Your Personal Paleo Code: The 3-Step Plan to Lose Weight, Reverse Disease, and Stay Fit and Healthy for Life (22 page)

Chocolate can be safely consumed by eating only dark chocolate (greater than 70 percent cacao content, with greater than 85 percent preferred), limiting your intake to a small serving (about the size of a silver dollar), and not eating it at night if you’re sensitive to its stimulating effect.

Now that we’ve discussed
which
foods you may want to introduce, I’m going to propose a schedule for
when
to reintroduce them based on my experience with how well tolerated they are by the majority of people I work with and on our understanding of their biochemical composition.

If you don’t tolerate one food in a particular category, that doesn’t necessarily mean you won’t tolerate other foods in that category. This is especially true for dairy and nightshades. For example, I have several patients who can’t tolerate yogurt, cheese, or kefir but do just fine with butter and cream. Likewise, some of my patients can’t eat tomatoes or eggplant but have no problem with white potatoes.

There’s a specific order for reintroducing dairy products based on how likely you are to react to them, which is in turn determined by their sugar
and protein content. People who are intolerant to dairy are reacting to the sugar (lactose), the proteins (such as casein, butyrophilin, and lactoglobulins), or, in some cases, both. But as I mentioned, some dairy products have negligible amounts of both casein and lactose. These are usually well tolerated, even in cases where people are reacting to lactose or milk protein (provided the reaction is an intolerance, not an allergy).

Since most dairy products contain protein, I’m going to focus on the lactose content of dairy foods. As a general rule, anything below 2 percent lactose can be tolerated by the majority of those who are lactose-intolerant, as long as they don’t overdo it. If you find yourself reacting to a dairy food with very low amounts of lactose, it’s likely you are intolerant to milk protein and will have to avoid cow’s-milk products (with the possible exception of ghee, which contains only trace amounts of protein, and butter, which contains very low amounts). However, goat and sheep dairy products contain a different type of protein than cow dairy products. Because of this, some people who can’t consume cow dairy products are able to safely consume goat and sheep dairy. If you determine that you can’t tolerate cow-milk products (kefir, yogurt, cheese, milk), then you may want to try goat or sheep dairy during the reintroduction phase.

Dairy products are listed below from lowest to highest lactose content. Ghee was permitted during the Reset, so unless you removed it, you can start with butter and proceed to the next item. If you don’t want to reintroduce a particular item on this list, simply move on to the next.

1. Ghee (clarified butter).
Ghee is butter with the milk solids removed. You can think of it as butter oil. Butter has almost no lactose to begin with, and the lactose is in the milk solids, so ghee has virtually no detectable lactose. The level of protein is also nearly undetectable in ghee.

2. Butter.
Butter is only 0.8 percent to 1 percent of lactose. It is well tolerated by all but the most lactose-sensitive individuals.

3. Kefir.
Kefir is milk that has been fermented by strains of beneficial bacteria and yeast. (See my website for instructions on how to make it at home.) Since the yeast and bacteria consume (ferment) the lactose in the milk, the longer the milk is fermented, the less lactose it will have.
I’ve seen estimates of the lactose content of homemade kefir ranging from 0 percent to 3.5 percent. At twenty-four to thirty-six hours of fermentation, it’s likely to contain less than 1 percent lactose. Kefir purchased in the store is often not fermented as long as that and is likely toward the upper end of the range.

4. Yogurt.
Yogurt is milk that has been fermented by strains of lactic acid–producing bacteria (again, see my website for instructions on how to make it at home). As is the case with kefir, the longer you ferment yogurt, the less lactose it will have. If you ferment it for twenty-four-plus hours, it’s likely to have negligible amounts of lactose and may be well tolerated even by lactose-sensitive individuals. Most varieties of store-bought yogurt, including Greek-style yogurts, are typically fermented for only three to four hours and its lactose content ranges from 4.1 to 4.7 percent. If you react to store-bought yogurt, try making it at home and fermenting it for at least twenty-four hours.

5. Cheese.
Hard cheeses like Cheddar, Parmesan, Romano, and so on tend to be very low in lactose, ranging from 0 to 3.5 percent. Soft cheeses often range between 0 and 5 percent lactose. Be aware that cheese does contain a significant amount of casein, so if you’re casein-intolerant, you’ll need to avoid it.

6. Full-fat (whipping or heavy) cream.
Cream is mostly fat and is 2.8 to 3.0 percent lactose. Although it is above the 2 percent safe range, in my experience, moderate amounts of cream are usually well tolerated even by those who are lactose-intolerant.

7. Sour cream.
Sour cream ranges from 3.0 to 4.3 percent lactose. If you don’t tolerate store-bought sour cream, you can try making it at home. See my website for instructions.

8. Ice cream.
Yes, I said it—ice cream! Homemade ice cream is a luxurious occasional treat. It contains 3.1 to 8.4 percent lactose, so it is usually not a good choice for the lactose-intolerant.

