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Reader Feedback: A Roundup with My Reflections

Posted by on January 15, 2013 53 comments

We were very curious to see how readers would react to the new edition. Some of the reactions I think are interesting.

How Paleo is PHD? How PHD is Paleo?

One of my New Year’s resolutions is to do more on social media. Google+ has “communities” now and a few days ago I started a Perfect Health Dieters community just to see what it’s like. Paul Halliday, proprietor of Living in the Ice Age, left this note:

I bought your book since you were pointed out as someone who was more favourable about the role of carbs and very very much enjoyed the read.

My preconception about the PHD being a pro-carb diet were stopped in their tracks. In fact, the PHD is not a pro-carb diet at all. I read the book as very much a straight down the line paleo book with the inclusion that we need carbs to keep a number of basic bodily functions working as expected.

Two years ago it was totally shocking that a Paleo diet could include white rice (a grain! milled at that!), dairy, and other Neolithic foods. Now we’re “straight down the line paleo.”

In recent weeks, Robb Wolf has endorsed carbs and starches (part 1, part 2, part 3). Terms of our coinage, like “safe starches” and “supplemental foods” (meaning foods that one should eat on a regular schedule for their micronutrients, as people take supplements) have entered the Paleo vernacular. (See, for example, Mark Sisson’s recent post on supplemental foods.)

We couldn’t be happier about this. Not only is it progress toward better health, it is flattering to us.

I think the shift toward less restrictive diets speaks to the maturation of the ancestral health movement. Paleo is becoming a diet that is healthier, tastier, and more accessible and convenient to the general public; and gurus are following the evidence to more scientifically sound recommendations. That bodes well for our movement’s chances to become mainstream.

Responses to Our Obesity Ideas

A fair part of the new material in the book has to do with weight loss and obesity (see What’s New in the New Edition, 2: How to Lose Weight). I’m happy to see that a number of readers found the discussion illuminating.

Mark Lofquist, for instance, paraphrased an important observation from our book:

“Telling an obese person not to eat too much is as effective as telling a person with a cold not to cough too much.” (/paraphrased) -Dr Paul Jaminet

The original line can be found on page 176. Our position is that weight loss results from improved health combined with an energy deficit; eating less food generates an energy deficit but doesn’t necessarily improve health. In fact, if the previous diet was malnourishing, then eating less will make it more malnourishing and therefore will worsen health. The result will often be yo-yo weight regain and obesity that is more severe and intractable than before.

For effective weight loss, therefore, it’s inadequate to tell a person “Don’t eat too much.” You have to tell them how this may be accomplished in a healthful, satisfying way. This is what we try to do.

In fact, it’s best to focus on health first, and then the weight loss becomes easy. In an intelligent Amazon review, Navy87Guy notes:

I think it’s very telling that only a short chapter is actually devoted to the discussion of weight loss — because it is based upon all of the other principles that have already been outlined. The discussion in the weight loss chapter on the scientific origins of obesity is fascinating and sobering at the same time.

Great observation! Little needs to be said about weight loss once it has been explained how to be healthy. Good health leads to easy weight loss.

Have we succeeded in enabling weight loss? On Facebook, Henrik Johnsen shared some good news:

Today I can once again fit 3 pairs of pants that gave up wearing about 8 years ago. I’ve been losing weight steadily for the past 5 months by switching to Perfect Health Diet by Paul Jaminet and I’ve never eating so much fat and tasty food before in my life! Every meal’s a banquet! Thanks Paul! 😀

Kendal Lenton said:

Last week I decided to change my life, been eating great, and already down 8 lbs. Thank you Mark’s Daily Apple and Perfect Health Diet for helping me change my life.

Meanwhile, Laura at This Felicitous Life would like to lose a few pounds, but has been maintaining her weight. She has an idea that may fix that:

I’ve given it a lot of thought and done some scientific research and have come to a very cutting-edge hypothesis:

Maybe I should stop drinking 1/4 cup (or more) of heavy whipping cream in my coffee every day.

Heh. Yes, some people can lose weight eating whatever they want; just choosing healthy foods in the right proportions is enough. Others have to watch portion sizes or, as we discussed in Perfect Health Diet: Weight Loss Version, trim the fat.

It’s sad, but we can’t always have everything we want!

The Healer’s Perspective

One of my recent projects has been helping the Ancestral Health Society set up a new journal, the Journal of Evolution and Health. We have chosen a platform, are about to start editorial operations, and the first issue may appear as early as summer.

