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Easy Paleo Meatballs

Paleo Meatballs

Easy Paleo Meatballs:

If you are looking for a quick and easy Paleo meatball recipe, this one is for you!  The key to moist meatballs every single time is how you cook them.  Although browning meatballs adds extra flavor, it can sometimes impart some toughness to the meat.  Instead, I essentially poach  my meatballs in crushed tomatoes and the results are amazing.  Try them and let me know what ya’ll think!


1 Pound Ground Turkey

1 Pound Ground Beef

1 Tbsp Salt

1 Tsp Cracked Black Pepper

1 Tsp Garlic Powder

1 Tsp Onion Powder

2 Tbsp Coconut Flour

1 Tsp Dried Basil

1 Tsp Dried Oregano

28 oz Can Crushed Tomatoes with Basil


  1. In a large mixing bowl, combing both meats with the salt, pepper, garlic powder, onion powder, coconut flour, and dried spices.  Combine them thoroughly but take care not to over work the mixture.
  2. In a deep sauce pan large enough to hold the meatballs in one layer pour in one third of the tomatoes to coat the bottom of the pan.
  3. For each meatball form 1/3 of a cup of the meat mixture into a ball and set in the sauce pan in one layer.  Pour the remaining tomatoes on the top of the meatballs, season with 1 tsp of salt, and set over medium heat.  Once the contents start to bubble away turn the head down to a simmer, cover, and allow to cook for a minimum of 30 minutes.  The longer they cook the softer your meatballs will be.
  4. 15 Minutes before you are ready to eat take the over off and allow the sauce to reduce to a slightly thicker consistency.
  5. Serve with spaghetti squash, sautéed zucchini noodles, or all by themselves!

Click HERE for a downloadable PDF of this recipe!


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Posted by on August 23, 2016 in Main Entree, Recipes


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DANGER: Is “Paleo Friendly” the New “Fat Free?”

10Baked Pumpkin Spice Doughnuts_1_Fotor

There is a real problem going on these days in the Paleo community, and I think many need to take great caution not to fall victim.  In two words…”Paleo Friendly”.

Years ago when fat became the devil in America a new catch phrase was born; “low fat.”  Think about it, the very idea of something being low fat didn’t mean a hill of beans 30 years ago.  Once the food industry realized that this simple phrase would attract millions to buy, and make them billions in profit, it became a real food phenomenon.  All of a sudden you should not eat an oreo, but you could polish off an entire box of Snackwells and it was all good.  They are low fat so they don’t count!

Here is another one…”sugar free.”  Type 2 diabetics, on the average, love their sweets.  They know they can’t justify eating overtly sweet treats, so they run for the “sugar free” items almost as if they don’t count.  Once sugar became a bad thing, the food industry did all they could to come up with sugar substitutes.  That lasted for a while, but then…once they became questionable because they are “artificial,” they set out to make sugar substitutes made with real sugar!  HUH?!  You can’t make this stuff up.

This simplistic thinking can be dangerous.  Being low fat does not make things healthy, and neither does being sugar free.  But, here is the kicker, the newest catchphrase is “paleo friendly.”  And yes, simply being paleo friendly does not make things less dangerous.  If we are not careful, it could be the ultimate downfall of the Paleo lifestyle.

Paleo became a viable option for many because it makes physiologic sense.  Fuel your body with real food based on a low carbohydrate and protein rich diet, and achieve success in weight loss and overall health.  One of the great debates has always been what things truly are “Paleo” and which ones are not.  Once those lines are drawn, then it seems that any combination or concoction is fair game as long as the ingredients add up.  Is that the right line of thinking?

To me it is overly simplistic reasoning, and it can indeed be dangerous.  Suddenly if you crave your treats, you can find a “paleo friendly” version of just about anything.  Cookbooks are everywhere promising Paleo treats, Paleo baking, Paleo sweets.  All the current necessary buzzwords are there; gluten-free, dairy-free, no refined sugars, etc.  Paleo cakes, paleo ice cream, paleo cookies, paleo pies, paleo candy!  Where does it stop?

Most who know me and spend time around me these days know how I eat, and that has even spread to the pharmaceutical representatives who visit us on a daily basis.  They often bring snacks for the doctors and staff, and over time those who visit my brother and I’s station at the office have learned that we prefer fresh fruits, vegetables, and nuts over processed treats and baked goodies.  Some have even learned the catchphrase “paleo friendly” and at times bring us treats from local bakeries that have figured out that Paleo people still love their sweets as long as the ingredients fit the bill!  The other day I was brought a “Paleo bar” which was promised to be made of “100% Paleo Friendly Ingredients.”  It was, and it was so sickeningly sweet that I could only take two bites before having to stop!  It was a mix of a candy bar and a granola bar made of paleo safe ingredients.  It was “paleo friendly,” but it certainly was not good for me.

As you continue on your Paleo journey do not fall victim to the term “paleo friendly.”  After all, what is the Paleo lifestyle all about?  Is it not about establishing a healthy relationship with food?  Isn’t why you eat foods and what you are hoping to accomplish through eating certain foods important?  I believe that it is; in fact I believe that is the whole game.  You can crave a paleo cookie as badly as you crave an oreo, so don’t fool yourself in thinking there is a difference!  Give some thought to this idea, and ask yourself WHY you are eating those Paleo “treats.”  Did you used to eat the Snackwells because they were “low fat?”  Come on, be honest!  Don’t fall victim to this latest “catchphrase.”  It’s not worth it…

We will talk more about this topic in the coming months.  As always, I appreciate everyone’s input in the comments below.  I have done some work to the blog and plan to try and post more often in the coming year.  I will post more on Paleo, and more on my outdoor activities.  Make sure and check out my YouTube channel as well and click that subscribe button!  Much fun and excitement is to come soon on the blog and the channel this year 🙂



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Series Revisted: Keys To Paleo Success Part 1/4 – Cooking

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.


