Tag Archives: Opinion

Update on Calcium Supplementation in Post-Menopausal Women

One of the most common topics I discuss with my female patients concerns osteoporosis and calcium supplementation.  There have been several recent studies related to calcium supplementation in the news lately and I thought it would be a great topic to discuss, particularly in conjunction with the Paleo lifestyle.

Osteoporosis is a condition where bones lose strength from loss of the calcium matrix that makes them strong to begin with.  Once bones start to demineralize it leaves you more susceptible to fractures.  Every year millions of females fall and break their hips often leading to nursing home stays, and death from secondary infections are not uncommon.  For years the mainstay of prevention for post-menopausal women has been appropriate supplementation with calcium and Vitamin D.  Vitamin D is necessary for your body to be able to absorb dietary calcium.  Recently these recommendations have come under fire from several areas.

Before we get too far into this it’s important you discuss calcium supplementation in the context of how old the patient is and what her menopausal status is.  This post is concerning post-menopausal women who do not have a diagnosis of osteoporosis.  Optimum bone health is a different topic all together for pre-menopausal women as the presence of female hormones changes the game completely.  Also, if a women has already been diagnosed with osteoporosis, supplementation with calcium would likely still be recommended given a risk-benefit analysis.

That said, it has always been common knowledge that if you want to keep your bones strong after menopause, you need to make sure and take in enough calcium and vitamin D.  Recommended daily supplements vary but often call for at least 400 IUs of Vitamin D and 1000mg of Calcium.  This is in fact what I have recommended for my patients for years…but that is changing rapidly.

The first problem came last year when a meta-analysis came out in the British Journal of Medicine that showed a modest increase in the risk of cardiovascular events, especially heart attacks, with routine use of calcium supplementation with or without vitamin D.  The most interesting thing is that this was a meta-analysis of the Women’s Health Initiative Study, the same study we had used for years to justify our use of calcium to prevent fractures!

Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis BMJ 2011; 342 doi: 10.1136/bmj.d2040 (Published 19 April 2011)

To help you better understand the connection between calcium and vascular disease look at these pictures.

The picture on the left is a normal heart, notice the relative consistency in the density of the chambers and the vessels.  On the right is a diseased heart with hardened arteries.  Note first the size difference, diseased hearts tend to work harder, enlarging the muscles and making it less efficient.  Also notice the white spots noted by the arrows; these are the coronary arteries that supply blood flow to the heart itself.  When you have a heart attack, it is these arteries that are affected.

Here is an example of calcified arteries in the brain.  Hardening of the arteries can happen anywhere; in the heart as above leads to heart attacks, and examples like these in the cerebral arteries lead to strokes.  Calcium shows up bright white on Xray which is why bones show up that way.  Note there is very little difference between the skull bones and these cerebral arteries!  So you need calcium intake, but could too much intake lead to accumulation in the wrong places?  This study seems to indicate that may be the case.

More recently the US Preventive Services Task Force released recommendations that post-menopausal women should not take daily low doses of calcium and vitamin D to prevent bone fractures.  They cited a lack of definitive evidence to show it actually works, and also pointed to the chance of increased rate of heart disease and kidney stones from too much calcium.  Vitamin D has also been a hot topic of late as some say it can help prevent some cancers.  The task force also reported that at this time there is insufficient evidence to support these claims.

So what are we to do?  The fact that there are 1.5 MILLION osteoporosis related fractures in the US every year makes this a massively important topic.  Here is what a typical femoral neck fracture looks like before and after total hip replacement.

But, before we get to what to do, let’s talk about how we got here in the first place?

It’s very common in medicine to find something in nature that helps prevent disease and try to replicate that benefit with supplementation.  Take lycopene for example, which is found naturally in tomatoes.  It was found that lycopene could reduce the risk of prostate cancer in men, so it was isolated and given to men in supplement form.  Funny thing is, it only seemed to help prevent cancer when it was in a TOMATO!  Supplements offered no benefit.

Taking this concept to calcium, a recent study showed that females who took the recommended daily calcium dose in SUPPLEMENT form had a higher risk of heart disease, while women getting the same amount of calcium from FOOD did not have this higher risk.  Imagine that, God designed calcium to strengthen your bones, but only when you eat it the way he meant you to!

I hear everyone now, but how do I get enough calcium doing Paleo when I can’t eat dairy?  You ladies sitting down?  There are more sources of calcium then just dairy…quite a few actually.  Here are some examples:

(Ignore the soybeans listed above, and replace with a favorite of mine…figs!)

Listen to this statement from Suzanne Steinbaum, spokeswoman for the American Heart Association.  “To tell people, ‘take calcium and vitamin D to prevent fractures as you get older.’ that’s not panning out anymore.  Even if you are at risk for a fracture, maybe you have to try other lifestyle changes, like diet and weight-bearing exercise.”  Don’t you like the way she put it…MAYBE you’ll just have to try actually eating right and moving around a bit!  If this statement does not sum up why we have an osteoporosis problem in the first place, nothing will.

There is no question that osteoporosis is on the rise.  This is due to multiple reasons, but in my opinion it is from over reliance on supplementation for prevention over the traditional recommendations of dietary calcium, Vitamin D from the sun, and plenty of weight bearing exercise.  Many hoped you could just stay on the couch and take some pills and all would be well.  Like so many times before, we have learned that taking the easy way out just does not work.

So what is a post-menopausal female to do to prevent osteoporosis?  That’s pretty simple.  I think the recommended daily intake of Calcium still needs to be around 1000mg, but just make sure you get it from your diet, not from supplements.  The take home message of these recent studies is that calcium in the form of supplements do not appear to minimize fracture risk in this population, and that they may in fact increase the risk of heart attack and kidney stones.

Make an appointment and talk to your doctor about calcium and whether you should be taking it.  Are you pre-menopausal?  Prevention strategies will be very different for you, and again I encourage you to talk to your doctor to make sure you are on the right track.

The PaleolithicMD motto is Real Food…Real Health.  I can’t think of a simpler way to combine all the lessons calcium supplementation has shown us.  You need more calcium, just eat it in REAL FOOD!  Don’t ignore God’s gifts of calcium rich foods in favor of modern day convenience.  After all, calcium pills don’t grow on trees…figs do.



Posted by on June 26, 2012 in General Paleo Discussion


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The Negative Side of Paleo: Yes, There is One!

Last night I had the pleasure of participating in a lecture which served as the start of an 8 week Paleo/Crossfit challenge for 6 patients who have undergone successful bariatric surgery.  To be considered a success you must lose over 50% of your weight so they have all undergone significant transformations.  That said, they were all selected for this program by their surgeon because they have stopped losing weight and have not reached their goals.  They came into the night with no clue what lie ahead or any knowledge that the Paleo diet would be recommended for the program

As William Albritton (CrossFit Alexandria Trainer) and I presented the information, the reaction was typical.  They did not understand why the Paleo no-nos are bad for you, and wanted explanations of how many of these supposedly “healthy” foods are bad for them.  As we talked to them, I started to think about how I would react when presented so much information in so little time.  I could see intimidation in their eyes as we checked off every common kind of food they could no longer eat.  This got me thinking on a grander scale about some of the negative that Paleo can bring out in people.  Yes, I think there is in fact negative that can come from Paleo!  So, here are some of the things I consider to be the negative side of Paleo.

Stress:  Nobody in life is perfect, and even the person you consider to be the most amazing follower of Paleo there is does in fact eat the wrong things at times.  Sometimes people overtly cheat, but often we will cheat with things we are not even aware of.  I think it is vital not to obsess about being perfect when you were in fact created to not be.  When I first started Paleo I was quite guilty of this.  I worried so much about cheating that even on the odd occasions when I would, I would almost get depressed afterwards for losing my discipline.  I eventually realized that the pressure I was putting myself under was a major stress in my life, and it was quite frankly unhealthy to live with that kind of stress.  To the contrary, part of the Paleo lifestyle should be about minimizing the stress in your life in order to maximize the hormonal environment in which we live.  By constantly micro-managing my life and my diet I was defeating one of the most vital parts of this lifestyle.  On top of that, I was pretty much not making it as fun as it should be.  When I think of Paleo I think of fun, varied, energetic, delicious, simple, healthy, freeing…all things you can only experience if you don’t stress about perfection.

