ALL my PaleoFX notes, as promised!

First off, I’d just like to say thank you to all the women (and men!) out there who left me such beautiful comments and messages following my last blog post. I had over 20,000 views on it since I posted it last night, which is completely astounding to me!!

I’m not sure what I said that resonated so strongly with so many of you, but it was really touching to hear that I’d made such a big impact on many of my fellow ‘cave girls’. I guess what I said has been on the minds of many women who weren’t feeling so great about themselves based on a lot of the messages being circulated around the internet regarding what a ‘Paleo’ woman is, and what she should or shouldn’t look like.

Wanting what you don't have... Paleo?

I’m all for a super fit, lean woman, as long as she is happy with the amount of time and energy it takes to maintain that physique. I’m glad that certain women are naturally lean and yet still make the wise decision to eat healthy food, even if they’re not trying to lose weight. But most of all, I want to remind everyone that health and happiness come first. If you’re struggling with your body image in spite of doing all the ‘right’ things with your diet and lifestyle, I hope this last blog post will encourage you to figure out what truly matters in life, more than what you look like. It’s something that I struggle with myself, but I hope as a community we can all encourage each other to move forward and embrace our healthy lifestyle for what it really gives us – health and vitality – and not get hung up on the image goals.

So, without further ado, here are the rest of my PaleoFX notes from the conference. Thanks so much for helping me reach 2000+ fans, and I hope you enjoy!

Paul Jaminet

  • Sources of insight about diet
    • Paleolithic, mammalian, breast milk, fasting ability, innate food preferences of brain
    • Nutrient-toxin view: optimize nutrition while avoiding toxin
  • Paleo diet: 30% plant, 70% animal
    • ~20% carb, 15-20% protein (sum is constant for mammals)
    • Mammals all have same basic nutrient needs
      • What differs is the nature of the digestive tract
      • Herbivores and carnivores have different guts
        • In herbivores, bacteria ‘eat all the carbs’
      • Nutrients delivered to the body are very similar at the end
        • Always a SFA and MUFA rich diet
    • Brain prefers glucose
      • Humans have bigger brains than other mammals
      • 20-30% carb consumption is a ‘healthy ratio’
    • Eating more carbs and protein promotes fertility, muscle, mood
      • Less for longevity, immunity
  • Macronutrients for Body Composition and Fitness (New material, will be blogging about it)
    • Useful-to-useless macronutrient ratio
    • People with more muscle would live longer in starvation scenario due to improved nutrition availability during self-cannibalization
    • When you’re malnourished, your brain upregulates your appetite to get you to eat more to meet your nutrient needs
    • In various pathologies, you can lose the ability to be active or release heat for energy
      • Excess macros have nowhere to go besides adipose tissue
    • American diet is ‘63% Useful’
      • 66% of calories come from foods not in PHD plan
      • Rise in PUFA consumption = obesity
    • Traditional bodybuilding diets are 100% useful
      • Low in PUFA, high in SFA
    • Many people find weight loss easiest in 20-30% range
      • Body reduces energy expenditure to conserve glucose, increase appetite to provide more carbs
  • Three body compartments important for health
    • Cells – fat, protein, water
    • Fluid
    • Extracellular matrix – Protein, glucose, minerals
      • Scaffolds can be used to construct new organs
      • Has all the structure of an organ after being decellularized
        • Take someone else’s scaffolding, insert your stem cells, and grow a tissue that has your DNA
        • Demonstrates importance of matrix in determining health
        • Cells perform only with the right matrix so we need to supply matrix materials
      • Can get the matrix materials from bone broths, gelatin
        • Most traditional diets include these types of food
    • Benefits of Fluids
      • Dehydration disrupts brain function, rduced athleticism, slower metabolism, higher cortisol
      • Salt lowers mortality in CVD, is crucial for health
        • Elephants will mine 700 ft deep into a mountain to get at a salt mine
    • Bone broths provide electrolytes (eg. potassium), scaffolding materials, fluids
      • Can help with fitness, recovery
      • Eat bone broths every day if possible
        • Brain is designed to make you happy when you eat something nourishing for you
        • Every meal becomes better when you include soup
        • Seaweed concentrates sea minerals too
          • Avoid kelp, which picks up metals
  • Minimizing Infection
    • Everyone is infected and burden increases with age
    • Geographic distribution of germs – warm, high level of ticks/mosquitos
      • Correlates with chronic disease rates (Southeast US)
      • Diabetes, stroke, obesity
    • Avoiding unnecessary infections
      • Wash hands, cook food thoroughly, get sun and vit D
        • Get tested for vitamin D levels
      • Diagnose infections and use antimicrobial medicines when appropriate
        • We need commensal bacteria so antibiotics can damage our gut flora but antifungals and antiprotozoals affect gut less
        • Stool test should be a standard diagnostic test
  • Minimize inflammation
    • Immune activity is tiring – eg. leaky gut, food allergies
      • Chronic fatigue = active immune system
        • Usually infections or food sensitivity
    • Avoid Toxic foods
      • Wheat, soy, corn, (cereal grains) make toxins that target mammals
      • Proteins in wheat bran are designed to shut down mammalian digestion
      • Wheat toxins enter the body, affect brain development
    • Plants produce antifungal toxins which actually help us
      • Just don’t eat too many of any one vegetable
    • For an athlete, there’s no reason to eat toxic foods
    • Nourish toxin removal system in liver
  • Lifestyle changes
    • Fast overnight, exercise to get food, eat, then rest
    • Protect circadian rhythms, IF, variable intensity exercise, reduce stress
    • Social interaction is good for health
  • If you want to be fit, your first task is to get healthy
  • Making bone broths:
    • Avoid fatty parts of chicken (high omega 6)
    • Simmer bones for an hour, then discard water
      • gets rid of blood, contaminants
    • Simmer another couple hours
      • Remove fat and meat, use in later cooking
    • Add new water with acid (vinegar) to pull matrix tissues and minerals out of the bone, cook much longer
      • Avoids fatty acid oxidation
  • Intermittent fasting
    • Contingent on health, some people have health issues that make IF inappropriate
      • Sometimes glucose regulation issues
      • Maybe take a spoonful of coconut oil – SCFAs help provide ketones that reduce glucose deficiency
    • Eat something a little flavorless, can help reduce appetite
    • Pay attention to own body, if you’re healthy you shouldn’t have an issue with IF
  • Taking care of pathogens
    • After hygiene developments, selection pressure forced pathogens to evolve capability to hide in body and cause chronic rather than acute disease
      • Chronic diseases of aging associated with infection
      • Eg. Cytomegalovirus makes you more likely to get diabetes, cancer
      • All pathogens upregulate some cluster of diseases
    • Hard to diagnose and decide how to treat
      • Pros and cons of treatment – judgment call
    • Antibiotics – doxycycline is relatively benign towards gut flora
      • Can take for 4-6 months without damaging gut flora
    • A lot of value to diagnosing and treating infections
  • Pork issues
    • Most pathogenic parts of pork = blood, liver, and digestive tract
    • Always rinse pork products
    • Most pathogens are killed by thorough cooking
      • Never eat pork rare (oops, undercooked pork sausage this AM!)
    • Safer cuts are meats, pork belly

