#364 – AMA #75: Diets: how to evaluate and implement any diet including keto, carnivore, vegan, Mediterranean, and more

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I'm your host, Peter Attia.

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So without further delay, here's today's sneak peek of the Ask Me Anything episode.

Welcome to Ask Me Anything AMA, episode 75.

In today's AMA, we're taking a closer look at how to choose a diet for yourself rather than which diet is the best of them all.

I start by laying out the five non-negotiables every sustainable eating pattern must hit.

Energy balance, metabolic health, adequacy of protein, micronutrient sufficiency, and long-term adherence.

From there, we introduce a simple rubric.

First, define the diet's rules, then pinpoint its strengths and ideal users, and finally surface the potential pitfalls so you can make corrections when necessary.

With that framework, I walk through the four diets you asked about most.

Ketogenic, carnivore, vegan, and Mediterranean to show how to apply the framework.

We discuss why I'm aiming this episode at the majority of people who feel confused, not the diet zealots, so everyone has a common sense roadmap.

A deep dive into each of the five non-negotiables for any diet and how missing even one can sink long-term results.

Applying the Define Strengths Weaknesses rubric to keto, carnivore, vegan, and Mediterranean diets, highlighting metabolic effects, micronutrient gaps, and adherence hurdles.

Practical ways to track progress, DEXA scans, important lab metrics like fasting insulin, hemoglobin A1C, CGMs, and simple symptoms to log so you know whether a diet is actually working.

Why there's no single perfect diet, and instead the best diet meets those five core needs and your current goals, and how to iterate as life changes.

If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page.

And if you're not a subscriber, you can watch the sneak peek of this video on our YouTube page.

So, without further delay, I hope you enjoy AMA 75.

Peter, welcome to another Ask Me Anything.

How you feeling?

I'm honored to be back.

Thank you for having me.

Do you ever think about just sleeping in the podcast studio so you can just be ready at any given moment if we need you to record something?

I think there are times when my wife would like that.

We should just on the other side of the table in the studio, just put a tent.

And every now and then, you and the boys just camp in the studio.

Could work.

That could work.

All right.

Speaking of the boys, quick chess update.

We had a little chess tournament, in-house chess tournament this weekend.

I made it to the finals with the youngest, my youngest boy, and I was playing kind of a bananas game, kind of playing lights out chess.

And this is the one that loves to trash talk, so it was awesome.

And then I made this idiotic blunder.

And in a second, the game changed.

And five moves later, it's checkmate against me.

And I was like, God, this is why I love and hate this game so much.

I do love that you started this by bragging about making it to the finals of an in-house chess tournament, which composed of three people.

No, no, no.

There were a few others.

There were some other people in the tournament.

Yeah, yeah, yeah.

I thought it was you and the two boys, both under 11.

And I was like, it's kind of

audacious to brag about making it to the finals of a three-person chess tournament, two of which can't even drive yet.

But

okay, that's good to hear there was more people involved.

The bigger question is, when you lost that game, did any pieces go flying through the air?

It happened one time, Nick.

One time.

I'll never live it down.

One time during this chess tournament?

No, no, no.

It only happened that one time.

I am not a chess piece thrower ordinarily.

That's because Mama Atia put her foot down.

That's true.

Have you gotten Jill to start playing chess yet?

Zero chance Jill will ever play chess.

I don't know.

Never say never.

You sometimes do things that you said you never were going to do in the past.

So you kind of never know.

I mean, much like this AMA, which is all on not only your favorite meta topic, but your favorite micro topic.

Not only is this nutrition focused, but it's diet specific focused, which anyone who's listened to this for a while knows maybe not your favorite topic to cover, but I think it's going to be really good.

Here's why.

We get a ton of questions on diets, and I think it's because there's so much information in the ether on diets.

And so what we did is we gathered those questions, we went to the audience, asked for questions, combined them all, organized them, and we're going to structure them in this way.

The goal here is to not be a nutrition AMA, which we've done before, which we can link.