One goal of this journal is to document the successful health improvements that are often brought about by ancestral diets and lifestyles. Doctors and other clinicians are the best sources for that information, since they can see how multiple patients respond to the diet, and see negative as well as positive responses. To help bring Perfect Health Dieters and healers together in sufficient numbers to create a critical mass of knowledge, I’ve created a Healers page, and I invite healing professionals who would like to investigate the value of the Perfect Health Diet to list themselves there.

One medical doctor who has been recommending our book to patients is Dr. Shira Miller of The Integrative Center in Los Angeles. She wrote recently to say that “my patients are loving the book.”

Over at Amazon, Dr. Verne Weisberg says our book is “seriously important” and writes, “As a physician who treats obesity, I highly recommend that anyone looking to correct any of the multitude of ailments that stem from diet give careful consideration to what they have to say.”

I really liked the Amazon review from Denise Baxter, a certified health coach:

My clients are overjoyed with the changes they are experiencing in their bodies and their minds. They find their meals more enjoyable and easier to prepare. They appreciate being able to fix one meal for the entire family. One of my diabetics was able to lower her insulin yet again, and reduce her blood sugars even further by adding some safe starches. Although she had a great deal of trepidation about doing so, she loves the results.

This book is a gem and has answered many of my long standing questions. Paul and Shou-Ching Jaminet have made an enormous contribution with their many years of work. I will not be surprised to see their work make a significant difference in the health of our nation.

Other Amazon Reviews

R.U. Kidding-Me made me laugh:

As I read through this book there were quite a few what I like to call “Holy s*** moments” where I was so happy to read things that actually make sense.

In the end, even if you did not agree with or understand all of it, you emerge from this book like one does from a fog and you realize that you are definitely smarter than the person sitting next to you 🙂 Whoa! Mind blowing!!

Justin Sutherland:

Despite being full of research, the book is a pleasure to read and is easy to follow. I kept turning pages and saying to myself, “well, when you put it that way, of course!”

T., Quinton left a heartfelt review:

Although I wouldn’t wish illness on anyone, I’m grateful that the Jaminet’s were able to contribute immensely to society as a whole while conquering their own illnesses…. I have lost weight even though I’m not trying to, and am rarely hungry.

Navy87Guy has a complaint:

My only complaint is that they use the word “diet” in the title. While they use it in the academic sense (i.e., the foods that you habitually eat to provide sustenance), too many people only think of “diet” as a restriction in your food intake to promote weight loss. I prefer to think of the authors’ book as a “lifestyle”, rather than simply a prescription for changing your food intake. That view is reinforced by the holistic treatment of the impacts of circadian rhythm disruption on health – a fascinating chapter that probably could have as much impact on your overall health as your choice of food!

TMac had the same thought: “It pains me that the Jaminets decided to call their plan the Perfect Health Diet, rather than the Perfect Health Lifestyle.”

We liked G. Nesta’s comment:

When something just makes sense and seems right, you know it. I am basically back to the diet of my parents and grandparents who lived into their 80s and were active and happy their entire lives. This is my favorite diet/health book that i have read.

Our thanks to everyone who has left an Amazon review!

Vegetarian Concerns

I’m planning a post or series of posts looking at the healthfulness of vegetarian diets. Recently Beth, a vegetarian considering a switch, asked about T. Colin Campbell’s claim that protein causes cancer. Elyse L offered some good advice for former vegetarians considering PHD:

Many folks following PHD (and Paleo) are former vegetarians or vegans. For me, I started digging into all of the information out there pro and con and finally decided to just give it a try and see how I feel. For me, I had immediate relief from lethargy, allergies and arthritis. What’s the worst that can happen? Give it a few weeks and see how you feel. If you listen to your body it will tell you what’s best.

The commenters on Allison’s post

Allison’s tale of her ongoing recovery from panic disorder, OCD, and chronic fatigue brought fascinating comments from readers who are addressing similar chronic diseases.

Jennifer has benefited from homeopathy and PHD:

The Perfect Health diet helped me in many ways. I lost weight that I could never lose and improved my cognition and memory. I also felt more together and calmer than I ever had in my life but I still had panic attacks. I had certain triggers that couldn’t be erased. So when my daughter got PANDAS, I did a lot of research and read a lot of accounts of children being helped by homeopathy (I know….I hear the collective groans of disbelief)….. My daughter and I have been going to [a practitioner of the heilkunst method of homeopathy] once a month since September. Most of her issues have been completely resolved and I am completely panic free and my insomnia (which I had for over a year…could not sleep without drugs) is completely resolved. I have inner strength that I have never had and I sleep like a baby…. I know many people are skeptical about homeopathy or know little about it but I am proof that it works … I do credit the Perfect Health diet for allowing homeopathy to work as spectacularly as it has for me since I think my issues would remain chronic if I weren’t on an optimal diet.

