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The Fatome
What is the Best Source of Fat on a Ketogenic Diet?

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Quick Summary tl;dr

The “fatome” is the unique balance of fats we each consume in our diets that influences our health.

Our optimal fatomes are unique to us and depend on our genomes, microbiomes, lifestyles, and nutritional perspectives.

The top 8 sources of healthy fats are extra virgin avocado oil, grass-fed beef, cacao butter, virgin coconut oil, ghee, extra virgin olive oil, macadamia oil, salmon and fish oil.

Table of Contents

What is the Best Source of Fat on a Ketogenic Diet?

The ketosphere is pretty segregated, almost in a religious manner, on this issue. Some argue that we evolved to eat animal proteins and fats. This includes a higher proportion of saturated fats, which are stable and resistant to oxidation.

Others argue Mediterranean-keto is superior, given its high proportion of healthy monounsaturated fats (olive oil), Omega-3 fats (fish), and probiotic plant material, as well as the association between Mediterranean diets, longevity, and low rates of Alzheimer’s disease ( 1).

We come to the discussion with our own biases, often informed by our personal (and very legitimate) health journeys. But this piece isn’t about sticking to our guns; it’s about thinking critically to add nuance to the discussion and, at the same time, help you optimize your personal “fatome.” But, wait, what’s a “fatome?”

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What is a "Fatome"?

You’ve heard of the genomes and microbiomes. These are the unique sets of genes and microbes that fingerprint each of us and interact within our bodies to influence our health. Why shouldn’t we have a “fatome” — the unique balance of fats we each consume in our diets that influences our health?

The key word in the above paragraph is “interacts.” Each “ome” interacts in its own network and with the others. The genome, microbiome, and fatome all talk with each other. And, as with any team, the qualities of one player should complement those of the others.

In short, there is no one best “fatome.” We can’t tell you what your is, but we can nudge you down the road of self-study by providing the following background information to hopefully help you decide what fatty factors are most important to you.

1. Long-Chain Saturated Fatty Acid Profile

Not all long-chain saturated fatty acids are equal. Long-chain saturated fatty acids differ in the length of their tails, from 14 carbons to 22 carbons.

The three long chain fatty acids to focus on are 14, 16, and 18-carbon, myristic acid, palmitic acid, and stearic acid. In general, myristic acid and palmitic acid can decrease the expression of LDL receptors on your liver ( 2). This is not bad because it can increase LDL, it’s (potentially) bad because of how it can increase LDL. By decreasing LDL uptake at the liver, LDL in the blood has more time to get oxidized, condense, and become atherogenic. Steric acid does not decrease LDL receptor expression on the liver, which is good ( 2).

Therefore, saturated fat sources that have a higher “stearic acid to (palmitic acid + myristic acid)” ratio may, in some people, be preferable. (This is not a clinically proven fact; it’s simply forward-thinking speculation.) If you take a look at the list below, this would imply cacao (chocolate) saturated fat may be better than dairy fat, other factors being equal. #HighFatFoodforThought

Saturated fat sources that have a higher stearic acid to (palmitic acid + myristic acid) ratio may, in some people, be preferable.

2. Medium Chain Triglycerides (MCTs)

Medium-chain triglycerides (MCTs) go straight to the liver, rather than into systemic circulation. They can also drift into our cells’ mitochondria, without the need for transportation assistance. In short, this means that MCTs get used as more immediate fuel ( 3) and get turned into ketones more quickly than other fat sources.

Coconut oil is rich in MCTs, particularly the 12-carbon, lauric acid. (As an aside, there’s some controversy over whether lauric acid is a long-chain or medium-chain fatty acid. Based on how it’s biologically processed, however, it appears to be medium-chain ( 4)).

What are medium-chain triglycerides? MCTs get used as more immediate fuel and get turned into ketones more quickly than other fat sources.

3. Monounsaturated Fatty Acids (MUFAs)

Monounsaturated fatty acids (MUFAs), and their primary sources (olive oil, avocados, and macadamia nuts), many consider to be superfoods. Real extra virgin olive oil is perhaps the best fat source of antioxidant, anti-inflammatory polyphenols.

Avocados don’t have quite as many polyphenols as olive oil, but avocados themselves are packed with fibers and avocado oil has a great smoke point for cooking (more below) pro-inflammatory.

However, olive oil and avocado oil have a slight potential drawback: they are each 10-14% Omega-6. These pro-inflammatory essential fatty acids are fine (and unavoidable) to consume in moderation, but if you are like me and can consume over 1.5 Liters of olive oil per week, those Omega-6 can add up, potentially contributing to more harmful oxidative stress in the body.

So, if you’re Mediterranean-Keto, what do you do?

Here are two suggestions:

  • Add in more macadamia nut and macadamia nut oil, which are rich in MUFAs, but much lower in Omega-6 (only 2% vs. olive oil and avocado oil’s >10%).
  • I personally found that including some, but not too much, virgin coconut oil and raw organic coconut butter improved my oxidized LDL levels.

Most of the MUFAs in your diet will be oleic acid. Oleic acid is awesome because it gets converted into a metabolite called oleoylethanolamide (OEA) which activates the fat-burning transcription factor PPAR𝛼 and stimulates TRPV1 receptors on the vagus nerve to make you feel full ( 5).

There is, however, another (rarer) MUFA worth mentioning: palmitoleic acid, also known as Omega-7. Palmitoleic acid is richest in macadamia nuts, synergizes with Omega-3s (found in fish), and can help improve serum lipids ( 6), decrease inflammation ( 7), and increase insulin sensitivity ( 8). Omega-7 palmitoleic acid is also the founding member of the class of hormones called “lipokines” ( 9)!

Oleic acid helps fat burning and helps induce satiety. Palmitoleic acid (found in macadamia nuts) is a founding member of “lipokine” hormones that are good for the brain, heart, and tummy.

4. Omega-3 Fatty Acids

Fatty Fish (SMASH: Salmon, Mackerel, Anchovies, Sardines, Herring) are your sources of the Omega-3 fatty acids, EPA and DHA. You need adequate EPA and DHA for optimal health as both decrease inflammation. DHA is a major building block of the brain.

Land sources of Omega-3s, such as flax seeds and walnuts, only contain ALA. ALA can be converted into EPA and DHA, but only at extremely low levels. Therefore, you either need to have some fish in your diet or supplement with EPA and DHA in some form. This doesn’t need to be fish oils, if you are vegetarian. Fish get their EPA and DHA from eating marine algae. There are algae-based EPA and DHA supplements available as well. If you do supplement, krill oil is ideal because it contains a high amount of a special form of DHA (lyso-DHA) that’s best able to cross into the brain using a special transport system ( 10).

Adequate intake of EPA and DHA is important for optimal health as both decrease inflammation. DHA is a major building block of the brain.

5. Smoke Points

You ruin an oil if you overheat it. The most heat-resistant fat sources are avocado oil and ghee. Select your favorite (or alternate between both) depending on your personal preference. Most other oils, including olive oil, can be used for low-temperature cooking (see compare and contrast table). Never overheat fish or flax seed oils as they are among the most heat sensitive.

The most heat-resistant fat sources are avocado oil and ghee. Never overheat fish or flax seed oils as they are among the most heat sensitive.