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Posted by on February 24, 2015 in General Paleo Discussion, Uncategorized


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Real Patient Results – The Accidental Paleo and a Priority Check

Greetings everyone.  I saw a patient yesterday that I have seen for quite some time, and I noticed right away reviewing her chart before going in the room that she had lost 19 pounds since her last visit 4 months ago.  When I went in to see her I asked how she was, and she said she felt great.  Turns out she had gone to see a nutritionist and was following her advice.  Also, she was trying to walk more, but not too succesful with that endeavour.  I asked her what the nutritionist had recommended, and this was her answer.  “Well, essentially I can only eat meat and vegetables.  I can’t eat much fruit and no dairy or grains.  Basically doc, it’s meat and veggies.  And man, do I miss cheese!”  As we reviewed a bit more, you guessed it, she was basically eating a paleo diet without calling it one.  But, here is the kicker.  Once she reaches her goals, the nutritionist says she can slowly introduce things back into her diet and just watch her weight.  She could see in my face that she had finally said something I did not agree with!

So, how was she doing?  As expected she had lost weight (actually 19 pounds in two months since starting this), she had tons of energy, she had lost a total of 9 inches body wise, and “doc I sleep like a log!”  I can’t tell you how many people who go Paleo that swear that they have never slept so good in their entire lives.  It’s so predictable it’s not surprising anymore at all.

Labs you ask?  Well, fasting sugar from last visit was 105, this time 87.  Cholesterol?  Well she takes a statin for cholesterol because her numbers were as such off the meds 283/146/46/208 (Total Chol/Trig/HDL/LDL).  On the meds they had dropped to 197/150/43/124.  In the last two months she had decided to DROP her statin dose to every other day, and her numbers today were 166/73/46/105.  So, her numbers were much better on both the Paleo diet AND her statin every other day.  Then she revealed her secret…she had stopped the statin completely 5 days ago and was hoping to stay off.  I asked her if 1) she was planning on continuing her lifestyle change and 2) if she was willing to re-start the statin if off of it her numbers went back up to worrisome levels.  She said yes to both, and we hatched a plan to keep her off her meds for three months and see how she looks then.  We will recheck her cholesterol and hope we can keep her off the statin, and hope that she continues to lose more weight.  To be continued!

Now quickly, back to the nutritionist and her plan to “phase” things back into the diet after “goals are complete.”  Let me explain something to everyone, if your health related goals are “short-term” goals, you will create nothing but “short-term” health.  Why, why on earth would you do something that helps you lose weight, feel great, and sleep like a log for a while, then go back to your old ways?

Let’s say you made a ton of bad decisions, and get yourself in tons of debt.  You decide enough is enough, and you visit a financial planner who comes up with a comprehensive plan to get you out of debt.  Kill the credit cards, stop the travel, no more eating out etc.  Then he tells you “Once you get out of this hole, we will slowly re-introduce all your bad habits and hope for the best.”  No one in their right mind would say that’s a good plan!  But, since we LOVE cheese, we think re-introducing it after reaching our goals seems reasonable, if not “fair” in some way.  I mean after all, how can we survive without cheese??!  In reality, this is the theory behind every “diet” in the books, and that my friends is why diets don’t work!

Most of us care for and manage our money much more than we do our health.  Where are your priorities?  We put junk in our mouths when we would never think of putting 50 Octane gas into our precious vehicle.  We get the cheapest meat we can find and buy the most expensive cell phone and plan we very well can’t afford.  We afford the expensive car lease but not the gym membership that we so desperately need.  (The Nav and leather seats were only $40 more a month!) Why?  I would love to hear a good answer 😦

Your health is a long-term investment, don’t make it about short-term gains.  Your short-term gains lead to my long-term gains…my bank account that is.

Eat Clean, Be Smart, Think LONG-TERM



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An Update on Things!

Greetings everyone! Just a quick update on how things are going, since I totally suck at consistently updating the blog… I have to be honest, keeping up with posting on a regular basis while keeping up a full time medical practice, being a husband and dad, exercising when I can, and sleeping adequately is hard!! I’m on vacation right now in North Georgia and am enjoying relaxing!

Things are well, kids are growing, and this update will be short as I’m pecking away at my iPad keyboard which tends to aggregate me! So what’s going on?

-The family garden is going well. This is our first actual attempt to grow a garden and we are starting to enjoy the harvest. Regular tomatoes, cucumbers, okra, and ton of peppers so far. Also, our apple trees that we planted 5 years ago have applets this year! It takes years to produce, and you have to hope they cross pollinate….woohoo!!

-I continue to push the Paleo lifestyle in my traditional Internal Medicine practice…and of coarse many patients remain resistant (shocker). That said, I am very pleased that in my small Louisiana town the Paleo community is growing. My good friend and next door neighbor the Fit Paleo Mom even has a special Summer Cooking Series on a local TV station spotlighting Paleo cooking. Honestly guys, if you have not checked out her recipe blog DO IT, it’s great. In the last several years since I began my Paleo life, our small town has really come a long way, and I feel it is very much fueled by the Paleo community. We have two local farms producing grass fed beef, a local organic farm producing amazing produce they sell twice a week (they also sell pastured pork, fresh farm eggs, and are developing ducks to sell), and our local big chain grocery has tremendously expanded their organic produce and food area. Our community is passionate about sourcing our food, and local business has responded.

-I have personally started to push my road cycling. I dabbled in it a few years ago and bought a nice starter Specialized bike. I enjoyed it, but rode off and on. A few months ago I decided to push it, make goals, trying to get faster and better. More than anything the quiet time it gives me is amazing. I cherish alone time, and my bike has become a sanctuary. Cycling is now my main exercise, and I’m loving it. I’m doing what I normally do…reading all I can on improving my cycling and am already seeing the steady results. I entered a local race, the Tour de Bayou 2013 in November. This is very unlike me, as I’m not that competitive by nature. I’m pretty excited though, should be fun (I’ll get a T-shirt too 🙂 ).

