It’s both surprising and embarrassing that humans, with our big brains, are the only animals that don’t seem to know what they ought to eat. How did we get here—and, most importantly, what can we do about it?
Nearly all diseases can be cured if they are attacked at their root causes: toxic foods, malnutrition, and chronic infections.
Nearly everyone can achieve a healthy weight and a long, healthy life by eating as they were meant to eat.”
These are bold claims! Yet in my professional judgment, its lucid explanations based on careful, patient research justify the following assertion:
The Perfect Health Diet is the new baseline from which all future attempts to determine the optimal human diet must be argued and measured.
How Does The Perfect Health Diet Work?
I’ve often described my own approach to nutrition as an attempt to combine archaeology (evidence from the past) with biochemistry (evidence of the present) , using each to fill in what we don’t yet know or understand of the other.
The PHD (as I’ll refer to it henceforth, for brevity) takes a similar approach: it uses what we know of human evolutionary context (and of modern hunter-gatherer diets) as a starting point—but unlike most “Paleo” diet books, it moves quickly forward to the present.
The central concept of the book is: for each nutrient necessary for human life, there is a peak health range for its consumption. Too little of a nutrient causes poor health due to deficiency, and too much causes poor health due to toxicity. (Even water can be toxic if we drink enough of it!)
So, the authors set out to find the peak health range for every known necessary nutrient. From this knowledge, they choose a range of whole foods (and approximate quantities in which to consume them) that bring the known nutrients into the peak health range, while keeping toxic antinutrients below their threshold of toxicity (usually by eliminating them altogether).
This emphasis on whole foods distinguishes the PHD from many other scientific, reductionistic approaches: the Jaminets understand and accept that we don’t know (and, perhaps, can’t know) every substance necessary for human life.
“Food is full of nutrients that we don’t know we need. We share a common biology with plants and animals, and their tissues contain premade biological compounds that are valuable to us and that we may not be able to construct in adequate quantities from purified nutrients.” -pp. 66-67
The bulk of the book is devoted to finding the peak health ranges for macronutrients (Part II), micronutrients (Part IV)—and antinutrients, whose peak health range is often zero (Part III). (I personally find Part IV extremely illuminating, as it identifies several micronutrients in which we can easily become deficient even with careful eating, and recommends a small, carefully chosen list of supplements in response.)
When referring to human diet and metabolism, “macronutrients” are nutrients that can be burned for energy: protein, fat, carbohydrate. (The calorie content of a food is due to macronutrients.)
“Micronutrients” are required to support metabolism, but cannot be burned for energy: vitamins and minerals. (As such, micronutrients are generally required in much smaller quantities.)
Part V provides specific applications of the PHD to issues from fungal infections, to cancer, to GERD; it explains why cholesterol is a nutrient, not a poison, and what those “cholesterol numbers” really mean; it discusses uses of intermittent fasting and techniques for better sleep…
…and, yes, it includes one very short chapter on weight loss. But by the time you’ve read that far, you’ll have such a solid understanding of nutrition and metabolism that it’ll seem perfectly reasonable for the book to be structured in this way, and you’ll know all you need to in order to reach a healthy weight and body composition.
(Warning: the PHD is not intended to, by itself, give you a “six pack”! But you’ll have a much better chance at it by starting with the PHD, achieving a state of good health and body composition, and only then trying to optimize for sub-10% bodyfat.)
In refreshing contrast to most diet plans, the PHD emphasizes that healthy food should be delicious, because our tastes for nutrients like fat and salt don’t exist to tempt us or make us obese. Our tastes exist to guide us towards the nutrients we need—as long as we choose from evolutionarily appropriate, PHD-approved foods.
I’ve been recommending the original edition of the Perfect Health Diet since long before the first AHS in 2011, so many of my readers are already familiar with it.
Paul Jaminet modestly claims “The Scribner edition is 50% longer; almost half of the material is new. Original material is revised and updated,” but I felt as if I were reading a completely new book. The new edition flows more logically—and though it contains much more information than the old edition, it somehow feels less intimidating. And as a bonus, it’s substantially cheaper despite being printed in hardback!
