Ep66: Dr Zsófia Clemens PhD – Paleo-Ketogenic Diet Benefits & Tips

In today’s interview I get to speak with neurobiologist and clinical researcher, Dr Zsófia Clemens.

We talk about about how the Paleo-Ketogenic Diet (PKD) can cure multiple health issues by healing, what Zsófia believes to be, the underlying cause to all serious health problems – intestinal permeability.

In today’s interview, we get a chance to talk about how the PKD approach differs from other paleo/low-carb/ketogenic and carnivore diets.

While there are similarities between these diets, Zsófia believes the increased therapeutical effectiveness and the absence of negative side-effects (and more serious consequences) are due the some vital differences.

No dairy or plant-based oils, such as coconut oil, is a big one.

However, there is also the stricter guidelines around the necessary fat content and organ meat that needs to be consumed for optimal health and results.

I enjoyed this interview with Zsófia and I learned a lot from our conversation.

She shared a lot of valuable information and insights into why some people may not be getting the desired results or may be struggling with certain side-effects (such as leg cramps, thyroid issues) even after making the switch to low carb/keto lifestyle.

I also learned some great tips on how to remedy these!

Special thanks to Zsofia for joining me on the show.

Enjoy the episode!

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Show Notes with Timestamp Links

Find summarised highlights of what we talk about during the interview.

Use the clickable timestamp links to jump direct to those points in the audio file below:

[00:19] – Introducing, Dr Zsofia Clemens, a neurobiologist and clinical researcher specializing in nutrition, nutritional therapy, and neurology. She is a specialist in the Palaeolithic ketogenic physiology, and the head of the PaleoMedicina research group in Hungary, which has been using the Palaeolithic ketogenic diet exclusively since 2013 to help patients with a variety of conditions.

[01:30] – What is a Palaeolithic-Ketogenic diet (a.k.a PKD)? In short, it is an animal meat-based diet that requires eating animal fat and organ meats. Zsofia explains how they use the meat-based approach in combination with the ketogenic diet to treat many severe diseases.

[03:31] – PKD sounds a lot like a keto-carnivore diet. The difference is, however, that the PKD has clear guidelines with regards to dairy products, a clearly defined protein to fat ratio as well as advice on including organ meats as an important part of the diet; all of this is unclear with the carnivore diet.

[05:36] – The PKD excludes some components that are included in the classical ketogenic diet. Number one is the dairy and there is a lot of research and reasoning why it should be excluded. Dairy is especially harmful if you are suffering from autoimmune disease or cancer as it is linked to boosting tumour genesis and causing type one diabetes; in fact, type one diabetes could result from a ketogenic diet that includes a lot of dairy!

[08:16] – The problem is not due to lactose, but the milk protein. Zsofia explains this is because milk promotes tissue growth so that the small animal grows, and that dairy shouldn’t be consumed past the age of three.

[09:26] – Zsofia has seen this connection between dairy and disease both in patients and in clinical research studies. For males, it commonly manifests as prostate cancer and for women, breast cancer.

[10:27] – Dairy is not a good option even for people who are just looking to get their fat content up; the fat should come from animal meat instead of dairy products. Zsofia explains some side-effects she sees with many patients on the classical ketogenic diet include magnesium deficiency, iron deficiency, anaemia, as well as more serious side-effects and pneumonia because of less than optimal diets.

[12:59] – The risks are the same for both the classical 80/20 ketogenic diet and the modified ketogenic or Atkins diets because the diet components are the same e.g. heavy cream, coconut oil etc. Dr Eric Kossoff has shown this with his epilepsy clinic studies which looked at the efficacy vs side-effects of these types of diets.

[15:05] – Zsofia talks about the efficacy of the classical ketogenic diet being much lower than most people think; only one child in 10 becomes seizure free, and 50% have half the amount of seizures. While this is a significant improvement, the PKD almost always results in seizures stopping completely.

[17:12] – Children who are put on the classical ketogenic diet for the short-term are taken off it when they are ready. PKD should be sustained for their entire life because there are no negative effects like you get with the classical ketogenic approach. e.g. bone quality decrease in growing children (so they are usually smaller than the average) because of the unhealthy composition of the diet, not ketosis itself. (Listen to our interview with Emma Williams From Matthews Friends for more on the Ketogenic diet and seizure control).

[18:58] – Zsofia also believes medium chain triglyceride oils, or MCT oils, are detrimental because they are plant oils and cause gastrointestinal issues. Examples include: GI pain, diarrhoea, constipation and increased inflammation.

[19:48] – People are increasingly adopting a ketogenic way of living just for the ketosis component and using MCT in their drinks or on food could also be causing issues over the long term. Zsofia explains coconut oil (or any type of vegetable oil) start to develop decreased thyroid function and increased fatigue.

