Perfect Health Diet: Weight Loss Version

We started 2011 with a discussion of Experiences, Good and Bad, On the Diet; which led us into the issue of weight loss, especially for peri-menopausal and older women.

This is an especially poignant issue for erp, who is 76 years old and would like to lose weight for her upcoming knee replacement surgery, but cannot walk.

This is the toughest possible scenario for weight loss:

  • Whether for genetic (X vs Y chromosome) or hormonal reasons, women are more prone to putting on weight than men. (Men are more prone to diabetes.)
  • Hormonal changes after menopause seem to make it tougher for women to lose weight.
  • A petite woman doesn’t need as many calories as a larger person … but her micronutrient needs, and thus her appetite, may still be high.
  • Aging brings more efficient energy utilization and reduced energy expenditure. Thus, the elderly have a smaller energy “sink” in which to dispose of excess fat. A teenager can eat like a horse and stay thin; not so an older person.
  • An injury that prevents walking makes it even harder to burn off fat. Walking is a tremendous aid to fat loss.

Designing a weight loss diet for someone like erp really forces a hard look at how to optimize a weight loss diet. Get it even a little bit wrong, and the diet either won’t work for weight loss, or will be malnourishing.

The Three Keys for Weight Loss

The three keys for an effective and healthy weight loss diet, as I see it, are:

  1. Elimination of food toxins. Food toxins are the primary cause of obesity and you can’t expect to cure a condition by causing it!
  2. Perfect nourishment. The diet should be as nourishing as possible. The dieter should be in the “plateau range” of every nutrient – vitamins, minerals, organic molecules, carbs, protein, and fats.
  3. Calorie restriction. You have to be in energy deficit to lose weight.

The main food toxins to avoid are fructose, polyunsaturated fat, and wheat (see Why We Get Fat: Food Toxins). In my advice to erp, I suggested replacing some of her fruit with “safe starches” like potatoes, and replacing her PUFA-containing nuts with low-PUFA macadamia nuts or other foods.

But the harder part is achieving a calorie restricted diet when so few calories are being expended, and yet avoiding malnutrition. How may that be done?

Eat Protein and Carbs; Reduce Fat

This may surprise many readers, since we’re fat-friendly, but there should be no reduction in carb or protein consumption on weight loss diets. Calorie restriction should come out of fat.

The Perfect Health Diet “plateau range” for carbs and protein is 600 to 1200 calories. Eating less than 600 combined carb+protein calories per day raises the specter of either protein deficiency (leading to hunger) or glucose deficiency (leading to zero-carb dangers).

So if a typical daily intake is 400 carb calories and 300 protein calories, there’s really not much room to cut protein or carbs.

Remember that the body doesn’t have a significant store of carbs; the body’s total glycogen supply amounts to about a day’s needs. Nor does it have a store of protein, apart from skeletal muscle; and you don’t want to lose your muscle.

But it does have a large store of fat – those adipose cells that you want to shrink.

So to conserve muscle and reduce fat tissue, you have to eat your normal allotment of protein and carbs while restricting fat intake. As long as there is no serious dysfunction of adipose cells, they will release fat as needed to meet the body’s fat needs. And that’s what you want – fat being moved out of adipose cells to be burned.

So your calorie-restricted weight loss diet will be just as nourishing as your regular diet. Only the source of the nourishing fats – adipose cells instead of food – will be different.

Eat Nourishing Fats

But not all fat can be removed from the diet. The reason is that not all nutrients found in fat-containing foods are stored in adipose cells.

You see, fats are stored in adipose cells as triglycerides. But we need to get other lipid molecules, not just fatty acids, from food. The really crucial molecules are the phospholipids, especially phosphatidylcholine.

Choline, inositol, and a few others are organic molecules are bonded to fats in cellular membranes. We need to obtain these from our foods in order to be well nourished.

