Around the Web; Revisiting Green Meadows Farm

A few months ago we toured Green Meadows Farm; I wrote about it here. Tomorrow, Shou-Ching and I will be there at 3 pm for a casual talk, Q&A session, and book signing. We’ll discuss what evolution tells us about the optimal diet, and the PHD food plate; but mostly we’ll just be chatting with whoever shows up. Green Meadows Farm also has a great farmstand where you can buy organic food of all kinds.

Green Meadows Farm is located at 656 Asbury Street, South Hamilton, MA. Directions are available on their web site.

Also, Jimmy Moore has just informed me that I was voted #4 guest of the year by Livin’ La Vida Low-Carb readers and will be back for “Encore Week” in January. Thanks, LLVLC fans! I’m excited to talk to Jimmy again, this will be a fun interview.

Sometime this month we’re also going to put together a 7-day meal plan for anyone who wants to try our diet for weight loss. But Jay Wright beat us to the punch, sharing the meals that helped him lose 80 pounds in less than eight months.

[1] Music to read by: From Enya:

[2] Interesting posts this week:

Pal Jabekk explores what happens when you can’t utilize glycogen.

The possibility that XMRV, a new human retrovirus, might cause chronic fatigue syndrome has degenerated into a fiasco. Judy Miskovitz, the principal investigator, has been dismissed from the Whittemore Peterson Institute and arrested on charges of stealing her research notes, which WPI claims belong to them. Dr. Jamie Deckoff-Jones, a chronic fatigue sufferer herself, offers her view of the affair.

Emily Deans discusses mitochondrial dysfunction and depression.

NPR notes that the innate food reward system drives kids to eat more carbs than adults. No surprise there: breast milk is 40% carbs, and we know that’s optimal for infants; the optimum for adults is probably significantly lower.

Stephan Guyenet summarizes some new review papers on the food reward theory of obesity. Dr. Srdjan Ostric comments on the role of food reward in obesity.

Jamie Scott, That Paleo Guy, comments on the circadian variability of sun damage risk. What’s the best time of day to go to the beach?

Canadian political philosopher Colin Farrelly quotes Leonard Hayflick in Nature writing that “Prehistoric human remains have never revealed individuals older than about 50 years of age.” Can this be true? Can bones reveal the age of death so precisely?

The New York Times reports that exercise improves memory.

Seth Roberts reports on a rat who favors pate, salmon sashimi, and scrambled eggs. What a lucky rat!

Japan Times reports on Japanese research indicating that beef and pork consumption is associated with colon cancer risk.

Vitamin B12 deficiency can cause skin lesions.

Dienekes points out that African-Americans are losing the genes that give Africans resistance to malaria.

Dr Briffa reports that low-carb diets look good for cancer patients.

Barry Sears discusses how contestants on “The Biggest Loser” eat.

Wired asks if the obesity epidemic could be due in part to over-use of antibiotics.

Cheeseslave reports that intermittent fasting gave her insomnia and belly fat, perhaps because fasting led her to drink alcohol, and alcohol can induce zinc and magnesium deficiencies.

Steph at Midlife Makeover Year found that eliminating fructose, even from fruit, eliminated her eczema.

Dr David Brownstein argues that the optimal sodium intake is 4 to 6 g/day (1.8 to 2.7 tsp salt).

USA Today reports benefits from a ketogenic diet for Parkinson’s patients.

More pregnancies, more health? Reason at FightAging! reports that fetal stem cells can repair the mother during pregnancy.

[3] Cute animals: Odd couple:

Via Yves Smith.

[4] Me and the GAPS Diet at Wise Traditions: Foot in mouth disease?

Dr. Natasha Campbell-McBride, originator of the Gut and Psychology Syndrome (GAPS) diet, has done a tremendous job refining the Specific Carbohydrate Diet and helping a number of people recover from gut dysbiosis. She is also one of the most popular speakers at the Weston A Price Foundation Wise Traditions conferences – deservedly so, from what I was able to see of her talk.

