What’s New in the New Edition, 2: How to Lose Weight

NOTE: What’s New in the New Edition, 1 is here; and here is the Amazon book page.

Scribner wanted the new edition to show people how to lose weight. We were happy to do that. I’d been planning to devote 2012 to weight loss and obesity blog posts, and then to write an obesity and weight loss book in 2013. We just moved the schedule up and squeezed the ideas into Perfect Health Diet.

Our book offers a unique take on obesity and weight loss. Some of the science is original to us – the ideas do not appear in Pubmed – and the conclusions are unusual for diet books:

The best diet for weight loss is delicious and does not generate cravings or more than mild hunger. You can – and should! – lose weight with minimal suffering.

The popular diets that generate the quickest short-term weight loss are not optimal for long-term sustainable weight loss; they are prone to yo-yo weight regain.

Unlike those diets, the Perfect Health Diet offers a path to lasting weight less and permanent restoration of normal weight and normal body composition.

If we’re right about the science and these conclusions, then our book could be a game-changer for weight loss.

Filling in Some Missing Context

The major defect of squeezing our obesity & weight loss material into Perfect Health Diet, instead of distributing it over two books, is that we didn’t have space to provide a lot of context to the obesity material. Our stage-setting chapters were devoted to the general question of “what’s a healthy diet” and were framed with a discussion of Michael Pollan’s food rules, not with discussion of issues specific to obesity and weight loss.

So let me add some context here.

The Recipe for a Popular Weight Loss Book

The recipe for a popular weight loss book seems to be:

  • Declare that doltish mainstream authorities are stuck in some absurdly mistaken view, and their loyalty to this paradigm has led them to overlook the key to weight loss.
  • The key to weight loss is simple:  give up a single villainous food.

This formula has been followed to good effect by Dr. William Davis (Wheat Belly) who vilifies wheat, Gary Taubes (Good Calories, Bad Calories and Why We Get Fat) who vilifies carbs in general or sugar specifically, and Dr. Robert Lustig (Fat Chance) who vilifies sugar.

The view that authors attribute to mainstream authorities is, often, a straw man. Here is Gary Taubes in his Reddit “Ask Me Anything” describing the absurdly mistaken view that he calls “calories in, calories out”:

Imagine we have a pair of identical twins. Say 18-year-old boys. Every day we measure their energy expenditure and every day we feed them exactly how many calories they expend. So we match calories in to calories out. They get both the same diet with one exception: one gets 300 calories of sugar or HFCS where the other gets 300 calories of a different carbohydrate or of fat. Then we continue this feeding experiment for the next 20 years or so….

If you believe obesity is about calorie-in-calories-out and that’s the only thing that matters, then both twins are going to end up exactly the same weight with exactly same amount of fat on their body and they’re both going to end up expending the same amount of energy.

The view he is describing is that dietary quality doesn’t matter a whit, only quantity of calories matters: the only thing that affects body weight, fat mass, and energy expenditure is how many calories were consumed, and how many calories are consumed isn’t affected by dietary quality.

In other words, a diet of nothing but cotton candy, Twinkies, and Coca-Cola would generate after 20 years exactly the same body composition and health as a diet of fish, rice, and vegetables.

Is there a single person in the world who holds this view?

Here is a review of Dr. Lustig’s Fat Chance:

The book repeats and expands on the main point of contention in the sugar wars: whether our bodies treat all calories the same. The old guard says yes: A calorie is a calorie; steak or soda, doesn’t matter. Eat more calories than you burn, you’ll gain weight. Lustig believes that our bodies react to some types of calories differently than others. [PAJ: emphasis added]

The “old guard” does not always take kindly to the assertion that it never occurred to them that the body might react differently to different foods. The article notes:

[A] leading endocrinologist, who asked to go unnamed, called Lustig an “idiot.”

These are times when I wish our diet approved of popcorn!

Now, let me be clear: these authors are giving good advice. Indeed, we give the same advice. With Drs. Davis and Lustig, we recommend eliminating wheat and added sugar; with Taubes, we believe the average American should cut carb intake roughly in half. Taking these steps will help people lose weight.

But these books have significant flaws:

  • The advice is incomplete. There are many factors which promote obesity. Removal of a single factor will rarely normalize weight.
  • The scientific background is misleading. It often seems that the goal is not so much to provide insight, as to set up a compelling and entertaining narrative. The story reads like the script of a Hollywood action movie: a frightening and mysterious problem appears which befuddles everyone – a solution is proposed – a hero implements the solution.

Perhaps it is not possible to write books more popular than these, but I think it is possible to write books that provide more insight and have a better chance of delivering lasting weight loss to readers who are willing to invest effort.

Obesity is a complex disorder, and many factors contribute to it. I think we did a fairly good job of addressing many of those factors – enough to enable nearly all readers to lose weight effectively, but also to gain a deeper understanding of obesity and its causes.

The Puzzle of Fatty Acid Ratios

The focus on wheat, sugar, and carbs in the popular diet books ignores what may be the primary cause of the obesity epidemic. In my Q&A with Latest in Paleo readers, I gave six reasons why omega-6 fats promote obesity. Some of these are discussed in detail in the book.

Any explanation for the obesity epidemic should account for the accumulation of omega-6 fatty acids in the body that has coincided with the obesity epidemic:

This is a plot found on p 115 of the book; the data was compiled by Stephan Guyenet of Whole Health Source, the circles are the omega-6 fraction in adipose tissue, and the crosses are the obesity rate among 18-29 year olds. It is hard to make sense of this pattern if omega-6 fats are not causing the obesity epidemic. No carb-centric explanation for obesity will tend to make omega-6 fats accumulate this way. Unlike some of the other weight loss books, we make a good faith effort to explain data like this.

Why Do Low-Carb Diets Work?

The omega-6 accumulation is only one of a number of puzzles that a good theory of weight loss and weight gain should explain. Another is the efficacy of low-carb diets.

If carbs don’t cause obesity, why do low-carb diets promote weight loss?

This issue is explored in chapter 17, where we show reasons why reducing carbs to 30% of energy or less will be beneficial for weight loss, but also why there’s generally little long-term benefit from further reductions in carb intake. Low-carb is good, but very low-carb isn’t better for long-term weight loss.

The Problem of Yo-Yo Weight Loss

Another important puzzle: Why is yo-yo weight loss and regain so common?

Here is Jay Wright’s weight loss history, mentioned in the book at page 184:

Although he had successful short-term weight loss on a number of diets, including very low-carb Paleo, they always made him hungry and sooner or later the weight was regained.

On our diet, Jay reached his normal weight in October 2011. He emailed me a happy new year wish, and remains at his normal weight 15 months later – the first time since college he’s been able to maintain that weight.

Why did our diet normalize his weight permanently without hunger, when other weight loss diets led to hunger and weight regain? That is the primary subject of our chapter 17, and is one of our original contributions to the theory of obesity.

Malnutrition and Weight Gain

We argue that malnutrition is a potent cause of increased appetite and weight gain.

A theme of Weston A. Price’s Nutrition and Physical Degeneration is that pregnancy depletes nutrients in the mother, frequently leading (especially in closely spaced pregnancies) to malnutrition in both mother and child.

If we’re right, then this could be why pregnancies, especially closely spaced pregnancies, tend to produce maternal weight gain.

I got a New Year’s update from Jennifer Fulwiler, another source of a reader report in the book (on p 11). She’s now pregnant with her sixth child, and left a comment noting her much improved health this pregnancy:

I have been following the PHD for this pregnancy. The results have been amazing. In fact, with all five of my previous pregnancies I had debilitating, severe morning sickness. On the PHD, I had almost none!

In an email she gave further details:

My husband and I have a reality show that recently started airing [insert joke here about what we may have done to be deemed “reality show material”], and when the episodes air I’ve been engaging with fans on social media. One of the most common responses I get is that people are shocked that I look so healthy, since I’m pregnant with my sixth child in eight years. A lot of people just assume that women who have many and/or closely spaced pregnancies simply have to be overweight.

I used to assume that too. In fact, that had been my personal experience: I seemed to add a few pounds with each pregnancy, and after I had my fifth child I found myself tired, achy, and 35 pounds overweight. Thanks to the PHD I lost all the weight, and when the show was filmed, in my first trimester of pregnancy with my sixth child, I weighed the same as I did the day I got married, and felt better than I ever had in my life. A lot of people who watched the show asked me what my secret was, and of course I directed them to the PHD!

Here’s the first episode of Jennifer’s reality show:

She does indeed look healthy, energetic, and more than a match for a Texas scorpion!

Conclusion

I mentioned the other day that we got a 4* review at Amazon:

This diet has controlled my cravings. After almost 40 years of interest in and great benefits from proper nutrition, I believe this is as close to perfect eating as we can get…. I didn’t give it 5 stars for two reasons: 1. no recipes…but can get those online and 2. very technical, leaving more explanation or clarification.

That about covers the pros and cons of our book as a weight loss guide. Our story isn’t quite as simple as the other diet books. Perfect Health Diet doesn’t resemble a Hollywood action movie.

But if you want to understand the science and find a successful program for long-term weight loss, we’re the best choice on the market. Perfect Health Diet will eliminate cravings and hunger, get you close to perfect eating, and help you normalize weight for the rest of your life.

