Archive for June, 2016
I’ve mentioned this story a couple of times before, but given the topic of this post, it bears repeating:
The Older Brother and I had a conversation some years back as our dad was fading from Alzheimer’s. The Older Brother noted that while our great-grandfather was sharp until nearly age 100, our grandmother developed Alzheimer’s in her 80s, and our dad had (in retrospect) started succumbing in his late 60s. Seeing the progression, The Older Brother said, “Well, we’re screwed.” (That’s the family-friendly version of his analysis.)
I replied that Alzheimer’s is probably a form of diabetes, not a genetic destiny. We can avoid or delay it for decades by eating a good diet.
Turns out a good diet might even reverse the condition to an impressive degree. Here’s part of the abstract of a 2014 pilot program published in the journal Aging:
This report describes a novel, comprehensive, and personalized therapeutic program that is based on the underlying pathogenesis of Alzheimer’s disease, and which involves multiple modalities designed to achieve metabolic enhancement for neurodegeneration (MEND). The first 10 patients who have utilized this program include patients with memory loss associated with Alzheimer’s disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI). Nine of the 10 displayed subjective or objective improvement in cognition beginning within 3-6 months, with the one failure being a patient with very late stage AD.
Six of the patients had had to discontinue working or were struggling with their jobs at the time of presentation, and all were able to return to work or continue working with improved performance. Improvements have been sustained, and at this time the longest patient follow-up is two and one-half years from initial treatment, with sustained and marked improvement.
Sustained and marked improvement? Six of 10 patients able to return to work? Why wasn’t this all over the news?! Perhaps because there’s no miracle drug involved. The therapeutic program employed here was mostly about diet and other lifestyle changes.
The paper opens with a long discussion of the biology of Alzheimer’s and the history (not an impressive one) of drug therapies. Let’s skip those and get into the therapies employed with these patients. Here are two examples:
A 67-year-old woman presented with two years of progressive memory loss. She held a demanding job that involved preparing analytical reports and traveling widely, but found herself no longer able to analyze data or prepare the reports, and therefore was forced to consider quitting her job. She noted that when she would read, by the time she reached the bottom of a page she would have to start at the top once again, since she was unable to remember the material she had just read.
She was no longer able to remember numbers, and had to write down even 4-digit numbers to remember them. She also began to have trouble navigating on the road: even on familiar roads, she would become lost trying to figure out where to enter or exit the road. She also noticed that she would mix up the names of her pets, and forget where the light switches were in her home of years.
Sounds a lot like my dad around the same age. Long before we realized he was suffering from Alzheimer’s, my mom complained to me that my dad just wanted to vegetate in front of the TV at night and didn’t read anymore – which seemed odd, given that he used to devour books and could quote facts from them years after reading them. His driving also became so erratic, we had to talk him into giving it up before he killed someone. Later, of course, we realized he’d stopped reading because he couldn’t remember what he’d just read.
Here’s the therapy for Patient One:
As noted above, and following an extended discussion of the components of the therapeutic program, the patient began on some but not all of the system: (1) she eliminated all simple carbohydrates, leading to a weight loss of 20 pounds; (2) she eliminated gluten and processed food from her diet, and increased vegetables, fruits, and non-farmed fish; (3) in order to reduce stress, she began yoga, and ultimately became a yoga instructor; (4) as a second measure to reduce the stress of her job, she began to meditate for 20 minutes twice per day;  she took melatonin 0.5mg po qhs; (6) she increased her sleep from 4-5 hours per night to 7-8 hours per night; (7) she took methylcobalamin 1mg each day; (8) she took vitamin D3 2000IU each day; (9) she took fish oil 2000mg each day; (10) she took CoQ10 200mg each day; (11) she optimized her oral hygiene using an electric flosser and electric toothbrush; (12) following discussion with her primary care provider, she reinstated HRT (hormone replacement therapy) that had been discontinued following the WHI report in 2002; (13) she fasted for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime; (14) she exercised for a minimum of 30 minutes, 4-6 days per week.
No simple carbs. Ditch the gluten. Exercising, some over-the-counter supplements, more sleep and more exercise. Now here are the results:
She began System 1.0, and was able to adhere to some but not all of the protocol components. Nonetheless, after three months she noted that all of her symptoms had abated: she was able to navigate without problems, remember telephone numbers without difficulty, prepare reports and do all of her work without difficulty, read and retain information, and, overall, she became asymptomatic. She noted that her memory was now better than it had been in many years. On one occasion, she developed an acute viral illness, discontinued the program, and noticed a decline, which reversed when she reinstated the program. Two and one-half years later, now age 70, she remains asymptomatic and continues to work full-time.
Big Pharma, eat your hearts out. No drug has come close to those results.
