December 2010

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The results from the Reader Survey are in. 147 people responded (thank you!). The drawing winners will be notified early next week and will have their choice of $75 off a Paleo Detox Program or $50 off a Case Review.

Click the thumbnails below for full-size screenshots of the survey results, and click here to view the survey results in a separate window.

Graph of survey results for next blog series
Survey results for class series topics
Survey results for preferred learning formats
Survey results for obstacles to getting care

As you can see, Balancing Male & Female Hormones just barely edged out New Paradigm for Autoimmune Disease as the topic for the next series. So I’ll begin with hormones next, and then move on to autoimmunity. However, I’ll probably write some solo articles prior to starting the next series.

The most popular topics for the online class series are optimal nutrition, digestive health, movement & exercise, thyroid and autoimmune disease. See below for more information about these classes will work.

Blog posts are by far the most popular learning format, followed by eBooks, special reports and podcasts. I’m hoping to cover all of these formats in the coming year.

For those who need care but aren’t getting it, the top two reasons were “can’t afford it” and “can’t find a good practitioner in my area”. One of my goals for 2011 is to offer options for care that are accessible to people living outside of the SF Bay Area, as well as those with limited economic means. Again, see below for more on this.

New programs, products & services for 2011

I’ve got a number of things in the works for 2011:

  • The Paleo Detox Program. This is a 30-day, supervised anti-inflammatory program incorporating a paleo-type elimination diet, high quality supplements and botanicals, and guidelines for stress management and exercise. It can be done individually, or as part of a group, and both options are available in-person (SF Bay Area) and long-distance (worldwide). The first group starts in February. For general information, visit For more information about the February group, visit
  • Online class series. I’m planning an online class series on various topics. Each series will last 6-weeks, with one 1.5 hour class each week, covering a single topic (i.e. optimal nutrition, digestive health, thyroid, etc.). The classes will be conducted via webinar and accessible to anyone with an internet connection and either a telephone, computer headset or Skype. Each class will begin with a slide presentation and conclude with a Q&A period. I’m excited about this format because I think it will address, at least in part, the two most common reasons people aren’t getting care: the expense, and not being able to find a practitioner in their area. I’m hoping to launch the first class series in April, and the topic will probably be either Optimal Nutrition or Digestive Health. I’m also planning to make each series available on DVD for those that aren’t able to tune-in to the actual class.
  • eBooks. I love eBooks myself, and judging from the survey results, you do too. I plan to write a series of eBooks on the same topics I’ve covered on the blog. Titles might include “How To Prevent Heart Disease Without Drugs”, “7 Steps to Perfect Digestion”, “Take Control of Your Blood Sugar”, etc. The series I write on the blog are quite technical and research-focused. The eBooks will be the “how-to” companion guides to the series. I haven’t decided on the first eBook topic yet, but my goal is to have it published by July.
  • Podcast. I love this format as well, and enjoyed my first two podcasts. However, I think podcasts are better when there’s an interactive element – like an interview, or a Q&A (like Robb Wolf’s Paleo Solution). I especially like the idea of a Q&A, where you could send in your questions via email, Twitter or Facebook, and I would respond to them in the podcast. It’s more fun to do that with another person, and right now that’s the missing element. Any ideas?

Facebook & Twitter

If you haven’t already, join us on Facebook and Twitter. The Healthy Skeptic Page on Facebook has over 2,000 fans, with a lively discussion on a wide range of topics related to health and nutrition. I post links to studies and articles, recipes, pictures of meals, special offers and coupons, and more. It’s also a great way to interact with other Healthy Skeptic readers who may share similar interests.

I use Twitter in a similar way, but because of the nature of the medium, I end up posting a lot more links to studies, articles & recipes there than I do on Facebook.

Site redesign

Quite a few people mentioned that they like the site design in the surveys, and I do too. That said, I’ll be launching several new programs and services next year and the current site isn’t well-organized to accomodate them. Also, it’s lacking some important “under-the-hood” functionality. So I’m going to be doing a fairly significant site upgrade and redesign in the next month or two.

Interview with Jimmy Moore on Livin’ La Vida Low-Carb

On January 12th I’ll be recording an interview with Jimmy Moore from the Livin’ La Vida Low-Carb Show. We’re going to chat about cholesterol, statins, diabesity and anything else that comes up. The show will be episode 464 and will air on April 14th, just before Jimmy’s interview with Dr. Uffe Ravnskov (a pioneering cholesterol skeptic). Cool!

