For today’s edition of Dear Mark, I’m answering several questions drawn from the comment board of last week’s post on fasting vs carb restriction . First, how do I square my recommendations with the successful reports of potato dieters losing weight on a high-carb tuber diet? Second, is Leangains optimal for mass gain? Third, how do I use extra virgin olive oil, butter, and ghee? Fourth, could exogenous ketones help a man with dementia, MS, and seizures? Fifth, how should a woman with stalled weight loss integrate fasting?
Walter Sobchak asked:
If “carbs” are so bad, how do people eat only potatoes and lose large amounts of weight? Andrew Taylor (SpudFit.com) and Penn Jillette (Penn & Teller) are two high-profile people, but there are lots more. Of course, I wouldn’t recommend an unbalanced diet of only one food, but the point is that potatoes are a natural food and are not inherently detrimental.
I agree that potato-only diets are a quick weight loss hack.
Potato-only diets work well because they’re so monotonous. When your only option is a plain potato, it’s extremely hard to overeat. It’s the combination of fat and carbohydrates that’s so easy to overeat, and that causes the most metabolic problems.
Potatoes are surprisingly nutrient-dense. They have complete protein, containing all the necessary amino acids. You won’t be bodybuilding on all-potatoes, but there’s enough protein in there to stave off muscle loss for a week or so.
Cooking and cooling your potatoes  converts some of the glucose  into resistant starch , which feeds your gut bacteria and cannot be digested by your body. This lowers the effective glucose load.
I could recommend the potato-only diet, ditch the keto/low-carb/Primal talk, and people who listened to me would still lose weight. But they’d miss out on all the other benefits, not least of which is the delicious food. In short, the potato-only diet isn’t the worst thing out there, but I wouldn’t recommend it as a long-term strategy.
Mattias Carlsson asked:
I have a question for advice if someone know. According to most sources I find the so called anabolic window persist at least 24 hours after resistance training. How can then an intermittent fasting with 8 hour eating as in lean gains, from what I understand, be optimal on training days. It seems to me that a bit of overeating on carbs and protein during all this time would be most beneficial?
I don’t know that it’s optimal for sheer mass gain. But it does seem to strike a nice balance between “gains” and “staying lean.” You may not bulk up as quickly as you would cramming food in your gullet. You will gain lean mass without gaining so much of the squishy mass that normally accompanies what passes for “gains.”
Michael Levin wondered:
Question: EVOO, Ghee and grass-fed butter–which to use when and for what?
EVOO: salads, marinades, sautéing. It’s actually far more resistant  to heat than most people think; the polyphenols protect against oxidative damage.
Butter : Cooking eggs and other breakfast items, melted with broccoli/shrimp, finishing steaks and reduction sauces.
Beth Olson asked:
What are your thoughts on exogenous ketones? My dad has MS and dementia and seizures way too often. Should we try adding these?
I can’t give your dad any medical advice. You can talk to his doctors, however, and show them this study  where exogenous ketones reduced seizure activity in mice. You can show them that coconut oil and MCT oil—two other routes for generation of ketones—have shown efficacy  against cognitive decline in patients with Alzheimer’s or dementia.
I suspect exogenous ketones can help. I also suspect they’d be far more helpful on top of a low-carb, high-fat diet with plenty of healthy lifestyle modifications.
That’s the thing with dementia: there isn’t a pill that fixes everything, or even a single intervention. In the one study  that actually got major results, researchers had Alzheimer’s patients undertake a dramatic diet, exercise, and lifestyle shift. Here’s what each subject did:
- Eliminate all simple carbs and follow a low-glycemic, low-grain (especially refined grains) diet meant to reduce hyperinsulinemia.
- Observe a 12-hour eating window and 12-hour fast each day, including at least three hours before bed.
- Stress reduction (yoga, meditation , whatever works for the individual).
- Get 8 hours of sleep a night (with melatonin if required).
- Do 30-60 minutes of exercise 4-6 days per week.
- Get regular brain stimulation (exercises, games, crosswords).
- Supplement to optimize homocysteine, vitamin B12, CRP levels.
- Take vitamin D  and vitamin K2.
- Improve gut health (prebiotics and probiotics).
- Eat antioxidant-rich foods and spices  (blueberries, turmeric). 
- Optimize hormone balance (thyroid  panel, cortisol, pregnenolone, progesterone, estrogen, testosterone ).
- Obtain adequate DHA to support synaptic health (fish oil , fish).
- Optimize mitochondrial function (CoQ10, zinc, selenium, other nutrients).
- Use medium chain triglycerides (coconut oil , MCT oil ). You could possibly use exogenous ketones here too.
Bring that study to your dad’s doctors and see what they have to say. If they aren’t blown away by the possibilities and open to give it a try, I’d be shocked. Hopefully your dad is game. I’d love to hear how it works.
Lisa Chupity asked:
I went Primal/Paleo back in March of 2012. I lost the 15 pounds I wanted to lose. In 2015, 7 pounds crept on, and for the life of me, I can’t lose ‘em! April of this year, I went Keto. I track my macros, and do my best to keep my carbs to 20 grams per day, tho I don’t beat myself up if I have 24. I haven’t lost an ounce! I’m going to have to do the IF thing, I’m sure. As it is, my breakfast is bone broth (1 1/2 cups) and a mug of Coffee with Brain Octane in it. Lunch is yer basic “Big Ass Salad”. Dinner is good, too, and within Keto guidelines. I try to keep my caloric intake to ~1600 calories/day.
To add to the mess, I have Multiple Sclerosis, so stuff like Cross Fit is outta the picture. I can manage some stationary cycling, and some Pilates, with lighter modifications. Any advice?
If you try IF, do the “early restricted feeding” rather than late. You’re already doing a kind of “fast” in the morning, just drinking broth and coffee with MCTs, and it doesn’t seem to be working.
Eat some fat and protein for breakfast with a few carbs. Eggs and bacon with a side of cantaloupe or berries. An omelet with spinach and onions and cheese. Steak and greens and half a banana. Emphase whole-food fat and protein. Have coffee and broth, too, if you like. This and lunch should be your biggest whack of calories.
Eat your Big Ass Salad for lunch. Drop dinner, or make it really light and no later than 5 or 6 PM.
Terry Wahls has a great Primal-friendly MS protocol. Check out her Ted talk  and go from there if it interests you.
Good luck and keep us apprised of your results.
That’s it for today, folks. Take care, be well, thanks for reading and writing!