Why did Peter discontinue the ketogenic diet? And what's his dietary strategy for 2018? (AMA #1)

This AMA Clip is a segment pulled from an "Ask Me Anything" episode of The Drive titled: #04 – AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more. Original release date: 7/9/18.

About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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[richardayala]

After five years of Keto, I lost 60 lbs of fat, worked out during that time and achieved my weight fat content goal. Now I do time restricted eating 18 to 20 hours of fasting, them eat. Like the Dr said, limit the junk, but don’t deprive! I have been this way now for two years and haven’t gained one pound! Beef, fist, veggies, some fruits, toast, love toast, potatoes. Feel great and I continue working out on weights. I am 74 years of age by the way. 5’7”, 150 lbs weight, 10% body fat! 50 pushups, 20 pull-ups, some cycling, walking two or three miles a day, working on the yard and garden!

[Glad.Tidings.To.The.Strangers.]

I tried vegan, I lost a bunch of weight. I tried Atkins, I lost a bunch of weight. I tried Keto, I lost a bunch of weight. They all work, but I found none of them sustainable. I found just being consistent with exercise and eating whole foods much easier and sustainable for the long run. Just eliminate processed foods and refined sugars.

[emblem]

Keto changed my life. Lost 33lbs in 3 months! It caused me to realize just how much sugar i was overconsuming. It raised my awareness on processed foods.(things you can achieve without Keto) It also put me in line with the ability to go omad as well as fasting. Reducing the sugar eliminated inflammation in my feet, fingers and knees that i thought was me getting "old." Nope it was the sugar. My joints feel 100% better than 10 yrars ago. At the very least Keto is a great dietary reset. For me it is my favorite way of eating so im like 90% on yet since i spend so much time in ketosis i have zero concern about going in and out of ketosis. Im not bound by that ideal. Being mostly OMAD and physically active I get away with eating whatever i want calorically but i invariably return to keto for weeks on end just because i feel better overall on it in general. I'd never be mad at someone for ditching Keto! Its not that serious. But me? I love Keto. But I'm not cultish about it. I would suggest for beginners 3 months of strict keto to get the full benefit and understanding of how to do it. As well as your bodys adaptatoon to it. In and out of ketosis early on you will never experience the fat burning machine your body can become when youre fat adapted.

[HillcrestGames]

Keto was a great way to reset my obviously broken eating habits, as I was never hungry and had stable energy levels. It also helped me to totally reverse insulin resistance, and improved depression and anxiety to a point where I was able to get momentum in the right direction. I'm kind of banking on the idea that occasional keto can improve metabolic flexibility, but I don't think that's really clinically tested thoroughly yet. So every few months I do a couple weeks of keto now, but otherwise I do <100g healthy carbs including >30g fiber a day, and very high protein and very low saturated fat. Also Flexitarian and eat lots of quality fish like salmon, mountains of low-glycemic vegetables. My glucose is better than it was at the end of a strict 2 year keto diet alone, and I'm losing more weight. Closing in on 90 total pounds lost now.

[nyguy]

I had the opposite experience on keto. Went there for diabetes and did lower my A1c. I was not obese BTW. On keto, my athletic performance (running and lifting) suffered terribly and I was never comfortable and was not easy to get along with. I quit keto after 6 months and got a CGM. I tested what I can eat and what really spikes my blood sugar, and came up with what seems a very healthy diet FOR ME. The diet is protein heavy, includes meat, certain fruits, vegetables and pasta (yes really). But I stay away from potatoes and rice for the most part, and I don’t eat much bread. I eat root vegetables like carrots and beets without issue. I stay far away from processed foods and most things with added sugar, except on very special occasions. I’ve concluded that we are all different and that there is no 1 solution for everyone. If keto works for you. Awesome! If not, find what does. But do the work to find it. You’ll be much happier and healthier.

[nickmogensen]

Peter Attia has a loving and caring way of talking about health topics - which I think is very, very important to get more people on board a healthy lifestyle.

[Beefcake]

After 2 years with almost no carbs I missed them too. But when I went back on carbs I just didn’t feel as good. So now I mostly eat keto but I’ve found that I can have carbs occasionally if I want them with no issues. About once a month I eat Thai food or Italian with a bunch of carbs. As long as I don’t do it day after day I feel fine.

