There's no such thing as a "no-carb" diet

When I tell patients how I advise a wheat-free, cornstarch-free, sugar-free diet on the background of a low-carbohydrate diet, some people ask: "But can I live on a no-carb diet?"

Well, there's no such thing as a "no-carb" diet. Low-carb, yes. No-carb, no.

Here are the carbohydrate contents of various "low-carb" foods:

Gouda cheese--3 oz contains 1.65 grams carbohydrates
Mozzarella cheese--1 cup contains 2.89 grams carbohydrates
Walnuts--4 oz (56 nuts) contains 2.96 grams carbohydrates
Almonds--4 oz contains 1.38 grams carbohydrates
Sour cream--one-half cup contains 3.31 grams carbohydrates
Red wine--3.5 oz glass contains 2.69 grams carbohydrates
Eggplant--1 cup cooked contains 8.33 grams carbohydrates
Green pepper--1 medium-sized raw contains 5.52 grams carbohydrates
Cucumber--1 medium contains 4.34 grams carbohydrates
Tomato--1 medium contains 4.82 grams carbohydrates

(Nutrition data from USDA Nutrient Database)

In other words, foods thought to be "low-carb" actually contain a modest quantity of carbohydrates.

Such modest quantities of carbohydrates may not be enough to trip your blood sugar. But add up all the "low-carb" foods you consume over the course of a day and you can easily achieve 30 grams or more carbohydrates per day even without consuming any higher carbohydrate foods.

Comments (24) -

  • Belfast Biker

    7/26/2010 9:46:20 PM |

    ...and no-one on a low-carb diet will eat those.  There are much better alternatives.  No story here.

    May as well have put pasta on the list.

  • Food, flora and felines

    7/26/2010 11:22:38 PM |

    Yes looking at it like that you realise how a diet based on starchy veg, grains and fruits (not to mention all the processed cereals and refined sugars) can add up to one hell of a lot of carbs! No wonder we're such a sickly species.

  • bobby

    7/26/2010 11:45:36 PM |

    Dr. Davis: Where to you get adequate carbs when you are running long distances, including the marathon distance?

  • Anonymous

    7/27/2010 12:02:01 AM |

    Would like to see what Dr. Davis' opinion is about coconuts and their products.

    It the picture in the head of the blog and there no single post about it!

  • Anonymous

    7/27/2010 12:41:11 AM |

    There are those who seek to achieve a no carb diet - see this forum for details: http://forum.zeroinginonhealth.com/

  • Cheryl

    7/27/2010 12:41:56 AM |

    Here is a forum that talks about achieving zero carb - http://forum.zeroinginonhealth.com/

  • Leptin

    7/27/2010 1:13:37 AM |

    ...and those 30 grams of carbs would mean you were on a very low carb diet indeed.  As a percentage of 2,000 calories, it would be 6%.  The other 94% would have to come from protein and fat.  Since too much protein taxes the kidneys and will turn to glucose if needed, your only choice in this very low carb scenario would be to go ~ 80% fat.

    Just clarifying that this is the intent of the 30g example.

  • Lori Miller

    7/27/2010 1:24:40 AM |

    Are these total carbs or net carbs? My understanding is that carbs that are fiber aren't digested.

    This is quite a bit of food, too.

  • Drs. Cynthia and David

    7/27/2010 1:56:57 AM |

    To answer bobby's question, you don't!  I routinely run 50K events and just ran the San Francisco Marathon on very-low carb, pre-race, during the race, and post-race.  If you're adapted to a low-carb diet and fat-burning, you don't need carbs at all for fueling muscle activity.  In fact running fat-fueled gives you more stable long-lasting energy, no highs and lows, no bonking, and you can go much longer on no added fuel at all.

    David

  • kellgy

    7/27/2010 2:33:33 AM |

    I would think the opened coconut is not dissimilar in representing plaque build up in our vessels.

    Funny though, because I believe coconut is beneficial in many ways. I started cooking with it recently due to its high tolerance to heat, my perspective change in saturated fats and exploration of Indian foods.

    BTW, I have cut out wheat, rarely eat corn starches and keep sugar usually in the single digits g/day while eating 70% of the items posted in Dr. Davis' on my low carb regimen. Some of the benefits so far are 40+ pounds lost and a decrease in BP. Systolic is now normal (reducing the resting pressure is a bit more challenging). Looking forward to what the next two months bring . . . .