I’m going to be a dad!

Finally, a bit of personal news. My wife is 3 months pregnant and we’re expecting a beautiful baby in July. I’m so excited.

Obviously things will slow down a bit here at the blog in the summer, as I’ll have my hands full with a new baby and a busy private practice. But as you can see above, I’m hoping to get a lot accomplished between now and then.

I’ve also naturally been doing a lot of research these past few months on maternal nutrition for conception, pregnancy and breastfeeding, so it’s possible that this could end up being the topic of a class series, or at least a few blog posts.

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Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

Food fascism and the 80/20 rule

picture of facism cartoonOver the past few months I’ve been writing a lot (here on the blog, and on my Facebook page) about the benefits of a Paleo diet. And while I do think it’s probably the healthiest diet for us humans to eat, I’m not dogmatic about it. At least I try not to be. I realize that I may have come off that way recently, so I want to take a few moments to clarify my position.

There’s no doubt in my mind that a Paleo diet is what we’ve evolved to eat. That’s hard to argue with. But that doesn’t mean it’s impossible to be healthy while eating foods that are not considered “Paleo”, regardless of what the Paleo zealots will tell you. Some of the foods the Paleo diet excludes are more harmful than others, and of course there’s a significant amount of individual variation.

I think the evidence is crystal clear that wheat, sugar/high-fructose corn syrup and industrial seed oils are toxic to the body and contribute to virtually all modern, degenerative diseases – from diabetes and obesity to heart disease and autoimmunity. There’s also substantial evidence that soy, in its processed form (i.e. soy milk, soy protein isolate, etc.) is an endocrine disruptor and anti-nutrient and is best avoided.

Beyond that, however, things start to get murky. The Paleo diet excludes dairy products and grains. Yet Weston A. Price identified isolated groups of people, like the traditional Swiss Loetschental, who were exceptionally healthy and subsisted primarily on a diet of bread, milk & cheese.

Strict Paleo diets also exclude potatoes, claiming that the saponins and glycoalkaloids they contain make them unfit for human consumption. Yet as Stephan Guyenet’s recent articles have revealed, it’s quite possible to eat a lot of potatoes and be perfectly healthy. In fact, Stephan’s most recent article on the subject was about a guy named Chris Voigt who ate nothing but potatoes for two months. Did he keel over and die? Did he get fat? Hardly. He not only lost weight (21 pounds), but also experienced improvements in several other markers, such as a decrease in fasting glucose & triglycerides, and presumably an increase in insulin sensitivity.

There’s a similar story with legumes and nightshades. They aren’t Paleo, but I haven’t seen any evidence to convince me that these foods play a significant role in the modern disease epidemic.

What about carbs? Low-carb diets are all the rage. And while it’s true that very low carb diets can help with weight loss, there’s no evidence that they are superior to moderate carb diets (@100g/d) for healthy people.

Here’s the thing. As convenient as it would be to have a “one-size fits all” diet that works for everyone, we’re not robots. We’re more diverse than that. Someone who’s dealing with an autoimmune disease, leaky gut, arthritis and skin rashes would certainly benefit from a strict Paleo diet and may even need to follow that approach for the rest of their lives. But for someone that is fundamentally healthy, such a diet may be unnecessarily restrictive. They might do perfectly well eating grains (other than wheat), especially when those grains have been properly prepared by soaking and/or sprouting. Dairy is similar. I have patients that tolerate it well in spite of being quite ill (they’ve removed it for long periods and added it back in without negative effects).

In Traditional Chinese Medicine, we also consider the effect of season, geographical location, constitution, state of health and lifestyle when making dietary recommendations. So not only is each person different, what works for one person at one time may not work for that same person at another time.

So with this in mind, what do I recommend people eat?

The answer, of course, depends on the person. For healthy people, I suggest they follow a high-fat, nutrient dense diet that removes the most significant food toxins (wheat, sugar/HFCS & industrial seed oils). If they do well with properly prepared grains and raw, fermented or at least organic dairy products, I don’t have a problem with that.

I also suggest they follow what I call the 80/20 rule. 80% of the time they should follow the guidelines very closely, and 20% of the time they’re free to loosen up and just eat what they want to eat. There’s a lot more to life than food, and in fact I believe (as did the ancient Chinese) that in some cases it’s better to eat the wrong food with the right attitude than the other way around.

