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Nine Tips for the New Carnivore

Transitioning from one thing to another can be difficult. It doesn’t matter where you’re starting or where you’re going. Changes in relationships, jobs, and family situations are challenging, and diet is the same. The transition period is a stressful time on your physiology, and problems can often manifest in several ways. A new diet, regardless of its composition, affects gut function, causes a stress response, and induces some metabolic changes. But I can give you some ideas of what to expect and how to handle any issues.

One of the most common issues of the transition period to a carnivore diet is fatigue, lethargy, or poor energy. As you ramp up your metabolic machinery to deal with a new fuel source, you initially will be fairly inefficient. Your capacity to extract all the nutrition from meat may be compromised. Many people suffer from decreased stomach acid production or other digestive maladies, and those issues may take a while to resolve after you transition to a carnivore diet. While your body works on resolving those issues, you may find that you can’t eat as much as you need to, or perhaps you’ll eat quite a bit but won’t fully absorb it. Whether you’re undereating or not making use of all that you do eat, a lack of adequate calories and other nutrients can lead to poor energy or fatigue. Eating more is the most helpful solution for this, and it’s what I suggest as the first line of treatment. Increasing your meal frequency and adding salt to your diet often allow you to eat a bit more. For some people, digestive enzymes—like lipases, proteases, or HCl supplements—aid with the transition period. Most people can discontinue them after a few weeks.

Bowel Movements
Malabsorption, typically of fat, can often show up as steatorrhea, or fatty, loose stools. As you transition to the carnivore diet, your microbiome goes through a shift in its composition. The fiber-loving magical bacteria in your gut dies off and is replaced with meat-loving bacteria. One of the more common digestive issues as this happens is not constipation but diarrhea. Most people on a high-fiber diet are accustomed to daily (and often multiple daily) bowel movements. Going on a carnivore diet will dramatically reduce the volume of waste you produce, and it will likely lead to less frequent bowel movements. What many people mistake for constipation, particularly early on in the diet, is just a dramatic reduction in waste.
If you’re not having discomfort or pain when you have a bowel movement, you don’t have anything to be concerned about. Some people find that adding a bit more dietary fat or avoiding dairy can help things move a bit quicker. Can you suffer from true constipation while you’re on the carnivore diet? Sure, but it’s not common, and sometimes it’s a result of an electrolyte issue that has caused altered gut motility. Adding fat, fluids, and sometimes electrolytes can be helpful.

Gastroesophageal reflux disorder (GERD) is a common condition for many people. In most cases, the carnivore diet seems to clear up this problem. However, some people find that the diet makes reflux worse or that nausea or other types of dyspepsia occur. For some people, fat, or perhaps meat in general, is difficult to digest. Strategies to deal with this problem include lowering the fat content a bit and temporarily adding digestive aids as you go through the transition period. Hydrochloric acid supplements (most commonly betaine HCl) or a bile supplement (like ox bile) can be effective. Some people notice that not drinking water around mealtimes can help; the theory is that water in the stomach dilutes the stomach acid and decreases the acidity of the stomach, which leads to difficult digestion. Some people have observed that adding salt to their diet helps with symptoms of reflux as well.

Joint Pain and Gout
For the vast majority of carnivore converts, joint pain or other musculoskeletal pain diminishes or goes away completely. A small subset of people reports a temporary increase in pain as they first start the diet. One possible reason for this phenomenon of more pain is higher uric acid levels. We know that elevated uric acid levels are associated with gout, and a diet that puts someone into ketosis can sometimes lead to increased uric acid levels. The uric acid level likely increases because the body is inefficient at using the ketones, so for a while, more ketones are excreted as waste in the urine. The ketones the kidney excretes can competitively inhibit the excretion of uric acid, so the level of uric acid rises and potentially results in joint pain or other pains. Over time, your body becomes more efficient at using the ketones you produce, the uric acid levels often normalize, and the joint pain disappears.

Skin Conditions
Some people report that they develop a rash as they transition to the carnivore diet, but the incidence seems fairly rare. Skin issues are likely related to the elimination of ketones (as I describe in the previous section). In this case, the body excretes the ketones through the skin, which results in an irritation response. Skin conditions usually resolve with time as the body becomes more efficient with using ketones.

One transition-phase issue I dealt with was headaches. Headaches are most likely related to fluid and electrolyte shifts that occur as your body adjusts to the new eating regimen. In my case, the headaches were sporadic and very mild; I had them off and on for about ten days. For those who experience headaches when they first start the carnivore diet, I recommend eating more food and upping fluid and electrolyte intake. Even if you don’t alter your habits, the headaches generally pass fairly quickly.

Muscle Cramps
Muscle cramps are another fairly common occurrence that seems to crop up with some regularity among carnivore dieters. Electrolyte or hydration problems may be at play here. For most people, the cramps dissipate with more time on the diet. I’ve been following the diet for years, and I get an occasional muscle cramp, but I can almost always relate it to having exercised very hard and without eating at an appropriate time in relation to my exercise. Eating relatively soon after you exercise—at least within a few hours—can sometimes help reduce the occurrence of muscle cramps.
Some people find electrolyte supplementation helpful. People have tried adding regular salt (sodium chloride), potassium, and magnesium and have found varying results. Some people soak in Epsom salts to alleviate muscle cramps. If you experience cramps, the first thing I suggest you do is to look at your overall food intake to ensure it’s adequate. Beyond that, you can add various electrolytes in the form of salt (such as Redmond Real Salt) or electrolyte supplement.

