Monthly Archives: January 2012 - Page 2

Around the Web: Bears in the Woods Edition

My apologies: I have been busy with work obligations lately. I hope to return to a regular blogging schedule soon.

[1] News: The recent flurry of interviews is winding down:

Second, Shou-Ching and I have been invited to blog at Psychology Today, and we’ve accepted. We’ll mostly be cross-posting similar posts at both sites, but we may write some original posts introducing our diet to that audience.

Finally, I’m going to be speaking at Paleo(fx) in Austin, Texas, March 14-17.

[2] Music to Read By: Last week’s IZ video was popular so let’s try one more: “What a Wonderful World”:

[3] Interesting Items This Week:

Adventures in food reward: Eating from a red plate and drinking from a red cup causes people to eat 40% less food. (Via John J. Ray) Quiz for Stephan: What’s the better weight loss plan: Gourmet food on a red plate, or bland food on a white plate?

I mentioned Stabby Raccoon’s binge drinking protocol last week. I didn’t mention that Stabby is from Alberta, Canada; and that the closer you live to Stabby, the more likely you are to need his protocol. Here are the percentage of binge drinkers in each state, according to the New York Times:

Gregory Cochran ponders why anyone ever thought genetic mutations would be the cause of common diseases.

Dr. Brownstein claims that bromine toxins can be passed from parents to offspring, impairing their thyroid function. Salt and iodine supplementation both help excrete bromine.

Pal Jabekk discusses “the carnivore connection” to obesity: the Paleo environment selected for insulin resistance, the modern environment for insulin sensitivity.

Dr. Jack Kruse advises a patient to try a Paleo diet for 30 days in an attempt to avert surgery.

CarbSane discusses irisin, an exercise hormone that assists weight loss.

Bix tells us why TV chef Paula Deen “can’t keep pushing mac and cheese and deep-fried Twinkies.”

“Circadian rhythm therapies,” such as sociability and looking at human faces, improve health; Chris Kresser makes a case for nature as an effective therapy. I know it always makes Shou-Ching and me feel better. (Note to Steve: I first wrote “Shou-Ching and I” and then remembered you.)

In some hard-to-diagnose cases, Lyme MD says, “Acupuncture and traditional Chinese herbal therapy would be much better than what I have to offer.”

Chris Highcock reports that obesity-promoting gut flora protect against heart attacks by suppressing leptin, which worsens heart attacks.

Cheeseslave is embarrassed. Her waist to hip ratio is too high: 0.72.

Derrick Martin believes “macrobiology” is being neglected.

Paleo Pepper discusses causes of PCOS.

Via Tyler Cowen, a neat story on the communion wafer industry. Sister Lynn of the Benedictine Sisters of Perpetual Adoration learned how to make gluten-free wafers:

We eventually made a bread that worked with .01% gluten content [as compared to the 12-14% in normal communion wafers]… The Church said that was acceptable to them, so we gave the breads to people with coeliac’s [sic] disease and they had no reactions whatsoever.

A rare white penguin has been spotted in Antarctica:

Economists find that fasting during early pregnancy impairs the child’s intelligence.

Argentine President Christina Fernandez had her thyroid removed for fear of thyroid cancer, but it was a false alarm – her thyroid was fine.

Cygnia Rapp, the creator of Melt Organic Butter Spread, gave a very nice review of our book. She’s an organic food producer in Idaho.

New York City really does have a modern caveman. No, it’s not John Durant! But what is his diet?

Stephan addresses an issue – physiological insulin resistance on low-carb diets – we discussed in our reply to Ron Rosedale:

The first study to address this question was published in 1935 by Dr. H.P. Himsworth (Himsworth HP. Clin Sci 2:67. 1935).  He found that insulin sensitivity was increased by feeding a high-carbohydrate diet and decreased by feeding a low-carbohydrate diet, but these effects were only observed at very high (70-80%) and very low (less than 10%) carbohydrate intakes, respectively.

[4] Cute animal:

Via Yves Smith.

[5] New Papers and Books This Week:

Congratulations to two top Paleo bloggers who published new papers this week:

  • Chris Masterjohn has a new review paper, here, on the therapeutic potential of green tea.
  • Stephan Guyenet has a new review paper, here, on the regulation of food intake and body mass in obesity.

