Gunther gatherer raised an interesting issue in a comment to Tuesday’s post. Protein may be satiating in the short run; but what about the long run?
[H]igh protein keeps you full at first. But no one really knows for how long. Eventually it stops working and you find you’re eating a lot ON TOP of all the high protein you were already eating. All of us here tried Atkins long ago and fell off the bandwagon more than enough times to know it gets boring, stops working against hunger and doesn’t keep the fat off forever.
I agree. This is why we recommend a version of the normal Perfect Health Diet, which is normal — not high — in protein, for weight loss. Our diet isn’t the quickest way to lose weight, but we think it is likely to work best in the long run.
The Long-Term Effects of High-Protein Diets
I argued in Tuesday’s post that the satiating effects of protein had to be temporary, and that in the long run higher protein might cause, not reduced appetite, but only a slight change toward a leaner body composition.
A more interesting question is: could high-protein diets be positively harmful?
Maybe! Studies in both animals and humans indicate that eating high protein during childhood creates a predisposition for obesity in later life.
For instance, rats raised on a high-protein diet in childhood are more likely to become obese when given calorie-rich (sugar and fat) diets in adulthood. [1] The researchers conclude:
Our research demonstrating a significant susceptibility to an obese phenotype in rats weaned onto a high-protein diet and then challenged in adulthood with a high-fat high-sucrose diet suggests that lasting changes result from altering the composition of the first solid food that is consumed throughout growth into early adulthood. While all rats in this study consumed the same high energy diet during the last 6 weeks of the intervention, distinct metabolic profiles remained evident from exposure to the different diets during growth. This would suggest that these changes, either long-lasting or perhaps permanent, ultimately influenced the adiposity response of these rats to a high energy challenge in adulthood. Overall, it appears that a long-term diet high in protein, when mismatched with a high energy challenge, has negative effects on body mass and hormones and genes involved in glucose and lipid metabolism. [1]
The same phenomenon occurs in humans. In the book we mentioned a study showing that slightly higher protein level in infant formula – 9% protein vs 7% normally – caused children to become overweight two years later. [2]
So parents, let your kids follow their taste buds to high-carb, high-fat diets!
Might adult high protein diets promote later-life obesity too? I’m not aware of evidence, but I don’t think the possibility can be ruled out. I will look for evidence when I do research for two future blog series: one on protein intake, aging, and longevity; the other on connections between obesity and the human aging program.
Can You Be Lean on a Low-Protein Diet?
Tuesday’s post cited research indicating that we have a set point for protein intake: humans are genetically programmed to seek around 360 protein calories per day, and appetite becomes satiated once that is achieved.
But if protein intake determines appetite, then it seems those eating a low-protein diet face a Hobson’s choice:
- If total calories are not increased, then the low protein dieter can expect to have a chronically unsatisfied appetite.
- If total calories are increased, so that appetite is satisfied, then the low protein dieter can expect a higher equilibrium weight and a slightly less lean body.
Is it possible, then, to restrict protein, eat mostly carbs and fat which we know are the ingredients of appetizing desserts – and still achieve a lean healthy body, and feel comfortable?
Yes, I believe so.
Melanesians Do It
Gunther pointed out that Melanesians are lean and long-lived on low protein diets:
I think it would be a bit fairer to include some consideration and explanation of Melanesians and their extremely low protein diet (anywhere from 10% to only 3% protein daily). Their extremely high level fitness and body composition flies in the face of all of these high protein studies.
It’s true: Kitavans, Tokelauans, and other Melanesians eat high-carb and low-protein, yet they’re noted for “extreme leanness.” [3] Why?
Well, first of all, the Melanesian islander diet is a variant of the Perfect Health Diet: it is entirely free of food toxins. As I argued last week, eliminating toxins is the key to healthy weight regulation. But there are other factors.
Coconut Oil
The most abundant fatty acid in the diets of Kitavans and Tokelauans is lauric acid, the 12-carbon fatty acid which is the predominant fatty acid in coconut oil. [4, 5] These shorter-chain fatty acids are ketogenic and have significant effects on the body: for instance, they raise HDL levels. They also make people lean.
In one study, 8 weeks taking 1 tbsp per day coconut oil caused a significant decrease in body weight, waist size, and blood triglycerides. [6] In another, obese women who received 2 tbsp (30 ml) coconut oil per day slimmed their waist and increased HDL without an increase in LDL, while a comparison group receiving soybean oil did not slim their waist and had lower HDL with higher LDL and total cholesterol. [7]
Resistant Starch
Another feature of the Melanesian diet is that the biggest share of calories came from “safe starches” like yams, sweet potatoes, and sago.
These foods have a lot of fiber in the form of “resistant starch.” Digestion of resistant starch by colonic bacteria produces a lot of butyrate, a short-chain fatty acid that strongly promotes leanness.
