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Thread: A Critique of Jack Kruse's Recent Post page

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    A Critique of Jack Kruse's Recent Post

    HOW TO EAT POST LEPTIN RX FOR OPTIMAL LIFE? | Jack Kruse

    What This Post Is NOT about

    First thing’s first, I have been following Dr. Kruse’s blog since the very beginning. I agree with almost all of his points, and consider him to be one of the greatest minds in the paleo blogosphere (shout-out to Chris Masterjohn). Of course, I also follow the work of many other paleo bloggers, such as Mark, Robb, Dr. Eades, Chris Kresser, and countless others I’m forgetting to mention (sorry, this post wasn’t intended to be very detailed; I apologize for forgetting some other great minds!), but Dr. Kruse is one of the few paleo bloggers who makes informative posts with excruciating detail; as a biochemistry nerd, I find Dr. Kruse’s countless recommendations to be very helpful!

    In addition, I do not want to attack Dr. Kruse’s character. Personally, I like his character… Some of you may disagree with him stripping down in front of a sale’s lady when he lost weight, but this doesn’t take away from his credibility or his recommendations. To be quite honest, I don’t care if the guy is a madman (he gets really enthusiastic sometimes, but I don’t find him to be crazy! ) – I’m only interested in reading the material he presents.

    What This Post IS about

    This post is about science. It’s about information. I want to dispel misconceptions, give people the truth, and help people learn how to analyze the data. People need to learn how to look at statistics, clinical trials, biochemistry, physiology, anecdotal evidence (and possibly evolutionary data); people also need to learn to constantly challenge their beliefs and look at contrary evidence. If you do all this, you will easily find the “truth.” A good guide would be this: The Little Handbook of Statistical Practice

    The main point of this post is a criticism of Jack Kruse’s ideas about leptin. I agree with him on everything else (there’s not much to agree about when there’s a mountain of research – biochemical, clinical, anecdotal, etc. – proving his ideas), but he seems to think that he has leptin down to a science. Unfortunately, leptin is a newcomer to the hormone frontier, and there are thousands of things we don’t know about leptin. If you’re interested in some science, carry on!

    Without further ado, here is Dr. Kruse’s most recent post:


    First of all, his ideas about leptin, evolution, circadian rhythm, and leptin’s relation to fetus development are all very well supported by the current literature. Here’s a very nice paper (http://www.ncbi.nlm.nih.gov/pmc/arti...df/1011020.pdf) supporting (some of) Dr. Kruse’s findings. Also, if you use google scholar, you can find lots of research papers that support Dr. Kruse’s ideas about the leptin receptor (he mentions this himself).

    Now, onto some of his recommendations…

    Quote Originally Posted by Jack
    Avoid working out prior to breakfast. It is a circadian cycle breaker because it raises cortisol at a time it is already high.
    So? Hormones aren’t going to kill you. Cortisol isn’t always bad. Leptin isn’t always bad. Insulin isn’t always bad. Chronically high cortisol, leptin, and insulin levels are problematic. However, cortisol triggers the breakdown of triglycerides into FFAs and increases lipolysis (of course, this only happens when cortisol naturally spikes during the day, and not under cases of chronic stress). Leptin spikes are very beneficial for those of us who are lean (refeeds), and insulin spikes aren’t harmful for a healthy person.

    Actually, insulin spikes may be beneficial because they help build muscle, and if you’re that concerned about insulin spikes, you better cut out protein and carbs out of your diet; the former actually increases insulin about as much as carbs (+they also have a synergistic effect). Refer to this article for more information:Logic Does Not Apply Part 2: Breakfast

    Quote Originally Posted by Jack
    4. For optimal results you must get most of your daily activity between 9AM and 4PM when light cycles are strong year round. This is another reason I strongly advocate high vitamin D levels year round. *moreaboutNEAT*
    I agree with the NEAT part – it’s a great way to enjoy the fatty foods and still maintain a “healthy” bodyweight, but why SHOULD we get our daily activity between 9AM and 4PM? TBQH, I do agree with Dr. Kruse on this point. Exercising at night may throw your circardian rhythm out of whack, and if you do it too close to bedtime, you may end up finding it difficult to sleep. You can probably exercise as late as you want to, as long as it’s 3+ hours before bedtime, but I do see the logic behind Dr. Kruse’s recommendations – you may start associating nighttime with being active, and this may further disrupt sleep.

