Today I came upon a couple of treats that could easily torpedo a low-carb diet. Many people following a low-carb diet would grab these and throw them down without even thinking about it. I know it’s true because I’ve done it myself.
The photo at the top of this post is of a small sack of dried fruit and mixed nuts sold at Starbucks stores everywhere. I can’t tell you how many times I’ve popped in to a Starbucks to grab an Americano and walked out with one of these. You can see from the size of the sack relative to my hand that these aren’t very big.

If you take a look at the Nutrition Facts on the back, however, you can see that this little sack holds 2.5 servings and that each serving provides 160 calories. Since no one eats a single serving as defined (everyone eats the entire sack), this little treat adds 400 calories to the day’s total. I know that each serving contains 17 g of carb as per the label, making the entire bag sport 42.5 g of carb. But I also know that most people (myself included) won’t look at that number and will simply throw one of these back thinking, hey, these are just nuts with a little dried fruit. How bad can it be? Then wonder why the weight isn’t coming off. I’m using this example to show just how easy it is to run afoul of the carbs and calories in seemingly ‘healthful’ little snacks like this one.

Above you see a photo of an actual small bag of mixed nuts I pulled from our own pantry. I love nuts, and I snack on them all the time. But they are full of calories and have to be treated with care if you’re trying to lose weight.
As you can see from the nutritional label to the left, each serving of these nuts provides 190 calories, which doesn’t sound all that bad. At least not until you look a little more closely and realize that there are seven servings in this little bag. It’s easy, easy, easy (and I speak from personal experience) to eat an entire bag – that’s seven servings – at a sitting. I can go through one of these puppies while watching a movie without thinking twice about it. And eating a bag of these nuts means that you’ve downed 1330 calories. If you’re on a low-carb diet and are creating a caloric deficit of a couple of hundred calories per day, eating even a serving of these nuts will do your weight loss in. But who can eat just one serving? Each serving contains 4 g of effective carbohydrate (6 total minus 2 of fiber), so the entire bag contains only about 28 g carb. I know purists who read every label and stick religiously to a low-carb diet would avoid eating this entire bag because it would provide too many carbs. But far too many of us simply figure that nuts are a low-carb snack food and go for it. And take in 1330 calories in the process.
The purpose of this post isn’t to hector everyone about noshing, but is to let you know how easy it is to succumb to the lure of these kinds of snacks without really giving it much thought. And then wonder why the weight isn’t coming off. Now you know.
It takes a fair amount of diligence and care to lose all the weight you want to lose on a low-carb diet, and it can seem like a real pain. But it’s a whole lot less of a pain than losing on any other kind of diet. When I hear people complain about the difficulty of following a low-carb diet, I think of Winston Churchill’s great quote about the democratic form of government:

Many forms of Government have been tried and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed, it has been said that democracy is the worst form of government except all those other forms that have been tried from time to time.

It’s the same with a low-carb diet: it’s the worst diet available except all those other diets that have been tried from time to time.
In the next post I will bring you some good news to offset the bad news of these last couple of posts. I’ll show you how you can reach the point in low-carb dieting that allows you to snack on cheese, nuts and other low-carb, high-caloric-density treats without paying the price. Stay tuned.
In the meantime, if any of you have your own favorite snacks that are caloric torpedoes you would like to share with the group, please post them as a comment.


  1. Dear Dr Mike,
    I don’t wish to be chauvinistic, but you Seppos sure are stuck with poor nutrition panels. Here in the land of Oz, every item has two columns, one for the arbitrary serving size, and another — and this is important — with the number of grams of the item per 100 grams. That makes comparison between foods easy.
    Perfection, were it not for the inaccuracies of measurements that bedevil these figures. For example, one packet of macadamia nuts (not sugared!) claims 4 g/100g. Another has 16/100g. And they are supposed to subtract dietary fibre from carbs by law (not as in the US) but confusion reigns supreme here as well.
    Nowhere are any stupid % dietary requirements given, which saves us from more BS. Add to the fact that we have been metric since 1966. Even old fogies like me (57) don’t think in feet & inches anymore. My children have not a clue how big an inch is and a foot goes into a shoe.
    And thank heavens as our fluid ounces and gallons (Imperial measure) were quite different to yours (US measure). It made for highly confusing tables on the backs of exercise books when I was a kid! “How big is a mile?” I was asked a couple of months ago.
    But that still didn’t save me from eating way too many kcals (or kJoules as per our own labels!) until your timely previous post. And I read these labels. So low carb was still difficult to get right (at least for me) once the easy-to-lose chub disappears, despite better consumer info on packets. But it’s still way easier than low fat! Just an observation.
    (Live music brag: Charles Dutoit conducting Mozart’s Jupiter and Strauss’ Alpine Symphony tonight! Plus super-foul weather!!)
    Michael, the other.
    Ah, the Jupiter Symphony. My wifes’ all time favorite piece of music. She’ll be envious.
    P.S. What is a Seppo? I can figure it out from the context, but I’ve never heard that word. Derivation?

  2. Great Post! Nuts together with cheese is a favourite of mine. I also really like Lindt’s Excellence Bar containing 85% cocoa; tastes great, so much so that i find it hard not to devour the whole 100gram bars i buy in a single sitting. Fortunately, a 100gram bar contains less than 20 grams of carbs. It is actually very filling, too. Furthermore, for anyone with problems related to constipation while low-carbing, i find this bar works wonders for precipitating bowel movements, not that i have trouble in that department, given that i eat sufficient fat and drink plenty of fluids.

  3. Don’t know if he’s right, but Dr.William Davis says we only absorb a little over half the calories in almonds. He says:
    “One study, to my surprise, documented this phenomenon. In Manipulation of lipid bioaccessibility of almonds influences postprandial lipemia in healthy human subjects, it was determined that, of 100 calories ingested from the fat fraction of almonds, only about half was actually absorbed. The remaining half passed out in the stool. (They did this by collecting stool samples and comparing the fat composition after eating the different almonds preparations. This is not discussed in the limited text of the abstract.) In addition, postprandial (after-eating) surges in triglycerides were much less with whole almonds compared to the oil separated from the nut (i.e., broken down into almond oil + defatted almond flour). The researchers attributed the difference to the inhibitory effects of the almond nut’s “food matrix,” or the structural properties of chewed foods.”
    I would like to see this paper because I don’t believe it. I’ve seen too many studies in which fat intake is correlated with fat output through the bowel, and in a normal bowel almost all of the fat is absorbed. The fat in almonds isn’t any different than the fat in anything else, so I seriously doubt that half is not absorbed. But I’m willing to be persuaded – I just need to see the evidence.

  4. I’ve slipped down the slippery slope as well. My torpedo – Peak Protein Whole Grain Granola with Nuts (Bear Naked brand). A little sprinkle adds crunch. How bad can it be, it’s whole grain, seeds, nuts, with 5 grams of protein.
    I figured my sprinkle was probably 7-8 carbs. But I just checked, serving size is 1/4 cup which when I measured is clearly a light sprinkle (the granola globs are huge – big rocks). That means my sprinkles are if 1/4 cup (which they are more) are 16 grams carbs and 140 calories. CARB CREEP!

