Perfect Health Diet: Regain Health and Lose Weight by Eating the Way You Were Meant to Eat (Anglais) Relié – 11 décembre 2012
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Why We Start with an Evolutionary Perspective
Why understanding the big picture is so crucial to your health.
An ancient Indian story tells of eight blind men trying to discern the nature of an elephant. Each felt a different part and reached a different conclusion about the nature of the elephant.
The poet John Godfrey Saxe reported the outcome:
And so these men of Hindustan
Disputed loud and long,
Each in his own opinion
Exceeding stiff and strong,
Though each was partly in the right
And all were in the wrong.
Much the way experts quarrel about diet!
Why is it so hard to figure out the optimal diet?
Like the blind men in the fable, diet experts begin with no clear picture of what an elephant looks like and after lifelong investigations acquire only a partial grasp of the evidence. The biomedical database PubMed contains more than 22 million articles, and a million new papers are added each year. A typical scientist reads at most a thousand papers per year. No matter how long a scientist’s career, it’s impossible to read more than 0.1 percent of the literature. Most of this reading has to be in the scientist’s specialty—a small part of the elephant.
Adding to the problem is the complexity of human biology. We need to get many nutrients, maybe hundreds, from our food. Food contains thousands of toxins. With so many different ways food can nourish or harm us and so many different ways to assemble foods into a diet, picking out which diet is healthiest is like answering a multiple-choice test that has a billion choices. It’s easy to go wrong.
Looking at all this research is like looking at a disassembled jigsaw puzzle with no picture of the completed puzzle. It’s hard to tell how to put the pieces together.
A Big-Picture View We Can Trust
What we really need is a big-picture view—a view of the whole elephant. We need a reliable guide to the optimal diet, a guide that gives us an approximation to the truth at the very beginning of our investigations. This approximate answer can be a lodestar that guides us through the labyrinth of details, preventing many a wrong turn.
This is where an evolutionary perspective comes in. We know that healthy people and animals are more likely to survive the vicissitudes of life and have children and grandchildren. This means that evolution selects for healthful behaviors—including healthful eating.
If we’re looking for a human diet that evolution guarantees is healthful, the place to start is with the diets of the Paleolithic. The Paleolithic was so long—2.6 million years—that Paleolithic man became highly optimized for the Stone Age environment. In the last 10,000 years, mutations have become much more common due to population growth,1 but most beneficial mutations have not had time to become widespread. The historical era has been a period of genetic diversification and emerging but incomplete adaptation to modern life. That means if we want an environment, diet, and lifestyle that will be healthful for all of us, we have to look back to the Paleolithic.
SCIENCE OF THE PHD
Why We Share a Paleolithic Heritage
The Paleolithic began 2.6 million years ago with the invention of stone tools and ended 10,000 years ago with the invention of agriculture. The Paleolithic lasted a hundred thousand generations and was characterized by small populations, typically, tens or hundreds of thousands; at the end of the Paleolithic the human population was 3 million. The modern era has a large population—7 billion today—but evolution has had little time, less than five hundred generations, to work its magic.
We can calculate how long it will take before every possible mutation appears in some person, somewhere. Every child has a similar number of mutations—about 175 new point mutations among the 3 billion base pairs of the human genome.2
• In the Paleolithic, with 10,000 children per generation, it would have taken 8,000 generations, or 160,000 years, for each possible mutation to occur once.
• Today, with more than a billion children per generation, every possible point mutation now appears about twenty times per generation, or almost yearly.
We can also calculate the time required for a beneficial mutation to reach “fixation,” or universal presence throughout humanity. This time is on the order of ln(N)/s, where N is the population size and s is the selection coefficient, a measure of how beneficial the mutation is in terms of expected number of children.3
• In the Paleolithic, a mutation that raised the probability of having an extra child by only 0.1 percent would have reached fixation in 460,000 years. So a mutation with selective advantage of 0.1 percent would have occurred within the first 160,000 years of the Paleolithic, then become universal 460,000 years later—long before the Paleolithic was over.
• In the modern era, a similar mutation would occur every year but would require 200,000 years to reach fixation. The modern era is less than 10,000 years old, however, so few recently mutated genes have had time to become universal. As a result, our genetic adaptation to the new environment of modern life—agricultural foods, city living, the presence of governments and complex institutions—is incomplete. And human genetic diversity is greater than ever before.
Because mutations that would remove our adaptation to Paleolithic diets have had little time to spread through the population, it is likely that nearly everyone is extremely well adapted to Paleolithic diets. The same cannot be said for modern diets.|Perfect Health Diet
The Paleolithic Diet
• Eat real food: recently living plants and animals.
• Eat mostly plants—but low-carb!
• Among plant foods, favor in-ground starches.
• Don’t be afraid to eat fat! Hunter-gatherers flourished on a fat-rich diet.
The premise of “Paleo” diets is that foods hunted and gathered by our Paleolithic (“Old Stone Age”) ancestors represent the healthiest human way of eating, while agriculturally-produced foods may be dangerous to well-being.
There’s solid evidence backing this idea. Direct evidence for the superiority of Paleolithic diets comes from archaeological studies of ancient skeletons. These studies tell us that until the modern era, with our reduced rates of infectious disease, the Paleolithic was the healthiest epoch of human history.