I hope we can agree that it’s not just about IIFYM (“if it fits your macros”), nor it is simply about IIFYFAP (“if it fits your fatty acid profile”). Below are some additional factors to consider.

6. Probiotic Effects

Certain fat sources come with probiotic effects. Lauric acid ( 4) may help to kill off bad bacteria in your gut, while promoting good bacteria. Similarly, the fibers found in avocados and bacteria found in blue cheeses may each help to improve microbiome health.

7. Dairy Sources

Since I mentioned blue cheese, let’s talk dairy. In general, non-cow dairy sources are best. This is because cow dairy contains what’s known as “A1 casein,” which gets turned into an opioid in your gut that is pro-inflammatory and can cause constipation ( 11). Goat, sheep, and buffalo dairy are generally considered safer.

8. Whole Foods

Consider this: nature often packages fats in whole foods in a protective manner.

For example, the Omega-3s in salmon are healthy but fragile. That’s why wild salmon are pink! Yes. That’s why wild salmon are pink. When wild salmon are on their upstream marathon journey to breed, and exercising their little tails off, they generate a lot of oxidative stress. As a result, their bodies make “astaxanthin,” a potent antioxidant that protects the valuable Omega-3 fats.

When you eat wild salmon, you get the Omega-3 and astaxanthin (its bodyguard). When you eat only fish oil, you often don’t. That’s just one of hundreds of examples of how clever nature can be, which is why you always want to prioritize whole foods over packed foods or processed oils.

9. Inter-omic Interactions

Recall that we said everyone’s best fatome is unique. This is because all our other -omes are unique. We won’t delve into the interactions among the fatome and the genome, epigenome, transcriptome, proteome, metabolome, lipidome, microbiome, sociome and more (breath, Nick, breath). We will, however, provide you with two examples of what we mean by inter-omic interactions.

Genome Example

Take Alzheimer’s disease, the most common form of dementia and one of the greatest health burdens of our time. The major genetic risk factor for Alzheimer’s is the ApoE4 allele. This gene codes for a protein involved in the transportation and metabolism of fats.

People with ApoE4 tend to burn Omega-3s for fuel at higher levels ( 12), leaving less DHA for the brain to use for structure. Therefore, people with ApoE4 may do better with more fatty fish and marine sources of DHA in their diets.

The major genetic risk factor for Alzheimer’s is the ApoE4 allele. People with ApoE4 may do better with more fatty fish in their diet.

Microbiome Example

Do you suffer from constipation and bloating? Since irritable bowel syndrome impacts at least one-fifth of the world’s population (the constipation form is more common in females), I wouldn’t be surprised if this sounds like you. A common cause of these symptoms is the production of methane gas in your gut by methanogenic bacteria. This methane gas swells up your intestines, making you feel bloated, and also acts as a neurotransmitter to slow gastric motility and cause constipation ( 13).

How does this relate to your fatome? Well, these methanogenic bacteria produce methane using soluble fibers and  “FODMAPs”. They also compete with Lactobacillus bacteria, which help you handle dairy. Therefore, methanogen-positive folk may not do well with avocados (soluble fiber and FODMAPs) or cheeses (even A2 cheeses).

But, you’re never powerless. The microbiome is dynamic. You can shift if through diet. Why not get clever? For example, when I found out that I have 500% and 900% the average levels of two major methanogenic bacteria (and very few Lactobacillus), I decided to cut my avocado habit (and fiber load) to help starve the methanogens, while slowly (very slowly) adding in A2 cheese to help grow the little population of Lactobacillus still hanging on for dear life ( 14). This is personal and incomplete experiment (time will tell) is just meant to illustrate that knowledge is power. Thus, having read this far, you now have more the power!

The bugs in your gut influence the fats you should eat. Different microbiomes need different "fatomes".

So, let’s return to the starting question...

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What is the Best Source of Fat on a Ketogenic Diet?

I hope, by now you understand that the answer is not so simple. Your best “fatome” depends on your genome, microbiome, etc., lifestyle, and nutritional perspective. To help you start to ponder, we will leave you with some questions to help you reflect on what you just read:

  • Like saturated fat? Is it worth considering that not all saturated fats are created equal? Is it worth considering the stearic acid/(myristic + palmitic) ratio?

  • Are you Mediterranean-Keto? If so, could you be overconsuming olive oil and avocado oil? It is worth checking out macadamia nut oil (Thrive algae oil works too) and/or incorporating just a bit more saturated fat (virgin coconut oil, raw organic coconut butter, or ghee)?

  • Are you eating fatty fish, at least twice per week? Are you getting enough EPA and DHA? If you’re ApoE4, do you need more?

  • What oils do you use for cooking?

  • Are your fat sources mostly from extracted oils, or do they include whole foods?

  • Are your fats “extra virgin” (olive oil), virgin (coconut oil), and/or “raw” (nuts, coconuts, and dairy)?

  • And, finally, what self-experiments can you do to begin your quest to find your best fatome?!

The “fatome” is the unique balance of fats in our diets that influences our health. Our optimal fatomes are unique to us and depend on our genomes, microbiomes, lifestyles, and nutritional perspectives.

8 Sources of Healthy Fats on a Keto Diet

1.Extra Virgin Avocado Oil

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 15%
C16 – Palmitic Acid 13%
Monounsaturated Fats (MUFA) 15%
Oleic Acid 63%
Palmitoleic Acid (Ω-7) 5%
Polyunsaturated Fats (Ω-6) 14%
Smoke Point 400 ℉ (200 ℃)
Main Benefits high in Oleic Acid, high smoke point
Other Considerations if Mediterranean, PUFAs may add up

2. Grass-Fed Beef

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 55%
C16 – Palmitic Acid 30%
C18 - Stearic Acid 23%
Monounsaturated Fats (MUFA) 34%
Oleic Acid 31%
Polyunsaturated Fats (Ω-6) 5%
Smoke Point 390 ℉ (200 ℃)
Main Benefits low in Ω-6
Other Considerations high in saturated fats

3. Cacao Butter

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 63%
C16 – Palmitic Acid 26%
C18 - Stearic Acid 34%
Monounsaturated Fats (MUFA) 33%
Oleic Acid 33%
Polyunsaturated Fats (Ω-6) 3%
Smoke Point 450 ℉ (230 ℃)
Main Benefits high in Stearic/(Myristic + Palmitic) Acid ratio, low in Ω-6
Other Considerations high in saturated fats

4. Virgin Coconut Oil

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 35%
C14 – Myristic Acid 19%
C16 – Palmitic Acid 11%
C18 - Stearic Acid 5%
Medium Chain Triglycerides (MCT) 64%
C6 - Caproic Acid 1%
C8 - Caprylic Acid 9%
C10 - Capric Acid 6%
C12 - Lauric Acid 48%
Smoke Point 350 ℉ (175 ℃)
Main Benefits high in MCTs, especially Lauric Acid, low Ω-6
Other Considerations high in saturated fats

5. Ghee

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 62%
C14 – Myristic Acid 12%
C16 – Palmitic Acid 39%
C18 - Stearic Acid 14%
Monounsaturated Fats (MUFA) 28%
Oleic Acid 25%
Polyunsaturated Fats (Ω-6) 2%
Smoke Point 480 ℉ (250 ℃)
Main Benefits high smoke point, low in Ω-6, 4% C4 butyrate
Other Considerations high in saturated fats