  5. For those who are interested in maintaining a balance of Omega 3 and Omega 6 fatty acids, nuts (and nut butters) pose a significant problem.
    On average, about 30% of the fat content of mixed nuts is Omega 6 polyunsaturated fat (linoleic). So a single serving from the bag of mixed nuts you mentioned, contains 0.3 x 17g = 5.1 grams of Omega 6 fatty acid. Eating the whole bag would yield a whopping 35.7 grams of Omega 6.
    Dr Mary Enig in her book “Know Your Fats” suggests that our total requirement for Omega 6 (on a 2000 calorie diet) is about 5.5 grams and our total requirement for Omega 3 is about 2.25 grams. She suggests keeping the ratio in our diet of Omega 6 to Omega 3 at about 2:1. Since it is very difficult to obtain the required amount of Omega 3 we would need to scrupulously limit our intake of Omega 6 to meet the 2:1 ratio.
    Since we are inundated with other sources of Omega 6 (including grain fed meats and dairy) getting nearly our entire daily requirement of Omega 6 from a single serving of mixed nuts does not seem to be a good idea. As a believer in trying to maintain a balance between Omega 3 & 6, I find that nuts and nut butters are essentially eliminated from my diet.
    With few exceptions, my selection criteria for acceptable foods are: 1) low carb, 2) seek out sources of Omega 3, and 3) limit sources of Omega 6.
    I’m glad you are back blogging!
    Philip Thackray
    Pittsburgh, PA

  6. Hi Dr.:
    Thanks for all your hard work and advice! I just recently got your book and am reading it with great interest. I previously, by way of comment, asked you about hitting a wall in terms of losing weight and you responded and, as well, I read more of your blog and comments and, consistent with this one, I see that calories are something that can’t be ignored. In my own case, low carb dieting has eliminated the constant hunger I had with low calorie/high carb dieting, so I reviewed my own eating habits and eliminated several things which I was eating just out of boredom, or for the flavor. These included: every day, at least one small pack of almonds and usually a small pack of pistachios and/or peanuts and, sometimes, all three. I also eliminated all between meal snacking — usually a few pieces of cheese after supper, before supper, etc. What I do allow myself, and here is the suggestion: sugar free jello has no carbs/no calories and is sweet. I also found a type of chocolate bar that has only 1 net carb. I think it is called carb-o-lite, or something like that. I don’t think it is sold anymore, as I found it on clearance at a local discount store. They have 110 calories and 1 or 2 net grams of carbs. They are sweetened with erythritol, which, if my information is correct, has exactly NO glycemic impact. I have two of these chocolate bars, one after lunch and one after supper, per day. For breakfast, I have an Atkins shake and I have gotten out of the habit of eating more dinner than makes me full just because it tastes good. The long and short of it all is that with these few simple steps, I have started losing weight again, at the rate of about 1/2 pound a week, which I think is pretty good for being 14 months on l.c. diet and having already lost 20 lbs. since I started back then and being 30 pounds less than my all time high. Again, thanks for your explanation of why I was hitting the weight loss wall, your suggestions and for all you do. Hopefully others who have hit the wall despite being low carb will find something useful in my experience to get their weight loss going again.

  7. Thanks Doc,
    I sure enjoy this blog more than any I read and that’s a lot!!! It’s been 10 years now that I lost most of 80 lbs and it’s still off. My nemesis has been bock beer, I love the stuff!!! But man, a few bottles sure pack a carb/kcal punch. It’s easy to get carryed away when I’m out working in the yard all day.
    This sure is good reading!!!
    I solve the problem by never working in the yard.

  8. Nuts are a very satisfying snack for me and I’ve found a way not to overeat them.
    I keep raw nuts in the freezer. (I keep different kinds in separate freezer bags.) Before I freeze them, I find out the number of nuts per ounce so I can write it on the bag. I do this by weighing 4 ounces (too hard to weigh 1 ounce accurately), counting the nuts, and dividing by 4. I get the corresponding calorie count from the original container or from online nutrition data.
    When I want a nut snack, I simply count out the desired amount (often only 1/2 an ounce) and defrost/slightly roast them in the microwave. (This only takes a minute or so depending on the microwave.) I let them cool a bit before I eat them. (I also halve nuts like filberts or almonds if they’ve gotten hard.)
    This is win/win. The nuts stay fresher and the counting and defrosting prevents mindless overeating.
    Great idea!

  9. Nuts, seeds and dried fruit are the number one caloric enemy for me, so I’ve decided to avoid them as choices except on the rare occasion where I’m starving and/or the alternatives are worse. Just this past weekend I sabotaged a great low carb meal by following it up with about 1200 cals of almonds and walnuts.
    Cheese and yogurt is next, which again is why I avoid those under most circumstances as well. I can’t really imagine much on a “Paleo” diet that I would overeat. Berries? Avocados? Eggs? Cod Liver Oil? Maybe carrots or canned pumpkin are next in line, being the most carby veggies.

  10. Too true! I’ve been known to buy a six ounce can of smoked almonds and grab a handful at every red light. Only to reach home with 2/3 of the can gone. That’s about 700 calories I’ve eaten. I now put them in the trunk and leave them there. If i want some later I go to the car and count out 22 nuts. Rarely do i go back out a second time. Too bad I can’t do that with cheese.

  11. One of my favorite treats on mornings when I want an extra ‘boost’ is a Starbuck’s Quad-Venti-Sugar Free Cinnamon Dolce Breve made with heavy cream and no whipped cream or crumbles on top. There’s Virtually no carbs in all that (a few in the ‘sugar free’ syrup perhaps). But look at the size of the ‘Venti’ cup. Now imagine 4-5 shots of esppresso, and a shot or two of syrup, and ALLL the rest is heavy cream. Even when I skip breakfast, that’s probably more than enough calories to make up for it!
    I’ll sometimes have one of those in lieu of breakfast, and then top off with normal ‘work’ coffee over the course of the morning.
    On the plus size, that will knock me squarely back into ketosis in a matter of hours if I’ve cheated the day before!

  12. I don’t see how you can ignore the 42.5 grams of carbohydrates there! Four hundred calories is nothing. If I eat an extra 6 ounces of 667 calorie-Prime Rib each day for a week, I will not gain an ounce of weight. However, if I eat that bag of nuts every day for a week, I will gain weight, despite the 267 calorie difference. How do you explain that? Metabolic advantage, law of thermodynamics?
    The 42.5 grams of carbohydrate effect a “change in energy stores”. How? Because they raise insulin which slows down the flow of free fatty acids in and out of adipose tissue which causes weight gain, pure and simple. While my body is processing those 42.5 grams of carbohydrates, it is unable to utilize the stream of free fatty acids that would normally be in circulation. However, when I eat the Prime Rib, the fatty acids are only out of circulation for a short time and I am able to mobilize these fatty acids which keeps the size of my adipose tissue constant.
    Why is this not obvious?
    It is obvious. Problem is many people (myself included from time to time) tend to regard these things as acceptable low-carb snacks without really looking at the extra carbs and the extra calories. The post was simply a cautionary wake up for those who tend to do this and wonder why their weight loss is stalled on their low-carb diet.

  13. Nothing much to contribute here. Except I have the same problem. Made worse when there’s a bag of trailmix on my desk. It’s always gone (1800 calories!) by the end of the day. So I don’t buy them anymore. It’s hard to learn that I don’t need to eat everything I want. Now I’m living on two meals a day. Dr McCleary’s book isn’t about diet but it’s easily extrapolated. Snacking is a habit, like any other. You develop good and bad habits over time. Having read his book, I can see that the urge to have a snack is mind-based, nothing more. When I feel the urge, remembering that fact makes it easier to suppress it. I haven’t ‘snacked’ in several months now.

  14. I can see that what you are saying is absolutely true, but I thought we were talking about not losing while actually low carbing which is what is happening to me. I am getting less than 20 gms. of carbs according to fitday and still staying at the same weight. Does that mean that I have to go to less than 1200 calories to lose?
    Perhaps, but I seriously doubt it. I can’t say, though, without a lot more information. And even if I had the information, I can’t give specific personal dietary advice over the internet.