Leave a comment ?

175 Comments.

  1. Paul and Shou-ching,

    Congratulations on the new edition, which is outstanding. I found the updated section on supplements particularly helpful (and after reading it, suspect that I need more iodine and Vitamin D).

    The list of questions I accumulated while reading the new edition evaporated as I continued through the book: you managed to answer almost ever issue that came to mind.

    One question that I was left with concerns the status of fermented cod liver oil as a supplement. You were quite clear that you do not recommend fish oil as a Vitamin D supplement. Cod liver oil specifically was only mentioned in the context of particular studies that you discussed (usually positively), but without any mention of FCLO in the context of PHD.

    So, is FCLO just like any other fish oil, i.e. not recommended? Or is there a place for it as a supplement?

    I ask as an office worker who lives and works in a particularly polluted city, so FCLO is appealing as an A and D supplement. Many thanks!

    • Hi Remnant,

      We discourage FCLO for the same reasons we discourage CLO — fish and liver are better sources of the same nutrients — but we suspect that FCLO might be worse than CLO due to damage to vitamin A and DHA during the fermentation process.

      • Thanks for the response, Paul.

        It would be interesting to know if there were once benefits to the traditionaly sourced FCLO since the utility of such ancestral “superfoods” must have exceeded the detriments in a certain cultural and historical setting, but I guess we are living in a different nutritional milieu with better options. Thanks again.

      • Paul, just wanted to interject a bit of n=1 personal experience. Since I’ve been taking about a teaspoon of FCLO every day I’ve had no respiratory illness at all in nearly three years now. I used to get three or four colds every year of my life until I changed my diet about 6 years ago. At that time I started taking a minimally processed high vitamin CLO at about 1/2 teaspoon a day but still got about one cold per year over three years. Otherwise my diet hasn’t changed all that much over the last 6 years, so I’m reluctant to drop the FCLO to find out if it has made the difference.

        Like many foods, FCLO probably has pluses and minuses. The pluses would be the vitamins A and D and possibly some of the quinones. Analyses indicate that most of the A is palmitate with a little retinol and most of the D is D2 with a little D3. There appears to be a wide variety of quinones, but I haven’t found any details about the types. Minuses would likely be oxidized omega-3 fats and tyramine. I haven’t seen data on the lipid oxidation, but the amounts of tyramine are substantial in all samples tested (around 40 to 160 ppm) and are likely enough to bother some sensitive individuals. I suspect a variety of amines are primarily responsible for the unpleasant flavor, though some batches are quite mild in flavor and others fairly nasty. Interestingly, 71 mcg per 100 ml of B17 laetrile was found in one FCLO sample tested. Not sure whether that is good or bad. More details here: FCLO test data.

        • Hi Bryan,

          Vitamin A is definitely important for respiratory and digestive tract immunity, among other things. We don’t disagree that it’s good to get, the question is whether animal liver or FCLO is a better source. We favor animal livers (beef, lamb, and chicken mainly).

          • Paul, one potential problem with liver for some people is that it is very high in iron. That may be ideal for menstruating women, but others may have to be more careful and monitor serum ferritin levels. I’ve never had my serum ferritin or 25OH-D levels checked.

          • Hi Bryan,

            100 g chicken liver has 65% of the RDA of iron and 267% of the RDA of vitamin A (http://nutritiondata.self.com/facts/poultry-products/667/2). So while iron is a concern, you should be able to get adequate A without an excess of iron.

          • Any primary source on this critique we could look at that you base your opinion on? Thanks.

          • Hi Jeff,

            If you read our book you’ll see how much vitamin A we recommend, and that we recommend liver for other nutrients besides A (choline, copper, others), so liver is already supplying a big chunk of optimal A intake. Along with other food that doesn’t leave much room for CLO.

      • I’m having some trouble getting ahold of beef liver from grass-fed cows. Given how the livers of non-grass-fed cows fare (poorly), would you be good with FCLO in that case?

  2. Congratulations!!!
    A perfect health diet is very important for our health. Thanks Paul Jaminet for !

  3. All right, I have to call BS here. Shame on you. You have legitimate differences with Taubes but to use that quote to make your conclusion is just wrong. Taubes is posing a thought experiment that you are taking exactly backwards when you both agree!

    He *is* saying that the twins would end up in very different circumstances. He *is* saying that hormones matter. He *is* saying that food quality matters.

    I really thought you were above this kind of attack. Good grief, I like your book but would you please lay off Taubes and look for areas of agreement instead of attacking and using arguments based on willful mis-reading?

    You are listening to Guyenet too much. He is not nice. Kresser is another who is becoming distainful and weak. Pretty soon you all will sound like you have free’d your animal.

    Bah.

    • You misread that section of Paul’s article. He specifically says the quote he included from Taubes is Taubes’ (flawed) representation of the mainstream of nutritional information, not a representation of Taubes’ own views on nutrition. Please read up on what it means to say someone is using a Straw Man argument, as Paul is saying here of Taubes.

    • Hi Chuck,

      Yes, I agree with Taubes on the substance, but I don’t care for his rhetorical approach. I was criticizing him for posing a straw man argument, ie mischaracterizing the positions of academics/scholars.

      • Taubes is not attributing a strict belief in calories-in-calories-out to researchers (at least not in this particular quoted source). He merely is arguing that it is incorrect. Although I’m sure your question about whether anyone actually believes Twinkie calories are identical to any other was rhetorical, let me answer it anyway:

        Twinkie diet helps nutrition professor lose 27 pounds

        “For 10 weeks, Mark Haub, a professor of human nutrition at Kansas State University, ate one of these sugary cakelets every three hours, instead of meals. To add variety in his steady stream of Hostess and Little Debbie snacks, Haub munched on Doritos chips, sugary cereals and Oreos, too. His premise: That in weight loss, pure calorie counting is what matters most — not the nutritional value of the food. The premise held up

        The take-away from this article any average person will have is certainly that weight is purely calories-in-calories-out (even though Haub himself is not even that assertive of that conclusion, CNN certainly is). Whether the scientific community believes that or not, there is no question that the general public does thanks to articles like this. And as long as the general public believes it, there is value in arguing that it is false.

        It’s easy to fall into the trap of thinking the whole world is as well-informed as our community. The average person’s source of nutritional science is not the Journal of Lipid Research. It’s Huffington Post lifestyle bloggers and CNN articles like the above. And they really do push this nonsense on the public every day.

      • Gary’s November blog post on the subject (http://garytaubes.com/2012/11/what-would-happen-if-thoughts-and-thought-experiments-on-the-calorie-issue/) is (understandably) much subtler than his “Ask Me Anything” response:

        I’ve been arguing that the original sin in obesity research is this belief that our body fat is regulated by the amount of energy we consume and expend. I think this is simply the wrong way to think about obesity and the chronic diseases with which it associates, and it’s because this is the fundamental assumption underlying most obesity research, it’s the reason why we’ve made so little progress.

        (and much more)

        I agree that in the moment — well, anywhere, frankly — pith usually wins out. But I don’t know that Taubes in particular is as commonly reliant on straw-man demonization, nor is the Reddit thread the best representation of his efforts.

        “Good Calories, Bad Calories” is extremely inaccessible to an average diet-book reader — and I found incredibly good for the same reason (it’s history of the lipid hypothesis and its propagation forward through the decades is flabbergasting, regardless of what you think of Gary’s overall carbohydrate phobia).

        • “the original sin in obesity research is this belief that our body fat is regulated by the amount of energy we consume and expend.”

          that’s no straw man, that’s an accurate description. and taubes is out where the cows don’t roam if he still really believes that that’s not a fact! he can dress it up with causation arrows – focusing on what makes us consume excess energy – but you can’t get around the fact of it. body fat is absolutely regulated by energy balance.

  4. Hi Paul,

    Congrats on the new edition, I’m loving your diet!

    You wrote above:
    Some of the science is original to us – the ideas do not appear in Pubmed

    Are you planning on submitting this work to a peer-reviewed journal?

    Best wishes,

    Dennis Mendelson

  5. made bibimbap from the recipe in the book today for the first time. very fast and easy preparation and very tasty and satisfying! 6oz ribeye, 175g potatoes (mix of sweet and white), 3 egg yolks, 5 cherry tomatoes, baby spinach, little bit of lemon/lime juice, little bit of homemade bone broth for moisture, and decent amt of salt.

  6. Great post, as always! And TOO FUNNY! Not 30 minutes ago I just got done watching Jenn Fulwiler’s first episode!!! She is just phenomenal. Thank you for including this video in your post!

  7. Paul – Read your new book over the last 2 weeks and have had time to absorb it. My one critique is that you shift back and forth when describing the perfect diet in terms of macro ratios and kcal. You always give the calorie figures as absolutes without regard to sex, activity levels, etc… and to add confusion, you also say things like ‘eat a pound or so of meat/starch/veg’.

    I searched your Q&A blog, and found lots of others have this question. In the Q&A’s you will often say ‘these guidelines are general’.

    It seems to me you want everyone to eat about 1 pound each of starch, veggies, and meat per day consistently, manipulating the amount of fat one consumes in relation to weightloss goals and fitness levels.

