us in the right direction. The official guidelines on macronutrients is contained within the Nutrient Recommendations: Dietary Reference Intakes (DRI), which is freely available here: https://www.nap.edu/read/10490/chapter/1#ii The recommendations contained therein are accepted by the Institute of Medicine, the NIH, the National Academies and was undertaken by the National Research Council. Thus, the project to finalize these recommendations was funded and supported by the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion, the U.S. Food and Drug Administration, the NIH, the CDC, the Institute of Medicine, the USDA, the U.S. Department of Defense and some other fairly reputable bodies. Oddly, however, there is overt disclosure of involvement on the part of Roche Vitamins Inc., Mead Johnson Nutrition Group and M&M Mars. Clearly, each of these groups’ involvement is an obvious conflict of interest in determining dispassionate purely science-driven findings.  Even more odd is the admission of extreme shortcomings in these recommendations within the project’s own preface. One line reads, “although all reference values are based on data, available data were often sparse or drawn from studies with significant limitations in addressing various questions confronted by the panel and subcommittees.” Another line reads, “questions that were raised about requirements and recommended intakes could not be answered satisfactorily.” Nonetheless, although all of the aforementioned might lead an educated reader to expect outrageously high carbohydrate recommendations (as was the case with the food pyramid, Western breakfast culture, etc.) the conclusions are quite the contrary. If anything, the National Research Council really went out of its way to take into account as many considerations as possible. Chapter 6 Dietary Carbohydrates: Sugars and Starches is a treasure trove of citations from disparate research groups which drills down into known biological mechanisms. The authors admit to incredible layers of complexity far beyond even Glycemic Index ratings, chemical structure and World Health Organization’s attempts at answering carbohydrate-apropos questions. That is, any recommendation is only as good as it takes into account every other factor. Change one variable elsewhere (e.g. - the protein intake, an 18-hour fasted status, body mass, etc.); and the range of recommendations must consequently change. Most intriguing is that page 275, Clinical Effects of Inadequate Intake, is very clear about the sum total body of scientific knowledge on the subject: “the lower limit of dietary carbohydrate compatible with life apparently is zero.” The authors went on to describe how every attempt to confound this biological fact has come up entirely and unequivocally empty-handed. Humans require no exogenous carbohydrates whatsoever. ZERO. "the lower limit of dietary carbohydrate compatible with life apparently is zero" - The National Research Council The chapter does go on to explore what level of carbohydrate may be required in the absence or inadequacy of dietary protein or fats. However, even in clinical research on starvation, the human body is incredibly resilient at meeting all of its energy needs without much downside at all. Obviously, starvation cannot be continued for periods longer than a few weeks; and this doesn’t answer the question about optimal human performance, optimal athletic performance or tolerance. The authors do attempt to peg recommendations based on the energy demands of a theoretical male and female of various ages, zeroing in on about 100 grams per day for most ages, allotting for up to a possible approximate 200 grams per day for pregnant or nursing mothers. However, on page 281, they also invoke the Fomon research, which showed that EVEN WITH INFANTS THERE IS NO DIFFERENCE IN RATE OF GROWTH OR BRAIN DEVELOPMENT WITH A DIET COMPRISED OF 32% VERSUS 64% CARBOHYDRATES. The first conclusions are obvious: it is easy to state emphatically that carbohydrate need is zero; it is very difficult to emphatically say what additional intake of carbohydrate serves ANY benefit. Consequently, we are increasingly backed into a corner wherein the question moves away from “how many grams of carbohydrates should a human have?” to “how many grams of carbohydrates can someone get away with?” Or, who can tolerate carbs? Really. Who CAN tolerate carbs? Since even the people most tolerant of carbs will subject themselves to possible long-term consequences from the unavoidable inflammatory responses inherent within carbohydrate consumption, this question can’t well be answered with finality for the long-term. But we can look at the near-term. In the near-term, who can get away with carbs, and by what degree? The answer may be best answered first by clarifying what tolerance is exactly. Glucose tolerance is the ability to readily dispense of a rise in blood sugar. This comes down to hormone balance and systemic status of glucose transporters, insulin receptors, pancreatic, hepatic, adrenal and renal function. We can test it at each level or the gestalt. So we can answer this