Studies of animals also show that “wild” diets are the healthiest. For example:
• Thirty-two percent of pet cats and dogs are obese,1 but obesity is rare among wild wolves and tigers. It’s not only pets: feral rats living in cities and eating discarded human food have grown increasingly obese in parallel with the human obesity epidemic.2
• Zoo-born elephants live only half as long as elephants living wild in parks such as Amboseli National Park, Kenya.3 Zoo elephants also have much higher rates of obesity than wild elephants. Elephants make a great comparison animal, because they are rarely subject to predation in the wild.
What’s the “wild” human diet? Presumably, the diet obtained the same way wild animals obtain their food: by hunting and foraging in the manner of our Paleolithic ancestors.
READER REPORTS: A Cure for IBS
I’m 62 and have suffered, along with anyone who gets near me, with IBS for the past 25 or so years, and have tried just about every supplement to alleviate the condition without success. Since starting the PHD my symptoms disappeared in less than a week—and haven’t come back. As Billy Crystal would say, “UN beWEEV abo.” Thanks so much.
Paleolithic Health and Neolithic Decline
The tall stature and strong bones of Paleolithic skeletons indicate that Paleolithic humans were in remarkably good health. Paleolithic humans were tall and slender; cavities and signs of malnutrition or stress in bones were rare; muscle attachments were strong, and there was an absence of skeletal evidence of infections or malignancy.4
The adoption of farming in the Neolithic radically changed the diet, and with it came a dramatic loss of health. Farmers needed crops that yielded many calorie-rich seeds from each seed planted, so the harvest could feed the farmer’s family for a year and supply seeds for sowing in the spring. This required a turn of the diet to grains and legumes—foods that, as we shall see, are toxic.
After the adoption of agriculture, stature lessened; smaller tendon attachments show that muscles weakened; bone and teeth pathologies, such as cavities and osteoporosis, became common; hypoplasias show that periods of malnutrition were common; and signs of infections and inflammation became common.
SCIENCE OF THE PHD
The Neolithic Decline
A large number of journal articles, anthropology Ph.D. theses, and books discuss the collapse of health that is visible with the adoption of cereal grain agriculture.5 A few tidbits:
• Average height dropped, bottoming out at about five feet, three inches for men, five feet for women around 3000 B.C.—about five inches shorter than in the Early Upper Paleolithic.6
• Bones from the Neolithic site of Ganj Dareh in Israel, studied by the anthropologist Anagnostis Agelarakis, showed hypoplasias on the teeth, indicative of malnutrition when young; signs of ear infections and gum inflammation; broken or fractured bones; and arthritis. Those who survived childhood struggled to reach middle age.7
• Nine of sixteen Bronze Age mummies—and seven of the eight of people who died after age 45—in the Museum of Egyptian Antiquities, Cairo, had atherosclerosis.8
The drop in stature persisted throughout the agricultural era until modern times. Only in the twentieth century, with rising wealth and the elimination of many infectious diseases, did humans regain Paleolithic stature.
So Paleolithic diets were quite healthful—agricultural diets, not so much.
We’d better look into what those healthy Stone Age hunter-gatherers were eating!
Paleolithic Plant Foods: Savanna Starches
Many people assume that our distant ancestors resembled chimps and gorillas—forest-dwelling apes who ate fruit. That’s a mistake.
Our ancestors had a long association with open woodlands and tree-spotted grasslands. Where the fossils of human ancestors have been found, tree cover was generally less than 40 percent, sometimes as low as 5 percent.9
Fossils testify that our Paleolithic ancestors lived in open, grassy terrain. Fossil hominids lack the stiff spines and long powerful arms of forest-dwelling apes, and appear to have spent much of their time walking bipedally as grassland dwellers do.10 Ape bipedalism has a long history. Ardipithecus ramidus, which dates from about 4.4 million years ago, spent a significant amount of time walking bipedally,11 as did Oreopithecus bambolii, whose fossils date from 10 to 7 million years ago.12 Another bipedal hominoid dates to 21.6 million years ago.13 Very possibly the common human-chimp ancestor was a bipedal ape living in open terrain, and chimps and gorillas adapted to the forest after they diverged from the human line.
Not only did our hominid ancestors live in wooded grasslands, their food came from grasslands too. This has been proven by a clever method—“isotope signatures” of fossilized bones. Combined with the structure of hominid teeth, this evidence tells us that our ancestors were eating savanna tubers, roots, and corms—foods similar to our modern potato and taro. They had invented the digging stick and were eating starch!