6. Extra Virgin Olive Oil

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 14%
C16 – Palmitic Acid 11%
Monounsaturated Fats (MUFA) 73%
Oleic Acid 73%
Polyunsaturated Fats (Ω-6) 10%
Smoke Point 375 ℉ (190 ℃)
Main Benefits high in Oleic Acid and high in polyphenols!
Other Considerations if Mediterranean, PUFAs may add up

7. Macadamia Oil

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 12%
C16 – Palmitic Acid 8%
Monounsaturated Fats (MUFA) 75%
Oleic Acid 65%
Palmitoleic Acid (Ω-7) 19%
Polyunsaturated Fats (Ω-6) 3%
Smoke Point 390 ℉ (200 ℃)
Main Benefits high in Oleic & Palmitoleic Acid, high smoke point, low Ω-6
Other Considerations expensive

8. Salmon and Fish Oil

The Fatome: What is the Best Source of Fat on a Ketogenic Diet?

Saturated Fats (LCT) 25%
C16 – Palmitic Acid 15%
Monounsaturated Fats (MUFA) 28%
Oleic Acid 25%
Polyunsaturated Fats (Ω-6) 15%
Polyunsaturated Fats (Ω-3) 20%
EPA 9%
DHA 10%
Smoke Point Low
Main Benefits high in Ω-3!
Other Considerations low smoke point
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Comments (84)

When a new fat is tried, do you suggest a gradual increase of its intake rather trying a lot in the beginning itself? It has only been few weeks since I first ate macadamia nuts. Yesterday I ate around 50 of them throughout the day. The next day I didn't have bowel movement my HRV score went down from 8.5 to 7.3 suddenly. So it made me wonder if any new fat/fatty food item should be introduced slowly. Macadamia nuts are very low in oxalates/phytates but do you feel that its fine to consume 50 of them in a day?

It's not an exact science but I always think it a good idea to introduce new foods in moderation. Just because macadamia are lower than other nuts in anti-nutrients, it doesn't mean that there aren't compounds in their complex food matrix that could interact with your unique microbiome. Any food, and I do many any food, could be an irritant. The microbiome is enormously dynamic so it may need time to adjust and, I agree, 50 whole macadamia nuts is a large introduction. For reference, a serving of nuts is one ounce or 28.3 grams. 50 whole macadamia nuts is about 5 ounces or 142 grams. Soaking could also help, but I think that destroys the texture so I choose nut to soak unless I'm making butter. Why not try using them as a garnish to start. Crush ~10 and use them as a coating on a piece of salmon or for crumbling over salad etc. All that said, I wouldn't ever draw conclusions from one data point either. ;) -N

Should we worry about red meat being high in methionine? I hear that methionine is not great for microbiome in excess. How can we gauge how much of grass-fed, grass-finished red meat is excess? Any suggestions/recommendations on the limits of red meat consumption?

It's about the glycine to methionine ratio (G😜-r) and homocysteine (hc).
With respect to G😜-r, I like Dr. Paul Saladino's recommendation to have 10 grams of collagen protein for every 100 grams of muscle meat protein. Collagen is rich in glycine and helps increase the numerator in your G😜-r, balancing things out.
With respect to hc, methionine in covered into hc as part of the methylation cycle. It's critically to support your methylation cycle with a strong intake of particular micronutrients, including riboflavin, folate, vitamin B6 and vitamin B12. Luckily, eating nose-to-tail supplies us with adequate amounts of glycine (from connective tissues and organs, but you can also get from collagen proteins) and these critical B-vitamins, which are found at particularly high levels in organs like liver.
I would not suggest a particular limit on the intake of grass-fed red meat. But, if you're concerned about methionine, start by getting an hc blood test and see where you stand (if it's high, you can get an MTHFR genetic test to see if you might need extra of the above mentioned b-vitamins).

Goodness! With respect to my last reply, the G😜-r was not intended. That was supposed to be: G [colon] P-r. Why the P and not G [colon] M-r? Because I'm replying to this comment on Nov 27th at 4 am local time 12 hours after an indulgent Thanksgiving feast. Sleep deprivation and absence of ketosis (very rare for me) do not a happy Nick brain make. I hope you can see the humor in this, rather than the lack of professionalism. Just trying to keep up with waves comments/questions. I suppose 😜 does apply after all.

That's a funny one! Same thing happens when you type B [closing parenthesis] It happens to me all the time when I run polls on Instagram 😊

“have 10 grams of collagen protein for every 100 grams of muscle meat protein” : What about organ meats like liver, heart? Should this rule be followed for them too?

No, I wouldn't say so. Organs aren't made up only of collagen. Some might have blood vessels or attached connective tissue that contain collagen, but they aren't pure collagen. Historically, organs were prized because they were richer and nutrients and often eaten before muscle meat. In fact, in Inuit culture, I think the lean muscle meat is still given to the dogs and the organs and fats are reserved for the people. I'm not necessarily recommending this for you, but the 10:100 rule doesn't apply to organs.
Now, If you're carnivore or mostly animal based, I'd generally recommend the following (though I can't suggest what any individual should do): eat as close to nose-to-tail as possible. So, a spectrum of organs meats (liver, kidney, heart, spleen [not super taste IMO]) & whole organisms like muscles, oysters, whole sardines, etc. I choose to have a good amount of seafood, including fatty fish like salmon and mackerel. Meat is best grass-fed and finished or, at least, antibiotic free. If you're American and shop at Whole Foods, look for grade "4" at the butcher. If you shop online, White Oak Pastures is the place to go and buy your meat. Pork and poultry are fine, thought I don't make them a basis of the diet. Eggs are fantastic. Dairy (best A2) to tolerance and be wary with dairy if you're trying to lose weight.
Those are some general thoughts, but no easy rule of thumb for ratios among real animal foods.

Thanks Nick. I am not a carnivore but I eat 500g of red meat every week and also 100g of lamb liver. So I suppose 50g of collagen per week is enough? Also are there any downsides to consuming just ~50g of collagen per week without consuming any red meat?
For chicken, I consume only chicken breast to avoid PUFA. Does it not matter whether the chicken is anti-biotic, hormone free if only breast part of chicken is consumed?

Are black sesame seeds more nutritious than the common white ones?

I think the difference between black and white sesame seeds, in terms of flavor and appearance, outweigh the differences in nutrient composition. The fact that black sesame seeds are usually unhulled, whereas white sesame seeds are usually hulled (although you can easily buy unhulled white) is a reason for the purported benefits of black over white. Eating unhulled may provide a bit more fiber and calcium, but some people prefer the taste of hulled (especially when it comes to tahini). I think this is a situation where you have the luxury of making your decision based on how the seeds look as a garnish on the plate and your taste preferences. maybe Martina can provide some chef tips?

I love experimenting with black and white sesame seeds and tahini! I once made halva squares for one of my books using 3 different types of tahini. Light, brown and black. It looked really pretty. I don't think there is a big difference in the flavour though.

