Here’s part two of the Q & A with Paul Jaminet. Except where otherwise noted, reader questions are in bold and Jaminet’s answers are in plain text.
Norm: 1. Why do hunger and cravings for carbs increase for some people by introducing rice and potatoes whereas most of the people do not have that being low carb?
2. How do we know that symptoms associated with low carb like cold hands and feet, low thyroid etc. are NOT from eating less as hunger is dramatically reduced on a low carb diet?
3. Paul highly recommends 16 hours of fasting, would PHD provide the same benefits especially weight loss without 16 hours of fasting? Probably standard American diet would be a lot healthier with 16 hours of fasting? If calorie restriction is not good or creates problem for people especially in term of weight loss then why calorie restriction is achieved via intermittent fasting on PHD?
Many people on very low carb diets have hunger and cravings for carbs. Often it gets displaced into a craving for sweets or for alcohol.
For many low-carbers, adding rice and potatoes leads rapidly to a feeling of well being and satisfaction. It quiets appetite.
For others, eating rice or potatoes can trigger strong cravings for more. There are usually two components to this. First is a need for the body to replenish glucose-dependent proteins such as extracellular matrix; typically this takes at most a few weeks to a month, after which appetite diminishes. Second is an inflammatory reaction from gut pathogens that feed on the carbs. This requires fixing the gut dysbiosis or infections.
The low thyroid is a hormonal reaction to conserve glucose, and associated phenomena like cold hands and feet illustrate the inability of the body to properly maintain homeostasis when it is starved of a key nutrient. As far as reduced appetite on low-carb, there is a difference between reduced appetite due to a body being well nourished, and the anorexic lack of appetite that is induced during chronic starvation. The first is desirable, the second is not.
16 hour intermittent fasting is beneficial for health so long as the 8 hour feeding window falls in the daytime. PHD would still be an excellent (nourishing, low toxicity) diet without intermittent fasting, but this is another opportunity to improve health. Lifestyle is as important as diet for health.
It is not so much that PHD with intermittent fasting restricts calories, it is that it achieves optimal nourishment with the smallest possible caloric intake. In other words, one eats fewer calories without any restriction of nourishment when eating PHD. If this is hard to understand, try reading Chapter 17 of our book.
Gerard Pinzone: I’m interested in trying this out to see what difference it might make. I’ve heard that there may be an initial period of weight gain. If true, why? Can you provide a recommended schedule? Something like, “1 tablespoon of potato starch in the morning for one week, then increase by 1 tablespoon each week until you reach 4 tablespoons.” Is it better in the morning than night? Also, what issues are signs that we should stop and which should we grin and bear? Can we start/continue to take a probiotic? Should we?
Coming from SAD, people almost invariably lose weight when adopting PHD. I haven’t heard of any cases of weight gain in people coming from the standard American diet.
Coming from lower-carb diets, the immediate reaction can be either weight loss or weight gain. There are two principal reasons why weight gain may occur. It is partly a matter of low-carbers “adopting PHD” by simply adding starches to their Paleo diet, thus adding calories; and partly a matter of a gut dysbiosis or infection leading to greater inflammation when carbs are added. The solutions are (a) emphasize nutrient density and dietary balance so that hunger abates with lower calorie intake – that is, implement PHD more fully; and (b) address gut health through immune support and fermented foods and fiber.
I recommend just adopting PHD in toto from the beginning. There’s no reason to delay a good thing.
It’s fine to take probiotics but fermented vegetables usually contribute more.
JD: Just like all of this rethinking about RS, I’ve been rethinking the theory about optimal omega 3:6 ratios. Everything I remember reading about it recommends the ideal ratio is between 1:1 and 1:4. But what if it’s less about the ratios and more about eliminating bad fats (franken oils, factory farmed animals). Let’s say someone is following the Perfect Health Diet almost to a T, except most of their fat calories are coming from a high quality olive oil so the O3:6 ratio is closer to 1:8; is there any reason to think that person might less healthy than someone with a more ideal ratio? I do remember reading about how essential fatty acids from O3 and O6 fats compete for the same enzymes, but are there any studies out there that suggest excessive olive oil consumption interferes with therapeutic doses of O3 EFAs?
I guess my question could really be simplified to this; Is there any reason I should stop drowning my salads in olive oil?
Our peak health ranges are about 1% to 4% of calories from omega-6 fats (mainly linoleic acid) and 0.5% to 1.5% of energy from omega-3 fats (mainly from marine sources).
If you eat at the high end of the omega-6 range (4%) and the low end of the omega-3 range (0.5%), you’ll still have perfect health according to our analysis, and you’ll have an 8:1 ratio.
However, you have to hit fatty acid quantities spot on to be the peak health range for both with that ratio. If you have a 3:1 ratio, you could eat omega-6 anywhere from 1.5% to 4% of energy and still be in the peak health range for both. So that is a more desirable ratio to aim for.
Drowning your salads doesn’t sound good. How about flavoring your salads with olive oil?
Amberly: If using RS as a supplement (i.e. Potato Starch in a smoothie or cup of warm water), is there a “best” time of day to take it? In the morning? Before bed? All at once? Split into two or three doses?
Also, I am very sensitive to carbs and need to lose quite a bit of weight. What is the lowest number of carbs you would recommend going? Is it possible to stay in ketosis? Can you get the same health benefits from a cyclical ketogenic diet– i.e., VLC most of the time with one or two evenings a week of safe starches? Can you get health benefits by adding just RS (Potato Starch) but not the safe starches?
Take RS before your first meal. If you do intermittent fasting and your feeding window is 11 am to 7 pm, take the RS at 11 am.
I would recommend getting at least 20% of calories from carbs, but I think 30% is better for most people.
Lower carb diets should be seen as only temporary therapeutic diets, forms of extended fasting, not as permanent diets. Ketosis is fine, unless you have certain infections, but chronic starvation of desirable nutrients is not. I think it’s best to eat starches daily. No, your body needs glucose as well as a healthy gut flora.
MikeG: I believe you mean the enzyme amylase, rather than lipase? Amylase will hydrolyze the starch into maltose disaccharides first, then maltase (on the villi of the small intestine) will digest the maltoses into glucoses. Then the glucoses can be easily absorbed via transporters on the villi surface. This is why I cannot wrap my head around how fatty acids could blunt glucose spikes, or insulin spikes. Do the fatty acids bind to the glucoses? I suppose they could, given that we have glycolipids on our cell membranes.
I don’t know what this is referring to. If it’s our recommendation to combine starches with fats in order to reduce their glycemic index, the reason blood glucose is lowered by eating starches with fat has to do with delayed stomach emptying and improved metabolic regulation.
Troysdailybacon: With regards to Xylitol – I use it as a tooth protocol to fight cavities, but end up ingesting a small amount. I’ve heard that it acts like a prebiotic as well. But in the mouth, bad bacteria try to metabolize it, but can’t, so the bacteria die off. How does Xylitol react in the gut? Will it feed the good bacteria and produce butyrate? Or, like in the mouth, will it kill off good and/or bad bacteria in the gut?
Xylitol like other sugar alcohols can be fermented by some bacteria, and it has antimicrobial effects against others, so it will alter the gut flora (and the oral flora). I am not sure we know enough to say whether the changes are good or bad.
In in vitro studies, xylitol doesn’t seem especially effective at preventing cavities – it doesn’t do nearly as well as fluoride; and it also appears ineffective in human studies. This may be one of those cases where positive early studies don’t seem to be replicable.
Rob: Do you recommend supplementing with additional resistant starch (potato starch) and other fermentable fibers (inulin, pectin, etc.) or just getting these things from food? What are the potential negative effects of too much resistant starch and fermentable fibers?
I recommend getting fiber from food, but designing one’s diet and preparing food to make it fiber-rich. This can be done by eating natural whole foods, copious fruits and vegetables, and pre-cooking and refrigerating starches.
It is unclear what the negative effects of too much fiber would be, but there is surely a point when you can get too much.
I think of it in ecological terms. You are crafting an ecosystem in your gut, and you want an ecology that favors evolution of a healthful flora.
Humans have an overnight fast of 12-16 hours and a daily feeding window of 8-12 hours. Gut bacteria have a reproductive life cycle of about an hour when food is available. So during your daily feeding, your bacteria have enough food to reproduce and could potentially double their numbers 8 times, or increase their population 256-fold. Then they go through an overnight fast, and their numbers diminish. Ecologically it is a boom-bust cycle similar to deer multiplying when food is abundant and then starving in the winter.
Within the overnight fast, your immune system has an advantage in shaping the ecology. Where probiotic flora are present, it can reward them by generating mucus; where inflammatory pathogens are present, it punishes them with antimicrobial peptides. During the fast, microbes are relatively defenseless due to lack of resources. During feeding, microbes have the upper hand.
Providing lots of fiber creates a boom-bust ecology on a daily cycle, while a low-fiber diet creates more stable bacterial population levels.
In general, you want to eat the amount of fiber that maximizes microbial diversity (that is, genetic diversity) in the gut. Low microbial diversity is associated with disease, high diversity with great health.
