The Paleo Ketogenic Diet - this is a diet which we all should follow

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Please see My book - Paleo-Ketogenic: The Why and The How for more detail.



Eating the correct evolutionary diet is the single most important thing you can do to improve and maintain health. Therefore, I make no apologies for labouring this point! In order to succeed at this diet, one must first understand the intellectual imperatives as to why such a diet is so important and then one must stick at it! The most common reasons for failing at this diet, once convinced of its importance, are that

  • Some people are so fatigued that they do not have the energy to prepare the meals
  • Many people find the 'loss' of bread is enough to make them give up
  • Equally, many people find that the 'loss' of dairy is also enough to make them give up

Therefore, there are 4 webpages that follow:

Why we should all be eating a Paleo Ketogenic diet (‘PK Diet’)

“Let Medicine be thy food and food be thy medicine”
Hippocrates, c. 460 – c. 370 BC

Humans evolved over two and half million years eating a ketogenic, paleo diet. This is the diet which best suits our bowels, body and brains. If we wish to live to our full potential in terms of quality and quantity of life, this is the diet naturally selected through Evolution.

However, evolution is only really interested in getting us to childbearing age. Once Richard Dawkins’ selfish gene has been passed on to the next generation we are effectively on the evolutionary scrap heap. We should all be eating the paleo ketogenic (PK) diet all the time, but as we age, our bowels, bodies and brains work less efficiently and so the imperative to stick with this diet increases. Younger people can get away with less correct diets and this leads many to believe that their present diet is “OK” because “that is what I have always eaten”.

Metabolic syndrome has been a helpful tool to allow primitive man to survive winters. The idea is that when the Autumn windfall comes, the carbohydrate craving is switched on as we feast on the natural and delicious Autumn harvests of grains, root vegetables and fruits. This makes us fat (food storage and winter insulation) and lethargic (energy conservation). A high carbohydrate diet switches on the hormonal response which inhibits fat burning – primarily insulin (insulin lays down fat) but also mild hypothyroidism. Of course when the Autumn feast came to an end, because it ran out or rotted, Homo Sapiens switched back into normal fat burning mode.

Primitive man gained huge evolutionary advantage through being able to run on two fuels – fats and carbohydrates. Indeed, we can eat a greater variety of foods than any other mammal (bar perhaps the pig! – I love pigs!). This metabolic flexibility plus the Agricultural revolution meant that more people survived, the land could support more of us and so more achieved child-bearing age than ever before. The population of Earth sky-rocketed with this “dual fuel effect”. However, what gets us to child-bearing age is not necessarily good for longevity. Having metabolic syndrome that is prolonged for years will dump us prematurely on the evolutionary scrap heap.

For modern Western Man, we live in a state of permanent Autumn with addictive carbohydrate foods constantly, conveniently and cheaply available. We are in constant metabolic syndrome with all the short term (fat and fatigue) and long term (heart disease, cancer and dementia) problems associated with such - see "Prevent and Cure Diabetes - delicious diets not dangerous drugs

Getting through the Metabolic Hinterland

The metabolic switch from burning sugar and starches to fat and fibre is difficult because it is metabolically easier work to burn sugar and starch. Burning fat is less efficient and metabolically expensive (which is why the Atkins diet is so effective). There is a horrible inertia in the system which means that during the switch we have a deeply unpleasant window of time when we cannot burn carbohydrate (because we are cutting them out) and we cannot burn fat (because it takes a couple of weeks for the hormonal system to switch on fat burning). This window of time is called “metabolic inflexibility”. It is so easy to give up during this window and just go back to our old ways of eating cheap addictive carbohydrates – in the short term this will give us our fix and we will “feel better” but in the longer term, this course of action has disastrous consequences. This desire to “take the easy route” has been an essential part of survival but now, in times of plenty, it is a damned nuisance!

The journey through this “metabolic hinterland” must become your personal crusade, indeed your Pilgrim’s progress. I have done it and can now smile smugly from a ketogenic nirvana. But at least I am cheering you on from the other side……so read on and be encouraged!