Richard Nikoley’s new book, Free The Animal: Lose Weight & Fat With The Paleo Diet, has come out. From the cover image I at first thought the title was “Beyond the Blog,” and even Richard refers to it as “My ‘Beyond the Blog’ Book”. Congratulations, Richard.

Finally, Chris Highcock of Conditioning Research has come out with an ebook, Hillfit: Strength. The booklet is available for download from I was able to read a copy and it is excellent.

His booklet is an introduction to fitness. It is designed to help readers develop versatile and functional strength that enables them to excel at natural human movement. Chris breaks strength down into 5 basic functional patterns – two upper body patterns (pushing and pulling), two lower body (squatting and hip-hinging), and one whole body (running/hiking) – and shows exercises that can be done indoors without equipment to develop strength in all five patterns.

Although this is marketed as a booklet to make you “Hillfit”, ie good at moving over mountains and hills, it could just as well have been titled “Lifefit.”

Congratulations on an excellent book, Chris.

PS – Doug McGuff also has a review. Doug had a great week as well, he was interviewed by Dr Mercola and sold a lot of copies of Body By Science.

[6] Of Safe Starches and Ketogenic Dieting: Lucas Tafur discusses safe starches and blood glucose. He adds:

Despite my obvious differences with Paul (33), his dietary advice is very reasonable and his diet is the first I recommend.

Thanks, Lucas. It is not clear to me why we have differences. The main difference seems to be that Lucas equates low-carb and ketosis (for instance, in his most recent post he says “I will use low carbohydrate and ketogenic diets equally,” ie, interchangeably), whereas I distinguish them because you can generate ketones even on a high-carb diet by flooding the liver with MCT oil or coconut oil. In the post in which he disagreed with me, Lucas took my critique of zero-carb diets to be a critique of ketogenic diets, which I did not intend at all; I believe ketogenic diets are therapeutic for many conditions and should be a weapon in everyone’s dietary arsenal. I simply believe that making a diet ketogenic through the use of carb-starvation, rather than by MCT oil, should be viewed as a method of short-term fasting that is unsafe as a long-term diet.

I understand that Lucas has increased his “safe starch” consumption recently, so perhaps we are converging!

[7] From the Comments:

Joan reported her work-in-progress results from using PHD for Crohn’s:

Results? Well, I’m still off steroids which my gastroenterologist didn’t think would happen! I do still get diarrhea and pain at times but that is often a result of my experimentation with different things. I got alot of bloating and gas when I first introduced carbs and 100g of rice (uncooked weight) looked enormous. The bloating is decreasing and my stomach capacity must have increased! I’m getting closer to understanding what works for me so hope things will settle down further. A major improvement has been my increase in energy; I no longer require one or 2 naps during the day and I’m slowly upping my exercise.

It definitely is a “work in progress” but I feel confident this is the right path. Steroids have wrecked my body (I have an artificial hip due to osteoporosis) and the future looked grim. Thank you Paul and Shou-Ching for giving me hope.

Joan also did a do-it-yourself fecal transplant using a colonic enema kit, and reports results. KH quotes Proverbs 13:12 in reply: “Hope deferred makes the heart sick, but a longing fulfilled is a tree of life.”

Lance Strish notes that Dr Greger opposes fermented foods. On the strength of Seth Roberts, the Weston A Price Foundation, and many traditional cuisines, we have included fermented foods in our food plate and have been eating them ourselves for the last year, but I’m still open to counter-evidence. Live cultures are surely not risk-free.

Rob links to an interesting story. High fiber did not solve Hitler’s gut dysbiosis – and neither did strychnine, cocaine, or amphetamines.

Mario notes evidence linking Sjogren’s syndrome to viral infections.

Kyle and Connie Warner give us interesting stories about the links between cyanobacteria and ALS and Parkinson’s.

