A case for simplicity

Case 1. Bev

Bev is a jolly 63yo farmer who came in to the hospital after suffering a minor stroke. One quiet afternoon when I spot our medical student looking a bit out of place (well, even more so than usually) I take him to see Bev for a neurological exam practice. Bev looks flattered and obediently sits back in her bed, being the perfect patient. I remind the student that we start with a general observation of the patient,the side of bed assessment. He dutifully recites “alert, comfortable and in no respiratory distress”. I gently nudge him to describe the patient’s body habitus, the student gets instantly embarrassed and looks lost. How do you tell a patient she is fat? I explain while looking at Bev that her central obesity is an important risk factor which may be pertinent to diagnosis at hand. Bev chuckles good-naturedly: “I love me food, I’ve always been a good baker!”.

Most medical students hate the neuro exam: it’s tedious, long, complicated and seemingly impossible to make smooth. I don’t rush him and Bev seems happy with the attention. The student correctly identifies the weakness on the left side of Bev’s face. He asks Bev to blow up her cheeks, Bev makes a valiant attempt but ends up making a noise like letting out air of a balloon and promptly laughs. I hear laughs from the other side of the curtain: evidently this has been a source of amusement to other patients as well. Bev’s limb weakness is improving and we take her for a gait assessment. With her tiny feet, narrow shoulders, perfectly rotund middle and a wide crooked smile, she looks almost comically cute. The student summarises the findings of his examination and correctly identifies that Bev has likely suffered an ischaemic stroke in the area of a middle cerebral artery in the right brain hemisphere. I thank Bev for being the perfect model for us, she wisely nods:
- They all gotta learn somehow, don’t they? So you think it’s gonna get better for me, doc?
I point out that she already has made marked progress and then ask her how she feels about the future.
- Oh I know. I gotta watch that cholesterol, don’t I? No more fish’n’chips for this chickie! (laughs)
I tell her I’ll come back to chat to her about diet before her discharge, thinking I’ll get to her before she gets fed some pseudo-nutritional rubbish.

Two days later, on my day off, Bev suffered a major stroke. The nurse found her in the morning, stiff in her bed, unable to move, call out or ring the bell. The stroke affected the other side of her brain and left her completely paralysed on what just 2 days ago was her “good side”. I never got to see her again because she was transferred to another hospital to a dedicated stroke unit.

Case 2. John

I only find out about John at morning rounds as he was admitted last night. I barely have enough time to register “64yo male transferred post BKA” on my handover sheet as we enter his room. BKA stands for Below Knee Amputation. John has just had his second one. As I stand in the room while the consultant chats to John about his surgery my eyes keep drifting to an empty space below John’s knees. No matter how many times I have seen it, this sight still unnerves me.

I distinctly recollect one of my most distressing experiences in operating theatres when I was assisting in a BKA. My job was to stand at the bottom of the table and stabilise (a.k.a hold tightly) the foot and calf of the leg being amputated. I still remember own visceral startle when the toes suddenly started to move, as if in a mute protest, when the surgeon was severing the tendons at the knee. At some point through the cut the lower leg stopped being a part of the human being and became an object. As the last thread connecting it to the breathing body was dissected I was left holding that object in my hands, temporarily stunned, until the nurse offered a big bucket to deposit it in.

John is looking defiant. The consultant has just finished drawing a pretty bleak picture and suggesting a nursing home placement. I feel the hot wave of indignation at this seemingly cruel crushing of a patient’s determination to maintain independence and mobility. John repeats mulishly that he wants to have double prosthesis, he wants to walk again. Later that day I find out that my anger was misplaced. While his raging diabetes destroyed the small vessels in his feet and opened him up to ugly ulcers and gangrenous infections, John’s dementia caused him irretrievable short term memory loss and, consequently, an inability to learn new skills required for amputation rehab. He has been on insulin for years but has been steadily forgetting to inject himself in the evenings when he gets most confused.

