Free the Animal

Reader Questions - At You

I'm going to borrow a page from Mark Sisson and try something out. Anyone willing and able to help field some reader questions? I hope so, and with that hope, here goes. I'll alert each questioner to this post so that they can be prepared to add supplemental info where needed.

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Q1. From Joe:

I have been reading the blog for about 6 months and had tremendous success eating Paelo style. I had a quick question - Sometimes when I eat refined foods (grains, bread, pretzels, hoagies etc...) my mood becomes nasty. I get angry for little or no reason. When I go back to strictly paleo, I am more patient and I am more pleasant overall. Do you know of or have you ever heard of anything about how food effect a persons mood?

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Q2. From Marc:

Perhaps you can help me, I started eating paleo and following a plan very similar to yours about 3-4 months ago since then I have gained 12 pounds. Not muscle. Pants getting tighter. 220lbs to 232. Basically at a loss on what to do next. Any advice would be appreciated. Blood work good, thyroid ok.

[Ed: He goes on to detail some exercise & eating habits that seem completely appropriate to me.]

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Q3. From Tom.

Richard, I'm a follower of Free The Animal. I happened to come across a blog site called Heart Scan and noticed a comment you'd sent about your thyroid and tsh levels. This caught my attention because I 'suffer' from thyroid problems. When I was 13, I had surgery for Graves Disease and a portion of my thyroid was removed. My levels appeared to be fine after until I started gaining weight in my late 30's. I went and had my tsh levels checked. All out of whack. I was placed on synthroid and my levels went down; however, I felt terrible and my heart would randomly palpitate making me think I was having a heart attack. I told my primary care physician about this and she said my blood test results were within 'recommended standards' and I needed to continue the regimen even though it didn't make me feel any better. I had her send me to the local endocrinologist. That turned out to be a waste of time! She had diabetes posters all over her office and that appeared to be her 'bread & butter'. She told me I just had to get used to being over weight and not feeling good. In fact, she said I might not even have any thyroid tissue left. Sounded like a life sentence to me from an 'expert'. When I got home, I chucked the synthroid down the toilet and went to a naturopath. I started taking a non-prescription thyroid supplement and also a daily kelp tablet. The heart palpitations went away. I started feeling better. About this same time, I stumbled across Art Devany's Evolutionary Fitness website and later Free The Animal. I also went and had an ultra sound scan and found out I still had thyroid tissue. I've lost weight and my eyebrows are growing back (another telltale sign of thyroid problems). I know I need to eventually have my tsh levels checked; but, I feel good and my cholesterol levels are lower now than when I was on synthroid. I'm hesitant to have the western medicine gurus get me in their clutches again.  Any words of wisdom?

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OK readers; anyone want to weigh in? I'll be happy to engage in comments as well. Thanks, as always, to the many of you willing to lend a hand to your fellow travelers.

Mom Rings In: "Amazing Results"

I last reported on my mom (68, type 2) getting off insulin injections in March. The benefits of the paleo lifestyle continue to stack up, now seeming to ease arthritis pain, as well as nerve damage in the feet from going undiagnosed as a type 2 for so long.

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I don't know if it is removing grains, sugars, vegetable oils, etc. from my diet, or the supplements I am now taking, or a combination, but I am getting amazing results that I didn't even think about at the time I started.  Even though I take medication for rheumatoid arthritis I still had some pain.  I tried and succeeded in keeping the Methotrexate at a low dosage because of the damage it can cause to the liver.  I was willing to live with some pain and did not allow it to alter my lifestyle.  I always had some pain in my lower legs and feet, my knees, my hips, my shoulders and neck, and my hands, especially my thumbs.  I had additional pain in my feet caused from nerve damage from diabetes.  Several of my toes were actually frozen. I couldn't move them except with my hand.  They always hurt.

Well, I still have nerve damage in my feet but there is little pain, just kind of a feeling like some of the toes are tingly.  I do not have complete movement back yet, but a measurable improvement, especially on my left foot.  I can actually separate all the toes without using my hand, just by wanting to.  My right foot is improving but at a slower rate.  It was the worst of the two so that is understandable.  I don't have pain  in the rest of my body.

I should be able to get off the oral diabetic meds within the next couple of months.  After that I will try to get rid of the meds for arthritis.  It is scary, because if it doesn't work it is 3 months of total and complete hell.  But I am going to try it.  I want to be on the supplements and the paleo program for a while longer before I do.

Thank you, thank you, thank you.

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Well, what can I say? 

Reader Feedback - Doctors and Cholesterol

First up, an email from Robert, who'll become a medical doctor in under a week. He must be completely thrilled, eh?

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Just wanted to say hello. I’ve been a regular reader for several months now and thought I should take a moment to introduce myself. My name is Robert and I will be an MD in about six days. I’ll be starting an internal medicine residency in Reno, NV in July. I am both excited and nervous about starting, nervous largely because my patience with “modern” medicine is in rapid decline and I have three years of attending physicians to deal with. Yes, Richard, all of the doctors I have worked with personally approach health and nutrition in as mindless a manner as you think and often rant about.

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I know, Robert, and isn't it the damnedest thing? Here you spend all that time, money and effort -- all the while enduring an enormous burden in terms of mental and physical stress and fatigue -- and it would certainly be an appropriate reward to be held in the sort of superman high esteem doctors have traditionally and often deservedly been held.

But I think it's safe to say that owing to the Internet, with its legions of people like me who deal in facts, logic and principles -- and not so much in titles, degrees and positions -- that we're in a situation where the gig is up. Doctors have largely squandered the goodwill they've earned over a century of hard, dedicated, lifesaving work. Thankfully, there are a growing number of docs like your very-soon-to-be self who have come to see the light. It's going to be an uphill battle for a long time.

For instance, Tim, another reader, sent me his lipid panel for comment. Though I don't expect you to comment, Robert, I have an idea that you would interpret it far differently from Tim's doctor. So, as frustrating as it is, this is a step in the right direction. There's that.

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February, 2008, 225 lbs, years on the Standard American Diet:

Total 173
Trig 109
HDL 60
LDL (calc) 91
VLDL 22
Ratio 2.9

July, 2008, 160 lbs, through calorie counting, semi starvation, yet semi-low carb:

Total 145
Trig 38
HDL 69
LDL (calc) 68
VLDL 8
Ratio 2.1

Been going Paleo(!) since Sept 08, intermittent fasting, 3 days a week lifting hard efforts, sprints, eating tons of meat! Actually heading down the road for 90 days of meat only (2+ weeks in right now) so I did another panel:

May 1, 2009, 170 lbs, more muscle!

Total 226
Trig 34
HDL 82
LDL (calc) 137
VLDL 7
Ratio 2.8

Should I be concerned of the rise in Total and LDL?  From what I've read on your blog, Dr. Eades, and other sources, I don't think so.  I am more fearful of the 145 total number (cancer! etc) than the 226!  But my doctor is of the opposite opinion.

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His doctor is of the opposite opinion, but why? Has the doctor been reading Eades, Davis, Sears, Briffa, or the many others out there and concluded that they are wrong? I doubt it. Tim's doctor is probably what I now refer to as a "regurgitator," i.e., as applied to the medical profession: someone who is trained to expertly diagnose and treat in accordance with conventional "wisdom," right or wrong. My non-medical opinion is that we ought to be cheering his great success in improving his health in a way that reflects every well done study and observation of this sort of thing I've seen.

For example, his C-reactive protein was .3 (a "BTW" in another part of his email), where "normal" is < 3 mg/l. This is a strong marker for inflammation -- the very thing that small, dense LDL acts upon to cause heart disease. Also, the ratios they have given Tim are of Total/HDL, which remain steady, as his HDL went from 60 to 82 (all the while you hear great cheering amongst the ignorant masses when someone goes from 45-50 and credits oatmeal or Cheerios). Normal for that ratio is 4-6, because grain and sugar eaters have such miserably low HDL. Ideal is 2-3. Mine was 2.1, so was my wife's, thereabouts, so there's three data points on that for Paleo: IDEAL.

The more important ratio by far, in my opinion, is Trigs/HDL. This is one of the biggest associations with cardiovascular disease (CVD). Again, grain and sugar eaters have abysmally low HDL (the thing that carries oxidized LDL out of your arteries and back to the liver for recycling) combined with elevated triglycerides, which is dissolved fat in the blood. Yes, ironic, isn't it? You want low levels of circulating fat in your blood? Replace grain and sugar with fat in your diet and the very first thing that will happen is that your Trigs (fat in your blood) drop precipitously. Guaranteed.

Tim went from a decent level of 109 ("normal" is considered < 150, but that's only because it's based on normal for grain and sugar eaters) to a whopping low of 34. Of course, he did it by replacing crap in his diet (grain and sugar) with real food like animals and their fat. 

