4

votes

Perfect Health Diet tweaks?

Answered on August 19, 2014
Created January 19, 2012 at 7:24 AM

I am reading through the Perfect Health Diet. I am wondering if there are any tweaks you have found helpful?

5a506bcfafe352e8fe11ebac285aa3e4

on February 07, 2012
at 12:33 AM

I always wonder about the French. Do they have high LDL numbers, as their per capita butter comsumtion has always been much higher than in the US? Or are they somehow immune to butter's effects?

C00e493393828df34be65ddc25456c7c

(610)

on January 23, 2012
at 10:17 AM

Yes, I look forward to Paul addressing too

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on January 21, 2012
at 05:44 AM

Good points, those particular saturated fatty acids both increase synthesis and decrease clearance of LDL, and in the context of generally good metabolic health and good diet I wouldn't be worried about a bit of downregulation of the LDL receptor, but I can't see how LDL of 400 would mean anything other than an extreme inability to clear it, which can mean oxidized cholesterol. I look forward to seeing Paul address this.

D1c02d4fc5125a670cf419dbb3e18ba7

on January 21, 2012
at 04:56 AM

Seafood is Paleo and some people go into anaphylactic shock when eating it and possibly die. That doesn't mean recommendations in Paleoland to eat seafood are reckless. Anyone that takes dietary advice from ANY source no matter how well reasoned and supported needs to evaluate their n=1.

9e20abb05f3f6e3cc4bb107f8980aecd

(5939)

on January 21, 2012
at 03:50 AM

Thanks, Eric. Thanks, Travis, you got me. I still think you shouldn't give up on butter, but use it to troubleshoot some missing element in your diet.

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on January 21, 2012
at 03:16 AM

Thanks Travis. Very well put. Much apreciated.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on January 21, 2012
at 01:13 AM

Travis, your thinking and writing is damn good. Pleasure to read.

Medium avatar

(39831)

on January 20, 2012
at 04:24 AM

"PS: I never said eat as much butter or cream as you want." Pg. 99: "Saturated and monounsaturated fats are the safest calories source - indeed the only calorie source that is non-toxic in very high doses - and should provide the bulk of calories. **Eat as much as you like.** Meats, fish, and eggs are excellent sources. **So are dairy fats like butter and cream.** " Kinda seems like you did.

Medium avatar

(39831)

on January 20, 2012
at 04:23 AM

"PS: I never said eat as much butter or cream as you want." Pg. 99: "Saturated and monounsaturated fats are the safest calories source - indeed the only calorie source that is non-toxic in very high doses - and should provide the bulk of calories. **Eat as much as you like.** Meats, fish, and eggs are excellent sources. **So are dairy fats like butter and cream.** Kinda seems like you did.

Medium avatar

(39831)

on January 20, 2012
at 04:22 AM

"PS: I never said eat as much butter or cream as you want." Pg. 99: "Saturated and monounsaturated fats are the safest calories source - indeed the only calorie source that is non-toxic in very high doses - and should provide the bulk of calories. Eat as much as you like. Meats, fish, and eggs are excellent sources. **So are dairy fats like butter and cream.** Kinda seems like you did.

Medium avatar

(39831)

on January 20, 2012
at 04:22 AM

"PS: I never said eat as much butter or cream as you want." Pg. 99: "Saturated and monounsaturated fats are the safest calories source - indeed the only calorie source that is non-toxic in very high doses - and should provide the bulk of calories. **Eat as much as you like.** Meats, fish, and eggs are excellent sources. **So are dairy fats like butter and cream.**" Kinda seems like you did.

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on January 19, 2012
at 10:36 PM

Hi Paul! I am enjoying your book.

Medium avatar

(39831)

on January 19, 2012
at 10:30 PM

DePaw: When I hit 393, I was eating mostly ghee.

Medium avatar

(39831)

on January 19, 2012
at 10:09 PM

At the very least, there should be some word of caution for the potentially susceptible. It'd be far safer and more evolutionarily consistent if people just ate the same amount of fat in the form of suet. With how much liver and wild ocean creatures I eat, a trace mineral deficiency just isn't likely.

9e20abb05f3f6e3cc4bb107f8980aecd

(5939)

on January 19, 2012
at 09:52 PM

Hi Travis, if butter has that effect I'd advise you to look at underlying reasons for it, such as micronutrient deficiencies. Just as intolerance of carbs indicates a pathology that should be fixed, intolerance of butter does too. It should be possible to eat butter without ill effect. ... PS: I never said eat as much butter or cream as you want. People can want odd things. I do think butter is a generally benign food. I wouldn't look to butter as a fundamental cause of health problems.

