Low-Carb Diet is Best – Who Knew?

As I’m sure many of you are aware, we are getting ready for launch next week of the Grain Brain Cookbook. The mission of the new cookbook is to demonstrate how incredibly wonderful it is to eat low-carb higher fat food in terms of flavor, diversity, and health effects.

Over the past year since the launch of Grain Brain I have done my very best to bring to the public awareness the science that supports our recommendation for a lower carbohydrate, higher fat diet. This is the diet that research has demonstrated to be the most effective not only in terms of various health parameters like markers of inflammation, but weight-loss as well.

So it is certainly highly validating that with just one more week to go until the launch of the Grain Brain Cookbook, the highly respected medical journal, Annals of Internal Medicine, has published a new research study entitled Effects of Low Carbohydrate and Low-Fat diets: A randomized Trial. This study, supported by The National Institutes of Health, looked at a group of 148 men and women, without cardiovascular disease or diabetes, and placed them either on a low-fat diet or low carbohydrate diet. Those consuming the low-carb diet ate considerably more fat than those who were on the low-fat diet who consumed a lot more carbohydrate. The study assessed the individuals at 12 months and found that those individuals on the low carbohydrate, high-fat diet  demonstrated significantly more weight loss compared to those on the typical low-fat recommended diet. There were also significant improvements in lipid parameters as well as markers of inflammation in those eating more fat and less carbs.

Interestingly, those consuming the high-fat diet actually took in just over 13% of their daily calories from saturated fat which is more than double the 5 to 6%  recommended by the American Heart Association. The low-fat group consumed more cereals grains and starches, and their total dietary fat was reduced to less than 30% of their daily calories which is typically what most governmental agencies still recommend, despite research like this study.

There are two fundamental reasons that a low carbohydrate high-fat diet are the cornerstone recommendations of Grain Brain and now the Grain Brain Cookbook. First, this is a diet that is in line with what humans have consumed for virtually the entire time we have lived on this planet. Second, our most well respected scientific journals are now lining up confirming that this is absolutely the best diet for human health as we now see in yet another well-publicized report.

Again, it’s very exciting that we are bringing forth the Grain Brain Cookbook on the heels of this important research. You can eat low-carb and high-fat, and enjoy your food not just because it tastes great, but because it’s good for your health!

Later this month (September 12th), I’ll be appearing on the Dr. Oz Show where I will discuss exactly how to implement this diet and why it’s so important not only for general health, but for brain health as well. See you then!

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  • Wauneta

    I’m a big fan of the high fat portion especially if from animals. I have followed a low carb low minimal sugar diet for several years with issues. I have managed to lose 90+ pounds a keep it off. Exercise of course! We humans are unique individuals and if low carb will help you lose weight then go for ot! No matter what ‘didt’ your on if you take in more.calories than you burn you will gain weight.
    GO luck to all.

    • Brad

      The whole gist of this diet is how your body metabolizes fat and protein vs carbs. Your body uses unburned carbs and attempts to store as much as possible as body fat. Not true for protein and fat. You do not either burn or store 100% of your calories. Much of it passes through you. What your body doesn’t either burn or store as fat, it passes, so the theory of calories vs burn is a fallacy. Fat and protein have tons of calories and you don’t burn them all, guaranteed. High fat diets are naturally higher in calories. A typical work out burns no more than 500 or so calories, no where near the burn needed to match the added calories from a high fat diet, yet, people are losing weight fast on the high fat, low carb diet. Its about what your body does with the different food types.

      • Art Lynch

        You are supposed to train your body to burn fat instead of glucose (carbs). You will train it to burn fat if you reduce the carbs.

        You must also watch your proteins and stay within the right quantity for your lean body mass. If your proteins are too high you’ll continue to be a glucose burner and will have the attendant health problems.

        If you’re burning glucose then the high fat you’re eating is going to be deposited as fat in your body.

  • Bibi

    My only problem with this diet is I look like a stick!!! I was already size zero and now I am size double zero ( lol, exaggerating little bit). But it’s worth it.