Bloodwork, Body Comp, and Hormones Panel (Angelo Coppola moderates)

  • Jack Kruse, Chris Kresser, Lane Sebring, Ruthie Harper, Beverly Myer, Will Mitchell, Dan Kalish
  • What bloodwork panels should ‘healthy’ people get?
    • Jack – Assuming that people are healthy. “Quick Paleo Workup” – CRP, vitamin D, DHEA. How do you sleep? If I don’t have to go further, they don’t need me. “Optimizing Labs” blog post.
    • Ruthie – Big difference between ‘healthy’ and optimal health. Parameters need to be redefined, based on functional people but not optimally healthy. Need bloodwork for a roadmap to determine what needs to be addressed.
    • Will – In my clinic, 90% of patients can’t regulate their blood sugar
    • Chris – blood sugar pre and post meal, HBA1c, basic thyroid panel including T4, T3, rT3, magnesium, B12 (digestive issues), comprehensive metabolic panel, immune function, iron panel plus ferritin – many women iron deficient, many men iron overloaded (may be main cause of low testosterone). Men aren’t aware they are iron overloaded. Can affect blood sugar regulation and testosterone production.
    • Beverly – People often bring in their ‘normal’ bloodwork. Can’t always judge by bell curve and ranges provided.
    • Ruthie – your Physician is looking for disease, we’re looking for optimal wellness. Often miss thyroid antibodies.
  • Triglycerides – how do you lower?
    • Beverly – Trigs are directly related to glucose surge from excess carbohydrates. Too much glucose and insulin trying to fill cells, needs to be stored somewhere, ends up storing in blood fats, fatty liver. Stabilizing blood sugar drops trig levels. Strengthens adrenals by not having fluctuating blood sugar all the time
    • Ruthie – If your trigs are high, you’re not going to lose weight. You need to burn through triglycerides before you can access body fat stores.
    • Lane – Compare trigs to HDL, good measure of insulin sensitivity. VAT cells – visceral adipose tissue put out molecules that cause inflammation, blocks insulin receptors. Stop insulting VAT cells with a bad diet.
    • Ruthie – Fat is its own organ system that signals body to do things. Directly related to CRP, insulin resistance. Trigs need to be less than 100.
    • Jack – Many times clinical symptoms are more important than lab values. Many doctors don’t know how lab values correlate to symptoms.
    • Lane – Low cortisol is common and many doctors don’t even know what it means to have low cortisol. Endocrine system (bioidentical hormones) is especially misunderstood by standard physicians. Lab values are misleading, normal range often is just listed as ‘less than’.
    • Ruthie – treating thyroid without treating adrenals can make patient feel worse.
    • Chris – I commonly see people go on Paleo and their trigs actually go up. 1/3 Americans have NAFLD. Increase in dietary choline causes fatty liver to unload, which makes cholesterol and trigs go up initially but it eventually comes down. With HbA1c, its not reliable in individuals, based on assumption that RBC turnover is 90 days in everyone, which isn’t true. Important to test fasting and post-meal blood sugar to compare to HbA1c. High HbA1c numbers can indicate anemia.
  • Hormone deficiencies and symptoms
    • Lane – Cortisol deficiency and adrenal fatigue from stress. Low testosterone. Causes low energy levels, stress affects you more. Cortisol is required to provide glucose to the brain. Cortisol crashes later in the day, but starts happening earlier. Can also keep you awake at night. Low thyroid leads to low energy, fat gain.
    • Jack – Pay attention to T3 and rT3, low T3 can raise LDL. Probably one of the most mismanaged hormone in medicine.
    • Ruthie – Many people with cholesterol issues need thyroid testing. Only free components of hormones are working at the cell, this is what has to be looked at to determine hormone levels. I see a lot of estrogen/progesterone deficiencies in female athletes. They lose their ovulation.
    • Dan Kalish – Everything we’re talking about is lifestyle driven. Don’t get too involved with lab values. Look at gut function, amino acid levels, digestion, etc. Functional medicine testing should be a warm up before you get really sick.