SCIENCE OF THE PHD
How We Know Paleolithic Hominids
Ate In-Ground Starches
Carbon comes in heavy (carbon-13) and light (carbon-12) forms, and grasses and sedges (“C4 plants”) incorporate relatively more carbon-13 than other plants. So the carbon-13 to carbon-12 ratio in a skeleton tells us what fraction of the creature’s food was obtained from grassland plants or animals that ate grassland plants.14
There is considerable variability, but in general grassland plants predominated in the diet of Paleolithic and earlier hominids. This created a puzzle, known as the “C4 conundrum.” Hominids such as Australopithecus africanus and Paranthropus robustus did not have the right kind of teeth for eating grasses and were not thought to be major hunters of grazing animals, yet their bones show that they got their carbon from grasses. The resolution of the puzzle: those apes were getting their dietary carbon from C4 plant underground storage organs—tubers and corms similar to the modern potato and taro.15
This emphasis on starchy roots, tubers, corms, and rhizomes continued throughout the Paleolithic. Food residues from Upper Paleolithic sites dated to 30,000 years ago show that the grinding of starchy roots and rhizomes into flours and foodstuffs was a common practice.16 Microfossils on Neanderthal teeth from around 44,000 years ago show evidence of the consumption of many roots and tubers, some of which show evidence of cooking.17 Neanderthal consumption of starchy plants goes back at least 250,000 years.18
Modern hunter-gatherers who live in environments that lack starchy plants all trade for starches produced elsewhere. The anthropologist Thomas Headland proposed that it would not be possible for humans to survive in forest environments without such trade; this was debated as the “wild yam question.”19
READER REPORTS: Weight Loss, Improved Energy
I am in the middle of the wardrobe crisis that I’ve been waiting to have for ten years: all my clothes are too big. I don’t mean a little loose; I mean I perpetually look like I’m headed out to an M.C. Hammer costume contest.
Over the past few months I’ve lost 25 pounds. That’s a good thing, since the drop on the scale was a side effect of lifestyle changes that have left me with more stamina and energy than I had when I was 20.
It’s not an exaggeration to say that the Perfect Health Diet changed my life.
A final line of evidence—genetics—supports the idea that our Paleolithic ancestors ate starches. Chimps have two copies of the gene for salivary amylase, the enzyme that digests starches. Humans worldwide average seven copies of the gene; aboriginal peoples eating low-starch diets, such as the rain forest–dwelling BiAka and Mbuti pygmies of the Congo Basin, average 5.4 copies.20 A plausible interpretation is that our Paleolithic ancestors ate enough starch to reach 5 to 6 copies of the amylase gene and that subsequent evolution since the Neolithic invention of cereal grain agriculture has increased the amylase copy number a bit further.
Paleolithic Animal Foods
The Paleolithic began with the invention of stone tools about 2.6 million years ago. These tools were used to hunt animals, tear meat, and cut bones to reach the marrow. Bone marrow consumption is attested from 1.9 million years ago.21 The pursuit of marrow, which is nearly all fat, shows that animal fats were a sought-after part of the early Paleolithic diet.
By 1.75 million years ago, ancestral Homo had spread to northern latitudes, where plant foods are relatively scarce. It is likely these northern hominids were eating a meat-based diet.
By 40,000 years ago, we can tell that Neanderthals (hunting herbivores such as mammoths) and humans (hunting many species with an emphasis on fish) were top-level carnivores. Upper Paleolithic humans weren’t getting protein from plants—no beans for them!—and were higher-level carnivores than wolves and arctic foxes.22
SCIENCE OF THE PHD
Isotope Signatures of Protein Sources
Nitrogen is found in protein and comes in heavy (nitrogen-15) and light (nitrogen-14) forms. Whenever an animal eats protein, it tends to incorporate nitrogen-15 in tissues and exhale or excrete nitrogen-14, so the ratio of heavy to light nitrogen increases by 3 to 4 percent with every step up the food chain.
Unfortunately nitrogen-15 is unstable and is only preserved in bones and teeth from the last 50,000 years, so we have no idea how high on the food chain Australopithecus or Homo habilis were. But nitrogen isotope ratios show that both humans and Neanderthals were at the top of the food chain and getting nearly all their protein from animal food sources.
Another sign that Paleolithic humans were doing a lot of hunting is animal extinctions. The arrival of Paleolithic humans in Australia and the Americas was quickly followed by the extinction of large animal species. Earlier, in Eurasia and Africa, species such as mammoths and saber-toothed tigers were hunted to extinction.
Animal extinctions began at an early date. Between 1.9 million and 1.5 million years ago, Homo erectus appears to have caused the extinction of twenty-three of the twenty-nine known species of large African carnivores.23 The six species that survived were “hypercarnivores,” such as lions and leopards, which ate only meat; the twenty-three that went extinct were omnivores such as civets, which scavenged and ate a wide range of foods. It is thought that they went extinct because they were in direct competition for scavenged carcasses with hominids.24
Subsequent advances in human culture were often followed by new animal extinctions. The extinction of elephants from the Levant around 400,000 years ago was probably due to hunting by archaic humans.25
What Was the Proportion of Animal to Plant Food?
Anthropologists debate the relative proportions of plant and animal food in the diet of our Paleolithic ancestors. Unfortunately, for the earlier part of the Paleolithic there is no evidence that directly answers that question.
We do know that a great expansion of brain sizes occurred during the Paleolithic, and it was probably made possible by new calorie-rich food sources. There are two major theories:
1. Stone tools and cooperative hunting enabled our Paleolithic ancestors to obtain fatty animal foods.26
2. Control of fire enabled our Paleolithic ancestors to cook starchy plants, rendering them less toxic and more digestible. This greatly increased the calories obtainable from plant foods.27
The second theory has been popularized by Richard Wrangham in his book Catching Fire: How Cooking Made Us Human. However, most anthropologists favor the first. The use of stone tools coincided with the brain expansion; while the first known use of fire was 1 million years ago,28 routine use of fire may have begun only 300,000 to 400,000 years ago,29 and more sophisticated use of fire such as heat treatment of tools may have begun 164,000 years ago.30
So the foods driving the brain size expansion during the Paleolithic were probably fatty animal foods.