    • Eve-Loraine

      Do you need to eat a lot more fat? I haven’t read anything about how to put weight on.

      • Michele

        Muscle mass … lift heavy and build muscle will give excellent shape to both males and females

      • Montagu

        Eating more healthy fats on this diet is necessary for energy & health especially if you still feel hungry, but it won’t make you gain weight (fat) if your body is in “fat burning” mode.

        Eating this diet will not turn you into an anorexic or make you unhealthily thin… whether you were too thin or too fat before, it will bring your body closer to its “natural” composition (strong, agile, and more attractive) while keeping you satiated and mentally clear & balanced. Some people are naturally built to be more thin than others.

        If you are naturally thin AND strong and healthy like it seems Bibi is, I guess it just means finding a good tailor/seamstress, or clothes stores that cater to your size, or taking up sewing as a hobby :-)

    • Jane

      I am having the same issue. Lost 20 lbs. puts me less than sz 2. Where do you buy your clothes? I am too “mature” for the jr.sizes. 5 and 1/2 yrs. on this WOE and feel wonderful.

      • knslovinggod

        How long did it take you to lose 20 pds.? I need to do that! I can’t figure out how much I should eat of what?

      • knslovinggod

        What eating plan have you followed?

  • Kathy

    How can I get enough magnesium in my diet to avoid muscle cramps while following a low carb diet?

    • Eve-Loraine

      I take about 300mg of magnesium citrate-malate as a supplement.

    • AndyF


      Just did a quick google search on natural sources of magnesium and picked one of the first ones.

      • Andrea

        I dont think that is a good idea. Great source are nuts, almonds but they are loaded with omegas 6 that maybe will ruin your whole system. I stopped to eat omegas in general. See Ray Peat articles.

    • Minnie

      Kathy: If you are interested in stopping the cramps in about a minute or a tad more try the following: The name is Stops Leg & Foot Cramps. It is a Proven Old Amish Formula: My health food store had it and it is a miracle.

    • Sandy

      I get muscle cramps all the time on low carb and find if I just grab 16-20 oz of water they stop. Of course, I also do stretching exercises as my legs tighten up.

    • Nancy

      Kathy, try bathing in Epsom salts. The magnesium in it is absorbed through the skin. Believe me, it works!

  • Sophie

    Please put out a directive about What time of day to take which supplements

  • Cheryl

    I am all for this diet – and yet it seems to me it is a diet for those who are financially secure. Buying ‘clean’ (grass fed, organic, sustainably caught) animal protein is extremely costly not just to our pocket books but to our planet. We are at 7.2 billion peeps and counting. Another 2.5 billion are estimated to be added by 2050. How is this diet sustainable or environmentally ethical??

    • ASRN

      i do not believe it is the “grass fed”,organic and sustainably caught,animal protein that is the problem. if animals are raised ethically,and with proper land management(as Joel Salatin does on his Polyface Farm. the environment actually benefits. The CAFO methods( confined animal feeding operations) which feed the animals food THEY did not evolve to eat are the problem.

      • Arcas EarthSoul

        And also understand that CAFO grain-fed meat production is subsidized by tax credits to the corn/soy farmers. The true cost is much higher.

    • Joe Texan

      A pound of clean, hormone and drug free, grass feed hamburger costs $8.00. You can make four 1/4 pound hamburgers. A McDonald’s hamburger contains about 25 cents worth of diseased beef and cost $3.50.

    • ASRN

      think about all the medical insurance “Co-Pays” you will save because you are healthier

      • David Perlmutter

        Great point!

    • FernDale Farm

      I used to think the same. Granted revamping your kitchen can be expensive, getting rid of all the bad foods and bringing in the ones you can use (like all the different oils, flours, gourmet butter and chesse, and yes grass fed meats) But considering I have always spent 150-200 per week for my family on groceries and I now spend 100-150 it has actually gotten cheaper. Reason being- we eat higher quality food that satisfies our appetite and we eat less. And eating truffles for dessert with a glass of wine compared to eating a Mrs. Smith pie with a glass of coke…. NO COMPARISON.

