Experiences, Good and Bad, On the Diet

A number of people have now given us feedback after starting the diet, and I think this is a good time to review the effects, good and bad, that people have experienced.

In upcoming posts, I’ll discuss the negative experiences further and explore possible causes.

Positive Experiences

It’s gratifying that most people who have tried our diet have reported very positive experiences. Those who read the comment threads or Amazon reviews will have seen some of them; I get others via email.

Here are two from Amazon reviews:

I have battled Celiac disease for some time and got about 80% better with a Paleo diet… but the Perfect Health Diet was the first book that could finally answer that last 20% with science based logic. (Jordan Reasoner)

UPDATE: Jordan has an e-book, SCD Lifestyle: Surviving to Thriving, which looks great for bowel disease sufferers. He gives us an update on his personal progress in the comments.

I can’t believe how much better I feel!…

I had been eating (very) low-carb and high-protein for the better part of a decade – and I had gotten a lot of practice arrogantly dismissing suggestions (from any source) that I should change anything about my diet….

Results: (after 1.5 months or so.)

  1. I’m no longer “brain-dead” and unable to think in the evenings after work.
  2. I no longer have fruit or chocolate cravings.
  3. I’m much happier, and wake up looking forward to the day.
  4. I’ve been much more social.
  5. The extra starch has not resulted in weight gain. (I always gained weight when eating carbs before.)
  6. It looks like the fasting (which I’ve never tried before) is helping my alertness and also contributing to healthy weight loss.

It took less than a week for me to notice dramatic changes….

I can’t recommend this book highly enough. (gp2x)

Here are two from the last few days’ comments.

Yours is by far, the best Paleo / Ancestral diet that makes sense….  I was very strict Paleo for a good 8 months, and yes felt fantastic and lost 10ks etc.  But then started feeling tired, moody.  Enter some carbs (from the suggestion of your book) in the source of potato and rice and taro – and now I’m feeling a whole lot better.  Did I put on weight.  Of course not!  Essentially now I eat what my body craves.  I can listen to it now and it responds accordingly.  It knows when it needs more carbs (eg., after exercise).  And it knows how much as well. (Lisa Weis)

Since reading Gary Taubes’ Good Calories, Bad Calories my life has been transformed. Who knew that butter was a healthy food.  Previous to reading GCBC I was a fruit fiend.  I ate bowls and bowls of cherries this past summer and wondered by I could not lose weight.  I reached my weight loss goals by eliminating grains and limiting dairy to butter and cream and reducing fruit intake.  That said, over the last month or so, I was wondering why my body seemed to be drying out from the inside out.  I want to tweak my diet to optimum health and found your book. The information about the importance of mucin was helpful.  What was missing in my diet was the carbs that you and the missus recommend.  Sweet potatos, white rice etc.  Maybe less protein than I’ve been eating and more saturated fat.  (I’m alarmed by the stomach and other cancers suffered by long term adherence to the Optimal diet …)  I’m having better results every day.  I am fascinated that I have a laboratory of my own body to put your ideas to a test and have them show positive results.  Thank you both so much for your work and above responses to questions and comments. (Doris)

I think these positive experiences are impressive considering that most of our readers have come from the low-carb Paleo community. Low-carb Paleo diets are far healthier than the Standard American Diet, and so improving health further is quite an accomplishment.

Another group that we are trying to help are people with chronic diseases. Probably most readers who did not arrive from the low-carb Paleo community have come from the chronic disease community. It’s a little early to report results, but at least some people are finding promise in our diet. Natalie wrote:

As someone dealing with chronic disease (a very unfun combination of Lyme, Babesia, and Bartonella), I know I’m always looking to find out more of what has worked and what did not work for others.

This blog along with many of the readers of this blog have been a tremendous help to me personally.  For example, I now know I can avoid the daily “coma naps” if I don’t go crazy on the carbohydrates.  I’ve actually received some excellent diet advice from my doctor, but he never told me to chill on the carbs!  (Natalie)

Ketogenic diets are frequently mentioned by us as potentially therapeutic for many diseases. I’ve blogged previously about Claire’s discovery that ketogenic diets help her gastroparesis and Rob’s suppression of his lifelong migraines through fasting and ketogenic dieting.  

As more chronic disease sufferers try the diet – for instance, Darren who has Lyme disease – we hope to prove that the Perfect Health Diet in conjunction with antibiotic therapies can lead to cures for these difficult-to-treat conditions.

Negative Experiences

So far, all the negative experiences I am aware of have come from low-carb dieters who had difficulty after adding carbs and/or cutting protein.

Don Matesz is an interesting case, because his own diet was already a “Perfect Health Diet.” His diet, if I’m not mistaken, was in the low end of our carb range and high end of our protein range. As a test he reduced protein and added carbs, heading toward the high end of our carb range and low end of our protein range. He didn’t like the results:

Just to experiment, for a couple of days Tracy and I reduced our meat intake by half.  I reduced my meat intake from more than a pound daily to just about one-half pound, and, as the Jaminets suggest, replaced the protein with starchy carbohydrates (potatoes and sweet potatoes).  For both Tracy and I, this resulted in a noticeable decline in mood and a dramatic increase in hunger and intestinal gas, along with a disruption of bowel function….

UPDATE: Don says that he does best eating above the bottom end of our optimal carb range, but that for years he has gotten into trouble whenever carbs reach 100g/day (the middle of our optimal range). It sounds to me like an unresolved gut dysbiosis.

Don’s commenter SamAbroad had a similar experience with reducing protein intake:

But I’ve also been following the PHD, and to be honest, I am so hungry and cranky when I restrict protein.

UPDATE: SamAbroad turns out to be our Sarah, and she says that the Perfect Health Diet “has been one of the best things I’ve ever done for my health.” Maybe we should move her to the Positive Experiences group!

I’m still following the diet, I eat circa 100g carbs from starch a day not including veg and this has been one of the best things I’ve ever done for my health along with including a vitamin C supplement. My low-level depression and anxiety have completely disappeared and the diet is considerably more varied and easier to stick to than VLC.

Sarah’s issue is that she needs to eat at least the midrange of our carb+protein “plateau range,” for reasons as yet unknown.

Chris Masterjohn had trouble with sweet potatoes:

Although sweet potatoes are considered a safe starch on the Perfect Health Diet, they are not very safe for me. When I discovered how yummy sweet potato fries are, I started eating several sweet potatoes per day. Within a few days, I was limping and my neck was stiff. By the end of the week, my limp was extreme. I looked online to see if I was eating anything high in oxalates, and sure enough, sweet potatoes are loaded with them. My symptoms dramatically improved after one day off sweet potatoes and were gone the second day.