Diets low in choline strongly promote obesity. Therefore, anyone seeking to lose weight should be sure to eat a choline-rich diet.

The easiest way to do that is to eat 3 eggs a day and a ¼ pound beef liver once a week.

Another type of lipid that may be missing from adipose cells are omega-3 fats. Balancing the omega-6 to omega-3 ratio is helpful against obesity, and most people are omega-3 deficient. So eating up to 1 pound of salmon or sardines per week may assist weight loss.

Beef and lamb – meats that are low in omega-6 fats – would be good choices for any additional meat.

Be Super-Nourished

The body’s appetite regulation mechanisms are highly attuned to your micronutrient needs. Micronutrient deficiencies will tend to induce a strong appetite for food, as your body tries to get you to obtain more nutrition. This could be a major reason why “empty calories” such as cotton candy are fattening.

Our book has some examples of “micronutritious foods”: variety meats, bone soups, seaweed, shellfish, eggs, and vegetables.

Nutritious, low-calorie foods like bone soups can be very helpful for weight loss. Soups can also be a good way for someone who doesn’t like vegetables to obtain them.

In addition, I would recommend that every person on a weight-loss diet take our full supplement regimen: a daily multivitamin, D, K2, C, magnesium, copper, chromium, iodine, and selenium. Also, I would suggest taking our optional B vitamins: thiamin, riboflavin, pantothenic acid, biotin, vitamin B6, vitamin B12, and choline (note the exclusion of niacin and folic acid).

Keeping Calories Down

What is the minimum calorie intake that meets all these nutrient considerations?  Eggs, salmon, and beef have more fat than protein, so if you’re aiming for 400 carb calories and 300 protein calories, you’ll probably eat at least 500 fat calories per day. So it would seem to be impossible to go below about 1200 calories per day while still being well nourished.

The place to cut calories, then, is the extra fats. Perfect Health Diet favorites like butter, coconut oil, and cream are, sadly, top candidates for reduction.

Of course, the more active you are, the more you can include those fats.

For less active people, the Weight Loss Version of the Perfect Health Diet becomes similar to a lot of popular diets. Many diets recommend a roughly even calorie distribution, with 30-40% of carbs, protein, and fats. This is what a calorie-restricted version of the Perfect Health Diet should look like too.

So, the perfect day in a weight loss diet: soup, potatoes or other safe starch, salmon, eggs, vegetables. Not too much fat in the sauces!

A good meal might look like this:


Mash the sweet potato with eggs instead of butter, and this would fit our weight loss recipe.

Conclusion

It’s a little humbling that I’ve started 2011 with 5 posts on the subject of healthy weight loss, but have only scratched the surface of this complex topic.

For instance: In the book we used the rubric “metabolic damage” to describe the biological dysfunction associated with obesity. But we never really chased the complex biology of exactly that damage consists of – and how it can best be healed.

Today, I’ve presented what I believe is the best strategy for healthy weight loss. But other techniques – such as ketogenic dieting, intermittent fasting, exercise, and more – can contribute to healing the metabolic damage of obesity. As 2011 goes on, I’ll return to this topic.

I am intensely interested in the experiences of anyone trying to lose weight using our diet, and I hope that together, we can understand the disease of obesity better, and figure out good ways to achieve both healthy weight loss and a permanent recovery from metabolic damage of all kinds. So please, if you are trying to lose weight, keep me posted on your experiences, whatever they may be!

Related Posts

From 2011:

From 2010:

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394 Comments.

  1. Paul, yes he’s very overweight, but loses weight easily. He’s lost 30 lbs without trying very hard and gives in to the crazing (not a typo) for pasta, but he’s cut down drastically on bread and desserts, so he gets full credit. He’s of Italian background and can’t be expected to never again eat his beloved macaroni.

  2. What does he think of rice noodles?

    They take a bit of getting used to, because they’re softer, but after a while they seem much tastier than wheat noodles. At least that’s been our experience.

