The Carnivore Code: Unlocking the Secrets to Optimal Health by Returning to Our Ancestral Diet

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This study hasn’t been peer reviewed yet so it should be interpreted with caution, but it also has notable strengths: analyses were all designed and publicly registered in advance, it was conducted by an experienced epidemiologist, and the data set is large, detailed, and represents 20+ years of follow-up. The strongest evidence supporting the book’s claim comes from stable isotope studies, but the book only directly cites one such study. The recipes are unlike I've ever seen, with pizza made entirely of animal products - that's real meat lover's pizza for you!

A key piece of evidence presented by The Carnivore Code is a publication from the Framingham Study, including two graphs of its data on pages 187 and 189. Normally, peristaltic waves pass through the length of our small bowel and sweep down towards the colon, preventing overgrowth of bacteria in the upper portions of our digestive tract. Page 103: “One of the more positive effects experienced by those on a carnivore diet is weight loss. I agree that the meat you eat should be raised humanely on pastured land with real foods they eat, though I don't know how many people who follow this lifestyle could afford to eat 100% animal products 100% of the time that are raised this way.

We focus on the references in The Carnivore Code related to the connection between LDL, cardiovascular disease, and all-cause mortality.

If you're looking for a good basic meat cookbook, however, this one is fairly straightforward, I'll give it that.

The Carnivore Code argues that current and historical hunter-gatherers eat less animal food than our distant ancestors did because they live in marginal habitats, but two studies of this idea did not support it. The issue is that White Oak Pastures doesn’t just produce beef, and cows aren’t the only way carbon gets into the soil.

Page 192: “Those of us with good insulin sensitivity are essentially a different breed, and there are many striking stories of plaque regression among insulin-sensitive individuals with ‘elevated LDL’ eating carnivore or ketogenic diets. So it’s not clear how relevant these ancient menus are to modern people of European descent, and they don’t seem very relevant at all to people of non-European descent. Usually, when extraordinary preliminary findings like this are followed up with more rigorous study designs, the results aren’t as impressive and they often disappear completely. The Carnivore Code repeatedly emphasizes one study in particular, in which 63 adults in Singapore with constipation were instructed to eat a very-low-fiber diet for 6 months.Still, it shows that at least some studies haven’t found fiber supplements to be effective for constipation. Together, these arguments are far more convincing than a small number of unsupportive studies selected from a large body of mostly-supportive literature. The citation is a pilot study testing the impact of a low-carbohydrate ketogenic diet on signs and symptoms of PCOS.

Clinical case series like this are a valid form of evidence but they’re much less convincing than gold-standard study designs like randomized controlled trials. The paper cites other papers in which calcium oxalate crystals have been associated with lobular carcinoma in situ.

All studies we identified report that carbon sequestration greatly offsets greenhouse gas emissions from cows, but not necessarily enough to make production carbon-negative ( 1, 2, 3). As previously discussed, there are several strong lines of evidence supporting the idea that high LDL increases cardiovascular risk. We think the diet is likely to be helpful for obesity and type 2 diabetes, but beyond that we really don’t know. The book’s references in support of this claim received a score of 1, meaning that they generally don’t support the book’s claim that high LDL on a carnivore diet is not harmful.