Chris’s commenter Lisa also had trouble with sweet potatoes:

I’ve been very achy since I started eating sweet potatoes daily. Why would some of us be maladapted to oxalates?… I’m wondering if after a long stint of LC/paleo eating I’ve become intolerant to oxalates or to starch in general.

UPDATE: We discuss possible reasons for problems with sweet potatoes here.

Several people have gained weight after starting the diet. This Amazon review doesn’t come right and say that the reviewer experienced weight gain, but I’m guessing that was the case:

It is worth emphasizing what another reviewer noted: The Perfect Health Diet is not focused on weight loss. In fact, if you are coming to the diet from a zero-carb or very-low-carb regimen, you can count on an immediate and substantial weight gain if you suddenly adopt the recommended intake of “400 carb calories [100 grams] per day of starchy tubers, rice, fruit, and berries.” (K. Hix)

From the comments, Maggy reported weight gain:

Following your advice, I added back a bit of “safe starch” last week, and decreased protein intake, keeping sat fat and MCF pretty high. Well, I got on the scale today and have managed to put on 5 pounds! I’m trying to figure out what is going on and what I need to tweak. I do need to lose a good 20-30 lbs, and while I don’t want to compromise health, I also don’t want to put back on what I managed to lose doing a VLC diet.

Is this an adjustment period I need to get through? Maybe I’m one of those broken metabolism folks who has to stick with VLC? (Maggy)

These negative experiences will be the subject of my next few posts.

Because individuals are so variable, it is often not possible to figure out what is going on without experimentation with different dietary variations and considerable communication. Therefore, I’m most grateful to people like Maggy who are willing to experiment and share their experiences with us.

Conclusion

It’s interesting that the same dietary change – adding “safe starches” to a low-carb Paleo diet – made some people feel better and others worse.

This series may also lead us into the question of trade-offs in diet. These trade-offs may cause different people to prefer different diets. For instance:

  • Shifting from lean-meat-and-vegetables to starches and fats may increase the pleasure of eating and improve health in some, but promote weight gain in others.
  • Higher protein may promote athleticism and fertility, but shorten lifespan (as it does in some animals).

In writing our book, we tried to present the evidence underlying all of our recommendations, and provide healthy ranges for the various nutrients with explanation why the reader might prefer to be at the high or low ends of the range. Our goal was to empower each reader to find his or her own “perfect health diet,” not to rigidly prescribe a specific way of eating.

But negative experiences on a diet can also have diagnostic value. For instance, when I first adopted a low-carb Paleo diet I developed severe fungal skin infections. The new diet revealed an infection I hadn’t known I had. For this reason, even negative experiences can be beneficial, as they may open a path to curing an underlying but hitherto concealed health problem.

We see this blog as a communal enterprise, in which we and our readers together try to discover the truth about diet and health. Therefore, we hope that anyone who does have negative experiences on the diet will not hesitate to report them in the comment threads and work with us to discover the cause.

Leave a comment ?

185 Comments.

  1. i always wonder why people link paleo and low-carb so persistently. paleo is not defined as low-carb at all. even sisson (as probably the most “visible” paleo advocate on the net) recommends 100-150g carbs a day, which is moderate carb, but certainly not low-carb. i think the problem is more that as people cut out grains and stuff that they don’t even realize how low they get in carbs with time. this happens to me from time to time as well, and then i have to plan to include more carbs again, especially after workouts.
    i think the amount of carbs should be a function of muscle mass x activity. the more muscular and the more active, the more carbs are needed and tolerated. but again: paleo != low-carb by definition.
    wrt to low-protein – i’m not convinced at all. i def. feel better with more protein (in the 1-1.5g/kg range). who cares if it ages me 1% faster, if i’m weak as a vegan in the mean time.. *g*

  2. I started PHD a few weeks ago, after finding the blog, and then reading the book. I have only positive experiences to report. I was not LC beforehand, but I had been aware of Paleo nutrition for a while, and had been recently reading PaNu, Hyperlipid, Whole Health Source, Lean Saloon, and Conditioning Research. The concept of an ancestreal diet made sense to me, and when I stumbled on PHD, it came together in a consistent, scientific package that was easy to implement.

    I had been overweight in the past, and lost weight by low-calorie dieting on processed foods, along with strength training. After a while I would revert to some degree of overeating, and have to diet again. I’m mildly overweight now but I have been losing 2 lbs. per week on the PHD. Keep in mind this is before any calorie counting. I keep telling myself I will plug things in to Fitday, but so far my hunger is autoregulating itself and the weight is coming off. I also do IF (16/8) with a couple of 24’s since I started. On the other hand, I had some deviations from the diet over the holidays without consequence. I also have 0-2 glasses of wine per night which hasn’t slowed weight loss. The only formal exercise I do is < 10 minutes per week of Body By Science style HIT weight training.

    Besides weight loss, I feel great. I haven't wanted to eat any take-out or sweets, and that is unusual for me. So, if you are lurking, I encourage you to give the diet a try. Reading the book is worthwhile even if you are familiar with the concepts. The section on fats is particularly well explained.

  3. Thanks again for this informative post. Paul, I would very much like to know your stance on dairy and, of course, I fully respect if you do not have the time to give a detailed reply here. Maybe you could make this a post if your time allows for it? In your book you mentioned what is my main concern as well, the IGF 1 growth hormone that occurs even in organic milk of untreated cows. The opinion in the Paleo community seems to range from “milk is not at all acceptable” to “butter and cream are good and yoghurt/fermented dairy is okay”. The opinion of the Weston Prize organisation is very favorable towards (raw) milk but I feel they are VERY ignorant on the potential concerns that need at least thouroughly discussed. For example 85-90% of cows in the USA are infected with bovine leukemia (in Germany, luckily, this is very rare); it is not at all clear that it cannot be of dangerous for people over time and promote the development of leukemia in humans. Sally Fallon answered one reader`s question conderning this issue on the Weston Price homepage something like that she didn`t believe that this is true which didn`t satisfy me at all, as well as her stance that the natural occuring IGF 1 was a reason why milk is of such healing power – clearly ignoring that there is at least some proof that is promotes growth of hormone-related cancer (breat/ovaries/prostate).
    I do not know what to make of it…I like dairy (full-fat, cream, butter, some cheeses, yoghurt) but I am very concerned about the IGF 1…Do you have an idea if this is more in the “watery” part or in the fat (Does butter has more IGF 1 than whey for it is so concentrated)? Do you have an opinion on it being harmful at all or not? And raw dairy? Would you eat it? Sorry, that has become a long post…

  4. After experimenting with adding modest amounts of “safe starches” to my much lower-carb routine, I have noticed a modest weight gain of 3-5 lbs. I wonder if it’s merely glycogen and water repletion.

