Kurt Harris MD

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« Proof that orthorexia exists | Main | A quick post on FH and statins »
Monday
Feb282011

William Munny eats his vegetables


A while back I wrote a couple of essays expressing my skepticism about the notion that supplementing with plant compounds – resveratrol, acai, “antioxidants” - was a plausible route to improved health.

Do you believe in magic?

Plants and plant compounds are not essential or magic 

In the second essay I said:

Look, I don't read everything but I read a lot. I am not interested in dying early. The minute I see plausible evidence of some magic supplement working or an essential plant that is not common to all humans, I'll be the first one to promote it.

I've also expressed my skepticism that we could be evolved to be dependent on any particular plant or plant compound, inasmuch as the requirement for animal products at some level is an absolute, but probably not for plants, and in any case there is no one type of plant that has been consistently available across the variety of biomes occupied by humans.

At the same time, in posts like this, I have rejected the absurd idea that humans are not designed to eat any carbohydrate or plants. Note that this was written in August of 2009, so my agnosticism on macronutrient ratios and my emphasis on avoiding the putative NAD (neolithic agents of disease) has been a matter of record from the beginning.

I said:

I eat a VLC nearly carnivorous diet. The most important elements of this are no wheat or other grains, zero plant oils and very low fructose. Whether the carb level is 2% or 10% or even 20% with preservation of these more important parameters, I have not seen evidence there is a difference. 

PaNu is proscriptive (don't eat that food!) because the way to the EM2 is to avoid the neolithic agents of wheat, linoleic acid and fructose, not through duplicating a particular dietary composition from the paleolithic period - there was too much variety to even do that, and much of what I read about what “paleo man” ate is pure conjecture if not paleofantasy.

At the same time as I’ve scoffed at the cultural obsession with fruits and vegetables, it has always seemed plausible to me that eating some plant matter along with your animal products is probably healthier than otherwise. It’s just that most of the usual justifications for fruit and vegetables don’t ring true, and the few intervention trials where subjects have been exhorted to eat more fruit, vegetables or fiber have failed to show benefit. Such as:

 1) Women’s Health Study

2) WHEL Trial

3) Polyp Prevention Trial

Note that these trial results leave open the idea that eating some vegetables or fruits is healthier than none. They only refute the conventional wisdom that the more you eat of them, the better.

Analyses of RDA percentages, where vitamin requirements have been derived from the SAD, have never been convincing to me. I have tended to agree with Dr. Bernstein that eating some veggies is a hedge against going without unspecified beneficial compounds.

As I find meals garnished with and flavored by veggies more enjoyable, I’ve eaten plenty of veggies and some fruit even when I’ve been eating VLC. My addition of starchy vegetables (and limited rice) 6 months ago was purely for reasons of physical performance due to increased physical activity.

So to date I’ve felt that animal products should generally be favored over plants (If forced, take the steak over the potato) but eating some plant based whole foods has had two benefits besides the obvious one of palatability:

1)   Eating some starch/ sugars avoids chronic deep ketosis and improves physical performance and work capacity

2) Eating a variety of plants should be a hedge against micronutrient deficiencies in our Neolithic/industrial food environment

I’ve so far read nothing to change my thinking about these intuitions, but now Stephan has recently posted a two part series, replete with up-to-date references, which provide some scientific backing for my rejection of the “magic compounds” meme.

At the same time, he has provided an additional highly plausible reason to include a moderate variety of colorful plants in your diet, besides starch for fuel and the micronutrient hedge.

Polyphenols Part I

Polyphenols Part II

I’ve clipped some key quotes from these excellent essays, and followed with comments of my own in roman:

Stephan says:

Polyphenols are a diverse class of molecules containing multiple phenol rings. They are synthesized in large amounts by plants, certain fungi and a few animals, and serve many purposes, including defense against predators/infections, defense against sunlight damage and chemical oxidation, and coloration. The color of many fruits and vegetables, such as blueberries, eggplants, red potatoes and apples comes from polyphenols. Some familiar classes of polyphenols in the diet-health literature are flavonoids, isoflavonoids, anthocyanidins, and lignins. 

Polyphenols are often, but not always, defensive compounds that interfere with digestive processes, which is why they often taste bitter and/or astringent.

So we are not forgetting that plants can’t run. Plants elaborate defensive secondary compounds, some of which are specifically designed to mess with “plant predators” like herbivores, vegans and even normal people like us.

Polyphenols that manage to cross the gut barrier are rapidly degraded by the liver, just like a variety of other foreign molecules, again suggesting that the body doesn't want them hanging around.

Things that are rapidly arrested by the liver police should not be recruited en masse – this argues against taking antioxidant supplements or try to “load up” on one particular substance.

The most visible hypothesis of how polyphenols influence health is the idea that they are antioxidants, protecting against the ravages of reactive oxygen species.

This is the mainstream view of “antioxidants”. You can’t turn around without seeing an article advocating that we load up on blueberries, or red wine, or green tea, or whatever, for the supposed “antioxidant” effects.

For a good discussion of the basis for this meme - the idea that we need to fight the damage caused by leakage of free radicals from our mitochondrial furnaces with supplements - I recommend Sex, Power, Suicide by Nick Lane. This book is a must-read.

Suffice to say this antioxidant supplementation idea increasingly seems not just implausible, but totally back-asswards.

Here are a few references that show the perverse effects of trying to fight oxidation by eating excess antioxidants.

4) Antioxidants prevent health-promoting effects of exercise

5) Vitamin C decreases muscle mitochondrial biogenesis and hampers training-induced adaptations in endurance performance

6) Lasting antioxidant effect of flavonoid-free diet

Stephan Continues:

The body treats polyphenols as potentially harmful foreign chemicals, or "xenobiotics" 

Both radiation and polyphenols activate a cellular response that is similar in many ways. Both activate the transcription factor Nrf2, which activates genes that are involved in detoxification of chemicals and antioxidant defense**(9, 10, 11, 12). This is thought to be due to the fact that polyphenols, just like radiation, may temporarily increase the level of oxidative stress inside cells.

In other words, the benefit of low doses of radiation – the kind we get naturally all the time from cosmic rays and naturally occurring radioactive isotopes – and the slightly toxic colorful compounds called polyphenols found in fruits and vegetables, is that both act through hormesis.

