Q&A with Fat Head Readers

Tom Naughton, producer and star of Fat Head, has recently been migrating toward PHD. The resistant starch philia that has been sweeping through the ancestral health world got him started, and after experiencing some benefits from resistant starch and then potatoes, Tom decided to go back and read our book. He liked it and reviewed it positively.

Tom invited me to do a Q&A with his readers, who had lots of great questions. Here it is.

Questions and Answers

Jeanne Wallace: “Should we eat a serving of safe starch daily? And must a baked potato be cold in order to be healthful or is room temp okay?”

You should eat a serving of safe starch several times a day – with every meal! No, baked potatoes do not have to be served cold. Room temperature is OK but body temperature or warmer is even better. Make your potatoes enjoyable.

Vlc eater: “Do you recommend PHD for diabetics and prediabetics? If VLC eliminates fasting glucose issues and leads to better glocose levels overall, do you see a problem? Also, is it possible that the self-reported mood issues reported here are a manifestation of mild carb addiction?”

Yes, I do recommend PHD for diabetics and pre-diabetics.

I discussed this question in a previous blog post (“Safe Starches Symposium: Dr Ron Rosedale,” Nov 1, 2011). The basic biology here is that the body’s physiology is optimized for a carbohydrate intake of around 30%. At higher carbohydrate intakes, glucose disposal pathways (such as switching muscle cells from fat to glucose burning) are invoked; at lower carbohydrate intake, “triage” of glucose occurs, reserving it for the brain, and some useful carb-dependent functions are lost. Both extremes are stressful, and in metabolic disorders, both extremes may be difficult to handle.

In diabetes, the body does not dispose of excess carbohydrate properly, so carb intakes above about 30% are harmful. However, all carb intakes of 30% or lower are handled quite well in terms of blood glucose levels. This has been demonstrated in many studies. I like the LoBAG (Low Bio-Available Glucose) diet studies of Mary Gannon and Frank Nuttall, which are quite close to PHD. They tested both 20% carb and 30% carb diets in diabetics, and both carb levels were handled quite well. Here is data from Gannon & Nuttall’s 2004 study of a 20% carb diet (graph is actually from a later paper by Volek & Feinman).

Over a 24 hour period, blood glucose levels were tracked in Type II diabetics on their usual diets (blue and grey triangles) and after 5 weeks on a 55% carb – 15% protein – 30% fat (yellow circles) or 20% carb – 30% protein – 50% fat diet (blue circles):

You can see that on the 20% carb diet blood glucose came close to non-diabetic levels. The same thing happened in later studies of a 30% carb diet.

What happens when diabetics go to very low carb diets, 10% carb or less? The body invokes “triage” mechanisms for glucose conservation under carbohydrate starvation. Among these are hormonal changes including low T3 thyroid hormone and high cortisol. This condition makes fasting problematic and diabetics tend to develop high blood glucose levels in the morning after the overnight fast. Due to high fasting glucose and severe insulin resistance, HbA1c may be elevated by this strategy compared to a 20% or 30% carb diet. Various pathologies, including hypoglycemic episodes, dysregulation of serum fatty acid levels, ketoacidosis, and adrenal dysfunction become more likely. The long-term dangers described in our “zero-carb dangers” series are also present, including a higher risk for some infections, kidney stones, and other ailments.

Evidence that resistant starch helps diabetics also supports the prescription of starchy foods. It’s likely that natural whole foods will be found to be the best source of fiber, and resistant starch in nature is always accompanied by digestible starch.

PHD has generated very good results in diabetics and so, while diabetics might possibly benefit from a slight bias toward lower carbohydrate and higher protein vis-à-vis the healthy, the ordinary version of PHD seems to be very close to optimal for diabetics.

Ben: “Where can I see a very recent photo of you and your wife? (I see the author/advocate’s physical appearance as a data point when considering a proposed approach to nutrition.)”

We haven’t taken many photos lately, but you can see a video of me from January this year at a blog post we did for Dr. Alejandro Junger’s Clean Program. Here’s a look:

Our May Perfect Health Retreat begins next week and we’ll take photos and post them to our blog and social media. Keep an eye out there for up-to-date photos and maybe video.

Allison: “I want to know recommendations of how to use “safe starch” for weight loss.”

Eat it! Getting about 20%-25% of calories as safe starches (30% of calories as carbs) is optimal for weight loss. It’s best to cook them in a batch and save them in the refrigerator until meal time, when you can quickly re-heat them. This is both convenient and generates more resistant starch.

Maggie: “One of my Resting Metabolic Rate test results showed that my fat burning/glucose burning ratio is .98, meaning I burn .98 glucose. I do not burn much fat (a better score would be .85, for example). Does this mean my dietary fat percentage should be lower than Paul’s recommendations for weight loss because my body is a slow fat burner? What can I do to increase my fat burning rate?”

I am not sure what test you took. A standard test to assess fat burning vs glucose burning is the Respiratory Quotient, which is close to 1.0 when burning glucose exclusively and close to 0.7 when burning fats exclusively. But no one gets a number as high as 0.98 at rest, though it can get that high during intense exertion.

At rest, the Respiratory Quotient should approach 0.7, but in the obese it tends to get stuck at maybe 0.85. To enable it to go lower, you want to support mitochondrial health and train yourself to burn fats better. Supplementing vitamin C and pantothenic acid may help, also daily exercise and circadian rhythm entrainment.

Martin: “What’s your opinion on a cyclic-ketogenic diet, with a carb refeed once a week only? Also, does it matter when one eats carbs during a day (e.g. morning vs. evening) and how it is combined with protein and fats?”

I think once a week is too infrequent for carb feeding. I think daily carb feeding is best.

Carbs are best eaten during the daytime in a fairly narrow feeding window. Relative to protein, carbs should be biased later in the feeding window, protein earlier. But both should be eaten together. Just make the first meal a little more protein rich, the last meal a little more carb rich, or follow it with a sweet dessert.

Fritters: “I own your book, but the whole idea of organ meats, bone broth and fish nauseates me. Also, I’ve heard people with AI problems are sometimes fixed by removing nightshades from their diet. In any case, I have an AI problem and am on prednisone all the time, which shoves my blood sugar way up. I’ve felt a LITTLE better on less nightshades, so I want to keep doing that, but I want to eat closer to the Perfect Health diet without gaining too much weight because of the increased blood sugar from the prednisone. What areas do you think I should concentrate on to get closer to perfect health? I’m already avoiding sugars, wheat and crap-oils.”

Yes, it’s true that many people with autoimmune issues benefit from dropping nightshades. In general, autoimmunity originates with foreign compounds entering the body through a leaky gut, which is the same way food sensitivities originate. Nightshade toxins are immunogenic and can easily generate food sensitivities in people with a leaky gut.

PHD with nightshades removed is essentially a Paleo autoimmune protocol.

Prednisone is a drug I don’t like, it suppresses immunity which suppresses symptoms but often worsens the underlying disease – and it has negative side effects as you’ve experienced.

Focus on eating PHD meals in which starches are paired with meats, vegetables, fats, and acids; support immune function with vitamin A (liver, spinach, carrots), vitamin D (sunshine), daily exercise, intermittent fasting, circadian rhythm entrainment, zinc, iodine, and vitamin C; include collagen (bones, joints, tendons in soups and stews) for wound healing and gut barrier integrity.

Teresa Grodi: “My question for Paul is regarding the “Candida Diet”. I know lots of people, especially postpartum women dealing with bad thrush, who are on the anti-candida diet, which prohibits what you would determine “safe starches”. I think I saw in passing that you had some problems with the anti-candida diets, regarding the prohibition of safe starches, and I thought maybe you could elaborate, with an eye to postpartum/breast feeding mothers. I would love to be able to help my fellow mothers.”

Very low-carb diets will flare fungal infections by suppressing antifungal immunity and reducing the population of probiotic bacteria in the gut, which compete with fungi. A balanced diet with 30% carbs is best for candida.

My answer to vlc eater above about why 30% carb is best for diabetes also applies to Candida: you want a well nourished body, including nourishment with glucose, but without an excess that could feed the infection. It’s only carb intakes above 30% that provide that excess. Carb intakes below 30% starve immune function, extracellular matrix maintenance, and mucus production, all of which help defend against Candida.

Eating liver, getting sunshine, intermittent fasting, circadian rhythm entrainment, and eating fermented vegetables are other elements of a good anti-Candida strategy.

Tony: “Dr. Jaminet’s phd proposes safe carbohydrates to replenish daily glucose stores. He proposes safe carbs because of the damaging health effects of grain carbs (except rice). If a subject occasionally (1,2,3 times a week?) consumed bad starches instead of good starches won’t these bad starches still replenish his glucose stores? Won’t the good fats blunt any insulin spike from the bad starches? In other words, phd with bad starches, wholly or partially, occasionally. Would subject’s health still go down the tubes? Would subject gain weight or stall a weight loss?”

Yes, all starches will replenish glycogen (glucose stores). What makes a starch “good” or “bad” (we use the terms “safe” and “toxic”) is not the starch but associated compounds which can be toxic to us.

I can’t say that your health will go down the tubes if you eat bad starches like wheat. Only that they appear to be risky things to eat. They do harm some people. It’s possible that even in people who appear to be unharmed, they do insidious damage. We can’t know for sure, we just think that it’s prudent to avoid wheat.

No, wheat won’t necessarily cause weight gain by itself. It is associated with higher body mass indexes, however, and there may be mechanisms by which it can promote leaky gut which is inflammatory and promotes weight gain. I think it will be slightly easier to lose weight without it.

Lily: “I am sensitive to sugar, and have a huge addiction to it. Starches like white rice tend to raise my blood sugar too much and I end up binging (even if I have it with a fat source). Are there safe starches that I can eat that won’t raise my blood sugar so much? Potatoes seem to affect me the same way white rice does. I would eat potatoes with the peel, or try brown rice, but don’t those have anti-nutrients? Are there starches that are safe for me, a sugar addict with a body that doesn’t handle sugar very well?”

I’ve heard many stories like yours and people are often surprised to find that all of those things clear up pretty quickly on PHD. The pattern:

  1. Binging and cravings and addictive behaviors typically follow starvation, so I’ll guess you’ve been too low carb for too long. Your brain knows your body needs carbs and when it’s available says, “Ah! We’ve found the nutrient we need! Go eat this precious sugar/starch before this rare and vital food disappears!” To fix this, eat PHD levels of carbs. Over time the craving/addiction will go away.
  2. Weight gain from eating carbs usually indicates a leaky gut and a dysbiotic gut flora, such that when you expose your gut to carbohydrates you get inflammation which activates adipose tissue (an immune organ) and causes it to grow. It also relates to the binging, after past starvation your appetite is upregulated temporarily when you get a chance to repair malnourishment.
  3. High blood sugar upon eating starch indicates that (a) you are cooking and eating it incorrectly and/or (b) you lack the gut flora needed for proper glycemic regulation. To fix (a), read this post, and to fix (b), you need more fiber, including some resistant starch, and fermented vegetables.

