November 17 2014

Dear Mark: Butter and Coagulation; Early Weaning and Growth Charts

By Mark Sisson
92 Comments

ButterFor today’s edition of Dear Mark, we’ve got a quick two-parter. First up, I discuss the results of a 2008 study into the effect of high acute intakes of various fat sources on postprandial (i.e. after eating) blood coagulation markers. Since butter came out looking not so hot, a reader wonders whether this should impact our butter consumption. Find out what I think down below. And after that, I explore infant growth charts and early weaning from breast milk in response to a new father’s question about a doctor’s suggestion.

Let’s go:

Dear Mark,

I study health and nutrition, and the book we use (Understanding Nutrition by Whitney Rolfes, 13th edition) is all about eating less saturated fat. They cite a quite convincing study that shows that butter could promote blood clotting. I read the whole study and couldn’t find any faults using my limited abilities. The study is: “Chronic dietary fat intake modifies the postprandial response of hemostatic markers to a single fatty test meal” It appeared in the American journal of clinical nutrition. Am J Clin Nutr February 2008 vol. 87 no. 2 317-322. I’d like to hear your thoughts about it!

Kind regards,

Bram

Great question, Bram. Let’s look at this study. The researchers, as you say, were looking for dietary patterns that increase the risk of blood coagulation. It’s easy to understand why: if a blood clot blocks the flow of blood, you get a heart attack.

To start, subjects were placed into one of three diet groups for 4 weeks:

A high monounsaturated fatty acid (MUFA) diet based on olive oil – 15/47/38% protein/carb/fat, with 24% of total calories from MUFA, less than 10% from saturated fatty acids (SFA), and 4% from polyunsaturated fatty acids (PUFA), of which 0.4% came in the form of ALA omega-3.

A high SFA diet based on butter – 15/47/38% protein/carb/fat, with 22% of total calories from SFA, 12% from MUFA, and 4% from PUFA (of which 0.4% came in the form of ALA omega-3)

A high carb/omega-3 diet based on walnuts – 15/55/30% protein/carb/fat, with less than 10% from SFA, 12% from MUFA, and 8% from PUFA (of which 2% came from ALA omega-3)

After the four weeks, the subjects all tested their markers of blood clotting in a fasted state. None of the diets had a distinct effect.

Next, the researchers tested the same clotting markers immediately after a large meal resembling their assigned diets to see if the postprandial picture was different. It was:

In all dietary groups, markers of coagulation were elevated after meals. However, the butter group had worse numbers. There’s no way around that. So, avoid all butter altogether?

Not so fast.

The meal was huge, comprising roughly half to 2/3 the total number of calories they typically ate in a day. All groups felt the effects, with coagulation biomarkers going up across the board. So olive oil and walnuts also “could promote blood clotting” along with butter, provided you eat enough calories in a sitting.

The butter group ate about a quarter to a third of a stick of butter with their meal. Is that a typical way to eat butter? It’s definitely way more than I use in a sitting.

The butter group consumed very little omega-3, just 0.4% of calories. And what they did consume came from alpha linoleic acid, the less effective plant form of omega-3. Having a little salmon with your butter – or perhaps a little butter with your salmon – will probably make a big difference.

Most importantly (in my opinion), the butter group ate about half their calories as carbs – far from low-carb. As I’ve already covered, large amounts of saturated fat don’t pair well with large doses of carbs. You can definitely get away with eating carbs and fat together, especially if you’re lean and active, but when you’re eating 2/3 of your daily calories in a single sitting, things get hairy. That’s a huge amount of food to deal with at once. And energy overload (of any source) will increase insulin resistance, which is frequently linked to increased blood coagulation. Combining palmitic acid (in butter) with carbohydrate makes it even worse and amplifies the insulin response.

The specific foods included in the diets (besides the fat sources) weren’t available in the study text, so I can’t know for sure, but the researchers do mention that the carbs came from bread. In women, a recent study found that while butter used on bread increased the risk of heart attack, butter used for cooking did not increase the risk.

Other lifestyle factors modify the effect. Berries consumed with a high-fat meal have been shown to reduce the increased postprandial coagulation markers, and regular exercise (or simply being fit) also reduces the postprandial coagulation response; I bet going for a 20 minute walk after meals would also be beneficial. Berries and regular exercise are standard Primal fare, wouldn’t you say?

I know it’s fun to brag about heroic doses of grass-fed butter. And thumbing your nose at the health authorities who caution against even a single pat of the stuff by actually buying and eating butter is important. But be careful not to go too far in the other direction. Just because some butter is safe and health-promoting doesn’t mean a half stick as a meal is safe and health-promoting.

Does anyone really need a half stick of butter with (or as) their meal? Aren’t there other things a person can be eating with butter instead of just piling on more and more?

Instead:

Eat a variety of foods, including colorful fruits and vegetables.

Don’t just eat butter. Eat olive oil. Eat fatty fish. Eat nuts. And yes, eat butter. Make sure it’s pastured, as this truly does make a difference in the metabolic response.

Exercise regularly and move frequently.

Don’t eat huge meals representing 2/3 your daily caloric allotment of mostly fat and carbs. That’s basically the Standard American Diet.

Tread carefully on the extremes. If you’re going to eat a stick of butter, you’re better off keeping carbs very low. If you’re going to eat a bag of potatoes, you’re better off keeping fat very low.

Hope that helps!

My wife and I both eat primaly and our kids are rapidly becoming more primal! Our youngest is currently 4 months and being breastfed, however weight gain is very slow and our health visitor is recommending early weaning. Any thoughts on this and weaning a baby primally in general?

David

Congratulations!

You may have nothing to worry about. Exclusively breastfed babies travel a different growth trajectory than formula-fed babies, and the growth charts used by doctors may not be up to date. The chart from the World Health Organization is ideal for breastfed babies, as it reflects growth patterns in children who were breastfed for at least 4 months and usually up through a full year.

The 1977 growth chart used babies who were weaned at 4 months and primarily fed formula. That’s not representative of a breastfed baby, whose normal growth slows down right around month three.

In its own FAQ, the CDC recommends against using the CDC growth chart for breastfed babies and admits that the WHO chart shows how “infants should grow rather than simply do grow.”

Make sure your health visitor is referencing the WHO growth chart before proceeding.