Turning Others Off:  Ok, it’s one thing if you obsess and stress about your own diet, but have you ever been around the Paleo guy who has a seizure when you put Splenda in your coffee?  I see you out there!  I think it is so important to be supportive of your fellow Paleo brothers and sisters with a great deal of understanding.  In my house for example, I will confess to all of you that I can in fact be….a little annoying about the Paleo thing.  (I’m certain my wife will make herself available for interviews on this topic if needed 🙂  I was so crazy about it the first few months that my wife has since confessed to me that the reason she did not get on board at first is that I was smothering her with Paleo talk and I may, although I’m not completely accepting this, have looked at her a little funny when she ate certain things.  Who wants to deal with that?!

Don’t make that mistake, and luckily I think I figured it out pretty quick.  One of the things I emphasized during our talk last night was that we are all humans and that I certainly was not 100% on Paleo.  I do in fact try my best to eat clean, but it’s not worth alienating others over.  When people follow the Paleo lifestyle for some time I find that they start to feel proud to be a little different, proud to know that they are making a difference in their long term health with their diet.  That said, care must be taken not to look down on others for either not following Paleo, or not following as “well” as you do.  Don’t be that guy!

Missing the Big Picture:  If you do it, why do you follow Paleo?  To lose weight?  To look better?  To get stronger?  To get faster?  As a doctor I think your answer should be simple…to be healthier.  When you are trying to talk to others about the lifestyle it is easy to get off track.  Just last night during our “Introduction to Paleo” talk here are some of the tangents we went on:  How the food industry manipulates foods to trick us, fast food companies targeting kids with advertising, the use of “heart-healthy” labels on foods such as cereals, what does “cage free” really mean, are artificial sweeteners healthy, are green beans really Paleo, are cows treated humanely in typical slaughter houses?  Now look, each of these questions are important in certain conversations, but I personally don’t think they belong in an intro to Paleo talk.  Paleo comes down to two simple lists: what you can eat, and what you can’t eat.  You eat these things and don’t eat these things in order to get healthier.  What can topics like these do?  What could they easily have done last night?  They quite simply get in the way of Paleo’s basic message.  Several times during the talk I could see people’s eyes start to glaze over with too much information.  One lady asked where in the grocery store she could find “omega-3s”.  We were emphasizing them too much and it was getting confusing.  Topics like these are details that are less important than the big picture with Paleo.  Don’t get lost in the forest of Paleo facts and politics, just eat real food and get healthy!

Making Paleo an Idol:  “You shall have no other god’s before me.” Exodus 20:3 (ESV)  I don’t want to get biblical here on you…well ok, yes I do…but this is really important.  Your life ultimately needs to be about God, family, love, relationships; things that matter more than others.  Not ten days into changing to Paleo I told my wife that I feared it was becoming an idol for me, and that if I could not separate myself from that I may have to give it up.  Obsession with Paleo can be a major battle for many, just like obsession with exercise is for others.  Following Paleo cannot become more important to you than your spouse, or your kids, or your family.  Before you dismiss this, think a moment and I’m sure you know someone who fits this mold.  It may even be you!  Know anyone who won’t go to family get togethers because the rest of the family doesn’t eat Paleo?  Have you completely shut off friends from your life because they eat bread?!  Paleo cannot and must not stand between you and the important things in life.  If Paleo is an idol in your life don’t panic, just take a step back and evaluate how it is affecting those things you love the most.  Make it important, but make a list of things that must always go ahead of it.  Stick to your list and all will be well.

These are just a few of the thoughts that I jotted down during our talk last night.  I have lived through some of the negatives of Paleo myself, and I want to warn others of the dangers!  Our goal must always be to spread paleo to as many others as possible with the hope of making them happier and healthier.  If people see you more stressed than you were before you went Paleo, if you turn others off by being critical of their diets, if you miss the big picture and concentrate instead on minor aspects of the lifestyle, or if you make Paleo an idol that stands before your beloved friends and family; you likely won’t make many converts!

Paleo is good!  If there are any areas of your life where it comes to Paleo that are negative or bad, address them and change them!



Posted by on June 24, 2012 in General Paleo Discussion


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Coffee and Gluten: My Current Take

Greetings everyone, it’s been a few days since I’ve posted anything.  On the twitterverse the last few days there has been a great deal of talk about coffee and it’s apparent “danger” particularly with respects to possible gluten related sensitivity.  I love coffee, and I hate to see it get a bad name.  So, lets look at this a little more carefully.

First lets look at the source of this information.  Well, the problem is, there is no real source!  A chiropractor published information form “internal lab research” that 10% of coffee is a protein that cross reacts with gluten antibodies.  That is all the information we have.  I see no research study, no detailed information such as what type of coffee was tested, how it was tested, or how they connect this information to clinical implications.  How many coffees were tested etc?  I did a quick search on for “coffee and gluten” and I got zero hits.  So basically we have an “expert” stating his findings, and no actual data backing up his claims.  I would be vary wary of accepting this kind of statement as fact until we see more information.  Hopefully more detailed information will come soon, until then I will keep drinking my java.

I would like to note that after a quick we search on google, I was able to find the following organizations who have declared coffee gluten free:

-The Celiac Sprue Association

-The National Foundation for Celiac Awareness

-The University of Chicago Celiac Disease Center

-The Mayo Clinic

Please check the labels of your coffee as not all are gluten free due to processing conditions.  That said, most are clearly labeled if they contain no gluten or gluten byproducts.

Now, is coffee bad for you?  Let’s look at some research with coffee that tells us that the stuff is actually good for us!

-Drinking one to five cups of coffee per day reduces your risk of having a stroke by as much as 25 percent. (Susanna C. Larsson, et al. “Coffee Consumption and Risk of Stroke in Women.” Stroke: American Heart Association Journals, 119, 1116-1123.)

-Women who drink four cups of coffee per day are 20 percent less likely to be clinically depressed than women who drink only one cup of coffee per week. (Michael Lucas, et al. “Coffee, Caffeine, and Risk of Depression Among Women.”  Archives of Internal Medicine, 171 (17), 1571-1578.)

-People who drink more than six cups of coffee per day are 35 percent less likely to have type 2 diabetes than people who drink fewer than two cups of coffee per day. (Rob van Dam and Hu, Frank. “Coffee Consumption and Risk of Type 2 Diabetes.”  Journal of the American Medical Association, 294 (1), 97-104.)

-A Harvard School of Public Health study shows that men who drink six cups of coffee a day have a 60 percent decreased chance of developing a dangerous form of prostate cancer, as well as a 20 percent decreased chance of developing any other kinds of prostate cancer. (Journal of National Cancer Institute)

-Drinking a few cups of coffee a day could lower the risk of developing Parkinson’s disease by as much as 25 percent, according to a study published last year in the Journal of Alzheimer’s Disease. (Journal of Alzheimer’s Disease)

-Coffee moderately reduces the incidence of dying from cardiovascular disease (Lopez-Garcia et al. The Relationship of Coffee Consumption with Mortality” Annals of Internal Medicine 2008

-Coffee consumption found to be inversely associated with total and cause-specific mortality.  Freedman et al. Association of Coffee Drinking with Total and Cause-Specific Mortality. New England Journal of Medicine 2012

JAMA, Archives of Internal Medicine, Stroke, New England Journal of Medicine…we are talking heavy hitters here.  It is very, very hard to get research published in these peer-reviewed journals.  You can never believe everything you read, but starting with a well respected source is always comforting.

Now please understand, I am not discounting the above claims of cross-reactivity of 1/10 of coffee to gluten, I just cannot be convinced without any further evidence.  As in all things, you need to weight the good with the bad when making food choices.  As long as we have a wealth of solid clinical data showing the multiple health benefits of coffee I would be slow to stop drinking based on one article presented without evidence.

