Vegetarian doesn't necessarily mean someone was eating a lot of "vegetables". They could've had a high grain and legume diet. But you already know that.

Is it really ketogenic, though? My understanding is that coconut oil, since it produces its own ketones when it breaks down, can make it APPEAR your body is in ketosis, even though it actually isn't. And 5 TBS a day is a LOT. Am I incorrect in my assumption?

That crossed my mind too, but level three, or Paleo Plus, is still very low carb. At that level, the non-gluten grains, and starchy vegetables are gone, total veg and protein are reduced. She has a detailed history of ketogenic diets and use of MCTs in that section of book. Stated her ketones by meter were .4 to 3.0 and calls PaleoPlus a "mild state of nutritional ketosis".

You can eat a lot of fiber and remain in ketosis. During my experiments I was often eating 30-50 grams of carbs per day but staying deeply in ketosis since most of it was fiber.

There's an MCT-based diet for epilepsy, where they use MCT oil to allow the kids to eat more carbs and still remain in ketosis. I guess it depends--if the benefits come from ketones themselves, it might not matter where those ketones came from. To the extent that decreasing glucose metabolism matters--like say in cancer, I guess then probably it does matter. Mary Newport reported seeing improvements in her husband's Alzheimer's, originally, just stirring coconut oil into his oatmeal. Although she did go to a lower carb diet later on.

I'm wondering lately if increasing ketones through MCT oil would decrease gluconeogenesis--if gluconeogenesis occurs largely in response to the brain's demand for fuel, it makes sense that this might be true--making the true carb count of a fairly low carb diet effectively lower. There might also be a hormonal response to ketones of some sort that would alter the effect of glucose on the metabolism.

To the extent it's the ketones at work, though, I'd think lowest carbs possible plus coconut oil would be most effective.

http://www.ncbi.nlm.nih.gov/pubmed/24615175

Same 1971 study that lead to this MCT Ketogenic for kids, is how she created her diet, calling it a Modified MCT Ketogenic Diet. How low could she drop the green, sulfur-rich and colored vegetables yet still get enough of their nutrients? how much could she raise organ meats and drop protein? how much to fill in with other low carb nutrient sources like seaweed? and after all that juggling...how much coconut oil had to be added to stay in ketosis for its neurological benefits. The resulting plan is what has worked for her and many clinic patients, but if someone tries this and is not in ketosis, then they have to tighten the carbs further and there are instructions for that too.

This level of the Wahls Protocol is not for the casual dieter, but for the truly committed with a severe auto-immune condition. Her clinic patients have all three options, but if accepted into one of her clinical trials, this is the level you must do.

Great thread, thanks.
I'm still trying to wrap my mind around some of the coconut oil/ketosis issues, and this is a help.

Before I'd focused on whether or not you'd get a false positive on the ketostix, but this is much more interesting...

Ummm...what she said!

Book review by The Paleo Mom, author of another Auto-Immune Protocol book:
http://www.thepaleomom.com/2014/03/...erry-wahls.html

Dr. Wahls' three levels of diet in her 400 page book have all the details and personal adjustments allowable for a reader to implement her auto-immune protocol as best they are able given their medical conditions. These are not weight loss diets, though that may be a side effect. The OP is already on an AIP and both versions are focused on a similar outcome, though Wahls does include more coconut oil for neurological support.

Just started reading this yesterday - it's very interesting (in particular the ketogenic level.)

I am giving serious consideration to transitioning to this diet for next month (it's very close to AIP which I'm doing now).

And the Paleo Plus (ketogenic) level should actually work for weight loss, one of the indications is obesity. I like her suggestion of checking urine ketones regularly and adjusting accordingly too - should help me see what changes are needed.

My biggest challenge will be incorporating some of the "nutritionally dense" foods that I find yucky (seaweed, organ meats) but one step at a time... Just following the plan as outlined without worrying about those details would still require some adjusting of what I'm doing now (I've not been doing IF, for example). Some of it is pretty close to how I've ended up eating due to AIP though (lots of veggies, although not in the proportions of type she outlines, and quite a bit of coconut milk, but again, maybe not as much as she says). And protein might need a slight downward nudge again...

I'm already starting to do some of those paleo cult things like making bone broth, adding gelatin to smoothies and fermenting my own foods...

When I saw her first video years ago, I thought that her improvements probably came from ditching processed junk, grains, dairy and sugar. This more recent video you posted was of particular interest to me because she explains that she was following Cordain's Paleo for five years while she continued to decline. It was changing from paleo to her own plan that brought about her enormous improvements.

After seeing this last week I bought beets, carrots, kale, mushrooms, onions and liver. I couldn't handle the liver, despite my best effort. Fortunately I like pate, rumaki, and oysters (about half the body weight of an oyster is its liver).

I'm going to start adding back a lot of colorful veggies to my diet. I used to eat loads of them but cut back when I went low carb. I suppose I'll have to cut out something else.

The nine cups of vegetables in her plan sound daunting but apparently she when she says 1 cup she means 1 cup raw or 1/2 cup cooked. She has three categories of veggies so it works out to 1/2 cup (cooked) of each type of veggie at each meal. That doesn't sound like so much anymore.

Paleo cult things? I thought these were more from "Nourishing Traditions", and Weston A. Price. Though in my case I've been making bone broth since I started to cook (I call it "broth", as adding "bone" to the title seems redundant). Gelatin was a popular thing to supplement in my teen years, to strengthen nails and hair - so also not quite such a new idea. And fermented foods - one of the oldest ways to preserve foods is now seen as a "cult thing"? -- Oh my.

LOL! I know what you mean, Verbena (bone broth versus broth). I guess you can make broth with meat too, but bones was always how I did it.

I don't think you can call paleo a cult without also calling every other way-of-eating a cult, including Atkins.

Hmmm... maybe I should be doing this. I have so much pain and inflammation.

Nancy, she mentions that some people who come to her clinic start with the "level 1" Wahls Diet, and as they feel better, move up to the more rigorous protocols. Or some go direct to level 3, which since you have been paleo for a while, might make sense for you to try. Each level is quite specific on getting x amounts of three types of veg and all those extra nutrients to help heal inflammation. Green smoothies is another way to down all that vegetable matter, maybe hide the seaweed or dulse flakes too. Going without both dairy and eggs would be a tough one for me, but that is the rule for all three levels.