The prescription will be familiar to anyone in the Paleo and ancestral health community: eat meat, fish, eggs, leafy vegetables, root vegetables and other “safe starches”, and fruits; use natural saturated and monounsaturated fats, like butter, coconut oil, and olive oil, for cooking and flavor; avoid grains, legumes (including peanuts), “vegetable oils”, and refined sugar; don’t forget to eat fatty fish and shellfish, bone broths, and beef liver. Peeled white potatoes and white rice (in moderation) are OK, as is butter and fermented dairy. A few carefully-chosen supplement recommendations round out the diet.
I hope it’s clear that I view the new edition of the Perfect Health Diet as an indispensable resource. However, there are some changes I would make.
The most glaring omission: the footnotes don’t exist in the book! A note on the first page of each chapter directs you to a page on the Perfect Health Diet website to find them. While I do enjoy the convenience of being able to click links when I’m online, I strongly dislike having the source of an assertion hidden from me unless I have a computer and an Internet connection right at hand. Frankly, I find this omission disconcerting, and while I understand that having pages almost completely covered in footnotes (as in the old edition) is distracting, I hope Scribner will correct the deficiency by adding endnotes to subsequent printings.
Moving on: while the PHD does briefly discuss tweaking protein intake for longevity or body recomposition, I would like to see more acknowledgment and exploration of biochemical and metabolic individuality, and of the benefits of varying dietary composition over time. For instance, we’re starting to learn a great deal about how various genetic mutations affect our processing and conversion of nutrients, and why some people require more of certain nutrients than others. While we still might not understand exactly why, there are clearly some people with metabolic issues around carbohydrate (even “safe starches”). And not all VLC issues are caused by insufficient starch or solved by more starch.
However, I don’t wish my comments to detract from the fact that the PHD is a masterwork.
It’s difficult to communicate just how comprehensive the new Perfect Health Diet is. You could pick almost any paragraph with a footnote, blow that single study up to book length, add breathless hype and a celebrity endorsement, and start a new fad diet equivalent to hundreds of others that are sitting on bookstore shelves, right now. Reading the PHD exposes both the bankruptcy of mainstream dietary advice, and the poverty of most well-known alternatives (all of which, according to the statistics, fail miserably). Most importantly, it provides us with a credible, science-based alternative that isn’t vulnerable to the typical naive arguments like “But cavemen only lived to age 25″ or “That’ll raise my cholesterol.”
The PHD is clearly the product of many years of careful research, real-world testing, and hard work. As I said above, “The Perfect Health Diet is the new baseline from which all future attempts to determine the optimal human diet must be argued and measured.”
In case my point isn’t clear: yes, that means you should buy a copy and read it. Even if you find your own nutritional optimum to lie outside their guidelines, the supplement recommendations alone will save you the price of the book…
…and the wealth of information it contains may allow you, or someone you know and value, to attain perfect health.
You can support gnolls.org by buying the new Perfect Health Diet (or anything else) through this link. It costs you nothing, and I get a small spiff.
(Legal disclaimer: I received a pre-publication copy of the book for free.)
There are two approaches to “going Paleo”: the “taper off” approach, in which you eliminate non-Paleo foods from your life in multiple steps as you feel ready, and the “boot camp/detox” approach, in which you commit to a completely new diet all at once.
The most vocal and successful proponents of the boot camp/detox approach to Paleo are Dallas and Melissa Hartwig. In their “Whole30″ program, you commit to eating 100% strict Paleo for 30 days. No cheat days, no 80/20 rule, no white rice or white potatoes, no exceptions. The purpose of It Starts With Food is simple—to get you to do a Whole 30—and the Hartwigs are betting that your health and life will improve so greatly that you’ll stick with it…
…or at least be cautious about re-introducing non-Whole30 foods, so you can rationally evaluate the effect of each one instead of simply falling off the wagon.
What Distinguishes “It Starts With Food” From The Other Paleo Books Out There?