Now, in case you're suspicious about the veracity of this Trig/HDL ratio being of prime importance, there's a lot out there. How about this, a 1990 (!) interview with then director of the massive, long-term Framingham Heart Study, Dr. William Castelli.

"There's a subgroup of people who have an HDL under 40 and triglycerides over 150," he explains. "These people have galloping proression of their cholesterol deposits, which will eventually lead to heart disease, and the average physician is not picking it up."

You can read the whole interview.

So, what did Tim's Trig/HDL ratio do while progressing from SAD to Paleo? It went from 1.8, which is on the very low side of ideal (< 2), to .4, which is on the screaming bleeding high side of ideal. Mine is also .4, so is my wife's, thereabouts, so three more data points for ya. Tim achieves a 4.5 magnitude improvement on his Trig/HDL ratio.

I wonder what Cheerios would have done for him.

But that's not all. His LDL is calculated, and rather than rehashing the pitfalls of calculated LDL, I'll just refer you to my 2-part series: What Do You Think You Know About LDL Cholesterol? (part 1; part 2). For another reference, here's how LDL ought to be measured: NMR LippoProfile.

But what can we glean from the information provided? Well, it turns out that the Trig/HDL ratio is a reasonable marker for LDL particle size. Remember, and you can find out more here, but small & dense LDL particles are the real danger. Guess what else? grains and sugar give you a profile where most of your LDL is small and dense, while a high fat (natural, i.e., animal) diet gives you LDL that's large and fluffy, which is inversely associated with CVD, so far as I can tell.

Ratio of Triglycerides to HDL Cholesterol Is an Indicator of LDL Particle Size in Patients With Type 2 Diabetes and Normal HDL Cholesterol Levels

RESULTS — Clinical characteristics, pharmacological therapies, lifestyle, and prevalence of diabetes-related complications were similar in both patient groups. LDL size correlated negatively with plasma triglycerides (TGs) (R2= 0.52) and positively with HDL cholesterol (R2=0.14). However, an inverse correlation between the TG–to–HDL cholesterol molar ratio and LDL size was even stronger (R2= 0.59). The ratio was >1.33 in 90% of the patients with small LDL particles (95% CI 79.3–100) and 16.5% of those with larger LDL particles. A cutoff point of 1.33 for the TG–to–HDL cholesterol ratio distinguishes between patients having small LDL values better than TG cutoff of 1.70 and 1.45 mmol/l.

Let's unpack this, and by the way, while this may look incomprehensible to many of you, do know that a couple of years ago it would have been to me too. I can only encourage you to persevere. You can develop an ability to pretty well understand this stuff. Yes, consult a doctor (hopefully one like new-doc Robert), but go in knowing and understanding what you're talking about. If a doctor is ever offended by your accumulated knowledge and insistence on questions and clear explanations, you need to find a new one.

• LDL size correlated negatively with plasma triglycerides: higher Trigs = smaller LDL particles (bad)
• ...and positively with HDL cholesterol: lower HDL = smaller LDL particles (bad)
• However, an inverse correlation between the TG–to–HDL cholesterol molar ratio and LDL size was even stronger: the ratio is even more important, i.e., the higher the ratio, the smaller (badder) the LDL particles. Stunningly striking: 90% of those with small dense LDL (bad bad bad) had a Trig/HDL ratio greater than 1.33.

So, what's an average Trig/HDL ratio? I don't have time to look up averages and verify sources, but let's just assume an "on the edge" level for both Trigs (150) and HDL (40). 

That's a whopping ratio of 3.75, well above that 1.33 "cutoff"!!! So, if you present to your medical professional with better-than-"normal" triglycerides of 149 and HDLs of 41, he's going to give you a big high 5, and tell you you're on the right track. He's probably not going to even measure your C-reactive protein to determine inflammation markers, nor your Lipoprotein(a), or even homocysteine. And Tim? Before his transformation? Even with a very moderate Trig level by "normal" standards, he had a ratio of 1.8, well over that 1.33 "cutoff" between likely (with 90% confidence) small dense LDL and large fluffy. And now, at .4? Fergettaboutit. He's going to have an NMR per a subsequent email, but I can already tell you what it's going to show.

[Late edit: Note that as commenter below, GoEd, has correctly pointed out, that 1.33 ratio is based on European units for Trigs and cholesterol, i.e., mmol/l instead of mg/dl. That would all be fine and good, but Trigs and cholesterol convert differently. Dumb mistake, as I've made these conversions a number of times. So, at any rate, the ratio for Trigs and cholesterol based upon mg/dl is about 3.0, not 1.33. So, still, our example of a "normal, excellent" profile at a ratio of 3.75 is still well above the cutoff, albeit not quite as dramatically as I first implied.]

Though it is probably achievable to have a a small percentage of small LDL on a standard diet, I'm far more certain that it's going to be far easier accomplishing it on a paleo-like diet.

By the way, my lipid panels over the last year are here and here, my last with HDLs of 133. Yes: 133.

Afterthought: Tim has VLDL measurements, and the only thing I know is that lower is better. However, I've no idea how they are measured, how reliable they are as a marker, or any relevant studies. If an astute reader can educate me and the rest of us, please do so -- with my sincere gratitude.

A Great Email (FTA tops Zone; Medical Professionals)

As I muddle around, trying to get back in sync from the long weekend -- of which I took every advantage -- here's an email from Eileen that came in last Friday that I was really pleased to receive.

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I just wanted to let you know that you are certainly changing (saving?) lives with your blog.  I forget how I found Free The Animal, but it was shortly after I started my New Year's resolution to drop the 20 lbs I'd gained in the past 18 months.  I had the idea that I was going to Zone because it had helped me lose weight in the past, although I remember quitting because it was a hassle to weigh and measure every bite of food (and quite frankly, I was starving on 12 blocks/day).  Anyway, finding your blog coincided nicely with my Zone procrastination so I decided to follow your recommendations instead.  January 1st, I weighed 145 lbs and a week ago, 125 lbs.  The best part of that is that much of the weight lost was this big spare tire of fat around my waist and no starving.

Also thanks to you/your blog, I began to supplement Vit D heavily. I should mention here that I'm an RN, and since it was cold & flu season the topic came up with some of my coworkers regarding Vitamin D supplementation.  One of the older nurses was telling the younger girls how important it was to take "the recommended 400 IU per day".  If I didn't read your blog, I wouldn't have known that 400 IU isn't likely to do much for people with D deficiency.  I kept taking 6000 IU (and kept my mouth shut - can't argue with some of those old battleaxes and win).  D Action sent my test results in April and my level is 76.

My annual "physical" is coming up in a few weeks, and I am curious to see if my physician will check my cholesterol.  Last year my HDL was a pathetic 38. I'm hoping that after 5 months of healthy eating, there is an improvement.

So thank you, Richard.  Because of your drive to educate the rest of us, you have helped me make truly positive changes in my life and health.  Keep up the great work!

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Pretty amazing, eh? The Zone, a working life amongst medical professionals, and all it really takes is some decent common sense to eat real food, plenty of natural fat, and the rest takes care of itself.

Hearty congratulations to Eileen.

Great Comments: Experience, Knowledge, Encouragement and Inspiration

Wow do we have some great readers who are willing to share all that in the title and more. A couple of days ago I posted this plea, from someone trying to get things together in terms of diet, exercise, health.

The community really responded. There are many great comments there, and I encourage you to read them all, but I also want to re-post a couple as recognition for some really good help.

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First, from David:

Obviously you got into your current condition through a combination of what you eat, how much you eat and what you do (or don't) for exercise. Here's the obvious. Keep doing the same and you'll continue down the same path, at least as fast. if you figure you're 60-80 lbs overweight now, you'll be another 60-80 lbs heavier in 10 years. So here's something obvious ... change what you eat, change how much you eat, change your exercise. Now, we all know that is easier said than done. After all we eat the amount that we do because we're hungry. Overweight people have a hard time exercising, because they're overweight. I think the place to start is with WHAT you eat.

Start with the easy changes. Dump all fructose that is not in fruit. That means dump soda. Dump almost every breakfast cereal. READ the ingredients of stuff you buy. If it includes sugar, high fructose corn syrop, corn solids et cetera ... DO NOT buy it. Google on how the body metabolizes fructose, how it goes straight to abdominal fat, how it does not give you any sense of fullness, and what abdominal fat does to your body and your liver in particular. That should motivate you.

Dump anything made with any kind of fat or oil identified as hydrogenated or modified.

If you do that it will make a huge difference.

