Here’s part two of my interview with Richard Nikoley, Tim “Tatertot” Steele and Grace Liu about resistant starch. Given how many questions I asked and the comprehensive answers, I decided to divide the interview into three parts.
Fat Head: What do you think of the high-maize resistant starch the corn refiners are promoting? From some of your comments, I get the feeling you consider it yet another industrial food we can do without.
Tim: I’m very disappointed in the direction that the makers of Hi-Maize have taken it. Here they have a substance with the potential to help billions, yet they only want to put it in bakery goods and snacks so they can promote them as “high fiber foods.” The people who make Hi-Maize are the same ones who make High Fructose Corn Syrup. Since that bubble burst, they are looking for ways to refill the coffers of the corn producers. The studies in which Hi-Maize, or High Amylose Maize Starch (HAMS) was used to show marked metabolic improvements required approximately 20-40g of RS per day. This level makes most people fart, so when they put it in food, they are very careful to get it in at a level that ensures nobody “squeaks one off” in church, God forbid. This fart-proof level is the same issue that inulin and other prebiotic supplement makers had to deal with. A level of RS that produces no farts in 90% of the consumers is a level that does no good for 100% of people eating it for its “high fiber” benefits.
Grace: Movies like Fat Head, and others — King Corn and Future of Our Food — brought awareness and enlightenment for me about the dangers of the greed and perversions of industry interests including USDA collusion and GMO Big Agriculture. Part of the reason industrialized nations have epidemic gut problems, many experts believe, is secondary to GMO foods in the food supply that make up 80-90% of the American SAD food pyramid: GMO grain and GMO Bt corn fed livestock (pork, poultry, beef), GMO grain crops, GMO Bt corn, GMO soy, GMO sugar beets, etc. We have moved away from sustainable, organic, heirloom and biodynamic farming and livestock production and all its abundant life, including the soil organisms and other gut-preserving probiotics that live on the roots, tubers, shoots, fruits and leaves of our crops.
Fat Head: Lower glucose levels are a nice benefit, but I wasn’t getting the high fasting glucose levels that you and other people have reported on a very low-carb diet – perhaps because I’m low-carb but not zero-carb, and I usually have a high-carb Saturday night meal. So reports of lower fasting glucose levels didn’t persuade me to run out and buy potato starch. But when you wrote several posts about resistant starch and gut bacteria, you got my attention. Describe how resistant starch affects our gut microbiome.
Tim: RS is ALL about the gut bugs –100%. The first studies on RS in the late ‘80s and early ‘90s didn’t take the gut microbiome into account, and lots of their studies made it look like RS was not all it was cracked up to be. However, give a person RS for a couple weeks and allow their gut bugs to grow and change, then try the same studies — big difference. If most people had really good gut flora and all that was lacking was some fermentable fiber, then RS would be HUGE on its own.
Unfortunately, with widespread overuse of antibiotics, sanitized food and living conditions, and a disconnect from the microbes that live in the dirt, most people just don’t have the right set of gut bugs to take full advantage of simply adding RS to their diet. Back in the ‘80s and ‘90s when they first started looking into prebiotic fibers, they noted that about 75% of test subjects could not tolerate RS or inulin over 30 or so grams per day, causing them excessive gas, bloating, and pain. Now I suspect it’s even higher. The folks who can’t tolerate RS are the ones who need it most! For them, a good program of probiotics and fermented food should get them back on track.
Richard: It’s really been quite a deal for me. Unlike you, Tom, I’d had high fasting numbers for years and recently had seen a post-meal spike as high as 194 after a carby meal. Thing is, as I already said, my carb intake was very sporadic. Now, someone’s gonna say “Well, then you’re diabetic, or pre-diabetic, by clinical definition.” Well, that’s the rub. I just did a post about the Inuit and how in three studies, 1928, 1936 and 1972, they found no ketosis in the Inuit (To Reiterate, Just In Case You Missed It: No Elevated Ketone Levels in the Inuit), even though they are low carb, about 55g per day on average, mostly from the glycogen in fresh, raw animals (liver, meat, skin and surprisingly enough, whale blubber—the most carby of all). So researchers give them a glucose tolerance test and they passed with flying colors, with max spikes right to about 140. Keep in mind that nowadays in LC forums and comment threads all over, people have convinced themselves that they literally cannot have carbs. Why? Because they have physiological insulin resistance, high fasting BG, and so when they go eat a piece of their kid’s birthday cake and get 160-180, they self diagnose as diabetic or pre-diabetic and the prophesy is self-fulfilled.
