Questions and Troubleshooting #

What were your symptoms before the protocol? #

I had lots of unpredictable bathroom emergencies. I would alternate between diarrhea and constipation. I would sometimes require what seemed like endless amounts of toilet paper. I felt constantly fatigued and frequently needed naps. My skin quality was dull and sometimes flaky. I generally had no zest for life. These problems didn’t start until my early 30s, and before that I would say my gut was pretty normal.

No more bathroom emergencies! It’s super predictable and also there is much less urgency when I do need to go. I don’t have to hang up the phone or end a meeting. I just go at my leisure when it’s time. Basically I no longer need toilet paper as long as I keep several servings of potatoes in my diet unless I eat something weird.
But perhaps the most awesome improvement is my energy levels are way up! Fatigue is nearly gone and seems to be improving. Skin seems much improved. I don’t notice anymore flaking, and weirdly my face looks much less puffy and my cheekbones have become more distinct (in a good way).

For the strict protocol, I would definitely avoid processed meats because they have a lot of weird things in them. Otherwise, the main reason meats do not find there way into the protocol is because they are typically high in fat. You can certainly add meat as your gut improves, but to keep to the low-fat aspect, you will have to watch portion sizes. If your bile function is good, then low-fat is probably less of a strict requirement for you.

I have previously experimented with a very low-carb diet for 3 months. Compared to a “normal” mid-fat, mid-carb diet, my gut function was better but still not great. My mental clarity was also better on the low-carb diet compared to the “normal” diet. However, I find my mental clarity to be at least as good continuing to follow a low-fat, high-carb diet while maintaining aspects of the protocol. I know low-fat diets are not exactly in vogue these days, but the aim of the protocol was to fix leaky gut and not really jump into the low-fat vs low-carb debate. In my opinion, the evidence is very clear that a high carb diet is no problem as long as fat consumption is kept very low.

I personally like to work out and now that I find myself with a lot more energy, I am working out more and aiming to keep my protein consumption high. I admit at first I had to do some thinking about how to eat high protein but low fat, which generally implies keeping meat consumption low to moderate. But it’s actually been pretty easy. I use nonfat greek yogurt, skim milk (heated up with instant coffee to add some flavor), and protein powders and it hasn’t been a problem to get to 100g+ per day. Potatoes actually have decent protein content at 2.5g per 100g and you will be eating a lot of them. Also feel free to add more meat if you find that the higher fat doesn’t cause you any problems when you start adding in more foods.

I really don’t as long as I keep the fat quite low. In fact, one of the nice things about keeping fat low is that I otherwise don’t have to care about how much I eat. In this study, subjects were able to eat ad libitum - meaning without restriction - on a very low fat diet and did not gain any weight. Their respiratory quotient just increased in proportion to carbs. Pretty incredible when you think about it.

The only time I experienced a bit of constipation on the protocol was when I added in some low-fat mozzarella. So maybe lay off the cheese or high-calcium foods if this is also a problem for you. Otherwise, a lot of times constipation is due to lack of magnesium, so you could try adding foods high in magnesium or supplementing.

Pale stools are generally due to a lack of bile production or release. It also means that you are going to have trouble absorbing fat-soluble vitamins. You can try taking bile salts to improve this. I personally take this bile supplement if I go out to eat with friends or family since it’s hard to know just how much fat is in a restaurant meal and adding a bile supplement increases the chance that fat gets digested properly and doesn’t increase endotoxin.

I also had this impression from reading nutrition and ‘pop sci’ articles on health. But one thing you’ll notice is that there are actually different types of fiber: soluble and insoluble. Even among soluble and insoluble fibers there are further distinctions. Next you’ll notice that these articles almost never distinguish between which fiber they are talking about. Does it matter? It probably matters since soluble fiber swells up with water to about 5X its volume while insoluble fiber doesn’t. It probably matters since some insoluble fibers can be antibacterial while others are not. It probably matters since different soluble fiber types feed different bacteria types. It seems more than a bit problematic that most articles don’t discuss these distinctions. At the least, the only double-blind study I ever saw relating to fiber showed without a doubt that the low fiber diet is better for all outcomes. Given that the arguments for fiber are usually of the “everyone knows” variety but the actual documented evidence for it is little, I prefer to go with the documented evidence. For this protocol, most of a potato’s fiber is in the skin (which you aren’t eating) and most of the rest should be in the form of the resistant starch which we are taking advantage of to feed to good bacteria which will make the beneficial butyric acid.