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Book Review: Perfect Health Diet (Scribner Edition, December 2012)
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December 20, 2012
2:38 pm
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Stipetic:

"Pseudoscience" is far too harsh, and I disagree with that judgment.  I think his reasoning for determining the carbohydrate intake that doesn't require conversion from protein (or burning excess carbs, or de novo lipogenesis) is correct.  The problem is biochemical individuality: there appear to be individual differences in our response to and ability to process dietary carbohydrate, there are definitely individual differences in metabolic flexibility, which affect our baseline need for carbohydrate...and some of us simply aren't happy with the homeostasis we achieve at physiological intake.  

Yet the PHD gives us an excellent starting point -- one which will be healthy and satisfying for most people, myself included.

eddie:

We traded T-shirts.  Jamie proudly rocks "Die Biting The Throat," and I proudly rock "Chaos and Pain."  Hey, I knew him before he held the raw record at 181 😀

Paula:

The PHD absolutely makes specific recommendations for starch intake -- both by calories, and by approximate weight and volume of PHD-approved foods.  One of the strengths of the book is that it translates all the science into easily-achievable takeaways.

Paul:

Digestive and metabolic intolerance are two completely different creatures.  I think issues with regular starch (as opposed to "soluble fiber" or other FODMAPs) are metabolic issues, not digestive...but I'm open to discussion.

E Craig:

That's a good point about casein vs. lactose.  It's why I differentiate them in Eat Like A Predator and whenever the discussion comes up, and why I recommend dairy fats for everyone but counsel caution with dairy proteins and sugars.

JD Magaw:

Other researchers use the term "FODMAP" for the carbohydrates in question, but they generally concentrate on the IBS issue.  The site you linked appears to contend that they play a primary role in SIBO (and therefore GERD), which is also plausible.  I'm glad it's helped you.

eddie:

It's always been very difficult for me to gain lean mass, so I'm enjoying figuring out exactly what I have to do in order to make that happen.  I'm not ready to write an article yet, though. 

JS

December 20, 2012
9:46 pm
Loren
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Thanks for hugely informative and fascinating discussion

December 21, 2012
3:00 am
Stipetic
Guest

Okay, pseudoscience was harsh. Apologies to Paul, who I believe is a great spokesperson for the eat real food movement. Speculation, rather, work for you?

I'm not sure if you were there in the first incarnation of the dangers of VLC dieting. But the crux of it was based on a post on a blog claiming that a commenter knew of more than two people who had died of stomach cancer on the Dr. Kwasniewski's Optimal Diet. Far from scientific. I'm sure he's expanded his repertoire by now, but I still remember that he staked his position on the badness of VLC first and only later did he do his due diligence on the science (I prefer it when the process is reversed). It doesn't mean he got it wrong. Just wished it hadn't happened this way.

Maybe I owe it to him to check out the new and improved version of his book (I have the first edition, signed by Paul hinmself!).

December 25, 2012
2:19 am
R.
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@Stanton: Traditional advice in regards to putting on lean mass is to eat a ton (at least enough so you're getting over maintenance), and, obviously, lift a ton. I'd be interested to read your article when you're ready to write it!

December 28, 2012
5:37 pm
Paul N
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Good review JS.

I pre-ordered the book myself and read it cover to cover in a week. Truly a "can't put it down" book, that had me staying up to 2am reading about the importance of sleep and following circadian rythms!

As an engineer myself, I thoroughly appreciate the evidence - both ancestral and scientific- based approach. Historic and modern civil engineering follows a similar pattern - the old school ways are not always the best, but there is always a reason why they were the way they were, and we can learn from it. And sometimes, the old school ways are still the best.

@ David Porter
if you really want to know why we need supplements, try growing your own tomatoes in compost enriched soil, and compare that to a store bought, hydroponically grown one - which do you think has more nutrients? Most commercial fruit and veg crops are much lower in micronutrients, flavonoids, polyphenols etc than heirloom or wild varieties. The price of greater yield is lower nutrient content.
If you can grow a lot of your own (fruit, veg, meat and milk), or know someone who does, you can probably get by with a lot less supplements. For the rest of us, that's just the way it is.

@ Paula. If you are having problems with starches, I highly recommend the GAPS diet - I personally know of two women who have resolved their starch (and a host of related gut issues) with this approach. Takes time, but, unlike just avoidance, it actually heals so that you can handle these foods again

January 2, 2013
12:32 am
Kelly Fitzsimmons
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Great unbiased review of a Diet/Lifestyle plan.
Great Website, found your through the Paleo Rodeo.
Keep up the good work.
-kelly

January 3, 2013
9:32 pm
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Stipetic:

The new edition is, as I said, a masterwork -- and it's the first book I recommend to anyone who wonders how I eat or what I recommend.