-Lastly I’m staring to make it a point to get my kids and I outside much more. With them small my wife and I’s enjoyment of hiking, camping, kayaking etc slowed down tremendously. They just could not enjoy these activities being so small. At Easter we went camping in Texas, and after a VERY cold first night we really enjoyed being outside. Nighttime fireside chats with my daughter were priceless. We are utilizing our love of Geocaching to get outside as well, and if you are looking for a way to get your kids excited about getting outside, CHECK IT OUT! On this vacation we took the kids on a 3 hour river Kayak trip and they absolutely loved it. Kourt and I are so excited as we feel we can start enjoying this part of our life again now that the kids are old enough to tag along, and most importantly enjoy it! We have many plans coming together, the first of which is a 4-5 night canoe camping trip next year…float by day, fireside by night :). This way the kids don’t have to carry much, the canoes can do that for us. Oh how I love being outside…

I’m honest, I’m not as good at updating the blog as I should be. I’ll get better, but I know it will be intermittent while my kids are small. If you want though, please follow my Instagram feed as I update it regularly with my meals and adventures. I really enjoy interacting with you all, and truly love our inspirational community. As always, you can find me on Twitter @PaleolothicMD.

Keep in touch, God bless, and stay safe.



Posted by on July 26, 2013 in General Paleo Discussion


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Sous Vide Cooking – What a Warm Bath Can Do For Your Food

For those of you who have read my blog for some time, you know how much value I place on cooking.  In fact, one of my 4 Keys to Paleo Success is cooking at home!  I have a wife, two hungry kids, and a full medical practice.  I also happen to be the one and only cook in my home…so, I am always looking for ways to make easy and convenient food that my family enjoys.

Some may say I have a bit of an obsession with kitchen equipment (especially my wife).  That said, no matter how big your kitchen is you eventually run out of room to store things.  So a couple of years ago when I started to look into Sous Vide technology to say that my wife was a little cold on the idea would be an understatement.  She was convinced that this would be another high dollar toy to collect dust in the pantry (I would like to say, there are none of those to speak of…:).  After several years, my Sous Vide is still going strong, and even my wife has admitted to me that it was probably the most useful appliance we have ever bought to cook with!  Now that’s saying something.  I use my sous vide so much that it has a permanent place on our kitchen counter because it is pretty much always on!

If you have ever uttered the words “I just don’t have time to cook”, the sous vide could be the answer you have been looking for. When I mention the sous vide to others they are usually intrigued and completely in the dark about the technology.  That’s why I decided why not do a blog post on it and see if we can get more people perfectly cooking meals at home!

The Concept:  Sous Vide is French for “Under Vacuum.”  This method of cooking uses a precisely controlled water bath to cook food that is vacuum sealed in airtight plastic bags.  To do it you need a vacuum seal device like your typical Food Saver, and a way to precisely control a water bath’s temperature.  By cooking food in this way you assure that the food is always cooked to the precise temperature that you would like, and you never have to worry about ruining that expensive piece of meat you bought!  In the end it is a very simple concept: cook food to precisely the right temperature to get optimum results (oh, and it can’t be any easier to do).

All you do is decide on what you want to cook, soak it at the appropriate temperature for an adequate amount of time, and finish it off with a quick sear to achieve the crispy brown exterior that adds so much to the flavor of meat.  Now the science behind sous vide cooking is extensive, and can be very complex, but you can keep it pretty simple by experimenting with cooking times on your own and never rushing the process.  Check out this page at for specific cooking times, or totally geek out with the Sous Vide Dash mobile app to better control your cooking times!

The most important thing to remember is my opinion is to adequately season your food before vacuum sealing AND before searing.  This leads to the most consistent results and great flavor.  In addition, don’t forget to thoroughly DRY off your meat prior to searing or you just won’t get the amazing results your food deserves.

The Cost:  You can spend thousands on amazing sous vide systems, but unless you are commercial chef there is absolutely no need.  I use the Sous Vide Supreme Demi that I paid $329 on Amazon for (you can spend an extra $100 for the slightly larger standard side Supreme).  I also bought a Food Saver vacuum machine from Sam’s Club for around $130, and I was ready to go.  Is this equipment cheap? Absolutely not!  Is it worth it, I would have to say every penny.

Sous Vide Supreme has a home on my countertop.

Sous Vide Supreme has a home on my countertop.

The Convenience:  Most large pieces of meat take hours to cook in the oven, and the results are often variable.  You cook a Ribeye roast and the outer parts are overcooked while the interior can be a bit raw.  A very expensive piece of meat normally turns out good, but why risk it and instead always make it great!  Lets say you have a 4 pound Ribeye roast and you want to cook it perfectly rare/medium rare.  Hands on time includes getting it out of its packaging and seasoning it.  Next you place it in a Food Saver bag and seal it.  So far, total time, maybe two minutes.  Get your Sous Vide out, fill it with water, set it to your desired temperature (I prefer 130F for beef), and place your roast inside.  Using a chart or the mobile app you can easily determine the minimum time needed to cook your roast.  The key is that you find out the MINIMUM time, but that is not a MAXIMUM time!  You cannot overcook your meat, as it will never go above 130F no matter how long it sits in the water.  Let’s say it takes 5 hours to cook, you can leave it 8-9 hours until you get home from work without any issue whatsoever.  In fact, with tougher cuts of meat I often cook them for 24-72 hours.  I’m sure you can keep meat in too long and it will mess with the texture, but I have yet to have any major issues with that.  The key is that under most circumstances, the meat can wait for YOU to be ready to finish it off, not vice versa.  Once I get home I put a cast iron skillet on full blast gas to heat up while I take the roast out of the bag and thoroughly dry it.  I add a little more seasoning and brown it on each side in a little coconut oil for 30-45 seconds.  Total hands on time for the roast 10 minutes MAX, and the results are perfect.

Ribeye Roast drying off

Ribeye Roast drying off

Finished Ribeye Roast (Notice edge to edge perfection)

Finished Ribeye Roast (Notice edge to edge perfection)

This convenience aspect is why we love the sous vide so much.  The main part of our dinner many nights is perfectly cooked animal based protein, and the sous vide makes it amazingly easy to prepare with very little time invested.  I have cooked countless cuts of meat this way, and I am yet to have a problem with the results.