We do have solid evidence for the diets of modern hunter-gatherers, which probably closely resemble the diets of the Upper Paleolithic. They may be our most useful guide to what a “Paleo diet” for modern humans should look like.
Modern Hunter-Gatherer Diets
The first attempt by an anthropologist to quantify the diets of modern hunter-gatherers was the 1967 Ethnographic Atlas of G. P. Murdock, which was corrected in 1999 by J. P. Gray.31 This looked at 229 aboriginal groups still living in a way that resembled their traditional lifestyle.
The data were analyzed by Loren Cordain and colleagues.32 They found that hunter-gatherers obtained most of their energy from animal foods—meat, fish, and eggs:
• 46 hunter-gatherer groups obtained 85 percent or more of their energy from meat, fish, and eggs, but no groups obtained 85 percent of energy from plant sources. There were no vegetarian hunter-gatherers.
• 133 hunter-gatherer groups obtained 65 percent or more of their energy from meat, fish, and eggs; only 8 groups obtained 65 percent of energy from plants.
• The median group obtained 70 percent of their energy from animal foods, 30 percent from plant foods.
Plant foods contain both carbohydrates and fat. Tropical groups ate the most plant foods, and many of those plant foods, such as nuts, coconuts, and palm fruit, were rich in fat. So carbohydrate intake was well below 35 percent for the overwhelming majority of groups.
The data in the Ethnographic Atlas are dated, and some researchers consider them unreliable.33 Fortunately, detailed studies of the diets of authentic hunter-gatherers have been conducted very recently, and they confirm the results from the Ethnographic Atlas. On our blog, we looked at a study of nine hunter-gatherers—Onge of the Andaman Islands, Anbarra and Arnhem aborigines of northern Australia, Aché of eastern Paraguay, Nukak of south-eastern Colombia, Hiwi of Venezuela, !Kung Bushmen of the Kalahari desert of southern Africa, Gwi Bushmen of Botswana, and Hadza of north-central Tanzania—by anthropologists Hillard Kaplan, Kim Hill, Jane Lancaster, and Ana Magdalena Hurtado.34
Every group ate a substantial amount of meat. Animal foods provided 50 to 85 percent of calories. The !Kung ate the least meat but still averaged 0.57 pounds per day of meat.
Roots and other in-ground plants were the most important plant food. Seeds and nuts were a small contributor for every group but the !Kung, who ate mongongo nuts, a fatty food. “Fruits” were more often fatty nuts than the sugary fruits we are familiar with; for instance, the Nukak ate the palm oil–rich fruit of the palm tree, and the Hadza ate a number of fatty fruits. Only the Gwi consumed a significant amount of sweet fruits, chiefly melons.
In eight of the nine cultures, roots were a much more important source of calories than fruits. Among the Gwi, fruits and roots provided an equal share of calories.
Measured by calories, the diets were generally low in carbohydrates and high in fat. Seven of nine cultures—the Onge, Anbarra, Arnhem, Aché, Nukak, Hiwi, and !Kung—ate 10 to 20 percent carbs. For the Gwi San a majority of calories were carbs, and for the Hadza about 40 percent of calories were carbs. For most groups, fat intake ranged from 40 to 70 percent of calories.
Plant and Animal Food Balance
Although carbohydrates are a small part of calories for many hunter-gatherers, this does not mean they are unimportant. In fact, carbohydrates are a prized part of the diet among modern hunter-gatherers.
Indeed, the Mbuti pygmies of the Congo have two words for hunger: “protein hunger” (ekbelu) and “calorie hunger” (njala). In remote hunting camps on the Ituri plateau of the northeastern Congo, Mbuti generate very high hunting returns and dry large quantities of surplus meat for trade but have no access to starchy plants; in their camps they often complain of njala. Similarly, when the Maku hunters of the Amazon Basin run out of cassava in the forest, no matter how much meat they have, they “have no food.”35
“Drying Out” from Too Few Carbohydrates
I reached my weight loss goals by eliminating grains and limiting dairy to butter and cream and reducing fruit intake. That said, over the last month or so, I was wondering why my body seemed to be drying out from the inside out. I wanted to tweak my diet to optimum health and found your book. The information about the importance of mucin was helpful. What was missing in my diet were the carbs that you recommend. Sweet potatoes, white rice etc. Maybe less protein than I’ve been eating and more saturated fat. . . .
I’m having better results every day. I am fascinated that I have a laboratory of my own body to put your ideas to a test and have them show positive results. Thank you both so much.
—Doris Hames, Atlanta, Georgia
The natural inference is that a healthful diet needs a certain amount of plant foods to balance its animal foods. As we’ll see, starchy in-ground plants are so calorie poor that even obtaining a mere 15 percent of calories from carbs means consuming more plant foods than animal foods by weight. The Paleolithic diet may have been low-carb, but it wasn’t low-plant.