      • FernDale Farm

        when I say, “flour” I mean almond, coconut, garbanzo, ect meals. I love to cook and won’t give that up but we are committed to going low carb low sugar no gluten and I have never felt better

    • Montagu

      As a society and individually I think we should eat (more of) the whole animal, not just the muscle meat.

      In terms of economics, buy the cheapest cuts of high quality protein. This usually means cuts that require slow-cooking. I go to the farmer’s market and look for beef shanks, pork hocks, heart (which is just another muscle meat, but denser), chicken/duck carcasses, and bison/beef soup bones.

      Eating meat slow-cooked on the bone is much healthier than just focusing on muscle meat only, as you get the gelatin and marrow out of the joints and bone.

      And if it’s pasture-raised meat, its fats have a significantly different composition and are quite good for us! More calories from healthy fat is a good thing.

      Once meat-on-bone is slow cooked 6+ hours, I often get enough meat easily coming off the bones to make a good stirfry or a good pile of meat for 2 people, then I put the bones back in the broth and keep it slowly brewing until the broth is done. If your broth gels after cooling in the fridge, it’s got a good amount of healthy gelatin in it.

      Bone broth is great not just for soups and gravies but if it’s flavored right, it’s good for a soothing afternoon drink on its own. I find I can break a flu coming on, or get over it quicker, just by increasing my intake of bone broth.

      Real bone-based broth is “protein-sparing”– that means that you don’t need as much protein from other sources (i.e. muscle meat) in your diet if you consume bone broth.

  • Caroline Raphael

    I have been following a low carb high fat diet for over 7 years now and have never felt better. I actually didn’t know about any research on any of this, I just listened to my body and I noticed that when I ate a lot of carbs I was bloated and tired and so I stopped gluten and also diary altogether and started putting together foods that felt right… I didn’t realise till a couple of years ago when I was doing a nutrition course that my diet was very low carb and high fat, which according to the course I was doing was not good for my health – which did confuse me as I had never felt better in my life. It is great there is now research to back this up – thank you Doctor Perlmutter for being prepared to say what most are not…

    And Kathy, Re magnesium – I take a supplement by BioCeuticals called Ultra Muscleze, which I finds really supports me.

  • Aristotle

    I have been on this diet from May til this past Tuesday and am going to have to get off of it because I keep experiencing too much dehydration (sometimes dangerous) and the symptoms that go with it. Those symptoms are severe constipation, light headedness, weakness.

    I have lost so much weight that I am going to have to go back to more carbs (probably 150-g per day) in order to rebuild muscle. I am all skin and bones now. My knees are giving me alot of trouble. I am a 53 – year old, 120-lb, very active male and I need my carbs and protein in order to help build back muscle and retain water. Do not try this diet without first doing alot of research. It can be dangerous. I might titrate back to less carbs and protein in the winter but now I am rebuilding muscle and water.

    • Art Lynch

      Even though you may be using a low carb high fat diet you may still be burning glucose instead of fat. check your sugar consumption. Fruit may be providing you with too much sugar.

      Also, if you are truely on low carbs and high fat watch your protein. Don’t eat more than 1/2 gram per pound of lean body mass. At 120 pounds I would guess that your protein should max out at about 50 grams per day. Don’t eat more than 15 grams per meal.

      Your body will take the excess protein and convert it to glucose. It will also use your muscle and bone to make glucose. With those two things happening you are a sugar burner and not a fat burner.

      • Candace

        Thanks for the info. This is very interesting and I hadn’t ever heard of this concept. So in order to switch the body out of glucose burning mode into fat burning mode — you need to be on a diet high in veggies, moderate amounts of fat, low carbs, low sugar, with the proper amounts of protein based on body weight with not more than 15g per meal? Any other secrets? Thanks!