Next consider dumping grains. It took me about 5 years to admit that it was worth trying. I have never looked back. It was hard to do, but like quitting smoking, it is fantastic afterwards.

Learn about how to reset your hormones, such as insulin and leptin. They are way out of balance now. I know this because you are overweight.

Once the weight is coming off and once you purge the crap out of your diet, you will feel more energy and will be able to exercise.

Cut fructose and work on your hormones and you'll start feeling full after eating.

These are all simple things but they are up to you. YOU have to make a change. Right now just about any change would be better than carrying on with your current path. Good luck and keep writing here for support. Richard has collected some good people here.

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Patrik:

Who's right? Is the AHA, Cleveland Clinic, Cholesterol Fascists, etc? Or is it the people such as Weston Price, Sally Fallon, Mary Enig, Udo Erasmus, and Ussi Rasnikov and their beliefs on what is the determining factor(s) in heart-disease?

It is easy for anyone to say: I am right. Here is why. Also, humans have a tendency to try and split the difference as in "I don't know who is right, let's just agree that both parties are 50% right".

This, I think, in evaluating fitness/health/life philosophy is incorrect.

Here is what I use to evaluate Paleo versus Conventional Medicine/Fitness. Use at your own risk.

1) What is the underlying framework that any specific advice rests on?

Modern medicine/fitness almost completely ignores evolution. I think this is wrong as "Nothing in Biology Makes Sense Except in the Light of Evolution."

2) Cui bono?

Modern medicine and pharma. Don't get me wrong, I am for Free Markets and I do think that pharma has done a lot -- but in some cases, the incentives are not aligned correctly.

3) So-called studies and "science"

Again, don't get the wrong impression. I use reason and logic to arrive at my conclusions about Paleo BUT I'd advise reading this post when it comes to evaluating "studies"

There is increasing concern that in modern research, false findings may be the majority or even the vast majority of published research claims. However, this should not be surprising. It can be proven that most claimed research findings are false.

BTW cui bono is also relevant when it comes to "science". Do you think that "scientists" aren't subject to confirmation bias?

4) Very important. A healthy amount of both empiricism and skepticism. Is Paleo working for you?

My experience: it has changed my life. I wish I been raised this way.

Aside from the empirical aspects of Paleo -- there is much conjecture. We don't know what the Paleolithic was like.

For example, the debate over sat fat in the Paleo community. (Personally, I don't think it is harmful and suspect it is healthful. But Loren Cordain could certainly be right and I could be dead wrong.)

Are we, right at this very point, getting some things 100% wrong? We sure as hell are.

But so is Western Medicine. Again, don't get me wrong. If I am in a car accident, get me to a emergency room, use all of western medicine, pharma incuded, and fix me up stat!

I don't know if that helps -- but this is how I view epistemological questions of who is right and why they are.

My recommendation: Get off your ass, suck it up and try it. Stop pussyfooting.

If it doesn't work after an honest effort, 3 months or so, nothing is stopping you from going back to the ostensible healthy Standard Government Recommended Diet.

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Erik:

You got it right with "unwilling," but not "unable." It's up to you, man. And you've been keeping up with paleo/Weston Price literature since age 18? Man. What's stopping you?

I first happened upon paleo when I rescued a flat-coat retriever puppy from a trailer park in Escondido. The guy was undernourished and I, of course, rushed to the nearest Petco for a bag of Nutro-Max. Lamb flavor, I believe. "Flavor" shoulda tipped me off. Anyway, he didn't react well. Loose stool, runny nose, sluggish temperament. Something was wrong, and I figured it just might be diet. I was just an English major in school, but I knew the basics of evolution - and I just kinda figured "Hey, this dog is, for all intents and purposes, a wolf. Wolves don't cook and process their meals. Why the hell is he eating all these polysyllabic ingredients?"

I did a bit of digging around online and found that entire communities had sprung up around raw, ancestral feeding. Raw meat, bones, organs. It made perfect sense, and Charlie (my pup) agreed. Shiny coat, boundless energy, white teeth - it worked to perfection.

I got to thinking that maybe the same sorta dietary concept could be applied to all animals. Maybe even, or especially, humans. I'd been putting on a fair amount of weight, having ballooned up to 235 lbs at age 25 (with a fair amount of muscle underneath, but still...), and I figured something new (or ancient) might work.

It did. I dropped the grains, the legumes, and most of the starches, upped the fats and protein, and started paying attention to everything I ate. I also dropped the body fat. Thanks to blogs like Richard's and Mark Sisson's and Stephan's, I got into Weston Price and all the fat soluble vitamin stuff. Cod liver oil, activator X, raw dairy. This way of eating / living / behaving / works so flawlessly it feels like magic. The way vitamins D, A, and K2 work in concert to heal cavities and regulate calcification? Absolutely insane. Such elegant simplicity. Such beauty. Nature wins again.

How can you see the evidence, read the testimonials, acknowledge the millennia of real world case studies that support it - and still reject the paleo way? I can understand if you were ignorant of this stuff, but you've been reading about it for decades! C'mon! I'll echo a previous commenter and say, "Give it three months."

Three months of fatty steaks, coconut milk curries, and handfuls of macadamia nuts. Heaping salads with feta and olive oil dressing. Roasted chicken, crispy skin, organs, and all. The odd fast. A few days of intense workouts every week, no more than forty five minutes per session. Dust the cobwebs off those old football muscles! Go for a hike every once in awhile. Play with your kid (once she's walking). Hell, I sometimes use my (now full-grown) retriever as a mobile, asymmetrical weight. You could do the same with your kid if cautious (I'm no parent, so perhaps I suggest heresy). No weights or gym membership? Check craigslist for a cheap set or buy sandbags from the hardware store. Bodyweight is good enough, too; when I was heavy, one of the advantages was built in resistance training.

While I don't appreciate the clunky foot cocoons they peddle, Nike had it right with "Just do it." So, yeah: do it, man. Good luck (though you won't really need it... it's all just so easy).

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And those were just three out of a dozen of helpful comments. Feel welcome to read 'em all.

Oh, by the way, this is really the norm here, now. Just last week another reader in need of help got an outpouring.

Thanks you commenters, for such willingness to share and help.

A Reader Question

Here's one that I think applies to a whole lot of folks. They know, but practice is tough.

I stumbled across your web-site a few months back and must say that I find it thoroughly entertaining and thought-provoking.

I am 43 yrd old married father of a nine month old-daughter who is frightened to death of dying prematurely of heart disease and yet I am still unwilling or unable to make lasting changes in my lifestyle to lessen the chance of this occurring. Being 5' 7.5" tall and weighing 242 is not healthy w/a cholesterol level of 302 with a BMI over 35 is a far cry from my days of being athletic while playing football.

The ironic twist to this sad tale is that I have been an avid reader of nutrition & Exercise related materials since I was 15 yrs old, I am very knowledgeable but even I am completely confused as to what to eat!! Who else reads the Paleolithic Prescription at 18 for fun and went to school to be a nutritionist!! Who's right? Is the AHA, Cleveland Clinic, Cholesterol Fascists, etc? Or is it the people such as Weston Price, Sally Fallon, Mary Enig, Udo Erasmus, and Ussi Rasnikov and their beliefs on what is the determining factor(s) in heart-disease?

I guess I am reaching out to you, do in part, because you come across as a sincere, intelligent, honest man trying to provide quality information whom I am seeking advice from. Any information that you may have in taking that 1st step in the right direction, what to focus on, where people are making the biggest mistakes and what further reading would you suggest would be extremely helpful.

Wow.

There's a lot of ways I could tackle this, but I'm going to do so from the perspective of my own experience. But, first, the who's right question: nature and human evolution are right. Most simply: to accept that dietary saturated fat from animals higher than 10% of calories causes high cholesterol causes heart disease, stroke, death is to ignore and reject the whole logic of the evolution of species. It is arrogant and ignorant at the same time, with predictable results: people die early.

This is how arrogant these killers are, and I mean that: we are now several decades into them offering advice that is literally killing and debilitating people and I am never going to shy away from that. It is the very prescriptions they have offered to cut healthful, natural fats, preplacing them with fats created from what used to be industrial waste, all wrapped up in refined sugar and "healthywholegrains," that has created this obesity, diabetes, heart disease epidemic, now progressing even to children.

Paleo or modified Paleo is a principle. This should never be forgotten, downplayed, nor should an opportunity be missed to contrast it with all other diet prescriptions. The Paleo principle begins with an observation: animals, in the wild. What do you see? Provided their environment is suitable to their biological requirments, they thrive in pristine health. They are simply living in accordance with their natures. "Man is the only animal that can sink below his own nature" -- Ayn Rand. And while modern civilization provides us many means and choice to produce and create for ourselves environments to sustain us when a natural one is lacking (bridges, dams, homes, skyscrapers, airplanes, gardens, etc., unlike wild animals), it also provides us the means and choice to ignore or reject our natures. Unfortunately, the choice we lack is whether or not we'll have to live the consequences.