There was a lot of interest among the Wise Traditions attendees in what I thought of GAPS. Many people came up to me to ask about it, and the first question posed in the question and answer session asked what I thought of GAPS. I tried to make the point that there are many pathogens that can afflict the gut and, while GAPS is great for many gut disorders, no single dietary prescription is going to be perfect for all of them. The GAPS prescription of eschewing starches and obtaining carbs from sugary sources like honey is one of those prescriptions: often beneficial in gut disorders, but not always.

A few PHD readers, whose cases are listed on our “Results” page (see Angie and Bella), had trouble on GAPS and were able to fix their problems by adding starches. I suspect their diets had been ketogenic without starches and the ketones were feeding eukaryotic infections; adding starches eliminated the ketone production and helped them overcome the infections.

Apparently I gave the impression – no doubt I mis-spoke in some fashion – that I thought GAPS was a ketogenic diet. Dr. Tom Cowan spoke to me about it soon afterward. Dr. Judy Tsafrir, who uses the GAPS diet in her psychiatry practice, heard about the episode and wrote about it. I wrote a comment on Judy’s post clarifying my perspective.

I’d like to reprint that comment here, so that my attitude toward GAPS can be placed more prominently into the public record. I have the utmost respect for GAPS; with lore derived both from the Specific Carbohydrate Diet and from years of clinical experience by Dr. Campbell-McBride herself and other nutritionists, it is arguably the leading methodology available today for dealing with gut dysbiosis.

Here is my comment from Judy’s site:

Hi Judy,

A few clarifications. It is not starches per se that are protective of the gut, but glucose; this is needed for mucus production, for preservation of the intestinal barrier, and for immune function. It is possible in very low-carb diets, especially if protein intake is limited, to significantly reduce mucus production and impair the integrity of the gut mucosa and barrier.

Both starches and sugars (such as are found in honey, squash, and carrots) are possible sources of glucose. In cases of gut dysbiosis, one wants to avoid foods that feed pathogens. Both starches and sugars can do this.

Some pathogens benefit from fructose, and fructose malabsorption is very common in bowel diseases.

Many pathogens can also benefit from resistant starch, or the branched structures in starch that humans cannot digest. Starchy foods tend to be fiber rich. As such, they are often problematic in bowel disorders.

I often recommend dextrose or rice syrup, which is readily digestible to glucose only, for bowel disorders. This seems to be the safest glucose source.

There is such a diversity of pathogens in bowel diseases, that no single dietary prescription is universally safe. Zero-carb diets are potentially problematic due to glucose deficiency or ketosis that favors certain pathogens; and for any given carb source, there is a pathogen that can flourish on it.

GAPS came up in my talk in response to a question someone asked. I had recently had two people on GAPS diets report that when they added starches, in line with our recommendations, their health improved and they were able to clear lingering gut problems, including fungal infections. Of course I have no idea how faithfully they were following Dr Campbell-McBride’s recommendations; but I think their cases illustrate the points you make in your final two paragraphs. Every pathology is unique, and diets have to be tailored to individual needs.

I am not quite sure what I said, since this was extemporaneous and I haven’t watched the video, but the symptoms those two readers had were ones that tend to develop on ketogenic diets. If they were excluding fructose because it gave them gut symptoms, then their diet could easily have become ketogenic. I do not think that GAPS is ketogenic in general, but in at least those two cases its attempted application seems to have been so.

I have the utmost respect for Dr Campbell-McBride and I am well aware of the many people her diet has helped. I hope no one thinks that I was in any way denigrating her diet or her very valuable work. I was able to attend part of her talk at Wise Traditions and thought it was the most valuable talk I saw at the conference.

Best, Paul

[5] Interesting comments this week:

[6] Not the Weekly Video: Samsung introduces a new sport: “Extreme Shepherding”

[7] Shou-Ching’s Photo-Art:

[8] Weekly Video: Dr Terry Wahls treats her multiple sclerosis effectively with a high-vegetable Paleo-type diet:

31 Comments.

  1. Thanks for the Enya link. Best version of that song I’ve ever heard, and so appropriate at this point in the Christmas season. Come, Emmanuel!

    Thanks for the reminder of Sears blogging about The Biggest Loser. It points out that you can lose a lot of weight with exercise under the right conditions, which are rare.