9. Buttermilk.
Buttermilk is a cultured-milk product that is often added to pancake mixes. It contains roughly 3.6 to 5.0 percent lactose.

10. Milk (whole, 2 percent, 1 percent, nonfat).
These are about 3.7 to 5.1 percent lactose. Fluid milk is not well tolerated by most people, so I
generally don’t recommend it. (The exception would be raw milk, which can be legally obtained in some states. Raw milk is often well tolerated even by those who can’t drink pasteurized milk.) Low-fat and nonfat milk have higher lactose content than whole milk. I do not recommend consuming reduced-fat milk products for any reason—this goes for yogurts, cheeses, and other dairy products as well. If you must have milk, go for whole! For at-a-glance information on the foods discussed in this chapter (caffeine content, lactose content, and so forth), see the charts on my website.

As I have indicated, extensive preparation is required to make grains and legumes more digestible and improve their nutrient bioavailability. If you really miss grains or legumes in your diet, are healthy and have a strong digestive system, and are willing to take the necessary steps to prepare grains and legumes, then you may reintroduce them in modest amounts (that is, about three to five servings per week) during Step 2.

I suggest starting with white rice and fermented buckwheat, since they are low in phytic acid and other antinutrients and are less likely to irritate the gut. Beyond white rice and buckwheat, I don’t think it matters much what order you reintroduce properly prepared grains and legumes in. Just be sure to reintroduce them one at a time, and carefully track your symptoms as you do. And remember, even soaked and fermented grains and legumes should never displace more nutrient-dense foods like meat, fish, vegetables, nuts, seeds, and fruits.

If you’ve been on the autoimmune/arthritis version of the Step 1 Reset, in which you removed eggs and nightshades, you may want to reintroduce these after you’ve tried dairy and/or buckwheat and white rice.

I suggest reintroducing eggs first, because they’re one of the most nutrient-dense superfoods nature has made available to us. They’re also tasty, versatile, and easy to prepare. Be aware that some people react negatively to egg whites (one of the most common food allergens). However, it’s much less common for people to react to the yolks. This is fortunate, because the yolks contain the majority of the nutrients and are by far the healthiest part of the egg. If you don’t tolerate egg whites, you can continue to eat the yolks. Try hard-boiling eggs, then removing and eating the solid yolks if you want a quick source of nutrients without worrying about raw-egg safety or egg-white contamination. You can also make egg-yolk omelets.

There is a lot of variation in how people react to nightshades, but I advise reintroducing them (after eggs) in the following order:

Which alcoholic drinks you reintroduce depends primarily on your preference. I haven’t noticed one particular class being tolerated better than another. That said, wine does tend to have more sugar than spirits, so if you are sensitive to sugar, it may be wise to start with something like tequila or vodka (if you like them, that is). The reintroduction schedule could look like this:

In general, I’d recommend limiting alcohol consumption to three to five drinks per week.

The particular order of reintroduction of the recommended sweeteners is not important, but this fact is:
sugar is sugar
. Yes, natural sweeteners do have higher nutrient content than the processed sugars, but in general (with the exception of molasses), these nutrients are not enough to make a significant contribution to the diet. Since you will be eating only minimal amounts of these sweeteners, the most important consideration is their glucose-to-fructose ratio—especially if you have digestive problems. Refer to the listing
here
for recommended sweeteners; remember to avoid agave syrup, brown-rice syrup, and all artificial sweeteners.

I suggest beginning with the lower-caffeine beverages, like green tea and twig tea, first. If you do well with those, you can move on to black tea and coffee. (See the caffeine section
here
in this chapter for information on which beverages have the highest and lowest amounts of caffeine, and visit my website for information on the caffeine content of specific coffees, teas, soft drinks, and energy drinks.) Remember that coffee from Starbucks and other vendors can have significantly higher amounts of caffeine than coffee you brew at home! If you notice any worsening of sleep, fluctuations in energy or mood, irritability, anxiety, or agitation when you reintroduce coffee or black tea, remove it again for a few days and then try starting with the lower-caffeine beverages again. Decaf coffee is another possibility, though it is not completely free of caffeine. Most estimates I’ve seen suggest it has about five milligrams of caffeine.

Start with a silver-dollar-size piece of dark chocolate (greater than 70 percent cacao, and preferably greater than 85 percent), and have it earlier in the day—perhaps after lunch. The reason I suggest this is that some people are very stimulated by chocolate, and it can interfere with sleep. If you don’t notice that effect, or any other ill effects, you’re free to eat one to two silver-dollar-size pieces of dark chocolate per day if you wish. Another great way to enjoy chocolate is to add unsweetened, raw cacao nibs or powder to smoothies. Try combining nut milk, coconut milk, and/or kefir with half a banana and some raw cacao powder for a special treat.