Welcome, Healthy Skeptics!

One of my favorite blogs is Chris Kresser’s The Healthy Skeptic, so I was quite pleased a few weeks ago when he somehow discovered our blog and purchased a copy of our e-book. I’m even more pleased to see that he liked it:  He’s written a glowing review.

As Chris mentioned, everyone who buys the e-book will receive a free copy of the completed book, expected to be available in October. Simply email your address to paul@perfecthealthretreat.com and I will see that you receive your free copy as soon as it is available.

As he mentioned, the e-book, which is an early draft, has three sections. The final book will have a fourth, on healing and preventing disease.

The book is the fruit of five years of research and three years of writing. We began studying diet in 2005 in order to learn how to cure our own seemingly incurable chronic diseases. We began writing the book in 2008 partly because of the old axiom – “the best way to learn is to teach”; being forced to sift through the literature carefully would help us refine our ideas – and partly to share what we then knew with friends and family. By 2010 we had actually cured our own diseases, and had gained sufficient confidence in our ideas to bring them before the public. Indeed, we felt an obligation to do so. We know how many people suffer from “incurable” chronic diseases and premature aging. We believe that, with proper diet and appropriate antibiotics, nearly all diseases can be cured, and nearly everyone can become a healthy centenarian.

It will please us greatly if others find our book useful.  Thank you, Chris, for letting your readers know about it!

Leave a comment ?

33 Comments.

  1. I am glad you are beginning to get the attention you deserve.

  2. Paul,

    Thanks to you and Shou-Ching for all of your labors! It’s great to know I now have a resource I can recommend to my patients without explaining a bunch of caveats first.

    Chris

  3. Just hopped over from Chris and really happy to discover such a fine blog! How could you been hiding?!
    I´m nearly over 12 years primal eater with LC and ketogenic episodes. Improved everything from asthma, atopic dermatitis, hashimoto and mood stuff regarding to Asperger´s. My last riddle is why I easily gain weight with SFA but not with PUFA/MUFA. Great work you do with very pleasant style. Thanks.

    • Hi Byron, Welcome! Glad to hear you’re doing well. The weight gain on SFA but not PUFA is a riddle. Over what duration of SFA eating or PUFA eating are we talking about? Are we talking foods here, or oils like butter? How much PUFA are we talking about, and what kind?

  4. Paul and Shou-Ching,

    I have been looking for a book for a long time to give to friends and family to summarize and synthesize the best ideas from the LC and paleo diet blogosphere. Your book is fantastic, the best I have read. Thanks for doing this. I look forward to the hardcover version.

  5. What are your thoughts on adrenal fatigue? Some paleo bloggers such as Kurt Harris dismiss it as a myth and others such as Robb Wolf believe it is a major issue. Do you have any thoughts on whether it is a real issue and what may cause it? Some other bloggers suggest that a low carb diet can create or exacerbate adrenal fatige issues or maybe thyroid issues.

  6. Hi Todd,

    Well, adrenal dysfunction is a reality and many chronic disease patients have messed up adrenals. Whether this is properly characterized as “fatigue” is another question – I would assume that is what Dr. Harris objected to.

    It’s always difficult in these diseases to distinguish what is a causal pathology at the root of disease and what is a symptom that will clear when other, more fundamental causes such as infections are cleared.

    My feeling is that these pathologies are often easier to cure than to understand. They usually come down to food toxins, malnourishing diets, and infections, and when those three problems are fixed, problems generally resolve.

    The hard part is that many infections are occult and doctors aren’t geared up to diagnose or treat them.

    Taking Matt Stone as an example of one who critiques a low-carb diet on adrenal hormone grounds: I think most people who develop these problems will be found to be (a) suffering from chronic infections that increase need for glucose, and (b) eating too low-carb and developing glucose deprivation. I think the criticism of very low-carb diets is well founded. They are risky, not robust to infections as a good diet should be. And unnecessary: there is no benefit to cutting carbs below around 500 calories in healthy people — lower in some people with metabolic dysfunction, e.g. diabetes, epilepsy, cancer, etc.

    But I don’t think the adrenal problems will develop if 200 calories of starches are eaten daily, and 600 calories of carb + protein. So you don’t need a lot of carbs to avoid the issues Matt worries about.

  7. Very nice blog! I have a question for you. I’m aware of calcium feeding biofilms in isolation. Does taking magnesium as an isolated supplement also have this effect? Art from cooling inflammation seems to think so.

  8. Yes, great book. Really on the next level. Thank you!

  9. Hi Aaron – Yes, calcium, iron, and magnesium are the three primary minerals of bacterial biofilms. Biofilms also utilize heavy metals, which is why people with chronic disease sometimes develop heavy metal poisoning during treatment as biofilms that built up heavy metals over decades release their constituents.