    If I have that right, I love it! It makes eating much easier as it throws macro ratios out the window. The problem, though, is it also throws off macro-ratios. For instance, if you are striving to maintain a 30-20-50 (C-P-F) ratio, you can’t lower your fat intake without raising one of the other two–it always has to add up to 100.

    I know for a fact people want to be able to pin down one macro and adjust the other two off that constant. For instance, it is oft said to consume 1g protein per pound of LBM. Once I know exactly how much protein to consume, I can manipulate fat and carb to come up with an eating plan.

    You don’t seem to have a protein requirement other than ‘eat .5 to 1 pound of meat daily’. Is that by design? How can one tailor that to their individual needs? ie. building muscle, losing fat, maintaining.

    Thanks!
    Tatertot

    • Hi Tater,

      Yes, that’s right. It’s impossible to make a single guideline that is simple and optimal for everyone. So those are different ways of getting into the ballpark and people can adjust each one a bit. Fat is the most adjustable so I never say eat X amount of fat calories; for carbs and protein we have more specific requirements so I do quote calories there.

      So if you want to pin down a macro, pin down protein first and then carbs.

      Yes, 0.5 to 1 pound of meat provides optimal protein. I think we address some reasons to tailor it in the Protein chapter.

      • What’s funny is that all of your recommendations seem like they were perfectly tailored to me…I’m a 47yo guy, 175lbs, very active. If I eat 1 pound of meat, 1 pound of potatoes, 1 pound of various veggies, 4 egg yolks and some fat from cheese, CO, or butter, it puts me squarely where I want to be.

        • Well, thanks for validating our diet!

          I heard you are writing a book, you should let me write the introduction.

          • I was toying with a book, more a booklet, for my farmer’s market customers. Don’t need to now! You wrote it. If I get ambitious, and really do write a book–the intro is yours.

            The National Potato Council should start paying you royalties–ha!

  8. Great article Paul. I own the original PHD and was hesitant to buy the new edition but this information on obesity and weight loss that you shared so freely has put me over the edge and I just placed me order on Amazon. Happy New Year!

  9. Next topic…you guessed it: Potatoes!

    For me and many other Americans, potatoes are the only realistic option for safe starch up to 1 pound per day. Rice is fine to eat, but has none of the satiety effects of the potato. Sweet potatoes are OK, but hardly anyone makes them a daily staple. The other safe starches (taro, plantain, cassava, etc…) may be great, but I have never eaten any of them, don’t know how to buy or cook, and can’t imagine they have the versatility of the potato. You could easily call the PHD the “Potato Diet” and just put the other safe starches in the veggie category.

    I have been doing some crazy things with potatoes, as you know, but realized I should just be eating a sensible diet with the right amount of potatoes. Thanks to you, and my curious nature, I have found that 1 pound of potatoes per day seems to be a perfect number for me.

    Here’s an interesting observation that also doesn’t seem to be in PubMed or any studies: When I (and others) eat 1-2 pounds of potato, mostly cooked and cooled, little to no fat, and up to .5 pounds of meat, I am in heavy ketosis as indicated by Ketostix. I’m sure this is the effect of the RS and short-chain fatty acids. Sure seems like a guy like you could exploit this phenomenon.

    One other shout-out. Do a little research on purple potatoes (not purple sweet potatoes). They are super-high in antioxidants and the RS brings antioxidants in-tact to the colon like almost no other food source. Google Scholar ‘purple potato+antioxidants’ Many studies done on this specific potato!

    Happy New Year

    I have toyed with ketogenic diets in the past, and had a hard time even registering ketosis on Ketostix while eating VLC. If I eat a high starch, low fat diet, I can feel the effects by day 2 and see it on the sticks.

    • Hi tater,

      Very interesting about the ketostix. It does sound like a butyrate phenomenon.

      Potatoes are indeed a great starch. It’s true that many safe starches are unfamiliar to Americans, but most people like some variety in their diet, so we’ll keep them in.

      • I was just kidding around–you should definitely keep all the safe starches together. An awesome blog idea would be for ways to buy, prep, keep, and cook them. I’d be willing to bet only a small percentage of your readers have ever had any other safe starches besides sweet potatoes, potatoes, and rice. I had fried plantains in a restaurant once and poi in Hawaii, but that’s it. Maybe 2013 will be my year to explore the tropical starches.

        • Plaintains are easy if you can get them. I like to fry them with a mixture of macadamia nut oil or coconut oil and left-over bacon grease. Add some salt and lemon and boom. They are cheap and tasty. Sometimes I then use the left-over oil to make some sweet potato fries. I like the Asian white varieties much better than the orange ones. I’m lucky that I have access to both where I shop, so for me I indeed have daily staples other than standard potatoes.

      • Hi Paul,

        This might actually explain it why Tatertots was getting that good Ketoe reading. Take a look at the video by Kiefer, its only 2 minutes.
        here is the link
        http://www.youtube.com/watch?v=JIgLeo9eQLQ

        But basically the Ketostix only show you ketones and not if you are Ketogenic, if you eat a lot of carbs, your body does not have much to do with Ketoes and you pee them out, that is why you get a high reading. But it also happens in the morning and after exercise.
        Stort January 3, 2013 at 8:29 pm

        here is the link
        http://www.youtube.com/watch?v=JIgLeo9eQLQ

    • @Tatertot,

      Great comments – I discovered purple potatoes last year and love them – will have to try them cold now.

      In regards to ketosis, i remember reading a blog post from someone who had been doing an LC paleo diet, but could not get themselves into ketosis. They then, at someones suggestion, took a couple of spoonfuls of flaxseed oil, and the next day the ketostix showed they were in full ketosis.

      Interesting that you can get into ketosis on the (cold) potato diet too…

      Potato salad is one of my most favourite foods, ever. Be interesting to see how it goes with purple spuds!

  10. “In other words, a diet of nothing but cotton candy, Twinkies, and Coca-Cola would generate after 20 years exactly the same body composition and health as a diet of fish, rice, and vegetables.

    Is there a single person in the world who holds this view?”

    Yes, unfortunately! That was taught to me in school, that’s what my Weight Watchers-following mother and mother-in-law think (yes, their weights have been yo-yoing for many years), and that’s what my late friend PJ thought. PJ was obese and lost 85 or so of his 175 lbs. to lose by eating the same foods as before but restricting calories. Unfortunately, that didn’t appear to sit too well with his brain, because he unexpectedly committed suicide after a year on that diet. He had planned to write a book once he reached his goal weight, a “back-to-basics” book about how it really is just about calories.

    I’m not saying PJ’s case is representative, of course, but lots of uninformed people really do think it’s literally just calories in, calories out. They tend to say that the advantage of unprocessed foods is merely that they tend to fill you up while providing fewer calories, making the necessary calorie restriction easier. (*facepalm*) Thank you for providing such clear and cogent information to the contrary! It is definitely needed.

    • This line of thinking gets reinforced when you see healthy-looking, normal weight people eating tons of junk-food. Some people can get away with lots of crap in their diet, young people can get away with murder (dietary-speaking) it seems, but in some way, a poor diet will catch up with you eventually.

    • Hi Amelia,

      Very sorry to hear about your friend PJ. Of course simply eating less of a bad diet is unhealthy.

      I guess I stand corrected about the calories in calories out view. Nevertheless, I think it’s accurate to say that most academics think that food quality matters.

      • Paul,
        I love your work but I have to chime in here about people believing calories trump quality. About 12 years ago I took a nutrition class at a local community college and one piece of advice that the teacher gave that stuck with me was this statement by her: “I don’t like to admit it but if you exercise enough you can eat anything you want.”

        I held that view (taught to me by a teacher no less!) while my weight eventually ballooned up to 280lbs up and down. I ate whatever I wanted. At one point in my life I ate half a dozen donuts for breakfast each morning for several months! After all it’s not the quality of food impacts my appetite, it’s my lack of will power, right? I blamed myself for my weakness (I think the calorie concept can be devastating psychologically too because it inflicts guilt on individuals that simply don’t know better.) until I read Gary Taubes’ “Why We Get Fat”.

        It was difficult at first to realize I had been duped. But once I accepted the fact that different foods affect my body differently I felt utterly liberated. I eventually did buy into Taubes’ low-carb theory and went on the Atkins diet and lost about 40lbs (currently at 220lbs). Since then I have been following the whole ‘safe starch controversy’ and have experimented with various (unmeasured) amounts of carbs (fruits, sweets, & starches) and have remained fairly weight stable (+/-5lbs).

        In short, when experts say ‘it’s all about the calories’ us lay people hear that we can eat all the (corn oil) French fries and candy bars our calories allow.

        While Taubes is probably a bit off the mark with low-carb-for-everything he also brought to the table other things in his book, 1. Saturated Fat is not harmful and 2. Food quality trumps calories. Before I read Taubes’ book I unabashedly was eating lots of healthy high fiber whole-grain bread slathered with “I Can’t Believe It’s Not Butter,” tempura vegies, low-fat mocha Frappuccino’s, and diet coke.

  11. Hi Paul, are you moderating comments now? I posted one earlier today re: Gary Taubes and haven’t seen it appear. Just using this as a test comment but also to see if my other one is in some WordPress holding zone. Thanks!