If you do go with early weaning, consider implementing some foods rich in prebiotic fibers to reduce the risk of food intolerances. In one recent study, researchers used prebiotics during the post-weaning period to induce tolerance in a mouse model of allergy (where allergies are basically guaranteed). Both galactooligosaccharides (GOS) and inulin were effective. GOS resemble (and approximate the effect of) the prebiotics found in breastmilk, while inulin – found in foods like leeks, jerusalem artichokes, and jicama – is an indigestible blend of fructose polymers that your gut bacteria break down into short chain fatty acids. If your kid’s not into leeks, jerusalem artichokes, and jicama, you can always buy supplements of both GOS and inulin and add a small bit to food they do like. Smoothies, milk, yogurt, and other amenable food mediums will all work.

Oh, and if you do wean, keep the breast milk flowing! That will also improve your child’s tolerance of newly introduced foods and it’s actually the recommended path by most experts.

Thanks for reading, everyone. Be sure to chime in with your own responses if you have anything to add to (or counter) what I wrote!

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92 thoughts on “Dear Mark: Butter and Coagulation; Early Weaning and Growth Charts”

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  1. Fats in the presence of carbohydrates such as in the study are damaging, for sure. Another thing that usually isn’t studied is source of the butter. As with any animal consumption, if the animal was sick and fat, it will probably make you sick and fat as well from eating it.

  2. When I saw that the carbs averaged about 50%, It was pretty obvious the trials were on a basic SAD eating pattern.

    1. Yes, a study that draws conclusions about fat, but the diet is 50% carbs. That may be a flaw or a bias at the start.

  3. Re early weaning: I simply could not produce enough breast milk for my large son – nearly 10lb at birth. I continued to breast feed, and supplemented my milk after the first two months with home-cooked pureed vegetables, chicken, and lamb, mashed banana, and pureed fruits. I also gave him small amounts of home-cooked oatmeal. He thrived. He’s now 32, 6′ 1″ tall, and very nicely built. That’s not just maternal prejudice!

    There’s no need to feel guilty about supplementing breast milk, and it does no harm to the child. If you decide to supplement with formula, that’s okay too; just choose the formula very carefully.

    1. I know you did the best you could with the info you had at that time (32 yrs ago we were still in the dark ages of human lactation) but that dietary plan for an infant is TERRIBLE, and yes, HARMFUL.

      1. Yes, I did the best I could, and it wasn’t half bad! My son is tall, slim but well-muscled, strong, has never had a filling or any tooth decay, and he’s healthy. My daughter was about 5 months old when I started the same terrible and harmful practices with her despite having ample milk for her needs. She too has perfect teeth, is above average height, and is, at 34, strong and healthy. The children of my peer group, who suffered the same barbarous feeding practices in our dark age society, have also turned out pretty darned well. I reject your attempts to shame me and impose your ideology on me.

        1. Very good reply SuzU 🙂

          And on another note: I was brainwashed 2 years ago into exclusive breatsfeeding (“you WILL produce enough milk if you stick to it, and pump, and breastfeed every 5 min and don’t worry the weight gain the curve is different for breastfed babies etc.. etc…).

          Long story short I stick to exclusive breastfeeding waaayyy too long (with the support of the ped) I started supplementing only when my baby was 1 month and a half. she regained her birth weight at 1 month only and looking back at the pic her face is so skinny it is painful to watch.

          My milk was not enough, and whatever la leche league wants you to believe it does happen. Some people just don’t produce enough milk. And before anybody jumps in saying “mothers naturally produce enough milk” I’ll say that “in nature” you also have infertile women, why is it so hard to believe that being a good milk producer doesn’t happen to 100% of mothers? That’s what extended family/the tribe was for, some women would help breatsfeed other women’s babies..

          Formula is not evil. It is a great replacement for breastmilk, not perfect, but great

    2. I concur. Our daughter was big, strong, and with a big appetite. We breastfed for a little over a year but had to supplement with formula. My partner’s poor breasts simply couldn’t keep up (15-18 times per day around the clock) and she wasn’t a big producer of the more satiating high milk. So our daughter would had suffered without supplementation. I assume, back in the day, in a tribal society, a wet nurse or another mom would provide the supplementation.

  4. Respectfully, the “health visitor” sounds uneducated. Is the baby meeting other milestones? Has the baby remained on the same size percentile? If so, it appears there would be little to worry about. If not, does the baby appear hungry after a feeding, it may be time to introduce other foods now. Weaning to me implies stopping breast feeding, I cannot imagine why that would be suggested at 4 mos. Supplement with other foods/formula if baby does not appear to be getting enough. Is Mom eating enough for milk supply? We weaned my daughter at 2 1/2, though she started eating other foods at 6 months (though she was big at 4 mos so not an issue as raised by David). What could be more primal than mother’s milk? Health and best wishes.

    1. David, I agree with Colleen; my daughter was a very large baby (nearly 10lbs at birth!) and is still in the 90th percentile for height and weight at age 5. She nursed exclusively for 5.5 months and was fully weaned at 2.75 years. If your baby meeting other milestones, then I wouldn’t worry about the height/weight charts that are designed for formula fed infants.

      While not primal, I would recommend the book, “Super Baby Food” http://www.superbabyfood.com/ as a guide to starting “real foods” with your child. It helped me so much, and I attribute the early introduction of real food to my daughter still being a very good eater!

      Of course, only you and your wife can know what’s best for your baby. Good luck!

    2. Health visitors are notoriously full of shit, particularly when it comes to breastfeeding knowledge. They are nurses first, before they do their HV training, which is all the more concerning IMO!
      Also, the term weaning in this instance here (in the UK where I’m assuming David is from) denotes the introduction of solids into an infant’s diet, not stopping breastfeeding altogether. The official NHS guideline is in line with the WHO recommendation that children ahould e breastfed until at least two years old (although finding NHS health professionals who actually KNOW this is another matter entirely!).

      This health visitor is behind the times. The official NHS recommendation is to wait until baby is 26 weeks (or 6 months) to introduce solids, and this is primarily due to enauring the baby has reached an appropriate level of gut maturity. In addition, the standard recommendation of baby rice as a first food is slowly falling out of fashion (because it’s crap!).
      Personally, my baby’s first food was mashed hard boiled egg yolk (mixed with expressed breast milk to form a creamy consistency). We also gave him bone broth, mashed fruits and vegetables, and later on very soft, stewed meats.

    3. I think the issue here is a difference in the meaning of “weaning”. Here in the states, it means to stop breastfeeding, whereas in Europe, weaning means adding foods to the diet (aka starting solids). Mark is using the European definition, as he is recommending adding additional foods, not removing breast milk from the equation.

