Matt Stone - Dr Kurt Harris critiques

Archevore - Archevore Blog - 180 + 180 = 360

180 + 180 = 360

Reader Jeff writes in with a comment about Matt Stone of 180 Health.

Matt is the subtle attention-shy guy who poses shirtless holding a pig’s head on his blog.
Matt doesn’t really need any attention from me, he is busy commenting in a “contrarian” fashion all over the blogosphere right now. However, enough readers are asking me what I think that I should say something, I suppose.

Jeff writes regarding Matt Stone's guest post on Tom Naughton's blog re colton osborn's question- i just went over and read the post at the link. i think the key section is:
And therein lies the true danger of uber-low-carbohydrate diets. All my experience tells me that, the first few years aside, a low-carbohydrate diet and certainly a full-blown ketogenic diet exacerbates a low metabolism. It is not a matter of having a genetically-doomed dysfunctional thyroid gland; it is fixable, and it lies at the core of the health problems we’ve seen explode over the last century. This is why all prolonged restricted diets, low-carb included, in the words of Robert Atkins himself (from page 303 of Dr. Atkins’ New Diet Revolution):
“…tend to shut down thyroid function. This is usually not a problem with the thyroid gland but with the liver, which fails to convert T4 into the more active thyroid principle, T3. The diagnosis is made on clinical grounds with the presence of fatigue, sluggishness, dry skin, coarse or falling hair, an elevation in cholesterol, or a low body temperature.”
To that I will add constipation, bad moods, heartburn, cold hands and feet, and a whole host of other minor but significant health problems. To get an idea of how “shutting down the thyroid” can manifest, Mark Starr’s chapter on Hypothyroidism symptoms is 83 pages long.
Jeff here- most of what is in the post is fully compatible with PaNu. But Matt Stone asserts that once you've been on zero carb or very low carb for a while [several years] you'll run into problems as specified above. The carbs he recommends sound like potatoes and rice, not clear what he thinks about whole grains, but the bottom line question seems to be about thyroid function over the long term.  I read the post and it starts out reasonably. Matt's hyping a pseudo -contrarian position that has some truth to it, but reading him later he goes off the rails when he starts talking about cortisol and thyroid function.

His first target is really a straw man. PaNu, Wholehealthsource and Peter at Hyperlipid all target fructose and linoleic acid as the main causes of metabolic disturbance in the western diet. Even Gary Taubes in his recent lectures has said "it may indeed all be fructose". None of us, read carefully, claims that "carbohydrates = disease".

His observation that some people may not feel good, even "hypometabolic" on VLC I don't take issue with. It seems like common sense that you might feel better eating more or less of just about anything. As long as you are avoiding the neolithic agents, tinker away! (That's for Brett and Nassim)
My blog with 60 or so main posts and pushing 3000 comments does not have any content from me prescribing precise ratios of anything, except for when advising how to lose weight. I respect the Optimal diet and Peter but I think any tightly defined macro ratio is rather artificial, including Kwasniewski's. I am sure that bias shows in my irritation at the bodybuilding questions : )

At the same time, Stone's statement that long term ketogenic eating per se ruins your metabolism is much less supportable than the "all carbs are metabolic poison" straw man he is attacking. Again, even Taubes does not really say this in GCBC.

My own view on the ratio of carbs in the diet should be pretty clear by now.

1) I think a wide range is tolerable for those with normal metabolism. For those about to ask "how wide" - OK, let's say 5% to 40% or even more if you can tolerate it and the rest of your food is very high quality. If your metabolism is damaged (you know who you are - type II or obesity prone) or you don't tolerate starches well like me, you should probably stay on the low end of carb intake. 

2) I think the paleolithic principle itself argues against LC and VLC being damaging the same way it argues against plants and all carbs as being poison. It just makes no sense, as it implies that humans in any given econiche, even one rich in a huge variety of animal foods, would have been at risk of metabolic damage from being in long term mild ketosis if they were not able to find enough starchy tubers and fruit in season. (We've agreed that grains like white rice are a recent food, I hope).
Enough nonstarchy greens to choke a gorilla with an otherwise all animal diet will not keep you totally out of ketosis, I guarantee. If it did, I wouldn't want to share your bathroom.
Of course, you can start eating a lot of coconuts like the Tokelauans or Kitavans and you can elevate your B-hydroxybutyrate even with a normal carb intake. Uh-oh - now our thyroid glands will die!

3) I suppose it is a corollary of my own paleo principle that I don't like approaches that require "seeking" behavior for something that provides only calories. "I'd better eat some carbs or my thyroid and adrenal glands will be screwed up". Really? HGs had to consciously think about whether they were getting enough starch? Or is starch just something that we eat because it helps us not starve? 

4) On the other hand, avoidance behavior is totally compatible with the paleolithic principle. "Avoid that, as it is outside of our evolutionary experience or causes metabolic effects that are outside our experience in the amounts that are available". This is my template. Fructose, wheat and excess linoleic acid.

5) It is true that being in negative energy balance – losing weight -generates an energy conserving response. That is not surprising. Once you are at equilibrium though, does a lower free T3 with normal TSH and T4 on lower carbs mean something pathologic? What if you had cold hands and a low basal temperature when even you ate 50% of calories as carbs? Are you now supposed to go from 10% to 70% to "restart your thyroid" or are you rather still hypothyroid because you have always been hypothyroid and you are just no longer euphoric now that you have stopped losing weight? Remembering your mood or body sensations one hour ago is hard enough. We are supposed to remember what they were years ago?

6) In answer to the idea that we need to carefully regulate macronutrient ratios to control the function of our thyroid and adrenal glands I have only one comment for now:
Lacks biological and evolutionary plausibility.

To summarize, Matt is a clever and entertaining writer, but his main target is a straw man, as most of the science oriented paleonutrition blogs are not really "low carb" blogs at all. His observation that starch per se need not be unhealthy is not really that controversial.

Matt's claims about his own serum BG after meals should be published as a case report in a medical journal. They are at odds with clinical studies I have read on glucose metabolism in normal highly insulin sensitive young people (can you say "superhuman"?).

Matt's got some good observations, but is over or mis-interpreting the literature in the realm of endocrinology. I did not notice if he has any medical or scientific credentials, but his views of hormonal action lack nuance, to say the least. He is also avidly mining the "I feel like shite, it must be my thyroid or adrenal glands" meme.