Takeaway: The Diet of the Paleolithic
The Paleolithic diet was a fat-predominant, low-carbohydrate diet. Calories came mainly from fat-bearing animal foods, but plant foods were an essential part of the diet and comprised most of the weight. Typically:
• Carbohydrates made up 15 to 20 percent of calories, with excursions toward 50 percent depending on food availability. Most calories came from fatty animal foods.
• Plant foods consisted predominantly of starchy in-ground carbohydrate sources such as roots, rhizomes, tubers, and corms plus above-ground fat sources such as coconuts, palm fruit, and mongongo nuts. Sweet fruits were rarely a major part of the diet.
It was on a majority-fat, low-carb diet mainly composed of animal foods and in-ground plants that our ancestors evolved from a regional population of small-brained African apes numbering (probably) in the tens of thousands to a highly intelligent species at the top of the food chain and a global population in the millions.
As our Paleolithic ancestors who dominated the globe were characterized by tall stature and healthy teeth and bones and their health deteriorated as soon as their diet was altered, we think it’s safe to say that such a low-carb, high-plant, starch-meat-and-fat-based diet is a healthful human diet.
Revue de presse
“The Perfect Health Diet is the missing link. It bridges the gap between the philosophical, broad-based, almost intuitive ancestral approach to health and the hard-core data hounds who need to see proof at every step. The authors are scientists through and through, an astrophysicist and a molecular biologist, who deftly wield the scepter of cold, hard science while paying homage to the inescapable wisdom of traditional, ancestral, evolutionary health.”—Mark Sisson, author of The Primal Blueprint and founder of marksdailyapple.com
“From the best of what we know about ancestral science and the natural world comes a modern-day formula proven to return us to optimal health. The Perfect Health Diet delivers exactly what it promises.”—Dallas & Melissa Hartwig, authors of It Starts With Food
“The sanest overview of what to eat I have ever seen. If you are going to read only one thing on the subject, read this.”—Seth Roberts, Ph.D., professor emeritus of psychology at UC Berkeley and author of The Shangri-La Diet
"Whenever any of my clients ask me a health/performance diet question, I just tell them to go to Perfect Health Diet; I trust that anything that appears in the book has been thoroughly researched and examined. One of my best friends was on the diet while undergoing chemo and his bloodwork numbers were so good that they would have been considered average...for a person without cancer. This book is my number one nutritional resource for my family, friends, and clients.” (Court Wing, Co-founder and Head of Training, CrossFit NYC)
"This book provides the missing link between Paleolithic diets and complete health and vitality, and provides a complete foundation for total ancestral health in the modern age."—Aaron Blaisdell, Professor of Psychology at UCLA and President of the Ancestral Health Society.
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It is a testimony to the insightfulness of this book that it persuaded me to change.
How was I persuaded?
* The Jaminets are highly educated (Ph.D.s both), but not they're not nutritionists and are not bound by any party line.
* They amass a huge volume of scientific literature in support of their assertions - about 1/3 of every page is journal citations.
* They write clearly, and are clearly motivated by a desire to share the keys they've discovered for better health.
* Time after time, while reading, I exclaimed "so *that's* why!" - there's an overarching framework they build, and after reading it I have a much broader and deeper understanding of health and nutrition.
The changes I made were:
1. Eat a modest amount (15-20%) of calories as carbs from what they call "safe starches" (rice & potatoes in my case.)
2. Eat a large (~70%) of calories from fat. In particular, I consume dramatically more butter (kerrygold!), and I've added a fair bit of coconut oil too.
3. (As a result, the amount of protein I eat has dropped somewhat.)
4. Supplementing with a mix of the vitamins they recommend.
5. Doing a 24-hour fast once a week.
Results: (after 1.5 months or so.)
1. I'm no longer "brain-dead" and unable to think in the evenings after work.
2. I no longer have fruit or chocolate cravings.
3. I'm much happier, and wake up looking forward to the day.
4. I've been much more social.
5. The extra starch has not resulted in weight gain. (I always gained weight when eating carbs before.)
6. It looks like the fasting (which I've never tried before) is helping my alertness and also contributing to healthy weight loss.
It took less than a week for me to notice dramatic changes. The diet guidelines are straightforward and fit on a page, but the explanatory material is priceless. The Jaminets post on an ongoing basis at their perfecthealthdiet dot com blog as well.
I can't recommend this book highly enough.
The end product is a diet that has similar macronutrient ratios to Pacific islanders with high levels of longevity and resistance to disease. How they deduce that such a diet is optimal is pretty interesting. The authors use the premise that your body can convert one type of macronutrient to another, but such conversion may not be optimal. Why go completely high protein when your body will just make glucose from protein? Why go high carb when the carbohydrates above 600 calories a day are converted to saturated fat? The authors also point to the nutrients in human milk as evidence on what might be optimal to eat. The discussion of macronutrients (fats, proteins, carbohydrates) was the most detailed I have seen in any nutrition book for a non-professional audience.
The diet is a "paleolithic" diet in that it suggests avoiding food toxins such as fructose (sugar), grains other than white rice, legumes and omega 6 polyunsaturated fatty acids. The book is quite specific about the evidence on these toxins. The diet is fine with so-called "safe starches", such as potatoes and white rice. It ends up being a high fat diet by calories as protein and carbohydrates are given generous upper bounds. Coconut oil is praised.