    I imagine I could test this theory by eliminating the starches for a day or two. My understanding is that the hormonally-driven effects on both glycogen and water retention are very fast. On the other hand, body weight measurements are quite “noisy” (i.e., there are typically a lot of seemingly random day to day fluctuations of several pounds due to a variety of unmonitored factors). So the results would not be completely straightforward to interpret. I bet that cycling on and off the starches a few times would tell the tale, however.

  5. I’m an italian “weak vegan”, as Qualia says, and I wanted to underline the fact that not being able to digest a sweet potato, is really bad.
    Maybe the strictly low-carb diet changed dramatically the gut microflora, but I don’t think it’s a plus!
    I am happy to say that, being nearly vegan, when it occasionally happended of eating eggs or ghee (indian or asian restaurants for example) I’ve always digested well the small ammount of animal product.
    So must I conclude my digestion is better that the one of a strictly lowcarb eater?
    Anyhow great blog, really!
    Best wishes 🙂

  6. Hi qualia,

    Yes, Sisson is essentially compatible with our macronutrient ratios … His book came out while ours was in progress and anticipated a few of our recommendations … It was good to see that. Of course Cordain was not opposed to plant food either.

    But there has been an odd opposition to starches. So with some Paleo authorities, our differences are subtle and relate more to composition of carb calories than to quantity.

    Hi Robert,

    Great! Your experience is exactly what we predicted and hoped would happen for most people: steady weight loss; no hunger; autoregulation of food intake without need for calorie counting; ability to stick to the diet with pleasure; and no risk of subsequent overeating (to fix malnutrition), weight gains, or health problems.

    So I’m very happy to hear your comment.

    But people come in many different situations and health conditions, and we have to try to understand what’s going on when the diet doesn’t work as expected.

    Hi Bill,

    The glycogen/glycoprotein idea is very possible. If that mechanism is really responsible for 5 pounds, that would suggest that many of our very low carb friends have been starving their bodies of glucose. Glycoproteins are needed to prevent all kinds of disease, so if this theory is correct then

    I would not expect elimination of starches for a day or two to be sufficient. I think the water must be held mostly by glycoproteins, not glycogen. They might build up quickly to the level the body wants once glucose is restored, but take a long time to be lost when the diet is restricted.

    I should look back to the fasting/starvation experiments to see how long water is lost.

    The good news is that if this explanation is correct, the 5 pounds is a one-time gain and will not worsen body composition (the pounds will not be in the waist). And people should feel better.

    Another factor is micronutrition. I gained ten pounds after I started supplementing micronutrients, with improved body composition. I believe this was in muscle and bone density, and is beneficial. If people are implementing all aspects of the diet at once, it may be hard to sort these one-time changes out.

    Best, Paul

  7. Hi Iris,

    I think you and I are in the same boat re milk. I do think that raw milk is more digestible and less likely to cause the allergy/sensitivity problems. On the other hand, most cows in the US are infected with various pathogens. Mastitis is very common, and viral diseases leading to leukemia also. Pathogens that infect mammals can often cause disease in humans. So you should definitely “know your cow” and trust that it is healthy before drinking raw milk.

    In our home, we eat butter and drink heavy cream but don’t touch milk. We’ll also eat cheese and yogurt, but these are not staples.

    IGF-1 promotes cancer and shortens lifespan, although it does promote muscle growth, so this is definitely a concern. It is water soluble and should be lower in butter and cream than in milk, and lowest in clarified butter.

    So clarified butter is the only milk product we can endorse without reservation, but we like the taste so much and it’s so helpful for cooking that we are willing to overlook the risks for certain fatty dairy products.

    The science is not adequate to precisely quantify these risks, so it’s a judgment call and you have to balance your taste for these foods against the risks.

    Best, Paul

  8. Hi mammafelice,

    I’m sure you do have better gut flora than many people!

    I raised the issue of gut flora in my comment at Don’s site, but Don believes that shouldn’t be an issue in his case.

    Thanks for the comment! I’m glad you like the blog.

    Best, Paul

  9. I’ve been extraordinarily LC for nine months or so, with the occasional cheat day for the first few months (desire to cheat went away a few months ago).

    Prior to that I was extremely low-fat, calorie-counting, high-carb, distance-running fool for 15 years. What an awakening 2010 was.

    I am just *now* after reading PHD — despite being on the blog for the past few months — adding carbs back to my diet. I tend to be an all-or-nothing type. Whenever I introduce carbs (same thing now) I immediately gain 2-3lbs, though not really in the waistline. But I still freak out about it.

    I am also adding the micronutrients this week, which I am looking forward to.

    I lift once a week and would like to build muscle and get rid of the remaining belly fat that’s been with me since I was a kid.

    Will let ya know how carbs + supplements change/affect it!

  10. Thanks, John!

    I’m optimistic that in most people early weight gains will prove to be associated with improving body composition, not worsening. But experience will tell!

    Best, Paul

  11. Hi Paul,

    Thanks for posting my review!

    I’m continuing to learn from your book all the time. I’ve been experimenting with several of your recommendations. Your transparency posting both good and bad reviews is so refreshing, and keeping with the theme I wanted to follow up with an update on whats been happening since I left that review in Oct.

    Quick background:

    – I have Celiac Disease and went GF for 2 years and got sicker
    – I started the Specific Carbohydrate Diet (SCD) in 2009 (no grains/starches/sugars),
    – I made many tweaks to get SCD to work for me (no dairy, egg, nuts)
    – I got 80% of my health back and now have calmed most of the physical symptoms of my disease.
    – Now I’m looking at the last 20%, but not to find my “cure” – just to feel even better.
    – In the meantime I wrote my own book about how I created my own version of SCD and help many others do the same.

    Right now I’m eating 3,000 calories a day of 60% fats, 30% proteins, and 10% carbs consisting of fats, meat, veggies, and very small portions of fruit (like 10 raspberries). I’ve been eating this way very strict for almost 2 years now.

    Here’s what I’ve done for the last 20% so far:

    #1: Increasing my daily fat intake to 60% with coconut oil, olive oil, 6 grams/day of fish oil supplementation, and avocados caused a huge improvement in energy, clarity, and BM’s.

    #2: I feel the best borderline ketogenic. As soon as I eat more a handful of fruit I get horrible gas/cramping/loose stool/bad breath/etc.

    #2: Took 5,000 IU’s of D3 and got my 25OD level to 65 ng/ml.

    #3: Digestive enzymes and HCL took fat/protein digestion to a whole new level

    #4: Introduce 200 CFU’s/day of a diverse probiotic with 11 strains of both Lacto and Bifida – helped digestion/Bm’s dramatically

    #5: Iodine – I got up to 12.5 mg/day for 45 days and it tossed my thyroid into chaos, I felt hypothyroid symptoms but didn’t gain any weight though.