Finally, Dale wonders if we designed this dog’s diet:

Actually I bet a “Perfect Puppy Diet” book would do well. I notice on Amazon that The Culinary Canine is doing well, perhaps because of great recipes like “Muttloaf”:

[8] Not the Weekly Video: Owl – or blood-sucking bat?:

[9] How Henry Harpending Escaped Being Turned Into a Frog:

Everyone except the Americans agreed that witchcraft was a terrible problem, that there was danger all around, and that it was vitally important to maintain amicable relations with others and to reject feelings of anger or jealousy in oneself. The way it works is like this: perhaps Greg falls and hurts himself, he knows it must be witchcraft, he discovers that I am seething with jealousy of his facility with words, so it was my witchcraft that made him fall. What is surprising is that I was completely unaware of having witched him so he bears me no ill will. I feel bad about his misfortune and do my best to get rid of my bad feelings because with them I am a danger to friends and family. Among Herero there is no such thing as an accident, there is no such thing as a natural death, witchcraft in some form is behind all of it. Did you have a gastrointestinal upset this morning? Clearly someone slipped some pink potion in the milk. Except for a few atheists there was no disagreement about this. Emotions get projected over vast distances so beware.

Even more interesting to us was the universal understanding that white people were not vulnerable to witchcraft and could neither feel it nor understand it. White people literally lack a crucial sense, or part of the brain. An upside, I was told, was that we did not face the dangers that locals faced. On the other hand our bad feelings could be projected so as good citizens we had to monitor careful our own “hearts”.

This all went on for an hour or so and I am ashamed to admit, here, that when the crunch came I blinked. Our employees were so adamant to show me the truth that they pooled their money so they could take me to the local witch doctor, who would turn me into a frog. “Of course he can do that, it is easy for them to do, even to white people” they said. I thought for a very short time and took the coward’s way out, I refused their interesting offer, the risk was a little too much for me.

[10] Shou-Ching’s Photo Art:

[11] Paleolithic animal diets: Paleophil questioned whether Paleolithic hunters passed up the lean portions of meat. I mentioned in my reply a link from Mark Sisson showing that even beetles adjust their food sources to optimize nutrient ratios.

But maybe a better example would be killer whales, who scorn the lean shark meat but eat the liver:

[12] Weekly Video: What Do Bears Do In the (Ontario) Woods?

Around the Web: Epiphany Sunday Edition

A few announcements: We have a first draft of an Index to the book on the Errata+Index page. Leave requests for additional keywords in the comments. Also, Australian readers can now buy our book at

[1] Thank you, Dr Mercola and readers: I was delighted to talk to Dr Mercola; he is a gracious host and has a great ability to distill complex ideas down to essentials. His article and video yesterday make a great introduction to our ideas.

This blog and our book are a scientific enterprise: our goal is to prove that a multi-step process, beginning with diet and nutrition and often culminating in diagnosis and treatment of infections, is the best way to prevent and heal chronic disease. Convincing evidence that this is true can be gathered only if large numbers of people to try our diet. So we’re very happy and excited to be able to share our ideas with Dr Mercola’s audience.

[2] About that study:  Several readers emailed to ask for a link to the Japanese study, mentioned in my interview with Dr Mercola and highlighted in his headline, showing reduced IQ in wheat eaters. Here it is:

Taki Y et al. Breakfast Staple Types Affect Brain Gray Matter Volume and Cognitive Function in Healthy Children. PLoS One. 2010 Dec 8;5(12):e15213. Free full text.

[3] Music to Read By: “Somewhere Over the Rainbow” was the first dance at our wedding, and we honeymooned in Hawaii, so this is double good:

[4] New this week:

Mark Sisson says body fat setpoint is “so 2011”. Heh! Thanks Mark.

Chris Masterjohn drops a bombshell: The textbooks are wrong, we can make glucose from ketones. This helps resolve a problem I’ve been puzzling over: given the physiological need for glucose, why aren’t zero-carb diets catastrophically unhealthy? And why do they seem to be tougher for skinny folk to tolerate than the overweight?

Dr John Briffa’s new book, Escape the Diet Trap, is out in the UK. Unfortunately it’s not yet available in the US, but Americans can check out John’s blog, which I rely on for regular reminders to stay hydrated, plus lots of other good advice.

Melissa McEwen explains why Paleo didn’t fix her IBS.