Case 3. Pat

Pat is a 47 year old Indigenous woman who presented to our Emergency Department with chest pain. The ECG and cardiac markers do not show any signs of heart muscle damage but she is at high risk for coronary artery disease as she is a former heavy smoker and a diabetic. Routine nursing observations show that her average blood sugar has been between 25-30 mmol/L (450-540 mg/dL) over the last day. She normally takes metformin but it’s clearly not doing very much. Like many Indigenous patients she doesn’t look grossly overweight, with her skinny arms and legs sticking out of her hospital gown. The gown cannot fully hide her round belly though, and I have to double check the notes that she is not pregnant. No, she is not. I try to be gentle when I tell Pat that she is likely going to need “the needles”. Sometimes the mere mention of injecting insulin serves as a good wake up call and a good opener to the lifestyle modification conversation. Pat doesn’t seem phased: “Ok doc”. I feel a hint of frustration: the conversation is not going the way I planned. I try to bring it back to the diet, saying that stopping junk food may be an easier solution than injecting yourself every day. “I don’t eat junk food, doc! I didn’t have Maccas for yonks!” – she protests. I note a half empty 2 L apple juice bottle on her bedside table: “And what’s this? You can’t have that with your sugars!” She looks confused. I take a breath and start to rant about soft drinks and sugar but she has already turned off and when her mobile phone rings she picks it up leaving me with my mouth open mid-sentence. As she starts to chat, I walk away taking the juice bottle off her table and pouring it out into the nearest sink.

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My other life, on this blog, as a part of Whole9, on social media, is like another world. Highly motivated people sharing their success stories, intelligent eyes watching our Whole9 South Pacific presentation, challenging questions being asked – I find my enthusiasm recharged and renewed. Although recently I see more and more splinters appear in the community.

Recently a video made rounds in “Paleosphere”. Some bloggers that I respect and follow found it offensive in its simplicity. I won’t comment on the video itself, I have a few minor quibbles with it myself, although I wouldn’t hesitate for a moment to show it to my average patient. I want to comment on the “It’s not that simple” critique. Maybe it’s not that the message is too simple, maybe we are trying to make it too complicated. We dissect this diet thing to its smallest constituents, calories vs grams vs ratios vs micronutrients vs cytokines vs endocannabinoids. Critical scientific discussion is enormously valuable and discourse should only be viewed as the way forward. But somehow discourse all too quickly  turns into a personal attack, a spiteful tweet or a post from the safety of a computer screen. And, sadly, some who used to offer valuable contribution to the body of knowledge now seem to offer nothing but negativity. Are we turning into the equivalent of elderly cranky academics arguing about the best fire-fighting methods while the room is engulfed in flames?

What about your average reader who has just googled Paleo or primal or ancestral health? Are we causing “paralysis by analysis” by not making it crystal clear what we actually all agree on? Even those firmly indoctrinated in beef broth/bacon/kale seem occasionally lost. Sometimes getting lost is easy if you are given a way out – maybe Lustig is wrong and sugar is ok? Maybe Taubes is delusional and it’s time to count calories again? Oh no, this thing is not simple at all! Let’s browse through some blogs, maybe we can catch the author out, find an error in the archives and pronounce the final judgment. It’s not exactly helpful for own health problems but sure is satisfying.

I did not choose the three cases for their dramatic value, I chose them because they are average. I see between 20 and 30 Bevs, Johns and Pats daily. Sure, I love reading the latest research papers in a search for truth but for these guys I want SIMPLE. I need a heuristic. If your goals are getting to a single percentage body fat, running a marathon or continue setting PBs by doing smashfit 5 days a week (hopefully not all at the same time!) you may need more tweaking but you are not exactly your Average Joe, are you? My favourite Internet testimonial this year is a 71 yo lady on a social security budget who reduced her HbA1C, came off insulin and halved her blood pressure medications, probably without giving a second thought to the latest blogosphere drama.