We believe chronic infections are an under-recognized cause of disease, and Hunter’s wife illustrates that thesis. She benefited from antiviral treatments:

Allison, everything you describe sounds like you could be my wife Tiffany in another life!

A couple years ago Tiffany decided to stop taking birth control and her health took a turn for the worse as those hormones were apparently helping to keep her “functioning” all the previous years and she suddenly developed amenorrhea and hypothyroidism. Finding an endocrinologist who would actually agree that she was hypothyroid was impossible but we kept trying until she eventually progressed to be so bad that she was officially diagnosed but after trying many different thyroid medications, none ever helped her “feel” better and no one could find the cause of her thyroid issues. We finally came across an ad in the paper for a chiropractor who said he specialized in thyroid disorders and chronic fatigue syndrome so we went to see him and he ordered hundreds of blood tests looking for infections. In the end he diagnosed her with a chronic viral infection of Epstein-Barr Virus (mono) among a couple others and he told us that he has seen this in multiple patients and Epstein-Barr is always related to chronic fatigue and thyroid issues. Chiropractors cannot prescribe medicine in the state of Florida so he transferred her to a semi-retired infectious disease specialist who he had worked with for previous patients, Dr David Reifsnyder in Lakeland, FL. Dr Reifsnyder agreed that Epstein-Barr is the main cause of her hypothyroidism and chronic fatigue and told us how he has treated hundreds of patients for this throughout his career and that they always have active Epstein-Barr infections but that most doctors don’t know how to test and diagnose an active chronic Epstein-Barr infection, even before he could test for the virus he said that he discovered patients with these symptoms would respond to antiviral treatment, and that Tiffany would have to take antivirals daily for the next 2-4 years but that he was sure this would eventually clear up all of her issues, however recovery would be a slow process as her HPA axis recovered and got “back into sync”.

We noticed her improving almost immediately after starting the daily antivirals and it’s now almost 1 year later and she’s stopped taking antidepressants and just seems to have no desire to visit psychiatrists any more, something she had been doing for all of her adult life, I think they had tried putting her on every antidepressant possible over the years. She has also stopped taking thyroid medications and her body has normalized her thyroid levels on its own. She doesn’t have fatigue issues any more, she wakes up feeling more refreshed in the mornings and doesn’t want to sleep all day any more, she’s even started wanting to exercise and go jogging, something she enjoyed as a kid on the school track team but had given up as she got older and dealt with these issues. And after 1.5 years with a complete absense of her menstrual cycle her female sex hormones have normalized on their own and her regular menstrual cycle returned.

Jo had also suffered from panic disorder and other problems, but is doing better after getting antimicrobial treatment and eating PHD:

My life has been marked by fears – they literally dictated most of my choices. Finally, a diagnosis of autoimmunity that triggered an 8-year long search for remedies. I started addressing gut infections – gut imbalances and H.Pylori – then herpes viruses, then mono then, under Paul’s suggestion, I requested a course of fluconazole for a fungal skin condition that might actually be systemic. I saw improvements only when I addressed these infections together with a PHD compliant diet. The tics are still with me and are cyclical – which makes me think of some parasite I have not identified yet. But many other symptoms disappeared and for the first time I have a different perspective in life. In addition to infections I had several nutrient deficiencies – I was prone to break bones and hurt myself continuously, partly because of an anxious behavior and partly because of low vitamin D. I know very well what you mean about overcoming the memories and the habit of living life to cater fears. Plus, I spent so much time finding a psychological cause, torturing myself with any possible technique to train my mind…I wish I had known.

There is a great need for better diagnostic tools, better treatments, and more doctors who are willing to investigate and address chronic infectious conditions. But hopefully these stories will help move medicine in the right direction.

Last But Not Least

In my New Year’s Day post I quoted Jennifer Fulwiler to the effect that she was having a comfortable sixth pregnancy:

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

[A]fter I had my fifth child I found myself tired, achy, and 35 pounds overweight. Thanks to the PHD I lost all the weight, and when the show was filmed, in my first trimester of pregnancy with my sixth child, I weighed the same as I did the day I got married, and felt better than I ever had in my life.

Fortune being fickle, soon afterward Jennifer experienced shortness of breath and checked into a hospital. Pregnancy is a risk factor for clotting, and Jennifer is homozygous for a mutation which leads to overproduction of Factor II (prothrombin). Her clotting disorder, which is shared by about 1 person in 10,000, was discovered during her second pregnancy when she suffered deep vein thrombosis. This time around the clotting caused pulmonary embolisms.