What distinguishes the different Paleo books isn’t so much their actual dietary recommendations. Sure, the Perfect Health Diet permits white rice and white potatoes, both it and the Primal Blueprint are moderately tolerant of dairy, and there is still a bit of push-pull over optimal fat and carb content…but at the end of the day, everyone agrees that meat and vegetables ought to be the foundation of our diet (plus eggs unless you’re allergic, and fruit in moderation), and that anything containing grains, seed oils, and/or refined sugar is right out.
Therefore, I won’t spend a lot of time on the factual content of It Starts With Food, because it won’t be surprising to anyone in the paleo community—especially if you’ve already read Robb Wolf’s The Paleo Solution, of which ISWF’s middle sections are, in most respects, a less chatty and informal version. (Although ISWF is explicitly saturated fat-tolerant, though not fat-philic, and it’s worth noting that clarified butter gets a hall pass.)
What distinguishes ISWF is the approach it takes to advocacy. For instance, the Perfect Health Diet is primarily based on modern-day biology and biochemistry, and the Primal Blueprint works mostly from an evolutionary context. In contrast, It Starts With Food bases itself on changing your relationship with food, using a tough-love (though not harsh) approach throughout.
“The food you eat either makes you more healthy or less healthy. Those are your two options. There is no food neutral; there is no food Switzerland…” (p. 12)
However, it’s not all whip-cracking and ominous warnings. Aside from the usual promises of better health, relief from sickness, etc.—anecdotes of which are planted throughout the text—Chapter 4 closes with the following promises:
First, you will once again be able to appreciate the natural, delicious flavors (including sweet, fatty, and salty) found in whole foods.
Second, the pleasure and reward you experience when eating that delicious food will once again be closely tied with nutrition, satiation, and satiety—you’ll be able to stop eating because you’re satisfied, not because you’re “full”.
Third, you will never again be controlled by your food. (p. 38)
The Hartwigs maintain these themes throughout: if you eat according to the Whole 30, you ought not to have to count calories, always be hungry, or continually crave cheat foods.
Goal: To Sell You The Whole30
The Hartwigs’ stated goal is to convince you that it’s a good idea to do the Whole30—to be strict Paleo for 30 days straight—without cheating. And since they know that most such New Year’s Resolution-styled efforts end in abject failure, they want to make it as easy for you as they can.
Then, after you’ve been “clean” for 30 days, you can start evaluating your favorite non-Whole30 foods to see what effect their reintroduction has on you.
Does It Succeed?
I think the best argument for trying a Whole30 is found on page 204:
“Think of it like this. You’re allergic to cats, and you own ten of them. One day, fed up with your allergies, you decide to get rid of nine of your cats. Will you feel better?”
And the reason I think this book will succeed in convincing many people to try a Whole30 is primarily because of Chapter 16 (“Meal Planning Made Easy”) and Appendix A (“The Meal Map”). Too many diet books, paleo and otherwise, leave the reader with a giant list of forbidden foods (including everything you eat on a daily basis) and, if you’re lucky, a thinly veiled advertisement for another book with actual recipes in it. “Now what do I do?” you think.
In contrast, these two chapters of ISWF tell you everything you need to complete a Whole30 on your own. Their quantity guidelines are both simple and refreshing (“one to two palm-size servings of protein” … “a meal-size portion is the number of eggs you can hold in one hand”). Even better is their mix-and-match approach to meats, vegetables, spices, and sauces, which allows the reader to create hundreds of their own dishes using the flavor combinations they personally find most palatable.
I’ve been using the “one-skillet cooking” technique for quite a while, and Appendix A has given me several new ideas to try.
I do have a couple nits to pick. The information on magnesium left out the important fact that if magnesium citrate gives you the runs, other chelates, like malate and glyclnate, have a much reduced laxative effect. Also, ghee and clarified butter are not the same thing! (To make ghee, you must “toast” the residual proteins before pouring off the pure butterfat.) And while this isn’t a quibble, it’s worth noting that “coconut aminos”—a common ingredient in the recipes—are a soy sauce substitute.
However, this is small stuff.
It Starts With Foodsuccessfully balances encouragement, tough love, and a simple yet option-rich meal plan to produce a solid, well-placed motivational kick in the butt. In other words, it’s everything you need to do a Whole30 except your own desire and willingness to try it.
