What If Fat is the Solution? An Interview with Drs. Jeff Volek & Stephen Phinney Part 2

What If Fat is the Solution? An Interview with Jeff Volek & Stephen Phinney by Dana Carpender Part 2

Read Part 1 of Dana’s Interview here.

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This article was originally written in 2013 by Dana Carpender in an exclusive interview with Drs. Jeff Volek and Stephen Phinney for our April 2013 digital issue of CarbSmart Magazine. The article discusses the benefits of a low-carbohydrate, high-fat diet and the misconceptions surrounding this dietary approach. While the article was originally published a decade ago, it has been updated on April 4, 2023 to reflect the most recent research and developments in the field of low-carb nutrition. The updated article provides important information for those who are interested in adopting a low-carb lifestyle and want to stay up-to-date on the latest research and knowledge in the field.

Dana: Thank you for your information regarding sodium and carbohydrate restriction, it has been vital to me. For our readers, can you please sum up this information?

Steve and Jeff: Salt (sodium) is one of the most maligned human nutrient requirements. Without it we can’t live, but too much of it (particularly when we eat a high-carb diet) can harm some of us. How to resolve this paradox? The answer has been available for over 4 decades. Solid science has defined a concept called ‘the natriuresis of fasting’. translation: when we are keto-adapted, our kidneys accelerate their excretion of salt.

Sodium helps to define how much volume there is in our circulation. So when we are keto-adapted, we need enough salt to keep our circulation working properly. Not enough salt during a low-carb diet causes headaches, light headedness, constipation, and even fainting.

How much salt? One to two teaspoons per day is enough. But because our kidneys are constantly excreting it when we are ketotic, we need to take it in moderation every day, and particularly before exercise or heat
exposure to avoid lightheadedness or dizziness.

A good solution to this is making your own broth from beef or chicken bones (or vegetable stock) with one teaspoon of salt added per quart. Two cups per day of this broth provides half our daily minimum sodium recommendation (plus other good minerals like potassium and magnesium).

Dana: I can remember when many water coolers had dispensers of salt tablets; everyone knew that salt depletion could make you lightheaded. But then, that was in the 1960s, before low-fat/high-carb mania and super-sized sodas — and before everyone had air-conditioning. Insulin levels were lower and perspiration was higher. And of course historically salt was an extremely valuable commodity of commerce — it’s the root of the word “salary,” salt money.

Instead of daily broth — although I do make bone broth, and soup from it — I bought empty gelatin capsules and filled them with good, mined, ancient sea-bed sea salt. Three to four per day make a big, big difference in how well I feel. I believe one can still buy salt tablets at pharmacies, but I prefer higher-quality salt.

And readers, take this seriously. When I get hyponatremic (sodium deficient) I wake up with nasty, nasty headaches — a sign that my brain is swelling. Not good. Less alarmingly, but still unpleasant, I become exhausted, terribly achy, and yes, light-headed.

As a big health sciences geek, I was fascinated by your information regarding lactate and gluconeogenesis. Just how viable a source of glucose is the lactic acid produced during a workout?

Steve and Jeff: Excellent question. If you are eating a high-carb diet, then glucose is clearly a ‘throw away’ fuel. Furthermore, in the context of exercising on a high-carb diet, getting rid of lactate (lactic acid rapidly disassociates into a lactate and hydrogen ion) becomes a problem.

But on a high-fat, moderate protein, low-carb diet, we need to think of lactate as ‘green energy’. Rather than burning it all the way to Co2 and water, we burn mostly free fatty acids or ketones and recover lactate as glucose/glycogen. In the past, scientists have described this as a ‘salvage pathway’. But in a more holistic world, perhaps this is the normal pathway.

As an analogy, if you drive a Prius, the battery is small and your gas tank relatively big. But in city driving (think intermittent anaerobic exercise), the battery plays a big role in overall fuel economy (storing energy during braking and giving it back for acceleration). Similarly, when you are keto-adapted, fat is your big fuel tank whereas glycogen-to-lactate-to-glycogen acts like a hybrid battery.

Go figure.

Dana: What are you both doing personally to stay keto-adapted—what are your personal go-to foods or habits?

Jeff: I don’t count calories or calculate nutrient intakes, but I do measure fasting blood ketones in the morning, which are consistently between 0.5 and 2.0 mmol/l. I’d estimate my daily intake at less than 50 grams of carbs and 100-120 grams of protein and I include more or less fat based on feel.

I have no problem maintaining a healthy weight. I like to experiment with different recipes, preparation techniques and occasionally new ingredients when I have time, but the staples are various egg-based dishes (quiche, ice cream, omelets, fried eggs, etc.), heavy cream, olive oil, butter, nuts, all varieties of beef, bacon, sausage, pepperoni, pork rinds, Greek yogurt, specific fruits (tomatoes, berries, olives), and non-starchy vegetables. I drink a fair amount of coffee and red wine, and use xylitol and liquid sucralose as a sweetener.

Steve: Over our 7-plus years of collaboration, Jeff and I have evolved to eat very similar diets; so my protein and carb intakes as well as fasting blood ketones look much like his. Given that I eat only 600-700 Calories from protein and carbs, the key to making this work long-term is to get the majority of my calories from fat. I make one 5-cup batch of ice cream (sweetened with xylitol) per week, and limit myself to a single ⅔ cup serving per day. I use my homemade chicken broth as stock for a range of creamed soups — sorrel, tomato bisque, and most recently a delicious recipe for leek and cauliflower soup. On a recent visit to Norway, I was introduced to ‘Rippe’ (roast pork belly), which turns out to be almost identical to the Vietnamese specialty ‘thit heo quay’. So here in California, the best place to get fresh pork belly is in our Asian supermarket. Slow roasted and then broiled to crackle the skin, it is delicious hot and keeps well to serve along with eggs (instead of bacon) or with stir fry. And being an organic gardener, I eat lots of fresh greens and non-starchy vegetables year-round.

Dana: Now I have to see if my local Asian market has thit heo quay. Sounds divine!

Thanks again, guys. In particular, I find this a fascinating bridge between the world of low carb, which has largely been made up of those of us who were born with less-than-optimal metabolisms, and the world of Paleo, which has been made up mostly of athletes. It’s very cool to hear from serious athletes who pursue their sports on a ketogenic diet; it fills an important gap. That the two of you are not only experienced but have such strong scientific backgrounds and years of research experience makes it all the more fascinating.

If you missed Part 1, read it here.

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