      1. Thanks for all the interesting posts, for clarity I am using the UK definition for weaning (i.e. adding foods). Our issue (or the health visitors issue) is that baby dropped from 98th ‘centile (at birth) to the 2nd (but is following it now).

        1. Another thing to consider, was your wife hooked up to any fluids during the birth? That intravenous fluid also goes to the baby, so many babies are “artificially” heavier at birth. 🙂

  5. a comment to David….It might not hurt to check in with a lactation consultant as well. I also, ate (and do eat) primally with my newborn and was breast-feeding. My lactation consultant was a wealth of support and information and kept me from worrying. LC’s who are part of the IBLCE certification (this should be the acronym after their names) have the most extensive knowledge about weaning and mother/baby nutrition. Also, our midwife/naturopath didn’t do growth charts with us for the first 6 months. It just never came up and I was too tired to think about it, but in retrospect I realized what a blessing it was to not have to worry about a standardized test and how my son fit into it…

    http://songofourheritage.blogspot.com/2014/11/rendering-suet.html

  6. Appreciate you showing people how to read the fine print when it comes to research. It makes it easier for me to do this on my own now.

  7. I would just like to share my experience with breastfeeding our second child. He was breastfed only until 6 months when we started supplementing with other foods, not formula though. His weight percentile dropped as well, down to about the 10th percentile. He seemed satisfied, happy and was sleeping well so I kept only breastfeeding despite the suggestion of his pediatrician to add formula. At 6 months he started eating some solids but held onto his 10th percentile ranking for 6 to 12 more months. Now he is back around the 50th percentile for weight at 30 months old. There are more details but my point is just this, if your child seems healthy, is growing steadily, and not falling off the growth charts than it is possible that all is well. But really, you won’t know for sure until you’re on the other side of things. The energy we spend worrying is so completely draining. No matter what you choose to do, it sounds like you have the very best at heart for your little one and that goes a long way towards creating a healthy, thriving individual.

  8. Fats aren’t the problem…until they are combined with sugars and starchy carbs such as potatoes and grain products, including rice and possibly cornmeal. I use the term “starchy carbs” to distinguish them from fruit and most vegies, which are also carbs but are necessary for a healthy diet.

    Fats have long been assigned the role of culprit because the so-called experts simply refuse to believe that anything as seemingly innocuous as breads, pasta, etc. could possibly be the root of so many health issues. Bread is the staff of life, right? So how could it ever be a problem? (Never mind that it’s usually eaten in combination with various fatty foods.) The Mediterranean diet is based on pasta, right? (Well, no, actually it isn’t.)

    Go ahead and eat the healthy fats. Just reverse the conventional thinking and either drastically reduce or eliminate the starchy foods–as with a Paleo diet–and voila! A myriad of health issues will disappear as if by magic.

  9. The butter info is very useful and thought provoking. I continue struggling to get my glucose as low as it needs to be. Dairy fat does seem to be an issue. I have reduced it but apparently I haven’t been careful enough about mixing it with carbs. (I do always buy local, pastured butter.)

    I will admit that there have been times in the past when I put 1/3 of a cube of butter on a potato or sweet potato. And farther in the past I have put 1/2 a cube on a huge potato. (Standard at restaurants promoting huge portions. Or both lots of butter AND lots of sour cream.) I love potatoes swimming in butter, but I also love potato salad made from resistant starch increased small, waxy potatoes and virgin olive oil.

    In contrast to most Paleo folks, I do no find naked baked potatoes “tasteless, disgusting swill useful only as a carrier for butter.” They taste great to me. I sometimes have cold, naked leftover potatoes with my breakfast eggs.

    1. I thought fats on carbs helps slow down the rise in blood sugar, which should be a positive thing. Someone help me with this.

      1. In general. But note Mark’s comment that combining palmitic acid (in butter) with carbohydrate amplifies insulin resistance.

        It is obviously complicated and we don’t know for sure how it all works.

      2. read Marks book….its quite helpful….it helped me a lot regarding my blood sugar.

    2. I also loved baked potatoes doused with butter and sour cream, maybe some bacon bits and chives–in other words, the works. I just can’t eat that way any more. I feel much better on a diet that’s minus the potatoes and other starchy foods. I would rather feel good than cater to my clueless taste buds.

      It’s also worth pointing out in this thread that resistant starch may not be a good idea for people with musculoskeletal problems such as rheumatoid arthritis and ankylosing spondylitis, or for irritable bowel problems. If resistant starch makes you (collective “you”) feel worse, then it’s a good indication that starches in general are more of a foe than a friend.

  10. “I read the whole study and couldn’t find any faults using my limited abilities.”

    Bram,

    Suggest changing “my limited abilities” to “my current understanding”. This goes for all word choices involving the self. Words have power. Don’t self impose negativity or limit your potential. More positive words beget more confidence!

    1. Wow thank you Ron! That’s good to keep in mind. I just didn’t want to look like the guy who thinks he has figured it all out.

    2. Thanks for the reminder that words have power. There is NOTHING we can eat that would be “to die for” but there is a LOT that would give us “reason to live”. I’ve changed my way of speaking and when people say that it was “to die for” I say “please don’t die” ….. he, he,he…

  11. Mark said: “As I’ve already covered, large amounts of saturated fat don’t pair well with large doses of carbs.”

    Is there a link to this coverage?

    I’m a little confused. I’m trying to add some carbs back to my diet, and I thought I was doing the right thing by eating them with fat, to slow digestion and soften the glucose spike. I might eat 1 cup of white rice, or maybe as much as 2 cups of potato, usually with a generous amount of beef fat and / or ghee. I’m not exactly drowning the carbs in butter, but, fairly generous with the fats.

    1. I do this as well, ala Sugar Blockers diet. I think the key may be in the difference between glycemic index and glycemic load. The blockers significantly lower the insulin response from high glycemic foods, but eat enough of them and eventually the load will overwhelm your system.

    2. John, not all carbs are created equal. Lower-glycemic vegies are much healthier than an overload of rice, potatoes, and other starchy carbs. Two cups of potatoes is a LOT. Add to that a “generous amount” of fat and you have the perfect recipe for rapid weight gain, to say nothing of a few other associated health issues. Mark is right; the combination of (starchy) carbs and fat are bad news in the long run.