    #6: Magnesium – I tried “natural calm” for a week starting with 1/2 tbsp and I got diarrhea

    #7: Fermented foods – I tried sauerkraut everyday for 45 days to improve digestion but got gas

    Here’s what I’m still missing:

    I’m still struggling with certain intolerances. For example if I eat more than a cup of raspberries or blueberries I get horrible gas and loose stools.

    I also react to eggs, tomatoes, and the sugar in alcohol with the same physical symptoms.

    It’s leading me to believe I’m still battling intolerance’s caused by a leaky gut even though it’s been almost 2 years.

    My immune system is also still very active with high activity of neutrophils and eosinophils. I’d love to hear your thoughts on more experiments to calm the immune response and leaky gut issues and/or poor gut flora (despite aggressive probiotic support).

    If I’ve already optimized “my optimal diet” and using prudent and high quality supplements, what else can I test?

    I have pretty extensive bloodwork and CDSA tests tracking my progress, so I’ve tried to be very transparent with my experience from the insights in your book. I’m open to keep testing and getting better.

    Thanks for doing what you do!

    Jordan Reasoner

  12. Paul, do you have an opinion on the protein in coconut flour (mine has 20 g protein/100 g flour which is pretty high, but it is a good organic brand, 100% natural). Is it as potentially harmful as other plant proteins or do you think it is acceptable?

  13. Hi Jordan,

    Glad to hear about your book! I’ll update the post to mention it.

    It sounds like you have a small intestinal infection of some kind. Fructose in particular seems to get absorbed by pathogens much more readily than by the gut. With glucose the gut seems to be better at competing with the pathogens. So there are more signs of bacterial activity with fructose consumption in small bowel infections.

    Any bowel infection will create a leaky gut and that will lead to systemic food sensitivities.

    I think you’re doing nearly everything very well diet and nutrition wise, so I would look next to biofilm busting strategies and then antibiotics – maybe the two together, since antibiotics don’t penetrate biofilms well, so need biofilm dissolution to be effective.

    There may be diagnostic tests your doctor can do for intestinal infections. If you could determine a specific species then it would be easier to find an effective antibiotic.

    Best, Paul

    Hi Iris,

    All plant proteins can be toxic, but coconut I don’t think is very toxic.

    Allergenicity is one measure of toxicity likelihood, and coconut meal is less allergenic than cashews or almonds, which we support eating in moderation.

    Unlike grains and legumes, nuts have not been very accessible to mammals/herbivores and so they’ve haven’t had strong evolutionary reasons to develop proteins that specifically target mammals.

    So I consider coconut flour safe until further evidence pops up, probably safer than almond meal.

    Best, Paul

  14. Thanks for taking the time to respond Paul!

    It’s so kind of you to take the time and provide feedback for people like this, I really appreciate it as an avid PHD reader/tester.

    You’re right about the symptoms related to the fructose/glucose and how that all relates to an infection. The connection to leaky gut also makes sense. Thank you for that!

    I had a couple clarifying questions:

    – In the past I assumed that I have Small Intestinal Bacterial Overgrowth (SIBO) from poor gut flora. Is there a difference between SIBO and pathogenic infections?

    – Infection to me means intracellular, so maybe that means that SIBO is extracellular or in the gut films if I understand correctly. So that might tie into the biofilm gut busting techniques to get to the infection. I’ve only read a little on this, do you have any recommendations on good resources to learn more?

    – I would be interested to learn more about examples of the types of intestinal infections you’re referring to. I’m thinking it’s deeper than the usual Candida(yeast), C. Diff., Hpylori we always hear about.

    – Also, do you have an advice on a direction to head for what types of tests I can try? I’ve done CDSA’s and I know there hydrogen testing and other things, but what would help pinpoint the type of intestinal infection? (This will help me prepare for my Dr. apt).

    Thanks again for any time you have to share your experience. It means a lot.

    In good health,

    Jordan

    I would ask for some examples and testing would be nice

  15. Hi Jordan,

    SIBO is usually diagnosed from hydrogen production by the bacteria. So this diagnosis implies large quantities of particular kinds of pathogens.

    The response to fructose suggests an extracellular and therefore biofilm-forming pathogen, rather than an intracellular pathogen. The kinds of bacteria that generate SIBO are of this kind.

    So you could have SIBO. You might take a hydrogen breath test. A good antibiotic for bowel infections is Rifaximin, since it doesn’t enter the body and remains concentrated in the gut. (See http://en.wikipedia.org/wiki/Rifaximin.)

    There are doctors who specialize in this area, I think you should try to find one. There’s no substitute for wide clinical experience and ability to employ all the diagnostic tools of modern medicine. Other diagnostic tools include endoscopies to look for ulcers, blood tests for antibody seropositivity to specific pathogens, etc. A doctor would be the best judge of what tests to try.

    By the way, on the iodine, I’m guessing you didn’t increase the dose slowly. I would recommend starting at a 500 mcg kelp tablet, and then doubling the dose once a month — so to 2 kelp tablets after 1 month, 4 kelp tablets afer 2 months, a quarter Iodoral (3.25 mg) after 3 months, half Iodoral after 4 months, full Iodoral after 5 months — but go slower if there are any side effects or thyroid symptoms after a month.

    The iodine is good for immune function and so it’s good to get iodine levels up, but only at a rate that doesn’t disturb the thyroid.

    Best, Paul

  16. I had read Don Matesz’s post the other day and had had a couple of thoughts. One, I wouldn’t be surprised if someone who had been essentially low-carbing it didn’t feel spot on when adding starchy carbs back into their diet. I’d guess there are questions of sufficient enzymes etc that would resolve after a similar breaking in period (it certainly works that way in reverse, doesn’t it?).

    I also wouldn’t be surprised about weight gain. Presumably these folks are normally running on fairly low glycogen stores. Add some starchy carbs back, and the resulting water weight gain could be a handful of pounds presumably.

    Finally, it’s interesting you thought Don’s protein intake was at the high end of your range. I would have guessed based on the meals that he posts that it’s a good bit higher. But even if it isn’t (interesting, the meal composition he posts here actually has quite a bit of carbs), one of the things I’ve been thinking is the issue of lots of protein when your metabolism is out-of-whack.

    Don’s a healthy guy. Someone like myself who is overweight and trying to lose is, I suspect, not really better off my eating lots more protein than I need. Those deaminated amino acids aren’t helping me (already have a higher uric acid level than I need) or my insulin levels!