    How does he like his macaroni? We’ll try to come up with a rice pasta dish in his honor.

  3. @erp, I think you would agree that both men and women need to take responsibility for pregnancies. And that starts with both boys and girls learning about how pregnancy happens and is best prevented. I, too, have my doubts whether schools can do the job of educating children about sex and sexuality. Just to follow the nutrition metaphor a moment, I know that each time my child comes home with information about a proper, “healthy” diet from school, I have to sit down and explain to her in a way that she can understand why I disagree with her wellness teacher’s model and why we do things differently at home.

    @ JM, I agree about stalls being the toughest thing in weight loss. I have lost weight, lots of it, being VLC/LC. I’ve done it twice, and it was much harder the second time. Also, both times I regained the weight back and some extra. I can also say that it’s entirely possible to hit a stall when you’re VLC. I think it’s all a matter of how long one wants to spend losing weight. I think what PHD does is offer an option that restores health, and in the long term normalizes body weight as an outcome. LC and VLC approaches take an almost opposite tact: You hopefully lose weight quickly first, and your health eventually responds by improving.

  4. Maggy – Well said!

    I may have to quote you in future.

    My thought is: Loss of ability to naturally regulate weight is a disorder of health. Lose weight in an unhealthy way and the disorder may become worse. Heal the disorder and weight loss should become easy.

    I think the body naturally tends to heal itself on a healthy diet, but healing can take time.

  5. Paul, quote away! I quote you all the time, so it’s only fair.

  6. Maggy C.,

    Your having to explain away something one of your daughter’s teachers is saying while needing to affirm what other teachers are telling her is why being a grandmother is so much nicer than being a mother. 🙂 … and of course, boys need to take responsibility for pregnacy, but girls need to do it first and foremost.

    Paul, My husband doesn’t like rice noodles. We’ve tried several varieties and I have to admit, I don’t like them much either, but then, I’m not a pasta fanatic.

    I’d rather have tomato sauce, known around here as gravy, over plain white rice — to him, it goes against the nature of all things holy.

    Name the dish: The Cranky Grouch

  7. “Cranky Grouch’s Pasta” … famous Chinese dishes often have names like that. General Tsao’s Chicken, Dong Po’s Pork. This could be very big in China.

  8. Archibald Springer

    @Poisonguy,

    Congratulations on losing 23 kilos (50+) lbs in 7 months. I’m sure that it makes you feel very good about yourself. I know because I’ve done the same thing several times – the same 50 lbs over and over of course. But come back regularly – say every five years – and let us know how you’re doing in the long run. And in the meantime make sure to spread the word about insulin being the key to weight control. It may be the magic we’re all looking for.

  9. Paul, Let me know the Chinese characters and I’ll have a t-shirt made up for him.

  10. @Archibald Springer, I am certain many LC and VLC dieters can tell you what it’s like when you stall or even start putting on weight, even though you’re being absolutely meticulous about staying at LC/VLC levels. You become even more restrictive, and nothing happens. You muster the fortitude to stick to the regimen for a number of weeks, even months, and either nothing happens or the weight starts to inch up. The only thing that might make the numbers budge at this point might be to reduce caloric intake, reduce protein intake. But for how long? Until the next stall? And then you restrict even more. I don’t know, but to my ears this starts sounding like an eating disorder. If there is a way to lose weight without going the LC or VLC route, it’s worth the time and effort, in my opinion. To put it in a slightly different way, if I’m going to be on the planet for 8 or 9 decades at most, if I’m lucky, I don’t want to spend it losing and gaining the same 40 pounds over and over again.

  11. Poisonguy wrote my post.

    What’s going on here?

    You’re super smart, Paul, but the move away from hormones and enzymes (insulin, LPL, HSL, etc) and towards a calories in/calories out model – finely expressed by Leoluca Criscione PhD’s comment – is surely wrong.