  12. I just had to share this. Paleo folks love to hate Dr. McDougall, but if they read this and did it, they’d be better off! As I read this, I could just hear Paul saying, “Or….you could just eat the Perfect Health Diet!”

    I’ve said for a long time that the optimal diet will end up being a cross between paleo and vegan…and so it has come to fruition: The Perfect Health Diet

    http://www.drmcdougall.com/misc/2011nl/dec/eatmorestarch.htm

    “…my recommendation to help people who are gaining more weight and losing more health is to not intentionally give up any of the foods that they currently love: do not stop eating eggs Benedict, hot dogs topped with beef chili, pepperoni pizza, fried chicken, or ice cream sundaes. Instead, I ask them to pledge to make one—and only one—addition to their diet: Eat more starch. Just add an extra 600 to 900 calories of starchy comfort foods daily, like the college-men in the study did, in order to see similar remarkable benefits.

    This commitment means adding any one of the following to your regular diet:

    3 to 4 cups of steamed rice
    3 to 4 cups of boiled corn
    3 to 4 mashed potatoes
    3 to 4 baked sweet potatoes
    2 to 4 cups of cooked beans, peas, or lentils
    3 to 4 cups of boiled spaghetti noodles
    6 to 12 slices of fresh bread”

    • Just read the conclusion of the link above:

      “The McDougall Diet is a tool, not a religion—the benefits are not “all or nothing.” However, I hope that once you experience the healing power of starches you will become greedy and want all the good health you can get. With undeniable proof from a couple of months of additional rice and potatoes, you should eventually make starches 75 to 85 percent of your diet, with the remainder coming from fruits and vegetables—and one day soon, forgo all the meat, dairy, and vegetable oils. Your adjustment will be quicker and easier than you ever imagined, you will enjoy your foods, and you will be thrilled with the results.”

      Makes you chuckle, no?

  13. Tatertot,kinda confused here…are you recommending the McDougall diet or the Perfect Health Diet?Also,in the above posts I see where you posted that you eat 1 pound of starch,1 pound of meat per day but then below you say….

    “ere’s an interesting observation that also doesn’t seem to be in PubMed or any studies: When I (and others) eat 1-2 pounds of potato, mostly cooked and cooled, little to no fat, and up to .5 pounds of meat, I am in heavy ketosis as indicated by Ketostix. I’m sure this is the effect of the RS and short-chain fatty acids. Sure seems like a guy like you could exploit this phenomenon.”

    So are you eating 1 or 2 pounds of potatoes a day and is it 1 pound of meat or .5 a pound per day.I ask because this ketosis while eating so much starch is mind boggling to me.If you increase meat to 1 pound does the ketosis go away?Can you try eating rice for the starch and post your results as to if your still in ketosis.Is the lowfat a reason for the ketosis and would adding in fat reduce it?

  14. Not advocating McDougall’s diet at all–just showed that for the power of starch. I like Paul’s safe starches better than McDougall’s for sure! They are pretty close except for the grain-based ones.

    I am going forward in 2013 eating 1 pound of starch, 1 pound of other veg, and 1 pound of meat along with other things I mentioned.

    I was doing some crazy stuff with potatoes as a means for fast weightloss in 2012. It worked like a champ, but after reading PHD I see the folly of my ways.

    The ketosis seen on high starch is real. Gut bacteria convert the starch to a short-chain fatty acid and creates ketones. Paul probably can explain it better.

    • Very interesting views you developped tatertot !! Thanks a lot for this “fuel” in my brain ! 😛
      Could you explain ‘the crazy stuff” you mentionned..? 😉 I’m very curious about that, because as i witnessed in an earlier post, since I came back from a VLC diet, and have begun PHD, my body craves for potatoes… As iI begin to count “pounds” as suggested by Paul, I can remark the potatoes stuff is about 2 pounds sometimes.. or more.. My body seems to be able to tolerate potatoes better than sugary plants (carrots, beets, or winter squashes)..Could you tell us your story with “potatoes” -as I am a huge fan of this terrific plant ! – and maybe witness than more than 1 pound starch per day is able to make people healthy and loose weight..? Can a lot of starch (coming from potatoes of course ! 🙂 ) can enhance gut bacteria and being able to install a healthier gut flora for instance ? Thanks evrybody : you’re amazing !!! Best for all, July

      • This is what started it all. A guy named Otzi, who is a really cool guy from Alaska stumbled across the fact you could eat nothing but potatoes and lose tones of weight:

        http://www.marksdailyapple.com/forum/thread67137.html

        I tried it and it worked and started this thread:

        http://www.marksdailyapple.com/forum/thread70009.html

        Otzi recently used potatoes to lose 10lbs of holiday weight:
        http://www.marksdailyapple.com/forum/thread74055.html

        Some other folks tried it and liked it:
        http://www.marksdailyapple.com/forum/thread72366.html

        Paul Jaminet gave his take on the Potato Diet and in my opinion, hit the nail on the head. This post led me to see that potatoes should simply be a part of your daily healthy eating.

        http://www.latestinpaleo.com/blog/2012/12/16/perfect-health-diet-qa-with-paul-jaminet.html

        There have been numerous other blog posts and comments on the efficacy of an all-potato diet. At first it seems so counter-inuitive that many initially reject it. The ones who looked past their carb fear and tried it did so to great success.

        • Amazing !Thanks a lot tatertot ! I live in France and your resources are very helpful : I didn’t know them and potatoes benefits are not at all considered at all here.. ! Thanks a lot for sharing ! 💡 .A lot of questions are coming I’d like to ask you for more ! 😀 💡 In your experience, what about going on a large amount of potatoes on a long term diet ? And what would be the maximum amount of potatoes to eat when reintroducing prot, and fat..? Paul, I think it would be interesting to have your thoughts on this matter..for example, my experience in the body craving for potatoes seems so strange,I cannot make the difference if the body really needs all this starch or if it’s only a temporary pleasure matter. Anyway, I feel great with a lot of potatoes in one day, and am finewith cutting on sugary plants. Do you both, Tatertot, and Paul, believe it’s sustainable for a long term diet on an optimal health point of view ?

          • I can’t answer that very well. I had given up potatoes completely for over two years because I thought they would hurt my weightloss and health. Re-introducing them has been a great experience…I do better at exercising, sleep better, and generally feel better.

            I think, like Paul says, up to a pound a day, but if you eat two pounds and you are meeting your goals in weight and health–why not?

  15. I know all about your potato experience as I read every thread on it. :mrgreen: This ketosis from starch thing is kinda crazy though but I do believe you guys that are seeing this on the keto strips.

    And I feel great on PHD but on Mcdougall not so hot.On Mcdougall I was starting to feel unhealthy and had to stop.But man this 2 days of potatoes only is eyeopening.Fat just melting off and energy thru the roof without that glycogen depleted feelings of weakness when exerting your muscles.Don’t know what is different though compared to Mcdougall.

    When you say one pound of starch/veg/meat you throw me though.One pound of meat I understand but one pound of starch from pasta is a box and that is 1600cal while one pound of potato is 330cal.And my goodness…..I shudder to think how much veggie it takes to eat a pound of them.

    What are your thoughts on eating rice only and what happens to the ketones?

    • To really enhance the ketosis, eat cooked and cooled potatoes.

      On implementing the PHD, go visit a site like http://www.fitday.com Plug in 8 oz salmon, 8 oz beef steak, 1 pound potato, 1/2 pound banana, 1/4 pound beets, 1/4 pound carrots, and 4 egg yolks. That’s what I ate today…should come out to about 1800kcal with C-P-F like 36-30-35. I also ate a big hunk of cheese (2 oz) and 3 TBS of butter. That puts me at about 2300kcal, with C-P-F at 28-26-46…spot on for PHD recommendations!

      In my old Primal Blueprint days, I would have had the same calories, but way more protein and way less carbs, with zero starch.

      A pound of salad veggies isn’t that much, especially if you include a piece or two of fruit.

      Eating just potatoes for 7-14 days will cause rapid fat loss, but when you are done, adopt the PHD and you shouldn’t have to go to that extreme again.

      I find PHD eating much more intuitive than Primal Blueprint or paleo in general. 1 pound starch, 1 pound fruit&veg, 1 pound meat and some fat in form of butter or cheese. I think that’s way easier than figuring out what to eat based on macro ratios or calories.

      • Hi Tatertot,

        It seems like protein of 26% is much higher than PHD 15% recommendation.

        Maybe it’s because eggs should be included in the 1 pound meat.

        At least a half pound, probably not more than one pound, of fatty meats, seafood, and eggs.

        Jaminet, Paul; Jaminet, Shou-Ching (2012-12-11). Perfect Health Diet (Kindle Location 206). Simon & Schuster, Inc.. Kindle Edition.

      • So to clarify, for weight loss, one should be eating (per day) 1 lb starch, 1 lb fruit and veg, about 1 lb protein and just cut fat?

        • I think the 1 pound of each is a starting point for most people. Individuals will have to titrate the amounts based on individual results and goals.

          I played around with the food weights on fitday and using 1 pound each seemed to fit pretty good for me, based on what I was eating before and maintaining my weight with.