Above all, you need a balanced, nourishing diet and immune support. See my previous answers to Teresa Grodi and Fritters for some tips. Your mindset should be oriented toward health, not weight. You should accept that an initial weight gain may be “baked in the cake” so to speak, it is already inevitable thanks to past deprivation, accept it and move on to healing yourself and once healed you will be able to re-lose the weight in a natural and healthful way, and reach your goal weight safely.

Carnivore: “My dilemma is when on a VLC diet my blood sugar (A1C test) very good, fasting glucose very high (I am diabetic) When I start some safe starches (tried potatoes and beans) morning fasting glucose excellent – blood sugar throughout the day – way too high after the meals – and even with medication is coming down in a few hours (too slow). So, my question is: how can one determine how much safe starch is safe? (for a female diabetic approaching the retirement age) and what kind of starch: potatoes, beans, sweet potatoes? I assume rice is out of question for diabetics like me.

This is a very common pattern. See my answer to vlc eater above. 20% to 30% carbs is best. If postprandial blood sugars are high, make sure you are cooking and eating starches properly and working on your gut flora with fiber and fermented vegetables.

Chad: “When weight lifting to gain muscle, most experts say you need to consume massive amounts of carbs in order to gain muscle. Then when you wish to slim down you reduce carbs. I prefer paleo style diets and it makes sense, but I also want to lose fat and gain muscle. The instructions to do so seem to directly conflict with the Paleo Diet idea. How do you induce your body to increase muscle size without consuming nothing but carbs only to go LC to get super lean later? Is increased insulin production necessary to increase muscle size? How do you do that and not become insulin resistant? Body builders get huge muscles and super lean all the time on this super high carb/super low carb cycle and its just so confusing.

The main instrument to vary is total calorie intake, and the relationship between calorie intake, periods of fasting, and the timing and intensity of workouts. Macronutrient proportions should be close to PHD ratios at all times, with slight variations synchronized with workout schedule.

High calorie intakes lead to gain of mass (both lean mass and adipose tissue); low calorie intakes lead to slimming (both lean mass and adipose tissue). The type of physical activity you undertake places the focus on a different mass reservoir. When you do intense workouts, you are focusing the body on muscle; you want high calorie intake at this time to promote muscle growth. When you are resting, you are focusing the body metabolically on adipose tissue – at this time you want to fast and reduce calorie intake to promote loss of adipose mass.

Macronutrient ratios should vary toward more fat and carbs when your calorie intake is high (e.g. eat more dessert like foods) and less fat and carbs when your calorie intake is low – in other words, your protein intake should be more stable than your fat and carb intake. But this is something you will do naturally. It doesn’t need to be consciously directed, and it doesn’t need to be extreme. You do need to direct your conscious mind to varying total calorie intake in sync with your workout intensity, and vary your workout intensity.

Work out every day, but vary the intensity, and vary the calories in sync with workload.

Pierson: “Regarding fructose, what is his opinion on foods like fruit, honey, and sweet syrups? While it does make sense to avoid processed industrial anything, what about whole-foods sweeteners?”

A little bit of honey or sweet syrups is OK. I think you’ll find that on low-carb diets without added sugar, your tastes change and very little honey is needed to make foods taste appealingly sweet. If you weighed the honey and calculated how many calories it had, you’d find it was very small. One teaspoon of honey weighs about 6 grams and has about 18 calories, about 9 calories of fructose or 0.4% of daily energy intake. That’s not going to kill you. We recommend getting about 100 calories of fructose daily from all sources, including fruit.

Fruit and berries are excellent foods and not to be avoided. We recommend eating 2-3 pieces of fruit or servings of berries daily.

Charles Grashow: “If LDL-P increases isn’t that bad regardless of the particle size? Larger particles can still get thru the endothelium and become oxidized it just might take longer.”

Yes. The LDL particles get oxidized in the bloodstream and then taken up by white blood cells, activating inflammation and potentially turning them into “foam cells” and assisting formation of atherosclerotic plaques. Endotoxemia (influx of endotoxins from the gut) is usually the biggest driver of LDL particle oxidation. More LDL particles and more endotoxins = more oxLDL reaching white blood cells = more inflammation and faster plaque formation.

Steve Parker MD: “The preface of the Scribner edition mentions your health issues while eating the standard Amercian diet: neuropathy, memory loss, impaired mood, physical sluggishness, and rosacea. You attribute your subsequent scurvy to the very-low-carb paleo diet you adopted to resolve the original issues. Did your personal physician(s) make the diagnoses and say they were diet-related? Uptodate.com says this about rosacea: “The pathways that lead to the development of rosacea are not well understood. Proposed contributing factors include abnormalities in innate immunity, inflammatory reactions to cutaneous microorganisms, ultraviolet damage, and vascular dysfunction.” Your other three SAD-related problems each have easily 10-20 things that can cause them, many of them unrelated to diet. By the way, I enjoyed the book and learned a fair amount from it. Folks eating the standard American diet should be better off switching to PHD.”

My doctor acknowledged the symptoms but was baffled about the cause, as was I. Rosacea was diagnosed by multiple dermatologists. After we optimized PHD my rosacea faded over a period of about 2-3 years. I would not be diagnosed with it today, though at times I still see traces of it.

The memory loss went away during a three month course of antibiotics, taken in the later stages of transitioning from Paleo to PHD.

The things my doctor was clearly able to diagnose were not very helpful to me. For instance, after my VLC and scurvy phase, my belly became bloated and a fairly hard nodule formed which my doctor said was a lipoma. We did a barium enema and it found diffuse diverticulosis. But that was not a cause of my health problems, it was an effect of the VLC-scurvy mistake. I found the various testing we did interesting and educational, but in the end it didn’t show me a path forward. It was diet, lifestyle, and a somewhat speculative round of antibiotics that cleared things up.

Thanks for the praise!

Ryan H: “In your book you explain that fats and acids (ex: vinegar, lemon/lime juice) blunt the insulin spike of starches. To my knowledge you do not mention or recommend cinnamon doing the same. I am just wondering what your take on cinnamon is? I have heard that it lowers blood glucose levels. P.S. Cinnamon on a sweet potato is pretty good!”

Cinnamon is good, but like all good things, it’s possible to get too much. Eating to optimize flavor is a good guide to the optimal amount. I agree, cinnamon and butter on sweet potatoes is delicious!

Mike W: “Do you make any distinction, health-wise, between short-chain saturated fats and long-chain? The reason I ask is that foods heavy in short-chain sat fats (bovine milk, coconut oil, palm kernel oil) seem to give me clogged pores and acne, so I avoid them. This is no hardship for me, I was never big on cheese, butter, or coconut anyway. The fatty foods I do eat – eggs, meat, nuts, chocolate – don’t bother my skin at all, and in my research I’ve found their sat fats are almost exclusively 14-carbons or longer. Besides keeping my skin clear, I can justify my short-chain avoidance from an ancestral standpoint. I doubt my distant ancestors had access to coconuts, and as I understand it, human milk has a lot less short-chain fats than bovine milk. So… are short-chain saturated fatty acids an essential nutrient? Am I missing something by avoiding them?”

Yes, short-chain and long-chain saturated fats are discussed in different chapters of our book because their biological effects are quite different.

I suspect your problem is more related to consuming oils, than to the chain-length of the fatty acids. Try supplementing pantothenic acid, zinc, and choline (or eat egg yolks and liver) and I bet you will tolerate the oils a lot better.

Coconut milk is not an essential food, but it is a healthful one, and we recommend it.

Ryan H: “You advise if one needs to consume something during a fast (for hunger reasons), a spoonful of coconut oil or mct oil is allowed without it hindering the fast. What is your take on butter or cream during a fast (like in coffee)? Will it break the fast and autophagy. I am just wondering since some LC people recommend it and say you are still reaping the benefits of fasting since you’re not consuming protein or carbs.”

Protein disrupts a fast the most, carbs next, fats the least. If you want a bit of cream in your coffee, that’s fine. If you are concerned about its effect on autophagy, delay your breakfast an extra 10 minutes, that will get the lost autophagy back.

Becky: “For the nightshade avoiders among us: Does packaged tapioca starch serve as a resistant starch? If so, can it be eaten like potato starch … in water, raw? I use it to make baked biscuits. Will they, cooled, provide resistant starch? Cassava, sago and taro are not available here. I like to keep rice to a minimum. Plantains, green bananas and sweet potatoes are my starches. I got diverticulitis on VLC and am enormously vested in getting my gut biome fed with resistant starch. I am the Becky quoted in your book, in the thyroid discussion. To update, Hashimoto’s antibodies DISAPPEARED from my TPO blood tests, and my doctor says I no longer have Hashimoto’s. He thinks it was probably giving up wheat.”

Hi Becky, it’s great that your Hashi’s is gone! And thanks for contributing your story to our book!

Detailed questions about resistant starch content of various foods under various cooking methods should be directed to Tim and Grace, who have been researching those things.

I would say however that you should not eat tapioca starch in water raw. Rather, make it into foods like your biscuits and eat them as parts of meals in the PHD manner, accompanied by butter, vinegar, vegetables, and meat. Or at least, as a dessert with butter and vinegar.

Norm: “1. Why do hunger and cravings for carbs increase for some people by introducing rice and potatoes whereas most of the people do not have that being low carb?

2. How do we know that symptoms associated with low carb like cold hands and feet, low thyroid etc are NOT from eating less as hunger is dramatically reduced on a low carb diet?

3. Paul highly recommends 16 hours of fasting, would PHD provide the same benefits especially weight loss without 16 hours of fasting? Probably standard American diet would be a lot healthier with 16 hours of fasting? If calorie restriction is not good or creates problem for people especially in term of weight loss then why calorie restriction is achieved via intermittent fasting on PHD?”

Many people on very low carb diets have hunger and cravings for carbs. Often it gets displaced into a craving for sweets or for alcohol.

For many low-carbers, adding rice and potatoes leads rapidly to a feeling of well being and satisfaction. It quiets appetite.

For others, eating rice or potatoes can trigger strong cravings for more. For reasons why, see my answer to Lily above. There are usually two components to this. First is a need for the body to replenish glucose-dependent proteins such as extracellular matrix; typically this takes at most a few weeks to a month, after which appetite diminishes. Second is an inflammatory reaction from gut pathogens that feed on the carbs. This requires fixing the gut dysbiosis or infections.

The low thyroid is a hormonal reaction to conserve glucose, and associated phenomena like cold hands and feet illustrate the inability of the body to properly maintain homeostasis when it is starved of a key nutrient. As far as reduced appetite on low-carb, there is a difference between reduced appetite due to a body being well nourished, and the anorexic lack of appetite that is induced during chronic starvation. The first is desirable, the second is not.

16 hour intermittent fasting is beneficial for health so long as the 8 hour feeding window falls in the daytime. PHD would still be an excellent (nourishing, low toxicity) diet without intermittent fasting, but this is another opportunity to improve health. Lifestyle is as important as diet for health.

It is not so much that PHD with intermittent fasting restricts calories, it is that it achieves optimal nourishment with the smallest possible caloric intake. In other words, one eats fewer calories without any restriction of nourishment when eating PHD. If this is hard to understand, try reading Chapter 17 of our book.

