Q&A With Latest in Paleo Readers

Angelo Coppola has some nice things to say about our book:

Recently, I was asked by someone who had just completed reading two of the most popular Paleo diet books, which books I would recommend for further reading.

My response was something like, “Maybe you’ve read enough, and it’s time to ask yourself, ‘what’s next?’ What do you want to do with the Paleo approach, besides read about it?”

Well, my answer would have been different had he asked me this question after I had gotten my hands on the latest edition of The Perfect Health Diet…. I strongly recommend a short detour through Paul & Shou Ching Jaminet’s latest research.

Angelo also asked me to do a Q&A with his readers. He’s posted it and I have to say they asked some good questions. Several of them were questions our readers had previously asked us to comment on:

On the fructose issue, Marisa H asked a good question: “I am fructose intolerant. If fructose is sooooo great, why does this condition exist, and not glucose intolerance?”

Here are the questions Angelo’s readers posed:

  • Do you have any specific tweaks or recommendations for those with autoimmune conditions? And with respect to infections, is the most common concern gut infection, or are there other types that people should be aware of to consider or look for in their attempts at healing? – Erin L.
  • How important is it to have carbs with every meal vs. ‘backloading’ them all after a workout.  – Phil U. (@philsplace)
  • You talked about the correlation between the increase in omega-6 fats and overweight.  Please explain why omega-6 fats contribute to weight gain. – Jack
  • I’d love to hear Paul’s thought on Andrew Kim’s 4 part series of blog posts on “Fructose > Glucose”. – Michael
  • What are your thoughts on the Potato Diet, which has been gaining some popularity in online Paleo communities as a short-term solution for weight loss? – Angelo

Head on over to Latest in Paleo to see my answers!

Leave a comment ?

73 Comments.

  1. Logically Illogical

    Hi Paul,

    Just finished reading the revised edition of PHD diet (read the first edition when it came out, as well).

    I really enjoyed the new material, and continue to find the topic of circadian rhythm enhancement fascinating. Very much enjoyed that part.

    Quick question on the subject of cholesterol. It appears that the science is evolving more towards a focus on LDP-P, rather than LDL-C. I noticed that your discussion of cholesterol in both book versions maintains that the primary indicators of cardiovascular risk continue to be HDL/Triglyceride ratio and pattern type (i.e. Type A vs Type B).

    I enjoy my butter and coconut oil immensely, but have kept an eye towards this evolving focus on LDP-P. Are you aware of any research on the effect of our favorite fats on LDP-P, and if so, if they change the practical implications for diet?

    Thanks again for all you do.

  2. Hi Paul,

    In that Q&A you mention that fructose should be consumed with coconut milk to reverse the adenosine loss caused by fructose. I didn’t see any mention of this in the new edition of the book… What is it exactly about coconut milk that mitigates the harmful effects of fructose?

    -Thanks
    Adam

  3. Paul — I am just finishing up the new edition of your book and am very excited to implement your strategies into my diet. I’ve been attempting for months to adhere to either a Primal and/or GAPS style diet for months now, but never felt satisfied with either one and inherently felt I needed some starch in my diet.

    I have a number of questions for you, though, and I’m not sure if this is the correct forum to ask them, but if not, please direct me to the proper place.