  12. erp,

    the “exhaustion” you mean is exactly related to the sarcopenia (muscle loss) you experience.
    Sarcopenia happens with age anyways and if you’re injured on top, you will naturally move less and thus speed up the sarcopenia(lose muscle faster).
    That’s why I suggested strength training first. If you strengthen your muscles you may stop sarcopenia, even reverse and everyday tasks will be easy again. They won’t exhaust you anymore. Of course, don’t exercise the injured leg for the time beeing (see my first post here).

  13. @ D: Maybe it’s not an either/or situation. Maybe it’s both/and. I think PHD is a dialectical approach that, beyond excluding things that are definitely bad for the human organism (wheat, fructose, seed oil), invites people to decide whether they want to be higher protein and fat or lower protein with the addition of some safe carbs in the form of starch. I see the argument for including benign carbs as threefold: One, a more even, albeit slow weight loss that will accompany improving health, Two, a preventive measure against problems like GI cancers that seem to be showing up in folks who are excluding starch in favor of protein and fat, and Three, findings that protein restriction is a feature of cultures that produce high numbers of centenarians.

    In the case of individuals who need to lose weight, PHD recommends a moderate approach. The 600 total calories taken in the form of protein and starch are non-negotiable. But to lose weight, one has to be in a calorie deficit. People find that to be easier when eating higher protein. But because the starch calories are non-negotiable (i.e. you need some amount of glucose for the brain, and also for the mucosa), the place to pull back would be in the fat category. This is by no means a low fat or no fat recommendation, and can be achieved in a few long-term adjustments. For me, this has meant decreasing the amount of heavy cream I consume each day with my coffee, and drinking more tea. It has meant using cheese very sparingly. It has meant eating less bacon (which I was never crazy about to begin with), and having my over-easy eggs on a bed of excellent, fragrant white rice. This is in no way a return to the USDA food pyramid. I see it more as a trapezoid.

  14. Hi D,

    I haven’t moved away from hormones and enzymes!

    There’s no inconsistency between that and calories in / calories out. Hormones determine calories in and calories out, but behavior can influence hormones and calories in/calories out.

    I’m surprised this is so controversial. You guys seem to be positing two extreme incompatible models – but the food/activity level and the molecular mechanisms level are distinct and not alternative theories.

    My view, contra Leoluca’s, is that food does matter apart from its calorie content. What matters is not calories only but nourishment and toxicity. Carbs are good when they are nourishing and bad when they are toxic – and dose-response curves say they can be both. Food can make you fat … but Hara Hachi Bu can also play a role in a weight loss regimen.

    Best, Paul

    PS – Maggy, thanks for sticking up for me! Well said.

  15. JM, as you point out you’ve got to do what works for you. I tried Paul’s PHD for a month and didn’t loss a glob of fat (didn’t gain one either), so it didn’t work for me to lose weight. So I went back to what worked and took what I could from PHD that I could implement in my scheme.

    Archibald, I report back in five years, then. Noted in my day planner.

    Paul, well said above (too bad Hara Hachi Bu doesn’t seem to work for the Okinawans once they leave Okinawa! How do you say, “Don’t eat the toxic food” in Okinawan?).

  16. Franco, I know you’re right and copied your suggestions for implementation later. It’s less than a week until surgery and I don’t feel I can take on anything new, not even simple exercises.

  17. Poisonguy, Okinawans are now eating modern industrial foods and getting fat and diabetic – even on Okinawa.

    I agree that Hara Hachi Bu is only effective on a healthy diet. In that post I mentioned that Hara Hachi Bu didn’t even restrict calories! Just protein.

  18. Paul, this is really me trying to put it in my own words so that I know I’m grasping the full implications of your recommendations.

