Diet - what you need to eat to slow the normal ageing process

Preamble - issuing of new chapters to My book Ecological Medicine

Date of Issue - January 2021

This page is a copy of the new updated Chapter 21, The Paleo-Ketogenic diet ,from My book Ecological Medicine - The Antidote to Big Pharma and Fast Foods.

Ecological Medicine has 79 chapters and 5 appendices. It is an ongoing project and as I extend my knowledge, I will add new ideas all the time by updating already existing chapters.

So that people who have already bought Ecological Medicine do not feel as if they have an out of date copy, I will make these updated chapters available free online as they are written. Also, at regular intervals, Ecological Medicine will be reprinted and these reprints will incorporate all the chapter updates that have occurred since the last print.

You can purchase the whole book from these links

Ecological Medicine for UK delivery

Ecological Medicine for delivery to USA

Ecological Medicine for delivery to Europe

Ecological Medicine for delivery to the Rest of the World

Download of revised Chapter 21 The Paleo-Ketogenic diet Ecological Medicine

You can download this new chapter here:

Chapter 21 The Paleo-Ketogenic diet Updated January 2021

Full Text of revised Chapter 21 The Paleo-Ketogenic diet Ecological Medicine

“The Cure is in the Kitchen”

Dr Sherry Rogers, environmental physician

The PK diet is non-negotiable. I spend more time talking about diet and cooking than all other subjects put together. Changing one’s diet is the most difficult but the most important thing one needs to do for good health. See My book - Paleo-Ketogenic: The Why and The How.

Remember outside autumn primitive man ate a paleo-ketogenic diet and this would be largely comprised of raw meat and/or raw fish and shellfish depending on where he lived. That was it. You may think this a boring diet, but boredom is secondary to survival! For some of the sickest patients, we have to return to this very primitive diet to allow them to recover. Natasha Campbell McBride describes this diet in her book “The GAPS diet”. An essential part of this diet is to access bone marrow. Perhaps this is what drove primitive man to using tools to smash open this treasure chest of fat and micronutrients and so the clever ones survived? Neanderthal man had a larger brain than modern man. As my patients often hear in the consulting room…

“….my job is to get you well not to entertain you”
Yours Truly “Sarah”

Guess what? I am not going to live my life eating raw meat and raw fish just so that I can live to a great age! We all have to work out a compromise diet that gets the best of both worlds. And that is going to be different for everyone and will change with age. For me, greed gets in the way – I love good food! So, we all need a starting point which can then be relaxed or tightened up on depending on age and disease state. Younger, healthy, physically active people can take more liberties than old sick ones! I find myself in the old, healthy category and so I am still no paragon of virtue.

What to eat - a reasonable starting point for most is:

As much as you like of

Fats – saturated fats for energy such as lard, butter, ideally ghee (so long as you are sure you are not allergic to. I am …. dammit), goose fat, coconut oil, palm oil.
Oils – unsaturated fats which are also fuels but contain essential omega 3, 6 and 9 fatty acids. Hemp oil is ideal containing the perfect proportion of omega 6 to omega 3 ie 4:1. These must be cold pressed and not used for cooking or you risk “flipping” them into toxic trans fats. Only cook with bio-chemically stable, saturated fats. See My book - Paleo-Ketogenic: The Why and The How for more on good and bad fats.
Fibre (this is often included in the carb count of foods and leads to some confusion!). Eat enough fibre until you are crapping like one of Denis Burkitt’s Africans. Burkitt, consultant surgeon, observed that indigenous Africans did not suffer Western diseases. For these Africans, normal defaecation means twice daily squatting to produce a turd effortlessly (no straining) cucumber size, no cracks, no balling, soft and inoffensive . To be precise, type 4 on the Bristol stool chart – and yes - you can purchase the T shirt so emblazoned. To achieve that which colo-rectal surgeons dream of, you need to consume half a PK loaf daily (see My book - Paleo-Ketogenic: The Why and The How) or its fibre equivalent. Then invest in a squatty potty – I was delighted to read that some have “motion sensitive lights”. High fibre diet means that fermentation of such in the large bowel generates vitamin K.