I was intrigued by the sample Perfect Health Diet meal plans at PaleoHacks. Heather said, “I was strictly PHD and took all the supplements for awhile and it really helped me get out of a scary place health-wise.”

Pepsi claims that Mountain Dew dissolves flesh. No, not in advertising; it is their legal defense to a lawsuit claiming a mouse was found in a can of Mountain Dew.

Seth Roberts is in Tokyo, which has some of the best food in the world. His findings remind me of our discussions of “gourmet Paleo”: simple food can be incredibly tasty:

I had seven dishes. Every one surprised me and tasted great….  No meal at Chez Panisse or anywhere else has pushed me to do two new things….

There are so many great restaurants [in Tokyo] it doesn’t matter…. [T]his “plain” meal, with cheap ingredients and relatively little labor, will continue to influence and teach me …

Speaking of Japan, Dennis Mangan finds a paper claiming that mortality increased slightly when the Fukushima radioactive plume reached the United States. This is a surprising result.

Gary Taubes has a journalism piece in Science about insulin and cancer.

Gary’s petition to the New York Times has almost 400 signatures from low-carb and Paleo community members. I wish the petition had said something like: “Low-carb and Paleo diets have been shown to alleviate many pathologies associated with obesity, including dyslipidemia and metabolic syndrome. Many dieters have found low-carb and Paleo diets an effective aid to weight loss. It would be interesting for the Times to continue its investigation of ‘The Fat Trap’ by looking at whether low-carb and Paleo diets can help the obese escape the trap.” Unfortunately, the petition had a number of statements I felt were inappropriate, so I didn’t sign.

CarbSane has her own objections to the petition.

Dallas and Melissa Hartwig have kicked off 2012 with Version 5.12 of their “Whole30” program. I hear through the grapevine that a few knock-offs are being developed. Stabby Raccoon is doing the “Perfect30”: a Whole30 with rice, potatoes, butter, and sour cream. Aravindan Balasubramanian is developing the “Good Enough 30.”

The Scientist looks at how parasites exert mind control.

Stephan Guyenet had a good holiday: his TEDx Harvard Law School talk came out, and so did a paper on which he was fourth author.

Stan the Heretic looks at ketones, histone deacetylation, and schizophrenia. If ketones are effective deacetylase inhibitors, they would be helpful against cancer too.

ItstheWooo found that supplements cured her hypoglycemia.

Epstein-Barr Virus has always been closely linked to multiple sclerosis, and new research clarifies a mechanism.

Dr Emily Deans has a rant. My reaction is similar to Jamie Scott’s.

Jamie also has a nice piece on how dietary fats modulate intestinal barrier integrity.

Steven Hamley has a lot of ideas about obesity.

Better nourished elderly have better brain health.

Cate Shanahan thinks the Middletons are an example of “second sibling syndrome.”

Via Instapundit, mice whose food is supplemented by extra vitamins, ginseng, and garlic live longer and maintain better cognitive function than mice on ordinary chow. I take this as proof that standard lab chow is malnourishing.

Via cillakat, Psychology Today discusses research showing that progesterone can heal damaged brains.

Cancer Research UK presents a graph showing things you can do to reduce cancer risk.

I’m sorry to hear that Venus Williams has Sjogren’s syndrome, but I doubt her new vegan diet is the solution.

[5] Cute animals:

[6] Cute animal woman of the year:

[7] Via erp:

[8] Magnesium and vitamin B6 calm over-excitable children: So says this paper. But would it work on this girl?

[9] Interesting comments:

  • Ken offers some natural therapies for FMS/CFS.
  • Callie found that melatonin can cause depression.

[10] Not the Weekly Video: You’ve heard of the genome, proteome, and glycome … now, the newest frontier of medical research: the beardome:

[11] Shou-Ching’s Photo Art:

[12] Weekly Video: If the winter has you pining for the tropics, here’s a look at Fiji and Tonga:

My Theory of Obesity, I: “The Fat Trap”

In the January 1 edition of The New York Times Magazine, Tara Parker-Pope’s “The Fat Trap” looks at one of the most interesting aspects of obesity: how difficult it is to keep lost weight from coming back.

I skimmed it when it first came out, but after an email arrived this morning inviting me to sign a petition authored by Gary Taubes, I decided to read it carefully.