question definitively in any individual. People merely need to test blood sugar prior to eating, test again after spiking after eating, and find that they return to pre-meal baseline within 30 minutes after spiking. That would indicate that this particular individual tolerates well that bolus of that carbohydrate under those circumstances. But we could draw the conclusions no further. Just as the authors of the DRI paper concluded, every variable affects everything else. If the amount of dietary fat or protein for that person varies the very next day, the tolerance would be different. If the activity level varies, the tolerance would be different. And so on. In my experience with glucose testing on clients and with my own readings over the past 13 years, the Venn Diagram above is far too forgiving (but given the question of tolerance I’m erring on the high side). Even a heavily-muscled, extremely lean, young, highly-active male or female with ectomorphic tendencies and great genetics who is aiming to gain size will eventually run into body fat gains and increased risk of all-cause mortality not long after 3-4 grams per kg bodyweight per day. Most people can't tolerate 1g/kg/d. It is true that there are healthy and long-lived cultures who have a higher percent of carbohydrate intake. But they are playing by different rules. We can cross-reference the Tsimane and Okinawans who both tolerate and even thrive with a 70% dietary carbohydrate intake. Nonetheless, their total food intake is so minimal as to fall within or under the 1-2 g/kg/d guideline, and in both cultures there is nonexistent processed food, nonexistent sedentary behavior and nonexistent obesity. So they have the cards stacked in their favor to begin with. In the industrialized Western World, we have an end-spectrum example of stratospheric carbohydrate tolerance: elite ultra-endurance athletes. In the Tour de France, for example, cyclists gain no body fat during competition. They may even lose up to 10lbs while eating as much food as they can fit into their bodies. We do know that the act of physical exercise inhibits insulin production and its release; and we know that Tour cyclists are dispensing hundreds of thousands of milligrams of glucose per hour. Their average daily carbohydrate consumption is about 850g (https://www.ncbi.nlm.nih.gov/pubmed/9506803). And the average weight of a Tour cyclist is 68kg. Therefore, at least in the near-term we know of a far-end-of-spectrum tolerance of 12.5g/kg/d or more. Keep in mind, competitive ultra-endurance activity has been clocked at an average of 10,000 calories per day on the Total Energy Expenditure (TEE) measurements (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292109/), with a high of around 14,000 calories or more expended by some athletes. Their activity level is so astronomical that in theory some could tolerate (if the gut could handle it) over 3,000 grams of carbohydrates per day. But that is the absolute upper limit only during competition for the most elite of ultra-endurance athletes. Ergo, we are left with transient guidelines based first on the body composition tendency of the individual (which will dictate metabolic rate, and distribution of energy to prevalent tissues), second on the sufficiency of other macronutrients, and lastly on excesses incurred by activity level. This is also why there are numerous athletes who can tolerate, at least in the near-term, higher carbohydrate consumption. They tend toward lower body fat percentage than that of the average populace. They generally carry an absolute amount of lean tissue that is far greater than that of the average populace. They may even be attempting to grow more tissue. Their eating habits may even more closely reflect that of traditional cultures (that is, they must be more intentional in their inclusion of micronutrient sufficiency and nutrient dense foods). And their TEE is multiples of that of the average populace. Summary: Who must have carbs? - The entirety of science says no one Who should have carbs? - Maybe infants and nursing moms * I do not include athletes in this heading because there is no finality on the discussion with respect to exogenous carbohydrate consumption and athletic performance. Though one can reason that there ought to be a need, based on certain understandings about citric acid cycle and muscle fiber type, rigorous research has failed to bear this out even if we narrow our definition of “should” to the possible immediate benefit in training or competition. Chapter 6 contains breadth on this topic. The NRC notes more than once that dietary consumption of protein can suffice in this regard. Also, there exist fairly conclusive findings which indicate there is no downside in athletic performance with extreme carbohydrate restriction (http://www.elev8wellness.com/wellblog_best_nutrition_training_coaching_experts/-please-stop-the-carbs-because-science) even for intense activity among advanced athletes. To be fair, it seems that people must first transition through a period (3-42 days) of fuel-preference alteration before they can enjoy uninhibited