Gerard Pinzone: “I’m interested in trying this out to see what difference it might make. I’ve heard that there may be an initial period of weight gain. If true, why? Can you provide a recommended schedule? Something like, “1 tablespoon of potato starch in the morning for one week, then increase by 1 tablespoon each week until you reach 4 tablespoons.” Is it better in the morning than night? Also, what issues are signs that we should stop and which should we grin and bear? Can we start/continue to take a probiotic? Should we?”

Coming from SAD, people almost invariably lose weight when adopting PHD. I haven’t heard of any cases of weight gain in people coming from the standard American diet.

Coming from lower-carb diets, the immediate reaction can be either weight loss or weight gain. There are two principal reasons why weight gain may occur. It is partly a matter of low-carbers “adopting PHD” by simply adding starches to their Paleo diet, thus adding calories; and partly a matter of a gut dysbiosis or infection leading to greater inflammation when carbs are added. The solutions are (a) emphasize nutrient density and dietary balance so that hunger abates with lower calorie intake – that is, implement PHD more fully; and (b) address gut health through immune support and fermented foods and fiber.

I recommend just adopting PHD in toto from the beginning. There’s no reason to delay a good thing.

It’s fine to take probiotics but fermented vegetables usually contribute more.

JD says: “Just like all of this rethinking about RS, I’ve been rethinking the theory about optimal omega 3:6 ratios. Everything I remember reading about it recommends the ideal ratio is between 1:1 and 1:4. But what if it’s less about the ratios and more about eliminating bad fats (franken oils, factory farmed animals). Let’s say someone is following the Perfect Health Diet almost to a T, except most of their fat calories are coming from a high quality olive oil so the O3:6 ratio is closer to 1:8; is there any reason to think that person might less healthy than someone with a more ideal ratio? I do remember reading about how essential fatty acids from O3 and O6 fats compete for the same enzymes, but are there any studies out there that suggest excessive olive oil consumption interferes with therapeutic doses of O3 EFAs?

I guess my question could really be simplified to this; Is there any reason I should stop drowning my salads in olive oil?”

Our peak health ranges are about 1% to 4% of calories from omega-6 fats (mainly linoleic acid) and 0.5% to 1.5% of energy from omega-3 fats (mainly from marine sources).

If you eat at the high end of the omega-6 range (4%) and the low end of the omega-3 range (0.5%), you’ll still have perfect health according to our analysis, and you’ll have an 8:1 ratio.

However, you have to hit fatty acid quantities spot on to be the peak health range for both with that ratio. If you have a 3:1 ratio, you could eat omega-6 anywhere from 1.5% to 4% of energy and still be in the peak health range for both. So that is a more desirable ratio to aim for.

Drowning your salads doesn’t sound good. How about flavoring your salads with olive oil?

Amberly: “If using RS as a supplement (ie Potato Starch in a smoothie or cup of warm water), is there a “best” time of day to take it? In the morning? Before bed? All at once? Split into two or three doses?

Also, I am very sensitive to carbs and need to lose quite a bit of weight. What is the lowest number of carbs you would recommend going? Is it possible to stay in ketosis? Can you get the same health benefits from a cyclical ketogenic diet–IE VLC most of the time with one or two evenings a week of safe starches? Can you get health benefits by adding just RS (ie Potato Starch) but not the safe starches?”

Take RS before your first meal. If you do intermittent fasting and your feeding window is 11 am to 7 pm, take the RS at 11 am.

I would recommend getting at least 20% of calories from carbs, but I think 30% is better for most people.

Lower carb diets should be seen as only temporary therapeutic diets, forms of extended fasting, not as permanent diets. Ketosis is fine, unless you have certain infections, but chronic starvation of desirable nutrients is not. I think it’s best to eat starches daily. No, your body needs glucose as well as a healthy gut flora.

Mike G: “I believe you mean the enzyme amylase, rather than lipase? Amylase will hydrolyze the starch into maltose disaccharides first, then maltase (on the villi of the small intestine) will digest the maltoses into glucoses. Then the glucoses can be easily absorbed via transporters on the villi surface. This is why I cannot wrap my head around how fatty acids could blunt glucose spikes, or insulin spikes. Do the fatty acids bind to the glucoses? I suppose they could, given that we have glycolipids on our cell membranes.”

I don’t know what this is referring to. If it’s our recommendation to combine starches with fats in order to reduce their glycemic index, the reason blood glucose is lowered by eating starches with fat has to do with delayed stomach emptying and improved metabolic regulation.

Troysdailybacon: “With regards to Xylitol – I use it as a tooth protocol to fight cavities, but end up injesting a small amount. I’ve heard that it acts like a prebiotic as well. But in the mouth, bad bacteria try to metabolize it, but can’t, so the bacteria die off. How does Xylitol react in the gut? Will it feed the good bacteria and produce butyrate? Or, like in the mouth, will it kill off good and/or bad bacteria in the gut?”

Xylitol like other sugar alcohols can be fermented by some bacteria, and it has antimicrobial effects against others, so it will alter the gut flora (and the oral flora). I am not sure we know enough to say whether the changes are good or bad.

In in vitro studies, xylitol doesn’t seem especially effective at preventing cavities – it doesn’t do nearly as well as fluoride; and it also appears ineffective in human studies. This may be one of those cases where positive early studies don’t seem to be replicable.

Rob: “Do you recommend supplementing with additional resistant starch (potato starch) and other fermentable fibers (inulin, pectin, etc) or just getting these things from food? What are the potential negative effects of too much resistant starch and fermentable fibers?”

I recommend getting fiber from food, but designing one’s diet and preparing food to make it fiber-rich. This can be done by eating natural whole foods, copious fruits and vegetables, and pre-cooking and refrigerating starches.

It is unclear what the negative effects of too much fiber would be, but there is surely a point when you can get too much.

I think of it in ecological terms. You are crafting an ecosystem in your gut, and you want an ecology that favors evolution of a healthful flora.

Humans have an overnight fast of 12-16 hours and a daily feeding window of 8-12 hours. Gut bacteria have a reproductive life cycle of about an hour when food is available. So during your daily feeding, your bacteria have enough food to reproduce and could potentially double their numbers 8 times, or increase their population 256-fold. Then they go through an overnight fast, and their numbers diminish. Ecologically it is a boom-bust cycle similar to deer multiplying when food is abundant and then starving in the winter.

Within the overnight fast, your immune system has an advantage in shaping the ecology. Where probiotic flora are present, it can reward them by generating mucus; where inflammatory pathogens are present, it punishes them with antimicrobial peptides. During the fast, microbes are relatively defenseless due to lack of resources. During feeding, microbes have the upper hand.

Providing lots of fiber creates a boom-bust ecology on a daily cycle, while a low-fiber diet creates more stable bacterial population levels.

In general, you want to eat the amount of fiber that maximizes microbial diversity (that is, genetic diversity) in the gut. Low microbial diversity is associated with disease, high diversity with great health.

Boom-bust ecologies create a different set of selective pressures on bacteria than ecological systems with stable food supplies. Potentially, too great an amount of fiber might reduce microbial diversity by rewarding species that are able to reproduce most rapidly during the food “boom” and preserve their numbers by hibernating during the overnight “famine”. Many beneficial species may not compete successful with hyper-growers like E. coli in such an ecosystem.

Low microbial diversity in the gut is associated with many diseases. Usually low diversity results from starvation of fiber, but conceivably supplementation with large doses of resistant starch could bring about a similar result.

I consider the optimal amount of fiber to still be an open research question. We don’t know the answer. But I am confident the optimal amount is not “infinite fiber.” There will be some amount that is too much.

Incidentally, getting a diversity of fiber types – not just resistant starch – will be important, as this too will promote microbial diversity. This is one reason a natural whole foods approach is likely to be optimal.

TMA: “I haven’t read your book but what I’ve read about your diet on your website sounds appealing. One concern I have though is the number of different supplements you recommend. I’d be leery of low dose lithium for example. Do you discuss your rationale for these supplements in your book? And how would you suggest that people gauge their responses to a given supplement when there are so many and the purported effects are subtle and subjective?”

Yes, we discuss the rationale for supplements in our book. I think if you compare our supplement list to the list of ingredients in a multivitamin, you’ll see that our list is much shorter.

Lithium is a good example. It is one of those compounds we seem to need for optimal health, longevity, and neurological function, yet it is removed from the modern water supply and is depleted in soils by repetitive  annual planting of plants in agriculture. Compounding those environmental reductions is the fact that most people don’t eat many vegetables. So it is easy for a diet to be deficient in lithium.

It’s a good practice to stop supplements entirely for a few weeks every once in a while and see if you feel better or worse without them.

Gabe: “I’ve heard you refer to your own experience in dealing with and/or eliminating chronic infections. Can you offer us some insights or advice on the solutions you found to these chronic infections, and/or what kind of medical practitioner one should consult? If one is already seeing a medical practitioner, what kinds of testing would indicate that practitioner is thoroughly considering what you know to be the right kinds of tests?”

My personal solution was PHD plus antibiotics. I would recommend trying PHD (including the lifestyle advice – intermittent fasting, daily exercise, circadian rhythm entrainment) first and trying antibiotics as a last resort.

Testing is a complex question. The patient’s symptoms provide clues, lab tests provide clues, the practitioner has to understand biology and interpret them. There is no recipe that fits every patient, and you can waste a lot of money on uninformative tests. It’s best to find a clinician with good judgment to help you.

Howard Lee Harkness: “Is the “soluble fiber” in chia seed (gel) a suitable “resistant starch” for the PHD? I’ve been experimenting with chia seed gel, and I have noticed that when I eat a serving (about 3 tbl chia seed soaked in 8 oz water about 15 minutes & added to a 20g protein shake with ice, coconut oil and MCT), I am not hungry again for a very long time (12 hours or more). However, I have not noticed any weight loss over the past week. My other main source of soluble fiber is raw carrot (about 1/2 cup per day), which I’ve been trying for about 3 weeks, again with no change in weight. Background: I easily lost a bit over 100 lbs on an Atkins-style diet starting in late 1999, but have remained weight-stable at roughly 50 lbs over goal (give or take about 10 lbs) since 2002.”

I am not familiar with chia seeds, although I do see that they can help rats with dyslipidemia and fatty liver. You might ask Tim and Grace about their resistant starch content.

Kathy from Maine: “1. Tom said at the end of the post, “Perhaps you’ll be persuaded to eat a potato smothered in grass-fed butter.” From my limited reading of PHD, I took away the message that the plan is higher fat (65%), but that fat should come from what naturally occurs in foods and NOT ADDED to foods, like butter on the baked potato, etc. Did I misread this?

2. I’m confused on the 140 degrees. I thought that after the initial cooking and cooling, it was critical that the food NOT be reheated more than 140 degrees to reap the most resistant starch.

3. PHD recommends approximately 15% protein, which on a 2000-calorie diet would be 300 calories, or just 75 grams of protein. How does this correlate to Phinney & Volek’s advice in “Art & Science of LC Living” (and in a podcast I heard from Phinney) that everyone needs three 30-gram servings of protein daily, for a total of 90 – 100 grams or more in order to trigger protein muscle synthesis? In that book, they showed a table of a weight loss plan for a woman, and it advocated 100 grams of protein through all stages of the weight loss from “induction” through maintenance. Also, Dr. Eades notes in his Lifeplan book that women over 50 actually need more protein than men (and recommends at least 100 grams daily) because women of that age don’t absorb as much of the protein as do the men. I’ve always tried to get at least 100 grams a day. Is that too much, in Jaminet’s thinking? Or is 75 – 100 grams a good ballpark figure?”

