The New "Perfect Health Diet" and "Sex At Dawn"

One of the perks of being a Psychology Today blogger (besides a small quarterly paycheck) is that I get a ton of newly released books sent my way. Unfortunately, as my daughters are getting older and our lives more complicated, schedule-wise, I have less time to read and less time to post. In the fall, when I teach, my time goes to zero. Unless I forgo sleep (not a feasible option for very long, as I'm not young anymore!), I will be behind on book reviews for quite some time. I feel especially guilty about Toni Bernhard's How To Be Sick and Dr. Drew Ramsey's The Happiness Diet. Eventually I will get to you!

The very first freebie book I was sent came from Dr. Chris Ryan and Caclita Jetha, Sex At Dawn. As I had read Geoffrey Miller's The Mating Mind (which I loved) and Matt Ridley's The Red Queen (also very interesting), Sex At Dawn was an interesting counterpoint to round out the trilogy. Evolutionary Psychology's sexual selection meme is the sobering characterization of women as prostitutes of a kind, trading sexual access for wealth for her children by a powerful male, whereas men are ravening beasts, driven by sexual needs to spread semen every which way. It's not a particularly kind way to look at the human race, your mother, or your father… but science doesn't judge. Enter Sex At Dawn, with the idea that humans are more like bonobos than hierarchical chimpanzees.

The basic message of Sex At Dawn is this one: Humans lived in small, highly related tribes. Sex and marriage were malleable and polyamory was common. Within the tribe, relations were so close that it wouldn't matter much if your woman's child were yours or someone else's in the tribe. "Cheating" is normal and doesn't reflect lack of moral fibre or willpower. It's human nature.

In many ways I like Sex At Dawn, though I do tend to agree with criticisms that it misuses the science to promote one couple's view of polyamory. Having witnessed jealousy amongst my small children from day one, it is hard for me to imagine that sexual jealousy is not a natural human trait (which Ryan and Jetha argue). But from a clinical psychiatry perspective, when I deal with patients who are dealing with infidelity, I do like having the wildly dissident views from Sex At Dawn to discuss with patients. Like 50 Shades of Gray (disastrous from a literary perspective and weirdly conventional, it is widely read so a useful tool to discuss sexual power, the difference between men and women's sexuality, and the power of fantasy), Sex At Dawn sets out a different sexual milepost. A new way to think about human sexuality. My favorite part of it is the determination to cast humans as loving, sensual, social creatures rather than the jealous hoarders we often play. Whether S@D's characterization is accurate is a lesson in critical thinking. I think it is important to read the critiques along with the book.

Which brings me to the new Perfect Health Diet, sent to me not so long ago by Paul and Shou-Ching Jaminet. Disclaimer, they are adorable (as a loving and devoted couple) and amazing and guided me around the Asian grocery store in addition to giving me a copy of both editions of their book. I can't say enough positive about Paul and Shou-Ching in person. Now there is basically no sex in Perfect Health Diet, but it has some similarities to Sex At Dawn. Mostly that it is an earnest, aggressive take on the mainstream, with Paul and Shou-Ching's patented mild smarty-pants writing style. Sodium? Eat more of it. Saturated fat? Healthy! Omega 6 and legumes? Poison in excess! (One of my favorite chapters is the one on Omega 6 fatty acids. The science of eicosanoids is hideously complex, but Paul and Shou-Ching have done their best to discuss the complexity and break it down.

I think that anyone following the food recommendations of the Perfect Health Diet would find themselves in a healthier and happier state of being.  They are straight-up paleo + rice and a bit of dairy with a good amount of carbohydrate, but are moderately low carb and high healthy fat.  I don't always agree with Paul and Shou-Ching with regards to chronic infections, as I feel we have co-evolved with parasites, and our immune systems function best with certain chronic infections on board. I don't know about the safety of their aggressive message for eliminating chronic infections, which our immune system may have sequestered and dealt wih on its own terms. Certainly we did not co-evolve with our modern epidemic viruses and herpes and all that…but it is a complicated area that deserves close study. Anti-fungals and anti-virals tend to be uniquely toxic to the liver and human health.

The reasoning behind the PHD has been enhanced and modified for the new version. They have a breezy, intellectual style, but I think (a bit like Sex At Dawn) they can be a bit guilty of misrepresenting the literature. For example, they credit me (thank you!) for a study I blogged about way back when…Wheat, Rice, and Children's Brains.  We all know it was a crap study in a crap journal (sorry, PLoSOne) and we came up with some damning unaccounted for confounders in the comments. But in Perfect Health Diet, they postulate that the difference between wheat and rice as a staple could account for the differences in IQ between Asian and other children. The literature on sodium is also not as damning as they represent, with some very thoughtful critiques of the key studies easily found in major medical journals.

That said, I like their reasoning about mammalian diets, fasting, and breastmilk as models for human diets. Why not? It gives us something to wrap our heads around. I like the no holds barred questioning of the status quo. One must just keep in mind that no guru has all the answers. No one does.

From a public health perspective, my main message owuld be to eschew processed foods, don't worry about labels and calculations, and to focus on foods which bear no label. I suppose some grains like oatmeal are fine for most, in the context of nutrient rich diets. I'm not the biggest fan of wheat, though some may tolerate it. I love the nutrients in dairy though I don't tolerate it well myself. Corn has some cross reactivity and is certainly guilty by association in processed food.  Rice…I like Chris Kresser's take. I prefer potatoes, squash, pumpkin, tapioca, banana, etc. for starches.

So for people wanting to tweak, and for those wanting to look at a therapeutic ketogenic diet, I do prefer the Jaminets' flexible take. I don't agree with killing all infections at all costs. Not sure the Jaminets do either, though they are far more aggressive than I am.

The new version of the Perfect Health Diet has far more explanation, up to date literature cites, and a more reasonable take on the science behind the macronutrient recommendations. I still think Paul and Shou-Ching are thoughtful like few in the paleosphere. Am I as certain as they are? No, and that gives me pause. But read their book. Like Sex At Dawn, it will open your mind.