What can we learn from breast milk? Part 1: Macronutrients

Warning: post contains maths!

Breast milk is 1% protein, 6.9% carbohydrate and 4.4% fat by weight, or 5.6% protein, 38.8% carbohydrate and 55.6% fat by calories. It is low in protein and high in both fat and carbohydrates... Or is it?

Protein

Due to babies huge energy requirements*, they actually get ~0.89 grams of protein per pound body weight**, but this is more than an adult needs as the infant is growing rapidly so this amount can be seen as the maximum we would need (especially considering formulas made with higher protein levels are toxic to infants). This translates as 150lb adult needing a maximum of ~134 grams of protein a day, and at 2000 calories a day, this is 27% of calories.

* An infant weighing 5kg/11lbs needs 700 calories; this is ~64 calories per pound. A 150lb adult may need 2000 calories, or ~13 calories per pound. The infant’s energy requirements are almost five times that of an adult’s on a per weight basis.

**700 calories @ 5.6% protein = 39.2 calories from protein = 9.8g protein / 11lbs = 0.89 protein/lbs.

How little protein do we need though if that's the maximum? Well many keto dieters eat as little as 60g of protein a day fine (~12% @ 2000 calories), but this is usually done in fear of slightly higher fasting blood glucose levels on a ketogenic/low-carb diet even though such a thing is perfectly natural and safe. They're eating the absolute minimum they can get away with, which I think is a poor strategy. The body has an efficient system for getting rid of excess protein, via urea and uric acid. As previously discussed uric acid is a potent antioxidant and why I think we don't get scurvy on all meat diets, so protein in excess of our pure tissue requirement can be seen as a good thing!

Phinney/Volek in The Art And Science of Low Carb Living/Performance generally recommend 1.5g/kg protein (~0.68g/lb), this is ~102g at150lbs (~20% @ 2000 calories). Other recommendations include 0.7+g/lb of lean mass (84g/150lbs@20%bf, 17% @ 2000 calories), this seems much more reasonable minimum. Basing your protein needs off lean mass rather than whole mass is much smarter, as fat tissue doesn't increase protein requirements but muscle mass does. 102g of protein is almost exactly half way between 84g and 134g, so is a good middle ground target of protein intake.

Carbohydrates

The brain is the biggest user of carbohydrates in the body; in infants, it uses 50% of the body’s total energy requirements, but by adulthood only uses up 20%. This means the adult brain uses 40% of the energy required by an infant brain: this works out to ~15% of calories from carbohydrates (38.8% x 40% = 15.5%).

BUT... the carbohydrate source is lactose, made of glucose and galactose. Now galactose is very special, it's not used as an energy fuel like glucose, it's used for myelin synthesis (that is making nerve insulation), this is why human breast milk is so high in lactose, for the galactose! So that ~15% becomes ~7% of calories coming from carbs for an adult (~38g @ 2000 calories).

BUT... we can make glucose from protein (via gluconeogenesis) and glycerol from fats. Gluconeogenesis is constant regardless of diet, as we've discussed before, but as far as I'm aware there is no cap on glycerol->glucose synthesis. Estimates are at about 10% of whole fat can be converted to glucose from the glycerol.

The actual dietary requirement for carbohydrates is zero, and even infants do very well on ketogenic diets; we can synthesis all the glucose we need (which is less while in ketosis) from GNG and glycerol. The main reason for muscle wastage in starvation is it's being used for GNG (which is constant even in starvation), this supplies the glucose requirement easily and blood glucose levels remain steady right up until you die.

Fat

The rest of the body’s calories come from fat, which in an adult eating ~27% protein and ~7% carbohydrates is ~66%, or ~147 grams of fat on a 2000-calorie diet. This would be the minimum fat, as this is the maximum protein and carbohydrates we need. Taking in our minimum 84g protein and no carbs would mean we need to eat 83% of our calories as fat or ~184 grams of fat on a 2000-calorie diet.

