Tag Archives: autoimmune

Dr Shawn Baker’s Carnivore Diet: a review

Interest in the controversial carnivore diet (a.k.a. zero carb) diet is booming!

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After trying low carb, paleo, and keto, for some people cutting out all carbs and plant foods is the next logical progression in their journey towards optimal health and diabetes control.

But, to some, this sounds counterintuitive!

Could eating only meat be healthy?

What about all those nutrients you get from plants?

Won’t you get too much protein?

What about fibre?

 

This article looks at the pros and cons of the carnivore diet through the lens of the Nutrient Optimiser.

I’m not sure that the carnivore diet is optimal for everyone.  But in light of all the n = 1s, it’s hard to say it doesn’t work really well for some people.

Does the carnivore diet break all the rules of nutrition?

I’m inquisitive.

Thinking out loud.

My aim is to understand the common factors of nutrition that help people thrive so we can apply them in a systematised manner.

Why is the carnivore diet becoming popular?

Other than Shawn Baker, there are a few interesting examples of people who have successfully followed a carnivorous diet for a long time and seem to be thriving.

Joe and Charlene Anderson

Charlene (45) and Joe (60) Anderson have been eating nothing but fatty steak for nineteen years, including through two healthy pregnancies.[1] [2] [3]

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Transitioning to a meat-only diet wasn’t all smooth sailing.  Joe says:

Once I tried a specific, fatty, meat-only diet I felt miserable at first. Massive headaches, depression, fatigue and nausea were common.

By the end of two weeks, however, the veil lifted and I felt great! I discovered that eating this clean meat-only diet was very healing, and I had my own demons and ill health that had to be expelled.

Charlene’s path to healing has taken considerably longer. Although she felt great immediately removing all the fibers, vegetables, and grains that she had been eating for years, she also felt the effects of starving out her Lyme bacteria.

Her body would cycle back and forth from feeling great as the Lyme died off, to feeling horrible because the Lyme was dying off. She gritted her teeth, dug in, and stayed on plan.[4] 

Charlene looks to be doing just fine these days.[5] [6]

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You can read more about Charlene’s journey at Meat Heals or follow Joe on Twitter.

Amber O’Hearn

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Amber is another prominent zero carber who progressed to a carnivorous diet after her success with low carb stalled.  She cut out all plant foods (other than coffee) and found her bipolar benefited significantly and her weight loss improved!

Amber has done a lot of thoughtful research and documented her journey at ketotic.org and empiri.ca.  She doesn’t claim that the carnivorous way of life is right for everyone, but she makes a good case for why we may not necessarily need fruit and “heart healthy grains” to be healthy.

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Dr Georgia Ede

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Psychiatrist Dr Georgia Ede on her Diagnosis Diet blog highlights anti-nutrients in plant-based foods (e.g. phytic acid, goitrogens, oxalates, and tannins) in not just grains and soy, but also cruciferous veggies such as spinach and broccoli, that also contain lots of vitamins and minerals.  Georgia says:

Nutrient bioavailability from plants is in many cases significantly compromised. Just because a plant contains a nutrient does not mean we can access it. One example: due to the oxalate within spinach, virtually none of the iron within spinach is available to the human body. As a second example, the zinc in oysters is virtually impossible to absorb if the oysters are consumed with corn tortillas.

There are too many variables to consider in a mixed diet to be certain how foods will interact in various individuals. Recommended daily intakes for nutrients are based on faulty assumptions and the data used to generate them comes from people eating standard diets. Diets high in refined carbs deplete many nutrients, increasing our apparent requirements.

While some people may benefit from restricting these compounds in their diet, I’m not sure that it’s necessary or optimal for everyone.

Many stressors in life are hormetic and can make you stronger in the long term.  While some people are delicate, we can’t always live in a bubble.

And plant compounds such as oxalates can affect availability you can’t absorb nutrients if they’re not actually available in the foods you are eating.  There is a trade-off between quantity and absorption.  It’s hard to quantify these things but the calculations that I’ve done based on the limited data available indicates that you should probably eat your spinach if you enjoy it.

Dr Gundry

While not strictly a carnivore, Dr Stephen Gundry has recently released The Plant Paradox where he speaks of the dangers of lectins and antinutrients in grains and legumes that many people struggle with, especially if they are prone to an autoimmune response.

While his book title may be a little misleading, Gundry still supports eating nutrient dense green leafy vegetables.

Paleo Medicina

While many people are talking about meat causing cancer Paleo Medicina are using a carnivore diet to treat cancer, autoimmune and other chronic conditions.  This Ketogeek podcast interview with biologist and clinical researcher Dr Zsofia Clemens is an intriguing listen!

Online groups

There are also a number of large online groups of people who swear by just eating meat, including Principia Carnivora and Zeroing in On Health.

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What I find fascinating is that these groups are every bit as passionate about their dietary approach as the plant-based vegans at the other end of the dietary spectrum who also claim that their diet was responsible for healing them of all their ailments.

While online groups are amazing for bringing together like-minded people to support each other on their journey, they are not exactly randomised trials and can suffer from confirmation bias, groupthink and survivorship bias (i.e. only the people that benefit continue to remain in the group and contribute).

I’m not accusing anyone particular of these traits, just nothing that online groups can be subject to these symptoms.  It’s hard to separate the anecdote from the science.

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Dr Baker has established the World Carnivore Tribe group which has a ton of positive anecdotes as well as Meat Heals which has been set up to gather n=1 experiences on a carnivorous way of life.

There’s no denying a LOT of people have found improved their quality of life when they simplified their diet to meat only.

It makes me wonder what the common factors of the optimal human diet are when people are zealous advocates of what appear to be polar opposite approaches.  How do we identify what works and systematise it to help everyone to move towards optimal?

Rather than forcing vegans to be carnivores and carnivores to be vegan, how can we optimise your food choices while still respecting your preferences?

(If you’re interested, we dig into the possible fundamental principles of nutrition in the followup to this article – Optimising Dr Shawn Baker’s Carnivore Diet from First Principles).

Dr Shawn Baker

Dr Shawn Baker (@SBakerMB, shawnbaker1967) is the latest high profile proponent of the carnivore approach to nutrition to burst onto the scene.

Shawn is a strength athlete who needs a lot of food.  In the past, this included plenty of cereals, low-fat yogurt, skim milk, pasta and grains to maintain weight with his high level of activity.[7]

After experiencing digestive issues exacerbated by his poor diet (note the similar story with others who have benefitted from zero carb), he progressively experimented with his diet, moving from the typical high carb to paleo, then low carb, then a targeted ketogenic diet.  However, he found that he would suffer gut distress when he added carbs back in on the cyclic keto approach, and eventually settled on a meat-only carnivorous dietary approach.

He has since gone to set world records in indoor rowing and continues to workout like a beast at 51.

He has been interviewed on a number of podcasts promoting nequalsmany, where he is trying to pool the experiences and test data from a range of people following a carnivorous diet.

Shawn saw a need to gather health and performance data from people following a carnivorous diet to try to understand why they seemed to be thriving in spite of cutting across a lot of mainstream health recommendations.

While I haven’t seen any analysis of the crowdsourced data yet, he recently carried out some testing on himself after a year as a carnivore, which we will look at later in this post.

Nutritional analysis

I’m intrigued at how someone like Shawn could be thriving, so I pinged Dr Baker on Twitter to get his standard diet to analyse in the Nutrient Optimiser.

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The Nutrient Optimiser is a tool designed to help people balance their diet primarily at a micronutrient level.  It then identifies food that provides the nutrients that they need that they are currently not getting in adequate quantities.

As well as maximising micronutrients, the Nutrient Optimiser can manipulate macronutrients and energy density to help you achieve your goals, for example:

  • if you are managing diabetes, we can reduce the insulin load of your diet to help stabilise your blood sugar levels or even further to achieve therapeutic ketosis,
  • if you are fuelling for an endurance event, we can wind up the energy density to help you to get more energy in, and
  • if you are looking to lose weight, we can reduce energy density to ensure you get the nutrient you need with foods that are more filling.

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What I like most about the Nutrient Optimiser is that it removes the various conflicts of interest to demonstrate that the foods that we typically know intuitively are bad for us (e.g. hyper-palatable processed junk foods) provide minimal levels of nutrition and should be avoided.

Balancing your nutrition at a micronutrient level helps to cut through the confusion and commercial bias using widely recognised nutrient targets.   Whether you want to eat only plants for ethical reasons or only animal-based foods because that’s all you can tolerate, the Nutrient Optimiser can help you find the food that will work for you.

My hope is that the Nutrient Optimiser be adopted widely as to help improve your diet regardless of your preferences or goals.

Limitations of a plant-based diet

In systems design, things get interesting when you take them to their limits.

You need to test how something performs at the extremes to iron out the bugs.  In the case of the Nutrient Optimiser, the limits to be tested are macronutrient extremes (carbs, fat, protein) or extremes of plant- vs animal-based food sources.

One of the problems with the Daily Reference Intake (DRI) for essential nutrients is that they were developed in the context of an agriculture-based western diet.   At the extremes, we need to understand which parameters are still relevant and which ones need to be modified.

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In a previous post, we looked at the nutritional sufficiency of the recipes in Dr Greger’s How Not to Die Cookbook.  As shown in the micronutrient nutritional profile below, a plant-based diet contains adequate quantities of most of the essential nutrients other than omega 3, vitamin B12, and choline.

