Carnivore Diet: What Now?
The low carb craze has swept over the world for the past 20 years. From Atkins popularity in the early 2000’s, to the masses that follow a ketogenic diet today, carbohydrates have been frequently demonized by people trying to lead a healthier life. But one diet has broken free from the low-carb pack and is making a name for itself, with prominent supporters including Joe Rogan, Jordan Peterson, and Mark Bell: The Carnivore Diet.
The Carnivore Diet (i.e., Zero Carb Diet) consists of the consumption of only meat and dairy products. Reported benefits of this diet include weight loss, mental clarity, and chronic disease regulation. Additionally, many people have used this diet as an “elimination” strategy to pinpoint specific foods that cause them physical distress. Like any emerging dietary strategy, the Carnivore Diet has been surrounded with frequent criticism and misinformation. To separate fact from fiction and get to the bottom of why this diet appears to have changed so many lives, we at WDA interviewed Dr. Shawn Baker, author of “The Carnivore Diet”.
Dr. Baker is a former orthopedic surgeon, a former New Zealand professional rugby player, and the possessor of multiple American weightlifting records. He received his medical doctorate at Texas Tech University in 2001 and completed his residency at the University of Texas in 2006. After completing his medical studies, Dr. Baker joined the United States Air Force for a year and a half, serving as Chief of Orthopedics for multiple bases across Afghanistan. After leaving his job as the Chief of Surgery at a private practice in New Mexico, he ventured on a path to optimize his own health. Dr. Baker abandoned his decade-long Ketogenic Diet and embarked on the Carnivore Diet. Within a few years, Dr. Baker authored “The Carnivore Diet”, was interviewed on the Joe Rogan Podcast, and co-founded Meatrx, a website where thousands of carnivores worldwide interact and share their success stories.
Nutritional Considerations for Diabetics
Restriction of a particular class of foods in one’s diet (whether that be carbohydrates, fats, meat, etc.) has become common in attempts to seek a healthier lifestyle. Despite the theoretical rationale for these restrictions, limiting exposure to an entire food group will inevitably increase one’s risk of nutrient deficiency syndromes. Therefore, restrictive diets require careful planning to maintain optimal vitamin and mineral levels.
A Carnivore Diet has the potential to benefit diabetic populations via improved blood glucose management and may aid in weight loss via improved satiety. Numerous studies (including randomized controlled trials) have revealed that low carbohydrate diets have the potential to improve blood glucose management and improve bodyweight metrics in diabetic patients [1,2,3,4,5]. While weight loss is unanimously considered to be beneficial for the management of diabetes in obese patients, low carbohydrate diets are more effective than low calorie and low glycemic index diets in improving blood glucose control, and reducing a patient’s need for medication [6,7]. Anecdotally, Dr. Baker has observed many of these same findings within his Meatrx community and has seen both type 1 and 2 diabetics improve their glucose control and reduce their need for medication.
There is data suggesting a correlation between red meat consumption and the risk of developing type 2 diabetes [8,9,10]. Studies directly investigating the effects of red meat consumption on diabetes appear to be limited and are by no means conclusive. The risk of diabetic ketoacidosis (DKA) is a significant concern amongst diabetic patients looking to replace dietary carbohydrates with a higher fat diet. As described by the Mayo Clinic, DKA is a life-threatening condition that occurs when fat breaks down in the liver (due to lack of available glucose) produces an excess of ketones in the bloodstream [11]. As mentioned by Dr. Baker, individuals with diabetes seeking to consume a high-fat diet should consult a medical professional and develop a diligent routine for monitoring blood glucose to ensure blood ketone levels remain in the reference range.
Vitamin C, Dietary Fat, and Cholesterol
Reducing consumption of fruits and vegetables in exchange for animal fats and proteins has created controversy, particularly surrounding the topic of vitamin C. The antioxidant and immune-boosting effects of vitamin C have been well classified. However, there has been ambiguity in the quantification of the amount of exogenous vitamin C consumption which is necessary for the prevention of deficiency syndromes and the optimization of general health [12].
Scurvy is a recognized vitamin C deficiency syndrome that affects the bones and connective tissues and can be fatal in severe cases. Research suggests that to prevent scurvy, just 10 mg of vitamin C consumption daily is required [13]. For reference, a serving of 5 large strawberries provides approximately 60mg of vitamin C, so 10mg is not a lot [14]! An astute reader will recognize that simply preventing disease and optimizing health are NOT the same thing. In our interview, Dr. Baker suggests that an individual’s overall metabolic status may impact their body’s vitamin C requirements. He proposes that consumption of red meat and a low carbohydrate diet may limit the need for vitamin C by increasing the presence of other antioxidants like uric acid and may improve the absorption of vitamin C. Dr. Baker mentions that in his experience, vitamin C deficiency has not significantly impacted carnivores, but that additional clinical trials are required to confirm these observations.
On the topic of health and longevity, debates on the impact of saturated fat and cholesterol on cardiovascular health have been prominent over the past several decades. While the position of global cardiology associations has evolved, saturated fat and cholesterol still possess negative connotations. As new evidence presents itself, Dr. Baker and other prominent meat-based diet supporters have advocated that the topic is far more nuanced than the “saturated fat + cholesterol = bad” paradigm.
Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are the two main types of cholesterol in our body (and are both protein and fat molecules that carry cholesterol in the blood) [15]. HDL is generally considered to be the “good cholesterol”, whereas LDL is considered the "bad cholesterol” due to its association with coronary artery disease and atherosclerosis [16]. In both their 2017 dietary recommendation and their 2021 updated commentary, the American Heart Association has suggested that consumption of saturated fat in products like red meat is associated with increased LDL, and that replacement of saturated fat with other mono or polyunsaturated fats may yield better cardiovascular outcomes [17,18,19]. In Dr. Baker’s point of view, simply measuring cholesterol may not be sufficient to get a full picture of cardiovascular health in a particular patient, and that other biomarkers including the size of LDL particles, blood triglyceride levels, and the ratio of LDL: HDL cholesterol must also be considered before drawing conclusions [20]. Dr. Baker also notes that saturated fat in the blood can be generated by de-novo lipogenesis in the liver, which uses excess fats, carbohydrates, or fructose as building blocks. For this reason, saturated fat in the blood may be present due to an excess of calories and not just the consumption of dietary saturated fat.
Attempting to draw dietary recommendations from the vast, and often contradictory body of literature is an arduous and frustrating task. Different studies and meta-analyses can produce vastly different conclusions. Members of the carnivore community (as well as Dr. Baker himself) have reported nearly immaculate blood lipid panels and coronary calcium scores, suggesting there may be more than meets the eye in terms of saturated fat consumption.
In our discussion of high fat meat-based diets, Dr. Baker pointed out that meat not only contains saturated fat but is rich in monounsaturated fats known to possess a slew of health-promoting properties [21]. From an evolutionary perspective, Dr. Baker informed us that the evidence indicates that early humans were frequent consumers of animal fats and that for this reason (among others), humans may be more well adapted to consume these types of products as opposed to the highly processed vegetable oils found in modern processed foods. When asked if processed meats (like lunch meats) should be included in a Carnivore Diet, Dr. Baker notes that in the grand scheme of poor dietary habits, consuming a small amount of processed meats will not likely be harmful, but individuals should look for products that do not contain excessive amounts of nitrates or preservatives. If possible, he suggests that individuals limit their consumption of processed seed oils, trans fats, and focus the majority of their dietary fat intake on animal fats and unprocessed vegetable fats that they can handle well. Like many university students, if trying to save money on meat, Dr. Baker recommends three easy steps: purchase meat in bulk, learn to cook at home and stop buying junk food. For students looking to reduce their carbon footprint and enjoy beef while minimizing ethical concerns, Dr. Baker recommends purchasing meats sourced from ranches that utilize regenerative agriculture as opposed to factory-farmed beef.
Some of the harshest criticisms of the Carnivore Diet have come from members of the vegan community. From a purely nutritional standpoint, Dr. Baker points out that both meat-based and plant-based diets have their advantages and disadvantages, but that both can be beneficial for long term health if implemented correctly. Dr. Baker highlights that individuals seeking to follow a vegan diet should opt for minimally processed whole foods and avoid artificial vegan replacement foods ridden with vegetable oils and preservatives. Although still possible, obtaining large amounts of high-quality complete proteins (proteins containing all of the essential amino acids) on a vegan style diet will require more diligent planning than individuals who eat animal products. Meat, eggs, and dairy contain some of the highest quality and most bioavailable protein, so limiting their consumption will yield challenges in obtaining optimal protein levels [22]. Like any restrictive diet, those opting to limit meat consumption should be aware of potential nutritional deficiencies (like Vitamin B-12) and should consult a medical professional to ensure they are taking the necessary supplements to avoid health consequences.
Modern Medical Industry and Diet Culture
Despite the efforts of Dr. Baker and other dietary advocates, there is still a long way to go before diet and exercise become staples in every medical practitioner’s toolbox. While research has not yet identified a perfect diet, it is glaringly obvious that various dietary interventions can have an enormous impact on preventing and treating disease. In our interview, Dr. Baker mentions that in his experience, one of the main issues with today’s medical industry is a focus on treating disease, as opposed to preventing it. Dr. Baker highlights that drug companies stand to profit from the prescription of drugs once an illness has already been presented and that politicians will likely be reluctant to embrace the changes necessary for large scale dietary alterations if they do not align with their economic goals. Dr. Baker also pointed out that like countless other specialities, physicians in his former field of orthopedic surgery are compensated for operations and procedures, and that physicians are generally not compensated for giving generalized advice related to the prevention of illness.
One of Dr. Baker’s biggest criticisms of the nutrition industry is its reliance on weak correlational epidemiological studies. He states that many of the results garnered from these observational studies rely on questionnaires from the public, and are generally limited to drawing correlations that may be confounded by a host of other factors. In the field of nutrition, the use of the gold standard randomized controlled trials (RCTs) has been greatly limited due to ethical considerations. To combat what he considers flawed research, Dr. Baker has crowdfunded over $100,000 to run a clinical trial that will investigate the safety of a Carnivore Diet over an extended period of time, and may provide novel insight regarding the safety of saturated fat and cholesterol intake from red meat.
Concluding remarks
As mentioned above, the topic of nutrition, particularly as it relates to the management of medical conditions like diabetes is a continually evolving topic with no “one-diet fits all” model. There are innumerable dietary interventions that warrant consideration, and as more research is conducted, recommendations will allow individuals and health professionals to make more informed dietary decisions. In our discussion, it became clear that Dr. Baker’s message is that to truly alter diet culture, changes must be driven by the general population, not just medical professionals or those in a position of power. Easy accessibility to junk food has contributed to a society ridden with poor eating habits, highlighting the need for advocacy and education. When asked if he ever gets bored of eating just a few foods, Dr. Baker responded, “I don’t ever get bored of breathing air!”. This statement represents the power a shift in mindset can have on the impact of one’s health dramatically.
Note: Before making significant dietary changes, always consult a nutritionist, or registered medical professional.
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