    Of course, the low-carbers would argue that I should probably be just going ketogenic all the way. Me, my thought is to moderate carbs so that if and when I do add in some occasional extra carbs, I can handle it better.

    Anyways, that’s my current rationale. Besides, I really like peas … so have been happy to have them back in my diet ;).

  17. One other thing, not sure if it’s on your radar, but think it would be great if you attended (or spoke … they claim slots are filled but maybe there is wiggle room) at the Ancestral Health symposium this summer (see http://ancestryfoundation.org/).

  18. Hi Beth,

    Interesting, that meal of Don’s you linked to is basically spot on for our recommendations: “Protein 16% of energy, carbohydrate 25% of energy, fat 59% of energy.”

    I was surprised that Don had trouble on the low-protein end of the diet because he eats so close to our diet normally.

    Your thoughts that high protein may be more, not less, harmful for overweight people could be right. This is an area I have avoided learning about because the literature is so complex, but I will delve into it this year.

    I would have loved to attend the Ancestral Health symposium but it’s in Los Angeles, I’m in Boston, and I hate to travel. If they do one on the east coast I’ll be much more inclined to attend. Sounds like great fun though!

    Best, Paul

  19. Hi.
    Do you have any info/feedback on psoriasis,from Art Ayers blog it seems to be related to imflammation in the gut.been gluten free for 8 weeks now and do have more energy,still tweaking the diet as i only got the book last week but feel confident heading in the right direction.
    thanks

  20. Hi Chris,

    Psoriasis can arise from infections. It can also arise from a loss of skin integrity that allows bacteria and toxins to enter the body and cause immune reactions — just as leaky gut does. There may be other causes too. Since you probably won’t have leaky skin without leaky gut, and most systemic infections enter through the gut, I think it’s most unlikely you would develop psoriasis without first having an inflammatory gut problem. So I agree with Art about the association.

    With diseases of unknown cause, it’s best to do the diet and nutrition steps first, see if it resolves, then try more aggressive therapies like antimicrobials.

    After you’ve been on the diet and nutrition for a while, let me know how you’re doing and I’ll help you troubleshoot.

    Best, Paul

  21. Awesome Paul – thanks for the feedback and the link!

    Jordan

  22. thankyou Paul.will let you know after some time,meanwhile shall be taking a look at all the info here.

  23. I’ve been reading your book, and learning a lot. Thank you. I was diagnosed with colitis in 2002 and finally got it about 80-90% under control in 2009 with the Specific Carbohydrate Diet. My search for something that could heal me has taken about 2 years so far. I started blogging about it as part catharsis, and part outreach, in hopes that the dialog it generated would be helpful to both me and the readers.

    I’m excited to try some things I gleaned from your book, but I have a couple of questions first.

    1. I can’t eat yogurt or take probiotics because they give me hives and terrible itching all over. I’ve never heard of anyone else with this problem. have you? I also can’t think why that would be… other than leaky gut, the bacteria are giving off something that I’m responding to. This is enigmatic to me, and frustrating b/c the yogurt helps my colitis symptoms. I’ve tried changing the probiotic medium, brand; yogurt, brand; strains–all hives, so I reasoned it was the bacteria, not something in the milk/yogurt per se. I’m fine with aged cheese, so I reasoned it wasn’t casein. Thoughts?

    2. I’m beginning bacteriotherapy on 14 Jan; your series on gut problems spured me to finally do my research and make it happen. My GI is cautiously on board and he will supervise the treatment period.
    I’m excited, but scared. I’m scared that the antibiotics won’t work fully if there is a strong biofilm, and wonder if you have suggestions that I can try to augment the antibiotic portion of the therapy? I.E., how exactly can I help to dissolve a biofilm, if it’s there, in the two weeks I have before the first infusion? I can try berry compotes or unsweetened, homemade jam, but otherwise I’m stuck.

    Interestingly, I ate lots of cranberries before Christmas, and they sent me into a mini-flare but my BM stayed normal (Weird) except for a white mucusy sheathing uniformly around the outside of the stool. I’ve never heard of this either. Looked like either tissue or plaque.

    3. Also, during the infusions, I plan on eating (for the first time since I started the SCD almost 2 years ago) some starches. I am planning on using your safe starch list as a guide. White rice first, then yams or sweet potato. Do you have suggestions? The idea here is that I will now need to feed this new spectrum of bacteria, and I can do so more broadly than I could on the SCD. I’ve spent so much time on the SCD starving them, that eating starches or other SCD ‘illegals’ feels…awkward, like someone telling me to go ahead and pee in my bed, it’ll be fine.

    I would love to hear your thoughts.
    Best,
    Matt Robinson

  24. Hi Matt,

    1. That’s interesting. Since it happens with probiotics it seems to be the bacteria rather than an allergy to dairy proteins.

    A few brain-storming thoughts:

    a) When I had my worst bowel symptoms, I would get a strong immune response to probiotics. At that time I had a leaky gut and any meal would make me tired for 3 hours, to the point I might have to lie down and couldn’t work. Taking probiotics would give me ~2 day mild systemic infection. So the bacteria can enter the body and trigger immune response when you have gut problems.

    b) There are reports of allergies to Lactobacillus, so that’s a possibility.

    c) There can be very complex interactions between multiple species of pathogens and the immune system. So the probiotic bacteria may signal the immune cells in a way that precipitates a fight between the immune system and pathogens. All chronic human pathogens have evolved ways to suppress immune function, or to redirect it. Possibly your pathogens have re-directed the immune response toward probiotic species of bacteria!

    d) Maybe the effect is positive and these are die-off toxicity effects. See below for my comment on the cranberry experience.

    Obviously these are very vague thoughts and I don’t know if these have support in the literature or could match your specific symptoms.

    2. We had a bit on biofilms on the bowel disease series; you might also read up on some of the clinical biofilm-busting protocols, e.g. Dr. Usman’s protocol for autism patients.

    Since antibiotics don’t penetrate biofilms well it’s desirable to combine a biofilm strategy with the antibiotics.

    It sounds like the cranberries did something good for you! They disrupted an infection somehow.

    Typically there are negative symptoms or flares whenever you make progress against a well-entrenched infection. If they die, pathogens disintegrate into fragments of toxic proteins and excite a much stronger immune response. If they disperse, they try to establish new infections elsewhere in the body. So it’s common for therapeutic steps to produce seemingly negative symptoms.

    3. I do think rice is the best to start with, since we humans digest that well. I wouldn’t give too much food to gut pathogens until you have taken steps to improve the mix of gut flora. But a little bit of starch may assist immune function. You will have to experiment and go by trial-and-error. Rice will help with some infections, hurt with others.

    Best, Paul

  25. I also gained a few pounds adding starches back in, but no visible changes. I also believe that starches have been helping me to gain muscle quickly, which is nice because I lost quite a bit from surgery. I am not restricting protein however.