It’s impossible to know whether it contributed, but a few weeks before symptoms began Jennifer began taking a multivitamin with a number of coagulation-modulating ingredients. I may as well reiterate here for those trying to follow our diet without reading the new edition: One of the updated bits of advice is that we now recommend AGAINST taking a multivitamin, even in pregnancy.

Jennifer is at home and has resumed blogging, but I know she would appreciate prayers.

Around the Web; Davy Jones Goes to His Locker Edition

Posted by on March 3, 2012 30 comments

The Paleo Summit continues: today we have Cate Shanahan, Keith Norris, and Daniel Chong; tomorrow the summit wraps up with Jimmy Moore, Stephanie Greunke, and Dean Dwyer.

To download the full set of videos, you can buy the Paleo Summit upgrade package:

[1] Music to read by: Davy Jones passed away at 66 from a heart attack:

He looked good 8 months ago, just overweight:

One more for the road:

[2] Interesting items:

Beth Mazur organized discussions at PaleoHacks for each of the Paleo Summit talks. Here is a list:

Jimmy Moore asks, “What’s With The Antagonism About Low-Carb From The Paleo Community Lately?”

Richard Nikoley‘s ideas have been sipping scotch in the back of his mind, and now that his safe starch experiment is going well, they’re ready to come out:

Four days in, and I’m averaging 300-400 calories below what I was averaging before. I feel more full on average, more satisfied, sleep WAY better, and have a mental go-for-it attitude I haven’t felt since I was on that high-fat diet, in caloric deficit and losing 60 pounds.

I’ve lost between 2 and 3 pounds since weighing in Saturday morning when this all began.

SCD Kat is giving up starches after contracting appendicitis. Get well soon, Kat!

J Stanton gives us the next big thing: the Australopithecine Paleo Diet.

Conner Whitney, cancer survivor, chef, and author of Zest for Life: The Mediterranean Anti-Cancer Diet, explains healthy ways to create processed meats, including home-made bacon.

Bruce Charlton reports that nerve function has degraded 35% since the 1880s. He thinks it’s due to genetic changes; I would put my money on dietary changes and the evolution of chronic infectious pathogens since the invention of plumbing and water treatment.

Fight Aging! notes a 1929 study in which rats lived 10% longer when some of their dietary wheat was replaced with milk. Elsewhere, Fight Aging! notes that HDAC inhibitors can reverse Alzheimer’s in a mouse model. This is interesting, because many foods contain HDAC inhibitors, and HDAC inhibitors are also effective against cancer, as I will blog about in my next cancer post.

We’re pleased to be featured in “Dan’s Report”.

Dan’s Plan reprints a post by JD Moyer that starts with the links between Toxoplasma infection and traffic accidents, and ends by saying you should drag your doctor into the modern era.

A Mongolian-trained Harvard doctor thinks modern milk has too much progesterone. Mongolian milk is much healthier.

Cate Shanahan thinks that the elevation of rT3 and decrease of T3 thyroid hormone sometimes seen on extreme low-carb diets is due to abrupt reduction in carb intake. I think it’s due to the body being unable to manufacture enough glucose to meet its needs.

Jack Kruse offered two posts: First, why you shouldn’t eat a banana if you find yourself in Calgary, Canada on Dec 31st. Second, why the death of a patient from cold taught him that we should expose ourselves to cold. Melissa McEwen thinks Jack’s posts deserve criticism. Melissa’s post has a vigorous comment thread that includes comments by me, Chris Kresser, Kurt Harris, Steve Parker, and others.

Walking the dog can be hazardous to your health.

The New York Times reports: postprandial blood glucose will be better regulated if you keep moving.

Stephan Guyenet reports that more palatable foods are less satiating.

More on food reward: The history of toothpaste shows that the Flavorists were already getting started in the early 1900s.

Paleo ideas are going mainstream: FoxNews has a slide show featuring nutritionist Carol Cottrill’s advice to avoid processed foods.

Dr Steve Parker reviews Mark Hyman’s book, which is #1 on Amazon.

Robert Su asks: what does it mean if you can hear your heartbeat?

Judy Tsafrir discusses the FODMAP diet.

Via Ruthie, cuddling dying pets can sometimes give the owner a life-threatening infection. A hospital in Akron, Ohio, saw three such cases in a year.

Jennifer Fulwiler remarks upon a photo series of New Yorkers eating dinner: “I was surprised by the number of people who ate alone and/or who watched TV or used the computer during dinner.” New York is a lonely place.

