Dr. Sanjeev Balakrishnan holds a Master of Medicine in Family Medicine from the National University of Singapore and is currently a GP working in Perth, Western Australia. Dr. Balakrishnan has more than two decades of experience and is very passionate about the management of obesity, type 2 diabetes and metabolic syndrome through healthy eating. He is an advocate for the low carbohydrate-high healthy fat diet and is the creator of Low Carb WA. He is a fully credentialed Family Physician in Singapore and is a Fellow of the Royal Australian College of General Practitioners.
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Scope and baseline expectations
- Carnivore diet definition: meat-based intake; vegetable removal alone does not meet the definition.
- Diet compliance failures: non-meat inputs and “hidden sabotage” from drinks and add-ons.
Common hidden inputs that disrupt outcomes
- Alcohol intake is common alongside meat intake.
- Alcohol is energy-dense and interferes with fat breakdown.
- “Low carb” and “low alcohol” beers still interfere with fat loss.
- Artificial sweeteners increase hunger and cravings.
- Diet soda intake can coexist with “only meat” food intake; insulin and blood sugar abnormalities persist with high diet soda intake.
- Dairy intake is a frequent high-calorie add-on; cheese and cream are calorie-dense.
- Dairy lactose and casein can trigger an insulin response and cravings.
- Coffee intake is often high; coffee add-ins: cream or milk.
Energy intake, fat intake, and satiety mechanics
- High-fat foods are calorie-dense; “fat is healthy” does not remove energy-balance constraints.
- Excess fat intake can exceed need before satiety cues terminate intake.
- Insufficient fat intake increases hunger.
- Dietary fat avoidance can coexist with reliance on leaner cuts and reduced calories.
Meal timing and under- or over-eating patterns
- Eating once per day can reduce total intake below requirement in some cases.
- Chronic under-eating produces perceived starvation physiology.
- Yo-yo restriction and refeeding patterns increase diet stress and reduce ketosis persistence.
Stress, sleep, and sex-specific factors
- High stress and elevated cortisol conditions reduce weight-loss feasibility.
- Late-day exercise and disrupted sleep reduce weight-loss feasibility.
- Women have diet sensitivity tied to hormonal cycles.
- Hormone-related phases can reduce weight-loss feasibility even with nutrient-dense intake.
Tracking, expectations, and symptom monitoring
- Daily weighing can dominate perceived success and defeat.
- Body recomposition and healing require time; weight alone is not a success metric.
- Symptom tracking: energy, hunger, mood, bowel patterns.
Gastrointestinal and electrolyte-related troubleshooting
- Constipation and diarrhea occur during carnivore transitions.
- Some individuals require a slower transition for gut adaptation.
- Cramping occurs and co-occurs with inadequate fat and salt intake in some cases.
- Magnesium supplementation occurs for cramps in some cases.
- Carbohydrate intake occurs in some cases to reduce cramps.
Practical constraints and optional foods
- Meat prioritization is a core operating rule.
- Optional items: dairy, nuts, fruits, sweeteners; optional status does not prevent adverse effects when intake is high.
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