Summary

So understanding the macronutrient ratios of breast milk in context of the body it is designed for gives up a good idea of what ratios are healthy for an adult human. This works out to ~17-27% protein, ~0-7% carbohydrates, ~66-83% fat, or 84-137g protein, 0-38g carbs, and 147-184g fat on a 2000-calorie diet. Such a diet would almost always be ketogenic (very metabolically damaged people may not handle even 38g carbs).

As calorie expenditure increases, say due to increased exercise, the extra calorie should come from fat, little extra protein or carbs are needed. During very heavy exercise some non-insulin-stimulating carb source may be used to aid recovery such as super starch, palatinose, or possibly pure fructose in order to refill glycogen stores (as discussed previously our ability to refill glycogen is limited by GNG and is less than that of other carnivores).

Phytic Acid Nutrients

Absorption:

Mineral	Absorption factor by removing / lowering phytic acid	Average	RDA
Calcium	x1.3, x1.2	1.25	1,000 --> 800mg (WAPF: 680 --> 544mg)
Magnesium	x2.5	2.5	420 --> 168mg
Zinc	high/no: x6.2, x4.8; high/low: x3.2, x1.6/1.5, x1.5, x1.4, 2.1	3.54	11 --> 3.1mg
Iron	x1.5, x2.1/1.7	1.77	18 --> 10.2mg
Manganese	x2.3	2.3	2.3 --> 1.0mg
Copper	x2.1/2.4V, x1.1^	1.15	0.9 --> 0.78mg
Phosphorus	x1.46, x1.5 (estimates)	1.48	700 --> 473mg (WAPF: 1300 --> 878mg)

Calcium:

Actual requirements studied here: http://mostlymeatiswhatieat.blogspot.co.uk/2013/05/calcium.html


Magnesium:

Although the need predicted by phytic acid removal is only ~168mg of magnesium, most people are deficient because our soils are depleted due to industrial farming and artificial fertilisers, and our water is no longer a good source as it's removal at source because it damages pipes. For this reason I will not be lowering the RDA of magnesium and recommend supplementation to ensure sufficient intake.


Manganese:

Although only ~1mg of manganese is needed due to lack of phytic acid, a meat and liver based diet only provides ~0.5mg, as manganese is needed for carbohydrate metabolism it's likely this is sufficient. Shellfish, such as mussels, are rich in manganese though so for those concerned are a great addition, as are bass, trout, and pike. Spices too such as cloves, ginger, cinnamon, spearmint, and turmeric are also fairly rich in manganese. Tea is very rich in manganese but may be poorly absorbed due to the tannins it contains.


Copper & Zinc:

The USDA RDA for copper and zinc are 0.9mg and 11mg respectively. My original menu provided 1.9mg and 22.9mg respectively. Both give a zinc/copper ratio ~12 so it's likely that this ratio is the ideal.

Although copper need based on absorption factors above predicts that less copper is needed than zinc, more important is the ratio, with ideal being ~12, at 0.78mg copper this means you need ~9.4mg zinc, easily achievable on a carnivore diet with plenty of meat.

Meat needs to be balanced with liver, especially lamb/beef liver which are very rich in copper to keep this ratio optimum. Pork liver in less rich in copper, instead being richer in iron.

Copper & Iron:

Copper and iron deficiencies can cause hypothyroidism, most plants have plenty of copper and grains are fortified with iron. Some cases of lower thyroid function in low/zero-carb may be due to lowered intakes of copper and iron due to relying only on muscle meat, these minerals are needed to convert the inactive T4 to the active T3 and may be a reason why we see lowered T3 in low/zero-carb diets (though lowered T3 in of itself is not hypothyroidism). Muscle meats have lots of zinc, very little copper, and are ok for iron; organs though, like liver, are very rich in copper and iron. Adding liver to a low/zero-carb diet will likely help thyroid function if it's caused by these deficiencies (link and link). Too high copper will also decrease iron absorption though, so all these minerals need to be balanced properly.