We are onto something good here. It’s real and, let me tell you, it may better than any expensive medication I can offer my patients. SIMPLE will get most people most of the way there. Here is my heuristic:

- eat meat/fish/eggs + vegetables (tubers, greens) three times a day to satiety and activity levels

- prioritise your sleep

- move in a way you enjoy

Do this every day for 3 months. Without dissecting, or philosophising, or looking for a loophole. This may just be enough to see change.

 

 

 

 

 

 

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56 thoughts on “A case for simplicity

  1. Very well said!

    It’s a huge paradigm shift for most people – “simple” is the only way to avoid freaking them out and losing them.

    I’d add more but it would just over complicate things ;)

  2. I will not apologize for slamming that Slim is Simple video. I have endorsed many books and videos that contain plenty of inaccuracies such as Primal Blueprint and The Paleo Solution, but none is so inaccurate at the core like that video. Slim is not simple. Pat is likely to try paleo and get frustrated when she realizes that, like many actual older women I have known in the paleo community. I was always clear with the older women that I introduced paleo to, like my mother, that slim is not simple and that their goals were going to have to be more health-oriented and long-term. That video seemed like a thinly veiled attempt to sell a book and blogspam. Real food is simple, paleo at its core is pretty simple even with the variations that have emerged- slim is not simple. And things like “clogging foods”? It’s like something Doctor Oz would say and not at all how the body works even as a metaphor. If you need something colorful and simple, there is Practical Paleo and a host of other books.

    • Hi Melissa, I think that video is actually very similar to a Dr Oz show: simple, flashy and geared towards general audience. My gripe is not so much with the fact that yourself or others critiqued the video, but with the whole culture of debating moot points while sending out conflicting messages to a general public. There will never be a perfect video or a perfect book. And, unfortunately, people like Pam are unlikely to ever pick up a book on nutrition, no matter how colourful. I think you and I just face very different audiences. Thank you for your comment.

      • I have just looked at that video, and I think people like Pam would watch it. The broad thrust of the video is not too bad though the sink anology is a bit odd, but the message is simple and direct, and certainly a good place to start a conversation. I agree that not everyone will get “slim”, but they will get healthy. I feel people need a set of traffic lights, a few simple rules, and as they progress they can delve deeper into the nuances of nutrition, or simply stick to the program! There were heaps of further reading at the end of it as well, for those who want to go further.

        • I agree Heather. There is a huge scope to take this further if people desire. Some people may start with that video, or Tom Naughton’s Fat Head, or some other simple message. A few will make changes and get interested in further research. But the reality is, many people won’t. I don’t think it’s fair to condemn them to a lifetime of junk food just because they can’t/won’t read a journal article.

  3. Oh wow. I so love your clarity, and like you feel saddened by the suffering around us. I think one of the other elephants in the room ( and it is standing room only), is bariatric surgery. A friend of mine sees my health (and I am one of the average rather than shredded ones), but simply labels my approach as “interesting”, in favour of irreversible surgery that takes away her grehlin production and condemns her to a life of eating out of a tea cup. It’s very sad, and in some ways the simple message (the sound grabs), seems too simple. This woman felt the only way forward was a surgical response to an environmental issue. Keep talking I’m listening.

  4. I am relatively new to the Paleo lifestyle and I’m in that place where I am like a sponge – trying to absorb as much information out there as I can (and at times, the amount that is out there makes me feel very overwhelmed). I watched that video last week and I appreciated it for what it was. I say if that video affected one person enough to start introducing change to their lifestyle, then it was a success. There’s a lot to be said for stripping things back to Simple.

    • Hi Julie, fantastic to hear you are changing your lifestyle. And I totally understand how things can be overwhelming. It’s good to learn all the science behind it if you are interested but it’s NOT a prerequisite for making huge improvements in your health. One advice I give to any newbie in this: get the basics right, leave the tweaking for later.

  5. Thank you for the email Anastasia,
    I so look forward to seeing them. I have just put a link to your Blog in the Sweet Poison and the Wheat Belly facebook pages :)

  6. Really well said, Anastasia. I agree — although I like healthy debate, I feel like I see more and more splintering and fighting about micro details that just don’t matter for most of the people who want or need to try this lifestyle. There’s a time and a place for that, and I don’t begrudge those who want to do it in that time and place, but when it takes over the main message it’s hugely detrimental to what most of you (all of us) are trying to do, which is to get more people healthy.