          As Paul mentioned above, it may be best for people to first determine their protein requirements and then adjust the intake of starch/fruit/veg/fat to that.

          Eggs are kind of hard to figure. They don’t weigh much, so it’s hard to add them in to your pound of meat. I like to put hard-boiled egg yolks on my lunch salad and don’t really count them as ‘meat’, more as ‘supplemental food’.

          Another thing that throws the macros off and makes it hard to come up with a good 30-20-50 type split, is that the meat you eat has both fat and protein. It’s nearly impossible to judge the amount of fat in a piece of beef steak or chicken portion.

          I really like the idea of just eating toward a certain ‘poundage’ of food versus continually trying to hit magical macro ratios. I think it’s worth playing with the numbers and dialing in an approximate amount to eat, but once that’s settled, it should be really easy to figure out how much to eat each day just by eyeballing the portion sizes.

          For instance, most potatoes of restaurant-size weigh 1/2 pound. A pretty big salad with several different types of veggies weighs about 3/4 pound. A banana weighs about 1/4 pound. A piece of meat the size of a deck of cards weighs about 1/4 pound. A can of sardines is 1/4 pound.

          So, for me shooting for 1 pound each, it’s 2 potatoes, a big salad and a piece of fruit, a can of sardines and 3 more servings of meat. That leaves room to add in a handful of nuts, some egg yolks, some dark chocolate and maybe a glass of wine or some cheese and lots of butter on a potato.

          If I find eating like this is leading to undesirable weight gain, the first thing to start cutting would be butter, cheese, nuts, or trimming fat from meat.

          What do you think, Paul, am I getting it close?

          • Thanks, Tater! Your explanation is really helpful. And you’re absolutely right, one thing I was struggling with about cutting down fat is the fact that a lot of the protein (mostly beef) also comes with fat so it’s difficult to gauge how much fat I’m actually consuming. I will, however, try to trim the excess off so as to minimize “residual” fat as much as possible.

            Also, how can I go about establishing my protein requirements? I’m having trouble locating Paul’s reference above.

            Thanks!

            Tess

          • Oops, one more thing I forgot to ask you Tatortot- do you ever use rice flour? I’m just wondering if I use those to make crackers and pizza crust and such, how I can integrate that into my daily “poundage” since I imagine ounce to ounce, the flour is a lot more dense.

          • I don’t want to speak for Paul, but concerning protein requirements, since Mark Sisson wrote the intro, I will give you Mark Siison’s take on protein…Mark says ”
            I, myself, try to get at least 1 gram per pound of body weight per day (165). I can survive on less, but I’m all about maintaining my lean mass. You can only do that with protein, and I don’t believe the current RDA allows for that, especially in active individuals.”
            Read more: http://www.marksdailyapple.com/dietary-protein/#ixzz2GwEQoK00

            However, Mark is like an ultra athletic sculpted muscular guy. He has also recommended people get between .5 and 1g per pound of lean body weight.

            When deciding my protein requirement, I took my scale weight (170) and subtracted about 15% for body fat coming up with 145 pounds of lean body mass. Therefore I figure I should be eating between 72 and 145g protein per day. 1 pound of beef steak has roughly 125g of protein. 1 pound of salmon has 110g protein.

            So, for me, the recommendation to eat 1 pound of meat per day is about as close to exact as I could ask for. Days I work out, I may eat a little more. But, most days, 1 pound of meat is a very good target.

          • I have a box of rice flour, I only use it sparingly, like a spoonful if I need to thicken something or coat something, but honestly I rarely use it. I have gotten completely away from trying to make fake flour products.

        • Hi Tess,

          I think 1 lb starch, 0.5 lb meat/fish/eggs, and 1 lb vegetables/fruit/berries/sugary root vegetables like beets would be a good starting point for women. Add more if you are hungry. See http://perfecthealthdiet.com/2011/02/perfect-health-diet-weight-loss-version/

          On calorie-restricted weight loss PHD the fraction of carbs and protein does go up.

          Tatertot’s discussion is good. For men, especially athletes, 1 pound of meat is about right.

      • Tatertot:

        Must the cooked and cooled potatoes be eaten cold in order to maximize the resistant starch? IOW: Will re heating them reduce the resistant starch that has been created?

        Is this effect the equal iin sweet potatoes as white or do you get get more resistant starch from white potatoes?

        Ellen

        • I’m very confident that this applies to all of the safe starches, but I am 100% sure of this effect in white potatoes…

          There are two ways to get the maximum RS from a potato:

          1. Eat it raw
          2. Boil until tender, cool to below 40 deg F, and eat either cold or heated to no more than 150 degrees.

          The initial cooking causes the natural starch particles to gel. In this state they are readily absorbed. Digestion of this type of starch actually starts in the mouth, then continues in the stomach and finishes in the small intestine. This starch is almost all converted to glucose once it enters the body.

          Cooling that starch to between 40 deg and freezing causes the gelatinized starch to crystalize. It it’s crystalized state, it is resistant to digestion by the amylase that is normally used to digest gelatinized starch. This means it passes all the way through the digestive system intact and doesn’t get digested until it enters the large intestine where it serves as food for gut bacteria. The gut bacteria eat the RS and turn it into butyrate, a type of fat. This fat feeds specialized colon cells and is absorbed into the blood stream where it is equally beneficial. Many people say that eating butyrate-rich foods is the same thing, but that has not been proven and is unlikely as butyrate-rich foods (like butter) are easily digested and absorbed into the body long before they reach the colon.

          Here is a study that was done on the RS eaten by Chinese people. If you poke around, you will find the RS content of various foods and see that the potato stands out above the rest.

          http://apjcn.nhri.org.tw/server/APJCN/Volume19/vol19.2/Finished/18_1223_274-282.pdf

          From the study:

          ““…In general, tubers and legumes
          had more RS than cereals. Among the selected foods,potato showed the highest amount of RS.”

          “…The highest RS content, among the tuber products tested, was found in fresh potato (72.0%), which was almost six times higher than in the preserved sample.”

          “…refrigeration of boiled potatoes might influence the formation of retrograded starch considerably. Therefore, when steamed or roasted potatoes were stored at 4C for
          24 h, the RS contents increased considerably. The nature of the RS formed was retrograded amylopectin, since retrogradation of amylose is favored at around 100C. ”

  16. Hi Paul, the new book is great! I felt like I was reading a whole new book, and I took a lot away from it. I have a question about oysters – I have been learning to prepare oysters and I would like to use them regularly as a supplemental food. Do you have any ideas about how many (roughly) would be a good weekly allotment, and if they could be eaten all at once in a big meal, or over several different days? Thanks!

    • Hi Laura,

      Oysters are a great supplemental food. You can drop the weekly zinc supplement if you eat them regularly.

      Based on our recommended zinc intake, 50 g of oysters per week, or about 4 oysters, would be a good amount to eat (http://nutritiondata.self.com/facts/finfish-and-shellfish-products/4189/2). For an upper limit, maybe 10 per week on average?

      • Oh, good, I was afraid I would have to eat dozens to have the effect! And oysters are expensive! I like to broil them with an herbed almond flour and rice-cracker-crumb topping, because I don’t have the guts to eat them raw. Thanks for the help!

        • I eat canned, smoked or plain oysters. I get them either packed in water or olive oil. Probably nor as good as fresh, but I think everything you need is in there and way too easy!

  17. It seems to me you are too critical of the “one bad food” books. If these books get people off your D and F grade foods, they accomplish a great deal of good. I find your new book great, but I cannot get even people close to me interested. If more sensational books can get their attention, I am happy that they can improve their health, even if it isn’t “perfect”.

    • Hi roadrunner,

      I agree. The books make excellent recommendations and I think they are doing an effective job of improving people’s diets. And certainly, our book is not for everyone.

      Hopefully your friends and family will find our cookbook, when it comes out, much easier to read and helpful to their health journeys.

  18. Great Stuff Tatertot :mrgreen: I was amazed to see that a pound of veg is so easy to consume and pound of rice is similar to pound of potato calorie wise.Only thing off is a pound of pasta but one shouldn’t really be eating it when following PHD.

    And I love convenience and this diet hits the spot for me.I buy 1 pound microwaveable bags of small potatoes.Add in half a pound stew meat and some veggies and I am set.

    One thing I found out today though is that by adding in meat then my calorie level that I lose weight at leaves me starving.Potatoes only and 1200 is super easy.But today I ate like above and was starving.Broke down and had a bagel at work.But I felt amazing all day and just finished a 3 circuit workout done with vigor!!!Hmmmm,maybe alternate a normal day with a potato day?

    Are you still in ketosis after adding in the one pound meat/veg and fat?

    • The ketosis effect ended when I started eating normally, although that doesn’t mean the mechanism behind the ketosis is gone, ie. resistant starch/butyrate

      The ketosis was seen when eating 2-4 lbs of potatoes a day and minimal fat and protein at a huge calorie deficit. This is not recommended in PHD and probably not the best way to lose fat.

    • Just did a quick lookup on the calories of cooked rice & cooked potatoes.
      I used cronometer for these numbers, all cooked weight and for 16 oz (1 pound),
      – Potatoes boiled without skin, 390 calories.
      – White rice, glutinous, 440 calories.
      – White rice, long grain, 590 calories.