Boom-bust ecologies create a different set of selective pressures on bacteria than ecological systems with stable food supplies. Potentially, too great an amount of fiber might reduce microbial diversity by rewarding species that are able to reproduce most rapidly during the food “boom” and preserve their numbers by hibernating during the overnight “famine”. Many beneficial species may not compete successful with hyper-growers like E. coli in such an ecosystem.
Low microbial diversity in the gut is associated with many diseases. Usually low diversity results from starvation of fiber, but conceivably supplementation with large doses of resistant starch could bring about a similar result.
I consider the optimal amount of fiber to still be an open research question. We don’t know the answer. But I am confident the optimal amount is not “infinite fiber.” There will be some amount that is too much.
Incidentally, getting a diversity of fiber types – not just resistant starch – will be important, as this too will promote microbial diversity. This is one reason a natural whole foods approach is likely to be optimal.
TMA: I haven’t read your book but what I’ve read about your diet on your website sounds appealing. One concern I have though is the number of different supplements you recommend. I’d be leery of low dose lithium for example. Do you discuss your rationale for these supplements in your book? And how would you suggest that people gauge their responses to a given supplement when there are so many and the purported effects are subtle and subjective?
Yes, we discuss the rationale for supplements in our book. I think if you compare our supplement list to the list of ingredients in a multivitamin, you’ll see that our list is much shorter.
Lithium is a good example. It is one of those compounds we seem to need for optimal health, longevity, and neurological function, yet it is removed from the modern water supply and is depleted in soils by repetitive annual planting of plants in agriculture. Compounding those environmental reductions is the fact that most people don’t eat many vegetables. So it is easy for a diet to be deficient in lithium.
It’s a good practice to stop supplements entirely for a few weeks every once in a while and see if you feel better or worse without them.
Gabe: I’ve heard you refer to your own experience in dealing with and/or eliminating chronic infections. Can you offer us some insights or advice on the solutions you found to these chronic infections, and/or what kind of medical practitioner one should consult? If one is already seeing a medical practitioner, what kinds of testing would indicate that practitioner is thoroughly considering what you know to be the right kinds of tests?
My personal solution was PHD plus antibiotics. I would recommend trying PHD (including the lifestyle advice – intermittent fasting, daily exercise, circadian rhythm entrainment) first and trying antibiotics as a last resort.
Testing is a complex question. The patient’s symptoms provide clues, lab tests provide clues, the practitioner has to understand biology and interpret them. There is no recipe that fits every patient, and you can waste a lot of money on uninformative tests. It’s best to find a clinician with good judgment to help you.
Howard Lee Harkness: Is the “soluble fiber” in chia seed (gel) a suitable “resistant starch” for the PHD? I’ve been experimenting with chia seed gel, and I have noticed that when I eat a serving (about 3 tbl chia seed soaked in 8 oz water about 15 minutes & added to a 20g protein shake with ice, coconut oil and MCT), I am not hungry again for a very long time (12 hours or more). However, I have not noticed any weight loss over the past week. My other main source of soluble fiber is raw carrot (about 1/2 cup per day), which I’ve been trying for about 3 weeks, again with no change in weight. Background: I easily lost a bit over 100 lbs on an Atkins-style diet starting in late 1999, but have remained weight-stable at roughly 50 lbs over goal (give or take about 10 lbs) since 2002.
I am not familiar with chia seeds, although I do see that they can help rats with dyslipidemia and fatty liver. You might ask Tim and Grace about their resistant starch content.
Kathy from Maine: 1. Tom said at the end of the post, “Perhaps you’ll be persuaded to eat a potato smothered in grass-fed butter.” From my limited reading of PHD, I took away the message that the plan is higher fat (65%), but that fat should come from what naturally occurs in foods and NOT ADDED to foods, like butter on the baked potato, etc. Did I misread this?
2. I’m confused on the 140 degrees. I thought that after the initial cooking and cooling, it was critical that the food NOT be reheated more than 140 degrees to reap the most resistant starch.
3. PHD recommends approximately 15% protein, which on a 2000-calorie diet would be 300 calories, or just 75 grams of protein. How does this correlate to Phinney & Volek’s advice in “Art & Science of LC Living” (and in a podcast I heard from Phinney) that everyone needs three 30-gram servings of protein daily, for a total of 90 – 100 grams or more in order to trigger protein muscle synthesis? In that book, they showed a table of a weight loss plan for a woman, and it advocated 100 grams of protein through all stages of the weight loss from “induction” through maintenance. Also, Dr. Eades notes in his Lifeplan book that women over 50 actually need more protein than men (and recommends at least 100 grams daily) because women of that age don’t absorb as much of the protein as do the men. I’ve always tried to get at least 100 grams a day. Is that too much, in Jaminet’s thinking? Or is 75 – 100 grams a good ballpark figure?
The recommended PHD macronutrient ratios are 30% carb, 15% protein, 55% fat.
Yes, most fat should come from natural whole foods, but most people will probably eat 2-4 tbsp per day of oils from cooking oil, salad dressing, coconut milk, butter, and other oils. It’s good to put butter or sour cream on a potato.
Resistant starch starts to melt (become digestible) with cooking above the boiling point of water, and the strongest rise in melting occurs between 60˚C and 70˚C (140˚F and 160˚F). Five minutes of cooking at 70˚C / 160˚F will eliminate nearly all resistant starch. It can take several days of refrigeration to restore the resistant starch content.
However, briefly warming a potato in the microwave will not raise the potato temperature to 70˚C, and will not destroy much resistant starch.
It’s true that if you want to maximize muscle mass, you should eat more protein than 15%. However, if you want to maximize longevity, 15% is a good number.
We actually give a peak health range for protein that ranges up to 150 grams (600 calories) per day. So the Phinney & Volek numbers are compatible with PHD. Where you choose to fall within that range is a matter of personal preference.
I’ve seen no evidence that elderly women need more protein than elderly men. All studies of centenarians show that elderly women eat less protein than men, and they outlive the men. It would be strange if they ate less and lived longer even though they needed more.
Amberly: In creating the most RS from a SS, does it matter how the item is cooked/cooled? IE does it matter if you bake the potato and then eat it immediately after it has mostly cooled (below 140), or does it form more RS if it is baked/boiled then put in the refrigerator overnight, and then reheated? Same type of idea with rice. Does the longer a food is cooled the more RS it creates, or is it pretty much the same?
General principles, you don’t want starches to become dehydrated. So use gentle water-based cooking methods like boiling or steaming. If you have an autoimmune disease or food sensitivities, favor cooking them in a pressure cooker.
You don’t need to cook starches for a long time to gelatinize them – just cook them as you would normally – but you do need to cool them for a while if your goal is to form extra resistant starch. Refrigerate them at least overnight, and resistant starch content actually continues to increase through 4 to 7 days of refrigeration.
Daci: What about green bananas as a safe starch? I really miss them since being on a lchf diet. I like them better than ripe ones. Always have. Any thoughts?
Eat them! Bananas are a great food, green or yellow.
George: Big fan of PHD and have been incorporating resistant starch particularly in the form of 4 Tbl of Bob’s Red Mill Unmodified Potato starch. Question: Give the nutritional breakdown of 4 Tbl of Potato Starch (160 calories/40 grams of carbohydrate): do does amounts contribute to the PHD minimum levels of starch 400-600 calories per day if this form of starch bypasses digestion in the stomach and small intestine and instead is largely digested by gut bacteria in the large intestine/colon? Or is it recommended to eat some starch that is not “resistant”? If so, how much of “resistant” and non-resistant starch should be consumed or does it not matter?
No, resistant starch does not count as a carbohydrate source. It is a short-chain fatty acid source providing about 1 to 1.5 calories fatty acids per gram. It doesn’t provide any carbohydrates. Of course, it is always accompanied by digestible starch in real foods. Those count as carbohydrates.
Yes, you should always combine resistant starch with digestible starch. In general, I think a natural whole foods approach is going to work out best in the end.
General guidelines, you want about 20-25% of calories as digestible starch from “safe starches,” about 10% of calories as sugars from fruits, beets, carrots, and the like, and about 2% of calories from maybe 30 grams of fiber per day, probably about half from resistant starch naturally formed in “safe starches” and half from a diverse array of fruits and vegetables.
Pam: You have milk as a not to be consumed. But, what about raw milk? I have been drinking raw goat milk for about a year. And then there is the Milk Cure from the early 20th century. Your thoughts?
Hi Pam, as we say in the book, milk is in many ways close to the ideal food, but our food production system does not inspire confidence in it. I would say you do need confidence in your dairy farmer, that he uses aseptic procedures to prevent contamination of the goat milk by goat dung (easy to occur, in nature the udders are often contaminated by stool as a means to pass maternal gut microbes to offspring) and keeps his goats healthy. There is a risk of infections such as brucellosis. Overall I am somewhat doubtful of the advantages of habitually drinking even well sourced milk, but I don’t have strong feelings about it. It can be curative for some conditions, though a good diet would also generally be curative of those conditions. Milk is simply an easy way to obtain a good diet.
Fight! (Just kidding)
The Internet is large, everyone’s got opinions, and we could waste a lot of time trading opinions. For that reason I think critics should generally be ignored, if all they have is opinions without any specific (which is to say, constructive) criticism.