    -Steve

  2. I’m honored to be mentioned in your post! Thank you very much; Shou-Ching is rightfully looking forward to trying the ris a la mande :)

    Let me add that you should feel free to, no, wait – you should ;) – add extra heavy cream.
    As with all recipes, it varies from home to home, and the one I found was apparently a little “lower fat”. 500ml (2 cups) seem to be just as normal with that same amount of rice.

    Also, I was wondering what you think of the high milk (casein) content?
    I know vegans tend to use soy milk or rice milk. Obviously, the soy milk is out of question; I don’t have experience with using rice milk, but I suspect you would get less flavour.

    /Rikke

  3. Hi Steve,

    It is a great song!

    Exercise definitely helps. The Biggest Loser is totally the opposite of a clinical trial – specifically selected to find those who can most readily lose massive amounts of weight – but it’s good to see that end of the disease distribution. I’m sure it’s given a lot of people hope.

    Hi Rikke,

    We think milk is OK for most people, including us. But we’ll go with cream in your dessert :)

  4. Hi Paul: Would like to hear more about resistant starch if this is an interest of yours. Also, with regard to starch in general, us older adults may want to be at the bottom range or maybe lower- PHD recommendation of 50G if as i do there is CAD to be concerned about and susceptibility to the generation of small LDL. You may not be so worried about the small LDL, but i think the research highlights it as an important factor in heart disease.

    As one who has suffered with atopic eczema, I have found no inclusion or exclusion of food/supplements to be of help. There are about 20 different genes involved in atopic derm, and the skin has an issue in maintaining moisture, hence when it is dry out those afflicted suffer, unless they moisturize frequently.
    Enjoyed your book, and hope that you might address changing nutritional and hence diet recommendations for the aging human- age 60+. My own sense is that less carbs should be consumed and little starch as the body system no matter what effort is taken to preclude aging, is not as efficient as it once was.
    Thanks for your interesting, practical and sensible thoughts.

  5. Hi Steve,

    How dietary needs change with age is a great question. At this point for me it’s a research question. Older people definitely have reduced calorie needs but does that affect one macronutrient more than another? That I don’t know.

    The issue of small LDL came up in my CrossFit NYC q&a session. The Paleo community tends to view sdLDL as pathological and good to get rid of via low carbing, but that is unproven. LDL has immune functions and sdLDL performs these more sensitively. That leads to greater inflammation, but also a more rapid immune response to infection. In a healthy person with a non-inflammatory diet it might be good to have this kind of “early warning” system operating via a modest amount of small LDL. At any rate this is an open question for research.

    Best, Paul

  6. I love Shou-Ching’s photo and choice of quote and assume the contraption is one among the 10,000. A great sense of humor as well as exquisite esthetics and excellent choice of a husband!

    BTW – Pls hurry up with your diet for the elderly.

  7. Hi erp,

    I’m guessing that contraption actually does work. It’s even sold at Amazon: http://www.amazon.com/Heritage-Classic-Stained-Finished-Tip-Up/dp/B002TQ43NI/ref=pd_sim_sbs_sg_4.

    So you’re looking to move on to a new diet, are you? :)

  8. If you’re going to do a diet for the elderly, it’ll need to be sooner rather than later to do me any good. :-)

    Re: Ice Fishing. I should have known better than to think it was too silly to be real although the ice fishermen we knew in Vermont especially liked pulling the legs of a couple of gullible city slickers from NYC with so many outrageous stories of derring-do, we never knew what to believe.

  9. Hi Paul, (love your work) in you book and also here you often relate to human breast milk as being 54% fat and as a good reference to dietary guidelines. Where this number is coming from? WIKI says 4.2%, reading online articles show ~5.4% fat in human breast milk… thanks

  10. Hi erp,

    I’m counting on you to be around for a long, long time.

    Hi crossi,

    54% = percent of calories.

    5.4% = percent of weight. Weight is mostly water.

    Likewise you often see cow’s milk quoted as whole (3.2% fat), 2% fat, 1% fat, skim. This is fraction by weight, not fraction of calories.

  11. Oh my goodness. Did anyone else laugh so hard they were crying while watching “Extreme Shepherding”? Thanks for the great laughs.