        • Art Lynch

          Candice, all correct except high fat. Your caloric intake must be highest in fats.

          Please note, i am not a doctor. I am relating from what my research of what several doctors have written for the popular press and a few scientific journal articles.

          Now is the time I wish Dr. Perlmutter would weigh in on this discussion ;0}

      • Aristotle

        Hello Art,
        Until Tuesday I was consuming no fruit. My daily carb intake was 50-g. Protein was 80-g. At 54 kilograms of body weight that calculates to 1.5 g of protein per kilogram of body weight. Most people will agree that I am in ketosis.

        Being in ketosis is not my issue. Staying hydrated and keeping muscle mass is. I would rather be in nutritional ketosis but I have to do physical labor and need my muscles and I need to keep my water. Those two seem to be evading me. Thanks for the concern.

        • Art Lynch

          Hello, Aristotle,
          I can’t find my notes from Dr. Perlmutter’s Grain Brain about specific protein requirements, but two other very creditable doctors who tout very similar diets to Dr. Perlmutter’s say that your daily protein need is 1/2 gram per pound of lean mass. If you are 18.5% body fat then at 120 pounds your max protein intake should be 48.9 grams.

          Anything over that is excess and will be converted to glucose for fuel. In addition a diet heavy in proteins can produce toxic by-products.

          I don’t think you are in ketosis. If you’re consuming 30 grams of excess protein you are burning glucose made from the excess protein. What is your fasting blood sugar reading? I’ll bet it’s high eighties or nineties. You can’t be in ketosis with readings that high.

          On the other hand, if I were you, I wouldn’t go below 40 grams protein per day. If you’re too low in protein intake, your body will steal it from your lean muscle mass and bones. That’ll make you weak and frail.

          Good luck.

          • Aristotle

            Hello Art,
            I would be interested in seeing that data on protein requirements. I’ve been down to 1.2 g protein per kilogram of body weight. Dr Perlmutter recomends max 1.2 g protein per kilogram of body weight. You can find my other texts on this site and you will also read his advice to me on those topics. He has never mentioned to me 1/2 gram per pound of lean mass.
            I have been heavily researching Low Carb diets since embarking on this diet in May utilizing resources such as Steve Phinney, Jeff Volek, Jimmy Moore, Paul Jaminet, Eric Westman, Stephen Gundry, and many many more; and have reached the conclusion that 80 – g of protein per day for my weight 120-lbs, and activity level (High) is okay.
            If you have more data would you please share it with me?

            Also, would you mind sharing your markers?
            If you would like my email address I will be glad to provide that.

            Thank you so much. I miss being in nutritional ketosis.

          • Art Lynch

            I’m sorry for the delay in responding.

            The primary reason why I looked for other references for protein needs was because even though I followed Dr. Perlmutter’s program nearly to the letter I was getting blood glucose readings in the high eighties and low nineties. My Ketostix readings were indicating very mild to slightly moderate ketosis. Since starting Dr. Permutter’s program I dropped weight from about 155 to 140 pounds (I’m 6′ tall with an average to slight frame, and more active than usual for eighty years old) My present body fat is 18.5%. I don’t recall it ever being more than 19% – perhaps before I became concerned about such things.

            Dr. Permutter does note that in extreme weight loss (starvation) your body will steal protein from muscle and bone and make glucose. Since I wasn’t any complex carbs and not more than a cup of fruit a day, where was the glucose coming from?

            I found two references, Dr. Ron Rosedale and Dr. Joseph Mercola, who limited proteins to 1/2 gram per pound of lean body mass. Dr. Permutter’s recommendation is .8 – 1.2 grams per body weight (it didn’t say lean body mass).

            When I cut my intake of proteins to within 5 grams of the Rosedale suggestion I get a glucose reading in the high seventies and low eighties. However, I’m always hungry.

            I guess I should have prefaced my first remarks by saying our bodies may behave differently under the same program. After all, we are not uniform robots.