  15. Those “serving-size” portions truly are criminal.
    Labels for anything that common sense would dictate is clearly packaged for consumption by a single person at a single sitting should have per-package nutritional information (even it if is alongside the arbitrary “serving size” nutritional information.
    That “serving size” is the insidious villain on nutrition labeling. Even when people are trained to be in the habit of reading the label for fat/carb/fiber content, they (myself included, unless I am being truly diligent) will by nature overlook the “serving size” specified.
    That said, another rule of thumb I use is the fat-carb ratio. I generally won’t eat anything that has less than 2:1 (or 3:1) fat-to-carb, per gram – better yet, 10:1.
    My primary issue with calorie-counting is that, generally, on a low-carb diet, appetite is a pretty accurate indicator of need for dietary intake. As Taubes points out in GCBC, exercise mainly results in increasing appetite, because it increases the need for nutritional replenishment.
    I think my main issue now is not that my appetite is misleading me, but rather my choices for satiating that appetite (post-dinner hunger in the evening would lead to a snack of almonds, peanuts, or mixed nuts, sometimes with several ounces of cheese). My problem, I think, is that I’ve not been engaging in the rigorous exercise (2 hours of tennis daily) that eased my original, 80-pound low-carb weight loss. So, I need to satiate my appetite with less calorically dense snacks.
    To start, I have replaced my nuts-and-cheese snack with pepperoni slices. The fat content in pepperoni is unencumbered by the fiber/carbs in nuts, and I’m finding that a much-decreased overall caloric intake of pepperoni is as satisfying as 1/2 to 1 cup of mixed nuts.
    Ultimately, though, if I were to guess part of your next post, I would say that exercise is the key to being able to handle calorically dense, low-carb snacks while maintaining weight loss, since the exercise increases the nutritional demand of the body.
    Hi Chip–
    I, too, tend to snack on Italian sausage for a couple of reasons. First, I love the taste of it. Second, I have to cut it, then peal it before I can eat it, which slows me down. Nuts, by contrast, I can simply throw back by the handful. Third, because Italian sausage is hard, it takes me a while to chew it, which also slows down my consumption.
    You are wrong about the next post; it has nothing (or at most, very little) to do with exercise.

  16. Glenlivet 18 yr old!
    (I’d go for the 30 year old Mac, but can’t really afford it, unlike some fancy pants best selling author types)
    there’s also Guinness (lower in carbs/calories than you’d expect, but still…)
    and wine….
    and gin…
    I’m still on the drinking man’s diet, apparently.
    The 30 year old Mac was a gift. I would have never bought it myself. However I did just purchase a bottle of 18 year old Jameson. Talk about ambrosia. I’m about to switch over from Scotch to Irish whiskey for good.

  17. I adore butter, and I recently upgraded to organic butter from grass-fed cows, which makes it even more adorable. But of course, butter alone is not all that interesting–you have to spread it on something, so I buy crackers without hydrogenated oil and fairly low carb (1.5 g per cracker). If I stick to just four crackers and 1 T. butter, it’s a nice little treat and not too costly in calories or carbs, but if I sit down to read with a knife, the butter dish and box of crackers in front of me, pretty soon I’ve lost count of how many crackers and how much butter. Another treat is to whip one cup of cream, fold it into 8 oz. softened cream cheese, add a cup of Splenda, and whatever flavor extract (lemon, orange, etc.) or sugar-free flavored syrup to taste you like. I love Middle Eastern food, so I add a splash of rose water and ground pistachios. Then the trick is eat only about half a cup a day for a snack instead of most of it all at once. So the lesson here is portion out your treat ahead of eating it, and don’t eat mindlessly out of a box, package, or bowl.
    I’m glad you are reminding us that eating low-carb does not mean you can eat as much as you want of whatever low-carb food you want. I think when we embark on eating low-carb, we are so elated that we get to eat so many things that for so long we were told were bad for us that we forget that portion control still applies, especially for certain foods. It’s human nature that we don’t like to have to say no to ourselves, but unfortunately, it’s often in our long-term best interest to do so.

  18. Seppo is a not-very-attractive term for American:
    I love it. I can now feel justified whenever I use a “not-very-attractive term” for anyone else.
    Seppo must be a word that hasn’t penetrated the American consciousness because I’ve never heard it, and I would be that 99 percent of the population here would be clueless about it.
    Thanks for the definition.

  19. Dr. Mike,
    You mentioned in your reply to “mrfreddy” that you are switching from scotch to irish whiskey. Being Irish, i’ve drank my fair share of Paddy’s Irish whiskey and Jameson. I recently switched from Jameson to Canadian Club. I’m also a big fan of a portugal brandy called Neto Costa.
    Lastly, i would love your opinion on the comment made by Philip Thackray. Basically, how important do you think keeping the omega oils (namely omega 3 and 6) in relative balance is if a person is low-carbing? I surmise that the ratio of omega 3 to 6 is very important if a person is eating a mixed diet, but does the same apply to a low-carber?
    I don’t think there is any comparison between Jameson and Canadian Club, but different strokes…
    I believe strongly that the omega-3 to omega-6 ratio is important for health, but I don’t think it makes a lot of difference in whether or not one loses weight. Both contain an equal number of calories. I make this statement kind of shooting from the hip – it is strictly my opinion based on thinking things through, not based on a recent review of the medical literature on the subject.

  20. Wow! Thanks for the quick and lengthy and informative response! You’re right, of course. A lot of people lie about what and how much they eat, or fool themselves. But I know you also understand that there are those of us who precisely measure and record what they eat. No one is perfect. I slip up from time to time, but I never — and I mean never — grab a bag of something and down it without first looking to see the nutritional information and deciding if it’s worth it.
    Women just seem to have it harder. We have to dance backwards and in heels, we have to pee sitting down, we get paid less, we starve ourselves to lose a pound while the men in our lives eat one fewer peanut a week and lose 30 pounds … need I go on? And now I have to deal with menopause. The deck is stacked against us.
    I’ve taken bio-identical hormones (Vivelle-DOT and Prometrium) for 3 months now, but my doctor doesn’t believe in testing; she wants to treat based on how I feel. So, yes, I feel a bit better (hot flashes and night sweats are way down) … but do I feel as good as I can? How do I know if my hormones are in balance or not?
    Methinks I need to find a doctor who will order some tests.
    Oh, and Jameson’s and Canadian Club? No contest.
    You do indeed need to get tested. I like saliva testing because it provides a good measure of the active hormone, because in order to make its way into the saliva, the hormone has to be active. Monitoring how you feel is fine, but there is no substitute for a good laboratory evaluation. You learn a lot of interesting things. Let me give you an example.
    MD takes bioidentical hormones so she gets tested. I don’t, but she has been after me to get tested so that I will know what my baseline is. I finally relented and sent off a saliva test a couple of weeks ago, and I got back some surprising results. I was pleased to discover that all my hormones were within normal limits except for two: my estradiol and progesterone were both hugely high, at least for a male. My estradiol was 3.5 pg/ml (normal for males 0.5 – 2.2) and my progesterone was 403 (normal 12-104). MD uses the cream version of her hormones, which, we learned can rub off on a sleeping partner pretty easily. So it turns out that I have been getting my share of her hormones. No wonder my voice is losing some of its resonance and my breasts are getting larger. (Just kidding.) So, many interesting things can be learned from lab tests. You will no doubt be pleased to learn that we have taken steps to prevent my getting a portion of her hormones, so I hope that next time around the tests will show ALL of my hormone levels to be normal, not just the male ones.
    As to the hormones you’re taking, the Vivelle-DOT is fine as long as it’s dosed properly (based on lab results), but I’m not crazy about the Prometrium even though it is bioidentical progesterone. Oral medications of this type go into the blood from the GI tract and make in immediate passage through the liver before reaching the rest of the circulation. How much the liver degrades the medication is a function of how the liver is working at the precise moment the medication hits it. If the liver’s detox capacity is mildly compromised because of some fatty infiltration or because you’ve taken a recent Tylenol or because you’ve had a glass of wine (or Jameson’s) or even a cup or two of coffee, the dose will make it through largely untouched and blood levels will be high. If, on the other hand, your liver is working at top capacity, it’s likely that the medication will be detoxed and blood levels will be lower. Varying blood levels are a hallmark of hormones taken orally, which is why we prefer the creams and gels. When rubbed into the skin, these hormones go through the circulation before hitting the liver and are cleared more slowly allowing more precise and unvarying blood levels.

