Every once in a while, I am alternately stunned and amused by what I see being promoted in the name of good health. I had one of those “stunningly amusing” episodes when I took an eight-day vacation with my family to an all-vegetarian health and adventure retreat in Costa Rica several months ago. We had joined a group of 125 headed by Dr. John McDougall, an accomplished and well-respected physician who uses a strict vegetarian/vegan lifestyle to address disease states in his patients and (ostensibly) to promote better health among the general population. I wasn’t too keen on attending, strict carnivore that I am, but I’m always up for an experiment of one and, moreover, I was convinced by my mostly-vegetarian wife and her vegan parents that our extended family would enjoy a nice tropical vacation together. And the food promised to be so yummy… so I made the leap with my wife, two kids, the in-laws and some cousins.

First off, I must say, I did have a very enjoyable time in Costa Rica with my family, rafting, diving, zip lining and hiking…but after what I witnessed during my stay, I can assure you that I have never been so certain that the Primal Blueprint way of eating – which I have embraced for over 30 years now – is the best way to achieve and maintain excellent health. Frankly, I was appalled at both the information being disseminated during this event and at what I saw being served at every meal in the name of “health food.”
I am an omnivore and always have been. Carrie, my wife, was a vegetarian for fifteen years until I convinced her about five years ago to starting adding fish to her diet to get more protein. She still considers herself, in the words of the Outback Steakhouse guy, a “semi-veg.” My wife’s parents have been strict vegans for nearly thirty years and are ardent followers of Dr. McDougall. McDougall’s own story involves having had a severe stroke at age 19 from which, at 59, he still limps. He became an MD and eventually realized that diet was an important part of the health equation. He’s a very likable and charming guy. I had a few superficial discussions with him, even attended a few of his nightly lectures. His heart is certainly in the right place, but I fear he is leading people down a wholly inappropriate dietary path. At the risk of oversimplifying, the basis of his program is that almost all starch is good, all fat is bad and meat of any kind is deadly. It is, in his words, a “starch-based” diet, high in grains and legumes.
The attendees were generally divided into two groups: those who were fairly new to the program – many of them had some serious weight to lose – and those who had been on the McDougall program for several years. Many of the latter group, I gathered, had come to McDougall originally with one or more chronic diseases and on multiple medications. Each evening, after the adventure activity of the day (all of which were pretty sedate), Dr. McDougall would deliver a lecture intended to inform the group of the evils of traditional medicine and big pharma – much of which I generally agree with – and to demonize beef, pork, chicken, fish, dairy of all kinds and most forms of soy. I got the general gist after the first evening. He’s not a fan of supplements either. But he does imply that when you eat vegetarian, you can have all you want…and therein lay the source of much amusement for me.
The lecture would adjourn and everyone would line up for the buffet line which would, at virtually every meal, include copious amounts of breads and rolls, rice, potatoes, pasta, beans, some anemic-looking steamed vegetables and a romaine-only lettuce salad. No dressings allowed. The only fat I could see was in the guacamole that served as a spread. The desert table had a variety of fruits and at least two choices of so-called “healthy” cakes. The drinks were generally overly sweetened fruit drinks.
Now I’m not one to judge. Okay, I am, but I usually keep my mouth shut – except herein. I watched at every meal as overweight, unhealthy people piled their plates with at least two pounds of bread, pasta, rice, potatoes, beans, desert cake, and a glass of fruit juice. Sometimes they went back for more. By my calculations these people were consuming 200 to 300 or more grams of (mostly simple) carbohydrates at each of three meals. There was no way these folks were going to lose fat on this trip. It was, in my view, a type 2 diabetes epidemic in-the-making.
In fending for myself, I focused mainly on the salads and the black beans mixed with a little rice. As you regular readers know, I don’t “do” breads, potatoes, pasta, desserts or fruit drinks. I think they are unhealthy. Go figure. I have to say, it sure got old after a day or two.

This is Kina’s Flickr Photo
Of those who had already been on the McDougall program for years, I had the following general observation: they don’t look too healthy. People who subsist on grains and simple carbs at the expense of quality protein for any length of time tend to lose muscle mass, regardless of their exercise regimen. They are what we call “skinny fat“. Essentially, they have no lean tissue and yet they have surprisingly high body fat levels, despite their loose “skin and bones” appearance. Lean body mass is a major defining criterion of good health; and these folks were sorely lacking. Excess carbohydrate turns to fat pretty easily, but you can neither build nor preserve muscle with it. Herein lies the confusion for many folks: while glucose serves as short-term fuel for muscles, it does not build nor maintain them. One woman, a 62-year old triathlete who trains hours a day and competes almost every weekend authoritatively suggested that I was a fool to eat meat and that I should embrace the McDougall program as she had for 15 years. Problem was, she looked like hell. No muscle tone at all and, I suspect, a fairly high body fat for someone who fancied herself an athlete. It took all I had to keep from saying something that might have spoiled her trip!
As with any diet regimen, Dr. McDougall backs his theories up with studies. But that’s the biggest problem with the “science” of nutrition: anyone can find a study here or there that supports almost any premise. To wit: Fish is great because it’s a source of important Omega 3 fats, but fish is bad because it’s a source of toxic heavy metals, but fish is great because the heavy metals are not actually present at realistically dangerous levels, but fish is bad because the fish lobby was the one funding the study on relative safety, and on ad infinitum.
If there were a right answer, everyone would be doing it. I guess the best any of us can do is to align the “receptivity filters” in our brains with our current belief systems and create habits that reinforce those beliefs – and that, hopefully, result in healthy bodies and minds. Ultimately, I have chosen to believe that we were programmed to eat primarily small portions of meat and vegetables, with a little fruit thrown in occasionally. It works for me (53 years old, 5’10” 165 lbs and 8% body fat).

Problem is, if you have no understanding of biology or chemistry, you can easily fall for that old vegan argument that meat is bad (notwithstanding the fact that there has never, in the entire history of man, been a country, culture or race that subsisted entirely on vegetables without animal flesh of some kind). Many people do fall for it. They also fall for the old “protein leaches calcium” argument, completely ignoring the fact that bones require protein as well as weight bearing activity to promote bone density and prevent osteoporosis. Or that stress has a far greater impact on preventing absorption of calcium than excess protein in the diet. But here I am giving you my opinion again and it’s only based on studies that my filters have shown align with my own beliefs…
I was fascinated by what I saw to be the complete antithesis of a healthy diet being offered up as the healthiest way to eat. And by people willing to accept that they could eat all they want of this high-carb fare and regain their lost health in the process. Try as I might, I couldn’t avoid losing a few pounds of hard-fought muscle myself over the week. Luckily, I was able to regain homeostasis shortly after returning home. And ultimately, I was left with a confidence that following Primal Blueprint path is exactly what humans were designed to do.
What are your thoughts on vegetarianism, carbohydrates, and protein?
Be sure to stick around for today’s Tuesday 10.
Best of MDA
(This piece was originally posted at my friend Art DeVany’s blog.)
[tags] Costa Rica, Dr. McDougall, vegan, vegetarian, carbohydrates, starch, protein, diabetes [/tags]
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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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