Here are two more things to keep in mind when it comes to the convenience of sous vide cooking.  Lets say you find a good deal and want to buy some meat in bulk…you are likely going to freeze some of your bounty.  Simply season the meat, vacuum seal it, label it, and stuff it in the freezer.  When it comes time to cook your meat no need to defrost it, simply stick it into the sous vide at the right temperature frozen, and add an hour or so to the cooking time.  Perfect meat, straight from the freezer, and no time consuming defrost!

Lastly, how many of you have had this happen?  You plan to make chicken thighs for dinner and they are soaking away in the sous vide.  For whatever reason you end up staying out later than you want, the kids get hungry, and you take them to a local eatery for dinner to less complicate your life.  What to do with the thighs?  When you get home take them out of the sous vide and dunk them in a cold water bath.  Once completely cooled place them, bag and all, into your fridge.  In the next day or two simply pop them back into the pre-heated sous vide for an hour to heat them through and proceed with dinner as usual!  I have even frozen completely cooked sous vide meat as an experiment and reheated it straight from the freezer.  Meat was perfect…you just can’t seem to go wrong.

The Consistency:  I can’t tell you how nice it is to know that what I cook will be perfectly cooked to my family’s liking every single time.  As many of you we spend the time to source our meat locally and make sure it is raised in a healthy and responsible manner.  Those of you who do the same no doubt know that this meat does come at a cost.  Nothing aggravates me more than taking an expensive piece of meat and not having it come out just right…or even worse, totally killing it!  That simply does not happen with the Sous Vide.  It’s 100% guaranteed to be perfect if you can just set the temperature right and cook it long enough.

This consistency also leads to enjoying meat at it’s best.  While beef is often cooked rare and enjoyed that way (my 7 year old daughter recently sent a steak back at a restaurant because it was medium…much to done for her!), other meats in particular pork are often overcooked for fear of food borne illness.  When you calculate the time to cook meats you can calculate the time for the core of your meat to reach a certain temperature, or you can calculate the time to Pasteurize the meat to the core.

Sous Vide Dash for iPad

Sous Vide Dash for iPad

That means you can cook a pork tenderloin or roast to medium long enough to kill any potential bacteria, and finally be able to enjoy amazingly juicy pork!  I had honestly given up on pork tenderloin as it always turned out too dry for my liking no matter what I did!  The sous vide has brought all pork back to my kitchen, and I am amazed at what I was missing with poor temperature control!

The Versatility:  To say you can cook anything in the Sous Vide is not an over-statement.  I have cooked just about every type of animal and cut of animal out there, and I have gotten amazing results.  Want to cook seafood? Go for it.  Veggies? Have at it.  You can even cook eggs in a sous vide!

The Results:  If you have not figured it out yet, the Sous Vide has led to some of the most amazing meat dishes I have every made, with little to no energy expended on my part.  I never have to worry about how dinner will turn out.  Here are some examples of dinners from my Sous Vide Supreme.

Searing off a roast in the cast iron skillet

Searing off a roast in the cast iron skillet

Sliced Roast, perfectly cooked

Sliced Roast, perfectly cooked

Sealed and ready for a dip!

Sealed and ready for a dip!

Steaks dried off before the sear

Steaks dried off before the sear

Finished Steak

Finished Steak

Grass Fed Chuck Roast

Grass Fed Chuck Roast

Finished Roast

Finished Roast

Chicken Thighs ready for searing

Chicken Thighs ready for searing

Chicken Thighs, Skin Crisped to Perfection

Chicken Thighs, Skin Crisped to Perfection

Crispiest Chicken Thighs ever

Crispiest Chicken Thighs ever

Grass fed roast being sealed

Grass fed roast being sealed

Roast out of the Sous Vide

Roast out of the Sous Vide

Finished and perfectly cooked roast

Finished and perfectly cooked roast

Pork roast completed

Pork roast completed

Perfectly cooked Pork Roast

Perfectly cooked Pork Roast

I hope this has given you even a little bit of interest in Sous Vide cooking!  There is no doubt that the cost of the equipment to cook this way can be hard to afford.  All I can tell you is that I have owned my fair share of kitchen equipment in my day, and I would be hard pressed to find a more valuable member of my cooking arsenal than my fancy water bath.  Have experience with a Sous Vide of your own?  Share your experiences and new ideas on what to throw in and at what temperature!  Here are some useful links for Sous Vide cooking!

Nom Nom Paleo – Amazing food blog that first peaked my interest in Sous Vide Cooking.  I really can’t tell you guys enough how much you need to check out Michelle’s blog.  It’s beautiful, witty, and delicious!  Check out her recipes and her iPad app that includes many recipes specific to Sous Vide.  The chicken thigh recipe above?  All Nom Nom!

Sous Vide Supreme – Makers of what I think are the most affordable and easy to use Sous Vide cookers for the home cook.

Douglas Baldwin – Expert if Sous Vide Cooking and Non-Linear Waves

Modernist Cuisine – Great article on “Why cook Sous Vide”

Sous Vide Cooking – A Blog all about Sous Vide Cooking!


Posted by on April 30, 2013 in General Paleo Discussion


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Restless Leg Syndrome: Is Your Diet Related?

As an everyday part of my sleep practice, I often see patients who complain of problems falling asleep due to symptoms in their legs when they get in bed. It can be anything from “restlessness” to “deep pain” in the legs, but almost always follows a typical pattern. What these patients suffer from is called Restless Leg Syndrome (RLS), and it is more common than you may think. Lets learn a little about it, and investigate whether or not diet can either lead to, or relieve the symptoms of this often misunderstood condition.