Macadamia nuts are only one of the two sources containing Omega-7 but do you strongly feel that it is pretty useful to eat few macadamia nuts everyday to improve the health? The reason I am asking this is because, as much as I love the taste and fat profile of macadamia nuts, I am reluctant on buying them because they are too pricey. And I am wondering what is the real need to consume them when many of our forefathers or even our parents didn't even know/consume these nuts(as they are grown in only few regions of the world) yet still stayed quite healthy. You might say that we don't live like our ancestors or even our grand-parents. But do you think that there would be a difference in health between two current individuals(who eat either clean, whole-food keto or non-keto) over-time who eat exactly the same except that one of them has 10-12 macadamia nuts everyday and the other has none?

I'll keep this one short and to the point. Macadamia are super pricey. You're spot on. They are a dietary tool, not a necessity, and your overall health will not suffer for not including them and their exogenous Palmitoleic Acid. Drop of rain in the ocean - if you live a healthy lifestyle and eat a healthy diet. Put it out of your mind and give your wallet a kiss and a hug.

Can olive oil help in lowering histamine? I read that it helps the body release the enzyme Diamine Oxidase

The Oleic Acid MUFA in olive oil actually triggers the release of histamine. As a compensatory reaction, most people's bodies upregulate DAO. Could olive oil consumption be thought of as a sort of hermetic stressor, or histamine tolerance training, with respect to histamine? Maybe. However, if you are truly genetically compromised in the DAO compartment, this feedback loop may work less efficiently. In effect, if you have histamine intolerance due to a genetic mutation in the DAO gene then olive oil may not increase DAO. This doesn't sound like your case, given the information in your next question. I would consume olive oil but wouldn't necessarily bank that it's going to increase your DAO levels to a point where you can eat a bucket of chocolate and blue cheese ;).

I have histamine-intolerance possibly developed when I had constipation. Would the soaking of nuts/seeds or making nut butters increase the histamine? Is it best for histamine-intolerant people like me to eat raw nuts/seeds? I make keto pestos and keep them in fridge for 2 weeks and consume it daily. Would the histamine be raised everyday while its in fridge? Also is it fine to consume ACV while I try to treat this issue by going on a low-histamine diet?

I think this question may be better suited for a histamine intolerance discussion group. Perhaps you can join one on Facebook or find someone with particular expertise in this area. Martina and I love answer questions, but as we get hundreds, we try to fight the tendency to answer questions that appear to us off topic for the blog/post in question, both for the benefit of the community reading posts and comments who may want the discussion to stay focused, and to discourage too many personal questions that are unrelated. We love them, but it becomes a bit unsustainable in terms of our personal time when blogs turn into personal advice forums. I hope you understand. Note, I don't get paid for this. I'm an PhD scientist and MD student. I do this to help and because I'm passionate about it, but also need to balance this "hobby" with my responsibilities. Sorry to get personal & whiney, but I thought a transparent explanation of my apparent question dodging was warranted for this one.

Nick, what fat sources and how much do you recommend for getting a good amount of Vitamin-E everyday for good skin health? I looked at http://www.whfoods.com/genpage.php?pfriendly=1&tname=nutrient&dbid=111 and I don't eat any of those leafy greens and I also rarely consume sunflower seeds, almonds as they are PUFA rich. So I am wondering how to get Vit-E from other fat sources. I do consume 10-20 hazelnuts everyday.

If you want to boost your vitamin E intake without consume seeds or leafy green veg, you can get some vitamin E from ghee and grass-fed beef tallow, but I think the solution is one you've already hinted at... hazelnuts. More specifically, maybe go buy some virgin hazelnut oil and add it to drinks (coffee/milk/milk substitute) Try this drink: 0.5 cup Milkademia's macadamia milk, 2 Tbsp Hazelnut oil, .5 tsp Ceylon cinnamon, 1/8tsp-1/4tsp sea salt, optional stevia/erythritol, optional coconut butter (melted), optional dash of almond extract or vanilla, then froth it like a mad-man. That drink wouldn't contain ~13mg vitamin E (RDA fro males is 15 mg). If you want the RDA all in one drink, just bump the hazelnut oil dose by half a Tbsp. I also know we have another (better) recipe, thanks to Martina, in our upcoming book.

I can confirm that that recipe is delicious, one of my favourite breakfast drinks!

Thanks Nick. Are there any benefits of raw hazelnuts over hazelnut oil? Asking because I am worried about phytates in them as I plan to eat 50g of them daily for the benefits. Or would most of the anti-nutrients in them be killed if I soak them for 12-24 hours? Also extra virgin hazelnut oil seems to be impossible to find, so consuming hazelnuts seems to be the only way.

What is your ranking for seeds? Would you recommend any seeds other than flax/chia? Sunflower seeds seem have high PUFA, would you recommend them?

I like flax and chia because of the high ALA omega-3 and low omega-6. Beyond that, what I would say is (1) greater variety will give a greater range of nutrients (2) seeds can be considered an acceptable garish for salads, keto breads, etc. Like eggs, seeds are naturally rich in micronutrients because they necessarily contain all that's needed to bring forth life. Also, naturally packaged omega-6 are far healthier in the context of whole foods as compared to lineoleic acid in processed vegetable oils. There's decent evidence that omega-6 from Whole Foods really aren't that inflammatory at all. But, given where the evidence stands now, I still wouldn't myself be comfortable snacking on walnuts or almonds or most seeds routinely. (3) Sesame seeds are great. Sesame/tahini/sesame oil contains a trio of lignin antioxidants that more than compensates for the relatively high omega-6 content (at least as compared to macadamia, avocado, and olive oils).

Nick, what is your opinion on consuming a keto fat bomb like https://www.ketobrick.com/collections/all-products-excluding-route/products/original-keto-brick to fulfil the calorie needs? These bricks are made from very high quality ingredients. Would you say its good enough to consume 1/2 this brick a day for getting 500 calories? I found this brick to be easy to add sufficient calories and good fat daily to meet my calorie needs.

I’m generally against processed foods of that sort. I think homemade fat bombs made with real foods should be fine, but I never recommend buying processed/packaged foods. Having looked at the ketobrick recipe, nothing stands out to me as particularly horrible, so if it works for you to meet your fat needs and fits well into your lifestyle, that’s fine. I am sympathetic to your plight of needing to get more fats in. Personally, I love making homemade mayo. Every other day I do this: 2 egg yolks + 1 tsp salt + 1 tsp ginger juice or lemon juice… blend… slowly drizzle in 18 - 24 tbsp  macadamia nut oil split with EVOO. Then I’ll include that in my diet and remake it – each time with different added spices  to keep things interesting – every other day. Takes 5-10 minutes. Also, Martina has a fat bomb book that’s great. Maybe worth checking out? Also, if you’re smart about varieties of particular foods you eat, you can really bump the fat quite easily. For example, Roquefort cheese is super creamy and fatty and dense, as compared to feta. I’ve recently been putting the former in my eggs as opposed to the latter. Of course, go for fatty meat cuts, & maybe buy a coffee frother and just add pure coconut oil or C8 MCT to your drinks with a bit of salt. There are lots of ways to get fat in, is my point, without the need for processed foods. But, again, you do you. The formula for ketobrick isn't that bad.