  12. Hi, Paul,

    I’m one of the people you mentioned in regards to having trouble on the GAPS diet and you were right to suspect I have a hard time digesting fructose. And I have trouble with nuts and was having problems with many vegetables too (basically everything on the FODMAPS list) so the diet had become by default a ketogenic diet for me. Maybe it is taking longer for my gut to heal because I eat potatoes and white rice. Who knows. But I feel so much better, my digestion is still improving, I’m not constantly hungry, and I really enjoy the food I eat. I’ll gladly eat this way for the rest of my life.

    GAPS diet and SCD are great and have helped a lot of people. But I’m very thankful that you are contributing to the discussion too!

  13. When I ate a VLC diet I found that hard liquor was extremely satisfying. As soon as I added back starches, my desire for alcohol diminished greatly.
    Like Cheeseslave’s experience when she IF’d, I wonder if a craving for alcohol could show the body is trying to prop up blood sugar levels and wants ethanol, since it digests quickly to glucose.

  14. Paul: Thanks for your response. The key question you raised is small amounts. Depending upon starch level, my small LDL can be as much as 50% of total LDL, so i have to play around with starch ingestion to get it to a small %of total LDL, say 10, or even 20%. the cardiologist specialists view this as a fist line of action, but total LDL particle levels is still material. Paleo levels of 2,00 total particles even if mostly large is uncharted territory. The more that hang around even in an anti-inflammatory environment(which i do not think can be absolute) the greater the chance of degradation and their getting lodged in the artery.

  15. Just adding in my similar experience to Peter’s. When VLC Paleo I was sucking down 2-3 glasses of wine a night. I’ve bumped up my carbs to the PHD level, and have been able to stay off alcohol entirely for the last couple of months. I’ve also lost about 5 more lbs since upping my carbs and quitting alcohol. Now when I get a strong craving for alcohol, I can “satisfy” it by having a few starchy carbs. Since going off alcohol and upping carbs I’ve seen improvements in my mental function and sleep pattern.

  16. At uni we had someone try to sell us the benefits of resistant starch. The CSIRO did some fiddling with food to produce a high resistant starch product called barleymax.

    As far as health benefits go it seems resistant starch is essentially the same as fibre. Both are fermented, butyric acid is the result (also found in butter), which is the agent of the health promoting effects.

  17. I’m glad to see the question of glucose deficiency on the GAPS diet being addressed. I am one of the people Paul mentioned who improved after switching from GAPS to PHD.

    It is often said that GAPS isn’t a low carb diet. This is technically true. But there’s more to that story. The approved carb sources are from foods you probably wouldn’t want to eat a lot of, like honey, nuts and fruit. Higher carb veggies like carrots and beets are allowed, but it’s unlikely you’d eat enough to avoid glucose deficiency. Beans and lentils are allowed on full GAPS but are not often tolerated by those with dysbiosis. Plus, there’s the issue of toxins. All in all, I doubt healthy intake of the main GAPS carb sources provides enough net glucose to avoid deficiency.

    The prevailing sentiment on the GAPS message board is that if one wants to mount an aggressive attack against Candida one should avoid the few GAPS-legal sources of carbohydrate in an attempt to starve the fungus. In doing so it’s almost impossible to avoid ketosis. This is where I found trouble – ketosis exacerbated my fungal infection, the very infection I was targeting!

    However, I was able to cure a bacterial dysbiosis on GAPS. As Paul points out, what is good for one pathogen may be bad for another. (Why does this have to be so tricky?)

    I am a big a fan of Dr. Campbell-McBride – I owe her a lifetime of gratitude for healing my reflux and opening my eyes to how diet can cure many illnesses. But there’s a black hole in the GAPS diet that some of us unwittingly fall into, and it would be nice if we could help each other avert that fall.

  18. Hi Paul,

    thanks for the mention RE: the microwave research paper. Look forward to hearing your views on that one!

    The lady in the TED talk video that had the crippling MS said she originally got good results slowing her disease down using extra polyunsaturates in the form of omega 3’s. The impression i get is that she is a big fan of lots of them. Am i misinterpreting this?

    In response to the GAPS vs PHD diets, you mention that certain pathogens thrive in a ketotic state whilst others can thrive on starches. Would it be possible to use the Modified Ketogenic Diet you have discussed previously that uses higher carbs, but keeps ketosis up via supplementary MCT’s and ketogenic amino acids, to produce an internal environment generally unfavourable to most pathogens?