      So potentially, weight for weight (cooked), you could end up getting a lot more calories from rice than from potatoes.
      Which may be worth paying attention to, depending on ones personal goals.

      • …& the starch numbers for each (cooked 16 oz) were,
        – Potatoes boiled without skin, 78.7 grams.
        – White rice, glutinous, 90.0 grams.
        – White rice, long grain, 125.7 grams.

        • And…just a quick Google search for “Food Satiety Index” will show you why potato is superior to rice in terms of hunger banishment.

          Another interesting comparison between the two is the amino acid score, potato has all of the essential amino acids, while rice is found lacking in several of them.

  19. RS is a two way street: only good for those with normal digestion; for those with GERD or SIBO, it may be best to avoid.
    The ketosis with high starch is something i for one have never heard about; only interest is academic since i have no desire to be in ketosis.
    High starch diet is not so great for all. There is a sub-set of the population for whom a high starch, low fat diet will cause small LDL-P to sky rocket. See Pub Med.
    PHD is a great general guideline: one needs to adjust its recommendation according to individual needs: activity, how you process nutrients, etc
    That is why Paul provides for ranges for starch as an example.

  20. I am deeply grateful to you, Paul and Shou-Ching. I have been at work for years to find the right ways to eat and live, and have made progress, but your research and your clear explanations of it hold promise for helping me move forward with fewer missteps.

    I have finished the book and bought the supplements. For about a week, I have been trying the addition of safe starches to my formerly Primal meals. I am far from a pound of starch, but may get there. I have been trying IF, and it’s workable without great difficulty. I do Bikram yoga 3-4 times a week. I have avoided gluten for four years, with one misguided exception of five months, brought on by incorrect advice from a health practitioner’s misunderstanding of a food sensitivity test. It has been more than a year since I have had gluten, and I eat very few grains of any sort — so excited about white rice, which I adore.

    My main urgent interest at the moment is to lose enough weight to lower blood pressure. My doc says 15 more pounds may do the trick. I am at 173; 5′ 6″, 63 years old. (I once weighed 215 pounds.) My particular challenges include chronic Epstein-Barr Virus and hypothyroidism (three little Armour Thyroid caps/day).

    I am particularly happy that you have included some information about Epstein-Barr in your book. The amount of help I have been able to glean from online sources and my own well-meaning health care practitioners about healing this condition is vanishingly small. Nothing, really. I decided some time ago that the best I could do would be to try to heal the gut, hoping that would strengthen my immune system, and it has, noticeably. (Many fewer sinus infections and colds.)

    Is there any specific advice, within the PHD approach, that might help accelerate weight loss when chronic EBV and hypothyroidism are present? I have looked a good bit through the website, and would be delighted to learn I have missed this information.

    Any guidance appreciated.

    • Hi kywonder,

      There are some things we know are helpful — intermittent fasting, circadian rhythm enhancement, vitamin D and vitamin A, vitamin C, control of iron levels, treatment of hypothyroidism, regular but not stressful exercise (yoga is great). Most of these are discussed in the book.

      There are no magic bullets for these viral infections, but optimizing many little things can sometimes make a huge difference in outcome.

      I think the advice of our book is the best we have to offer. It sounds like you’re doing a good job of healthy living and making some progress, so I would just keep making small improvements.

      • Thank you. Headed outside for the second time on this cold day – Circadian Rhythm enhancement – new for me. (Though I stopped looking at any screen after dinner two months ago, after reading The Primal Blueprint, and have had a markedly easier time going to sleep.)

        • As a Primal-adding-resistant-starch-and-supplements person, I’m happy to report that weight loss has resumed after a few days of gain or no change once I added in winter squash, white potatoes, sweet potatoes or white rice daily. I’ve been taking the daily supplements for a week or so, and am happy I can tolerate both the Vitamin C and Magnesium, which had been problems in the past. I did my first weekly supplement infusion on Sunday. My goal with all the efforts is normal blood pressure. I have gradually exited from highly problematic Valsartan/HCT, and am in the early stages of taking a custom blend of Chinese herbs for hypertension. Question: Sunday night, about 12 hours after taking the weekly supplements with food, I had an episode of extremely high pitched tinnitus, faint tingling in forearms and palms, and mildly elevated pulse. Wondering (1) whether it might have been the B vitamins? or one of the other supplements I don’t know as well. If so, should I reduce amounts? or just try again a week later, maybe earlier in the day? My iodine supplement still hasn’t come, so I wondered if not having that is an issue, though as a person with hypothyroidism I’m a little afraid of the iodine, I admit. Anyway, advice about the “episode” welcome. I had not eaten, drunk, or moved in any other unusual way that day. The episode lasted about two hours.

          • Hi kywonder,

            It is good that you tolerate magnesium as that is probably helpful for high blood pressure. I would say the C, D, and K2 are important too, but also the supplemental foods like liver are crucial.

            It does seem likely that one or more of the B vitamins or other supplements caused those symptoms, and it will be good for you to track down which it was because it might help you diagnose an underlying condition. Try cutting out most of the supplements and just taking one or two at a time.

          • Thank you for this helpful advice, Paul. I didn’t say but am eating the supplemental foods, too. Lamb liver this week (first time ever!) I will try taking only one B vit at a time for a while and see what happens. Thank you again.

  21. While we are having the discussion about resistant starch, and interesting, and wonderfully simple, trial from Sweden, comparing the the RS content of cooked and cooled potatoes, and also the glycaemic response of same, with our without an olive oil vinigarette.

    http://www.ncbi.nlm.nih.gov/pubmed/16034360

    As per Paul’s PHD recommendations, eating that starch with oil and an acid lowers the glycaemic (and insulin) response significantly.

    I am surprised that the RS fraction did not increase more with cooling, but evidence from elsewhere suggests that higher cooking temperatures (baking, frying) generate more RS on cooling than does boiling/steaming.

    In any case, potato salad is looking better all the time!

    • Great find, Paul N., In studies I have seen, the RS of cooked and cooled potatoes reaches it’s highest when cooled to between -9 and 5 deg C, they used 8 deg C for some reason…maybe refrigeration practices in Sweden? Anyway, most US refrigerators are set to about 3-4 deg C (37-40 deg F). The scientists may have sold themselves short by not cooling the potatoes enough.

      I have been eating about 50% of my potatoes or rice cold, and even a slice or two of raw potato when cutting them up. Here’s a nice discussion on eating raw potato:
      http://www.utsandiego.com/news/2009/aug/05/1f5focusm195324-pros-and-cons-munching-raw-potatoe/

  22. Hi Mr. Jaminet,

    I really love your blog and loved your first book. You made an assertion in this blog post that I *think* needs questioning:

    “No carb-centric explanation for obesity will tend to make omega-6 fats accumulate this way”

    This implies that the cause of n-6 accumulation in tissues is wholly unrelated to carb intake, but do we know that to be true? I think your implied reasoning is that the n-6 intake in the diet determines n-6 levels in tissues. If that’s true then you should support it. I have seen as much implied by Dr. Lands but not shown outright to be true and to be the only cause. Is it possible that the cellular content of fatty acids could be somewhat determined by the remainder of the diet? I.e. if carb/sugar intake is high then perhaps the tissues *tend* to take up more n-6 vs. n-3? Or perhaps there is some 3rd, 4th, or 5th explanation.

    I’m thinking your assertion shouldn’t go unquestioned unless you know how tissues “decide” to alter their fatty acid balances.

    best!
    Thanks,
    jesse

    • Hi Jesse,

      I do think high-carb diets inhibit omega-6 disposal, so that omega-6 fats are more likely to accumulate on high-carb diets, and people are more likely to become obese on high-carb diets.

      But I don’t think this is a “carb-centric” view of obesity along the Gary Taubes line. It is an omega-6 centric view of obesity to which carbs contribute by suppressing omega-6 disposal.

      Maybe an “omega-6 centric carb peripheral” view of obesity.

  23. What are the benefits of Resistant Starch?

    How can one use it to improve gut health? e.g. if RS is a PREbiotic, would it be a good idea to eat it with fermented foods so it can support the good bacteria from the fermented foods when they enter the colon?

    Thanks,

    Jude

    • Hi Jude,

      Yes, it does tend to improve gut health and is a prebiotic. It is good to eat it regularly but I don’t believe it needs to be eaten simultaneously with fermented foods. It might be better to eat the fermented foods separately, so that microbes not well suited to life in the colon are allowed to die.

      • Dear Paul,
        Would you have a kind of list mentionning the type of fermented foods recommended depending the type of gut problem ..? IBS,SIBO, Fungal infections.. etc..Thanks a lot ! July

  24. Hi Paul,
    I have the first version and will soon be getting the current version of the PHD.
    Did you ever address why you came out with the second version so closely on the heels of the first version? Was it due to commercial considerations? I’m just curious. Thanks.

  25. Just bought the new book (have the old one too)! I can’t wait to devour it. Thanks for all the help Paul and Shou-Jing!

  26. Why does the guy in your picture at the top of the page look so unhealthy? I guess looks may not matter so long as you feel well but the guy does look a bit unhealthy just the same.