Hormesis is when a small stress induces a healthy response in an organism, such that the organism is healthier than without the stress exposure. Any stress that we have defenses for, that we would expect to encounter on an evolutionary basis, is a candidate to be hormetic. Think of this as a necessary, but not sufficient, set of conditions, though.

The perfect example of hormesis is exercise. Exercise creates oxidative stress, and resistance exercise in particular literally destroys muscle tissue. Hormesis explains the “paradox” (which is no paradox at all) that marathon running and other extreme endurance sports could be quite bad for your health, but that more moderate exercise is much better than no exercise at all. This explains why I write posts like this and this, yet I continue to run about 8-10 K per week in addition to strength training twice a week.

Are you starting to see a pattern here?

Run 10-15 K/ week. Don’t run 100 K/week. 

Lift weights 1-2 x per week. Don’t lift weights every day.

Go hungry or fast now and then. Don’t be in ketosis 24/7

Eat a moderate variety of colorful plants. Don’t take Resveratrol pills.

We can extend this principle to some other areas once we understand hormesis.

Don’t freak out about dental or medical xrays if you need them.

Don’t obsess about unavoidable “microtoxins” in the food supply. The natural ones outnumber the unnatural ones, and we are designed to deal with them. Focus on the macrotoxins – the NAD (Neolithic agents of disease).

And more speculatively, we might think about other environmental exposures that are, or could be hormetic. A little is good, lots more might be bad. 

UV A and B from Sunshine – Non-burning exposure makes vitamin D and improves mood. Excess sun on white skin causes skin cancer and wrinkles.

Fructose – Creates oxidative stress and we’ve been exposed to it for millions of years. Our liver and gut defend us against large doses. In larges doses, fructose is a NAD. Could it be beneficial in small doses?

Stephan Continues:

Just as in the case of radiation, high doses of resveratrol are harmful rather than helpful. This has obvious implications for the supplementation of resveratrol and other polyphenols.

I think that overall, the evidence suggests that polyphenol-rich foods are healthy in moderation, and eating them on a regular basis is generally a good idea. Certain other plant chemicals, such as suforaphane found in cruciferous vegetables, and allicin found in garlic, exhibit similar effects and may also act by hormesis (27). Some of the best-studied polyphenol-rich foods are tea (particularly green tea), blueberries, extra-virgin olive oil, red wine, citrus fruits, hibiscus tea, soy, dark chocolate, coffee, turmeric and other herbs and spices, and a number of traditional medicinal herbs. A good rule of thumb is to "eat the rainbow", choosing foods with a variety of colors.

My food color palette is probably smaller than Stephan’s, but I do consume dark chocolate, coffee, tea and green tea in pretty decent amounts, in addition to colorful veggies like sweet potato, tomato and "Atkins vegetables" like salad greens, and limited citrus fruits.

Note the variety of plant matter mentioned, some of which (tea) does not even have caloric value. Remember, these are “plant poisons and other rotten stuff” and any particular substance will likely not be tolerated by everyone.

People say they don’t tolerate white potatoes. I believe them. People say they can’t eat tomatoes. I believe them. Some people are sensitive to coffee. Some people are lactose intolerant. Some people really are allergic to casein, shellfish, eggs or beef proteins.

So just like we are on theoretical and practical thin ice saying no one should eat dairy, or everyone should eat beef or shellfish, we can’t reasonably say everyone should eat any particular plant, only more so.

I say everyone should include some, if not a preponderance, of animal foods, and I even say for most people that ruminant products are the best, but I don’t really specify beef or lamb.

In the case of plants, because the beneficial compounds providing the hormetic effect are toxins, the effects on you personally are even more likely to be highly idiosyncratic. So how can I recommend which toxin will be best for you?

So I feel confident now making the following recommendation about plant consumption. 

Eat enough plant material to keep you out of constant ketosis. Favor plants as whole foods rich in starch over fructose for caloric value, but try to include a moderate variety of colorful plants as well, for the likely hormetic effects. After these criteria, pick the particular plants you eat based on palatability and your individual tolerance.

Back to a final summary comment from Stephan:

Supplementing with polyphenols and other plant chemicals in amounts that would not be achievable by eating food is probably not a good idea.

I sometimes think Stephan may be more British than French.

 William Munny would re-phrase this sentence to say:

 “If you take antioxidant supplements, you have rocks in your head”


Thanks to Sean for a good laugh over dubbing me the “Clint Eastwood of Nutrition” with the following imagined quote on his blog:

"I've killed just about everything that walks or crawled at one time or another. And I'm here to kill you, Ancel Keys, for what you done to the nutrition".

- William Munny is the retired gunfighter in Unforgiven, played by Clint

 

Thanks to several of my friends - Peter for providing links and further background on antioxidants and vegetables. - Dr. Mike and Dr. Emily for providing full text papers to a man isolated at ice station zebra.

NOTE: Comments are OPEN for this post. I've decided to try opening comments on selected posts when I feel I have time to moderate and read them. We'll see how it goes....

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Reader Comments (50)

Hello Dr. Harris,

I've been devouring your blog for the past few months and often come back to it and reread different posts in order to convince myself that the way I've begun feeding my family (PaNu, of course) is right. The most difficult part is getting my kids to eat less carbohydrate in the form of bread, pasta, cereal (that's a big one), etc. I've resorted to giving them gluten-free products instead, although I don't know if that is good for their health in the long term. What do you think?

I also have a question regarding what you wrote in this post about not worrying about the microtoxins in our food supply. All the the literature I've read has scared me into staying away from the fruits, vegetables and meat and dairy products that are the most contaminated with synthetic pesticides and herbicides, antibiotics, etc., as much as possible. Have I been wasting my money on these foods? Even if the synthetic chemicals on them and in them aren't as horrible as we are lead to believe, aren't they considered to be more nutritious than conventionally produced foods?

Thanks for your time in responding to my questions.

February 28, 2011 | Unregistered CommenterAnik B.

I am a recent adopter of Paleo Nutrition and given I have started weight training a few months ago, I have heard the recommendation that I take vitamin supplements. My current regimen per day is: 8 Omega-3 capsules, Calcium, Vitamin D, Vitamin E and Vitamin C. I am convinced that this schedule is beneficial, however I have recently seen a documentary "Food Matters" that argues that one could effectively take as many vitamins as he/she chooses. The film goes on to argue that very high doses of some vitamins (C for a myriad of disorders and Niacin (B3) for depression) can cure chronic conditions. Should I be wary of what I heard from this documentary in light of this article you have posted for today?