    1. I have been avoiding omega 6 fats in my diet and in cooking, but have read that evening primrose oil is the one kind of omega 6 that is anti-inflammatory and therefore beneficial. Your thoughts?
    2. You state in your book that we should not take supplemental fish oils, but the fermented cod liver oil by Green Pastures is highly recommend by the WAP and GAPS folks, especially in a mix that combines high vitamin butter oil. Is this really any different from the standard fish oils that your research showed were harmful?
    3. I’m confused about dairy. I have looked and looked in your book, but it doesn’t seem to state hard and fast rules about dairy. In one part, you specifically state not to drink milk but it’s ok (and even beneficial) to ingest fermented dairy such as yogurt and kefir and dairy fat products like cream and butter. But there are several stories in your book that seem to indicate that drinking raw milk is beneficial. Can you give me some guidelines here?
    4. Do you have any experience/thoughts on liposomal vitamin C? It is traditionally made with soy lecithin and even though the manufacturer of one of the most popular liposomal products says that tests indicated no detectable levels of soy proteins remaining in the lecithin that was included, I have been making my own using sunflower lecithin, but after reading your book, I’m unsure whether this is desirable or not. Could you please comment?
    5. And finally, on the topic of hypo-thyroidism: I have been taking 1/2 grain of Armour for months now due to elevated TSH levels. My temperatures have improved, but are still below optimal. However, whenever I try to increase the amount of Armour I take, my bp drops (I have a history of adrenal issues, and this seems to indicate too much stress on my adrenals) and it also induces menstrual bleeding, regardless of where I am in my cycle. After reading your section on iodine yesterday, I took a dose of oidine made from kelp and the break-through bleeding started within hours. If this is just transitional, I can deal with it, but no one (including my doctor) seems to be able to tell me what’s going on and why I can’t seem to get my temperature up to at least averaging 98.6. Thoughts?

    I apologize for bombarding you with so many questions, but I was so impressed by your book — it seems to tie together all the things I suspected were true for my body along with the wisdom of WAP, Chris Kresser and others I’ve been following for some time and I’d really like to hear your thoughts.

    • Hi Sharon,

      I would avoid evening primrose oil too. It might be therapeutic for certain conditions, but healthy people shouldn’t supplement it.

      I am not a fan of fermented fish oil. Both the DHA and the vitamin A are quite fragile and time plus fermentation will generate toxins from them. There are other ways to get the benefits of fermentation, such as fermented vegetables and aged cheese.

      It’s hard to make hard and fast rules about dairy because it is a very complex food and there are many individual differences in response to it, also dairy comes in many different forms with varying health effects. As a general thing we recommend including fatty and fermented dairy (butter, sour cream, whole-fat yogurt, cheese) but excluding milk. However, individuals vary. Raw milk is better digested and better tolerated than pasteurized homogenized milk, but it is also at higher risk of carrying pathogens, so buyer beware.

      I don’t think it’s a problem to take liposomal vitamin C made from soy lecithin. However, I don’t think it’s necessary either.

      Iodine and hypothyroidism are tricky. First, I would be cautious about kelp, as it contains other compounds that may cause harm; also the dose of kelp tablets, typically 500 mcg, may be too high to start with. Rather try starting first with mixing in a little seafood (shrimp, shellfish, seaweed, marine fish) regularly into your diet. If that goes OK then get the 225 mcg potassium with iodide tablets on a recommended supplements page and try cutting them with a razor into fragments — quarters (56 mcg) or eighths (28 mcg) and taking one of those fragments a day. Also, try supplementing selenium 200 mcg twice per week, make sure you get the recommended copper either from beef liver or supplements, and give yourself a month to normalize things. Also, test your iron status and give blood if it is high or supplement if it is low.

      Hypothyroidism is slow to heal so you want to address as many seemingly unrelated defects in your diet and lifestyle as you can before doing much with iodine.

      Best, Paul

  4. Paul — Thank you so much for your thoughtful answers.

    What about Lugol’s solution? I have both some of that and some of the kelp, but I realize the amount in either may be too great. I would certainly be willing to go with the potassium w/iodide tablets if you think that’s better than the Lugol’s — I’ve just read so many people swearing by the Lugol’s, but it’s pretty strong too.

    My iron has been a bit low in the past, but has finally reached fairly normal status. I take Solgar’s dessicated beef liver tablets (the only one recommended by Sally Fallon), so I think I’m ok there.

    I haven’t seen adrenal issues mentioned on your site so far (but I haven’t read every post yet either). I’m currently taking adrenal cortex extract and timing my armour thyroid according to the circadian method, meaning I take it a couple of hours prior to rising for the day to maximize its ability to nourish my adrenals. (There’s a w book and a site about the T3CM if you care to read about it.) With these additions, my bp levels are pretty normal, but I was curious if you had any additional suggestions in that regard. I do all my cooking with coconut oil or ghee (occasionally a little olive oil) and I know saturated fats help the adrenals too.

