Dr.D...

What curious insights...

Don't forget the lobbyists who get the 'Gold' onto the Medicare and Medi-Cal/Medicaid formularies (approved drug lists) though cheap, OTC or generic alternatives exist.

Guess who pays for these indirectly?

BTW, this does not occur at the VA MC system level which has been awesomely managed and deliver I believe good healthcare and effective drug care.

-G

Dr.D...

What curious insights...

Don't forget the lobbyists who get the 'Gold' onto the Medicare and Medi-Cal/Medicaid formularies (approved drug lists) though cheap, OTC or generic alternatives exist.

Guess who pays for these indirectly?

BTW, this does not occur at the VA MC system level which has been awesomely managed and deliver I believe good healthcare and effective drug care.

-G

Dr. D,

I was taking Armour Thyroid for several years(90mg)and levels were checked and remained 'normal'. Recently, having no rx insurance I found that the AT is considerably more expensive than synthroid, so my dr recommended I switch to the correct converted dosage to get the cheaper price.  I have been concerned that the synthroid is not as good, as effective, as the AT I was taking.  By your final comment on the post are you saying those meds are pretty equivalent in effectiveness, in your opinion? It would really help me to know if I have made a good decision to follow the price and not sacrifice effectiveness.

Thanks,
Jan

I live in the UK where strontium in the form of patented Strontium Ranelate (Protelos) is prescribed for the treatment of osteoporosis. I am prescribed it. It works ! I've been having it 18 months and my bone density has increased and it doesn't have the side effects of the bisphosphonates. The 'supplemental' form strontium (strontium citrate for example) however is not available in health food shops in the UK. In the US the supplemental form of strontium is available in health food stores but Strontium Ranleate has not been approved by the FDA - strange !

Still, I'm happy as the medication only costs me the flat rate prescription charge of £7 for three months supply....so there can sometimes be a benefit depending on where you live. It currently costs me just over £25 a month to buy omega-3 fish oil from my local health food shop so next time I see my cardiologist I'm going to ask him to prescribe me Omacor as it will save me tons of money if I can get it on prescription....don't know if he'll oblige though.

Gee, thanks for stealing my golden parachute, Doc.

With my 401(k) having turned into a 104(k) this year, I planned on enacting my Vit D analogue project in 2009 with hopes of making it big.

You've foiled my plan!

(P.S. I was also going to ask Sally Fields to be the spokeswoman for my D analogue and in the commercial, she would say something like, "I thought taking Vitamin D and Calcium would help stop my bone loss, but turns out, it didn't." Then she should plug my FDA-approved drug. Oh wait, doesn't that commercial already exist?).

Does anyone know a good Vit K2 to take, so many choices.  Thank you!

Jan Jones,
Normally you can buy a generic Armour for much less than what Armour costs.  However, since this summer there has been a supply problem with the dessicated thyroid products, which has made some of the generic forms unavailable and may have driven up the Armour price.

Cost aside, from someone who has been totally dependent on thyroid supplementation for 59 years because of a congenital disorder, Synthroid is not equivalent to a dessicated thyroid such as Armour.  Synthroid only has T4, whereas Armour has T4, T3, T2, T1, and calcitonin, which are all naturally produced by the human thyroid.  For an in-depth perspective of the superiority of Armour from a patient's point of view, see www.stopthethyroidmadness.com.
Lynn

Lynn,

Thanks for your perspective.  Since I switched about 3 months ago, I have thought I didn't feel quite the same on the synthroid but I was attributing some of that to the change.  Next week I will have my levels checked to see if it has remained in the "normal" range on the generic synthroid.  Even if it is ok, I am leaning towards asking the dr to go back to AT.  I am still wondering if Dr.D is categorizing it in the same group as the quasi-drug/vitamins he mentions, meaning it's not really any better. My dr seems to think they are equivalent.
I have read the info on AT, which is why I started on it over 6 years ago and at the time I had rx coverage. Dr.D is correct in his assertion that one way or another it's all about $$.

Jan

Grandma S., I take Thorne Research MK-4 K2.

It's a little pricey, but at dietary supplementation dosage of less than 1mg/day, a $60 bottle should last about 18 months. (1mg/day is one drop.)

Search with google for vendors with the best price.

Grandma S.,

I can't speak for everyone, but I like Life Extension's K2 supplement. It's not terribly expensive, and has more K2 than a lot of the other brands. 100 mcg of MK-7, and 1,000 mcg of MK-4. It's not the only one that's good, of course, but I like it.

Here's the link at LEF: http://www.lef.org/Vitamins-Supplements/Item01224/Super-K-with-Advanced-K2-Complex.html

Also look for LEF's K2 for a cheaper price (w/ free shipping) at healthmegamall.com.

Hope this helps!

Jan-

Sorry for the imprecision.

I believe that Armour thyroid is superior to T4-only preparations. While there are some published data to support this, real life makes it patently clear as day. People feel better, lose weight more effectively, have better cholesterol values, including Lp(a).

Jan Jones,
The way you feel is a much better measure of thyroid sufficiency than any blood test.  Blood tests don't measure what is happening at the cellular level. Factors such as adrenal insufficiency and thyroid antibodies can leave a person with good thyroid levels in the blood but not enough hormone in the cells.

I'm curious as to what levels you will be having checked.  The best blood tests for determining thyroid sufficiency are the Free T3 and Free T4, which measure thyroid hormone levels.  The TSH is a useless test for anyone already on supplemental thyroid. It is only an indirect measure of thyroid sufficiency and actually measures the pituitary hormone produced as part of a feedback loop. If you're supplementing, you've disturbed the normal feedback loop. I don't understand why doctors settle for the myriad of problems associated with TSH tests when they can directly measure thyroid levels with a Free T3 and Free T4 test.  But nonetheless the TSH test is considered the gold standard.  

Even when I have been on too low a dose of generic Armour, as measured by hypo symptoms and low-in-range FT3 and FT4 readings, my TSH level was only .011 (ref range 0.35-5.50).  After years of supplementing, I guess my brain has learned that producing thyroid stimulating hormone (TSH) is useless.  Just one example of why the TSH test shouldn't be relied on.