    On a personal and professional level, I am very interested in incorporating PHD into a protocol for treating people with eating disorders. I believe that the current model of treatment is full of flaws that place people who are already vulnerable at even more risk. I believe that the psychologist has to be also the nutritionist, and that separating out the two approaches is incompatible with how the human mind-body works. And I also believe that any approach that isn’t fully integrated into the treating professional’s own way of life is also bound to fail. You can’t support people through things that you, yourself, don’t really implicitly understand.

  19. Hi Maggy, I hope it works! You know I believe that nutrition may turn out to be the key to psychology.

  20. Dear Erp,

    I wanted to wish you great success and a speedy recovery with the upcoming surgery.

    Good luck, Perry

  21. Maggy C.

    I hope you report on how your theory works with real patients.

    Perry,

    You are sweet and I thank you for your good wishes.

  22. Just ordered your book Paul. I’m looking very forward to it.

  23. Thanks, Ellen! I hope you enjoy it.

  24. erp, I will do so. I’m going on the notion that people who are seeking treatment for eating disorders, and “weird food relationships”, as many of my patients have referred to their struggles, they need and want to talk about food and eating, and many clinicians do not want this. It’s like saying someone who has a sexual dysfunction cannot talk to a therapist about sex… absurd!

    Good luck with your surgery!

  25. Maggy C.,

    Looking forward to reading about people successfully dealing with their eating disorders.

    Good luck and thanks for your good wishes.

  26. Link Love Sunday « Slimm Chance - pingback on February 6, 2011 at 6:00 am
  27. Maggie, YOURE AWESOME!!! i have been trying to advocate this for like a year now!! it isnt met with a lot of acceptance in my experience. i was going to weekly meetups and the whole time it was about ‘food times’ meeting meal plan requirements, and something they called optional addons they freaked out about. they thought they were killing the demon because they had a sip of coke and i was like WTF this is making no sense. so i stopped, and started my blog. i mean, results speak for themself, i have put on over 25lbs eating real food and i feel ‘normal’ for the most part.

    the hardest obstacle is facing the ‘orthorexia’ label you kinda get which IMO makes no sense because real food is real food is real food. coke and bread will never be real food i dont get it, this is the frustrating aspect.

    http://jamesgreenblattmd.com/blog/

    have you read that guys book?? he is of the opinion that curing EDs and brain malfunctions is nutritionally based too. i have readhis wholeblog, but i have no money so havent bought the book but it may be worth a read!

  28. Perfect Health Diet » Cranky Grouch’s Spaghetti - pingback on February 6, 2011 at 5:50 pm
  29. Paul, just a quick question.
    When you’re talking about the weight of food to be eaten in a day (see page 111)- meat for example, are you talking about cooked or uncooked weight?

  30. Hi GeeBee,

    Well, cooked, but the weights are only approximate. Eat to appetite with Hara Hachi Bu and intermittent fasting for weight control. Depending on the foods you eat and your personal needs, actual weight will vary.

  31. Mallory, I actually have had success treating college students for ED’s. Most of my colleagues would roll their eyes upon getting someone on their roster who had an ED. Many psychologists find ED patients to be particularly difficult and even “boring”. It’s like that when you don’t know what to look for, what to elicit, and how to help. Those who were referred from the Health Service were obligated to go for weekly blind weigh-ins and check-ins with the nutritionist who gave them checklists and eating plans. This was definitely patterned on the approved APA/AMA protocol, and I often found myself at odds with what the medical staff was trying to do, especially for patients who weren’t dangerously underweight, but still actively restricting, bingeing, or purging.

    People with ED’s need constant support on all levels. And they need to trust you, or they will elude you. If the ED is a defense, which it very well may be, then treatment is bound to fail if you threaten to remove the defense too quickly without replacing it with something else. So, the patient’s trust, his feeling understood and cared for, his feeling respected for having done the best given his circumstances, these are all things that, IMO, cannot be established by demanding weekly weigh-ins and checklists. Most people with ED’s really truly don’t know what the heck to eat. The best advice they get is to eat according to the “healthy” standard food pyramid, which to me is just one evolutionary outcome of the Puritanical foundations of American culture (along with sexual repression) that requires strict adherence to set guidelines and its natural counterbalance of guilt. Black-white thinking at its best.