    Thanks again for all the great information. It finally feels like I’ve found a way of eating that will help regain health and also be enjoyable! Any chance there’s a cookbook/mealplan generator (similar to Chris Kresser’s) coming on board soon?

    • Hi Sharon,

      Lugol’s is great but you have to be able to control the dose to match your own iodine needs.

      Beef liver can be quite high in copper, so be sure to check that you’re not getting an excess of that.

      I don’t have other suggestions for treating adrenal issues and I’m glad you’re tending to them.

      We’re working on a cookbook and a mealplan generator will likely follow. We’re somewhat behind on our work, but we definitely want to create that.

      Best, Paul

    • Lugol’s can be really cost effective. One drop provides 2.5 mg of iodine. You can put a drop in water, then cover the glass and drink the contents over however many days you decide.

      • I’m guessing that the 2.5 mg per drop applies to the “2% Lugols solution”.

        Just be careful, as the strength of Lugols solution may vary from place to place (Country to Country).

        The Lugol’s solution that i have is 5% and each drop is 6.25 mg Iodine…so you can see why you have to be careful & need to know what you are using.

        The original Lugol’s was 5% but i think that has now been restricted in the US & only 1% (1.25 mg iodine per drop) and 2% (2.5 mg iodine per drop) are available.

        http://en.wikipedia.org/wiki/Lugol's_iodine

  5. I had been dying to get the new book, frustrated that I been so short on time and haven’t been able to finish it. Thank You Paul & Shou-Ching!So here’s the big question. Is the PHD with some subtle tweeks not only ideal for health but performance also? For fans of Robb Wolf & Greg Everett’s podcast Kiefer from DH was on and made a couple of points that seemed to me to echo points made in the new book? Anyone but me thinking what about ” BulletProof Coffee ” post workout & all carbs at dinner?

    • Mike,

      I think a well-formulated paleo diet (w/ a tuned carb level) is great for performance in athletic endeavors in general. However, at the extreme end of performance, one can optimize for things that aren’t so great for longevity/health.

      For example, the Dangerously Hardcore stuff, Carb Night and Carb Backloading, resemble the well-known cyclic ketogenic and targeted ketogenic diets (respectively.) While these are great for muscle building, the desire to spike insulin as high/fast as possible is the exact opposite of what the PHD would recommend.

      Personally, I’ve married a bunch of the concepts. Quality foods, very low carb on off days and in the mornings, and a ton of starch after late-day workouts.

      • b-nasty,
        Thank You for your comments, my Wife and I are almost 3 years into our own experimentation with diet. I can tell by your response you are familiar with some of the authors/bloggers that we have followed at times. I wonder though for a healthy
        person are brief spikes in blood sugar really that bad?
        Personally I feel best with few carbs but Paul has me concerned that even if I feel “good” the VLC eating is not ideal.

        Thanks Again

        • Mike,

          I too feel better with lower carb levels. Much closer to the ketosis version of the PHD (~50g) than at the higher levels recommended for the general diet (150g+.)

          I do think one can use the carb timing strategy to one’s advantage, however. Post workout (weightlifting preferably) is the best time to eat whatever carb load. The muscles are more insulin sensitive and there are beneficial effects dealing with GLUT4 translocation.

    • Hi Mike,

      I do think we’re very good for performance … we target health but there’s a 95% overlap.

      I would love to see more athletes try our diet because I think it will work better than what most of them are doing now.

      I am not convinced that all carbs at dinner is desirable however. Working out fasted and eating carbs after is good.

      • Thank You Paul I really appreciate your input. We have been eating vlc as of late but you have me thinking its time to give the PHD a real test by doing it right. We work out fasted in the early AM and continue to fast till 2 or 3. I am concerned that
        carbs at 8AM are not great for my body composition, although Kiefer would advocate Protein shake and a ripe banana following fasted AM training.

        Thanks Again, on to chapter 14!