Lynn M
I positively endorse your comments based on experience of >30 years of T4->T4+T3->Armour Thyroid->generic (Armour)
The latter is actually shipped free of charge under Humana Medicare part D.(RightSourceRX)
(An excellent price! )
MikeV

PS:In earlier posts/comments re: thyroid,there was a suggestion that vitamin D3 supplements could significantly impact TSH readings. I would like to hear if this has been observed by others.
M

Having taken Levoxyl T4 in combination with a small dose of compounded, timed-release natural thyroid hormone when I was seeing a fantastic out-of-network endo (unfortunately, he was also out-of-state and the distance made it hard to use his services last year).

Now my new (HMO network) endo prescribed  Levoxyl (T4) only, and I can say that T4 only wasn't right for me, though my labs were great (TSH about 1.0 and FreeT4 just fine).  I just didn't feel quite right on T4 alone.  

I was able to convince the endo last spring to add Cytomel (T3) with the T4, which is much better than T4 alone, but not nearly as good as the combination of T4 and T3 in the natural thyroid extract in a ratio that mimics human thyroid physiology (98%-2%, Armour is a porcine ratio of 80%-20%).  

So I think I'm going to continue looking for a new local doc who has the expertise to use compounded natural thyroid extract in the way that worked best for me, even if it means paying more out-of-pocket.  

Like processed industrial food that will fill you up but won't nourish your body, some cheaper things just aren't worth the savings.

Mike V,

I've noticed my own TSH improve from 1.3-1.9 to 1.0 on vitamin D supplementation to 25(OH)D 70 ng/ml. I stopped vitamin D this summer and noticed the TSH trended back up to 1.3.

I've seen this trend for patients as well -- though the more wheat-damaged/addicted -- the less the improvement seen with vitamin D repletion. Guess that is to be expected.

Yes -- there is limited science but there is a significant observation between lower TSH and summer months. I wonder WHY??

Thank you for your info and all your insightful comments here!

-G

Mike V,

I've noticed my own TSH improve from 1.3-1.9 to 1.0 on vitamin D supplementation to 25(OH)D 70 ng/ml. I stopped vitamin D this summer and noticed the TSH trended back up to 1.3.

I've seen this trend for patients as well -- though the more wheat-damaged/addicted -- the less the improvement seen with vitamin D repletion. Guess that is to be expected.

Yes -- there is limited science but there is a significant observation between lower TSH and summer months. I wonder WHY??

Thank you for your info and all your insightful comments here!

-G

Dr B G mentioned the seasonal aspect of thyroid function.  I definitely think there's something to that.  

When I was first treated for hypothroidism by Dr. Kenneth Blanchard, who is located near Boston MA, he mentioned that many, if not most of his patients need a very slight dose-up tweak in the fall-winter months.   But I live in mild San Diego, so he wasn't sure if I'd experience that effect.  I saw him in early July that first time.  In hindsight, summer has always been my least hypothyroid-feeling time of year.

But sure enough,  that fall I was dragging my knuckles.  The addition of an extra 50 mcg tablet of Levoxyl for a days, followed by just one more 50 mcg tablet of Levoxyl *a week* helped a lot throughout the winter.  Periodic lab draws were used in addition to my symptoms (or lack of them).  By the time I saw him again in June (with labs drawn and reviewed in the interim) I was back to the original dose.  

This seasonal cycle has been my experience for three years since beginning thyroid hormone supplementation, and feels quite pronounced to me every Fall, but the dose adjustment needed is very minor.  I seem to have settled on a fall-winter cycle of 2 x 50 mcg Levoxyl 5 days a week, 1 x 50 mcg 2 days a week; and a late spring-summer cycle of 2 x 50 mcg 4 days a week, 1 x 50 mcg 3 days a week.

And I don't think this cycle is temperature or weather-induced, but rather by less daylight, as the San Diego area usually has some of its warmest temps in the Fall (the winds shift from the onshore breezes to dry, warm winds from the desert).  The second time I called the endo to say I had some symptoms return or increase, he mentioned that my file indicated  that I called the same week the previous year.  So it's not that I was tuned into the calendar, either, it had to be pointed out to me, though now I am aware of it, of course.

Dr B G, and Anna:
Thanks for the interesting feedback.
Vitamin D seems to be regarded as a hormone, or at least a prohormone, and I have seen it suggested that it may increase thyroid sensitivity in the tissues. If so I would expect the control feedback loop to lower the thyroid stimulating hormone (TSH) which of course calls for less to be secreted.


My interest relates to the following.
I have a 'night time only' wake up phenomenon, that is a sort of "adrenoline rush" with heart racing.
This was rare at first but increased a month or two after a Fall vitamin D3 increase about two years ago.

Now it prefers the half hour after falling asleep, or prior to normal AM awakening.
My heart "plumbing and electrical" are in excellent order, and sleep apnea has been eliminated.
   Anna, did you have specific symptoms from the extra T3 fraction of porcine thyroid, or is it perhaps just a matter of preference, or of not feeling your 'best'?
I have been using it for some years, and although aware, have not questioned it till now.
  
I guess it could be a factor in my sleeping, even with the shorter half-life. My age (72) could also be a factor.
My next step will be FT3, FT4 and 25(OH) testing.
Thank you again for the respones.
Mike V

I would be interested to know if Dr D or anyone else believes that the higher porcine T3/T4 ratio has caused specific symptoms?

Mike V,

Vit D3 is indeed a hormone precursor.  The vitamin in its name is sort of misleading.  

I've never taken Armour, so I can't comment on it.  I've always either taken straight T4 (Levoxyl); Levoxyl with a small dose of compounded natural [porcine] thyroid extract in a timed-release preparation; or Levoxyl (T4) with Cytomel (T3).  The later is what I am currently taking, prescribed by the endo in my HMO network.

The Levoxyl with the added compounded thyroid extract was prescribed by Dr. Kenneth Blanchard (author of What Your Doctor May Not Tell You About Hypothyroidism).  He feels that the 80/20% ratio of T4/T3 in Armour is not the best ratio for humans; he says they do well initially, but over time, the T3 content is too high for humans.  He's an endocrinologist MD and has a PhD in biochemistry, and he's hypothyroid himself.  He prefers to Rx in a T4/T3 ratio of about 98/2% and uses 50 mcg tablets of Levoxyl because they have no dyes that can cause issues for some people, and the compounded thyroid dose (for the T3), using a formula to come up with the 98/2% amounts.  