Disclaimer: I received two free copies of this book, and gave one away to a lucky member of the gnolls.org mailing list. And if you buy a copy of It Starts With Food from any of the Amazon links on this page, including this one, I get a small spiff. (At no cost to you…buying stuff through my affiliate links is a great way to make Amazon contribute to gnolls.org. Note that you can buy anything, not just the item you clicked through to.)
Note that if you’re new to my ongoing blockbuster series “Why Are We Hungry?”, it’s best to start at Part I. Otherwise, if you haven’t already, you should read the latest installment, "When Satiation Fails"—because like the previous article "When Satiety Fails", it both presents important information and ties together a lot of issues that are currently vexing the community. And we’re not done yet!
Finally, I note with pleasure that several readers and regular commenters are already starting to pull together the Big Picture on their own. This is great! If I’ve explained the science correctly, the consequences and conclusions should follow logically and be non-controversial.
Ever since I was little, my mother used an analogy that, for me, is still the mental equivalent of worn-out disc brakes squealing in metal-to-metal contact—or the incessant, high-pitched, yelping bark of an obsessively manicured lapdog suffocating in a cloud of its owner’s perfume.
She called it the “pain thermometer”, and it goes something like this:
It doesn’t matter how much you don’t like something or how much it hurts. Until your pain thermometer reaches the top, you won’t do anything about it.
Typing that still makes me wince, so I’ll say it my way:
We don’t get what we want: we get what we are just barely willing to tolerate.
This is a powerful concept, and it explains so much about the world and our lives. We want honest politicians, but we’re willing to tolerate corrupt, venal liars. We want privacy, but we’re willing to tolerate a surveillance state. And we want to be healthy and fit, but we’re willing to tolerate being sick, obese, and diabetic.
Stated more explicitly, it doesn’t matter how crummy your life is or how much pain you’re in—unless you get so fed up that you finally do something about it.
“Network” was released in 1976—35 years ago—and that speech could have been made yesterday. Think about that for a minute.
Unfortunately, yelling out your window won’t solve anything, which is where Howard Beale’s ideas ran out. But until you’ve decided that you’re no longer willing to tolerate your situation, nothing will change. The change is up to you.
How Did We Get Here?
Based on the paleo eaters I’ve talked to, including the authors of more than one well-known paleo diet book, very few of us came to the concept of ancestral health from a position of strength. Most of us tried a paleo diet because of medical problems that the medical establishment was (and is) remarkably powerless to treat, or because the side effects of the medications were just as bad as the disease. GERD, IBS, arthritis, innumerable autoimmune syndromes, poor sleep and digestion, or just long-term malaise…and, of course, anywhere from 15 to 200 extra pounds of fat and its associated metabolic syndromes that both “heart-healthy whole grains” and “eat less, move more” were powerless to shed.
In other words, we had to become so broken that we were no longer willing to tolerate being broken.
This leads naturally into my review of “Sugar Nation”.
Congratulations, You’re Prediabetic: Jeff O’Connell’s Wakeup Call
Synopsis: Jeff O’Connell, despite being tall, slim, and apparently in decent physical shape (he’s been the editor of everything from Muscle & Fitness to Men’s Health to Bodybuilding.com), finds out that he’s not just stressed out from work: he’s inherited his father’s Type II diabetes. He doesn’t want to end up like his father, dying bedridden with amputations and on dialysis, and the advice he was given upon diagnosis seems remarkably inadequate:
Dr. H, having told me that I was prediabetic, mumbled something about switching from white rice to brown. He also instructed me to come back in six months for another round of blood work. Wow, that’s it? I thought. I didn’t know much about disease, but managing it seemed like it should require more than tweaking my order at the local Chinese restaurant.
What I didn’t receive, and what most patients don’t receive, is any advice that would address, let alone fix, the problem…”
Currently $14.36 at Amazon.com (price may change)
The rest of “Sugar Nation” recounts Jeff’s effort to understand what Type II diabetes is, and what he can do about it—with an additional twist that I’ll leave readers to discover. Though Jeff’s prescription will be shocking to anyone in the mainstream, its two pillars shouldn’t be a great surprise to most of my readers, or anyone in the paleosphere: T2D is a defect of glucose metabolism, it is treatable by diet and exercise, and you should therefore 1) stop eating so much friggin’ glucose, i.e. eat a low-carb diet, and 2) perform short, intense, glycogen-depleting exercise to help restore your insulin sensitivity.