Unfortunately, the 80/20 rule doesn’t apply to those dealing with serious health challenges or allergies or intolerances to specific foods. It’s never a good idea for someone with Hashimoto’s disease and gluten intolerance, for example, to just throw caution to the wind and have a pancake feast. That could trigger an immune reaction lasting up to several weeks.

Likewise, if someone comes to see me in my private practice and they’re dealing with multiple health problems, one thing I often do is put them on a strict Paleo diet for a short period of time. Why? Because it gives us a baseline to work from. By removing all common food toxins and observing what happens, we learn which foods may be contributing to their issues and to what extent. From there the next steps usually become a lot more clear.

Ultimately, each of my patients ends up discovering their own ideal diet through experimentation and careful tracking. Some might end up doing the strict Paleo thing indefinitely. Others find they tolerate dairy, nightshades and even properly-prepared grains (gasp!) quite well.

Where do I fit in? I’m somewhere in the middle. I avoid grains with the exception of occasional homemade sourdough buckwheat crepes (which is technically not a grain anyway), but I do eat a lot of raw, fermented dairy products like kefir, yogurt and creme fraiche. I also don’t seem to have a problem with nightshades, so I eat tomatoes and chili peppers in moderate quantities. I do, however, avoid white potatoes because I don’t feel good when I eat them.

So there you have it: my manifesto on food and health, and how to use the 80/20 rule to avoid food fascism.

Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

Reader survey and upcoming events

The last post on high intensity exercise wrapped up the series on diabesity. I’d love to get your input on topics for the next blog series as well as various classes and programs I plan to launch in the next few months, so I’ve created a brief survey.

In return for your help, I’ll be doing a drawing of completed surveys. There will be three winners, and each will receive their choice of $75 off a Paleo Detox Program or $50 off a Case Review. Make sure to enter your email address to be included in the drawing.

Please click here to complete the survey.

I’ll be giving four free public talks on the importance of detoxification in health in January. Subjects covered include the increasing toxic burden, the connection between food and environmental toxins and modern diseases like obesity, diabetes & heart disease, the role of a paleo-type diet in protecting against toxic overload, and specific nutrients necessary for proper detoxification. See below for dates. I hope to see you at one of them!

11:00am – 1:00pm @Ralph Bunche Academy
1240 18th St, Oakland, CA 94607
Between Mandela Pkwy & Adeline St. Ample on-street parking is available.

7:00pm – 8:30pm @Acupuncture & Integrative Medicine College, Berkeley
2550 Shattuck Avenue (at Blake)
10-minute walk south on Shattuck from downtown Berkeley BART

11:30am – 1:00pm @Crossfit Oakland
5741 Doyle St, Emerville, CA 94608
5 blocks west of San Pablo, just off Powell St.. Ample on-street parking.

7:00pm – 8:30pm @American College of Traditional Chinese Medicine
555 De Haro Street (at 18th), Room E, San Francisco, CA 94107
Ample on-street parking is available.

Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

sweatingI believe regular movement and exercise is essential to health. As Stephan Guyenet pointed out in a recent blog post, our paleolithic ancestors had a different word for exercise: “life“. They naturally spent a lot of time outdoors in the sun, walking, hunting, gathering, and performing various other physically-oriented tasks. They had no concept of this as “exercise” or “working out”. It was just life.

But while exercise contributes to health in several different ways, it’s not very effective for weight loss. Or, more specifically, I should say that low-intensity, “cardio” – which is how most people exercise – is not effective for weight loss.

Why cardio doesn’t work

How could this be? There are three main reasons:

  • caloric burn during exercise is generally small;
  • people who exercise more also tend to eat more (which negates the weight regulating effect of exercise); and,
  • increasing specific periods of exercise may cause people to become more sedentary otherwise.

In an example of the first reason, a study following women over a one-year period found that in order to lose one kilogram (2.2 pounds) of fat, they had to exercise for an average of 77 hours. That’s a lot of time on the treadmill just to lose 2 pounds!

In an example of the second reason, a study found that people who exercise tend to eat more afterwards, and that they tend to crave high-calorie foods. The title of this study says it all: “Acute compensatory eating following exercise is associated with implicit hedonic wanting for food.” I love it when researchers have a sense of humor.

In an example of the third reason, one study assigned 34 overweight and obese women to an exercise program for 8 weeks. Fat loss at the end of the study was an average of 0.0kg. Not very impressive. But the researchers noticed that some women did lose weight, while others actually gained. What was the difference? In the women that didn’t lose weight, the increase in specific periods of exercise corresponded with a decrease in overall energy expenditure. Translation: they were more likely to be couch potatoes when they weren’t exercising, which negated the calorie-burning effect of their workouts.