      1. If by rapid weight gain you mean rapid replenishment of depleted glycogen stores, sure.

      2. I agree, 2 c of potatoes is probably too much, but, the non-starchy vegetable route wasn’t working for me. I still eat a lot of veggies, but, I’m pretty sure I need a little carbohydrate. I’m more interested in stable blood glucose and insulin sensitivity, and would like to read more about combining saturated fats and “safe” starches in a healthy way. This post says the subject has been covered, but, I’m not getting much, trying to google several years of MDA for posts about combining carbs and saturated fats. Weight loss is very low priority for me, at this time. I’m probably underweight.

        Thanks!

  12. Our son (12) has cystic fibrosis, and we found out when his weight kept dropping (he had developed pancreatic insufficiency). But that was at about a year old, and he had been happily breastfeeding (and digesting well) up to the point where we introduced solid foods. I think one of the reasons he remains in excellent health is that he got all the health benefits from breastfeeding that first year. I agree with others–as long as your child is healthy and happy, keep up the breastfeeding!

  13. What Mark said about pairing some salmon with the butter is true–Omega-3 from fish sources is blood-thinning. Now why seniors on blood-thinners cannot just do the same sort of thing–pair some salmon with leafy greens (a no-no food for them) is beyond me…other than maybe Big Pharma wouldn’t get its due.

    As it is, you read the local Senior Center menus posted in the daily paper (or on the website), and you’ll see plenty of industrial institutional foods (canned stuff), pre-prepared meats (like fish sticks), and bread of one form or another, but NO leafy greens or raw vegetation (including a salad bar). It’s because most (if not all) of their residents are on blood thinners, and cannot eat them due to the vitamin K content. I say BRING ON THE SALMON AND KALE! Then, the seniors would probably recover enough to walk right out of there.

    1. I think the main reason they feed them that way is because it’s cheap. It’s like the prison system, you get huge bonuses for saving money. And where they try to save money is on food.

      God, I hope they have real food if I ever end up in one of those places (old folks home/senior center) when I’m an old man. Our poor seniors are being poisoned to death.

  14. To the breastfeeding parents,

    Whoa, the person telling you to wean is way off base. Wean to what? I nursed my kids for close to 4 years old each, and they all had lower growth rates than expected. Big deal! I learned by my second child to go to fewer doctor visits and judge health on development and appearance instead. As a retired La Leche League leader, I highly recommend you look for either a LLL group in your area or consult a Board Certified Lactation Consultant in your area for a second opinion if you are worried.

    1. Here in the UK (where I’m assuming the question originated as we have health visitors) the term ‘weaning’ used in this context does not mean stopping breastfeeding altogether. It just means adding solids into the baby’s diet. Our official NHS recommendation is the same as the WHO; children should be breastfed until at least two years old (although societally this full-term breastfeeding is not the norm and receives a lot of backlash from ill-informed public and health care professionals alike).
      Thank god for our local LLL groups! Our leaders and members are forever having to correct ignorant health visitors, nurses, and even doctors on breastfeeding information.

  15. I like the hint towards prebiotic baby food. Take some organic broth, boil down some leeks and sunchokes for the inulin. Process into a smooth puree with a stick blender, serve warm. It sounds like it would be better than anything pulled of a market shelf with a baby’s picture on it.

  16. From the article: “It’s easy to understand why: if a blood clot blocks the flow of blood, you get a heart attack.”

    Uh, no. If a blood clot blocks the flow of blood in a vessel that supplies the heart, you get a heart attack. Thrombi (or emboli that lodge) in other areas can cause other problems, e.g., in the brain, it’d be called a stroke.

  17. Fat will slow the blood sugar spike but fat also works in opposition of insulin so your blood sugar will raise slower because of the fat but it will also stay out there longer because it doesn’t raise insulin needed to cover the meal. I am a recently diagnosed type 1 insulin dependent diabetic and I do know even with injected insulin that a high fat meal raises my blood sugar and it stays high longer. I have found balanced meals of low GI veggies, moderate amounts of protein accompanied by SOME healthy fats keep my steady. If this works for a diabetic it would stand to reason it would work for a non diabetic and perhaps even prevent it. Balanced smaller meals (Overload raises me a lot too) is optimal, at least in my situation. Added fats should be used as a condiment. I eat salads or veggies with about a TBSP of EVOO, 3 oz protein (their fats included) and my ratios always remain about 65-70% fat, 20ish protein and 10% carbs. My point is it doesn’t take much fat to have a ‘high fat diet’. If I add nuts or fats to my proteins and veggies my fat % goes way up. IF I ever have starch it is small amounts of sweet potato but that still spikes me with or without fat. I just stay high longer with the fat

  18. I forgot to add that fat will require extra insulin at the next meal as well. It can raise your blood sugar in excess of 8-10 hours and I find this to be true. That’s why balance is key. Lots of veggies, moderate protein as 53% of protein turns to sugar as well. Fat will not directly raise your blood sugar but it works in opposition of insulin so indirectly it does raise it.

      1. Well you can believe me and I believe you. The proof is on my glucometer. Some nights I gorge on nuts, go to bed at a good number and wake up high. It takes extra insulin the whole day to get back to normal. Fat, especially saturated fat will raise blood sugar. I don’t have a problem with EVOO but who can over eat that? Saturated fat has been proven to be harder to burn. I do eat grass fed beef and lamb but in smaller portions than fish. I just don’t add any other fat to my meal when I do. I used to think fat was a free diabetic macro but it’s not. A lot of times it doesn’t show up for hours! It has been long said that dietary fat is the driver of insulin resistance. True. The up slow is better than a spike but the stay up isn’t so good. Balance, that’s my mantra. like I said, it’s not hard to have a high fat diet with leafy greens, moderate protein and a little added fat to the veggies. There really is no ‘free’ food for a diabetic. Even on insulin I have found low carb, moderate protein and just enough fat to satisfy the perfect meal. Have you read The Rosedale Diet? he is very Primal with a few exceptions and great for blood sugar.

        1. These are very interesting findings, especially for me as a non-diabetic. It seems these rules just apply to me, too, if I want to keep my weight and not slowly gain. It seems that portion size, keeping carbs low and not eating too much fat is crucial. I had to learn, even on a primal diet there is a thing like too much fat, even if it is a healthy fat. And when I eat just a little too much calorie dense food in the evening, I gain weight.

    1. Hey Krisitn,
      Thank you for posting. Would you be able to give me some examples of the kinds of foods you incorporate in your diet and how you pair them? What would a dinner look like? Please don’t include salads since there are as many ways to make one as there are people on the planet. Thank you ahead of time.