Think of it this way; If a drug company released “internal lab data” claiming it’s drug superior to another, and left it at that, would you believe it?  They could of course be right, but why not provide more information to help people make more informed decisions.  Without this information it leaves too many questions unanswered to change your behavior.  Including information about the specialty lab which can test you for this condition also should concern us for an underlying connection between the source and the proprietary reference lab.

The world of medical information changes daily, and the internet makes this information spread like wild fire in only a few days time.  When presented with information, particularly information pertaining to your health, always take a step back and examine the source, the credibility of the source, and any information contrary to that which is being presented.

My mind will always remain open, and it may change concerning coffee and gluten if more definitive clinical data is presented strong enough to change my mind.  For now though I see no scientifically based reason to stop drinking coffee.  In fact, I see a great deal of scientific evidence that I should probably drink more!

Yes you are right, a nice hot cup sounds pretty good right about now!



Posted by on June 19, 2012 in General Paleo Discussion


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Why I Do What I Do: Check This Out! (Plus a Little Advice)

I hope most of you read my last post about my high school classmate turned patient who after several years of “gentle” encouragement finally decided to go Paleo and has done great. He texted me yesterday after he read the post and told me he is going strong! He is out of town working, and is faithful to his Paleo ways.

I got a wonderful surprise this morning in my inbox in the form of a comment to this post. Here it is…

Thank you for “bitching” at him to change his life. You have also changed mine, I am his mother and I also have diabetes and he has convinced me to start the diet also. I am feeling so much better and my fasting sugar has gone from 178 to 119 in 2 1/2 weeks and I have lost 5 lbs. Great diet, easy to do and I am proud of him and the support that his wife is giving to him and changing the children’s eating habits also. Thanks again Dr G!

Now tell me, how awesome is that!   My friend had often shared his concern about his mother and his desires for her to come see me.  Of course, I would always challenge him that the best way to help his mom change was to change himself. Well, he has listened, and so has she!

I want to take a moment to really commend these two people for changing their lives and giving Paleo a chance. I do not have diabetes and I can honestly say it would be an extremely difficult diagnosis to deal with. I ask all of you to not only encourage those around you with diabetes to talk to their doctors and try Paleo, but to do so with compassion. Most diabetics do poorly with their diet mainly out of a sense of rebellion; they just don’t want to live the life of, or accept the diagnosis of diabetes. If you do not have diabetes, you simply will never understand what they go through on a daily basis. If you are frustrated with a friend or family member because they won’t “listen,” try to put yourself in their shoes. Compassion, not criticism will ultimately lead to success!

Pass it on…



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A Physician’s Whole 30 Experience: What I Learned

30 days ago I began a journey that has taken me farther into myself then I knew I could go. Today it ends, and I would like to take you inside my journey and share with you how it has changed my diet, my health, and my spirit.

The Process: Around 9 months ago I decided to change my diet to one based on a Paleo framework. I spent years looking at different diets and my paleo adventure has finally landed me on solid ground. I “gave up” so many foods that I felt I was doing about as much as I could for my health. Despite that, I still had a few strongholds; the biggest of which was Diet Dr. Pepper.

For months I have been recommending a dietary challenge to patients that were interested based on Dallas and Melissa Hartwig’s Whole 30. I would normally feel somewhat strict to recommend the entire plan, and would often tell patients to follow it completely except for the artificial sweetener rule. I did this to give my patients a break, but also because I could not give that up myself. I try hard to live by the rules I preach, so this seemed easiest to me! The more I traveled into my Paleo journey, the more I felt the real calling to participate in the Whole 30 myself. I knew it would be hard, but I just felt it was the right thing for me. My diet has been pretty strict from the beginning, and essentially converting to the Whole 30 meant eliminating artificial sweetener, the small amount of heavy cream I drink with my coffee daily, and nitrates in preserved food. Otherwise, no real change! How hard could that be right?

30 Days ago I started the challenge with confidence and concern. I knew dropping the caffeine in soda would be hard, but I had no idea how bad it would be initially. The first day of the challenge was the worst I have felt in YEARS. I had a terrible headache the entire day, and felt almost in a fog. As the day progressed seeing patients in my clinic became harder and harder, and I almost gave in and drank a soda. What stopped me was the realization of just how bad things were! I felt terrible, all because I drink too many sodas. I pushed through, and made the determination not to drink any caffeine at all until I felt better. That night when I got home I was absolutely cranky (my wife will concur I am certain!) I did the best I could and went to bed as quickly as I could. As I lay in bed, head pounding, I wondered how long I could take it. It was literally incapacitating, and I feared how well I could work another day like that.

I slept off the headache, and awoke to a new day…headache free! I stuck to my guns and chose water over coffee every day for the next 10 days. I have not had another headache since that first day, and I am amazed at just how bad I felt. I felt sick, there is no other way to describe it. After 10 days I started drinking some coffee again, simply because I love coffee, not because I NEEDED it. It was a very freeing experience.

Despite the headache disappearing, I still craved diet soda. After much thought I realized that I drank it mainly to kill my need for something sweet. I had eliminated so many strongholds in my diet, but this one had become my primary one. I can say honestly that this craving for diet soda lasted a good two weeks before I FINALLY got over it. It sucked!

As far as food goes, the Whole 30 was not terrible for me. I eat a pretty clean diet to start with, and my main adjustment was bringing lunch with me from home as not to chance any illegal items when we order out often from the clinic. I can imagine that the shock to the system from a non-Paleo diet to a Whole 30 would be tremendous, and I am glad I did not have to face that!

Due to poor planning on my part, the end of my Whole 30 coincided with a week long family vacation to the Great Smoky Mountains. This was hard, by far the hardest part of the plan. By the time we left though I was over 20 days in, and there was NO WAY I was going to kill it. I sucked it up, and did all I could to stay on track. I ordered as detailed as I could when out to eat, and stuck to safe foods when none were available. Of note, when I do another Whole 30, I will make sure I’m not on vacation during any of it!

So how did the Whole 30 help my health? Here are a few observations:

Acne: I don’t have terrible acne at all, but I do still suffer with an occasional pimple. For three weeks I have not had a single pimple. Pretty amazing stuff.

Energy: I thought Paleo had given me all the energy I needed, but I was wrong that it was all I could have! Although subtle, the increase in energy on a day to day basis I experienced by taking the next step to the Whole 30 was encouraging. I never really got tired, even on the long drives during our vacation which in the past would have sent me shopping for caffeine in one form or another.

Cravings: Again, although I felt my food cravings were gone once I went Paleo, the Whole 30 taught me that my major remaining craving, diet soda, was as strong as ever. It took a good while to get rid of this one, but it was well worth it. Diet soda turned out to be the one little thing I kept for myself, and I had no idea the pull it had on me. I don’t think that drinking diet soda made me feel tremendously bad per se, but I was drinking it for the WRONG reasons. That was enough to concern me and push through the 30 days. Will I ever drink diet soda again? I would be a bold faced liar if I said I would not, but my intake will be cut by 80-90% long term. That is something I can live with, and be very proud of.

Weight Loss: After changing to a Paleo diet I lost 25 pounds without really trying at all. During my Whole 30 I lost 5 more pounds, so that is 30 pounds overall…not too shabby!. My BMI has dropped from 30.6 to 26.3. I still have some way to go, but I’m very pleased with the overall drop so far.

Mood: I have noticed a definite improvement in my mood during the Whole 30. I’m generally a pretty positive guy, and I really like what I do. Still, everyone has times when stress or anxiety get to them. This would happen to me typically when the work day would zoom out of control, or the kids would act up. I think two things led to the improvement in my mood:

—Knowledge of Health – Just knowing that I was doing something very important for my health was so invigorating. Diet, weight, and emotion are intertwined to the point they are indistinguishable. Negative emotions can be crippling, but positive emotions can fuel you to the max. I knew I was getting healthier every day, and that made me feel awesome.