    Quote Originally Posted by Jack
    5. For lunch, if you need to eat it, (some won’t eventually) you should consider eating 25% of remaining daily carbs. I use this meal as a snack now. Rarely is it a big meal for me any longer and if I am IFing this is the one meal I cut like a bad habit.
    What’s the logic behind this recommendation?

    Quote Originally Posted by Jack
    6. Critical point: The best time to work out biologically occurs when it is least likely to be convenient for you because of our neolithic lives wont allow it. I re-tooled my entire schedule as a surgeon to make this work optimally for me to lose weight and change my body. It is that important biologically to get to optimal. 1-5 PM is the ideal workout window. For best results try to do the exercise in bright sunlight.
    Dr. K is acting like an alarmist by stating things like “because our Neolithic lives won’t allow it.” As I mentioned in the introduction of this post, I will NOT attack Dr. Kruse’s character, but come on...You’re asking everyone to change their schedule when they could easily do their daily activity in the morning (as I mentioned above, this isn’t bad)?

    Quote Originally Posted by Jack
    7. Dinner should be eaten within 45 minutes to 1 hour of this late afternoon work out. During dinner you want to make sure to include a lot of protein (25-75 grams), the remainder of your carb allotment and the balance in fats. The type of fats at dinner are also critical. Try to concentrate on 10-18 carbon fats because these are best at stimulating Cholecystokinin (CCK) that destroys the night time appetite. I use coconut oil, ghee, pastured butter, and bacon lard to get this effect. I use the fat to cover the carbs and the protein most times in sauces.

    OK, so let me get this straight. You’re eating a very light lunch (or none at all), and you expect to lift weights and gain muscle? You NEED a pre-workout meal. While a post-workout meal isn’t necessary, pre-workout meals consisting of carbs + protein should be sufficient. Of course, carbs before workouts aren’t absolutely necessary, and you may want to go on the BCAA approach, but you should still get something in before training. Additionally, since Dr. Kruse is so big on autophagy, why does he eat so much protein (breakfast + dinner)? Protein restriction / fasting are as good as – or even better than – kcal restriction for longevity purposes, and they may delay the onset of or even eliminate the risk of neurodegenerative diseases.

    And…Nutrition and muscle protein synthesis: a descriptive review

    Quote Originally Posted by Jack
    8. Try to complete dinner by 7 PM. This is critical in autumn and winter time to get to optimal results. 8PM is the outer limit for dinner in spring and summer. I actually alter my meal times very precisely as the light cycle changes during the year. Many people might find this too regimented. I agree with this but I do it because I had a huge clinical move to make from 44% body fat. Doing this strictly my first year I lost 133 pounds in 11 months. So the details make a huge difference in good vs. Optimal.
    Again, the circadian rhythm thing. Yeah, I guess I could see how eating after 8 PM or too close to bedtime may be detrimental, but being obsessive about eating before 7, 8 PM, or whatever will not help you lose more weight (and will probably give you an eating disorder). Dr. Kruse lost so much weight because he fixed his circadian rhythm, reduced kcal intake, started exercising, and started eating a healthy, nutritious diet.

    Dr. Kruse wouldn’t have lost THAT much weight if he kept his kcal intake constant and went on a paleo diet; he also wouldn’t have lost that much weight if he had only fixed his circadian rhythm. This is just a case of anecdotal evidence, and while it is important to analyze conclusions using a bit of anecdotal evidence, Dr. Kruse is using anecdotal evidence to justify his whole point!
    Last edited by TERGRAM; 11-22-2011 at 06:27 AM.

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    Quote Originally Posted by Jack
    Sleep by 11PM in spring and summer months. I stay up longer June 10th to July 10th due to summer solstice on June 21. During this time of the year I tend to have higher body fat with longer light cycles. In autumn and winter I am in bed by 10 PM.
    …Sleeping an hour or two hours later than usual isn’t suddenly going to make you have more fat. There are thousands of possible factors that may be influencing Dr. Kruse’s body fat gain during the summer months, and I really don’t see why he’s using his experience to justify his claims. On the other hand, I do agree with him on the alarm clock thing. When you adjust your circadian rhythm, increase your iodine intake, and eat a healthy diet, you’ll wake up feeling energized and will probably never need an alarm clock. As far as anecdotal evidence goes, I have never used an alarm clock and always wake up feeling refreshed (no matter how little sleep I get).