KGH: Spend some more time reading the blog. I only take magnesium.

February 28, 2011 | Unregistered CommenterRyan

Hey Kurt,
Thanks for opening up the comments, I've been wanting to ask you a question. Even though this is not an area that you concentrate on, I think it it related. Anyways, like you I am very interested in eating foods that won't kill us, I'm also very intrigued by what the body needs at it's most basic level to support muscle and general functions but not appreciable levels of body fat. I'm not a bodybuilder but I do like to research around how to lose bodyfat safely while ignoring all the noise out there. With that said, I agree with you that staying out of ketosis makes sense, therefore carbohydrate intake should be enough to avoid chronic ketosis while supporting physical activity levels. After carbs, I think protein would fall somewhere between 70-120 grams after reading Brad Pilons research. That leaves fat. While I know that there are lots of good things in grassfed ruminant fats, Kerry Gold butter for example, and some omega-3's from wild salmon likely won't hurt, I'm just curious as to how much one would need. My thought experiment would be to define the base level of nutrition that one would need to average in order to not harm the body but also at the same time not support much body fat, say north of 8% for a male. I don't know if you think about this stuff but I'd be very curious to hear your thoughts. Thanks for your posts, there are very valuable in sifting through all the nutrition junk out there. Also, sorry if this didn't flow too well. I wrote it on my cell so it's hard to re-read.

KGH: I can't tell what your question is.

February 28, 2011 | Unregistered CommenterMark

I'll assume you are talking about whether organic food is worth the money. Eating so called "organic" is a complex topic hard to answer in few sentences. Generally the whole concept is itself unscientific. It's more of a political and marketing concept.

As plants grow by assembling inorganic molecules into living structures, the concept of "organic" grown foods really makes no sense.

And crude oil is 100% organic.

Organic pasteurized low fat milk, for instance is still lowfat milk. Certified organic grain fed meat is not as good as not certified grass fed. So for animal products I pay attention to only pastured and I could care less about "organic". With fruits and vegetables, it is more about the variety than the organic certification. I personally don't ever pay extra for organic vegetables, but that is because I eat a lot of home grown stuff and stuff I buy locally at farmer's markets. None of that is certified organic.

And you probably already know that some "organic" pesticides are actually more toxic than "synthetic" ones....

The one upside to the "organic" label is avoiding the GMO products.

February 28, 2011 | Registered CommenterKurt G. Harris MD

Sorry for the word dump. I'm basically asking your thoughts on the minimum amounts needed for fat and protein to keep the body healthy, assuming one does some resistance training and doesn't eat The Neolithic agents. You have already covered carbs. Thanks Kurt.

KGH I neve measure these things for myself so I can't really do it to for you. If you are eating 20% of calories as starch, and the rest is animal products, eat to satiety and you'll get plenty. This is not really one of those weigh and measure bodybuilding sites

February 28, 2011 | Unregistered CommenterMark

Kurt,

Thanks for the shout out, I reckon you write mighty fine when you ain't all likered up and killin' everything that walks or crawled..

Very interesting hypothesis that hormesis is responsible for the actual benefits of antioxidants. It bypasses all these hypotheses about loads of different antioxidants being required in different amounts to balance metabolic oxidation. The idea that it is the hormetic load as opposed to the quality or variety or naturalness of antioxidants certainly has an Occam's Razor simplicity to it.

February 28, 2011 | Unregistered CommenterSean

This pans exactly with what I observed in Africa. For the last 10 years I've been several times on Comoros and Gabon and contrary to other mzungus (whities), I was always completely immersed in the local environment. This meant I ate, drank, slept exactly like the locals. What I noticed in both cultures is the variety of plants used but in very small quantities, only the caloric dense starchy plants were consumed in bigger quantities (kassava, ignams, taro, rice). , These colored plants were more used as spices than anything else. Meat of course was highly valued especially offals. Fruits are consumed, but only seasonally (yes even on the equator does the supply of fruits follow seasonality) and as treats. On Comoros, people also eat only twice a day, they prepare for an evening meal and the breakfast consists of eating up the leftovers. Through the whole day, nothing else is eaten normally.

Second point. I think it is also a big mistake put fruit and vegetable in the same category. As you did with your macro-nutrient deconstruction, we should absolutly separate fruits from vegetables. I don't think that kale, spinach or kassava-leaves have the same impact, function and result than mangoes, pears and apples on our metabolism.
That's the thing that drives me nuts since I looked into the nutrition "science", everything gets mixed up until the message can not be useful. ALA mixed with DHA, EPA, natural trans-fats CLA with the artificial one, fruits with vegetable, starchy plants with greens and so on..

KGH: I did not mention the preference for veggies over fruits because if you're trying to limit fructose at all that will come naturally. Thanks for your comments. They square well with Prof. Gumby.

February 28, 2011 | Unregistered Commentergallier2

I have been living and gardening in Florida for last 11 years and as a result I got an impression that plants are in a disproportionally more danger from insects then from herbivores or omnivores.(there is a forest behind my garden - plenty of wild life). So defense mechanisms in plants should be developed mostly against insects.Of course, there are some spikes and thorns - those are aimed towards herbivores. Only since recently most people live without parasite colony inside. It seems likely that people developed a taste for plants with bitter, hot, flavorful compounds in order to fight insects with the weapon designed for the same purpose by plants and got extremely adjusted to have the deference chemicals in circulation to the point that living without such toxins is almost as unhealthy as living without germs.

February 28, 2011 | Unregistered CommenterGalina L.

I truly enjoy this blog.

Like many I've been around the horn on 'eating'.

What has always irked me is this: If a largely plant based diet is best, then what exactly did humanity do the 8 months a year plants are not available for consumption?

Maybe it is just me, but advice flying in the face of simply truths and reality should tweak that part of our brains that detects nonsense.

February 28, 2011 | Unregistered CommenterMike Shea

Thank you for another great post, Dr Munny. "Any man don't wanna get killed better clear on out the back."

Anik, Denise Minger did a good post re organics - deadly "natural" pesticides, what's worth it, the least nasty produce etc:

http://rawfoodsos.com/2010/04/30/the-lowdown-on-organic-foo/

You should read her excellent blog if you haven't already. If only for ammo vs. powerful vegans and their books.