So, for that part, I suspect you know plenty enough to have confidence in a natural, paleo, primal, evfit -- or even a low-carb or WAPF lifestyle.

So what's stopping you? You are. Nobody but yourself. While the fear of early death is a powerful force, let's face it: most people don't actually die young, even those who abuse their bodies. So, it's not like overweight people in their 40s are dropping like flies all around you and you're just gonna ignore it.

It's probably more like my own experience. Life just catches up with you.

I began seeing the weight creep in the early 90s and I knew all about Atkins. I even knew it worked, and I have never in my life worried about eating animals or whatever fat happens to come with them. I grew up on good home cooking, by far and large real food. I tried Atkins at least a half-dozen times over the years, and probably six weeks and 15 pounds was the best I ever got out of it, and in months I'd have gained it all back, with interest.

What changed? I wish I new. I just finally got fed up one day, went to the gym, signed up with a trainer and started pushing weight around twice per week for 30 minutes each. That was May 2007, two years ago this month. I mildly watched what I ate, but I was of the mistaken belief that I could do it mostly by exercise with a little attention to diet, while it's the reverse that's true. But, I kept with the workouts, felt better, looked better, clothes fit better. I was losing a pound per month and getting stronger. It was about 4-5 months later that I really began to tighten up eating and my fat loss doubled. Then, a couple of months later I incorporated intermittent fasting. That was the single thing that made me connect all the dots and really understand human beings as animals.

You might have to do some fasting to see what I mean, so I'll just say that it's in our natures to be hungry fairly often, and the paleo way of eating ensures that this hunger is natural and invigorating rather than nauseous and debilitating when one exists off processed foods and refined sugars.

So, I suppose that my advice would be to pick one of the three aspects and get going: workouts, food, or fasting. When you see good results with the first, add another.

As to confusion over what to eat, here's a good rule of thumb: could you eat it raw if you had to? If the answer to that is yes, then you're a go. If the answer is no (grains, sugar cane, industrial waste chemically processed into "food?"), then keep away.

For reading, there's a few important links on my Overview page. I actually just updated that yesterday to add Mark Sisson's Primal Blueprint 101 page, which is a tremendous resource.

Does anyone else have any comments, advice, experience or inspiration to offer this reader?

Help For a Fellow Traveller?

If I had a paid subscription, here's where I'd have you pay (in comments with your own experiences). From a comment to a previous post:

I have a question. I am married to a vegetarian, so low carb per se is not possible. Even if it wasn't in India it is quite a bit more difficult to do.

I am trying to reduce my Wheat consumption. Now down to 8 rotis (indian flat bread) per week. It is whole grain.

I am thinking of replacing a few of them with fermented flat breads (aka naan) soon.

I have also increased my butter and ghee (aka butter oil) consumption. I have also increased my meat and egg consumption.

The problem I am facing is that over the weekend when I try to go low carb, for a full day, next morning I have vertigo (not the messy one just head spinning). I guess my brain is going bonkers with no glucose. Is there any solution.

I cannot go completely low carb. And it seems that the liver will not start producing glucose just because I have not had carbs for a day. I have heard that some people need to go at it for a couple of weeks to get their liver to respond.

I could try two days of the weekend tops with low carb diet, but not anymore. Its not practical.

Do you think it is going to be beneficial to try to get into low carb, for this small duration, because I just feel dizzy, and nothing else is happening. Is it possible to get your liver to respond, without going to the long induction period. How long was your induction period?

So, any help, from your own experiences?

Here's my input.

First, I had no idea that naan was fermented. That's good, as a great garlic naan is second to none, and I might cheat with one a few times per year -- with a good butter chicken or lamb curry.

As to the low carb, my chief concern is that if your health is normal, zero carb (or low) for a human being is a natural (as differentiated from normal or routine) state of affairs.

in other words, my own natural tendency is to think that, rather than there being something fundamentally wrong with low or zero carb, there's something wrong with me when, in principle, every ancestral person not living in the tropics faced that state of affairs regularly.

The ability is within us.

So, without knowing anything about the individual (his ultimate responsibility), my own personality and drive is such that I would go to the principle: this is programmed within me, and it's only the bugs that exist that are stopping me.

I'd want to conquer it. I'd just simply push through, and a fast might be the best way. If you deprive all nutrition, your body might be more amenable to kicking in gluconeogenesis to get the glucose your brain needs. have you tried a serious water-only fast for 30 hours?

Alternatively, the Atkins induction is a decent way to begin the whole ordeal. It's neither Paleo nor a long term lifestyle, but it will get most people over the hump.

Here's another suggestion from a friend of mine who began this whole thing in dire straights: stay in bed for three days. Seriously. How does one define sickness? If you can't exist without carbs for a few days, aren't you sick? If so, there's no shame in just calling it what it is and bedding down for the 2-3 days needed.

To sun it up, I don't think low or zero carb is in any way a necessary long-term lifestyle unless you're in a metabolic condition (e.g., type 2) that dictates it indefinitely. I'm not necessarily low carb by Atkins standards. Some days are near zero carb, and others, between 100-200. I enjoy mixing things up, but always under the principle of Real Food (naan & rice don't count -- those are rare exceptions for me). That said, I could only be slack on the carbs knowing that I could go zero indefinitely.

Obviously, this isn't advice or prescription. It's me, and I hope others take a moment or two to give you (and all the other beginners who'll read this) their perspectives.

Quick Reader Question

Alicia asks:

Assuming a person is in ketosis, eating clean, exercising, sleeping enough, and otherwise taking good care of herself, is there a limit to how fast it's safe to lose fat?

I'm interested in a general answer, but it might help to know a little about me. I'm a 32-year-old female who is about 70 pounds overweight. I've noticed that when I eat very clean (all real food, less than 50g carbs a day, 90-95% on plan), the scale drops .5 or 1 pound a day. For me, this has amounted to about 4 pounds a week. (The scale always holds steady after a cheat meal.) I eat whenever I get hungry and am not doing IF at this point.

Granted, I've only been doing this a few weeks. But my weight loss appears to be speeding up as my habits get better. My sense from reading Good Calories, Bad Calories is that my body will self-regulate, using up fatty acids as freely as they're available. I just wonder if there's a point where I would want to purposely slow down my rate of fat loss for some reason.

Well, I'd first have to say that there's a lot of people who wish they had your "problem."

Actually, it's not a problem at all and is quite normal for someone in the first couple of weeks that's got 70 pounds to lose. Assuming your normal weight is 130, then 70 pounds is quite a huge percentage of your total (I'm just guessing, of course).

The other thing is that if you've only been at this a few weeks (8-12 pounds lost?) then probably only about a half of that is fat, if that. The rest is water, assuming you're eating plenty of protein so as to preserve lean mass. Once you reduce the carbs so that your body has to begin depleting stored glycogen, water comes along with it. Off the top of my head, for every gram of stored glycogen in your system 1.5 - 2 grams of water is required to keep it there. When you use it, the water comes off too, and this is why low-carb dieters always get an initial burst of loss.

And now you say that it may be accelerating. I'd bet that's just temporary and is probably a function of your changing appetite. As you lose weight, you require less energy and as you become a fat burner, you're more in tune with hunger, so are probably eating less energy without even realizing it. So, you'll end up with a push & pull, manifest in periods of slower loss and then faster loss as your body adjusts.

The bottom line is that as you come closer and closer to your goal, your fat loss will almost certainly slow. This will be an excellent time to incorporate intermittent fasting into your way of living. You'll hit plateaus that may take weeks to break through but with IF can get you through in a few days. On the other hand, you're young, so this may end up being quite quick and easy for you.

In the end, don't worry. Congratulate yourself on finally finding a sustainable life. And, enjoy the rapid fat loss for as long as you can. Finally, think of this: how rapidly to hibernating bears lose fat, and does anyone think that's a problem?

Any Ideas For a Fellow Traveller?