Copper:

Dose range	Approximate daily intakes	Health outcomes
>5.0 mg/kg bw	(350mg/70kg)	Gastrointestinal metallothionein induced (possible differing effects of acute and chronic exposure)
100 µg/kg bw	(7mg/70kg)	Plateau of absorption maintained; homeostatic mechanisms regulate absorption of copper
34 µg/kg bw	(2.38mg/70kg)	Hepatic uptake, sequestration and excretion effect homeostasis; glutathione-dependent uptake of copper; binding to metallothionein; and lysosomal excretion of copper
11 µg/kg bw	(0.77mg/70kg)	Biliary excretion and gastrointestinal uptake normal
9 µg/kg bw	(0.63mg/70kg)	Hepatic deposit(s) reduced; conservation of  endogenous copper; gastrointestinal absorption increased
8.5 µg/kg bw	(0.595mg/70kg)	Negative copper balance
5.2 µg/kg bw	(0.364mg/70kg)	Functional defects, such as lysyl oxidase and superoxide dismutase activities reduced; impaired substrate metabolism
2 µg/kg bw	(0.14mg/70kg)	Peripheral pools disrupted; gross dysfunction and disturbance of metabolism of other nutrients; death

(source)
My final recommendation for copper will be 1-2.4mg, and zinc to be in the x12 ratio still.

Many already have too much copper though due to toxic build up from too much plant foods and so my diet will have slightly on the lower side of the copper range in order to help regain balance. Therefore. my diet will use mainly pork liver as it is low in copper (instead being richer in iron), this also allows for more liver and therefore vitamin A in the diet (see fat soluble vitamins recommendations), but still provides plenty of copper. As you will see in the final post this choice of liver is perfect for balanced nutrition when other copper-rich foods such as kidneys are also included.

Protein Propaganda Pisses Me Off

There are a lot of pictures going round on various social media sites and elsewhere showing examples of 'protein-rich foods', and quite simply this pictures are outright lies! They are misleading, and real numbers provided are also wrong (sometimes by a lot), and people just assume they're true and think they can get enough protein just eating spinach. You'd have to eat ~1.75kg of spinach to get 50g of protein, I don't think anyone would actually be able to manage this but it would sure as hell be funny to watch.

Just as a note, these pictures are almost always associated with raw vegan diets, so all data is of raw, not cooked food.

Ok, lets take a look a a couple of pictures:

Some versions of this picture has a line of text at the bottom mentioning that the numbers of percentage by calorie (rather than weight), but most have this line cut off.

 Lets go to the USDA food nutrition database (http://nutritiondata.self.com) and double check these:

Food	% calories	grams/100g	grams for 50g protein
Spinach	30.1%	2.86g	1,750g
Kale	16.1%	3.3g	1,515g
Broccoli	20.2%	2.82g	1,775g
Cauliflower	18.7%	1.92g	2,605g
Mushroom (white)	36.3%	3.09g	1,620g
Parsley	19.9%	2.97g	1,685g
Cucumber	10.3%	0.65g	7,690g
Peppers	10.5%	0.86g	5,815g
Cabbage (red)	11.2%	1.43g	3,495g
Tomato	11.9%	0.88g	5,680g
Beef (composite of trimmed retail cuts, separable lean and  fat, trimmed to 1/8" fat, all grades)	34%	18.68g	270g
Chicken (skinless breast)	79.5%	21.23g	235g
Eggs (chicken)	34.6%	12.56g	400g (8 medium)

Number of plants falsely given higher high percentage of calories as protein = 9.5/10 (Only giving half a point from mushroom because the difference was small.

But percentage of calories from protein matter little, we just want to make sure we get enough protein per day. 50 grams of protein is roughly the recommended daily allowance (RDA) for a 150lbs adult (46g for female, 56g for male), it's also a nice round number which we can use to compare how much of a food we need to get the small amount of protein. As I said in my introductory paragraph, you'll need ~1.75kg (~1750g) of spinach for 50g protein. You'll also need about   5.7kg of tomato to get 50g of protein. But you only need ~270g of beef, or 235g of chicken breast. The chicken breast really pisses me off, because they claim it's low in protein (23%) when in fact of all the foods mentioned it is the highest in protein both as percentage of calories and by weight! Maybe they were using another cut of chicken but the picture shows skinless boneless breasts so that's what I data I pulled out.