KGH: Bruce Ames first pointed out that natural toxins are more abundant than man-made ones. Been a while since I read his stuff, though.

February 28, 2011 | Unregistered CommenterRichard M

Sounds good Kurt. Thanks for your input.

February 28, 2011 | Unregistered CommenterMark

Welcome back, Dr. Harris/Munny (I know you weren't really gone, but it was feeling a bit that way). I am thoroughly enjoying this exploration.

The Archives of Internal Medicine released study results a couple weeks ago purporting to show that fiber intake --- particularly grain fiber intake --- was inversely related to death from cardio, infectious and respiratory diseases. (I'd paste the link in, but I'm not sure what "All HTML will be escaped" means!)

I'd be curious to get your take on this.

February 28, 2011 | Unregistered Commentermattman26

Hi Matt

Need a link to a full text paper and then time to comment. No guarantee, though.

February 28, 2011 | Registered CommenterKurt G. Harris MD

Hmmmm. Here's an extract http://archinte.ama-assn.org/cgi/content/short/archinternmed.2011.18

I don't have access to full text; perhaps another reader will be able to supply it.

Matt

February 28, 2011 | Unregistered Commentermattman26

Hi Dr. Harris

I am still unsure about your running regimen - 10-15 K/ week. That does not sound moderate to me at all
though I have no insights or reasons of my own. If one subscribed to the heart-beat rhythm theory (Art De Vany's) of chronic cardio promoting metronomic heart-beats as opposed to the natural fractal beats, then 10-15K runs per week would seem to be enough to induce them. Or it could all be horseshit. I'm not sure.
What do you think?

KGH:

When natural heart beats are actually "fractal", that is called atrial fibrillation - an abnormal arrythmia - and it has squat to do with running. I would avoid listening to economists theorize about cardiology.

10-15 K a WEEK is "chronic cardio? Maybe 10-15 K a DAY is.

Another dumb "paleo" myth, even dumber than thinking we have to do lots of cardio to avoid heart disease.

February 28, 2011 | Unregistered CommenterContemplationist

I think Mat is talking about a study Mark recently mentioned.
http://www.marksdailyapple.com/will-eating-whole-grain-fiber-help-you-live-longer/

February 28, 2011 | Unregistered CommenterMichal

I am really glad you broke down this stuff into understandable language. Some of these posts I come across are hard to understand without signifigant scientific backround.

I understand that I am healthy and some vegetable, fruit and startch will not harm me, and will actually help by adding a little stress to my system. As far as overweight individuals you recomend high fat, moderate protein and almost no carbs from vegetables or elsewhere. Being in a state of ketosis/ketonuria. Is this still the recomendation?

February 28, 2011 | Unregistered CommenterClay

"When natural heart beats are actually "fractal", that is called atrial fibrillation - an abnormal arrythmia - and it has squat to do with running."

Kurt, I have been doing a lot of reading recently about Heart Rate Variability and what happens when you overtrain (and clearly 10-15K per week of running isn't overtraining). From what I understand, a healthy resting heart shows a great degree of variability, being modulated in short cycles by the parasymphetic nervous system and over longer cycles by the sympathetic nervous system. In an overtrained state, you will likely see less variability (and this state looks very similar to chronic stress). As a proxy for HRV, you can also look at orthostatic heart rate (the difference in your resting HR in a seated vs. a standing position). When all is well, you will see a pretty decent gap between the two reading; however when you are stressed or overtrained, the gap decreases. Does this match your understanding?

...Tim

KGH: Pretty much, yes. When overtrained, your sympathetic tone will be more "on" and therefore higher heart rate in the AM and probably the vagal tone will be overrridden with inspiration, etc.

My endurance athlete friends say to pay attention to morning HR as a sign of overtraining. Mine is about 48 in the AM and about 60 right now. If I do exhausting physical work for days on end, or if I get only 6 hours of sleep, it will be closer to 60 or more when I wake up.

The other way the HRV can decrease pathologically is in diabetes. Glycosylation damage will affect the function of the vagus nerve - an autonomic neuropathy. Dr. Bernstein mentions this as a fairly sensitive physical sign for the adequacy of blood glucose control.

February 28, 2011 | Unregistered CommenterTim Huntley

Hello Dr. Harris. Maybe I missed it in your prior blog entries, but why do you recommend against constant ketosis. I've been in "weight loss mode" for the last ~18 months and have been maintaining ketosis, but I'm now approaching "weight maintenance mode" and am starting to explore how/why I should shift my eating habits.

Thanks in advance for any reply, and thanks for such an excellent blog. It's one of my top recommendations when friends ask how I lost all my weight.

KGH:

Thanks! You can read Thoughts on Ketosis parts 1 and 2 just a few blog posts ago. If adding back some starches, try sweet potato hash browns fried in coconut oil for breakfast, or just add some chopped up white potatoes to your bone broth or stew. You can also add some boiled white rice to chili.

Fair warning - eating cooked potatoes later when they are cold can give you gas due to resistant starch formation.

I'm sure this will start a firestorm too, but ripe bananas are great. Mostly starch and not too much fructose. Very portable. Excellent travel carbs and great after workouts.

February 28, 2011 | Unregistered CommenterChris B

I am thankful you opened comments. I didn't want to send an email about a post, but find commenting more appropriate.

I loved your post quoting Isaac Brock. It blew my mind because I never took you to be an indy rock fan. Your blog went from a 7 to a twelve in my book. Maybe I shouldn't entrust my health to a rock star predisposition. But **** it. I never would have thought in a million years you knew who MM was, let alone quote on of their most prolific lyrics. I find the thought process so interesting.

My other favorite thought from that song goes something like " O'h my God and O'h my cat, I told my dad what I need..." An Atheist who puts as much credentials in his cat as he does God..

I had the pleasure of spending a couple hours hanging with IB and his sidekick "The Regal" about seven years ago. Hands down the most interesting guy I have ever met. Still have his signed set list with the running ink from the Greyhound he spilled on it. The crazy thing in my mind is that you would have such a diifferent and yet equally engaging conversation.

He is the weirdest/most interesting person I have ever met.

You don't have to post this. I know it doesn't add shit to your site. If you want some rare MM just email and it is yours.

KGH: Yes, I am a huge Modest Mouse fan. For lyrics, I love Nick Cave and old Elvis Costello as well. You're saying you have some music files? I would be quite interested.