    I enjoy reading a lot of blog posts and dissecting scientific information — and taking it or leaving it, based on my own opinions and experiences — but what I enjoy the most reading is the regular success stories, whether from Robb Wolf’s blog, or Mark Sisson’s blog, or the AWLR blog, or anywhere else. They inspire me, they reassure me. Because almost every single success story is a regular Joe finding a cure for their health problems through this sort of diet. Those are the things that matter the most to me — seeing sick people getting better. Ultimately, I believe that’s what this is about.

    I talk diet with a lot of friends, but I keep it simple unless they want more. I’ve helped half a dozen friends go Paleo and get health improvements from it, which means a lot to me, and the more they want to discuss diet, the more technical I’m happy to get. But for my friend who still lives on microwave dinners, takeout pizzas, sugar-laden alcohol, and pain meds, I keep it simple. If I overwhelm him with micronutrient discussion, he’s not going to listen. And I don’t want to lose him to diabetes or heart disease because I couldn’t shut up when I needed to.

    It must be hard for you, seeing what you see every day at work, and knowing what you know. You have real strength of soul to continue what you do; and I totally understand why you put so much into your blog and now the Whole 9 thing. I have oodles of respect for you. Keep up the fantastic work. Eventually, maybe even in our lifetime, what you see in the hospitals now won’t be the norm anymore.

    • Great comment, thanks Cassiel. I don’t think we realise how much damage we can do to this community by appearing as a constantly squabbling group, unable to agree on anything. I welcome any debate or criticism but all too often people just want to pick holes for the sake of it or find excuses that allow them to justify own bad habits.
      I use exactly the same strategy with friends: restrained, but ready to answer questions if they are interested. And thank you for your kind words. Some days I feel like we are facing this huge mountain, some days I feel like we are making small in-roads. :)

      • We are facing a huge mountain, but it’s the type of mountain that can be conquered if enough of us keep at it. All the in-roads you make, they’re making a difference! :D

  7. For me, this lifestyle is all about health. I was pre-diabetic and had watched my grandmother go through two below knew amputations. She was due to have the rest of her leg amputated higher up but lung cancer got to her first. Yes, she was diabetic. My sister is diabetic and treats her illness very casually – she is a great role model for me not to become!

    I blog about diabetes and illnesses caused by the way we eat nearly every day. I get some negative feedback from people who still hold the belief that “everything in moderation” is OK – it is not OK if you are diabetic. I was astounded to read the other day that the Australian Diabetes Council says sugar has nothing to do with diabetes!

    The level of “new sick” people astounds me and I think in the coming years, will astound everyone. I certainly don’t intent to be one of them. I totally understand what you are saying about the Paleo community and have sensed a lot of discourse among the different groups. My attitude is a simple one – real food, no wheat, no sugar, a little potato or rice if you don’t have blood sugar issues and that’s about it. I keep it really simple and for me it is all about keeping blood sugar low and even. I don’t have medical knowledge like you but I sure have tried to educate myself about why the world is getting so sick so that I can not only help myself and my family but everyone I can reach out to.

    • Lynda, I think it’s fantastic that you are taking your health into your own hands. Many people, even with a similar family history, give up or blame genetics or just blindly take the pills and injections. And you are absolutely right: people like “everything in moderation” because then they don’t have to take a good hard look at themselves. Good luck with everything.