[velikijoxotnik]

I'm still mostly keto, after exceeding my weight-loss goal of 70 lbs (in 6 months), but I'm not hard-core keto. I also believe that avoiding crap food is really the key. I love steamed leafy greens and eat them quite often, even though they knock me down to a low-ketosis level (or kick me out of ketosis altogether). I've heard many proponents of the ketogenic diet declare that good, leafy green veggies don't really count against the max-carb target (20g, or whatever), since the leafy greens metabolize MUCH more slowly that surgary/starchy foods. I do still avoid starches. No pasta, potatoes, or rice. No vegetable or seed oils, either. Many of my friends and family have been impressed by my get-healthy journey and results, and have sought my advice on how to start keto. I tell them to, first, cut out all boxed/packed processed crap food first. Next, focus on fatty meats and organ meats. Then, read the packages, if sugar is added (or has a high-sugar level), put it back on the shelf. Plant-based and Ketogenic proponents are often played off as enemies of each other. I am keto, but I believe that teh important common element that our two lifestyles have with each other is that we avoid processed food and go for foods that are as close as possible to how they occur in nature. I've always been a firm believer that the best option for anything rarely lies at either extreme, but is somewhere in the middle. Finding that middle ground that works for you is the hard part.

[Thedudeabides]

Keto saved my health and slowly my wife adapted to it too because she saw my body changing. I have a 3yr old and a 6yr old and you’re right, it’s too hard to be on a keto diet. I added some foods I love like mango ect, and what I realized is eating Whole Foods and no grains is what makes my body function like a well oiled machine. If I eat pasta, bread ect I get major joint pain onset for 3-5 day’s. If I stay to my diet I feel invincible to body inflammation. No I love my boring foods. Thank you Peter you have given me the tools to achieve my best body to date.

[sharonchriswell]

I was keto three yrs. Decided now to eat Whole Foods. Make sourdough. Skip breakfast. Maintaining weight.cut

[winstonthomas]

I did keto diet and even started a keto business. I had electrolyte issues and keto threw it off more because I was not taking in enough fruits. I still restrict processed carbs but I now eat tons of fruits. Works better for me.

[lilystonne]

People should eat the way that suits them. If Dr. Attila can eat carbs without negative impact, good for him. He admits that the markers are not as good but he is okay with it. Don’t religiously follow any regime without reason.

[AlexandrinaSerban]

Ive recently started following the ketogenic diet with the *HyperKeto* plan, and I have to admit, Im seeing some impressive results! Energy all day long, and the fat is melting away.

[leonardochaves]

I’ve been following Peter for years trying to understand all the intricate aspects of human metabolism, this is a fascinating world. All this years I questioned myself why Peter do all this experimentation with himself. Sometimes sounds like a pain. I’m coming from Peter’s interview with Esther Perel and now I’m assuming that Peter is entering in another level of live and happiness. Happy for Peter! Cheers

[Fercho]

As someone who struggled with insulin resistance and weight fluctuations, discovering HyperKeto was a game-changer. Unlike fad diets that promise quick fixes but often lead to disappointment, HyperKeto offers a sustainable approach to weight loss and improved metabolic health. By limiting carbohydrate intake and prioritizing healthy fats, this program helps stabilize blood sugar levels and promote fat loss without sacrificing taste or satisfaction. Trust me, HyperKeto is not just a diet—it's a lifestyle transformation.

[WorldsBestGuys]

Enjoyment is also a health factor that many people forget

[Nonduality]

It's important to see how others approach keto, but you have to create your own approach and keep it flexible as you continue to learn and your body changes. I think the two principles that hold true, no matter what your approach, include staying away from junk food and practicing intermittent fasting.

[jimrutherford]

When you get older, I'm 57 soon, you start to reap the results of years of high carbs and you want to feel good again so i started keto 4 months ago. Lost a lot of weight and haven't felt better in 40 years. I don't think I can go back to feeling the way I did pre keto.

[allisonfalin]

Did keto as an endurance athlete per a coach’s insistence. Held to it with daily blood checks for 9 months. LDL and trigs doubled, performance tanked and glucose and A1c when up, not down.I obliterated my gut microbiome and developed a nice case of small intestinal overgrowth.

[bethhayes]

Im 67 and have seen and been on all the fads that have come and gone. Ive never really been overweight, have always eaten basically healthy. What works for me is a balanced healthy diet. Fruits, vegetables, nuts, leans meats, whole grains. Enjoyable and healthy. So simple, really.