I got this email the other day, most of which is a fascinating and fantastic success story, but with a bit of disappointment at the end. Jeff and I (along with some input from Dr. B.G of Animal Pharm) have tossed around a few ideas, but I'm wondering if there's any out there who might offer their own ideas.

~~~

Hi Richard. I hope that you can please bear with me as this is going to be a rather long winded post, but it is currently 3am, and after several recent sleepless nights I am having a difficult time coping!

Background information: male, 46 yrs of age. High caliber athlete my whole life - top level ice hockey player until 20yrs of age; national flatwater kayaker after that; then ironman triathlete for 7 yrs until 2001.

Nutritional and health background: ate a typical North American diet until about 1992, at which time became interested in diet in terms of health and performance improvement. Result: strict vegan from 1985-2001. However, despite 20+ hrs of intense training per week could never lose abdominal fat, had a blood pressure of 140/100, and developed exercise induced cardiac problems (supraventricular tachycardia) and an irregular heartbeat at rest (PAC’s). Other than these problems though (which I just “lived with”) I never had any of the “energy crash” or “foggy” problems with an extremely high carb diet. In fact, I felt great eating grains and high carb.

In 2003 though my hypertension and increasingly “annoying” exercise induced SVT (now up to 100 ten minute episodes a year) were really starting to bother me. So I sought medical advice. By now though, I had become increasingly disillusioned with the mainstream medical establishment. So I went to see Dr. Mercola (yes, THE Dr. Mercola!).

Since then, and for the last 6 yrs, I have been eating 100% strict paleo foods. And by 100% strict, I mean 100% strict!!!! Not one speck of sugar, chemicals, crap, grains of any kind, or dairy – NOTHING, other than fruit, vegetables, meat, and fish. NOTHING!!! And drinking only water.

What I found was that my health improved dramatically. I felt great, I never got sick, and I lost some weight, despite exercising very little (although admittedly, I only had about 10 lbs of fat to lose with my previous high carb, exercise fanatic lifestyle).

However, I did note one thing. Despite my strict paleo diet, I was not eating low carb. In fact, I was probably eating upwards of 20 pieces of fruit a day!! Like my pre-paleo days though, I never felt bad, nor did I experience any energy crash eating higher carb. My blood pressure improved slightly (maybe 130/90), but my heart rate was still irregular (PAC’s) and I had fewer, but still present episodes of SVT.

So, 6 months ago, after reading hours and hours of you, DeVany, Eades, Sears, Davis, Colpo, Lyle McDonald, MDA, TTP, Hyperlipid, Whole Health Source, Animal Pharm, etc, etc, etc, I decided to go TRUE low carb paleo. Shouldn’t be too hard I thought, since it didn’t require changing ANY of the foods that I was currently eating, only the ratios.

Result: absolutely astounding……almost!!! For 6 months now, blood pressure perfect (118/78), heartbeat absolutely regular. Not one irregular heartbeat – no PAC’s, no SVT. All of this sustained for the past 6 months. Leaned right out too – very low % bodyfat, and this on no exercise at all!! However, this has come at a cost, and hence the requirement of this post.

For the past 6 months I have restricted my carbs to 40 grams a day, eating only pure clean paleo foods as previously mentioned. And while my heartbeat regularity, blood pressure, and physical appearance have been great, my energy is now non-existent. I am overcome with immense, excruciating fatigue. Something that sleep cannot overcome, and something that I have never felt before in my life. I have also had a headache and brain ”fog” for approximately 4 out of the last 6 months. A low grade headache, but debilitating nonetheless, and I hadn’t had a headache previous to this since 1985.

I have tried reducing carbs down to 20g for a few weeks, and even upping them to 75g for a few weeks, but neither has had an impact on the headaches or fatigue. As far as I know, I am eating perfect. Plenty of calories. High fat, med protein, low carb. Pure, organic food. Strict paleo. Plenty of fresh, clean water. No other beverages at all except water. Fish oil and vitamin D.

I know Lyle McDonald has written that some individuals who are not overly insulin sensitive (FYI – my fasting insulin was < 2 when I saw Mercola when I was a high carb vegan) never fully overcome the fatigue of LC and actually require a minimum of 110-150g of carbs a day. Still LC I guess, but I am having trouble “seeing this” given all else that I have read regarding no actual requirement for carbs etc, etc.

I feel that I am 95% of the way there to finding my perfect diet. I have to be. The improvement in blood pressure, heartbeat, and body composition cannot be ignored. But the fatigue and headaches……..HELP!!!! I am having an increasingly difficult time coping, and the frustration is truly depressing.

Thank you very much for taking the time to read this.

~~~

I'm sure Jeff will appreciate any and all comments that help him toward fixing this single disappointment in an otherwise terrific story.

Reader Real Results

I'm perilously behind in many small posting projects, and that includes a number of things my great readers have emailed over to me. Trust me: I see everything. Hell, I even have a very complimentary email from Dr. William Davis of Track Your Plaque heroism and fame, as yet unanswered, and that's woefully embarrassing. But I'll get to everything, sooner or later. Man, it has been one busy week.

But, first things first. With all adoration and respect to all readers and supporters of this blogging effort, not to mention the mutual support and help out to those who need it most, this reader is just a bit special to me.

Email from mom, who turns 68 one month from today.

~~~

Just about a year ago I went to a new doctor at Kaiser. He seemed different than other doctors I had. He had read my file and was familiar with my history. He said I was the most controlled diabetic he had ever had for a patient. He told me that if I would lose about 15 pounds he would work with me to get off insulin. Another 15 after that and he believed I could get off oral medication and control the diabetes with diet alone.

Well, I tell you, it has been a slow and difficult journey. When you are taking insulin it is so difficult to lose weight. Added to that, I was not totally convinced that low carb was completely ok. I didn't see the need to follow your program completely. I thought moderation was the answer. As I lost weight I slowly decreased the amount of insulin I was taking, but it was still slow, with many ups and downs.

I am now within seven pounds of the first goal the doctor set for me. My insulin was down from 12 N insulin (slow acting) and 4 R insulin (fast acting) in the morning and 16 N insulin and 5 R insulin at night to no R insulin at all and 5 N insulin in the morning an 6 N insulin at night. I thought, "what is 7 pounds, what difference could that make?" So 5 days ago I stopped taking insulin. I also started following your recommendation totally. My blood sugar levels are non diabetic, ranging from 84 to 98. I am taking the supplements you suggested and am totally off grains and all the other things you say are unhealthy for us. I have been off sugars and vegetable oils for a long time.

I think our trip to Puerto Vallarta was the turning point. I could really see the difference in Dad, plus being with you every day, discussing this with you, and feeling the results myself did it for me. I am feeling great. Next week I will go in for blood test and about a week after that I will see my doctor. He said at the beginning of this that when I got off insulin he would change my oral medications till I could get off them. I want that to happen as soon as possible. By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years. I don't think it was water either because I have been continually dieting for years and even changing diets has not resulted in a big water loss in years.

~~~

"By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years." Couldn't have a thing to do with the decreased amount of insulin. "A calorie is a calorie." That one's for the theoreticians over practicians, out there.

Well that's wonderful news, eh? Could not be happier or more satisfied. A big part of why I do what I do here is keeping my wonderful parents in good health. Thankfully, they don't follow physician advice blindly. While I wouldn't want them to follow my advice blindly, either, they do know that I have the respect of many respected MD's and other highly educated people in the health field, and they know that I care tremendously.

Mom mentioned dad. Well, he does look great, and at 71, has regained a youthful outlook and activity level. He was out in the sun, the pool, even the ocean every day in Puerto Vallarta. He still has about 30 pounds to go (about 30 lost so far), but he's on his way. He just emailed this morning to say that he just completed his first 30-hr fast, felt great, and couldn't even finish his break-fast steak. He's done a number of 24-hr fasts, so, just as expected, this was a cinch for him.

And, he's becoming quite the efficient fat burner. See, there was some concern in the last couple of weeks, as he began having random, even fasted blood glucose levels of 120-130 and even slightly above, but never over 140, which is the real danger zone. While his A1C remains a reasonable 5.1, randomness was causing worry. My intuitive (i.e., non-medical) thinking was that he's in vastly uncharted territory for modern medicine. How often do doctors deal with high random glucose readings for a patient who has been very low carb for months (paleo style), has dropped 30 pounds, and fasts regularly? Based on my own experimentation with taking my (24-hr) fasting BG from 85 to 115, not by eating sugar, but by going to the gym and hitting the weights hard for 30 minutes, reasoned that the blood glucose can only be coming from body fat mobilization and that his body is fine with the level. In fact, it seems an ideal situation for me. His body is allowing his BG to remain slightly elevated rather than secreting insulin to drive it back into tissues (as fat, of course).

So, I posted an inquiry on Art's private blog, and Dr. Doug McGuff (a reader of this blog; and who just published Body by Science) was kind enough to provide some very useful and interesting information:

WRT your dad’s slightly high glucose reading, I might have a few possible explainations.

1) Was he truly fasted? If he cheated with a little black coffe, the caffeine could have activated phosphorylase and cleaved some glycogen which was released into the blood.