For example, butyrate improves insulin sensitivity and prevents rats from becoming obese. [8]
Hara Hachi Bu
But the most reliable strategy seems to have been worked out by Asian and Pacific cultures long ago, many thousands of years ago.
The key is that if the diet is well nourishing, then appetite will be mild and easy to consciously control. What will be experienced is not hunger, which indicates malnourishment, but a mild desire for food that can easily be ignored.
There is an ancient Chinese saying:
In Japanese the saying is Hara Hachi Bu, eat until eight-tenths full. Hara Hachi Bu is common practice in Okinawa, where it helped produce the world’s most long-lived population.
As we note in the book, the traditional Okinawan diet is extremely close to the Perfect Health Diet: the Okinawan diet was rich in safe starches and animal fats, and near the low end of our recommended protein range: Okinawans ate about 300 g (2/3 pound) meat and fish per day.
The key here is that on a low-protein diet, eating until eight-tenths full is not a calorie-restricted diet. It is a calorie-sufficient diet that isn’t quite satiating because it is low in protein.
Intermittent fasting is a helpful part of Hara Hachi Bu. Eating only within a relatively short window each day makes it easy to keep calories down.
My Experience
I have been practicing protein restriction for several years, eating coconut oil and safe starches for several years, and practicing daily intermittent fasting for over six months. I drink tea or lemon-flavored water through the morning, and on most days eat only between 2 pm and 8 pm. If I snack during the fast it is usually either a piece of dark chocolate or some coconut oil.
I sometimes go many days eating relatively little, then eat a lot for a few days. Physical activity – sports, intense exercise, running – increases my appetite noticeably. Regardless, I never feel hungry. It is easy to complete the daily fast: some tea, sometimes with coconut oil or dark chocolate, is enough. I now do total fasting on religious fast days – for instance, I now do a 64-hour fast from Holy Thursday through Easter Sunday morning. Generally, as soon as I focus my attention on work I forget that I wanted food.
(This is a very good sign for my health, by the way. During my long chronic illness I couldn’t tolerate fasting at all.)
I haven’t noticed difficulty adding muscle when I work out. I believe I would add muscle more easily on a higher-protein diet, but as it is I add muscle more easily than I used to on the standard American diet. I’m content with my body composition.
Conclusion
I am convinced that by eating coconut oil, getting carbs from safe starches, and practicing intermittent fasting and Hara Hachi Bu, most people can become well-muscled and lean on a low-protein diet without any sense of hardship.
Since a carb-fat mix is the classic recipe for dessert, this makes for an extremely tasty diet.
If you want the surest way to lose weight over the next few days, eat a high-protein diet. But if you want a long-term diet that maximizes longevity by restricting protein, consider eating a tablespoon or two of coconut oil per day, fasting for 16 hours a day, and finishing your meal eight-tenths full.
If you walk a hundred steps after dinner, you just might become a healthy centenarian!
References
[1] Maurer AD et al. Consumption of diets high in prebiotic fiber or protein during growth influences the response to a high fat and sucrose diet in adulthood in rats. Nutr Metab (Lond). 2010 Sep 29;7:77. http://pmid.us/20920272.
[2] European Childhood Obesity Trial Study Group. Lower protein in infant formula is associated with lower weight up to age 2 y: a randomized clinical trial. Am J Clin Nutr. 2009 Jun;89(6):1836-45. http://pmid.us/19386747.
[3] Lindeberg S et al. Haemostatic variables in Pacific Islanders apparently free from stroke and ischaemic heart disease–the Kitava Study. Thromb Haemost. 1997 Jan;77(1):94-8. http://pmid.us/9031456.
[4] Lindeberg S et al. Lipoprotein composition and serum cholesterol ester fatty acids in nonwesternized Melanesians. Lipids. 1996 Feb;31(2):153-8. http://pmid.us/8835402.
[5] Lindeberg S, Vessby B. Fatty acid composition of cholesterol esters and serum tocopherols in Melanesians apparently free from cardiovascular disease – the Kitava study. Nutr Metab Cardiovasc Dis. 1995; 5: 45-53.
[6] Xue C et al. Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects. Eur J Clin Nutr. 2009 Jul;63(7):879-86. http://pmid.us/19156155.
[7] Assunção ML et al. Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity. Lipids. 2009 Jul;44(7):593-601. http://pmid.us/19437058.
[8] Gao Z et al. Butyrate improves insulin sensitivity and increases energy expenditure in mice. Diabetes. 2009 Jul;58(7):1509-17. http://pmid.us/19366864.
via this link:
Paul,
This is a great post. Your recommendations are really starting to come together from a lot of directions and has me looking forward to the day when I can handle the fasting.