  • Dr. William Davis

    7/27/2010 3:46:08 AM |

    Bobby and Drs. Cynthia and David-

    I have seen the gamut of carbohydrate needs with elite levels of endurance exercise, from those who need to use a glucose source, such as bananas or Goo with exercise, to those who need nothing but water.

    There seems to be individual variation in glucose needs during extreme endurance exercise, though needs clearly diminish the longer you follow a low-carbohydrate restriction.

    Think of how hunter gatherers of eons ago ran tens of miles on empty stomachs.

  • Patrik

    7/27/2010 9:13:28 AM |

    Well, when you eat a no-carb diet you avoid those low-carb foods. Instead, you only eat food containg no (or very close to zero) carbs: meat, fish, egg, clarified butter (ghee), and coconut oil.

    If you are liberal, you may add ordinary butter and some cheese. Giving you no more than 1-2 grams of carbs per day. Wink

    Here you can find Swedish guy, Michel Blomgren, that eats almost no carbs, and train hard: http://translate.google.com/translate?u=http://michelblomgren.blogspot.com/p/vad-jag-ater.html&sl=sv&tl=en

  • Alex

    7/27/2010 12:20:05 PM |

    There's a body builder at my gym who's in his 60s, and he's been eating a very low carb diet for 15+ years. While his musculature is great, his skin looks saggy and old. It makes me wonder if his skin might look better if he'd had greater intake of Vit C (for collagen) and other phytonutrients (antioxidants).

  • Anonymous

    7/27/2010 12:27:52 PM |

    I have a friend who is a recognized authority on sports medicine.  He's generally opposed to all processed foods, especially high fructose drinks but endorses the consumption of such drinks during extreme aerobic competitive exercise saying they give a huge quick boost in energy.

  • Anonymous

    7/27/2010 1:01:01 PM |

    "Think of how hunter gatherers of eons ago ran tens of miles on empty stomachs."

    I find it difficult to use such examples as good/valid reference points. In my opinion there is s big difference between running by choice and running because you have to for survival.

  • PJNOIR

    7/27/2010 1:08:26 PM |

    Belfast Biker is way off the mark - those all legit foods to eat - veggies some fermented diary (cheese), small amounts of seeds and nuts- Pasta is not even close to being sensible for that list.

    Dublin pjnoir.

  • Kevin

    7/27/2010 1:50:42 PM |

    My understanding is there's an obligate requirement for sugar in the Krebs cycle.  If the body runs low on stored carbs it makes its own through gluconeogenesis. But that means catabolising muscle tissue.  In 50 and 100 mile races I eat all the potatoes and sugary sweets available at the aid stations but for daily diet I stick with low carb.  For my Sunday long runs I often run out of glycogen.  At that point my pace falls from 9 to 12mph.

    kevin

  • malpaz

    7/27/2010 3:41:52 PM |

    HOW HEALTHY IS IT TO BE IN CONSTANT KETOSIs though?? There are no long term studies, no hunter gatherer was ever in constant ketosis. he/she was in and out. i understand low carb for glucose problems but it seems to be managing te problem not fixing it. eventually a low carb diet leads to a VLC diet leads to a ZC diet like the crazy people at zeroing in on health. the more you drop your carbs the more insulin resistance you force upon yourself.

    Just eat real food, and real fat

    about coconut stuff...IMO unless your a kitavan person you dont really need it. does anyone know ANY existing data not supported or sponsored by the coconut industry? i dont think it is all it is cracked up to be. no one has been consuming it long enough, unless again you are a kitavan and also eating like 70% sweet potatos.

    there arent coconuts over in africa where we originated

  • rdyck

    7/28/2010 12:14:14 AM |

    Carbohydrates are not an essential macronutrient. Fat and protein are. There was a study done on two men who ate nothing but meat for a year. The results may suprise some. See Nothing but meat for a year

  • Anonymous

    7/28/2010 6:06:41 PM |

    Dr Davis

    After starting fish oil and vitamin D3 and eliminating sugar/wheat/pasteurised milk my hunger seems to have ratcheted up! i wonder whats going on here? Is this normal?
    There is no dearth of calories in the diet!

  • Anonymous

    7/28/2010 6:29:52 PM |

    After starting fish oil and vitamin D3 and eliminating sugar/wheat/pasteurised milk my hunger seems to have ratcheted up! i wonder whats going on here? Is this normal?
    There is no dearth of calories in the diet!