Dr. Blanchard is the one who came up with way I take the Levoxyl, 2 tablets some days and only 1 tablet some others, because the T4 has such a long half life in the body.  Averaging the dose like on a weekly basis seems to be fine, so I have continued to do that with my current local endo, but it does drive my current endo a bit batty, but he can find little to argue with it.  If my TSH is a bit too low I adjust how many days I take only 1 tablet up or down.

I really needed that bit of extra T3 and noticed it in mental processing and daily productivity, though I don't think it was reflected in my labs at all.  So my HMO endo added a small dose of Cytomel, but it gives me about 6% T3 now, and my TSH was .06 last time instead of hovering arounf 1.0.  So I dropped 1 tablet of 50mcg Levoxyl one day a week. I'm about to get labs done again so we'll see.  

If I had to chose my own ratio, I think I'd do best on just a bit more T3 than Dr. Blanchard allows, and just a bit less than I get in the daily 1 tablet of Cytomel, perhaps around 4-5%.  I also liked the timed release compounded version better than Cytomel, which wears off too soon due to its short half life in the body (and it's too small a capsule to divide, but I take the smallest dose).  

I have been taking a lot more Vit D3 lately to a) get my 25 (OH)D level up and to fend off colds this winter.  It'll be interesting to see if that is also reflected on my thryoid labs.  I'll report if anything significant shows up.

Incidentally, I also had some gluten and casein sensitivity and gene tests done by Enterolab (www dot entrolab dot com) recently, and I was positive for IgA antibodies (both gluten and casein), anti-transglutaminase IgA, and genes for gluten sensitivity (my son has similar results except he had one celiac gene and one gluten sensitivity gene - I know of  one person in my husband's extended family with celiac sprue).  I wanted to know this because gluten reactions often correlate to autoimmune hypothyroidism (I don't think I've ever had thyroid antibodies tested though).

Anna:
Thank you once again for your detailed response.
I will check out Dr Blanchard for info on my query.

MikeV

Mike V,

Are you taking vitamin D or A in the evening?

These stimulate people most frequently (as they are related to daytime-foods, right? and of course solar radiation exposures).

Take these during AM or daytime hours only.

Armour apparently has a short half-life -- consider with your MD and try taking only in the AM.

Hope you feel better and resolve the nighttime waking!

Mike V,

Are you taking vitamin D or A in the evening?

These stimulate people most frequently (as they are related to daytime-foods, right? and of course solar radiation exposures).

Take these during AM or daytime hours only.

Armour apparently has a short half-life -- consider with your MD and try taking only in the AM.

Hope you feel better and resolve the nighttime waking!

Mike V,

Another thought occurred to me.  How's your blood glucose? Is it steady from a fairly low carb diet?  Or could you be consuming too many carbs in the evening?

Evening carbs can initiate insulin secretion at night and drive down BG.    While sleeping, the body  senses lowered BG (maybe not even too low) and prompts an adrenaline rush to quickly raise BG, because  the liver  is "dumping" some glucose into the bloodsteam.  That series of glucose regulatory events is enough to wake some with palpitations people at the times and in the manner you describe (especially early morning, about 3-6 am), and they often see morning BG ("dawn phenomenon" as the highest BG readings of the day.  

Another thought is that if you are taking your Armour later in the day (I think many people take Armour in divided doses during the day), perhaps the last dose is too late and the relatively high T3 kicks in too strongly.  Or it could be just too much T3 for you.  In which case, a combo of T4 and Armour (to create a different ratio than 80%T4-20%T3) might be worth trying.  In my experience, though, the average endo or primary care doc doesn't want to fiddle like that, so good luck.  The ratios aren't hard to figure out (though I had to refresh my Jr High algebra memories , so maybe you could ask your doc for some samples of 50 mcg Levoxyl and titrate it yourself to see how it goes.  Hopefully you have a open-minded doc.  

BTW, I'm taking my Vit D earlier in the day now, too P (by 1 pm) because it might have been contributing to my "night owl" tendencies, too.  makes sense to not take it later than the hours of strong sun wavelengths, anyway.  

Good luck, keep us posted.

Dr B G & Anna:
Thanks for your thoughts. Incidentally I think it is not insignificant that the topics of Vitamin D and and Hypothyroidism are some of the most 'commented' on Dr D's Blog. I am convinced that getting them both right is fundamental to overall western health and well being, and all is not yet fully understood.
  
I have already pretty much eliminated the time of day, and dosing of thyroid and concluded that T should be taken in the morning, and I take nothing late at night. I have suspected for a while that T3 fraction could be a problem, but you read the Drs with T, you come across Dr John C Lowe who disagrees strongly with Ken Blanchard's position on T3. He himself has been taking solely T3 for decades without consequences!
Many seem to agree that TSH is not a reliable indicator, and FT3 FT4 basal temperature,and 'how the heck you feel' should be relied on.
Yet others suggest that we hypothyroids come in two types. Type 1 (low producers, and Type 2 (supposedly involving adrenal insufficiency). Maybe some of us can be both?

Possibly vitamin D can stimulate both the tissue sensitivity to T, and/or the ability of various tissues to convert T4 to T3.
*****************************

The following caused my (young male, 'you MUST treat the TSH number) doctor to laugh uproariously.

I told him that I had moderated my "wake up" problem with celery.
However, with celery juice, you reach a point of 'diminishing returns'.
When he asked why, I told him that celery juice is very seriously diuretic.

http://www.herbs2000.com/herbs/herbs_celery.htm


Excerpt:

The essential oil found in the celery was studied in extensive clinical researches carried out in Germany and China during the 1970s and 1980s. In these studies, it was found that the oil possessed a calming effect on the functioning of the human central nervous system and could be used to alleviate nervous disorders. On further examination, some of the chemicals in the essential oil were also found to effect anti-spasmodic, sedative, and anticonvulsant actions on the human body. The effectiveness of the oil in treating high blood pressure problems have been confirmed in studies conducted on the essential oil of the celery in the Peoples Republic of China.  

I am now trying the seed.