It's much more to focus on diets.

And to do it in a way that doesn't really talk about everyone should follow this diet or this diet or this diet and and not to kind of join the tribal battles that people see, but instead really just take a pragmatic listen and really identify how can anyone listening to this understand the pros, cons, how to think about diets and put it into their own life.

In it, we want to give people a framework to evaluate a dietary approach, whether you follow the same one now that you did years ago or you change in the future.

To do that, we'll start by laying out the five non-negotiables that you think any diet must address.

So no matter if it's vegan or carnivore, what are the approaches that they all should follow?

And then we're going to evaluate each diet through a framework, which is what are the core requirements for that diet to work?

What are its strengths, including who is it best suited for?

Because oftentimes we've talked is sometimes there's going to be different diets that are better for different people.

So what is that and why is that?

And then we'll look at its weaknesses, which is if someone's going to follow a diet, what are some of the pitfalls and how can they be addressed and how can they avoid those?

And then with that framework, we'll cover four of the diets that are asked about us the most, seem to be talked about the most, and paint the broadest picture, which is keto, carnivore, vegan, and Mediterranean.

And we'll close with practical takeaways.

So we got a lot of diet talk today.

Anything you want to add before we roll into it?

I think think that's a good setup.

I'll add two unrelated comments.

The first is, yeah, you pointed out how much I just generally don't enjoy this subject matter.

And the reason for it is it tends to very quickly degrade into tribal religious discussions as opposed to scientific discussions.

And there tends to be almost a morality that comes out of this, which I just frankly don't think belongs in the space.

But at the convincing of many listeners and our team have reluctantly decided that it's worth doing.

And I think that sort of feeds into the second point, which is I came into this kicking and screaming, not wanting to do it.

But I think Josh Rocher on our team did a great job of pointing out,

Peter, you're not doing this for the extremes.

You're not doing this for the extremists in each of these camps.

You're not doing this for someone who is so hardcore in a dietary camp that they believe that their diet is the one one true diet and anyone who doesn't eat that way is an awful human being.

You're not trying to talk that person off that perch.

You're doing this for, frankly, the 87%

of people who are confused, who are in the middle, who don't quite know what to do, who have tried this and they're not sure if it makes sense.

I think that was a very helpful framing for me because it's very easy for me to focus on the fanatics.

And the fanatics across all lenses really turn me off.

But as long as I just keep in my mind that I'm not talking to those people, I'm here for virtually everybody else, which fortunately is the majority of people who just kind of want some common sense frameworks for how to evaluate these dietary strategies.

So, with that said, I feel a little bit better about it.

That's great.

I imagine you'd feel even better if you won that in-house chess tournament, but it's probably always good to have a tournament.

I don't think we're not having a rematch, and don't think I am not going to put a world of hurt on that little seven-year-old

in chess,

Just to clarify.

By the way, he spent the rest of the weekend walking around the house telling everybody how he smoked my bags.

I mean, you couldn't help but laugh.

You have to, especially because it sounds like he did.

He did.

It sounds like he just put you in his pocket.

Just.

Yep.

We could talk about that all day.

We'll save that for the seven-year-old roundtable.

We still need to set up.

All right.

So Maybe before we start, we've kind of mentioned quickly, we did a nutrition AMA somewhat recently.

We'll link to it.

Do you just kind of want to walk through how you think about nutrition and diets a little differently?

Yeah, so the nutrition AMA, which was released, I think it was December of last year, it covered the big picture questions.

Is there a best diet?

How does nutrition compare to exercise for health outcomes?

How much protein do you actually need for maintenance versus muscle growth?

But it didn't really delve into, I think, the way most people think about it, which is individual dietary approaches.

Now, in the past, I've said, look, people should pick a diet that they can stick to and that meets a certain list of non-negotiable physiologic states and needs.

But how to exactly go about doing that, we haven't talked about that, frankly.

And frankly, what should people watch out for?

How do you make a decision and know if it's the right choice for you?

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