  21. Yes, it’s easy to overdo it while mindlessly noshing — a handful here, a handful there. And it’s easy to not realize how much you’re eating.
    Allow me to speak for myself and for so many other women (and men) out there that I “talk” with every day on the low-carb forums. I/we weigh and measure EVERYTHING. There is no mindless noshing for me. I don’t reach for a handful of almonds. I measure out 1/4 cup. I’ve even gone so far as to count the nuts in a serving, put them in a small bowl, and then “nosh” on that. I’ve even gone so far as to do all this, and then put half back because I’m so aware of the calories.
    And it’s the same for an awful lot of people. I use FitDay to track foods (others use any one of a number of online trackers out there). As long as you’re entering in your food precisely, which I do, you’re very well aware of the calories, as well as fat, protein, and carbs.
    Many of the people I converse with on the forums know EXACTLY how many calories, etc., they’re taking in every day. They’ve figured out their BMR and calculated with activity level to boot.
    Not everyone who is having trouble losing weight on a low-carb eating plan is taking in more calories/carbs/protein/fat than they think. Many of us are having trouble DESPITE the fact that we weigh and measure everything.
    And no, most people I know would not grab a package of anything and eat it without analyzing the nutrition information on the back of the package, figure out serving size, and then agonize over whether they can “afford” it on any given day.
    Oops. I’m ranting again. But you should know me by now: “Caution: I’m out of estrogen and I’ve got a gun.” 🙂
    You are obviously more disciplined than I.
    But, I have a quibble based on many years of direct hands-on experience taking care of a whole lot of patients. People either lie about what they’re eating or they fool themselves. I practiced for many years in Little Rock, AR and for a few years in Boulder, CO. Both are relatively small cities, and I often ran into my patients out and around in both places. On numerous occasions I’ve had patients in my office weeping to me that they just weren’t losing weight. When I would ask them to go through their diet’s with me to see if they were somehow straying, these people would become indignant and tell me in no uncertain terms that they were following the diet TO THE LETTER. I can’t tell you how many times I’ve run into these same patients in restaurants with big desserts on their plates or a half-eaten baked potato or other food they shouldn’t be eating. This has happened so frequently that I’m reluctant to believe anyone who gives me the story of precisely following a low-carb, low-calorie diet and not losing…or even gaining.
    Now, having said this, I do believe that some people – primarily women in menopausal and peri-meonopausal years – do have great difficulty in losing weight, especially around their middles. Estrogen moves fat from the waist to the hips and but. That’s what happens during puberty when estrogen surges: women go from the baby fatty poochy bellies and non-existent butts of pre-adolescence to the flat bellies and bigger hips of adult womanhood. Things move in the opposite direction with the onset of menopause when estrogen levels decline.
    Plus, many women are insulin resistant and hyperinsulinemic when they reach menopause (not because of menopause, but because of a lifetime of overeating the wrong foods), which adds a double whammy to the equation. Hyperinsulinemia prods the liver to make more sex hormone-binding globulin (SHBG), a substance that binds to the sex hormones and makes them less available for the body to use. As SHBG increases the levels of free estrogen and free testosterone decrease. Since estrogen is already decreasing as menopause approaches, the little left that is bound up isn’t effective much at all, leading to a further increase of fat in the abdomen. This increase of fat increases the level of insulin resistance, resulting in more hyperinsulinemia, and the beat goes on. (Also, the decrease in free testosterone results in the marked decrease in libido that accompanies menopause.)
    The way to deal with this is to (1) work dietarily to decrease insulin resistance; and (2) get hormones measured and take bioidentical hormones to bring lowered hormones up to normal levels.
    Hope this helps.

  22. I am a 30 year male and have been following the following diet for about 4 years after reading Power Protein. I guess someone might be interested to know what I do!
    1. breakfast. 3-5 eggs. 4 good quality sausages, and a tin of tomatoes. all steam cooked.
    2. lunch – bag of nuts, about 100-200g I would say, almonds and brazils. such an easy lunch, no hassle.
    3. dinner, big steak..lamb curry with spinach and tomatoes, non cooked veg generally since i find it removes the hassle of cooking!
    4. now comes the vice. berries and thick thick cream. i must eat a full bowl each day.
    5. 100% chocolate. I get it imported, expensive but wonderful. about 50g.
    also take krill, curcumin, vit d, magnesium, vit e.
    overall, I am losing weight, but do have a few concerns. the level of cream addition (is there a cream addiction help group?) and the omega 6 ratio to omega 3.
    I fear you’re going to have a lot of people after your scalp. Others don’t find it this easy to lose.
    If you are losing, I wouldn’t change a thing. Once you reach the point in your weight-loss journey when you do quit losing (assuming you reach such a point; some don’t), you may have to make some decisions as to what you’re prepared to ditch from your regimen. But until then, I wouldn’t worry about it. Even the cream addiction. You’re getting some omega-6 from the nuts, but you’re compensating with the krill oil.

  23. Hi Dr. Eades:
    Those people who have lied to their doctors about what they eat really tick me off, because it tends to make my doctor more skeptical when I very honestly report what I eat.
    I am a compulsive weigher and a measurer. I drive my husband nuts. I refuse to lick a spoon or have a taste of anything. I don’t snack. I calculated my BMR and I tailor my calories to this number. I follow my reccomended protein and carbs from PPLP. I eat a nearly-purist PPLP diet (with the exception that I use some liquid sucralose, stevia and vinegar on occasion) because of dairy and gluten sensitivities (intolerances? allergies? I never know what to call the darn things – they make me sick). I have not cheated since I started low carb, period. Oh – wait – not true. Somebody slipped me some shrimp that had been marinated in sugar on Easter – they said it hadn’t been, but the sugar rush that came after I ate it told a different story.
    I am also in my periomenopausal years. I lost all sorts of weight and then just stopped cold about 70 pounds north of where I need to be. I can only hope that your next book addresses these issues, because I am one frustrated and hormone-crazed middle-aged woman at this point. It drives me nuts to feel that I am just spinning my wheels….
    When’s that book coming out?
    The book is coming out in January 2009, but maybe the publisher will let us leak a little between now and then.

  24. doc,
    This tendency to overeat high-caloric snacks seems to apply to nearly everyone. Which begs the question of why we don’t get satisfied and lose our appetite after a couple hundred calories. Shouldn’t the brain tell us we are no longer hungry? Maybe a topic for another post (or a prior one — didn’t look).
    Wine is my downfall. More than 10-12 ounces (~330 ml) and I cannot control my appetite very well at all. Satiety? Forget it!
    I have the same problem with booze of all sorts, which is why I try to watch my intake of the stuff like a hawk. Not only does alcohol contain calories (a little over 7 per gram), enough of it makes you not particularly care about those calories or any other calories.

  25. What are your thoughts on refeeds to break weightloss stalls?
    I hate to sound ignorant, but I don’t really know what you mean by ‘refeeds.’