Let’s look at one more case history. Here’s what the paper says about Patient Two:
A 69-year-old entrepreneur and professional man presented with 11 years of slowly progressive memory loss, which had accelerated over the past one or two years. In 2002, at the age of 58, he had been unable to recall the combination of the lock on his locker, and he felt that this was out of the ordinary for him…. He noted that he had progressive difficulty recognizing the faces at work (prosopagnosia), and had to have his assistants prompt him with the daily schedule. He also recalled an event during which he was several chapters into a book before he finally realized that it was a book he had read previously. In addition, he lost an ability he had had for most of his life: the ability to add columns of numbers rapidly in his head.
Here’s his therapy:
The patient began on the following parts of the overall therapeutic system: (1) he fasted for a minimum of three hours between dinner and bedtime, and for a minimum of 12 hours between dinner and breakfast; (2) he eliminated simple carbohydrates and processed foods from his diet; (3) he increased consumption of vegetables and fruits, and limited consumption of fish to non-farmed, and meat to occasional grass-fed beef or organic chicken; (4) he took probiotics; (5) he took coconut oil i tsp bid; (6) he exercised strenuously, swimming 3-4 times per week, cycling twice per week, and running once per week; (7) he took melatonin 0.5mg po qhs, and tried to sleep as close to 8 hours per night as his schedule would allow; (8) he took herbs Bacopa monniera 250mg, Ashwagandha 500mg, and turmeric 400mg each day; (9) he took methylcobalamin 1mg, methyltetrahydrofolate 0.8mg, and pyridoxine-5-phosphate 50mg each day; (10) he took citicoline 500mg po bid; (11) he took vitamin C 1g per day, vitamin D3 5000IU per day, vitamin E 400IU per day, CoQ10 200mg per day, Zn picolinate 50mg per day, and α-lipoic acid 100mg per day; (12) he took DHA (docosahexaenoic acid) 320mg and EPA (eicosapentaenoic acid) 180mg per day.
And his results:
He began on the therapeutic program, and after six months, his wife, co-workers, and he all noted improvement. He lost 10 pounds. He was able to recognize faces at work unlike before, was able to remember his daily schedule, and was able to function at work without difficulty. He was also noted to be quicker with his responses. His life-long ability to add columns of numbers rapidly in his head, which he had lost during his progressive cognitive decline, returned. His wife pointed out that, although he had clearly shown improvement, the more striking effect was that he had been accelerating in his decline over the prior year or two, and this had been completely halted.
Ditch the processed foods, eat real foods. Exercise and get enough sleep. Take some supplements to replace the nutrients that were plentiful in hunter-gatherer diets, but are missing in modern diets. Next thing you know, the guy can add columns of numbers in his head again.
I think we’re seeing why Alzheimer’s was rare in hunter-gatherer societies. It isn’t some harsh sentence handed down by fate or genes. It’s a condition caused by (in many cases, anyway) the same garbage diet that makes people fat and diabetic.
So no, I don’t believe The Older Brother and I will succumb to the disease that caused our dad to fade away in front of our eyes. I expect to be blogging and making wisecracks at age 97 … with The Older Brother sitting in when I need a vacation.
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I recently wrote a couple of posts explaining that over the years, I’ve revised my explanation of “the alternative hypothesis” from this:
More Carbohydrates => Higher Insulin => Fat Storage
Damaging Diet => Hormonal Disruption => Fat Storage
It’s not the biologically beneficial rise in insulin after a meal that makes people obese, I said in those posts. It’s chronically high insulin (along with other hormonal disruptions) resulting from a bad diet.
In comments, a few of you suggested I read Dr. Jason Fung’s book The Obesity Code because it expresses similar ideas. Good suggestion. It’s an enlightening and very readable book – meaning it passes my “Aunt Martha” test. Your Aunt Martha could read this book without giving up because she doesn’t want to keep a medical dictionary on her desk.
As I expected, insulin is still front and center in Fung’s explanation of why we get fat. In fact, the book’s cover includes the subhead Why your body’s own insulin is the key to controlling your weight. After citing plenty of research to effectively dismiss the “it’s all about consuming too many calories” explanation of obesity in the early chapters, Fung begins chapter seven like this:
I can make you fat. Actually I can make anyone fat. How? By prescribing insulin. It won’t matter that you have willpower, or that you exercise. It won’t matter what you choose to eat. It’s simply a matter of enough insulin and enough time.
Wait … hasn’t Dr. Fung read on the internet that we mustn’t blame insulin because it’s actually a wunnerful, wunnerful appetite suppressant? Well, perhaps he has … but if so, I’m sure he laughed. He has years of clinical experience with the stuff, as he explains in the book’s introduction:
I’ve often watched patients start insulin treatment for their diabetes, knowing that most will gain weight. “Doctor,” they say, “you’ve always told me to lose weight. But the insulin you gave me makes me gain so much weight. How is this helpful?”