Ms. Parker-Pope’s article is excellent. Since it presents valuable evidence on some issues I have been planning to write about, I thought I’d use it to begin expounding my theory of obesity.

The Yo-Yo Dieting Pattern

A common experience on weight loss diets is successful weight loss – but often not to normal weight – followed by unremitting hunger that requires heroic willpower to resist, and ultimate capitulation leading to weight regain. This pattern may repeat itself in yo-yo fashion.

Parker-Pope describes a recent study from The New England Journal of Medicine:

After a year, the patients already had regained an average of 11 of the pounds they struggled so hard to lose. They also reported feeling far more hungry and preoccupied with food than before they lost the weight.

While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, the Australian team detected something new. A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost…. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

The study measured hormonal levels a year after the weight loss:

One year after the initial weight loss, there were still significant differences from baseline in the mean levels of leptin (P<0.001), peptide YY (P<0.001), cholecystokinin (P=0.04), insulin (P=0.01), ghrelin (P<0.001), gastric inhibitory polypeptide (P<0.001), and pancreatic polypeptide (P=0.002), as well as hunger (P<0.001).

Note that insulin levels were still lowered, even as the participants were re-gaining weight:

Decreases in insulin levels after weight loss were evident, and the interaction between postprandial period and study week was significant (P<0.001), with significant reductions in meal-stimulated insulin release 30 and 60 minutes after eating, both from baseline to week 10 (P<0.001 for the two postprandial comparisons) and from baseline to week 62 (P<0.001 for the comparison at 30 minutes; P = 0.01 for the comparison at 60 minutes).

Gary Taubes, in his petition, complains that Ms. Parker-Pope “forgot to mention that the hormone insulin is primarily responsible for storing fat in her fat tissue”; perhaps this omission was just as well.

Resistance to Weight Gain

There is variability in the response to overfeeding. Commenting on a seminal series of experiments published in the 1990s by Canadian researchers Claude Bouchard and Angelo Tremblay, Parker-Pope writes:

That experimental binge should have translated into a weight gain of roughly 24 pounds (based on 3,500 calories to a pound). But some gained less than 10 pounds, while others gained as much as 29 pounds.

Note that eating a pound’s worth of calories typically led to something like a half-pound of weight gain; this shows that weight increases lead to energy expenditure increases. This was in a study in which the subjects were prevented from exercising. Likely the weight gain would have been generally lower if the subjects had been free to move as they wished.

Genes Influence But Don’t Decide

Genes – at least the known ones – are not determinate for obesity:

Recently the British television show “Embarrassing Fat Bodies” asked Frayling’s lab to test for fat-promoting genes, and the results showed one very overweight family had a lower-than-average risk for obesity.

Successful Weight Loss Is Possible

Some people do lose weight successfully:

The National Weight Control Registry tracks 10,000 people who have lost weight and have kept it off. “We set it up in response to comments that nobody ever succeeds at weight loss,” says Rena Wing, a professor of psychiatry and human behavior at Brown University’s Alpert Medical School, who helped create the registry with James O. Hill, director of the Center for Human Nutrition at the University of Colorado at Denver. “We had two goals: to prove there were people who did, and to try to learn from them about what they do to achieve this long-term weight loss.” Anyone who has lost 30 pounds and kept it off for at least a year is eligible to join the study, though the average member has lost 70 pounds and remained at that weight for six years.

Kudos to Drs. Wing and Hill: This is precisely the kind of data-gathering effort that is needed to help us understand weight loss.

The results, at least as reported by the Times piece, aren’t what most dieters want to hear. The people who kept weight off were those who basically continued some form of calorie restriction indefinitely:

There is no consistent pattern to how people in the registry lost weight — some did it on Weight Watchers, others with Jenny Craig, some by cutting carbs on the Atkins diet and a very small number lost weight through surgery. But their eating and exercise habits appear to reflect what researchers find in the lab: to lose weight and keep it off, a person must eat fewer calories and exercise far more than a person who maintains the same weight naturally.

If this is true, then few people have figured out how to cure their obesity. Rather, they’ve just found ways to keep weight off while remaining “metabolically damaged.” They can’t live like normal people and maintain a normal weight.