    Of these, we recommend supplementing magnesium regardless of disease status because it is so important for health, including immune function. You can go a long time without calcium without any ill effects, so that’s one to avoid if you have gut disease. Iron is an intermediate case, you need to avoid deficiency but shouldn’t provide any extra.

  10. Paul,

    Thanks for the great answer. Yes Matt Stone was the critic to whom I was looking for a response!

  11. Thanks for answering, Paul.
    The first years of my primal eating was more PUFA with fish, seafood, poultry, all veggies + fruits, flaxseed oil. Than more meat, beef and lamb, coconut stuff, lots of ghee + red palm oil, green veggies + seldom pure fish oil. For sure more protein/fat than with PUFA but than I had also more carbs like potatoes/fruits. I thought there would be a kind of compensation.
    I should mention that I´m not overweight. BMI 20. Just want to maintain that. Maybee it´s not the fat type only but the relation of all 3 macronutrients. It seems I do better with a middle protein-fat/low carb as with high fat-protein/vl-zero carb.
    Greetings from Munich.

  12. Hi Byron,

    Since you are very slender (BMI 20) I’m wondering what kind of weight you’re talking about gaining – muscle or fat? It would be a good idea to put on some muscle I would think.

    Since your PUFA diet had only modest PUFA content and is high in omega-3, it’s very different from the usual high PUFA diet. One factor to consider is that it takes ~4 years for omega-6 levels in tissue to return to normal (low) levels after you stop eating vegetable oils, so the extra omega-3 could have a beneficial compensating effect in the first years of primal eating.

    One thing that happened to me when I fixed my nutrition was that I gained 10 pounds with no change in body shape — getting more slender in fact. I think I added a lot of bone mineral density. Magnesium/D/K/iodine supplementation were the keys. So better nutrition on the SFA diet could be a factor too.

    Since you say you have more protein/fat on the SFA diet but also more carbs, it sounds like more calories overall. This would make easier weight gain on the SFA diet no mystery at all.

    Since at a BMI of 20 gaining weight is probably a plus, I would take that as a credit to the SFA diet in the absence of further information.

    Just noticed your last line — yes, low-carb (200 to 500 carb calories per day) is always going to be healthier than very low / zero carb (< 200 carb calories per day). You need some glucose for good health and eating carbs is the least stressful and least risky way to obtain them.

  13. Hi Paul,

    “low-carb (200 to 500 carb calories per day) is always going to be healthier than very low / zero carb”

    I’m zero-carb as I’ve found Ketosis has greatly reduced my depression / suicidal tendencies, however I do worry that this might not be “healthy”.

    You mentioned “some mental health and neurological disorders, may benefit from very low-carb “ketogenic” diets” and I was wondering if there’s any more advice you can give on finding that sweet spot?

    Ketosis hasn’t cured me, I still have bad days and take SSRI’s but it’s certainly better than boatloading carbs for “serotonin” like I used to.

    P.S. As someone who can’t abide fish, what would you recommend instead of fish-oil capsules?

    Keep up the great work.

    Regards,

    WP

  14. Hi Winalot – Yes, I should have qualified that line to say that 200-500 calories will always be healthier FOR HEALTHY PEOPLE. Some diseases do benefit from ketogenic diets. Brain/neurological/mental health conditions chief among them.

    I’m very glad that you’ve found a ketogenic diet. So many people with these disorders fail to do so.

    I do have dietary advice for ketogenic dieters. In general, I recommend 200 starch calories a day. This will not prevent generation of ketones if you take a lot of ketogenic short-chain fats and will protect you against glycoprotein deficiencies leading to bowel cancers and other nasty long-term side effects, not to mention impaired immunity against extracellular pathogens.

    This should be accompanied by a boatload of coconut oil for those ketogenic fats. I suggest about 1500 calories / 6 fluid ounces / 12 tbsp coconut oil per day. This sounds like a lot, I know, but it is therapeutic.

    Also, get 400 calories protein per day. This is higher than our normal protein recommendation.

    Finally, I highly recommend antibiotics, since I believe bacterial infections of the brain (leading to tryptophan sequestration by interferon-gamma and IDO) are far and away the most likely cause of your depression and serotonin deficiency. I would start by assuming this is C. pneumoniae, the most common brain pathogen, and take the Wheldon protocol antibiotics. You can find a good guide at http://cpnhelp.org.

    If you can’t abide fish, I would try the liquid refrigerated fish oils in bottles rather than the capsules.

    Good luck! Let me know how your condition progresses/regresses.