athleticism with carbohydrate intake suppression. Who can tolerate some carbs? - Anyone who is trying to grow tissue - Anyone who is very lean - Several traditional cultures Who can tolerate some more carbs? - Energy expenditure machines Among those who can tolerate carbs, how much at maximum can they get away with? - According to the National Research Council, 28g/d (for infants) up to around 100-130g/d for most youths and adults, and around 200g/d for pregnant or nursing mothers, depending on other variables - It seems about 1-2g/kg/d per categorical variable that is in your favor - Infinite theoretical endpoint with commensurate or supra-commensurate energy expenditure (keep in mind that the endpoint example provided above had athletes consuming an average of about 850g of carbs, which is 3,400 kCal, while their average TEE was about 10,000 kCal; so they are far more than exhausting their blood sugar spike from all food {not just carbs}, any amino acids, fatty acids and triglycerides, and ketones in the blood, AND their muscle and liver glycogen - in the average populace this would be akin to a 5-7 day outright fast while still somewhat active)
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 https://www.nytimes.com/2017/11/02/health/heart-disease-stents.html?smprod=nytcore-iphone&smid=nytcore-iphone-share
Heart stents fail to reduce chest pain. Best line of article: "All cardiology guidelines should be revised". The implications are extreme. When friends and family suggest that you get a second opinion from a medical specialist, it is precisely because of discoveries like these. No one can stay on top of the continuous revision occurring in the sciences. And many of our remedies, you must remember, were based on now-antiquated understandings of human health.  Just even in the last 5-10 years, there have been quite a few discoveries in human biology and physiology which turned former wisdom on its head. Some systems which were previously unknown or misunderstood altogether have had major revelations (e.g. - glucose transporters in the regulation of energy within the body). As a product, certain conditions whose progression was once accepted as unavoidable or determined turned out to be quite the contrary. Type II diabetes is among them. Recently, there are several studies challenging the conventional narrative on diabetes, one of which I just this last month shared: http://www.elev8wellness.com/wellblog_best_nutrition_training_coaching_experts/cure-diabetes-in-short-order.
Several years ago I was already trying to encourage people to take this understanding into their own hands: http://www.elev8wellness.com/wellblog_best_nutrition_training_coaching_experts/lose-15lbs-for-15-in-2015. It's actually a very straight-forward and simple set of behaviors to prevent, stop the progression toward, or reverse already-existing diabetes. And the number of stories of people who've pulled it off is ever-growing. Prior to that, however, there was already conclusive evidence that one could reverse diabetes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/. And I might add that wholly absent in the discussion about reversal of diabetes is any mention of drug therapy. Not to be confused with type I Diabetes, type II is a daily progression toward or away from harm to receptors. Although there is some evidence advances in immunology and organ transplant are going to change our views about type I as well, what I'm talking about here is the very common and ever-evolving systemic regulation of energy within everyone. It's not really an issue which has different perspectives or has been up for debate for about a decade. It's simply a matter of compliance and patient willingness. All of us are on a spectrum moving toward or away from diabetes (glucose intolerance and insulin resistance). Regardless of your diagnosis, you are either moving toward or away. None of us enjoy a fixed status as "not diabetic" OR "diabetic." It is continuously in flux, within the year, the month, the week, the day, the hour, the minute. The research is clear. The mechanisms are known. Deplete stored energy in the body and you will restore youthful control of blood sugar and insulin. Fast. Exercise. Restrict intake. Do something to deplete stored energy. That will stop or reverse the trend toward or into diabetes. Anything else is moving us toward it.  I know when you're going to quit, and before you do. But because it's an embracing of weakness, you can turn it around by developing strength of character before it's too late. I wrote about this not long ago here in an exhorting fashion. However, there's another piece to the puzzle which I didn't explore in any depth with that article, but on which I do place most the focus in the video below: internal integrity. What is it and how do you build it? Watch and learn.   Donna Randall, one of the best physique athletes, is getting ready to step on stage with the best in the world, hamming it up with one of the best of all time, prepping with my co-coach Aaron Kanner, the best in the business. Thanks to Andrea Mason (also the best) for the shoutouts.