Thank you Nick! Just adding a link to the book in case you prefer making your own fat bombs: ketodietapp.com/books#book2

What is your view on taking pure grass-fed whey protein isolate/concentrate in keto? Would there be big insulin spike if whey is consumed along with other fat sources? Would you suggest isolate or concentrate or neither?

Whey is among the most insulinogenic of proteins. I, personally, can’t think of a single reason for including protein powders in the diet. Totally my opinion, but they are mostly a scam. Having said that, I think a pure whey isolate (no additives) won’t hurt you. In certain contexts, it could be beneficial. For example, having whey after a workout could help spike insulin to build up the anabolic signal for muscle growth. But that’s just theory. There isn’t good evidence that spiking insulin after a workout in the semi-mythical anabolic window actually makes a meaningful difference on muscular gains in the long-term. If muscle growth is your area of interest, I suggest checking out Brad Schoenfeld. Here’s a good review: http://www.lookgreatnaked.com/articles/mechanisms_of_muscle_hypertrophy.pdf

I have to agree with Nick. The only time I use whey protein isolate is in baked keto recipes because it works well as a replacement for gluten which is typically avoided on a keto diet. Nutritionally you don't need whey protein isolate but it's practical in some recipes. If you like making smoothies, I personally prefer collagen powder.

I heard from a well known nutritionist that supplementing 250mg of Glutathione is useful for overall health and skin. Could you tell me what you think about it and if 250mg daily is actually necessary and what fat sources could be eaten for getting 250mg of Glutathione daily?

Glutathione is an endogenous antioxidant. Your body makes all you need. Other antioxidants, like vitamin C, aren’t made by your body. If one eats a healthy low-inflammation low oxidative stress diet and lives a complementary lifestyle, glutathione supplements shouldn’t be required. If you want to boost your overall antioxidant profile, eating whole foods and low-carb is the best way to go. In fact, ketones (BHB) increase NADPH via (i) decreasing glycolysis and increasing pentose phosphate pathway flux and (ii) increase citrate export by the citrate-isocitrate and citrate pyruvate shuttles. Jargon aside, this is important because it’s NADPH that support ALL antioxidant systems, including glutathione. Glutathione is not used and excreted but regenerated (redox cycles) and that regeneration is supported by NADPH. You aren’t going to hurt yourself supplementing with glutathione, but I think it’s only going to be actively helpful if you eat poorly and don’t sleep or don’t exercise. Hopefully, Martina can help with the first of these and you choose to live a healthy lifestyle? If so, I wouldn’t waste your money. The main supplement I recommend, if you aren’t taking it, is vitamin D3 at 2000-5000IU, along with K2 MK7 at >90ug. Those are the hardest to get in the diet. Hope that helps/is reassuring.

I thought chromium too should be supplemented as I thought we couldn't get enough through diet. I thought lamb/beef liver is rich in it but couldn't find its mention in reliable sources like https://fdc.nal.usda.gov/fdc-app.html#/food-details/172615/nutrients. What foods do you suggest eating for getting sufficient chromium?

Chromium is found in trace amounts in many foods. Because of its wide distribution, including in meats, vegetables, and nuts, it isn't a common deficiency. The NIH health profession facts sheet even notes, "Chromium deficiency has not been reported in healthy populations, and no definitive deficiency symptoms have been established." Another reason making recommendations is difficult is that chromium levels in a given product vary based on the agricultural conditions, including soil chromium content. You'll note that levels for any given food vary widely depending on what source you check. Having said that, I'll throw you a bone and list some foods that are purportedly high in chromium: broccoli, liver, yeast, egg yolk, mussels.

Having low % of PUFA in daily foods is recommended but Omega-3s like EPA/DHA are also PUFA. Could you explain what kind of PUFA is inflammatory and what is not? I know PUFA from vegetable oils is bad but can we have 30-40% of total fats from PUFAs of wild SMASH fish?

Yes, PUFAs have multiple double bonds but are differentiated by where those double bonds appear in the carbon tail of fat molecules. Omega-3s have the last double bond 3 from the end of the tail, whereas omega-6 have them 6 from the end of the tail. The placement of the bond determines how the fat is processed and into what molecules it can be turned. In general, omega-3s have anti-inflammatory properties and omega-6 have inflammatory properties. When someone recommends keeping PUFA low, they are usually talking about omega-6 because omega-6 are just so much more prevalent. A salmon fillet, an amazing source of omega-3, might have 1.9 grams of EPA/DHA, but cook it in 2 tbsp grapeseed oil and that’s plus 19 grams of omega-6! As for your 30-40% question, unless you eat a low-fat diet, it would be really hard to get that much omega-3. I, for example, get 10 grams of Omega-3 as EPA/DHA per day and that’s a lot! (I have genetics that make this preferable.) I watch my Omega-6 and keep it below 15g per day so my ratio is good. That means my total PUFA as is only ~5-10% of my total fat intake on any given day. I suggest targeting 3+ grams of omega-3, if you can, and keeping you Omega-6 as low as possible. Having said that, there is literature suggesting omega-6 from whole foods (like nuts) isn’t nearly as bad as those from processed foods. This is an area of debate. – Stay tuned for upcoming blog + 6 minute lecture all about Omega-3. Martina and Nikos are setting it up now…

Thanks Nick. Regarding Omega-6 from nuts, it would be great if you could address your suggested limits and scenarios for consumption of hazelnuts, pecans, brazil nuts. I read your mdlingo nut ranking. Since hazelnuts is in Tier-3 and pecans/brazil nuts are high in Omega-6, I felt that its better to not consume them daily at all. So it would be great if you could give your recommendation on daily consumption of nuts beyond macadamia and also seeds like sunflower seeds, flax seeds, chia seeds if one has the 2-3g of DHA/EPA from fish daily and maintains an Omega-3 to 6 ratio of recommended 1:3.

Two suggestions. (1) I would suggest keeping consumption of nuts and seeds other than macadamia, hazelnuts, flax, and chia to <1 ounce per day. Most are fine as a garnish and I group hazelnuts with macadamia nuts because they are similarly higher MUFA than other nuts (though the PUFA content is higher in hazelnuts than macadamia). Hazelnuts are slightly higher in carbs than macadamia, but they can still be a good part of a Keto Diet, provided you're not doing a 3:1 or 4:1 Keto Diet. (2) Don't heat nuts above 140C for 20 minutes. If you have almonds / walnuts, never above 130C. This will damage the omega-6 fats. With respect to pecans and Brazil nuts specifically, I'd apply the 1 ounce guidelines to both and use them as acceptable garnishes. Brazil nuts are also used by many people as a selenium supplement. Seeds other than flax and chia are also fine garnishes, with sesame seeds being great because their omega-6 is largely offset by their lignin antioxidants.

For hazelnuts, would you suggest to buy the blanched ones to avoid the phytates? Also regarding flax, should one need to really worry about estrogenic properties if just its consumed within 1/4 cup flax meal?