—Feeling of Health – Besides knowing I was healthier, I FELT healthier! For all the reasons above, as well as sleeping well, I just had a general glow of health to me. Other’s noticed and made comments, and that will help anyone feel better! I don’t think I can really explain this, you just gotta try it to find out!

Must Have Foods: Many people are looking for the foods that are key to a successful Whole 30, and I will give my humble opinion. Here is what I couldn’t live without.

-Avocados – There is no better snack alone, or added to a protein than one.

-Coconut Milk – Such a great milk substitute for any occasion.

-Dried Fruit – Watch this as it can be a sugar substitute for you, but in moderation; often saves me

-Eggs – What else can you say about the totally versatile egg?

Homemade Beef Jerky Sometimes you just need beef!

Big picture: So what is the big picture benefit to me from my Whole 30? There are several things I would like to point out. First, it truly allowed me to put the focus back on using food as nourishment for my body, and not as a pleasure per se. Now look, I love food, and that will never change. But it’s so hard to separate sometimes the difference between what you eat to fill a “void” or “craving” in your life, versus what you eat to adequately fuel your body. You can easily fuel your body with wonderful, real, and delicious food which means you don’t have to turn to food for anything other than that. As I say, Real Food for Real Health.

Limiting my diet to this real food also brought back something else that I feel we often lose; the real taste of food. We are inundated with flavors that we quite frankly were not ever supposed to experience! As you will all (if you are smart!) soon read in the Hartwig’s book It Starts With Food the food industry has created foods that are fattier, saltier, and sweeter than anything nature can provide. This kind of numbs our taste buds to real food. Take for example marinating a steak such as in a sugary Teriyaki sauce. If you have a wonderful cut of beef, why take away from the flavor at all with anything more than a little salt and pepper? Why not taste the meat for what it is, and the glorious fat for all it can be? Are “smoked” almonds really better than raw almonds? Is a maraschino cherry better than a super ripe fresh cherry? Is a tub of store bought greenish faux-guacamole better than home made, or just a freshly sliced ripe avocado? If you really taste things, the answer is no for all these.

The reason that the food industry has designed foods to be fattier, saltier, and sweeter than nature intended is that they are taking tasteless and inedible food and creating a “food” for you to eat, and for them to make money off of. By design the Whole 30 takes all that away. What you are left with it food as God intended it to be. The Whole 30 gave me my taste buds back!

Lastly, the Whole 30 taught me that once again, even when I think I’m doing my best, I am not! It’s not good enough to do Paleo and hang on to dietary strongholds. The effort to bring about even more change in your life can produce serious dividends. I learned that and am so glad that I did.

So, you only have two things left to do. First, commit to doing your own Whole 30 right NOW! And second, pre-order the Hartwig’s book and soak it up as soon as you can. I will be doing a full review of the book once I am finished, but I am taking my time to really gain everything I can from it. I am not a paid spokesman, and I gain nothing from you getting their book. To the contrary, it is you that has everything to gain from reading it.

Please consider doing the Whole 30 challenge yourself. Ask yourself these questions…is what you are doing right now working? Are you happy with how you feel? Could you use more energy? Are you sleeping soundly? Are you worried about chronic disease? Are you sick and tired of being CONTROLLED by food? It’s just 30 days…







Posted by on June 6, 2012 in General Paleo Discussion


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Keys to Paleo Success Part 4: Being Conscious

In the final part of this series on my keys to Paleo success we will talk about consciousness; not being awake, but being alert!  Together with cooking, understanding, and patience this will conclude the series on keys to success.  How conscious you are on a day to day basis may ultimately determine just how successful the Paleo lifestyle will be for you.

Eating: It’s fairly obvious that you must be supremely aware of what you are eating to be successful.  There are certain areas though that I think are more important as they are the most likely to make you slip up. 

Although I don’t encourage calorie counting to my patients, I do ask my patients to be conscious overall of how much food they are eating.  Eat slowly and enjoy your food that way you give it time to settle and for your natural sense of satiety to kick in.  It is not uncommon to overeat even while eating clean.  There is a sense at times that since the food is clean, you can eat as much as you want.  Although technically true, try to be aware of what your body really needs and not just what you think it wants. 

When you are shopping at the grocery always be aware of this; even when you have multiple food choices, there is almost always one that is better than the other.  For example choosing a leaner cut of meat will be better than a fattier cut.  By all means, eat a ribeye at times, but fit in some leaner meats as well.  I want you to also read every label you can in the grocery.  Even when you think that you know what is in there, check again.  Are there nitrate free choices for some of your meat choices?  If so, try to get them as often as you can. 

Also take the time to ask your grocer, or preferably a butcher or meat farmer where the meat you are buying is from, what it is fed,  and how it is raised.  Do not feel obligated to eat only grass fed meat; although optimal, it is not possible or practical for many people out there, even myself at times.  Lastly, look at anything that is processed in any way with skepticism.  As my goal is 90% compliance with my Paleo diet, I very rarely blatantly eat what I know is not good for me.  I look at what I consume that is processed, or not prepared by me as being unclean, and it accounts for my 10% fudge factor. 

Eating is an absolute joy for me, and it should be for you as well.  When you do it consciously, ALL the time, it can be fun and enjoyable instead of the dread it has become for many.

Feelings:  I want you to be completely aware of how you are feeling at all times.  Before you eat make yourself aware of just how hungry you are.  While eating, enjoy how the food makes you feel, and eat slowly enough to feel how full your meal is making you before you overeat.  Tie your feelings together with eating in every way that you can and it will really help you be more successful.

One key are of feelings I want you to be aware of is how certain foods make you feel, especially pay attention when you cheat.  Everybody reacts differently to foods, and even to non-Paleo foods.  I have learned over time what kinds of foods I can and can’t cheat with if I expect to feel well.  Keeping a food diary early in your journey will really help with this are of your lifestyle.  You want to be able to look back and say “I feel really sluggish, what could I have eating in the last few days to cause this?”  Is your stomach more unsettled than usual?  It’s probably something you ate!

Another thing to really pay attention to when you cheat is WHY did you cheat?  If you are like me, emotional eating can be a problem.  Don’t just look back at cheats and see how they made you feel, but look at what emotions led to you cheating.  Over time you can analyze what circumstances or emotions trigger cheating so you can control them.  You want cheating to make you feel GOOD when you do it because there is no guilt involved, but that will take time and patience to achieve.

Are you hurting somewhere that you normally don’t day to day, or after a workout?  I’m not talking about typical soreness post workout; you know when something is not right. People come in to the office all the time and complain to me about something.  I talk to them about it, and come up with a plan to figure out what could be causing it.  Commonly the patient then says something along the lines of “It’s not that big a deal, let’s just not worry about it.”  Symptoms are your body’s way of talking to you.  People who ignore their symptoms are the one’s that end up with medical conditions or injuries that could likely have been prevented with earlier intervention.  If you feel something is wrong, there probably I something wrong.  Instead of just living with it, how about calling your doctor, making an apt, and getting it sorted out!

Food and feelings always go hand in hand.  Get a good hold on both concerning all aspects of your life and your diet and you will be happy you did.

Sleep:  This is such an important part of your life, I don’t want you to overlook it in any way.  The number of people out there who chronically get too little sleep is staggering.  Do something for me, for the next month keep a sleep log.  You can get great little apps for your smart phone if you would like, but it’s easy enough to do on your own.  Here is a link to the sleep diary Sleep Diary my sleep center gives out to patients and it is very useful.  I want everyone to be very aware of how much sleep they are getting and how much they are not getting.  Everyone is also different with how much sleep it “enough” for them.  The sleep literature says normal sleep is anywhere from 6-10 hours a night, but you have to see what is best for you. 