 - - - - -

I want to start with my absolute scream at the computer how can anyone be this stupid point: Figs. They are 3% protein by calories, and you'd need to eat 6.7kg of them to get 50g protein. If figs are a high protein food then coconut oil is high in omega-6 fatty acids (hint it's really low!).

Ditto the avocados, only 4.2% by calories, but you'd only need to eat 2.5kg for 50g protein which'll give you 4000 calories just from avocados! Similarly goji berries are 3.6% protein by calories and you'd need to eat 7kg of them to get 50g of protein, that's more than the figs!!

Some of these foods aren't that bad really though. Hemp seeds are ~25% by calories, 135-150g for 50g protein (several data entries on CRONometer for hemp seeds (CRONometer draws from the USDA database and also has lots of brand names of health-foods)). This is likely the best protein source in the picture.

Now for a few funny ones: Brazil nuts are 8% protein by calories and you need 350g for 50g of protein, but you'll also get ~7000ug of selenium which will kill you. Chia is 12% by calories, 300g for 50g protein. But you'll have massive diarrhoea with that, as even a few tablespoons will clear you out.

Spinach, kale, and broccoli I've already covered in the last picture.

Maca: 26.7% by calories, and you need 250g for 50g protein. Not bad, but as it's a 'superfood' good luck affording it and enjoy eating a whole bag of powder in one go :P That'll also come with 150g of carb which may be high for some people.

With sprouts, it appears to be legume sprouts in the picture. Many sprouts are rich in protein because the legumes are protein-rich, but be careful as many sprouts lose protein during the sprouting process depending in species. Don't eat kidney bean sprouts raw either, they're poisonous. Mung bean sprouts, aka the bean sprouts in chinese food, are 24.6% protein by calories, but you'd need to eat ~1.6kg to get 50g of protein because they're so full of water.

I don't have data for barley grass juice, but I do for wheat grass juice: 78.7% by calories, and you need to drink ~405ml pure juice for 50g protein, have fun trying to drink all that!!

Spirulina: 54.8% protein by calories, and you need to eat 845g to get 50g of protein, which is really hard as you're eating pond-scummy bacteria.


 - - - - -

Food	% calories	grams/100g	grams for 50g protein
Almonds	12.8%	21.2g	236g
Pumpkin seeds	18.8%	30.2g	166g
Asparagus	26.5%	2.2g	2,273g
Quinoa (raw)	15.3%	14.1g	355g
Peas	23.2%	5.4g	926g
Sweet potatoes	5.1%	1.6g	3,125g
Sesame seeds	10.7%	17.7g	282g
Sunflower seeds	12.3%	20.8g	240g
Watercress	50.8%	2.3g	2,174g

Pumpkin seeds aren't that bad actually, but 166g will give you ~34g of omega-6 fatty acids too, same story with the other seeds.


 - - - - -

Legumes:

Now not mentioned in these pictures as a good protein source is legumes as they must be cooked or sprouted (we already talked about sprouting), and as we know cooked food is bad for us (not!). Cooked lentils are 26.9% protein by calories, and you need 2.8 cups (~555g) for 50g of protein (raw measure ~1cup dry, ~195g), which will also give 112g carbohydrates. Not bad for a vegan protein source.


Summary:

If you want protein, eat meat not greens. For plant based protein go for hemp seeds and cooked legumes like lentils and kidney beans.


Musings:

When a vegan points out that a cow can grow big on a vegan diet, point out the high protein content of wheat grass, but they also eat all day every day to digest it and need four stomach and multiple chewings to digest it. Gorillas also eat high-protein leaves too and also spend a lot of time eating a lot of food, have huge caecums, and eat their poop for vitamin B12 (go search youtube, there are thousands of videos capturing different apes doing this). Also these animals are actually eating a ketogenic diet as the huge amounts of fibre eaten are fermented into short chain fatty acids such as butyric acid (named for being in butter) which they get ~65% or more of their calories from (more for cows as fermentation is earlier)! (link) If you really want to eat like a herbivore, grow/buy ~3kg of watercress daily and ferment it until it's nice and rich in butyric acid then drink/eat the resulting concoction. Mmm, gross, that's why real herbivores ferment in their guts... which we're not able to do. Now grow a pair and eat your damn steak!