    I am also assuming they are aiding my healing? I read something about glycosaminoglycans needing surplus glucose, so making sure I have enough glucose would presumably be helpful.

  26. Hi Paul,

    I’m curious if you found there was a difference between an optimal diet when healthy and the optimal diet during the period you were fighting an infection. I have Rhumatoid Arthritis and I started a low, pulse-dosed antibiotic about two months ago.

    If the infectious theory holds water, is it just a matter of time before the antibiotics become noticably effective or is it important to use diet as another way to suppress bacterial activity? My main concern right now is minimizing inflammation as a way to reduce pain and joint dysfunction. I am back to using a cane on a frequent basis and as an active person that is very frustrating.

    Personally my results with diet are very similar to Jordans but for slightly different reasons. My joints fare best on a ketogenic diet, but mind and muscles are happier if they are fed small amount of carbs. After multiple experiments, I find that I do better with small amounts of white rice than I do with sweet potato. The potato seems to bring on longer lived bouts of joint inflammation (>24 hours) where the rice induced inflammation is short lived (an hour or two).

    Also, I tried the Iodoral supplement. I must have increased the doseage too quickly because I gained several pounds for no reason. Having a washout period of a few weeks allowed me to drop the weight without a change in diet or activity. My weight tends to be very stable so right or wrong I attributed the gain to the supplement.

    Best,
    Szara

  27. Hi Abby,

    Yes, I do think they will help your healing. You need glycoproteins to construct almost any tissue, and starving yourself of glucose can only be bad.

    Hi Szara,

    I think diet makes a huge difference when fighting infections.

    My systemic infection was caused by antibiotics when I was on a bad diet (I think clearing the gut of probiotic flora made it easy for pathogens to infect me) and was cured by nearly the same antibiotics once I was on a good diet. So I believe that diet and nutrition and immune function make or break the effectiveness of antibiotics.

    A ketogenic diet is definitely the best for dealing with bacterial and viral infections. But I think it’s safest to include a little carbs from starch and generate ketones from coconut oil, rather than try to generate ketones via carb starvation. This is for the concerns discussed in the zero carb dangers series.

    I do think rice is better than more fiber-rich starches for most chronic disease patients, because usually the gut is leaky and feeding gut bacteria will bring lots of toxins into the body. So you want to make your carbs as digestible as possible. You might want to try pure glucose (dextrose), that is even more digestible than rice and has no fiber at all.

    It took me 6 months to get up to one Iodoral per day. I think it’s good to be patient. You lose more by messing up your thyroid than by having iodine around; yet if you can get more iodine while doing no harm to the thyroid, it’s a clear gain. Especially if you have a chronic infection.

    Too much iodine at once can induce a reactive hypothyroidism which might be what happened to you.

    As far as whether the antibiotics are going to be effective, that’s a good question. I noticed an effect right away, so in my case it was never in doubt. If you haven’t noticed any effect from antibiotics, then it’s still an open question whether you have a systemic bacterial infection. There could be a viral infection or maybe some other autoimmune or toxicity issue. It sounds from the response to potatoes that you have a leaky gut and some kind of gut infection. This could be leaking endotoxins into the body that collect in joint fluid and cause inflammation.

    One difficulty with low-dose antibiotics is that you may not get a clear indication of whether they are working, even if they are. I used higher dose antibiotics, in line with what they use for acute infections. I don’t know what would have happened if I’d tried low-dose antibiotics.

    It’s all experimental from here, Szara, but good diet and nutrition should help immensely.

    Best, Paul

  28. Hey Paul,

    I have been reading your blog and I find it fascinating. I went on VLC paleo to fix some stubborn gut issues about 6 months ago, and I think I am at the point where I have to experiment with some fruit and starch in my diet. Low carb has done wonders for my digestion, and that along with intermittent fasting have gave my gut some long awaited peace. The problem is I have lost to much weight, and I am looking to add about 15 pounds of muscle mass. I would love to know what your opinion is on “carb refeeds,” or having a really large consumption of “paleo” carbohydrates, maybe once or twice a week, or would it be better for me to consume most of my carbs post-workout?

    Thanks for your excellent blog, really looking forward to reading future posts.

  29. Hi Paul
    Wonderful idea to invite discussion open to pros and cons of diet change. A refreshing change from the prescriptive attitude seen elsewhere. Your book is not only useful for practical health improvement but is very interesting as a reasoned inquiry into nutrition and metabolism on purely academic grounds. From the comments it seems that most posters come to the diet from some fairly refractory disease seeking help and that each person experiences widely different responses. The wide variance in results seen, to my mind is a strong reason to trust self-experimentation above all. PHD sets a very plausible starting point and posters’ experiences provide ideas for safe experiments.
    I have experienced surprisingly good outcomes after 6 months on essentially the TPH diet but there were also transient negative results. My motivation did not arise from disease and so I am inclined to think a little more critically. Your approach is credible as it avoids the common logical fallacies eg we should ask for Grock’s advice.
    The internal body environment (ie inflammation, disease, ROS stress, gut flora, foreign chemicals etc) is such a bundle of interdependent variables that it would be surprising if everyone responded in the same way. Perhaps you may consider a future post on that complex topic. As an aside, when the topic of diet arises with friends, I am totally baffled how to logically justify a diet change in absence of some desperate health need; a change seems just too risky. I have to agree with them that on the basis of “received wisdom” or battle of the authorities, “paleo” does not do well (yet). Perhaps your work will help educate the new authorities.
    Morris

  30. Hi Robert,

    Welcome!

    I think some carbs are very desirable, but I don’t think it’s necessary to do really large “carb refeeds.” I doubt those would do any harm, but I don’t see any desirable biological pathway that they’re exercising.

    Specific timing of carbs has only minor effects. For building muscle mass, the key is excess total calories, plus good levels of all nutrients. Be well nourished. You might check out our supplement recommendations page for our micronutrient recommendations. Glucose is a nutrient, so you shouldn’t be too low in it, or in protein. But you don’t need as much of either as many bodybuilders believe, as long as total calories are high.

    You will probably find that eating excess calories is easier with carbs, since carbs+fat is tastier and it is easier to add calories.

    I think you should try to listen to your body and eat what it seems to crave.

    Best, Paul

  31. Hi Morris,

    I definitely agree with you on the need for self-experimentation, especially in disease; and that experimentation should best come from a “plausible starting point” like our diet. You have to get reasonably close to optimum for experiments to give reliable clues about what works.

    This week’s posts, thinking about the varied reactions to the diet, are a start on this topic.