    Interesting enough, the patients I worked with who did eventually transcend their eating issues were those who weren’t referred through health services, and/or those who eventually stopped going to health services.

  32. Cold brewed coffee! I just discovered it, and for the first time ever, I’m able to drink and actually enjoy to the point of preferring my coffee black. This is meaningful to me, and maybe to other PHD’ers because coffee has been a major source of fat calories for me, as I have been drinking it with milk, and then heavy cream during my VLC stint prior to discovering PHD. Try as I might to take it black, I was never successful, until now.

    This now really changes the game for me in terms of being able to cut back on the fat in order to follow the weight loss version of PHD a little more easily.

    I am posting a “how to” in the open thread for recipes in case anyone else is interested in trying this out.

    (As a side note: It just so happens that the coffee drinking cultures prior to the arrival of coffee in Europe did extract the liquor via a cold brew process. Coffee brewed cold does not require the addition of sugar for palatability. Also, according to a very interesting book titled “Sweetness and Power” (by Mintz, I believe, but will double-check on that), the introduction of stimulants such as coffee, tea, and chocolate in Europe, and by extension, America, definitely contributed to the growing demand for and consumption of sugar. It totally makes sense to me.)

  33. I’ve been drinking black coffee without sugar all my life and like it just fine. I thought adding cream was part of the diet plan and of course, I didn’t mind that it was also absolutely fantastically delicious, but now I’ll just go back to boring, but tasty, black coffee (I use half regular coffee and half a hazelnut blend).

  34. I may be the only person in the world this happens to, but the smell of Hazlenut coffee actually immediately gives me a splitting headache.

    Good luck with your surgery, erp!

  35. Paul,

    From the perspective of an athlete who is looking to both lean out and put on muscle at the same time, I’ve found the combination of the Perfect Health Diet and daily fasted training (daily 16 hour fasts + fasted workouts) to be an excellent path.

    One question I had is about whether it makes sense to add Coconut Oil to the fasted period right before a workout (fasts are broken directly after a workout). From reading everything you’ve written, it seems to me it would only accentuate the benefits of fasted training (more ketogenic/fat burning) while also providing a good, non-insulinogenic source of energy for the workout. Am I right in thinking that?

    My only reservation is the idea that perhaps the coconut oil might not in fact lead to more fat loss since it would be providing energy in the form of MCTs that your body would regularly tap from body fat. Thanks for any advice on this front.

  36. Hi Tim,

    That’s an interesting question.

    Most of the adaptations to intense exercise take place in a 24-hr period after the exercise. So what you eat in that window is important. Adding extra coconut oil in that window will probably help you add muscle but as you say may reduce leanness. If your sport has weight limits you should probably avoid the coconut oil in the days immediately before events.

    Re taking coconut oil before the workout, I have not been able to find papers the directly address the effects of exercising in a non-fasting ketotic state.

    Ketosis seems to be a natural adaptation to strenuous endurance exercise (e.g. http://www.ncbi.nlm.nih.gov/pubmed/11226017). Apparently it promotes fat-burning. So pre-workout coconut oil might be a good way to promote endurance.

    Endurance (2 hr) exercise increases muscle uptake of ketones (http://www.ncbi.nlm.nih.gov/pubmed/2656155).

    Overall there seems to be very limited evidence regarding pre-workout coconut oil. If it helps, it would be most likely to help an endurance athlete.

    You might want to try an experiment yourself and see what happens!