[22:50] – As well as decreasing thyroid function, Zsofia explains that these oils cause autoimmune issues which in turn attack the thyroid gland and cause problems. She believes that the root of all autoimmune disease is the increase in membrane permeability and there is no way to reverse this other than adopting the PKD.

[25:11] – In Zsofia’s clinic they measure intestinal permeability with [95]90708-4/pdf" target="_blank" rel="noopener" data-lasso-id="3486">PEG 400 testing when possible. She explains it can be a relatively expensive test, but is a relatively simple process to perform clinically. You start by ingesting a solution then your urine sample gets tested for specific markers that shouldn’t normally be in the urine and indicate a leaky gut.

[28:35] – Zonulin is another marker for intestinal permeability, but it is not a direct measurement since it is measured in the blood. It indicates membrane permeability in general, not just in the intestines. This is important as there are other membrane barriers that can get leaky with time incl. the mouth, nose, or the most important one, the blood-brain barrier.

[30:01] – Even our blood-brain barrier could become affected by what we’re eating. This then contributes to brain fog, as well as potentially more serious conditions. Zsofia explains that first, the intestinal permeability develops and over time other members become compromised giving rise to autoimmune diseases.

[36:16] – PKD is adapted from the Paleo diet, but to ensure the gut lining is healthy and there is no autoimmune reaction attacking multiple systems in your body, it goes a step further. No gluten, nuts and other plant-based foods are allowed.

[32:24] – Colostrum, which is derived from dairy, is used as a treatment for irritable gut and helps with gut issues for certain individuals. Zsofia explains why she doesn’t believe colostrum is a good solution; studies she has seen use methodology she disagrees with, affecting the reliability of the results and she’s never seen colostrum reverse any serious disease.

[34:29] – Previous guests on the show, including, Mikhaila Peterson, Amber O’Hearn, Kelly Hogan, and Dr. Shaun Baker had great success on carnivore diets. Mikhaila especially has an autoimmune condition which improved drastically. Zsofia has seen this happen many times; reversing intestinal permeability is the basis for these results.

[35:41] – If symptoms resolve on a PKD diet can certain foods ever be re-introduced? Zsofia advises against this because these barriers are highly dynamic and eating certain foods will affect the lining leading to symptoms returning. There are certain foods that should never be consumed; these include dairy, cereals, and vegetable oils. Allowances can be made by increasing vegetable or fruit intake and drinking a limited amount of coffee.

[37:10] – What’s in coffee that Zsofia feels is detrimental? She explains coffee is a plant and all plants are full of bioactive substances. One of these groups is the polyphenol group.

[38:29] – We know that a Western diet, high in carbohydrates, results in high production of free radicles in the mitochondria. A diet high in antioxidants (which counteract oxidative stress) such as vitamin E, vitamin C, and polyphenols is considered beneficial. Zsofia explains, however, that the polyphenols are “double-faced” molecules, and act as pro-oxidants in some conditions and antioxidants in others.

[40:39] – Zsofia explains how they have never seen a patient develop vitamin C deficiency on PKD. She explains this is only a concern if blood glucose level is high, due to a phenomenon called glucose ascorbate antagonism; the availability of vitamin C is much lower in high carb contexts. Her tip is that Vitamin C needs to come from organ meats because there is not much of it in other meat.

[43:32] – While there is a risk of nutritional deficiency on a carnivore diet where no organ meat is included, Zsofia does not exclude the possibility that healthy people could be fine without it. But those patients who are recovering from illness will need more nutrients to regenerate tissue.

[44:34] – The organ meat with the highest concentrations of minerals and vitamins is the liver and the brain; the brain can contain 100 times the vitamins found in the blood of the animal! Bone broth is also good initially to help with the leaky gut, but it is not sustainable to only eat broth. As a base for good long- and short-term health, Zsofia recommends eating fatty meat and organ meats.

[47:07] – Carnivores usually underestimate the amount of fat they should be eating. We need to replace the energy from carbohydrates with enough fat to avoid energy problems. The ratio should be 2 fat to 1 protein.

[48:18]- Some good examples of fat sources include tallow, streaky bacon, bone marrow and fat drippings as well as good quality sausage or smoked slab.

[51:18] – One pitfall with an all meat diet is that people could be eating too much protein and not enough fat. The average person shouldn’t need more than 400 grams a day provided they keep to the correct ratios; if you are doing a lot of exercise, this needs to be increased accordingly. Zsofia always encourages patients to ensure they are adding enough (animal) fat to their meal.

[54:27] – Is salt an important component to longevity on this diet too? Zsofia explains that more salt is needed when eating a carbohydrate-based diet because of the sodium-dependent glucose channel. Decreasing the carbohydrates in your diet and in your blood means less salt is needed. Any additional salt, however, is excreted by your kidney without a problem.