However, once in a while it may be educational to see what authors think of their opinionated critics, so I thought I’d offer comments on a conversation between Harry and Tom. Harry in bold, Tom in italic, my commentary in regular font:
Harry: Paul’s central thesis (that toxins cause disease, and should therefore be minimised) is a leap of faith.
Paul: That is overstating our thesis. First, our diet is primarily focused on nutrient optimization, not toxin minimization. Toxin reduction is a secondary goal; the idea is that given two equally nourishing alternatives, say wheat or white rice, if there is evidence that one is significantly more toxic than the other (in this case, wheat more toxic than rice), we should avoid that one and get the nutrition from the safer source.
Harry continues: If toxins do in fact cause disease (that is, chronic consumption of low doses of toxins; we all know that consumption of high doses makes one very ill…or dead), then it simply does not follow that they should be minimised.
Hormesis in the body occurs in many systems, including the digestive/metabolic systems. It would certainly strike us as strange if we surmised that, since working to exhaustion causes death, then lying prone all day is the best way to avoid death. Similarly, it is strange (although understandable) that one might think that toxins should be avoided at all costs. Just like exposure to bacteria challenges and ultimately strengthens the immune system, so too it is possible that exposure to a certain level of dietary toxins is preferable to a completely ‘safe’ diet.
Paul: We discuss hormesis prominently in the book; see pages 192-193 at the beginning of Chapter 18, Food Toxins. The reason we aren’t concerned about the toxins in vegetables is that the doses are usually at hormetic or inconsequential levels.
Harry: The resolution to this question ultimately lies with controlled studies…but given the difficulty of assessing variables in the human diet, this may be a long time coming.
Paul: It is virtually impossible to do controlled studies of low-level toxicity. We are concerned about effects that may take a month or two off an 80 year life. To detect such effects would require an experiment lasting at least 80 years.
Harry: In the interim, how about we swear off alarmist diet gurus that demonise foods that have been eaten by humans for centuries…and instead just shoot for a balanced diet that is mostly unprocessed foods? Too boring?
Paul: I object to the claim that we “demonize” any food. No, we weigh the evidence for each food’s merits and demerits, and find some foods wanting.
Harry’s main objection is to our eschewal of certain foods, such as wheat and soy, which have been eaten by humans for centuries. But is it really alarmist to point out that many people have noticed health improvements from removal of wheat, that the biomedical literature notes many cases of people harmed by wheat consumption, that research is exposing mechanisms by which wheat compounds do harm, that statistically countries that don’t eat much wheat tend to have longer lifespans (especially after correcting for income), and that there is no evidence for the presence of nutrients in wheat that cannot be obtained equally well from our “safe starches”?
In order to maximize the healthfulness of a diet – and finding the maximally healthful diet was the purpose of our book, thus the aspirational name “perfect health diet” – we have to weigh risks, such as the loss of sperm in men eating soy, and the cognitive impairment experienced by people eating tofu, against the benefits of eating a food, assessed in an “opportunity cost” sense against alternative food choices. Soy and wheat, in our judgment, do not pass this test.
Tom Naughton: A balanced diet of mostly unprocessed food is exactly what he recommends. As for toxins, he’s quite clear that it’s a matter of “the dose makes the poison.” He describes safe starches as low-toxin foods, not no-toxin foods. So I think you’re more in agreement than not.
Paul: Thank you Tom. Exactly right.
Harry: Yes, of course the dose makes the poison. My point exactly.
Paul’s view is that the dose should always be as low as possible. This is where we are getting into pure hypothetical territory. There is a possibility (one that is reasonable given what we know about hormesis) that a dose of certain toxins somewhat higher than the lowest possible is superior in terms of promoting good health (just as exposure to some bacteria is far better for the immune system than living in a sterile environment).
Paul: Again, a mis-statement of our views. We discuss many cases of toxic foods that we recommend eating. For example, on page 195 we discuss the case of a woman who nearly died from eating raw bok choy. We recommend cooking vegetables to reduce toxicity and eating a variety of vegetables, not the same vegetable every day, to reduce toxin dosage. We don’t say, “eat the lowest possible dose of bok choy,” rather, “eat bok choy in moderation prepared in a way that reduces toxicity.”
Harry: As I said, it would be wickedly difficult to determine the optimal levels of dietary toxins using the scientific method, but it is just conjecture to argue that since a high dose of toxicity is bad for health, the lowest possible dose should be recommended. This is a classic case where ‘common sense’ (a priori reasoning and induction) does not necessarily yield the truth…hence the need for empirical testing.
Paul: The same straw man again, we don’t make that argument. More empirical testing is desirable, yes, but we have to make decisions about what to eat on the evidence available now. Harry appears to favor the decision rule, “eat everything until empirical testing convicts it beyond a shadow of doubt,” but we prefer our rule, “weigh the evidence and avoid foods that appear to deliver an excess of harm over help.”
Harry: I guess I’m just over people running a contestable notion up the flagpole and passing it off as truth. The history of dietary advice is replete with such ideas, which while superficially attractive, turned out to be fruitless.
Tom Naughton: Well, I personally like the idea of running a contestable notion up the flagpole. The passing it off as truth part is a different matter.
Paul: Well said, Tom.
Forming contestable hypotheses and evaluating evidence pro and con in order to come to judgments of their truth is science. Many judgments are tentative and subject to later correction. Harry here comes perilously close to rejecting science per se on the ground that scientific judgments might later turn out to be have been mistaken.
On the other hand, if it is only duplicitous judgments and foundationless claims that Harry objects to, his objection does not apply to us. We show our reasoning and cite the evidence that supports our conclusions.
However, Harry’s concern may apply to himself. Is he certain he is not spreading foundationless claims about diet book authors on the Internet?
Thank you, Tom, and Fat Head readers for the opportunity to answer your questions. It’s been my pleasure!
It’s been our pleasure reading your answers, Paul. Thank you very much for taking the time — Tom.
If you enjoy my posts, please consider a small donation to the Fat Head Kids GoFundMe campaign.
Seems like the big variable is the gut. Some folks do not experience the dry eyes, lack of mucus while eating VLC while others do…myself for instance. The problem with using me for an example of why a VLC is bad is that I never stopped using sucralose and aspartame. Additionally I have gone through a few bouts of strong antibiotic treatments in the last 5 years.
So now I am running a experiment to see if I can straighten my gut out with pre and pro-biotics as well certain beneficial foods. Once I get that straightened out I will go back to my preferred way of eating. Once a day VLC.
The deeper into the rabbit hole we wander the more complicated it all seems. I don’t appreciate it when anyone sounds certain of their beliefs when talking about diet. Seems unwise and careless…
Well, I certainly wouldn’t call VLC “bad.” Lots of people do fine on it. But I hope this series of posts convinces people who aren’t doing fine on it to look into PHD as a better alternative for them.
The rabbit hole will keep getting deeper. Every time we think we have it all figured out, something new and controversial will pop up and destroy our conclusive sense of resolution on the matter.
We really ought not to judge too harshly those who hold specific beliefs. Beliefs are a prerequisite of progress. To live some scientifically draconian, 100% empirically based existence is to venture down an infinite number of bottomless rabbit holes and never put it all together. At some point, somebody has to adopt a stance and risk being wrong, or we’ll never have any ideas to test. The people that do so are doing the dirty work for the rest of us, and they are risking their reputations, money, etc in the process.
The beauty of this complex mess is that different people come to different conclusions. If we discipline ourselves to — 1) never stop being willing to learn, and 2) always get information from a variety of sources, not just one or two — then we put the onus of enlightenment on ourselves rather than someone else. Then we do not have to be angry at people if later they turn out to be wrong. They are human, after all, and nobody is forcing us to listen to them (the USDA, FDA, and other government agencies notwithstanding).
Very well said.
Well said…I wish that Peter and Gary get their research facility up and running. It seems pretty apparent that ignoring the processes of digestion was pretty short sighted.
Seems like the big variable is the gut. Some folks do not experience the dry eyes, lack of mucus while eating VLC while others do…myself for instance. The problem with using me for an example of why a VLC is bad is that I never stopped using sucralose and aspartame. Additionally I have gone through a few bouts of strong antibiotic treatments in the last 5 years.
So now I am running a experiment to see if I can straighten my gut out with pre and pro-biotics as well certain beneficial foods. Once I get that straightened out I will go back to my preferred way of eating. Once a day VLC.
The deeper into the rabbit hole we wander the more complicated it all seems. I don’t appreciate it when anyone sounds certain of their beliefs when talking about diet. Seems unwise and careless…
Well, I certainly wouldn’t call VLC “bad.” Lots of people do fine on it. But I hope this series of posts convinces people who aren’t doing fine on it to look into PHD as a better alternative for them.
The rabbit hole will keep getting deeper. Every time we think we have it all figured out, something new and controversial will pop up and destroy our conclusive sense of resolution on the matter.
