Chris: Right, so how can somebody, the second part of that question is how can someone distinguish between, what are the symptoms of infection first and then how can someone distinguish between the different types of infection fungal, bacterial, parasitic?
Paul: Yeah well this is one place I think diet can really help, is in diagnosis. Medicine is still in a primitive state it’s not very good for diagnosing these infections much less treating them. But a lot of these pathogens respond very differently to different diets. So one of the key differences is in how they respond to a ketogenic diet for instance. So pathogens that have mitochondria like fungi and protozoa can metabolize ketones for energy. Bacteria and viruses can’t, and so if you go on a ketogenic diet you’ll starve bacteria and viruses but you’ll feed fungi and protozoa. And so a simple thing to do is go on a ketogenic diet for a while, do your symptoms get worse or better. And that can tell you which class of pathogen you have, one with mitochondria or one that doesn’t have mitochondria. And those kinds of tests can be a big help, and I think part of the reason medicine doesn’t succeed against all these diseases is that nobody varies their diet, they’re always eating the same diet. It’s always 50% carbs with lots of wheat and sugar, plenty of vegetable oils, if you tell people to change their diet and eat healthy they look around and find other sources of the same nutrients, certainly never sample a ketogenic diet. So our basic diet, the perfect health diet, aims to be pretty much balanced, it aims to supply in food the amounts of nutrients that your body needs. And we tweak it in various ways so we tend to be very slightly low carb, but for therapeutic purposes and certain diseases we might go to more extreme diets like a ketogenic diet that’s more low carb or there’s a few diseases that may benefit from going higher carb. But also even apart from treatment the diet is a good diagnostic tool. And it’s also helpful for gut infections to vary the types of food you eat, different foods get digested in different places in the digestive tract. Different things are accessible to different kinds of pathogens, the time scales in which things happen have diagnostic value. So fungi tend to do everything slower than bacteria, they multiply a lot slower, so fungal infections tend to be relatively stable whereas bacterial infections can be much more variable. There’s a lot of ways you can manipulate diet and help understand your own disease and that can guide you to good treatments.
Chris: What’s interesting is, as you’re probably aware in the alternative health world there’s a lot of different perceptions about how to deal with fungal infections and the word candida is thrown around a lot, which I think obviously that candida infection is real but I also, in my experience see it kind of slapped on as a diagnosis of exclusion, meaning we can’t figure out what else it is so we’ll just call it candida. But I’m really interested in what you were saying, I read your article when you talked about how fungi can utilize ketones and tend to progress on ketogenic diets because one of the interesting things about how the candida diet is typically administered is people remove fruit, they remove carbohydrates, starchy tubers and grains and I think they end up being on a very low carbohydrate diet in a lot of cases and perhaps not completely ketogenic or not strongly ketogenic but maybe mildly ketogenic and I see a lot of patients who just get worse and worse on those diets so I wonder if it has something to do with this mechanism that you’re talking about.
Paul: Yeah I think it’s very likely. It’s not bad to go low carb by standard American diet standards, I think probably optimal for candida might be 600-800 carb calories a day, the average American gets maybe 1700 so cutting carbs in half for the average American is a good move. But going too low carb definitely risks systemic invasion so the very low carb approach, it’s not bad for a fungal gut infection but it’s not that good either. It doesn’t do that much to promote good bacteria taking over the gut. A lot of plant foods can really help suppress fungi in the gut and promote bacteria. So they can help give you a better gut flora and I think a lot of people who go extremely low carb can end up with a gut dysbiosis of some kind after years on these extreme low carb diets.