Paleo Helps

The piece then goes on to discuss the case of Janice and Adam Bridge. Mrs. Bridge peaked at 330 pounds in 2004, now weighs 195; Mr. Bridge peaked at 310 pounds and now weighs 200.

Mrs. Bridge stays at 195 pounds with a reduced-carb Paleo-style diet:

Based on metabolism data she collected from the weight-loss clinic and her own calculations, she has discovered that to keep her current weight of 195 pounds, she can eat 2,000 calories a day as long as she burns 500 calories in exercise. She avoids junk food, bread and pasta and many dairy products and tries to make sure nearly a third of her calories come from protein.

No junk food (presumably sugar), bread, pasta, or dairy is pretty Paleo. Compared to the standard American diet, it’s low in carbs and high in protein.

Persistent Alterations in the Formerly Obese

The article points to other sources of evidence for metabolic differences between the obese and the never-obese.

[O]ne woman who entered the Columbia studies [of Drs Rudolph Leibel and Michael Rosenbaum] at 230 pounds was eating about 3,000 calories to maintain that weight. Once she dropped to 190 pounds, losing 17 percent of her body weight, metabolic studies determined that she needed about 2,300 daily calories to maintain the new lower weight. That may sound like plenty, but the typical 30-year-old 190-pound woman can consume about 2,600 calories to maintain her weight — 300 more calories than the woman who dieted to get there.

Presumably 190 pounds is still obese for the “typical” 30-year-old woman. So the reduced-weight obese woman is burning fewer calories than a same-size obese woman who never reduced her weight.

So obesity followed by a malnourishing weight loss diet often creates persistent changes that hinder further weight loss, or even maintenance of the lower weight. One observation:

Muscle biopsies taken before, during and after weight loss show that once a person drops weight, their muscle fibers undergo a transformation, making them more like highly efficient “slow twitch” muscle fibers. A result is that after losing weight, your muscles burn 20 to 25 percent fewer calories during everyday activity and moderate aerobic exercise than those of a person who is naturally at the same weight.

Another observation in these patients is persistent hunger. Self-reported hunger is confirmed by observable changes in the brain:

After weight loss, when the dieter looked at food, the scans showed a bigger response in the parts of the brain associated with reward and a lower response in the areas associated with control.

In the Columbia patients, the effect is highly persistent:

How long this state lasts isn’t known, but preliminary research at Columbia suggests that for as many as six years after weight loss, the body continues to defend the old, higher weight by burning off far fewer calories than would be expected. The problem could persist indefinitely.

What Caused the Metabolic Alterations?

Are these persistent alterations to the body caused by the original obesity, or by the malnourishing diet that produced the weight loss? Dr. Leibel believes that the cause was the obesity, but that it is slow-acting – requiring an extended period of fatness:

What’s not clear from the research is whether there is a window during which we can gain weight and then lose it without creating biological backlash…. [R]esearchers don’t know how long it takes for the body to reset itself permanently to a higher weight. The good news is that it doesn’t seem to happen overnight.

“For a mouse, I know the time period is somewhere around eight months,” Leibel says. “Before that time, a fat mouse can come back to being a skinny mouse again without too much adjustment. For a human we don’t know, but I’m pretty sure it’s not measured in months, but in years.”

However, other researchers are exploring the possibility that it was the malnourishing weight loss diet that was at fault:

One question many researchers think about is whether losing weight more slowly would make it more sustainable than the fast weight loss often used in scientific studies. Leibel says the pace of weight loss is unlikely to make a difference, because the body’s warning system is based solely on how much fat a person loses, not how quickly he or she loses it. Even so, Proietto is now conducting a study using a slower weight-loss method and following dieters for three years instead of one.

My Theory of Obesity: Lean Tissue Feedback

I’m going to be spelling out my theory of obesity over coming months, but let me introduce here a few hypotheses which can account for the data reported in Ms. Parker-Pope’s article.

I believe the brain defends not only (or primarily) an amount of fat mass, but also the health of the body, as reflected by the quantity and quality of lean tissue.