References:
1
http://www.facebook.com/photo.php?fbid=395100227225462
http://www.facebook.com/photo.php?fbid=524174750943005
2
http://www.facebook.com/photo.php?fbid=534121186613769
3
https://www.facebook.com/photo.php?fbid=363770357056467

Note:
If my numbers are wrong at all, please let me know and I will correct this article. I'd rather say I was wrong then continue to spread lies, unlike some people.

Calcium

Sources other than dairy:

Small bones: fish (sardines, etc), eaten with the fish or as broth.
Big bones: beef/lamb/pork/chicken/etc, as broth.
Eggshells, as broth.
Green leafy vegetables: darker the better, cook well and eat with fat. Avoid greens high in oxalic acid though, such as spinach, beets, celery, pecans, tea, and cocoa. (Although these aren't eaten on a carnivorous diet)


Maximising calcium:

Absorption		Excretion
Increases	Decreases	Increases	Decreases
Viamin D	Phytic & oxalic acids	Fibre	Potassium
Animal Protein	Caffeine		Boron (-44%!)
Phosphatase**	High cortisol (metabolic stress)
	Magnesium*
	Phosphorus*
Vitamin K2 to get it into bones and not into arteries.

* Although magnesium and phosphorus help calcium balance it should not be eaten/taken at the same time as calcium as they can compete for absorption.

** Phosphatase is an enzyme in raw milk, it is destroyed when milk is pasteurised (in fact they test that this enzyme is dead to confirm it’s pasteurised). This is why most studies show milk doesn’t help bone health: they used pasteurised milk! If you want to drink milk, drink it unpasteurised.


Some other nutrients that help are copper (found in liver), iodine (seaweed, seafood), vitamin A (liver, egg yolks, dairy fats), silicon (bones, dark green leafy veg, certain spring waters), strontium (dairy, shellfish), sodium (salt), CoQ10 (heart), vitamin B5 (liver, egg yolks, dairy), boron (I can't find any good animal food sources of this), zinc (red meat), and manganese (tea/spices).

Nutrients that hinder include sugar (refined and natural), lead, cadmium, fluoride and excess phosphorus (see note above).


Weston A Price on how much calcium/phosphorus we need:

• 680mg Calcium
• 1,300mg Phosphorus

Factoring in our absorption increases from lack of phytic acid this actually comes out as needing ~544mg calcium (just over half an egg shell's worth). Regarding phosphorus, at lot of that phosphorus on a WAPF diet is locked up in phytic acid so much less is needed on a phytic acid free diet.


Bones:

Bones have lots of phosphorus, as bones are made from hydroxylapatite [Ca5(PO4)3(OH)] and some calcium carbonate. Together these make up 65% of bones, water 25%, and the remaining 10% is formed by magnesium, sodium, potassium, sulphate, and other trace minerals. This means that bones are ~10% calcium and 6% phosphorus by weight (~1.7 Ca:P ratio). As a diet of pure muscle meat has little to no calcium (unless using ground meat due to trace amounts of bone in it), adding ~600mg calcium worth of broth will actually add about ~360mg of phosphorus too, and my upcoming second version of the perfect carnivore diet menu has about ~940mg of phosphorus (and ~160mg calcium), so adding broth rather than egg shells (as used in version 1) will ~1300mg phosphorus and ~760mg calcium which is in line with the WAPF recommendations.


Breast Milk:

Breast milk contains ~320mg calcium per litre, and this is about how much an infant drinks. Not very much at all considering how fast they're growing and calcifying their bones. We can probably safely assume that an adult is unlikely to need more calcium than a growing infant, even though some calcium will be needed for bone turnover, replaces trace loss in urine, etc.

It's interesting the RDA for calcium under a year old is only 200-260mg, and jumps to 700mg at one year then 1,300mg after 4 years. Although I can't find the source at the moment, I remember reading a study looking at primitive cultures, their calcium intake and their fracture rates, many got only 200-300mg of calcium and had very little fractures, no culture ate under 200mg. This all points to us not actually needing very much calcium at all really, and rather needing more of calcium's co-factors for healthy bones.