Epidemiology: The numbers vary widely in the literature as far as the overall prevalence of RLS across the population, but it’s safe to say 5-10% of Americans suffer from some form of RLS throughout their lives. Importantly, this is not just a disease of adults, as it is felt that the overall prevalence is similar in children as well. In these children, RLS symptoms are often misdiagnosed as “growing pains” and the sleep disruption it causes often leads to night after night of unrestful and disjointed sleep. When adults get tired we get sleepy, when kids get tired they get cranky, agitated, disruptive, and even hyper. Needless to say, many experts believe unrecognized RLS in kids could account for a good number of cases labeled as ADHD. As in many things in sleep medicine, this remains controversial.

Pathogenesis: RLS can be grouped into two main categories, as can many disease states; it is either primary or secondary.

Primary RLS is idiopathic, meaning there is no real identifiable cause. Observational studies point to it being a genetic disease with autosomal dominant inheritance. The underlying genetic defect occurs somewhere in the metabolism of dopamine in the central nervous system, although imaging studies using SPECT and PET imaging of dopamine producing areas have produced often conflicting data. Given that Parkinson’s disease is clearly known to be related to dopamine defects in the CNS, and the fact that Parkinson’s medicines have been successfully used to treat RLS, this is an important area of current research in Neuroscience.

Secondary RLS is felt to be caused by a number of other conditions; in other words, RLS is a symptom of these problems. Here are a few of the most common (and the one we are most interested in).

-Iron Deficiency – Since the original description of RLS, iron deficiency has been considered one of the most likely causes. Study after study have consistently showed decreased iron stores (ferritin) in RLS patients vs. controls. MRI estimates of brain iron concentration in the substantia nigra (the area that makes dopamine) have also been consistently lower in RLS patients. That said, these findings are FAR from universal, so it is only part of the story.

End-Stage Renal Disease – If you take care of hemodialysis patients for very long, you quickly hear the same complaints of RLS pop up time after time. The cause of RLS in these patients has many theories, from iron deficiency to low parathyroid hormone (PTH) levels. Research is ongoing.

Diabetes Mellitus – RLS often co-exists with peripheral neuropathy and can be quite debilitating.

Multiple Sclerosis – The data on RLS and MS is in its infancy, but I can tell you that over half of my MS patients have clear RLS. There is a connection.

Parkinson’s Disease – Although dopamine is related to both conditions, studies have failed to consistently find a link between RLS and Parkinson’s. This is frustrating as both disorders clearly point to the substantial nigra in the CNS as to location of disease. Our hope is that a breakthrough in one disease will lead to a ray of hope in the other. Only time will tell…

-There are many other disease states related to RLS, and often listed in the miscellaneous file are vitamin deficiencies and obesity. We’ll talk more about them later.

Clinical Manifestations and Diagnosis: Here is how describes RLS.

Although the subjective symptoms of RLS are often difficult to describe, the clinical features are highly stereotyped. The hallmark of RLS is a marked discomfort in the legs that occurs only at rest and is immediately relieved by movement. The abnormal feelings are typically deep seated and localized below the knees. Distribution is usually bilateral, but some asymmetry may occur and the arms can be affected in more severe cases.

Terms that patients use to describe the symptoms include crawling, creeping, pulling, itching, drawing, or stretching, all localized to deep structures rather than the skin. Pain and tingling paresthesia of the type that occurs in painful peripheral neuropathy are usually absent, and there is no sensitivity to touching of the skin.

Symptoms typically worsen towards the end of the day and are maximal at night, when they appear within 15 to 30 minutes of reclining in bed. In severe cases symptoms may occur earlier in the day while the patient is seated, thereby interfering with attending meetings, sitting in a movie theater, and similar activities. In milder cases patients will fidget, move in bed, and kick or massage their legs for relief. Patients with more severe symptoms feel forced to get out of bed and pace the floor to relieve symptoms.

The International Restless Legs Study Group proposed the following four features as essential criteria for the diagnosis of RLS:

1) An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. Sometimes the urge to move is present without the uncomfortable sensations, and sometimes the arms or other body parts are involved in addition to the legs.

2) The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.

3) The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.

4) The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night. When symptoms are severe, the worsening at night may not be noticeable but must have been previously present.

Dietary Treatment: There are tons of resources on the internet about standard pharmacologic treatment of RLS, and that is not the main topic of this post. What we are going to look at now is common non-pharmacologic treatments for RLS, in particular diet related treatments. Let’s see where this takes us!

According to the RLS Foundation there are multiple foods that should be avoided in order to minimize or eliminate RLS symptoms. These include caffeine, alcohol, ice cream, as well as pasta and bread.

Now you all know this is a Paleo blog, and are you seeing what I just saw? Pasta and bread??? Why? We all know why…say it with me…GLUTEN!

Both Celiac Disease(CD) and Gluten Sensitive Enteropathy (GSE) lead to abnormal small intestine mucosa due to inflammation. This inflammation leads to malabsorption, and this is the pathway which connects it with RLS. We saw above that a classic cause of secondary RLS is iron deficiency anemia. We all know gluten is indigestible by the human small intestine, and it causes some degree of inflammation for anyone who eats it. People with CD or GSE have pathologic inflammation in their gut, thus making it impossible for them to appropriately absorb dietary iron. Give these people long enough and their ferritin and iron levels get low enough to put them at risk for developing RLS symptoms.

So how related are CD and RLS? Lets look at some clinical data for answers. One study showed the incidence of RLS in CD patients to be 35%, of these, 40% also had iron deficiency. In another study, 31% of CD patients had RLS vs only 4% of the control group. Also, iron levels in this study were statistically significantly lower in the CD patients with RLS than in those without the disease. BUT, after all was said and done, no clear correlation was found in this study between RLS and either a gluten free diet or iron metabolism.

Yet another study showed that GSE antibodies were NOT associated with RLS unless there was an associated underlying anemia. Everyone confused yet?! Let’s look at one more thing before we try to figure all this out.

Interestingly enough, another commonly recognized cause of secondary RLS is magnesium deficiency. Many people with RLS are amazed to see a rapid resolution of symptoms simply by taking OTC magnesium supplements…but not all get relief. Why do some get relief, and some not? Why do very controlled studies show some people get complete resolution of RLS symptoms when adapting a gluten free diet, and other get no relief at all?