  37. Thanks, will do! I’ll report back here if I find anything interesting.

  38. hi paul
    for what reason do you not recommend to take niacin and folic acid again? sorry if i missed your explanation somewhere else. is it just because of the “inactive” form of folic acid? how about methyl-folate?

    btw, have you seen this post from thepaleoguy? http://twitter.com/thatpaleoguy/status/35455512900276225

    this is extreeemely interesting. who is the biggest population having IBS problems? women. who is taking the most facial creams containing retinol derivates? women. who recently had newly developed gluten sensitivity and IBS/allergies, and also has used a facial cream for men which contained a retinol derivate during the same time frame? me. this retinol link is something that should be *very* closely watched and studied me thinks..

  39. Hi qualia,

    It’s discussed in detail in the book.

    It’s not really known why folic acid supplementation has produced such bad results in clinical trials, while folate looks good epidemiologically. One possibility is that the synthetic folic acid is harmful while food folate isn’t. However, it could just be that too much of either is no good.

    I didn’t see that tweet, interesting. You know we oppose too much vitamin A.

    Best, Paul

  40. Just to bring back some of the original points of this thread…

    Am a (waaay) postmenopausal woman who would love to drop 5-10 lbs., but have found this exhaustingly hard to do. Went LC for months until my body dried up and started to grow yeast, fungal and bacterial infections for the first time in decades. Following the advice in the PHD blog & book has me feeling much better, but not lighter, yet, alas.

    BTW, have been a psychologist all these years and am so happy to see dietary approaches to mental health come around again (anybody remember the infamous insulin treatments in mental hospitals)?

  41. Hi Holly,

    Welcome! I’m glad our diet is helping you. I’m sure you saw that fungal infections were something I experienced on a very low-carb diet, and played a big part in causing us to do the research that led to the Perfect Health Diet.

    I wasn’t aware that insulin was used as a therapy in mental hospitals. I’m sure there’s some good stories in there!

    Best, Paul

  42. Hi Paul

    I’m waiting for the e-book version to buy, so I apologise if I’m not up to speed on your work. I have read around here though.

    I was low carb for a while, lost weight, stalled for 10 months and then started to gain weight while still being ‘good’ on LC. Anyway I have increased my carbs a bit and am trying the Fast5 method of IF which I hope will help me lose the last 10lbs, or at least stop the weight gain.

    Anyway my question is this: I take two tablespoons of coconut oil with my morning coffee, while fasting. This is for the health benefits of the oil mainly although I thought it might help with fat burning (my fast is from 5pm to midday). I was wondering whether I should stop this due to the high numbr of calories while I am trying to lose weight. There is a school of thought that the oil can enhance metabolism. I would be interested in your opinion on this.

    Many thanks

  43. Hi Jo,

    Welcome! I’m sorry about the late e-books, I keep getting swamped with work and haven’t been able to focus on it.

    I agree with both points of view on coconut oil. (So I may not be much help. 🙂 )

    If your goal is short-term weight loss, then cutting the coconut oil and reducing calories will help.

    However, coconut oil does have some benefits. First, it creates ketones which avoid some of the metabolically damaged pathways involving glucose and fatty acids. Thus, long-term use of coconut oil may increase ATP levels in damaged cells and promote recovery. Also, if coconut oil substitutes for other oils, it promotes leanness.

    If you are active, then I would take the coconut oil; you can still be in calorie restriction just by eating a little less of some other fat. However, if you’re in the inactive postmenopausal woman category and utilize very few calories, then I would either drop the coconut oil or become more active.

    Best, Paul

  44. Thank you so much for taking the time to respond. I will keep it in for now and keep a check on the rest of the fat in my diet. I am moderately active and not postmenopausal (yet!) .

  45. So, in your book, it says that 400 calories from carbs, 300 from protein and 1300 from fat is the perfect health diet for slender people and will help obese people slim down. I realize that this post was in response to people for which this didn’t work, but I didn’t know where else to ask this question.

    I realize that you may be hesitant to give “medical advice”, so I want to ask your *opinion* only. The above formula gives you 2000 calories per day. I’m nursing an almost-one-year-old and have heard that nursing burns 500 calories per day. Would you think that aiming for 2500 calories per day in my case would be sufficient for both nursing and weight loss?