  26. Philip Thackray: “For those who are interested in maintaining a balance of Omega 3 and Omega 6 fatty acids, nuts (and nut butters) pose a significant problem.”
    Very good point. Some nuts are lower in PUFAs than others. You say that nuts average 30% omega-6 by fat. Macadamias are 2-4% PUFAs total. Hazelnuts are about 9-10%. Coconuts are 1-2% PUFAs. So, eating those would bring the average down. Limiting the high-PUFA nuts like walnuts, pecans, almonds, peanuts, and brazil nuts would also be a good idea.
    “Since we are inundated with other sources of Omega 6 (including grain fed meats and dairy) getting nearly our entire daily requirement of Omega 6 from a single serving of mixed nuts does not seem to be a good idea.”
    Beef and dairy are extremely low in PUFAs (3-4% of fat). Those are not the big problem, IMO. Eating a lot of nuts, seeds, vegetable oils, and other junk is. Chicken and turkey are also too high in PUFAs, IMO. Duck and goose are better (11-13% PUFAs vs 21-23%).
    “As a believer in trying to maintain a balance between Omega 3 & 6, I find that nuts and nut butters are essentially eliminated from my diet.”
    I feel that most people would be wise to avoid nuts and seeds entirely. If they do eat nuts, I would get raw nuts first, then dry roasted nuts. If they are not unsalted, then take a handful and rinse all the salt off of them. I prefer to just have a spoonful of good macadamia oil every day. That has provided noticeable benefits (my feet are now as soft and smooth as my hands) and the mac oil I’m getting tastes delicious (8.5 ounce bottles). I also use some coconut oil in cooking and just as a supplement eaten straight from the jar.
    “With few exceptions, my selection criteria for acceptable foods are: 1) low carb, 2) seek out sources of Omega 3, and 3) limit sources of Omega 6.”
    I would focus on #3, then #1. I’m not so sure that #2 is important. I think the excess omega-6 in modern diets increases the need for omega-3. If you avoid omega-6 oils and don’t eat a lot of nuts (other than coconut, macadamia, and maybe hazelnut), you will not have an extreme omega-6 imbalance. It will be easy to balance with fish or brain, if you choose to do so. I am not convinced that it really matters. We need to have studies that isolate the high omega-6, grains, refined sugars, and trans fatty acids in the modern diet.
    My own preference in terms of importance would be #1, #3, #2.

  27. I should point out that it’s a term of endearment. Mine is the country where “You old Bastard” is a compliment. Joan Sutherland used to stop traffic waving at friends like Pavarotti across the street and yelling, “Hello, You Old Bastard!”
    I love it. I’ve been trying to think of a few good Seppo jokes, but they just don’t work. How many Seppos does it take to screw in a light bulb? Answer: one. They’re just not that funny.

  28. My torpedo comes when instead of my normal one glass of red wine and a piece of dark chocolate, I end up having three or four glasses of wine, and then devouring any remaining chocolate in the house. I’ve learned my lesson now. I don’t buy the chocolate. Once I reach me weight goal (lost 43, 10 or so to go), then I might add it back.
    You’ll love the next post.

  29. Dr Mike, you’re commenting on your comments again. 😉
    I understand the concept of the caloric torpedo, but are you gaining any weight?
    My caloric torpedos (yes for stall, but no for weight gain):
    1. One Ounce of Cheddar Cheese popcorn (movie night). This actually equates to a fairly good-sized bowl that I can never finish.
    2. Home made popcorn with a ton of butter, real lard, and a good dose of sea salt. This may require two bowls, but the butter really satisfies.
    2. Mrs. Mays Naturals- nut clusters. Blogged by MDE at some point, they now come in 2 serving packages which is perfect for my spouse and myself. Not so great for myself only.
    3. Cheesecake. Perfect, NY style, sugar free cheesecake that I’ve spent years perfecting. Very fatty, very good. No weight loss, but no weight gain.
    4. Chocolate. Amadei Porcelana, or Amadei Chuao. Anybody still eating Lindt should give this stuff a try. Best chocolate in the world.
    5. Bacon.
    6. Onions (a very dangerous thing, especially caramelized with steak).
    I can eat these luxurious foods (in addition to the steaks, etc) and not gain. Like I said before, I’ll try and give up the nuts, cheese, popcorn, etc to lose that final 10. But I’m NOT giving up my 5g ecc chocolate. 🙂
    You’ve hit on the topic of the next post after the best seller list.

  30. Wine and pistachio nuts with the shells on.
    Why so dangerous?
    (1) A little wine is healthy, right? Just a few carbs per glass.
    (2) This bowl of pistachios is mostly shell, right? Just a few carbs per bowl.
    (3) I’m thirsty. Better drink some water, and while I’m up, just another wee glass of wine.
    (4) Mmmm, and maybe just a few more nuts.
    (5) More wine? Why thanks, honey. Just a splash. I’m watching my weight.
    Ah, yes, a treacherous path down which I have trod myself…

  31. I find that what slows my consumption of nuts vastly is to buy the unshelled variety. Walnuts and almonds take enough time to shell, that you can’t simply knock them back by the handful. Sunflower seeds are also good for that, although most are too salted (and they give you really really awful breath). I love pistachios but those are so easy to shell that it hardly makes a difference. Still, if you portion them out instead of sitting down with the whole bag, you will naturally eat less, because the shells take more room in your bowl. I tend to eat in front of the computer, so I will typically make myself a snack, and bring it with me. Rarely will I go back for more.
    And here is an innovative weight loss method, take up online gaming. I’ve lost weight and so has my husband. The mechanism is easy….we are too focused on gaming to snack. We still take the time to eat a good meal however. In his case, he’s lost quite a lot of weight because he has started to limit his consumption of alcohol. He finds that drinking dulls his reflexes. Whatever works 🙂
    Good idea about consuming nuts only after having to shell them; bad idea about taking up online gaming. Good idea about limiting consumption of alcohol; bad idea about taking up online gaming. Why is it a bad idea to take up online gaming? I don’t know, and since I don’t understand it, it just sounds like a bad idea.

  32. Dr. Mike,
    Thanks for the tidbits about the issues women have with (peri)menopause. As someone knocking on the perimenopause door, I have been in the dark as to appropriate resources to stay healthy, maintain my own sanity as well as the sanity of my DH, and answers to questions that I did not know that I wanted to ask.
    I purchased the Brain Trust Program by Dr. Mc Cleary, initially thinking it would be to help my Mom with her Menopause issues, but I think it actually will be for my use instead…but maybe I can still get her interested. Another jewel is your blog and the dialogue you engage in with Commenters regarding your personal experience at home as well as the Medical viewpoint–thanks to both you and Dr. Mary Dan! That information will help me with my conversations with my own doctor.
    Are there any other good resources for perimenopause (books, websites)? Most of what I see on the web is hosted by Big Pharma and can hardly be considered objective.
    I don’t know of any good resources on peri-menopause other than Dr. McCleary’s and the Signature Pharmacy website (We have no financial affiliation with Signature Pharmacy). Maybe some other readers can enlighten us.

  33. The more I stare at that bag…yes there are nuts but aren’t those pieces of chocolate and also dried fruit there? I don’t know of any low-carb plan that would allow the chocolate or the dried fruit. The nuts seems to be the healthiest thing in that bag and that’s quite a stretch!
    There are bits of dried fruit, but no chocolate. And a good low-carb plan would indeed limit the consumption of dried fruit. My point was that it’s easy to be beguiled by what appears to be a small, healthful snack into screwing up your low-carb diet.

  34. Dr. Mike,
    A little off topic: which brands of bio-identical hormones is MD taking? My wife was just tested, and her levels are very low. Her doctor wants to prescribe oral horse derived hormones.
    From a little research, it seems that Estrogel and Prochieve are good ones. The medical profession is in a sad state if I have to be researching stuff… And there is no female testosterone outside of compounding pharmacies, as far as I can tell.
    A suggestion: maybe MD could do a post on the subject on her blog. But my wife’s follow up visit is on Monday, so we could use some suggestions ASAP.
    MD uses bioidentical hormones that are formulated by a compounding pharmacy. She likes those because she can be very specific about dosages rather than being shoe horned into a particular manufacturer’s dosage limitations. She uses creams instead of oral meds, which make for more consistent dosing. You can read about bioidentical hormones on the Signature Pharmacy website.

  35. Dr. Mike, first, make Karen turn over her ‘perfect’ low carb cheesecake recipe!
    Second, how do feel about the injectable pellets that are a popular delivery method for the bio hormones. everyone i know is getting a pellet in the bum. and they only have to do it once every couple months. seems easier than cream. Thanks…
    Hi Susan–
    I can’t make Karen turn over her recipe for the ‘perfect’ low-carb cheesecake, but I can beg.
    I’m not crazy about injectable pellets because once they’re there, they’re there. There is no titrating the proper dose. I much prefer the creams and gels.