[3] Cute animals: Looking for ideas to treat the mange on your baby sloth?

Also, be careful in Calgary: Stabby’s Japanese cousin is visiting.

[4] Only in Japan: Japan is a special culture. Many tsunami survivors lost all their family photos in the flood, and Japanese photographer Nobuyuki Kobayashi, with the help of hair and makeup volunteers and a legion of grade school students, decided to make up the loss with professional portraits and letters of support from schoolchildren. Here’s a slideshow.

This is Katsuko Abe, age 71, with her dog Kaede, getting ready for her portrait:

[5] Giving up weight for Lent? In the same post I linked above, Jennifer Fulwiler shares some good news:

As I look for something to wear this weekend, I’m reminded that I am in the middle of the wardrobe crisis that I’ve been waiting to have for ten years: all my clothes are too big. I don’t mean a little loose; I mean I perpetually look like I’m headed out to an M.C. Hammer costume contest.

Over the past few months I’ve lost 25 pounds. That’s a good thing, mainly since the drop on the scale was more of a side effect of lifestyle changes that have left me with more stamina and energy than I had when I was 20….

It’s too long a story to explain in detail here, but the short-short version is that it was Perfect Health Diet + rethinking what a reasonable portion size looks like + accepting that spiritual warfare really does come into play with getting healthy + learning to depend on a good jog for an energy boost.

[6] More on pork: Via Dan Moffet, another reason to avoid undercooked pork:

[7] Not the weekly video: Via Chris Highcock, Jeb Corliss makes a spectacular base jump in a wingsuit:

This was in Switzerland. On 16 January 2012, Jeb suffered multiple leg fractures in a similar jump off Table Mountain, Cape Town, South Africa.

[8] Shou-Ching’s Photo-Art:

[9] Weekly video: The Dance of the Water Sleeves:

Around the Web: Epiphany Sunday Edition

Posted by on January 8, 2012 46 comments

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

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

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

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

Taki Y et al. Breakfast Staple Types Affect Brain Gray Matter Volume and Cognitive Function in Healthy Children. PLoS One. 2010 Dec 8;5(12):e15213. http://pmid.us/21170334. Free full text.

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

[4] New this week:

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

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

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

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

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

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

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

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

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

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

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

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

CarbSane has her own objections to the petition.

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

The Scientist looks at how parasites exert mind control.

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

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

ItstheWooo found that supplements cured her hypoglycemia.

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

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

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

Steven Hamley has a lot of ideas about obesity.

Better nourished elderly have better brain health.

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

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

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

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

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

[5] Cute animals:

[6] Cute animal woman of the year:

[7] Via erp:

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

[9] Interesting comments:

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

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

[11] Shou-Ching’s Photo Art:

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

2011 in Review: Top Posts

Posted by on December 31, 2011 15 comments

It’s been a great year for us, full of fun and learning. In this last post of 2011 I’ll review the year’s most interesting posts. Early next week, I’ll add a few more thoughts about 2011 and preview our plans for 2012.

But first let me give a shout out to Stabby Raccoon’s “Guide to Binge Drinking,” at the new group blog “Highbrow Paleo.” If you plan to drink alcohol on New Year’s Eve, either for pleasure or to raise your HDL, you might want to look up Stabby’s advice.

The Puzzle of High LDL on Paleo

One of the more interesting puzzles we delved into this year was the problem of high LDL on Paleo.

Reader Larry Eshelman had this problem, and gathered a large number of examples of low-carb Paleo dieters with high LDL: Low Carb Paleo, and LDL is Soaring – Help!, Mar 2, 2011. We suggested a possible remedy – repairing deficiencies in micronutrients known to be crucial to vascular function – in Answer Day: What Causes High LDL on Low-Carb Paleo?, Mar 3, 2011.

That remedy worked for Larry, and we’ll do an update on his case soon. But it wasn’t the whole story, and later in the year we looked at another cause of high LDL on Paleo – low thyroid hormone levels – in High LDL on Paleo Revisited: Low Carb & the Thyroid, Sep 1, 2011. Going too low-carb causes a reduction in T3 thyroid hormone levels, which leads to inactivation of LDL receptors and potentially large increases in LDL levels. Gregory Barton shared his case history.

Blood Lipids as Diagnostic Tools

We were also led to think about blood lipids because lipoproteins are immune molecules of considerable importance in fighting infectious diseases. We talked about the immune functions of HDL in HDL and Immunity, Apr 12, 2011, and HDL: Higher is Good, But is Highest Best?, Apr 14, 2011. We talked about the immune functions of LDL, VLDL, and Lp(a) in Blood Lipids and Infectious Disease, Part II, Jul 12, 2011.