  19. This addressing breast feeding question really needs to be asked of a qualified medical practioner (ND, some MDs, midwives).

    It is not recommended to introduce foods to babies as early as 4 months, possible, but NOT recommended. Many children at that age just cannot tolerate solid foods yet. Their digestive systems aren’t ready yet and often they are not showing signs of readiness for food (at least 6 months of age, sitting up on their own, able to push food away from them, genuine interested in parents food, teeth starting to come in, ability to not gag on solid foods). If your baby does not exhibit these signs, I would NOT introduce food!

    Keep breastfeeding regardless whether you’re introducing foods. Breast feeding (or formula if necessary) should remain the most of the child’s calories until they are fully weaned. Be sure to breast feed your baby before you offer them foods, otherwise they may refuse to breastfeed because they are full and then they won’t get adequate calories. Familiarize yourself with the correct way to introduce foods (and it’s not rice cereal). One of the best things to start with is pureed avocado.

    Overall, growth charts are a tool. As doctors we are concerned that the child is TRACKING along a percentile line. A sharp drop off OR above the line is concerning, but steady increasing progress (weight gain, height increase) that tracks along a steady trajectory of any percentile is definitely FINE! You also have to assess… is my child doing well? Are they happy? Do they have any other symptoms that are concerning? Many parents are caught up in the fact that their child is not in the 97th percentile, but what really matters is how they track along the line, if it’s steady, GOOD! If it starts to drop off their curve, NOT good.

    Hope this helps. Try seeing an Naturopathic doctor in your area (if you have one!) and there are some awesome books out there that can help your journey also.

    Written by a 3 yeard medical student.

    1. I am thinking the same as Meagan on this. Babies can lose weight when solids are introduced — the low-calorie veg/chicken puree (or low-nutrient but filling rice cereal) can displace high -energy, brain-fuelling breast milk. It’s too risky when the brain is growing so fast.

    2. Wow, amazing post! You might actually restore (some of) my faith in your profession! 🙂

  20. Thank you Mark for the excellent answer! This really helps me to learn how to read studies myself. I like the way we are thinking from a basic framework and continually making small adjustments along the way. What I have learned from this is to consume a little less butter, but only from trustworthy sources. The carb/fat combination is something I would like to know more about. Perhaps I can study is myself in a few years!

  21. I have about half a stick of butter, a big spoonful of coconut oil and two eggs in my coffee almost every morning.

  22. Something seems unusual about the claim that combining fat with carbohydrate increases the glycemic response. Paul Jaminet from the Perfect Health Diet, which is very similar to PB, claims the exact opposite, with dairy being especially helpful to slowing the GI response due to slowed gastric emptying.

    http://perfecthealthdiet.com/2011/10/how-to-minimize-hyperglycemic-toxicity/

    He cites a study described here: http://www.gnolls.org/1029/fat-and-glycemic-index-the-myth-of-complex-carbohydrates/

    Maybe when the overall size of the meal is taken into account, this changes. Also I wonder if the studies take into account how the potatoes are prepared. That is, whether or not they are aggressively heated, and/or chilled first before reheating.

  23. Once again, the information on here keeps getting trickier and trickier for me to follow. I also, like many others ,have been adding fats to starchy carbs in order to reduce the insulin response because that is what I thought we were supposed to do. This makes me think I should not be eating any starchy carbs at all because without the fat I am under the impression they will raise insulin levels and will store fat. When and what foods pair well with fat without involving the pancreas?

    It seems like I can’t go one month since March when I started this way of eating without reading something that completely derails what I thought was a healthy way of eating for me. What would a diet look like if you wanted to reduce the insulin response after eating? I thought I knew, but obviously not. My friends are going to kill me for leading them down the wrong path once again. We are all eating sweet potatoes with butter, and quinoa with butter. EVIL!

    1. I think the key issue isn’t the direct pairing of starches and fats, it’s combining a high-carb and high-fat approach. Just because you’re eating a sweet potato with butter at dinner doesn’t mean you’re eating a high carbohydrate load that could combine badly with your fat intake. I think unless you’re eating well over 100g of carbohydrates a day – and getting them all from starchy junk carbs, and not exercising – you’re not likely to run into the kind of problems indicated by the study.

      1. http://www.drkaslow.com/html/food_combining.html

        I thought so too, then I started a search on my own like I usually do when something upsets me to no end like this butter and carb thing and ran across this link above.

        I also found a thing about the caffeine in coffee causing a blood sugar spike, something about the caffeine cause the liver to dump glycogen in the stomach raising BS. So, I am with Mel who wrote down below this post. Trying to figure out how to eat correctly is getting exhausting. I would say I am a relatively healthy person. Rarely sick, feel good, no aches and pains and on no medication. Of course according to the link above, I could be causing damage and will reap what I have sown later in life, so feeling good now is no guarantee I am doing the right thing. It is getting to the point where living is not worth it anymore. Too much trouble managing the health of a human body in 2014!
        Interesting how one little experiment with dumping grains and sugar for Lent (On a whim because I couldn’t think of anything else to do and others at work were doing it) would lead to so much anxiety about food.

        1. All of the information in the link appears to be pure theory with no particular scientific, or even anecdotal, evidence behind it, and most food combining theories I’ve read have more to do with digestion than blood sugar or heart disease. Unless you’re eating high-starch foods at every meal, rather than as occasional variety to your diet, I think you might be way overthinking this whole thing. The article in the link only cautions against pure starch combined with fat. I can’t imagine that enjoying the occasional sweet potato with butter is going to do extensive long term damage. Protein + green/cruciferous veggies cooked in fat (or raw, if appropriate) at most meals, occasionally (once or twice a week) supplemented with starchier foods (sweet potatoes ftw!) is a simple formula to follow that avoids most of the blood sugar/heart disease pitfalls of the SAD.

  24. My wife couldn’t produce much milk about 3 months in, so we had to feed our infant formula. But as soon as he was able to drink raw cow and goat milk and primal foods, he had a big growth spurt. He is barely 2 years old and is at the 100 percentile for height and weight (according to Kaiser). Right now he’s 37 lbs and at a height of 36.5″. I’m a manlet, so he didn’t get the height from me or my wife…

    We don’t feed him any grains, sugar, processed foods, seed oils, etc., so I’m sure his love of healthy foods has helped him grow. The kid loves his beef!

