About Kelly Brogan

KELLY BROGAN, MD, is a holistic psychiatrist, author of the New York Times Bestselling book, A Mind of Your Own, Own Your Self, the children’s book, A Time For Rain, and co-editor of the landmark textbook Integrative Therapies for Depression.

Does Low Carb = Low Energy?

I have yet to meet a woman on a long-term, low carb diet who is loving life. I’m here to explain why I think this may be the case.

While we have, collectively, reacted to the low-fat brainwashing of the past half-century, with a defiant, “Fat rules!” attitude, this zeal may be taking us too far astray. I am passionate about the ancestral diet and everything implied by “going back to our roots”, but I also raise a brow at more rigid interpretations, assumptions, and academic flourishes about true replication of a Paleolithic diet. We’ve relinquished Darwin and redeemed Lamarck, so the truth is that we can evolve (or devolve) within one generation. Adaptations to stress and environmental exposures can change our biology and impact our grandchildren.

Thanks to the work of Weston Price, we may not have to go back as far as the Paleolithic to send the body a signal of safety. As recently as the early 1900s, he found traditional cultures flourishing, many with incorporation of agricultural foods like grains and legumes. That said, we also know that the microbiome plays a powerful role in adaptation to these foods, and that some of our guts may not be up for the challenge.

Back in my self-experimentation days, I spent two months on a carb-restricted diet, kicking starchy veggies, fruit, and grains to the curb. I felt great for two weeks, and not a day after. I felt cloudy, tired, and started obsessing about moisturizer and conditioner. Perhaps this is most relevant for those with a history of compromised thyroid function, as the Jaminets have discussed, but I believe it’s relevant to many women.

Many Body Types = Many Right Diets

I look to the Hadza whose women foster gender-distinct microbial profiles, ostensibly related to their consumption of honey and tubers.

I look to the work of my mentor, Dr. Nicholas Gonzalez, who used 10 dietary types, each with dozens of variations, none of which were ketogenic (restrictive of carbs below 100g daily to produce ketones as a source of energy). In case after case of long-term survival with metastatic cancers, none of his patients hopped on this integrative oncology bandwagon.

I look to papers like one by Dr. Karen Hardy, published in Quarterly Review of Biology (seems like we should be re-viewing biology quarterly, in my opinion!),  entitled “The Importance of Dietary Carbohydrate in Human Evolution.”

Pass the Potato

In an effort to better understand our perceived leap into the conscious realm, researchers have posed many theories about the pivotal role of fire and of increased meat consumption. Dr. Hardy posits that, based on archaeologic, anthropologic, genetic, and physiologic data, it was actually the coevolution of cultural use of fire, cooked starch, and salivary/pancreatic amylase that afforded the brain the capacity for a quantum leap in evolution. Summarized here, Hardy et al bring the following claims to the table:

(1) The human brain uses up to 25% of the body’s energy budget and up to 60% of blood glucose. While synthesis of glucose from other sources is possible, it is not the most efficient way, and these high glucose demands are unlikely to have been met on a low carbohydrate diet;

(2) Human pregnancy and lactation place additional demands on the body’s glucose budget and low maternal blood glucose levels compromise the health of both the mother and her offspring;

(3) Starches would have been readily available to ancestral human populations in the form of tubers, as well as in seeds and some fruits and nuts;

(4) While raw starches are often only poorly digested in humans, when cooked they lose their crystalline structure and become far more easily digested;

(5) Salivary amylase genes are usually present in many copies (average ~6) in humans, but in only 2 copies in other primates. This increases the amount of salivary amylase produced and so increases the ability to digest starch. The exact date when salivary amylase genes multiplied remains uncertain, but genetic evidence suggests it was at some point in the last 1 million years.

Kelly Brogan Diet

For the past eight years, I have used a moderate carb ancestral diet in the treatment of depression with astounding results. This diet focuses on tubers as a source of carbohydrate, and, after one month of slate-clearing (microbial shifting), re-incorporates gluten-free grains, white potatoes, and even beans (soaked). In addition to providing a form of usable energy, these “cellular starches” (as opposed to flour-based starches which are acellular) may play an important gut-rehabilitating role as microbiota accessible carbohydrates or prebiotics.

Sugar and flour-based foods can be particularly problematic for those prone to anxiety and depression because of the simultaneous effects on the hormonal, inflammatory, and gut ecology level. Here is how and why we must distinguish between health-promoting and health-effacing carbs.

According to Spreadbury:

Due to being made up of cells, virtually all “ancestral foods” have markedly lower carbohydrate densities than flour- and sugar-containing foods, a property quite independent of glycemic index. Thus the “forgotten organ” of the gastrointestinal microbiota is a prime candidate to be influenced by evolutionarily unprecedented postprandial luminal carbohydrate concentrations. The present hypothesis suggests that in parallel with the bacterial effects of sugars on dental and periodontal health, acellular flours, sugars, and processed foods produce an inflammatory microbiota via the upper gastrointestinal tract, with fat able to effect a “double hit” by increasing systemic absorption of lipopolysaccharide.

More than a prescription, this collective body of research raises awareness around the power of inherited epigenetic adaptation as a concert of our environment, physiology, and cultural practice. There cannot be one diet for everyone, beyond the clear benefits of a transition to a whole food diet. Excluding traditional foods such as fruit, root vegetables, and even grains, and beans can serve an important purpose as an acute therapeutic intervention but is unlikely to result in long-term gut-brain optimization and balance.

Featured Image Source: Maciej Szlachta

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