2) His returning insulin sensitivity may have set him up for a variant of the “Somogi phenomenon”. The Somogi phenomenon can occur in diabetics who take too high of a dose of their evening insulin. During the wee hours of the morning hypoglycemia kicks in triggering epenephrine-induced glycogen cleavage which produces an elevation of their AM glucose. With your dad, his improving insulin sensitivity allows him to fully stock his glycogen stores. During his overnight fast, his insulin now works with a vengence, his blood sugar drops enough to trigger glyogenolysis from his glycogen stores, and voila! A transient supranormal rise in blood sugar. A tip off would be if his pillow case or pajamas were a little sweaty upon wakening. The same epinephrine that cleaves glycogen will activate the sweat glands. You may have experienced the same thing when you first started paleo, or when you first tried intermittent fasting. This is just part of the transition from being a sugar-burner to a fat-burner, and IMO is no big deal. Fasting insulin is a much better metric to follow.

Yep. It seems obvious to me, and some may disagree, but if fasting insulin levels are low in the face of an elevated BG that's less than 140 (150 is when tissue damage stats to occur), then that tells me that your body is simply seeing no reason to spike insulin. It's doing just fine. Leave it alone. Moreover, if BG is "elevated" thusly and insulin remains low, then that blood sugar is going to fuel your body's work, which equates to weight loss. To lose body fat, you must first mobilize body fat, which your body then converts to useable energy (glucose), and then uses it.

Reader Questions and Results

Let's plow through another group. First up is some results from Deborah.

I stumbled across your site probably on a blogroll from someone else (Mark Sisson maybe), and have been enjoying your writing immensely. I'm trying very hard to stick to a Paleo diet (or the Eades plan or Atkins ... anyway, a way of eating based on principles of all three), and I find that it really helps to read all the bloggers. I just turned 56, and have had the same 25-30 pounds on my frame for so long I surely can't call it "baby weight" anymore. The babies are 21 and 19, for pete's sake. My husband, who is most marvelous in every other way, isn't particularly supportive of this way of eating, though at least he doesn't try to sabotage it (he's been told by the doc to skip the chicken skin, lay off the butter, all the usual doctorly advice).

Anyway. Deciding to take control of my own diet, I've finally lost a few pounds (I need to get from 185 or so down to at least 160, which on a large-boned woman who does weight training is, I think, reasonable), by eating protein and fat, cutting the bad carbs (yay, cauliflower) and weight training. And though the fat is now starting to come off slowly, I just feel so much better that I really relate to the posts on your blog about the major changes in well-being fostered by this way of eating. When energy, sleep, concentration and mood improve so drastically, there's no question about falling off the wagon.

Absolutely! Patience. The fat will come off, and in the meantime you get to feel great. As I saif in my email reply to you, you're husband is more likely to "evolve" into a Paleo-like approach as he observes the results you obtain. Be sure to always gently point out when he's tired and weary, and you're not, and can go and go.

Next, minneapolis J asks:

If I just want to grill hamburgers what sauces could I use that are more accomdalbe to paleo eating?

Well, I personally like to do the same sorts of sauces that I do for steaks and other meats (see the Food Porn category). Use a beef stock, reduce, and go to work. The possibilities are endless. Here's a couple of posts showing what I did sauce-wise for ground beef.

Low-Carb Meatloaf

How About Some Food Pics?

Another thing you can do is make your own tomato sauce, or get canned, and then spice it up with various things to make it Italian like, or more wild, such as with rosemary, sage, savory and such. Again, possibilities are endless, experiment, and never do it exactly the same way twice. That's my policy. Let us know how it goes, J. Also, I'll point out that J has decided to do some blogging, so I wish him well with that.

Brock emails:

I know nanotechnology isn't your normal blogging topic, but I thought this was relevant to why we should approach diet as scientists: confidently assuming we can understand with enough data, but humbly assuming we don't have all the data yet. This fascinating protein structure is common to all forms of life (which means it must be -really- important to be genetically preserved through a billion years of evolution), and we have no idea what it's for. Humbling.

It's important, now and then, that I reiterate my profound respect for science, medicine, and technology, as well as my confidence in man's mind, along with its ability to continually gain knoweldge, build, and improve human life.

Frankly, I would like nothing more than to pop a pill every day for perfect optimal nutrition, and plug into the wall to recharge. Well, perhaps that's going a little far; suffice to say that I strongly support efforts leading to "escape velocity".

Next up is Mario:

Great blog. I've been following your progress for some time now. I am a university instructor at UNM and CNM here in Albuquerque, and I must say, your enthusiasm for D3 is persuasive, which is why I thought you might find the following line of thought interesting. Taubes (who's book I know you've read) tells us (p.439) that seasonal weight fluctuations in hibernators suggest that annual fluctuations in insulin drive the yearly cycle of weight. He then speculates that this same mechanism might explain the annual patterns of weight fluctuations in humans as well. He cites two studies and states that "when researchers have measured seasonal variations in insulin levels...they have invariably reported that insulin in late fall and early winter [is] twice as high...and lowest in late spring and early summer." What is signaling these changes? Vitamin D3 may be a likely candidate since it is the one thing we know of for sure that is radically influenced by seasonal changes, especially since its peak synthesis occurs in the spring and summer in temperate climates.

I found two studies to support this notion (though I didn't really look very hard). A study from the Int. J. Clin. Pract. 2003 May, 57 (4) 258-61 evaluated the effect of D3 supplementation on insulin resistance and found a 21.4 % decrease in insulin resistance after one month. Another more recent study in Diabet. Med. 2009 Jan, 26 (1) 19-27 showed a similar effect. In light of your recent trip to Mexico and your extensive reflection and experience with this topic (and supplementation), I was wondering what your reflections are regarding this line of conjecture.

Well, this is probably a bit out of my league, and so those better educated, please chime in on the comments. By coincidence, this very thing was alluded to in Jimmy Moore's interview of Dr. Steven Gundry I blogged the other day.

Enlightened Heart Surgeons and Cardiologists

Bears, for instance, actually become insulin resistant, i.e., temporary T2 diabetic (perhaps signaled by eating sweet berries, length of day, sunlight, internal clock, or some combination). The body seems to know just what to do to pack on massive weight in advance of hibernation.

So, some of the same is likely going on in humans, only the hibernation never comes and the fat just stacks up year after year.

Well, that's it for this session. I'll hopefully be able to get to the rest by tomorrow.

Reader Questions (Part 1)

I accumulated a number of questions while away, so this is where I'll attempt to deal with them. I'll have Part 2 up tomorrow (I went from oldest working my way to newest).

Michael asks:

I recently subscribed to your blog. I had tangentially followed dietary issues over the years, but never put much thought into what I ate. A few months ago, though, due to some new medicine I was on which decreased my appetite quite a bit, I started eating a lot less and what I did eat tended to be relatively high in fat. I've lost 15 pounds since then. Now, having discovered that there's a whole way of managing diet that lines up with my recent experience, I want to start doing it right. So, what's the best place to start for someone who needs to learn from the beginning about paleo eating? Any advice you can give will be very much appreciated.

Well, I think right here is a good place, as well as my other resources. It's not well organized, but over time -- not much -- you'll really start to pick up on things. I am attempting to organize things better on this page, and I'll try to get some more updates in there soon, but check out the links already there. In the meantime, feel free to ask further questions in email or the post comments.

Marc asks:

Question for on Vit. D supplements. Do you take sublingual tablets or regular (swallow) capsules? Curious if there is a big difference that you know off. Thanks in advance.

First, make sure it is D3 you are taking and not anything else. I take Carlson gel caps, 2,000 units each, three per day. They're the size of a raindrop. According to Dr. Davis, he has had no success with D3 in tablet form. See here.

This next is a comment from Liana. No question, really, but I did want to highlight its importance for you vegans and veggies out there.

Next is a comment from madmax:

This is tangentially related to this post but I am really curious of what you make of this. Is it me or does McDonald just not get it?

Without digging too deeply into it (I've read enough of his stuff in the past), I think he has not given adequate thought or attention to hormonal signals and hunger.

For me, it's about hunger, not calories at all. If you're hungry all the time, and it's usually that deep, gnawing, nauseating hunger when you are, you're going to fail. Now, whether you're fat 'cause you eat too much (McDonald), or you eat too much because you're fat (Taubes), it doesn't really matter in that context. Cure the hunger (Paleo-like does it every time -- as well as fasting), and you will revert to a natural human being in body composition over time.