The recommended PHD macronutrient ratios are 30% carb, 15% protein, 55% fat.

Yes, most fat should come from natural whole foods, but most people will probably eat 2-4 tbsp per day of oils from cooking oil, salad dressing, coconut milk, butter, and other oils. It’s good to put butter or sour cream on a potato.

Resistant starch starts to melt (become digestible) with cooking above the boiling point of water, and the strongest rise in melting occurs between 60˚C and 70˚C (140˚F and 160˚F). Five minutes of cooking at 70˚C / 160˚F will eliminate nearly all resistant starch. It can take several days of refrigeration to restore the resistant starch content.

However, briefly warming a potato in the microwave will not raise the potato temperature to 70˚C, and will not destroy much resistant starch.

It’s true that if you want to maximize muscle mass, you should eat more protein than 15%. However, if you want to maximize longevity, 15% is a good number.

We actually give a peak health range for protein that ranges up to 150 grams (600 calories) per day. So the Phinney & Volek numbers are compatible with PHD. Where you choose to fall within that range is a matter of personal preference.

I’ve seen no evidence that elderly women need more protein than elderly men. All studies of centenarians show that elderly women eat less protein than men, and they outlive the men. It would be strange if they ate less and lived longer even though they needed more.

Amberly: “In creating the most RS from a SS, does it matter how the item is cooked/cooled? IE does it matter if you bake the potato and then eat it immediately after it has mostly cooled (below 140), or does it form more RS if it is baked/boiled then put in the refrigerator overnight, and then reheated? Same type of idea with rice. Does the longer a food is cooled the more RS it creates, or is it pretty much the same?”

General principles, you don’t want starches to become dehydrated. So use gentle water-based cooking methods like boiling or steaming. If you have an autoimmune disease or food sensitivities, favor cooking them in a pressure cooker.

You don’t need to cook starches for a long time to gelatinize them – just cook them as you would normally – but you do need to cool them for a while if your goal is to form extra resistant starch. Refrigerate them at least overnight, and resistant starch content actually continues to increase through 4 to 7 days of refrigeration.

Daci: “What about green bananas as a safe starch? I really miss them since being on a lchf diet. I like them better than ripe ones. Always have. Any thoughts?”

Eat them! Bananas are a great food, green or yellow.

George: “Big fan of PHD and have been incorporating resistant starch particularly in the form of 4 Tbl of Bob’s Red Mill Unmodified Potato starch. Question: Give the nutritional breakdown of 4 Tbl of Potato Starch (160 calories/40 grams of carbohydrate): do does amounts contribute to the PHD minimum levels of starch 400-600 calories per day if this form of starch bypasses digestion in the stomach and small intestine and instead is largely digested by gut bacteria in the large intestine/colon? Or is it recommended to eat some starch that is not “resistant”? If so, how much of “resistant” and Non-resistant starch should be consumed or does it not matter?”

No, resistant starch does not count as a carbohydrate source. It is a short-chain fatty acid source providing about 1 to 1.5 calories fatty acids per gram. It doesn’t provide any carbohydrates. Of course, it is always accompanied by digestible starch in real foods. Those count as carbohydrates.

Yes, you should always combine resistant starch with digestible starch. In general, I think a natural whole foods approach is going to work out best in the end.

General guidelines, you want about 20-25% of calories as digestible starch from “safe starches,” about 10% of calories as sugars from fruits, beets, carrots, and the like, and about 2% of calories from maybe 30 grams of fiber per day, probably about half from resistant starch naturally formed in “safe starches” and half from a diverse array of fruits and vegetables.

Pam: “You have milk as a not to be consumed. But, what about raw milk? I have been drinking raw goat milk for about a year. And then there is the Milk Cure from the early 20th century. Your thoughts?”

Hi Pam, as we say in the book, milk is in many ways close to the ideal food, but our food production system does not inspire confidence in it. I would say you do need confidence in your dairy farmer, that he uses aseptic procedures to prevent contamination of the goat milk by goat dung (easy to occur, in nature the udders are often contaminated by stool as a means to pass maternal gut microbes to offspring) and keeps his goats healthy. There is a risk of infections such as brucellosis. Overall I am somewhat doubtful of the advantages of habitually drinking even well sourced milk, but I don’t have strong feelings about it. It can be curative for some conditions, though a good diet would also generally be curative of those conditions. Milk is simply an easy way to obtain a good diet.

Fight! (Just kidding)

The Internet is large, everyone’s got opinions, and we could waste a lot of time trading opinions. For that reason I think critics should generally be ignored, if all they have is opinions without any specific (which is to say, constructive) criticism.

However, once in a while it may be educational to see what authors think of their opinionated critics, so I thought I’d offer comments on a conversation between Harry and Tom. Harry in bold, Tom in italic, my commentary in regular font:

[Harry:] Paul’s central thesis (that toxins cause disease, and should therefore be minimised) is a leap of faith.

Paul: That is overstating our thesis. First, our diet is primarily focused on nutrient optimization, not toxin minimization. Toxin reduction is a secondary goal; the idea is that given two equally nourishing alternatives, say wheat or white rice, if there is evidence that one is significantly more toxic than the other (in this case, wheat more toxic than rice), we should avoid that one and get the nutrition from the safer source.

[Harry continues:] If toxins do in fact cause disease (that is, chronic consumption of low doses of toxins; we all know that consumption of high doses makes one very ill…or dead), then it simply does not follow that they should be minimised.

Hormesis in the body occurs in many systems, including the digestive/metabolic systems. It would certainly strike us as strange if we surmised that, since working to exhaustion causes death, then lying prone all day is the best way to avoid death. Similarly, it is strange (although understandable) that one might think that toxins should be avoided at all costs. Just like exposure to bacteria challenges and ultimately strengthens the immune system, so too it is possible that exposure to a certain level of dietary toxins is preferable to a completely ‘safe’ diet.

Paul: We discuss hormesis prominently in the book; see pages 192-193 at the beginning of Chapter 18, Food Toxins. The reason we aren’t concerned about the toxins in vegetables is that the doses are usually at hormetic or inconsequential levels.

[Harry:] The resolution to this question ultimately lies with controlled studies…but given the difficulty of assessing variables in the human diet, this may be a long time coming.

Paul: It is virtually impossible to do controlled studies of low-level toxicity. We are concerned about effects that may take a month or two off an 80 year life. To detect such effects would require an experiment lasting at least 80 years.

[Harry:] In the interim, how about we swear off alarmist diet gurus that demonise foods that have been eaten by humans for centuries…and instead just shoot for a balanced diet that is mostly unprocessed foods? Too boring?”

Paul: I object to the claim that we “demonize” any food. No, we weigh the evidence for each food’s merits and demerits, and find some foods wanting.

Harry’s main objection is to our eschewal of certain foods, such as wheat and soy, which have been eaten by humans for centuries. But is it really alarmist to point out that many people have noticed health improvements from removal of wheat, that the biomedical literature notes many cases of people harmed by wheat consumption, that research is exposing mechanisms by which wheat compounds do harm, that statistically countries that don’t eat much wheat tend to have longer lifespans (especially after correcting for income), and that there is no evidence for the presence of nutrients in wheat that cannot be obtained equally well from our “safe starches”?

In order to maximize the healthfulness of a diet – and finding the maximally healthful diet was the purpose of our book, thus the aspirational name “perfect health diet” – we have to weigh risks, such as the loss of sperm in men eating soy, and the cognitive impairment experienced by people eating tofu, against the benefits of eating a food, assessed in an “opportunity cost” sense against alternative food choices. Soy and wheat, in our judgment, do not pass this test.

[Tom Naughton:] A balanced diet of mostly unprocessed food is exactly what he recommends. As for toxins, he’s quite clear that it’s a matter of “the dose makes the poison.” He describes safe starches as low-toxin foods, not no-toxin foods. So I think you’re more in agreement than not.

Paul: Thank you Tom. Exactly right.

[Harry again:] Yes, of course the dose makes the poison. My point exactly.

Paul’s view is that the dose should always be as low as possible. This is where we are getting into pure hypothetical territory. There is a possibility (one that is reasonable given what we know about hormesis) that a dose of certain toxins somewhat higher than the lowest possible is superior in terms of promoting good health (just as exposure to some bacteria is far better for the immune system than living in a sterile environment).

Paul: Again, a mis-statement of our views. We discuss many cases of toxic foods that we recommend eating. For example, on page 195 we discuss the case of a woman who nearly died from eating raw bok choy. We recommend cooking vegetables to reduce toxicity and eating a variety of vegetables, not the same vegetable every day, to reduce toxin dosage. We don’t say, “eat the lowest possible dose of bok choy,” rather, “eat bok choy in moderation prepared in a way that reduces toxicity.”

[Harry:] As I said, it would be wickedly difficult to determine the optimal levels of dietary toxins using the scientific method, but it is just conjecture to argue that since a high dose of toxicity is bad for health, the lowest possible dose should be recommended. This is a classic case where ‘common sense’ (a priori reasoning and induction) does not necessarily yield the truth…hence the need for empirical testing.

Paul: The same straw man again, we don’t make that argument. More empirical testing is desirable, yes, but we have to make decisions about what to eat on the evidence available now. Harry appears to favor the decision rule, “eat everything until empirical testing convicts it beyond a shadow of doubt,” but we prefer our rule, “weigh the evidence and avoid foods that appear to deliver an excess of harm over help.”

[Harry:] I guess I’m just over people running a contestable notion up the flagpole and passing it off as truth. The history of dietary advice is replete with such ideas, which while superficially attractive, turned out to be fruitless.”

[Tom:] Well, I personally like the idea of running a contestable notion up the flagpole. The passing it off as truth part is a different matter.

Paul: Well said Tom.

Forming contestable hypotheses and evaluating evidence pro and con in order to come to judgments of their truth is science. Many judgments are tentative and subject to later correction. Harry here comes perilously close to rejecting science per se on the ground that scientific judgments might later turn out to be have been mistaken.

On the other hand, if it is only duplicitous judgments and foundationless claims that Harry objects to, his objection does not apply to us. We show our reasoning and cite the evidence that supports our conclusions.

However, Harry’s concern may apply to himself. Is he certain he is not spreading foundationless claims about diet book authors on the Internet?

Thank You!

Thank you, Tom, and Fat Head readers for the opportunity to answer your questions. It’s been my pleasure!

Leave a comment ?

71 Comments.

  1. Great post! Q&A was very helpful.
    What has really been pressing for me is whether resistant starches help against candida or exacerbate it. I could have sworn that some of my candida symptoms flare up when I take resistant starches in the form of unmodified potato starch, but it’s very hard to pinpoint at the same time. If, say we don’t have a very good gut flora, is there a risk of feeding more of the candida than the good bacteria in your gut? Or perhaps I should try a different form of RS (not unmodified potato starch)?

  2. I liked the clarity of thought in your response to the critic.

  3. After reading Tom’s series on the Perfect Health Diet recently, I bought the book and started the plan. I’m not sure what caught my attention this time, because I’ve read about safe and resistant starches before, but dismissed those ideas as “not for me” and “my body just doesn’t tolerate any carbs at all.”