Foods that have less than 5% carb of which the most important are:

linseed (see My book - Paleo-Ketogenic: The Why and The How which has a great recipe for linseed bread which looks and behaves like a small Hovis, it also makes a great base for muesli and porridge). These days I find making buns quicker and they cook reliably well in 40mins at 220 degrees. Fashion the dough into a rolling pin shape and cut out 12 discs.
coconut cream. The Grace coconut milk is head and shoulders above all others with a 2% carb content. It is a great dairy alternative
brazil and pecan nuts are less than 5% carb.
salad (lettuce, cucumber, tomato, pepper etc), avocado pear and olives (phew! I love them both)
green leafy vegetables,
mushrooms and fungi - a difficulty with this diet is eating enough fat. These foods are great for frying as they mop up delicious saturated fats
fermented foods (sauerkraut, kefir) - since the carb content has been fermented out by microbes

Care with:

meat, fish, shellfish and eggs – not too much as excessive amounts can be converted back to carbohydrate. See My book - Paleo-Ketogenic: The Why and The How for details (ho ho you are going to have to buy that now!)
Salt – 1 tpnful (5 grams) daily. Ideally use sunshine salt as below
Coffee and tea in moderation

Care with foods of 5-10% carb – much more detail in "My book - Paleo-Ketogenic: The Why and The How"

Berries
Some nuts: almonds
Herbs and spices – these do have a carb content but in the small amounts normally used these are not going to spike sugar levels

Avoid foods of >10% carb as they switch on addictive eating. I know. I too am an addict. All grains, pulses, fruits and their juices, many nuts and seeds. Junk food which is characterised by its high carb content and additive potential

No dairy products except ghee. See chapter 18 for the why.

No sweeteners, natural or artificial which simply switch on the physical and psychological craving

Make sure you are in ketosis through testing

Ketones arise through fat burning which generate three types of ketone:

Beta hydroxybutyric acid present in and which can be measured in the blood – this is the most accurate measure, but testing strips are expensive. I am mean and a wimp so I do not use this method
Acetoacetate is excreted in the urine. Testing is cheap and easy with urine keto-stix but as the body becomes more efficient at matching ketone production to demand, urine tests may show false negatives.
Acetone is exhaled and can be measured with breath testing. This is my preferred method as you can easily test after every meal to ensure you have not overdone the carbs.

Trouble-shooting the ketone breath test

What to expect normally

If you are sufficiently low carb, expect to blow 2-4 parts per million (ppm) of ketones at all times of day and night.
However the body will always use sugar in preference to ketones. This means that ANY amount of ketones in the breath means that you are in ketosis.
If you blow very high ketones eg up to 10 ppm, this may be for reasons of:

When stressed, there is an outpouring of adrenalin and this stimulates fat burning
Over-dosing with thyroid hormones may cause high levels of ketones.
Fasting – even on a PK diet you consume some carbohydrates! With fasting you get ALL your calories from fat so ketones are higher.
Contamination as below.

You can get false positive results

The mechanism used to measure ketones is the same as that for measuring alcohol.
You may see a positive if:

You have consumed any alcohol in the past 24 hours (depending on how much!)
If you have an upper fermenting gut then this too produces alcohol.
Any products containing alcohol may give a positive result! I checked this myself with an alcohol wipe (often used for hand sanitising) to clean the mouth piece and this gave a high reading!.
The meter measure parts per million – it is very sensitive! You only need a tiny amount of contaminant to upset the result. Many household cleaners contain volatile organic compounds which may register on the meter!

You can get false negative results

If you have anything to eat or drink in the preceding 20 mins then that may affect the test. For example I know if I have a sip of coffee then that may be followed by a negative reading.

The actual figure may not reflect blood levels of ketones

This is partly because blood ketones are different (beta hydroxy butyric acid) whereas breath ketones are acetones.

The result may not square with urine ketones

Again this is because urine ketones are different (acetoacetate). It is common to see ketones on a breath test but the urine test is negative Also with time, the body gets better at matching energy demands to delivery, so less ketones are “wasted” through urinary losses

Being in ketosis is NOT dangerous

Most doctors do not know or understand physiological ketosis. They only know about diabetic ketoacidosis and may panic if you tell them you are in ketosis!

When ketosis is a problem

Ketosis is ONLY a medical problem if you are diabetic and your blood sugars are running high (either because your medication is insufficient OR you are consuming too many carbs). For example a blood sugar above 10mmol/l and/or the presence of sugar in your urine and YES THIS IS A MEDICAL EMERGENCY.
Bear in mind that the DIY home tests for blood sugar rely on a test that employs glucose oxidase. Vitamin C cross-reacts – so if you are taking vitamin C to bowel tolerance your blood will be saturated with vitamin C and this may give false highs. My experience is that this may be 2-3mmols/l higher than the actual blood glucose. That is to say an apparent reading of 7-8mols/l equates to a real reading of 4-5mmol of glucose.