We really ought not to judge too harshly those who hold specific beliefs. Beliefs are a prerequisite of progress. To live some scientifically draconian, 100% empirically based existence is to venture down an infinite number of bottomless rabbit holes and never put it all together. At some point, somebody has to adopt a stance and risk being wrong, or we’ll never have any ideas to test. The people that do so are doing the dirty work for the rest of us, and they are risking their reputations, money, etc in the process.
The beauty of this complex mess is that different people come to different conclusions. If we discipline ourselves to — 1) never stop being willing to learn, and 2) always get information from a variety of sources, not just one or two — then we put the onus of enlightenment on ourselves rather than someone else. Then we do not have to be angry at people if later they turn out to be wrong. They are human, after all, and nobody is forcing us to listen to them (the USDA, FDA, and other government agencies notwithstanding).
Very well said.
Well said…I wish that Peter and Gary get their research facility up and running. It seems pretty apparent that ignoring the processes of digestion was pretty short sighted.
Peter and Gary’s “research facility” is up and running. It’s called NuSI, and you can find a description of the studies it’s funding here: http://nusi.org/the-science/current-science-in-progress/#.U3P9S-9OXcs
This has been a great dialog that I have enjoyed and learned from. Thanks to all who contributed. Having been paleo for several years and enjoying many benefits, I like to think of myself has being open to whatever the science shows is the best path forward. These exchanges help all of us to keep thinking about what’s best for each of us and make personal choices accordingly. The PHD and whole resistant starch concept is a great opportunity for all of us to ask how we can eat better.
Hi Tom, before I learned from you about RS friendly probiotics, like Garden of Life Primal Defense you advertise and I bought, I was using a probiotic that did not include homeostatic soil organisms (HSOs).
Would it be detrimental if I still consume the previous probiotic with Garden of Life?
Thanks!
I’m no expert on the topic, but I would think a variety of probiotics would be beneficial.
My Naturopath told me it was not about the number of organisms listed on the label (like 30 billion etc), but the variety of strains included. I rotate like 5 different ones Primal Defense included. Seems to works very well.
This has been a great dialog that I have enjoyed and learned from. Thanks to all who contributed. Having been paleo for several years and enjoying many benefits, I like to think of myself has being open to whatever the science shows is the best path forward. These exchanges help all of us to keep thinking about what’s best for each of us and make personal choices accordingly. The PHD and whole resistant starch concept is a great opportunity for all of us to ask how we can eat better.
Hi Tom, before I learned from you about RS friendly probiotics, like Garden of Life Primal Defense you advertise and I bought, I was using a probiotic that did not include homeostatic soil organisms (HSOs).
Would it be detrimental if I still consume the previous probiotic with Garden of Life?
Thanks!
I’m no expert on the topic, but I would think a variety of probiotics would be beneficial.
My Naturopath told me it was not about the number of organisms listed on the label (like 30 billion etc), but the variety of strains included. I rotate like 5 different ones Primal Defense included. Seems to works very well.
Very interesting points regarding microbiota boom & bust cycles – this is very relevant to the module I am currently studying (Infectious Diseases).
I have bought the PHD book but have not yet read it (but am very familiar with the work of the Jaminets). Could you please post a handful of study links which – according to you – identify the biomolecular mechanisms linking reduced carb intake to a pathological thyroid dysregulation?
Thanks!
I’ll send you to the source. He has links in his post:
http://perfecthealthdiet.com/2011/08/carbohydrates-and-the-thyroid/
Dr. Rosedale acknowledges the change in thyroid as well, but would obviously object to the term “pathological thyroid dysregulation.” He insists it’s a healthy adaptation, so that’s the focus of the debate.
MikeG asks: “This is why I cannot wrap my head around how fatty acids could blunt glucose spikes, or insulin spikes. Do the fatty acids bind to the glucoses? ”
No, they do not, it works differently. These are quite new findings. First, there is something called intestinal gluconeogenesis (forget gluconeogenesis in the liver from glycogen, this is something else):
“It has been established that the gut is much more than a digestive tract. It has the capacity to participate in the control of energy homeostasis via the secretion of various hormones. It can also contribute to the control of glucose homeostasis via its high glycolytic capacity and a recently described function, gluconeogenesis.”
http://www.ncbi.nlm.nih.gov/pubmed/19474723
Second, we know that microbiota ferments dietary fiber into SCFAs.
And third, the SCFAs play a role in glucose regulation:
“Fibers, specific oligosaccharides and resistant starch reach the colon intact, where they induce shifts in the composition and function of intestinal bacteria (shifts indicated by different colors). Intestinal bacteria use these compounds as substrates for the production of the short-chain fatty acids acetate, propionate and butyrate. These microbial metabolites are taken up by intestinal epithelial cells called enterocytes. Butyrate mainly feeds the enterocytes, whereas acetate and propionate reach the liver by the portal vein. Enterocytes can synthesize and release glucose to the portal vein. Propionate and butyrate promote intestinal gluconeogenesis (IGN) in different ways. Butyrate directly activates the expression of gluconeogenic genes in enterocytes by cAMP signaling whereas propionate stimulates gluconeogenesis by functioning as a gluconeogenic substrate and by FFAR3-dependent stimulation of peripheral nerves of the portal vein. The resulting gut-to-brain afferent nervous signal is required for activation of IGN, and nerves leaving the brain convey IGN-inducing signals back to the portal vein. It is not known how the efferent signals control IGN.”
A picture here:
http://www.nature.com/nbt/journal/v32/n3/fig_tab/nbt.2845_F1.html
And for the non-believers — from the last FTA blog post:
The short-chain fatty acid acetate reduces appetite via a central homeostatic mechanism
“… we show that colonic acetate crosses the blood–brain barrier and is taken up by the brain. Intraperitoneal acetate results in appetite suppression and hypothalamic neuronal activation patterning. We also show that acetate administration is associated with activation of acetyl-CoA carboxylase and changes in the expression profiles of regulatory neuropeptides that favour appetite suppression. Furthermore, we demonstrate through 13C high-resolution magic-angle-spinning that 13C acetate from fermentation of 13C-labelled carbohydrate in the colon increases hypothalamic 13C acetate above baseline levels.”
http://www.nature.com/ncomms/2014/140429/ncomms4611/full/ncomms4611.html
Wow this information is great !! I wondered about the appetite suppression connection. For me it only takes 1Tbsp of RS via unmodified potato starch and its like I’m full for several hours afterwards.
Tammy, we could look at it also like this:
The gut microbes telling the brain: Thank you, we have enjoyed our meal and we aren′t hungry any more. You don′t have to search for food any more.
Isn′t it wonderful?
Wonderful indeed. But why would the appetite suppression happen straight after eating RS? No need for RS to get down to the colon and actually get digested?
Yes, this is fascinating. Somebody will figure it out once, surely. Do not forget the digestion starts when you see or think of some food. Then you taste it in your mouth, it mixes with saliva there… all the systems (lymphatic, digestive, neural, etc.) are connected, possibly in ways the science knows nothing about yet. There are bacteria lurking ewerywhere, waiting, feeling, communicating. So what if the very presence of starch in the mouth, or somewhere on the way before the colon, triggers some signalling?
Okay, here is some more science on satiation.
Starch digestion begins in the mouth by by salivary alpha amylase enzyme interacting with amylose (that is a part of starch structure), and the enzymatic breakdown continues when the enzyme is released from the pancreas into the first part of the small intestine after the food moves through the stomach. The enzyme breaks down the starch at specific bonds, chopping up amylose and amylopectin into small pieces. These pieces turn out to be maltose, maltotriose, and limit dextrins which contain two, three and about five glucoses each.
NOw, maltose is the interesting one, as there have been studies done showing that maltose interacts with receptors for carbohydrate sensing in the digestive tract and that upregulates the satiation signalling to the brain.
See for instance here:
Carbohydrate sensing in the human mouth: effects on exercise performance and brain activity
http://jp.physoc.org/content/587/8/1779.full
“In summary, we have shown that both sweet and non-sweet carbohydrate in the human mouth activate a variety of brain areas, some of which may be involved in reward and the regulation of motor activity. We suggest that activation of these regions of the brain may provide a mechanism to explain the improvement in exercise performance that is observed when carbohydrate is present in the mouth. The findings also support the existence of oral receptors sensitive to the caloric value of carbohydrate and which are independent of sweetness. “
Gemma,
Thanks for the science – very intriguing. I can see how the high glycolytic activity of the gut would help prevent glucose spikes (glucose is broken in half to pyruvate). But the gluconeogenic activity would increase glucose concentrations in the blood. So technically, the gut can influence glucose “homeostasis” (it can add glucose to the blood or prevent it from entering the blood), but I know what will happen if I have a serving of safe starch – my blood glucose goes through the roof – even if I combine it with fat. Paul said the idea of having some fat along with the starch was to increase the stomach “empty time.” This would make sense, since your starches wouldn’t reach intestinal amylases as fast as they would if the meal was starch alone. However this has not been my experience since going LC back in 1999. As soon as I add starch back, I have trouble.
I liked the part about colonic acetate inhibiting appetite in the brain. But don’t liver-derived ketones do the same thing? I started my first RS dose this morning (1 tblsp of Bob’s Red Mill Potato Starch), so I’ll see what happens to my appetite as the day goes along.