  15. Byron – One important point: If weight gain is hard you may have a vitamin C deficiency. That’s needed for collagen / extracellular matrix formation. That’s a risk factor on zero-carb diets, which inhibit ascorbate recycling and can induce tissue scurvy. I would do a vitamin C tolerance test (take 1 g vitamin C every 15 minutes until bowel intolerance is reached). If the amount you need to take is large, then you are deficient. Supplement 1 g per day thereafter.

    Get off zero carb and address micronutrition and I think you’ll find it’s much easier to add muscle.

  16. Hi Paul,

    Many thanks for your valuable time and insight.

    When you advise on boatloading coconut oil, is this in addition to current diet or a replacement?

    I do consume coconut oil (not to the level you advise though), together with eggs, butter, pork, beef, some offal (ox heart) and bones (typically chicken), sometimes cheese and clotted cream.

    I’m pretty lean, ~10% bodyfat, which I sometimes think can undermine mental health, although I’m rarely ill / sick (apart from the depression) and I was the same BMI when I consumed 5000+ calories in the high-carb days.

    The only pills I pop are fish oils, vitamin d and the SSRI’s. I’m tapering the SSRI’s over the coming years (yes, taking my time) as I do find it rough if I reduce too much, too soon.

    I’ve never heard of the Wheldon protocol before and will invest some time in the site. Are antibiotics the only solution or is there a food based alternative?

    You don’t seem adverse to supplementing vitamins and minerals; I’ve been trying to get rid of as many manmade pills as possible so it’s perplexing!

    Regards,

    WP

  17. Hi Winalot,

    In the standard Perfect Health Diet we recommend about 2 tbsp coconut oil per day.

    For the ketogenic diet you need a lot more for glucose replacement and neuroprotection. The assumption is that the neurons are threatened by bacteria, are really starved for glucose, and you need to replace ~300 calories a day with ketones. To generate that many ketones, very large amounts of coconut oil are helpful as a sort of supplemental food. I would imagine 1500 calories of coconut oil might replace 600 calories of other foods. Thus total calories would increase, but I wouldn’t expect you to gain weight just from coconut oil.

    Your diet sounds great, but add a little starch in for safety. You don’t need to be zero carb to generate ketones.

    We mention our eight recommended supplements on “the diet” page. I would definitely take all eight.

    Antibiotics and food complement each other. I’m going to do a post on this tomorrow, discussing your case and Michelle’s.

    Best, Paul

  18. Hi Paul,

    Thanks for the “realtime” reply 🙂

    I saw your list of recommended supplements on the diet page and have gleaned your views on doses and brands from blog comments; perhaps a post to summarise this would be useful?

    The main issue prohibiting me from more supplementation is cost, as it can get quite expensive when the shopping list is long.

    Add me to the list for your book when it’s released and I’m looking forward to your next post.

    Regards,

    WP

  19. Paul,

    What is your opinion of cyclic ketogenic diets or periodic high calorie or high carb “refeeds” to reestablish leptin levels?

  20. Hi Todd,

    In general I like intermittency. Ketogenic diets have a lot of benefits for disease prevention. We suggest a mix of intermittent fasting and occasional ketogenic diet days mixed in with our regular diet.

    The key point here is that the regular Perfect Health Diet and the ketogenic variant are both healthy diets. In the final version of the book we review the various mammalian diet strategies and the regular Perfect Health Diet could be called an “Omnivore strategy” and the ketogenic diet a “Herbivore strategy.” So both are healthy for mammals, have proven their worth in 200 million years of evolutionary selection, and since both strategies are healthy individually switching between them is sure to be healthy too.

    Intermittency in total calorie intake is probably also good for the athletically inclined. High calorie intake helps build muscle; low calorie intake helps optimize metabolism and increase mitochondrial efficiency. So overfeeding days and fast days are good for athleticism.

    Intermittency in carbs might be beneficial, I suppose, but that’s more doubtful. Keep in mind in reading what follows that I’ve never tried to figure out how to optimize a diet for body building or rapid weight loss. I really care only about health and especially robustness against potential problems. I’m not so interested in achieving extreme leanness, although I have ended up quite lean.

    Here’s my take. I think carbs from safe starches are healthy as long as one doesn’t string too many >600 carb calorie days in a row together. A diet that averages 600 carb calories per day is still very close to perfect if all the carbs are “safe starches.”

    I expect that varying between 200 and 600 carb calories a day is a sufficient variability to achieve any available hormonal benefits from carb intermittency. Since both are safe levels of carbs to eat at indefinitely, I would recommend this as a strategy for those who want to try carb intermittency. Eat 600 carb calories a day for whatever period you like, then 200 carb calories a day with coconut oil for whatever period you like.

