Is a zero-carb diet healthy or not? Let's ask the low-carb experts

October 4, 8:31 PMLow-Carb Lifestyle ExaminerJimmy Moore

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Is a meat and water only zero-carb diet good for you?

Following the overwhelming response to a previous Low-Carb Examiner column asking the question whether a zero-carb diet is appropriate for a pregnant woman to follow, I decided to tap into my resources and ask some prominent members of the low-carb community to express their thoughts and reactions to what some would describe as a rather extreme version of the healthy low-carb lifestyle that so many of us enjoy. You’ll notice many of the responses explain that a zero-carb diet in modern society is vastly different from what a zero-carb diet from primitive groups like the Inuit consumed and that there really is no such thing as a truly carbohydrate-free diet.

The simple question I asked them was this: “Is a zero-carb diet healthy or not?”

Here’s what they said:

DR. JONNY BOWDEN
“I think it’s a pretty theoretical question. Even the Inuit living on walrus blubber and seal meat probably got some carbohydrates in their diet, and even a lion living on zebras and hyenas gets some carbs (in the entrails of their prey, who themselves graze on grass). But as a practical matter, I think its not very advisable. There’s too much evidence for the health properties of the plant phenols, polyphenols, flavonoids, vitamins, minerals and fiber found in abundance in vegetables and fruit.

I know there are people who seem to do pretty darn well with minimum amounts of these foods, but I suspect they are genetically or metabolically adapted to these diets more than the rest of us. Personally, I wouldn’t choose a no-carb diet, though I wouldn’t doubt that you could survive on one (which you, by the way, could not do on a zero-fat or zero-protein diet!). I think the good stuff in vegetables and low-sugar fruit is just too good to leave off the menu, and I think you can get all the benefits of low-sugar eating and still include plenty of vegetables and berries.”

KENT ALTENA (BOWULF)
“I actually made a YouTube video on this topic recently and here is a summary of the video: ‘I am pretty convinced that for most people going zero carb is an unnecessary step. Sure there are some very metabolically resistant and/or people suffering with hyperinsulinemia. For the most part, most people should be getting their veggies in and not fearing adding back a reasonable amount of carbs. Trying to discover what the magic number per day can certainly be trying, but your health will appreciate it. Thinking zero carbs is the answer also misses number of things: phytonutrients without getting more chemicals, fiber-rich vegetables, and carbs present in other non-veggie sources, like nuts, eggs, or cheese. Unless you are really hyper sensitive to carbs, enjoy the variety of nature and food selection.’

I think eating zero carb CAN be healthy, but it requires a level of vigilance and dedication to get adequate levels of nutrients that a standard low carber does not have to be as concerned. The meat and other items they eat can have the vitamins within the fat they eat like the Inuit used to get from blubber and organ meats. More than likely though modern zero carbers will need to be vigilant to supplement their diet with other items. Therefore, I would only recommend the diet to only those who are really metabolically resistant. I think you can see that in Dr. Atkins’ reticence in promoting the fat fast.”

JUDY BARNES BAKER
“It should be possible to live entirely without plant foods, since many of our ancestors did and some societies that exist today still do, but that is not the same as living on a diet of nothing but muscle meat from domesticated animals. The Arctic explorer, Vilhjalmur Stefansson, proved in the early 1900s that you could be healthy on a diet of meat, fat, and water. He and a companion had themselves locked into a hospital ward and were fed a diet that consisted of 80% fat and 20% animal protein for one year and suffered no ill effects. However, he believed that you needed to eat some of the meat raw (or at least rare) and include organ meats. He pointed out that during his time living with the Inuit, he had eaten whole fish, including the bones, organs, tails, and heads.

Also, some non-plant foods do have carbs, oysters, scallops, liver, and eggs, for example, so a diet without plants is not necessarily a zero-carb diet. Does this mean some carbs are necessary? Probably not, but some variety might be. I think we all agree that the starch and sugar in plants are not essential for humans. The argument that there are other necessary elements in fruits, vegetables, and grains was refuted by Gary Taubes in Good Calories, Bad Calories. He said that it is the anti-nutrients in grains that cause us to need additional vitamins and minerals.

So, I guess my answer to your question would be that, in my opinion, you could live without plants and be healthy, pregnant or not, IF you had access to a wide variety of fresh, natural, unprocessed meat and fat, fish, and crustaceans and good, clean, mineral-rich water, all hard to come by where I live. Otherwise, including a few berries, nuts, and green vegetables might be prudent.”