    The reason i ask is I have had mild gut issues for a few years now, ever since i contracted gastric flu and food poisoning of unspecified cause during a holiday in Israel back in 2008. I also developed a number of grain, legume, and dairy intolerences since that holiday that i still cant shake. Since i dont know what the real problem is, and neither do the doctors (i had blood tests, gastroscopes, and faecal analysis at the time and they coldnt determine what it was), i would like a diet that makes it generally difficult for most pathogens to survive.

  19. I was very inspired by Dr. Wahls. Our greenhouse is full of leafy greens and since we will be eating even more than before, now there will be fewer for the chickens!

    Also I am playing around with eating a raw chopped clove of garlic and some parsley. It seems to give me great energy. I came across this site which has some good information, with regard to vegetables, though not diet as a whole — ( i.e.: chop or crush garlic clove and wait 5 to 10 min before consuming or cooking to allow the allin to convert to allicin, the more beneficial compound)

    http://www.whfoods.com/genpage.php?tname=foodspice&dbid=60

  20. Ellen — and Paul J — have you seen the book Healing Spices yet?

    I’m interested on the PHD take on it… It’s well-referenced and by an “experimental therapeutics in cancer division” guy (PhD) at MD Anderson in Houston.

    This book seems to be more on the micronutrients side than macro, but fascinating.

    Thanks
    ~ Brad

    Here’s a link to it at Amazon:
    http://www.amazon.com/Healing-Spices-Everyday-Exotic-Disease/dp/1402776632

  21. every time i see a link between red meat & colon caner,

    I just wonder about the mechanism.

    How?

    protein is digested in the stomach.

    so under normal operation, the only food stuff colon sees is fiber.

    so suppose that red meat is harmful to digestive system, one’d think it should be stomach.

    unless there’re other factors or pathways i’m missing.

    Could it be due to bad gut flora?

    (i also saw some study that shows vegetarians have higher colon cancer rate but forget where; i have a personal interest in cancer, in particular, colon cancer)

    ps. i love Sou Ching’s quote.

    regards,

  22. Thanks Brad, that just went on my wish list!

  23. Maybe red meat and cancer link has more to do with how meat is cooked i.e. seared black/ barbecued. I don’t think the issue of cooking methods have been addressed properly within Paleo or low carb forums. Often the discussions have centered upon nutritional contents or healing potentials of certain foods, while ignoring the fact that even healthy foods when cooked improperly, can become toxic. Perfect example is overheating certain healthy oils like olive oil. Oil at very high temperatures becomes toxic, yet I see people sautee their veggies in olive oil over extremely high heat, thus rendering a healthy meal toxic.

  24. Hi Angie & Bella,

    Thanks much for sharing your stories. On Judy’s post she says she contacted Dr Campbell-McBride who told her that “she has not seen one GAPS patient who needed starch in any form.” I think your experiences are a useful corrective, re-affirming the diversity of pathogens which can afflict the gut and the need for an adaptive approach which both nourishes the body and deals with the specific gut ecology of the patient. Starches may be good to remove in most gut dysbiosis cases, but certainly not all.

    Hi Peter, Clarissa,

    Those are fascinating experiences, thank you for sharing. I’ve heard a lot of people say their craving for sugar disappeared when they added starches, it’s interesting that this works for alcohol too.

    Hi Rob,

    The modified ketogenic diet we recommend is optimal for nourishing the human brain; it’s not designed to starve pathogens, other than CNS bacteria. Unfortunately, the biggest problem with it is that it’s probably pretty good at feeding eukaryotic pathogens (fungi, protozoa).

    If you don’t have those infections and do have a neurological problem, then our version of the ketogenic diet will probably be very good for you.

    MS is probably viral or bacterial in origin so the modified ketogenic diet should work well.

    For your personal case, I think it’s worth doing experiments with these different diets. A ketogenic diet might help you; hard to say until you try it.

    Hi Brad,

    Thanks, that looks like a great book for us.