    Also, you don’t NEED 7.5 – 8 hours of sleep. That’s one of the biggest myths of the health industry. If you can feel energized and refreshed on six hours of sleep, don’t beat yourself up and think that you’re not getting enough sleep. Conversely, don’t think that sleeping 9+ hours is healthy. Generally, anything over 8 hours for most people isn’t too good for mortality rates (not to mention spending half of your life sleeping – boring!).

    Quote Originally Posted by Jack
    If you are active, drop all of the top ten paleo supplements I mentioned in that blog. They were only meant for the transition from a sugar burning metabolism to a fat burning furnace as the permanent paleo template takes flight. If you are not active, I would strongly consider you remain on PQQ and vitamin D3. Try to optimize your vitamin D levels to 70-100 ng/mL.
    Why would anyone drop PQQ if they’re active? Yeah, PQQ isn’t necessary for someone eating parsley and spinach everyday, but most of us don’t have access to those foods everyday. In addition, not all of us live at the equator, so some people may end up getting extremely low amounts of vitamin D, even if they are “active.” Furthermore, unless you’re eating seaweed everyday, it’s going to be difficult getting optimal amounts of iodine and magnesium. Coenzyme Q supplementation can’t hurt, too.

    Quote Originally Posted by Jack
    If you decide to Intermittent Fasting do not skip breakfast ever. It is the key to circadian congruity and optimal body composition. You will see below how this determines body comp and not the amount of exercise one does.
    Does Dr. Kruse really think that eating breakfast and having an optimal circadian rhythm will really make people “shred fat” or whatever? Exercise drastically influences body composition; skipping breakfast has zero negative effects, and is likely beneficial. Again, this article is very good at explaining my thoughts: Logic Does Not Apply Part 2: Breakfast
    If what he’s saying is true, then those obese people who eat a breakfast of coffee, omlettes, and bacon shouldn’t even be obese!

    Quote Originally Posted by Jack
    High protein consumption occurs at night now, not at breakfast as it did in the Leptin Rx reset. The reason is because late afternoon is when the human body is normally programmed to undergo up regulation of protein synthesis biochemically. This maneuver actually influences our body composition more than any exercise could if it was added to the equation at all.
    Why would this change when you’re leptin sensitive? Does Dr. Kruse’s program make people lose muscle mass because they eat a high protein load in the morning when (supposedly) the optimal time for protein synthesis is at night? I agree with his take on eating most protein at night (but TBQH, it wouldn’t make much of a difference otherwise), though I do find it weird that he does not give his readers any rationale for going from eating most protein at breakfast and then suddenly switching to most protein at night because you’re leptin “sensitive.”

    Also, countless research papers have stated that (The time course for elevated muscle prote... [Can J Appl Physiol. 1995] - PubMed - NCBI + related citations) protein synthesis is almost doubled for more than 24 hours following resistance exercise, so other than satiety factors, night vs. morning protein consumption isn’t going to make much of a difference. While I do agree with Dr. Kruse that there does seem to be a biochemical basis for increased protein synthesis during sleep / late afternoon (+autophagy), I haven’t seen any research specifically addressing this topic. Either way, I tend to agree with Dr. Kruse on this point because most recent research indicates that getting most of your kcals (and protein) at night > consuming those same kcals (and protein) during the day.

    Quote Originally Posted by Jack
    Carb macro’s should parallel activity and light cycles. Too often I hear many in the “primal world” talk about carbs and activity. They always forget about the light cycle. If you are real active and work out more than 4 days a week in sunlight you can handle 30% of your calories from carbs. If not consider 10-20% range. …
    Not only does Dr. Kruse fail to mention WHY we should follow this piece of advice from a biochemical perspective, but there is also zero research to support this notion. Also, zero carb? Seriously? Why?