… Like many doctors, I believed that weight gain was caloric imbalance – eating too much and moving too little. But if that were so, why did the medication I prescribed – insulin – cause such relentless weight gain?
Fung answers his own question in chapter seven:
Everything about human metabolism, including the body set weight, is hormonally regulated. A critical physiological variable such as body fatness is not left up the vagaries of daily caloric intake and exercise. Instead, hormones precisely and tightly regulate body fat. We don’t consciously control our body weight any more than we control our heart rates, our basal metabolic rates, our body temperatures or our breathing.
But it isn’t just about insulin. Fung includes chapters on cortisol (which triggers weight gain partly by raising insulin) and other hormones, such as leptin, that are involved in weight regulation.
And insulin isn’t just about how many grams of carbohydrate we consume. As Fung writes in chapter nine:
The carbohydrate-insulin hypothesis, the idea that carbohydrates cause weight gain because of insulin secretion, was not exactly wrong. Carbohydrate-rich foods certainly do increase insulin levels to a greater extent than the other macronutrients. High insulin certainly does lead to obesity.
However, the hypothesis stands incomplete. There are many problems, with the paradox of the Asian rice eater being the most obvious.
… Indeed, many primitive societies that ate mostly carbohydrates have low obesity rates. In 1989, Dr. Staffan Lindeberg studied the residents of Kitava, one of the Trobriand Isands in Papua New Guinea’s archipelago – one of the last places on Earth where people ate a largely traditional diet. Starchy vegetables, including yam, sweet potato, taro and cassava, made up the basis of their diet.
It isn’t foods that raise insulin that make us fat, Fung explains in the following chapters. It’s foods that lead to insulin resistance. Once we become insulin resistant, the entire hormonal system goes out of whack. Fung spends the next few chapters describing the foods that likely make us insulin resistant (sugar being a primary culprit) and how insulin resistance makes us fat.
Insulin resistance is largely about what we eat. But rolling back the effects – and perhaps preventing insulin resistance in the first place – is also about when we eat. That was the most useful message in the book for me, since I’ve already read rather a lot about the effects of foods.
As Fung explains, insulin is supposed to rise after meals. But then it’s supposed to drop and stay low for several hours. Back when few Americans were overweight, that’s what happened — because we ate three meals per day, period. Now we add constant snacking into the mix. When I was shooting interviews for Fat Head, Dr. Eric Oliver, author of Fat Politics, said that while people like Morgan Spurlock want to blame obesity on restaurants for serving larger meals, the real problem seems to be how often we eat between meals. Fung explains why that’s such a problem:
The balance between the fed state (insulin dominant) and the fasted state (insulin deficient) has been completely destroyed. We are now spending most of our time in the fed state.
… We are taught to eat the moment we roll out of bed. We are taught to eat throughout the day and again just before we sleep. We spend up to 18 hours in the insulin-dominant state, with only six hours insulin-deficient.
A lousy diet, of course, makes snacking irresistible. Refined carbs jack up your blood sugar, and your body responds by flooding your bloodstream with enough insulin to give you low blood sugar. If you work in an office, I’m sure you’ve seen exactly what Fung is describing. I see people eat their white-bread sandwiches at noon, and by 3:30 they’re back in the cafeteria, trying to decide if they should raise blood sugar with a candy bar, a bag of chips, or some microwaved popcorn.
Fung describes this as the vicious cycle that leads to insulin resistance. When insulin is too high, too often, cells down-regulate their insulin receptors. Then the body cranks out more insulin to try to lower high blood sugar. Then we get fatter. And hungrier. And snack more often.
Part of the cure is real food, and Fung devotes a good chunk of the book to the topic. But another part of the cure is to dial back insulin resistance through intermittent fasting. As you know, I’m a fan of the Wisdom of Crowds. Fung reminds the reader that in nearly all ancient cultures, periodic fasting was considered a boon to good health. It was part of their wisdom.
In the final chapter, Fung lays out the why and the how of intermittent fasting. Here’s part of the why:
To break the insulin-resistance cycle, we must have recurrent periods of very low insulin levels. But how can we induce our body into a temporary state of very low insulin levels?
We know that eating the proper foods prevents high levels, but it won’t do much to lower them. Some foods are better than others; nonetheless, all foods increase insulin production. If all foods raise insulin, then the only way for us to lower it is to completely abstain from food. The answer we are looking for is, in a word, fasting.
In the rest of chapter, Fung describes the hormonal effects of fasting and dispels the many myths about going without food … such as “it will depress your metabolism.” Interestingly, the research he cites here and in other chapters shows that while living on a low-calorie, low-fat diet will indeed slow down your metabolism, periodic fasting doesn’t. Apparently we’re built for it. Given that paleo man’s hunts weren’t always successful, that makes sense.