So it is plausible to speak in terms of set points, but there are two set points: a “fat mass set point”, and a “lean tissue quality set point.” The second is dominant: Lean tissue is essential to life, while gains in fat mass may diminish fitness in some environments but will increase fitness in others and are rarely catastrophic. So the tissue-quality set point usually dominates the fat mass set point in its influence upon the brain and behavior.

Feedback to the brain about the quantity of fat mass comes to the brain through a hormone, leptin, that researchers can easily monitor; but feedback about the state of lean tissue comes through the nerves, which sense the state of tissues throughout the body. Lean tissue is too important for health, and can be degraded in so many different ways, that signals about its state cannot be entrusted to a fragile, low-bandwidth mechanism like a hormone. Lean tissue signaling uses the high-bandwidth communications of the nervous system. This feedback system is hard for researchers to monitor.

So the “fat mass set point” is visible to researchers, but the “lean tissue quality set point” is invisible. This is why researchers focus on the fat mass set point, while actual dieters, who know their own experiences are not explained by a simple fat mass set point theory, resist the idea.

Malnutrition will decrease tissue quality, triggering the brain to increase appetite (to get more nutrients) and diminish resource utilization (to conserve nutrients).

If the diet is deficient in the nutrients needed to build tissue, but rich in calories, then tissue-driven increases in appetite and reductions in nutrient utilization may (not necessarily, because the body has many resources for optimizing lean tissue and fat mass independently) lead to an increase in fat mass. Eventually a rise in leptin counterbalances the tissue-driven signals, but this occurs at a new equilibrium featuring higher fat mass, higher appetite, and reduced nutrient utilization compared to the pre-obese state.

Leptin signaling is responsible for the resistance to fat mass increases. The degree to which this resistance affects outcomes depends on the quality of lean tissue. The higher the quality of lean tissue, the less the brain needs to protect it and the more sensitive it is to leptin. The lower the quality of lean tissue, the more lean-tissue drives dominate and the more the brain ignores leptin signals (is “leptin resistant”).

Malnourishing “starvation” weight loss diets degrade lean tissue, and therefore they make the brain hungrier then it was before the weight loss, more eager to conserve resources that might be useful to lean tissue, and more leptin resistant.

However, weight loss diets that restrict calories, but improve the nourishment of lean tissue, should have the opposite effect. They should make the brain less hungry, less focused on conserving resources, and more leptin sensitive.

How much has to be eaten to provide adequate nourishment to lean tissue? In Perfect Health Diet: Weight Loss Version (Feb 1, 2011), I explored this question. Just to provide the necessary macronutrients to maintain lean tissue, I believe it’s necessary to consume at least 1200 calories per day. To optimize micronutrients as well, it’s probably necessary to supplement, even on a 1200 calorie diet. This is on a perfectly-designed diet. The less nourishing the diet, the more calories will be needed to eliminate tissue-driven hunger.

The Experiences of Perfect Health Dieters

A few Perfect Health Dieters have been using our diet for weight loss for a long enough period of time – 9-12 months – to test this hypothesis.

Jay Wright’s Weight Loss Journey (Dec 1, 2011) is a carefully chronicled account. Jay became overweight in college, obese by age 28, and had been obese for 10 years by the time he started our diet. He described his weight loss history:

I was a yo-yo dieter – I could lose weight but it always ended up even higher. I tried meal shake replacements, frozen dinners to limit calories, no meat/meat, no dairy/dairy, acid/alkaline, exercise/no exercise while dieting, no cash or credit cards in my wallet going to work so I wouldn’t stop at a fast food, punishment where I had to eat a raw tomato if I cheat (I hate raw tomatoes), and many other vegetarian leaning and mental tricks.  A pattern emerged with these diets.  I would starve with low energy for about a week or two until my will power ran out. Then, I would go eat something “bad.”  If I continued to repeat the pattern and managed to be “successful,” I stayed hungry even once I reached my goal weight.  I tried to transition to a “regular” amount of food to stop starving and just maintain but to no avail.  My weight went right back up even higher than before even without cheating on the diets.

This yo-yo pattern of hunger followed by weight regain exactly fits the experiences described in Tara Parker-Pope’s article.

