📚 Finished reading The PK Cookbook by Sarah Myhill.

Yes, I actually read a cookbook. To be fair this isn’t the sort of book you would think you were getting if you bought a cookbook. There’s not all that many recipes in it. It’s mainly a description of the how, what and why of Dr Myhill’s favoured diet, the Paleo-Keto (or PK) diet.

  • Paleo, in the sense of a diet that " consists of natural, unprocessed foods and rejects grains and dairy".

  • Keto, as in a diet “that results in the metabolic state whereby the majority of the body’s energy is derived from ketone bodies in the blood - the state of ketosis.”

Overall, it’s basically a high-fat, high-fibre, low-carb diet. You can get a good idea of what the book is about from her website’s wiki, starting here.

An example menu for a day’s food provided includes:

  • A breakfast of Coyo natural yoghurt, chia seeds, PK bread and some macadamia nut butter.
  • Lunch is mackerel in basil and tomato sauce, avocados and frozen berries as dessert.
  • Dinner might be tuna with tomato, cucumber, lettuce, mayonnaise and pine nuts.

Her claims are that, whether you’re suffering from a chronic medical condition or are of good health, then following this diet will benefit your health and longevity. She’s one of those folk appears to believe a change from the typical (western) diet to her favoured one is helpful for almost any malady.

But in particular she claims it to be particularly helpful for people who suffer from conditions such as ME, Chronic Fatigue Syndrome or aspects of Long Covid. This includes a lot of people these days. To the best of my knowledge there are as yet few if any generally accepted, proven and effective treatments for these conditions so one can see why people would want to try even rather experimental ideas.

One hellish side-effect of these conditions can be that the person concerned has far too little energy to contemplate cooking up a big pot of stock and baking “PK bread” each day which is really the platonic ideal of this diet. The author reports regularly collecting water from her local spring, harvesting her crops and slaughtering her livestock; surely opportunities not available to the majority of readers. So, to suit the rest of us and especially those suffering with extreme fatigue, the book includes handy shortcuts and an optional pre-written meal plan that’s designed to get one through the first few weeks if you’re in this situation.

This sort of low-effort onboarding is appealing to me. But what’s less appealing to my preferences is that it’s quite hard to fit it into a vegetarian or vegan framework, although reportedly not impossible. I don’t think she thinks those preferences are particularly healthy for a human though.

She warns of an onboarding challenge though - the first few days or weeks are likely to be fairly difficult or painful as your body changes to adapt to its new conditions. As with all restrictive diets, it’s a difficult intervention to stick to, which she acknowledges, but basically says you’ve got to try if you want the benefits.

It must be noted that Dr Myhill is a controversial character. The UK’s General Medical Council banned her from practicing for a while - the most serious reasons for which seem to be around the promotion of “alternative” treatments for Covid-19, and seemingly a general skepticism regarding vaccine effectiveness and safety. These are opinions I struggle to get over. I think they are dangerous. But I suppose even if she’s very wrong about that, it’s possible she might be right about other stuff.

In any case, on the diet front, I’m never going to be someone to tell someone who suffered from an illness that they are wrong if they believe that some intervention helped them even in the absence of conclusive scientific evidence. After all, even interventions that have been designed to have absolutely no biochemical basis for efficacy can help some people with some conditions. There are multiple people who testify to success on this diet. Absence of evidence isn’t always the same as the evidence of absence, although the two can of course coincide.

Of course a different level of evidence should be required - or at least the limitations made transparent - if you’re proselytising an intervention as a panacea for other people. That’s a case which I’m not convinced has been made in this book, even if there are the occasional scientific references given. This diet is counter-intuitive and prescriptive enough that I wouldn’t feel all that comfortable embracing it whole-heartedly without the advice or monitoring from a medic, nutritionist or other knowledgeable person. It’s also not one that everyone will find themselves able to stick with long term; a known issue with the more traditional Keto diet.

Of course it’s also a known and uncontroversial fact that dietary changes in general can greatly improve one’s heath in general or act as treatment for specific maladies. The Keto diet for instance has a long history of success in the treatment of epilepsy for those that find it possible to stick to. I’m not so sure about the Paleo diet - there seems to be less conclusive research (but certainly not none - still, as ever, “more research is needed”) and occasionally a dependency on a kind of appeal to nature in how people speak about it. But some of its traditional recommendations are certainly in line with the mainstream thinking around healthy diets.