Saturday, January 18, 2014

Being, Having, and Doing: The Metaphysics of Disease

This is a copy of an article I wrote for Highbrow Paleo in 2011. I have not edited it.

Several years ago, I had an acquaintance who had previously been diagnosed with diabetes. He began a low carb diet, against the advice of his doctor, (this was in the dark 90′s), and over a period of time his symptoms abated, until one day his doctor announced that he no longer had diabetes (though in a bizarre, but perhaps common feat of cognitive dissonance, she could not help but advise him that he “really should eat more carbs”). Of course, my friend hadn’t actually stopped being a diabetic. If he were to have started eating carbs again, as recommended, he would quickly have returned to his diabetic state. What it means to “be” a diabetic is to have the susceptibility to manifest diabetes under the right, or perhaps I should say wrong, circumstances.

We all have weaknesses, to a greater or lesser extent. We all have our own special ways in which our bodies break down in response to a poor environment. For some diseases, we call this “being”. We “are” diabetic, epileptic, alcoholic, schizophrenic. For some reason, we identify less with other diseases. A person merely “has” cancer, heart disease, Alzheimer’s, or MS, even though these are not considered less permanent conditions once identified, even if they can go into remission. It does seem somewhat arbitrary that a person who was theretofore “normal” suddenly becomes or acquires a disease that they then are or have for the rest of their lives regardless of whether the disease continues to manifest. There may be a sense in which we are all diabetic, for example, even never having had symptoms. We all have the potential to some degree, no matter how small, and just because the degree is not yet known, it doesn’t make it not so.

In any case, what truly matters to a person who is or has or happens to know they have a genetic predisposition to such a condition, is whether or not their body is doing that which characterizes the disease. It is for this reason that one would seek to optimize their environment: to prevent themselves from “doing” a disease state. The Paleo diet and lifestyle is conceived with this in mind. It is reasoned both from an evolutionary standpoint: eat only that kind of food to which the body is well-adapted; and from a clinical perspective: do not eat foods which tend to cause disease. Without seeking to re-enact the environment in which we evolved — an impossible, and not particularly desirable goal (civilization does have some benefits) — one attempts to create a metabolic environment which is maximally healthful, and to which we do not tend to respond by breaking down in our various ways.

For my part, I am a fat person living in a reasonably fit body. (Fat is one of those rare states that we treat linguistically as transient, even though the obese, pre-obese, and post-obese have a signature metabolic profile such that a formerly fat person is not the same as a naturally thin one. This contributes to the blaming of fat people for their condition that would never be tolerated for other diseases.) I have Bipolar II, but for some years now my moods have no longer been disordered, and I use no medication. I wasn’t able to achieve this with a diet that is “just” Paleo, however, or even just low in carbohydrate. My body continues to do fat and bipolar unless I eat nothing but meat (though coffee and tea are mercifully tolerated). No doubt, there are people for whom even this is not enough, and others for whom it is not necessary. My idiosyncratic susceptibilities are simply deeper than most. However, I consider it likely that a great many people will do without disease simply by following a Paleo or low carb diet, or both. If nothing else, they are starting points that make sense for anyone wishing to give their body the best chance to manifest wholeness and well-being, whatever its underlying constitution may be.

Monday, January 13, 2014

Recent changes

I've been at this carnivory lifestyle for years now, and I'm still learning how to improve it.

Here are two examples:

  1. I stopped eating dairy products mid-November.

    I already knew I couldn't eat cottage cheese or yoghurt, without experiencing cravings, but I also gave up hard cheese (which I didn't eat a lot of, but sometimes at parties), butter, and heavy cream. I am slowly but surely dropping size. I've been worrying about these last 10 pounds for a couple of years, and now my regular pants are falling down. Go figure. I mean, Go, Figure! That's without extra exercise (the running I talked about in August lasted only a few weeks, and even the weightlifting I usually do was mostly left out over the holidays) and without restricting calories by design.

    I interpret this to mean that dairy products were interfering with my satiety, perhaps because of the extra insulin boost they induce. Unfortunately, I haven't had serum ketone strips for a while, so I don't know if this corresponds to higher ketones or not.

  2. I more fully embraced lard.

    I set aside the butter, and more recently I also set aside the coconut oil. (I didn't use coconut oil when I started carnivory, but I have used it for a long time in the hopes of increasing ketones, and to enjoy in the Bullet-Proof-style coffee.) I have been known to eat mayonnaise from time to time, just because it tastes good on cold chicken, even though I would otherwise never touch soy or canola oil. I stopped doing that, too.

    You know what I've re-discovered?

    Bacon drippings. I've been dutifully collecting the stuff for years, filtering it through a paper towel, and frying with it. Still, it always would get to the point where I had more than I was using. But now I'm eating it.

    • With a little salt, I think it is just as good as mayonnaise for egg or chicken salad.
    • I blend it into broth, and a cup of that is every bit as delicious as a bullet-proof coffee in my book.
    • I still fry with it, but I add more than I used to.
    • I dip bites of leaner meat into it.

    I've shifted my attitude further in the direction of considering fat a food, and in considering plants to be suboptimal sources, even if they happen to have MCTs or high saturated fat content.

    Don't forget that fat is actually an organ. Whoever said that skin was the largest organ in the body was wrong. Lard doesn't just have a beautiful fatty acid profile. It has choline, a little zinc and selenium, vitamin E, and a lot of vitamin D.

Oh yeah, and in stark contrast to butter and coconut oil, it is essentially free. It's a by-product of something the family already eats, and my rate is still below the supply.

Wednesday, January 8, 2014

Wait — why eat only meat?