Blanched hazelnuts will be lower in phytatic acid, yes. In general, the physic acid is most concentrated in the skin. The same goes for almonds.
Flax is particularly rich in lignin phytoestrogens (pubmed.ncbi.nlm.nih.gov/8789715/). Now, I doubt it would cause a normal healthy person any serious side effects - like gynecomastia - but if you're especially concerned about phytoestrogens, then don't consume too much flax.
Keep in mind also that every food has some  potential 'problem' that one can wag a finger at. Always ask if the reason one is trying to reduce or eliminate a food is because of internet fear mongering or because one has particular reason to avoid it based on their individual case. Just my two cents.

What can be done to alleviate the harmful affects of heavy metals in fish? I have recently started consuming 200g of wild sea mackerel daily but today I stumbled upon https://www.researchgate.net/publication/320620615_HEAVY_METAL_CONCENTRATIONS_IN_SELECTED_EDIBLE_FISHES_FROM_FISHING_HARBOUR_OF_VISAKHAPATNAM_ANDHRA_PRADESHINDIA to realize that the sea from where I get my mackerel supposedly has heavy metals 😔. Do you also feel that the heavy metal content of mackerel is high as written in that paper?
Can we do some tests to understand if the body has those metals? I am thinking of consuming 200g of this mackerel daily for 6 months and test my body to find out if the fish really has the harmful metals and if they are indeed affecting me.

You’re right in that heavy metals can be an issue – in particular mercury.  With regards to Mackerel, it’s king mackerel that’s the big worry because, similar to shark, tuna, or swordfish, it’s high on the food chain. Toxins/heavy metals accumulate more in fish higher on the food chain. Therefore, I recommend eating lower on the food chain. Some great options are sardines, wild sockeye salmon, and the best of the best is fish roe/eggs. They contain an especially brain bioavailable DHA form called lyso-DHA. You can also get your mercury tested to see if it’s actually high. Personally, I eat seafood everyday and my mercury is only a little bit out of range. It’s one of few parameters on my metabolic panel that isn’t ideal and I accept that to get more omega-3. Having said that, my mercury didn’t go down much when I ate less seafood and more meat after three months, so it could just be me. Lastly, I know people who swear by consuming Chlorella algae with their seafood. It chaelates metals so they don’t get absorbed by your system. Check out Sun Chlorella. – Stay tuned for upcoming blog + 6 minute lecture all about Omega-3. Martina and Nikos are setting it up now…

Thanks Nick. So do you recommend consuming tablets like Sun Chlorella's if mercury levels are high? I am planning to buy similar one: www.amazon.in/.../B07YRNPC5X

It's worth a try for sure. Consume when you eat fish.

Nick, what are your views on flax seeds? I like to consume flax seed wraps(total of 1/4 cup flax seed flour) in daily for my dinner daily along with veggies/meat. What are the pros and cons of consuming 1/4 cup flax seed flour daily you think?

Flax is ALA, which is the less active form of omega 3. The body only converts a little into EPA/DHA, which are the forms you want. Also, make sure not to heat flax too much because the oil is very fragile (has to do with farnesoid metabolism… won’t go down that rabbit hole.) having said that, ¼ cup flax isn’t going to hurt you. Also, there is a study in rats showing that combining ALA + turmeric/curcumin can increase ALA to DHA conversion enough to increase DHA levels in rat brains, correlating with reductions in anxiety. So maybe add some turmeric? – Stay tuned for upcoming blog + 6 minute lecture all about Omega-3. Martina and Nikos are setting it up now…

Sure, I will add turmeric. What about reducing the anti-nutrients in flax or chia? Would you recommend soaking them like an overnight chia pudding to make them more bio-available? Is soaking chia or flax useful at all because we can't drain the soaked fluid off anyway because they form a jell?

Soaking will draw out compounds you're trying to eliminate into the water or "aqueous chia solution." Pre-boiling and/or fermenting/sprouting can help.

Thanks Nick. Could you/Martina please tell how chia or flax can be sprouted or fermented? Wouldn't boiling again form a jell with chia/flax? 🤔

I'm not sure I can answer this. I suppose it will be a bit tricky. You may want to google this - I bet some vegan blogs will have more info on sprouting flax/chia (and whether it's even possible).

Grass-fed lamb/beef tallow has good Steric to Palm+Myr ratios but even a home-made tallow has to be cooked for 4-5 hours(with simmering temperature on pot for example). But a extra virgin coconut/avocado/olive oil is mechanically pressed with a much lower temperature I suppose.
1) Could you help me understand if such a low-temperature homemade grass-fed tallow is still better nutritionally than the likes of EVOO/EVCO/EVAO even though its supposedly heated for much longer time than others in preparation of the fat?
2) After a tallow is made, it would be used for cooking again whether its mild or not. Does oxidation happen because this meat fat is being heated again? How does the oxidation of such a tallow vary compared to EVCO/EVAO which also have high spoke points?
3) I know that even during early 1900s, our ancestors used tallow for cooking and they must have also rendered it from beef/lamb fat for 4-5 hours I suppose. Do you have any views to share about their practices and usage of tallow?

Tim, may I call you Tallow Tim ;), thanks for your nuanced questions. 1) I hope I didn’t state that tallow is nutritionally superior to EVOO/EVCO/EVAO. I don’t believe this to be the case. In general, heating fat oxidizes it. I’m not aware of literature specifically on how much fat is oxidized during the simmer/rending process, but keep in mind that water boils at 100C, so the temperature is necessarily pretty low, even if the exposure is long. I wouldn’t fuss over it. 2) yes, heating tallow does cause fat oxidation. Heating is just going to do that. So, one can accept that and enjoy warm/cooked food, or if you choose to go completely raw carnivore, I wish you luck. Of course, I’m joking. Just cook at lowish temperatures and the effect on fat oxidation will be meaningless with respect to what matters – clinical outcomes. I’ve tested this on myself with periods of raw yolks versus fried yolks (6 per day) in 1/4c EVCO and the effect is nil on my blood levels of oxidized cholesterol and lipoproteins. 3) No particular comments on ancestral practices of tallow making. If you have done research and have wisdom to share, feel free to do so. But I would comment that “1900s” doesn’t qualify as ancestral from an evolutionary perspective. This is just a facet of culture and I don’t read too much into it nutritionally. But, yes, it’s better than margarine ;).

What about sesame oil or tahini? Even though Omega-6 in it isn't a matter of concern, should one be vary of consuming a lot of it? Or is it good consuming ~6 tbsp of tahini to get the anti-oxident benefits of it?

I suspect you are correct. Tahini, sesame, and sesame oil in moderation. I haven't done the experiment with tahini, but let me tell you something of note with respect to olive oil. There was a time when I was consuming 12 Tbsp - 1 cup of extremely high quality EVOO per day. When I swapped out half for virgin coconut oil, my oxLDL dropped. Why? Well there are a few explanations (and I have to give a nod to Dave Feldman's demonstration that oxLDL runs with LDLp & my LDLp dropped) but one possibility is this: EVOO is ~10% omega-6. That's not high, but when you have a lot it mounts up. 15 Tbsp EVOO would therefore be 17 grams omega-6. Yes, I did get a load of antioxidants with it, but I would suspect that above a certain dose the antioxidants are redundant or the system gets saturated. As Tahini/sesame is a higher proportion omega-6 than EVOO, I'd suspect the threshold point at which the antioxidants hit saturation / the omega-6 accumulation overcomes the antioxidant factor is even lower. Pulling numbers entirely out of thin air (because people seem to like concrete recommendations), I'd suggest staying below 1/4 cup tahini. Hope that's helpful.