    Quote Originally Posted by Jack
    Exercise/activity is optimal for us between 9AM and 4PM biologically. I understand this might be hard to fit into your schedule but the payoff is massive. Let me explain why now. Remember that cortisol is highest in the AM to allow us to wake up. If you exercise before breakfast you are risking elevating your cortisol even higher. This will cause a pregnenolone steal syndrome and ruin your hormonal response that controls your lean muscle mass and fat ratios and eventually your body composition. If you continue to do this over time, it will slow your protein synthesis that occurs later in the afternoon and evening, that increases your body comp. Moreover, It will also ruin your sleep cycle (checked by having low DHEA levels) and you risk being in an overtrained situation. I think this is the biggest error I see in the paleo community because they are trying to fit their “neolithic life” into their day best from a time stand point. My advice is don’t even try it
    Cortisol isn’t a problem (see above). Moreover, sleep problems are not ALWAYS related to low DHEA, and some people actually don’t sleep as much as the average person (with or without classic symptoms of insomnia) due to genetic mutations or developmental / fetus disorders that can’t be fixed with diet (or even medication, which is a short-term solution anyway).

    Quote Originally Posted by Jack
    You get the best (optimal) protein synthesis benefit if exercise occurs 1-4PM. Make sure your lifting days occur on the days of the week you can accomplish this. Save sprinting days for days that this wont work for your schedule. Use common sense about building this into your own life. Optimize your schedule to benefit your body composition. If you fight this trend you can still get ripped up but you will exhaust your stem cells in doing so and you will lose years on the back end of your life. Timing is that important.
    You won’t exhaust your stem cells if you’re exercising in the morning or anywhere outside the 1-4 PM window. Where’s the research or biochemical basis behind Dr. Kruse’s fear of stem cell depletion?

    Quote Originally Posted by Jack
    To show you how important meal timing to the light cycles are to us humans consider these facts regarding exercise and meal timing. If you are able to yoke your workout to your evening protein dinner meal (within 30-45 minutes) you actually “triple the amount of protein synthesis” that occurs compared to those who do not. … When do we see ads in the newspapers for weight loss aids? The answer is around New Years Day in January. Why? Because humans tend to get fat in winter so sports stores place ads when they are most likely to gain revenue. …
    I didn’t find anything in his citations that seemed to support this statement. Also, if this effect really does happen, should I expect my arms to grow 3 inches instead of 1 inch after follow this regime? Besides, humans gain weight in the winter because they eat crazy amounts of food during the holidays. The increased food consumption during the holidays is not because of a problem in circadian rhythms; rather, people increase their food consumption because of cultural expectations / peer pressure during the holidays. However, I do agree that this effect is further contributing to the already damaged circadian rhythms of the modern day man.

    Quote Originally Posted by Jack
    The high protein and fats we eat at dinner diminish our appetite tremendously and this allows leptin released from your fat cells to enter the hypothalamus from midnight to 2 AM to send second messenger chemicals to the thyroid to allow us to burn excess calories stored in fat to be burned at the uncoupling proteins in muscles as we sleep in stage 3 and 4 sleep
    Quote Originally Posted by Jack
    Cortisol is supposed to spike at wakefulness not during our sleep. People who awaken with high cortisol levels will also be drawn to eat a lot of carbohydrates at breakfast

    OK, so now we seem to be getting some biochemistry on his protein recommendations. As I mentioned above, I guess I agree with him on this point, but why doesn’t he specifically state that protein consumption needs to be increased at night when doing the Leptin Rx?

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    9.
    Quote Originally Posted by Jack
    This is why patients with sleep apnea have terrible body composition as a rule
    Correlation =/= causation. I’d argue that most people with sleep apnea already had hormonal problems before getting the sleep apnea. I do think that the sleep apnea may aggravate the already existing poor body composition, but it is this very same poor body composition that put the patient’s hormones out of whack and made him get sleep apnea. Of course, there may be other causes of sleep apnea, but poorly balanced hormones / high cytokine levels are the biggest players in the sleep apnea epidemic.
    10.
    Quote Originally Posted by Jack
    Cortisol is supposed to spike at wakefulness not during our sleep. People who awaken with high cortisol levels will also be drawn to eat a lot of carbohydrates at breakfast.
    This is interesting, but is there anything but anecdotal evidence to support his point? Most people who chronically crave carbohydrates probably have thousands of other awry metabolic processes going on in their bodies – they’re probably obese, have an eating disorder, have other hormonal problems, etc. Why would cortisol spikes during the night make people crave carbohydrates? Could it be that there are other conditions that are making people crave carbohydrates?