Conclusion: Lets say your mom has RLS, and her mom had RLS, and her dad had RLS…what are your chances? I would say pretty good. In this case, there is clearly a autosomal dominant gene being passed down through the generations causing RLS. That gene leads to a yet unknown defect in dopamine metabolism in the substantia nigra of your CNS, and thus to your RLS. Gluten is no where in this picture! Although many want to believe that Paleo can fix everything, it simply can’t. Lets say one day your car stops running, and after checking it over you realize it’s just out of gas! You fill her up and she fires right up. I think we would all agree that your view is skewed if you believe that no matter what happens to your car, if it stops running, all you need to do is put gas in and it will work. Gas is not the only necessary part of your car to make it run! Likewise, gluten is just a piece of the puzzle.

That said, gluten can be and often is an important issue to address in RLS. What is the pathway to a gluten free diet improving RLS symptoms? First of all, you have to have RLS that is secondary in nature, not primary. Next, the cause of your RLS needs to be either iron deficiency anemia or magnesium deficiency. (I by no means believe these are the only two nutritional causes of RLS, but they are the most common and most studied) Now, if your iron or magnesium deficiency is caused by malabsorption from CD or GSE, you may be in luck! This pathway explains why we have such variable results in studies concerning gluten, iron metabolism, and RLS. For someone’s RLS to respond positively to a gluten free diet they not only need to have an underlying gluten problem, but that problem must also be leading to clinical iron or magnesium deficiency. If we look at one of the studies above where the incidence of RLS in CD patients was 35%, and only 40% of those had iron deficiency; that means a gluten free diet will likely only help 40% of 35% of the original study population! Even that is if you get 100% response to the diet in those who are “primed” to respond.

One of my biggest messages I try to get out through my blog is that although adapting a Paleo diet can do amazing things for your life and for your health, it can not substitute for traditional Western medicine in every instance. If your RLS is related to dopamine (in other words, genetically handed down), and you want relief of your symptoms, it’s best if you see your doctor and get a prescription for medicines that will increase dopamine in your CNS. You can go gluten free forever and never get the results that you need. Do not become single minded, it won’t get you anywhere but walking around at midnight again frustrated and tired.

In the end RLS is a very important cause of morbidity in America, and around the world. How do I use this information in my practice?

-In RLS patients I often recommend a trial of gluten free diet to see how symptoms respond, particularly in patients with no family history of RLS, or a positive family history of CD.

-In iron deficiency anemia patients who fail to respond to iron replacement, I often test them for CD as an underlying cause of malabsorption.

Think you may have RLS? Talk to your doctor or contact a local board certified sleep physician to get evaluated. I often used to tell patients that RLS would not kill them, it would just make them want to kill themselves. Recent data showing how short sleep times, in and of themselves, can increase overall mortality has me changing my tune. That topic though…is for another blog post in the future!

I hope this post finds you all well, God Bless.


PS – Because it’s fun to share, I thought I might give yall my two favorite “home remedies” that I’ve heard over the years for treating RLS. Now please, I DO NOT RECOMMEND THEM, just sharing. One gentleman told me his best method was putting homemade charcoal in a sock, smashing it up a bit, and rubbing the sock all over his legs before bed time. The blacker his legs got, the better he said he slept.

This can only be outdone by the man who told me after years of experimenting, he found that rubbing paint thinner on his legs at bedtime led to a nice sound sleep…….. I quickly made sure neither he or his wife smoked! You just can’t make this stuff up…!


Restless Leg Syndrome Foundation: About RLS Section on RLS

Dig Dis Sci. 2010 Jun;55(6):1667-73. doi: 10.1007/s10620-009-0943-9.

Celiac disease is associated with restless legs syndrome.

Weinstock LB, Walters AS, Mullin GE, Duntley SP.

Source Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63141, USA

Mov Disord. 2010 May 15;25(7):877-81. doi: 10.1002/mds.22903.

Restless legs syndrome is a common feature of adult celiac disease.

Moccia M, Pellecchia MT, Erro R, Zingone F, Marelli S, Barone DG, Ciacci C, Strambi LF, Barone P.

Source Department of Neurological Sciences, University Federico II and IDC Hermitage Capodimonte, Naples, Italy.

Acta Neurol Belg. 2011 Dec;111(4):282-6.

Prevalence of gluten sensitive enteropathy antibodies in restless legs syndrome.

Cikrikcioglu MA, Halac G, Hursitoglu M, Erkal H, Cakirca M, Kinas BE, Erek A, Yetmis M, Gundogan E, Tukek T.

Source Department of Internal Medicine, Bezmialem Vakif University, Medical Faculty, Fatih, Istanbul, Turkey

Sleep Med. 2009 Aug;10(7):763-5. doi: 10.1016/j.sleep.2008.07.014. Epub 2009 Jan 12.

Celiac disease as a possible cause for low serum ferritin in patients with restless legs syndrome.

Manchanda S, Davies CR, Picchietti D.

Source University of Illinois at Urbana-Champaign, College of Medicine, 506 S. Mathews Avenue, Suite 190, Urbana, IL 61801, USA.


Posted by on April 23, 2013 in General Paleo Discussion


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In Defense of Paleo: No WORDs Needed!

Courtesy of a Quick Google Images Search or Two…




Carb Consumption/Obesity DIRECTLY Proportional


Adult Obesity Related Diseases

Incidence of Diabetes

Incidence of Childhood Diabetes

Incidence of Vascular Disease (Flat Line)

Incidence of Heart Attack (Flat Line)

How Many Are Diet/Obesity Related?