THEN you need to balance up total calories, protein and carbs

Total calories per day – look this up from your age, weight, height and activity. Do not eat less than this or your body will simply switch off calorie burning to make you tired, foggy, cold and depressed. See Calorie Calculator

Proteins such as meat, eggs, fish and shellfish. These are zero carb BUT if eaten in excess the body can convert them into sugars. A rule of thumb is to allow 0.7 to 0.9 grams of protein per pound of lean body mass. See below for protein leverage. The PK diet is not a high protein diet. It is a high fat and fibre diet (relative to Western diets). Fibre is important to satisfy the appetite. The key is no refined or heavily processed foods and calculate your protein needs.

Protein Leverage

The body cannot store protein, but daily protein is essential for survival. We have a protein appetite which will make us crave food until that appetite has been satisfied. If you are eating a low protein diet, you will be driven to eat more food. In that process you overeat carbs and fat and so expect to gain weight. Conversely, eat a high protein diet and you tend to undereat and lose weight. Get your protein intake right to help maintain a normal weight. (Note a high protein diet is not desirable as the body then has to deal with the toxic consequences of too much protein! Listen to your body and appetite - it will tell you how much you need!)

How to calculate your protein requirement

First you need to calculate your BMR (basal metabolic rate).

There are many equations to calculate your BMR, and from there your calorie needs. We shall be using a tried and tested formula for the BMR, the Mifflin - St Jeor equations (see Wikipedia page on BMR) which are:

For Men - BMR = {10 X Weight[KGS]} PLUS {6.25 X Height [cms]} MINUS {5 x Age [years]} PLUS 5
For Women - {10 X Weight[KGS]} PLUS {6.25 X Height [cms]} MINUS {5 x Age [years]} MINUS 161

If you'd rather not do the maths, this handy online calculator does it for you - BMR calculator

You will then need to multiply up your BMR [as calculated above] by these factors depending on your level of activity. Again the website above does this for you:

Sedentary - calories required = BMR x 1.2
Lightly active - calories required = BMR x 1.375
Moderately active (moderate exercise 3-5 days)- calories required = BMR x 1.55
Very active (hard exercise 6-7 days a week)- calories required = BMR x 1.725
Super active (hard exercise and sport and physical job)- calories required = BMR x 1.9

So, here is a worked example [on me].

And here is a screenshot of said website and its calculation:

Now you can calculate your protein requirements as below:

Proteins are found in such foods as meat, eggs, fish and shellfish. Here are some common protein-rich foods:

Food	Protein content in gms per 100gms	On the plate looks like……approx	What do I eat?	Protein content approx
Eggs	13	Two eggs	Breakfast 2 eggs	13
Beef	26	A medium beef burger
Pork	31	A small pork chop	Supper main course - chops	31
Bacon	Up to 39 depending on how fat! One slice 8 grams
Lamb	26	One lamb chop
Chicken, Duck	20	Whole breast or whole leg
Fresh Fish	29	A good chunk!
Prawns	25	A prawn 'cocktail' starter	Supper starters - pate or fish	25
Brazil nuts	15		Snacks	10-15
				MY TOTAL = 79 -> 84

Once you have things roughly balanced out your body will do the rest - -appetite and desire for food is remarkably accurate once you have addiction out of the way! Interestingly before I did this calculation, the above was what I ate – so my brain and body had worked it out already.

If the keto diet really does not suit short term

This may be due to a 'DDD' reaction – see chapter 28 [see Diet, Detox and Die-off Reactions: expect to get worse. ]

If the keto diet really does not suit long term

If the keto diet really does not suit long term We do know that sugar is a vital part of metabolism – NOT as a fuel, but as a building block to make DNA and RNA. It is also essential for detoxing via the glucuronide pathway in the liver.

I think the most important information is that being in ketosis tells us our glycogen stores are squeezed dry. At this point consuming some carbs is fine – if you slip out of ketosis for a short time then you are doing no harm. I am sometimes out of ketosis in the morning - but by late afternoon I am invariably blowing ketones.