I have though adopted the 15% range for protein intake and it has help me tremendously. I had attacks of what most assuredly was gout even though uric acid levels were measuring 5.5 mg/dl. It wasn’t until I dropped the high protein habit I pick up from version 1 of paleo low carb eating that the gout problems went away so thanks for that. ( and yes, I am familiar with how the body is suppose to regulate acid base balance and all the c02 exhalation and fructose stuff)
I wish I could fast but it seams to get me sick. I have a fungal infection, it goes back 20 years and flares if I fast. Sugar intake knocks it down so it has me in a spot. I’ve have just begun 2 week treatment with dulfican and with my doctor, are considering antibiotics afterward for what we feel may be an infection of the heart valves.
Does the fasting make you look old? (I am guessing no or you wouldn’t be doing it!) I am remembering the Gary Taubes comment on how he has aged. I agree and feel the same thing has happened to me while I was low carbing. I know the IF seemed to cue the phenomena with me. I don’t know the mechanism but suspect ROS brought on by any infections feeling challenged by the fasting, low carb, and keytones.
Thanks again Paul
Paul – Another super post.
Out of strange curiosity, what kind of tea do you drink? I know in the book you recommend green tea but any particular kind? Does one type fit particularly well into the PHD scheme? I’m a big fan of jasmine tea. Thanks!
Thanks for sharing your experiences. I will now consider adding daily intermittent fasting and a lower intake of protein to my arsenal in my quest for optimal health.
It’s true that many long lived cultures eat high carb. I used to believe we have to reduce our glucose/carbs intake thanks to the researches they did on worms:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7MFH-4PT7RDC-7&_user=1023310&_coverDate=10%2F03%2F2007&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1622220942&_rerunOrigin=scholar.google&_acct=C000050501&_version=1&_urlVersion=0&_userid=1023310&md5=6ddddbe37ed6debb8d30cb267b7d4e88&searchtype=a
By the way, a high protein diet seems to slim down baby pigs:
http://www.ncbi.nlm.nih.gov/pubmed/21123765
I agree with you that a high protein diet is good way to lose weight. Maybe parents wishing to help their kids to lose weight should encourage them to eat more protein?
great posts – some comments: being lean and long lived vs. having high fitness performance – compatible or antagonistic goals?
fungal symptoms and carb consumption – does low(er) carb “starve” the fungus and cause the flare ups, while eating carbs causes the fungus to be fed and therefore stay around? therefore would eating even the recommended starches prevent healing, especially when combined with fructose sensitivity, insulin resistance, and leaky gut-like issues?
Hi Perry,
I’m glad your gout is gone!
Of course I also had a fungal infection that I acquired at birth and that was the main thing that stopped me from fasting. I would stay away from fasting until that is gone. Fasting will make the fungal infection worse.
Definitely you need adequate glucose to deal with fungi. I would get at least 400 calories a day from glucose. Avoid fructose however.
I don’t think I look old from fasting but I suspect it would take more than 6 months to tell!
Hi Erich,
We’re planning a Sunday post on tea, maybe we’ll do it this Sunday. We get our tea from Taiwan, it’s not easy to find here.
Any tea you like will fit into the PHD scheme!
Hi Daniel,
Humans are different from worms in that we maintain glucose levels independently of our food / culture medium. So reducing carb intake doesn’t do much to change the exposure of most cells to glucose.
I’m afraid your first link is broken for me.
The second link, I haven’t read the paper, but the abstract indicates they lost weight in the first 28 days on the high-protein diet but had larger adipose cells by day 160. That’s consistent with short-term weight loss, long-term more fatty.
I think for kids the evidence is that high-protein diets are dangerous. See today’s post. I wouldn’t take that route for kids.
Hi Darius,
Isn’t that the $64,000 question? It does seem that there are trade-offs, but we’re exploring to see if we can find a regime that gets the best of both worlds. Or at least 80% of the best.
Fungal infections – lower carb starves the immune system and lets fungi grow unmolested. The anti-fungal immune response is very limited and solely reliant on glucose for production of reactive oxygen species (ROS).
Dietary glucose is very helpful for fungal infections.
Hi Paul, I would like to share my experience, Ive been eating healthy almost all my life (im 29), I have tried vegetarian, macrobiotic, blood type, & for 8 month paleo….in this 8 month of paleo eating my results where
trigs went from 62 to 98,
TC from 145 to 277
hdl from 46 to 69
ldl from 75 to 175
vldl from 12.4 to 19.6
Glucose from 87 to 100
Also Abnormally high liver enzimes, urea, total proteins and ureic nitrogen.also high lactic deshidrogenase.
The first results were taken in 2008, by that time I was eating basically beans(soaked),fish,eggs,little red meat,olive oil, some ghee,goat cheese,quinoa,rice,oats,(no wheat)kefir.
The second results were after 8 month on a more paleo low carb (120grs/day) diet, with fatty organic meat for breakfast and dinner, cooking with generous amounts of butter. I banned all beans, grains,kefir (exp. goat cheese).