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However, as carnivore diet proponents will be quick to point out, not all nutrients provided by animal- and plant-based foods are the same. Although certain vitamins and minerals exist under the same name, their form and bioavailability differ between plants and animals.

For example, iron in animal foods exists in the form of heme and is more bioavailable than the elemental iron supplied by plants. Animal foods also provide forms of nutrients that the body requires, such as retinol (vitamin A) and EPA / DHA (omega-3s), whereas plant foods supply precursors to these nutrients (beta-carotene and alpha-linolenic acid, respectively).

Unfortunately, we don’t yet have enough data to quantify these variables accurately.  I hope that in the next few years there will be more research that will help us quantify the effect of bioavailability and antinutrients on the amount of nutrients absorbed compared to just what goes into our mouth.

We do need to keep these limitations in mind when analysing a purely plant-based diet, especially if someone is displaying symptoms of deficiency in the nutrients that are borderline.

Carnivore diet

In a similar way, we need to understand the limitations that may apply to a carnivorous diet.  The chart below shows the nutrient profile of a carnivore diet versus all foods in the food system USDA database.  It seems to be harder to meet the Daily Recommended Intake levels of vitamin K1, calcium, vitamin E, vitamin C, and folate. magnesium and potassium just barely make it.

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If you don’t mind some organ meats, you can get a very respectable micronutrient profile in real life.  A great example is Amy, who comes in at #13 on the Nutrient Optimiser Leaderboard with her carnivorous diet with plenty of organ meats, and is meeting the daily intake levels for everything except vitamin C, manganese, vitamin K1, calcium, magnesium, vitamin E, and vitamin D (check out her full report here).

Not everyone likes offal, so the chart below shows the nutrient profile if we remove it.  We would struggle to get adequate vitamin K1, manganese, folate, calcium, vitamin C, vitamin A, vitamin E, and magnesium.  The nutrient score drops from 75% to 67% (although, even without accounting for bioavailability, it is still better than the plant-based diet at 63%).

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Shawn Baker’s diet analysis

Let’s look at what we learn from analysing Dr Baker’s diet.  Shown below is Dr Baker’s average daily intake with lots of steak and hamburger mince with some cheese, eggs, shrimp, and salmon entered into Cronometer.

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The micronutrient fingerprint of Dr Baker’s diet is shown below.  You can check out his full Nutrient Optimiser analysis here.

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At the bottom of the chart , we see that Dr Baker’s diet has a ton of vitamin B12, zinc, iron, and amino acids.  However, at the top of the chart (see the zoomed in segment below), we see that Dr Baker’s diet is lacking in vitamin C, manganese, vitamin A, vitamin D, vitamin K1, folate, calcium, omega 3, and pantothenic acid (at least when you use the RDI as your benchmark).

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However, what do we make of the fact that Dr Baker and a number of his friends appear to be thriving?  Are the recommended nutrient levels just plain wrong?  Which ones are relevant in this context?

In response to my preliminary analysis, Shawn commented:

As you point out, some of the micronutrients may become less of a requirement based upon overall dietary scheme. 

Personally, I don’t necessarily believe the DRIs are relevant to a carnivorous diet in general and would look at clinical endpoints.  For example, calcium deficiency has a clinical manifestation and developing signs of it should lead to deterioration of health rather than its enhancement as I’ve experienced and the same with countless other pure meat eaters. 

It is relevant to note that there are many zero-carb people that have been going many years, to some several decades, on just muscle meats and no offal at all and who also maintain excellent health.

There is no point in telling someone to stop doing something if they are thriving.  However, at the same time I can’t stop thinking of Dr Bruce Ames’ Triage Theory which suggests that, in the absence of adequate nutrients, the body will prioritise nutrients geared towards short-term survival rather than optimal health and longevity.

Dr Baker’s n=1 data

Dr Baker has been spearheading a nequalsmany crowdsourcing of a range of data from people following a carnivorous diet.  While I’m eager to see the full analysis of the data when it’s available, Shawn recently discussed his own test results after fourteen months on a carnivorous diet with Robb Wolf.  I highly recommend you have a listen to the interview on the Paleo Solution Podcast.

Cholesterol

To my eyes, Dr Baker’s cholesterol values are fairly unremarkable other than to note that his TG:HDL ratio is 1.3 (which is good) and his total cholesterol : HDL is 4.6 which is OK.[8] [9]  However, I’m no expert in this contentious area.

Alex Leaf of Examine.com noted that “High LDL-p, low HDL to LDL ratio, low HDL to non-HDL ratio are All strong CVD risk factors”.

Meanwhile, while Dave Feldman of Cholesterol Code offered the following comments:

  • LDL-C and LDL-P are both on the lower end for a low carber who is as lean and fit as Dr Baker is. I suspect this is due to his emphasis on resistance training, which can reduce LDL scores due to a higher rate of use for muscle repair.
  • Small LDL-P is low at 283, and clearly very Pattern A.
  • HDL-C — 40 mg/dL is low for a zero carber.
  • HDL-P was highlighted as being low (out of range) at 28. However, I see this frequently with low carbers across the board.
  • Triglycerides — 54 is certainly very correlative with a very athletic, insulin sensitive metabolism.
  • Lipoprotein (a) — 2 nmol/L is one of the lowest scores I’ve ever seen (maybe THE lowest).
  • The score I most care about is Remnant Cholesterol which is calculated by subtracting both HDL-C and LDL-C from Total Cholesterol. His score of just 11 mg/dL is extremely low risk and suggests he has a very efficient fat metabolism.

HbA1c

What is more interesting and puzzling is Baker’s HbA1c of 6.3% with a fasting blood sugar of 121 mg/dL.

This HbA1c level puts him on the borderline of prediabetes and full-blown type 2 diabetes,[10] which I wouldn’t have expected.   A HbA1c of 6.4% and a fasting glucose of 126 is the cut off for type 2 diabetes. HbA1c of less than 5.0% and fasting glucose of less than 95 mg/dL are typically associated with lower all-cause mortality.[11] [12]

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What is puzzling here is that, while Shawn’s HbA1c is high, he has a fasting insulin level of 2.6 mIU/L which is very low which either suggests he is very insulin sensitive or his pancreas is not producing enough insulin.

Since the release of the Robb Wolf podcast there has been a ton of speculation about his results.  It will be interesting to see if he follows up on any of the gratuitous suggestions for further testing.

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Some people point to HbA1c being an unreliable measure due to the fact that red blood cells live longer in healthier people, however, Dr Baker’s blood sugar values correlate with the HbA1c values.

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Some will say that the 6.1 g/kg/LBM or 560 g of protein per day is driving gluconeogenesis.  (This is a contentious and complicated topic that I have covered at length in the article Why do my blood sugars rise after a high protein meal?)

If you look at things from a total energy perspective you could say that Shawn is just eating a lot to fuel his activity (more than 4000 calories per day) and hence his blood sugars are staying high.

Perhaps it’s a case of extreme physiological insulin resistance where the body chooses to keep glucose levels higher where there is less glucose available and lower insulin levels?

However, I think it’s worth noting that essential minerals such as potassium, calcium, and sodium are essential for maintaining insulin sensitivity.[13] [14] [15]  While the body does a pretty good job of maintaining acid/base balance, the kidneys still need enough substrate (e.g. alkaline minerals such as potassium, magnesium, and sodium) to be able to do this.

Once the kidneys stop being able to tightly regulate pH we can get metabolic acidosis which goes hand in hand with type 2 diabetes.[16] [17] [18] [19]  (This is another complex and contentious topic that I covered in Alkaline Diet vs Acidic Ketones.)

It’s interesting to hear in his discussion with Robb that Dr Baker is finding benefit from adding sodium and electrolytes.  Many people on a low carb dietary approach find that supplementing minerals is important.  The Nutrient Optimiser analysis typically finds that people need more potassium or magnesium rather than sodium.  Sodium is fairly easy to get while potassium and magnesium is much harder for most people.  There are a range of studies suggesting that a higher potassium : sodium ratio is desirable.[20] [21] [22]

At the same time, Dr Baker’s HbA1c could have been a lot higher before he started his carnivore diet due to the high dietary load to fuel so much exercise and bulking and the meat only diet could be improving his HbA1c.  We just don’t know from the available data.

I look forward to the full analysis of the data from the nequalsmany participants.  However, based on the results of Shawn’s n=1 it may be too early to say that zero carb is the cure for type 2 diabetes.

Testosterone

While there are anecdotes of an animal-based carnivorous diet raising testosterone levels, Dr Baker’s endogenous testosterone levels are lower than you might expect given his level of muscularity, leanness, and endurance.

As discussed in the interview with Robb he is experiencing no symptoms of low testosterone and suggests that, similar to TSH and insulin, he may be more sensitive to testosterone and hence the body doesn’t need as much of it.  Others have been more sceptical of Baker’s testosterone results.

Are the nutrient recommendations relevant to someone following a carnivorous approach?

Given that the RDIs are designed to prevent nutrient deficiencies in most of the population, they will be conservative for most people when it comes to deficiencies.  However, what constitutes optimal is a different matter.

The challenge in using the RDIs at extremes is that they have not been adjusted to cater for varying requirements of people following a vegan, keto, or carnivorous approach.