February 28, 2011 | Unregistered Commenterclay

Hi Dr. Harris
I’m glad you’ve opened comments, I have a question. What is a reasonable time period to observe/conclude re health biomarkers vs nutrition changes? Cell replacement half-life, 1-3 years? Quick background. Went from normal weight and healthy to normal weight and healthier on a diet like the one you recommend, SAD previously. Now 8 months later I am eating about 1000Kcal/day more, feeling great, not gaining weight but wondering were the extra energy is going. BTW there are no obvious symptoms to suspect poor nutrient absorption or parasites. In my view your outlook on nutrition is refreshingly rational. I would add to that, the value of experimentation for some, but only because of my personal experience.
Morris

February 28, 2011 | Unregistered CommenterMorris39

Not to much to add, but I appreciate how Panu represents paleo as something beyond Atkin + organic with miscellaneous creepy rules.

The answer to why eating fruits / veggies apparently has some benefit over being 100% raw meat on paleo boards tends to run into some crazy, defensive, statements.

February 28, 2011 | Unregistered CommenterTurnkey

Thank you for opening up comments. I'm glad you are back posting again, adding your unique voice to the "Paleo" sphere.

Dr. Eades said in one of his posts that a small amount of fructose improves glucose metabolism. So if your question about a small amount of fructose was not rhetorical maybe he could provide you with details.

I'm of to read your posts about ketosis. I'd come to the conclusion that it was a desirable state, but have to admit that maybe it could be overdone. Most days I'm zero carb, but I'm not fanatical about it (I've heard that there's this guy gunning for the fanatical zero carbers - he compares them to Hezbollah).

Kgh: yes I've heard that. I was talking about a hormetic effect.

March 1, 2011 | Unregistered CommenterWalter

Dr. Harris,

I usually don't comment, especially if I have nothing substantial to add, even more especially if the blogger has outed his problem with comments (which I understand very much). But, here I am saying: superb post! Very nuanced and very easy to read, very calmly delivered.

My question is about hormesis in general. You said something that I have thought for longer and makes a lot of sense, but didn't find any research on: hormesis only works if the stressors have been part of our evolutionary history. That would mean the sort of stressor and the dose.

Would this imply that wheat and seed oils are not candidates for hormesis?

March 1, 2011 | Unregistered Commenterpieter d

PS - I'm on the last chapter of The Worldly Philosophers. Thanks for the book recommendations. I've bookmarked that page.

March 1, 2011 | Unregistered CommenterWalter

I am in for ripe bananas, they have almost become my staple carb (well, not really) along with half and half

Strangely enough, during my today's walk I had Cave's Deanna playing in my head while pondering some nutrition/lifestyle issues and then I realized that PaNu blog is kind of Nick Cave-ish: loads of excellent lyrics in every piece, need twenty big buckets to catch them in.

March 1, 2011 | Unregistered CommenterTomas

Hi Dr. Harris and thanks for opening up this post to comments. All of these thoughts about hormesis seem to jive well with other theories about what is being called the "Anabolic" and "Catabolic" states. Anabolic is, obviously, when the body is growing both fat and muscle, and it is initiated by ingestion of protein and/or glucose (real food). Restriction of protein and/or glucose (or complete fasting) will cause activation of the Catabolic state. Anabolic would involve some activation of mTOR while Catabolic is a product of increased AMPK signalling.

So, my point: all of the hormetic agents you and Stephen mention seem to activate AMPK signalling, causing temporary cell autophagy, sympathetic nervous system activation (think when you drink coffee or eat chocolate, or during exercise), which leads to lipolysis, proteolysis and general "house cleaning" for the cells and any mis-folded proteins.

Our evolution, as I see it, never had much simultaneous mixture of the Catabolic agents you mention AND the Anabolic ones (protein and glucose). In other words, we weren't finding berries at the same time as eating a hunt, or spicing meat (anabolic) with garlic or pepper (hormetic/catabolic) or having red wine with our steak. There was a clear delineation between ingestion of Food and ingestion of Other Plant Stuff With Hormetic Properties.

Could the confusion between mTOR signalling with AMPK signalling caused by our "balanced eating" of fruits, vegetables, spices, sugars and meat at the same meal be part of the cause of diseases of civilisation?

KGH:

I am not sure what to call this kind of ad-hoc reasoning, but it seems to be prevalent in paleo-land and is partly why I dislike the paleo label. Starting with an armchair assumption about what hominins or humans were"exposed to over millions of years of evolution (which is quite out of reach), and then saying that any two things that were never experienced at the same time (as if we could possibly know such a thing), if we put them together, that must be bad because it "never" happened during millions of years of evolution....

Don't combine fat with carbs?

Protein with glucose?

Don't combine steak with pepper?

We were designed by evolution to break if we eat foods to which we are otherwise perfectly adapted in such a way that they occupy our guts at the same time? Paleo man is smart enough to know this and observe this "rule" through 3 million years of evolution?

There is no a priori reason to assume that novel food combinations should be harmful. More to the point, a rule like "paleo man would not eat berries at the same time as meat" is not only unknowable, is makes no sense if you really think about it.

Here is a quick counterfactual.. Breakfast in the HG tribe is meat leftover from last night. The hunting party leaves and immediately a beehive or bunch of berries is encountered. Gastric emptying half-time for solid food is over an hour, and they are only 30 minutes into the hunt. They have no wristwatches nor any knowledge at all they they even have stomachs, but they have keen instincts about such things. A young hunter begins to grab a handful of berries and is stopped by his elder, who grabs his arm and give him a stern look. "It's bad medicine to combine carbohydrate and protein, young man, leave those berries for the birds." Or bears, or pigs, or other omnivores that can be observed to eat sugar and fat and protein in close proximity.

"There was a clear delineation between ingestion of Food and ingestion of Other Plant Stuff With Hormetic Properties."

How can such a thing be knowable?

March 1, 2011 | Unregistered Commentergunther gatherer

KGH wrote: Fructose – Creates oxidative stress and we’ve been exposed to it for millions of years. Our liver and gut defend us against large doses. In larges doses, fructose is a NAD. Could it be beneficial in small doses?

