Most people on this forum know of Jimmy Moore, the high-profile popularizer of the LC diet. At Paul Jaminet's (creator of the Perfect Health Diet (PHD)) invitation and expense, Jimmy Moore and his wife, Christine, attended the most recent Perfect Health Retreat. Jimmy's passionate review of their experience led to Jaminet's reply.

None of this is news, per se, but since Moore's a public figure and made some sensational claims, I thought members of this forum might be interested in the two people's public statements.

Thanks for posting. I often find myself defending Jimmy--but in this case, yes, I think he could have been much more gracious to his host. I don't think the perfect health diet is so perfect--probably largely because I did the Zone diet for an extended time, and it really didn't take.




This part here of Jaminet's post, though, I have a bone to pick with. Glucolipotoxicity has been demonstrated in in vitro studies (tissue or cells in a petri dish etc., for anybody who doesn't know). Yes, elevated free fatty acids paired with elevated glucose causes damage. No, it hasn't been demonstrated with glucose concentrations that would correlate with a blood glucose level of 100, only with one that is considerably higher.

Also, glucose is a good correlate for how much glucose there is in the blood. What it isn't a good correlate for is how much glucose is available to tissues in the body, to be taken up from the blood. It's pretty hard for glucose to participate in glucolipotoxicity in the pancreas, liver, etc. if excess glucose never actually gets delivered to the tissues. I think it's fair to say that this is nonsense. How a person is supposed to suffer from glucose toxicity and 'glucose deficiency' at the same time is beyond me.

Edited to add;

I should probably address what Jaminet said next;



First, the "presumably" here is wrong. It isn't presumable that this decrease in alpha and beta cells was due to poisoning by glucolipotoxicity.

How does the system "decide" how many cells of a particular type should be maintained/developed in the first place? How about need? A mouse that is taking in 95 percent fat in its diet, feeding its brain on ketones, doesn't need to produce very much insulin. The need for beta cells is decreased. The same is true of glucagon. Glucagon's action is to ensure that there is enough fuel for the brain, etc. In a low glucose, low insulin setting, the need for glucagon is also greatly reduced. Large counterregulatory surges of glucagon aren't needed where the possibility of hypoglycemia (or at least hypoglycemic crisis, glucose could be quite low safely, if ketones are high enough) isn't an issue.

Bone, muscle, fat, neuronal cells. Differentiation of all of these cell types has been show to be affected by the demands put on the tissue. The liver and gut have a remarkable ability to regenerate themselves according to the demands that are placed on them. The whole system is plastic, I don't see why this should exclude alpha and beta cells.

Scaremongering.

One more thing--for a mouse, a ketogenic diet is 95 percent fat. That's because their brain as a percentage of their metabolism is smaller than ours. It doesn't take much protein and glycerol for them to be able to produce enough glucose to make ketosis unnecessary. Even the 90 percent ketogenic diet has twice as many non-fat calories as a ratio. Jimmy Moore's has three times as many, many high fat low carbers have four or times as many. By the time a mouse's diet is truly ketogenic, it's probably deficient in protein as well.

Isn't Paul Jaminet a real doc of medicine with a license to practice? He should know about hyperglycemia. I do. The whole world knows about hyperglycemia.

http://en.wikipedia.org/wiki/Hyperglycemia

Wikipedia is unreliable. It's written by regular folks. This fact and the quote above illustrates well just how much the whole world knows about hyperglycemia. It knows pretty much everything there is to know. So why not Paul? Oh wait, maybe 140mg/ld post-prandial isn't actually hyperglycemia. It is. Just not chronic hyperglycemia. It's merely transient and Paul seems to think that makes all the difference. It does not. Even transient hyperglycemia causes damage. How do I know?

http://en.wikipedia.org/wiki/Glycated_hemoglobin

The whole world knows that too. Why not Paul? Note that the bold text above explicitly applies to diabetes mellitus, but the bold text above that implicitly applies to everybody including diabetics.

Well done, Jimmy. You keep doing what you know is best for you.

Nope. He's a doctor, but not of medicine.

Can't help it. From Paul's reply:

When are carbs consumed on low-carb ketogenic diets? Never mind that. Paul, are you saying your Perfect Health Diet is expected to produce high BG post-prandial so it's not a problem? Or are you saying high BG post-prandial is a problem when somebody who normally eats LCKD suddenly eats your Perfect Health Diet? Or are you saying both? Let me rephrase. Are you saying the high BG post-prandial from somebody who normally eats LCKD makes your Perfect Health Diet look bad, so you turn it around and blame the LCKD for the high BG post-prandial instead? Yeah, that's exactly what you're saying, Paul. But what about insulin resistance? Inconsequential. The very nature of LCKD makes insulin resistance irrelevant precisely because LCKD does not cause high BG post-prandial. It's your Perfect Health Diet that causes high BG post-prandial no matter how much you wish it not to be. It's right in the name: Post-prandial.