MikeV

It is a formula like this that brought Lovaza-brand omega-3 fatty acids to market, Niaspan brand of niacin, ergocalciferol form of vitamin D, Folbee (prescription combination B vitamins), with a slightly different spin for Synthroid (since the Armour Thyroid it is meant to replace is not a nutritional supplement, but a low-cost, generic thyroid replacement).

Really? You're trotting out the anti-carnivore rant again?
Would you like to back up your claim that we somehow need fibre?
Or polyphenols and flavonoids, and tocotrienols, in the absence of the oxidised situations they counter?
Do you consider that Vitamin C is absorbed better when dietary glucose is minimised, as the two require the same uptake system and glucose will hog that system if it's present?
If we need Vitamin K1, why didn't the Inuit suffer debilitating deficiencies?
Why didn't they die young of bone fragility if their blood pH was truly so dangerously affected by acid load?

It seems like your ideas here are based on unproven theories, not practical, clinical scientific demonstrations. If you'd like to link to studies demonstrating how individuals following a carnivorous diet (preferably one based on pastured, wild animals) suffer in the manner you've outlined, I'd love to read them.

I really respect your blog and your efforts with helping your patients find lifestyles that work for them, but uninformed, unsupported posts like these are very disappointing.

Absolutely correct, as always.  I switched from the Standard American Diet 5 years ago to a raw, plant based diet of dark green leafy vegetables, nuts, seeds, healthy fats and lean protein... no low carb, highly processed or over cooked meats. Totally eliminated wheat and corn based foods, and especially anything with HFCS. My blood sugar has dropped to below 100 1 and 2 hour post prandial and my A1C is 4.5.  Also, triglycerides are 50 and VAP shows mostly large LDL.  It really works, and I have seen it work for others who have followed the same program.  I write about it at my blog: myoptimalhealthresource.blogspot.com. Having read Dr. Davis for years, I would like to thank him for his spot on information!

How about crushing a nice 10oz grass fed, organic, free range steak along with that salad, and then the whole debate of plant vs animal debate is moot?

It's a myth that eating a high animal protein low carb diet will cause bone loss. Studies do not support this.

http://www.ncbi.nlm.nih.gov/pubmed/16718399?dopt=Abstract

to include more plant-based options in anyone's diet, this blog post from Chris Masterjohn seems to contradict your 6th point.

So although I may arch an eyebrow at that point, I still agree that we shouldn't be consuming animal products ad libitum at the expense of plant-based options.

Randy Watson

Do we really need fiber? I recall a chapter in Taubes' book saying that fiber doesn't do much for you if you're not constipated. And Vilhjalmur Stefansson went for 2 years without eating vegetables and had no problems with scurvy. Apparently anti-nutrients in carbs up our vitamin C requirements. If I recall correctly it uses the same GLUT transporters glucose does.

Lots of Carbs and  O-6 in nuts;this is good?

No thanks.. I'll stick to the eggs meat and cheese and get plenty of Vit C in the process. You absolutely don't need plants in your diet, they aren't magic..

Vitamin-C can be supplied by raw green chillies.

Is Vitamin-K1 required? I thought all vitamin-K1 does is to convert to K2.

IS Fiber essential? if yes, then in what quantity?

Dr Davis, Do the plant foods you list in your suggested breakfast menus at the end qualify as low carb?

wow, I can just see the pro-animal fat nuts rushing to retort to this one... pardon the pun, but it's like red meat to a caged lion...

Actually, it wasn't UNTIL I ate more saturated fat (in the form of butter and coconut oil) that I saw a significant improvement in my HDL. Up until that point it was hovering around 50'ish. It shot up to 80 after incorporating the coconut oil. Unless you would consider coconut oil plant based even though it's mostly saturated fat?

I sincerely attribute my improved HDL to saturated fat.

but that... but that means we can't use low carb as an excuse to indulge in an orgy of gluttony with bacon, cheese mayo and steak.

Do you think eating a balanced plant/animal diet (low-carb) would be sufficient as an everyday diet/lifestyle?

I've been doing a similar low-carb ketogenic diet the last 4-5 months and never felt better. I'm planning on doing the ketogenic diet again but my doctor and my girlfriend her dietician said that this diet is very bad for the liver and the cardiovascular system.

The only drawback in my opinion is the lack of fruits in order to stay in keto.

What's your take on this?

Oops, forgot to include the link to the paper:

http://www.ajcn.org/cgi/content/full/71/3/682

I am on a fish diet where 50% of my calories are coming from it(wild salmon) and have finally gained an ideal weight but i also eat some fruits and dark chocolate as well.There is a lot to be said about acidity factor which means that we are meant to eat both heavy and light foods to balance. The most important omission from diet would be grains , processed foods and vegetable oils.

I thought that one of the observations that explorer Steffansson made on the health of his Inuit hosts was the lack of scurvy in the settlement.

I also believe that in the absence of plant food,it has been concluded that meat can supply sufficient Vitamin C to prevent scurvy.

It seems to me that to conclude " that humans were meant to eat lots of plants" is a conclusion too far.

I suggest that the "or" in your should not be read as "either/or" but the "logical or" meaning " one or both".

Utterly ridiculous suggestion. Regardless of all the details that have been covered by previous posters, do you consider eating modern fruit and vegetables to be 'in tune' with the way we were designed to eat?

A plant based diet is only possible through modern means, mainly transportation. I'm sure American olive oil is fantastic.

I really don't think you've thought this through. Where are the calories? Do you drink a pint of walnut oil a day? Keeping carbohydrates and  animal sources down leaves you incredibly limited.

Lastly, the idea of a 'side dish' of meat is absurd. Picture the scene: Hunter Tom in England kills an Auroch, begins gorging on the bountiful fat surrounding it's kidneys but then remembers: 'oh, better stop, I have boiled nettles awaiting'.

Get real, kids don't like vegetables for a reason.

With the Inuit argument you should consider whether they consumed the gut contents of the animals they ate.

So by this reasoning we should avoid fruits because of their citric acid content?

Too many people assume that anyone on a LC diet is pigging out out on huge amounts of fatty meats and cheese, with no vegetables. This is simply not true.

It's like criticizing someone on a low-fat diet by saying they're eating a breakfast consisting of two bowls of cereal, 3 cups of skim milk, 5 pieces of toast, 2 tablespoons of jam, and 3 glasses of OJ.