Update (19/12/13):
I found the source I was originally referring to:

The importance of vitamin K2:

Many people know of vitamin K1, found in dark green leafy vegetables. Vitamin K2 can be made from K1 but only in small amounts (similar to our poor beta-carotene to retinol conversion). Vitamin K1 helps blood clotting (recent studies show K2 mk-4 can do this too), but vitamin K2 has many other jobs: Vitamin D helps you absorb calcium, but vitamin K2 gets it into the bones. Without vitamin K2, absorbed calcium tends to end up in your arteries causing heart disease! Never take a calcium supplement unless you take plenty of vitamin K2 with it.

Vitamin K2 found in fermented plant foods, like natto and sauerkraut, is a different form than found in animal foods (‘Mk-4’ in animal foods, ‘mk-7’ in fermented plants). When a plant rich in vitamin K1 is fermented, bacteria turn some of it into K2 mk-7. Mk-7 doesn’t get absorbed into body tissues well so can build up in the blood. This mk-7 is actually slowly broken down into the animal form mk-4, think of it like a slow release form.

The reason K2 mk-4 is found in animal foods is because that’s the form animal made from K1. Grass-fed animal fats are rich in K2 mk-4 because their food has loads of vitamin K1 and their digestive systems are great at converting K1 to K2 (unlike ours). Any food that concentrates healthy animal fats is rich in K2 mk-4. Examples include cheese (awesome calcium + K2 combo), liver (that’s where the body stores it; foie gras (fatty goose liver) has huge amounts), and egg yolks have lots for the growing chick.

Links on k2:
http://blog.trackyourplaque.com/2007/12/food-sources-of-vitamin-k2.html
http://www.springboard4health.com/notebook/v_k2.html
http://www.drpasswater.com/nutrition_library/Schurgers2.html (research with graphs)


My recommendations:

Get at least 200-300mg calcium every day, which is about a quarter of an egg shell's worth. Make sure you eat plenty of animal protein and fats, avoid anti-nutrients, eat some liver (for the copper!), egg yolks, seafood/weed, and salt (sodium and potassium) too for the co-factors (as listed above), and drink unfluoridated water preferably one high in silicon.

At a very minimal zero carb diet, I would say to make sure you're getting more calcium than steak provides (0mg), at least eat ground meat which has traces of bone in it (1lb 30% fat ground beef has ~108mg calcium) and drink some broth or make egg shell calcium (2 shells a week provides ~285mg calcium a day).

How little vitamin A is enough?

There have been many discussions between me and the zero carb community as to how much vitamin A is needed to avoid deficiency, they maintain that fatty muscle meat has enough to prevent deficiency and that extra source such as egg yolks, dairy fat, or the dreaded liver aren't needed. I could not find data showing the amount of vitamin A in beef, most nutritional databases have is zero. But as promised I continued my search into why many do not seem to be becoming deficient in this nutrient...

In human tissue, there is some retinol (vitamin A) present in the fatty tissue, muscle, and heart: fatty tissue contains on average 1.46ug/gm, muscle 0.35ug/gm, and heart 1.08ug/gm [source, table 1 page 253]. Assuming beef is about the same (not condoning cannibalism here :P ), a diet of 500g lean muscle meat and 200g fat (for 100g protein and 200g fat, ~2000 calories ~80% from fat) would give us ~467ug of retinol (~1556.5IU).

The USDA RDA for vitamin A is 900ug or 3000IU, which is about double our calculations; assuming increased absorption from plenty of fat and lack of anti-nutrients, this may well be enough to prevent deficiency. The paper also investigates blood plasma retinol levels and concludes that 1,200ug retinol is needed to maintain a healthy blood level, and under 600ug a day is when eye changes start to occur [page 273-274]. Again assuming increased absorption on a carnivore diet, fatty muscle meat way well be enough to prevent deficiency, but may not be enough to maintain a more desirable blood level.

