The purpose of this blog is to serve as a way for me to explain what the heck it is I'm doing to myself for the next year. The number of shocked, confused or otherwise disturbed looks I've received over the past month have convinced me that it's time to put something like this together. It's obviously difficult to answer all questions someone might have in a single conversation without forgetting an important detail or mangling the delivery, so I hope that this site will serve to do a better job than I do in person!
For this blog to work, you have to do one thing for me. You have to assume that I’m not a moron, that I’m not deluded, and that I have put and am putting fairly significant effort into validating the safety and validity of this experiment. Please grant me the courtesy of an open mind and a fair hearing – if I’m wrong, I’d love to hear how and why, so long as the rebuttal is formed logically and on sound evidence.
With that out of the way, I'll start at the beginning.
I was diagnosed with Crohn's Disease in 2003 at age 19. I was in ROTC at the time and weighed in at 137 for my final PT test - and I'm 6'3". I was placed on prednisone and asacol, cortico-steroid and anti-inflammatory drugs respectively, and eventually gained weight up into the 155-165 range depending on what time of day I stepped on the scale.
For obvious reasons, this sparked an interest in diet and health. After about a year of very strict eating (according to a random plan which was based on a poorly researched jumble of knowledge), it became clear that the medication was doing its job with or without my dietary restrictions. Since I was able to live my life without thinking much about it, I gradually relaxed most of my restrictions. I still limited the dairy to hard cheese or yogurt, rarely drank (after my sophomore year in college, that is) and typically tried to eat what I believed, without much justification, to be healthy.
In 2007, I received the first indication that perhaps this strategy might not be ideal. A colonoscopy revealed a large inflammatory polyp in my intestine. Inflammatory polyps rarely develop into colon cancer and are associated with inflammatory bowel diseases, but there it was. The doctor took a biopsy and it came back negative for cancer. At the time, I shrugged it off and went on living.
In June of 2009, there was a discussion at the lunch table at work about diet and health. For some reason, I recalled something I had read about a medical study done on two men who ate nothing but meat for an entire year. There was suitable skepticism of that claim, and I couldn't remember important details, so I went back to my desk to see if what I remembered was true.
As it turns out, there actually was such an experiment. Vilhamur Stefansson and Karsten Anderson ate nothing but meat under the supervision of the Bellevue Medical hospital in
This experiment was preceded by a fair amount of controversy. The diet experts of the day proclaimed that both men would be stricken with scurvy within weeks or months and the experiment would have to be terminated in order to save them from certain death. When the year was completed and both men remained in good health, there was an even greater stir. The lead doctor in the study wrote that the most remarkable thing about the results was the totally unremarkable nature of the results - both men were hale, healthy and content.
I was somewhat startled to read all this. It took a few days of confirmatory googling before I was willing to believe that this was true, but when I discovered the text of the study on one of the medical journal publication sites, it was impossible to deny the veracity of the report. (See 1)
It was also impossible to square with what I believed to be "healthy". Fat is bad, right? Red meat causes cancer and rots in your guts, right? How didn't they get constipated without adequate fiber? They avoided deficiency diseases somehow, but how? The entire framework of what I believed to be healthy had been challenged, and it was a challenge I couldn't back away from.
I dove into Stefansson's background and discovered that he had spent about a decade, in aggregate, exploring the
THAT caught my attention.
Now, I can understand if one is skeptical of the claim that primitive populations had vanishingly small incidences of one the number one killers in modern society. I was for a while as well. However, the more I looked into it, the more independent sources I found claiming exactly that. Missionaries or pioneer doctors would go to an unsettled frontier and begin treating the native peoples. (4). So long as those natives were living according to their traditional lifestyle, eating their traditional diet, they rarely showed signs of any heart disease, cancer, metabolic disorder or tooth decay. As the frontier moved through and those cultures began to westernize, that rapidly changed. The change was so rapid that individual doctors who worked the same areas were able to record the shift over the course of a single generation.
Weston Price, a dentist in the 1930s, traveled around the world attempting to catalogue the health of primitive populations. He would compare populations of the same “racial stock”, or basically groups of people that were from the same geographical area or tribe, who were eating either a traditional diet or were eating a westernized diet. In all cases, those eating the traditional diet were in better health than those eating the westernized diet, and rarely showed any signs of the diseases of civilization. (5)
This isn't to say that pre-industrial societies were free of all ills. They still got infectious diseases, still broke bones, suffered through famine and drought and a generally harsh existence. They just didn't get cancer or have heart attacks. A standard response to this I get a lot is "oh they just died at twenty so they didn't have time to get heart disease." This is not supported by the data. The meme about cavemen only living to twenty is one of those things that one repeats without thinking or confirming it - and when you try to confirm it, you quickly realize that it's a mangling of reality. If you discount child mortality, most primitive cultures had life spans rivaling those of industrial societies. Their ages at death were close as well. (6)
As I discovered all this, I started to realize that it wasn't something I could just ignore. It was a fundamental challenge to the way I was living my life, made all the more relevant by the fact that I suffered from one of those previously non-existent diseases. I continued to read and research, but within the course of a week I was very well convinced that I needed to make a lifestyle change, if only as an experiment. So in late June, I began low-carbing.
Keto-adaption is not fun. The standard American diet is carbohydrate based - depending on what you eat on a given day, you might get upwards of 60% or more of your calories from carbohydrate. A low-carb diet is fat based. Adapting your metabolism from one to the other is not a trivial undertaking for your body. It takes a week or two before the initial period is over, more for some people, less for others. Full adaptation in trained cyclists took about 7 weeks in one study of a ketogenic diet, and that might only represent something like 90% adaptation (7). Full keto-adaption is probably an ongoing thing, much like adapting to whatever diet you happen to be eating. Worse, my Crohn's is active in the last section of my small intestine, which is where a fat and the byproducts of fat metabolism are absorbed by the body. A predominately fat based diet is not easy for my intestines to extract energy from.