R.:

You've pretty much nailed it.  There are refinements, depending on how "ripped" you want to get, but what I've found is that over-analysis generally leads to overly-restrictive diets and no mass gain.

Paul N:

Empirical evidence can't tell you what's best -- but it will definitely tell you what works.  In contrast, theory can potentially tell you what's best -- but it can't tell you what works in reality.

Kelly:

Thank you!  In a world saturated with information, I continue to emphasize quality over quantity.  You can browse the index if you're impatient with the pace of my updates.

JS

January 14, 2013
4:21 pm
Beowulf
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I read the original PHD and I'm mostly through the newest incarnation. I really like the latter, but I DO wish the citations weren't only online.

As for the VLC vs. safe starch debates that seems rampant in paleo circles and forums as of late [and please note, I don't have specific dates or citations for any of this, just my own gut sense]. I suspect that many people who were early adopters of paleolithic style eating had distressed metabolisms, in other words they were fat and diabetic. After all, few but the desperate are going to be interested in what at the time was a highly fringe diet. For that group a VLC eating style probably gave them a host of benefits, and obviously some people still do very well on that for decades. Now that paleo had gone somewhat more mainstream [enough to warrant criticism from major groups 🙂 ] a broader group of people are trying it including the modestly overweight and the lean and athletic.

First, the need for extended VLC eating may play the strongest role for those that have been rendered carb-intolerant by a lifetime of influences creating carb-intolerant gene expression. The presentation by Chris Masterjohn at the AHS 2012 comes to mind.

Secondly, for paleo eaters with a higher intensity workout schedule (cross-fit, P90X, mixed martial arts) those safe starches may be critical to performance. While it is possible for the body to do a heck of a lot of work with minimal carb intakes especially at low levels of intensity, the drive to reach even higher levels of achievement will incline some to "need" safe starches, sometimes a LOT of them.

Third, I have observed that often the most vocal proponents in forums of "carbs aren't bad!" and "you NEED starch!" are young, lean, highly active males. Their activity level may support that need (see reason #2), but I also suspect that they're simply too young to have the effects of poor dietary choices of any type truly affect their physique and health.

Lastly, I suspect that our cultural preference for muscle meats over organ meats creates certain deficiencies in the body. Being VLC on ground beef and some mixed greens probably isn't going to provide your body with what it needs to sustain good health in the long run.

Just my two-cents worth.

January 14, 2013
4:29 pm
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Halifax, UK
Gnoll
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That, and the PHD makes a pretty strong case for some simple starches being absolutely necessary for good health amongst more sedentary people. I viewed the PHD as a carb-focussed diet before I read the book ... my illusions were shattered ... the second edition is more so, more defined. More mainstream paleo is just starting to accept and understand what Paul & Shou-Ching have already found.

Living in the Ice Age
http://livingintheiceage.pjgh.co.uk

January 14, 2013
11:02 pm
R.
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Agreed. The PHD is excellent - it feels like paleo without the pseudoscience, basically. The Jaminets tend to have their own perspectives on issues too, which is nice because you know you're not buying into dogma.

@Stanton: Agreed. Optimization is definitely required for bodybuilders, but just eating a paleo/PHD type diet and making sure to get enough protein should do wonders. If you want to go that extra step, Layne Norton recommends taking protein in several meals throughout the day (up to 50g per meal). I haven't dug into the research of what is actually required to get the body in an anabolic state besides the obvious intake of protein, so I'm not too solid on specifics.

January 15, 2013
8:48 am
Madison, WI, USA
Gnoll
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Yes, after trying Keto (VLC) several times while practicing my Aikido(martial art), I was quite tired and believe that's what gave me the tennis elbow I am now recovering from.  I have since added a post or pre workout sweet potato and/or banana.

 

VLC might work for some who are not cross-fiters, martial artists, but I've learned via personal experience that it simply does not fit my current fitness goals.  Robb Wolf had a blog series about this very topic and Richard Nikoley's potato diet hack was also mentioned.

"Often we forget . . . the sky reaches to the ground . . . with each step . . . we fly."  ~We Fly, The House Jacks

January 15, 2013
11:03 pm
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Beowulf:

I've had many of the same thoughts you've had, and agree substantively with what you said. 

A lean, active young man looking to lose the 20 vanity pounds he gained drinking beer in college is unlikely to have the same metabolic issues as a menopausal woman who became obese at puberty and has been over 100 pounds overweight ever since. 

Furthermore, I suspect that people will find the same "magical" weight loss properties on almost any diet which only permits one single whole food.  I spoke of "sensory-specific satiety" in my hunger series...it's a well-known phenomenon in which our desire to eat more of a food decreases as we eat it, irrespective of any of its other characteristics.

Finally, I have to note that the only person to exhaustively and objectively document their progress on the potato diet reported an epic failure: they actually gained weight and fat mass.