Many people are quick to dismiss the RDIs entirely in view of the numerous anecdotes of people thriving with no plant-based foods.  But I’m eager to understand, as much as we can with the available data, how the parameters might change and what is still relevant and important.

While the DRIs are based on people eating a standard western diet, anecdotally many people seem to find they need to supplement electrolytes when they reduce or remove carbohydrates sources from their diet, so I don’t think we can say that someone on a carnivorous diet would have a lower requirement for electrolytes such as sodium, magnesium or potassium.

Does the carnivore diet break the Nutrient Optimiser?

Dr Baker isn’t going out of his way to chase micronutrients.  I think the fact that he’s eating more than 4000 calories per day will help to make up for the lower availability of some nutrients in animal vs plant-based foods.

A fairer illustration of the potential of the potential of a carnivorous is the nutrient profile for Amy which is shown below, who is following a carnivore diet with heaps of organ meat.

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Although Amy has gone out of her way to maximise her micronutrients as much as anyone practically could with a carnivorous diet she is still not meeting the RDI for vitamin K1, vitamin C, calcium, vitamin E, sodium, and magnesium.

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But is this really an issue?

The Nutrient Optimiser has a zero carb/carnivore diet option for people who chose to eat that way for preference or due to other issues.  This allows people who chose to follow this approach to help manage autoimmune or digestive issues to fine tune their micronutrients as much as possible within those constraints.

The question for me, then, is whether we need to worry about these possible deficiencies?

Vitamin K2 can be converted to K1

Vitamin K1 is primarily found in plants while K2 is synthesised by bacteria in the large intestine of animals and humans.  Vitamin K2 (menaquinones MK1 through MK4) is only a fairly recent discovery.  Hence the USDA food database only contains data on the quantity of K1 (phylloquinone) in foods.

The good news is that most people can convert K2 to K1 and vice versa depending on demand.[23]  Hence, low dietary vitamin K1 intake may not be an issue if you are getting plenty of K2 from sources such as eggs, butter, and liver.

Some nutrients are more bioavailable

As we mentioned before, vitamin A and omega 3 are more bioavailable from animal-based sources.   However, I don’t think this is a real issue either way as it is quite easy to get plenty of these nutrients on a carnivorous diet.

The effect of anti-nutrients on absorption

Iron, calcium, and magnesium may be more bioavailable when there are no oxalates in the diet.[24]  Adequate iron is rarely a problem for someone eating adequate amounts of animal-based protein.  Excess iron is often a problem in males.  Shawn’s ferritin is within range but perhaps above optimal for males.

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Calcium and magnesium do tend to be harder to find, but without plant matter in the diet, it may be more bioavailable.

Grains and legumes can contain lectins, glutens, and phytates that can affect the absorption of minerals like potassium and magnesium.[25]  Unfortunately, we don’t yet have enough data to calculate how much of the various nutrients are getting into your system from the food once you account for bioavailability.

Cooking vegetables also greatly reduces anti-nutrient levels, which adds another layer of complexity to figuring out how much we absorb in a diet of both cooked and raw foods.

For many people, grains just aren’t worth it, especially if they have pre-existing digestive issues.  I’m not sure, however, that the same principle applies to all vegetables.

Personally, my digestion is pretty robust, so I’m not too worried about oxalates in spinach.  I figure the benefit of getting all the vitamins more than offsets the negative impacts, at least for me.  Some plant-based compounds (e.g. sulforaphane) may have a beneficial hormetic effect.[26][27] [28] [29]  However, for some people, their gut is so messed up by modern processed foods that they find they need to cut out all fibre containing foods.

Essential nutrients we require less of when we eat less glucose

There is some evidence to suggest that Vitamin C is not as much of a priority for someone with less glucose to process.   There are examples of plenty of people surviving with minimal vitamin C on a zero carb diet.[30]

Vitamin C is also probably underreported from animal food and often assumed to be zero.  If you want to dig into this more, you can check out Amber O’Hearn’s comprehensive article on vitamin C on a ketogenic diet.

Nutrients that there are is no deficiency testing for

Manganese

There are also a number of nutrients that are based on population average intakes rather than deficiency testing, such as manganese.[31]

Given that manganese is associated with carbohydrate metabolism, there may be a lesser requirement for people following a carnivorous diet.  There may be limited use in chasing targets that are simply based on average intakes of people eating a typical western diet.

Manganese is high in organ meats, which are prized by cultures that do not have access to a lot of plant-based foods, so it is possible to get adequate quantities.    While someone on a zero-carb diet may not need as much, manganese still seems to be a useful nutrient.

Vitamin E

Similarly, the RDI for Vitamin E is based on median population intake levels[32] rather than any deficiency testing, and it is possible that the requirements may be lower for someone not eating as much glucose.

Pantothenic acid (Vitamin B5)

Shawn is not quite meeting the RDI for Vitamin B5 but may not need more unless he has high intakes of alcohol or coffee or has high levels of stress.  The target levels are based on the average intake from population studies, so there’s probably no need to chase the target here for someone on a carnivore diet.

Nutrients that are still important

Vitamin D

Without a lot of seafood, Shawn is not getting a lot of Vitamin D from his food.  However, a lack of dietary vitamin D is not unique to carnivores.  The RDI levels for vitamin D levels are based on the amount required to maintain serum 25(OH)D levels with minimal sunlight.  Interestingly, as shown in the test results, Shawn’s serum vitamin D levels are on the lower end of normal.

Folate

Shawn is getting lower levels of folate compared to the estimated average requirement.  Again, folate can easily be obtained from organ meats which are prized in cultures that do not have access to plant-based foods.

Calcium

Shawn is also not meeting the RDI for calcium.  Calcium can be obtained on a carnivore diet from eggs and sardines or other bony fish.  Target calcium levels are based on balance studies,[33] and your calcium requirements will increase with age.

Omega 3

Shawn is getting a solid amount of omega 3, though not enough to meet the RDI levels or achieve ideal omega 3 : omega 6 balance.   Again, omega 3 is not hard to get from animal-based products if they include some seafood.

Magnesium and potassium

Magnesium and potassium are two minerals that many people do not get enough of when they reduce their carbohydrate intake, particularly green veggies.

The keto flu is a common symptom that people experience early in their ketogenic journey that they can fix with supplementation of alkalising minerals.

I struggle to see that there is a lesser requirement for these minerals on a keto or carnivore diet.  Though itis conceivable that bioavailability is improved when plants are removed from the diet, there is not really enough data to quantify this.

Don’t focus on just one nutrient

All in all, I think nutrients are important.  However, getting wrapped up in chasing the absolute DRI for individual nutrients can be problematic due to the numerous factors outlined above.  Our nutrient requirements will also change based on a range of things such as activity, life stage, the other things you are eating, your gut health and nutrient absorption.

Life is all about making the best choices we can with imperfect data.  We can’t let the lack of perfect stop us from using the data that we have available.  To smooth out the limitations of individual nutrients, the Nutrient Optimiser prioritises foods that contain a cluster of the ten or so nutrients you are getting less of and identifies the foods and meals that contain these nutrients in larger quantities.

So sure, maybe you don’t need as much K1, manganese, vitamin C on a carnivorous diet, the Nutrient Optimiser will help you find the foods that contain the other nutrients that can be harder with your preferred approach to finding the nutrients that are still important.

Historically, humans seem to adapt pretty well to a wide range of food environments over time.  What we don’t seem to do well with is modern hyperpalatable nutrient poor energy-dense foods that are flavoured and coloured to make us think that they are good for us, but actually contain very little actual nutrition.

What about the Maasai?

Many people refer to the Maasai tribe in Africa, who survive on nothing but milk, meat, and blood from their animals, as a precedent for the carnivorous approach.

While they are a thriving, beautiful people, keep in mind that they are drinking blood from their animals and eating fresh meat, nose to tail.

This is not the same as eating only drained muscle meat that has been hung for a long time.  It’s pretty hard to get fresh, undrained meat let alone fresh blood in the west.

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Who should try a carnivorous diet?

One common theme I see for people who seem to thrive on a carnivorous approach is some sort of gut issues (e.g. permeability or bacterial overgrowth) or some sort of autoimmune condition, perhaps due to long-term exposure to processed low nutrient-poor foods.

If your gut is already compromised, then cutting down on fibre and other plant matter, particularly grains, nuts and seeds seems to work wonders for many people.  If you have issues that you find are only healed by staying strictly carnivore then, by all means, stick with it.

You could also use carnivore as an elimination phase and then slowly reintroduce other foods back in to see if you can tolerate them.  You may enjoy a diet that is less restrictive and makes it easier to get the nutrients you need from your diet.  I recommend checking out Chris Kresser’s The Paleo Cure or Natasha Campbell McBride’s GAPS Diet if you want to follow this elimination and reintroduction type approach.

Some people find great success with a carnivore dietary approach.  There are a ton of great testimonials at meatheals.com.  At the same time, I have seen many others that carnivore didn’t work out for.  One friend Samantha found that she became hypersensitive to the smallest whiff of flour and found improvement through a course of probiotics.

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The general motto of the carnivore crowd is to just eat meat when hungry.   This works well for many, but not all.

