Dear Mark: Two Weeks Off Primal, Pili Nuts, Fasting and Micronutrient Deficiencies

PastaIn today’s edition of Dear Mark, I cover three questions from readers. First is from Richard, who’s taking his father back to the old country – Italy, to be exact – for a two week vacation to visit the place of his birth where he’ll be immersed in pasta, sweets, and liquor and completely at the mercy of his hosts. What should he do? Second, what’s the deal with pili nuts? Are they worth including in a Primal way of eating? And finally, a reader is worried about nutrient deficiencies when fasting. There’s really nothing to worry about as long as you’re reasonable about your fasting habits, and I explain why below.

Let’s go:

Thank you for the great public service you provide!

I’ve happily followed a Primal lifestyle for nearly two years and feel great on it.

Now, I’m considering taking my father back to the small Italian island where he was born for about two weeks. This would mean an unavoidable break from Primal food – it would be a sugar and grain fest of pasta, sweets and liquor. Opting out would be rude to our hosts, difficult to explain and not feasible (there simply won’t be many alternatives as I won’t be self-catering at all).

Will all my Primal gains be lost? Before going Primal I lived on such a regimen and although I didn’t thrive on it, it didn’t destroy me either.

Will two weeks of anti-Primal living be worth it?


Yes. It will absolutely be worth it.

Being Primal, as you say yourself, is a lifestyle, not just a way of eating. Eating informs it but does not entirely define it.

Let’s see what a couple weeks spent in the company of your father in his ancestral homeland on the beautiful Mediterranean off the coast of Italy has to offer in the way of non-dietary lifestyle – and therefore health – enhancements:

Sunshine. It’s probably going to be sunny the entire time you’re there without being overly hot. You’ll fill up on vitamin D. You’ll be in a great mood and you’ll sleep well because you’ll be exposed to tons of bright, natural light during the day (which will set your circadian rhythm).

Community. You’re going to be socializing the entire time: big lunches, late dinners, flowing wine, laughs, old times recounted. Italian culture is well-known for supporting close-knit, strong communities, and this has been associated with multiple health benefits, including protection from heart disease and deaths from all causes. Partake. Gorge yourself on community. You’re only there for a couple weeks, so make the most of it.

Gratitude. You’ll be with your father. You know, that guy who gave you life, reared you, and provided the solid foundation you’ve used to become the man you are today. We owe a lot to our parents – and they to us – and this trip is a fantastic way to give thanks and show gratitude. And you may not know this, but giving gratitude has proven physiological health benefits. Hey, it’s almost like we’re meant to be around people who support us and deserve our gratitude.

And even the food isn’t as bad as you’re thinking. It’s probably going to be well-made, handcrafted with love and artisanship. The food will be fresh. There will be pasta and bread and sweets, yes, but it’ll be the highest quality possible (if you have a choice, go with risotto (rice) or polenta (corn) instead of pasta). Everything will be cooked in olive oil or butter, I’d imagine. These aren’t vegetarian cuisines, so you’ll have plenty of meat, good cheese, and charcuterie, plus whatever fresh produce is in season. Just eat a little less of the pasta, bread, and sweets and eat a little more of the meat, cheese, charcuterie, and produce. And since you’re on an island, you’ll have access to fresh seafood.

Will your gains be lost? I doubt it. If you end up eating more carbs (or food overall) than you’re used to eating, you can offset the hits to your fat-burning efficiency by increasing your activity levels. That could be going for a long walk every day, swimming in the brilliant blue sea, doing body weight workouts, running hill sprints a couple times a week, or anything that you feel like doing. It will all upregulate your substrate oxidation machinery.

If you’re coming from a ketogenic diet or something super low carb, you might have to endure a mini (re)induction period when you return. But it shouldn’t be anything devastating.

Hi Mark,

I guess you never received my question, on whether Pili Nuts that only grow in the Philippines, are considered primal. Bummer )-:

Time Traveler

Ah, it must have flown under my radar. Sorry about that. Let’s take a look and rectify the situation, though, huh?