  27. I can’t find the Kindle edition on Amazon.com – help! I *really* would love to order the new book asap. Thank you!

  28. Hey Paul.. do you have an official position on mushrooms? or quick yeasts used to make breads rise? or the xanthan or guar gum? Trying to make my diet 100% PHD since it has been working so well.
    thanks

    • Hi BS,

      We’re pro-mushrooms as long as it’s the food, not the drug. Fermenting yeasts are not bad to cook with unless you have a fungal infection. Xanthan or guar gum are not approved but if the dose is small it won’t matter unless you are sensitive to them, and it is hard to find some foods without them.

      • Hi Paul,
        Guar gum is derived from guar beans, so I understand why it is non-approved. Xanthan gum is derived by bacteria cell walls. Why is it non-approved? If the answer is in the book, I can look it up as I’m not all the way through the book yet.

        Thanks.

  29. Not the drug:) I made some rice bread with quick rise yeast and it was pretty damn good.. so good to know I can use it. It’s so hard to avoid some things… my coconut milk doesn’t really need guar gum but they throw it in there anyways.

  30. Just discovered ‘PHD’ and bought newest Kindle version. This is the first diet book I have purchased since the 1980’s (an early Atkin’s book).

    The approach outlined makes a lot of sense and love the simplicity of 1lb meat/starch/veg. planning.

    With that said, just finished chapter 13 (Medium chain fats/ketogenic) and thought I’d share my results from 7-weeks of coconut oil consumption (2 to 3 teaspoons per day). In comparison to my June 2012 blood chemistry, my December 2012 total cholesterol jumped from 229 to 305; triglycerides jumped from 79 to 149; LDL up from 167 to 227; and HDL declined from 46 to 44. Not what I was expecting based on my previous readings on the subject and my wife’s opposite results from coconut oil.

    Prior to both tests, my diet was very light on grains/gluten, simple carbs and almost zero potatoes/rice. Diet consisted mostly of meat, fish, vegetables, fruits and nuts.

    I am 5’10”, usually about 165 pounds. Since I have always had relatively high LDLs and low HDLs, I was very hopeful that a MCT oil would improve my LDL and HDL ratio. Plus, I have the genetic trait that increases the risk of an Alzheimer’s outcome (although, I should add, neither of my parents exhibited that disease despite living to their late 90’s) and was eager to make coconut oil a daily diet supplement.

    By reading your newest version, I’ve decided to modify my diet to match PHD, and once again, embrace potatoes and rice after years of avoiding. I would like to try an MCT oil again but am unsure how to do so without producing wacky HDL/LDL/Trig blood chemistry results.

    Any thoughts (recommendations) on how to proceed? Thanks.

    ‘PJ’

    • Hi PJim,

      We’ve done a series of “High LDL on Paleo” discussing reasons this happening. Usually it is one of (a) hypothyroidism, (b) iodine deficiency, or (c) copper deficiency. It is exacerbated by being too low carb. So I would suggest adding carbs, getting beef or lamb liver for copper, and seaweed or seafood for iodine.

      I’ll be adding more updates on the high LDL on Paleo problem. You can find our posts in the LDL category: http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/

      If you fix the other problems I don’t think MCT oil will be a problem for you.

      Best, Paul

      • Thanks, Paul.

        I will read those other posts and articles it links to. I will reply later with some additional personal information that may shed more light on my bodily response to coconut oil.

        PJ

      • Hi Paul,

        So, I ended up getting a blood test that indeed shows a deficiency in iodine (37 ug/L) and normal copper (85 ug/dl) – good call.

        I don’t exhibit the major symptoms of hypothyroidism, thus, per the blood results, I assume you would encourage an increased iodine consumption plan outlined in your book. Would that be a safe assumption?

        Once I start with increased iodine consumption, how long should I wait before getting another blood lipid test?

        Finally, would the iodine deficiency be a likely culprit for the higher than normal levels of bad LDL (non-fluffy)? Or is this the result of my APOE?4 gene?

        I’m trying to determine how best to modify the PHD diet if it’s the APOE?4 gene that is the principal driver of the bad LDL particle size.

        Thanks for any further input.

        PJim

        • Hi PJim,

          I do think more iodine consumption would be prudent.

          It can take about one month for thyroid function to normalize and then more time for lipids to reach equilibrium. So I wouldn’t rush to get tests, but within a few months, and at least one month after your last increase of iodine dose, would be a good time to test.

  31. Hello, I was just wondering if this is a very low calorie diet. I am thinking about either buying your book or going on medifast. I need to lose about 100 pounds, is this doable on your diet. And also can you kinda give me an idea of how many calories I will be consuming a day. On Medifast it is around 900. Thanks a bunch.

  32. Paul,

    Why does this read like he summarized PHD ?

    “http://www.marksdailyapple.com/are-you-eating-these-important-supplemental-foods/#more-34432”

    tx

  33. 1. no recipes…but can get those online and 2. very technical, leaving more explanation or clarification.


    Paul I guess you are already working on the Recipes book.

    You still need to write an expanded very long and technical more expensive book ala Good Calories Bad Calories :-).

    • Hi anand,

      This was our long and technical book. Do you mean a critique of other people’s work? As far as expounding our own ideas, this was technical enough I think.

  34. Dear Drs. Jaminet,
    I love your new book, I just had it shipped over from America. It has exceeded all of my expectations and I read a few pages every night, I really enjoy your writing style in this new version.

    I had to tell you that my husband has joined me on my PHD a few months ago. He’d been eating bread for breakfasts and lunches ever since he learned how to chew (I’m not kidding). He’s 51 years old, 6’1″ and he’s a short distance runner who had tiny “love handles” that he wanted to get rid of. He eliminated grains, pasta, legumes and the omega 6 oils.. well, you would not believe how he’s leaned out! I should have taken before / after photos.

    Now he’s worried that his face has become too thin looking… -do you think he should he increase his fats?

    Despite eating and sleeping well my weight still remains frozen at 210. Unreal! It’s been this weight for years. I’m going to implement your weight loss (no fat) version of PHD. I take the supplements too, sometimes they make me feel ill. (I think it’s the vit D / K2 pill).

    I wish you all the best in the New Year! Many thanks for your wonderful book (I got the Kindle version, too). I will keep you posted on my low (no) fat progress!
    love, Jen

    • Hi Jen,

      I don’t know but he should certainly be eating enough calories that he can add muscle easily if he does resistance training. Dairy fats and sufficient seafood for omega-3s are good fats for subcutaneous adipose tissue.

      Supplements shouldn’t make you feel ill so you might cut out individual supplements from time to time until you figure out what is causing it.

      For some people appetite control happens naturally, as with your husband, for others it is necessary to intentionally restrict calories to achieve weight loss. The key things for now are: do you feel well? Are you hunger- and craving-free? If so you’ve made a good start.

      Remember our weight loss version is not no fat, it’s just reduced fat / avoiding added fat. Be sure to get liver and salmon and other sources of healthy fats.

      Happy New Year!

      Paul

      • Dear Paul,
        Thank you for this information! I forgot to tell you that I do intermittent fasting and I feel great. I saw the recommended amounts for women (1 pound starch, .5 pound meat, 1 pound veg.) I don’t eat those amounts..

        Per day I fast with water, green tea until 2pm then have a cappuccino, then for dinner I typically eat 2 eggs, (or 8 shrimp, or 75 grams of salmon), 1.5 cups of rice (or potato) and .5 pounds of veg per day. dessert is 30 grams dark chocolate w/ tbsp nut butter. Our stir fry contains coconut oil or EVOO – I think that’s where I’m going WAY over with the fat. I will cut that out. Some days we snack on nuts and dried mango (I’ll cut those out, too). I’m very determined to do this!

        My husband eats plenty of yogurt, eggs, cheese, fruit, veg and seafood but he won’t touch red meat or chicken.

        Thank you,
        jen

  35. p.s. You asked if I’m hunger / craving free. Some days I crave potatoes, but when I was low carb i was always afraid to eat them. Since reading Tators potato thread I’m going to eat more (without butter). I do feel better when I eat potato. When I was very low carb I was manic depressive, it was horrible. Maybe my body is still out of whack from that awful time…

    • That’s good, I think you should eat more potatoes.

      The other angle to look at is gut dysbiosis/infection. Adipose tissue is an immune organ and any inflammation due to gut dysbiosis will make you hang on to fat. If it is still difficult to lose weight after you’ve adjusted diet and calories and implemented good circadian rhythm / exercise strategies as in our book, you might want to look into a stool test to evaluate your gut flora.

  36. Hey Paul, above you say ‘Dairy fats and sufficient seafood for omega-3s are good fats for subcutaneous adipose tissue.’ I understand the omega 3 taking the place of the omega 6 in the tissue, but how is dairy in particular helpful. Is the reason for stubborn fat the omega 6 or some infection, because I seem to be slimming around my body except my lower belly, or is it just the place place the fat will go from?

    Also just wanted your opinion on this supplement. Vitamin d3 and k2. I take two tabs to get 2000iu of d and 90mcg of k2. Is this fine if you want to avoid taking too many tablets?

    http://www.amazon.com/Now-foods-Vitamin-45mcg-120VC/dp/B0019QT9LA

    Thank you for merging the paleolithic with modern science!

    • Hi Abu,

      The D/K2 are fine.