Today is a big day with a lot of historical firsts. Everybody, give her some praise. The photo, though striking, doesn't do justice to the road she's traveled. Everyone has challenges in life; but hers have been epic. You don't know it, because, like a true champion, she doesn't publicize them, share them, or ask for one iota of pity based on circumstances. Tough as nails, she does the work for the sake of excellence alone, earns every step, requests no handout, and lets the work stand on its own without caveat. You'll be hard pressed to find another competitor in ANY sport who just lets the work express itself. You know that even the Olympia stage is filled with greats whose elevator speech starts with, "it was a hard journey coming off this last injury, sickness, breakup, job loss, genetic defect, working overnights, death in the family, etc.". Her elevator speech: N/A. Greatness speaks for itself. The British Medical Journal admits you can end diabetes with lifestyle alteration: http://www.ncl.ac.uk/press/news/2017/09/losingweightcanreversediabetes/
Another long-known biological fact gets a headline. Though this is a bit late, it's still poignant, because there are organizations and specialists in the field for whom this is news. Insulin sensitivity/resistance and glucose tolerance/intolerance are spectra. That is, you are not either/or with regards to glucose and insulin control. You are approaching one theoretical limit or the other. Thus, whichever direction you're headed can be reversed and changes from day to day based on many factors. In my experience, some diabetes-diagnosed clients do a complete about-face in 3-10 days of nutritional changes.  Ninety year old people improve with strength training.
People who started late in life can dramatically progress their athleticism. There are 101 year old marathon runners. There is a 91 year old female gymnast who can do movements some of the strongest Crossfit competitors in the world can't do yet. Look up pretty much any search string on sprinting, cognitive sharpness and nonagenarians, centenarians and supercentenarians; and you will find examples of people who do not just rapidly deteriorate as a result of minutes ticking by. The conventional modern thinking on what it means to age is unsupported by any actual scientific evidence. In logic, all you require to utterly destroy a proposed rule is a single counterexample. We have not one, but many. Age is B.S.  It occurred to me recently that the public doesn't know how common rapid weight loss and transformations are in the first 30, 60, 90 days. To the layperson, these stories may sound stupendous, awe-inspiring and rare. However, they are actually the rule. Every club, every boutique, every trainer, every workout video, has many many extreme transformations in the short term. There is nothing special or uncommon about this. In fact, this emphasis on excitement and rapid progress, it appears, causes long term failure. Long term success stories, you'll find, you won't find. Look up any statistic you want on the American public awareness of health and fitness, and its involvement in fitness programs and diets, and you will find that it is growing all the time. Every year the supplement industry grows. The fitness industry grows. The healthcare and pharmaceutical companies continue to expand dramatically. Yet, paradoxically, more people are unhealthy than ever. One in two American men and one in three American women will get a cancer diagnosis. If that weren't bad enough, Nepal and a handful of other countries in the world have a one in fifteen-hundred person incidence of cancer. So, this doesn't need to be the way we live. In fact, even within this country, the Amish have a 40-70% lower incidence of cancer than their non-Amish counterparts. Constant stimulation and incessant pursuit of excitement in general is rendering increasingly worse outcomes. And it isn't just that; more people think they aren't overweight than ever while concurrently obesity is at an all-time high. Obviously, something is wrong. That something is an unwillingness to consider what an enjoyable sustainable healthy lifestyle will look like. It's called the long game. Predominantly the fitness industry pedals rapid transformation, sexy advertising, short term focus, immediate gratification. Predominantly the consumer wants exactly the same. The answer, however, is the COMPLETE OPPOSITE. We have to find small changes which improve us, small changes which we can keep doing in perpetuity, small changes which add up to something big in the end. Right now most people aim for big initial changes, and these add up to degeneration and