A section on supplements gives reasonable advice to focus on a few key nutrients and to avoid a few other common supplements. All the advice is quite reasonable.
Readers who still need to be convinced that saturated fat and dietary cholesterol are not the causes of heart disease might start with a more basic book that fights all the introductory fights (Good Calories, Bad Calories by Taubes is one, albeit lengthy suggestion). But for someone buying into the basic paradigm and looking to optimize their own health through nutrition, the Perfect Health Diet is the best book to buy.
Great things about this book:
1. For those that just want the facts super-fast this book gives you a one page summary of the eating plan within the first 6 pages of the book. The book also contains lots of extra information backing up their conclusions as well, for those that want it.
2. This book is about eating healthily and how to improve your health and reduce your risk of getting ill in the future with diet - rather than just about mere weight loss - which is so refreshing. Slow weight normalisation is a side effect of following this diet for sure, but it is not the primary focus.
3. The research for the book began when the authors were each working to improve their own health issues through diet. The authors are genuinely nice people that are passionate about helping others get the same results they have and the subject of a healthy diet and this comes through clearly on every page of this book.
4. The diet the authors recommend is made up of 20% carbs, 65% fat and 15% protein. So it is a low/moderate carb, high fat and moderate protein diet by calories, and 35% animal foods and 65% plant foods by weight. This is very similar to a traditional Pacific Islander diet, the authors explain.
The sections explaining the facts of fats, carbs and protein are of a very high quality and seem to summarise the work of all the best books I have read on nutrition and diet lately. The problems with a high carb diet are clearly spelled out as are the benefits of a high fat diet.
5. The book also recommends avoiding all grains (other than rice), legumes, dry lean meats, vegetable oils and pasteurised dairy products and recommends eating unlimited non-starchy vegetables (750 grams a day or more or 1.5 pounds), 200 - 450 grams or so (0.5 to 1 pound) of fatty meat/seafood/eggs, about 4 teaspoons of healthy fats (ghee, lard and coconut oil and a bit of olive oil), and snacking on nuts, cheese and fruit.
The authors warn that while fibre can be helpful, for some people too much fibre can be a real problem.
6. Where this book differs from many others in the same (reduced-carb and traditional foods) vein is that it explains that, yes, while your body can make the glucose it needs from protein when you eat a low carb diet, this process taxes the body unnecessarily and the conversion may be inefficient. This is especially true for those that are ill, the authors explain.
Despite my making a bit of a hobby of reading a large amount of very good books on healthy eating and diet in recent years, no other book had made these same points. So having this explained so well finally was wonderful and it explained a lot!
(I did really well on a 20 grams of carbohydrate a day diet for 6 - 9 months or so. I felt well and had no more hypoglycemia and lost a lot of weight. But after that 6 months was up my body seemed to really struggle with it, perhaps due to the fact I have severe metabolic, endocrine, and cardiac problems. (I'm housebound and 95% bedbound and very disabled.) When I finally went back up to 50 - 75 grams of carbs a day (years later) I felt so much better, and finally was able to start losing some of the weight that had crept back on on my super-low carb regime. It was also a much more pleasant way to eat; being able to have 5 cups of veggies a day and a bit of fruit! I feel like staying on this super-low carb diet for so long delayed my health from beginning to improve as well, as it made my body work harder than it had to on food assimilation which of course leaves less metabolic energy and bodily resources left over for the work of healing.)
The book explains that eating very low carb and making your body convert proteins to carbs puts strain on the liver and uses up bodily resources, generates ammonia as a toxic by-product, puts a person at risk of glucose deprivation if the are ill or lacking in certain nutrients and makes nutrient deficiencies more likely due to lower fruit and vegetable intake. Very low carbohydrate intake can also cause problems with vitamin C utilisation that may even lead to scurvy, as vitamin C is stimulated by insulin. For these reasons they recommend eating an amount of carbs daily which is very close to how much the body actually needs; 200 - 400 carb calories daily (or roughly 50 - 100 grams of carbs daily).
I agree with the authors that healthy people will likely have few problems converting one macronutrients to another (such as protein to carbs, and carbs to fat) but for those of us that are ill it is best to save your body the work and to eat foods in the appropriate macro-nutrient percentages to start with. That just seems to make so much sense!
Things about the book I am not sure about, to some entent:
1. I'm not convinced that all of us can handle the foods the authors describe as "safe starches" and in those amounts. For me eating rice with meals gives me so much carbohydrate it leaves me feeling spacey, hungry and unsatisfied. I am also unconvinced that eating rice is better for you than eating the same amount of carbs in vegetable form, as the authors even say themselves in the book that rice is low in nutrients compared to other foods, calorie for calorie. There is no real nutrition in it, and so for me no reason to eat it - and lots of reasons not to.
I found it even more surprising that not only did the authors recommend eating rice often, but they even extended this to processed foods like rice crackers and rice noodles. Foods many of us with an interest in healthy eating and nutrient-dense eating just wouldn't want to eat at all.