If you’re still not convinced, the Cochrane group did a review of 43 individual studies on exercise for weight loss. Study length ranged from 3 to 12 months, and exercise sessions lasted on average 45 minutes with a frequency of 3-5 times per week. The results? On average, the additional weight loss from exercise averaged about 1 kg (2.2 pounds). Meh. Assuming they worked out for 45 minutes 4x/wk over 6 months, that means they had to exercise 69 hours to lose that 1 kg.

The purpose of this rather long introduction is simply to point out that low-intensity, “cardio” exercise is spectacularly ineffective for weight loss. But that doesn’t meal all types of exercise aren’t effective.

High-intensity intermittent training (HIIT)

HIIT is a type of exercise performed in short bursts (intervals) at high-intensity. Several studies have been done comparing HIIT to low-intensity, steady-state (“chronic cardio”, as Mark Sisson calls it) exercise, and HIIT has been shown to be superior in nearly every meaningful marker.

In this study, one group was assigned to “chronic cardio”, while the other was assigned to intervals of 8-second sprints. After 15 weeks, the researchers concluded:

Both exercise groups demonstrated a significant improvement (P less than 0.05) in cardiovascular fitness. However, only the HIIE group had a significant reduction in total body mass (TBM), fat mass (FM), trunk fat and fasting plasma insulin levels.

A pair of studies done at McMaster University found that “6-minutes of pure, hard exercise once a week could be just as effective as an hour of daily moderate activity“, according to the June 6, 2005 CNN article reporting on the study.

The study itself was published in the Journal of Applied Physiology, and it revealed that HIIT resulted in unique changes in skeletal muscle and endurance capacity that were previously believed to require hours of exercise each week.

A follow-up study confirmed the results. Despite the fact that the more conventional endurance exercise group spent 97.5 percent more time engaged in exercise, both groups of subjects improved to the same degree. The group that exercised 97.5 percent more received no additional benefit whatsoever from doing so. Considering the wear-and-tear and increased risk of injury associated with that much more exercise, there’s absolutely no point to doing “chronic cardio” when you can receive the same benefits with a fraction of the time and risk by doing HIIT.

The Cochrane study I linked to earlier in the article also found that high-intensity exercise was superior to “chronic cardio”. In particular, the researchers found that high-intensity exercise led to a greater decrease in fasting blood glucose levels than low-intensity exercise.

Why high-intensity exercise is better

bbsIn his excellent book on high-intensity strength training, Body By Science, Dr. Doug McGuff explains that high-intensity training is superior to chronic cardio because it produces a greater stimulus and thus more effectively empties the muscles and liver of glucose. This stimulus can last several days with HIIT, as opposed to just a few hours with low-intensity training.

HIIT also activates hormone-sensitive lipase (HSL), which mobilizes fatty acids for energy use. This means that during HIIT, both glucose and fatty acids will be burned, leading to greater fat loss and restoration of insulin sensitivity.

High-intensity strength training: best of all?

Both high-intensity running or bicycling sprints and high-intensity strength training are effective. But I believe high-intensity strength training is probably a better choice for most, simply because the wear-and-tear and risk of injury is lower – especially if the strength-training is performed using weight machines as described in Body By Science.

This is, in fact, the method of training I’ve been doing since April of this year. I admit I was somewhat skeptical about it all before I read Body By Science. But the research and the physiology was convincing, so I decided to give it a try.

The results have been incredible. My workout varies in length between 5 and 9 minutes a week. That’s right, I said minutes. With only a few exceptions, I’ve increased the amount of weight I can lift, the time I can lift it, or both, with each successive workout. My strength has increased and my physique is, if anything, better than it was when I was lifting 3x/week for much longer periods.

slowburnAside from the Body By Science (BBS) weight workout which I perform once a week, I stay active on a daily basis. I ride my bike or walk to work or to do errands, and rarely drive my car. I go on walks in the woods or on the beach. I surf when time permits. But I don’t do anything else for “exercise”. This routine not only feels great, it fits very well with my lifestyle and it is completely sustainable. It doesn’t feel like an effort at all.

If you’re interested in this kind of training, I’d recommend picking up a copy of Body By Science and checking out their excellent blog. You can post your weekly workout results and get help and suggestions from the very knowledgeable community there – including both authors of the book, Doug McGuff & John Little, and other experienced trainers and enthusiasts.