failure in the end. I've written about this before here. This is a significant problem which almost no one is addressing, because there's money to be made by continuing to promote this fallacious narrative, and the consumer continues to be complicit in supporting products and services which have no basis in science or long term effectiveness. To compound the problem, there's a false dichotomy which obscures a healthy way forward for the populace. You don't need to choose between throwing your hands up or being a fitness fanatic. There's this enormous chasm between the two which houses genuine health and realistic sustainability. We know that overeating and sedentary ambivalence isn't the answer. But the extreme opposite simply doesn't pan out either. Some people who are seemingly "fit" are even less healthy than their overweight counterparts. Being lean can certainly help fight a variety of risk factors; but excessive systemic stress in order to get and stay lean is more than a Faustian bargain. I've met with many former hard-dieters, exercise-purgers and physique competitors whose hormonal profile is shot; and they are having a tragic fight to even get to a normal body composition. Nevermind that among the millions of people on earth who have incredibly high quality of life into their 90s and beyond, NONE are carrying mountains of muscle. We want to be strong. We want to retain and build lean tissue. But any extreme is a dice roll with costs; and the bill will come due. Any excess in body mass (even lean tissue) is additional organ demand. Longevity studies on lucid centenarians and supercentenarians find they have lower body mass. Long story short: we need to get smaller, but not via means which overstress or injure us. It's been interesting to watch the trends of people attempting to do the right thing for their health. At first I was really pleased to see that boutique and specialty fitness programs had had the fastest growth in the fitness world by an enormous margin. They put to shame the combined efforts of all big box gyms; and they are increasingly eating a bigger and bigger piece of the pie. The monster clubs are an anachronistic dinosaur which is breathing its last breath. As I've been following this, I've kept thinking this was an indication of positive changes in health and fitness culture. However, it seems that people aren't investing in the boutiques out of a heightened sense of informed consumerism, educated decision-making or desire to be involved for the long haul. Instead, it's the new status symbol. The focus has completely shifted away from what is productive and beneficial for people, and it is preoccupied solely with feelgood in-crowd bragging rights. What could be and should be a symbol of returning the industry to meaningful practices and improved thinking in the consumer is just another kicking the can down the road. What's worse is that the large fitness organizations, sensing that they are getting absolutely crushed by the boutiques, have retaliated with a doubling down on their emphasis in the short term. If you've paid any attention at the advertising in big boxes, you've noticed they have totally abandoned sincerity. What once was at least a veiled attempt at being honorable is now a nonstop flood of promotion aimed at increasingly short term practices. As soon as one is over, the next pitch rears its head. I wish this were a joke, but I've seen "member challenges of the week." Yes, we are now trying to pump people up for only seven days. Before you know it, there are going to be programs promoting single day or single hour rapid transformation. The trend is actually moving further away from realistic sustainability and closer to sensationalizing extreme short term programs. I talk about that here: When we put this obsession with excitement in context, it's really such an oddity. In just about every other facet of life, we take for granted that worthwhile outcomes will be the product of years of commitment. Whether we consider someone's profession, schooling, artistic mastery, parenting, you name it, no one really thinks in timetables of 30-90 day commitments. We measure proficiency over a lifetime, over decades, over at least a few years at minimum. Think about that. Those are just subsets of life. Yet somehow we think it's reasonable that health and fitness, the very foundation for all your pursuits, the centerpiece of your ability to even perform in any and all subsets of life, should warrant an investment measured in days? It's ludicrous. But the deranged thinking that believes in extreme initial excitement as valuable goes hand-in-hand with short timetables.