I was listening to Mat Lalonde on the Paleo Solution, who explained the mechanisms behind fructose consumption quite nicely, and I'm paraphrasing: 'Fructose increases the activity of glucokinase, which means that your liver gets converted into a sugar-sponge when you have a lot of fructose around [possible rationale for sports drinks if you’re actually performing in elite endurance events such as the Tour de France.] (my brackets) A large bolus of fructose and glucose is going to rapidly fill liver glycogen stores, which means the remaining carbohydrates are going to be fed to the krebs cycle. Citric acid or citrate is going to overflow out of the citric acid cycle which is going to be fed into a pathway that induces de novo lipogenesis, and de novo lipogenesis is going to turn the carbohydrate into a fatty acid called palmitic acid.'

Kgh: I consider that part of the defense mechanism, not hormesis in the typical sense.

With the Tour de France analogy, when you have a high demand for glycogen, fructose may be seen in this context as the fastest, most efficient, substrate to replenish glycogen. (The Gatorade alibi?)

I'm not sure if this argues for the benefits of fructose in small doses, but small doses could theoretically supply the same 'benefit' that relatively larger amounts of glucose might be required for glycogen repletion, but also suggests that it would be easier to OD on the stuff as well, if we we're getting more of it than 'nature' intended.

March 1, 2011 | Unregistered CommenterBobK

Do you recommend B-12 and Folate supplements for those who take Metformin? I know people who follow PaNu guidelines but are unable to achieve normal BG without the Metformin due to hepatic issues.

March 1, 2011 | Unregistered CommenterRene

Would you consider musing about the relationship between nutrition, mechanics and osteoarthritis at some point?

As a healthcare educated fossil, I always regarded it as a DJD disorder and ran across a management CME which gives the current definition as joint failure as a result of impaired healing/ inflammatory contributors.

I'm digging around in the literature, but so far haven't found studies correlating traditional diets with the incidence and prevalence of OA. However, I did run across an Australian study that demonstrated a benefit of meat ingestion on hip OA while not showing a relationship with knee OA. Not being able to see the full study, I don't know what variables were controlled and how strong the study was.

The literature only references nutrition in relation to reducing obesity in patients with OA. It doesn't discuss nutrition as a preventative or as a treatment to reduce inflammation, enhance tissue integrity or to correct metabolic derangements.

March 1, 2011 | Unregistered Commenteraek

@Clay

I don't mean to put words in Dr. Harris' mouth but he states in his Thoughts on Ketosis I post that "PaNu is not intrinsically a weight loss prescription. It is not therapy. It is just eating in a non-damaging way." If you still need to lose a lot of weight (as I do), I think staying VLC (in ketosis) should be the immediate goal and his wonderfully succint weight lost post still applies.

March 1, 2011 | Unregistered CommenterEF (not Hutton)

Hi Dr. Harris,

First, let me just say thank you for writing this blog; it is certainly one of my favorite sites on the web, and I am very glad you take the time to write posts like these. I've read both of Stephan's posts and this one several times, and I had a couple of quick questions I was hoping to get your thoughts on.

First, I was wondering just how "strong" you consider the hormetic effect from plant compounds to really be. I've read Peter's "Fruits and Vegetables" series of posts, and he makes several good arguments that decreasing antioxidant consumption can sometimes be beneficial (such as the study (6) you quoted in this post), while increasing consumption probably doesn't have any significant effects (like (1), (2),and (3) above). I very much like Stephen's ideas on the hormesis model of how plant compounds may be beneficial, and I think it (along your thoughts in this post) explains a lot, not just about vegetables but about moderation in life in general: exercise, sunlight, fasting, etc... At the same time, though, I thought some of the beneficial results Stephan used to illustrate the effects of polyphenols in particular were actually rather small in the grand scheme of things - such as a slight reduction in blood pressure from drinking a half liter of OJ every day. This may be a good example of a positive hormetic effect, but I doubt you'd recommend drinking this much juice every day just for the hesperidin. I thought the benefits in most of the examples Stephan used just didn't seem as large or as beneficial as some of Peter's examples in limiting antioxidants, making me wonder just how good hormesis from polyphenols can really be, relatively speaking.

My question really boils down to the recommendation you make to "include a moderate variety of colorful plants". I definitely accept that this can be beneficial due to hormesis, and I would never argue to avoid vegetables; my question is about the phrase "moderate variety". Is this mostly aimed towards those who would claim that all vegetables are poisonous and should be avoided, which is clearly unreasonable? Or is this a stronger recommendation - should someone like me, who regularly consumes only a small variety of polyphenols (from coffee, chocolate, tomatoes, and sweet potatoes, plus limited fruit and green leafy veggies) actually make a deliberate effort to include a wider range of plants, solely to induce hormetic effects? In your opinion, are the benefits of hormesis strong enough to make such an effort worthwhile? Or is the question of polyphenol consumption, like the macronutrient ratio, just a wide spectrum of healthfulness - something like "it's healthier to eat at least some variety of plants than none at all, but stupid to take supplemental megadoses of plant compounds; anything in between is probably good". Would you agree with that sentiment, or am I off base?

Second, I would love to hear your thoughts on Stephan's "Second Mechanism", concerning the action of antioxidants consumed concurrently with fats to prevent oxidation of n-3 fatty acids during digestion. This caught my attention quickly, because it seems to be potentially significant; I remembered you stating that n-3 fatty acids are one of the least stable fats and are prone to oxidation in the gut. I try to eat high-GRAF (mostly from butter and cream), but most of the meat I eat is factory-farmed, bringing with it sometimes a fair amount of IRAF or NRAF as well, and I sometimes worry about getting enough n-3. Will doing something as simple as drinking a glass of red wine with dinner increase the amount of n-3 that makes it through digestion? Do you think this effect is significant enough to keep it in mind when eating, or do you think it is relatively small and unimportant?

Thanks again for writing a great blog and taking the time to participate in discussion!

-Joe

March 1, 2011 | Unregistered CommenterJoe

“If you take antioxidant supplements, you have rocks in your head”

That seems way overbroad. Different people clearly have different needs for vitamins and micronutrients -- I can easily see e.g. someone on a VLC diet be in need of Vitamin C supplements.

KGH: I didn't say VITAMIN - I said antioxidant supplements - that means taking a substance in quantities typically considered to have therapeutic antioxidant effects. People who take C for "life extension" don't take the RDA (which is based on the SAD in any case), they take grams at a time. If you are eating so low carb that you risk a C deficiency, the solution is to have a more normal diet by eating some potatoes, not to take a pill.