    Quote Originally Posted by Jack
    6. So if you do shift work you must be a great sleeper and run on a ketogenic paleo diet to have a chance of good body composition. I have met only one person in my life who did this.
    Ketogenic diets don’t magically make you have better body composition. This is largely a myth – ketogenic diets do help obese people fix their metabolic derangements, but they won’t help you “shred fat,” contrary to the advice of several paleo “gurus.” When you become a “fat burner,” you’re also increasing your fat intake, so there are no metabolic advantages between high carb vs. low carb vs. zero carb.

    As for the basis behind the leptin reset, eating a healthy diet will eliminate all the inflammation that was previously going on. I like his ideas about training your body to use food better, and I do acknowledge that eating at specific times during the day will dramatically help body composition (ghrelin is mainly regulated by the rhythmicity of food intake – if you eat at 2 PM everyday, you’ll notice way less hunger than if you were eating at 1 PM one day, 6 PM the next, 9 PM the other, etc.). However, Dr. Kruse seems to think that you can only be “optimal” using his leptin reset, and I really don’t know why he seems to think that all of his ideas about biochemistry are physiologically relevant.

    For example, one component of the leptin reset is a meal four hours before bedtime, but this isn’t absolutely necessary. As I argued above, people shouldn’t eat heavy meals before bedtime because of possible sleeping issues (and so that they learn to not associate food intake with bedtime, which may further aggravate sleep problems), but while eating a high carb meal at bedtime will increase insulin levels, it won’t affect GH release:

    ScienceDirect - Metabolism : Implications of growth hormone release in sleep Growth Hormone Secretion During Sleep: Impairment in Glucose Tolerance and Nonsuppressibility by Hyperglycemia Human Growth Hormone Release in Sleep: Nonsuppression by Acute Hyperglycemia

    In addition, prolactin seems to control leptin, not the other way around:
    Prolactin Stimulates Leptin Secretion by Rat White Adipose Tissue

    And…prolactin does seem to be correlated with sleep, but there’s conflicting research:

    Prolactin and rapid eye movement sleep regulation. [Sleep. 1995] - PubMed - NCBI
    Prolactin secretion and sleep. [Sleep. 1994] - PubMed - NCBI


    In conclusion, a bright scientist will use relevant research, anecdotal evidence, biochemistry, physiologically relevant biochemistry, clinical trials, etc. to prove his point. A bright scientist should also look at the evidence that opposes his view, and then come up with a conclusion for himself. This post is not meant to attack Dr. Kruse’s character, nor is it about how wrong he is about osteoporosis or diabetes.

    This post is about Dr. Kruse’s Leptin Rx, how to analyze scientific evidence, why you’d be better off just eating a paleo diet and having meals at specific times instead of eating a specific amount of macros / food that wouldn’t give you much benefit; oh, and let’s not forget that the Leptin Rx does work, but only because it suppresses appetite (heavy protein breakfast) and follows a paleo template.

    Finally, following a paleo/primal lifestyle with adequate supplementation, exercising, and having a positive attitude will easily make the fat go away. Remember, fixing your awry physiology is going to take a long time, but this diet / lifestyle is meant to be supported for the long-term. Of course, I don’t find much reason to eliminate grains / legumes, but that’s another topic for another thread.

    P.S.: Another tiny mistake I spotted on Dr. Kruse’s blog: the vitamin K recycled in the gut doesn’t get absorbed. People with gut problems probably don’t need that much more vitamin K than your average organ and egg-hater, IMO.

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    Granted, by now you can hardly be an MDA regular and not know who Jack Kruse is or have a ready link to his web site (which bloody well needs it's own damned forum already) but if you're going to cherry-pick his blog post, you should at least provide a LINK in your first post for folks who want to go read it for themselves in context.

    You know, just to be polite and all.