Furthermore, he repeatedly hammers home that the progression from insulin resistance to T2D to numbness, dialysis, amputations, and blindness is a direct consequence of diabetes “treatment” that advises patients who cannot properly metabolize carbohydrates to eat lots of carbohydrates—and, with them, an ever-expanding pharmacopoiea of drugs that fail to mitigate their poisonous effects.
Where I find the book to be most interesting, and most valuable, is in two areas: the history of diabetes treatment (as with obesity, past treatment programs were often more effective) and the demographics of its relentless spread, and in the dysfunctionality and outright corruption of the medical industry. He lays bare the deep, incestuous financial relationships between the American Diabetic Association and the pharmaceutical and medical equipment manufacturers who profit so handsomely from diabetics—as well as the profoundly malicious cluelessness of the mainstream medical community, including the NIH and AAFP:
During a 2007 interview with the American Association of Family Physicians’ then-president James King, M.D., a family physician in Selmer, Tennessee, I asked him how to eat properly as a prediabetic so that I could inform others in the pages of Men’s Health. “I tell diabetic patients to consume more carbohydrates—mainly from fruits and vegetables, not from simple sugars and starches—while decreasing the amount of meat and fat in their diet,” he said.
I e-mailed the lead author, Philip E. Cryer, M.D., professor of endocrinology and metabolism at Washington University School of Medicine … “A glucose-tolerance test is never indicated in the evaluation of a patient for hypoglycemia,” he wrote back.
… “I’m sorry, but that item’s not recommended for your diet,” said the pleasant woman on the other end of the line. I had told the doctors that I was prediabetic. I was impressed that this information had been conveyed to the cafeteria.
But I was also confused. “What, the peaches?” I asked. “No, the sausage.”
O’Connell is an experienced writer and journalist, and it shows: he exposes the rampant corruption and cluelessness in a remarkably neutral tone, without coming across as either paranoid or a crusader.
His understanding of the science is reasonably sound, too: he understands the role of glycogen depletion and how it improves metabolic flexibility, and even touches on the known issue of mitochondrial dysfunction in the obese. My only quibble is a whiff of saturated fat phobia here and there—but on the whole he does a solid job of understanding and communicating that low-carb necessarily means high-fat as well as high-protein, and that this is not a problem. And despite the title “Sugar Nation”, he is clear on the fact that “heart-healthy whole grains” are just as carb-heavy—and, therefore, unhealthy—as refined grains and refined sugars. However, I wish Jeff had summarized his hard-won knowledge at some point in the book: a short chapter, or even just a bullet list of “Here’s how I manage my Type II diabetes”, would have been welcome.
In conclusion, “Sugar Nation” is a hard-hitting exposé that reads more like a biography. While its basic prescription won’t be news to you, my readers, it’s a shocking accounting of the cluelessness and corruption of the mainstream medical establishment, and the extent of the suffering its terrible advice causes. It’s also a solid source of information for people in your life who can’t swallow “paleo” or “primal” but are still in danger of ruining their health. And it’s full of scary facts and trenchant observations, so I’ll close with one:
…The standard recommendation of consuming 50 percent of your calories from carbohydrates translates to 250 to 300 grams’ worth a day. Split over three squares a day…means consuming more than a glucose tolerance test’s worth of carbs at each meal. “We use glucose tolerance as a metabolic stress test and yet prescribe a diet that produces that at every meal,” says Raab. “It highlights just how ridiculous this advice is.”
Wrapping It Up: What Was Your Wakeup Call?
“Sugar Nation” is Jeff O’Connell’s story. What was YOUR wakeup call?
What finally made you say “I’ve got to do something about this” and motivated you to start eating like a predator?
Leave a comment, even if it’s just a link to the bio on your own blog…it’s always fascinating to hear others’ stories.
Live in freedom, live in beauty.
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