The most common cause of chronic fatigue is a very technical sleep diagnosis known as ISS, or Insufficient Sleep Syndrome J.  Do you suffer from this?  Well, do the sleep log and see how many hours of sleep you are getting.  Then ask yourself this question: “Am I more tired in the day than I feel I should be?”  If the answer is yes, make a concerted effort to increase your nightly sleep by at least one hour and keep logging your sleep.  Do you see an improvement in how you feel?  If you do, then keep getting more sleep.  If you don’t, or you have trouble falling asleep, don’t settle for how you feel please.  Look up a board certified sleep physician and make an appointment.  You will NEVER feel or be your best if you are not sleeping enough.  Insufficient sleep does more than make you tired, it is dangerous and increases your risk of chronic disease.  Most people simply go through life dealing with how they feel and not trying to fix it.  Become conscious of your sleep patterns and sleep volume, and make adjustments to improve them if needed. 

Ultimately you can read every book and follow every blog, but nobody out there is talking directly to you.  Only your body is talking directly to you, but you have to learn to be conscious of it and adjust to its needs.  Always remember that success with a Paleo lifestyle is up to you, and nobody can change that.  Don’t fall victim of thinking you can’t do it “right” so why bother, or that you are doing all you can.  Are you really?  Is there some place you can improve your health?  Do you have strongholds you are still not willing to give up? 

You want to succeed with your Paleo goals?  Learn to cook at home, be patient with yourself, acquire the understanding of why Paleo is right for you, and become conscious of every aspect of your life. 

Do you have specific keys that have helped you?  Post a response and share your experiences with everyone else.  If you have specific questions, always feel free to email me at  And as always, share this blog with anyone out there who you feel could benefit from learning more about the Paleo lifestyle. 



Posted by on June 3, 2012 in General Paleo Discussion


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Keys to Paleo Success Part 3: Patience (and the Paleo Cheat Hypothesis)

Today I will talk about one of my downfalls; not just with Paleo, but with life in general! I am guilty of not having much patience in life, and at times I think it hurts me in many ways. Let’s look at how patience is important to Paleo.

When you start down the road of a Paleo lifestyle, you are bound to have ups and downs. It is very hard, if not impossible to have the willpower to be perfect. Often you slip up and don’t even know it until much later. Even the definition of what is and is not paleo is fuzzy in certain areas so who is to know for sure where all of your choices will settle out.

I am a perfectionist, and that can be good in some places. When it comes to eating Paleo though, I have learned to avoid the temptation to think that I can be perfect. I think of my eating as a fuel meter that ranges from 0 to 100.

It is unrealistic that I can keep this meter pegged down at 100 all the time, and if I make that my only acceptable goal I will fail. I’m not saying that you should not care, or try to eat clean, but you must be patient with yourself. Life is after all to be enjoyed, and occasionally that may mean deviating from the Paleo path. I don’t do this often, but I have in the past, and I am certain I will again. The key is that when I choose to “cheat,” I do so very deliberately and with no remorse. I keep my fuel gauge as close to the 100 mark almost all the time, so I will allow for episodes of dietary indiscretion in rare instances.

When I started Paleo I was gung ho crazy to be perfect. One important part of Paleo I had not yet learned to appreciate is trying to eliminate stress from your life. If you place so much pressure on yourself to be perfect that a cheat will literally ruin your week, you have to reset your priorities a bit. I was guilty of such behavior, and I was taught early to change my ways by my biggest cheerleader…my lovely wife. One night about 4 months into changing to the Paleo lifestyle we took the kids to Dairy Queen. I can say honestly up to this point I had been 100% compliant to my knowledge, and it was becoming almost an obsession. For me, an obsession is easy to come by, and not healthy at all. We pulled through the drive thru and I ordered my kids some ice cream. As I looked at the menu, I just decided on a whim to order a Peanut Buster Parfait. I’ll be honest…I ate it all, and it was SO good. That night I could not sleep I felt so guilty. I had not planned it, and I felt weak to just order something so half-hazardly and eat it! I moped much of the next day and into the evening, and my wife, knowing me all too well, asked me what was wrong. She knew what was wrong, but asked anyway. I explained to her my guilt, and she simply asked me what I would tell a patient in that situation. It was easy to know that I would tell them that we all make errors, and you just move on.

This episode was very good for me in many ways. First I realized that even though I ate ice cream, it did not change my Paleo values in any way whatsoever. I picked up the next day and carried on with my clean diet. This showed me another aspect of food no longer controlling me. Food can control your behavior, but it can also control your reaction to your behavior. I essentially forgave myself for eating the Dairy Queen, and moved on! I never really looked back (remember the fuel gauge) and that’s something I had always had a hard time with.

This also led me to develop what I call the Paleo Cheat Hypothesis, and it goes like this. If a caveman walked into a cave way back in the day, and stumbled upon a Peanut Buster Parfait from Dairy Queen, would he taste it and reject it on principle? NO WAY! I have no doubt he would have eaten it and gone back home to tell his family! I know, I know, it’s a little silly, but just the same way that occasionally a prehistoric human found a comb of pure honey, we can occasionally gather edibles that are not the healthiest. It’s gonna happen to you eventually. You have two choices; either fester over it forever with the belief that you should have been perfect, or just let it go and move on. Just keep that gauge between 95-100 as much as possible, and everything will be ok. Always be patient with your fallible human self.

In addition to patience with yourself, you need patience with your progress. We all want to get healthier, fitter, happier, more energetic, and for our biomarkers like weight, blood pressure and cholesterol to improve. That said, it won’t happen overnight, and may not happen ever to the extent that we want. Don’t make demands on yourself and make them a prerequisite for success. Your goals are important, but so are the lessons that the journey will teach you. Use every day to learn from your successes, and your failures. Remember that going Paleo is a lifestyle, and a lifestyle lasts your whole life!

In life we all want to believe we can and should be perfect, and that we can be that way now. I advise all my patients to try to be all that they can be. This means pushing yourself, redefining what you feel you can achieve, but also to do this with a good deal of patience and appreciation for the journey. You will never be perfect, you weren’t designed to be perfect, and don’t be fooled into thinking there is anyone out there who is. I’m certainly not, and I’m actually kind of proud of that. In fact, my imperfection has taught me to be a better Christian, father, husband, doctor, and person overall.



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Keys To Paleo Success Part 2: Understanding

This is the second part in a series on what I feel are some of the keys to making the Paleo lifestyle successful for you over the long haul.  The first part of the series was on cooking and it seemed to be pretty well received.  Today’s topic? Understanding…

One of the most important things that will allow for long term commitment to anything in your life is understanding why you are doing it.  This may sound a bit simplistic or obvious, but take the time to think about it.  Changing your life in a way many consider “drastic” is not easy, and you need a good reason to do it!  When I started the journey on a Paleo diet I asked quite a few questions about why I should do this.  Being a physician and the fact that many Paleo principles go against much of what I was taught about diet and nutrition I set about learning as much as I could.  Making a fundamental change in your life, no matter what area it is in, requires a real belief in what you are doing.  Belief can only come with knowledge.

When my wife and I decided to go paleo, I downloaded and read Robb Wolf’s book The Paleo Solution.  I mentioned it in an earlier post, but I will give you this advice.  You need to understand two things about Paleo; how we do it, and why we do it.  Robb’s book gives you the option to simply read about the how to do it, and suggests you can follow Paleo without worrying about the why.  Of course he is right, but I think to be most affective you need to know the why.  How to follow Paleo is pretty simple as we all know.  There will be a point, or likely many points when you will feel like going back to your old ways.  A solid foundational knowledge on why you follow Paleo will serve you well during these times and get you back on track.

When I discuss any topic with my patients I hope that they ask me questions.  Curiosity about why I am telling them to do things a certain way lets me know they are thinking, and that they care about what we are talking about.  Simply taking something on blind faith is a risky proposition.  Don’t get me wrong, you have every reason to trust any of the major Paleo book writers like Robb Wolf, and his book is extremely well written, researched, and presented.  That said, you need to take ownership of your own life and health.  My experience with patients is simple; if they just accept what I’m saying to do and nod absent mindedly they are unlikely to have followed through with any recommendations I made when they return for their next follow up visit.  If they show interest and ask good questions, they are much more likely to show improvement.