  8. This post couldn’t have come at a better time. I recently started back on “paleo” after a year of ignorance and gross self-indulgence. I literally came to a crossroads that forced me to choose between staying in a constant state of pain, frustration, and eventual road to disease and diabetes or surrendering all the crap that got me to this position in the first place and facing the fact that in order to heal I had to accept that everything I knew about diet and health was wrong.
    I had lost 30 lbs on Atkins when I stumbled upon the paleo way of eating. I went a bit nuts and researched everything I could. In truth, I was overwhelmed by slight variations and rules that left me wondering who was right and who was wrong. I succumbed to societal pressure and fell back into old eating habits and eventually followed a doctor recommended diet that left me worse than ever . I finally just decided to glean the basics from everything I had read about Paleo. Avoid wheat, sugar, dairy, and agents of disease. Eat meat,fish,eggs, some veggies, fats, and move every day. But this was a long time coming.
    When I try and explain to others what to read and why I feel like people got overwhelmed. It’s not that simple and yet somehow it is. It’s not as simple as following this diet and immediately losing tons of weight. I am broken. Insulin resistance, adrenal fatigue, and hormonal balance have left me with a hard road ahead of me. Have I lost much weight? No, not a lot, but I already feel better and it makes all the difference. Unfortunately it’s not enough to convince the people I know that this is what will help them. A lot of people judge health by weight alone, but now I know better. I just wish they did too.

    • Congratulations on your progress. I agree the focus on weight is misguided, this is actually one of my quibbles (as I have clearly mentioned, I have had a few). Long term health must be the goal. Don’t worry about the others, you have your own health to worry about. Get plenty of support from people in a similar situation online, forums. Wishing you all the best.

  9. Very nicely said. The bickering in this community is so negative and undermines the more serious bloggers. I must say I most admire the bloggers who don’t engage in the unnecessary jousting despite being taunted and baited. Scientific argument is one thing…..but the bickering is no match for intelligent debate. Yes you need to keep advice simple for the average citizens out there. I don’t envy your task when the NHMRC releases their new dietary guidelines where they are still encouraging eating of “healthy wholegrains” and substituting polyunsaturated oils for saturated fats. They obviously missed last week’s BMJ paper on the dangers of polyunsaturated fats. Keep up the good work as more and more people will eventually get the message. Real food, realistic exercise and relaxing sleep are the ways to a healthy life.

    • Yes, Debra, the new Australian Guidelines are exactly that. The only good thing about them is the focus on food rather than nutrients and advice to reduce sugar. Totally agree re the bickering. It does more damage than we can even imagine.

  10. Probably, the Dr.Davis book is a very good example of a successful simple approach heavily slammed on few paleo blogs for some wild claims. Nowadays almost everyone who told me they decided to stop eating bread and cut on sugar told me they did it under the influence of that book. It is very fortunate for the general population that several paleo bloggers were not able to damage Dr.Davis’s successful marketing campaign. Despite all attempts to discredit him he managed to make a remarkable contribution toward public health , more substantial than all paleo-people combined. How helpful could be the introduction into the food snobbery which is a very popular theme on many paleo blogs?

    • I totally agree re Wheatbelly – I should have mentioned that in my comments. He has been responsible for much positive change due to one simple rule – cut wheat! I know he says more than that in the book but once people get the wheat message they look deeper and make further changes. His book certainly was pivotal in changing my life.

    • Dr Davies is definitely a controversial figure. I cannot help but be unsettled by his assertions but there is no denial that he probably made a bigger contribution to people getting off wheat than all of us bloggers combined.

      • I speculate that Dr.Davis choose the way he presents his case to the public based on his experience convincing his patients to change their diet and getting their attention, and he has plenty of such experience. You,Anastasia, already had a chance to notice that an average person in a hospital may need a different approach than a highly motivated paleo blog reader. What makes Dr.Davis controversial for people who are interested in nutrition, makes him successful in getting his message to others.

  11. Well said!!! I was thinking the very thing recently while listening to a podcast in which two “experts” were discussing their WEEKLY blood lipid panels :-/ One question they pondered for half an hour was from a guy who desperately wanted to reduce his body fat percentage from 15% to under 10%. I suddenly realized that I needed to go on a nutrition information fast–and quick. I’ve lost 80 lbs in the last year and am about 20 lbs from my goal, but listening to the obsessive, arcane chatter no longer motivates me. It’s starting to sound crazy and cultish.