In summary, the metabolic hinterland is characterised by:

  • Lack of fuel (either carbohydrates or fats) for the body to burn results in horrible symptoms of fatigue, feeling cold, foggy brain and depression.
  • The temptation to go for instant relief of these ghastly symptoms by eating carbohydrate such as banana.
  • But this spikes insulin.
  • An hour later on we again find ourselves in the metabolic hinterland with the worst of both worlds - the banana fuel has run out and the insulin spike means one cannot burn fat for some hours. Back to the fatigue, the freezer, the fog and the funk hole.
  • The overwhelming temptation, which subverts all else, is to eat another banana …….and so it goes on, just like the drug addict!

This explains why so many struggle initially with the PK diet. They start off by cutting down on carbohydrates instead of drastically reducing them. They drop into the metabolic hinterland and get stuck there, lethargic, foggy, cold and depressed. Instant relief is a banana away, short term temptation prevails and they slip back into metabolic syndrome. We must be better than Oscar Wilde!

“I can resist anything except temptation”
Oscar Wilde, 1854-1900

Clinical applications of the paleo ketogenic (PK) diet

I had to work in the field of ecological medicine for 35 years, see over 20,000 patients, and write My book Ecological Medicine - The Antidote to Big Pharma and Fast Foods to convince myself that the paleo ketogenic, diet was the diet we should all be eating. Since I do not ask my patients to do anything that I myself don’t do (or have at least tried), I started this diet myself. I have to say that this was with a with a great sense of bereavement. Was I going to miss all those foods I loved and had become used to eating? But having established myself on this diet I now know that this is what I shall be eating for the rest of my life.

As I get older, and perhaps wiser. I find myself spending more and more time discussing diet. This is the starting point for treating absolutely everything! However, it is also the most difficult thing I ask my patients to do. If I give my patients a list of interventions they need to make, they tend to cherry pick, choosing the easy things first. This invariably means that the diet is the last thing to change.

Diet is the first thing we could and should be doing to restore health! The up side of this is that diet is something we can all do – the treatment is in your shopping baskets, kitchens and plates. You don’t need any physicians, pills or potions! Dietary changes are empowering – they allow us to take back control of our health. However, dietary changes are also the most difficult for all the reasons that I detail in "Prevent and Cure Diabetes - delicious diets not dangerous drugs: addiction, habit and convenience. The job of this book is to try to make these dietary changes much easier.

My job is to get patients well as quickly as possible. I used to try to be nice to my patients and pussy-foot about trying dairy free diets, gluten free diets, low carbohydrate diets or whatever. These days I am much nastier as I cruelly say “my job is to get you well not to entertain you”. These days I start off with the toughest diet in order to get my patients well as quickly as possible. Once recovered they can then, as I call it, “do a deal with the devil”. Of course, one can get away with some foods on the occasional treat basis so long as one is consciously aware of what you are doing and are determined to get back on the wagon!

“Sometimes, you must be cruel to be kind”
Old English Proverb

This diet is paleo (no grains or dairy products) and ketogenic (low carbohydrate, sugar, fruit sugar, grains and root vegetables). One can eat some carbohydrates but too much and the diet fails. The aim is to fuel the body with fat and fibre, not sugar and starch. It is not a high protein diet.

How do you know you have done enough to move into fat burning?

Changing symptoms and signs and disease regression gives us our clues that you are fat burning.

Symptoms, signs, disease regression Notes
Energy levels improve See "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis"
Your teeth become glassy smooth Dental plaque gives teeth a rough surface. Dental plaque is the biofilm behind which teeth rotting bacteria, namely streptococcus mutans, hide. These microbes can only ferment sugar and starches. The ketogenic diet starves them out. Dental decay ceases. Hallitosis is often cured (halitosis may also derive from the fermenting gut and/or airways infections (chest, throat and sinus).
Clean tongue Tongues become dirty and discoloured because of bacterial colonies sticking to and fermenting on the tongue. Tongues should be pink and free from surface crud.

Gum disease (gingivitis) is driven by sugar and starches.