With help from blogger O Primitivo, we looked at what serum lipid levels optimize health in Blood Lipids and Infectious Disease, Part I, Jun 21, 2011. It’s higher than most think: TC between about 200 and 240 mg/dl is optimal.

We discussed ways to improve immune function by raising HDL in How to Raise HDL, Apr 20, 2011.

Don Matesz objected that newborns have very low serum cholesterol, so we looked at Low Serum Cholesterol in Newborn Babies, Jul 14, 2011. Breast-fed babies achieve normal serum cholesterol of about 200 mg/dl at age six months, which is also when their immune function normalizes.

Another objection was based on the claim by Paleo pioneers Boyd Eaton and Loren Cordain that hunter-gatherers had low serum cholesterol. That led us to a number of posts: Did Hunter-Gatherers Have Low Serum Cholesterol?, Jun 28, 2011; Serum Cholesterol Among the Eskimos and Inuit, Jul 1, 2011; Serum Cholesterol Among African Hunter-Gatherers, Jul 5, 2011; Serum Cholesterol Among Hunter-Gatherers: Conclusion, Jul 7, 2011. The upshot: healthy hunter-gatherers had normal serum cholesterol, with TC usually over 200 mg/dl. The cases of low serum cholesterol were either in stale samples collected from remote sites in the 1930s to 1950s without use of refrigeration and delays of weeks to months in measurement, or from hunter-gatherers with high rates of infectious disease from parasitic protozoa or worms.

This literature survey led us to the belief that there are really only two common causes for low total serum cholesterol (not counting statin consumption): eating a lipid deficient diet, such as a macrobiotic diet; or having an infection with a eukaryotic pathogen.

This means that anyone eating a high-fat diet who has low serum cholesterol should get checked out for eukaryotic infections, probably protozoa or worms. We’ve encouraged half a dozen people or so to do this.

Brendan is a great example. He first left a comment in May asking for advice:

I have rosacea, puffiness in my cheeks, post-nasal drip, frequent headaches, severe constipation (IBS), hypothyroidism, extremely low cholesterol, and a variety of neuropsychiatric symptoms (depression, anxiety, insomnia, and cognitive and motor problems).

“Extremely low cholesterol” is the tell-tale clue. He reported back in December: he did indeed have whipworm and entamoeba infections, and is now seeking treatment.

I like this story because it is a great example of what we’re trying to achieve on this blog. Diet, nutrition, and infections interact to product one’s health; we want to understand how to troubleshoot any problems. I’m excited that blood lipids are turning out to be good diagnostic markers for certain types of infection that are often overlooked.

The Challenge of Obesity

Our diet was designed to help people become healthy; it was not designed as a weight loss diet. Nevertheless, Shou-Ching and I were well aware of the failure of most weight loss diets to cure obesity – rather they tend to produce temporary weight loss followed by yo-yo weight regain – and we strongly suspected that a diet designed for general health might be the best strategy for long-term weight loss. So entering 2011, we were very curious how our diet would work for people trying to lose weight.

From Atkins to the Dukan Diet, recently embraced by Kate Middleton, popular diet books generally recommend high protein consumption, which seems to be very effective at promoting short-term weight loss. A few posts explored the place of protein in a weight loss diet, and whether there are alternatives to high protein: Protein, Satiety, and Body Composition, Jan 25, 2011; Low-Protein Leanness, Melanesians, and Hara Hachi Bu, Jan 27, 2011.

A few people who transitioned to our diet from very low-carb diets noticed an immediate gain of 3 to 5 pounds. This caused us to look into the issue of water weight: Water Weight: Does It Change When Changing Diets? Does It Matter?, Jan 14, 2011.

We also did a bit to link obesity to our favorite causes of disease – malnutrition, toxins, and infections – in Why We Get Fat: Food Toxins, Jan 20, 2011. Another post along this line was Obesity: Often An Infectious Disease, Sep 20, 2010.

Losing weight is especially hard for post-menopausal women, especially if they can’t exercise. Calorie needs may be as low as 1500 calories per day, making it hard to be well nourished on a calorie-restricted diet. The case of erp, a 76-year-old women with bad knees who needed to lose weight for knee replacement surgery, led us to clarify where the calories should come from when few can be eaten: Perfect Health Diet: Weight Loss Version, Feb 1, 2011.

