Dr. J on Running

How Paleo Saved My Life

7 December 2013

Four years ago, a routine blood test revealed a dramatic increase in my Prostate-Specific Antigen (PSA) levels from 1.8 ng/ml to 4.3 ng/ml. A repeat test returned 4.6. The normal range is under 4.0. A prostate biopsy and 11 painful punctures found no cancerous cells. I refrained from mistaking the absence of evidence of cancer for evidence of absence of cancer. I remembered the negative prostate biopsy that missed the cancer that ultimately took the life of Dr. George Sheehan, the foremost philosopher of running.

Coincident with these developments, I noticed a change in my urination habits. My urine became less fluent; the bladder felt full even after urination; I woke up repeatedly during the night to go potty; and my commute to work became a series of gas station hops.

A year after the first biopsy, my PSA level pushed even higher. Eleven more painful punctures found no cancerous cells either, but revealed a chronic inflammation that could explain the rise in PSA and my bladder symptoms. Dr. Makhuli, my urologist, diagnosed me with Benign Prostatic Hyperplasia (BPH), a condition that afflicts 50 percent of men over 50, and rises gradually to 80 percent of men over 80. Oh joy.

Dr. Makhuli offered me prescription drugs, which I declined promptly. I experimented with over-the-counter saw palmetto and beta sitosterol supplements, and I enjoyed a short-lived placebo effect. I subscribed to the Johns Hopkin’s prostate health email list under an assumed name, and read extensively about BPH. I contemplated taking up Dr. Makhuli on his offer of prescription drugs for the rest of my life, and weighed their side-effects against a one-time surgical intervention such as a Trans-Urethral Resection of the Prostate (TURP).

I chuckled when Paula announced that she went on a Paleo diet, and I included it in our Christmas message. Also known as a hunter-gatherer diet or the caveman diet, it makes up the second piece of a healthy lifestyle for Crossfit exercise fanatics. At work, Brian joined the Crossfit-Paleo movement. After my initial skepticism – cavemen on the Paleo diet enjoyed a life expectancy of 34 years - I stumbled upon the blog of Paleoista Nell Stephenson, and became intrigued by her claims that the Paleo diet propelled her from a middle of the pack triathlete to an age group winner and an 8-time Ironman.

Proponents of the Paleo diet base their claims on the pre-agricultural lifestyle of the Paleolithic era. In simple terms, the Paleo diet excludes grains, dairy, legumes, sugar, salt and junk food. It includes exclusively animals (you kill it, I grill it), fruits, vegetables and nuts. I found it simple and intriguing, but found no reason to try it … until I read that grains, dairy and legumes cause inflammation in various organs, and account for a large number of food allergies and exotic diseases. Organ inflammation rang a bell – it was the only finding from 22 painful punctures in my prostate.

I started gradually on a modified Paleo diet in early May, and went totally Paleo by June. Some Paleo advocates recommend 100% Paleo 80% of the time. Others insist on total adherence. Paleo purists go further up in the food chain, insisting on grass-fed beef and free-range chickens, and demanding olive and coconut oils for cooking. I adopted a first-order Paleo diet – if it is dead, I will eat it; I do not care what it ate before it died.

Six months into my Paleo experiment, I became a believer. I noticed a significant improvement in my bladder and prostate functions. My urine flow regained its vigor. I sleep often through the night, I drive to work with only one pit stop – to buy food or gas - and I drive home after work without stopping.

In preparation for my annual physical, I stopped all prostate-health supplements, abstained for 72 hours before blood work, and marched confidently into the clinic. My PSA dropped from 4.3 to 2.3 in six months, and my rectal exam was reminiscent of yesteryear. I explained to a skeptical urologist my lifestyle change, and he commented gingerly “whatever works.”

We have fallen now into a dietary routine. I have not eaten a slice of pizza in over six months, and I snicker at Brian’s P2 diet of pizza and Paleo. Cheese, peanuts and oatmeal are a thing of the past. Breakfast includes typically bacon and eggs, sweet or plain potatoes, cappuccino with almond-coconut milk, bananas and strawberries. Lunch varies from a handful of dry-roasted unsalted nuts in a can of tuna, to salad with grilled chicken. At the canteen, a dollar buys a boiled egg and a banana for post-run fuel. Dinner consists of dead animals, microwaved vegetables and sweet potatoes. I have rediscovered liver, avocados, baba ghannouj, and baked apples stuffed with raisins – until Marla pleads to eat out, then I order a cob salad. I have experimented even with making pancakes with coconut flour, and doused them with local maple syrup.

Dr. Loren Cordain, the father of the modern Paleo diet, recognizes that endurance athletes require additional fuel beyond what Paleo can provide in a timely manner. In his book “The Paleo Diet for Athletes” he argues that non-Paleo foods become essential supplements for endurance events lasting longer than 90 minutes, like my marathons. He recommends supplementing pre-race fuel, sustenance during a race, and post-race replenishment for a speedy recovery. I translated his guidance into a slice of raisin bread with my banana and cappuccino before a marathon, half a Protein Plus Powerbar every hour during the marathon, and all-I-can-eat tiramisu or bread pudding in hard sauce after the marathon.

The secondary benefits of my Paleo lifestyle included a drop in my body fat to 14 percent, regular clean bowel movements, and an overall sense of feeling good. My wife reported also several benefits from the second-hand effects of my diet. However, I have yet to notice any improvement in my marathon times, let alone winning any age-group award. May be I should look for much smaller marathons.

Dr. Kamal Jabbour enjoys once more using the big boys’ urinals in airports, instead of loitering in bathroom stalls. Dr. J's RUNNING Column appears in Cyberspace whenever endorphins call.

In a Nutshell
What is OutWhat is In
Bread, Pasta, RiceSweet and White Potatoes
Milk, Yogurt, CheeseEggs, Coconut Almond Milk
Beans, Peas, PeanutsAlmonds, Cashews, Walnuts
LentilsLiver and Onions
Sugar, Corn SyrupHoney, Maple Syrup
Corn, Corn OilAvocadoes, Olives, Olive Oil
FalafelBacon, Beef, Chicken, Pork
HummusBaba Ghannouj
Sweets, Cake90% Dark Chocolate
CerealsApples, Bananas, Cherries, Dates, Eggplants, Figs, Grapes
Wheat FlourCoconut Flour
Granola BarLarabar

© 2013 Dr Kamal Jabbour