  36. re: leak from the January 2009 book
    Table of contents would be a good start.
    PS: thanks the link on bioidentical hormones.
    As soon as I can, I’ll put it up.

  37. Refeeds are, at their most basic, a spike in calories. It can be for a meal, a day, a weekend. It can be a spike in calories using the same macros, or most typically, a carb load. They’re very common in weightlifting/body building circles.
    The most lay explanation is “stoking the metabolism” or “staving off the starvation response.” Which I don’t really buy. I mean one day of high calories is not going to have any meaningful impact on your metabolism. At least it didn’t in my experience. And I’m not convinced “metabolism” really varies that much.
    The more sophisticated rationale, and the one I’ve definitely seen work in my training, is glycogen reloading. The idea being that you low carb for 5-6 days, then carb refeed for 1-2 days (I’ve also done a carb meal every 2-3 days) which puts your body, over time, into a fat burning/metabolizing zone. That is, your body preferentially burns fat, just like you have mentioned in your recent posts, and you use that to your advantage to build muscle. After the 5-6 days of low carb, you’re spent on glycogen, so you reload on carbs and it all gets soaked up by the muscles and you go back to low carb after the muscles are full and before your body starts burning the carbs as fuel instead of fat.
    This relates to dealing with stalls in fat loss in that there is a natural ebb and flow to the calories and macros. It gives you the fat burning metabolism of low carb, and the anabolic/hormonal cascade of managed insulin rushes of high carb. If you wanted to focus on fat loss and muscle retention, the idea would be to diet hard for 5-6 days, then do a modest refeed, so as to keep from going into a “diet crash.” My preferred refeed method during fat loss is to spike calories after training. Presuming I train 3 times per week, that would be 3 refeed meals per week–enough to take advantage of the post-workout anabolic window, but modest enough to keep the calories low for the week.
    DiPasquale uses it in the Anabolic Diet and Adam Campbell uses it in certain phases in his TNT Diet, for example.
    Of course, the concept can be applied to strict low carb as well. Insulin spikes can be achieved in chronic low carbers with BCAAs–or at least that’s what I’ve read.
    I’ve also seen the concept applied to leptin management as well. Most recently in Joel Marion’s Cheat to Lose book.
    Thanks for the info. I’ve never used this technique and never really studied it, so I can’t comment intelligently. I do know that Jeff Volek (Adam Cambell’s co-author) has done studies showing that the best way to lose body fat and gain muscle is to follow a low-carb diet while performing resistance training.

  38. Oh dear,
    The classic bad set of Aussie puns was done by a guy I knew at uni(versity) by the name of Sandy Gutman, who among his other accomplishments taught me how to play mah jong. He had a national hit single called “Australiana” under the stage name of Austin Tayshus.
    Here it is on a web page that glosses the text for the benefit of Seppos everywhere:
    P.S. one day, I promise, I’ll do an on-topic post. One day…..
    P.P.S. I doubt that any of this sheds any light on Colpo’s temperament. He certainly doesn’t follow the national template of being laid back and laughing if someone takes the piss (“pokes fun at or says something insulting about one”).
    Funny piece, Australiana. Thanks for sending.
    I’ve referred to myself as a Seppo about a dozen times so far in mixed company and garnered nothing but blank stares. It’s a term that no one over hear really knows.
    How was the Jupiter?

  39. Well, I’m not Karen, but I do have my own recipe for cheesecake. Here’s the link to “Bawdy’s Cheesecake.” I promise you won’t be disappointed!
    May I also add something about the bio-identical hormone creams. I used a progesterone cream for about a month, but hated it. I was told to rub it into my inner thigh. The dose was so large (came with a syringe) that it took forever to rub in. So there I sat, on the edge of the toilet (lid down), rubbing my inner thighs for like 15 minutes every morning. I’ll definitely read the info on the Signature Pharmacy web site.
    I’m also seriously considering going back to the Women-to-Women Center here in Maine. I had a terrible experience there, but maybe it was just the person I saw. An acquaintance of mine also goes there, and her experience was night-and-day to mine. At least they test hormone levels with the saliva test, and they do compounding bio-identicals. I could always make an appointment with someone else, and see where that takes me.
    Hey Kathy–
    Thanks for the cheesecake recipe link (or at least thanks from the readers – I hate cheesecake).
    You shouldn’t have to spend 15 minutes rubbing cream in – MD spends about 5 seconds. You need to get a different formulation if it’s taking you that long.
    Good luck with the Women-to-Women Center. I had a long dinner with Dr. Northrup and her family in Maine several years ago, and she seemed to be on board with the whole low-carb concept. Or at least she was then. And she gave Dr. McCleary’s book (which is definitely low-carb) a good cover blurb. Let’s hope you have a better experience next time.

  40. I just saw that comments were closed on this post yesterday. If you can’t make an exception, maybe I could post this as a comment in your next column.
    GREAT idea, though, to close comments after a certain date.
    I can’t figure out why the comments should be closed. I checked my preferences, and comments should be open for 60 days.

  41. Here’s my cheesecake:
    Grind 4oz pecan meat in a food processor, melt 2 T butter, stir in 1T equivalent AS (artificial sweetener, I use a blend of liquid sucralose and stevia) and ground pecans. Press into the bottom of a 9 inch springform pan. Set pan in refrigerator for 15 minutes. Refine a 15oz carton of whole milk ricotta in food processor with 1T equivalent AS and 1 teaspoon vanilla, cover with plastic wrap and set in refrigerator.
    Preheat oven to 350° Beat 24 oz softened cream cheese together with 1 cup equivalent AS, beat in 4 eggs, one at a time, scraping bowl often, beat in 1 teaspoon vanilla. Pour into springform pan. Bake for 50-55 minutes. Remove from oven and spread top with ricotta mixture, bake another 5-10 minutes. Cool, run knife around the edge of the pan before removing ring. Makes 16 servings. 272 calories, 25.6g fat, 3g carb – 0.7g fiber = 2.3g 8.4g protein. If you use granular Splenda add 1.7g carb per slice.
    This is my adaptation of “Myra’s New York-Style Cheesecake,” google if interested.
    ps. I’ve never heard of Amadei chocolate but I can still get Lindt 85% at Wal-Mart (rural shopping mecca.) I also like Endangered Species 88%, I can only find that at the health food store 50 miles away.
    pps. Refeed is a body builder term. Some of them do a cyclic ketogenic diet where they raise the carbs and lower the fat for a day or two to replenish glycogen stores before returning to lower carb. This usually does not include bakery goods, white flour, sugar, etc. It’s mostly from veggies, brown rice, sweet potatoes, etc. Among some low carb dieters it has been observed that after weeks of toeing the line carb wise with no movement on the scale and sometimes even more restriction of carbs, calories and/or fat, consoling oneself with a candy bar, donut, several cookies or bowl of ice cream, etc. is often followed within a day or two by a loss of a few pounds. (I think it’s probably water.)
    I thank you on behalf of my readers for the cheesecake recipe. Sounds great. Now if only I liked cheesecake…

  42. Hi, Dr. MIke!
    I think that the poster who asked about “re-feeds” meant something similar to my today’s question in one of you recent posts. Since you (and the readers) may not be going back to that post (titled “Low Carb and Calories), I am repeating my question here:
    Some people (including your friend Tim Ferris) claim to be able to lose terridic amount of weight by following LC during the week and then re-feeding the carbs during the weekend (i.e. eating enormously high amounts of carbs for two days). This is supposed to prevent weight loss stalls (?).
    I don’t know how this is supposed to work scientifically so I hoped you could enlighten us. You can find more details on Tim’s web site.