The End…



Posted by on September 10, 2012 in General Paleo Discussion


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A Real “Genesis Experience”: 6 WLS Patients and How Paleo Changed Their Lives

Well Hurricane Issac came our way and thankfully we were spared any significant weather.  Many folks south of us are still struggling, and I ask for everyone to pray for their safety and a quick resolution to the chaos that has come into their lives. On top of the hurricane, much has been going on…where to begin…

Several months ago two of my friends and I decided to try something new.  All three of us follow a Paleo lifestyle, participate in CrossFit (each on very different levels as William is part owner of our local gym and one of the it’s trainers, and Sam has been attending CrossFit for much longer than I) and have a passion for helping others.  William Albritton is an engineer by trade, but spends all of his spare time as a CrossFit trainer and health coach.  Sam Bledsoe is somewhat of a rarity as I’m almost certain he is the only Paleo Bariatric Surgeon in the country!  He identified a group of his successful weight loss surgery (WLS) patients who had stopped losing weight after surgery, or plateaued.  He and William devised a plan to put them in an 8 week program based on strict Paleolithic nutrition and consistent application of CrossFit…lucky for me they asked me to join in the fun!  In total, there were 6 lucky participants.

Looking back at our first meeting it was pretty comical.  They really did not know what they were getting into, and we had to completely define the term “paleo” to them.  We set about explaining to them what and why we eat the way we do, and in the process I think I may have broken a few hearts.  Who knew what a stronghold someone’s oatmeal could be!  Regardless, they are all people of integrity, and they committed to our program by trusting our judgement.

So lets just look at this for a moment.  How much more difficult of a challenge could we ask for?  Here are 6 individuals who have fought their weight their whole lives, and who have lifelong food relationships that often were unhealthy.  When you have WLS a certain amount of weight loss is almost automatic, but the last of the loss is much harder.  Here is the thing though, each of these individuals was working hard through traditional weight loss regimens.  Low calorie, low fat, exercise at the gym when you can, walk when you can’t get to the gym…it just was not working.  There is a misconception that overweight individuals are inherently lazy, and this group of people blow that mold out of the water.  They were all trying, they were just trying the wrong things.  One of our group members had already lost 120 pounds since surgery, but had only lost 5 pounds in the 6 months or so before our challenge.  Bottom line is that they did not necessarily “get” what we were telling them, but they were willing to try something new.

So began the process, some form of exercise 5-6 times a week, half of them being CrossFit WODs, and the other days much more light walks or runs.  All along we held them accountable to following a Paleo regimen by turning in weekly food logs and helping them sort through the best choices to make.  Each had their own issues at the start, but they all worked hard to get through the beginning, and quickly began to thrive.  Their group workouts became a source of encouragement and our consistent interaction with them kept their eyes open at all times.  Slowly the magic started to happen, but they did not know exactly how much magic.  Why?  We strictly prohibited them from weighing themselves over the 8 weeks.  It was time to worry about health, not weight!

The results of our 8 weeks was amazing, and I’ll let two things do the talking.  First is a chart of the results.

The numbers in the first row are where each person started, the middle row is their end measurements, and the bottom row is the difference between the start and finish of the 8 weeks.  You are reading right, each person averaged around 20 INCHES of loss over the program.  Now THAT is results!

Please notice that even though overall weight loss was not earth shattering for all, the number of inches lost and overall improvement in body “tone” was awesome.  We did not have one unhappy participant!

Second I’ll let everyone read an essay that one of our participants wrote at the end of the program.  He is an amazing gentleman whose transformation following WLS and our program is nothing short of remarkable.  Here is what he had to say…

At the end of our journey we had a little get together at my home where we were all able to talk and share about the program, and we enjoyed some amazing Paleo food (including a healthy dose of @FitPaleoMom’s Chocolate Chip Cookies).  It was so inspirational to hear everyone’s stories about the struggles over the years, and the positive light that our program was able to put on their circumstances.  All six participants have officially joined CrossFit, and the road ahead will be nothing but success for them.  As a physician is it easy to get discouraged in the day to day grind of taking care of people.  I can honestly say at the end of the 8 weeks we owed, and gave, a heartfelt thanks to each participant for giving their all, and reminding us how much of a difference we all can make.  It was one of the most enjoyable journeys in both my personal and professional life.

So what do we do from here?  We have decided to spread the wealth and open our program to all comers in our area. [] We want to keep attracting people who would never consider coming to the gym and helping them revolutionize their lives.  People looking to “forge elite fitness” will find the gym, we need to go out and FIND everyday people who stand to benefit so much from a dramatic lifestyle change.  As a physician this is what really excites me, changing lives that have been abandoned and failed by the “system”.  If 6 WLS patients can see these changes, anyone can!

Hope all are well…



Posted by on September 3, 2012 in General Paleo Discussion


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My Take on the New Diet Pills Approved by the FDA (Do You Really Need to Ask!)

I’m sure many of you have seen that two new “Diet” pills were recently approved by the FDA.  Once I saw this, I braced myself for the inevitable flood of people coming to my office asking to be prescribed the latest quick fix; and as expected, I was not disappointed.  I’ve had at least 10 people over the last month ask for one of the new pills, and I thought this would be a great topic to discuss in this setting.  I’ve mentioned in prior posts that in my 15 years of training and private practice I have prescribed diet pills a grand total of ZERO times.  So, will these new medicines change my habits?  Lets look and see what we got.

Qsymia is a combination of phentermine and topiramate and has been approved by the FDA for “chronic weight management in adults who are obese, or overweight with at least one weight-related medical condition such as high blood pressure, Type II Diabetes, or High Cholesterol”.  [I would vote that these conditions, although they are “weight” related, should be more properly described as “nutrition” related…but I digress]  That is a quote from the product web page, and lets keep the information coming from the same source, the producers of Qsymia:

-The effect of Qsymia on cardiovascular morbidity and mortality has not been established. [emphasis added]

-The safety and effectiveness of Qsymia in combination with other products intended for weight loss…has not been established.

-Qsymia can harm your unborn baby.

-Qsymia can increase your heart rate at rest.

-Qsymia increases the risk of suicidal thoughts or behavior.

-Qsymia may affect how you think and is associated with difficulty with attention and concentration, memory, and word-finding. Therefore, use caution when operating hazardous machinery, including automobiles [emphasis added]

-The most common side effects seen in Qsymia clinical studies were tingling in the hands and feet, dizziness, change in taste, trouble sleeping, constipation, and dry mouth.