    • Lane – We can beat ourselves up trying to live the optimally healthy life. Do everything you can and get tested, but get low hormones balanced out
    • Chris – Very important to test cortisol (diurnal hormone) throughout the day. A single cortisol test doesn’t tell you anything about your rhythm. Need to test throughout day to see what the pattern is.
  • Hormone supplementation
    • Dan – Measure monthly cycle for women, see what the normal rhythm for female hormones is. We can get more precise about providing necessary hormones the exact time you need it. Perimenopausal women can even still have internal rhythms.
    • Beverly – Get diet and lifestyle in shape first, 50% of symptoms will go away in a month. Then we’ll start over with the symptoms that still exist. This is when I run the thyroid, sugar, hormone panels. If your adrenals are crashed, your thyroid will be low. A lot of docs throw synthetic T4 at you, which works for a few months but then stops after a while. Adrenals need to get functioning before thyroid can start performing. Slow release T3 may be a better hormone to take if you absolutely need thyroid supplementation.
    • Ruthie – Need do differentiate between hormones that are meant to decline and those that aren’t. We’re designed to maintain adrenal and thyroid function, but there will be a fall-off of reproductive hormones over time. You can support those hormone deficiencies with bioidentical hormones.
    • Will – Can use diet and chinese herbs to take patients out of things like premature ovarian failure. Hormones may be necessary for certain conditions.
    • Dan – I don’t think premature ovarian failure exists. (Dan and Lane get into discussion about how to treat these patients) Low doses of preg and DHEA to feed into hormone cycle, which can get estrogens to come back up.
    • Ruthie – Women have too much stress and our conversion suffers because of it. If we can use herbs or acupuncture to return function, that’s ideal, but sometimes you need the hormone for functions.
    • Chris – Several things required for proper hormone function besides diet and lifestyle: Blood sugar regulation, oxygen deliverability (anemia), fatty acid balance (o6-o3 ratio), liver/gallbladder function (detox pathways), gut dysbiosis makes inflammatory cytokines that affects entire hormone pathways. First address all those issues and see what happens with hormones. After that, this is the time to consider HRT or herbal treatments.
  • Biggest challenge is finding a physician that understands all these issues.
    • Jack – I can’t practice medicine on the internet. We’re transitioning traditional medicine into a new realm. My profession is ‘screwing ya’.
    • Ruthie – Its not that your doc doesnt want to help you, they just don’t know. Its time to take personal responsibility for your health, you have to get educated, keep reading and learning, request tests. No doctor has all the answers, we’re all learning, hopefully your doctor will tell you what they know and send you somewhere else when they don’t have expertise.
    • Lane – Worldhealth.net has anti-aging medicine. TX state board is taking away medical licenses for academic nonsense. We could use your help supporting doctors in this fight.
    • Chris – Paleo physicians network is a good starting place. Metametrix, Biohealth diagnoistics and other labs provide registry of practitioners that use that testing.
    • Jack – You’re all going to become your own doctors in 10-15 years.
    • Beverly – Don’t leave out health professionals that aren’t physicians. Nutritionists can help too.
    • Dan – You cant be your own physician for everything. You should be the primary person in charge but you need someone that knows more than you do about it to help guide you. Nutritionist, Doctors, Acupuncturists. Even a personal trainer that is well educated about this stuff can help.
  • How do clinicians under doctors that aren’t supportive navigate this system?
    • Jack – you just have to be crafty. We have major legal hurdles we have to follow. Its a dangerous game we’re getting involved in. Rules are different for every state where doctors practice. Marksdailyapple.com ”monster thread” is the “textbook of evolutionary medicine.” Doctors would get in trouble for putting this stuff on their websites.