I know buffalo milk is fattier than cow milk and hence richer in nutrients than cow milk. Is the same true for buffalo ghee vs cow ghee?

No because ghee is just fat. It doesn't matter how much the initial milk was in % fat if you're removing everything but the fat.

For grass-fed ghee, A2 or A1 doesn't matter, does it?

No because there should be no casein at all.

Organ meats are good but are there any specific benefits in consuming goat testicles instead of goat liver? I mean, if I already consume 100-200g of goat liver per week, could there be additional benefits in consuming goat testicles?

Practically speaking, I wouldn't go out of your way to purchase testicles. I think they cook up well and there is certainly no harm to adding them to your diet. But, in terms of organs, you get a lot of what you need from liver. I wouldn't eat more than 1/2 kilo per week just in case of hypervitaminosis A. Therefore, if you want to incorporate more organs, certainly go for the testes & also for heart (amazing source of COQ10) and kidney (rich in many nutrients like liver but lower in vitamin A). In truth, if you're willing to eat organs, the more diversity the better. But you get the biggest bang for you buck with liver and I wouldn't sub in testes for part of your 100-200g liver per week.

What is your opinion on egg diet? Basically only eating pasture-raised, free-range eggs(along with herbs/spices). I get good eggs which have orangish yolk because of chickens being given herbs, turmeric etc as well. Since eggs are also low in PUFA, wanted to know your opinion on eggs only diet.
I plan on eating three eggs for breakfast and three during dinner though. Would you suggest any limit on the number of eggs per day?

Eating only one food seems suboptimal. Eggs are a rich source of many nutrients (and obviously contain everything required to support a developing life), but that doesn't mean they are themselves complete nutrition. I don't think there is a reason to limit eggs and think a short bought of the egg diet for weight loss  is probably fine, but I don't suggest it for a long-term diet. Will you live? Probably. Will you thrive and be your best? Unlikely. Also, if you're eating just eggs, you're going to be calorie and protein deficient at just 6 (that's ~40 grams protein). I'm curious as to your motivation for doing an egg-only diet and excluding foods like liver, red meat, and seafood?

Thanks Nick. I have been trying to raise my protein to atleast 1-1.5 kg of my body weight and I am consuming some meat for lunch and 3 eggs for breakfast; and I don't always get fatty fish like SMASH here. So when I thought I could may be have 3 eggs for dinner as well as eggs are cheaper than meat for me, it just made me wonder if egg only diet is nutritious enough. I wouldn't do it anyway as it sucks 😅 and I also realized that even having 6 eggs per day is making me constipated, so I decided to go back to only 3 eggs per day.

To be clear, 1-1.5g/kg? E.g. if you're 80 kg = 80 g - 120 g protein? If so, a couple thoughts. If you're highly active or older than 50 you may want a bit more. Try to have fatty fish at least twice per week. Not only are they good protein sources but the omega-3 actually help with muscle maintaince and building. Fish & organs & grass-fed grass-finished meats, including lamb, and pastured organic eggs are all great. Can't go wrong. Personally, and this isn'ta a nutritional thing, I like to fry a couple eggs and leave the yolks running then cook a protein on the side (e.g. salmon or burger) and then drench both on high quality EVOO and then dip the protein in the yolk. Salt too, of course. Also, 3 egg omlette + different protein + spices every night, made in virgin coconut oil with EVOO or homemade mayo is delish! But to your original question... yep, eggs are very nutritious. They necessarily contain all that's needed to support life.

Yeah, I meant 1.5g 😅. Thanks for these tips.

Nick, if one doesn't have the fatty fish like SMASH, would you still suggest having fish like https://en.wikipedia.org/wiki/Catla everyday for Omega-3 and other nutrients however less they might be compared to SMASH? The thing is, I don't always find SMASH fish but can easily get Catla fish, so wanted to know your opinion on this. Catla is grown in river water BTW but they are not typically farm-raised.

I’m going to say no to Catla everyday because it’s a lean fish that’s relatively high on the food chain. When eating seafood daily, you’re going to want to think about the pro of omega-3 against the con on mercury. You want omega-3 but you don’t want your mercury levels to get too high. Calta is a lean fish that’s therefore low on omega-3 while being largish and moderate for mercury (not as bad as swordfish, tuna, or shark, but still). Therefore it’s “omega-3/ mercury ratio” - if you want to think about it that way - is low. Look for The fattiest fish that’s low in the food chain. If you can’t find any, consider a krill oil supplement.

Thanks Nick. What about https://en.wikipedia.org/wiki/Anguilla_bengalensis_bengalensis ? I couldn't find info about Omega-3 of this fish, so couldn't understand if this is one fish that can be consumed everyday.

might be hard to find data on that particular "fish," but assuming it's fresh water I'm guess it's low mercury and eel is nice and fatty. Most eel species I'm aware of have only 0.05 ppm mercury (very low). I'm not an expert of the Indian mottled eel, but if it's available to you I have no overt qualms with it. Sounds delish! & "The mucus of this eel is used in a medicine for arthritis."

Yes, Indian mottled eel is very delicious 😋. It is oily and a small fish. You should try "Bommidala pulusu" if you ever happen to visit Andhra Pradesh, India 🙂.

Thanks for the suggestion.

Hi Nicholas! Thank you for this really informative post. Read with great interest especially the bit about cow milk etc. and how to manage constipation when everything seems to “slow down”. Also wonder why some women find it hard to shift weight despite being keto and “normal” thyroid I wonder if more research can be done there?