    So far I have stuck to the principles of the 8-hour feeding window/16-hour fast, safe starches in my diet every day (although I can’t say yet that I’m eating them with every meal), coconut oil with a little cream in my coffee every morning, more sources of probiotics every day, and walking more steps more consistently (up to about 6k) during early morning and midday hours. The results are remarkable, and I can already see a bigger difference in my shape than just the 7 lbs I lost in 10 days. My tummy looks much flatter this time.

    I was apprehensive to start this plan because I had been a died-in-the-wool VLC’er (almost zero carb) for the past 3 years. I had good success initially (lost 45 lbs), but then about a year ago I gained 20 lbs over time and stalled there. I was sure adding safe starches back into my diet would cause my weight to skyrocket and I was prepared to give up the diet in three days *when* that happened. Not if, but when. I can’t tell you how pleased I am that I was wrong! Last night for dinner I had (rice starch) macaroni and cheese with mushrooms and fried onions. What a treat that was!

    I know this comes off sounding a little like a paid endorsement, but really I’m just a very, *very* pleased PHD reader.

  4. I question some of your statements about low-carb dieting and diabetes. For example, ” Various pathologies, including hypoglycemic episodes, dysregulation of serum fatty acid levels, ketoacidosis, and adrenal dysfunction become more likely.”

    In my experience, my hypoglycaemic episodes vanished on a LCHF diet. In the literature, there are studies where extreme hypoglycaemia is asymptomatic in people who are keto-adapted. This makes sense when you consider that the brain that is fed on ketones would not care if glucose levels dropped.

    I’m not sure what you mean by dysregulation of serum FA but in Volek’s research, people on a LCHF diet performed much better than controls in clearing post-prandial lipemia after oral fat loading.

    Ketoacidosis on LCHF is extremely rare in T2DM. I believe there is only one case report in the literature. This makes sense when you consider that it occurs when glucose is very high in the absence of insulin. Since hyperinsulinemia is hallmark of T2DM, and even with an advanced state of pancreatic dysfunction, there is still some beta cell capacity in T2DM, and that glucose is usually lowered when carbs are restricted, it is hard to understand how a LCHF diet would lead to ketoacidosis.

    With respect to adrenal dysfunction, again I am not clear on what you mean. If it is the one study that showed increased cortisol with LCHF, there were significant problems with the methodology there to the extent that one cannot conclude that a person who is adapted to a proper LCHF diet would experience high cortisol.

    In my experience, a person with T2DM needs to minimize CHO. Gannon and Nuttall did show big improvements in HbA1c with 30% CHO, however there was an even greater improvement on 20%. In fact, they showed a linear dose-response effect with diminishing CHO. As far as I know, they did not test at the 10% level but why would you assume that the trend would not continue?

    • This is typical misinformation being perpeturated by those who low carb. What’s perceived as hypoglycemia is not hypoglycemia if not confimed by BG readings. How did you in fact confirm that you or other low-carbers are hypoglycemic? Did you check with your meter? What you call hypoglycemia or symptoms of hypoglycemia is in fact hormonal dysregulation, most likely brought about by your low-carbing. Given enough time, VLCing and CHO intake at 10-20% could dysregulate cortisol. What will then happen is your cortisol upping your FBG while creating apparent symptoms of hypoglycemia, mimicking physiological insulin resistance. In fact, what passes for PIR is probably due to deepening hormonal dysfunction.

      At least you’re not claiming “reactive hypoglycemia,” which is a face-in-the-palm diagnosis by those who low carb. Btw, hyperinsulinemia is not necessarily a hallmark of T2DM, especially in advanced state of pancreating dysfunction. Hyperinsulinemia is a hallmark of prediabetes and early to mid stage T2DM; hypoinsulinemia takes over and your fasting insulin, if you low carb, will make you think you’re in ketogenic heaven, when in fact, you’re fast approaching a state of insulin deficiency. Happens all the time in the 3rd world, where most T2 diabetics are discovered insulin deficient, not insulin resistant.

      • Zorro, you appear to be confused. My profound hypoglycaemic episodes occurred prior to my diagnosis and disappeared after starting a low-carb diet and have never returned. I’m eleven years out, now, and continue to do well without meds. I am an MD and use this approach with my pre-diabetic and diabetic patients and nobody has developed hormonal dysfunction. Early studies demonstrated that even profound hypoglycaemia can be asymptomatic after keto-adapatation as the brain is no longer relying on glucose. Hyperinsulinemia is a hall mark of pre-diabetes and T2DM. Insulin deficiency can occur later in T2DM if you persist in eating a CHO rich diet. It is unlikely to occur on a low-carb diet as the demand for insulin is markedly reduced. AFAIK there has not been a human study to demonstrate the preventative effect of low CHO although there has been one murine study to date.

        • Jay, the reason why you’re confused is you subscribe to the shopworn theory of hyperglycemia => beta cell dysfunction => insulin dependence. Diabetes is not in fact caused by a high-carb diet or hyperglycemia. I don’t think even you’ll claim that. Hyperglycemia causes diabetic complications but is not the pathogenic driver of diabetes; it’s a symptom, not the reason for the disease. This is why a low-carb/ketogenic approach is inherently flawed for T2DM. I’ve yet to see a single person become insulin sensitive on such a diet; in fact, most people experience worsening BG homeostasis, not because of beta cell destruction caused by hyperglycemia but due to hormonal dysregulation and worsening intestinal gluconeogenesis. In fact, plenty of T2 diabetic on VLC diets end up on insulin precisely for that reason. The mistake you are making is attributing insulin deficiency to hyperglycemic beta cell dysfunction, when it’s been proven that’s not what’s happening. In fact, the worse outcome for your patients will be hormonal and immune dysfunction after being on a starvation diet that you propose. All of the low-carb doctors who treat diabetic patients have massive incidence of hormonal and immune dysfunction and I suspect you’re no exception. If you are, then, you probably don’t know how to diagnose hormonal and immunodeficiency.

  5. Another great article, Paul. Love to hear about your retreats too! Should you ever need a Stand Up Paddle Instructor and some stand up paddle beginner classes on a calm body of water near the retreat, let me know. I would love to be a part of the retreat and help out, by encouraging stress relieving exercise like Stand up paddling!

  6. Hi Paul,
    Random question for you that I’ve been wondering about: When I eat asparagus I typically shave the outer green layer of “skin” in order to make the asparagus easier to chew. Does peeling that outer layer of the asparagus’ skin throw away a lot of the nutrients or are most of them inside the asparagus as opposed to being stored in the skin? Thanks Paul!

  7. Nothing in biology makes sense except in light of evolution.” —This statement may be true scientifically, but it is surely false, when interpreted philosophically. (Science and philosophy are constantly being confused with one another.)

    The Aristotelian philosophical framework for understanding living things, namely, as beings that embody intrinsically functional anatomical systems which can flourish or not relative to the acquisition of the species-normal goods defined for that species, is prior to and more basic than any conceptual framework which arose post-Darwin. And the post-Darwinian concepts do not displace or replace or eliminate any of the Aristotelian ones that are truly basic and foundational in our understanding of the concept of life. The Darwinian notion of an adaptation, for example, is nearly impossible to assimilate within an Aristotelian philosophical framework for the understanding of biological phenomena; but this only means that the concept of an adaptation is a specialized technical concept, which ultimately shouldn’t be regarded as philosophically basic in the philosophical understanding of living things.

    There is no such thing as the “science of health”. There is, however, an applied science, called “health”. An applied science is the rational, thoughtful and informed application of scientific knowledge in light of some goal or purpose; and given that applied science involves the application of knowledge to the lives of persons (who are “ends in themselves”), it is constrained by the Kantian moral law. To apply knowledge for a practical purpose requires judgment. And so, an applied science essentially consists of “opinion” in a non-pejorative sense. (Think of the sense of “opinion” relevant to the notion of “legal opinion”.) Given that applied science applies the science in light of some goal or purpose, purposes, which, as Aristotle said, “aim at some good”, it is important that the applier of the science has a sense of the hierarchy of goods in life: namely, a sense of what goods take priority over others, and a sense of which goods are intrinsic and which are merely “means to ends”. (In acquiring this sense of hierarchical perspective, one may benefit from philosophical reflection on Aristotelian and Kantian ethics.)

    Opinion in a pejorative sense, i.e., assertion that is not based on evidence or understanding, has no place in either science or in philosophy. And so, Jaminet is surely correct that one should not express “opinions” about matters of science. However, whether one is free to express “opinions” about the application of a science, in the context of an applied science, is a different matter. In applied science, we should listen to people who (a) know the science and (b) have good judgment. But having good judgment requires, according to Aristotle, an aristocratic upbringing, sufficient life experience, and a sense of the hierarchy of goods; and we might add that it also requires perspective, philosophical clarity regarding what is what, objectivity, self-discipline and a willingness to further cultivate this faculty in adulthood.

    Consider what Wittgenstein has to say about the concept of “opinion” in the context of philosophy.

    “One of the greatest difficulties I find in explaining what I mean is this: You are inclined to put our difference in one way, as a difference of opinion. But I am not trying to persuade you to change your opinion. I am only trying to recommend a certain sort of investigation. If there is an opinion involved, my only opinion is that this sort of investigation is immensely important, and very much against the grain of some of you. If in these lectures I express any other opinion, I am making a fool of myself.” (Lectures on the Foundations of Mathematics)

    “Philosophy simply puts everything before us, and neither explains nor deduces anything.—Since everything lies open to view there is nothing to explain. For what is hidden, for example, is of no interest to us.” (Philosophical Investigations)

    “If one tried to advance these in philosophy, it would never be possible to debate them, because everyone would agree to them.” (Philosophical Investigations)

    • Correction: “If one tried to advance theses in philosophy, it would never be possible to debate them, because everyone would agree to them.” (Philosophical Investigations)

      Also, to clarity: it’s not that the Darwinian notion of an adaptation can’t find a place within an Aristotelian framework philosophical framework for the biological; it’s only that such a notion must be situated at the right level, in the order of understanding. In other words, it can’t be the first concept we invoke in a philosophical account of the nature of living things. It’s rather a concept that is pertinent to the understanding of living things when considered, scientifically, in light of the phenomenon of something’s having an evolutionary history. But the notions of “adaptation” and “natural selection” already presuppose for their intelligibility, conceptually speaking, the more basic Aristotelian concepts.

  8. How do I sign up for your newsletter? Thanks.

  9. Charles Nankin

    This is awesome stuff guys thank you. Some thoughts:

    1. For me I have always gotten a real kick out of combining foods – in the same meal, in the same bite! I sense that after taking a bite of one food, my taste-sense then would prefer a bit of one of the other foods on the plate.

    This seems kind of like a natural desire that is geared toward food combining, the importance of which you talk about. I like the idea of those Middle Eastern meals where you have a whole lot of small plates of different foods.

    Here in Brazil you often have fruit with your steak meal! Try combining a slice of picanha, with its soft edible fat layer, with a slice of pineapple/strawberry/orange etc. I love it.

    Also, surely before picking up that quick fruit snack as you run out the door, it would be better to eat it with some cream to slow it down? And delish too.