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Ironically, during the finalisation of this article, I contacted Amy (who has the amazing carnivore nutrient profile shown above) and she advised she was no longer following a zero carb dietary approach and was now pursuing a nutrient dense omnivorous approach.  She had found that she started to gain weight after 2.5 years on a carnivorous diet and her thyroid function diminished.  Amy, who was previously an admin for a major carnivore Facebook group, says:

“All of these, coupled with my EXTREMELY high LDL cholesterol of 500 and my 7-year lack of menstrual cycle, points directly to a failing thyroid.  ZC made it WORSE… MUCH worse.  I went back to a mixed diet in January of this year.  Within 2 weeks of this diet change, I regained all of my natural bowel motility.  And, surprisingly, within 2 months my menstrual cycle returned after 7 years of absence!!  I regained my energy, and I’m now walking daily again, doing daily hour-long sessions of yoga (which I used to love doing years ago), lifting weights 3 days a week, and doing 20 minute HIIT workouts 3 days a week.  I’ve put on some weight, but I look and feel very healthy.  I notice that I’m frequently hot now instead of cold, which I presume is a symptom of my thyroid upregulating to where it should be.  I am scheduled to have a complete thyroid panel, lipid panel, and other hormone tests run at the end of March to see where I am.  But I can clearly tell you that ZC did NOT do MY body any favors.”

Overall, it’s probably fair to say that a carnivore diet can benefit many, particularly if you have major digestive issues.  However, I think it’s probably too soon to say it’s optimal for everyone.

If you do want to pursue a carnivorous diet, then the Nutrient Optimiser can help you identify foods to get as much nutrition as you can within that framework.

If you find that you want something with a little bit more variety and want to include some plants, then there are autoimmune, lactose-free, nut free, or shellfish free options are available to suit your allergies, preferences and intolerances

Summary

  • Some people seem to benefit from a zero carb/carnivore diet, particularly if they have pre-existing gut permeability or bacterial overgrowth.
  • Cutting out nutrient-poor processed inflammatory foods is a common denominator in many successful diets.
  • It is harder to get some nutrients without plants, however, some of these nutrients may not be such a big deal if you are not eating a lot of carbohydrates.
  • While there are plenty of anecdotes, there is not yet a lot of large-scale quantitative research into the long-term impacts of a carnivore diet.
  • It’s still a good idea to maximise the micronutrients in your diet irrespective of your overarching dietary template.

 

 

If, like me, you’re intrigued by the carnivore diet then make sure you also read the followup aricle, Optimising Dr Shawn Baker’s CArnivore Diet from First Principles.

Food lists

I have included some food lists that may be of interest if you want to pursue a carnivorous approach or have major digestive issues.

Carnivore / zero carb

The foods listed below will provide you with the most nutrients per calorie without plants.  The food at the top of each section contains more of the nutrients that are harder to find per calorie.

Screenshot 2018-03-21 04.14.43.png

The nutrient profile of these foods is shown in the chart below.

Screenshot 2017-12-26 06.12.13.png

Carnivore / zero carb (diabetes friendly)

The problem with the nutrient dense carnivore approach is that it contains a lot of protein (63%).  This may drive satiety (meaning it will be hard to get enough calories in) or potentially be problematic for someone dosing with insulin due to the insulinogenic nature of the protein.  The foods below contain more fat which will make it easier to get adequate energy as well as reduce insulin requirements.

Screenshot 2018-03-21 04.23.03.png

The nutrient profile of these foods is shown below (i.e. more fat, less protein and lower micronutrients per calorie).

Screenshot 2017-12-26 07.54.40.png

Autoimmune & SIBO

Many people who benefit from a carnivorous have messed up digestion and/or autoimmune issues.  If you don’t want to go full carnivore, the food list below removes the most inflammatory foods and foods that commonly cause digestive issues while still contain a lot of nutrients.

The nutrient profile of these foods is shown below.

Autoimmune (low carb)

The food list below will provide nutrients with more fat which will enable you to get enough energy.

The nutrient profile of these foods is shown below.

Screenshot 2017-12-28 05.20.33.png

nutrient dense

For comparison, the most nutrient-dense foods are shown below.

The nutrient profile of these foods is shown below.  Keep in mind that these are the nutrients contained in the food and some of these nutrients will be less bioavailable.

 

Thanks

Special thanks to Shawn Baker, Robb Wolf, Alex Leaf, Amber O’Hearn, Dave Feldman, Robin Reyes, Helen Kendall and Raphi Sirt for their input and review into this article.

 

References

[1] http://www.getbig.com/boards/index.php?topic=574036.0

[2] https://www.inquisitr.com/2083582/carnivore-family-has-eaten-a-zero-carb-all-beef-diet-for-the-past-17-years/

[3] https://gistonice.wordpress.com/2015/05/11/when-eating-only-meat-becomes-a-way-of-life-family-lives-on-only-meat-for-the-past-17-years/

[4] http://www.getbig.com/boards/index.php?topic=574036.0

[5] https://zerocarbzen.com/tag/lyme-disease/

[6] https://thenortheasttoday.com/anderson-family-on-meat-diet-for-17-years/

[7] https://www.breaknutrition.com/episode-17-dr-shawn-baker-lifts-like-crane-eats-like-lion/

[8] https://www.ncbi.nlm.nih.gov/pubmed/11176761

[9] https://www.thebloodcode.com/know-your-tghdl-ratio-triglyceride-hdl-cholesterol/

[10] https://optimisingnutrition.com/2015/03/22/diabetes-102/

[11] https://optimisingnutrition.com/2015/07/20/the-glucose-ketone-relationship/

[12] https://cardiab.biomedcentral.com/articles/10.1186/1475-2840-12-164

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC301822/

[14] https://www.ncbi.nlm.nih.gov/pubmed/21036373

[15] https://optimisingnutrition.com/2017/10/21/redesigning-nutrition-from-first-principles/

[16] https://optimisingnutrition.com/2016/11/19/the-alkaline-diet-vs-acidic-ketones/

[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424466/

[18] http://downloads.hindawi.com/journals/jeph/2012/727630.pdf

[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/

[20] https://www.ncbi.nlm.nih.gov/pubmed/2224920/

[21] https://www.facebook.com/groups/OKL4Vitality/permalink/677232549136149/?hc_location=ufi

[22] https://www.facebook.com/groups/OKL4Vitality/permalink/652513618274709/?hc_location=ufi

[23] https://chrismasterjohnphd.com/2016/12/09/the-ultimate-vitamin-k2-resource/

[24] https://www.ncbi.nlm.nih.gov/pubmed/17440529

[25] jn.nutrition.org/cgi/content/full/129/7/1434S

[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635914/

[27] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273949/

[28] http://roguehealthandfitness.com/hormesis-health/

[29] http://www.organiclifestylemagazine.com/sulforaphane-why-your-cells-need-cruciferous-vegetables

[30] http://breaknutrition.com/ketogenic-diet-vitamin-c-101/

[31] https://www.nrv.gov.au/nutrients/manganese

[32] https://www.nrv.gov.au/nutrients/vitamin-e

[33] https://www.nrv.gov.au/nutrients/calcium

 

Post updated April 2018.

the most nutrient dense autoimmune friendly foods

An “autoimmune disease” develops when your immune system, which defends your body against disease, decides your own healthy cells are foreign.  As a result, your immune system attacks healthy body cells.[1]

The list of diseases that are said to be autoimmune related are extensive,[2] [3] and to add insult to injury, people with autoimmune issues often end up with challenging digestive issues.

An autoimmune dietary protocol eliminates foods that can trigger inflammation in people with more sensitive digestion that may be autoimmune related.  The foods typically eliminated include nuts, seeds, beans, grains, artificial sweeteners, dairy, alcohol, chocolate and nightshades.

The remaining foods largely involve vegetables, seafood and animal products.  Given that Type 1 Diabetes is an autoimmune condition I have also created a lower insulin load diabetes friendly autoimmune list of foods that that will be more gentle on blood glucose levels.

Although sticking to the autoimmune friendly list of foods is somewhat restrictive it is a very nutrient dense approach compared to other options as you can see in the comparison of the nutrient density of different nutritional approaches in the chart below where it came in at #2 of the thirteen approaches analysed.  The nutrients provided by these foods in comparison to the USDA foods database is shown below.

2017-02-18 (3).png

The nutrient density of the diabetes friendly list is shown below.

2017-02-18 (4).png

An autoimmune protocol is often a short term ‘reset’ where inflammatory foods are eliminated for a period.  Once things settle down potential other possible trigger foods are slowly reintroduced to see which foods can be tolerated.

For more information see Robb Woolf’s The Paleo Solution, Sarah Ballantyne’s The Paleo Approach or Chris Kresser The Paleo Cure.