        • I am eating a 80/10/10 C/P/F south west Indian diet for 45 days as part of a research study. It’s heavy in rice and has decent amount of sucrose. I am hoping to go about this as smart as I can.
          Paul, would having coffee/tea in the morning, small amount of egg/chicken and vegetables and the rice, fruit, vegetables and sucrose in the evening after I work out optimal for preventing fat gain?

          thanks,

          • Hi Henry,

            I doubt you’ll gain much fat on that diet but you may have difficulty holding on to muscle. It does sound like a reasonable implementation. I would avoid pure sucrose and eat more fruit, potentially have fruit with both meals.

  6. Wow–I’m famous!

    Loved your take on the Potato Diet. We had a few people doing just that on this thread: http://www.marksdailyapple.com/forum/thread72366.html I think the consensus is that the satiety effect really only come through when sticking to potatoes, though.

    Wonderful forum member, J3NN, charted her diet on her blog, http://j3nn.net/blog/2012/12/17/potato-plus-diet-results/ and included mega-info like blood sugar, weight, hunger, energy etc…

    They have taken to calling it the “Potato Reset” and it’s been especially popular around the holidays. We look at it as a way to “reset” your eating, weight, and relationship with food.

    These are the rough guidelines we came up with for the best version of the Potato Reset:

    1. Plan on eating mostly potatoes for 5-7 days (90%+ of calories)
    2. Eat between 2 and 4lbs of potatoes daily.
    3. Other foods allowed (but optional!): 1/2 cup sauerkraut, 1 cup bone broth, 1 tsp max daily coconut oil, olive oil, or butter,
    1-2oz lean meat daily. Unlimited coffee, tea, and water.
    4. Spices, salt, pepper, and vinegar OK.
    5. Lifting of Heavy Things discouraged, think ‘de-load week’ Lifting light things/walking OK.
    6. All normal supplements OK to continue
    7. IF’ing, especially by skipping breakfast encouraged.
    8. If you need to lose more weight, alternate the “Potato Reset” diet with healthy Primal Blueprint in 5-7 day increments.
    9. Not recommended for people who eat every 2-3 hours, have glucose issues, or have eating disorders.
    10. Highly recommended for people who have their hunger under control, have been eating PB style for 6 months or more, and are having trouble losing weight with the normal approaches.

    • Hi Tater,

      Sounds like a thoroughly worked out approach! You should write a bestseller!

      • I was hoping it will get a special place in your next book!

        You are kind of responsible, you know, with your safe starch ideas…

        One interesting note, many people have tried using rice and sweet potatoes, but found it easier to overeat on those and not get ‘full’. The other safe starches are not so readily available in the mass quantities needed for a week or two of the reset. Tapioca, yucca, plantain, etc… would be great candidates, but they are not really part of the American diet scene.

        People have loved the idea of going out and buying 25-30 lbs of nice organic potatoes of different varieties and then get inventive cooking them and eating soley potatoes until they are gone. Works like a champ!

        I’d love to see you give it a try and blog about it. You’ll quickly see that adding much more than a miniscule amount of fat and protein negates the satiety effect.

        Boiled and chilled potatoes top all the ‘food satiety’ lists and so end up being a great go-to food/snack when doing the reset, this trick also works great when following your diet, or any really.

        Thanks for your work with safe starches!

        • Hi Tatertot,

          It’s possible the fiber in potatoes, which is good for promoting butyrate production, is important. Rice doesn’t have much fiber.

          It is a clever diet and I’m impressed at all the effort that went into this experimentation!

          Merry Christmas!

  7. Feel free to exploit it’s potential! It’s all about sharing the knowledge. You must admit, a book on the subject would write itself! I can even picture the cover…a potato with a measuring tape cinched around it’s ‘waist’.

    Some have referred to the potato diet as ‘Nature’s HCG’ due to the unbelievable hunger blunting effects. Many others have mentioned a favorable sodium/potassium ratio, the full compliment of amino acids in a potato, and it’s perfect partners–salt and vinegar–all as possible contributors to the success.

  8. What about the sola nine in potatoes.it seems to be a problem for quite a few people,guess they’ll have to stick to rice etc.