B8592e62f9804ddabae73c1103d6bcb9

(1956)

on January 19, 2012
at 09:46 PM

Travis, does ghee do the same?

Medium avatar

(39831)

on January 19, 2012
at 09:26 PM

From an evolutionarily-informed diet perspective, there's a serious burden of proof on those claiming that a 65% fat diet or whatever with as much of it as butter or cream as you want is going to mesh well with our design.

Medium avatar

(39831)

on January 19, 2012
at 09:25 PM

I've seen probably 10-15 people in the Paleosphere who have shot their Total cholesterol in the ~400 range due to butter and cream, myself being one of them. When I cut it out, it plummeted back to within normal range. Many of us are clearly not designed for substantial amounts of that ratio of SAFAs, and it's incredibly difficult to keep a pool of LDL that large from oxidizing. http://paleohacks.com/questions/36855/i-think-i-may-have-figured-out-why-some-of-us-have-really-high-ldl#axzz1jrnjlKyo

93f44e8673d3ea2294cce085ebc96e13

(10502)

on January 19, 2012
at 08:24 PM

@Travis - Interesting - why is that?

Medium avatar

(39831)

on January 19, 2012
at 07:55 PM

Skip the butter...Jaminet should really recant on that one.

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on January 19, 2012
at 07:47 PM

Hacks, modifications, adaptations...

  • 1a98a40ba8ffdc5aa28d1324d01c6c9f

    asked by

    (20378)
  • Views
    5.6K
  • Last Activity
    1281D AGO
Frontpage book

Get FREE instant access to our Paleo For Beginners Guide & 15 FREE Recipes!

4 Answers

best answer

10
Medium avatar

on January 20, 2012
at 08:36 PM

First off, let me say that the PHD is the best book of its kind and that Jaminet did a (largely) excellent job of researching the material and putting it together.

That being said, I take issue with a few things. First, I think the 100g/wk liver target is too conservative. If I recall, part of the reasoning is that we ought to be taking a multivitamin, so we would run into too much overlap. If anything liver should be your multivitamin and should have total primacy over any supplement. Supplements should move around to accommodate liver, not the other way around. I personally eat about 25g of liver and 25g of heart per day (in sausage form). Liver truly is the only "superfood" and should be treated as such.

Secondly, I think fructose is only conditionally problematic and that the consumption of it alongside glucose at a time of low liver glycogen is highly advantageous. In fact, I would go so far as to say that (somewhat slowly) drinking a can of soda upon waking (as disgusting as that is) would not result in any real glycation, insulin resistance, elevated TGs etc. The problem with fructose as it is encountered by the average person is that they are totally sedentary and are thus never turning over their muscle glycogen. On top of that, they are constantly eating carbohydrates so their liver glycogen is almost always maxed out and they consume fructose at all times of the day. I think it's beneficial to eat something really sugary upon waking in order to dampen down the morning cortisol levels. These days I've been eating a tbsp or so of raw wildflower honey on a rice cake first thing in the morning. Delicious. [I will say that those for whom sweet foods trigger cravings/binges etc. should probably avoid it in toto.]

Most importantly, however, I think the pro-butter stance that I quoted above in the comments is potentially quite dangerous. There is nothing particularly controversial about the hypercholesterolemic effects of butter and cream. It is a phenomenon that is fairly well-documented in the scientific literature. The resistance I see to that idea makes me think that half the time I accidentally clicked to PastoralHacks (the other half of the time I think I'm on AtkinsHacks...but I digress). Anyway, the best paper that I've seen on the subject is this one:

http://www.jlr.org/content/36/8/1787.full.pdf

The take home message is that coconut raises cholesterol, but butter raises it twice as much, due to it's proportions of the specific hypercholesterolemic saturated fatty acids (myristic, lauric and palmitic acids). Another interesting part was the differential response to the diets based on gender, with HDL really spiking in women in response to these fats. I can't remember if that's due to more estrogen or less testosterone. More to the point, butter increases cholesteryl ester transfer activity (which, incidentally, also occurs when trans fats are consumed: http://www.nejm.org/doi/full/10.1056/nejm199906243402501 - note that the greater the amount of trans fats, the closer the LDL is to that produced by butter). This basically shuffles cholesterol and TGs around between the lipoproteins and results in lipoprotein aberrations. Since decreased CETP activity correlates with longevity: http://jama.ama-assn.org/content/290/15/2030.full we might be hesitant to eat a particular kind of fat that greatly enhances it.