If I choose to eat bacon and eggs, I'd have one poached egg with a quarter of a pat of butter, and 1 slice of bacon. Maybe 2.

In your point 1 you're comparing spinach with meat. Apples and oranges. You need to compare a complete animal- protein-including meal with a complete animal-protein-lacking meal.

Re point No. 2: you can get vitamin C from uncooked meat. Does this mean we're meant to eat uncooked meat?

I eat plenty of LC vegetables. I just don't eat an all-vegetable meal because I need protein to stabilize my blood sugar and hold me until the next meal.

It's very difficult to do a vegetarian LC diet because we need protein, and the usual vegetarian protein sources like beans and rice are too carby. The only exception is tofu, and one cannot live on tofu alone.

I totally disagree. The points on vitamin K and vitamin C are startling- very much at odds with my layman's research. Certain organ meats are sky high in vitamin C. The need for C also goes down on a low sugar diet. Conversion from K1 to the all important K2 is very poor in humans eating a plant based diet. Where is K2 MK4 found? Pastured eggs and dairy, seafood, organ meats, etc.

Ah, the voice of reason.  How the hell did you get in here?  

Stuffing oneself with 5000 calories of fat every day made no sense when I was reading Atkins 15 years ago.  I think we evolved to be able to eat healthily using animal and vegetable sources.  Our modern health problems don't stem from anything more than excesses of everything.  Although it's much harder to ingest excess vegetables compared with meat.  

kevin

The major problem I see in this recommendation is that without calorically dense, starchy carbs and/or a lot more fat it would be hard to take in enough calories. I can deal with the fat. Even Mark Sisson champions the Big Ass Salad. And Stephan at wholehealthsource has started including more veggies & carbs. I do think animal protein/fat should make up the bulk of the diet though.

Yeah, fiber's over-rated. So is olive oil. Olive oil never did *anything* for my lipid profile. Olive oil makes you fat.

People evolves, even to feed on pasta: http://www.visitlimonesulgarda.com/index.asp?menu=13.58

Thinking we're the same animal that fed on mammoths 10k years ago and that we have to eat that makes little sense.

Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense.

There are many people on the planet that live health and diets vary a lot.

Dr Davids, and anyone else for that matter, can only give pointers, but everyone has to find its own way to health and not expect it to be the same for every one and to be one single real truth.

We are 6 billion mutants with 6 billion different ideal diets

Now you're talking my language, Dr. D. Great post! I welcome more like this one. This reader wants to know everything you know on the subject of low carb plants vs high fat meat/dairy.

Jezwyn, you took the words right out of my mouth.

Let's see some proof for these claims.  You'll be hard-pressed to find it.

Tell the Masai and Inuit that you need a diet high in plant foods to be healthy.

I tend to believe that a diet with plant AND animal products is at least quasi-optimal, in part for evolutionary reasons:

http://healthcorrelator.blogspot.com/2010/02/lucy-was-vegetarian-and-sapiens.html

But on the acid-base blood balance argument, there are a number of other issues to consider:

- Lack of activity leads to bone demineralization, regardless of what you eat. Astronauts start losing bone mass soon after the start living in zero-gravity.

- Higher protein intake is associated with higher dietary calcium absorption.

- Higher serum levels of vitamin D are associated with increased serum calcium levels and bone mineralization. In fact, hypervitaminosis D leads to elevated serum calcium levels, even with low dietary calcium intake.

- The Inuit, on a traditional diet of animal meat and fat, have among the lowest (if not THE lowest) rates of tooth decay in the world - and bone mineralization is correlated with teeth health (although the correlation is not 1).

You describe my diet to a "t". Low animal products, lots of plant based. Low carb.So at 61, I am told I look in my 40's, rarely ( if ever) suffer from any of the common afflictions, and enjoy robust health. Gotta be something right about all this.
Confirmed heavy animal products in your diet lead to all sorts of problems. Minimize them and you minimize the problems.

Plants don't seem to help much in cancer prevention, so why heart disease? Fruit and vegetables have little effect on cancer risk, study finds.

Aw man, you lose credibility when you publish stuff like this...

I've been on a low carb diet for years, but my health was never so improved as when I finally cut all plant matter out of my diet.

-Amber

Is it my imagination or were the previous recommendations when I started reading this blog many months ago more evidenced-based pointing to specific studies, and lately they've been much shorter and more like "statements" of "fact" without any supporting documentation?

I don't get it.

Smells like someone's trying to court a little controversy to generate some buzz.

It's easy to forget the Stefansson all meat trial. It was supposed to answer all those questions and doubts about various deficiencies such as vitamin C or calcium. And it did in my view. So why does doubt still persist to this day?

If you believe that you should eat plants, then go ahead an eat them. But for a PSA, stick to the facts.

Sorry, in my haste to bring an argument in favor of an all meat diet, I forgot this argument against a plant based diet.

Dr Davis, you say "I believe a strong argument can be made that a low-carbohydrate but plant-based diet with animal products as the side dish is a better way to go."

It's already been weighed and measured and found to be lacking. In comes Ancel Keys and his semi-starvation experiment. It is exactly the kind of diet you propose: Low carb plant-based diet with animal products as the side dish. The result? Emaciation and neurosis. But that was a low calorie diet, you say. And probably lacked many nutrients, you say. Yes and yes. In comes the Biosphere 2 project which tried to fix one of those problems by administering the full RDA in vitamins and minerals every day. The result? Still emaciation and neurosis but admittedly to a lesser extent. Maybe it would work with ample calories?

I don't think it's merely a question of calories at this point. I think it's partly a question of essential nutrients found only in animal flesh. Or a question of the depleting nature of a high plant diet. In other words, eating a high plant diet requires more of those essential nutrients, including total calories, found only in animal flesh.

Ok. I just found your blog. Now I'm really confused. These two questions I'd like answered:

-Where do you agree/disagree with Esselstyn?

-What am I supposed to feed my three year old. He eats oatmeal and fruit for breakfast? (It's supposed to be healthy!)

Great post -- and to the vegetable naysayers -- there is more evidence to suggest than not that veggies are a healthy addition one's diet.

A low carb, non-veggie diet is an experiment -- "if" it turns out to be healthy, more power to it.

In the mean time -- I'm sticking with the decent epistemological studies out there that support the use of veggies/fruit the diet.