Sugars may come from protein (via gluconeogenesis) or of course eating carbs. Low protein and zero carb diets are not desirable. If you really struggle to get into ketosis, then I suggest the 5:2 diet. Ie you eat the best low carb you can manage for 5 days, then for 2 days a week you eat very low carb, or GAPs diet or possibly fast until you get into ketosis. The important point here is that to get into ketosis you have to squeeze dry the glycogen “sponges” in the liver and muscle. Once these are emptied, blood sugar control is much easier as the body is not relying on insulin and this avoids high blood sugar, and the blood sugar swings of metabolic syndrome.

REMEMBER THE ABOVE ARE NOT HARD AND FAST RULES – LISTEN TO YOUR BODY AND FOLLOW YOUR APPETITE. ONCE YOU ARE NOT ADDICTED TO FOODS THIS IS A REMARKABLY GOOD GUIDE

"Variety is the very spice of life, that gives it all its flavour."
William Cowper's poem The Task: 1785

Change your diet with the seasons and through life. Eat foods that you enjoy most because these will be the very foods that you need. A wide variety of foods will grow a wide variety of microbes in the gut. Include as many spices and herbs as you can. Taste has evolved for excellent reasons! Eat foods that are little processed. Become a gardener and grow your own.

Take micronutrients supplements for life to compensate for the deficiencies resulting from food production

A good multivitamin and multimineral. We need these simply because with Western agriculture there is a one-way movement of minerals from the soil, to plants, to animals and then to us humans. We throw them away. This lack of recycling means we are all deficient in such. Once again, we discuss this in much more detail in My book - Paleo-Ketogenic: The Why and The How, with referenced studies showing the result of this ‘one-way’ traffic.

I have got to the stage of my medicine where I know exactly what must be done so I am now trying to make this as easy and inexpensive as possible. So, I have put together “Sunshine salt” which contains all essential minerals from sodium and selenium to magnesium and manganese together with vit D 5,000iu and B12 5mgs in a 5 gram, 1 tspn dose. This does make life much easier. It tastes like a slightly piquant sea salt, can be used in cooking and means the rest of the family get a dose without realising it, especially that man who believes he is immortal.

Vitamin C- 5-15 grams (yes I mean 5,000 to 15,000mgs, and no that is not a big dose) daily. See chapter 31 vitamin C for the why.

Timing

Primitive man did not eat three regular meals a day, neither did he snack. Consultant neurologist Dale Bredesen reverses dementia with a PK diet but insists all daily food is consumed within a 10-hour window of time. For Dale Bredesen’s 2014 study see “Reversal of cognitive decline: A novel therapeutic program”

Once keto-adapted you may feel a bit peckish and deserving of a snack, but the good news is that you will not get the associated ‘energy dive’ experienced by the carb addict who must eat according to the clock. Carb addicts feel a sudden loss of energy and HAVE to feed their addiction to get rid of this awful feeling. The keto-adapted do not experience this. A weekly 24 hour fast is also good for the metabolism. It may be counter-intuitive, but the fact is that this enhances mental and physical performance.

If you have decided to go ahead with this diet, then believe me it is a bumpy ride. There is a whole new language to be learned. You will have to identify the glycogen sponge, anticipate the metabolic hinterland, get keto-adapted and prepare for detox and Herx reactions - see chapter 28. I simply cannot write all the nitty gritty detail here for this successful transition without losing the plot of this book……at least get My book - Paleo-Ketogenic: The Why and The How which holds your intellectual hand through this difficult transition. Or just do it………….

Once established on the PK diet

The word doctor comes from the Latin to teach. I can show you the path, but you have to walk it. You have to become your own doctor. All diagnosis starts with hypothesis. We know the PK diet is the starting point to treat every disease and that is non-negotiable. Stick with this diet for life and it may be that this is all you have to do. Once PK is established you have to ask if you are functioning to your full physical and mental potential? Only you can know this.

If you are functioning to your full potential, then you can take the occasional liberty with your diet. Primitive man surely did. He did so in the autumn although not with the high carb foods that we can now access. Alcohol is a peculiar problem – it is addictive, high carb and stimulates insulin directly. But I love alcohol, the jokes are so much funnier with a glass of cider on board and so I enjoy this occasional liberty at this stage in my life.

If you are not functioning to your full potential, then you must stick with the PK diet and read on! Even if you do not experience immediate benefits you will greatly increase your chance of a long and healthy life. It is a great consolation for me to be able to tell my CFS and ME patients that their best years are ahead of them.