    1. Three months can be a typical growth spurt time. Rarely means too little milk, just means nurse more so there will be more milk when it’s over.

  25. I really loved the answer on butter- we can get such a simple glimpse into something, but we have to look closer to really understand what is going on!

  26. Hi Tiff,

    BF is usually 2 large handfuls of bok choy stir fried with oregano, thyme ,sage and rosemary with a 1 oz lamb meatball, scallion and some celery. Occasionally I add some infused EVOO but not always as the rare lamb an herbs add enough flavor and it’s moist.

    Lunch is about 3 ounces steamed broccoli, asparagus, snap or green beans with 3 ounces of protein, usually fish and sometimes on a romaine lettuce wrap if it’s canned tuna or salmon. I will add seasonings and some EVOO and sea salt. I have some radishes, celery and carrots raw on the side.

    Dinner is almost always 2 cups of chopped spinach/power greens with EVOO, artichoke and sometimes a little hummus. Makes it gooey and I love gooey in the cold weather. Again I have some raw veggies. I have 3-4 oz protein. If it’s red meat or dark poultry I add no fat but if it’s white poultry or white fish I will add some EVOO. I usually steam my fish and just add sea salt and herbs or a spice blend at the end.

    I snack on romaine dipped in wasabi mayo, celery or a small handful of pumpkin seeds/walnuts

    I space my protein at least 4 hours apart. This tid bit has made a big difference. I was a grazer and ‘stacking’ protein raises insulin as well as blood sugar.

    I do the 3 legged stool. Low carb, moderate protein and 4 hours apart. Just enough fat to satisfy.

    I have many infused oils. Italian herb, sweet basil, orange, lime, lemon and garlic. I can make many different flavored meals with these and some fresh herbs. I used to be a gourmet cook. Now I just keep it fast and simple. I don’t care to spend time on food though I do like it to taste good. I eat to live now. I do miss making comfort foods but in the end comfort is about temp and flavor, not complication and time. I’m not going to lie, it does depress me sometimes but ‘off’ blood sugar and the roller coaster depresses me more. Balance…..

    Comfort foods to me are savory herbs on warm food, Summer is all about cilantro and basil on cold greens.

    I eat about 50-60g pure protein a day. Fish at least once a day if not twice, my lamb meatball in the morning and the rest is up for grabs. Some days poultry and some days red meats (grass fed beef, bison or lamb). I try not to eat more than 25g at one time, closer to 20g. I do weigh my protein and keep a good eye on my fat. I eat about 8-10 cups of green veggies a day. I try to keep saturated fat to a minimum but I do require fat so it’s usually EVOO and a few seeds/nuts. I am 50 years old 5’8 and 120#’s. I have never done well with starch, grains or sugar at all. I will occasionally have a small piece of dark chocolate and if we have company and I make roasted sweet potatoes I will have a few bites. I have a glass of red wine most nights. I do some yoga stretching in the morning and a little yoga at night. Too much exercise or any high intensity raises my BS .

    I also notice when we go out to eat and I eat more protein or fat than normal I go to bed higher and wake up higher. My morning predicts the rest of the day. High fasting BS means higher all day. Don’t get me wrong, eating this way keeps me between 90-115 most of the time. Eating out is more like 105-125. I am not in danger zone but I eat to stay away. I have also been fortunate (or diligent ) enough to be able to take very low doses of insulin this way. I would have no idea how much insulin to take for a piece of cake. The tricky part is getting my insulin there at the same time as my food. Too early I go low, too late I go high. I like to keep it VERY steady. OK. TMI but IF you have any further questions I would be happy to help. Diabetes sucks and although everyone’s is different, most rules still apply. I have tested everything possible on my glucometer and have read for years. I kept mine very well controlled for years until genetics took the lead.

    1. Thanks for your detailed post! More power to you! I won’t eat like that though. Perhaps you saw my recent “stubborn senior” success story.

      I’m not on insulin (not adding yet ’cause I don’t intend to). I am convinced that just being more careful about how I eat and getting plenty of exercise will keep me at a reasonable level. There are new drugs in the pipeline too.

      Different strokes for different folks.

      1. You probably shouldn’t eat like me. I am a 120# female. I’m thinking you need more food than me.

        I too held this off for many years through diet and exercise. I had normal numbers. Literally, overnight, in one night my fastings went from 85 to 250 and I couldn’t bring them down. Genetics slammed the door in my face. I do have to admit over the last few years prior I had to change the diet multiple times. Less food, less carbs, less protein and fat. Then the gate just closed. I went from great BS to insulin. No other meds in between.

        I have not seen your stubborn senior post but would be interested to read it

        1. The stubborn senior post was Sept. 26 of this year. If I put the link here, this will get held for mod.

          Early this year, my glucose was OK, typically around 110-120. A couple times it dropped below 80 and I had to eat some carbs. Then it shot up well over 300. Part of the problem may have been two courses of antibiotics. Now, if I don’t cheat, it is around 185. If I cheat, 250.

  27. I always see big babies mentioned when this subject comes up. My twins were full term. They weren’t fully weaned until about 16 months. They eat a pretty healthy, primal inspired diet. They love braunschweiger. And were ahead of the curve on all the physical milestones. Crawled at 5 months were walking at ten months. One is right around the 50th %tile for height and weight, while the other one is below the second percentile. Both are tracking along the growth chart. I am in the 75 percentile for height and my wife is in the 95 percentile for height.

    Their cousin was never breast fed ate the SAD and is a giant. Not fat but well above 98 percentile line on height.

    My point is just because your kid isn’t topping the growth chart doesn’t mean your doing anything wrong. All kids grow at different rates. Some are slow growers at first. Some stay small some will end up tall. Dont’ Worry, Be Happy.

  28. Tiff,
    In short, lots of green low GI veggies, a few berries if you want , 3 ounces of protein 3x a day and some mono fats should make up the bulk of your meals. Snacks are more veggies or a few nuts and seeds, The rest is condiment portions. Butter, dark chocolate, more nuts/seeds, coconut oil etc. Keep it simple. Red meat a few times a week . The only foods I eat with more than one ingredient are the marinated artichokes, dark chocolate and wasabi mayo. Diabetes is hard enough.

    1. Thank you so much for your posts Kristin. I appreciate it greatly!!
      Namaste

  29. People on the forums often brag of their copious butter consumption. As far as combining fat with carbs, that’s basically exactly what the perfect health diet promotes.