Next, not a question as much as an admonition from an MD. Paleo Newbie says:

I used to try (I am out of my general medicine internship and into specialty now) to get all my diabetic patients to low carb diets but they cant quit the fast food and refined carbs and barely got any physical activity. I know you are very critical of pill pushing doctors but we don't get much to work with. Also, our hands are tied by medicare practice guidelines (we are reimbursed this way) or malpractice will follow. For example, a 6 month trial of diet and excercise for a patient with high blood pressure before we offer an anti-hypertensive unless the patient declines. In my personal experience, 1 out of every 30 or so patients gave a reasonable effort to get out and walk and change their diet. As such, I just added on the diabetic drugs and anti-hypertensive until control and wean once they do better. Do that, and you get labeled a pill pushing drone doctor. I could debate this for hours but I can't do much unless the patient takes some responsibility. I can't cure double cheeseburgers and milkshakes, but I can give you an extra 10 units of insulin!

Hah! "I can't cure double cheeseburgers and milkshakes, but I can give you an extra 10 units of insulin!" Beautiful, and you're exactly right. Thank Zeus (and all the gods who've come along later) that we have that stuff available. So, I agree. Help them however you can, even if it means giving them insulin so they can eat Snickers bars.

That said, I wish doctors would 1) think more independently, and 2) learn about proper nutrition and give patients the choice: "red pill, or blue pill," to reference The Matrix. T2 patients should know that insulin is an option but not generally a necessity. Looks like you're one of the good ones, Doc.

Ankit asks:

When you have a minute, could you tell me what you have against legumes? I'm curious to learn more, so if you could point me toward any information; I would appreciate. Its my understanding that if I were to remove the toxins via soaking; they would be an acceptable foodstuff. Look forward to your thoughts.

Well, I deal in principles and for a Paleo-like plan, legumes are somewhere on the scale that's worse then dairy (for most), better then grains. I just don't do them much. Yea, a couple tablespoons of refried beans (hopefully with lotsa lard) every now and then. I like things simple, I don't really need legumes (I like animal fat lots better), so it's my choice to avoid them 95% of the time. But, if you do, I believe lentils are the best in terms of available protein and low anti-nutrients. Also, always soak them. The Weston Price Foundation has a good article on that.

Philip asks:

Art seems to really know what he is talking about. Could you tell me how to do an Art DeVany approved workout. What does he advocate for cardio? (I already lift) A long one hour walk with random sprints? How often?

I don't really want to speak for Art, and I especially don't really want to be a surrogate for his paid subscription blog. That said, he explains his workout routine reasonably well in his EvFit essay. Unfortunately, the link to that is not working -- though it was very recently. I've sent Art an email to let him know, in case that was unintentional.

From what I recall, he does a hierarchical workout, i.e., he lifts until a burn sets in, increases the weight and immediately goes again until burn, then increases and immediately goes again. So, it might be something like 12, 6, 3 in terms of reps. Of course, you'll need to figure out the proper weight through trial. He doesn't advocate cardio at all. The heart, he contends, is designed to operate on randomness and not steady state. As for walking, we are of course evolutionarily designed to do a lot of it. I walk 3-4 miles per day and have been doing so for about 7 years. Yes, sprints are great (and Art had a post on it on his subscription blog just today).

Personally, I get good enough results with my trainer (an exercise physiologist), and so have never been that interested to follow Art's exercise advice in terms of weights (though, one day, when I decide to go it alone), so sorry I can't be of more help.

King Fat

Reader Andrew sends a question in email.

After discovering I was Celiac, I found Celiac.com, then the Paleo diet, then Art De Vany's Blog, then yours. Thanks for the blog. I've got a quick question that I couldn't figure out where to post. I'm still pretty new to the Paleo diet. It's been working great, but I want to make sure I'm not [edited] myself up. So I know that we probably can't get more than 35% of our calories from protein (I guess the kidneys fry?), but even if I eat 20% of my calories as plants, this leaves 80% of my calories coming from meat. If I eat 20% complex carbs, 30% protein, then 50% of my carbs to come from fat, right? Where do I get the fat from? Should I simply eat a lot of avacados and olive oil? Or does most meat have enough fat that it's not a problem?

Andrew: You're exactly right.

Now, your kidneys won't fry at all; you will simply find yourself incapable of overdosing on meat (i.e., you'll eventually get sick and puke).

Yes, explicitly: fat is the secret to success. This is why I eat both fatty and lean meat, even ground beef and uncured sausages sometimes, like Polish. I also make a lot of fat based sauces for meats (you can develop ways to thicken without wheat or starch -- see my Food Porn category). I cook in various fats liberally, and I also use lots of coconut milk and coconut oil (which is like peanut butter, and I sometimes lick it right off the spoon).

Give it a shot. Fat is king. And BTW, you might monitor Mark Sisson's site as well. He often makes this point about fat.

Reader Questions

Reader Auti emails in:

You look 30 years younger and absolutely amazing! I am impressed with your results...

I am a 31 year old nurse. I follow Marksdaily apple as well as Arthur De Vany. I have dabbled in low carb only to go on a splurge by the end of the night when my cranky mind is driving me toward that oh so yummy and deadly cookie.

Not that I am over weight, because I am not but I followed a low fat calorie counting diet for a long time and it made me very food obsessed. I want to find the joy again and I definately found that once I stopped dieting.

However, now I want that energy, clear thinking, drive, reduced risk of cancer, no risk of diabetes, and youthful aging. I am sure it is a low carb diet but I have yet to perfect it.

Can you offer any advice as to what you have learned and how you have stopped cheating...

OH my goodness, you eat so much fat. I am not a fat free person (I used to be) but I would be scared my ass would grow bigger if I did that. Do you think that this diet is ok for women as well as men or are we different in some way?

First of all, notice how you recognize the food obsession. This is key. Hunger (see here too). The truth is, the Paleo way is the only way I know to cure the obsession and get control of hunger. I think this is why many low-carbers fail. Low carb is a fine approach, but not fundamental. A true Paleo diet can vary widely in terms of carbohydrate, because that's not fundamental or essential. Eating foods we evolved to eat is essential, and for most people (obese and/or diabetic would be an exception), that in itself will be enough to utterly transform them.

And it's not just on the outside, but also on the inside where these obsessions live. I have found personally that I not only look younger, but I feel far younger and my attitude is far closer to the way it was when I was back in college. To some extent, I have become somewhat carefree in the sense that I no longer obsess about much of anything. I think modernity has set us up in such a way that we grossly overestimate the quality of our own knowledge; and worse, we put far too much effort into trying to predict and control future outcomes. You simply have to adopt and take care of sound principles, and then see what the future brings.

So, though I still do cheat, it is truly becoming less frequent because I'm not hungry and I'm not obsessed. When I do eat, I replace the normal low-nutrition foods like bread, pasta, rice, legumes, and sweets with more meat, more fat, more veggies, or some fruits or nuts, or a combination of all. So, just my very exercise of eating, in itself, gives me 100 - 300% more nutrition for the same calories as what most other people eat. Could it be that's why Paleo eaters experience a wild taming of hunger and other obsessive behaviors? That would be my speculation. Having a fully nourished body would naturally balance hormones. I'd have to say that my guess would be that food obsession is rooted in hunger, and hunger in malnourishment. Even if one is getting sufficient energy on an average diet, they are most likely malnourished in a number of important nutrients. When that happens, I would speculate that it sets off cascades of hormones that result in a person becoming ravenous and obsessive about food.

I think this diet is perfect for both men and women. It's nature's diet. How else can it be? And besides, you're only 31. There are disputes about fat content and saturated fat. I uniformly think they are all wet and I think Loren Cordain is dead wrong, both about protein and fat proportions, and about saturated fat. Fat is king. If someone thinks they are going to get 35% of energy from protein so they can watch the fat, I think they are fooling themselves. Fat is king. Fat is what makes this work. We simply must get over the notion that natural fats are anything but very healthful and nutritious.

Americans are so fat for one primary reason: fear of fat. That is the dammed truth.

Later: A friend just emailed this article about the differences in hunger between men and women. What I take from that is it's even more crucial for a woman to be on a Paleo-like diet.

Reader Reactions; Q&A

I'm quite overdue on this, but here it is. I am increasingly overwhelmed by the great appreciation shown both in comments and emails. Here's some of the things that have been hitting the inbox, lately.

Pauline rings in from England:

I have been reading your blog/webpage since I discovered Art devany's and wanted to write that there are probably lots of us who go online to read and absorb your experiences and try to integrate them into our own lives. we don't necessarily add comments or feel ready to comment, your webpage is very easy to follow and is not too laden with scientific jargon which is hard for a layperson to follow. So, in a word, you are doing a fantastic job, even if we are marking your influence...we are listening and learning. I have been reading up on your archive material and have been wondering at what point you changed it to solely concentrate on the stone age diet EF/IF info, ie I am trying to catch up with you backwards from the start, if you know what I mean. Maybe other newcomers would like to do that and it would be nice to have a pointer to start from in the archive material. Is there a specific place where you tell your whole story, how you started, what pace you lost weight, your difficulties etc, or is it mostly in the archive materials. I have read bits here and there.