Because Qsymia contains phentermine (a pharmacologic cousin to amphetamine) it is classified as a federally controlled substance, indicating it can be abused or lead to drug dependence.  It’s basic mechanism of action is to reduce hunger and increase the release of serotonin and dopamine in the brain.  It’s important to note that topiramate, also known commercially as Topamax is a seizure and migraine medicine that just so happens to make people feel full.

The other drug recently approved is called Belviq (lorcaserin hydrochloride) and is approved for essentially the same indications as Qsymia.  Again, let’s look at the package insert for some indications and cautions:

-The safety and efficacy of coadministration with other products for weight loss have not been established

-The effect of Belviq on cardiovascular morbidity and mortality has not been established [emphasis added]

-Warnings and Precautions were listed for:

1) Serotonin Syndrome or Neuroleptic Malignant Syndrome – which means this drug should be VERY cautiously given with traditional antidepressants

2) Valvular Heart Disease

3) Cognitive Impairment

4) Psychiatric euphoria and dissociation

5) Monitor for depression or suicidal thoughts

Most common adverse reactions (greater than 5%) in non-diabetic patients are headache, dizziness, fatigue, nausea, dry mouth, and constipation, and in diabetic patients are hypoglycemia, headache, back pain, cough, and fatigue.

Belviq’s mechanism of action is that it stimulates brain receptors for serotonin, a neurotransmitter that initiates feelings of fullness.  Basically, both of these drugs try to trick your brain into thinking that you are full.

So, will I prescribe any of these medicines for my patients?  Well you guessed it, the answer is no!  The reason is simple, SAFETY.  We may all remember Fen Phen, a diet pill from some years back that was taken off the market due to causing serious valvular heart disease resulting in congestive heart failure.  I remember vividly being called to the ER soon after I moved back to Louisiana to admit a young lady with heart failure.  I remember thinking it odd that a 32 year old female would be in severe heart failure, but the mystery was revealed once I got to the ER and spoke to her.  Turns out she had taken Fen Phen for TWO WEEKS in an effort to lose a few pounds and fit in a dress for a friend’s wedding.  She developed severe Mitral Valvular Heart Disease and resultant heart failure.  She had a valve replacement, but it never worked well and she had severe chronic congestive heart failure as a result.  The look on her face telling me the story said it all…”I was an idiot, looked for a quick fix, and look at me now.”  I really felt bad for her.

A year ago both of these drugs came up for FDA approval and they were denied…why?  They were not felt to be safe from the cardiovascular standpoint, and both seemed to have significant teratogenic effects.  It is simply not known if these drugs can potentially cause the same valvular heart disease that Fen Phen caused.  Now look, I’m not at all saying they will, but information from the MANUFACTURERS themselves clearly state that the risks are unknown.  Also not, the Phen is Fen Phen…yep, it’s short for phentermine.  The FDA stated that the medicines were given approval essentially because doctors needed “something” to combat the worsening obesity epidemic.  I see it as a basic act of desperation from the FDA, and truthfully I understand their viewpoint on this.  Do I agree with it? No, but I understand where they are coming from.  Regardless, this physician won’t be writing out scripts for these meds any time soon.

Now that I got this out of the way, let me make one simple point for anyone out there considering asking their doctor for one of these pills.  There is the misconception out there amongst many people that diet pills are an answer.  Some great conspiracy is holding back doctors from prescribing these meds and we should all be thinner and get to eat more of the things we want without consequences.  Well, let me ask you a few questions…

-If these pills worked, would there be ONE FAT DOCTOR IN THE WORLD? I may not be able to prescribe these meds for myself, but I certainly have 50 buddies on speed dial that could.  Think about it!

-Let’s take it a step farther, would there be any fat people in the world at all, especially those with money? Ever seen a fat rich person?  Sure!  There are plenty around.  Would there be ONE FAT RICH PERSON in the world if it was as easy as finding the right pill?

If you make a statement about your plan to lose weight, and the word “diet” is somewhere in the sentence, just give up because you are going to fail.  By definition a diet is something you are either “on” or “off”.  You will likely lose weight while on it, and gain it back when you get off it.  So essentially all “diets” will result in a yo-yo affect to your weight.

One other thing, the FDA has approved these medicines as “an addition to a reduced-calorie diet and exercise program.”  They are not designed to simply remove the weight without requiring any effort from the patient.  What does that mean?  If you simply take the pills and do not change any of your already bad habits…you will fail again in improving your health longterm through significant weight loss.

There are certain things in life that are easy, and some that are hard.  There are also differences in how difficult or hard those same things are for some to achieve versus others.  Take a look at this well demonstrated problem in America…

Obesity is a very complex problem and it’s rise in America is multi-factorial: lack of exercise, reliance on cheap food built on the backbone of highly processed carbohydrates, poverty, lack of nutritional education, reliance on “quick-fixes” as a society, government subsidies on corn and soy, the gradual extinction of cooking at home combined with increasing numbers of families chronically obtaining dinner through the car window, lack of sleep, an abundance of stress (and cortisol) in our lives!, manipulation of the food supply to promote weight gain, etc.  I could go on and on.  So, REALLY, does ANYONE think a little pill can even put a dent in any of this?

How do we fix obesity?  Well, it’s not easy, but we must get at the root cause if we are to get anywhere.  My motto is Real Food…Real Health.  In the end, the beginning of the end of obesity must itself begin with a transition back to eating Real Food as a society.  I’ve seen it around the web and twitter as JERF (Just Eat Real Food).  This must start on an individual level, with individual families deciding that enough junk is enough.  My family has made that choice, so can yours!

Know anyone thinking about asking their doctor for one of these new pills?  Invite them to read this post, and then ask them to join you on a journey to Real Health by emphasizing Real Food in their life again.  Need more information?  Browse around my blog for ways to change your life.  Are you a reader, check out It Starts with Food by my friends Dallas and Melissa Hartwig.  Don’t know where to start?  Easy…JERF!



Posted by on August 25, 2012 in General Paleo Discussion


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