The foods listed below represent the top 10% of the USDA food database using this ranking system.  Also included in the table are the nutrient density score, percentage of insulinogenic calories, insulin load, energy density and the multicriteria analysis score (MCA) that combines all these factors.

autoimmune protocol (nutrient dense)

vegetables, spices and fruit 

image19

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
endive 11 23% 1 17 3.0
chicory greens 11 23% 2 23 2.9
spinach 12 49% 4 23 2.8
watercress 13 65% 2 11 2.8
dandelion greens 11 54% 7 45 2.5
beet greens 9 35% 2 22 2.4
basil 10 47% 3 23 2.4
escarole 8 24% 1 19 2.4
chard 10 51% 3 19 2.4
asparagus 10 50% 3 22 2.4
zucchini 9 40% 2 17 2.4
arugula 9 45% 3 25 2.3
lettuce 10 50% 2 15 2.3
Chinese cabbage 10 54% 2 12 2.2
sage 7 26% 26 315 2.2
alfalfa 7 19% 1 23 2.2
parsley 9 48% 5 36 2.1
curry powder 6 13% 14 325 2.1
summer squash 8 45% 2 19 2.0
okra 8 50% 3 22 2.0
paprika 6 27% 26 282 2.0
cloves 7 35% 35 274 1.9
broccoli 8 50% 5 35 1.9
collards 7 37% 4 33 1.9
turnip greens 7 44% 4 29 1.8
thyme 6 34% 31 276 1.8
brown mushrooms 9 73% 5 22 1.8
cucumber 6 39% 1 12 1.7
chives 7 48% 4 30 1.7
celery 7 50% 3 18 1.6
artichokes 6 49% 7 47 1.6
cabbage 7 55% 4 23 1.6
marjoram 5 31% 27 271 1.6
cauliflower 6 50% 4 25 1.6
sauerkraut 5 39% 2 19 1.5
portabella mushrooms 6 55% 5 29 1.5
edamame 5 41% 13 121 1.5
poppy seeds 3 17% 23 525 1.4
shiitake mushroom 6 58% 7 39 1.4
white mushroom 7 65% 5 22 1.4
celery flakes 6 53% 42 319 1.4
seaweed (wakame) 8 79% 11 45 1.3
radicchio 6 67% 4 23 1.3
rhubarb 5 55% 3 21 1.2
kale 6 60% 5 28 1.2
bamboo shoots 6 60% 5 27 1.2
radishes 4 43% 2 16 1.2
yeast extract spread 5 59% 27 185 1.2
seaweed (kelp) 7 77% 10 43 1.2
turnips 5 51% 3 21 1.2
Brussel sprouts 4 50% 6 42 1.1
Rutabagas, raw 5 57% 6 37 1.1
chayote 3 40% 3 24 1.1
onions 5 65% 6 32 1.0
blackberries 2 27% 3 43 1.0
tarragon 4 62% 56 295 0.9
pumpkin 6 76% 4 20 0.9
carrots 4 61% 4 23 0.9
peas 4 65% 7 42 0.9
spirulina 5 70% 6 26 0.8
avocado -0 8% 3 160 0.8
red cabbage 3 55% 5 29 0.8


seafood

image21

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
fish roe 9 47% 18 143 2.2
caviar 6 33% 23 264 1.8
mackerel 4 14% 10 305 1.6
trout 6 45% 18 168 1.6
salmon 7 52% 20 156 1.6
flounder 7 57% 12 86 1.6
oyster 7 59% 14 102 1.5
cod 8 71% 48 290 1.5
sardine 5 37% 19 208 1.5
sturgeon 6 49% 16 135 1.5
halibut 7 66% 17 111 1.5
crayfish 7 67% 13 82 1.5
crab 8 71% 14 83 1.4
cisco 4 29% 13 177 1.4
pollock 7 69% 18 111 1.4
perch 6 62% 14 96 1.3
rockfish 7 66% 17 109 1.3
anchovy 4 44% 22 210 1.3
lobster 7 71% 15 89 1.2
herring 3 36% 19 217 1.2
shrimp 6 69% 19 119 1.1
whiting 6 66% 18 116 1.1
haddock 6 71% 19 116 1.1
white fish 6 70% 18 108 1.1
clam 5 73% 25 142 0.9

animal products

image09

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
beef brains 4 22% 8 151 1.6
lamb liver 5 48% 20 168 1.3
ham (lean only) 5 59% 17 113 1.1
lamb kidney 4 52% 15 112 1.1
turkey ham 3 45% 14 124 1.0
lamb sweetbread 3 43% 15 144 1.0
turkey liver 3 47% 21 189 1.0
lamb brains 2 27% 10 154 0.9
ground turkey 1 30% 19 258 0.8
turkey (skinless) 2 40% 16 170 0.8
turkey heart 3 47% 20 174 0.8
roast ham 2 41% 18 178 0.8

autoimmune protocol (diabetes friendly)

Vegetables, spices and fruit

image19

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
endive 14 23% 1 17 2.5
chicory greens 13 23% 2 23 2.3
escarole 11 24% 1 19 2.1
alfalfa 10 19% 1 23 2.1
curry powder 6 13% 14 325 1.8
beet greens 11 35% 2 22 1.8
spinach 13 49% 4 23 1.7
zucchini 11 40% 2 17 1.7
paprika 7 27% 26 282 1.6
arugula 12 45% 3 25 1.6
basil 12 47% 3 23 1.6
sage 7 26% 26 315 1.6
asparagus 12 50% 3 22 1.5
chard 12 51% 3 19 1.4
watercress 15 65% 2 11 1.4
parsley 11 48% 5 36 1.4
avocado 0 8% 3 160 1.4
cucumber 8 39% 1 12 1.4
lettuce 11 50% 2 15 1.4
poppy seeds 3 17% 23 525 1.4
collards 7 37% 4 33 1.4
summer squash 9 45% 2 19 1.3
cloves 7 35% 35 274 1.3
broccoli 10 50% 5 35 1.3
thyme 6 34% 31 276 1.3
olives -2 3% 1 145 1.3
dandelion greens 11 54% 7 45 1.3
okra 10 50% 3 22 1.3
Chinese cabbage 10 54% 2 12 1.2
marjoram 4 31% 27 271 1.2
chives 8 48% 4 30 1.2
turnip greens 7 44% 4 29 1.2
sauerkraut 6 39% 2 19 1.1
celery 8 50% 3 18 1.1
blackberries 3 27% 3 43 1.1
cauliflower 8 50% 4 25 1.1
chayote 5 40% 3 24 1.1
portabella mushrooms 9 55% 5 29 1.0
edamame 5 41% 13 121 1.0
radishes 5 43% 2 16 1.0
artichokes 7 49% 7 47 1.0
brown mushrooms 13 73% 5 22 1.0
shiitake mushroom 9 58% 7 39 0.9
raspberries 1 30% 4 52 0.9
cabbage 7 55% 4 23 0.9

seafood

image21

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
mackerel 3 14% 10 305 1.5
caviar 8 33% 23 264 1.5
fish roe 9 47% 18 143 1.3
cisco 3 29% 13 177 1.1
trout 7 45% 18 168 1.1
sardine 5 37% 19 208 1.1
oyster 9 59% 14 102 1.0
herring 3 36% 19 217 0.9
salmon 7 52% 20 156 0.9
sturgeon 6 49% 16 135 0.9
anchovy 5 44% 22 210 0.9

animal products

image09

food ND % insulinogenic insulin load (g/100g) calories/100g MCA
beef brains 5 22% 8 151 1.5
lamb brains 3 27% 10 154 1.2
lamb liver 8 48% 20 168 1.1
sweetbread -2 12% 9 318 1.1
liver sausage -2 13% 10 331 1.0
turkey bacon -1 19% 11 226 1.0
bacon -3 11% 11 417 1.0
meatballs -1 19% 14 286 1.0
kielbasa -2 15% 12 325 0.9
bratwurst -2 16% 13 333 0.9
ground turkey 2 30% 19 258 0.9
salami -1 18% 17 378 0.9
turkey -1 20% 21 414 0.9
turkey liver 6 47% 21 189 0.9
ham 1 29% 11 149 0.9
pepperoni -3 13% 16 504 0.9
headcheese -2 20% 8 157 0.9
lamb kidney 7 52% 15 112 0.9
bologna -4 11% 9 310 0.9
pork ribs -2 18% 16 361 0.9
bologna -0 26% 11 172 0.9
pork sausage -0 25% 13 217 0.9
pork sausage -2 20% 16 325 0.8
knackwurst -3 16% 12 307 0.8
turkey drumstick (with skin) 0 28% 15 221 0.8
chorizo -2 17% 19 455 0.8
chicken liver pate 1 34% 17 201 0.8

other dietary approaches

The table below contains links to separate blog posts and printable .pdfs for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

image02

references

[1] http://www.healthline.com/health/autoimmune-disorders

[2] https://en.wikipedia.org/wiki/Autoimmune_disease

[3] https://www.aarda.org/disease-list/

optimal foods for YOU

It’s no secret that there is no perfect diet for everyone.  Your nutritional requirements depend on many factors, including your age, health status, activity levels, and goals.

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I’ve spent a lot of time over the last couple of years designing prioritised food lists to suit a range of goals and situations.  This article summarises this labour of love into what I hope will be a useful resource that will help a lot of people.

I have grouped the various food lists into the following categories:

  • foods to optimise your metabolic health (e.g. therapeutic ketosis, diabetes management, weight loss, bodybuilding, and athletic performance, etc.),
  • foods that boost specific nutrients associated with common health conditions,
  • ethical, philosophical and religious considerations, and
  • macronutrient and micronutrient extremes (low carb, keto, high protein, low protein, etc.).

For those of you who just want to know which foods you should eat more of, I have included the food lists up front.

If you want to understand how I have developed the various food lists, continue reading to the end of the article.