Though many of us are highly skeptical of statins, there is a subset of the population that clearly benefits from their use, i.e. those with familial hypercholesterolemia. These people (who are heterozygous, the homozygous version is deadly in childhood) will hit cholesterol levels in the 3-500 range pretty much no matter what they eat. It's well documented that they have a greatly increased risk of atherosclerosis as a result. We may be skeptical of 210 total cholesterol being unhealthy, but what about double that? Where are you going to draw the line and just how are you going to explain it away? Jaminet's convenient explanation is that it's not the butter, it's some micronutrient deficiency. I see no reason why it can't be purely the result of butter and cream consumption and the subsequent upregulation of CETP.

The primary hypercholesterolemic mechanism at play itself may be something else such as a downregulation of the liver's absorption and recycling of lipoproteins. Whatever the mechanism, the result is increased LDL. I am allergic to coconut oil, so I consumed none in order to hit a total cholesterol of 393, but if I hadn't been, it may have been even higher. I've seen 3-4 people on Paleo Hacks who hit a TC of 500-something via butter and cream and many others in that range around the paleosphere.

Butter and cream are essentially anti-statin drugs that we did not evolve to consume, and certainly not in the amounts that are frequently encountered in high fat diets. Advising people to not restrict their fat intake or their butter/cream intake within that fat intake is highly irresponsible since the effect in many people is simulated familial hypercholesterolemia, with the corresponding increase in CHD risk.

It is not out of the realm of possibility that someone could follow this advice to the letter, not bother getting a lipid panel, and have a heart attack as a result. This issue is deadly serious.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on January 21, 2012
at 01:13 AM

Travis, your thinking and writing is damn good. Pleasure to read.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on January 21, 2012
at 05:44 AM

Good points, those particular saturated fatty acids both increase synthesis and decrease clearance of LDL, and in the context of generally good metabolic health and good diet I wouldn't be worried about a bit of downregulation of the LDL receptor, but I can't see how LDL of 400 would mean anything other than an extreme inability to clear it, which can mean oxidized cholesterol. I look forward to seeing Paul address this.

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on January 21, 2012
at 03:16 AM

Thanks Travis. Very well put. Much apreciated.

D1c02d4fc5125a670cf419dbb3e18ba7

on January 21, 2012
at 04:56 AM

Seafood is Paleo and some people go into anaphylactic shock when eating it and possibly die. That doesn't mean recommendations in Paleoland to eat seafood are reckless. Anyone that takes dietary advice from ANY source no matter how well reasoned and supported needs to evaluate their n=1.

C00e493393828df34be65ddc25456c7c

(610)

on January 23, 2012
at 10:17 AM

Yes, I look forward to Paul addressing too

5a506bcfafe352e8fe11ebac285aa3e4

on February 07, 2012
at 12:33 AM

I always wonder about the French. Do they have high LDL numbers, as their per capita butter comsumtion has always been much higher than in the US? Or are they somehow immune to butter's effects?

2
3586aa41f702f26b55481afeed3620e5

on February 06, 2012
at 10:14 AM

WHat about the idea that your LDL or Total values being enabled to reach such high numbers with butter having something to do with thyroid function and the ability of your metabolism to turn cholesterol into all of those things your body can use?

What about the idea (one of my issues with people diving into high fat diets) is that you cant utilize those levels of fat for consumption until your metabolism is much higher?

Thanks,zzzzzzzzzzzz

0
5bbc3c6990de797dd6d04d597823984d

on August 14, 2012
at 09:46 PM

Thank you for this information. I am very much interested in dietary factors that raise cholesterol. Ever since I learned to restrict my carbs to <100g/day, my total cholesterol and trigs dropped to 110 and 40, despite eating a lot of coconut oil and butter fat. Those levels do not correlate with optimum health and longevity for a person over 55. Even eating 4000 mg cholesterol/day in the form of pork brains 5 days a week only raised my TC to 185. N=1 is more important than generalizations!

0
4d6aa1a676240b15dc569ff8ade0500f

(2546)

on January 19, 2012
at 07:45 PM

what do you mean by tweaks exactly?

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on January 19, 2012
at 07:47 PM

Hacks, modifications, adaptations...

Answer Question


Get FREE instant access to our
Paleo For Beginners Guide & 15 FREE Recipes!