“The Chinese do not draw any distinction between food and medicine”  Lin Yutang (1895-1976) Chinese writer. The importance of Living, ch. 9, sect. 7'

Fasting – a great therapeutic tool

Primitive man feasted and fasted. So do all carnivores. It makes perfect evolutionary sense that to fast enhances physical and mental performance – it made Man a better hunter. He got hungry for food….and we use this very word to describe the will and energy to succeed. Mozart produced his finest works when hungry for money, so did Van Gogh and Dickens. Being hungry enhances performance.

"Fasting is the first principle of medicine: fast and see the strength of the spirit reveal itself"
Rumi 1207 - 1273) 13th-century Persian, poet, faqih, Islamic scholar, theologian, and Sufi mystic originally from Greater Khorasan in Greater Iran

It goes without saying that fasting should not be used as a therapeutic tool in the case of anyone with an eating disorder.

Why fasting is such a great tool

Weight loss

We know calorie restriction does not work. It is easy to see why – prolonged mild starvation results in the body shutting down energy expenditure. This makes you physically tired, brain-dead and depressed. The body quickly matches energy spending to energy delivery so weight loss ceases but you remain fat, fatigued, foggy and in a funk hole.

The answer is to take advantage of the inherent, metabolic inertia so that it takes several days for metabolism to slow. Eat your normal PK diet for 5 days then fast for 2. You continue to fat burn at your normal rate throughout, so mental and physical energy remains normal but your weekly calorie consumption is reduced by 2/7ths (28%).

Fat comes off the belly first – this is because when fasting there can be no gut fermentation (fat is dumped where the immune system is busy). The modern fad to treat obesity is bariatric surgery (252,000 operations in UK 2018). Yes, it works for weight losses, but health losses include: dumping syndrome, malnutrition, vomiting, ulcers, bowel obstruction, hernia, blood clots, gallstones and more. Fasting is more effective and a darn sight safer.

Hypertension and cholesterol

Both of course normalise on a PK diet. Fasting makes this happen more quickly. If they do not normalise, look for other causes such as high homocysteine, thyroid problems and sleep disturbance.

Restore insulin sensitivity

This is the hallmark of diabetes. If not already in ketosis, fasting empties glycogen stores, reverses insulin resistance and is the fastest way to lose weight, reverse metabolic syndrome and diabetes. Diabetics and their doctors are naturally anxious about low blood sugar. This can ONLY happen if prescribed medication to lower blood sugar. The key is to monitor blood sugar closely and as levels comes down, as it inevitably does, reduce the dose of medication. Type II diabetics should be able to stop all medication. Type I diabetics MUST use continuous blood sugar monitoring such as Dexcom. They eventually need a smaller dose of insulin. The “brittle” diabetics are stabilised.

Doctors always fret about their patients being in ketosis because the only state they know about is diabetic ketoacidosis – a dire emergency. Diabetic ketoacidosis occurs when blood sugar is very high. This problem is entirely preventable with careful blood sugar monitoring.

Please note that if you are taking bowel tolerance doses of vitamin C this will give false highs on home testing kits which rely on glucose oxidase. I have to say this gave me a terrible fright when I tested my own blood sugar to find it at 7.8mmol/l (ref range 4.5 – 5.6). I send off the same sample to the lab which came back at 5.4mmol/l.

Human growth hormone spikes with fasting - this results in more muscle being laid down (so we can run faster and throw those primitive spears further) together with fat burning. Metabolic rate increases by up to 14%. Again we see that fasting enhances performance – the Samurai warrior fasted before fighting.

Indeed, before battle, the Samurai warrior was advised to drink only "hot water that had been poured over rice." (‘The Hundred Rules of War’ Tsukahara Bokuden, 1489 – 1571.) Interested readers can still buy this book - ‘The Hundred Rules of War’ by Tsukahara Bokuden. For film buffs, the scene from the Seven Samurai, in which the character Gorobei’s swordsmanship skills are tested is based on an episode from Tsukahara’s life.

Back to insulin sensitivity! I suspect, but do not yet know, that fasting also improves thyroid hormone receptor resistance, perhaps for the same reason it reverses insulin hormone receptor resistance. I say this because I have now seen several able to reduce their daily dose of thyroid hormone with fasting regimes.

To treat infections

All infections, including viral, are fed by sugar. Fasting and rest means all energy is available for the immune system to fight the good fight.