However, Jay’s experience on PHD breaks the pattern. Jay went from 250 pounds to 170 pounds – his normal weight – in six months. Weight loss was steady and he experienced little hunger. He’s maintained his normal weight without regain for 3 months.

This is just as my theory predicts. PHD is a lean-tissue supporting diet, and if his lean tissue is well nourished, he should feel little hunger. If his lean tissue heals fast enough, then his lean-tissue drive will decrease faster than his leptin signaling, his equilibrium weight determined by the balance of these two drives will always be below his actual weight, and he should experience smooth weight loss. Which he did:

Jay’s experience is counter-evidence to many of the ideas put forth by the academic researchers in Ms. Parker-Pope’s article. For instance, Dr. Leibel’s theory that months of obesity create a persistent rise in set point is refuted; Jay had been obese for 10 years but his set point was quickly reset.

Here are Jay’s before and after photos:


I’ll be spelling out my theory of obesity in much more detail later; this is only a first installment.

But I’ll say this: I’ve been gratified by the experiences of people who have tried our diet for weight loss. Our Results page has many reports of reduced hunger, reduced food cravings, and weight loss.

Even those who have not lost weight have reported greatly reduced hunger. I think that means their lean tissue is becoming better nourished, causing the brain to feel less urgency about acquiring more nutrients.

I think this reduction in hunger is the proper first step to healthy weight loss. And I hope that in time we can gather enough case studies to prove that a nourishing diet like the Perfect Health Diet is the best approach to weight loss — and to a genuine cure for obesity.

Talks and Interviews, 2011 and 2012

One of the most enjoyable aspects of 2011 was the opportunity to speak about our diet.

Meeting readers and making new friends was delightful. And preparing the talks forced me to think about what parts of our message were most important, and to find the most powerful supporting evidence and images for each point. I feel

Thank You!

I’m grateful to everyone who attended my talks this year, but most deeply grateful to:

  • Sally Fallon and the Weston A Price Foundation for inviting me to speak at Wise Traditions 2011.
  • Court Wing, Hari Singh, and Joshua Newman for the opportunity to speak at CrossFit NYC.

Wise Traditions was a tremendous conference; if you ever have a chance to go, don’t miss it.

Court Wing was a wonderful host, the audience was fantastic – we took questions for about an hour after the talk – and Shou-Ching and I had a great time. CrossFit NYC has just moved into new space, so if you’re looking for a gym in New York, be sure to check them out.

When I get a chance I’ll go through these talks, find replacements for any copyrighted images, and post the slides.

Dr Mercola Video Interview

One of the happiest outcomes of the Wise Traditions conference was my meeting with Dr. Joseph Mercola. Since the conference we’ve spoken for several hours and traded emails, and I’ve been impressed with his friendliness and his ability to get to the heart of matters and boil complex issues down to essentials.

Dr Mercola recorded a 90-minute video interview with me which will go out in his newsletter on Saturday, January 7. However, his team has already posted it on Youtube. I hope I’m not stealing any of his thunder by embedding it here:

Dr Mercola is a tremendous interviewer and I really like the content. I hope no one minds that I shift my weight back and forth. I wasn’t aware that I was doing this, I suppose it’s a habit developed from working at a standing desk.

Jimmy Moore, Encore Week

I’m appearing tomorrow, January 3, on Encore Week of Jimmy Moore’s Livin’ La Vida Low-Carb Show.

Jimmy hasn’t posted the interview yet (UPDATE: The interview is here), but he does have a preview. My preview segment runs from 3:00 to 5:30:

Jimmy used a photo from this site that dates from 2009, when my rosacea was bad. One more reminder that it’s time to update all our photos!

Joanne Nelson, Joanne Unleashed

Joanne Nelson of Joanne Unleashed has also posted an interview with me. It’s another excellent introduction to our diet.

Upcoming Interviews

Miriam Knight of New Consciousness Review will interview me on January 4, and will air Tuesday January 10 at 9 am on KWRM 106.9 FM in Seattle, and on and iTunes.

Sean Croxton of Underground Wellness has invited me to appear on his radio show on Thursday, January 19 at 5pm PST/8pm EST.

I’m excited about all of these opportunities, and I hope you enjoy them too!