So take the time to read The Paleo Solution cover to cover and UNDERSTAND.  Although the Paleo lifestyle will offer you significant improvements in many areas of your life it is not good as a means to an end of a single specific goal such as weight loss.  Look at your health as a whole and see all the ways changing your diet could help you.  Look FORWARD in your life and see how changes today can change your life tremendously many years from now.  Don’t simplify the decision to go Paleo but rather make it about long term happiness and health.

Once you fully understand the driving principles behind why following the Paleo lifestyle is best for you, you will be able to pass it on to others.  Whether it be to patients or clients of your own, friends, or even family, proper understanding will allow you to successfully lead those you care about to also go Paleo.  This ultimately is where we can make the most impact on our future.

So take the time to learn and understand Paleo, what it does, and why it does it.  You do not need a medical degree to grasp the basic concepts.  I try to learn something new about Paleo everyday, and you have all the resources you will ever need with a computer and an internet connection. You will be questioned about your diet by many, and if you plan on helping them understand why you are right (and they are wrong!) you need convincing knowledge on your side.  Study up, past the test, and join the fight!



Posted by on May 30, 2012 in General Paleo Discussion


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Have Trouble Talking to Others About Paleo? Here’s What I Do.

One of my biggest challenges is introducing the Paleo diet to patients who are initially very reluctant to listen.  I’m sure all of you have this problem whether it’s to your friends or family members who are curious about all this “caveman” business.  Several of my twitter friends asked if I could post about how I approach this problem with my patients, so I’ll give it a try.  I will attempt to write it as a dialogue between me (E) and a patient (P).  Along the way I may stop and fill in with some additional info.  I certainly do not review this entire thing with every single patient, but I hit the high points and address the most pressing questions they may have.

Most of the time the question of diet and weight loss comes up in this fashion…

P: I swear I’m doing everything right doc, and I just can’t lose any weight.  I’m very frustrated and I really don’t think that I am eating very much.  What can I do?

E: Ok, so what you are doing is not working.  Let’s start with you taking me through a typical day in your diet.  Take yesterday for example, what did you eat?

P: Ok, I eat oatmeal every morning because it is good for my cholesterol.  Most days I also eat a yogurt, and maybe a piece of fruit.  For lunch I normally eat a sandwich like tuna salad or chicken salad…with low fat mayo and whole grain bread.  Baked Lays or something on the side, all low fat stuff or I won’t eat it.  For dinner I may eat a little more, but I figure I haven’t eaten much all day so I allow myself to eat a bit more.  I’ll typically eat chicken or fish, usually broiled, and some vegetables on the side.  My husband loves cornbread, so we eat a lot of that as well.  I’ll usually eat a little desert, like a little chocolate or a few cookies; just a little something sweet ya know to kill my sweet tooth.  That’s really it.

E: So no snacking during the day?

P: Well yeah, I snack on things here or there.  Come to think of it, I probably eat more junk snacking than anything else.  Just little stuff though; a few chips here, a couple of M&Ms there, not enough to really matter though I think.

E: Ok, that’s what you eat, what do you drink all day?

P: Well, I hate water, and I can’t stand Diet Coke.  I do force myself to drink water as much as I can, but I just HAVE to have at least a coke every day.  I just can’t do without it.  Maybe some days I’ll drink two, but that’s not the norm for me.

E: What size cokes?  Are we talking a can, or a bigger soda like from Sonic or something?

P: Oh I just love Sonic Ice, so I go there almost every day.  So yeah, it’s usually a large coke from Sonic or McDonalds when I’m swinging through there to get the kids something after school.

E: So how long have you been eating this way trying to lose weight?

P: I’ve been doing this for years.  I may lose a little weight here or there, but I can’t seem to make any real ground?  I swear I just don’t see where I eat that much food.

E: So what you are saying is what you are doing isn’t working right?


Ok, this is a good time for a note.  When you are talking to patients, or even friends who are questioning the Paleo diet, you want to get a good foothold on what their current “diet” is, and whether it is working or not.  Most people do not inquire about lifestyles or diets if they are totally content with how things are going for them.  Ask them questions, establish patterns and identify weaknesses.  Most importantly, make them admit that what they are doing, although they feel it is “right”, is not working!

E: Ok, I’m going to tell you how I eat.  I spent years also trying to figure out what the best way to get off weight and keep it off, and this is what I feel is your best bet.  I’ll make it easy by just saying what I do eat.  I eat meat, vegetables, fruits in moderation, eggs, any nut except for a peanut, and healthy oils like olive oil, coconut oil, or avocado oil.  Anything else is off limits.

P: So how do you make a sandwich?

E: I don’t.

P: What do you eat for breakfast?  I mean I need to eat oatmeal for my cholesterol don’t I?  And calcium, where do I get my calcium for my bones?  Wait a minute (desperate opening of mouth)…what about cheese?

E: No cheese, no dairy of any kind.  I eat whatever I want for breakfast as long as it is on the list I just gave you.  It’s not hard it’s just different.

P: There is no way I could do that.  I can’t live without a lot of things on that list.  I mean what do you drink?  Don’t say water, I told you I hate water.

E: I drink water.

P: (Blank stare of disbelief as if I didn’t hear her water comment) That sounds crazy.

E:  Well them I’m crazy I guess because I’ve been eating this way for quite a while and it has done wonders for how I feel and for my health overall.  I sleep better than I ever have, I’m hardly ever hungry, I don’t fight the cravings for food I used to, my stomach isn’t upset all the time, and I’ve lost weight without tons of effort and have no trouble keeping it off.  Isn’t that what you are looking for?

P: Yes, but I can’t eat that way.  I’ve tried Atkins before and I just can’t take it for too long.  You basically eat Atkins right?

E: No, not at all.  I eat based on what is called the Paleo diet, or the Caveman diet.  The key is that it’s not a diet at all, it’s a change in the way you do things.  You have to be willing to change permanently; it’s a lifestyle cha…

P: Yeah, yeah, I know, a lifestyle change and all that.  But why, why can’t you eat dairy?  Milk is good for you, everyone knows that!  And oatmeal, I mean come on, oatmeal is so healthy!

E: I disagree.  We can look at each individual area of foods you need to avoid and discuss why if you would like, but I can simplify it in one word: insulin.  Insulin’s job is to make sure that your blood sugar stays controlled in a very tight range.  When you eat a diet based primarily on carbohydrates it causes your global insulin levels to be higher than they should be because your body is working overtime to keep your sugar tightly controlled.  This increased insulin causes two things; it makes you hungry, and it stores sugar as fat.  So the more carbohydrates you eat, the more insulin your pancreas produces.  All the while this insulin is making you hungrier and fatter.  As a consequence of accumulating more fat your body also starts to require more and more insulin to control blood sugar, and eventually your body stops listening…you become resistant to your own insulin.  At that point you develop Type 2, or insulin resistant diabetes.  This is how your current diet is leading to your downfall.  Understand?

P: Well, sort of.  But I don’t eat donuts or potatoes or anything, I just don’t see where I eat that many carbs?

E: You told me you eat bread for sandwiches, yogurt, oatmeal, chocolate, cookies, and soda.  All those are carb based right?  It sounds like to me you eat primarily carbs on a daily basis, am I wrong?

P: But I eat whole wheat bread and pasta, and low fat yogurt or skim milk for dairy!

E: Pasta, you never said anything about pasta?

P: Oh, pasta is a major weakness.  I love pasta so much, and I was so proud of myself for finally getting used to the whole wheat stuff.

E: To your body bread is bread, and pasta is pasta no matter the type of wheat…they are carbs.  And milk, ever notice that a cup of skim milk has around 100 calories, and a cup of whole milk has a little over 140 calories?

P: Oh, I don’t drink whole milk or skim milk, I drink 2%!

E: Focus, you’re missing the point here.  Like I was saying, you would figure if they take all that high calorie fat out of milk it should really drop the calories right?  Fat does have twice as many calories as carbs or protein after all.  But, it only drop it 40 calories or so per cup!  The reason is that when food manufacturers take fat out of food, they add in carbohydrates to make the food taste ok.  So by avoiding the fat, you are contributing to the insulin train we discussed earlier.  What I’m trying to tell you is that fat is not your enemy, as long as it is the right kind of fat.  Carbs on the other hand are for the most part universally bad, unless it is in fruit and you want to eat that in moderation as I said earlier.  After all, a carb is a carb.

