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.
summerizer
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.
I found I needed to supplement magnesium and salt. Leave either or and I get cramps. When I notice cramping in the first hour or three it can be resolved by magnesium or salt (whichever is deficient)
My most fast magnesium supplement for dealing with cramps is magnesium bicarbonate, made by adding 15mL of milk of magnesia to 1L of soda water and waiting about half an hour. Very quick when I made it the day before, takes about half an hour when I didn't. Solves cramps in seconds.
When I'm away from home I take a magnesium tablet daily to ensure I don't need a quick solution
I treat the 1L of magnesium bicarbonate as two doses
Does taking the magnesium give you the runs? I've always found it to be a little adventurous