      Dairy just provides generally useful fats. The body stores useful fats subcutaneously and trash around the waist. Saturated fats can be unsaturated to monounsaturated fats but it can’t go the other way, so eating saturated fats in dairy provides a good mix of useful fats.

      If your belly fat refuses to go away, you presumably have inflammation around your gut. Adipose tissue is an immune organ and holds on to fat when there is inflammation. You should work on improving your gut flora, maybe get a stool test if you think there might be an infectious origin. Also watch out for food sensitivities.

      • Nice that makes a lot of sense. And on workout days we have to increase all macros by 20-25%. Does this also account for fructose, so 100 fructose calories can become 125 fructose calories for example? and 500 glucose becomes 625 calories instead of 500.

  37. Paul:

    I would consider myself a Paleo/Primal eater but am very much enjoying the new PHD book! Has lots of information I have not seen elsewhere.

    I do take issue with you point above that hard to explain correlation between omega 6 and obesity without blaming omega 6. Correlation does not equal causation. I don’t pretend to have the same level of knowledge you do, but couldn’t the increase in this graph be attributed to (1) shifting to corn fed animals (from grass) and (2) shifting from eating lower omega 6 foods (butter) to vegetable oil, or beef to poultry, i.e. consuming more omega 6. While the increase in obesity being caused by increase in general caloric or (bad) carb intake?

    I really don’t know much about omega 6 beyond the fact I am not interested in processed vegetable oils, and will have to look at that section of the book again, as well as the Q&A you reference.

  38. How’s the forum coming on Paul?

  39. Lustig just had a pretty good interview on Jimmy Moore’s podcast. He even mentions omega 6 fats: http://livinlavidalowcarb.com/blog/the-llvlc-show-episode-640-dr-robert-lustig-takes-on-big-food-with-fat-chance/

  40. Paul, amazing book you’v put together with your wife. I’m currently trying to lose fat/gain muscle on the weight loss version but also am interested in increasing health,immunity,acne and thyroid function with iodine and cofacters etc. But, I don’t know if maybe being in a calorie deficit and not having plenty of saturate fat calories will slow down health,immunity and thyroid improvements although I’m getting important fats and nutrients from yolks, liver, fish, some yogurt.

    Could trying to do both-weight loss by intermittent fasting/reduced fat calories and improving health/ thyroid with iodine and the other supplements be too stressful and cause adrenal fatigue as i’v been experiencing some symptoms, especially the fasting. But then isn’t fasting ment to improve health and hypothyroidism due to enhancing the circadian rhythms as well. I’m just a bit confused on how to go about things. Should I fast>improves circadian rhythm>improve hypothyroidism and immunity>get rid of adrenal fatigue>lose weight naturally. Should that be how things work out, adrenal fatigue is confusing!

    • Hi Adam,

      If you’re experiencing adrenal fatigue, I would do something less stressful, like eating more calories and having a small breakfast / shorter fast.

      I think it’s best to prioritize health ahead of weight loss. When health improves, weight loss gets easier.

  41. Hi Paul,
    I find it difficult keeping fat calories down while maintaining adequate protein intake while on the weight loss version of PHD, mainly due to the average fat content of beef. Short term, would it be acceptable to use whey protein for a portion (half?) of my daily protein intake in order to get a good handle on keeping calories limited for weight loss? Thanks!

    • Hi Tod,

      That’s OK, but I’m surprised you need it. Most cuts of beef are 50-50 protein and fat which is OK.

      • Hi Paul,
        Does that mean that the fat that is contained in beef does not count when cutting fat calories down? (i.e., cut off the excess fat but what is inside the meat is ok to eat?)

        Also, and I know this is nitpicking, but when you say 1/2 pound meat for women, is that before of after cooking?

        Thanks!

        • Hi Cathi,

          It does mean you should eat beef, and yes, trim off excess fat if you are trying to lose weight.

          That’s before cooking. 1/2 lb is the minimum, 3/4 may be typical.

  42. Hi everyone!
    So, the potato thing….for breakfast…. you could have some bone broth with mashed potato and have it as soup….? Or does that defeat the purpose cuz it’s not cold. I’m trying to imagine a way the potatoes could be yummy….
    jana

  43. Hi Paul:
    Your book is great, and I follow the diet.

    However, lately I have noticed that when wearing socks all day, my ankles, and lower legs have left marks on the skin. I checked out the internet and found that this may be water retention or edema. There were some sites that said salt intake (cheeses, which you recommend) should not be eaten due to salt content.

    Paul I am very concerned about this puffiness of the lower legs. Short of seeing my Doctor to rule out kidney or heart issues (I am otherwise in good shape) I am concerned about this. Is it possible after being a vegetarian for so long, and now eating a Paleo meat based diet, that perhaps these foods have contributed to this problem of the swelling of the lower legs?
    Thanks Paul!

    • Hi Lawrence,

      Yes, it is edema. It suggests an electrolyte imbalance. Sometimes this is caused by impaired kidney function, but let’s assume for the moment that a dietary imbalance of electrolytes is the main issue.

      You might try stopping electrolyte supplementation, eg magnesium. Try getting a good amount of potassium to balance sodium intake by eating tomatoes and potatoes and bananas daily. Try getting an appropriate amount of calcium from bone broth, say 3 bowls per week. You could try going on or off lithium supplements which modulate potassium/sodium handling.

      Another possible factor is thyroid/adrenal function. You might be very careful about iodine and selenium. If you are supplementing iodine reduce the dose and see if that helps. Also, see if avoiding intermittent fasting improves matters.

      Please keep me posted on how this goes. I would like to know what is going on.

  44. I just recently finished your book and love it! I’m looking to drop ~5lbs (5’8″, 43 yr old female) and am wondering if anyone has posted their diet anywhere along with amounts that they are eating (specific to the weight loss version)? Many thanks – I think I will try adding in potatoes instead of rice (I love rice). It actually makes sense from an ancestral standpoint – I’m from Irish, Swedish decent. Thanks for the all the great info Tatertot (love your screen name by the way :-).

    • How funny! I only check the blog about once a week, and I see my name!

      Here’s an update on my PHD experience so far:

      I was low, low carb (zero starch) for about 2 years. I lost almost 100 pounds and gained significant strength, but in the last 6-12 months on this regimen, my workouts stalled, sleep suffered, feet were cold, I got put on hypothyroid meds for high TSH.

      My weight had been stable at 165 for almost a year, which is 10 pounds less than I ever thought I would be, BTW. I started this journey at 250lbs.

      Since Jan 1st 2013, I have been including at least one pound of starch per day. Mostly potatoes, lots of them cold, a few slices raw per day. I have been eating without thought to calories and trying to be very compliant with all aspects of PHD including the supplemental foods. My only vitamins are Vit D3, 5000IU/day and K2(not sure the dose right off).

      I started the year at 168lbs, and 45 days later I am at 171lbs. I have also made significant gains on the pullup bar and stared doing pushups (200 3X week).

      My waist measurement has increased by about 1/2″, but I am clearly stronger.

      My feet are no longer cold, my evening body temp prior to Jan 1st was in the 95-96 range, it has slowly built up to 97.9-98.6 range. I’m getting labs tomorrow to test thyroid and will hopefully be off the meds by next week.

      My plan is to continue eating this way until I have gained 7-8 pounds. If that never happens, that’s great! If it does, I will probably examine my diet and cut out some sour cream, nuts, or cheese first and then maybe cycle carbs a bit lower on non-workout days.

      My only concern at this point is my Fasting Blood Glucose. Prior to PHD, it was pretty reliably in the 90-100 range. Now it is in the 110-120 range, this morning it was 122.

      If I check it after eating a starchy meal, it will spike to 150-160, then quickly drop to the 90’s. It’s usually at 90 when I go to bed, so I’m not really worried, but just curious why it’s so high in the morning.

      Off to Hawaii for 10 days! Aloha!

  45. I am on the PHD weight loss version and had a question about avocados – would you suggest that as being the 1 tbsp of fat/day? Do avocados measure out the same as butter/coconut oil?

    Thank you!

  46. Many thanks, Paul! I appreciate your time. Thank you for such an awesome book and website.

  47. Hi Paul,

    Have both of your books and had a question for you – I enjoy potatoes and sweet potatoes but my gut does not (grumbly stomach noises). I have not eaten them a lot so maybe that is why (weird since I’m Irish decent). My question is, is there any problem with just using rice and bananas as the main starch to make up the correct amount of starch? I am on the weight loss version of PHD (would like to drop about 7lbs). Thank you for any help you can offer.

    • Rice and bananas are good sources of carbs, but they don’t have much fiber. Potatoes do have a lot of fiber and sweet potatoes at lot of FODMAPs, it is the fiber making your stomach rumble. I would try to eat little bits of potato, eg a fingerling potato a day, along with your rice and bananas, and see if you can build up a population of gut bacteria who help you digest them better.

  48. Many thanks for taking the time to answer Paul. I will do that. Thank you SO much for this wonderful website and all your time that you and Shou-Ching devote to those of us trying to figure out our diets!

Leave a Comment


NOTE - You can use these HTML tags and attributes:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

This site uses Akismet to reduce spam. Learn how your comment data is processed.