    2. Protein intake? OK how about this for a natural regulating system: I have always thought that when I eat too much protein, my body produces excess waste, which produces a bit of an underarm odour. Thats one sign that I’m eating too much protein :/ hehe

    3. You mention that the natural response to activity is to increase caloric intake, and that without extra activity, an increase in carbs AND fat intake will create adipose matter… Is that totally accurate?

    Cheers,

  10. Thanks for answering my question! What a wealth of information this post is! I will be archiving it for future reference.

  11. Hi! I’ve read that fruits, melons and berries should be eaten separately from other products, because mixing them will cause cancer and other ailments. What do you think?

  12. Got to love “harry’s” objection to Paul’s use of ‘a priori reasoning and induction’, which is actually a pretty good summary of his entire argument.
    Does he realize that inductive reasoning is the basis of pretty much all the sciences? Nothing in science is 100% deducible except in mathematics.

  13. Diana Durnford

    Hi Paul,

    Does the 30% carb rule for candida apply also to other types of infections such as Lyme and its co-infections, chlamydia pneumonia, etc? Does it make a difference if you have multiple bacterial, fungal, and viral infections all at once?

    I see so many people struggling with this and your input would be invaluable.

    Thanks so much,

    Diana.

  14. Hi,
    I was on this site commenting a couple of months ago, but having a lot of issues, including odd infections. This finally got figured out as it turned out I had a very badly infected tooth that had to be extracted. My dentist said this was probably causing the other issues. So that got cleared up. At the time, my regular doctor also ran many blood tests and and other tests, and they were supposedly fine, no diabetes, normal liver and kidney function, etc. But now I have been having other issues. I am at my wit’s end trying to figure out what is wrong with me. I have always had terrible allergies, I was having allergy tests run when I was 7 years old. I have not always been good about following their advice, it’s hard sometimes with modern life, stress, etc. I had a blood allergy test done five years ago by a naturopath but nothing since. At that time, I was mild to moderately allergic to so many things, I just wanted to throw my hands in the air. My worst allergy was to gluten, but also milk, strawberries, corn, garlic, chocolate, etc.
    The past couple of months, I developed almost constant exhaustion plus headaches all the time and I’ve never been a headache type person.
    I am also working a very stressful job I hate and friends have suggested this could be part of the issue.
    I felt so dried out and head-ache-y, I first went off my antidepressant a couple of weeks ago as it does cause headaches. It helped a little, but not a lot. I am okay emotionally, just a bit more flat and I’m seeing my psychiatrist tomorrow.
    I then quit all caffeine, which helped a lot. The headaches have improved dramatically and my energy has improved some as well. But I still get them at times, woke up today with a pretty bad one.
    I’ve also had bad indigestion all weekend, having to use the restroom a lot. I am having strange reactions to foods as well. A few weekends ago, I had a small blizzard at Dairy Queen, immediately became exhausted and fell asleep for three hours. Today, I ate some Ben and Jerry’s frozen yogurt and also became exhausted and feel asleep for a couple of hours. I don’t seem to react the same to all sweets though, yesterday I had some gluten free cookies, gluten free biscuits with jam and a little 70 percent dark chocolate, and was fine. I also had Sprite one day last week with my sandwich at work and was okay. But come to think of it, we had ice cream at work one day and I was tired and crabby after having it. So I guess ice cream is out for me.
    I also have a shallow, dry, hacking cough that won’t go away and my eyes burn at night. I had an appointment to see my doctor this past week, but I take public transit and there was a mechanical issue with the train lines that day so couldn’t get to my appointment.
    I also struggle with whether to do PHD/paleo as I feel spiritually that I shouldn’t eat animals. I have read there are some PHD veggie people but I never could find info in the back of the book on this or on the site.
    Just wondering if Paul or anyone has any thoughts or ideas. I’m so frustrated. Thank you.

    • Hi Tom,

      I feel for you, I had a hidden tooth infection and a cracked tooth until I found a really good dentist who listened to me and poked around instead of relying on the x-ray, which didn’t show anything.

      First encouragement. don’t get hung up on a label like “paleo” or some notion that you have to eat tons of meat. Actually read the book and look at the food chart and you’ll find the meat component is not the large. There are PHD veggie people, but Paul has said that it’s hard to be well-nourished without eating eggs and dairy. If you can eat eggs and dairy you can see your way clear to eating bone broth and organ meats that will be helpful.

      For all your issues, they sound like what I would go through on a regular basis before PHD and frankly, I’d almost be willing to bet that you are just simply eating too much sugar and processed foods. It’s not sexy or anything, but PHD WILL help you if you follow all the recommendations and get the supplements (sugar cravings can be caused by micro-nutrient deficiencies).

      Your best bet is to just really follow the basic PHD diet for 3 -4 months, including managing your stress and circadian function.

      Don’t get into micro-focusing on each specific ailment or food reaction right now (unless it’s a really dangerous allergic reaction) as that will make you crazy and add to your stress. It takes several months for the body to heal itself of gut issues or recover from micronutrient deficiency.

      After a few months of following PHD you might find all your symptoms are gone, or any remaining ones will be very clear and you can come back here with really specific questions or go to your doctor.

      I guess the short answer is, it’s a process, be patient and do the diet.

      Good luck!

    • Allergies could be a sign that you have histamine intolerance. Dairy is a common trigger. Cutting out sweets will help too.

  15. Hey Paul,

    I came across this article recently and I thought it might be of interest to you regarding the treatment of bacterial infections (this experiment was done on staph). Niacin helps clear the infection:

    http://www.jci.org/articles/view/62070?search%5Barticle_text%5D=vitamin+b3&search%5Bauthors_text%5D=

    Annie

  16. Tom,
    I would try the GAPS diet if I were you. It is for healing gut problems that result in widespread allergies.
    -Annie

  17. Thanks Elizabeth and Annie for the responses, I’m going to look at GAPS for sure. My therapist also seems to think I am having some type of detox, clean out reaction from a serious infection being removed from my body.

  18. Excellent article, Paul. 🙂 I like how you differentiate between the different types of bodily mass. Excellent detail.

    It is very important for the Blogosphere to understand that most scientific ideas are wrong. Most experiments are wrong, too. ( the first time they are done). This is not taught often enough.

    Take care,
    Raz

  19. Hi, I was wondering if anyone can let me know how you get a pound of starches, a pound of sugary veggies and fruit, plus another pound of the other veggies.

    I’ve been eating more starches and fruit after 2 years of lower carb. Not very low carb but about 60-80 total. This past week I’ve been near 150 from safe starches and a serving of fruit a day but it’s nowhere near 2 lbs. Today was/will be 5 oz boiled potato, 6 oz plantain, 7 oz apple, 4 oz tomato, 3 oz onion, and 2 oz carrots and I’m at 147g carbs from starches and sugar veggies. I’m not counting salad veggies as per the book.

    If I add extra starches I’ll go over 150 grams of carbs. Am I doing something wrong? BTW, I was hesitant to add starches but feel fine, lots of energy, no sweet cravings, and lost 3 lbs! My chronically dry lips were soft again within 2 days. And I’ve been Paleo for 2 1/2 years just without regular starches. Amazing!

    If I could just tweak the amounts and figure out how to get to the pound of starches without going over on carbs that’d be great.

  20. In explaining why there is no such thing as the “science of health”, perhaps it will help to provide a comparison with the somewhat different case of “cognitive neuroscience”.

    There is no such self-standing science as “cognitive neuroscience”; the contemporary notion that there is is nonsensical; what there is is neuroscience, on the one hand, and traditional psychology, on the other. There is then a project in which people correlate neuroscientific structures and processes with the exercise and possession of psychological capacities on the part of human beings. This project is called “cognitive neuroscience”, but it is not a separate self-standing science; it is really the act of linking up of the results of two different legitimate sciences—namely, neuroscience, which is a natural science, and, traditional psychology, which is not a natural science, but is, primarily, a human science and, secondarily, a science of the animal psyche.

    But in the case of the study “health”, which is an applied science, you have a combination of biology, chemistry, anthropology, psychology, and, then, in turn, the formation of reasoned opinion in the application of this knowledge to a person’s life, which in turn presupposes an understanding of ethics in both the Aristotelian and the Kantian sense (and ethics is not a science at all). In the Aristotelian sense, ethics is a theory of human flourishing, where the human is regarded as a Rational and Political animal. In the Kantian sense, ethics is the account of what it means to be a person in the context of other persons, where a person is defined as the being who is responsible for the care of its soul, where the soul is understood, not in a Christian or in an Aristotelian sense, but in a Socratic sense and signifies one’s personal integrity, the sense of obligation towards “the true” and “the truth”.

    Jaminet’s book should primarily be regarded as a treatise in anatomy and physiology (both being branches of biology) with some conjectures regarding the correlation between these biological findings and human health. Anatomical flourishing can be the object of natural science, but human health is not an object of natural science.

    And the two are not even “for all practical purposes” equivalent. For example, someone whose body exists in a state of anatomical flourishing but who obsesses about food their whole life is not regarded as a “picture of health”.

    • When one learns how to run properly, the distinction between cardio and resistance training starts to vanish. Good and safe running is extremely demanding in a muscular sense. If one wants to avoid injury to the lower leg when running, one must learn to use one’s muscles (glutes and hamstrings), while maintaining anatomically natural posture (see Foundation Training), and while maintaining an extremely fast cadence. One must also learn how to relax (one’s wrists, shoulder blades and ankles). One must learn to feel the subtle and gradual transition in the total bodily formation (and angle with respect to the ground) that occurs in jogging to sprinting. It is a fundamental mistake to “voluntarily lean forward at the ankles”. Jogging is wholly upright. Sprinting is slightly angled, but the change in bodily formation is a wholly involuntary phenomenon that arises due to sheer physical forces, forces that can only be safely managed with the proper muscular cycle, posture, relaxation, and cadence. One has no control over one’s running; one only has the option of managing (coping with) or not managing (not coping with) the forces in a way that is safe. (See the work of Lee Saxby)

      Theories of barefoot running are subject to philosophical confusion just like anything else in the theoretical realm. The fundamental philosophical misunderstanding is to confuse the discussion of the human being with the discussion of the anatomy of the human being and in turn with the discussion of the human being qua mere physical body (in the sense of a body, qua projectile, in physics). Thus we say things like “lean forward at the ankles” or “land on the ball of the foot” or “land as quietly as possible”; this makes it sound like we are advising the human being to do something, when it fact this is an anatomical description of something that happens to the body qua physical projectile when subject to forces given an initial anatomical formation. All one can advise the human being to do is to utilize a technique that allows one to safely cope with the physical behavior of the body qua physical projectile.

      • Also, to avoid injury, one needs to feel the heel and big toe fully engage with the ground, as the foot travels behind the body, while also maintaining stable and upright posture.

        • The single best exercise in preparation for running is pogo jumping, done with proper form. Stand with perfect posture (see Foundation Training), with feet together; hop up and down with a fast rhythmic cadence; allow ankles to fully relax, allowing full use the big toe and heel-ground-contact, allowing the inside of the knees to close inwards toward one another. Do this until it becomes automated; then go run!