Metabolic health, diabetes management, weight loss and athletic performance

Most people do well if they eat more nutrient dense foods.  However, we can tailor our food choices beyond nutrient density to better suit different people with different goals.

The table below contains optimal food for various metabolic situations.  In the table below you can:

  • click on the ‘PDF’ to open a printable list of ‘foods’,
  • download the list as graphic to save to your phone by clicking on the ‘foods’, or
  • click on the ‘nutrients’ to see the amount of each nutrient that those groups of foods contain.
approach average glucose (mg/dL) average glucose (mmol/L) PDF foods nutrients
well formulated ketogenic diet > 140 > 7.8 PDF foods nutrients
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8 PDF foods nutrients
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 PDF foods nutrients
protein sparing modified fast (PSMF) < 97 < 5.4 PDF foods nutrients
most nutrient dense < 97 < 5.4 PDF foods nutrients
nutrient dense maintenance < 97 < 5.4 PDF foods nutrients
bodybuilder < 97 < 5.4 PDF foods nutrients
endurance athlete < 97 < 5.4 PDF foods nutrients

I hope that these lists will help all those people who just don’t know what to eat.  Lots of people, my family included, have found these useful to print out and stick to their fridge or take it shopping for some inspiration.

If you belong to the 50% of the population that has diabetes or pre-diabetes,[1] your priority should be to normalise your blood glucose levels with a lower insulin load diet.  You can use your current blood sugar levels to choose the nutritional approach that will best support your journey towards optimal metabolic health.

The well- formulated ketogenic diet approach is designed for someone who has very high blood sugars or requires therapeutic ketosis.  The diabetes and nutritional ketosis approach will be more nutritious and suit people looking to manage their diabetes.  Before too long, with the reduction of processed carbohydrates, your blood sugar levels will stabilise to more optimal levels.

Once you have your blood glucose levels under control, you can then focus even more on increasing nutrient density and reducing energy density if you are looking to lose weight.   The weight loss (insulin resistant) foods will help you to reduce the energy density of your diet while keeping the insulin load down.  Stabilising blood sugar levels, normalising insulin levels and reducing hyper palatable processed carbs will help many normalise their appetite, reduce food cravings and naturally eat less.

The protein-sparing modified fast (PSMF) approach aims to provide all the essential vitamins, minerals and amino acids with the minimum amount of energy to enable you to achieve aggressive weight loss while minimising your chance of developing nutrient deficiencies, keeping cravings at bay and losing your lean muscle mass.

In the long run, you may even find you have the energy to work out or build muscle for fitness and longevity.  This increased level of activity may require higher levels of protein and other nutrients.   You may also need higher energy density foods to enable you to ingest enough energy to support your activity levels.

The bodybuilder food list will provide you with plenty of amino acids and minerals to support recovery while the endurance athlete food list increases energy density to fuel increased activity levels while still keeping nutrient density high to fuel activity levels.

How do I implement all this information?

Not that long ago, before the advent of artificial flavours, colourings, refrigerators and packaged food, we were more in touch with our actual nutritional needs and went hunting and gathering in search of the foods that contained the nutrients we needed.  We ate until we got what we needed from the food and stopped.

The idea is that these food lists would help you to refine your food choices and make up for your appetite that might have been corrupted by the modern food system.  When you go shopping each week try to buy more of the foods that are at the top of your list and make sure you find a way to incorporate them into your cooking during the week.  You will not be able to eat all of the foods on the list.  You may find that you like some more than others.  Keep working down the list until you find foods that you enjoy and can easily eat lots of.

You will likely need to prepare your food more than relying as much on processed and pre-packed foods.  It may take a little bit more effort, but your health is worth it!

Nutrients to address deficiencies associated with common conditions

Most people are somewhere on the spectrum of metabolic health and will do well focusing on the foods that keep their blood sugars stable.  However, there are others that have developed specific conditions exacerbated by long term nutrient deficiencies.  Hence, focusing on the foods that provide more of the nutrients associated with these conditions can help manage or even reverse some of these conditions for some people.

The table below contains a range of food lists that are designed to provide more of the nutrients related to a diverse range of common health issues.  Eating these foods will not guarantee a reversal of a particular condition.  However, prioritising these foods will improve your chances of recovery and minimise reliance on drugs and other medicines.

If you don’t yet have any of these conditions, simply focusing on the most nutrient dense foods[2][3] may reduce your chances of developing poor health.

Some foods make an appearance on many of the lists (e.g. spinach, watercress, broccoli, organ meats).  However, as you look through each of the lists, you will see that they are unique in their ranking of the various foods required to provide the prioritised nutrients.  While eating any of the foods on the list will be helpful, focusing on the foods towards the top of the list will maximise the nutrients you need for your condition.

approach score PDF foods nutrients wheel references
most nutrient dense foods 99.0% PDF foods nutrients
aggressive weight loss (PSMF) 98.4% PDF foods nutrients wheel references
adrenal fatigue 99.1% PDF foods nutrients
asthma 98.5% PDF foods nutrients wheel
autism 95.5% PDF foods nutrients wheel references
depression 98.3% PDF foods nutrients wheel references
dyslipidemia 99.1% PDF foods nutrients wheel references
estrogen 98.4% PDF foods nutrients wheel references
fatigue 98.1% PDF foods nutrients wheel references
female fertility 98.3% PDF foods nutrients wheel references
hypertension 98.2% PDF foods nutrients wheel references
hypothyroidism 98.8% PDF foods nutrients wheel references
inflammation 98.3% PDF foods nutrients wheel references
methylation 97.6% PDF foods nutrients wheel references
sleep and insomnia 98.8% PDF foods nutrients wheel references
telomeres 96.9% PDF foods nutrients wheel references
low carb autoimmune friendly 97.3% PDF foods nutrients
alkaline (diabetes friendly) 96.9% PDF foods nutrients
testosterone 97.7% PDF foods nutrients wheel references
alkaline 96.4% PDF foods nutrients
autoimmune & SIBO 95.7% PDF foods nutrients
weight loss (insulin resistant) 99.3% PDF foods nutrients wheel references
diabetes friendly, autoimmune, & SIBO 76.0% PDF foods nutrients

The nutrients prioritised in these lists are generally based on research compiled by Spectracell which identified nutrients that are typically deficient in a range of conditions.  You can click on the “wheel” and “references” in the table for more details.   Check out the full Spectracell nutrient wheels for a range of conditions here.

Where there is no Spectracell “wheel” available, the nutrients used in the analysis were based on the Nutrient Bible by Henry Oseki which is an excellent detailed resource on the individual nutrients as well as the likely nutrients to support various conditions.

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The value of real food

Many modern foods are fortified with synthetic nutrients (e.g. folic acid, B vitamins, vitamin A, vitamin D, iron, iodine, etc.).[4]  While it may appear that the food companies are doing this for the benefit of your health or to make up for deficiencies in their processed foods grown quickly using chemical fertilisers, there is good research suggesting that fortification helps to ensure that we don’t lose interest in what would otherwise be bland unpalatable foods.[5] [6] [7]

By adding in a smattering of nutrients that our body actively seeks (e.g. iron, folate, B vitamins, sodium etc) we will maintain an increased appetite for these foods while not getting the range of other nutrients that are also important but do not drive our appetite to the same degree (e.g. potassium, magnesium, choline and vitamin E).

Paul Jaminet in his Perfect Health Diet[8] says “Potassium is the intracellular electrolyte while sodium is the extracellular electrolyte.  Cells continually pump sodium outside the cell and potassium inside.  Good health depends on the proper dietary balance between potassium and sodium.  Paleolithic diets were high in potassium, low in sodium; salt was rare and highly valued.  So we evolved mechanisms for protecting against the threat of low sodium levels: a food reward system that powerfully rewards salt consumption, and a hormonal network that shuts down urination and sweating whenever sodium is scarce.  There are no similar mechanisms to protect us against low potassium levels, even though they are every bit as devastating for our health.”

While supplements can be helpful, obtaining nutrients from whole foods will also maximise your chance of absorption and increase your chance of getting all the necessary complementary micronutrients in adequate quantities without being excessive. Note: excess supplementation of minerals can quickly cause diarrhoea, or the kidneys will excrete excess nutrients from supplements.’

I have not included fortified foods that may score highly due to a narrow range of synthetic micronutrients that have been added to highly processed and sugar ladened products.

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Nutritious whole foods will provide you with not only the essential nutrients that we can quantify but all the other beneficial non-essential nutrients, phytonutrients, enzymes, and cofactors[9] [10] that are not yet quantified or in the USDA database.

Ethical, philosophical and religious considerations

Many people choose to base their food choices on moral convictions or religious beliefs.  I do not have any issue with people making their food choices based on ethical considerations or religious beliefs.  I do, however, object to people claiming that their approach is nutritionally superior and forcing it onto others on that premise which is not supported by science.