Sure, throwing down your throat tens of pills and capsules a day of everything under the sun "just in case" is a remarkably bad idea, but that's not a counter-argument to intelligent use of antioxidants, especially if you have a general idea about your personal levels of oxidative stress and how they vary.

KGH: I disagree. I agree with Stephan that eating whole foods is the best way to get the hormetic stress from antioxidants that may be beneficial. The whole point of our posts is that they don't work by countering your personal level of oxidative stress at all. The hormetic effect is that they enhance it.

March 1, 2011 | Unregistered CommenterKaa

As I was reading this post, I thought, "What a shame he doesn't allow comments; I'd love to be able to thank him for his writing."

So thank you!

March 1, 2011 | Unregistered CommenterTom

hehe KGH: "If you are eating so VLC that you risk a C deficiency, the solution is to have a more normal diet by eating some potatoes, not to take a pill."

....common sense at it's best, love that comment. If people would just apply it to themselves and stop trying to mock everyone else.

March 1, 2011 | Unregistered CommenterMallory

I didn't know about the leaving your email condition for comments. I says "optional" so I left it out with my last comment. Anyway I hope my second attempt will possibly allow me to hear your thoughts on my original comment. Many thanks.

BTW, lipopolysaccharides from bacteria also cause hormesis in studies. We could add that to the list, as it's definitely something we evolved with.

March 1, 2011 | Unregistered Commentergunther gatherer

Dr. Harris, please forgive the follow-up post, but I thought of a question I'd love to ask you.

I would like to know my "calcium score", but...

a) am not sure of the exact test to ask for
b) don't want to get it through my insurance, as I don't trust what they will do with the info

So, if you're willing, what test (and/or imaging device) is the one I want, and can you suggest a good way to approach a facility that might result in their offering to do that test for me for a reasonable cash amount? (And what do you think such an amount might be?)

Thank you.

KGH: Calcium scores are usually cheap - about $ 2-300 in most markets. Search the web. You want a 64 slice machine (Siemens or GE are best) at minimum for an accurate score. EBT is OK, but not as available.

names: coronary calcium, calcium score, CAC (coronary artery calcium) It's a type of CAT scan.

March 1, 2011 | Unregistered CommenterTom

KGH: I disagree. I agree with Stephan that eating whole foods is the best way to get the hormetic stress from antioxidants that may be beneficial. The whole point of our posts is that they don't work by countering your personal level of oxidative stress at all. The hormetic effect is that they ENHANCE it! Have you atually read Stephan's two posts?

Yes, I've read Stephan's posts and I've glanced at some of your references, specifically at the Danish flavonoid study (BTW, I wasn't impressed with it -- they had problems some of which they waved away by proclaiming their subjects to be high-responders and low-responders as necessary :-) They also explicitly said their findings contradict other studies).

My understanding is that oxidative stress causes a natural and appropriate response from the body (hello, homeostasis) which is generally beneficial in not-too-huge amounts. Supplying the organism with external anti-oxidants would suppress the response and so deny you the benefits.

That's all fine and dandy, but I don't think it would be controversial to say that you could have enough oxidative stress to overwhelm the natural response or get it to the too-high levels. Sure, in the ideal world the proper counter is get the oxidative stress back down (don't run marathons or guzzle pints of PUFAs), but life is complicated and all choices involve trade-offs. As I said, I wouldn't advocate taking anti-oxidants "just so", but if you have reason to believe you are under unusual, extreme stress at the moment, I don't see why they would be a bad idea.

I guess I don't like absolute pronouncements of the "X = bad, always" type :-) Actually, I don't think you like them either.

Kaa

KGH:

You are still missing the point that if "antioxidants" enhance our antioxidant defenses via hormesis, they are in fact doing it by BEING OXIDANTS, not by compensating for a high oxidative stress load via direct anti-oxidant action. So when you say:

"That's all fine and dandy, but I don't think it would be controversial to say that you could have enough oxidative stress to overwhelm the natural response or get it to the too-high levels."

and imply that it would be reasonable to add MORE oxidative stress via vitamin C or whatever, you are proposing something alien to the idea of hormesis - the idea that the Vitamin C is protecting you from the already existing oxidative stress.

"I wouldn't advocate taking anti-oxidants "just so", but if you have reason to believe you are under unusual, extreme stress at the moment, I don't see why they would be a bad idea."

It would be a bad idea because it is just more stress and hormesis by definition cannot be more of the same stress!

Getting a chest x-ray on the same day you have radiation therapy for prostate cancer is not going to be hormetic - it can't be if we stipulate that it is working via hormesis....

Adding MORE stress when you are under a lot of stress cannot possibly work VIA HORMESIS - so I will continue to say it's stupid to take big doses of anti-oxidants. If you want to argue they work via direct action, you are disagreeing with me, Stephan and Peter. And if you think they can help via hormesis in the context of an extant overload of OX stress, that is not via hormesis and I disagree.

You are misunderstanding the idea of hormesis, or disagreeing that that is how polyphenols or "antioxidants" provide benefit. Either way, you are not going to change my mind, so let it rest.

March 1, 2011 | Unregistered CommenterKaa

"Would this imply that wheat and seed oils are not candidates for hormesis?"

Hormesis can only occur when the body encounters something it believes to be a toxin.

I see no evidence that linoleic acid evinces a hormetic response. It's a perfectly reasonable PUFA that is essential in small doses and is incorporated into cell membranes, as well as being upconverted to arachidonic acid. The problem with LA is its quantity relative to LNA and its crowding out of n-3 fats from the eicosanoid pathways AFAIK.

As far as wheat, gluten exorphins are not treated as a toxin by the body...which is the problem! They should be, but instead they bind to HPTA receptors and cause havoc. Phytic acid chelates minerals, which doesn't stimulate a hormetic response...it just makes the minerals not bioavailable.

I'll let someone else discuss WGA as I'm not 100% certain of the mechanisms.

JS
www.gnolls.org

KGH: I agree, the issue with LA is that it is not "perceived" to be a toxin but is an essential (in vitamin qauntities) fat that is passively allowed to displace other PUFA in our membranes.

That's why I am starting to see excess n-6 as more nefarious than fructose, perhaps, which we do treat a bit like a toxin.

WGA is a lectin protein, so could be hormetic in very small amounts, but the mechanism would have to be different than for polyphenols most likely and I am sure the amounts would be less than in a pizza.

March 1, 2011 | Unregistered CommenterJ. Stanton

Either way, you are not going to change my mind, so let it rest.