So then how come the Inuit eating low carb can handle a bolus dose of glucose? The secret is in two things: 1) all the prebiotic fibers they get from the glycans in fresh raw blood, organs and meat, so they have healthier guts than your average modern LC dieter and 2) they have a massive protein intake, 250g and up. Try eating 250g protein daily without drinking it. So, they had plenty of dietary protein to fuel gluconeogenesis without causing insulin resistance. But what happens if you fast them for 82 hours, putting them into no-shit ketosis and forcing physiological insulin resistance? Give them the same bolus dose of glucose and they spike to 280-300 and 3 hours later, they’re still above 230.
Interestingly enough, some negative reaction to that post focuses more on measuring methods for ketones, insisting that it’s a LCHF diet — missing the point that it’s the very high protein that’s making the difference — and for some inexplicable reason, continuing to insist that they just must have really been in ketosis in spite of three studies spanning 44 years finding no ketosis amongst Inuit eating their traditional LC diet. For some reason, perpetual, chronic ketosis just simply has to be a very healthful thing to do, beyond it being proven therapeutic for certain medical conditions, and in spite of the very unhealthful thing that happened to their BG numbers when there’s no dispute about them being in deep ketosis after an 82 hr fast.
There’s much work to be done.
Fat Head: You’ve written that living on a very-low-carb diet might even starve our gut bacteria in the long term. Is there evidence for that, or is it more of a concern that warrants more research?
Tim: Well, here’s my stance on that…a VLC diet, such as an Atkins induction-type keto diet, isn’t going to completely kill off all your gut bugs, but what will happen is that the ones that do all the “good stuff” we’ve been talking about — for instance, producing butyrate and stimulating gut health — will be relegated to the minority. The majority of your gut bugs on a VLC diet are ones that can eat any old plant matter, animal scraps, and the lining of your intestine — the mucus layer. A gut thus populated has a high pH, pathogens thrive, and colonocytes starve. The good gut bugs are more than likely still there, just hiding and waiting for enough food for them to once again flourish. These populations change fast, even on a “by-meal” basis. Long-term eating habits set up long-term health patterns. We can eat however we want in survival situations, or any short-term diet intervention, but in the long run, a colon with ample butyrate and populated with beneficial microbes such as those that eat RS and the ones that benefit from the RS feeding frenzy is best.
Another thing to consider, Tom, is your lifestyle on the farm … your close association with chickens, animals, dirt, trees and fresh foods give you a leg up compared to most people. Your gut is most likely populated with all the soil-based organisms and lactic acid producers that folks are paying dearly for. I’d guess that for you, a big slug of RS gave your gut bugs a real treat and they were trying to tell you something: FEED US! What do your chickens do when you miss a day of feeding them? They cluck and fuss and let you know they are hungry. When well fed, they lay eggs and grow big juicy breasts and drumsticks. It’s the same with your gut bugs. Treat them like your farm animals or crops, feed, fertilize, and treat them well and they will pay it back in spades.
Grace: I love VLC and LC diets. They will always have a place therapeutically and clinically, I believe. My problem is that for some or many, these diets compromise or will eventually compromise 1) the gut and 2) adrenal/thyroid/gonad health. In four different LC or VLC short-term studies, prominent core gut microbial populations were dramatically reduced. These gut populations are important for health because not only do they serve vital functions such as expelling pathogens, vitamin processing and production (A, K2, B) and maintaining healthy immunity, they are also huge butyrate factories, pumping out butyrate which keeps gut tight junctions tight, immunity intestinal integrity intact, pathogens low and insulin sensitivity appropriate via the GPR41/43 receptors.
In one study, the researchers examined the shifts in gut populations during an Atkins induction diet (24 g carb/day) for 4 wks. With the VLC diet, they observed an enormous drop in butyrate to a fraction (about one-quarter) of the maintenance diet level. Four very significant subpopulations of gut bugs were decimated by the VLC low fiber and RS-deficient diet: Bifidobacteria, Ruminococci, Roseburia, and F. prausnitzii.
The study groups ate salads, but this was not apparently enough to sustain the important core gut communities. Salads may provide about 10 grams of non-starch fiber, but zero RS or oligosaccharides for them to feed on. These prominent populations are also highly correlated to longevity and robustness in centenarian and aging studies. In more and more gut microbiota studies, these populations are found missing in disorders and disease, yet found in great abundance and diversity in the healthy. Their favorite substrate to feed on is resistant starch.
Strict paleo diets that eliminate legumes, GF grass grains, roots and tubers may also exert the same detrimental gut effects as RS-deficient Atkins because the gut has to contend with the same conflict: a deficiency of RS and soluble fibers from starchy ‘plant babies.’ Without RS and other fiber, fecal carcinogens are not diluted, N-nitroso compounds occur at higher amounts, stool pH increases (allowing more pathogenic growths), and microbial-derived antioxidants such as ferulate and other phenolic compounds decrease.
Fat Head: If we do starve our gut bacteria, what would be the negative health effects?