    Though, given his level of consistent off the cuff silliness I'm surprised people are still bothering to pick Dr. K apart or point out what he has gone and got wrong / overstated / exaggerated / mis-assumed *this time* . . .

    *shrUg*

    For my money assuming Jack got at least 1/3 of whatever he's going on about out of whack (if not flat out wrong) is just a given.
    Last edited by brahnamin; 11-22-2011 at 05:10 AM. Reason: to fix link

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    Quote Originally Posted by brahnamin View Post
    Granted, by now you can hardly be an MDA regular and not know who Jack Kruse is or have a ready link to his web site (which bloody well needs it's own damned forum already) but if you're going to cherry-pick his blog post, you should at least provide a LINK in your first post for folks who want to go read it for themselves in context.

    You know, just to be polite and all.

    Though, given his level of consistent off the cuff silliness I'm surprised people are still bothering to pick Dr. K apart or point out what he has gone and got wrong / overstated / exaggerated / mis-assumed *this time* . . .

    *shrUg*

    For my money assuming Jack got at least 1/3 of whatever he's going on about out of whack (if not flat out wrong) is just a given.
    OK, I've added a link to the first post.

    BTW, I bothered to pick this post apart because I hope that SOMEONE out there will have learned a couple of new things concerning physiology / logic; and really, why would anyone want to follow the Leptin Rx if it isn't any better than the good 'ol Primal diet?

    I just HOPE that people are going to read this post and think, "Hey, maybe I should rethink all of what I'm doing. What is the science behind this? What is the science behind that?"

    Hmm...

    Thanks for replying!

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    Quote Originally Posted by TERGRAM View Post
    OK, so let me get this straight. You’re eating a very light lunch (or none at all), and you expect to lift weights and gain muscle? You NEED a pre-workout meal.
    I and many many others have found this to be untrue. It's part of the bodybuilder paranoia that modern fitness has inherited.
    You lousy kids! Get off my savannah!

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    Quote Originally Posted by TERGRAM View Post
    OK, I've added a link to the first post.

    BTW, I bothered to pick this post apart because I hope that SOMEONE out there will have learned a couple of new things concerning physiology / logic; and really, why would anyone want to follow the Leptin Rx if it isn't any better than the good 'ol Primal diet?!
    Luck with that . . .

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    this post is awesome.... that is all

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    The vast majority of people who post on this forum can only speak from their own experience (N=1). I will sometimes post about a trick that worked for me, IF'ing, LHT, macros, etc... Dr. Kruse is a neurosurgeon who uses primal blueprint/paleo diets to actually treat patients. He also lost a tremendous amount of weight and tests his own blood on a regular basis. I think he knows exactly what works for him and his patients through the eyes of a doctor who is treating patients. Others may look at all this with eyes of the formerly obese, currently obese, or prior eating disordered eyes. I personally love to read all of Dr. Kruse's postings on here, paleohacks, and his blogs. There are huge pearls of wisdom in what he writes. I'm sure good ol' MARGRET (TERGRAM) could pick apart every sentence that Mark Sisson writes as well and MalPaz would agree with the critique.

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    Quote Originally Posted by otzi View Post
    The vast majority of people who post on this forum can only speak from their own experience (N=1). I will sometimes post about a trick that worked for me, IF'ing, LHT, macros, etc... Dr. Kruse is a neurosurgeon who uses primal blueprint/paleo diets to actually treat patients. He also lost a tremendous amount of weight and tests his own blood on a regular basis. I think he knows exactly what works for him and his patients through the eyes of a doctor who is treating patients. Others may look at all this with eyes of the formerly obese, currently obese, or prior eating disordered eyes. I personally love to read all of Dr. Kruse's postings on here, paleohacks, and his blogs. There are huge pearls of wisdom in what he writes. I'm sure good ol' MARGRET (TERGRAM) could pick apart every sentence that Mark Sisson writes as well and MalPaz would agree with the critique.
    nah marks awesome... doesnt fear the fruit or nuts, loves the offal and lamb.... doesnt care when he works out just does, at some point... more lackadaisical approaches need to be taken with primal to make it individually successful. i dont have beef with Kruse, i just dont believe he is as accurate a worshiper as many believe.

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