            I appreciate your input.

          • Montagu

            Just a thought Art, are you getting enough salt? Low carb flushes salt quickly through the system. I add a small amount of sea salt to my mineral water.

          • Art Lynch

            Good question, but, I’m sure I do. My last blood test (and previous ones) showed sodium levels to be on high normal (144 with a normal high 145), and chloride level the same (104 with a normal high of 107).

            The bulk of that is from the natural amounts in my food. I use very rarely any salt at the table, and I usually use half of what recipes call for. I do all our cooking because my wife is in early stage Alzheimer’s Disease.

            The reason why my slat usage is as it is is because of those sodium and chloride readings.

          • Aristotle

            Hello Art,
            How is your wife doing? Hope all is well.

            I am sure that you follow Steve Phinney. If so why do not you follow his protocol and increase your sodium intake?
            Also, has any consensus been made on ‘safe starches’ for keeping cortisol levels down and mucus production?
            It seems like there was a debate taking place between Rosedale and Jaminet a couple of years ago.


          • Aristotle

            Thanks for the reply. I do not check this often. A better way for me to communicate is by email. My email address is aristotle@triad.rr.com
            I am extremely active and believe that I need more protein. I listened to Jimmy Moore’s interview of John Kiefer and John believes that an extended period of nutritional ketosis can be detrimental to ones health.
            Thank you,

          • Art Lynch

            Hmmm. I’ve just finished Jimmy Moore’s book Keto Clarity, and he and others who advised him in the writing of the book say the opposite – that being in nutritional ketosis indefinitely is not detrimental to one’s health.

            He and some of his other advisors do recommend that protein cannot be unlimited.

            I guess we all hear and follow different drummers. However, we’ll all have better health following the advise of Perlmutter, Davis, Rosedale, and others with similar viewpoints. Just keep the carbs low, the fat high, and don’t sweat the petty stuff.

            I’ll have to listen to that pod cast.

            To your good health,


          • Aristotle

            I have been checking my ketones every morning when I wake up with ketone strips, just like Dr. Perlmutter recommends. They are usually slightly to moderately to sometimes darker purple. So this would indicate to me that 80-g protein is okay for me. I would like to discuss this topic with you in depth.

          • Aristotle


            You have to have a solid understanding of protein if you want to be successful with the Grain Brain diet.

  • Leonie

    Re Magnesium – Australian cancer ‘alternative/pioneer’ Dr Ruth Cilento told my husband to take magnesium for his sever leg cramps. That worked for many years, but gradually lost effectiveness. He is now 72 and uses a spray-on formula from a health shop and it works well again. We have been told that as we age, we gradually loose our ability to absorb magnesium from the gut.

  • Yvonne Forsman

    Thank you for telling us about the Dr Oz show! I set my TV on recording both the 9 am and the 3 pm show. Looking forward to watch you again, Dr Perlmutter! :-)

  • JP

    Good morning Dr Perlmutter.
    How can this diet impact the symptoms and progressive effects of Parkinson’s . Diagnosed at 43…now 51. Is it possible to decrease the progression of my disease ?
    I exercise, keep fit, take the prescribed meds…but wonder if the diet you promote can benefit me too ? Are there specific foods that would benefit me to help manage or decrease my symptoms ?
    Looking forward to your comments
    Thank you

  • Kathy

    I have recently read ‘Grain Brain’, which I found to be a great help to me. It was so informative and written in a way we could understand. My husband and I have been following a low-carb / high fat diet for 7 months now. We are also gluten-free and I am also dairy-free. We recently had blood tests done and our cholesterol profile has gone through the roof. My total cholesterol, for example, was at 300! I used to take Lipitor, but discontinued it a few months ago. Should we be concerned wth the high fat circulating in our veins?

    • David Perlmutter

      I don’t believe total cholesterol, in isolation, is a valuable number to track.