  9. Some people are sensitive to nightshades, so certainly they would not want to partake.

    We also made the butyrate connection early on. Removing all forms of resistant starch from the diet, as paleo used to do, could not be optimal for gut health. You know what has one of the best arrays of resistant starch and creates butyrate like nothing else? Cooked and cooled potatoes. Seems strange that cooling them changes their structure so much, but it really does. Also, vinegar changes the absorption rate of the resistant starch and aids in butyrate production…German Potato Salad anyone?

  10. Thanks for replies.
    Clear spring make a nice rice vinegar,would this be suitable?
    Also ume plum concentrate seems a healthy dressing,any comments on this Paul?
    Thanks

  11. Hey Paul,

    I wanted to inquire about your comment that high fructose intake promotes endotoxemia. I came to the same conclusion recently, but have been struggling with the mechanism of how.

    My initial thought was that large amounts of fructose are difficult to absorb and thus can feed gram negative gut microbes (thereby producing endotoxin), explaining why sucrose seems to reduce many of the negative effects of fructose alone (by enhanced fructose uptake via glut4).

    However, this is almost entirely speculative. I’ve been discussing this with others and have come up numerous other potential mechanisms with little evidence for any (every factor from buytrate to ROS to leptin has come up).

    So I guess I was wondering: what do you think the causative link (or, more likely, links) is/are between fructose and endotoxemia?

    • Hi M,

      We discuss this in the new edition. Fructose malabsorption is indeed one mechanism. It is true that some of the evidence is a bit speculative and the precise reasons why high-sugar diets produce a dysbiotic flora are not known, but there does seem to be a correlation between fructose consumption and dysbiosis/endotoxemia.

      One possibility is that our natural flora coevolved with us and so on our historical diets — which didn’t include much sucrose until a century ago — they were adapted to low-sucrose foods. Eating sugar favors microbes that aren’t as friendly.

  12. I would love to see this book on Audibl.com/

  13. Hi Paul, Catherine here. (you advised me regarding adding some carbs back for borderline low, normal thyroid, getting a.m. morning light and exercise before jumping the gun with t3, 4 comounded) I just spent a month in the Middle East and began having palpitations so I backed off the thyroid meds. (it could have been a wee bit of hypervigilance also, he he) Anyway, I feel fine but have some hand and calf cramps which I notice is a common theme and I saw a post at Paleo Hacks regarding same. I ordered your new book, loved the first one. I’m a groupie. :mrgreen: Keep up the great work and stay on your HIGH ROAD. 😆

    • hi Catherine, out of interest,
      when you say “hand and calf cramps which I notice is a common theme”.

      What are they a common theme for or of?

      Thanks

    • Hi Catherine,

      Cramps are common on low-carb diets due to electrolyte deficiencies (potassium, magnesium, calcium, sodium, maybe even lithium). Usually tending to those will fix it.

  14. Paul – I was going to wait until I got your new book to ask this, but since it’s on back-order from Amazon (good for you!) and won’t get here til January, I thought I’d ask now.

    You mentioned butyrate as a possible explanation for the success of the Potato Diet.

    Butyrate is produced by gut bacteria in the colon and feeds off of resistant starch. One way to increase the amount of RS in potatoes and rice is to cook and cool it. The cooling causes a process called ‘retrogradation’ to occur which re-assembles the starch into resistant starch.

    Resistant starch has some ‘magical’ properties. One is that the calorie count of food containing RS is over-stated since the RS is providing energy to gut bacteria and not us, and it is converted to a short-chain fatty acid before we digest it. This would account for the seeming inconsistency of CICO when on the potato diet. Many attribute the inconsistency to muscle wasting, but I think it stems more from an even greater calorie deficit than the data for potatoes indicate.

    I have been eating PHD style for some time now with a twist…most of my starch comes from rice and potatoes which were cooked and cooled. This one tweak has seemingly created the perfect storm of satiety, gut health, and weight maintenance. I love sauerkraut–but it hates me, terrible gas! Same as broccoli, cabbage, and some others, but now I eat these with wild abandon! I ate a large bowl of kimchi–a move which would have led to me taking up residence in the garage for two days before, and nary a poot!

    I’m hoping the nature of RS is discussed in your new book, along with ways to increase it in foods (cooking and cooling). Any words of wisdom for us concerning RS?