  43. Angelyne, good advice about getting unshelled nuts. Combine that with raw unsalted nuts and there will be less tendency to shovel them down by the handful. But I think we also need to be honest and admit that nuts aren’t as healthy as meat, eggs, butter, shellfish, etc. And nuts are fattening to many people, esp women. Men can usually eat lots of nuts on a low-carb diet and remain weight stable. I think many people would feel better and look better if they avoided all or most nuts. Occasionally I have some raw macadamias or dry roasted macadamias with the salt rinsed off of them. They are a bland nut, so the salted ones just taste like salt. Generally, I eat macadamia oil and coconut oil instead of the nuts. And I feel better than I ever did while i was eating lots of nuts. They aren’t a healthy food, IMO. They are a compromise food, a lesser evil than grains, refined sugars, and junk foods perhaps.
    I agree that meat is a better choice, but not nearly so handy.

  44. Dr Mike, this has been a great blog of yours and much needed clarification of some of my weight loss issues.
    What I would like to know is: what is the mechanism behind weight gain (I assume that means fat storage) when carbs are severely limited? You have explained in PP and PPLP the mechanism behind the storage of fat by the production of insulin to counterbalance high blood sugar. When blood sugar is in the normal range and the pancreas does not have to produce insulin to control it and when we eat more fat than we use, what happens to the extra fat in our systems. You alluded to the fact that fat is absorbed through the large intestine. Then what happens?
    I’ll explain all this in the next post.

  45. While reading this post, I was patting myself on the back because I pride myself on limiting nut and cheese intake. Then Chip Bennett’s comment made me chuckle and remember that snacking on thinly sliced salami was a favorite of mine and didn’t cause me problems until I started making peanut butter and salami sandwiches out of them!
    Mistakes were made (but not be me!) 🙂
    Thanks for sharing so much!
    Thanks for reading.

  46. Great blog posts lately – thank you! I’m an Atkins devotee, currently transitioning over to Protein Power Life Plan.
    Anyway – were ‘most’ of my carbs coming from vegetables? Nope, they were not. A lot of my carbs and calories were coming from dairy – sloshing cream into my coffee without measuring, eating too much cheese, making recipes with all kinds of cheese, sour cream, cream etc. Plus, I was ‘gooping’ on way too much blue cheese and ranch dressing onto stuff.
    Next up was realizing I was intolerant/sensitive to dairy – finally managed to ditch dairy altogether. Lost the bloat, cleared up digestive issues.
    But then, what happened is that ‘most’ of my carbs were coming from macadamia nuts and salted almonds!
    Made an interesting little discovery today – those sliced natural almonds with the skins on that you can get in the baking aisle of any grocery store – they’re only 6 carbs and 4 fiber per quarter cup serving. Not salty so that they’re not quite as addictive. In any case – these are *great* to sprinkle onto salads or vegetables – a generous two tablespoon serving of these sliced natural almonds works out to be only 0.9 total carbs. They’re great toasted in a dry frying pan for approximately 30-60 seconds and tossed onto a salad or tossed into some broccoli. Even without toasting them – a nice addition to salads and veggies. A real ‘carb-bargain’.
    No more ‘snack nuts’ for me!
    Thanks again for these great blog posts lately.
    But how many calories are in those two generous tablespoons?

  47. Thanks Dr M.,
    The Jupiter was great, and we even got the exposition repeat for the first movement. It pisses me off when conductors don’t take this repeat: the whole thing then seems lopsided and you don’t get your money’s worth. Dutoit always seems to takes this repeat in his recordings and on the platform, even with long ones like Symphonie Fantasique. Also the tempos were stately without being in the least boring, not rushed as so many do it these days.
    At which point, as we need another Aussie joke, let’s have two. Sir Thomas Beecham was conducting the Brisbane Symphony Orchestra and the lady principal cellist had a solo. Sir Thomas then remarked, “Madam, you have between your legs something that can give pleasure to millions, but all you seem to be able to do is scratch it!”
    The following is a true story. Only the names have been suppressed to protect the conductor. A certain composer friend of mine asked a certain player in a certain orchestra (OK it was the SSO) how the rehearsals of Shoenberg’s Pelleas und Melisande went.
    “It was a pub crawl, mate!” said the player.
    “Yeah, we had to go through it bar by bar.”
    Thanks for the Aussie/music jokes. Glad you enjoyed the Jupiter. As always, I’m envious.
    I did get to see MD’s group sing the Carmina Burana to two sold out performances last week. And the world premier of the accompanying ballet. It was excellent.

  48. Geeze – wish I could edit the typo. Ah well.
    Thought of something else – another of my ‘calorie torpedoes’ – that ‘gooping of creamy salad dressing thing’ – well, I’d plunk some salad greens onto a plate, throw in a few tomatoes, some cucumber. All good. Maybe some green onion ends too. Fine. But then, (back in my dairy-eating days), I’d also plunk down a big handful of grated cheese or cubed up cheddar pieces. Then, I’d do that ‘gooping’ thing with the dressing. Scoop out few generous tablespoonsful (the cutlery, and not the measuring spoon) of high calorie dressing. Then, even worse – I’d eat only the top layer of salad – all the dressing, the cheese, and maybe a few bites of vegetables that were underneath, but not much.
    A new thing that working for me? With any overly caloric or potentially ‘carb-y’ dressing, I measure out the portion (usually two tablespoons), dump my salad into a giant mixing bowl, put the two tablespoon serving (measured in flat measuring spoons, leveled off)…then mix everything up well with a wooden spoon or a spatula of sorts. This makes the dressing coat the whole salad – and I’m not overdoing it on the carbs or the calories.
    What typo? I didn’t see a typo.
    Sounds like you’re being diligent with these high-calorie, low-carb foods. It will pay off.

  49. Hi Dr. Eades
    I am going to slip in a few questions after giving my calorie torpeodo. Cheese, cheese, cheese – specifically mixed into my raw tartare – I can easily go through half a tub of gorgonzola. So, I simply don’t use any.
    For my questions (if you can please answer). I got a sudden high fever this week (103F, I am 34 year old male) and went to the doctor. As I am rarely ever sick, I was pretty bewildered because I knew I was hot but not that hot as I didn’t have a thermometer. Pretty scary because I went to the doctor on Wednesday after I cooled down, I don’t want to know what my temp was on Tuesday.
    The doc (actually a young girl from college i knew) was concerned because I didn’t have a sore throat but had a high fever. So I took a urine test and blood test and was told to watch the fever to make sure it came down and that I probably had the early onset of some strange viral illness.
    Well, I went home and sweated and popped extra strength Tylenol for the next 24 hours and my temp dropped. On Friday, I got a call from the doctor indicating that the tests didn’t show anything and that it was good my fever went away. However, they want a repeat (in case of lab error) because my platelets and hematocrit were a bit on the low side (touching on the anemic) and that there was a trace of protein in my urine. I being a worry wart, asked her, let’s assume it is not a lab mistake, is it the end of the world? She said no, but wanted a retest anyways.
    My questions. I am puzzled because I just gave blood a month ago and they test for hematrocrit and platelets to make sure you are ok – my scores according to the Stanford Blook bank were fine. Could my anemic-like readings have possibly, possibly, anything to do with the iron storage mechanism during a viral infection as described in PPLP? (the story of your friend with the girlfriend with the peg pig). I find it hard to believe that after a year of eating a pound of beef a day that I am suddenly slightly anemic after one blood donation.
    Also, I didn’t share with the doc that I am on an essentially zero carb diet. Do ketones or protein by products show up as ‘trace protein’ in urine? Of course, now my parents are freaking over the organic grassfed meat I eat and want me to ‘eat by my blood type’, which being A+ is an opposite diet of high carb, low fat, veggie stuff… (my concession to them for my next test is to eat a lot of chicken and more salads – this I can do, no way i am eating carbs for health)
    Can I get your thoughts on these topics Dr. Eades? I know it is not medical advice, I just wanted your thoughts. If one is on a low carb diet, can one simply eat a bunch of carbs in the morning of a afternoon blood test to not have ketone state by the afternoon?
    I can’t possibly diagnose what’s going on with you based on the information you’ve given me. But, fevers, such as the one you had, that come out of nowhere and have no other symptoms are almost always of viral origin. And these viruses can definitely cause some iron sequestering, but that’s an acute thing that would most likely show up as a low iron level and not anemia. Anemia takes longer than just a few days to become evident. But were you my patient, I would simply recheck your blood in a week or so after all symptoms have gone.
    Trace protein can easily show up in urine specimens, so it’s really nothing to worry about. And shouldn’t have anything to do with diet.
    I think the entire eat for your blood type idea is ludicrous, so I’m the wrong guy to ask for advice about that, unless you want the advice to be to ignore it.
    Eating carbs in the morning will definitely get rid of ketones for several hours.