Okay :-)

Two final points. One, I strongly doubt that specific properties of polyphenols about which Stephan writes extrapolate to all the anti-oxidants -- like, for example, the ascorbic acid. Two, the idea of anti-oxidants becoming oxidants has rather large problems with basic chemistry.

Kaa

KGH:

Sigh.

One last time:

They are not really antioxidants in vivo - they are in fact OXIDANTS. That is the whole point. They are not antioxidants in vivo. Nothing is "becoming" anything. They are causing oxidative damage. You're getting confused, I think. Go back and read Stephan's posts again. This is not a basic chemistry issue, and it is the biological property that matters anyway, not just the "basic chemistry".

Also, we are absolutely not talking about micronutrient properties like vitamins or essential fatty acids, etc. But even with these there is no evidence that supplementation beyond minimal requirements is beneficial.

March 1, 2011 | Unregistered CommenterKaa

Hi, generally in agreement with your overall approach, but have personally been looking at specific nutrients like folate and scratching my head over how one is supposed to get enough. And by "enough" I mean enough even to prevent things like spina bifida during pregnancy, etc. Seems one needs to eat an enormous qty of greens to reach those levels, and meats alone would never come close (unless you are eating liver...). If you have addressed this in other posts, a link would be great. Thanks.

March 1, 2011 | Unregistered CommenterSimon Funk

Do you still recommend ketosis or cutting carbohydrates for fat loss?

KGH: Sure, it works great.

March 1, 2011 | Unregistered CommenterKat

You and Stephen might be interested in this 2010 doctoral dissertation on phytochemicals:

http://arno.unimaas.nl/show.cgi?fid=20119

Brain Sterol Metabolism – Modulating Alzheimer’s Disease

Chapter IV: Irreversible accumulation of plant sterols in the brain

This is not necessarily desirable.

KGH: Sitosterolemia is proof of that. Phytosterols are fat soluble and so most predominant in plant oils - another reason to avoid most plant oils like corn and soy.

March 2, 2011 | Unregistered CommenterEd

Are essential antioxidant vitamins such as selenium, A, E, and C still anti-oxidants in vivo (when consumed)?

Do you think that the vitamin C in the exercise study acted as an anti-oxidant and therefore prevented the oxidation necessary for the body to respond appropriately by increase it's own defense to the hormetic stressor?

March 2, 2011 | Unregistered CommenterKatie

funny that Clint Eastwood was picked here. He was the mystery client advised by Durk and Sandy Shaw during their heyday. I often wonder what his current regimen looks like and I wonder what benefits if any, he assigns to his life extension regimen given his long and prolific career.

March 2, 2011 | Unregistered Commenterrrpf

Great blog! What about oats? They are supposed to contain fibers that are good for lowering cholesterol and contain litttle if any gluten? Do they have side effects that make up for them beeing grains and containing toxins?
I am a pilot and my flight surgeon is not too happy when he sees that my total has gone up from about 4.5 to 9 on the scale we use in Europe. I have been eating mostly the way you recommend for about a year and feel great and got from 15 bodyfat to about 9 without even trying as a nice side effect. Keep up the great work!

KGH: Read more of the blog - forget about "cholesterol" or eating oatmeal to lower it.

March 3, 2011 | Unregistered CommenterTom

For a while I've noticed what appears to be a philosophy of "conservatism" I suppose is the term, that's shared among you and others you know of. This article helps confirm this for me. I'm getting the message that what most Americans actually need is LESS: antioxidants, magic or "healthy" foods, and exercise.

For example: Rush Limbaugh's article on the "Twinkie Diet", which no doubt at least some are familiar with:
http://www.rushlimbaugh.com/home/daily/site_110810/content/01125106.guest.html
Most would be healthier with less calories PERIOD, instead of putting more food down their throats for the sake of some hidden magical nutrients.

Same deal with the HIT philosophy (Doug McGuff, Drew Baye), or Gary Taubes in regards to exercise. While most of America is deluded into believing they need to waste a ton of time on exercise like "cardio", these writers are clearly telling us this is not only unnecessary, but counterproductive.

So what I take away is that what we need is LESS: antioxidants, magic foods or food in general, exercise, and possibly less government intervention on this, too.

KGH:

Well, no. I can't agree that just eating less food is the issue. If you read more of this blog you'll see I believe that avoidance of particular neolithic agents of disease is the crux move in improving your health. Most metabolically disturbed people have an energy imbalance as a consequence of poisoning, not because they are failing to be "conservative" in their approach to eating. Eating only twinkies long term will kill you, with or without a caloric deficit. I don't care how much weight you lose due to monotony and disgust in the short term on a twinkie diet.

As far as "antioxidants and magic foods", I am arguing that we don't need them in excess for their magic properties more than that we need less of them.

My message is conservative only in saying that we should stick with maneuvers we have good evidence for being outside the EM2, and otherwise be rather cautious about adding special additives to the gas tank...

March 5, 2011 | Unregistered Commenterrobb

I hope you conclude that limited comments is a success. I feel that the comments here have resulted in increased communication and clarity rather than being a distraction. Of course its your decision, but whatever you decide I'd like to thank you for taking the time to make this experiment and for blogging. While I follow many good paleo bloggers (Peter, Stephan, Mike Eades, etc) your perspective in addition to their's has been very useful to me.

Your 12 steps has been very useful in helping interested people get started.

March 5, 2011 | Unregistered CommenterWalter

Great stuff,

I was so happy to hear about your moderate addition of starch to your diet, and the improved physical performance that came along with it.

I've tried VLC, which worked great for about 3-5 days, then I'd start jonesing for something sweet (usually I'd break down and drink a coke). Since adding a moderate amount of starch (rice, potatoes) to my diet I've had no problems staying on track, plus it seems to make it easier to lose my slightly pudgy middle.

The hardest thing now is cutting down on the seed derived oils. Canola/soy oil seems to be in everything!

Please keep up the interesting posts.

March 6, 2011 | Unregistered CommenterVanner

Fascinating post.

I guess I am still curious about minerals. While I am skeptical of "getting all your vitamins," your body cannot create minerals at will. Where do you get your iodine from? Kelp? What about potassium? I see that you get your copper and manganese from the chocolate. Still, I fear that a lot of people on this board suffer from mineral imbalances. Just asking.

Thank you for your time.

March 8, 2011 | Unregistered CommenterChris
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