Tim: Look at America…the modern, dyspeptic gut we’ve created: Frequent heartburn, loose stools or constipation, indigestion, smelly gas, GERD, IBS, or worse. You may even have one of the many autoimmune diseases that are running rampant, diabetes, metabolic syndrome, or cancer. Digestive diseases affect over 70 million people in the US alone! These diseases required 48.3 million ambulatory care visits, 21.7 million hospitalizations, and caused 245,921 deaths in 2009. Total cost for digestive diseases was estimated at $141.8 billion in 2004. And, these stats are getting worse, not better. It’s estimated that over 90 million Americans use antacids or other digestive upset medicines. Upset stomachs are the number one cause of self-treatment. These are all caused by “hungry gut bugs.”
Richard: Most people actually have both E. coli and C. difficile in them, but they are kept at bay by our symbionts and commensals. C. difficile causes about a half million sicknesses annually in the US, hospitalizes 250,000 and kills 15,000. Guess when the most common time is for an infection to occur? Immediately following a round of antibiotics. Now, connect them dots.
[On that topic, folks, you may want to listen to this NPR interview about the effects of antibiotics on the gut microbiome — Tom]
Fat Head: To experience the benefits of feeding our gut bacteria, we need gut bacteria to feed. Is it worth taking probiotics while adding resistant starch to the diet? Or do probiotic supplements just create expensive poop?
Richard: This was the last puzzle piece for me personally. I pounded three brands of soil-based organism probiotics that Grace recommends. I did this for a week or so but by about day three, it was very clear this was a huge benefit. Very notable was energy and sleep. Very interesting because I seemed to be relieved of this sort of regimented thing where you have to get 7-8 hours. It quickly became way different. Some nights 4-5 hours and others, 8-9 but less on average and when it was one of those 4-5 hour deals, I wasn’t just getting up at 4 a.m. because of insomnia. I was ready to hit it and felt great.
But the biggest deal of all was airborne allergies or, for all I know, food allergies. Anyway, I’ve had perpetual congestion, sneezing, runny nose and cough virtually all my life. Used to be on meds year round. LC Paleo did wonders for that initially. Got rid of the meds, felt a lot better. But it was creeping back and I’d always have to have tissue on hand, have to shoot Afrin some nights to get to sleep, and now and then, have to pop an OTC. Within 3 days on the SBO probiotics and for the first time ever, I’m breathing clearly through my nose 80-90% of the time. Seems to be getting even better, even though I’m down to just taking one or the other of those three products every day or two. They are pricey, so after pounding them the first week or two, I’d recommend stretching them out like that.
Lots of folks have now introduced these and many positive reports are beginning to come in. Clear breathing seems to be a common one.
Grace: Since you are a farmer, Tom, I am envious of the natural probiotics you and your family encounter daily! My family and I are suburbanites with no garden and the only healthy dirt I encounter is the few that rim our carrot tops or the little dusting on my organic greens that haven’t been blasted off by triple filtered water rinsing. Also I’ve had plenty of antibiotics in my lifetime which likely decimated my gut little did I know.
What I see anecdotally and clinically is that many people’s guts are missing core ancestral species (which is my AHS14 topic this year). Our gut bugs have taken a hit and the damage is immeasurable. By using functional medicine lab testing of stools and urine organic acids, I can see the damage. By talking to people, the damage is often evident as well. This is the same advanced testing that is bringing us rapid information about the gut microbiota over the last 10-15 years.
I can’t tell you how often I see Bifidobacter, Lactobacilli and other core ancestral species missing. I advocate a few good soil based organisms (SBO) probiotics such as Prescript Assist and AOR Probiotic-3, which do an excellent job of filling in nicely for now for the lack of soil exposures that our ancestors were immersed in, and we now have challenges in obtaining.
Modern, industrialized societies consume 100% of food, vegetables, and packaged beer that is sterile, dead, or hyper-hygienically clean. By contrast, our ancestral gut strains Bifidobacter, Lactobacilli, Clostridium, Bacilli, and wild yeasts all naturally co-exist on farm livestock, children, chickens, eggs, raw dairy, legumes, grass grains, tubers, roots and other plant sources.
Tim: In the ancient past, no one needed probiotics because we got all the new microbes we needed from dirty food, dirty fingers and a close connection with the Earth. In the more recent past, probiotics worked like migratory farm workers. As long as you used them, they gave you some benefits, but as soon as you stopped, they were gone because they had no incentive to stick around. With RS, that all changes. Probiotics now have a reason to stick around a while. If you are one of the 25% of people who cannot ferment RS, or even one of the 75% who can, you should take probiotics when first healing your gut or switching to a high RS diet. Most if not all of us are missing key gut bugs that are found in several probiotic supplements. In a diet filled with RS, inulin, glucomannan, and other prebiotics in the 20-40 gram per day range, these probiotics will not only survive, but kick ass on the pathogens and set the stage for stability and resilience in your gut’s ecosystem.