The lists in the table below will help you find the most nutrient dense foods associated with each of these approaches.  The food lists have been sorted based on their nutrient score from highest to lowest at the bottom of the table.

approach score PDF foods nutrient profile
the most nutrient dense foods 99% PDF foods nutrients
nutrient dense Paleo 99% PDF click nutrients
low carb Paleo foods 97% PDF foods nutrients
pescetarian 95% PDF foods nutrients
bivalve vegan 92% PDF foods nutrients
low carb pescetarian 95% PDF foods nutrients
whole food plant based 80% PDF foods nutrients
plant based (diabetes friendly) 76% PDF foods nutrients
zero carb 76% PDF foods nutrients
Paleo (without ND) 64% nutrients
zero carb (no offal) 58% PDF foods nutrients
plant based (without ND) 57% nutrients
zero carb (without ND) 42% foods nutrients

As you might expect, we achieve the most nutritious selection of foods when we focus purely on nutrients.   If you chose to limit your food choices due to other ethical considerations, then you should pay particular attention to the foods that will provide you with more of the harder-to-find essential nutrients.

In the long run, the goal is to get the nutrients we need from our food to enable us to thrive without over consuming energy.  This will give us the best chance of maintaining an ideal body weight, energy levels, performance and avoid the modern diseases of ageing.[11]

See the discussion below detailing the pros and cons of each approach and the nutrients that may need to be supplemented based on the various approaches.

Macronutrient extremes

Some people like to define their nutritional approach in terms of large or small quantities of a particular macronutrient (e.g. low carb, low fat, high protein, low protein, high or low saturated fat, etc.).  The analysis in the table below shows the implication on the nutrients available if you follow any of these approaches.

I think it’s useful to understand the pros and cons of these extremes, particularly in terms of the micronutrients available and the range of foods involved in any of these more extreme approaches.

While high protein, low carb or ketogenic appear to have some positive impact on nutrient density, focusing on the most nutrient dense foods provides a vastly superior micronutrient outcome.

approach score PDF foods nutrients
the most nutrient dense foods 99% PDF foods nutrients
average of all foods in USDA database 75% nutrients
high protein foods 58% PDF foods nutrients
lowest carb 54% nutrients
most ketogenic 42% PDF foods nutrients
highest fat 33% PDF foods nutrients
lowest saturated fat 32% nutrients
lowest fat 31% PDF foods nutrients
highest saturated fat 29% nutrients
lowest fat 31% PDF foods nutrients
the most insulinogenic foods 27% PDF foods nutrients
highest carb 15% nutrients
lowest protein 5% PDF foods nutrients
the avoid list 3% foods nutrients

So that brings us to the end of the food lists section.  I hope you find an approach that will suit your current goals and situation and have a glimpse of how you can continue to move your health forward.

I have intentionally included a lot of data in these tables to allow you to fully understand the pros and cons of each approach and compare the nutritional options you might be interested in.  I hope you will dig into the data in the table for the short list of approaches that you may be interested in.

If you want to learn more about how these lists were developed I invite you to read on to learn about nutrient density, insulin load and energy density, and how they can be combined, using the Nutrient Optimiser algorithm to optimise our food choices.

 

Nutrient density

While there are a range of useful parameters that we can use to optimise our nutrition, the most important is arguably nutrient density.

Nutrient density is simply the amount of nutrients per calorie or the amount of the essential nutrients you get in your food each day.  Ideally, we want to be meeting the daily recommended intake for all of the nutrients.

Micronutrients seem to have been largely overlooked in our current discussion about nutrition. Perhaps this is because micronutrients are harder to quantify.  Without an easy way to quantify micronutrients we tend to focus on simpler metrics such as fat, carbs, saturated fat, protein, vegan, plant based, Paleo, keto, etc.

Unfortunately, neither avoiding a particular nutrient (saturated fat, salt, cholesterol, etc) or aiming for a macronutrient extremes (high fat, low fat, low carb, high carb, high fibre, low protein, etc) or even following our religious or ethical convictions (vegan, vegetarian, plant based etc ) are especially useful when it comes to identifying foods that provide us with the most micronutrients.

But what if we could quantify the micronutrient content of the food we eat?

Enter nutrient density!

The graph below shows the average of the micronutrients in the eight thousand or so foods in the USDA food database as a proportion of the daily recommended daily intake (DRI).  Imagine you ate just a little bit of all of these eight thousand foods to make up your 2000 calories for the day.

The nutrients at the bottom of this chart are easy to obtain in our food system (e.g. vitamin C, vitamin B12, vitamin K, and various amino acids).  There is little need to worry about these easier to find nutrients.  However, where this analysis is useful is that it highlights the nutrients that we might have to pay extra attention to obtaining in adequate quantities (e.g. vitamin D, choline, vitamin E, potassium, magnesium, calcium, etc.).

After a lot experimenting with different approaches to develop a quantitative analysis method for optimising nutrient density, I found that:

  1. Prioritising foods that are high in only one nutrient (e.g. potassium, omega 3, magnesium, vitamin D, niacin, etc.) means you risk missing out on all the beneficial and complementary nutrients that typically come with real food and isn’t particularly useful.  You usually come up with a range of obscure processed foods that have been supplemented with that nutrient.
  2. Focusing on maximising the quantity of all the essential nutrients gives us a VERY high protein list of foods.  Protein is relatively easy to obtain in our food system.  Prioritising the amino acids provides a list of foods that will be very hard to consume because they are 70% protein.  We tend to get more than enough protein when we focus on the harder-to-obtain vitamins and minerals.
  3. Using the Nutrient Optimiser we can focus on the foods that contain more of the nutrients that are harder to find.  When we maximise a range of the harder-to-find nutrients, we get a variety of whole foods that contain a broad spectrum of the essential nutrients.

The chart below shows the nutrients provided by the top 10% of the foods in the USDA database when we prioritise for the harder-to-find nutrients (i.e. vitamin D, choline, vitamin E, calcium, potassium, magnesium, zinc, pantothenic acid, selenium, and niacin).  The red bars denote the nutrients that have been prioritised.   That is, foods that contain more of these micronutrients per calorie rank higher in the analysis.

If you compare the chart below to the chart above, you will see that by focusing on the foods that contain harder-to-find nutrients we significantly boost all thirty-four essential nutrients!

If you focus on eating foods in this list, you will have a good chance of getting plenty of the essential micronutrients.  The most nutrient dense foods in each category are at the top of the list, so you would ideally focus more on the food at the top of the list as much as you could.

I don’t think it matters too much if you want to focus more on animal or plant based foods.  We tend to achieve the best nutritional outcome when we include a range of vegetables, animal products and seafood.

  • What is notably missing from all of these lists is sugar and refined grains which have a very low nutrient density.
  • Fruits also do not feature in the lists (other than the exclusively plant based lists) due to the lower nutrients per calorie compared to nonstarchy vegetables and animal foods.
  • Dairy and nuts make an appearance on the lists only where it is not a priority to keep energy density low or to lose weight.
  • Red meat tends to feature more prominently when we need to boost nutrients such as glycine, cysteine and glutamine which are not as prevalent in seafood.

The nutrient score

You will notice the “nutrient score” for the most nutrient dense foods is 98.7%.  But what does this mean?

The nutrient score is designed to compare the various nutritional approaches quantitatively.  We want to meet the daily recommended intake of a particular nutrient.  However, there may not be much value getting more than twice the DRI.  Once you’ve achieved two times the DRI your efforts would be best spent seeking out other nutrients.  If we achieved two times the recommended daily intake for all the nutrients, we would get a score of 100%.  That is, we get a perfect score if the entire red rectangle was filled in.

A lot of these food lists score close to a perfect score because they contain a range of the most nutrient dense foods.  This is not practical in real life.  The nutrient score of a real life diet will be lower than the optimised short list of nutrient dense foods.  We tend to choose more energy dense foods that may not be as nutrient dense, or we don’t consume the range of foods that would be necessary to attain a very high nutrient score.  Dr Rhonda Patrick currently holds the record for the highest scoring food log with 82%.  You can check out her Nutrient Optimiser analysis here.

At the other end of the spectrum, we can see from the chart below that focusing on the least nutrient dense foods will provide an inferior outcome.   If all we have to eat is these nutrient poor foods, we will likely develop nutrient deficiencies.  Our cravings will drive our appetite to derail even our best calorie restriction intentions.

Energy density

The great thing about nutrient dense whole foods is that they typically force out the energy dense processed foods in our diet.

Whether it be low carb, whole food plant based or Paleo, the magic happens when we switch out nutrient deficient foods for foods that provide you with the nutrients we need with less energy.

The ‘problem’ however with nutrient dense whole foods is that they make it hard to ingest enough energy.  If you are active and are not wanting to lose weight, you may need some higher energy density foods.

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Over at KetoGains, they talk about using ‘fat as a lever’.[12]  If you are not worried about being low carb or ketogenic or your blood sugar control, you can also think of ‘energy density as a lever’ to manage the amount of energy you can get from your diet.  While a ketogenic diet is typically higher fat, if you want to lose body fat then some of the fat contribution to your diet should come from your body, with less fat required from your plate or coffee mug.

Energy density is a simple concept that can help you fine tune your food choices and is calculated by dividing the calories in a food by its weight.  Used in isolation it isn’t particularly useful, but can be helpful whne considered along with nutrient density once you have stabilised your blood sugars by tweaking the insulin load of the food you eat.

If you have stabilised your blood sugars and are trying to lose weight, then minimising the energy density of the foods you eat will help you feel physically full with less energy intake.  Practically this might involve filling up on more nonstarchy veggies and perhaps leaner cuts of meat.

Focusing on foods with a lower energy density can help you to get the nutrients you need without overdoing the energy intake.

Alternatively, if you are an athlete and need to ingest a lot of fuel, then focusing on higher energy density foods may be helpful.