    It’s interesting what leads people to change diets. Sometimes it’s desperation. In some diseases, however, people are terrified of changing. I’ve known cancer patients who would not consider varying from their doctor’s advice. It seems that people with minor middle age health complaints, or the healthy elderly, may be most open to change — disturbed at declining health, but not so fearful that they won’t experiment.

    We hoped to entertain people with a good science book, and make a persuasive enough case that people would try our diet. I’d like to think that our book will be influential, but it has a long way to go. Perhaps if enough people get good results on it, the “new authorities” will learn of our arguments.

    Best, Paul

  32. Paul, I hope my questions will not become annoying and if this is the case, please ignore them! I would like to ask you about the safety of whey protein powder. Does it still contain IGF 1 hormones or does the processing method eliminate them? Is it worth buying an organic brand (the only organic brand available in Germany is a concentrate)? I only eat moderate quantities of protein but I use to have a whey shake after a tough workout but if it is hormone-loaded it just isn`t worth it…Is egg protein an alternative?

  33. In addition to Iris’ question above, I’d also like to know of any evidence that the hormones in dairy, like IGF-1, are actually absorbed (i.e not broken down by digestion or inactivated by the liver), and if they are present in large enough quantities to actually have an impact in our bodies?

  34. Hi Iris,

    Whey does contain IGF-1, but the body may reduce its own production of IGF-1 to compensate (http://pmid.us/19471293), so it may not actually raise systemic IGF-1 levels. I don’t know whether organic brands would have less, I doubt it.

    Egg whites are probably lower in IGF-1 than whey. You could also just eat meat.

    I’m not sure it’s worth worrying about unless you have cancer. Just don’t eat too much.

    Best, Paul

    Hi remo,

    It seems that many hormones are absorbed, but what the clinical effects are is controversial.

    You might want to check out the paper I linked to above, it looks like the IGF-1 in whey may not have much effect.

    Cordain says that betacellulin in milk has a big effect, and causes acne, but it would be good to get more supporting evidence.

    It’s always hard to do in vivo studies!

    Best, Paul

  35. Hi Paul,

    Quick report: after intense (for a 70YO) fasting resistance exercise followed by normal PHD eating from noon until 8pm on Tuesday, did the cranberry/spinach/oil fast until about 2pm on Wednesday. Felt great during the fast: almost like progressively becoming ‘wired’, very energetic. I’m enjoying doing this about once a week so far.

    Jim

  36. Thanks Paul! This is helpful. I do think it’s the bacteria. Your story sounds familiar, except my symptoms are a bit different. \

    Never considered Lactobacillius allergy. Hmm.

    Sounds like I could go back to the cranberries (even though they produced a good Herxheimer Rxn), use some pancreatic enzymes on an empty stomach, and do a little bentonite clay…do that for the time before I take antibiotics. Does that sound right to you?

    You are right about not feeding the colonic flora right away. I won’t change my diet until after I begin the probiotic infusions.

  37. Hi Jim,

    That’s great! Thanks for the report.

    Hi Matt,

    Sounds like a good plan. A few comments:

    Charcoal and chlorella are other toxin-removing supplements people try in addition to bentonite clay. I’m not sure which is best, you may wish to experiment.

    I tend to favor polysaccharide digesting enzymes, which target biofilms, then proteases, and would avoid lipases. So pancreatic enzymes may not be the best choice. A biofilm-targeting enzyme supplement like Interfase, possibly the EDTA containing version Interfase Plus, would be more likely to help. I also like the Whole Foods Wholezyme mix.

    One thing I would caution is not to do too many things at once. These diseases are always experimental and it helps to proceed systematically, change one thing at a time, observe the results, and try to understand what’s going on.

    Best of luck!

  38. Hi Paul,

    Thanks for the follow up.

    In case you or anyone else has interest, the protocol use for RA is to use highest dose of tetracycline possible 3x week without causing a severe inflammatory reaction. Then, over time, working up to a higher does. More info on the protocol is available here: http://www.roadback.org/index.cfm/fuseaction/home.main.html.

    At this point I think this treatment is definitely doing something. The first week of treatment I felt like I had been run over by a truck. The second week my brain fog lifted and my joint pain vanished. Since then my reaction has been variable -some days I feel amazing other days I have flares. I have to stick with this protocol since that is all the MD I am working with is willing to support. I am considering travelling in the spring to see a different MD who treats this disease with a series of Clinda IVs for a week or so and then tetras to follow.

    On a side note, over the break between Christmas and New Years I decided to take the tetras daily for a week because of the pain I was experiencing. And because a curious mind wants to know… My reaction was bizarre. The joint pain and irritability continued to build over the week and then on the last day of my experiment, I got very sick. Felt off all morning, ran a fever that reached 101 by the evening. Puked. Immediately after that all joint pain was gone as was the fever. Not sure if that is coincidence or what but it sure was interesting. I think I’ll wait a while before repeating that one. 🙂

  39. Hi Szara,

    That’s great news!

    A lot of bacteria will happily live as parasites, producing a chronic infection with few symptoms, as long as that is comfortable for them. But under various conditions they may switch to an acute infection. For instance, if the host is dying, they may create an acute pneumonia in order to help them spread to a new host.

    It may be that the tetracycline inhibited their ability to produce proteins that protect them from the immune system. This produced a “war” between the immune system and the bacteria, and acute inflammatory/toxicity symptoms from bacterial die-off, immune cytokines, and bacteria attempting to become infectious as their resting places became unsafe.

    It’s all promising. Although die-off may be unpleasant, it’s progress. As far as antibiotics are concerned, I believe in the rule “go as fast as you can, but no faster.”

    Overall, it’s exciting that the antibiotics are working and you’ve even seen occasional relief of arthritis symptoms. That’s great for so early in the protocol. It suggests you’ll really get well in time.

    Too bad your doctor isn’t willing to experiment a bit in order to find what works best for you.

    Best of luck and thanks for the update.

  40. Hi Iris!

    Whey hydrolisate ISO-100 is available in Germany through this shop: http://www.hardcore-shop.co.uk/dymatize-iso-100-protein.html

    0 carbs, 0 fat and very easy to digest because of the hydrolisation which is factually a form of pre-digestion.
    I use it pure (rarely nowadays) or shaked with 3-4 egg yolks and cream (very delicious).

    Grüße aus dem Saarland.

    btw, I have no financial interest in the link provided, it’s just the shop I order from. That brand is really difficult to get in Germany.