    • Mary, I highly recommend you read our article on disconnecting on whole9. Sometimes we just need to step away from the social media, blogs, podcasts and actually LIVE what we are preaching. I keep a private Twitter account where I try to interact with people who bring value to our conversations. I try to avoid negative online people and blogs that don’t bring me much useful information. You wouldn’t invite people who you find boring, disruptive or aggressive into your house – why invite them via the Internet?

  12. great post, Anastasia — although i agree that Simple was TOO simple for universal problem-solving, i also feel that it was a good introduction to the subject for people who aren’t as interested in nutrition as some of us. as such, i posted it for friends to see on FB. it’s a sound, basic truth that “modern” foods and modern dietary recommendations have put us in the hole we’re in. if one wants to be healthy one has to make some efforts, and NOT rely on medicine to do the job by itself.

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  14. I personally liked the video, despite some inaccuracies. Simplicity is key to reaching the most people, and unfortunately, most people investigate diets or ways-of-eating due to weight problems, so stressing the ‘slim’ aspect, while perhaps slightly off, will get most peoples’ attention.
    I also agree that paleo has a PR problem. As someone pointed out, if you judge by the forums and comments on paleo sites, there are two main stereotypes in paleo that seem to dominate the conversations: 30-something males who successfully dropped 150+ pounds and are now wannabe power lifters, and 50-something obese females with numerous metabolic and glandular problems who can’t lose an ounce. And the blogs are indeed over-contentious, with (mostly male) hyper-egoed researchers or professional bloggers, criticizing others for their wrong-headedness and refusal to see the Truth (way too much adrenaline and testosterone!) Or a blog will get bogged down in some obstruse biochemical description of no use to anybody, especially since it usually involves vastly oversimplifying something that is very complex and only about 20% understood. It all gets very tedious after a while.

    Keep up the good work.

    • PR problem: I like it. It sure is fun to delve into the science but, like you said, there needs to be a simple message to the general public. For motivated patients (who are also unfortunately a rarity) I refer them to whole9life, Mark Sisson and Robb Wolf.

  15. Sadly many paleo blogs now remind me of my vegan days. Too many zealots treating diet with a religious fervor that really just turn people off.

  16. I think it’s important not to look past the fact that an awful lot of people would rather take the drug than change their lifestyle, regardless of how “simple” the message is. Your example of a patient tuning out when you were only saying to cut out sugary drinks illustrates this. And this person is ill in hospital and therefore you would have assumed highly motivated. The majority of people will probably not choose even a unified-message “paleo” diet, but it’s their choice even if it’s not mine or yours. I’ve had many conversations where people nod and agree with everything I say but they still don’t actually change anything.

    • Exactly. I think many people naively believe that we can change the world by educating everybody on the intricacies of biochemistry, endocrinology, gastroenterology and medical science in general.

  17. I agree that a simple core message would bring many people who need it most to a real food diet. What puzzles me is how you (or the creator of the video you referred to) can simplify it to the extent that you don’t even mention dietary fats. So much of the misconceptions about diet are a result of a misplaced fear of fat. I think you’re both close to something with real potential, but it’s inadequate if you act like fats don’t exist, or aren’t part of a healthy diet.

      • Thanks for your prompt response. I went to Start Here and was not surprised to find the following statement: “Saturated fat consumption has no correlation with heart disease or obesity. Replacing natural animal fats with man-made highly processed vegetable and seed oils contributes to our bodies’ pro-inflammatory state.” Back to my original point- what does surprise me is that this information (granted, in a simplified form) was not part of your basic message to the masses. Nor does the Slim is Simple video make reference to fats except one fleeting comment about avocados. Can you explain why you omitted it from your simple rule?

        • JoAnn, I am in no way affiliated with the video. I purely used it as a starting point of the conversation about how to deliver a message. Hence I have no idea what their reasoning is. From my point of view, I prefer focusing on food rather than its constituents. And of course, this is just a conversation starter.

  18. those three stories are horrible, thanks so much for sharing them!
    it is hard, i don’t tend to proselytise any more, it jsut becomes frustrating and gets nowhere.
    even when discussing sugar/high blood sugar and cancer links to someone who smokes and has lost 3 family members to various cancers does not make them stop drinking the coke.