Pili nuts are definitely a good choice. Fat-wise, they’re more saturated than any other nut I’ve seen with almost 9 grams of saturated fat per ounce. The rest is monounsaturated, with a small amount of polyunsaturated fat. According to a recent article in the Wall Street Journal, an ounce of pili nuts also has almost 100 milligrams of magnesium (more than any other nut) and 69% of the daily allowance for vitamin E (probably because these nuts are grown in Southeast Asia, the Phillipines, and Papua New Guinea and need to protect their fatty acids from the warm, humid climates; it’s always fun to co-opt a plant’s natural defenses for ourselves!).

No formal research has been done on the health effects of pili nut consumption, but based on the nutritional profile I think we can assume they’d be positive. Go for it.

Hi Mark!

I will be brief 🙂

I read your fasting articles and they are wonderful, but I have a quick question that I don’t think you answered:

What about the daily recommended USDA intake for vitamins, minerals, etc.? Wouldn’t a 24 hour fast leave us “malnourished” during that day and stop the normal body functioning? (I understand that skipping the calories is fine, as we have enough reserves.)



It’s possible to become malnourished from excessive caloric restriction, sure. Long term anorexics tend to have multiple nutrient deficiencies for the simple reason that they aren’t eating enough food. And in a recent study, obese subjects ended up deficient in a variety of micronutrients after following an 800-calorie-a-day diet for 12 weeks. But these are rather extreme examples of caloric restriction that I trust (and hope) you aren’t following.

Intermittent fasting is different. It’s, well, intermittent, rather than drawn out. Acute, not chronic. The occasional lapse in eating, not a constant state of lacking that tugs at your nutrient stores. If you’re doing 24 hour fasts, you’re doing them once, maybe twice a week, and eating relatively normal amounts of food the rest of the week.

Fat-soluble vitamins, like D, A, E, and K are stored in your body fat and liver, so day to day intake fluctuations shouldn’t impact your stores of those nutrients. And because you’re already eating a ton of fat-soluble vitamins (from offal, pastured animal products and meats, egg yolks, leafy greens, the occasional handful of nuts) and getting adequate sunlight (or taking vitamin D), you’ll have plenty saved up.

Water-soluble vitamins, like C, the Bs, and folate need to be eaten more frequently, but skipping a day doesn’t make a difference. Full blown avitaminosis disorders like beriberi (thiamine deficiency), pellagra (niacin deficiency), night blindness (vitamin A deficiency), anemia (iron or B12 deficiency), hypothyroidism (iodine deficiency), scurvy (vitamin C deficiency), or rickets (vitamin D deficiency) take a long time to manifest. A missed day here or there won’t matter as long as your overall diet is replete in nutrients. Evaluate your nutrient intake using a longer timescale.

If you’re still worried, you can always pop a quality multivitamin, or take specific minerals or vitamins that you suspect your diet lacks.

That’s it for this week. Thanks, everyone!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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46 thoughts on “Dear Mark: Two Weeks Off Primal, Pili Nuts, Fasting and Micronutrient Deficiencies”

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  1. Short and sweet. I practice IF as a matter of convenience, regularly skipping breakfast and sometimes lunch. Helps manage my caloric intake and my desire to snack.

  2. Most of your vitamins and minerals go to process food. So your need for vitamins and minerals during fasting is greatly reduced. Prolong fasting for weight loss was common during the 60s and 70s. So this subject is well studied. Numerous studies have shown that normal people can fast for 30 days on water alone.

  3. I like the third question, stop the normal body functioning. You could be in the middle of conference at work and all of a sudden you just stop functioning. It’s like an engine with an oil leak, eventually it just seizes up and you can kiss that engine goodbye.

  4. Thank you for your response to #1! Well-crafted. As long as there is no overt allergy, it definitely seems worth that once in a lifetime trip with a beloved family member. On your deathbed, do you think you’ll be remembering the glorious trip or wishing you hadn’t eaten the pasta that one time??