  41. Hey, Paul. I think that the mix of good and bad experiences may just reflect that everyone is an individual, and no single macro-nutrient ratio is ideal for everyone. For instance, someone who is obese/diabetic/pre-diabetic, would probably do better one the lower end of the carb spectrum and higher end of the fat spectrum. However, a young athlete, like myself, would likely do better on the higher end of the carb spectrum with a little lower fats. There seems to be no exact ratio that’s ideal. I mean, compare the Kitavans to the Masai. WHat does seem to matter the most is the food choices that make. By sticking to the recommended foods (meats, veggies, nuts/seeds, safe starches, some fruits, good oils/fats) we can be fairly sure that our bodies are safe from disease. That’s just my take.

    I found that going too low carb, even with really high fats, was not good for me. I also found that going too high protein was not good for me either. Now, I am trying to hit about 40%carbs, and 40% fats, and 20% protein from all good, clean sources. SO far I’m feeling great, have heaps of energy, and can focus well. I have been experimenting with different ratios over the past couple of years, and this seems, as of the past week or so, to be working the best…for me.

    In sum: Eat lots of good, healthy, whole foods, and if you listen closely enough, your body will tell you the right proportions.

  42. Thanks Paul. I agree with being systematic. Out of curiousity, why do you avoid Lipase?

  43. Potential to digest human cell membranes.

  44. Thanks for asking the Lipase thing Matt!

    Paul – could you expound on your point a bit, I understand the logic at a high level. But has this idea ever been shown in a study or research paper? Did you have an experience that caused you to connect these dots?

    I ask because I’ve been searching unsuccessfully for sometime to understand what happens to unused digestive enzymes (such as an overload scenario due to supplementing) and what if any feedback loops are suppressed during supplementation of digestive enzymes.

    Thanks for all your hard work!

  45. Paul, carb refeeds are thought to help raise leptin concentrations after bouts of low-carb dieting; the concept is popular in weightlifting circles (see http://www.johnberardi.com/articles/hormones/hungry_3.htm ).

    I suppose it depends on your goals. Maybe it’s the thing to do when you’re trying to achieve single-digit body fat percentage. For folks with excess fat stores, the problem is probably less leptin production and more leptin sensitivity.

  46. I’ve been on PHD for 11 days now, and definitely miss the carbs. My muscle tone has improved but I can definitely see a little muscle loss (I am very lean naturally). I plan to start lifting again soon and will probably up the carbs a bit then, but for now I’m following the diet and feeling pretty good.

    Paul, I know you are buried with questions right now, but do you think you could write a post in the future about cholesterol and the PHD/paleo diets? Specifically, I’m wondering what cholesterol numbers you think you are important- (e.g., LDL/HDL ratio or trig ratio). From the little I know, it seems like total cholesterol was initially the villain, then it was LDL, and now it is oxidized LDL?

    Thanks as always for your work.

  47. Hi Steven,

    I’m not aware of research papers discussing it, but I have broken a lipase capsule on my tongue and felt a very unpleasant burning/stinging. It’s also a danger listed in the warnings on lipase supplements.

    Of course if the lipase is diluted in food then it’s less likely to cause harm.

    The other side of this is the possibility that lipase could help digest gut pathogens and be therapeutic for small intestinal bacterial overgrowth. Possibly the mucosal barrier could protect our cells but not the bacteria. With a quick search I don’t see any research on that.

    I tend toward the “better safe than sorry” side on this one.

    Hi Beth,

    Thanks much! Very interesting.

    Hi Thomas,

    I think you should eat carbs to whatever feels optimal to you. Please let me know what that works out to be. I would be curious if it is higher than 600 calories, since in theory 600 should be enough to avoid gluconeogenesis and preserve muscle if adequate total calories are eaten. In the book, we recommend 600 + 50-100 per hour of training to elite athletes.

    I’m expecting to do an HDL post or two this month … might slip into February if I don’t finish work. Then some cholesterol and immunity and infectious disease stuff. I’m very interested in these topics.

    In regard to numbers, I trust the body to regulate cholesterol to what is optimal for you. In some diseases then blood cholesterol can go very high. Very low cholesterol levels are dangerous because they impair immunity and wound healing, but low LDL can be a marker of good health. Optimal total cholesterol can very widely, but generally more HDL is better. Fasting trigs should be low.

    Yes, oxLDL is a marker of bad diet and presages danger.

    Best, Paul

  48. Thanks for the reply, Paul. I will look forward to your future post on cholesterol.

    I am recuperating from ankle surgery from 3 weeks ago, and as a result I haven’t lifted at all during that period. I tend to lose muscle pretty quickly unless I’m stuffing my face and working out a lot.

    I am only eating 400-450 carb calories a day right now, so perhaps I should up that. Also, I mean to start eating two avocados a day along with 4 tbsps of coconut oil (I’m currently eating 1 avocado a day along with probably 2 tablespoons of coconut oil) in order to up my total caloric intake. I haven’t kept precise count, but I am sure my daily calories are down a bit since I started the PHD. When you’re a bad cook like me and you give up grains, getting your usual caloric intake gets a lot tougher. 🙂

  49. I’ve been doing PHD off and on for a couple of months now, and started on the supplements about 2 weeks ago. The holidays/travel interrupted my eating plan, so I’m a bit off kilter. I haven’t noticed too many changes with my body/brain, except I am much happier to have a more varied diet. I’d gotten rid of ongoing persistent acid reflux after I eliminated gluten a year ago. However it has now returned. I suspect it could be from an over-indulgence of dairy (casein intolerance) and a bit of sugar/pufas over the holidays. We’ll see.

    I noticed that I have to watch my portions when I eat potatoes, I tend to over-indulge, especially when I cook them in beef tallow! I haven’t noticed any depression or excess hunger at all. However, no weight loss. I actually gained a couple of pounds.

    I’ve been low-carb for about 18 months with 50 pounds to lose. I lost a bit of weight when I went gluten-free, but nothing for over a year. I have been using coconut oil for about 4 years now, and obviously it hasn’t done anything for me regarding weight, though my HDL is off the charts high. I’m not the only one who has this problem, either. I know of others, females, also over 50, who are frustrated because they are eating properly but the scale does not budge.

    Paul, what do you think about Gary Taubes statement (not a direct quote) about those of us who are on low carb diets, yet still can’t lose weight – that perhaps it might be too late for us? That due to eating poorly (high grains/pufas/low fat) for many years, and perhaps being post-menopausal, our body weight might not budge? I fear that may be the case with me, and it is very discouraging.

    I have a good friend my age who is on a typical lowfat/high carb, calorie restricted diet, who has lost 30 pounds. Of course, she will probably gain it back and get sick. Since I haven’t lost any weight, she thinks my diet is not so great. I know she is wrong, but it’s discouraging that some of us might never be able to slim down on a healthy diet, free of grains, sugars, and pufas because our metabolisms are permanently broken.

    Thoughts? Comments?

    Thanks for all that you do here. 🙂

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