The point of the carnivore diet is not to achieve a state of constant ketosis, and artificially manipulating fat ratios is not part of the program. I believe it’s counterproductive to measure ketones because it usually leads to unnecessary anxiety and a waste of money that you could otherwise spend on food. If you have a medical condition that requires you maintain a minimal level of ketones, you’re in a different situation. For most folks, though, I recommend putting away both the ketone monitor and the scale. Remember, your ultimate goal is to be in a position where appetite and eating are naturally controlled, and you’re not constrained by some arbitrary number or a predetermined fasting window.

Energy Level
Many people say they notice a general increase in their energy and work or exercise capacity. People often state that they have very restorative sleep, but the overall quantity of sleep they get decreases. Perhaps people on the carnivore diet require less sleep because they have better materials with which to repair their bodies, and they might be less beat up metabolically. However, not everyone immediately has deep, restorative sleep as soon as they transition to the carnivore diet. Some people have a hard time sleeping, particularly early on. Some people feel the need to urinate, and it wakes them up at night. Eating more protein can require more water for processing the food, which can lead to increased thirst. Salt ingestion also likely plays a role here. Modulating salt intake might be another strategy for preventing fluid shifts at night.

Excerpted from The Carnivore Diet, By Dr. Shawn Baker.
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Digging Up the Real Data on Minerals

When officials at the USDA came up with the recommended daily allowances (RDA), they primarily studied populations and individuals who consumed high-carb, grain-based diets. In a 2007 Institute of Medicine review of the RDA, several speakers asserted that the Dietary Reference Indices should be based on a higher standard of evidence than what had been used to formulate the recommendations. Basically, the RDAs are more or less a guess, and they certainly weren’t formulated by evaluating people who were eating low-carb or (heaven forbid!) meat-only diets. Consequently, we have no real idea of what the optimal or even sufficient levels of vitamins and minerals are for various subsets of dieters. For now, the entire dietary profession uses this low-quality evidence for the basis of almost all the current recommendations.

We’ve seen evidence of other differences in requirements for some vitamins, minerals, and cofactors. A deficiency of thiamine, for example, leads to a condition called beriberi, which results in severe neurological and cardiac disease. Researchers have found that an animal’s requirements for thiamine vary based on that animal’s carbohydrate consumption. This result was observed as far back as the late 1800s when scientists noted that animals fed a low-carbohydrate diet didn’t develop disease in the presence of low thiamine levels, but animals fed a high-carbohydrate diet developed disease at the same low thiamine levels.

Magnesium is a mineral that’s crucial for many human physiologic functions. Recently magnesium deficiency has been implicated as a potential source of numerous disease states. Interestingly, magnesium is a cofactor that is crucially involved in carbohydrate metabolism, and there is some research showing a relationship between blood glucose and magnesium levels. Is it possible that many people are identified as having a magnesium deficiency because of increased demand via high rates of carbohydrate ingestion? It’s certainly an interesting question, and that relationship would account for the lack of any clinically relevant nutrient deficiencies in our observations of the modern-day carnivore-dieter population.

Unfortunately, it’s challenging to make assessments about vitamin or mineral deficiencies. We can look for overt clinical symptoms and more subtle subclinical things like poor energy, sleep, or mood. Aside from those symptoms, we’re often limited to studying the things we can measure most easily, which generally comes down to a blood test.

For all the billions of dollars we spend annually on blood tests, the sad fact is that many are poor predictors of chronic issues. Sure, sometimes we can get important information from a blood test, but to think that a blood serum vitamin C level can tell us something specific, such as the cellular concentration of the vitamin C level in our left tibia, is misguided. Perhaps at steady state, when no environmental or internal changes are occurring, a certain level can be expected to exist, but the truth is that trafficking of materials in the blood can vary wildly.

Does sleep, exercise, recent meals, temperature, time of year, injury, or illness (not to mention thousands of other things) affect those concentrations? Almost certainly, the answer is yes. Another solution for identifying problems is to biopsy the tissues, which gives a far better representation of one’s nutritional state. The problem is that biopsies often are fairly painful, they require far more risk, and they’re expensive. Thus, we continue to rely on unreliable guesswork to make many of our decisions about how to address health issues.

One of the recurring themes that I like to talk about is that, despite what many people like to proclaim, the science of nutrition is not settled. (Stating that science is settled would completely undermine the basic concept of science.) Take this theory, for example: Red meat causes diabetes. The evidence in support of this theory would be based on population survey data that shows that people who eat more red meat have higher rates of diabetes. There’s nothing wrong with that theory as long as the data continues to support that claim.

However, what if you have information to the contrary—such as numerous accounts of people who eat only red meat and notice that their diabetes resolves? At this point, you have to adjust your hypothesis and modify your theory. You could say that maybe it was some other factor common to those meat eaters with diabetes that caused the disease; in other words, maybe meat combined with something else is to blame.

Unfortunately, we live in a time when entire industries and careers are built upon a particular hypothesis, and even in the face of new or overwhelming evidence, some people are unwilling to revisit or revise their original assumptions. This is human nature and to be expected. The unfortunate part is that those assumptions can affect many lives around the world, and many billions of dollars are tied up in it.

Here’s a general question to ponder before we go on: Why is it that every wild animal that eats meat as part of its diet doesn’t suffer from the chronic diseases that modern humans do? How can a food source that is ubiquitous throughout the animal kingdom and has been clearly eaten by humans for millions of years now suddenly be toxic to only humans while every other animal is just fine?

Excerpted from The Carnivore Diet, By Dr. Shawn Baker.

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