@ John Phillip,

I accomplished all those milestones, plus my HDL is over 70 mg/dl, all on a heavy carnivore dominant diet. John, you curiously did not divulge your HDL level.

@ Jenny,

Agreed.  Myths are hard to kill.  This acid/alkaline theory of disease is clearly a long standing one.  

Absence of renal and lung disease, the homeostatic mechanisms controlling the pH of our blood are incredibly robust and tightly regulated.  Even if you have poor regulation of bicarbonate concentrations in blood (dialysis patient) or you suffer from chronic respiratory acidosis (hyperventilation) it's not as though eating more plant foods and restricting meat and cheese will at all reverse the acidic condition these more serious underlying disturbances cause.

Even if meat and cheese yields a heavy acid load, all that may result is slightly more acidic urine.  There is no credible evidence that proves the act of intentionally alkalizing your own urine by dietary restrictions prevents or treats any disease, makes you feel better, or anything else.

The evolutionary evidence indicates our paleolithic (pre-agriculture) ancestors ate a LOT of meat. It doesn't make any sense that meat is unhealthy to humans.

And, the present-day evidence supports meat consumption, too.

In my case, I've been on a ~10% carb diet (mostly salad and vegetable carbs, no grains, very little fruits) for 5+ years. My blood stats are outrageously healthy (at 48 yrs old). HDL = 98, trigs 47, VLDL = 4, C-RP = 0.2. A1c = 4.8.  I can go on and on. I look 10 years younger than I am, my VO2 max is 52 (and I do not do any cardio), bodyfat = 10%, and I have no arterial plaque.

Sadly, I do not like seafood, so I eat red meat almost exclusively, plus a lot of coconut oil.

I also take over 40 supplements a day, including K2 (K1 is far less effective, not sure why you like it more, versus the animal version of K), tocotrienols (agree these are amazing), and numerous supps that reduce glycation, inflammation, and brain degeneration.

BTW, natural fed meats are greatly superior, but even grain fed meats are adequate. And red meat is healthier than chicken meat due to having significantly lower levels of polyunsaturated fatty acids.

I think in something so important as "nutrition", it is not possible to adopt an "one tooth paste menthality". It depends a lot on the environment, climate and hence the gut flora composition of each individual and the digestion issues.

During the past year of being part of the low-carb, paleo/primal community. I have observed for some people eating plants even in small quantities cause bloating , gut discomfort and eliminating them and a carnivoros diet has almost saved their lives , are much healthier . On the other hand some of the fittest members eat huge amont of animal food + huge amont of plant food.

As a mediterranean I am very used to eat plant food , and had concerns on eating VLC food due to acid/alkaline balance so did a bone densitometry through my traumatologist, to repeat it after 2 years feb 2010, and comparing the results ; there is a 10% bone density loss! Ofcourse in these 2 years of VLC I did a lot of mistakes with too much processed meat and LC junk foods at the beginning, and was an evolution towards the grass fed meat and realfood. And also the fact that a part from walking , I am quite sedentary too!

For me never felt right to leave out the plant food so drasticaly when I was doing VLC,I can enjoy a nice juicy beef steak , but with a side of salad or some steamed veg , the joy is even more and feels much better on my guts and the BG levels.

So is the matter of each personal biochemistry process and many factors influencing it.

It is a question of indivitual trial and error and listening to ones body needs. Then decide to be carnivoros, VLC, plant based, animal based , paleo or primal.

Dr. Davis,

I'd definitely be interested if you personally see results with any of your patients taken delta gold. I've been taking it a year now. I'm just trusting the small clinical trials, and hope they are legit.

Maasai are plant-eaters as well as meat-eaters.

Comment from Ethnobotany of the Loita Maasai   about the great "meat-eating Maasai" tribal culture:


"Animals are kept both for economic reasons
and as a source of food. Milk from cows, especially
fermented, is the main traditional food of the
Maasai. Herbal soup is an important part of the
diet for most people, men and women alike, but
especially for the warrior age group. It is taken as
a health food by ordinary people and as a drug by
warriors. Meat is usually eaten during ceremonies.
Wild food, especially fruits, tubers, resins and
roots, are still important, particularly to women
and those taking care of animals in the field."

Full-text here:http://unesdoc.unesco.org/images/0012/001266/126660e.pdf

David--

As we do not use tocotrienols in the program, we have no formal experience with it.

However, having had an extended conversation with Dr. Barry Tan, I have to say it is worth looking at again, though my in-depth interest dates back nearly 20 years.

The Masai may eat some animal foods, but they certainly aren't a "side dish" as you recommend.

Inuits eat lots of meats, but also eat plants.

Dr. Weston Price on observing the eating habits of the Inuits during the first 20 years of the 20th century (before substantial Western influence on the Inuit diet took root):

"The food of these Eskimos in their native state includes caribou, ground nuts which are gathered by mice and stored in caches, kelp which is gathered in season and stored for winter use, berries including cranberries which are preserved by freezing, blossoms of flowers preserved in seal oil, sorrel grass preserved in seal oil, and quantities of frozen fish. Another important food factor consists of the organs of the large animals of the sea, including certain layers of the skin of one of the species of whale, which was found to be very high in vitamin C."

Organ meats and the fat of cold water creatures are indeed richer in vitamin C than muscle meat that we consume. When is the last time you ate muktuk?

Oops, that should have read "The Masai may eat some plant foods, but they certainly aren't a side dish as you suggest."

I agree with a low carb diet based on animal and vegetal products, but I diagree with a so high fiber diet. See 'Fiber Menace' book, recommended by Weston Price Institute.

Help for the nut-allergic, please.

Dr David and all, you have a interesting tocotrienols report in Nutraceutical Magazine september 2009, its about newest tocotrienol supplement formulation, in page 42

http://www.nutraceuticalmag.com/NBT/pdf/2009/NBT_SO09.pdf

You're right. so all in all, the key is to balance everything and place more emphasis in eating plant-based foods than animal products, specifically meat. I've tried a low-carb diet upon my doctor's reccomendation due to my hypertension, and although it's not easy at first(coz I'm used to eating lots of carbs), I got used to it after some time.

You lost me on this one.

This is getting ridiculous. Carbohydrates are evil and animal products are bad. Yum, I'm looking forward to my dinner of olive oil, carrots and five different types of nuts! The Auschwitz diet, it really works!