Insulin load

As shown in my analysis of the food insulin index data below, the amount of carbohydrate correlates with how much our blood sugar rises in response to food.  [You can click on the images below to see more detail or click here to drill down into the data more in Tableau online.]

However, carbohydrates alone don’t do a great job of explaining our insulin response to the food we eat.  As you can see in the chart below, some high protein, low carb foods still elicit a significant insulin response.

We get a much better prediction of our insulin response to food once we account for the fibre and protein content of our food.  Thinking in terms of insulin load (i.e. net carbs + 0.56 x protein) is useful if you are manually injecting insulin to manage your diabetes.  If you are insulin resistant, you can reduce the insulin load of your diet to the point that your pancreas can keep up and maintain normal blood sugars.

Reducing the insulin load of your diet will help achieve more stable blood sugar levels and get off the insulin rollercoaster that drives hunger and energy levels.  While various studies have not been able to demonstrate a metabolic advantage of one macronutrient versus another, it seems that appetite control is easier for people who are insulin resistant when they manipulate their diet to stabilise their blood sugars.

While too much energy from any source can promote insulin resistance in the long run (note: the pancreas secretes insulin to stop the flow of energy out of the liver when we have plenty of energy coming in via the mouth), increasing the proportion of fat in your diet will lessen the amount of insulin required by your food.

Increasing the percentage of calories from fat in your diet will also reduce your glucose response to food.

Although protein does need some insulin to metabolise, higher protein foods will typically force out the processed carbohydrates and reduce your insulin levels.

So what does all this mean?

If you are part of the 50% of the population that has diabetes or prediabetes, then manipulating the insulin load of your diet will help you stabilise your blood sugar levels.  This is a critical priority.

The problem with focusing only on insulin load, however, is that the least insulinogenic foods are primarily refined fats (cream, butter, olive oil, etc.) and do not contain a lot of the essential vitamins, minerals, and amino acids that we need to thrive and be metabolically healthy.

The solution is to find the optimal balance between insulin load and nutrient density.  As your blood glucose levels start to improve you can start to focus more on nutrient density and then on reducing energy density if you still need to lose weight.

The various food lists have been developed using a multi-criteria analysis algorithm that uses nutrient density, energy density and insulin load to highlight the ideal foods for a particular person.

Pros and cons of different dietary approaches

The table below outlines the pros and cons of each of the higher level nutritional approaches, who they will be appropriate for and which nutrients are harder to find.

approach who harder to find nutrients Pros Cons
well-formulated ketogenic diet Someone with an average blood sugar greater than 140 mg/dL or 7.8mmol/L or people who require therapeutic ketosis (i.e. for the management of conditions such as epilepsy, cancer, Alzheimer’s, etc.) Vitamin D, choline, potassium, vitamin B5, zinc, niacin, magnesium, calcium selenium and folate. Aggressively lowers insulin load to stabilise blood sugars and drive ketogenesis.  Higher fat levels can help to increase satiety while in early adoption phase. High energy density and low nutrient density mean that it may not yield optimal weight loss or health in the long term for everyone.
diabetes and nutritional ketosis People with an average blood sugar of greater than 108 mg/dL or 6.0mmol/L. Choline, vitamin D, vitamin E, potassium, magnesium, vitamin B5, niacin, calcium and zinc. Helps optimise blood sugar control and eliminate the swings that can drive appetite. Higher energy density means that not everyone will achieve optimal weight without also focussing on energy density.
weight loss (insulin resistant) People who are slightly insulin resistant but want to lose weight. Vitamin D, choline, potassium, calcium, magnesium, vitamin E, zinc, niacin. Lower energy density will help ensure a reduction in energy intake.  Higher nutrient density will reduce cravings. Lower satiety due to lower energy intake.
protein-sparing modified fast (PSMF) Someone targeting aggressive short term weight loss while maintaining muscle mass. Vitamin D, choline, vitamin E, calcium, potassium, magnesium, zinc. Very nutrient dense and very low energy density will drive weight loss.  Very hard to overeat these foods. Significant discipline, racking and planning required.
nutrient dense maintenance Someone looking to maintain their current weight. Choline, vitamin D, potassium, calcium, magnesium, zinc. Higher energy density while still being nutrient dense.
bodybuilder Someone looking to repair and build muscle. Vitamin D, choline, potassium, calcium, magnesium, vitamin E, sodium, vitamin B5, zinc, folate and branched chain amino acids Support muscle growth. Not ideal for someone not working out.
endurance athlete Someone who is active Choline, vitamin D, potassium, calcium vitamin E, magnesium, vitamin B5 and leucine. Higher energy density foods to support activity.

This table summarises the assumptions used in developing the lists based on religious, ethical or philosophical considerations and provides some brief commentary for each nutritional approach.  I encourage you to look in more detail at the data to better understand your preferred approaches.

approach score Assumptions & constraints Comment 
the most nutrient dense foods 100% Prioritises the harder to find nutrients. Maximises nutrients per calorie.
nutrient dense Paleo 99% Excludes dairy, grains and processed foods as well as prioritising nutrient density. Very similar outcome to most nutrient dense approach, though with a reduced range of foods.
low carb Paleo foods 97% Reduced insulin load to stabilise blood sugars while also maximising nutrient density. Will stabilise blood sugars more than straight Paleo which can involve more high carb veggies.
pescetarian 95% Plant based plus fish prioritised for nutrient density. Some vegans or vegetarians are comfortable eating fish.
bivalve vegan 92% Plant based plus molluscs prioritised for nutrient density. Provides some nutrients that are harder to find on a purely plant based approach (omega 3, vitamin B12).  Some vegans are comfortable eating molluscs which are not considered by some to be sentient beings.
low carb pescetarian 95% Vegetarian plus fish with a focus on nutrient density and a lower insulin load. Provides a solid nutritional outcome without eating animals or dairy.
whole food plant based 80% Excludes processed foods and oils.  Prioritises nutrient density without focussing on amino acids It is hard to obtain adequate omega 3 or vitamin B12 on a WFPB approach and hence they may need to supplement.

Weight loss is likely due to the low energy density if you are able to stick to unprocessed foods only.

plant based (diabetes friendly) 76% Plant based only, with the focus on nutrient density and lower insulin load. It can be quite hard to achieve a low carb diet, at least in terms of percentages without using a lot of oils or nuts.
zero carb 76% Animal only foods prioritised for nutrient density. A zero carb dietary approach struggles to meet DRI for vitamins K, C and E, folate, potassium and calcium.

Although some argue that nutrient requirements are different in the absence of glucose, though there is limited research to date.

Paleo (without ND) 64% All Paleo foods without consideration of nutrient density. Limiting yourself to unprocessed “Paleo food” is no guarantee that you will achieve exceptional nutrient density.
zero carb (no offal) 58% Animal based foods excluding organ meats. Organ meats provide a lot of the nutrients in a ZC approach.  Not everyone enjoys and eats a lot of organ meats.
plant based (without ND) 57% All whole food plant based foods without consideration of nutrient density. A plant based nutritional approach is no guarantee that you will achieve high levels of nutrients.
zero carb (without ND) 42% Zero carb without nutrient density. A zero carb approach without consideration of nutrient density can provide a poor nutritional outcome.

Summary

Congratulations, you’ve nearly reached the end of this data-heavy article!!

My hope is that all this data will be useful for people seeking clear guidance on optimal food choices for them.  I hope it will help you cut through the confusion and conflicts of interest that so often plague our food system.

Nutrient density is the centre piece of the algorithm for optimising nutrition to suit people with different goals and to suit different circumstances.  When we focus on foods that contain more of the harder-to-find nutrients we tend to boost all nutrients across the board.

A range of optimal food lists have been prepared to suit different states of metabolic health by also considering:

  • insulin load and energy density,
  • pre-existing health conditions using targeted nutrients, and
  • optimal short list of foods that still fit within a person’s ethical or religious system.

Simply focusing on trying to consume more of the foods on these lists will go a long way to helping you achieve optimal nutrition, health and happiness.  If you’re still looking for further guidance to help you refine your food choices, then I invite you check out the Nutrient Optimiser which has been designed to identify areas where you could improve your nutrition and help you fine tune your food choices to help you move towards your chosen goal and dreams, whatever they may be.

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references

[1] https://optimisingnutrition.com/2015/03/22/diabetes-102/

[2] https://optimisingnutrition.com/2016/05/16/building-a-better-nutrient-density-index/

[3] https://optimisingnutrition.com/2015/03/22/towards-a-personalised-food-ranking-system/

[4] https://en.wikipedia.org/wiki/Food_fortification

[5] https://freetheanimal.com/2015/06/enrichment-theory-everything.html

[6] https://freetheanimal.com/2016/05/enrichment-promotes-everything.html

[7] https://freetheanimal.com/2015/10/fortification-obesity-refinements.html

[8] http://perfecthealthdiet.com/

[9] https://suppversity.blogspot.com.au/2017/08/vitamin-b6-b12-c-e-folate-iron.html

[10] http://suppversity.blogspot.com.au/2015/04/studies-confirm-natural-and-synthetic.html

[11] https://optimisingnutrition.com/2016/03/21/wanna-live-forever/

[12] https://ketogains.com/2017/06/energy-balance-macros-nutrient-density/