Paul:

They make a good case...but I have some evidence that the picture is incomplete, which I hope to discuss soon.  And while I continue to recommend the PHD as the best "paleo" diet book out there, I also continue to note that a significant fraction of people simply do better both mentally and physically on VLC, without the side effects Paul experienced. 

Again, biochemical individuality is real -- and while the theoretical optimum for the average person is an excellent starting point, it may not be the real-world optimum for you or I as an individual.

R.:

I'm sure Layne Norton would disagree with Martin at leangains, who is both giant and ripped, so who knows?  I tend more towards approaches that satisfy the 80/20 rule: 80% of the benefit for 20% of the work.  I'll let the professional weight class athletes and the body-image obsessed do the 80% of the work that gets that last 20% of benefit.

Jen W:

Jamie Scott over at thatpaleoguy gave a great presentation at AHS12 about the benefits of training in a carb-depleted state, while carbing up for events at which maximum performance is required.  But it's like training with a weighted vest: it'll hurt and slow you down until you take the vest off.

JS

January 25, 2013
10:03 pm
Ulrik
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J, I just saw your video from AHS12 – (Link edited, as it changed -JS) – awesome stuff! I think you did really well, and I learned a few things that maybe I missed from your original blog posts or that you perhaps added for the talk.

I thought maybe you should write a short post alerting your subscribers to the video? I discovered it quite by accident!

January 29, 2013
2:39 am
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Ulrik:

Here's the update with both the Vimeo and Youtube versions of my presentation, and a link to the bibliography.  And yes, there's a lot of new material in it, which I look forward to exploring in more detail.

JS

February 16, 2013
11:27 pm
Martin @ Leaky Gut R
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Now I am really inclined to order. Thank you for the review.

March 8, 2013
11:22 am
eddie watts
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J i have just begun trying out adding a few grams of dextrose to my protein shakes on the apex predator diet (currently in the middle phase).

just wondering if the suggestion was to do this in all shakes for a day or just those around workouts?

currently this past week i have added 5g dextrose to my pre and post workout shakes.

considering doing it with every shake but concerned this will elevate my dextrose intake over 30g a day without looking at veggies and stuff like that.

also did you hit rampage days with only paleo foods? how did you manage on that, this is the hardest part for me: to get enough carbs in to hit the suggested target on those days.

March 10, 2013
9:44 pm
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eddie:

I did it in all of them.  Again, the idea is that if you're basically doing a PSMF, some amount of the protein is simply going to be diverted to gluconeogenesis, so why not eat the glucose directly?  Bonus: extra insulin helps drive the protein into muscles.  Besides, 30g of dextrose a day is nothing, relatively speaking.

Keep in mind that as whey gets more expensive, the cheaper protein powders generally get cut with a bunch of maltodextrin (= glucose) anyway, so you might be getting 5-7g/scoop just from that.

No, I didn't keep strict paleo on Rampage days, though maintaining PHD was much easier: rice noodles are great if you're trying to get as many carbs down the hatch as possible (and, therefore, not great for weight loss).

Note that I haven't done APD for quite a while...I found that any diet at all causes me to not gain muscle mass unless I effectively Rampage for about 36 hours post-workout.  If it weren't for half and half, I don't think I could gain any muscle mass at all!

JS

March 11, 2013
3:02 am
eddie watts
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thanks for that, from tomorrow i will be doing it with every shake.
the blend shakes i use are very low in carbs but i use a UK only company so no use to you!

the last week i've experienced better results so this refinement will hopefully help too.

i've actually gained considerable muscle mass while dropping fat, just lucky like that i suppose, but upper back and shoulders are the primary areas, upper back was an area i just did not train as hard as previously so this is probably why.

worked out that my evening meals often work out around 250g protein and high in fat too, not as high as 250g admittedly, but i sleep so well on this diet too, which is odd for me.
although i don't intend doing this forever i think the evening high fat/protein meals will stay in some format moving forward.
sadly i don't have the freedom of being able to hit the gym twice a day even on weekends 🙁
my waist is now what it was when i got married and was hitting crossfit 5 days a week, but i'm now over a stone and a half heavier.
i don't know how much fat i've lost but only my waistline has got smaller, so it's definitely working.

plus it has stopped me constantly tinkering with my diet, which for me is a nice mental relief. i don't fret about it in the way some do, but i struggle to decide what to stick to for a long enough time to see results.
anyway, thanks for the answer J hope everything is going good for you 🙂

March 11, 2013
8:29 pm
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eddie:

That's excellent progress!   I'm glad the plan is working out for you.  It makes sense -- your body uses more than 30g of glucose a day, even in ketosis -- but it's nice to get empirical confirmation.  Make sure to tell Jamie sometime.

JS

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