We were happy that erp did indeed lose weight, dropping from size 16 to size 6. Another impressive case of weight loss was recorded by Jay Wright, who started our diet in March at 250 pounds and reached his goal weight of 170 pounds in October. Jay generously shared his story: Jay Wright’s Weight Loss Journey, Dec 1, 2011.

Stephan Guyenet, one of the finest diet and nutrition bloggers, introduced us to “food reward” and to the role in obesity of the brain modules that manage appetite and energy homeostasis. He had a back-and-forth with Gary Taubes over their differing views. I chimed in on a few occasions, notably in Gary Taubes and Stephan Guyenet: Three Views on Obesity, Aug 11, 2011, and Thoughts on Obesity Inspired by Stephan, Jun 2, 2011.

The Guyenet-Taubes debate gave me an opportunity to present a figure from a classic study by Maria Rupnick and colleagues. Giving or withholding an angiogenesis inhibitor causes ob/ob (obesity prone) mice to cycle between obese and normal weight:

It is hard to see how either a brain-centric view or a carb-and-insulin-centric view can account for this. I see this data as testimony to the complexity of biology.

I’m going to be developing my own theory of obesity in 2012; I previewed this theory in my talk at CrossFit NYC on November 19. One element was the subject of a 2011 post: How Does a Cell Avoid Obesity?, Jan 18, 2011. Leptin resistance and insulin resistance – two of the hallmarks of obesity – are symptoms of the disease of obesity, not its cause.

Therapeutic Ketogenic Diets

Ketogenic diets are potentially highly beneficial to neurological function, and are an under-utilized therapy for neurological conditions.

One reason they’re under-utilized is that clinical ketogenic diets have been poorly designed and malnourishing. We discussed how to make a diet ketogenic while minimizing health risks in Ketogenic Diets, I: Ways to Make a Diet Ketogenic, Feb 24, 2011, and Ketogenic Diets 2: Preventing Muscle and Bone Loss on Ketogenic Diets, Mar 10, 2011.

But the goal is to demonstrate that ketogenic diets can be therapeutic for various conditions. We had several great stories from people trying our version of the ketogenic diet.

Kate was able to relieve migraines and anxiety: A Cure for Migraines?:, Mar 29, 2011.

In a poignant story, we learned about a genetic disorder called NBIA (Neurodegeneration with Brain Iron Accumulation). Children with this disorder develop extremely painful muscle spasms and are usually in agony from around age 6, before dying in their teens. It turns out that a ketogenic diet effectively prevents the spasms and pain. Two parents of NBIA children shared photos of their kids in Ketogenic Diet for NBIA (Neurodegeneration with Brain Iron Accumulation), Feb 22, 2011. From being in constant pain, the boys had gone to “smiling and laughing all the time”:

Hypothyroidism

Thanks to our resident expert on hypothyroidism, Mario Renato Iwakura, we had a number of excellent discussions of how to optimize diet and nutrition for hypothyroidism.

First, Mario defended our support of selenium and iodine supplementation in cases of hypothyroidism, including Hashimoto’s autoimmune hypothyroidism, with a thorough review of the literature: see Iodine and Hashimoto’s Thyroiditis, Part I, May 24, 2011, and Iodine and Hashimoto’s Thyroiditis, Part 2, May 26, 2011. It is crucial to get selenium in the range 200 to 400 mcg per day, and to avoid an iodine deficiency. With optimal selenium, a wide range of iodine intakes are healthy, including quite high iodine intakes.

Later in the year, readers asked us to address claims by Anthony Colpo that low-carb diets would lead to “euthyroid sick syndrome,” a condition of low T3 thyroid hormone. We found support for that idea, but only for “very low-carb” diets, ie those with carbs below 200 calories per day (more in athletes or those with inadequate protein intake). Thyroid problems were also exacerbated when omega-6 fat intake was high. A literature search was unable to find instances of thyroid problems on low omega-6 and adequate carb diets. The main posts: Low Carb High Fat Diets and the Thyroid, Aug 18, 2011; Carbohydrates and the Thyroid, Aug 24, 2011; Mario Replies: Low Carb Diets and the Thyroid, II, Aug 30, 2011.

This was a useful discussion, as it led us back to the problem of high LDL on Paleo due to low T3 thyroid hormone levels caused by very low carb consumption.

The Place of Starches in a Paleo Diet

Given that some carbs should be eaten, what form should they take? There are two main food types of carbohydrate, sugars and starches.

I was surprised by the vehement opposition to starch consumption displayed by many low-carb advocates polled by Jimmy Moore in October. Most low-carb diets support the eating of sugary fruits and vegetables, and I would have thought that opposition to starches would be no greater than opposition to sugars. How wrong I was!