Chris Kresser – The truth about cholesterol

  • Thanked Chris Masterjohn for his contribution to CK’s knowledge
  • Warriors vs. Skeptics – Both are wrong, truth lies in the middle
  • Basic definitions
    • Cholesterol is a sterol, not a fat – found in tissues of all mammals
    • You don’t have cholesterol in the blood, needs to be carried in the blood by lipoproteins which also carries around triglycerides
  • The high dietary cholesterol causing CHD and death paradigm is prolific (infiltrative hypothesis)
    • Cholesterol DOES play a role but not what we think
    • Degenerative hypothesis – LDL is only a problem when it oxidizes
  • LDL plays important physiological roles – “taxi service” that makes sure our cells get the nutrients they need, calling LDL is ridiculous
    • Genetic disease causing cholesterol deficiency can be fatal
  • Many physiological roles of cholesterol
    • Structure, fights infections, endocrine health, growth and development, brain and nervous system (myelin), digestive health (tight junctions), antioxidant, mood (serotonin receptors)
    • Too low cholesterol is just as much of a problem
  • What is oxidative damage?
    • Natural process of energy production and storage, normally kept in check but oxidative stress can get high and antioxidant capacity gets low
      • Produces free radicals that damage DNA, causes chain of oxidative damage that is linked to heart disease, cancer, diabetes, modern chronic diseases in general
  • Increasing the risk of oxidative damage:
    • Vulnerable LDL
      • Delicate membranes – less saturated, more vulnerable to damage
        • PUFAs more vulnerable to oxidative damage than SaFA
        • High veg oils in diet make oxidized LDL go up
          • Strongest risk factor for lipid markers
          • Can predict 80% of heart disease
          • Hopefully an oxidized LDL test will be available soon
      • Concentration of o-6 fats in TISSUE (not RBCs) vs. heart disease in cultures
        • strong positive association
    • Poor antioxidant status
      • LDL is packaged with antioxidants to protect from oxidation as it travels the blood
        • Antioxidant supplements dont have benefit and may have harm
        • Antioxidant rich foods most important – animal products like butter, liver, red meat – CoQ10 and retinol
    • Lifestyle Factors
      • Infections, physical activity, pollution, etc.
    • Time
      • Amount of time that LDL spends in circulation determines likelihood of oxidizing
      • LDL receptor on cell causes release of nutrients from LDL particle
        • Small dense LDL particles are markers for heart disease
  • Practical framework
    • What is “high” cholesterol?
      • Look at traditional cultures with no heart disease
        • Masai – Diet is mainly milk, meat, and blood of animals, their average total cholesterol for men 130-135, women 145-170
          • Among lowest in world
        • Kitavan – Fish, coconuts, 75% kcal starchy tubers, males: 180, females 200-210
          • Women 40s/50s = 250
          • Most kitavans smoke, but still no heart disease
        • Inuit – 205-225
      • Normal cholesterol could be between 140-250 mg/dL average
    • If your cholesterol is above 250, your doctor will prescribe a statin
      • Normal variation in cholesterol range is +/- 35 mg/dL
      • Always get tested again if your cholesterol is ‘high’
      • Trigs variation is +/- 40
    • Total/HDL cholesterol is a good indicator of HD status
      • Ideal ratio is between 3-4 (but can vary up to 0.8)
    • Lipoprotein particle size testing is not ready for ‘prime time’ use
      • Inconclusive results about whether particle size actually predicts HD risk
      • Proxy marker for poor LDL receptor function
    • Cholesterol is a repair substance so high chol may reflect underlying conditions
      • Leptin Resistance
        • Affects LDL receptor activity
      • Thyroid
        • rT3 syndrome = hypothyroid at the cellular level
        • May not affect TSH or T4
        • May be due to hashimoto’s (low grade inflammation) and inflammatory cytokines
        • Selenium required for conversion of T4-T3 (difficult to get in diet)
          • Bound to mercury in ocean fish and we don’t absorb that complex, less mercury but also less selenium
        • Chronic stress can cause high rT3 – surgery, chronic illness, overtraining, disregulation of HPA axis
        • Insulin affects enzyme that converts T4-T3
          • very Low carb diet long term can cause lower T3 conversion and higher rT3 production
          • Issue to consider for people with thyroid
        • Plant goitregens (crucifers) interferes with uptake and utilization of iodine
          • Low intake of salt/iodine/seaveg
          • Steaming/boiling reduces goitregenic effect, while fermentation increases (be aware for thyroid issues)
          • Supplemental iodine can offset effects of these foods
      • Inflammation
        • Damage to tissue causes chol levels to rise
          • Infections, dental surgery, etc.
          • Treat infection to help lower LDL
      • Genetics
        • Familial hypercholesterolemia (FH) affects gene that codes for LDL receptor as well as Apo B
        • Homozygous carriers are rare and usually die by 25 from HD
        • Heterozygous more common (1/300-1/500) have a 3x greater risk of death from HD
  • After testing for all mechanisms, and you still have cholesterol above 250 (330+ usually FH)
    • Not time to take a statin
    • Minimize o6, maximize o3 intake
      • o3s are even more unsaturated than o6s
      • Fresh ground flax seeds can help lower cholesterol in men but apparently not women
    • Nutrient dense, antioxidant rich foods like organ meats
    • Tumeric, artichoke leaf, yaro, holy basil, hawthorne, red rice yeast extract can all be used as herbal remedies for high cholesterol
    • Reduce other risk factors – exercise, dont smoke, sleep, reduce stress
    • Still above 320-330 after all this – may need more aggressive approach
      • One of only populations that may need statins are FH
        • Long term complications – cognitive decline, depression, sexual disfunction
      • Optimize thyroid function
        • Test iodine and bromide levels – high bromide can cause hypo
        • Increase T4-T3 conversion, inhibited by stress and inflammation, low selenium
      • Thyroid hormone (low dose) eg. slow release T3 may be helpful
        • Cannot do on your own, too much can increase HD risk
    • High cholesterol may benefit from higher carb diet
      • LDL increased by high saturated fat, which may increase oxidation
      • Keeping LDL levels down can prevent LDL from oxidizing
      • T3 required to activate LDL receptor
        • Insulin required for conversion, so VLC may increase LDL oxidation
    • Very low trigs may indicate autoimmune function
    • Eating a lot of cholesterol can increase cholesterol in 30% of people
  • Iodine supplementation and Hashimoto’s
    • Only a problem in selenium deficiency
    • Risk mitigated by starting with very low dose
    • 80-90% of patients with Hashi do well with iodine/selenium supplementation
  • How to figure out nutrient deficiencies
    • Iodine/Bromide loading test, Copper deficiency in relation to zinc
  • Carbohydrates/glucose upregulates conversion of T4 to active T3
  • High HDL can be a marker for a problem since its a repair substance
    • 80-85 should be around upper limit, especially with high CRT or ferritin