Tom – any comment here?
Nothing to add, no.
@Mike G,
the popular expression “safe starches” should not be confused with the definition of a indigestible carbohydrates which serve as a food for gut bacteria (such as resistant starch, resistant dextrins, inulin, lignin, waxes, chitins, pectins, beta-glucans, and oligosaccharides, there are other non-starch polysaccharides such as arabinoxylans, cellulose, and many others). The ancestral diets were full of those. Do you have some in your diet?
The above linked “science” talks specifically these. You feed your gut bacteria and they help feeding you.
I’m no expert on the ketones. It was mentioned elsewhere that the initial positive effects of VLC or ketogenic diet could be due to starving the gut bugs, sort of a reset. And the hungry body /gut bacteria help forcing the host to run faster, think harder etc.
And another remark on a long-term ketogenic diet: it is interesting that its proponents recommend and promote using so called UCAN SuperStarch, which is a certain form of of Resistant Starch. If interested, read my comments here:
http://freetheanimal.com/2014/05/founder-saturated-admits.html#comment-601862
Very interesting points regarding microbiota boom & bust cycles – this is very relevant to the module I am currently studying (Infectious Diseases).
I have bought the PHD book but have not yet read it (but am very familiar with the work of the Jaminets). Could you please post a handful of study links which – according to you – identify the biomolecular mechanisms linking reduced carb intake to a pathological thyroid dysregulation?
Thanks!
I’ll send you to the source. He has links in his post:
http://perfecthealthdiet.com/2011/08/carbohydrates-and-the-thyroid/
Dr. Rosedale acknowledges the change in thyroid as well, but would obviously object to the term “pathological thyroid dysregulation.” He insists it’s a healthy adaptation, so that’s the focus of the debate.
This is all so confusing. As a type 2 diabetic I went VLC, got off my metformin, got my weight down to the lowest it has been in decades and would had a fasting blood glucose in the 80’s. The problem, cold hands and feet, could not tolerate cold or hot weather and had to get at least 8 hours of sleep a night or I would pay the next day.
Since Thanksgiving of 2013 I have added a carb nights every week or two. Started taking RS and I am brewing and drinking kombucha. The results? No longer cold, but I put on 20 lbs and my fasting BG has gone up into the low 100’s.
Now we’re talking about adding 100g of potatoes. Sounds scary to me but VLC had its problems too. I think adding a few carbs may be a good thing for me and I will have to acknowledge, as a type 2, I need a little help from meds and go back on a low dose of metformin to keep my fasting BG down. Hopefully, the weight grain stop at the 20 lbs.
The experiment of life continues, hopefully I’ll find what works.
It is confusing, but I believe that’s partly because there’s no single answer for everyone — not even a single answer for all type 2 diabetics. So we hear different results from different people.
“The recommended PHD macronutrient ratios are 30% carb, 15% protein, 55% fat.”
Curious what a sample meal with this breakdown would be – in actual foodstuffs, not macronutrient percentages. Of course I should probably just read the book, and maybe I will eventually.
They give sample meals in the book, yes.
Tom its not a big deal, everyone needs to make a buck, but it is a problem that every time a question comes up, we are told to buy the book. Given how much information has been merely shared by some of the titans of diet it is disconcerting.
Even watched that in play on Paul’s site where commenters are directed to buy the book…hmm.
There’s a LOT of information the PHD site, however. You could pretty much get the gist of it without buying the book. I like buying books to support the authors, however. Authors send me books in hopes I’ll review them, but in this case, I just ordered a copy before approaching Paul Jaminet for a Q & A.
Not trying to follow you around and nip at your heels, Pierre, but I must say, if I had written a book adequately covering a lot of the questions people asked me, I would be inclined to give the same reply: to buy the book. Otherwise, why did I spend all of that time, effort, and money writing it?
Fortunately, none of us are forced to buy anyone’s book. But complaining about someone encouraging us to buy their book makes it sound like we expect them to give us information (i.e. the fruit of their labor, i.e. a service) for free. Would you go to work at your job without being paid? That’s what it sounds like you expect Dr. J to do here.
I think a lot of us become (for lack of a gentler word) spoiled by all this free blog/internet information everywhere and end up losing sight of economics in this context. Indeed it is wonderful that so many bloggers give us information for free, but they do so out of the generosity of their own hearts. Their generosity does not entitle us to expect the same of everybody.
Well said
Hi,
there’s a section of “recipes” on PHD’s site.
1/4 C (uncooked) rice ~ 35 gm –> 1/2 C cooked
(i cooked it in broth & add butter, sometimes some spices. or properly soaked brown rice)
i normally have black tea + 1 TB HWC for breakfast (16 hr fast)
this gives only 70 – 80 gm of starch/day,
still leaves plenty of room to 100 – 150 gm (20% – 30% C)
(my diet is pretty close to PHD, but then i’m not trying to loose weight)
cheers,
MikeG asks: “This is why I cannot wrap my head around how fatty acids could blunt glucose spikes, or insulin spikes. Do the fatty acids bind to the glucoses? ”
No, they do not, it works differently. These are quite new findings. First, there is something called intestinal gluconeogenesis (forget gluconeogenesis in the liver from glycogen, this is something else):
“It has been established that the gut is much more than a digestive tract. It has the capacity to participate in the control of energy homeostasis via the secretion of various hormones. It can also contribute to the control of glucose homeostasis via its high glycolytic capacity and a recently described function, gluconeogenesis.”
http://www.ncbi.nlm.nih.gov/pubmed/19474723
Second, we know that microbiota ferments dietary fiber into SCFAs.
And third, the SCFAs play a role in glucose regulation:
“Fibers, specific oligosaccharides and resistant starch reach the colon intact, where they induce shifts in the composition and function of intestinal bacteria (shifts indicated by different colors). Intestinal bacteria use these compounds as substrates for the production of the short-chain fatty acids acetate, propionate and butyrate. These microbial metabolites are taken up by intestinal epithelial cells called enterocytes. Butyrate mainly feeds the enterocytes, whereas acetate and propionate reach the liver by the portal vein. Enterocytes can synthesize and release glucose to the portal vein. Propionate and butyrate promote intestinal gluconeogenesis (IGN) in different ways. Butyrate directly activates the expression of gluconeogenic genes in enterocytes by cAMP signaling whereas propionate stimulates gluconeogenesis by functioning as a gluconeogenic substrate and by FFAR3-dependent stimulation of peripheral nerves of the portal vein. The resulting gut-to-brain afferent nervous signal is required for activation of IGN, and nerves leaving the brain convey IGN-inducing signals back to the portal vein. It is not known how the efferent signals control IGN.”
A picture here:
http://www.nature.com/nbt/journal/v32/n3/fig_tab/nbt.2845_F1.html
And for the non-believers — from the last FTA blog post:
The short-chain fatty acid acetate reduces appetite via a central homeostatic mechanism
“… we show that colonic acetate crosses the blood–brain barrier and is taken up by the brain. Intraperitoneal acetate results in appetite suppression and hypothalamic neuronal activation patterning. We also show that acetate administration is associated with activation of acetyl-CoA carboxylase and changes in the expression profiles of regulatory neuropeptides that favour appetite suppression. Furthermore, we demonstrate through 13C high-resolution magic-angle-spinning that 13C acetate from fermentation of 13C-labelled carbohydrate in the colon increases hypothalamic 13C acetate above baseline levels.”
http://www.nature.com/ncomms/2014/140429/ncomms4611/full/ncomms4611.html
Wow this information is great !! I wondered about the appetite suppression connection. For me it only takes 1Tbsp of RS via unmodified potato starch and its like I’m full for several hours afterwards.
Tammy, we could look at it also like this:
The gut microbes telling the brain: Thank you, we have enjoyed our meal and we aren′t hungry any more. You don′t have to search for food any more.
Isn′t it wonderful?
Wonderful indeed. But why would the appetite suppression happen straight after eating RS? No need for RS to get down to the colon and actually get digested?
Yes, this is fascinating. Somebody will figure it out once, surely. Do not forget the digestion starts when you see or think of some food. Then you taste it in your mouth, it mixes with saliva there… all the systems (lymphatic, digestive, neural, etc.) are connected, possibly in ways the science knows nothing about yet. There are bacteria lurking ewerywhere, waiting, feeling, communicating. So what if the very presence of starch in the mouth, or somewhere on the way before the colon, triggers some signalling?
Okay, here is some more science on satiation.
Starch digestion begins in the mouth by by salivary alpha amylase enzyme interacting with amylose (that is a part of starch structure), and the enzymatic breakdown continues when the enzyme is released from the pancreas into the first part of the small intestine after the food moves through the stomach. The enzyme breaks down the starch at specific bonds, chopping up amylose and amylopectin into small pieces. These pieces turn out to be maltose, maltotriose, and limit dextrins which contain two, three and about five glucoses each.
NOw, maltose is the interesting one, as there have been studies done showing that maltose interacts with receptors for carbohydrate sensing in the digestive tract and that upregulates the satiation signalling to the brain.