    1. Doesn’t PHD recommend putting vinegar on potatoes to counteract an effect instead of lots of butter or even plain? I would have to look it up but I sprinkle vinegar on my baked tutors now with just a little butter per PHD. Tasty.

  30. As I have mentioned before, read the books ‘Bad Pharma’ & ‘Bad Science’ by Ben Goldacre. Most studies are biased towards the preferred outcome, which makes our lives really tough because the published results aren’t the whole truth.
    Did ‘Grok’ eat butter? Probably not, so as Mark says, be vigilant of it’s source and don’t overdo it.
    Does anyone really know the best way to ween a baby off breast milk? In the wild the growth of teeth is a good indicator that it’s time to stop, why should it be any different for us? Of course we are more ‘civilized’ so it’s not that simple. Trust your instincts and monitor your baby continuously, they’ll let you know if something doesn’t agree with them.
    My wife drank ‘Jungle Juice’ while pregnant and breast feeding to help with her milk supply and quality and both our children are pretty healthy. Some minor allergies which I blame on the cereals and sugars, but I could be wrong…

  31. When a child is three-four months they can have a growth spurt ,which mean you need to breast feed very often for a week or so just in order to produce more milk.
    Breast feed often = more milk ,breast feed less (breast milk + infant formula) = less milk.
    In Sweden the recommendation is 6 month with only breast milk and after that start with solid food + breast milk up until your child are two or stops by her/himself.

    If your child are content and happy don’t care about growth carts ,breast feed babies are very often not as fat as formula fed kids. Breast feed whenever your child wants it and do not follow special times for meals and you won’t have any problem.
    Breastfeeding the most natural thing on Earth. Good Luck from mum of 4 children that was breast feed between 10 months to 3 years.

    1. Great advice Liv, feed on demand. We have to learn to trust our babies and our bodies to provide everything they need.

  32. First, there are babies who are just small. I have several who are healthy and happy but clearly took their genetic cues from my tiny mother-in-law. If baby is happy, meeting developmental milestones and having enough wet and dirty diapers then all is probably fine. It is hard with a first baby when anything isn’t right “on schedule”.

    If you are nervous about baby’s weight gain there are a few things to consider. For babies under 12 months solid foods are for tasting and experiencing. They aren’t for nutrition. Breastmilk (and if needed, formula) provide everything baby needs for the first year. Furthermore, breastmilk is more calorically dense than formula (there is some variation in the caloric density based on mom’s diet, but eating primally would almost certainly gurantee high quality milk I’d think) so supplementing with formula wouldn’t make sense. Starting solid foods before 6 months is not reccommended for many reasons and what they would encourage feeding a 4 month old (though again, it is not advised) would be grains. Not good. Breastmilk is sufficient. All of CW (and marketing) will try to tell you otherwise, but if you are making enough milk (a IBCLC can weigh baby before and after a feeding if you are feeling paranoid that baby isn’t getting enough….normal feeling by the way) then all is well.

    If however, a woman is not getting enough calories/carbs to produce milk well. Or if she is losing weight too quickly and the toxins being dumped through the breast milk are bothering baby… These are things to suggest tweaking mom’s diet, not baby’s.

    Hang in there!.

  33. Not to say CW and health/social services don’t support breastfeeding. They do in theory, but their training is incredibly light on the subject most of the time. I actually print out information on breastfeeding to educate providers when I take my kids to appointments. It makes life easier when I can say, “Well the WHO says…” or “Actually here are three studies that show that is incorrect…”

    Be polite, but be aware the healthcare providers you are dealing with are often undereducated in this area. But be nice especially if it is a woman. If she didn’t meet her own breastfeeding goals it could be a sore spot.

  34. So, this is saying when I eat a sweet potato with butter, or even worse, a sweet potato with a steak, I’m doing harm to myself?

    I have to say I’m really exhausted of how eating has gotten to be so damn complicated. Every time I prepare a meal I feel like I need some manual to make sure I’m eating the right things, at the right time, paired with the right things, in the appropriate proportions, yada, yada. Why does feeding myself and my family have to be so stressful? Why is it everytime I think I’m doing right some blog posts something about how I’m basically killing my family. Eat fat. Eat grass fed meat. Eat grass fed butter. Ok. So, a bun less grass fed burger and an organic sweet potato with a pat of grass fed butter. I’ve got this. I’m doing great….oh wait, no. I’m giving my family blood clots. (And yes, we are a family that NEEDS carbs. I cannot do paleo/primal without losing much needed weight. My husband, myself, and my children are all EXTREMELY thin people. I am actually considered 20 lbs underweight) Why did we take the joy out of preparing and eating meals and replace it with this stress of “is this ok? Is someone going to turn around and say this is actually bad?” I just want to eat good food and be happy. I don’t want to read anymore that even eating what I thought I was “supposed” to is bad in some way. There comes a point in time when I have to brush articles like these off and say, “Who cares. I’m just going to eat food and be happy until I die.” I realized the stress from reading all these Dos and Donts and wandering what’s right all the time will kill me well before butter on a sweet potato will.

    1. Mel,

      I hear you completely! Food decisions are exhausting!!! When I get frustrated I try to remember there is no perfect food, combination, time etc so I just just try to make good decisions, eat foods in moderation, get the healthiest choices possible at the time and let the rest go. As you may have seen, I am diabetic and that in itself is extremely restricting so I just do the best I can at that given moment.

      You are very correct about stress making it worse!! I’m still working on that. You try to do everything right and then the ‘science’ and advice changes. You try to learn how to eat healthy by reading but then it makes you afraid to eat because there is so much conflicting advice. The best advice I have is to listen to your body and how foods make you feel. What else can you do?

    2. I feel the exact same way at times. “Don’t eat too much chicken! Okay…now don’t eat so much pork! OMG, that organic cashew butter is going to killllll youuuuuuuuuu!!! Eat Kale….Wait! Not too much, you’ll kill your thyroid!”

      I usually just take time off from reading all of the conflicting information and just eat good, whole foods without the microanalysis added in. You are not eating and feeding your family the SAD, so you are way ahead of the game!

      Now….go have a sweet potato with butter! 😉

  35. Harry,
    I read your blog. Very interesting and I’m glad you saw such improvements! The 1st time I heard my BS was high was when I had a horrible virus! I have read diabetes can be caused by viruses.