"Fast a cold fast a fever"
Old adage, Myhill adapted, with apologies

To detoxify

The greatest source of toxic stress in the body comes from the gut. See chapters 8 and 15. Obviously fasting greatly reduces this burden. Fat is a repository for fat soluble toxins – see chapter 28 DDD reactions. Fasting mobilises toxins PDQ ["Pretty Damn Quick"] which can be excreted as per chapter 34.

Auto-phagy (“self-eating”)

When fuel and raw materials do not come through from the gut, the body looks to self for fuel and raw materials. It finds energy initially from liver and muscle glycogen stores (about 2,000 calories – so the non-keto marathon runners get to 17 miles before “hitting a wall”) then by fat burning. Protein cannot be stored, so the body obtains such from recycling old, worn out cells. This is the metabolic equivalent of spring cleaning and it has profound beneficial effects. So-called auto-phagy has anti-inflammatory, rejuvenating, anti-cancer and healing properties. Indeed for thousands of years fasting has been used to treat an alphabet of disease: arterial disease and arthritis, brain tumours, cancer, dementia, epilepsy, fatigue, hypertension, gastritis, Hodgekin’s and more!

"Fasting is the greatest remedy - the physician within."
Paracelsus, 5th century Swiss German Renaissance physician, botanist.

Fasting shifts stem cells from a dormant state to a state of self-renewal so it is good for:

The immune system - old cells are killed off and young front line fighters grown.
The brain – neurones make more connections
The rest of the body – new young cells for the gut, liver, skin, blood vessels, connective tissue, heart, muscle and bone

To treat cancer

We know the ketogenic diet starves cancer cells of sugar, without which they cannot be fuelled. Fasting increases ketosis even more – combine this with the immune stimulation of fasting and vitamin C to bowel tolerance and yes, you are really winning!
Auto-phagy digests cancer cells too.
Fasting before and during chemotherapy enhances the effects of and minimises side effects. Fasting enhances the effect of radiotherapy. I would recommend fasting on the day before and the day of such treatments, possibly longer.

To treat dementia

Consultant neurologist Dr Dale Bredesen cured dementia with a ketogenic diet. Fasting does this faster. Remember foggy brain is an early symptom of dementia! See chapter 49 and above.

How to fast

FIRST get keto-adapted. This avoids many of the DDD reactions (chapter 28) which are an inevitable result of getting into ketosis. Anticipate: Social opprobrium - when I announced I was going to do a 5 day fast, my friends were immediately anxious for my physical and mental health! Fear of hunger – and accompanying such, fear of fatigue and fear of foggy brain. As you will discover there is nothing to fear and, with time and practice, you will look forward to your fasts! Hunger is greatly ameliorated by telling your brain that you are going to do it regardless of its nagging. You make your mind up and feel proud that you can do what all others fear.

"In the afternoon the digestion of the meal deprives me of the incomparable lightness which characterizes the fast days."  
Adalbert De Vogue,Benedictine monk 1924 – 2011

"I fast for greater physical and mental efficiency"
Plato 424/423 – 348/347 BC, Taught by Socrates, taught Aristotle

What you do consume on a fast

Yes, you must drink water and take electrolytes. The ideal mix is spring water with sunshine salt. Whilst one can drink pure water you cannot sweat or pee pure water – both contain minerals, not just sodium chloride (table salt) but all from magnesium and molybdenum to calcium and chromium. Sunshine salt provides every permitted essential mineral in the correct physiological proportions. This makes for the perfect hydration mix – 5 grams of sunshine salt per one litre of water drunk according to thirst.
Carry on your usually nutritional supplements including vitamin C at least 5 grams or to bowel tolerance.
If you are on prescription medication, carry on but monitor effects. The need for most comes down especially drugs for hypertension (check BP daily), diabetes (monitor blood sugar), asthma (check peak flow), pain-killers, anti-inflammatories and I suspect thyroid hormones (see chapter 30).

Do not confuse hunger pangs with greed or need. Use hot water and lemon juice to postpone the “break through” waves of hunger with and by the time you are sipping the wave has passed.

How long to fast

With Groundhog Basic - see Groundhog BASIC – what we should all be doing all the time

Start by eating all your PK meals within a 10 hour window of time. This means you are fasting 14 hours a day. Great start. Then move to one day a week of a 24 hour fast. This means you simply skip one breakfast a week. If you are already PK auto-phagy cuts in at 16 hours. Do a two day fast once a month. This means you skip two breakfasts and one evening meal Dr Thomas Seyfried, consultant oncologist, reckons we should all to an annual fast of one week to substantially reduce the incidence of all cancers.