For comparison, the amount of vitamin A in our calculations above can be found in 55g of cheese or 20g of butter or two eggs. So adding any of these to your diet would mean you reach the USDA RDA. To get the 1,200ug retinol that the article recommends you need to eat ~5,100 calories of meat, or just 2,000 calories of meat plus 15g of beef liver a day (or 10g lamb liver).


A whole cow will generally give 442lbs of bonless meat, 27lbs shanks/oxtail, 6lbs liver, 2lbs heart, and 2lbs tongue. This means that eating the whole animal you'd eat a pound of liver every 40 days if eating 2lbs. This is roughly similar to the Bear eating liver once a month. The cheese in his diet would have also provided some vitamin A/retinol. As I don't have the exact make up of his diet (other than him mentioning eating liver about once a month) I can't work out exactly how much vitamin A he was getting over the years but he was roughly eating liver in proportion to meat as found in a whole cow which is a very good strategy. A pound of beef liver every 40 days (~11g per day) gives us on average ~561ug retinol (~1876IU) a day, making the total in addition to the meat above 1,028ug (3,432.5IU) a day, above the USDA RDA and almost to the article's recommended 1,200ug retinol; so with some cheese we can easily reach this target.

A diet of meat, daily cheese, and liver every 40 days would quite likely be enough to even maintain optimal blood retinol levels, while a diet of just fatty muscle may be enough to just avoid deficiency.


So while fatty muscle meat may be enough to prevent deficiency, I still maintain that there is a difference between outright deficiency and optimum nutrition and will be sticking with the WAPF's recommendation for vitamin A in my carnivore RDA project, which is 10,000IU. This means including egg yolks, dairy fats, and of course occasionally the dreaded liver.

Fat Soluble Nutrients

Vitamin A:
The best source of knowledge on vitamin A seems to be the Weston A Price Foundation, which recommends at least 10,000IU for all adults (double that for pregnant/lactating women, half that for children <12 years old). This is much more than the USDA's upper limit, but so is the amount of saturated fat and cholesterol in this diet :P But if one is only getting the USDA RDA then it's likely to be enough to avoid strict deficiency, but not optimum.

Update on how little vitamin A is enough.


Vitamin D:
Actually a hormone and not really a nutrient. We get most of our need for this of from the sun, but some people can be deficient. It's best to get a blood test and supplement based on your levels. The Vitamin D Council recommends everyone take 1,000IU per 25lbs body weight (6kIU per 150lbs) and that the ideal level is ~50ng/ml or 145nmol/l. I took 5,000IU at more than 150lbs, and after a year had levels tested and result simply said '>200nmol/l' so clearly this to too much for me. Always go off your blood levels, not a specific IU recommendation!


Vitamin E:
Dr Udo says in his book "Fats that Heal Fats that Kill" that we need 0.65mg(?IU?) of vitamin E per gram of PUFA. This is a much better start for establishing a proper RDA for vitamin E compared to a flat 15mg RDA.

My diet version 2 gives 70% of that. As Udo is dealing with refined seed oils then the need of vitamin E is quite likely to be higher than with animal fats as saturated fats protect PUFAs from being oxidised. Udo's oil is 12.8/20.4/66.8% sat/mono/pufa with a omega-6:3 ratio of 0.44, while my diet is 47.3/47.6/5.1% and has a ratio of 2.3; as my diet has 3.7 times the saturated fat so the amount of vitamin E needed per PUFA may be as little as ~0.18mg/g. Using PUFA as a basis, my diet has ~7.6% the PUFA as his oil so this would mean vitamin E need is ~0.05mg/g PUFA.

Additionally the increased levels of glutathione (the most potent antioxidant in our body) on a carnivore diet due to increased intakes of cysteine, methinoine, and glycine (from meat, eggs, and gelatin respectively), means that the PUFA will be less prone to oxidation once in our blood. Some vitamin E or saturated will still be needed to prevent oxidation during storage and cooking though, but I'm perfectly happy that the vitamin E requirement is so low it's not worth worrying about as there are so many other protective systems in place.


Vitamin K1:

One major issue with a carnivore diet is lack of plants containing vitamin K1, animals foods contain no K1. Vitamin K1 is needed for coagulation, or is it? This study suggests that K2 can provide this function of K1, making K1 requirement nil in a carnivore diet providing plenty of K2.