    Hi pam, Jana,

    If there is a true red meat and cancer link, and not just an association, it’s probably mediated by Neu5Gc in some way. See eg http://www.ncbi.nlm.nih.gov/pubmed/21505105.

    Best, Paul

  25. Paul: Thank you so much for all the work you two have done. I love the PHD book and am very satisfied with the PHD diet. And the blog is so interesting and helpful and I love reading your blog entries and recipes, the questions, comments and your responses – it’s a wonderful community!

    I try to tell others about the book and the diet because I’m so excited about it, but almost everyone is very skeptical and they don’t want to try it – it’s too radical for them and they don’t want to give up their beloved but toxic foods. It’s very frustrating!

    I do wonder how long it would take for someone to start feeling better and notice an improvement in their health after adopting the PHD diet. I don’t remember if you talked about that in the book and I’ll have to read the results section more carefully to see what others say. I didn’t really have any health complaints before PHD, but I do think I am happier and have more energy and my carb cravings are pretty much gone because I’m no longer doing VLC and am enjoying healthy fats including more omega 3, and now enjoying safe starches like sweet potatoes. Don’t know how quick those changes came about though!

    Looking forward to another book from you both!

    Brad: Looks like an interesting book – I’ll definitely check it out!

    Here’s an interview with the author:
    http://www.theglobeandmail.com/life/health/spice-up-your-health-cancer-researcher-advises/article1880703/

    And here’s a review I found:
    http://naturalmedicinejournal.com/article_content.asp?article=208

    Thanks again – I can’t thank you enough – best to you!
    -Connie

  26. Re: alcohol and starch, I’m reminded of a book I read a while back called Potatoes not Prozac, by a doctor who noticed that when her clients gave up alcohol, they gravitated to sugar. She believes sugar sensitivity and alcoholism are related and treats both in part with a daily bedtime potato.

  27. Sorry to bug you again Paul, but further to what you said about the Modified Ketogenic Diet might be inappropriate for eukaryotic pathogens (fungi, protozoa), is it possible this issue could be offset by the liberal use of MCT oil that inc. lauric acid?

    I keep seeing mentions that MCTs are anti-fungal, esp. caprylic acid and lauric acid, so would a diet high in these be enough to directly work against eukaryotic pathogens that the diet might indirectly otherwise support?

    I also eat some foods naturally quite high in these such as roquefort cheese.

  28. Re: “every time i see a link between red meat & colon caner, I just wonder about the mechanism.”

    There is this: http://perfecthealthdiet.com/?p=4354 “Seth Roberts also linked to a paper showing that high-protein diets are bad for the colon, due to toxic protein metabolites.” (also links huntgatherlove MelissaMcEwen blogpost, which links to the PDF dissertation:

    http://arno.unimaas.nl/show.cgi?fid=16226
    “Most microorganisms prefer to ferment carbohydrate over protein and therefore saccharolytic
    bacterial fermentation occurs predominantly in the proximal colon, while proteolytic
    fermentation mainly takes place in the distal colon where fermentable
    carbohydrates are depleted. The latter is considered less favourable for the host
    because potentially toxic metabolites are formed such as ammonia, sulphurcontaining compounds, indoles and phenols. Since this distal part of the colon is
    the predominant location of several gastrointestinal disorders, such as ulcerative
    colitis and colon cancer, it could be hypothesised that the production of these toxic
    metabolites and a lower availability of SCFA are involved in the pathogeneses of
    these diseases.2, 3″

    It reminds me of toxic ammonia production from excess protein http://is.gd/xJpGqN

  29. Hi Paul,

    I’m actually curious about the cancer-causing red meat Japanese study.

    The vast majority of information I’ve read on Paleo diets be it through blogs or books advocate red meat consumption.

    What are your thoughts on this study and on red meats causing cancer (in general)?

  30. Hi Shameer,

    We’re one of the Paleo diets that advocates red meat, so of course we’re very interested too. That’s why we’re following the research on the topic.

    We haven’t come to any conclusions yet. But the prudent thing for cancer patients would be to emphasize seafood rather than red meat.

  31. When you say you recommend rice syrup or dextrose as a glucose source for those with dysbiosis caused possibly by bacterial pathogens, is this instead of the safe starches you recommend in your standard PHD diet? Many thanks