Paleo On Ramp – Liz Wolfe, Diana Rodgers, Diane Sanfilippo

Great for me to see because I plan on being a nutritional consultant, and getting their ideas on how to treat clients was really helpful

  • Spreading the Paleo information is grassroots – Emotional buy in
    • Not always just about food
  • How do you share information without turning people off?
    • Meet people where they are
  • “Dance party if we have time” – Liz
    • Liz is probably the funniest girl I’ve ever met :)
  • Case study format
    • The way you speak to a Crossfit athlete is not the way you speak to a mother
  • Female CrossFit athlete
    • Scared of fat (esp sat) eats the lean chicken broccoli coconut oil, takes fish oil
    • Motivation to lean out, increase performance, fit skinny jeans
    • Need to educate why eating fat doesn’t make you fat – need to have background information of why that works
    • Gender stereotype can exist
      • Emotional bridging the gap of what client is scared of eating
  • The Mom
    • Drinks diet coke, stressed with kids, doesnt work out, eats whole wheat, sugar substitutes
    • Get them to talk about why they came in, improves client relationship
    • Motivation to have more energy and lose weight for an event
      • Some unrealistic expectations – shift to focus on health first
    • Focus on the client first, dont try to change whole family’s behavior
  • Having trouble with fertility
    • Can be a quick fix
    • Going to be an issue for a lot of people in the future
    • Focus on positives of being a healthy parent, rather than on negatives
    • One of the most motivated case studies you’ll find
    • “Important to take care of yourself so you can take care of your baby”
    • Can’t always convince people to take on fertility diet well in advance of pregnancy
    • Vitamin A to D ratio is extremely important especially with pregnancy
    • People dealing with things like PCOS
  • The Coach with a cortisol belly
    • Want to look the part, improve athletic performance
    • Drinking lots of protein shakes, not a lot of time to cook
    • Set the example for the clients
    • Addressing the ‘cheat’ meals that might affect digestive function
    • Maybe they can’t be doing their own programming
    • Address coffee intake, supplements
    • Get them to see their situation differently
      • Dont burn the candle at both ends
      • Need to balance life
  • SAD client
    • Have really bad bloodwork numbers that need to get fixed
      • May or may not need to lose weight
    • Fill out food journal and include how they feel when they eat
      • Often leave the feelings column blank because they don’t pay attention
    • Usually somewhat incompetent in cooking
    • Numbers are powerful for these clients – statistical studies help
    • 30 Day Paleo protocol can often be very effective
      • Read Robb’s book
      • Test cortisol
    • Monitor blood glucose (fasting in AM)
  • Resistant vegetarian
    • Thoughtful eating is foundational
    • Long term vegans and vegetarians who have degenerative health issues
    • Biological fact that certain things that are healing are by nature from animal products
      • Not about a dogma, just no way around certain nutrients i.e. B12
    • Visits to specialists that cannot figure out issues
    • You’re not being asked to help, you’re being asked to ‘hack’ what they’re doing
    • Sometimes you just can’t help someone
      • Some people aren’t ready for change
  • When you hit rock bottom, that’s when you are most ready for change
    • Have compassion for where the client is
      • Especially for family members
    • You can’t always make it happen with certain clients but small changes can go a long way
    • Understand who you’re talking to