I recommend trying the authors' "safe starches" idea and seeing if it works for you, but being aware that for some of us these foods may be best avoided or minimised and eating LOTS of non-starchy veggies and 2-3 serves of fruit may work better for you.
2. Like many others I also cannot tolerate any of the dairy products the author recommends and also have egg allergy issues. I feel these issues could have been discussed a bit more in the book, as they are so so common. I also think fermented foods and drinks could have been emphasised more and disagree with the authors' assertions that nuts and seeds need only be soeaked if you eat a lot of them. For those of us with lots of gut and digestion problems, soaking all nuts and seeds can make a wonderful difference that is really noticeable.
(I wish so much I had learned about the importance of soaking nuts and eating fermented foods sooner!)
3. While this book provides a great summary of many of many of the best books on nutrition, the same cannot be said of the information given on supplements. This information was very patchy, incomplete and just plain wrong in many instances and it does not at all tally with the information given by those that are the genuine experts in this field. The information seems to come from strange sources, and not from genuine experts in the field. The RDAs are quoted a lot and discussed as if they were important and trustworthy and no names of orthomolecular experts or similar are really mentioned.
Such an average quality and incomplete guide may be okay for healthy people but for anyone battling serious health issues I would urge them to read far more deeply on this topic than this book allows and to ignore much of the information given in this book.
Despite what the authors of this book claim, those of us with serious health issues absolutely need intelligent and often intensive and wide-ranging supplementation along with a healthy diet before we can start to regain our health. We need as much of each nutrient as we actually need, and not just how much the RDA has been arbitrarily set at. Supplement plans must be individualised, as much as possible. We also need to take the right balance of nutrients, and not lots of one thing and none of another related thing. This has absolutely been my experience and holds true for vast numbers of other patients.
This sort of diet change is always the first step in improcving health however, and for some lucky people it may be enough. For others it is just the first essential step of many others!
(See: Detoxify or Die, Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians, Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and a Longer Life and Dr. Atkins' Vita-Nutrient Solution: Nature's Answer to Drugs and others, for more information on this topic.)
4. The book could have done with having wider margins and more white space on the page, as well as fewer black and white images of foods (many of which looked awful or were hard to make out). Overall the book was very well put together and well edited, however.
Even if you have read the wonderful books by Taubes, Fallon and Enig, Gedgaudes, Cordain, Price, Sisson, Schwartzbein, Shanahan, Eades etc. this book is still worth reading.
I rate this as a 5 star book for healthy people who want to learn to eat better, but not quite a 5 star book when it comes to being a complete guide for those battling serious illnesses. It isn't a complete guide to health for ill people, just a very solid starting point on diet. So that is why I give the book 4 stars overall.
Jodi Bassett, The Hummingbirds' Foundation for M.E. (HFME) and Health, Healing & Hummingbirds (HHH)
Background: I was an Atkins dieter in the 1990's. Lost a lot of weight, but staying on it was difficult.
Last year I came off a bout of depression determined to beat it without drugs. I stopped eating sugar and (surprise!) started losing weight. Since exercise is also helpful to depression, I thought that it would be better if I kept losing weight to reduce my chance of injury while exercising. Along the way I found that many of the things that are recommended in the Perfect Health Diet greatly helped me in losing weight.
I lost a total of seventy pounds. As a man at fifty-five years old and 195 pounds, I am now in better physical condition than I was in my 20's. This is due in large part to the dietary recommendations in the Perfect Health Diet.
What is even better is that the recommendations in the Perfect Health Diet led to removing the last things that were contributing to my depression. I believe now that grains and omega-6 in vegetable oil was making me depressed. That's why adding omega-3 fish oil to your diet helps fight depression, something I had started doing without understanding why.
To go back to the beginning, the Atkins diet had two flaws which undermined long-term weight loss:
1) Atkins diet "phases" lead to the idea that somehow you lose your weight and then slowly phase back into eating "normal" food. Atkins didn't say this exactly, but it's implied.
2) When Atkins wrote the Diet Revolution book, he didn't have access to the research that we have now, and couldn't see that some fats (high omega-6 vegetable oils) are bad for you, while some carbs in moderation (rice, sweet potato) are okay. His blanket recommendation to get rid of all carbs would have been better focused on SUGAR, FRUCTOSE and GRAINS.
The Perfect Health Diet is written so that you can read to whatever depth of scientific detail you want to. I am about done with my third time through. My particular health issue is depression, and the Perfect Health Diet has many links to dietary causes of depression. The most helpful aspect is that it is written from the perspective that this way of eating is a PERMANENT change, and that this way of eating is based on sound science, including cultural and epidemiology studies, not just lab experiments.
This book is a good companion volume to "Why We Get Fat: And What to Do About It" by Gary Taubes.
The only qualification that I would add is that the book recommends eating a lot of fish rather than using supplements for omega-3. This recommendation is based on the observation that most fish oil capsules are stored at room temperature and the oil may go rancid without you knowing it. My answer is to take fish oil as a liquid and KEEP IT REFRIGERATED. It's lemon or lime flavored and refrigeration keeps the the fishy taste down. No capsules needed, and it's actually cheaper than capsules.
Again, as a person who has lost seventy pounds and now enjoy a life free of depression. I wholeheartedly recommend the Perfect Health Diet.