    1. I totally agree. I love that Mark is so reasonable with his answers – it’s so well balanced and refreshing. And I’m totally jealous of anyone going to Italy! 😉

      1. Seriously. Italy is such a wonderful country.

        Personally, I throw aside whatever dietary restrictions I’ve got when I travel. I don’t want to waste a single moment of my vacation worrying about nutrition. I figure my body can take care of itself for a few days. We are omnivores and we can live on pretty much anything.

        And besides, the food in Italy is amazing.

        1. Agreed. Paleo should be a lifestyle, not a prison sentence. If weight worries are a factor, one trick would be to enjoy everything but keep carb portions fairly small. Permitting yourself to eat special-occasion food doesn’t mean you have to gorge on it.

  5. I love your response to the first question. There’s no need to worry about details when there’s a greater overall experience to be had. Life is too precious to think constantly about keeping to a certain diet (barring allergies of course.)

    1. Totally agree. We went back to my wife’s home village in Italy in 2009. It was exactly as Mark described it. Even though I couldn’t speak Italian we managed through my daughter translating. Great FRESH food, laughs, wine on into the night. Couldn’t get enough. Then during the day, walking, skiing (we went in winter), more fresh food (they killed a pig because we were coming… OMG! ????)

  6. First-ever comment in case #1 is reading. Of course I agree with everything Mark said and the trip is of value no matter what’s for dinner. But in my (long and wonderful) experience with visiting family in Italy, I would say that the enthusiasm for food and the feeding of guests can mean an amazing culinary adventure for you. Not sure what island, but if – say – lamb is a specialty, let them know how much you love it! And is there anyone still around who remembers how to cook with ortica (nettles) or other local wild greens? Who knows the best local raw cheeses? Probably yes, and they’ll be so delighted to be asked. Italians are of course proud of their food, and their traditions are much richer than just a lot of pasta dishes. They are generally SOO happy to show you how much they value those older traditions. Also because of how strong the rural connections were for most Italians until very recently, the memory of what happened at pig-slaughtering time (for example) are much more recent. You’ll generally find 60 or 70 year-olds who remember making blood pudding and cooking with lard, who knew farmers that understood all the local wild goodies, who know what a fresh egg is and who value a fresh fig more than any cooked dessert. Show them you’re interested in these things and they will be thrilled.
    Have a great trip!

  7. Loved the response to the first question. There has to be a little give and take if you want to be healthy for the rest of your life but also be sane. Being rigid all of the time will get you nowhere but the land of unhappiness.

  8. Does it count as fasting if you have cream in your coffee? I tried putting coconut oil in but it makes me feel ill. 🙂

      1. I think Paul Jaminet talks about including fats into an IF regimen is helpful from a Ketogenic standpoint, I would assume cream would fall into this category.

    1. Technically, it probably doesn’t count. Coconut oil would knock you out of a fast as well, but it would still be good ketogenic fuel.

      P.B. Community, correct me if i’m wrong.

      1. I think one of the main points of an intermittent fast is to reduce insulin resistance. Coconut oil shouldnt spike insulin so I think it is safe to assume it wont affect a fast. I use it on IF days – I just eat a tablespoon of it. Takes a while to get used to the texture and the fact youre just eating oil 🙂

        1. IF also activates autophagy — white blood cells (I forget which ones) destroying the “junk” left over from metabolic processes. I’ve been told that butter/coconut oil, etc. won’t interrupt autophagy, but I’d like to hear from people familiar with biochemistry on this matter.

        1. Cream contains pretty much no lactose. Half-and-half on the other hand… well, it’s half and half.

  9. The response to #1 is fantastic! It’s the reason MDA is the best. No dogma, no complex calculus about how to eat subversively primal, no bizarre work-arounds.
    Enjoying life is the ultimate objective. Most of the time, the primal lifestyle helps us enjoy it more. On those occasions when a life experience would be more enjoyable with a few compromises, then by all means make the compromises!