Vitamin K2:

Vitamin K2 can be synthesised by healthy gut bacterai but they need K1 as a starting point sadly. OTher sources include fats, especially dairy fats, grass-fed fats and feremented fats. I'm having a lot of toruble finding the specific amount of K2 needed but that may be because it's a very new vitamin and so little is known about it. Assuming the K1 requirement should be replaced wholely by K2, then this means ~80ug for adult, 150ug for eldery people.

Where can be find that much?
105g hard cheese a day will give you 80ug, 533g butter (grass-fed is better) or a similar amount of egg yolks, pastured egg yolks are better needing only ~249g. (source) The WAPF recommends taking high-vitamin butter oil which is a natural concentration of vitamin K2, but that it's not needed if one if eating a lot of grass-fed fats.

Supplementing:
Taking 1mg every 2 weeks gives an average of ~71ug per day, which in addition to the fats and egg yolks in the diet will provide ample amounts. But this is very unlikely to be needed because of the increased absorption from a high-fat anti-nutrient-free diet.

I would say not to worry about vitamin K2 though due to increased absorption  but our knowledge on this vitamin is severely lacking. Watch this space, as they say.

If you have osteoporosis or arterial calcification then supplementing is advised  up to 5mg a day may be needed in extreme cases if a VLC/ZC ketogenic diet doesn't help.


Caveat:
The WAPF warns not to take vitamin A without vitamin D, and not to take vitamin D without K2. So if you're deficient in vitamin D, don't eat liver just yet, and make sure to always eat plenty of animal fats, preferably grass-fed or cheese.

Further Implications of Lowered Gluconeogenesis: Vitamin C Synthesis

This is a follow up post to "Evolutionary Trade-Offs: Fast Versus Famine" and "Detox, Antioxidants, and Scurvy: Protein Beats Plants".

We already looked at how we manage without the ability to synthesise ascorbic acid aka vitamin C, by using uric acid derived from protein instead, but why do we do this? Why not just make vitamin C like other carnivores do? Indeed all carnivores make ascorbic acid, so why are we different?

I believe that our lower level of gluconeogenesis (GNG) is to blame. Ascorbic acid is synthesised from glucose, and with a diminished capacity to make glucose then we don't really have any spare, the muscles need all they can get. So to converse the precious small glucose pool we switched from using ascorbic acid (derived from glucose) to uric acid (derived from protein), and one big difference is the amount of the substance needed for the same anti-oxidant potential.

Most animals synthesise tens to hundreds of grams (not milligrams  of ascorbic acid daily, where-as in humans if we supplement 10 or more grams we can experience diarrhoea from too much vitamin C (less on a ketogenic diet). It's almost as if the body doesn't want extra vitamin C, and high levels can only be achieved through IVs. Amounts over 1.5mg/dL (or 1.3mgdL in females) is rapidly excreted through the urine (this is about 75mg (or 65mg in females)  in the whole blood) with a half life of about 15 minutes, this is less than the USDA RDA at 90mg (75mg for females)! The body is actually very good at maintaining tight levels of ascorbic acid in the blood, and the daily turn-over on a vitamin C free diet (but grain-rich) can be as little as 2.5mg, so perhaps even less on a ketogenic diet.

Where-as the amount of uric acid in the blood ranges from 3mg/dL to 7mg/dL in males and 3mg/dL to 6mg/dL in females (150-350mg or 150-300mg in the whole blood). Also although 'hyperuricaemia' (high uric acid levels) is set at 6 or 7 mg/dL, some people can have as high as 9.6mg/dL and not develop gout. Vegetarians can have as little as 2.7mg/dL uric acid.

So a normal uric acid level is two to ~4.5 times as much as the saturation level of ascorbic acid!

Not only do we not make ascorbic acid (because of lowered GNG) but the blood has very low saturation levels compared to uric acid and excess is rapidly excreted, excess uric acid is less easily excreted suggesting a preference for higher levels. This further supports by theory that uric acid replaced ascorbic acid in humans.