See for instance here:
Carbohydrate sensing in the human mouth: effects on exercise performance and brain activity
http://jp.physoc.org/content/587/8/1779.full
“In summary, we have shown that both sweet and non-sweet carbohydrate in the human mouth activate a variety of brain areas, some of which may be involved in reward and the regulation of motor activity. We suggest that activation of these regions of the brain may provide a mechanism to explain the improvement in exercise performance that is observed when carbohydrate is present in the mouth. The findings also support the existence of oral receptors sensitive to the caloric value of carbohydrate and which are independent of sweetness. “
“We suggest that activation of these regions of the brain may provide a mechanism to explain the improvement in exercise performance that is observed when carbohydrate is present in the mouth.”
Now I want to try playing a round of disc golf with half a potato in my mouth.
Gemma,
Thanks for the science – very intriguing. I can see how the high glycolytic activity of the gut would help prevent glucose spikes (glucose is broken in half to pyruvate). But the gluconeogenic activity would increase glucose concentrations in the blood. So technically, the gut can influence glucose “homeostasis” (it can add glucose to the blood or prevent it from entering the blood), but I know what will happen if I have a serving of safe starch – my blood glucose goes through the roof – even if I combine it with fat. Paul said the idea of having some fat along with the starch was to increase the stomach “empty time.” This would make sense, since your starches wouldn’t reach intestinal amylases as fast as they would if the meal was starch alone. However this has not been my experience since going LC back in 1999. As soon as I add starch back, I have trouble.
I liked the part about colonic acetate inhibiting appetite in the brain. But don’t liver-derived ketones do the same thing? I started my first RS dose this morning (1 tblsp of Bob’s Red Mill Potato Starch), so I’ll see what happens to my appetite as the day goes along.
Tom – any comment here?
Nothing to add, no.
@Mike G,
the popular expression “safe starches” should not be confused with the definition of a indigestible carbohydrates which serve as a food for gut bacteria (such as resistant starch, resistant dextrins, inulin, lignin, waxes, chitins, pectins, beta-glucans, and oligosaccharides, there are other non-starch polysaccharides such as arabinoxylans, cellulose, and many others). The ancestral diets were full of those. Do you have some in your diet?
The above linked “science” talks specifically these. You feed your gut bacteria and they help feeding you.
I’m no expert on the ketones. It was mentioned elsewhere that the initial positive effects of VLC or ketogenic diet could be due to starving the gut bugs, sort of a reset. And the hungry body /gut bacteria help forcing the host to run faster, think harder etc.
And another remark on a long-term ketogenic diet: it is interesting that its proponents recommend and promote using so called UCAN SuperStarch, which is a certain form of of Resistant Starch. If interested, read my comments here:
http://freetheanimal.com/2014/05/founder-saturated-admits.html#comment-601862
@Gemma,
There’s no confusion on my part. If you go back and read my initial post (the one you quoted above), you’ll see that I mention the oligosaccharides in the Quest Bars that I consume. So yes, I have some in my diet. I also get plenty of cellulose in the non-starchy vegetables that I consume. I also stated in that post that I planned on taking some probiotics (to make sure I have the proper gut bugs) and then start with the resistant starch (Bob’s Red Mill Potato Starch). Given that I am a man of my word, I took probiotics for a week, and now I’m on day 3 of the resistant starch. So far, no ill effects on 1 tablespoon per day. No gas, no bloating, nothing. I am starting to have those vivid dreams, however. I’ll increase the dose to 2 tablespoons in a couple of days. We’ll see what happens. Sorry if I sounded confused. I’m all for having my gut bugs feed me short-chain fatty acids, such as ketones, but I’m not sure I want my gut lining giving me more glucose via gluconeogenesis (unless it’s taking some stress off of my liver to do that job). I don’t mind the glycolytic capability, however. But I cannot, must not, add safe starches back into my diet, as Paul Jaminet recommends.
Peter Attia does an awful lot of aerobic exercise, so maybe he can handle more regular starch, as well as resistant starch. I do zero aerobic exercise. I just do my “slow burn” weight training once per week, and it works well for me. Thanks again for the science.
@Mike G
I’m not sure if cellulose brings anything to the human body. We are not cows. Oligos are fine, better would be from real food and fiber from fresh produce. Have your resistant starch and some probiotics too. Would you mind including some beans (quite some RS) instead of rice and potatoes? The intestinal gluconeogenesis will care of itself. And no, SCFAs are not ketones.
As to the SuperStarch, I have only presented the facts: it contains 67% of resistant starch.
@Gemma,
We’re splitting hairs here, as butyrate can easily be converted to beta-hydroxybutyrate (a ketone body), and acetate can be converted to aceto-acetate (a ketone body). I’m not sure if proprionate can be easily converted to it’s ketone body, but I wouldn’t bet against it.
I have no reason to dispute you about SuperStarch, as I don’t ever plan on taking the stuff.
I’m up to two tablespoons of Bob’s Red Mill Potato Starch per day, with no ill effects.
Carry on.
@Mike G
No, we are not talking the same, your ketogenic diet is starvation diet both for your body (your fat storage must be mobilised to keep energy balance) and your gut flora (if you do not feed them they find something else to eat – you). Short time OK, long time not so. Supplementing native potato starch is OK but may not be enough.
The more I learn about the interplay and cross talk of the human body with its microbiome the more I am amazed. We need each other.
Feeding butyrate etc. from fiber fermentation to the endothelial colon cells is not the same as ketone production in the liver.
It is difficult to discuss here as there is no notification system. I only checked here by chance today.
@ Gemma,
It is the same if we’re talking about acetate. And the study you referenced above proves it. Acetate enters the portal circulation. Do you know where the portal circulation goes? That’s right – the liver, and let the ketone body production begin. You were correct about proprionate, however. The liver makes glucose with it. But I’m OK with that as well. As long as I don’t have to consume my glucose, then I will stay at my reduced weight. If I follow your advice, or Paul Jaminet’s, I will return to my weight of 225 pounds. No thank you. And I don’t buy your claim that long term ketogenic diets are harmful. What long term studies have been done on humans? None to my knowledge. And I never said I was on a ketogenic diet, by the way. Just low enough in carbs that I don’t regain the 60 pounds of body fat. Believe me, if ever slip into ketosis, my wife lets me know – she won’t be in the same room with me (due to the bad breath). I don’t suffer from any of the conditions that Paul references (cold hands and feet, hypothyroidism, etc.). I feel great on most days. If my gut microbes were eating me, I think I would have symptoms – but I don’t.
@Mike G
So why are we even talking/arguing here, then?
If you are not striving to be “keto-adapted” — whatever it means, then it’s very okay with me and I can leave this comment section with a peaceful mind. It seems you are doing it right, you feel great and you are adding some more fiber (RS and others too, I hope), to be on the sure side. And that’s correct, as recent study on “paleo” diet finds a lot of fiber in the ancestral human nutrition, see:
Deconstructing the Paleolithic Diet: Components that Reduce Cardiovascular Disease Risk (full text)
http://link.springer.com/article/10.1007/s13668-014-0077-3/fulltext.html
And to remind anyone else here that long term ketogenic diet is no good, let’s look at some animals (I know, I know, I have stated previously that we are not ruminating cows, but some basic metabolic rules are true for us humans too). Se ketones come in handy if you are a fast growing newborn or pregnant or lactating, or exercising like mad. Otherwise it’s a sign of starvation and disease. Nice summary here:
On β-Hydroxybutyrate (from the veterinarian’s point of view)
https://ahdc.vet.cornell.edu/clinpath/modules/chem/BHB.htm
RE:Deconstructing the Paleolithic Diet: Components that Reduce Cardiovascular Disease Risk (full text)
http://link.springer.com/article/10.1007/s13668-014-0077-3/fulltext.html
How do they know that the Paleo diet was low sodium? We have knowledge of Paleolithic trade routes for flint, perhaps they existed for salt too. We know one migration route out of Africa followed the coastline closely.
Dear Paul,
To clarify my question from part 1 (sorry so late to respond), my Resting RQ avg is .98 (this was my respiratory quotient based on a test at a human performance university lab), Resting METs is .7, Resting VO2 is 2.3ml/kg/min, Thoracic gas volume was 4.159 (considered low) and my Resting kCal/day is 1664. The lab technician told me to do 30%Protein/40%Fat/30%Carb; I am also hypothyroid (non-hashimotos). I am concerned because my body doesn’t seem to burn any fat, just glucose…would you tell me what you think of this?
This is all so confusing. As a type 2 diabetic I went VLC, got off my metformin, got my weight down to the lowest it has been in decades and would had a fasting blood glucose in the 80’s. The problem, cold hands and feet, could not tolerate cold or hot weather and had to get at least 8 hours of sleep a night or I would pay the next day.
Since Thanksgiving of 2013 I have added a carb nights every week or two. Started taking RS and I am brewing and drinking kombucha. The results? No longer cold, but I put on 20 lbs and my fasting BG has gone up into the low 100’s.
Now we’re talking about adding 100g of potatoes. Sounds scary to me but VLC had its problems too. I think adding a few carbs may be a good thing for me and I will have to acknowledge, as a type 2, I need a little help from meds and go back on a low dose of metformin to keep my fasting BG down. Hopefully, the weight grain stop at the 20 lbs.