Another option that may be more accessible for some is Fred Hahn’s The Slow Burn Fitness Revolution. Fred also has a website and blog worth checking out.

Final note to slackers: the popular excuse of “I don’t have time to exercise” is no longer valid. You’ve got 6 minutes a week to do this. I know you do.

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Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

Friday smorgasbord

smorgasbordYou’ve probably noticed that I haven’t been able to write as much lately for the blog. I’ve been incredibly busy with my private practice, launching the Paleo Detox program, preparing and delivering talks locally, developing new content like ongoing class series and an eBook, and of course continuing my research on various topics.

I’ve got one more article to write for the series on diabesity. I’ll discuss what I believe to be the most effective form of exercise for restoring glucose tolerance and insulin sensitivity. I hope to get to that this weekend.

After that, I’ll be sending out a survey to get your input on the next series, as well as several other topics related to the blog and various projects I’ve got in the works.

I hope to get back to a more regular writing schedule at some point, but with everything going on it may take a while. In the meantime, I may try out some new formats, like posting a brief summary of articles from around the web that I’ve found interesting during the week.

Here are a few from this week.

Why Is My Cholesterol So High On This Diet?

In this article, Chris Masterjohn explains why some people see their cholesterol go up (often temporarily) when they switch to a nutrient-dense, whole-foods based diet. His theory, which is plausible from a physiological standpoint, is that the temporary cholesterol elevation is occurs because these folks are curing themselves of fatty liver disease.

In any event, we know that total and LDL cholesterol are weakly correlated with heart disease, so I’m never concerned when I see people’s cholesterol go up on a paleo or nutrient-dense diet. It’s expected. Especially when their HDL goes up and their triglycerides go down, which is the typical response.

Huge Metastudy: “Non Diabetic” Blood Sugars Cause “Diabetic” Retionopathy

Throughout my series on diabesity, I’ve presented evidence that blood sugar levels considered to be “normal” by mainstream standards are anything but, and that they can lead to complications like retinopathy and peripheral neuropathy.

Jenny Ruhl blogged today about a recently published meta-analysis that confirms this once again. In the study, blood sugar levels of 117 mg/dL or above, and an A1c of 6.3 or above (both below current limits) significantly increased the risk of retinopathy. But, as Jenny points out, the safe limits are lower still, because retinopathy is one of the last complications of diabetes to appear. Heart disease risk increases as post-meal blood sugars rise above 155 mg/dL, and increases in a straight line with A1c above 4.7, becoming quite significant as it rises above 6.

Grasse Based Health: Food For Thought

In this video, Peter Ballerstedt argues that animal protein and animal fat are not only superior to grains for human health, but also more sustainable from an agricultural and ecological perspective.

The presentation is quite dry, but the information is solid and it’s definitely worth watching.

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Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

I’m excited to announce the launch of the Paleo Detox Program.

It’s an evolutionary, evidence-based approach to restoring optimal function and health. The cornerstone of the program is a paleolithic diet which eliminates common food toxins like wheat, industrial seed oils, sugar and soy. The Paleo Detox also includes a targeted blend of nutrients to remove accumulated toxins and support the detox process, as well as guidelines for stress management and exercise.

The Paleo Detox is unlike any other detox program. It’s not a cleanse or a fast. I’m not going to starve you on lemon juice and maple syrup or make you drink nothing but mealy protein shakes for a month. The goal of the Paleo Detox is to reduce inflammation, regulate the immune system and super-charge the metabolism by nourishing you with nutrient-dense foods our bodies have evolved to eat.

The Paleo Detox is available in two formats: group programs that begin 3-4 times a year, and individual programs that begin whenever you’re ready. Both group and individual programs can be done in-person (in the SF Bay Area) and online (worldwide).

To learn more about how the Paleo Detox Program can help you feel better, live longer and perform at a higher level, watch the video below and visit

The first group begins in February 2011. To sign up, click the “Sign Up Now” button on the Paleo Detox website or visit

If you prefer to do an individual program, you can sign up anytime simply by contacting me through my professional website.

Finally, please pass this on to anyone you think might benefit. Getting started with a paleo diet can be a challenge. The Paleo Detox Program is designed to support and guide you through that process, so you can reap the benefits of a nutrient-dense, toxin-free diet.

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Need help? I consult with patients locally in the SF Bay Area and around the world via telephone & Skype. Please contact me to learn more.

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