LAURA DOLSON
“Zero-carb is not a good idea, and in fact is almost impossible for very long, as the number of foods that contain no carbohydrate at all is quite small. I’ve spent quite a lot of time designing low-carb menus that have all the essential nutrients in them. Although it is possible at 20 grams of net carbs, it is not at all easy. Just adding 10 or 15 more grams makes it much more attainable. If you want to make it easy, go to 40-50 grams per day, which means you can also get a wider variety of phytonutrients as well. I realize that there are some people who are extremely sensitive to carbohydrate and cannot tolerate this much, but in my experience most people can, especially if most of the carbohydrate comes from non-starchy vegetables. (For example, spinach and other greens have carbs, but they are so wrapped up in fiber that most people will not experience a blood glucose impact at normal amounts.) To eat zero carbs is to seriously restrict the range of nutrients you can eat, and not a good idea.”

DR. MARY C. VERNON
“First, of course, nothing I say should be taken as medical advice for any one person. That is a complex matter and requires individual consultation. That said, I believe there is quite a bit of historical information regarding very low carb diets. Meat has some glycogen, so even it is not completely zero carb. The Inuit were able to prosper in extremely tough climatic conditions eating very low carb diets. They were able to have children and breast feed them.

However, their zero carb diet might not translate to the Western world, because they ate things that are not favorite items in our culture and they ate at least some of these things without cooking them. So, we have historical information that this very low carb diet can be done, if done in the way the Inuit developed and practiced it. The European explorers who followed the Inuit example did fine. Those explorers who did not follow the Inuit way but ate as they were accustomed were not as successful.
The person who has studied this in great detail is Dr. Steve Phinney. I learned most of what I know about this from him.”

DR. JEFF VOLEK
“With normal foods it would be very difficult to achieve zero carbs. Even meat, eggs, cheese have some albeit few carbs. Sure you could survive, gluconeogenesis is more than adequate to maintain obligatory glucose needs. Although I’m a hardcore omnivore, meat at every meal with absolutely no other nutrition sounds incredibly monotonous and I suspect not optimal for health.”

DR. RICHARD FEINMAN
“This question is actually of some interest because, as you write, people get the idea that, because there is no biological requirement for dietary carbohydrate, zero carbohydrate diets are recommended. In fact, I don’t know anybody who recommends a zero carbohydrate diet but the question points up some of the confusion in the whole field. What you really want to know about a diet is the immediate effect on the plasma distribution of macronutrients. So a zero carbohydrate diet, of course, does not mean zero glucose in the blood.

Obviously, in the absence of diseases, you can survive for a long time with zero carbohydrate. That’s what you do when you’re starving. As far as we know, most of the undesirable effects of starvation reside in the absence of protein, total amount and availability of essential amino acids and, to a lesser extent, essential fatty acids. The other side of the coin is high and low fat where, if carbohydrate is low a high fat diet may have lower total fat in the plasma than a low-fat. The point is the limitations of ‘you are what you eat’ and it is not obvious, in terms of blood glucose that zero carbs is so different from low carbs. In general, more information is needed than the level of one nutrient to predict the effect of a diet.

A side issue is that it is probably impossible to get a zero-carb diet with normal food. Even meat has some carbohydrate in glycogen and cell material. When you brown meat in frying, the brown part is a reaction between the carbohydrate and protein in the meat. The browning reaction is called the Maillard reaction and is chemically similar to the reaction of glucose with proteins, under conditions where there is high blood glucose, to produce so-called advanced glycation products (AGEs), the best known of which is hemoglobin A1c.”

GARY TAUBES
“It does seem a bit extreme going to consume meat and water only, and as Dr. Carlson points out, muscle meat might not be sufficient to provide all the vitamins needed, if that’s all that’s being consumed. So, yes, why limit it to store bought meat and nothing else, other than to set up a hypothetical situation for discussion? Finally, one minor point: even a diet of meat and water is not zero carb. There will be a few percent carbohydrates from glycogen stored in the muscle.”

JACKIE EBERSTEIN
“There were only two circumstances when Dr. Atkins used a diet below 20 grams of carbs. One was the fat fast for limited periods used while attempting to break a plateau. The other was 0 carbs for 3 days before a patient visited the office to measure ketones on our breathe analyzer. The purpose was to determine how ketone-resistant a person was. In both of these circumstances patients were following their supplement program to avoid a lack of nutrients.

Dr. Atkins did not believe there was any benefit to less than 20 grams. Since he considered the program a permanent lifestyle the idea of avoiding all vegetables and the other foods that make up the 20 grams on Induction simply does not make sense in the long run. He wanted the plan to have as much variety, palatability, texture and phytonutrient content as possible and still get the job done.

It is vitally important to remember that weight, blood sugar and insulin balance as well as the nutrient intake of a woman in the months before pregnancy has an impact on the baby. I discussed some of this in this column I wrote. There is no reason why a pregnant woman can’t have a healthy and successful pregnancy as our patients did with an individualized low carb plan under appropriate supervision.”