    Thanks, and Merry Christmas!

  15. Tatertot that’s interesting.

    My concern is with bacteria forming in rice that has been cooked and then eaten later in the day.i have seen concern expressed over its safety,can anyone explain the safest way to eat and prepare pre cooked rice?
    Thanks
    Chris

  16. Not sure about rice bacteria, but I have read numerous studies that show the retrogradation of cooked starch occurs best at about 45 deg F or lower, so cooked potatoes or rice should be refrigerated until completely cooled for best effect.

    From Wikipedia: Retrogradation is a reaction that takes place in gelatinized starch when the amylose and amylopectin chains realign themselves, causing the liquid to gel.

    When native starch is heated and dissolves in water, the crystalline structure of amylose and amylopectin molecules are lost and they hydrate to form a viscous solution. If the viscous solution is cooled or left at lower temperature for long enough period, the linear molecules, amylose, and linear parts of amylopectin molecules retrograde and rearrange themselves again to a more crystalline structure. The linear chains place themselves parallel and form hydrogen bridges. In viscous solutions the viscosity increases to form a gel. At temperatures between –8 and +8 °C the aging process is enhanced drastically.

  17. Thanks for that.i make rice porridge for breakfast,so I will now cook it at night,refrigerate it and then have it for breakfast.i guess It would be ok eating it cold but does reheating cause any detrimental changes do you know,do you reheat or eat cold?
    Thanks
    Chris

  18. That’s something I hope Paul addresses…I can’t find the answer. I would suspect the retrograded RS stays viable through re-heating, but I’m basing that on the waxy appearance of a re-heated potato. Did you ever notice you can’t get a potato back to it’s dry, fluffy state after it’s been in the fridge all night?

    I wish corn was on the safe starch list, I used to love cold polenta and hominy.

  19. Yes potato does go its own way lol.

  20. Do you get the additional RS if the cooled starch is reheated or only if eaten cold? Sorry if that’s a basic question, but I’m unclear about it after reading this thread.

    Thanks!

  21. So to get the maximum starch eating it cold is the way .can be made tasty with some hot soup or similar I guess

  22. potato salad! (love…) 😛

  23. Hi Paul,

    Does cultured (probiotic) cows milk have any place on the PHD plate…?

    a shop near me has just started selling some. Here are the details;
    Organic full cream unhomogenised milk (from Tasmania) ‘with live cultures and beneficial enzymes’.
    (with acidophilus, bifidus, casei & bulgaricus).

    It is pasteurised, it has to be by law where i live.

    Thank You

  24. Darin,
    The channel island milk that Tescos sell is gold top and unhomogenised.that tastes great.also in Leicestershire is an organic dairy,you can buy raw milk.
    Chris

  25. Hello Paul,

    What supplements and advice would you have for someone who is suffering with Chilblains on my fingers and that my Rheumatologist said my condition is chronic and that I’m to avoid caffeine (like THAT’s going to happen!), stay as warm as possible, keep taking the vasodilator he has me on, and pull up my big girl pants and either deal with it or see a vascular surgeon.

    My right hand, while usable, is extremely uncomfortable. The swelling is going down, which is good, but the skin has spent so much time being stretched (sometimes to the point of splitting!), that it’s scarred and looks horribly dry and scaly. My left hand is mostly back to normal with some scarring on my ring finger and a couple of “minor” chilblains on other fingers.

    Here’s my dilemma. I have insurance, but do NOT have enough expendable income to have surgery. I also am deathly afraid of surgery, having had a pulmonary embolism when I had my baby by C-section. At this point, I’m not going to see the surgeon.

    However, this leads me to finding ways to keep warm. I have thyroid disease and Reynaud’s disease, both of which cause me to be cold anyway. Add to that the chilblains, which are secondary to the Reynaud’s in any case, and I’m miserable. I wear gloves almost all the time, have a space heater under my desk at work, yada yada yada. I’ve reduced my caffeine intake by drinking mostly tea now instead of coffee, but I’m not quite ready to give up either. I will cut back further though.