That's why rapid transformations are not just correlated with long term failure. They are causal. The mere act of holding up fleeting emotion as admirable IS immaturity. It excludes from its paradigm future success. Frankly, it excludes the future altogether. If your entire budget of energy and focus is aimed at the near term, doesn't that obligate you to divest from the long term? Of course it does. Here's the deal: we have to change the conversation entirely. Professionals, return to integrity. Please start setting appropriate expectations; and be honest about the fact that the more rapid someone's initial transformation, the less likely they are going to stay plugged in. Yes, it's irritating to see that "success" comes to the dishonest; but that should not be an excuse or equivocation to give up on doing the right thing. Consumers, as hard as it is, think about health and fitness as a lifelong investment. Determine what amount of energy above your current baseline is sustainable. Today, that may be the simple addition of a daily walk, meditative practice, or several glasses of clean water. In the future, it can be bigger and more dramatic investments. It's very much a Road Less Traveled type of situation. This isn't a victim-blaming by any stretch of the imagination. However, you do have to consider that people are conditioned through incentives; and as long as we incentivize "experts" to provide thrilling messages with no substance, the more the "experts" are going to feel the need to provide thrilling messages with no substance. I hear it all the time: we need that stimulus, that exuberance, that provocative intoxication to get people started; then we can do right by them. It sounds good. It seems to make sense. It feels fair. But it is exactly untrue. There is no evidence, no data, and no study to support that proposition. It's a feelgood lie, without even a few believable anecdotes. The time has come to shun rapid transformation. Seek and hold in esteem only worthwhile long term or lifelong investment and commitment. Do the right thing for the sake of doing the right thing. We will never end with integrity if we begin with spin.  Time and time again, every study on longevity finds that simple activity is insufficient for good health and fitness into old age. There is something special about subjecting the body to resistance or weight training. Indeed, the cultures whose constituents have incredibly long healthy life don't just do some more walking, Tai Chi or Yoga. They carry water pails. They pull up fishing nets. They till gardens. They work fields. They teach contact Karate. They do physical labor. They subject the body to resistance stress.
This is getting studied definitively now: http://news.wfu.edu/2017/10/31/lose-fat-preserve-muscle-weight-training-beats-cardio-older-adults/. The unique stress of additional loading against the skeleton, the integumentary system, muscle systems, and even the brain and nervous system is different than going for walks or hiking. It's not just different. It is better. Art de Vany has been working to define exactly what "aging" is. And in his tireless search, he's found no obligatory system which presses us to age. There is no genetic time clock. There is no predestined need for it. Rather, it's just accumulated damage paired with the tolerance of this declining ability. When we don't get up and do something difficult, we are reinforcing for our bodies that they SHOULD deteriorate. With deterioration comes increased risk of damage. With damage comes age. With age comes the fallacy that we should "take it easy." And so on. So, this doesn't mean you have to get a gym membership. But you do have to contract muscles hard in a way that tells your body it needs to get toughened up in preparation to dominate the normal demands of daily life. Otherwise you are going to accelerate aging and degeneration. I would argue that the gym facility affords many people a better way to do this, because the progressions can be meted out in an as-tolerated manner. That is, someone may really only be able to handle a 2lb dumbbell for a given exercise for a single set of 2-3 reps. With the artifice, the structure of a facility with this equipment, one can take a very strategic approach to modestly but progressively subjecting herself to ever-increasing demands in a slow and controlled fashion. In a few weeks, that same person may handle the 3lb dumbbells. She may handle two sets of 5-8 reps. And so on. Given that people require ease and convenience, I think it may be an unrealistically tall order to ask from the populace to get a little more serious about their heavy physical labor in a not-so-controlled environment, like hauling hay bales and some intensities which are far more unpredictable. Ergo, you must train with weights. |
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