The experiment of life continues, hopefully I’ll find what works.
It is confusing, but I believe that’s partly because there’s no single answer for everyone — not even a single answer for all type 2 diabetics. So we hear different results from different people.
“The recommended PHD macronutrient ratios are 30% carb, 15% protein, 55% fat.”
Curious what a sample meal with this breakdown would be – in actual foodstuffs, not macronutrient percentages. Of course I should probably just read the book, and maybe I will eventually.
They give sample meals in the book, yes.
Tom its not a big deal, everyone needs to make a buck, but it is a problem that every time a question comes up, we are told to buy the book. Given how much information has been merely shared by some of the titans of diet it is disconcerting.
Even watched that in play on Paul’s site where commenters are directed to buy the book…hmm.
There’s a LOT of information the PHD site, however. You could pretty much get the gist of it without buying the book. I like buying books to support the authors, however. Authors send me books in hopes I’ll review them, but in this case, I just ordered a copy before approaching Paul Jaminet for a Q & A.
> There’s a LOT of information the PHD site, however.
Indeed. One question I had was: what is the PHD target for FBG & PPBG.
This page on their site pretty well nails their view on that:
http://perfecthealthdiet.com/2011/11/safe-starches-symposium-dr-ron-rosedale/
If BG is the bottom line [today], the only questions would be:
Do all VLNC (Very Low Net Carb) diets have a long-term BG up-creep, and
Does an LC+SS (Safe Starch) diet fix that (or even drive BG lower), and do so indefinitely?
I don’t think we can ever say a particular macronutrient ratio produces a particular effect in all people. Too much variability among humans.
Staying on a VLC diet in perpetuity does seem to produce higher fasting glucose levels in many people because of the physiological insulin resistance. My fasting glucose wasn’t elevated before I switched to more of a Perfect Health Diet, but remember, I ate sweet potatoes or squash a couple of times per week and typically consumed a high-carb Mexican meal on Saturday night — that’s the big family night out. So I can’t say what my fasting glucose would have been if I’d been strict VLC all the time.
The lower glucose numbers among high-carb eaters he cites in one of the studies are the response to an oral glucose challenge — i.e., swallowing a big load of glucose. If you don’t plan to ever swallow a big load of glucose, I wouldn’t worry about that.
If your fasting glucose is elevated, then that’s something to address, whether by adding small servings of safe starches, or adding RS to your diet or both.
Tom, how do you feel after that Mexican meal? We have a really good diner down the road from me that serves authentic Mexican food with $5 burritos and $10 Mexican egg platters that are insanely good, but I haven’t eaten there in 3-4 years since going really low carb. I really don’t have cravings for any of it, but have thought once in a while to stop in and at least get a couple of tacos.
I feel fine after the meal. I usually order fajitas, so still heavy on the meat. The high-carb part is refried beans, some corn chips and a couple of beers. There’s rice on the plate, but like I said before, I find rice too bland to be appealing, so I give that to Alana. She likes rice.
> … some corn chips …
I’ve given up on corn entirely, and wrote up why at:
WFF: Corn (aka Maize, and including Teosinte)
http://wheatfreeforum.com/index.php/topic,906.0.html
Not trying to follow you around and nip at your heels, Pierre, but I must say, if I had written a book adequately covering a lot of the questions people asked me, I would be inclined to give the same reply: to buy the book. Otherwise, why did I spend all of that time, effort, and money writing it?
Fortunately, none of us are forced to buy anyone’s book. But complaining about someone encouraging us to buy their book makes it sound like we expect them to give us information (i.e. the fruit of their labor, i.e. a service) for free. Would you go to work at your job without being paid? That’s what it sounds like you expect Dr. J to do here.
I think a lot of us become (for lack of a gentler word) spoiled by all this free blog/internet information everywhere and end up losing sight of economics in this context. Indeed it is wonderful that so many bloggers give us information for free, but they do so out of the generosity of their own hearts. Their generosity does not entitle us to expect the same of everybody.
heh…Well no worries, given that “grew up” in the Usenet flight sim flame wars my hide is thick enough to take it.
Yes I guess I am spoiled. Given that Peter Attia, Peter “Hyperlipid”, Tom Naughton, and a whole host of very interesting people simply give it away in the interest of furthering our knowledge, I am spoiled. Peter “Hyperlipid” put up a post today that is worth reading. I have a natural skepticism.
Btw sounds like you have the book. Does Paul give references to all the studies he is using to come to his conclusions? So far studies done regarding diet have been pretty badly put together. Our own Tom Naughton is delightful when he is pulling them apart.
The book refers readers to this page for resources:
http://perfecthealthdiet.com/notes/
I don’t actually have the book, but I plan on getting it today. Just got a few iTunes gift cards for my birthday, and I intend to put them to good use on iBooks. 🙂
Well said
I bought the book and am working my way through it. However, if money was an issue, one could ask their public library to stock it. I started getting my books from the library, and if I really want to own it, then I buy it. Another way, if your library won’t get it, is to do Inter Library Loan. I had books from all over the US and Canada that way, and got them through the university I was attending. I was able to keep them for up to 6 weeks, too.
Hi,
there’s a section of “recipes” on PHD’s site.
1/4 C (uncooked) rice ~ 35 gm –> 1/2 C cooked
(i cooked it in broth & add butter, sometimes some spices. or properly soaked brown rice)
i normally have black tea + 1 TB HWC for breakfast (16 hr fast)
this gives only 70 – 80 gm of starch/day,
still leaves plenty of room to 100 – 150 gm (20% – 30% C)
(my diet is pretty close to PHD, but then i’m not trying to loose weight)
cheers,
For anyone familiar with the Jaminets’ work, I am wondering about circadian rhythm entrainment and timing of the intermittent fasting window. I try to get up by 5:00 am and be in bed between 9:00 and 10:00 pm. Is a feeding window of 11-7 too late and will it mess with the circadian rhythm? My husband doesn’t get home until 6, and I like to have family dinner, but I could eat earlier, like 8-4 if I had to.
Your 11-7 works. Key is make the window as consistent as possible. I.e don’t change it day to day to a 9am start or 1pm start. Also, make sure the feeding window is during daylight hours.
Dear Paul,
To clarify my question from part 1 (sorry so late to respond), my Resting RQ avg is .98 (this was my respiratory quotient based on a test at a human performance university lab), Resting METs is .7, Resting VO2 is 2.3ml/kg/min, Thoracic gas volume was 4.159 (considered low) and my Resting kCal/day is 1664. The lab technician told me to do 30%Protein/40%Fat/30%Carb; I am also hypothyroid (non-hashimotos). I am concerned because my body doesn’t seem to burn any fat, just glucose…would you tell me what you think of this?
For anyone familiar with the Jaminets’ work, I am wondering about circadian rhythm entrainment and timing of the intermittent fasting window. I try to get up by 5:00 am and be in bed between 9:00 and 10:00 pm. Is a feeding window of 11-7 too late and will it mess with the circadian rhythm? My husband doesn’t get home until 6, and I like to have family dinner, but I could eat earlier, like 8-4 if I had to.
Your 11-7 works. Key is make the window as consistent as possible. I.e don’t change it day to day to a 9am start or 1pm start. Also, make sure the feeding window is during daylight hours.
‘ If you have an autoimmune disease or food sensitivities, favor cooking them in a pressure cooker.’
I did a search of my e-book copy of PHD and on the PHD site, but I couldn’t find out why using a pressure cooker makes a difference for autoimmune disease or food sensitivities. Just curious as to what changes with pressure cooking that makes pressure cooking a preferred cooking method for safe starches.
Cant wait to read the book, have it ordered on kindle.
Struggling to find anywhere that will send potato starch to Ireland without looking for an extortionate delivery charge.
Thanks Tom & Jaminets for this Q&A
I got a lot from it.
Have to admit that I’m a lurker but have learned so much from everyone but I’ve finally had to ask this question. Are we stressing too much over the minutiae of eating?? In the arena of paleolithic diets paleo/primitive man did not go around micromanaging his diet. He didn’t worry about when to eat or how to eat. He just ate and he ate when food was available. While I’m extraordinarily interested in all of this science I am wondering if we are not missing the big picture here and that the paleo way of eating should be easy, or easier, than it is seemingly turning out to be. In terms of food paleo man was pretty opportunistic but was guided mostly by availability and climatic (i.e., limited food in winter) and by the movement of the sun through the sky (i.e.,harder to hunt at night so used that time to sleep). I guess what I’m saying is that I just can’t conceive of primitive people (even the ones today) stressing and obsessing over the minutiae of eating except to render what they ate edible. So how do we incorporate that “ease” of eating without worrying over every little bit we put into our mouths???
I agree. That’s why I don’t buy the idea that everyone needs to be on a VLC diet for life. Our paleo ancestors would have eaten what was available, which included roots and tubers.
‘ If you have an autoimmune disease or food sensitivities, favor cooking them in a pressure cooker.’
I did a search of my e-book copy of PHD and on the PHD site, but I couldn’t find out why using a pressure cooker makes a difference for autoimmune disease or food sensitivities. Just curious as to what changes with pressure cooking that makes pressure cooking a preferred cooking method for safe starches.