At the time of this writing, I am about two months into this process. More like a month and a half. My energy levels are slowly returning. My digestive processes went through some turbulence but seem to have normalized into a pattern. I dropped about seven pounds - prior to the start of the experiment, I would weigh in at 160 or so when I woke up. Now I weigh in at 153 pretty consistently.
Sometime towards the end of July, I began reading about fiber. Fiber has become one of those things that everyone knows is good for you and which you have to have in your diet. Ask why and you will receive some logical sounding answers such as that it adds bulk to your stool, thereby facilitating elimination and preventing constipation. Sometimes people will cite studies claiming health benefits to fiber, or claim that by moving things along very quickly it prevents toxic waste from building up.
As far as I can tell from reviewing the literature, none of this is proven. There appears to be little benefit for most people in adding fiber to the diet. It has no effect on cancer rates (8). Simple and obvious questions reveal the logic behind its effects on constipation to be incorrect – ie, how is it possible that Inuit who ate vanishingly small amounts of fiber didn’t all die of constipation? No properly constructed study has shown any effect in preventing constipation (9), and indeed virtually every fiber supplement carries with it a warning that it might cause constipation!
Worse, fiber, being indigestible, always reaches the large intestine intact, where it is fermented by various bacteria. The resulting chemical action and bacterial overgrowth is speculated to play a role in Crohn’s, though the focus is usually on simple sugars. The theory is that the immune response starts by attacking a bacterial infection in the colon, but gets derailed and begins attacking all intestinal tissue.
As someone with an irritated gut lining, it seems totally counter-productive for me to eat a bowel irritant which fuels unnecessary bacterial overgrowth. Unfortunately, if one is going to eat a low-carb AND low-fiber diet, one is left with almost no dietary option except meat and animal products. It took me the month of July to really reach this conclusion, but at the end I realized that there was no point in doing this by half measures. So on July 20th, I ate my last vegetable (some spinach).
My plan for the next year is fairly simple. I will eat nothing but meat and animal products, and drink nothing but water. I will avoid all food additives including artificial sweeteners (topic for another post!). I will measure the results of this diet by keeping a food diary, logging the frequency and severity of my bowel movements (a standard metric for Crohn's), logging my weight, and soon logging my energy levels by starting and logging a workout routine.
My last colonoscopy was August 1, 2009. The doctor discovered another inflammatory polyp and noted the usual inflammation associated with Crohn's. A further test of the results of this diet will be to see what my colonoscopy next year shows. I'll probably get a physical as well.
Some people have asked what would cause me to stop this diet. Well, if my energy levels do not recover to the point where I can do the things I like to do, I would consider terminating the experiment in September. If my weight drops into the low 140s, I would stop as well. If I begin to notice anything really 'weird', I'll assume that I'm starting to have a vitamin deficiency and start taking a multi-vitamin. If that doesn't clear things up in a week or two, then I will stop the diet. At six months, I will do a “gut check” to see if I want to continue. For now I'm testing the result obtained by Stefansson and others that showed that no added supplementation was required.
It’s important to note other individuals who claim to have eaten nothing but meat for long periods without issue. Owsley Stanley, of LSD and Grateful Dead soundman fame, is a dedicated adherent of the all-meat diet. Since he’s managed to survive for decades, I’m confident I can last a year. Random googling has turned up a “zero carb” forum, which is a community of people who eat nothing but meat, usually to lose weight, various blogs of people who have turned “carnivorous”, and other contemporary examples of humans surviving for at least one year on a carnivorous diet (10) (11). We will see if I have the same result.
So that's the introduction to what I'm doing. If you're still with me, I appreciate you taking the time to read this and hopefully it covers the basics. I will be writing additional posts in the coming days focusing on some of the claims I've made above, as well as trying to address the questions that seem to come up the most frequently. Above all, I want to assure everyone that I have not gone insane, that I haven't developed an eating disorder or otherwise cracked. I'm not going to start preaching, either, although if at the end of this year I'm in better health than I was at the beginning I hope that you don't ignore the implications for yourself. I consider this my choice and I have no desire to push my choices on other people. Above all, this is an experiment. I have no idea what the outcome will be, but I have no doubt that it will be interesting!
Phil
1 - Prolonged meat diets with a study of kidney function and ketosis: http://www.jbc.org/cgi/reprint/87/3/651
2 – Not By Bread Alone, Stefansson, pg. 15 – 39
3 – Cancer: A Disease of Civilization? Vilhjalmur Stefansson
4 - Good Calories, Bad Calories, Gary Taubes, pg. 89, (whole chapter entitled Diseases of Civilization)
5 – Nutrition and Physical Degeneration, Weston A. Price, the whole book.
6 – Longevity Among Hunter-Gatherers: A Cross-Cultural Examination, Michael Gurven, Hillard Kaplan: http://www.anth.ucsb.edu/faculty/gurven/papers/GurvenKaplan2007pdr.pdf
7 - Ketogenic diets and physical performance, Stephen D Phinney:
http://www.nutritionandmetabolism.com/content/1/1/2
8 - Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies: http://www.ncbi.nlm.nih.gov/pubmed/16352792?dopt=Citation
9 - An Evidence-Based Approach to the Management of Chronic Constipation in North America, American College of Gastroenterology Chronic Constipation Task Force:
http://www.nature.com/ajg/journal/v100/n1s/full/ajg2005519a.html
11 - http://zeroinginonhealth.com/
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