Optimization vs Performance Panel

  • Paul Jaminet, Mark Sisson, Ron Rosedale, Dallas Hartwig, Krista Scott-Dixon
  • Paul – All healthy people are similar but all unhealthy people are unhealthy in their own way. Eg. Certain diseases do poorly on ketogenic diets.
  • Mark – The main thing I look at is how can we extract the most amount of energy from the least amount of glucose input. My perspective is that everyone would benefit from the ancestral diet as a starting point, from there you make tweaks for your own situation.
  • Ron – Diseases are symptoms of specific metabolic disorders, especially chronic diseases of aging.
  • Dallas – Health and performance can be opposing positions. (either or) Build a deep foundation of health and then build performance on top of that. Chasing performance can end up excluding health
  • “Improve health and the performance will follow”
    • Dallas – Diet that optimizes hormone function, immune response to physical stimulus of exercise, ends up looking largely like a Paleo prescription. We think about it from a metabolic need perspective. Input must in some way match output.
    • Ron – Health and longevity is proportional to amount of fat vs. sugar that you burn for energy. Anaerobic activity requires burning glucose, so athletes can carbo-load before an event to maximize performance. They might take a hit on longevity or health, but it might be worth it for them. Train to burn fat effectively, then have glucose available for anaerobic components of performance.
    • Mark – This is about choices. When you choose to be an elite athlete, there are parts of that equation you have to factor in. If you choose to be a ‘sugar burning’ athlete, you need to be able to replenish those glycogen stores. You need to eliminate foods that cause systemic inflammation because that will cut down on your recovery, which is essential for athletic performance. You have to also look as health being a main driver, but elite fitness requires some level of health sacrifice. Diet cannot keep up with the demands of incredibly difficult MetCon workouts when people start to try to compete.
    • Paul – add roughly the amount of carbs you end up burning during exercise to compensate for extra glucose you’ve used. Doesn’t need to be a huge amount but most athletes will benefit from a bit extra.
    • Krista – If you don’t recover, you don’t perform, period. My goal is to take them to a state of health as good as possible. The time we put in the gym is not what is making us better, its the time we spend rejuvenating our health. We do not eat macronutrients, we eat food. Athletes are under a lot of psychological stress, so any diet we take in has to nourish all these aspects of ourselves. Sustainability is an issue too, we want our athletes to have as long of a career as possible. Don’t sacrifice health for a three month performance. I don’t counsel my clients a lot about macronutrients – people glaze over. Need to balance a variety of elements and optimize recovery.
  • Calories – how does it relate to performance?
    • Krista – I wrote a book called “F-ck Calories”. They’re an inadequate conceptual category. Has nothing to do with how organisms actually work. If you’re not performing well, we know you’re not eating right. The organism is extremely adaptive and complex.
    • Paul – Your body generally knows how much it needs. Some benefit to overfeeding following tough workout and underfeeding on rest days. The only reason to count calories is educational for most people.
    • Mark – There’s no way Michael Phelps eats 12,000 kcal a day, its bullshit. It makes a good story for the press. When your metabolism optimizes, you become more efficient at putting fuel through. You develop more mitochondria. Allows you to produce the energy you need without excess waste or metabolic byproducts, so you can do more with fewer calories. Improving your ability to extract energy from fat and ketones reduces reliance on rebuilding glycogen stores. I don’t look at calories, I look at efficiency of what you’re eating now. How little glucose do you need to perform the way you need to? You don’t want to overfill on carbohydrates, its better to do it with fat.
    • Ron – You’ll never know how many calories you’re eating, so don’t even try. What your cells get from your food is affected by many different factors. You want to eat the foods that will make your hormones tell your cells what to eat later. Maximize performance for the prime competition we’re in – living a long, healthy life.
    • Dallas – The type of fuel you put in affects the output you get. If your output is good, we’re not concerned with the number of kcals that go in, we just want to make the input-output system as efficient as possible. I’m concerned with the end result.
  • How do you know when you’ve switched to fat burning?
    • Mark – When you have less than 125 g CHO per day and you feel great. Gene and hormonal regulation occurs, and eventually the brain catches up. You reach a point where you can skip a meal and not realize it.
    • Ron – Energy levels are much more stable. Your body doesn’t store much sugar so you’re dependent on eating it. Increase in calm energy. Sleep better, think more clearly, not dependent on eating to sustain energy. My clients complain that they’re never hungry and they think they should be eating, but they are.
    • Mark – many ways for our body to make enough glucose if we’re adapted to burning fat efficiently
  • Increased cortisol levels due to sustained low carbohydrate
    • Paul – Lower T3 hormone is more of a concern than cortisol. Hormones are designed to respond to starvation, and you can get yourself into a state where your body has to stimulate gluconeogenesis. I don’t think thats generally a desirable state to be in long-term. We use ketogenic diets therapeutically but we do this by flooding the liver with MCTs rather than starvation, which produces stress response and can have negative side effects. Micronutrient deficiencies can affect ability to generate things you need when on a strict diet. If you get negative symptoms on carb restricted diets then experiment with adding carbs or maybe MCTs and see how you feel.
    • Ron – Low thyroid leads to extended lifespan. Functioning in a longevity mode makes our thyroid go down on purpose. TSH does not go up. I think the lowering of the thyroid is a good thing.