Please dont think Im trying to savotage high fat/paleo diet, I really do think that some people really thrive on this kind of diet, but maybe is not for everyone. I take blood test every year to check how my diet affects it and from what Ive seen my triglycerides have rise since including more red meat (or protein?)& sat fat. What puzzles me is the fasting blood glucose, is it possible that conventional wisdom have some truth??, could saturated fat really have a negative impact on some people. (im half japanese/spanish). Could japanese be more affected by high protein/fat diets??
Sorry for the epiloge I just wrote, but Im really fascinated on how same diets affect different kinds of people.
Tomorrow I will check with my doc to see if my liver kidneys, or gallblader was screwed up…hope is not too late!
Thanks soo much for your blog & work,
Jaime
I am a little confused on the protein issue. You refer to a set point of 360 protein cals per day for all adults. That’s about 90 grams, right? Do you consider that high protein or low protein? Are you assuming the conventional 2000 cals per day intake?
As a menopausal woman who less than 5 feet tall and an over-fat 123 lbs, I am often uncertain how dietary rules of thumb might apply to me.
Hi Kathy,
360 calories / 90 g I would say is normal, over 400 is high protein, 300 or less is low protein.
However, it’s a bit complicated. If you’re low carb then normal protein will be a bit higher, since some is used for gluconeogenesis.
I haven’t really looked into how protein needs scale with age, gender, and size, but normal protein for you will be somewhat lower.
A fair test is to look at what your body craves. Does meat taste good? As you go above your own protein set point meat – especially lean meat – will seem increasingly tasteless.
Hi Jaime,
I’m puzzled by your blood results. Not only fasting glucose but trigs, LDL, VLDL are odd as well.
These are definitely fasting numbers, 12+ hours after the last food?
You say you’re eating 120 g carbs per day — is that the weight of your food or is it 480 calories per day? Are you counting vegetables? Do you eat safe starches or fruits? If you were very low-carb these numbers would be easier to understand.
Japanese do have higher cholesterol numbers, their lowest mortality occurs with total cholesterol around 240. So you’re not terribly far off. Still, the increase surprises me.
Best, Paul
Paul, you write:
“Since a carb-fat mix is the classic recipe for dessert, this makes for an extremely tasty diet.”
What sort of desserts are you thinking about?
thanks,
Rick
Hi Rick,
You name them, the ingredients will have a fat and a carb. Ice cream, cake, cookies, chocolates, … the challenge is coming up with a dessert that doesn’t fit that rule.
Of course, when I say our whole diet tastes like dessert, I mean nutritious desserts!
Hi Paul,
Possibly a trivial question, but do you make a distinction between coconut oil and coconut milk in you tea? I’m on the slow road to reclaiming my body and would prefer to optimize all variables. (So far so good.) I can’t imagine that the relatively trivial amount of carbs consumed using the coconut milk in tea during a ‘fast’ would be consequential. Any thoughts?
Many thanks for the great blog.
Hi Peter,
Yes, coconut milk is fine during a fast, whether in tea or out.
Hi Paul,
Yes, these are fasting numbers (12 hrs after food)
120 grs = 480 cal. per day counting only starchy veg.
Starch sources are sweet potatoes, white rice, root veggies.
No fruit.
The thing that puzzles me the most is that before paleo I was eating almost a high carb diet (no wheat,veg oils, sugar) an everything was pretty much ok, once I introduce more meat & fat things start changing especially trigs.
I will keep experimenting with diet to sort things out.
Best,
Jaime
what’s the easiest way to get that 400 daily g of glucose while avoiding fructose?
and how could i check for certain if i had a fungal issue?
much appreciated
I thought your comments on protein not satieting hunger (and being hard to take in past a set point) are pretty close to true. I’m by no means a large woman – 5 foot 6 inches now 173 pounds – but I can tuck into a large, fatty steak with the biggest lumberjack. However, I have a problem choking down “pure proteins” like chicken breast. Despite incredible hunger this afternoon, I could only make it thru 1 breast before I lost my appetite – even became nauseous at the thought of taking another bite – and began craving the well-marbled steaks residing in my freezer. Unfortunately, the rumbling hunger pains remained.
Makes me wonder how my body tolerated the low-fat, low-calorie diets I followed as a teenager.
I do have 1 question : I’ve been struggling with hyperinsulemic hypoglycemia for years. It improves (I no longer need an OJ sugar shot to feel normal) on a high-fat diet but never really goes away. Since I usually take in more than my fair share of protein, could that have any meaningful effect on the insulin response?
Hi darius,
400 calories — safe starches (rice, potato, yam, etc) or glucose (e.g. rice syrup). Among fruit bananas are relatively high in glucose, low in fructose.
If you have skin infections, or oral thrush, it’s easy to diagnose. Any severe internal infection will generally also produce these.
If you don’t have visible external growths, then it’s tougher. They don’t have good diagnostic methods. It’s possible to culture yeast from stool. Abdominal bloating is a common symptom of colonic infections. There is an antibody test for Candida but not for other fungi – but I don’t think it’s very reliable.
Fungal infections are probably the most underdiagnosed condition in modern medicine. They’ve been found in autopsy studies to be the most common cause of death when the cause was unknown.