Just read Moore's review of the Good, Bad, and Ugly. Not surprising. I have yet to read Jaminet's response, however, I'm starting to sense a McDougall-like vibe from this guy. That in and of itself is enough to make me suspicious of everything he claims.

I read Jaminet's response and didn't read Moore's. I didn't think Jaminet's response was that bad. Jaminet is perceiving through the lens of his beliefs, just as, in my opinion, Moore does.

That's true, and I still need to read Jaminet's response to be fair. Read about Moore's experience, as it seems plausible. There is no doubt he has strong beliefs and preconceived notions based on his history, however, the recounting of his experience is interesting to say the least.

I don't think Jaminet is mean-spirited like McDougall. Just a little butt-sore because his friend Jimmy's report on staying at his retreat wasn't too flattering.

But he plays awful loose with the science. He speaks as if he has certain knowledge of things that merit suspicion at most. Like dry eyes signalling a glucose/glycoprotein deficiency. When something simpler--say, the well known dehydrating effects of a ketogenic diet--might be at work.

And the whole stomach cancer thing. Somebody shows up at the Hyperlipid blog, making a loose report about Optimal dieters in Poland getting stomach cancer. So he jumps to the conclusion that a mucin deficiency, caused by a glucose deficiency, is behind the stomach cancer. And the reference he used to show that Optimal dieters in Poland have unusually high rates of stomach cancer is that comment on Peter's blog. If you check PubMed, you'll find some studies looking to answer the question of why stomach cancer seems to be unusually high in Poland. Like this one;



I have no trouble at all with the idea that some people might do better with a bit more carbohydrate in their diet, and a low sugar moderate starch approach seems a reasonable way to go about it. My big problem is with the straitjacketing. Dropping the ketogenic approach from the toolbox narrows a person's option, for some people, it might be dropping the one approach most likely to work for them. Yes, Jaminet does have a "ketogenic" version of the Perfect Health Diet but it relies heavily on MCT's, and Jaminet has a very narrow group of people that he thinks it's appropriate for.

Agree on all points. I, too, believe that taking MCTs strictly to increase blood ketones tends to be counterproductive to those embracing a ketogenic approach for health and weight control. I occasionally use MCTs, but only to maintain my daily fat intake and not to boost ketone readings. Exogenous ketone stimulating substances seem to be counterproductive with the one of the primary decisions to be in ketosis in the first place, and that's to take advantage of your natural ability to burn your own fat stores. Hey, I'm walking around with a good food source, and I want to be able to use it!

Injecting or eating ketones cause BG and insulin to drop. Dropping insulin causes fat tissue to release more fat.

If eating MCT produces more ketones, those extra ketones will drop BG and insulin more than otherwise, just like they do when we inject or eat them directly (those are extras too). This lower-than-otherwise insulin will then allow fat tissue to release more fat than otherwise. That's the hypothesis, but experiments show only small effect.

If MCT is used within a high-carb diet, I think it's unlikely to produce any significant result when carbs disrupt the very systems that produce those ketones in the first place.

I didn't find it to be particularly un-gracious. He raved about how beautiful it was and finished up by expressing gratitude for the experience. No punches were pulled with the bad and the ugly, but it was all backed up with clear reason. Had there been disparaging comments fueled by emotion over fact, I would have a poor opinion of the review, but "not nice" isn't the same as "mean".

I think it's cool that Jimmy put his money where his mouth was, so to speak. It's one thing to say "I know that wouldn't work for me" but another to actually try it. I have to admit, I wouldn't have.

I guess it's the "good the bad and the ugly" format that made me say that, more than the content itself.

The acne seems like something that could be simply random.

Jaminet's claim that he can tell whether Jimmy gained weight at the retreat, just looking at the pictures that came just before and just after--I don't know. I can't tell. Unless you have the same lighting, the same pose, the same clothes--a change in weight has to be far more dramatic, on a person Jimmy's size, to be able to really tell.



This comment by Jaminet would make sense if Jimmy were wearing the same suit in both pictures. Since he's not, it's a pretty silly statement.




So--what? The thirteen pounds must have been gained in those three post-retreat days? It's not like a 13 pound weight gain in seven days for a person like Jimmy who suddenly reintroduce carbs into the diet is all that unlikely.

And the blue--Jimmy's fans are supportive. Plus they know his history--even when people are hissing at him for some weight rebound, he's always maintained some 100+ pounds of weight loss on low carb.

What I found most interesting were the discrepancies between Jimmy's appearance and comments immediately after the retreat and his later memories. FWIW, I agree that Jimmy looks heavier in the more recent photo. A different suit isn't going to alter the bulging waist and rounded face. And the video evidence regarding the alleged acne seems impossible to refute.