    But my guess is that the difference between (a) intermittency between 200 and 600 carb calories, and (b) eating a steady 400 calories a day, would be undetectable.

    Is carb intermittency necessary for health? No. Is it beneficial against disease, say bacterial infections or cancer? I doubt it. The bacteria or cancer cells probably gain more on the high carb days, when they can reproduce more easily, than they lose on the low-carb days when they can just hibernate.

    People on zero-carb diets would benefit from carb refeeding. But I doubt anyone on our diet, eating adequate carbs, would.

  21. Thanks for the response Paul.

  22. Todd, I might add that I don’t object to alternating 1000 carb calorie days and 200 carb calorie days, since that averages to 600 carb calories which is within our safe zone. And that seems to be roughly what a lot of the carb refeeders do. So I don’t object to it.

    I’m just not aware of benefits. If experience shows it does have benefits, that would be a new biological complexity to track down.

    I suspect the people who claim benefits from carb intermittency are actually experiencing benefits from total calorie intermittency.

  23. Hi Paul
    Just got your book , terrific read
    Would sushi be a perfect food with seaweed, white rice” and fish?
    Many thanks
    Bruce

  24. Hi Bruce,

    Yes, sushi is very healthy, we have it often.

    Only concern is parasites in the fish.

    But you can have cooked sushi too, we give an example on p 234. Download the “Color Companion” from the blog sidebar for a better quality picture.

    Best, Paul

  25. Will do
    Thanks so much for the quick reply
    Bruce

  26. I have just purchased your book and your theories resonate well with me. I’d just like to ask a couple of questions:
    1. I’m a little confused about how to work out the carb/protein/fat ratios. Does is require breaking down every food item into carb/protein/fat content and then working out your calories from that? Is a particular food simply a carb or a protein (e.g. yogurt – is that classed as a protein or a fat)
    2. It it necessary to have the correct ratios at every meal or over the whole day?
    3. I am 54 years old (female)have adrenal fatigue and Hashimoto’s thyroiditis but not taking any medication other than natural glandulars (from porcine sources), selenium 150mcg every 2nd day, a herbal Adrenal support formula and magnesium. For years I’ve been trying without success to feel energetic and get my ‘spark’ back. Now I’m going through menopause as well! Basically symptoms are: fatigue, head feels achey (although not a headache per se) as if it’s full of cotton wool, have an abnormal reaction to moderate exercise, hair thinning and the list goes on. I’ve resisted pharmaceuticals because the side effects can be more damaging than the disease but I’m unsure if I’m doing the right thing. I’d love to hear your take on this. Previous to your book, I was generally gluten free and ate healthily, no junk food. I am overweight at 75kg my height 5’6″ and having trouble losing it.
    Cheers,
    Kim

  27. Hi Kim,

    1. To get a detailed ratio, you would weigh your food and then look up its nutritional content on http://nutritiondata.com. However, that’s not really necessary. If you eat in the proportions on the Food Plate — ~ 1 lb safe starches, 0.5 to 1 lb meat, fish and eggs — you’ll be doing OK. Keep that ratio and scale it up or down according to appetite.

    2. No, you don’t need the correct ratios at every meal, but it’s good to come close most days.

    3. I think it’s good to resist pharmaceuticals, but you don’t necessarily want to avoid thyroid hormone. I think a few other supplements would help you, especially magnesium and vitamin D. You might want to read the various posts in our Hypothyroidism category. You might want to try an experiment with ketogenic dieting to see if that helps your cognitive symptoms. And you might consider testing antibiotics to see if they help.

    For weight loss, the single biggest key is to minimize omega-6 fats. After that, eat a highly nourishing diet; minimize fructose; eat macronutrients in appropriate amounts (400-600 carb calories a day, 300-400 protein calories, enough fat to be well nourished but little enough to be calorie restricted overall).

    Best, Paul

  28. Paul,
    Thank you so much for your prompt reply. I am loving this site and your book! I will follow those guidelines and see how I go.
    On another note, do you know anything about the issue of linolenic and linoleic acids plus arachidonic acid and other polyunsaturated fatty acids often being low in people with hypothyroidism. Apparently the effect of these fatty acids is to transport the blood calcium and other minerals into the tissues to be used to fuel metabolic and enzymatic processes. Also thyrotrophin, the thyroid protomorphogen. Protomorphogens are the extract of the nuclear material of the source gland, in this case, bovine thyroid gland. Protomorphogens bind with and neutralize antibodies that can destroy our tissues and organs. In the case of Hashimoto’s being an autoimmune disorder, neutralizing the attacking antibodies gives the gland a chance to rebuild itself. Look forward to hearing from you on this.
    Cheers, Kim 🙂

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