      • Kathy

        My blood glucose was 93. Total cholesterol 300. Triglicerides 96. HDH cholesterol 76. VLDL cholesterol 19. LDL cholesterol 205. T. chol/HDL ratio 3.9. LDL/HDL ratio 2.7. CRP 0.80. Vitamin D 70.1. I have an appt. with dr. this Thurs, I DON’T want to go back to taking statins. I covet your comments.

        • Art Lynch

          Ratios will tell you more than the plain numbers.
          Tryclicerides/HDL – 2 or less ideal
          Total cholesterol/HDL For women 3.3=1/2 average risk, 4.4=average risk
          LDL/HDL For women 1.5=1/2 average risk, 3.2=average risk.
          These figures and explanations are taken from a copy of my lipid panel test results

          • Kathy

            That is also good to know. When I took our blood tests results to the dr., he said we still have inflammation in the body (colon), hence we’re returning to square 1 and working to eliminate sugar from our diet. It’s tough to remove it all.

  • Aron

    It’s interesting to note that Dr. Fuhrman advocates for a low-carb and very low fat diet. On his PBS special, he shows how to prepare a salad and his home made salad dressing contains no oil. Aside from his recommendation for seeds, I couldn’t see any other source of oil or fat and certainly no meat seems to be part of his diet plan.

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  • Nancy

    Dr Robert Atkins knew!

  • Joan

    I have been on a low carb protocol for over 2 months but only lost 3 to 4 pounds. I do eat one fruit a day such as a peach or nectarine and lots of above ground veggies with good fats, etc. Do you think my eating that fruit is preventing weight loss? Otherwise I feel very good.

    • Montagu

      I think whole fruits are ok, just choose the lower sugar fruits, and be careful about how much you eat at a time (to avoid blood sugar spikes) and consider how much it consumes of your goal for average carb intake per day. I look at fruit as “nature’s candy” so I try to add it to healthy fats as a natural sweetener and flavor rather than eat it on its own.

      For a daily treat I consume about 1/2 cup of “fruity cream” — take a small amount of finely cut up fruit in a small bowl (like 3 small strawberries), and heat them up a bit first if you want a softer feel & sweeter flavor out of them. Then make a selection or mixture of the creamy fats you have in your fridge: i.e. coconut-milk yogurt or full-fat greek yogurt, heavy cream, creme freche, melted unsalted organic butter, goat’s milk cream cheese, and maybe add a 1/2 tsp of lemon-flavored cod liver oil for your omega-3s, etc. They say adding cinnamon can help prevent sugar spikes, so I add cinnamon with a dash of other spices as I feel in the mood (cloves, nutmeg, allspice, cardamom). Eat with a small spoon and treasure every little morsel of fruit smothered in healthy smoothness. MMMMM. Really satisfying. A 1/2 cup sometimes feels overindulgent so I’ll put the rest back in the fridge for later.

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  • Andrea

    Dear Dr. Perlmutter, I am in keto adaptation, (no grains, only vegetables 80-100 gr.) my only side effects so far are the cramps and hypoglicemia, so I had to stopped jogging and running.
    My question is, someone knows if should I take supplements as magnesium as long I am in ketogenesis?
    And second, in case the supplements of magnesium are temporary, Does it means that magnesium levels will be better by eating vegetables and meats, fat, etc, and will I stop to eliminate so drastically it in the urine?
    Thank you, in advance

  • Cathy-Lee Cunningham

    I have followed(this week) a very low carb, high fat way of eating. I’m a runner that do about 50Km/week, I’m not Fat-adapted or in Ketosis. I am a 56yr old woman, weighing 52kg. Thus not overweight.(have been running for 26yrs) I know low carbs is the way, as I’m very aware of brain health – My question: Am I eating too few daily carbs? ( Aprox 40Calories of carb) not sure how to monitor the carb intake. (Carbs being fruit/veg only, no complex carbs) ??

    • Cathy-Lee Cunningham

      Forgot to mention that I’m enquiring about the amount of Carbs to consume because I feel lethargic an struggling to complete my runs, thx.