The authors base their prohibitions of grains, legumes and vegetable oils on the concept of toxins inherent in these foods which cause various forms of damage to the body. However, they do not address the fact that environmental toxins accumulate in fat tissue, so unless you're eating animals that ate food that was never touched by pesticides, drank filtered water, lived in uncontamined bodies of water, or breathed filtered air, you're eating the chemicals that accumulated in their bodies. Animal liver, which the Jaminets recommend eating weekly, will contain even higher levels of toxins than fatty tissue, because the job of the liver is to filter toxins. Even though I eat only naturally-fed, humanely-raised animal products, I try to protect myself from the environmental toxins that will inevitably end up in those foods by taking chlorella and regularly going to the sauna. A good detox strategy is an essential part of modern-day paleo eating on our filthy planet. Within the context of our food system, it is certainly not true to say that "animal foods are generally non-toxic" (p.120).
I believe that the only mention of environmental toxins in this book is a recommendation not to eat tuna and swordfish because they are more likely to be contaminated than fish such as salmon and herring. But then the Jaminets go on to recommend eating farmed salmon, which researchers have found to contain much higher levels of PCBs, dioxins, and pesticides than wild salmon. The researchers, at the University at Albany Institute for Health and the Environment, recommend limiting consumption of farmed salmon to once or twice a month, based on EPA guidelines. (The Jaminets would have you eat up to a pound a week).
Farmed fish is acceptable to the Jaminets, as is feedlot beef, because it is naturally low in omega-6 fatty acids. And while they say it might be nice to buy pastured poultry and eggs, because the EFA ratio is better, it's more important to limit your consumption to a few times a week. According to the Jaminets, "animal foods should be selected for their fat content" (111). There is no discussion anywhere in this book of any other health problems associated with eating factory-farmed animal foods, and not a whisper of any environmental or moral reasons to choose naturally-raised animal products. It seems the Jaminets have focused their research so narrowly on technical questions of nutrition, that they really don't know much about the larger context of food production. For example, they seem to think that free-range chickens eat only "vegetables and insects, not cereal grains" (p. 110), but it's really not possible to raise healthy pastured chickens without supplementing their diet with feed. And in encouraging vegetarians to eat eggs and dairy, they claim that "no animals are killed to obtain these foods" (p. 269). As every vegan knows, almost all male chicks and calves in the egg and dairy industries are killed. They've never heard the slogan "veal depends on dairy"? They're not going to convince any vegans this way.
Animal products contain some inherent toxins too: considering the vast amount of research that went into this book, it's hard to believe that the authors missed the news about heme iron (the kind found in red meat): it has been found to form carcinogenic compounds in the gut (although research is inconclusive yet about whether eating fresh, unprocessed red meat causes colon cancer). However, this damage has been observed to be countered by the presence of chlorophyll in the gut. So to protect myself from this toxin, I always eat green, leafy vegetables at the same time I eat red meat. The authors do suggest always cooking meat with vegetables, but a more balanced book would have discussed the toxicity of heme iron. They do mention the opioid-like peptides, allergens, and naturally-occuring hormones found in milk, and they warn against copper build-up from eating too much beef liver.
In addition to environmental toxins, anyone contemplating buying some random piece of meat at Kroger's should know what else is likely to be in there: antibiotics and hormones, dyes, additives, etc. Oh, and that it was irradiated to kill the nasty things that result from feeding animals food they weren't designed to eat and from filthy industrial slaughterhouses. But if we are to believe the Jaminets, it's perfectly safe to eat animals that have eaten GMO corn and soy, although we ourselves should not eat anything genetically modified. According to them, "the best way to detoxify genetically modified grains" is to "let animals eat them first" (p. 156). In this heavily foot-noted book, this statement conspicuously lacks any references, such as studies comparing the tissue of animals that ate GMO feed vs. non-GMO feed. The Jaminets did, after all, just get done telling us that "such is the complexity of biology that seemingly innocuous genetic alterations can have far-reaching effects" (p.156).
I noticed a few other convenient inconsistencies which raised a flicker on my BS-detector and reduced my trust in the authors: on page 75 we read that Americans eat 3770 calories a day (roughly accurate, as of 2002, according to the UN Food and Agriculture Organization); but on page 174, to bolster their argument that Americans are undernourished, they claim that the average male "modern office worker" eats 2560 calories per day and his female co-worker a mere 1760 calories. In the section on grains, they tell us that because eating wheat germ increases stool weight, that means that eating wheat causes "large amounts of food to be excreted instead of digested" (p.123), although anyone who has read the section on fiber might wonder if that extra stool weight is actually made up of gut bacteria that proliferated feeding on the fiber. And it was just plain weird to see them recommending spirulina as a source of long-chain omega-3s for vegetarians, since spirulina is known to produce neurotoxins, something you'd think the authors would know about.
For anyone interested in paleo-style eating, I do recommend this book for its fascinating technical content; however, it needs to be placed within the larger context of industrial food production. There are many books covering that subject: Fast Food Nation and The Omnivore's Dilemma go in-depth; The Butcher's Guide to Well-Raised Meat gives a quick overview, and tells you what to do with your relatively non-toxic, ethically-produced meat.