    My weight has always been good and I work out (hard) regularly and have so for the last 30 years (I'm 53). My cholesterol is also good. I  didn't eat much processed food before but in the last 9 months have cut it out completely. No sugar, no white flour, no bread, less of all other grains and now I can't stop weight loss. I am below my desired weight and it keeps coming off. If I even walk too fast I lose weigh!! I tried adding more tubers with no luck. I added larger portions of quinoa...no help. I have now resorted to eating soaked brown rice which hasn't helped yet. I get roughly my bodyweight in protein per day. I am always hungry and I'm eating about every hour. I consume around 3000 calories per day. I'm 5'10 and went from my fighting weight of 183 to 168 as of this morning.  I need to get back to at least 173-175 but it won't happen unless I add back some more grains. I will now start increasing the portion sizes of the grains I'm eating but I am already up to close to 2 cups per serving!!! I have now added rice/quinoa to lunch meals also.

  • Anonymous

    7/29/2010 9:47:18 PM |

    you can train athletically on a low carb diet.  our bodies are highly efficient.  if you don't give it sugar, it will make energy from stored fat.  (and we all have fat, even thin people.)  the best training i ever did and strongest i ever was involved a low carb (vegetable) and hi protein diet.  After a few weeks, your body produces fuel differently.  if you're used to gooing or sports liquid, your body will have to acclimate to training without it.  But one you do, you'll notice your lactic threshold will be higher and you'll bonk much less.  Cashews are great instead of the goo...

  • Ed Terry

    7/29/2010 10:24:14 PM |

    The USDA National Nutrient Database for Windows is a great little tool is you're very serious about restricting the total number of carbs eaten in a day.  Combine that with weighing your food, and you can get a very good idea of all the nutrients going into your body.

    The aren't many studies showing the benefits of coconut oil.  However, in my case, adding coconut oil to me diet sent my HDL from 32 to 52.

  • Dr Eric Berg

    8/2/2010 4:37:23 PM |

    good luck to those who try this no-carb diet.

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A dirty little secret

A dirty little secret

Here's a dirty little secret many people don't know about.

If I implant a stent, I might get paid somewhere around $2000 for the heart catheterization, stent implantation, femoral artery closure device, hospitalization charges. That's not too bad.

But what if I'd like more? What if I'd like to squeeze this unsuspecting patient for more, or actually his/her insurance company?

Easy: Add on complex procedures to the basic procedure that yield more professional charges. For instance, I could perform laser angioplasty, a procedure that adds another couple thousand dollars. I might pull out the old rotational atherectomy device, a high-speed diamond tipped drill that also adds substantial professional charges. I might also use the intracoronary ultrasound device, an otherwise helpful device, but I might pull it out to use on everybody.

With the exception of ultrasound, all the "add-on" procedures were more popular in the early and mid-1990s--before they were shown in clinical studies to provide no advantage, perhaps even add to procedural risks.

Thus, a patient might undergo a heart catheterization, balloon angioplasty with stent implantation into the proximal left anterior descending coronary artery (LAD), followed by laser angioplasty of the mid-LAD, followed by intracoronary ultrasound of the vessel. Next, rotational atherectomy of the circumflex, followed by stent and ultrasound. Total charges for this 2-3 hour procedure? Somewhere around $8000 to the cardiologist. Of course, hospital charges are far more.

Ironically, patients are invariably impressed. Hearing that they went through all sort of high-tech procedures makes them grateful for receiving the benefits of the skills of their cardiologist. Of course, they would like have done as well with a far simpler procedure. Perhaps they didn't need the procedure at all.

If the excessive use of procedures and devices fails to benefit patients, why don't hospitals discourage it? Two reasons: 1) It's difficult to legislate or regulate decisions made on judgement, which can be a tough issue with many fuzzy edges, and 2) hospitals made oodles more money from the practice.

If you have a salesman in your new car lot and he outsells all his colleagues by 30-50% and makes you a couple hundred thousand a month more in sales. You've watched him at work and he's clearly good at it. But you suspect that he pushes the envelope of propriety frequently--badgering customers, add rustproofing to a little grandmother's car that will be driven 3000 miles a year, selling cars for prices far above what they would have sold for had the customer bargained more vigorously.
do you put a stop to it at the risk of pushing your star salesman away? Few would.

Only a minority of my colleagues are guilty of this despicable practice. I only know of a few who openly do it. Hopefully, you're not among their patients.
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