[56:16] – Zsofia also explains that unlike the loss of minerals that occurs during the adaptation process when switching to a classical keto diet, on PKD we get all the minerals we need in a more bioavailable form, e.g. if you had magnesium deficiency before, your magnesium levels will be normalised.

[56:48] – There are other transitory side-effects that occur when we switch the metabolism from carbs to fat; common ones are low energy, headaches and diarrhoea.

[57:40] – Tips for someone who is dealing with these symptoms is to be aware it’s only a transitory phenomenon. If diarrhoea persists, however, it is indicative that too much meat (in relation to fat) is being consumed. We discuss an interesting study of how PKD helped heal Crohn’s and stopped the need for meds; Zsofia cautions that patients on meds should be carefully managed by a qualified physician.

[1:00:50] – Some people complain meat gives them irritable bowel syndrome. While there are rare exceptions of people reacting more to red meat, the question in these cases needs to be, what kind of meat is it? Small nuances are important, substances such as additives or supplements, even in very small amounts, can derail progress made.

[1:03:51] – A common concern for many people is the question of fibre and normal bowel movements? You will have bowel movements much less frequently (in some cases only once in 10 days) but this does not mean you are constipated nor is it less healthy. The amount will also be smaller, but this is normal. Also, it is good to note that dairy can give you real constipation.

[1:06:26] – What about the debate that meat contributes to bowel cancer? Any links are not due to less frequent bowel movement but the additives and the consumption of processed meats with nitrites/nitrates.

[1:08:49] – Measuring blood glucose and ketones provide very useful feedback. Patients take measurements at home or while at the retreat get their blood glucose and ketones measured along with weight and blood pressure. It is all part of the learning process and good a way of making sure patients stick to the diet and stay in ketosis.

[1:10:15] – One of the problems with the carnivore diet is that if someone’s not eating enough fat they won’t be in ketosis. Zsofia explains that there is an optimal range of ketosis that should be reached, and it should be as consistent as possible every day to achieve the best therapeutic benefits and avoiding symptoms returning.

[1:13:19] – One side effect of the ketogenic diet is cramping. Zsofia explains this is due to the magnesium deficiency, which can be temporary. Her clinic published a study where they’ve have shown patients who have been following the PKD all had normal magnesium levels and no cramps. To solve this problem, stop eating fructose and eat meat and fat.

[1:16:44] – For people on low carbohydrate diet/ketogenic diets who are getting leg cramps it could indicate they are not getting enough magnesium. Combination of not eating enough organ meat and doing a lot of heavy exercise will deplete stores. Her tip is to help deal with muscle cramps; increase your intake of liver.

[1:17:58] – Zsofia explains how in young, newly diagnosed patients with type one diabetes, there is a narrow window (within six weeks of diagnosis) where the condition can be managed by strict adherence to the PKD, without injecting insulin. This is because their pancreas is still producing a small amount of insulin. Zsofia urges people not to try this on their own without consulting a medical professional.

[1:23:32] – Long-time type one diabetics normally don’t see spikes in glucose after fatty meals and are usually very stable; if this is not the case it can indicate problems and improper diet adherence or incorrect fat/protein ratio.

[1:24:33] – It is not overly surprising that this diet approach is suitable for type two diabetics to help the body heal because the blood glucose levels can be controlled with the classical ketogenic diet, the Palaeolithic diet or any low carb diet. Zsofia explains the PKD offers additional benefits in terms of inflammation and it is crucial if you want to prevent further complications of diabetes.

[1:26:14] – There are at least three inflammatory markers measured in patients; the C reactive protein (CRP), the erythrocyte sedimentation rate (ESR) and fibrinogen. Normally when someone adopts this way of eating, those markers normalize too. If not, there is usually a problem with the diet.

[1:27:24] – A patient comes to the clinics once a week, every month and their treatment focuses primarily on food; the fat, the protein and the organ meat. There’s no other supplements or medicines prescribed. In addition, at the clinic, they aim to educate the patient about dietary aspects, facilitate groups of patients so they can share experience, manage data on medications, and give advice for those medicines that cannot be stopped within a short period of time. They also set up a plan on how to control the disease for the long-term.

[1:30:23] – Zsofia explains that they never impose fasting on patients and argue against this practice in individuals with disease because they need to be nourished. Usually, this means two meals a day, which is a normal frequency of the meals due to higher satiety.

[1:32:10] – The clinic in Hungary is, for ethical reasons, only for patients who have a pre-existing condition. If someone wanted to learn more about adopting this way of eating, they are providing individual consultations on the internet.

[1:33:52] – For those wanting to find out more on related topics, read articles and more details about consultations visit the Paleomedicina clinic’s website.