          • The posture of the figure in the illustration below is poor. Moreover, the term “knee drive” does not properly describe the instinctive muscular action of the hip, during the retraction phase. When running well, what we reflexively engage in is more of a momentary forward swing from the hip (but hardly an “upwards drive”).

            http://www.nytimes.com/imagepages/2011/11/06/magazine/06running-vertical.html?ref=magazine

            In any case, the best way to get everything aligned and sufficiently relaxed and flexible is pogo-jumping.

            To run, instinctually employ a forward swing from the hip (not a “knee drive”), but land as you would when skillfully pogo-jumping in a wholly relaxed state, with the same sort of alignment.

          • The only shoe I’ve found that allows me to know with a reasonable level of confidence that I might have the opportunity to practice sound running technique is the Moc-3 from Soft Star—but with the insert removed. Luna Sandals are also fun to wear but create more interference. As for the other products I’ve tried, I find they nearly make it impossible to practice running.

          • http://runblogger.com/images/2010/08/on-running-form-ii-where-should-footstrike-occur-11.jpg

            The runner on the left has perfect running form.
            This is achieved from good posture, a very strong back, and relaxation (of ankles, arms, wrists)—(knees and hips relax immediately after foot leaves the ground).

            With proper posture, back strength, timed relaxation, and plyometric springiness (as in pogo jumping), the following is a description of what happens naturally.

            1. There is a landing on the outer part of the ball of foot slightly out in front of the body.
            2. The ankle is completely relaxed, at all times, and the foot begins to rotate underneath the body. (This ensures the whole of the foot eventually makes contact.)
            3. During the contact with the ground, the glutes apply pressure to the ground in stabilization and the body springs off the ground via the springiness of the tendons.
            4. The upper torso is pulled backwards AT ALL TIMES (as taught in Foundation Training) and there is a J curve at the bottom of the spine. This is the single most important point. Any sacrifice to posture, especially of the upper torso, will result in everything else falling to pieces.
            5. After the foot leaves the ground behind the body, the knee relaxes, allowing the leg to fold.
            6. The hip area is also relaxed allowing for maximal stride length.
            7. There is a natural cadence that is facilitated through a rhythm, naturally brought about from the combination of relaxation and springiness, and consists of 180 touchdowns per minute.

            Running should be effortless, springy and relaxed, even at high speeds. But it requires a strong back and a proper understanding of posture.

          • 8. Importantly, one subtly teeters in a punctuated manner, side to side. But this does not disrupt the cadence nor does it affect the relaxation of the ankles. This very slight punctuated side to side movement increases the power of running and reinforces the cadence.

          • Perhaps “teetering” is misleading and wrong; what is true is that one allows oneself to stand fully on each foot, so to speak, but in a punctuated rhythmic manner, with arms, relaxed, and moving in perfect sync with the rhythm.

            Running should be injury free, even at very long distances; and yet the motions of running are not, in any intuitive sense, “gentle”.

          • One dances or bounces on top of the glutes. The glutes are the muscle that absorbs the impact of landing and this bounce causes one to spring forward. The glutes are the only muscle that should be sore after running.

            One does not actively use any muscles when running; one merely allows the glutes to absorb the impact. There is a fast cadence which comes from the bounce of the glutes and subsequent relaxation. This impact absorbed by the glutes and the resulting bounce, which is facilitated by vertical posture and relaxed ankles, is what propels one forward.

          • What is indicated in the “100 up” is in fact a mere involuntary response, a reflex. This was not appreciated due to categorial confusion regarding the distinction between the biological mode and the human mode, and so a mere anatomical event which occurs mechanically as a by-product of correct form was interpreted, instead, as a human action that one was supposed to deliberately bring about.

            One (a) absorbs everything in the glutes and (b) releases; there is then a (c) forward jolt of the thigh at the hip, i.e., the “100 up”, which is purely reflexive. Ankles are relaxed at all times. There is a 180 cadence. Posture is vertical (in the manner of Foundation Training). Head is relaxed. That’s it.

          • One final remark: one must relax one’s neck, allowing one’s head to tilt back slightly. If this does not occur, the head does not properly weight the rest of the body.

    • There are two commonplace assumptions, grounded in conceptual confusions, which shed light on why we are inclined to assume that cognitive neuroscience is a self-standing science. (1) We have a tendency to collapse the conceptual distinction between the mind of a human being (i.e., the volitional, cognitive and cogitative capacities of the human animal), on the one hand, with the brain (which is the physiological prerequisite of a person’s having a mind), on the other. Or, (2) we assume (incoherently) that the mind is a computer program and the brain is a computer, and then further assume (incoherently) that computer-science has application to the natural world (i.e., to the brain) and/or to the nature of human psychology (the mind). In fact, computer science is the study of something squarely in the artifactual and mathematical realm and has absolutely no coherent application to anything either in psychology or in neuroscience.

      Similarly, the reason why we assume that “human health” could be a pure (and non-applied) science is because we collapse the conceptual distinctions between the human, animal and vegetal conceptual modes, and/or we collapse the conceptual distinction between the human being and the brain-body out of which the human being is biologically constituted. The health of a human being regarded purely in terms of the conceptual mode of the vegetal is not the same thing as the health of a human being as such (i.e., man qua healthy plant (e.g., man qua flourishing anatomical system) is not the same thing as man qua healthy man). Similarly, the health of a human being regarded purely in terms of the conceptual mode of the animal is not the same thing as the health of a human being as such (i.e., man qua healthy animal (e.g., man qua coordinated gymnast) is not the same thing as man qua healthy man).

    • Perhaps it was misleading to say that in running “cardio and strength collapse into one another”; what I mean though is that one needn’t exert oneself too much in a cardiovascular sense in running, even at high speeds, so long as one is totally relaxed, in the ways I’ve described above, and so long as one allows one’s glutes to fire at just the right time.

      Allow the hip area to extend to the maximal stride length, while maintaining vertical posture and a 180 cadence, to provide for the longest possible stride. One’s running should be as visually graceful as possible in an esthetic sense. Running is and must be high art.

      It is best to run in a totally relaxed, effortless and euphoric state.

  21. Hi Paul can you please comment on the differences of IF on women and man? Sarah Ballantyne, Stefany Ruper and Dave Asper all have posts claiming that IF is not so good for women because it harms the adrenals. Is it true?

    http://www.paleoforwomen.com/shattering-the-myth-of-fasting-for-women-a-review-of-female-specific-responses-to-fasting-in-the-literature/

    http://www.bulletproofexec.com/a-bad-combination-for-women-intermittent-fasting-and-paleo/

    • Paul’s concept of IF is quite different from most others that I’ve read about. A PHD IF can include beef or chicken broth with low-carb veggies (I usually have it with spinach, mushrooms, etc…)as well as modest amounts of other low carb foods. He also mentions that some people will need small amounts of protein as well. The book discusses the origin of his ideas on IF, including many cultures with healthy populations that routinely eat very lightly (low calorie) for much of the day, especially mornings, and then eat several meals later in the day (within a generally restricted window)

      • Thanks Hillary. Fasts should be calorie free or close to it, but a fast can (and should) contain calorie-free flavorful beverages like coffee or tea. The point of the soup (made from bones stock) with vegetables and salt is that the biggest stress during a fast (and during starvation) comes from dehydration or electrolyte deficiencies, so getting water, salt, potassium from vegetables, calcium and a bit of magnesium from the bones alleviates stress. If the soup has a few calories, that can be made up for by extending the fast 10-20 minutes. The next greatest stressor is lack of protein so the first meal should include protein.

    • Hi Maria,

      Fasting can be stressful for anyone, but one of the sources of stress – low bodily protein – is the source of its benefits. The other main stress, electrolyte deficiencies or dehydration, you can address with a bone-stock soup containing vegetables and salt.

      In the literature, what really makes IF harmful for women is chronic undereating. Men for some reason don’t tend to undereat, but women are prone to it, especially when doing IF. It is very important to eat just as much food in the IF feeding window as you would normally eat in a full day. If women eat enough food, they have no trouble fasting for 16 hours. Even in cases of adrenal insufficiency, if they tend to electrolytes they should do OK.

      • It is often recommended to eat high protein meal within first half hour of waking for purposes of restoring circadian rhythms, leptin sensistivity and adrenal health. So in your opinion Paul, fasting would not be detrimental in achieving these goals?

  22. Hi Paul…I am someone who is currently “stuck” on a very low carb after doing ketosis for a while. I’m not sure how to start increasing my carb intake in a way that minimizes reactions. I have lots of food allergies including histamine intolerance – possibly all caused by leaky gut, I’m not sure. My immune system seems hyper reactive to everything. I initially suspected SIBO but a breath test came back negative.
    I tried eating some sheeps yogurt the other day which caused me a horrendous reaction that I’m still recovering from.

    Perhaps the potato starch might be the best way to start?

  23. Charles Nankin

    this whole IF and delaying-carbs-in-the-day thing clicked for me when I saw Paul on the one hand and John Kiefer of Carb Backloading on the other – two very serious people but in different communities – saying very similar things about it.

    is it a coincidence that they’re both physicists?!

    and re carbs: it seems very difficult and unnatural to eat VLC, when you look at the foods in nature and food availability and taste sense.

  24. Charles Nankin

    this whole IF and delaying-carbs-in-the-day thing clicked for me when I saw Paul on the one hand and John Kiefer of Carb Backloading on the other – two very serious people but in different communities – saying very similar things about it.

    is it a coincidence that they’re both physicists?!

    and re carbs: it seems very difficult and unnatural to eat VLC permanently, when you look at the foods in nature and food availability and taste sense.

  25. I have always liked Tom Naughton. He is a good dude. I like how he presents his material .

    • Kierkegaard on Socrates

      “Though Socrates is called a popular philosopher….he is, was and will remain essentially unpopular. How many have grasped him….?….the heroic too, in essence, will remain equally unpopular in each generation. The heroic has relation to every individual, singly, every individual could become a hero. Heroism has no relation to the difference between one man and another (genius, artist, poet, noble, etc.) no, heroism means being a virtuoso in “the universally human.” Heroism means to be great in what every individual could be great in.”

      “Calling Socrates a genius is very stupid; if he had been a genius he would not have related himself to “the universally human” (i.e. to each human being), but would have placed himself outside it; however, then he would not have been a gadfly.”

      “Why did Socrates compare himself to a gadfly?
      Because he only wished his influence to be ethical. He did not want to be an admired genius, standing apart from the rest, whereby he actually would have made life easier for them, as they would say: “Yes, it’s all very fine for him, he is a genius.” No, he merely did what every human being can do; he comprehended what every human being can comprehend. Therein lies the epigrammatic. He grabbed hold of the individual and worried him, ceaselessly compelling and teasing him with this ordinary, universally human stuff. That made him a gadfly stirring up a person’s passion, and he did not permit that person indolently and effeminately to admire and go on admiring, but claimed his very soul. When a human being possess ethical strength, people like to elevate him into a genius, just to be rid of him; for his life constitutes a claim, a demand, on them.”