With Groundhog Acute - see Groundhog ACUTE - put in place at the first sign of any infection

Fasting is a no brainer – therapeutic and restful

With Groundhog Chronic - see Groundhog CHRONIC – the starting point to treat any chronic infection AND to live to our full potential

Do the GH Basic schedule then adjust the frequency of fasting according to how you feel and how pathology is regressing. One of the best predictors of longevity is the amount of food consumed. I am greedy and love food. I reckon fasting gives me the best of both worlds – you can be greedy (without bingeing) on feast days and not be hungry, helpless or hapless on fasting days.

Conclusion

Fasting is the most inexpensive therapeutic tool, it multitasks as above and the potential for side-effects or harm is miniscule**. I like that sort of medicine! When I fast the usual chores of shopping, cooking, washing up and clearing away vanish. I have more time and energy for all else. I have now come to joyfully anticipate my fasts.

**It goes without saying that the obvious exception is anyone with an eating disorder.

Overview and fine-tuning of the PK diet lifestyle

Issue	Why an issue? Good or Bad	What to do
Addiction to sugar, fruit, caffeine, alcohol, nicotine, cannabis	Addiction masks appetite and we consume for all the wrong reasons. Addictions disturb sleep quality and quantity. Addictions mask symptoms	Use addictions occasionally and in moderation
Most Westerners are carbohydrate addicts	Too much carb drives pathology: fatigue, obesity, diabetes, cancer, arteriosclerosis and dementia (type 3 diabetes)	Get into ketosis – use the ketone breath meter to demonstrate such. In ketosis your muscle and liver glycogen sponges are squeezed dry. That means the body can easily deal with any carbs in the diet. (I am usually in ketosis after breakfast, always in ketosis late afternoon)
	If you overwhelm the ability of the upper gut to digest, then it will ferment and that drives even more pathology! Symptoms include gastritis, reflux, GORD, bloating, burping and foggy brain. Pathology includes inflammation, auto-immunity, toxicity and much more	Do not overeat carbs. Take vitamin c to bowel tolerance Fast
Some carbohydrate is fine	Sugars are needed as building blocks (to make DNA, RNA and ATP) and to detox (glucuronidation), but not too much! The body can make sugar from proteins.	Use the ketone breath meter to monitor how you flip in and out of ketosis – that makes sure you are not over-loading with carbs. Get your carbs from vegetables, nuts and seeds. If you never blow positive for ketones, fast until you get a positive test.
Fats are highly desirable	As fuels – the keto-adapted athlete performs 10-15% better. As building materials – for energy delivery mitochondria, all cells especially brain and immune system	Eat fatty meats, fish, poultry, duck, eggs, butter. Lard, dripping, goose fat, coconut oil ideal for cooking Oils must not be heated (or you create toxic trans fats)
Dairy products are meant for young mammals	Too much is a risk for cancer, heart disease, osteoporosis	Cut out all dairy products. The safest dairy products are butter and ghee. Vegan butters, cheeses, coconut milks and coconut yoghurts make superb replacements
Western diets are low fibre	Fibre makes for chewing which stimulates digestion. Essential for the friendly fermentation in the large bowel to produce fuel (short chain fatty acids), vitamins (B and K) and bulk for effortless passage of stool. Friendly fermentation programmes the immune system and protects against infection	Eat sufficient fibre until you pass a Bristol stool chart number 4, once or twice daily effortlessly, ideally using a squatty potty. Make the PK linseed bread which is 24% fibre, 2% carb (see My book - Paleo-Ketogenic: The Why and The How)
Processed food	Is often addictive (high carb, low protein), deficient in micronutrients, toxic with chemicals, low in fibre.	Do not eat processed food! Eat real foods.
Eat as varied a diet as possible	We know that the more diverse the microbes of the gut the healthier. Each microbe has a liking for a certain food	Keep ringing the changes and eat foods that are in season.
	Once you have conquered addiction your body and brain will tell you what and how much to eat. It has separate appetites for protein, fat, carb, salt, micronutrients and possibly more.	Listen to your appetite – if you fancy it you probably need it!
	If we become ill, we develop an appetite for healing herbs, essential oils and other remedies. This is well established in animals and is called zoopharmacognosy – see Footnote 1. Humans are also animals.	Listen to your appetite, brain and body. When ill, it may tell you to fast and sniff!
Make sure you are eating sufficient calories	Many people half starve themselves in a misguided attempt to lose weight. This simply makes you tired, cold, foggy brained and depressed	Use the Harris Benedict equation (above) to work out your daily need
Vitamin C deficiency is pandemic	Humans have lost the ability to synthesise vitamin C from sugars	Take vitamin C as ascorbic acid little and often through the day. Everyone’s dose is different - take to bowel tolerance or to urine tolerance (test with vitamin C urine test strips - see Footnote 2) Most need 5-8 grams (5,000-8,000mgs) daily, much more for acute infections
Micronutrient deficiencies are pandemic	Soils are depleted by modern agriculture and lack of recycling of human compost back to the soils	Take a good multivitamin daily and Sunshine Salt 5 grams
Allergies are common.	Irritable bowel, headaches, asthma, arthritis often allergy driven	Cut out common allergens eg DAIRY GLUTEN YEAST Cut out known allergens
Protein is an essential on a daily basis	Protein leverage. Too little protein in the diet will stimulate the appetite to eat any food (often high carb foods) until the protein appetite is satisfied. Overeating calories causes obesity	Calculate your protein requirement as above
Food being constantly present in the upper gut	This means the stomach never has a chance to heal, repair and restore normal stomach acidity. Early supper improves sleep quality.	Eat all food within a 10-hour window of time. Do not snack. Breakfast at 7.30am, light lunch, supper by 5.30.
Food being constantly present in the mouth	This means the mouth never has a chance to heal, repair and reduce numbers of bacteria. Bacterial overgrowth leads to gum disease and tooth decay.	Ditto above.
Fasting has great benefits	Primitive man did not eat three meals a day. Fasting switches on autophagy which protects against cancer and degeneration. It switches on stem cells for the new growth of repair. Fasting clears the foggy brain. Fasting squeezes dry the glycogen sponge and gets you into ketosis rapidly	Do 24 hours fast weekly (eg skip breakfast and no lunch for one day a week) Do a 48 hour fast monthly. Perhaps do longer fasting once a year.
Exercise	Do the right sort of daily anaerobic exercise to increase muscle bulk. This keeps you strong and increases basal metabolic rate See “Ecological Medicine” chapter 23 Exercise – this must be the right sort to afford overall gains”	With more muscle you need to eat more. Jolly good! I love food and I am greedy!