Medicine is still rather primitive here. But since low-carb diets make people more prone to fungal and less prone to bacterial infections, I suspect medicine is going to have to catch up fast.
Hi Becky,
Protein does trigger insulin release, but usually it doesn’t cause hypoglycemia because it also triggers glucagon.
Maybe something got messed up and the insulin and glucagon don’t work together properly? Somebody like Jenny Ruhl (author of Blood Sugar 101) would be the go-to person for this question.
interesting post. i found this passage by your to be pretty much the goal and epitome of health:
*The key is that if the diet is well nourishing, then appetite will be mild and easy to consciously control. What will be experienced is not hunger, which indicates malnourishment, but a mild desire for food that can easily be ignored.
thing is, that is different for everyone. what meets the nutritional needs of one body is totally different for another, an example, Jamie who just posted his blood results. epigenetics considered, one body may need what the FDA considers 100% DV vitamin C while 100% for another person is met by far less vitamin C.
also, saying a lack of hunger during a fast is very misleading in my opinion and experience. “anorexia’ as a term is defined by a lack of hunger- which i suffered for close to 7 years.
im never hungry whether i eat all day or whether i dont eat for days, it doesnt matter either way. an occassional lack of hunger is probably a good sign, but a daily lack of hunger is another and probably should signal the downregulation of what ‘should’ be running and doing its job in your body. also, a constant lack of hunger also shold serve as a sign of hypothalamic & pituitary signaling errors, should it not?
i dont have an opinion on protein either way as i am totally convinced that if you meet your body’s nutritional needs whether you eat fat carbs or protein on top of that it doesnt really matter
I am sorry, but why exactly would fasting make someone look old??
Also If I suffer from dandruff, jock itch, and toenail fungus, is it quite possible that I have a full on fungal infection, and my daily 16 hour fasts are making it worse? I don’t want to give up fasting because it makes me feel light and good, especially when exercising. I can’t wait for you to go over this in more detail in future posts.
Hey Paul,
Big fan of your work and the website! Very interesting post these last two. My diet is mostly meat and veggies. I train fasted and I do consume whey and sweet potatoes or rice post workout before my bigger meal.
My questions…
– You say a tbls of coconut oil everyday will help in leaning out. What about coconut milk?
– How do these recommendations change for strength athletes like us who train 3-5 days a week?
– “humans are genetically programmed to seek around 360 protein calories per day, and appetite becomes satiated once that is achieved.” – seems a little too general considering we have people who are 100 lbs and people who are 300 lbs. What are your thoughts?
Thank you much and please keep up the great work!
– Raj
I break my 20h fast every evening now with the following shake:
– 1 banana
– 250 ml fresh whole milk
– ~50g Mascarpone
– 4 egg yolks
– (sometimes) 1/2 scoop of iso-100 whey vanilla -12,5g P)
Mainly fat+carbs, nothing more satsfying! I even don’t bother calculating the exact P/F/C-ratios. It makes me feel fresh and powerful immediately!
Then, around one to one and a half hours later I have my PHD-meal.
Sometimes I have a second (dessert)shake/ice cream just from frozen black current or cherries plus a bit whole milk/cream, sometimes 2-3 pieces of black chocolate.
Honestly, I never felt better and – look rather younger (or just fresher?), especially in the mirror next morning!
“64-hour fast”
Wow, 3 Days!
I’ve noticed my pores widen on such a long fast. I don’t like my “starving” look when doing it.
Great, thought provoking posts Paul. I find protein has done the trick for me and seems to be continuing to do so for rather care-free maintenance at this point. But, perhaps the road to true leanness will be through eating a bit less of it.
Still, you say 360 cal/day is our protein seeking threshold = 90g. For the “standard” diet of 15% protein, we’re talking 2400 cal/day total which is simply too much for most women. I think where us women are concerned, a goodly part of our weight problems are initiated by the first time we go on a diet based on that 15% number. It amounts to 45g protein for the formulaic 1200 cal/day diet, hence the hunger so many experience on such diets.
I’m gearing up to experiment with IF again. I did lose 10 lbs in 2 weeks back in 2009 (before plateauing out once again, but they didn’t return) when I did daily IF for three months. Early on I was also not eating enough and was worried that too low protein might cause losses in LBM. It’s a balancing act I suppose, because with my “density” I have toyed with the notion of DELIBERATELY losing some of my LBM.
Thanks, Mallory. I didn’t know that anorectics don’t get hungry!
Robert – I would guess dehydration can cause a transient appearance of age. You need extra salt and water during a fast, I would recommend other electrolytes (potassium, magnesium, maybe calcium) too. I would expect fasting to maintain a youthful appearance over the long run.
Hi Raj,
Coconut milk works just as well. It is about 85% coconut oil by calories.
Yes, there is variability across persons in macronutrient needs. It looks like I need to address that more.