Cant wait to read the book, have it ordered on kindle.
Struggling to find anywhere that will send potato starch to Ireland without looking for an extortionate delivery charge.
Thanks Tom & Jaminets for this Q&A
I got a lot from it.
Have to admit that I’m a lurker but have learned so much from everyone but I’ve finally had to ask this question. Are we stressing too much over the minutiae of eating?? In the arena of paleolithic diets paleo/primitive man did not go around micromanaging his diet. He didn’t worry about when to eat or how to eat. He just ate and he ate when food was available. While I’m extraordinarily interested in all of this science I am wondering if we are not missing the big picture here and that the paleo way of eating should be easy, or easier, than it is seemingly turning out to be. In terms of food paleo man was pretty opportunistic but was guided mostly by availability and climatic (i.e., limited food in winter) and by the movement of the sun through the sky (i.e.,harder to hunt at night so used that time to sleep). I guess what I’m saying is that I just can’t conceive of primitive people (even the ones today) stressing and obsessing over the minutiae of eating except to render what they ate edible. So how do we incorporate that “ease” of eating without worrying over every little bit we put into our mouths???
I agree. That’s why I don’t buy the idea that everyone needs to be on a VLC diet for life. Our paleo ancestors would have eaten what was available, which included roots and tubers.
Here’s a question that’s been lurking in my mind for a few days. If I’ve read these posts correctly, the Jaminets suggest that adding resistant starch is good, but getting the prebiotic boost from fermented vegetables is even better (e.g., sauerkraut, kimchee, etc.) My family loves sauerkraut, simmered for hours with sausages and meats (or bigos, as my mother would have called it). But I’ve been wondering, does that long cooking process negate the prebiotic value of the sauerkraut?
No idea on that one. If anyone knows, chime in.
Yes, heating fermented veggies kills the bacteria. That’s why canned sauerkraut isn’t a probiotic, just a vegetable. Make your own, or buy it in the refrigerated section of the store. Eat it cold or cool, maybe like slaw? I just bought some yesterday, and am hoping it still has the bugs. I’m not set up at the moment to make my own.
Thanks for the reply. I was pretty clear that the bacteria would suffer from the cooking. I was merely wondering if there was any value in the gut fermentation of the remaining fiber, considering that the long cooking process renders the sauerkraut pretty soft.
I read somewhere recently, though I can’t remember exactly where, that while cooking does kill the bacteria in fermented vegetables, the dead bacteria are also beneficial in some way*. The writer recommended having some heated and some not.
Speaking for myself, I am now making kombucha, kefir, ginger beer, and various fermented vegetables. I also use miso when making soup. Variety is the key.
* in searching for my source, I ran across this, which, for those of us with autoimmune conditions, sounds pretty scary: http://livingwellnessblog.wordpress.com/2013/01/23/probiotic-paradox/ I haven’t had time to examine it yet to see if it may be legitimate.
Here’s a question that’s been lurking in my mind for a few days. If I’ve read these posts correctly, the Jaminets suggest that adding resistant starch is good, but getting the prebiotic boost from fermented vegetables is even better (e.g., sauerkraut, kimchee, etc.) My family loves sauerkraut, simmered for hours with sausages and meats (or bigos, as my mother would have called it). But I’ve been wondering, does that long cooking process negate the prebiotic value of the sauerkraut?
No idea on that one. If anyone knows, chime in.
Yes, heating fermented veggies kills the bacteria. That’s why canned sauerkraut isn’t a probiotic, just a vegetable. Make your own, or buy it in the refrigerated section of the store. Eat it cold or cool, maybe like slaw? I just bought some yesterday, and am hoping it still has the bugs. I’m not set up at the moment to make my own.
Thanks for the reply. I was pretty clear that the bacteria would suffer from the cooking. I was merely wondering if there was any value in the gut fermentation of the remaining fiber, considering that the long cooking process renders the sauerkraut pretty soft.
I read somewhere recently, though I can’t remember exactly where, that while cooking does kill the bacteria in fermented vegetables, the dead bacteria are also beneficial in some way*. The writer recommended having some heated and some not.
Speaking for myself, I am now making kombucha, kefir, ginger beer, and various fermented vegetables. I also use miso when making soup. Variety is the key.
* in searching for my source, I ran across this, which, for those of us with autoimmune conditions, sounds pretty scary: http://livingwellnessblog.wordpress.com/2013/01/23/probiotic-paradox/ I haven’t had time to examine it yet to see if it may be legitimate.
Great post Tom,
I intermittently fast from 12:00pm-8:00pm. But Paul says fasting should be during the day- am I doing this wrong?
He suggests an 8-hour eating window, thus a 16-hour fast. Doesn’t really matter when you do it. The idea is to fast long enough for autophagy to occur.
Great post Tom,
I intermittently fast from 12:00pm-8:00pm. But Paul says fasting should be during the day- am I doing this wrong?
He suggests an 8-hour eating window, thus a 16-hour fast. Doesn’t really matter when you do it. The idea is to fast long enough for autophagy to occur.
Tom,
I finished The Big Fat Surprise yesterday – a stunningly good book – certainly worth several readings – unless of course that Paul Jaminet is correct.
In Jaminet responses to reader’s questions regarding safe starches he makes several quite serious claims regarding the dangers of low carbohydrate diets including: “low T3 thyroid hormone…high cortisol…HbA1c [elevation]…hypoglycemic episodes, dysregulation of serum fatty acid levels, ketoacidosis, and adrenal dysfunction…higher risk for some infections, kidney stones, and other ailments” Quite serious claims which if true should switch us all to Jaminet’s Perfect Health Diet or in not true should be directly answered in that they likely will dissuade some from trying the LCHF diet.
Does the evidence exist in the literature to answer Jaminet’s claims on way of the other? If not then it would surely be a great contribution for a detailed answer to be developed by a clinician.
I do appreciate your position of “peace and brotherhood” but these are serious charges and I think they deserve an answer. If Paul Jaminet is correct then Volek/Phinney/Westman are wrong and are endangering peoples health. On the other hand, if Volek/Phinney/Westman are correct, the Jaminet is condeming a lot of carb intolerant individuals to diminished health.
The references for the book can be found here:
http://perfecthealthdiet.com/notes/
Keep in mind Jaminet’s Perfect Health Diet is low-carb and high-fat — as low-carb and high-fat as the fast-food diet I was consuming while shooting Fat Head, but of course without the wheat or processed foods. PHD would also be pretty close to the maintenance phase of an Atkins diet, depending on the individual. The symptoms he describes are from staying in what Dr. Atkins labeled the “induction phase” long-term instead of for the two weeks Atkins prescribed.
Jaminet is quite adamant that we should be burning fat as our primary fuel, but he also makes a case that we should provide our bodies with a bit of glucose to supply our daily glucose needs instead of relying totally or primarily on gluconeogenesis in perpetuity.
I don’t believe everyone on a ketogenic diet will develop symptoms of glucose deficiency, but I also want people to know it’s a risk and that PHD would be the better alternative for those who don’t thrive on a strict VLC diet.
Tom,
I finished The Big Fat Surprise yesterday – a stunningly good book – certainly worth several readings – unless of course that Paul Jaminet is correct.
In Jaminet responses to reader’s questions regarding safe starches he makes several quite serious claims regarding the dangers of low carbohydrate diets including: “low T3 thyroid hormone…high cortisol…HbA1c [elevation]…hypoglycemic episodes, dysregulation of serum fatty acid levels, ketoacidosis, and adrenal dysfunction…higher risk for some infections, kidney stones, and other ailments” Quite serious claims which if true should switch us all to Jaminet’s Perfect Health Diet or in not true should be directly answered in that they likely will dissuade some from trying the LCHF diet.
Does the evidence exist in the literature to answer Jaminet’s claims on way of the other? If not then it would surely be a great contribution for a detailed answer to be developed by a clinician.
I do appreciate your position of “peace and brotherhood” but these are serious charges and I think they deserve an answer. If Paul Jaminet is correct then Volek/Phinney/Westman are wrong and are endangering peoples health. On the other hand, if Volek/Phinney/Westman are correct, the Jaminet is condeming a lot of carb intolerant individuals to diminished health.
The references for the book can be found here:
http://perfecthealthdiet.com/notes/
Keep in mind Jaminet’s Perfect Health Diet is low-carb and high-fat — as low-carb and high-fat as the fast-food diet I was consuming while shooting Fat Head, but of course without the wheat or processed foods. PHD would also be pretty close to the maintenance phase of an Atkins diet, depending on the individual. The symptoms he describes are from staying in what Dr. Atkins labeled the “induction phase” long-term instead of for the two weeks Atkins prescribed.
Jaminet is quite adamant that we should be burning fat as our primary fuel, but he also makes a case that we should provide our bodies with a bit of glucose to supply our daily glucose needs instead of relying totally or primarily on gluconeogenesis in perpetuity.
I don’t believe everyone on a ketogenic diet will develop symptoms of glucose deficiency, but I also want people to know it’s a risk and that PHD would be the better alternative for those who don’t thrive on a strict VLC diet.