  46. Hi April,

    Any numbers we give have to be adapted to your personal circumstance. You’ll know; the more calorie restricted you are, the faster you’ll lose weight.

    If you are already slender, then you don’t want to lose weight! So eat enough to make sure you maintain your weight and health. But don’t worry about small fluctuations. Follow your appetite.

    The key thing is don’t be malnourished and don’t be hungry. (Hunger is a reliable indicator of malnutrition.) Get all of both the macronutrients and micronutrients you need.

    Saturated and monounsaturated fats are the variable quantity, the knob you can turn to adjust your weight. Everything else you want to more or less optimize.

    There’s nothing wrong with eating 4,000 calories a day if your body seems to need it, or with eating 1,500. Listen to your body.

    Best, Paul

  47. Paul –

    Does a weight gain (~10 lbs) from introducing modest amounts of vegetable matter (white rice and potatoes) into a VLC diet on an already overweight body ( 6 ft 240 lbs) indicate an unhealthy inability to process such food (CHO)?

    Is it better for someone to reap some potential benefit from this amount of vegetables/starch in the diet and deal with the weight gain or take out the starch, drive into ketosis, and lose considerable weight?

    Thanks so much

  48. Hi Erich,

    My belief is that about 200 calories of starches a day is a good idea, just to avoid any risks from a very low-carb diet. Ideally it should displace 200 calories from other sources, and shouldn’t lead to weight gain.

    If ketosis is beneficial, I would do it intermittently. This can be achieved through intermittent fasting or by occasional “ketogenic diet” days.

    I think for hard loss, I would focus on these steps:
    1. Being extremely well nourished micronutrient-wise;
    2. Getting 200 carb calories and 400 protein calories per day – this should be enough to prevent carb or protein malnutrition, while minimizing insulin;
    3. Intermittent fasting as a routine practice, or some other means of calorie restriction like Hara Hachi Bu;
    4. Using a standing desk or some other means to remain physically active through much of the day.

    These are in addition to eliminating food toxins. Good sleep is also important, as is tending to thyroid and adrenal function.

    Best, Paul

    • Is 2oo carb calories and 400 protein calories a recommendation also for a 38 year old overweight woman who wants to gain muscle weight training?

      • Also, I find IF very very hard, I get so hungry in the morning and i can’t make the window earlier cause i weight train in the evening and need to eat protein after. Is IF really beneficial even if one is a woman with fibromyalgia and Hashimoto’s disease?

  49. Thank you for your awesome contributions educating all of us and allowing us to learn along with you about healthy dieting and weight loss. On that note I thought I would share what I thought was a very interesting insight by Dr. Oz on what he has found to be one of the most successful weight loss measures over the long term. He says it on this video I found on YouTube http://www.youtube.com/watch?v=97NijKNrjlQ&playnext=1&list=PL7CFFC052DFD3AEEF

    Brice

  50. Hi Paul,

    I just wanted to comment on what you said above in your article:

    “The body’s appetite regulation mechanisms are highly attuned to your micronutrient needs. Micronutrient deficiencies will tend to induce a strong appetite for food, as your body tries to get you to obtain more nutrition.”

    I totally agree with this. A few years back, having lost a lot of weight due to stress, once the stress began to subside I became ravenous, and would binge eat. This was confusing to me as I never had a problem like this before. It took me a long time to figure it out but once I started supplementing with magnesium the binging stopped. Once I started using digestive enzymes my appetite returned to normal and I now get the ‘full’ signal. Whereas when my body was scrambling for nutrients the ‘full’ signal wasnt coming on.

    Because of the stress and the on going high cortisol I have a lot of metabolic damage now. I am on T3 only, as my rT3 went high late last year, and I have trouble with my body comp, which is troubling to me for what I eat (mostly very well) and I am active.

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