For a strength athlete, protein needs are not increased much, but you want to avoid a deficiency which might lead to slight loss of muscle. So our normal “plateau range” of 200 to 600 protein calories per day becomes more like 360 to 600 per day — 500 to 600 if low-carb since some protein is lost to gluconeogenesis.
Franco – Sounds great!
Hi CarbSane,
That’s a great point about protein. In the book we usually used calorie numbers instead of percentages, since I think for carb and protein the actual calorie intake is much more consistent across persons than a percentage figure – especially when dieting. I’ll discuss that a bit on Tuesday.
Paul,
Yes, anorexics and chronic undereaters loose appetite after awhile due to poor leptin and hormone functioning.
Wanted to update you on my folliculitis. Well I went the antibiotic route combined with HBOT for a month then followed up with a series of 5 fecal transplant to restore gut flora. Digestion is almost 100% perfect (sometimes I take too much magnesium), skin is 95-99-100% clear. Not a full 100% all the time because I have realized that the folliculitis is localized to parts of my skin that have been damaged by product use/bad shaving/scarring. Once I started leaving my skin alone and not putting anything on it, it mostly resolved. And now when i get a tiny spot in the area where I had it, I realize it probably never was an infection at all. Just an area prone to getting infected due to mechanical damage and inflammation.
In regards to my low body temp (still around 97.5 most days, but has gone up around 98.1, 98.7 lately), after doing some research it is clear that my whole year and a half (winter 2006 till Spring 2008) of chronic undereating and over training (I was 18-19 and 5’7 and went from a muscular lean 135 to 105lbs in that time span) really screwed my hypothalamus-pituitary-hormone axis. I had low testosterone when I tested in August, it was 325. That is super low for a 21 year old male.
When first went paleo in summer 2009, then zero carb winter 09/spring 2010, and very low carb for summer of 2010, it is pretty easy to see why I still have some mild hypothyroid symptoms… low hormones from never eating enough! I am getting my rt3 tested to see if I have an excess as my t3 and t4 levels tested very good. Hashi’s has been ruled out several times.
Upon research, anorexics and overtrained atheletes have these same symptoms and they do actually take quite some time to recover, especially if any sort of food restriction is continuted.
Now I never was anorexic and didn’t quite understand how bad being so thin was until I stepped on the scale at 105 that spring of 08, and since I never counted calories and bothered with that sort of stuff, when I went ZC and VLC I clearly was not eating enough… after trying out FitDAY somedays I only ate 1300 calories, most around 1700, very few ever above 2000… very sad for a 21 year old male.. no wonder I complained that no matter how strong I got, I never got bigger!
Anyway this is long but I just wanted to let you know, that some of your symptoms listed for chronic infections can also just be chronic stress and overttraining… especially if those folks are young and have a history with overtraining or food issues, or both.
I am now eating a nutrient dense diet of yams and sweet potatoes of all kinds, loads of meat, saturated fat, eggs, avocaodos, veggies, and fermented raw milk, combined with some serious heavy lifting (squats, deadlifts, overhead press) twice a week, and emphasizing sleep and mediatation for relaxtion… and mostly importantly, no cardio expect the occassional hike and sprint!
It is very clear that infection=stress but unfortunately pure stress can also manifest with the same symptoms. Is there anyway for people to rule this out?
One guy on the cpnhelp site noted that if body temp improves with antibiotics then clearly chronic infection is a cause of stress/low temps/gland functioning. Mine temps did not improve on the antibiotics and my energy didn’t really change either. Another note is I never have a “herx” of any kind with any anti-microbial therapy… I suppose that could be another sign.
Well anyway this went too long, my apologies. Love your blog and will be passing on your book to someone I hold dear to my heart and was just diagnosed with HIV this past year.
Hi Paul,
This article: http://singularityhub.com/2010/10/15/amino-acids-extend-mice-life-by-12-humans-might-easily-benefit-from-same/#more-22110 seems to indicate that one would have a huge increase in life expectancy if he ate lots of protein, especially the Branched Chain Amino Acids (BCAA). It seem the dose is very high — according to the article, 1.5mg of BCAA per gram of body weight. That be about 100 gm of protein for a 70 kg man. What are your thoughts on this study?
Thank you.
Paul, in terms of anorexia, whether a person experiences hunger or not is pretty varied and individual. For sure, natural hunger cues and sensations get messed with, and the longer the person lives with the ED, the more compromised the natural physical and psychological signs. For some, the sensation of hunger becomes a sort of fetish. For people with ED’s, the cues of satiety are also compromised. What’s also interesting is that when a SAD-style diet, or elements thereof, enter into or supplant a previously traditional way of eating, obesity and degenerative diseases increase, but so do eating disorders.
When I work with people with ED’s I often suggest that they re-adopt some traditional eating behaviors, such as eating with others and avoiding eating alone as much as possible. I feel like the comensality piece is very often overlooked, but it’s an important part of being human. People in many parts of the world will skip a meal rather than eat alone. This may very well contribute to how IF fits into the picture of healthy, and seemingly effortless, weight management.