Footnote 1 - zoo pharmacognosy – This word derives from the Greek roots zoo ("animal"), pharmacon ("drug, medicine"), and gnosy ("knowing"). I loved Caroline Ingraham’s book “Animal Self-Medication” full of information and wonderful case histories – we should all learn from case histories!

Interested readers are also referred to “Really Wild Remedies—Medicinal Plant Use by Animals” by Jennifer A. Biser of the Smithsonian National Zoological Park, USA . Biser describes how local people learn remedies from animals:

“In Tanzania's Mahale Mountains National Park, a lethargic chimpanzee suffering from diarrhea and malaise slowly pulls a young shoot off a small tree called Vernonia amygdalina. She peels away the shoot's bark and leaves with her teeth, and begins chewing on the succulent pith. Swallowing the juice, she spits out most of the fibers, then continues to chew and swallow a few more stalks for half an hour. Nearby, pausing only to wipe the feverish sweat from her brow, the WaTongwe woman finishes crushing a few leaves and stems a fellow tribe member brought her from the mujonso, or "bitter leaf," tree. She soaks them in a bowl of cold water while her stomach aches with a dull pain. Closing her eyes and grimacing in anticipation of the liquid's foul taste, she holds her nose and gulps down the bitter elixir, hoping this reliable remedy will rid her of the intestinal pain that's plagued her for days. Recovered within 24 hours, both of these females resume business as usual. They were both suffering the effects of an intestinal parasite infection.And, in case you haven't guessed, they both ate from the same tree.”

Reference - 'Really Wild Remedies' by Jennifer A. Biser

Footnote 2 – Vitamin C urine test strips - these are readily available online. For example, see this product - Vitamin C urine test strips

Cookery Classes

Belinda Kassapian ("beinthekitchen") offers excellent cookery classes, either online or in workshops. See "beinthekitchen"

External Links

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