P: You are killing me here doc.

E: Sorry, but you asked!

P: Ok, so I kind of get the milk thing.  So why can’t I just change to whole milk?

E: Good question! The answer is that milk is not just made of fat, it also contains sugars and proteins.  It’s these sugars and proteins that cause an increase in your insulin levels when you drink it.  Importantly, this increase in insulin that is seen when milk raises your blood sugar is essentially the same for any milk: Whole, 2%, or skim.  So milk may be a source of calcium, but it comes with significant baggage.

P: So that’s it, all these foods increase my blood sugar and my insulin levels, so I can’t eat them.  Guess it sort of makes sense.

E: Yes, and no.  Dairy products can also teach us about the other main reason the Paleo diet eliminates what it does.  It’s called inflammation.

P: Inflammation?  Like a bug bite or something?

E: Yeah, exactly.  This can get complicated, but I’ll try to make it as easy as I can.  Milk proteins lead to chronic inflammation in your GI tract that change the way we absorb many foods.  To expand the list, other foods like wheat, legumes, and even soy to some extent cause this inflammation.  Think of your GI tract like an impenetrable wall.  That wall was designed to keep everything out of your bloodstream that is not supposed to get in there.  When you eat these pro-inflammatory foods, that smooth impenetrable wall becomes leaky and more like swiss cheese.  All sorts of proteins that are not supposed to enter the blood stream do so, and your body sees them as foreign.  Just like ant venom is foreign and your body builds an inflammatory response to it on your skin, your body will build an inflammatory response to say for example gluten in wheat products.  This chronic inflammation is felt to increase your risk of heart disease and stroke in particular over time.  Like I said, this can get complicated and I can give you some good information to read up on it.  Big picture is, you have to eliminate foods that will lead to chronic inflammation in your arteries.

P: But you are eliminating all these foods that I hear all the time are healthy?  How can I eat that much fat and stay healthy?  Isn’t eating fat the worst thing for your heart?

E: Like I said, it depends on the type of fat.  You know that fish oil you take?  I presume you take it because you read or heard that Omega-3 fats are good for you right?  Well, that’s right indeed.  Omega-3 fats are known to be much less atherogenic than Omega-6 fats…in other words, they don’t cause heart attacks or strokes.  So eating this way will help shift your diet from one primarily composed of Omega-6 fats to one mainly of Omega-3 fats.  Also, it will change the size of your cholesterol molecules.  Omega-6 fats lead to LDL, or bad cholesterol, molecules that are small and dense.  These small and dense molecules can easily lodge themselves into the “swiss cheese” like walls of your arteries at the moment.  When they lodge into the walls they form plaque, and that plaque leads to blockage, and that blockage leads to heart attacks and strokes.  If you can shift your diet to Omega-3 fats your LDL becomes what we call large and fluffy.  These large molecules pass smoothly along your artery walls and are not stored as plaque.  In other words, even if your cholesterol is a little high, it won’t be the dangerous kind.  Is this all coming together for you?

P: Yeah, I guess.  I just don’t understand why the government doesn’t talk about all this if it is true?  I mean look at the food pyramid.  My kid brought one home the other day from school and it’s build on whole grains!  I don’t understand that at all if what you are saying is true.

E: Well….that’s a hard one.  We could talk for hours on this one, but I’ll just tell you this.  The government and multiple medical associations bought into the fat = heart disease theory long ago.  They have spent decades trying to get people to eat less fat and more carbs.  In fact, they have succeeded.  As a nation we eat less fat today than we did 40 years ago.  But just look around and answer this question: Is it working?!  In the 1960’s the government took the data from one study that appeared to correlate rate of heart attacks with national dietary fat intake.  The study was terribly flawed and most of the data was not reported, but it was taken as law.  When the government decided to push the low fat diet as a cure for heart disease the obesity rate in America was just under 10%, and now it’s nearing 30%.  20% more obesity in 40 years or so, you tell me if it’s working.  My simple answer is that the government is wrong, and they are too deep into their beliefs to change their ways.  We’ve already agreed their plan hasn’t worked for you yet right?

P: Yeah, you’re right.

E: I’m always right.

P: Thanks for the confidence doc.  Here’s the deal though, I can’t do this.  You like to cook and stuff, and it sounds expensive.  There is no way I can so it.

E: What if you gave me 30 days?  Just 30 days to change your life.  You can go home today and kind of try it a bit, eat a few less sandwiches, and say you give it a shot.  But why not do it super strict for 30 days.  Get everything out of your system and see how you feel.  I’ll see you in 30 days and we’ll evaluate how you feel and if you think it’s worth continuing.  I’ll warn you though, I haven’t had one person who did the 30 days right who wanted to go back to eating the way they used to eat.  Go 30 days strict, and then I’ll ask for 90% compliance from here on out.  You can do anything for 30 days right?

P: I guess, but I’m not sure it’s worth it anyway.

E: Do you think I hate chocolate chip cookies? Or wedding cake? Or Chimichangas? Or fresh baked cinnamon rolls? Absolutely not! I love each and every one of them!  Almost everyone that follows a Paleo lifestyle loves these things.  So ask yourself this question.  If we all love those foods, why did we keep eating Paleo after 30 days?  It’s simple, cause it works and we feel better.  In fact, I never want to feel the way I used to feel before I changed my diet.  I’m pretty sure you won’t want to go back either.  Only one way to find out though…

P: Well doc, I’m going to reluctantly agree to give this a try.  I love many of the foods you have explained I can’t eat, but I’m so sick and tired of feeling like this I’m willing to give anything a try I guess.

E: You know what the best thing for me about this lifestyle change for me has been?  I am no longer in any way controlled by food.  You are controlled by food right now, you said yourself you cannot “live” without a coke every day.  Think about it, that soda controls your life!  I don’t worry about food as much anymore because I’m not as hungry and I don’t crave things as much.  Don’t get me wrong, I love food more than ever; just in a different way.  You have the power to change your life so much, all you have to do is give me 30 days.

P: All right doc, you win.  Let’s do it.

Now before you ask, no, I don’t have 45 minutes with every patient!  I made this conversation as complete as I can for educational purposes.  I challenge most patients to get a book on Paleo and educated themselves as much as possible about the dos, don’ts, and whys of the lifestyle.  If people put the effort to learn why they should do things a certain way, they are more likely to stick to it long term.  All you can do is start the educational process for people whether it be clients, friends, or family.  Always challenge them to learn more about Paleo before they just dismiss it as a “fad” diet sure to play out.  Memorize some numbers on our nation’s rates of obesity, diabetes, childhood diabetes, cancer, and other medical conditions tied closely to what we eat.  Above all else, challenge them to tell you that what they believe to be true is actually working.  If they insist that it is, they may be drinking too much of the Kool-Aid to ever see the light.  Don’t worry about that though, like I said all you can do is try.

I really hope this will help some of you talk to other people about Paleo, why you changed to it, and why they should as well.  It’s not easy since everyone has been exposed since birth to the vastly superior health qualities of milk and whole wheat among others.  Debunk them one point at a time, know your science, and point them to more detailed sources to complete the picture.

Fight the good fight everyone!  We must keep spreading the word about Paleo and science will continue to fall in our favor.  If you know of someone who may benefit from reading this, please direct them here, RT my tweet about it, or whatever!   Together we can change history, one loaf of whole wheat bread at a time 😉



Posted by on May 27, 2012 in General Paleo Discussion


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Keys to Paleo Success: Part 1

I have quickly come to understand what I believe are the major areas one must concentrate on in order to be successful for the long term with a Paleo lifestyle. I’m not talking about specifics when it comes to what you eat, or how you eat, it’s more about behaviors and attitudes. Today’s post is the first of a multi-part series discussing these areas, and today we concentrate on cooking at home.