Hi Bill,
I’m so glad you’re almost completely well! It’s remarkably what healthy eating and living can do.
The undereating / malnourishment syndrome I guess is a surprisingly common phenomenon. I’ve never studied that literature but I guess I will have to. It’s interesting that overtraining can induce some of the same symptoms.
My sympathies to your friend with HIV. It suppresses immunity and makes early onset of all the chronic infectious diseases likely. So, it’s very important to do something like our diet. Fasting may also help destroy some of the viruses and slow disease progression.
Best, Paul
Hi Robert,
That’s a very interesting topic — the differences among amino acids. Methionine shortens lifespan but branched chain amino acids raise it. This will make a good blog series at some point.
Thanks for the link!
Hi Maggy,
Thanks much. Sociability is as you say extremely important. I’m sure you’ve seen the reports that centenarians tend to have many more friends than people who die young … also the various health problems that develop among prisoners in solitary confinement. We’re definitely social animals.
I wonder if those prisoners get eating disorders?
I don’t know about folks in solitary confinement, but self-imposed loneliness and confinement is a common feature of EDs. I’ve yet to encounter someone with an ED who is not profoundly uncomfortable eating in the company of others. Concurrently, I know that if a person is willing to put effort into not eating alone, they have a better chance at recovery.
Robert,
that’s great news. I take 30g pure BCAA per day, some more will come naturally from whole food. My motivation was actually improved recovery from lifting but I’ll take the life extension bonus with pleasure!
Bill,
vise move to concentrate on the heavy lifts. Formalized “cardio” doesn’t help much beyound strength training. IMO simply walk regularly during normal day activities and something for fun (badminton, frisbee, basketball, whatever) occasionally is plenty.
Hi Paul,
I really enjoyed the book and enjoy the blog. I have found them both very helpful. Thanks for all the time you put into both. You mentioned earlier in this post that coconut milk is ok on the PHD. What do you think about guar gum that you find in almost all canned coconut milk?
Thanks
SJ
Hi SJ,
Guar gum is a natural food fiber and, like all natural fiber, it might be beneficial. If it were harmful it would most likely be in some cases of bowel disease. I personally don’t see it as something to avoid.
Best, Paul
This post is really appreciated, given the questions raised in the comments of the last one. Here is more proof that insulin resistance (and by extension, just about all diseases of civilization) is likely caused by a mechanism that reaches all the way to the mitochondria. Your cells respond to overnutrition by inducing insulin resistance in order to protect themselves perhaps…
http://www.ncbi.nlm.nih.gov/pubmed/19805130
When you see “starvation” in the text, substitute “protein restriction”, and see if this all fits together now. What is the macronutrient that notifies cells that there is adequate or inadequate nutrients in the organism’s outside environment? All signs point to protein, it seems. To your cells, protein is information, which triggers certain cellular reactions which turn down or turn up bodily insulin sensitivity, among other things.
Hey, come to think of it, maybe that’s another reason Melanesians can stay so lean on such a high carb diet: Low protein creates high insulin sensitivity! Hmm…
bill, whom i think i know, and myself are recovering from similar experiences just i was ‘diagnosed with anorexia. interesting comments, i agree with him 100%. meditation is underrated as well as figuiring out how to relax, i like laying in an empty field in the sun haha
maggie also makes a VERY good point… i use to be ‘that’ person, confined to my bubble, unsocial, didnt want to eat around others. it is hard, REALLY hard to force yourself after an ED to just ‘be social’ and ‘just eat’. however, practice makes perfect, and if there is ‘primal’ food being cooked up i am ALL OVER eating. its not so much other people seeingyou eat its that your not ‘in your bubble’ to do it. hard habit to break, but it is possible, again, learning to destress is the key. the other flip to it is that once your family has experienced an ED right alongside you, they do tend to stare… i like food as much as the next persona nd having people stare you down when you eat is a bit uhm… odd. i dont think they know they do it b/c i think it is just people caring so much and understanding absolutely nothing about what the mind of an ED person goes through
I’ve found guar bean gum to be bloating. There’s only one canned coconut milk I’ve found that doesn’t have it. That’s Natural Value Coconut Milk Lite, which is available at Amazon: http://www.amazon.com/gp/product/B001HTMS5I/ref=oss_product
thanks paul, i think the rice syrup will work better than preparing tubers everyday (although i do want to master that craft and source the good ones)
i guess that being low carb is exacerbating certain of my fungal-like issues: dandruff, flaking skin on feet, some type of jock itch like thing.
above, robert had a good question about if 16 hour fasts are making his similar symptoms worse…
on another note i have a long question about leangains and am waiting for a relevant post with which to strike! thanks again
Paul – how many hours after you 8:00PM feeding and bedtime?