  26. Hi, Paul. I have many questions for you, but only time for a brief one at this point. You and I have exchanged emails several times a couple of years ago as I fought coming back from LC/VLC and the inability to tolerate carbs despite many attempts. Battling thyroid and adrenal issues, (originating in pre-LC days, it appears) nightshift worker, the whole laundry list of strikes against me. Now trying to continue my low to moderate carb woe but prime my gut with probiotics, prebiotics and RS for a while and then to continue to attempt a comeback and develop the ability to tolerate and enjoy safe starches. I saw that you advised a poster not to use tapioca starch in water. That’s what I’ve been using, it seems to agree with me more than PS, but I am combining it with psyllium husk powder, an emptied probiotic capsule, and, at times, a little bit of coconut flour. (inulin!) Is this a bad idea?? The LAST thing I need to do is harm myself even more! I’ve been devouring info from your site, FTA, Animal Pharm, and the contributions of Tatertot, etc. I am beyond grateful to you all. Hoping I’ve finally, finally found something that may pull me out of this damn drain I’ve now circled for years. Daytime work is out of the question for at least one more year, so although I know that’s probably THE most important variable, it’s also the one that I am unable to budge just yet.

    • Hi Jen,

      Supplementing fiber is fine and often therapeutic, but I think it’s best to transition to a natural whole foods approach. You can eat a fiber-rich diet without flour and supplements.

      Glad you are making progress! Keep me posted.

      Best, Paul

  27. Hi Jen, can you describe the symptoms you experienced after going from vlc/lc to moderate carb? Did you had reactive hypoglycemia? How many grams of carbs were you eating before and for how long? I’m not a doctor I’m just asking because I am facing the same issues as you apparently, and would like to know more details. Hopefully Paul will ser this and help you.

  28. Gary Taubes is making a reference to the work of the early Wittgenstein when he says that the energy balance theory of weight gain is “nonsensical”. What he means is that this “theory” is a mere tautology.

    To be exact, however, Wittgenstein makes a distinction between a sentence that is literally “nonsensical” versus a sentence “without sense”. A tautology is “without sense” but it is not nonsensical. A nonsensical sentence contains one or more words that lack meaning. By contrast, a tautology is “without sense” because it fails to present any claim about how things are; i.e., a claim that could be true or false, depending upon how things are in the world.

    To say that “the body fattens because more fat is stored than burned” is not “nonsensical” but it is “without sense”, because it is a tautology and thus fails to stake a claim, that could be true or false, about how things are. This is because what “fattening” is IS just storing more fat than is burned. The proposition has the form of an explanation, but upon closer examination it says nothing at all. If anything, it is a loose way of stating the definition of “to fatten”. It is what John Locke calls a “trifling truth”.

    4.461 The proposition shows what it says, the tautology and the contradiction that they say nothing. The tautology has no truth-conditions, for it is unconditionally true; and the contradiction is on no condition true. Tautology and contradiction are without sense. (Like the point from which two arrows go out in opposite directions.) (I know, e.g. nothing about the weather, when I know that it rains or does not rain.)
    4.4611 Tautology and contradiction are, however, not nonsensical ; they are part of the symbolism, in the same way that “o” is part of the symbolism of Arithmetic.
    4.462 Tautology and contradiction are not pictures of the reality. They present no possible state of affairs. For the one allows every possible state of affairs, the other none.
    (Ludwig Wittgenstein. Tractatus Logico-Philosophicus)

    The question remains then, why does the body fatten? Is it because a person, due to circumstance or some psychological reason, eats more food than the body needs for normal functioning? That doesn’t seem likely, since some people have a very difficult time gaining much weight no matter how much they eat. The explanation would seem to turn, rather, on how the body uses the food that has been consumed; it comes down to whether the body is disposed to use the food to fatten the fat tissue or not. But then the question is—what leads one to have a body that is biologically disposed to fatten itself upon receiving food?—It seems unlikely that one could control this bodily-disposition by eating some kinds of foods and not others, e.g., carbs versus fat. For, some cultures eat carbs and others eat fat and there is little difference in body composition.

    Thus, it seems more likely that this bodily-disposition or lack thereof is a mere function of having a healthy body; and thus this disposition is indirectly (via the way diet influences health), not directly, related to the foods one eats.

    • On the use of mechanical analogies and metaphors in the theory of biological flourishing:

      Pace Descartes, humans are not machines; and moreover, although the analogy between biological systems, which embody intrinsic design, on the one hand, and extrinsically designed, mechanical artifacts, on the other, can be helpful, it is only helpful up to a point; and after that point, the analogy can become quite misleading and in numerous ways; (consider, e.g., what Gary Taubes has said about the misuse and misleading influence of “energy in/energy out” mechanical metaphors in the context of human biological body-fat regulation; either such metaphors lead to literal senselessness (in a Wittgensteinian sense) or they lead one to adopt a wrong and all too simple biological picture of the phenomenon (in which the biological system is not regarded as sufficiently dynamic, sensitive or systemically integrated); and this primitive biological picture in turn encourages the adoption of what is in fact a bogus psychological theory—namely, that we are psychologically disposed to want more energy than we are capable of using).

      A “machine” is fueled, has plenty of fuel, is low on fuel, runs out of fuel. The parts of a “machine” are or are not damaged by sufficient or insufficient lubrication with oil. A “cell” takes in nutrients and expels waste. A “human being” (i.e., Rational animal) eats meals that are balanced or not balanced, gourmet or not gourmet.

      Treating meals as though they were conceptually analogous to fuel or coolants or lubricating-oil leads to characteristic degenerate behaviors. The consumption of large amounts of macro or micro nutrients in isolation, e.g., is a conceptually confused and scientistic behavior that is encouraged by a mechanistic or mechanical understanding of human biology. It’s as though one thought “If a bathtub is overfilled, the water safely leaves via the bathtub overflow, without any flooding. Similarly….”

      A biological organism, which by its very nature exhibits intrinsic design, is analogous to an extrinsically designed machine; however, machines are not the sorts of things that are born or die. Machines can function well or badly, but they do not flourish or perish. Some machines can replicate themselves; but they do not give birth. Computers, which are a unique kind of machine, i.e., the machines that manipulate symbols—where such symbols are conventionally and arbitrarily coded as voltage ranges—cannot coherently have a psyche either in the animal (sentience) or the uniquely human sense (sapience).

      • The focus on “fitness” in the “evolutionary health community” rests on conceptual confusion.

        Fitness is an explicit goal of some humans, and it is not a goal that ranks among the highest ends of rational animals. So, why does this community frequently regard fitness as an end in itself, valued for its own sake?

        It’s as if we reasoned thus: “the natural selector” has designed us to be optimally “fit”; therefore we must not disobey the natural selector by squandering the potentially fit body-machine that it has designed for us. For, we say, our bodies are supposed to be fit, since that how the selector has designed them to be.

        But fitness in biology has nothing to do with fitness in an everyday sense. Fitness in an everyday sense is a quality of some human beings: it signifies strength, endurance, etc. By contrast, fitness in a biological sense is the statistical likelihood of genes passing through the arbitrary and meaningless hoop of survival-to-reproduction (I say arbitrary and meaningless because survival-to-reproduction is not an intrinsic goal of anything in nature: and the only time it becomes an explicit and extrinsic goal is in the context of human environmentalist work).

        Since we have not been literally designed by natural selection (which is a pure metaphor behind which lies a meaningless mechanism of genetic transfer limited by an arbitrary and meaningless constraint), and since we are not artefacts (i.e., designed-things) at all, but are living organisms, we have no obligation (as might be indicated by the blueprint of our designer) to pass through the utterly bizarre hoop of survival-to-reproduction, nor do we have any obligation to be physically fit, in the ordinary sense.

        If we want anatomical health, i.e., vegetal flourishing, then we should follow the advice outlined in the treatise called the Perfect Health Diet, which constitutes an historically important contribution to the understanding of vegetal flourishing. And as that text indicates, if one wants vegetal health, fitness is even counterproductive.

        If optimal vegetal flourishing is the goal, there needs to by some stress in the form of physical activity but not too much, and it must be done in just the right way and at just the right time. And its effect on circadian rhythms probably accounts for the vast majority of its instrumentally beneficial effects.

  29. Jogging is great for weight loss.

    And your work is realy great considering that you write long articles and also interesting articles. And it is amazing how much love you put in it.

  30. Anonymous - pingback on August 29, 2014 at 4:08 pm
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    Thanks Ber

  32. I am in need of some serious help. After getting ill over 5 years ago, I find myself on a more and more limited diet. I’ve tried every diet out there from paleo to AIP to Jack Kruse’s super low carb leptin reset. I’ll find a bit of improvement, but then get worse and worse.

    I’m at the point now where I react to everything – oxalates, salicylates, histamine, etc, etc. I have been eating super low carb for over 2 years now with mostly fat and protein and a little avocado here and there. I tried adding in some carbs a few months ago and felt fantastic – white rice, cabbage, dark chocolate, etc. It was great for about 2 weeks and then I crashed HARD again. I desperately feel like I need the carbs to help me gain much needed weight, give me energy and clear my foggy head, but I just don’t tolerate anything! It seems like every time I try to add a new food I just burn up uncontrollably. I can’t regulate my body temperature at all and my neck and face – pretty much my whole upper body feels like it’s on fire even when I’m in a 60-degree room!

    Can anyone offer me any guidance or resources to turn to? I’ve talked to so many doctors, nutritionists, etc. No one has been able to help and I’m going out of my mind. I’ve lost 40 lbs and at 5’6″ I’m down to 93 lbs. I’m terrified. Any help would be so appreciated!!

    • Hi BJ,

      I’d suggest joining our Facebook group, https://www.facebook.com/groups/perfecthealthdiet/, and posing your problem there. This is not something that can be addressed overnight or in a single comment, but try sticking as close to PHD as you can. You need to get well nourished first of all. Then you can work on clearing whatever infections and autoimmune/sensitivities you have.

      Best, Paul

      • Thanks very much Paul. I will join the FB group. I am trying to stick to the diet the best I can, but even safe starches are causing me to just overheat in a ridiculous way!

  33. What do you think of feeding/adding ‘good’ gut bacteria during the day (breakfast and lunch) by consuming prebiotics and probiotics and then starving/killing bad bacteria at night by consuming no prebiotics or probiotics as well as taking an antimicrobial like oil of oregano?

    The idea would be to cyclically advantage the ‘good’ bacteria and disadvantage the ‘bad’ bacteria so that, over time, the ‘good’ bacteria would more successfully colonize the gut.

    • I am skeptical about the value of oil of oregano at night. Its antimicrobial action is not specific to bad bacteria, and in general taking calories at night is harmful. Just the fast should be good at clearing microbes from the small intestine. Vinegar might be more valuable than oil of oregano. … Prebiotic and probiotics during the day are fine.

      • Right, Paul, but since oil of oregano’s antimicrobial action is not specific to bad bacteria (just as prebiotics do not just feed good bacteria), I am thinking that a cycle of feeding/adding for breakfast and lunch and starving/killing for dinner (meaning no fiber) might gradually change the balance of good-bad bacteria for the better.

  34. Hi Paul,
    Do you perchance have any recommendations for people with lipomas? I have been keto since April 2014 and consuming probably too much olive and avocado oil. I am wondering if the PUFAs are causing FFA. I have read that almonds might help with lipomas. Would you please consider making a suggestion?
    Thanks,
    Jim

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