    Just a little health background,
    I’ve had anxiety/depression off and on for years, literally since I was a small child, which actually seems a lot better now that my thyroid is being treated.
    Hypothyroid (I take Synthroid, calcium, vitamin D3)
    Reynaud’s (Primary) w/chilblains (I take Procardia)
    Tachycardia (I take Atenolol-which is noted for being bad for chilblains, but the doctor doesn’t want me to stop it. Last time I tried to wean off it, my resting heart rate was around 120-130)
    Osteoarthritis (from a hip injury when I was 20) No medication
    Fused L4-Sacrum (birth defect) No medication
    Migraines (These used to be very frequent, but thankfully not so much now) I don’t take medication for them unless they’re severe, then it’s OTC Excedrin or whatever.
    Mild OCD (undiagnosed, but a family history, so I know what it is) No medication.
    Degenerative disc disease. No medication.
    Mild allergies (they don’t really bother me and I don’t take anything for them, though I do take Benadryl at night to sleep)

    Before my thyroid diagnosis, I was having a lot of rashes, hives, psoriasis, joint pain, fatigue–I was sure it was Lupus or RA. All of that has gone away with my thyroid treatment, even the psoriasis I had since I was a teenager.

    I have been alternate day fasting for the last year and have lost 111 lbs arriving at my goal weight.

    Thank you for offering your time and wisdom to help with chronic illness.

  26. Hi Paul,
    I use lugols oil topically, about an inch square and don’t reapply it until the colour has been absorbed, sometimes right away, sometimes after a day or two. I’m thinking my body is regulating and using what it needs as it needs it. What do you think? Is this a safe way to get the iodine? Many thanks,
    Mira

  27. Hi Paul,

    I have been battling CFS/EBV with adrenal fatigue for a few years now. My question is would I still be able to heal if I start with the perfect health diet or should I start on a ketogenic diet to really help heal myself??

    Loved reading your book! As a current paleo eater I’m having a hard time wrapping my head around being able to eat white potatos and white rice, but I will give it a try!

    Thank you!
    Helene

    • Hi Helene,

      It’s very difficult to predict whether a ketogenic diet will help or hurt, and it’s easy to be malnourished on such a diet. I think it’s much better to start on regular PHD, stay on it for 3 months or until you notice health improvements stopping, and then do careful experiments testing whether the ketogenic variant helps or hurts.

      Best, Paul

  28. Having never liked potatoes much, I have tried them a bit while following PHD. I have suspected a nightshade sensitivity before, with joint pain the result of eating a lot of fresh tomatoes in summer. I have only recently begun including safe starches in my meals and, as everyone notes, the results are amazing and life-changing, all except the weight gain. I thought potato starch might be a path to getting more resistant starch without adding more calories from cooking. Tried a heaping tablespoon of Bob’s Unmodified yesterday, and last night experienced a host of low-grade pains in places I don’t usually ache. Does the potato starch concentrate whatever nightshade-ish substance it is that aggravates some people? I am gluten sensitive, with the same problem (joint pain) in different locations. Wondering about that potato starch.

    • Yes, it is plain potatoes unmodified. Hopefully Tatertot will see this and come by. He makes plantains and green bananas as well. Have you any problems with either of those? What about tapioca?

  29. Soy lecithin in my Celestial Seasonings Wild Berry Zinger tea. Who’d have thought? Avoid?

  30. Hi, I am new to PHD and believe this is the answer to all of my ills. However, after reading the book, I have a few questions. 1. I know chocolate is a good thing in small amounts (I think it is 1 oz. a week), but in what form if sugar is forbidden? 2. Are garbanzo beans off limits? I really don’t know if they are considered a legume or not? 3. Nothing was mention specifically about sesame seeds. Are they also off limits? I would appreciate answers to these questions. Thank you, Judy

    • Hi Judy,

      Eat 85% or higher chocolate to keep sugar down. 25 g per day is OK.

      Beans are off-limits from industrial sources, but if you buy them dehulled and then soak them and long-cook them in a pressure cooker, they’re acceptable.

      Sesame seeds like other seeds and nuts are pleasure foods to be eaten in moderation.

      best, Paul

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