I want to briefly clarify our position about the 30-day trial. Although we hypothesise that there may be benefits to avoiding or minimising plants, it is definitely not necessary to avoid plants to gain the benefits of ketosis! None of the studies that form the basis of our beliefs about ketogenic diets had any such restriction. As we said in the explanation of the experiment, you can even formulate a vegan diet that is ketogenic.

The 30-day trial can be compared to the original Atkins (1972) induction phase [1] or the Eades' “meat weeks” in their book The 6-week cure for the Middle-Aged Middle. While both of those allow a small amount of certain vegetables, one basic idea is shared:

More carbohydrate restriction can be more effective, especially at the beginning, even if you ultimately find a comfortable long-term diet containing more carbohydrate.

In addition to minimising the carbohydrate amount, the main reason we recommend an all-meat diet for the 30-day trial is that it helps avoid these pitfalls:

  • Accidentally misunderstanding carb sources (we've had several people tell us later they never realised that a food they were eating had that much carb in it).
  • More generally, not having to count things, which can be a source of anxiety and error.
  • Slippery-sloping: a little leads to a little more until the threshold is passed.
  • If you happen to fall on the low side of carb tolerance, you might miss the benefits entirely by choosing the wrong arbitrary cut-off, and then conclude it doesn't work for you.
  • Interference from food intolerances, fiber, or anti-nutrients (such as goitrogens or lectins).

Also, anecdotally, I and several people I have met had profoundly higher benefits from eating just meat. We don't know the mechanism for sure. Since you are going to all the trouble to try a keto diet anyway, you might as well find out if you are one of those at the same time.

If you are not one of those, you can go back to eating plants and no harm will have been done. I wish you much enjoyment. Vegetables can be exquisite, and I'd cry into my plate about my fate, if I didn't feel so fantastic and my choices weren't also excellent.


I categorise the Atkins diet into 3 major releases.

In the first edition, Dr. Atkins' Diet Revolution, there were no products, and there was no notion of “net carbs” (in which you subtract fiber from your carb count). You were allowed up to 2 cups of vegetables from a short list (mostly leafy greens). In the second major release, Dr. Atkins' New Diet Revolution, this becomes up to 20 grams, which he says is approximately 3 cups of salad, but which can be made up of any foods resulting in that count. The third major release, The New Atkins for a New You, came after his death, and was written by Drs. Westman, Phinney, and Volek. Its induction phase allows 20 grams of net carbs, which ultimately translates into a lot more vegetable matter.

There are groups to be found on the internet who live on what they call Atkins 72, because they have found that only that level of restriction works for them.

Sunday, January 5, 2014

Biochemical Warfare

In response to the 30-day trial that Zooko and I recently recommended, one correspondent argued about the importance of plant foods. He made several points I'd like to address, but the one I want to talk about here is one I've heard many times before. The statement is to the effect that plants are full of a variety of healthful compounds, many of which we have surely not even yet discovered.

This idea has an assumption behind it that I strongly disagree with: that we evolved to eat a significant amount of plant matter, and therefore we are likely to have optimised our functioning on the biochemical compounds in those plants. I disagree for the following reasons:

  • Whether we evolved eating a lot of plants is contentious. At the very least, there have been times and places that we had little to none.
  • What we do know about plants is that their survival strategy is biochemical. They generate many chemicals (many of which we surely have not even yet discovered) with which to poison their would-be eaters!

My correspondent went on about his diet, listing biochemicals in the foods he eats, and lining them up with diseases those chemicals have been shown to have promise in fighting.

I agree that the biochemicals in plants often turn out to have medicinal properties that we can make use of. For those properties, the chemical typically has to be extracted to get a high enough concentration to have any effect. These compounds are much like drugs we make ourselves, in that they usually have unwanted side-effects. Commonly, they are double edged swords. For example, some plant chemicals are widely touted because they harm cancer cells. The bad news is that they also harm your healthy cells. So like chemotherapy, it is a matter of hoping the healthy cells survive better than the cancerous ones.

In a recent article by Michael Pollan, whose brilliant slogan we bastardised without even a nod (we hope he takes it in stride) [1], he describes how plants produce chemicals, not just as a matter of growing, but in a real-time response to predators. For example:

"One of the most productive areas of plant research in recent years has been plant signalling. Since the early nineteen-eighties, it has been known that when a plant’s leaves are infected or chewed by insects they emit volatile chemicals that signal other leaves to mount a defense. Sometimes this warning signal contains information about the identity of the insect, gleaned from the taste of its saliva. Depending on the plant and the attacker, the defense might involve altering the leaf’s flavor or texture, or producing toxins or other compounds that render the plant’s flesh less digestible to herbivores. When antelopes browse acacia trees, the leaves produce tannins that make them unappetizing and difficult to digest. When food is scarce and acacias are overbrowsed, it has been reported, the trees produce sufficient amounts of toxin to kill the animals."

To think that we co-evolved with plants in symbiosis, them providing us with countless, needed medicinal concoctions, while we selectively kill them and eat them, seems a bit naive. While it's true that some species rely on having their seeds carried, undigested, for better distribution, or their pollen spread, this is does not imply they get value from having their very bodies eaten. Even that fruit and nectar need only be helpful to some species; It didn't evolve dependent on humans per se.

Finally, I find it a little sad that my correspondent is seeking to avoid disease through constant miniscule doses of medicine that are likely to be accompanied by as much toxin. There is no evidence that such a strategy has any beneficial effect. On the other hand, a ketogenic diet has increasingly stronger types of evidence suggesting it will protect against those diseases [2]. As we speak, randomised clinical trials are underway to help clarify whether this is true. Such is not the case for vegetable eating.

[1]For those of you who didn't recognise it, Michael Pollan famously recommended: "Eat food. Not too much. Mostly plants."
[2]See, for example, Zooko's and my post, The medical-grade diet.