We only became human because our ancestors included increasing amounts of meat and animal fat in their diet, which provided enough energy/EFAs for our brains to grow, which made us more intelligent and able to get even more meat and fat. Had they kept to their plant-based diet, we would still be swinging from the trees.

That, and cooked tubers. As in, potatoes.

What you are promoting on this site is anorexia and food phobias.I'm sure eating so little that your heart atrophies is super "heart healthy".

The article seems to be supported by vegan myths and our modern cultural bias/squeamishness against meat more than scientifically established facts.

Other skins such as those from large animals such as horse and smaller animals such as ... Plant-based parchment: Parchment paper. thanks for sharing the information.

That is a really interesting line of thought, and plus, I'm an on-and-off reader of your blog and really respect your opinions. I've been on the meat and cheese mostly diet, along with the occasional veggies, nuts, berries, melons, etc. Its a good way to eat, for me, but hey its a boring diet and I've been wanting some change and variety for quite some time. I'm going to take a crack at switching things up for a while, in the way that you are suggesting, and see how that goes for me. I certainly don't see any harm in giving it a shot. I'll comment back at some time in the future, probably on another post, and let you know how it goes. Thanks again for your insight. -- Mike

Jezwyn - were you going to just borrow my thunder or steal it?

Kidding - I could not have made those points as well or concisely as you did, thanks.

"Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense."
No, it doesn't, but when it actually happened, euros who lived/ate with the inuit reported more than once that they thrived.  This was tested in a hospital setting and confirmed.  In other words, we've more EVIDENCE that the Inuit diet was not beneficial because they were some genetic mutant - it was beneficial for humans in general.  

Congnitive dissonance?  only if you've bought the unproved conjectures so rampant in the science of diet.

I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion.  Having view points out there for people to make up their own minds is terrific.  But in the end we have to decide what we believe in.

great work Dr. D. stay the course and the debate will be healthy..pun intended.

Anonymous said...
"I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion. Having view points out there for people to make up their own minds is terrific. But in the end we have to decide what we believe in."

I agree.  Unfortunately the emotion in any hotbutton issue leads the insecure to spew vitriole which makes it harder to stay connected to the dialogue.

I'm hoping the doctor continues to espouse his viewpoint here.

Just read thru all the posts and what a hilarious set of temper tantrums!  Since we live in modern times, we can easily supplement K2, D3, and omega 3 (I certainly do on plant based diet)(for omega 3 I take about 200 mg/day of plant source DHA drops).

There are studies and there are studies and you have to actually read the details to see what they are measuring.  A little more fruits and veg than the crappy SAD, as in the study cited above, will have relatively little benefit though even at the amounts in the study there was a slight benefit.  Many Masai in fact were found to have plenty arteriosclerosis, just huge arteries from much more exercise than you or I will ever do.  Inuit skeletons do show severe osteoporosis and they tended to died young from hard living in a very tough and unforgiving environment.  Look around the rest of the world, aside from Inuit and Masai, all traditional cultures ate very small amounts of animal based foods and mostly plants.

Personally, my blood sugars postprandial were running 175-200 for several hours. Switched to no animal fat and reduced fat and calories and they would still spike but stay up much shorter duration.  Currently I eat 100% plants, getting about 35% fat from unsalted, raw nuts and around 150-160 grams of carbs per day. Carbs and protein also coming from about 1 1/2 cups beans per day. Protein is about 15% of calories. My postprandial sugars stay under 110 and usually are under 100, even with a little fruit tossed in for dessert...  Everybody has to find their own way but you guys really need to read research more carefully.

I had a doc tell me once he seldom if ever talked diet w/ patients as getting them to change was likely harder than getting them to change their religion!  I think that was cop-out as it is so important but a lot of truth there as well.

Stefansson's meat only trial is not conclusive, X-rays were use to measure osteoporosis which only detects it once there has been a 30% reduction in bone mass. Obviously, you are not going to lose 30% of bone mass in a year. You can read more about it here: http://donmatesz.blogspot.com/2010/03/paleo-diet-ph-does-it-matter-part-vii.html

There are also frozen eskimo skeletons that show severe osteoporosis in women that are only 30 years of age.

Eskimos were pushed to a really extreme environment in which we certainly did not evolve. Why anyone would use their diet as a model diet blows my mind.

We evolved in East Africa with dry and wet seasons. Warm all year round. It allowed for plenty of vegetation to grow, and for plenty of animals to thrive.  Tribes living in that region have a diet high in both animal and plant products. It's low in fructose and most of the carbs are coming from tubers (yielding a net alkaline effect). Some nuts may be used as well but not to the extent it was used in this post.

Is there an association between meat consumption and calcium excretion?

Is there an association between calcium excretion and bone loss?

Is there an association between meat consumption and bone loss?

Depending on what studies you read, there is an association w/ higher protein intake and bone loss, particularly for animal protein though I think plant too.  Amino acids are acids and need buffering.  If necessary, body will take alkaline minerals from bone to do the job.

Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat) ?

You confuse me.

Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines. I also ate 1 serving of sprouted pumpkin seeds, 1 cup of orange juice, 1 serving of brussels sprouts and 2 servings of spinach. From this I got 97% of DRIs for vitamins and 91% of minerals (I use CRON-O-Meter) in under 2500 calories.  48 grams of carbs.

I'm not finding it at all difficult to exceed minimums for vitamins and minerals found mostly in plant foods while still eating a low-carb animal-based diet.

"Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines."

Bonnie, have you no concern about GMO diary (hormone forced milk production), nitrites/added hormones/stress hormones in bacon, GMO corn and petro chem and drug residue in beef, etc? Or are all these from organic, free-range animals fed their natural diets?

"Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat)?"

Contemplationist, read this

http://diabetesupdate.blogspot.com/2009/09/lets-not-twist-history-to-support-our.html

From looking at the diet of contemporary hunter gatherers, an argument could be made that the ancestral diet contained a great deal of plants, as well as insects, small birds, lizards, etc.  The meat eaten was not the bulk or even the majority source of calories and it was all very very lean.

His advice makes sense for the vegans and vegetarians and low-fatters.  A huge step up for them and, most importantly, it's very 'foodie' and will appeal to them.