Dan Kalish

  • Stress hormones have a direct effect on brain chemistry
  • First thing body does with amino acids is make brain chemicals
  • Every year you stay on SSRIs the more the level of serotonin in your brain is dropping
    • More serotonin outside of synapse cause more receptors to be made
    • Going off meds makes you feel bad due to low serotonin and high receptors
  • Eating a more balanced diet, your body will take amino acids within hours and replace lost serotonin in brain
  • Chemical or physical trauma to post synaptic neuron from neurotoxins in environment
  • Much of the serotonin that you make is in the gut
  • Measuring levels of serotonin in the blood is not a good way to test what your levels are
  • If you load someone with the right amount of amino acids, you can see where they’re going and if the ‘gates are open’ to let serotonin and dopamine through
  • You have to take 5HTP and Tyrosine together to be safe
    • Need B vitamins and others as cofactors
  • Decrease neurotoxic load – cleaning products, get fillings out, flush out
    • Water and vegetables get you to pull out neurotoxins
    • Liver support supplements can help
    • Paleo foods eliminate foods that reduce detoxification
  • Clean up food, reduce environmental toxins, look at your history of neuro damage

Psychology of Change Panel

Emily Deans, Nora Gedgaudas, Roger Dickerman, Shilpi Mehta, David Pendergrass, Dan Pardi, Mark Sisson