Hi Annie,
We usually go to bed about 11:30. Shou-Ching usually goes to work at 9 am and comes home at 7 pm to avoid rush hour traffic, so we can’t easily finish eating before 8.
I think it would be better to eat earlier and go to bed earlier, but this is what is most practical for us.
Here is the entire PDF for the study I refer to above. I hope it helps frame some context for the whole insulin resistance question:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2764908/pdf/zpq17787.pdf
@Mallory, I agree that it’s very difficult to reintegrate social eating as part of ED recovery, and that it’s difficult for people with ED’s to feel safe around food, let alone around food AND other people. I hope I didn’t sound unempathic in my previous posts.
I think the other thing that ED recovery protocols do that is utterly un-helpful to people in recovery is to put them on a USDA-style “healthy” food-pyramid diet. Most recovery centers have conventionally-trained RD’s on staff who are, inevitably, pushing the conventional American “healthy” diet (which is what insurance will pay for, if it pays at all). I think they mean well (at least, I hope they do…), but very often these RD’s are, themselves, folks with ED’s who chose their profession as a way of sublimating their own issues.
IMO, the last thing a person in ED recovery needs is someone telling them to eat a diet high in whole grains, low in sat fats, “plenty of fruits and vegetables”, etc… For many people with ED’s the whole thing started with a commitment to “eating healthy” six times a day, which then required hours in the gym to burn calories, which then morphed into eliminating “bad” food (under a philosophy of “if less is better, then none is best”…) Any time I hear someone say, “I just eat healthy…” my antennae start to buzz.
People whose bodies and brains have been ravaged by weird food and eating rituals need real nourishment to heal, and what they mostly get is bad advice and harsh judgment. Is it any wonder that there is such a high rate of relapse?
maggie I LOVE THAT RESPONSE!!!!!!!! that is THE reason i blog, because i do not at all agree with how eating disorder treament ceners are run… i experienced WAYYYY to many bogus treatments, dieticians and ‘nutritionists’ and found the best solution was to ‘find what works for me’ and that meant learning not about eating disorders, but about the human mind, and the mind-body connection. it makes sense then, it was a ‘disease’ persay but something i needed to separate myself from and understand and realize it ‘wasnt real’ but a byproduct of malnutrition, so i studied nutrition and endocrinology and i am doing my best to get the word out!!!
like you, i have seen many people enter treatment, come out, and relapse. i use to go to a free meeting of ED people weekly and quickly learned it did much more harm than good, they were recently all out of treatment and ‘back inthe real world’ counting every granola bar gram that entered their mouths…so fed up, i left and dont attend them anymore. when i need a reality check my family knows oh too well how i act and as much as i hate it i just need to ground myself and realize i am more prone to malnutrition/weird brain function than the average joe!
ps- paul, sorry to rant about EDs…maggie i think should start a blog 🙂
Mallory, rant on! I agree, it would be great if Maggy had a blog.
@Mallory and Paul, I’m flattered that you feel what I write is blogworthy. Someday, maybe when I’ve got a solid bunch of information to offer I will blog. For now, however, I’m learning by helping individuals overcome their struggles with ED. I believe strongly that WHAT people eat plays a huge role in their mental and emotional well being, and I’m finding the information and discussion in this blog to be an invaluable resource.
do you have an email i can contact you at?
Paul,
First, thank you very much for sharing so much of your wisdom. Your book and site has been a big help to me and my family. It even got my parents (whom I gave a copy for Christmas) to give up wheat! I’m going to have to order another copy to loan out to the clients of my health practice.
Seeing as how people have been bringing up fungal questions I thought I’d throw in my own simple one: does the body use up any significant glucose in respiratory bursts to kill extracellular pathogens? Specifically, if I’m working to massively up-regulate this immune response does this meaningful alter the amount of carbs I should shoot for?
Thanks to your book a lot of pieces fell into place and I’ve realized I must have had fungal infections ever since I was a little kid and would get large white-gray scaly patches on my knees and elbows. Back when I went low carb I developed two warts on my big toes as well and would have one wrist break out in an inflamed red rash.
These have gotten noticeably better since I started adding more carbs back in, and I’m determined now to wipe out the fungal infections that I suspect underlies these outbreaks.
If I understand the biology correctly, the most likely limiting factors of Respitory Bursts are Selenium (which I’m taking 5 brazil nuts a day for), Iodine (I’m munching on dried seaweed throughout the day for this), Glutathione (I’m taking NAC and Whey protein as precursors), and Glucose (I’ve _stopped_ fasting and increased my carbs, having some right before bed and shortly after my coconut-oil morning-coffee to keep the ROS acid-nukes running).
I’ve realized though that I have no idea by what factor this is increasing my immune response and how this might effect my need for carbs.
Given my special circumstances should I go over 600 calories carbs while I’m in extracellular pathogen killing mode? Or is the amount of glucose used by the immune system small enough that I should stay in the upper PHD guideline? Thanks for all your help.
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