You may lose 1-2kgs of weight very quickly Carbohydrates are stored in the liver and muscle as glycogen. This has an osmotic pressure - -ie it holds water. Once glycogen is used up prior to fat burning this water is peed out. This is one reason why endurance athletes see a rapid improvement in performance—the power weight ratio is instantly better.
Blood sugar levels stabilise because the body is fat burning Levels of insulin and adrenalin remain constant. (Adrenalin spikes as blood sugars fall in someone not ketoadapted - low blood sugar “hypoglycaemia” symptoms are largely adrenalin symptoms – see "Prevent and Cure Diabetes - delicious diets not dangerous drugs)
You can miss a meal without getting an energy dive One can survive on fat burning for weeks (depending on the size of your fat store!). Indeed, windows of time of fasting stimulates new brain neurones to grow and this makes us cleverer.
You stop constantly thinking and obsessing about food There is a constant and reliable fuel available to the body. The brain is not consumed by that next carb fix.
Urine tests (ketostix) or blood tests show ketones are present The ketosis is mild, rarely above 4mmol/l. This is not just safe but highly desirable. Please note by contrast, in the highly dangerous condition of diabetic ketoacidosis levels are pathologically high at >20mmols/l.

Once fully keto-adapted, ketones may not show up in urine tests as the metabolism becomes more efficient.

Athletic performance improved See above - better power/weight ratio.
Physical and mental endurance ability is better The glycogen panty only last for 1,700Kcals (about 16 miles for marathon runners at which point they “hit a wall”. US athletes call this “bonking”).

The fat pantry, even in a lean athlete, can last 140,000Kcals!

Mental performance is improved The preferred fuel for the brain is ketones. The new born baby runs entirely on ketones with the brain using 60% of all energy production! The ketogenic diet is the starting point to treat all brain pathologies from mental disease and dementia to epilepsy and malignant tumours. Once keto-adapted the blood sugar can run as low as 1pmol/l without symptoms arising.
One feels calmer once in established ketosis (but more anxious whilst I the metabolic hinterland!) I suspect the symptom of stress arises when the brain knows it does not have the physical, mental or emotional energy to deal with Life’s challenges. Being in ketosis increases the energy available in all departments.

A ketogenic diet also increases levels of the calming neurotransmitter – GABA

Gut symptoms are often improved Irritable bowel syndrome results either from food allergy (typically grains, dairy and yeast) or upper fermenting gut. Reflux and bloating are typical symptoms of upper fermenting gut. Here, microbes are fermenting sugars and starches. My guess is that most bowel tumours (oesophageal, stomach and colon cancers) are driven by the fermenting gut.
Sleep quality is better. You may need fewer hours of sleep The commonest cause of disturbed and poor quality sleep is nocturnal hypoglycaemia.

Perhaps the next commonest cause is snoring due to allergy, typically to dairy products.

Any problem associated with metabolic syndrome and fermenting gut is improved eg Type 2 diabetes, hypertension, arthritis, irritable bladder etc See "Prevent and Cure Diabetes - delicious diets not dangerous drugs.

Many conditions I suspect are driven by allergy to gut microbes. These include polymyalgia rheumatica, many arthritides (eg rheumatoid arthritis, ankylosing spondylitis) venous ulcers, auto-immune conditions, intrinsic asthma, psoriasis, chronic urticaria, interstitial cystitis, many psychiatric conditions, inflammatory bowel disease, nephritis and many other possibilities. See My book Ecological Medicine - The Antidote to Big Pharma and Fast Foods

High fat diets improve the quality of skin and mucous membranes Dry skin, dry eyes, dry mouth, dry perineums (vulva and vagina) may result from low fat diets.
Protection from infections The immune system, like the brain, prefers to run on fats.

Infecting microbes largely run on sugar so, for example, diabetics are at much greater risk of infection. Indeed, the starting point for treating all acute and chronic infection is the PK diet. The PK diet is anti-fungal, anti-bacterial and also, interestingly, anti-viral (although I have yet to work out the mechanism of this!)

Any problem associated with inflammation The ketogenic diet is anti-inflammatory
Any problem associate with fatigue The preferred fuel of mitochondria is ketones. The heart and brain run 25% more efficiently burning ketones compared to sugar
“In short, let fat be thy medicine and medicine be thy fat!”
Dr Gabriela Segura, Consultant Cardiologist and Cardiothoracic surgeon

Cookery Classes

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

The Future

Doing the paleo ketogenic diet is highly protective against the diseases of Westerners. It is also highly protective against infection. Throughout evolution populations have been controlled by disease. This will inevitably come again in the form of a new plague, perhaps compounded by antibiotic resistance. Those people clever enough to work out that the PK diet is the one we should be doing AND who are disciplined enough to hold it in place will be the survivors of this plague. Natural selection and the survival of the fittest will prevail! Perhaps this provides you with extra incentive to act now!


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