  50. Two tablespoons natural sliced almonds:
    0.9 total carb
    2.8 protein
    7.0 fat
    0 fiber (less than one gram I guess)
    79 calories.
    So, about the same as any decently ‘low carb’ salad dressing – a bit of fat, few carbs. But, hey…it’s crunchy! Something that’s often missing in a lower-carb way of eating. Come to think of it, the two tablespoons sliced natural almonds is lower in carbs and calories than my Annie’s Naturals “Goddess” dressing. So yeah, it’s a bargain. Hopefully, I won’t have to keep them in my car or anything…

  51. MRE: “I agree that meat is a better choice [than nuts], but not nearly so handy.”
    If you make pemmican, it would be very handy. Raw meat is also a convenient choice. Or cold meat left-overs. Even summer sausage or something like that would probably be healthier than eating a lot of nuts or seeds. I think fiber is also a problem, not just the carbs. Nuts aren’t as satisfying as meat or eggs to me. When they are roasted and/or salted, they’re less satisfying. Most nuts aren’t raw, unless you get them unshelled. Even then, they are sometimes cooked. Plus, there are enyzme inhibitors and anti-nutrients in raw nuts and seeds. And many of them are rancid, but most people aren’t sensitive enough to detect this. So I think it’s best to stay away from roasted and/or salted nuts. They will make you eat more.

  52. One more comment on subject of HRT you may be interested in:
    My wife was prescribed a new product called Evamist (bio-identical estradiol), and reading the documentation, they actually “advertise” that it does not transfer to partner… (14.3)
    Thanks for the heads up. MD’s no longer transfers to her partner now that we’ve taken precautions. I would probably have trouble getting her to switch, since she likes what she’s using so much.

  53. Great reminder about the perils of nuts! I’ve stopped buying trail mix packets because I can’t eat half the stuff so it’s a waste of dried cranberries/cashews/etc. Walgreens is now selling almonds and mac nuts in perfectly portion controlled packets, so check ’em out if you need your nut fix without the temptation. 😀
    My danger food is peanut butter. No portion control with that substance. I suspect it has some sort of secret addictive compound, like the opioid peptides in dairy products. My rule is that peanut butter always has to go on or in something–no snacking from the jar!

  54. Food like snacks and such hasn’t been a big problem — so far. I do eat some cheese, but have stopped this now. My main snacks are green veg. I think – Higher Calorie = You’ll be a Higher Weight, Lower Calorie = You’ll be a Lower Weight.
    I’m on a lc diet (lifestyle change) and feel great. Every week I’ve lost weight, some weeks a lot, some a little. And, yeah there have been times where I’ve cheated a little, but I realise now that it was only because I seriously craved fat.
    The weeks that I DIDN’T go to the gym, I lost more. Strange that. I found aerobic session to be outstanding performance wise since the change in diet, but cycling (intense classes) fatigued me and the muscles in my thighs weren’t coping so well. Cycle classes only became harder. Some didn’t understand this when I explained, but those who exercise hard will know what I mean.
    I figured that the weight loss in the weeks that I didn’t exercise 5x week for 1 hour very intensely, was due to the fact that the extra ketones weren’t needed by my body and tissues and I was able to pass them out with breath and urine. When I did exercise, the ketones were used to fuel my body.
    The weight loss kept up however, and I found the diet more efficient with walking every day.
    I’ve read a few of your other comments to posters on other parts of ketosis and wondered if after the three or so months when your body gets used to using ketones, you can switch in a few good carbs for a couple of weeks to keep your weightloss on the hop and break it out of the stable state. Then, switch to lc again…. Which would explain why on the weeks that I have slipped out of lc, I lost a lot of weight after rigid adherence.
    Which is what has also happened to people I know on a lc diet. They stick to it rigidly for ages, then their weight loss slows, they eat things they probably shouldn’t for a couple of days or even a week or so, keep losing during that week, when the week before of sticking to the diet they lost nothing, but gained.
    Anyway, it would help to understand why this happens consistently.

  55. These two posts prove what I’ve been saying all along to my husband. It’s really too bad, but basically, we’re going to be eating lean meat and stuff like green beans and berries for the long haul, by and large. Not cheese, not nuts, not low carb strawberry cheesecake, not “low carb” bread, etc, on anything like a semi-daily basis. That’s life, actually. It’s easier to accept that and get over the childish feelings of unfairness (!) than to keep trying to find ways to make your diet more like it was, pre-Protein Power. There’s no going back and no going half-way back. I compensate by going and getting into those favorite jeans from 1985.
    I think you’re right on the money. I’ve looked at it like that for years, which doesn’t mean that I don’t sometimes go off the reservation, but only for brief periods. Then I check back in and lose what little I’ve gained.
    As I’ve always said, if you’ve got a metabolic problem that is solved by a low-carb diet, then you pretty much have to stay on a low-carb diet to keep it solved. People wouldn’t dream of taking medicine for dangerously high blood pressure, having their blood pressure get down to normal, then say, hey, my blood pressure is normal now, I don’t have to take the medicine any longer. Yet that’s what people do with diet all the time.

  56. Dr. Eades, Just thought it was funny, wanted to comment on your comment below!
    Good idea about consuming nuts only after having to shell them; bad idea about taking up online gaming. Good idea about limiting consumption of alcohol; bad idea about taking up online gaming. Why is it a bad idea to take up online gaming? I don’t know, and since I don’t understand it, it just sounds like a bad idea.
    I know you meant it to be funny about not understanding it so it sounds like a bad idea, but that’s just the attitude with most people about low carb. Don’t understand how it works, so it MUST be bad!! Right??? If it’s not CALORIE IS A CALORIE it’s evil 😉
    Well, I used to do silly games online in college for HOURS when I could waste time like that and I was a hottie size 6! It WAS a good thing instead of snacking! Except I would end up staying up half the night playing online pictionary with strangers around the world, drawing terribly with my mouse…wasn’t get that good growth hormone being up like that, though! 🙂 Guess there is a good and bad to everything…
    So true, so true.

  57. One of my downfalls while doing the low carb diet in the past was Breyers Carb Smart icecream. The key is to buy the bars, instead. They’re good and portioned so I can’t eat half the container standing up reading by the refrigerator. (b/c I was only going to have a tablespoon, of course!)
    With nuts I’ve gotten smart. I get out my handy 1/4th measuring cup and just eat the peanuts in the cup. Nuts and cheese I can get enough of easily, but back when I was doing WW or counting calories on my own I would physically have to throw away cakes in the trashcan outside to keep from eating them. I could probably eat a whole cake on any given day, even now, and THAT is one major reason I must do low carb, to keep that from happening. Cake cannot exist in my world, at least until I’m 2 sizes smaller, then maybe a little on my 1 cheat day a week. 🙂 (O/S) Does one cheat day a week really set us back much? I know Atkins said it does, but I don’t gain on those days, I just stay the same for a few more days after.
    ALSO, I like low carb dips (I have a great 7 layer dip with s/c, guac, taco meat, refriend beans, mixed cheese, tomato soo good) but the tortilla chips add up. Any good low carb tortilla chips out there?

  58. When I want something crunchy with my guacamole I cut a low carb tortilla into wedges, spray both sides with cooking spray, sprinkle a mixture of equal parts garlic powder, chili powder and salt on them and bake at 350° for 10 minutes. Don’t eat too many or you’ll get too much fiber.

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