  • Pendergrass – Overeat on Paleo food to cut down on cravings for other food.
  • Roger: Human foods vs Nonhuman foods, storytelling like Mark Sisson
  • Shilpi – We’re in a cultural revolution right now.
  • Emily – Stages of change – most people are in the first Pre-Contemplation stage. Buying a book and cooking this food is in the 4th stage. People will come up with reasons that their behavior is OK. You need to personalize it for the client. Confrontational interactions don’t go so well. Keep moving along until they can get into the action and maintenance stage. As a clinician you need to be a good model for your clients.
  • Mark – I tell people “I’m not sure you’re ready for Paleo yet.” You need to want them to WANT to make the change. Lead by example, enjoy your life, acknowledge your success, and let it trickle down to your friends and family.
  • Dan – We’re interested in behavior optimization – getting people to comply in a sustainable fashion. Define success, build the road, and walk the path. What is your definition of success? Building a road is turning your goal into an action plan. Walking the path is whether you’re living the lifestyle that is consistent with your goals and plan. Self tracking allows you to have awareness of whether you’re walking the path.
  • Nora – People are open to looking at things in a new way for the first time. Old ideas do die hard, and it ends up being a process even when people are excited about the information. People need to be able to be patient with themselves. Understand not just what they need to do but why. I’d rather not just tell people what to do, I’d rather them understand how their body works and why eating this way is important to them so when old habits start to resurface, people understand why its important to continue on. The education and self-awareness piece is really important. I tell people to get involved in their local WAPF chapter because they appreciate the same things we do. This community of people can help them establish resources and give them something to bounce off of. Being in a community of like-minded people is a great way to ensure long term success.
  • What resources do you recommend?
    • Dan – Quantified Self Movement has staggering potential to affect the health of the US. Goal Theory are more effective than other behavior change techniques and these devices help effect these behavior changes. Making it social and competitive can help that too.
    • Mark – Check out my Friday success story to show people on the fence what can happen when you adopt this lifestyle. It resonates with people to see the change rather than just hear the change.
    • Shilpi – Paleo Meetup groups help you get through challenges. Its great to see how different groups do it around the country.
    • David – In the end, this diet works well for people and the support for the addiction side makes this work.
  • Shilpi – myopia is an evolutionary mismatch. We’re not designed to be in front of a computer constantly. Take a break every 20 minutes to look 20 ft away. We don’t have the data to tell us whether someone could follow a paleo diet from birth and avoid this condition. Vitamin D plays a big role. Room for a lot of research.
  • Emily – I recommend finding a therapist in your area if you have a huge lifestyle change, lose a lot of weight, etc.
  • Roger – If someone keeps fighting you and wasting your time, fire the client.
    • Emily – I just stop working so hard and I just become more supportive for them.
    • Mark – Life is too short, and if they’re not into it, its not your job to fix them.
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  • Danielle

    Thanks for posting, Laura! I actually read it all :P I was one of the new fans as of yesterday and have already read through your entire blog (yeah, work was slow yesterday!). Can’t wait to see what else you come up with.

    Also, I’ve decided to try and be happy with my body. I’m 5’10″, 150#, fit, and still trying to “lose” those last bit of inches i’m sure only I can see. Our society is so screwed up. I’m just glad we are able to work together and bring back some sanity to the way women view themselves. I guess is has to start somewhere, right?

    Thanks again for taking the time to communicate your thoughts and points of view with the paleo community.

  • Brigita

    Hi Laura, I discovered your blog two weeks ago and am throughly enjoying it, thank you! I am currently in Acupuncture school and oriental medicine but my true passion is nutrition! Yay! I wanted to follow up on the part about fertility- another great way to help people understand how important nutrition is for pregnancy is to consider that when a woman becomes pregnant, she has her daughter AND her grand-daughter inside of her (as we ladies are born with all of our eggs)….all being designed based on the food she consumes and her current state of health (epi-genetics). So we as women are truly the keepers of the species!

  • Brigita

    Since we’re both in school- if you ever want to email back and forth- count me in! I couldn’t find your mail on the site, but you probably don’t post that! Thanks!

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  • http://www.mondieteticien.fr Laurent Buhler

    Thanks for your notes Laura! A goldmine to dig in!

  • aerobic en casa

    Hmm it appears like your blog ate my first comment (it was super long) so I guess I’ll just sum it up what I wrote and say, I’m thoroughly enjoying your blog. I as well am an aspiring blog writer but I’m still new to the whole thing. Do you have any recommendations for rookie blog writers? I’d definitely appreciate it.

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  • Andrea

    Wow, what a GREAT post. Makes me want to go to the summit next year!!!

  • http://gravatar.com/jolicoeur1 jolicoeur1

    Interesting post. I have been paleo for 8 months. 1 1/2 years ago I had blood work and did again last week. contradictions resulted. Last week I had low inflamation and large fluffy LDL and my HDL went up to 77, my Hashimotos antibodies went down from >1000 to 450, but my trigs went from 70 to 96 and my glucose went from 88 to 95. I eat rather strict Paleo, my carbs are not high (berries with my fatty breakfast and 1 or 2 sweet potatoes and whatever I get from veggies each day). I have lost 25 pounds over the last 8 months (now 150), I don’t get sick, no cold sores, building muscle, no more hunger, shakiness, agitation between meals. What could cause my trigs and glucose to go up? just a fluke? lessened fatty liver dumping into my blood ( my grandmother actually died from this, perhaps genetic)?
    thanks

    • Laura

      Have you only gotten one blood test? Those numbers can fluctuate at any point for a variety of reasons. I’d get tested at least one or two more times before making any assumptions about what that means.

      Check out Chris Kresser’s podcast with Chris Masterjohn on this topic.

      http://chriskresser.com/episode-16-chris-masterjohn-on-cholesterol-heart-disease-part-2

      • http://gravatar.com/jolicoeur1 jolicoeur1

        Just tested once, thanks I will check out that podcast

  • http://Www.paleobritain.com Jane Ritchie

    I wish I was there! Great post, thanks for sharing.