MARK SISSON
“Interesting question. Lots of variables to consider. As you know, I am not of the zero carb camp. I am a low-carbber. My optimum maintenance range is 100-150 grams a day. My weight loss recommended range is 50-100 and my ‘aggressive, short-term, hit the weight-loss hard’ range is under 50. It’s almost impossible to be zero carb if you are eating healthy fats (including nuts, seeds) and all manner of animal flesh. It’s clear that we CAN live without directly eating carbs.

The question is whether a pregnant woman raised her whole prior life on carbs can gestate a healthy baby without any. I wouldn’t recommend it (not that it can’t be done) given the types of protein/fat-only foods normally available. Veggies need to be included at some level to provide vitamins and minerals that can’t all be obtained from 99% of availble protein sources. Even Inuit eat plants in summer and animal stomach-contents otherwise.

While gestational diabetes is a possible problem at typical carb intakes, I don’t think it’s an issue in an exercising mother at 150g/day. My main goal in suggesting that some carbs are advisable would be simply to promote insulin sensitivity during development. The idea is that unless the child were to continue on with a life of zero carb, it might be less-than-optimum to set him up that way (that’s just intuitively).”

FRED HAHN
“We know that a low carb diet is healthful. Study after study and client after client has shown that this is so. Jimmy brings up a good question–can a ZERO carb diet be healthy or does it lack essential nutrients for ‘optimal’ human health? Well we know what Dean Ornish, Gary Null and others of their ilk would say. They’d say you’d be dead in a year from heart disease. Of course the Inuit peoples would prove this wrong. And you can’t say ‘Waitaminnut! The Eskimos had generations to adapt to this kind of diet.’ Why? When the British arctic explorers (Amundsen and crew) in the early part of the previous century ate what the Inuit ate for years they experienced robust health. Only when they switched back to eating to their local fare upon return to England did their health begin to suffer. So we know that going Eskimo does not kill us and can in fact improve our health.

But will going really low-carb to the point of zero carbs make us loco? Will it rob us of essential nutrients? The answer is tricky and it depends. If we are eating organ meats, bone marrow, etc. along with the rest of the common cuts of an animal there are few micronutrients we are not getting. But we usually don’t. So getting some of the micronutirents like vitamin C from a orange or green peppers might be a wise idea. Personally I eat an extremely low carb diet and enjoy robust health.”

NINA PLANCK
“Interesting debate. I don’t see the merits of zero-carb for pregnant women in part because steady blood sugar is so important and carbohydrates can be part of that. There are times when pregnant women will not be in the mood for protein, fat, and salt–vital as these nutrients are. Nothing wrong with a peach or a sweet potato because there’s a lot of good in them. But the ideal quantity of white flour and white sugar is undoubtedly zero, so if you can curb your addiction to carbage your baby will be much better off, and so will you.”

DR. NATHAN ELIASON
“It is probably just fine to have the mild ketosis associated with a very low carbohydrate diet during pregnancy. As you are aware, you can have a fairly low carbohydrate diet in which you are not in ketosis which almost surely is fine during pregnancy. On the other hand, a high carbohydrate diet likely will lead to complications which we see more and more frequently (macrosomia, neonatal hypoglycemia, gestational diabetes). The complications of having a baby which is too large are very real. However, we will surely never know for sure if a ketotic low carbohydrate diet is safe, and probably never know if a relatively low carbohydrate diet is safe because of the very real legal risk that obstetricians run. Unfortunately, it is far safer for them to recommend the ’standard’ high-carb, low-fat diet than to allow for anything outside of the standard.”

DANA CARPENDER
“Is a zero-carb diet healthy? For what values of ‘healthy?’ We have reason to believe that the Inuit (Eskimo) lived on a nearly carb-free diet during the winter, and they apparently didn’t suffer scurvy or other nutritional deficiency diseases. This is evidence that given the proper balance of animal foods, carbohydrate foods are inessential. On the other hand, the Inuit were eating a VERY different diet from your modern low carber. They ate game and wild-caught fish, not animal foods from domesticated animals that had been raised on a commercial diet. They ate a diet so high in fat many of us would find it unappealing. They ate parts of the animal many modern Americans won’t touch–liver, brains, kidneys, marrow, all of the organ meats (some of which, I might add, do contain a bit of carbs–liver especially.) And they ate much of their meat, fish, and blubber raw–and aged it well first. It is impossible to extrapolate from the effects of such a diet that a diet consisting solely of the animal foods available in your local grocery store, and familiar to modern American palates, is healthful, much less ideal.” (Read more of Dana’s thoughts on this subject by clicking here)

What say you?  Do you think there is any merit to a zero-carb diet in modern-day society?  Talk about it in the comments section below.