My original reply to the many low-carb gurus polled by Jimmy can be found here: Jimmy Moore’s seminar on “safe starches”: My reply, Oct 12, 2011. A week later I added a discussion of why the glycemic index or starches doesn’t matter when they are eaten the way we advise eating them: How to Minimize Hyperglycemic Toxicity, Oct 20, 2011. Dr Ron Rosedale enthusiastically continued the conversation, and I replied to Ron: Safe Starches Symposium: Dr Ron Rosedale, Nov 1, 2011.

Shortly afterward I spoke at the Wise Traditions conference of the Weston A Price Foundation – a great meeting! – and was asked about the GAPS diet of Dr. Natasha Campbell-McBride. It is an excellent diet which embodies a lot of clinical lore about how to heal gut dysbiosis, but its recommendation to avoid starches, while usually helpful, is not always the best course. There are pathogens capable of exploiting every human ecological niche and diet, including very low-carb or fructose-containing diets, and so there is no one diet that is perfect for every patient. Some cases of gut dysbiosis actually benefit from added starch. There seemed to be a bit of controversy about what I said, and I clarified my off-the-cuff comments here: Around the Web; Revisiting Green Meadows Farm, Dec 3, 2011.

Infectious Diseases

I thought I was going to blog a lot more about infectious diseases in 2011, but didn’t get around to it. Still, I got started in February with a few posts: They’ve Got Us Surrounded, Feb 8, 2011; Jaminet’s Corollary to the Ewald Hypothesis, Feb 11, 2011; and Evidence for Jaminet’s Corollary, Feb 15, 2011.

Circadian Rhythm Therapies

I’ve known for a long time that circadian rhythms were important for health. Disruption of circadian rhythms, for instance, by night shift work, is associated with higher rates of disease.

What I didn’t know, until I began to read Seth Roberts, is that simple dietary and lifestyle tactics can have a big impact on circadian rhythms. Seth Roberts and Circadian Therapy, Mar 22, 2011, looks at Seth’s work; “Intermittent Fasting as a Therapy for Hypothyroidism,” Dec 1, 2010, applies circadian rhythm therapies to hypothyroidism.

Cancer

We made a start toward discussing how to eat if you have cancer in two posts: Toward an Anti-Cancer Diet, Sep 15, 2011, and An Anti-Cancer Diet, Sep 28, 2011. Cancer is another disease in which circadian rhythm therapies seem to be important.

However, there’s much more to be said about cancer. We’ll probably discuss HDAC inhibition and anti-viral dieting in 2012.

Miscellaneous Disorders

Check out the “Diseases” categories in our Categories list for other disorders we’ve blogged about. A few items from 2011: Causes and Cures for Constipation, Apr 4, 2011; An Osteoarthritis Recovery Story, May 17, 2011; Around the Web; and Menstrual Cramp Remedy, Mar 5, 2011.

A Year of Food

In 2011, we decided to write a cookbook, and made an earnest start by posting a recipe once a week. Some of our favorite food posts:

Ox Feet Broth, Miso Soup, and Other Soups, Jan 2, 2011

Homemade Seasoned Seaweed, Jan 9, 2011

About Green Tea, Jan 30, 2011

Dong Po’s Pork, Feb 13, 2011

Pho (Vietnamese Noodle Soup), Feb 27, 2011

Pacific Sweet and Sour Salmon, Apr 10, 2011

Crème Brûlée, May 29, 2011

French Fried Potatoes and Sweet Potatoes, Jul 17, 2011

Chicken Wings, Sep 19, 2011

Sarah Atshan’s Lovely Food, Sep 11, 2011

Bi Bim Bap, Oct 16, 2011

Fermented Mixed Vegetables, Nov 27, 2011

Bengali Fish Curry (Machher Jhal), 2: The Recipe, Dec 27, 2011

Art

Shou-Ching wanted to be an artist but settled for being a scientist. This year she began to share some of her art work. We showed some of her paintings in Thank You From Shou-Ching, April 24, 2011, and her Photo Art appears weekly in our Around the Web posts. A complete compilation can be found on the Photo Art page.

Cute Animals

There were too many cute animals in the Around the Web posts to pick a favorite; but here’s one of my favorite places – Logan Pass, Glacier National Park, Montana:

Conclusion

It was a delightful year for us. We made a lot of new friends. Best of all, our diet seems to have improved the health of hundreds, maybe thousands, of people – often dramatically.

We wish all of our readers a very happy New Year! May all of us enjoy improved health in the year to come.