(apologies in advance... no time to edit prose of response but wanted to get you a reply)
Dear Kate,
This is a really interesting question. I wish I had more information on the topic, but I will share a couple of interesting tid-bits. First, on LCHF, thyroid panels tend not to be informative with regards to metabolic rate. The Virta health group has done some work on this (see their website). Basically, when you lose weight thyroid always goes down. But, while decreased thyroid usually correlates with decreased metabolic rate, this doesn't hold true on LCHF. Metabolic rate appears to remain consistent.
My own tests attest to this (of course, take any n = 1 with a grain of pink salt). My free T3 is rock-bottom low and I can't gain weight for the life of me. I weigh 115 pounds, exercise <10 hours per week (no cardio, only weights), do some yoga, a never eat less than 3000 Calories. When I can stomach it, my intake can get as high as 8000 Calories and I don't gain an ounce. (I know it's not a common problem so apologies if this sounds like I'm bragging. Trust me, I'm not). Anyway, I wasn't always like this. When I weighed 130 I was running marathons (should have had much higher caloric needs) and actually ate less, on average. So that's just a little testament to the fact that Calories are a finicky variable on LCHF. I'm going somewhere with this...
I've thought a lot about what changes on LCHF and about women's health/biological differences (I've even done a little bit of unpublished work on the topic). The first thing I'll comment on, before circling back to something that relates to my own experience, is sex hormones. Estrogen modulates metabolic rate, influences fat cell growth, and interacts with the stress axis. Manipulating estrogen in a strategic manner can be difficult. It also depends on a woman's menopausal status. If/when estrogen is at the root of the issue, it's simply important to avoid estrogen disruptors in the environment as a start (e.g. don't touch receipt paper). Lab tests are not that informative, but if you do get a lab test, you need to get the different forms of estrogen, free and bound (to sex-hormone binding globulin) and then have someone who is expert in both LCHF and endocrinology to interpret it in the context of diet. I have attempted this with a couple of people before, with moderate results. Granted, I'm not an expert in female health. But let's set estrogen aside now. I actually think it's a smaller player...
For most women, I think the weight plateau may have more to do with the microbiome! Work by Eran Segal (amazing researcher) shows that the microbiome adapts to caloric restriction. This is why Yo-yo diets actually tend to cause weight gain. When someone loses weight and regains it and loses it again, their microbiome retains its obesogenic profile. The more yo-yo cycles one endures, the more pro-fat gain the microbiome becomes. If you're not aware, the microbiome dictates our metabolism at least as much as anything else. But the opposite also appear to be true. Returning to my own experience, the longer I remain on keto, the more my microbiome changes, and the more my basal metabolic rate appears to increased. Once I hit a weight-stable point, I needed to eat about 2,400 Calories to maintain weight. Now, I need to eat >> 3,000 Calories (one year later). I suspect a plateau will come when my microbiome stabilizes. I do think someone needs to do a proper study on this.
ANYWAY... getting to my real speculation regarding women who hit a plateau... my best guess is that the culprit may be sociocultural. Women tend to be more calorie and portion aware than men. When women go LCHF, many allow their bodies to over restrict to the point of potential metabolic harm (thyroid maybe, but I think more about microbiome-adaptation vis-a-vis Segal's) work. What may end up happening is the reverse of my "male" scenario. I ate all I could and my metabolic rate climbed over time. Flip this on its head, and one would guess that a energy-deprived woman's gut bacteria balance may shift to prevent further weight loss on LCHF.
So, what to do. Well, I giant calorie bump probably won't work. So, step 1 I think would be to play with meal timing. Eat earlier in the day and perhaps in a <8 hour eating window each day. But, make sure not to further restrict intake. Step 2 could be to add in muscle-building exercise. The more muscle you have, the more energy your burn at rest, by far. This could resulting weight gain, at first, but along with improvements in body composition. I recommend waist circumference as a better metric than weight. There are other bio hacks one could try with particular polyphenols to help recover microbiome health, but I don't think that's likely to make a large impact. Also, make sure to get enough sleep. If all that doesn't work, one could experiment with a month of carnivore. I used to be very skeptical about carnivore, but the more I research it the more I think it's a viable option for many. (Best if you eat nose-to-tail). I've never actually walked anyone through it, although am experimenting with it myself, counter to my intuitions, and have been surprised by what I'm discovering through n =1 and reading the literature and corresponding with MDs (Dr. Robert Cywes is someone I recommend that you look up on YouTube).
Sorry, I know that was a lot an incoherent.

Thanks Nicholas! A reply is a reply, however incoherent you perceive it to be! I believe you're right regarding oestrogen as a post menopausal woman myself, the waistline increased from about the time I was starting to go into the menopause (so decreasing all female hormones).  I then read articles on "oestrogen dominance" which confused me; I enjoy the keto lifestyle but perhaps it might be easier to put on weight if I'm eating "too much fat" or - perhaps dairy which as many perceive being a potential issue for many of us.
Your suggestions are ones I have heard - so might try the carnivore version for a few days and then switch back.  Having been keto for over 3 years and initially hacked it pretty well, it's easy to switch back to "normal" eating on occasion which can be problematic too!  Thanks again 😊

NEW essential Fatty acid
So, just as a testament to how fast this field is developing, the evening before (May 18, 2020) Martina and I posted the above, a paper was published in Nature (one of the world's top scientific journals) arguing for a new essential fatty acid called "pentadecanoic acid."
There are a few cool things about pentadecanoic acid. First, it's actually a saturated fat.
Second, it's 15-carbons long, which makes it an "odd-chain" fatty acid. I won't delve into the biochemistry, but this means it's broken down slightly differently than even-chain fatty acids, which are more common.
Third, in some ways, it acts like an Omega-3 fat, even thought it's a saturated fat. For example, it activates PPAR proteins like an Omega-3 (specifically PPAR alpha and delta).
Pentadecanoic acid also repairs mitochondria and protects against inflammation.
The authors of this cool study hypothesize the the inverse relationship between whole milk and fatty dairy consumption (decreasing) and chronic disease rates (increases) relates to blood pentadecanoic acid levels.
if you want to go beyond this slap-dash reply to my blog post written on a iPhone, check out the paper: https://www.nature.com/articles/s41598-020-64960-y
AMAZING research coming out all the time!
Oh, and most important, Pentadecanoic acid is rich in butter and crustaceans. So great excuse for buttered lobster!
cool about found in #butter and some #fish (shrimp) activates PPAR, protect mito, decrease inflamm, protect ag chronic disease
Supplement pending
dose2mice in study=17 Tbsp butter for 70 kg human, ha!
https://nature.com/articles/s4159

I love salmon. Never hear of astaxanthin. How do I know if the fish I buy has been colored. I eat a lot of pacific king salmon. It's not always so pink. I noticed sockeye is usually pinker, almost red sometimes. Is sockeye better?

Wow. Observant! Three letter answer: Yes.
Wild Alaskan sockeye is the best salmon you can buy!
Sockeye is richest in astaxanthin and Alaska has actually banded farmed fishing so you know all the fish is truly wild.
Not pubmed, but I buy from this company, VitalChoice. Their website says, "A six-ounce portion of farmed Atlantic salmon averages 0.75 to 1.65 mg of astaxanthin, while wild sockeye salmon offers 6.75 mg of astaxanthin per six-ounce serving, or four to nine times as much."
https://www.vitalchoice.com/article/salmon-pigment-shows-weight-control-potential
And check out a cool graph here: https://www.researchgate.net/figure/Mean-astaxanthin-levels-in-the-muscle-of-prespawning-wild-Pacific-salmon-species-genus_fig3_233489744

My mother died of Alzheimer's, I love fish and have never heard of lyso-DHA. Can you elaborate on its benefits? That's really interesting. Where can I get it other than krill oil? Thank you in advance!

Dear Jennifer, thanks for the important question. I have to give credit to Dr. Rhonda Patrick of FoundMyFitness for what I know about lyso-DHA. Basically, free normal DHA gets into the brain by simple diffusion (think of a drop of ink in water). In a person with inflammation, the barrier between the body's blood and the brain can be damaged so this diffusion is impaired. Also, in people at genetic risk for Alzheimer's, there is evidence that DHA get burned for fuel more quickly so that there is less left over for the brain. By contrast, lyso-DHA has it's own transporter called MSFD2A that shuttles lyso-DHA into the brain directly. The fact that there is lyso-DHA in real fish, but not in most supplements, has been hypothesized to account for the fact that DHA supplements aren't as useful for the prevention of AD as fish (take that with a. grain of salt as it is an extrapolation  based on epidemiological data). In terms of sources, the best natural source is salmon caviar and other fish roe/eggs. Krill oil also contains high levels. So eat your roe/caviar or supplement with krill oil 😊. Hope that wasn't too jargony a reply. -N

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