    • Eddie, I generally avoid any diet conversations with smokers. As far as I am concerned, if a person still smokes, they are not very concerned about living in general. It’s easier just to step away and live them to it.

      • There’s a nice point that Jonathan Bailor has made in his podcasts a few times – that yeah, it’s awful that people still smoke, but the GOOD thing is that EVERYBODY (statistically, anyway) who smokes knows it’s terrible for them. They’re making an informed choice – a terrible choice, but an informed one.

        Getting to that point with food is going to take time and energy and noise, because Big Tobacco is a kitten compared to Big Agriculture – but science wins eventually, always, because it’s true.

      • Well, that seems very judgmental. In January 2012 I started eating a mostly paleo diet and exercising moderately, but it wasn’t until January 2013 that I quit smoking. I lost 80 lbs during 2012, but according to your philosophy, that’s meaningless because I still smoked.

        • I know smoking can be tough to quit. I have always been after my sister (a highly intelligent woman) to quit, but it is really hard for her. She is one of those that started when about 16; apparently the addiction gets more hard-wired into the young brain, if you start smoking before about 18 years old. And the quit-smoking aids, like the drug Chantix here in the US, can have terrible side effects. But you were absolutely right to go ahead and go paleo before quitting smoking; why wait? and who knows, it might be easier to quit after your brain settles down on paleo for awhile.

          • Thanks, Bill. It was/is very difficult. Certainly harder than giving up sugar. I also started quite young, and, while I was never a heavy smoker, I still miss it.

        • Hi Mary, it’s not judgemental, it’s reality. It’s fantastic that you have switched to Paleo diet but this would have done very little for your overall health UNLESS you also quit smoking. Being smoker increases your risk of heart disease/stroke by up to 4 times, to say nothing of cancer. Eating better and losing weight unfortunately would not mitigate that damage. And even as an ex-smoker you continue to carry some of these risks. However, like yourself, many people find that changing their diet is a “gateway” health behaviour which also helps them to quit smoking. I sincerely congratulate you on the changes you have made and wish you all the best.

  19. I agree, it should be simple but there are sooo many noisy, conflicting messages out there that it can be hard to sort the wood from the trees…even in paleo land. Having recently completed the Whole30 I feel amazing but now realise I have to live in the real world and not a 30 day food bubble. So thanks for your link http://whole9life.com/2012/11/are-you-a-good-food-island/. It made me laugh, as I think I move between the three Food Islands at the moment. Mostly I am trying very hard not to be a tedious zealot. I’ve finally found some balance with food in my life and for me it does come down to the simple list in your post.

    • Hi Suellen, I think we have all been through all three stages :) I also strive for balance daily and sometimes fail miserably by getting frustrated (mostly at the official advice, not individuals). Work in progress :)

  20. Love reading and learning what we can to naturally improve our health. My husband after three stents, seven statins a day, and BP meds was told he would never get off medication. Today, after working with Dr. Steven Grundry, author of “Diet Evolution”, he’s lost 30 pounds, works out each day, and is drug free! Food is medicine and we are believers.

  21. Do you and I see the same patients??? I am a PT in the States, and my primary treatment focus is neuro with some amputee/balance disorders regularly thrown in.

    Sadly, your first and second cases are a repeated daily case for me as well. On thought I have always had is this: are they (non paleo medical communotu) causing limited recovery in the stroke/TBI/etc neuro populations, by recommending low fat diets after their injury?

    I feel like my treatment success could be greatly enhanced

  22. If people would eat better, give the brain proper fuel for healing, and sleep! Sadly, none of this is viewed as important following a stroke….as noted at a recent conference I attended. I asked about these and was given an annoyed response of their lack of importance.

    I wish I could work with more Docs like you.

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  24. I wish I could sleep! Hot flashes despite being in menopause for 10 years keep waking me up 4-5 times a night and my mother still get them at 81. Argh!

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