The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet.  Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach.  Five ingredients.  Takes me five minutes.

The answer to "Plant-based or animal-based?" is "YES!"  Ditch the grains and we can discuss everything else later.

"The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet. Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach. Five ingredients. Takes me five minutes."

Took me about 15 max to make mine:  Pre-cooked beans from fridge plus huge pile of chopped veg in pressure cooker.  Up to pressure and run for 60-90 seconds.  Bring pressure down fast, dump in bowl, add some nuts/seeds, and eat.

We evolved as neither herbivores nor carnivores, we're omnivores.

It's always been normal for humans to eat BOTH plant and animal foods.

I think everyone should eat at least half their food, by volume, as nonstarchy vegetables and low-sugar fruits - a wide variety.  

That being said, meat, dairy and eggs, if raised on pasture, are darned healthy foods.

I think raw milk, pastured eggs and pasture-raised butter are some of the healthiest foods one could possibly eat.  

And besides being a health food in itself, butter makes getting your veggies in much more palatable, so... an artichoke dipped in butter ought to make all of us happy.  It certainly makes me happy.  ;)  

Bacon, if from healthy animals and just smoked as opposed to being pumped full of nitrites and nitrates, is a fine food.  

And if we all ate enough wild-caught shellfish, you'd be hard pressed to find all these iodine deficiencies you've been noticing.

Animal foods are not a problem so much as the US system of mass-raising animal foods in an extremely unhealthy manner is a problem.  

See http://www.eatwild.com to find good local sources of meat, dairy and eggs.  

IMO, the "right" answer to breakfast can be the omelet, cooked in butter, stuffed to overflowing with fried peppers,  onions and mushrooms, with a bit of grated cheese over the top.  

Eating plenty of vegetables does not preclude eating animal foods.

And really, you'd be pretty hard pressed to do low carb as a vegan and get anything like sufficient protein and fat.  A vegetarian, yes, if you eat lots of eggs and dairy, but a vegan, no.  

This isn't an either/or scenario, we do best eating both.

We could argue and fight for ever, Drstrange.
Stress hormones? As if the animals that humans used to kill went down happy and peaceful listening to Vivaldi. Are your vegetables all organic? And they do not contain any toxins or anti-nutrients, or nitrates, they also provide you with all the vitamins and minerals you need? Good for you. Oh, no, you need to supplement. Just as well you can afford to do it.

lightcan, not sure what you are going on about.  Really.  I was referring to the lifetime of tissues saturated in stress hormones of  industrial, factory raised animals which I have boycotted since the early 70's when I found out how they were being treated even then! And what does any of that have to do with supplements?  I take some because I am old and a bit paranoid but am quite sure I would be fine without (excepting B-12 and D).  As for organic, yes, probably 95% at least and since I don't buy meat which is expensive (especially free range/grass fed or wild caught which is only meat I would eat when eating it) but rather cheap organic beans instead, I can afford it.

Not fighting or arguing really at all. I have no "beef" against someone eating meat if they feel the need.  But the research I have read really does show that a diet based on bacon and butter and blue cheese is basically a death sentence.

I don't think that a diet based on butter, meat, fish, eggs and some greens is unhealthy. You think the opposite. I'm sure you can find studies that you think support your stance. That's why I said that there is a lot of debate going on, even between specialists, and asking people if their meat is organic and stress hormones free doesn't help.
Many people who care about their health (those that read these blogs, you and I included) are trying to do their best until the definitive answers come in. It's really hard for the majority of people to find quality food exactly because of those pervasive industrial food practices you talk about.
All the best.

I eat 100% plant foods and I feel the same as when I ate both plant and animal foods, except I feel much better stopping the toxic fish - way too much mercury for me. I think eating plant foods is much more convenient. I even eat soy, and don't understand why there's so much anti-soy stuff online.

That is very good comment you shared.Thank you so chat much that for you shared those things with us.Im wishing you chat sohbet to carry on with ur achivments.All the best .

Seriously, I am sick and tired of hearing "Low carb"  you don't mean low carb, you mean low grains don't you because plants are carbs..

Say what you mean, not what is popular

The biggest issue with these guidelines is NOT what they say to adults, but the fact that they're taught in school to children.  

I was in-between the 7 food groups and the pyramid, went to school with the 4 food groups myself.  Meat, dairy, grains, fruits & veggies.

People still think this way, have to remind hubby all the time that corn is a grain not a veggie.  Point being, we both "think" in the four food groups, and probably will our whole lives.  

We learned this stuff with our alphabet and arithmetic.

Anyways, the answer to the question is BOTH.  

We are OMNIVORES.  Look at your teeth: you're not a herbivore, and you're not a carnivore.

IMO, when you sit down to eat, half your plate should contain nonstarchy veggies.  In my opinion, NONSTARCHY vegetables is an entire food group.  If I'd designed the pyramid, that'd be at the bottom.  

This is not a veggie-based diet though.  Cause veggies are low calorie, and diets are defined as high fat or high carb or whatever, based on the percentage of calories.  So... you can eat EITHER a high carb or high fat diet with half your plate covered with nonstarchy veggies, as it depends on what's on the other half of your plate.

IMO, at least another quarter of your plate should be good protein - pastured beef, pork and poultry, free-range eggs, raw milk and yogurt and kefir and raw cheese, nuts and seeds, and (if you can tolerate the carbs) legumes.  I define "good" protein as ones that don't have bad fats with them - so largely saturated and monosaturated fats, with minimal PUFAs.

The only other "rules" are... do eat broth and other sources of gelatin, do eat fermented foods, don't eat HFCS and don't eat PUFAs/trans fats.  

The rest varies with the person - if bg issues, should stick to lower carb, etc, if not, eat french fries, whatever.

Cause... if you eat half your food as nonstarchy veggies and a quarter as good sources of protein, and get some good broth and fermented foods in weekly, eschew HFCS and PUFAs, even if the REST of your diet consists of nothing but hot fudge sundaes you'd be coming out ahead of the VAST MAJORITY of people.  

Course, you're BETTER off if you eat some starchy vegetables and fruit in this other 25%, but... veggies and protein sources with good fats... these contains the vast majority of the micronutrients any of us get.  

This is a simple enough system to teach to a small child, which is what I think the guidelines should be aiming for.