Some of the biggest complaints I here from my patients about the Paleo lifestyle revolve around cooking. “I can’t cook like that,” or “I can’t cook at all” are what I often get. Being inLouisianapeople just can’t wrap their heads around coming out of the kitchen without biscuits, rice or potatoes playing a major role in dinner. The same is true for any regional cuisine and that cuisine’s traditional staples. It’s almost sacrilegious to tell people that Grandma’s famous dinner rolls gotta go! The Paleo lifestyle revolves around what goes in your mouth, and what goes in our mouths every night has to revolve around a home kitchen putting out the right kind of meals.

Let’s talk restaurants. The first thing I suggest is to get over the idea that you can successfully convert to the paleo lifestyle by eating out every night. Although I do not instruct my patients to count calories when eating Paleo, I do think some obvious restraint is necessary. The average meal at a chain restaurant these days contains 400-750 calories for an appetizer, and 1200-1800 for a main course. These are averages, and many far exceed these numbers. Want to scare yourself more, take a look at the calorie numbers at common kid’s meals these days! Even splitting an appetizer, having an run of the mill entrée, along with a little bread and salad, you still are easily at 2000 calories on a good night. You simply can’t do this 4-5 nights a week and succeed.

Another problem with restaurants is cost. I have absolutely no problem going to a very nice restaurant and spending a little money on a nice meal (in fact, I rather enjoy it!). That said, when one of the biggest issues patients complain about is the cost of eating Paleo, you have to be smart where you spend your money. A 16 oz Ribeye at a local steakhouse is 24-28 dollars, the same Ribeye is 12-14 dollars at my local butcher. Take this evening for example. I am cooking crabcakes with red pepper coconut sauce, roasted asparagus and a side salad. Here are some rough numbers on the cost.


1 pound of Crabmeat – $16.00

½ bell pepper – $1.00

1 Shallot – $0.50

Paleo Mayo – $0.50

OldBaySeasoning – $3.00 (For whole thing!)

Asparagus – $4.00

Salad Greens – $4.00

Total – $29.00 or $7.25 per person

Local Seafood Restaurant:

2 Adult Crabcakes – $18.00 each

2 Kid’s Chicken Strip Meals (We won’t battle the kids out to dinner!) – $8.00 Each

2 Sides of Asparagus – $4.00 each

2 Waters – $2.00 each

2 Kids Drinks – $1.00 each

Total – $76.00, with Tax and Tip – $95.00! or an average of $23.75 per person

Now this is just an example, and I didn’t even give the kids crabcakes (which they love by the way). There is just no way anyone can argue that cooking at home is not immensely cheaper than eating out. The problem is many people don’t really see this because it just adds up. Ten bucks for lunch here, 50 for dinner there, and before you know it you have spent tons on dining out. I hear it all the time…”It’s just too expensive to cook at home!” Man! Get a calculator and discover the truth!

Another area of concern with restaurants is that you have NO IDEA what they are cooking your food with. Did you know that a Wendy’s chicken sandwich actually contains some beef?! Even nicer restaurants are out for one thing (as they probably should be) and that is to make their food taste as good as they can so you will come back and eat again. They don’t do that, as well as turn a profit by cooking with natural oils or without cutting some nutritional corners. A major part of the Paleo lifestyle is being completely aware of what is going into your mouth. You can’t do that going out to eat unless you know who is cooking for you well, and you are able to given them specific instructions on what to do and what not to do. It can be done, you just have to be very proactive when you order and make them understand how important it is to you that things are done right.

One last issue with eating out is that you are always prone to eat more when going out to dinner. Have you seen serving sizes these days! You go to a restaurant to eat, you are presented with a plethora of options, and given little extras to fill you up while you wait for your food to be cooked. How are we not going to overeat in these situations? How many of us when cooking at home serve an appetizer, bread, salad, main dish, and sides at every meal? When’s the last time your local Mexican joint failed to refill your chips and salsa on demand?!

Enough about eating out, lets talk cooking at home for the rest of the post. I get it, I’m a foodie kitchen dork who loves to cook and make my family happy at meal time. I also have tons of time and don’t work but 3 hours a day….NOT!! Maybe you don’t like to cook? Or is it that you don’t feel comfortable in the kitchen? Or maybe nothing turns out as good as it does at Chilis? Here is a few suggestions.

The first thing I suggest is that you keep a well stocked pantry at all times. When we designed our new house I let my wife essentially do the whole thing…except for my pantry. I knew exactly what I wanted, and I even ended up having the builders rip a wall down and steal more space from an adjacent guest closet to increase the size. No matter the size though, you need to keep pantry staples on hand so you don’t have to constantly be running to the store to get everyday items. If you make it a priority to stock your pantry, you can spread the cost out over 3-4 months and end up with a good stock on hand. I can’t emphasize your pantry enough.


Next I suggest you start easy and slow. Find some easy Paleo recipes on the internet or in a book and follow it step by step. Look here for a place to start! Read and understand the recipe well before starting, prepare your ingredients, and put it together. You just have to try! Don’t have much time, pull out the crock pot and take 10 minutes in the morning to fix dinner before you leave the house! This may sound obvious, but for a while I would stick to meals that you KNOW you and your family will love. If you are new to cooking, and your family is wishing Domino’s was delivering instead, the last thing you want is to try something a little out of the norm and (literally) leave a bad taste in their mouths. Cook some “fast balls down the middle of the plate” for a while to build your confidence, as well as the confidence of those you are cooking for. Once you feel pretty good about some easy recipes that everyone enjoys, start experimenting with new techniques and ingredients. Above all else, try to make cooking fun! Involve the kids and make a mess every once in a while. You are teaching your kids knowledge that will serve them a lifetime if they learn to produce great meals at home.

Another MAJOR component to successful cooking from the home is planning. If I don’t have anything planned for dinner when I leave the house in the morning, we probably have a 75% chance of getting take out that night. We spend more, eat more, and likely are eating some things we should not. Plan ahead for 2-3 days and try to have your ingredients on hand. Check your family schedule every week and look for things that could get in your way. Always have church till later on Wednesdays? Why not try making Wednesdays crock pot night and you don’t have to worry about dinner other than to get home and serve. We usually do go out to lunch every Sunday after church, so it gives everyone something to look forward to on the weekend. Just find a schedule and plan that is right for you and stick to it.

I want to give you guys two quick tips that I have discovered for myself over the years being the cook and planner in the house. First, I used to try to plan meals for the whole week on Sunday, and get everything bought early to cut on my trips to the grocery store. For me that just did not work very well. Almost always, what sounded good for dinner Thursday night when I was planning Sunday night did not sound as good when Thursday came around. This led to more going out to eat, and wasting of food I bought for that dinner if I did not quickly find another use for it. I now plan 2 days in advance maximum (unless I am using the Sous Vide for more than a 48 hour soak). I go to the store more, but it allows me to always keep what we eat fresh and more consistent with the moment.

Second I want to talk cooking temperature. If you have ever watched Mario Batali cook on TV he says often that the difference between a home cook and a chef is in the “aggressiveness of the heat.” What he means is that restaurant food tastes so good because they cook with high eat and are not afraid to slightly burn food to get that umami flavor we all love. Be aggressive, but to be so you have to be there while your food cooks. My wife can’t do this because she tries to do too many things at once and can’t concentrate on just cooking. Not a bad thing, it’s just who she is! To cook with high heat and get great flavor you have to watch and be there for all the action. Work on this and your food will start tasting better immediately.

I know this has been a sort of hodgepodge of thoughts, but cooking at home is absolutely essential to making Paleo fresh, affordable, and consistent in it’s results for you and your family. Make it fun for the whole family to find the best ingredients, visit local farmer’s markets, get to know the guy raising your beef if you can. If this is too much, maybe you can at least get to know the guy cutting your beef for you at the grocery store. One of my major goals as a dad and a cook is for my kids to know where food comes from. I don’t want them to think food comes though the car window, or from a box, or served mainly for us by a waiter at a restaurant. Real food comes from the home. And as I say; Real Food…Real Health.



Posted by on May 22, 2012 in Uncategorized


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