  10. I went to Italy shortly after becoming primal and found it remarkably easy to limit my intake of bread and pasta. In the restaurants in Rome, I could skip over the pasta course and even at the catered group meals, where it was harder to skip a course, the pasta dish was small, more of a side order than what you see in the USA. Bread was there too but usually not the main component of the meal. I enjoyed plenty of tasty meat, cheese, and vegetable dishes and of course red wine!

  11. I lived in Rome, Italy for six months. I ate pizza and pasta daily. I walked everywhere. I lost 30 pounds.

    1. I lived in Gaeta for 4 years, and did the same. Saw no need for a car, unless we went to Naples, Rome, or beyond…and WAY beyond meant hopping on a train.

  12. Fasting is at least of equal importance to me now as food selection. It has multiple benefits: not only developing discipline, but removing one from the crowd of followers, of commercialism, of hype. It makes one independent. My body would almost rather fast now than eat (on the 2 chosen days a week). It will help one develop emotionally, as well as physically, creating the ability to CHOOSE, instead of merely being in the flow of habit.

  13. I’m a little astounded that the first letter-writer even needed to write in. Talk about missing the forest for the trees.

  14. I live in Italy and have for nearly the past three years. Primal is easy. You can’t easily find coconut oil or avocado (but up in South Tyrol you sometimes can), but I eat risotto for primi (or skip the primo), have americanos, est tons of meat, veg, fresh fruit and raw, aged cheese. In Italy they get ‘gluten free’ pretty well. They know how to cook meat gently and crudo, carpaccio and tartare are readily available. I would say enjoy but if you want to not stray too much, you won’t actually have a problem at all…

  15. I wouldn’t worry too much about being non-primal/paleo during a vacation in Italy unless gluten is going to give you serious degestive issues. I spent a total of about 2 months in Europe (Italy for 2 weeks) for a study abroad/vacation a couple of years ago. For those two months I ate and drank lots of non-paleo items such as bread, pasta, pizza, beer etc. However, I did manage to keep most of my breakfasts paleo which I think helped a great deal.

    The lifestyle and food in Italy is just different. You will walk a lot and spend a lot of time in the sun. Even their bread has fewer ingredients and will only last for a day or so before it gets hard. You would be surprised at how healthy you can be when you spend a lot of time in the sun, get in a lot of activity, and have very little stress in your life. I gained a total of 3 pounds after a two-month non-paleo vacation in Europe. There is hope!

  16. Excellent response to the fasting article. Also, if IF, the amount eaten shouldn’t necessarily be reduced, just the eating time windows. Great stuff, Mark!

  17. Loved the answer to number one. I was stressing for that individual as well before reading your advice. Learning to get better at IF, it was hard to get out of the mindset that not eating is bad for you but I’m growing to like it and eventually will have a 24 fast.

  18. Re #3, I’m I guess what I would call a “natural IFer,” as my strong preference is to eat once a day. My parents ate a small breakfast and no lunch and a reasonable dinner I have realized, so I get it from somewhere. I have been eating in general once a day, 7 days a week for about 20+ years, and I seem fine. In short, I wouldn’t worry about it.

    Now, if I went to Italy, I would find a way around my strong natural tendency.

    1. So nice to hear that there are “natural IFers” around 😉

      I’m a natural IFer myself (I eat once a day), and the claim that 24h-IF should be done only occasionally scares me a bit…

      1. “I eat when I’m hungry” sounds perfectly healthy to me. There must be a normal curve, and I’m on one end of it. I’m not worrying about it. It’s nice to know there is another person out there!

  19. I’ll echo what some have already said… Separating ‘diet’ and ‘lifestyle’ for a second because you can keep the lifestyle and step away from the diet…. If I’m going to step away from my primal diet it’s going to be for a good reason. If I’m on a small Italian island you better bet that I’m going to enjoy some pasta and pizza. Would I do that for off the grocery store pasta or Domino’s pizza, hell no. Some small Italian island at the root of that gourmet history, absolutely!

    Enjoy your trip with your Dad, Richard! I’m envious!