Many thanks for reading this, writing from england, originally from south africa. on a learning curve with regard to weight, diet and nutrition.

[...]

I absolutely love your new design and layout. It is so eye-catching and coming from south africa, it reminds me of the twilight, the bushmen, the trees and savanahs of africa. wonderful, inspiring. a friend of mine gave his son a spear for his 21st, an original one, as if to say go and hunt and seek out your future,let this spear be your resource, your protector and your guide. your website is an inspiration, if only I could get my partner to read it, but that's ok cos I am the cook and the shopper and the one who is always quoting him from things I read. you webpage is an inspiration and I discovered taubes lecture (I got his good calories bad calories for my birthday in june, on request) and also visited dr eades webpage today. can't get a reasonably priced copy of dr weston prices book, but will keep looking its on my wish list. I too love to write and read - thank good for the internet, its a great place to explore anything.

Thanks so much for the kind comments. To answer your question, I first began blogging about fitness in May '07, so you can certainly hit the archives and read from there. I was also blogging about other things -- politics and other aspects of current events. However, the post titles should give you a clue most of the time as to what's diet and fitness related. I announced my plans to head in a different direction early in August of this year and by September was blogging exclusively about health, diet and fitness.

Next, my good friend Robert rings in from just down the hall:

Was thinking about the heirloom tomatoes I had a few weeks back and decided to pin down the most precise def. of heirloom plants. Generally gardeners consider any plant variety not in existence before 1951 to not be heirloom because, and this is the interesting part, that year marked the beginning of widespread introduction of hybrid varieties. Heirlooms are originals, often deemed unsuitable for the mass market.

http://en.wikipedia.org/wiki/Heirloom_plant

Amazing to think of how much Archer Daniels Midland and Monsanto and companies like that have shaped the foods we eat. While they deal mostly in grains and related products, they have their counterparts in all walks of agriculture. In all likelihood we have businessmen deciding what we (and the world) are going to eat.

It's pretty interesting to consider how "man made" so much of the stuff we eat is, and it's not just plants selectively bread, grafted, or genetically modified to be sweeter, less fibrous, more uniform in appearance, etc., but also the feedlot animals we eat. Even dogs and cats are essentially man made.

From Trygve:

First off, your blog is just super great so keep up the good work :)

I have some questions about the food,weight loss, asthma and allergy and i really hope you have the time to answear them. Would be really great.

Im a 22 year old guy. Ive tried alot of diets etc, currently I'm on the Rapid Fat Loss diet with fasting. Im around 10-12% bodyfat and have enough muscles. My goals in life are:

1. Get down to 6-8% body fat and remain there
2. Get the best health mentally and physical that i possibly can 
3. Get ridd of my asthma and allergy so i can live a life without medications. I believe people arent meant to take medications if they eat well
4. Be the best i possibly can be 

I also read that you eat less fat now? why is that? and how much are you eating now of the different nutrients?

My allergies are against dust, pollen, etc and also my stomach get uppset if I eat dairy products and also butter etc. I get a really enoying rash etc. and it's really frustrating

I see you recommend eating butter, cream, etc. many other foods that I can't eat :( and it seems so delicious your recipes.

I too suffered from allergies to dust, pollen, grasses and so on from an early age. Until January of this year I was on prescription medication daily for years; however, I just went through a whole spring and summer with barely a sneeze, no meds, and I used to be debilitated -- either unable to function because of the swelling, itch, congestion, runny nose, etc., or, I'd be doped and drowsy from the meds -- though that improved over time as better prescriptions became available.

I attribute the change to getting off grains in general and pretty much completely. I can cheat now and then to no effect, because that's an acute stress, not chronic daily intake. So, have you tried completely grain free, and if so, for how long? I'd say give it at least three months.

As far as dairy, I recently had an interesting experience there. I was drinking raw whole milk, figuring it would be OK, though not Paleo. One of my other issues was heartburn all the time and I had been on meds for that, which I stopped the same time as the allergy meds. However, I noticed I was getting heartburn more and more frequently, which I attributed to alcohol consumption. But guess what? I ran out of milk some weeks back and didn't get to the store for a number of days. Then, I realized: no heartburn. It wasn't the alcohol, it was the milk. Now, heavy cream or butter doesn't seem to bother me, at least not that I can tell, and I have dramatically cut my cheese intake to the level of a spice and replaced those fat calories with nuts. One thing you might try is ghee, which you can get at good stores (Indian food stores, too) or even make yourself. Ghee is 100% fat, i.e., all milk solids have been removed.

From Jay:

Over this weekend, I got time to read some of your old blog pieces and I am finding them quite fascinating. Your blog and Arthur Devany's have comparable ideas and you both have a sort of meals archive. However looking at Arthur Devany's, it encourages more of a lean meat, lower fat, wheras yours looks higher fat fattier meat. Now in all honesty I don't think fat is the true evil of American culture, but I want to raise the question. Do you think fats and oils such as a lard is terrible for the heart or is it the onion rings, fries, and fried chicken itself that causes heart disease. I was thinking about this because for a change I tried cooking my eggs in bacon grease and I had 3 strips of bacon (uncured from whole foods). In all honesty I do not feel like this is bad because I am not eating processed refined food and I am eating natural animal products. However, conventionally, people would frown on the idea of using lard or cooking/consuming bacon grease. Is animal fat such as bacon grease / lard really bad for us by itself or is it the stuff that it is used for that kills (i.e.french fries and onion rings)?

I think high fat is just dandy, but only in a relatively low-and-healthy carb environment, which is to say: carbs from veggies, fruits, nuts -- not cereal grains, refined sugars, etc. In fact, if your protein intake is where it should be and you're eating Paleo-style, it's almost guaranteed that your carbs are going to be low and your fats high -- and you ought to make them healthful fats, like all animals fats, olive oil and coconut oil. Lard and bacon drippings are just grand.

From Suzanne:

I was wondering if you can tell me what you know about the way pregnant women ate and lived way back when. I have been following a evolutionary fitness lifestyle making more and more changes as time went on. About 2 months after implementing a 24 hour fast 2 times per week I got pregnant with our third child. It seems silly to me to add grains back to my diet because I am pregnant...what about fasting? Do I just stop that all together? I understand weight loss is not my goal during pregnancy. But do you think body composition can still change during pregnany? I go to a crossfit gym 3 times a week for my intense bursts of training and do some low cardio walking etc. sporadically throughout the week.

Man I get a lot of questions about fasting and pregnancy. The short answer is that I don't really know. What I'm certain of is that we probably have evolved mechanisms that handle intermittent bouts of hunger just fine. But, there you are talking about survival and not optimal nutrition. My initial speculation when I first began thinking about this is that the logic of evolution / natural selection might suggest that when push comes to shove, nature is going to sacrifice you for the sake of the fetus. However, that appears not to be the case (PDF), at least not in rats. So, then, I suspect that if a high degree of malnourishment would damage the fetus over the health of the mother, it's because the mother is essential for the survival of the fetus and so there's no logic in compromising the mother's health for the sake of the offspring.

If you really want to fast, I'd probably limit it to once per week and keep it in the 15-18 hour range. More importantly, I would make really certain that you are getting plenty of A, D, and K2 (MK-4). If you search 'K2' on the blog you should get all the posts on that and the importance of A and D will present as well. Also, please read this recent post by Stephan on fat-soluble vitamin toxicity.

I would also strongly recommend Nutrition and Physical Degeneration by Weston Price.

From Tim:

Thanks for the posts, great blog. I've forwarded your blog to numerous pals. Went down the same road, Feb 9, 2008 I was 230lbs at 5'11". I managed to hit 160lbs by May 1, 2008. Yowza. Turned 40 on May 12, 2008 and I'm in better shape now than in my 20s. Awesome stuff. I always thought I was a pretty "big guy" but it turns out I was just obese. IF and weight lifting are my current focus, and my winter project (cold here in SD) to examine some muscle mass gains.

I've been gaining knowledge on Intermittent Fasting, Hi Intensity Interval Training, lifting, low carb nutrition and all that jazz. I've sucked up all the info I can from Mark Sisson, Mike Eades, Loren Cordain, Gary Taubes, and many more blogs and websites (such as your fine fine favorite).

Just wanted to drop you a "fan letter" of sorts to say your Blog does more good than you may ever know. Thanks.

Wow, Tim. That's 70 pounds in three months. As you say: "Yowza!" It really works, doesn't it? Thank you for the kind comments; big, huge congrats to you, and never ever go back.