    Would 185-250 be fasting numbers or 2 hours after meals? that would leave you with an A1C between 8 and 10. Too rich for my blood. Anything over 140 leads to nerve and organ damage. I was diagnosed at 10.4 and 3 months later 5.4 and my numbers have improved a lot since then. I have an appt next mon. Thinking it’ll be around 5 or less.

    I had lost 25#’s( I was down to 97#’s) in a short period, was very weak and didn’t respond to oral meds. They did a GAD test(simple blood test)and determined I needed insulin that type 2 meds wouldn’t help. I HATED the idea of insulin and still do however I hate the idea more than the insulin. It saved my life, literally. I was dying a slow death. The needles are small and rarely hurt. I gained my 25#’s and strength back in 2 months. My weight stopped exactly where it was before all this started. Gaining 10#’s a month made me a little nervous, LOL but it stopped and stayed there. I am on extremely low doses of meal and night time insulin and I like to keep it that way, hence the way I eat. Diabetes is viscous and I want to live a healthy rest of my life. I want my vision, to be able to walk etc. But that’s just me. I’m probably a little obsessed but whenever I stopped checking things got worse even though I changed nothing. The only thing that changed was time and progression.

    I hear you about the nuts/butters! I will always over eat them so I stopped buying them. If I crave them I will go to one of those self serve dispensers and just buy a small handful. Lame, I know but it keeps my hands out of the cookie jar! Nuts are like crack to me. AND they are one of the worst for my BS when I over eat them. It would never come back down.

    I hope for your continued health you figure things out. I think you know what you need to do, it just needs to be applied. If you’re anything like me, when you are told you can’t, you want it more! I am a foody, I love all food so I have given up so much but I really do feel better for it. I also feel a sense of self accomplishment and strength. There are always 2 sides to every story.

    Wishing you health!

  36. I’m not saying to discount studies, but instead look at them like a researcher would. A study tells us that X happened when Y was done. It doesn’t say that X happens when A is done, or B is done, or C. Those variables are different and would need their own studies to determine what would happen. And even then, studies are seldom conclusive on their own. Studies often create more questions than answers. Many of the same kind of studies need to be done many times to accurately paint the big picture.

    Too many people read a study and start generalizing them.

    1. Thanks for the good reminder Ben. Whipped my brain back into shape. Genetics and immune systems play a huge roll too. Everybody processes food differently. We all know to stay away from HFCS, trans fats, etc but when it comes to well sourced healthy foods, we are all on our own how we process these. Listening to our bodies is key. No diet fits all, even Primal/Paleo. The foods themselves may be pure and clean but if they don’t make us feel well, they are no longer healthy for us. Sweet potatoes are supposed to be healthy but if they raise my blood sugar to unhealthful ranges, I don’t consider them healthy. Just my opinion of course

  37. Sigh, OK, I will STOP eating so much butter…… or drinking it in my coffee. I like to have 2 cups of coffee but I don’t think it likes me back. Of course, in those go a tablespoon of butter and coconut oil and maybe an egg for fun now and then.
    When my son was just about 15 months old he was in the 25th percentile, so the lady at WIC told me “how to feed him” so he could thrive, chuckle. Uh, that means in real life give the boy MEAT and not grains. He LOVED meat for each meal so that’s what he got with all the other veggies and fruit he’d eat. Of course, when his bio mom had him for a few months and then “gave him back” it was a different story from the lady at WIC, she was pretty thankful that he was back at my house. She was doing her job trying to “help me feed my boy” even though he was getting plenty of good food, just not ready to shoot up. He’s a tall one now.

  38. Margit,

    Do you find the type of fat makes a difference? Seems to me EVOO doesn’t cause issues but saturated as well as nuts and seeds fats tend to add weight. They also seem to bog me down as well as make me hungrier if eaten in larger portions. the hungry part is probably a blood sugar/insulin imbalance.

  39. Dear Mark,

    I want to thank you for writing about accurate breastfeeding practices. As a lactation professional I work very hard to educate and reassure parents about normal baby growth and breastfeeding behavior. A lack of up to date information amongst some medical professionals can significantly harm and undermine a mother’s confidence in herself. Thank you for accurately informing and empowering parents. It is important to have a questioning attitude and get a second opinion if the advice you’re receiving feels wrong.

  40. Re: early weaning.

    If the baby’s growth is truly slow, and not just a small and slim baby, it would be necessary to make a change. One option is to try to boost the mother’s own milk supply by using prescription domperidone (see link below to Dr. Jack Newman’s suggested protocol) or by using the clinically proven herbal treatments fenugreek and blessed thistle. I never used domperidone, but I did use fenugreek and blessed thistle with noticable success. Also, one would want to ensure that the baby is being fed on demand and not encouraged to sleep through the night before natural readiness.

    If increasing the milk supply using medicinals is not desirable for the mother (some women are just uncomfortable with doing this) then I would absolutely add to the baby’s diet (whether with supplemental donor milk, or formula) or, at 4 months, it is not unreasonable to introduce a little solid food. But ideally, this would be done in addition to breastmilk, not instead of.

  41. Regarding breastfeeding difficulties, there is a factor that may be involved that I don’t think has been mentioned in these comments. A large number of babies are being born with tongue ties and lip ties these days. They contribute to all kinds of problems including slow weight gain, “colic,” reflux, painful nipples, mastitis, and failure of breastfeeding; as well as other problems later in life including tooth decay, speech problems, dental arch problems, and more. It is a lengthy topic to discuss thoroughly in a comment to a blog, but it is probably due to dominant genes expressing themselves more, use of synthetic vitamins such as folic acid, and also the fact that tongue ties are not longer snipped in the delivery room, as they used to be before formula feeding became normative some time after World War II. Make no mistake about it… breastfeeding is the biological norm for all mammals including humans, ideally exclusive for 6 months or until teeth begin to erupt, and hopefully continued for at least one year. From a primal persecutive, some breast milk would be included in a child’s diet until 4 years or possibly even beyond. To learn more about tongue tie and lip tie, visit http://www.drghaheri.com and http://www.kiddsteeth.com

  42. Mark says, “The butter group ate about a quarter to a third of a stick of butter with their meal. Is that a typical way to eat butter? It’s definitely way more than I use in a sitting.”

    then ends with:

    “Does anyone really need a half stick of butter with (or as) their meal? Aren’t there other things a person can be eating with butter instead of just piling on more and more?”

    How did 1/4 to a 1/3 change to 1/2? Typo? I think it’s because he know that many of his readers DO regularly eat 1/4 to a 1/3 a stick of butter in a meal.