  20. Thanks for the great response to No.1 Mark!
    I’m headed to Nepal shortly so that was timely advice for me.

    Anybody had a Nepalese eating experience lately??

    1. I haven’t spent much time in Nepal, but I basically live in India. In that part of the world, budget will determine everything. If you’re trekking, and want goat, the right price will make it possible–even if it is not possible. If that doesn’t make sense now, and your trip is long enough, it will later. Buffalo and other non-veg is probably widely available. I mean, I can find beef all over India. Just gotta know where to look. I did fine on daal bhat for years…

      1. Thanks for your reply, xxlarge! It’s good to know I can have an escape from rice and potato ha.

  21. RE: Question #1:

    Hey Richard – I am first generation Italian, just turned 70 years old, and would love,love, love to go to Italy.

    So, if you take ME along on your trip with you and your Dad, I’ll make sure YOU stay on a Primal/Paleo diet!!! ( Whether I do the same is another thing –) Just a thought!!! I think you’ll be pleasantly surprised as how easy it’s all going to be.

    Have a wonderful trip, enjoy, enjoy, enjoy and don’t stress so much!

  22. Personally, I wouldn’t worry too much about a trip to Italy, but, if I was anticipating a significantly higher intake of carbs, I might ramp up my carb consumption a little bit gradually. I’m afraid I’m a little metabolically broken. Being fairly fat adapted and a little carb intolerant, I worry a little bit about making a drastic or sudden increase in carbs.

    Any thoughts from anyone on that?


  23. Mark, thanks for replying to my question on Pili nuts.

    I also like the way your addressed the concerns of the traveler to Italy. In general, Italy is very accommodating to those with Celiac disease or otherwise. And all one has to tell the waiter when dinning out, is “senza glutine”. That will insure that all his\her dishes will be gluten free but tasty none the less.

    I always say, that when in Rome or Paris, one can indulge in the local delicacies, as long as it’s not something that is harmful to his health. Eating Gelato 5 time a day doesn’t qualify (-:

  24. It is a sad thing that people think of pasta when they think of Italian food. The overdose of bread and pasta is much more an American phenomenon, found in “Italian American” restaurants, etc. In Italy, pasta is generally just a side dish, though it is usually offered as part of any complete meal. Of course, so is a salad. Any proper Italian meal will have “insalata” as either an opener, or a side dish. REAL Italian cooking is incredibly varied, region to region, and season to season. Food in Italy is an art form!
    If this guy is going to be visiting any family with his dad, on a small Italian island, there is bound to be amazing regional food. I am deeply jealous! And if it is an island, I am betting that there will be lots of amazing seafood, as well as a delightful array of vegetables.
    I suspect that this guy will find that the food is not anywhere as far from primal as he fears. He should just relax and prepare to be delighted!

  25. for the fat soluble vitamins stored in your fat, does your body “know” where to get them when it needs them or is it a case of them being released as the fat is used by your body? if the latter is the case, then it seems to follow that some of the fat stored on your body is likely to have a lower vitamin content than other areas depending on what you ate when it was stored e.g. fat that was stored on a cheat day for example. i can see that during IF you’re not going to be storing any fat, but it seems sensible to ensure you get plenty of nutrients all the rest of the time

  26. What a brilliant reply to the first post! It almost made me cry ..I am going to Italy in a week and reading this has made me even more excited 🙂

  27. Wow, someone with the same question as I.

    Yes, every year since I can remember my family puts on a creole feast from Xmas till the day after new year. Granted it is all homemade stuff all farm fresh ingredients made the old way. It is once a year so I’ll just enjoy.

  28. There is so much more to Italian food than pasta! Yes, there are pasta dishes, but there are some very wonderful fish and pork dishes also made with Marinara sauces or rubbed with spices. True, you can’t make a special order at a home like you can a restaurant. Whenever I go out for Italian food, I always find things to order and I’m totally wheat intolerant. I hope I don’t end up having to worry about cross-contamination, because that would really suck.