Jimmy Moore and Dr. Fung are co-authoring a book titled Fasting Clarity that’s scheduled to be published later this year. I’m looking forward to reading the expanded version of this topic.
In the meantime, The Obesity Code is definitely worth adding to your library of diet and health books.
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Yup, still working overtime at the job. They want me to use up the hours budgeted for fiscal year 2016 (which ends July 1st) because any unspent dollars go POOF! (And then some unidentified programmer’s PC turns into a pumpkin. Or his shoes turn into glass slippers. Don’t remember exactly, but something bad happens.)
I couldn’t possibly put in enough hours this week to soak up the entire balance, but I’m doing my best. So it’s long days of coding for me … for a few more days.
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The most recent Dietary Guidelines declared that cholesterol is “no longer a nutrient of concern.” Yup, after nearly 40 years of warning people away from egg yolks, the government folks finally checked the actual science and then sort of admitted being wrong. It was a step forward. But, government being what it is, I suppose a corresponding step backwards was inevitable. Here are some quotes from a recent article in The Chicago Tribune:
The Obama administration is pressuring the food industry to make foods from breads to sliced turkey less salty, proposing long-awaited sodium guidelines in an effort to prevent thousands of deaths each year from heart disease and stroke.
So the Obama administration must have solid scientific evidence that reducing sodium in food products will prevent heart attacks and strokes … just like the First Lady must have solid evidence that telling kids “Let’s Move!” and cutting the fat and calories in their school lunches will reduce obesity. But we’ll come back to the salt-cardiovascular disease evidence.
The guidelines released Wednesday by the Food and Drug Administration are voluntary, so food companies won’t be required to comply, and it could be a year or more before they are final. But the idea is to persuade companies and restaurants — many of which have already lowered sodium levels in their products — to take a more consistent approach.
Ah, I see: the guidelines are voluntary. Based on government history, here’s how that will work:
“Hey, food companies, we’d like you volunteer to reduce the sodium in food.”
“No thanks. People don’t like the food as much when we lower the sodium.”
“You don’t seem to understand. We’re asking you to do this voluntarily.”
“Got it. Voluntary guidelines. So we choose not to follow them.”
“Well, then, we’ll have to force you to follow them.”
“But you said the guidelines were voluntary.”
“Yes, but you didn’t volunteer, so now we’re imposing them.”
Sodium content already is included on existing food labels, but the government has not set specific sodium recommendations. The guidelines suggest limits for about 150 categories of foods, from cereals to pizzas and sandwiches. There are two-year and 10-year goals.
And a five-year plan issued by the Kremlin.
Health officials from the FDA and the Centers for Disease Control and Prevention said overwhelming scientific evidence shows that blood pressure increases when sodium intake increases, increasing the chances of heart disease and stroke.
Overwhelming evidence, eh? That would mean 1) the science shows that high sodium intake leads to heart attacks and strokes, and 2) the science also shows that most Americans have a high sodium intake that puts them at risk. And let’s add a third point: before issuing a “voluntary” guideline for lowering the sodium in food, we’d want to be sure that people don’t respond to low-sodium foods by reaching for the salt shaker – which is what I do.
So how much sodium are we consuming, anyway?
Americans eat about 1½ teaspoons of salt daily, or 3,400 milligrams. That amount hasn’t gone down over the years, and it’s about a third more than the government recommends for good health. Most of that sodium is hidden inside common processed foods and restaurant meals, making it harder for consumers to control how much they eat.
I just explained that I have no trouble controlling how much sodium I eat. Give me low-sodium food, I reach for the salt shaker. That’s because 1) I like salt on my food, and 2) I’ve actually looked at the science – something regulators at the FDA apparently haven’t. Here’s a quote from a 2011 article in Scientific American:
A meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure.
And here are some quotes from a recent article about a new meta-analysis:
A controversial new study contends that a low-salt diet could be dangerous for your heart health.
Notice how it’s only “controversial” if a study concludes that government advice is wrong?
Restricting dietary salt to below 3,000 milligrams a day appears to increase the risk for heart disease similar to that of high blood pressure patients who eat too much salt, said lead researcher Andrew Mente.
He said his study results showed that a low-salt diet increases the risk of heart attack or stroke 26 percent for people without high blood pressure and 34 percent for people with high blood pressure.
For those with high blood pressure, too much dietary salt increases their risk 23 percent, the study said.
On the other hand, a diet with excess salt doesn’t increase the risk at all if blood pressure is normal, the study reported.
“Most of the population eats what they’re supposed to eat, based on the data,” Mente said. “They fall in the middle and that’s actually the sweet spot — the safest range of intake.”
Mente’s study is observational, and you know what I think of observational studies are far as demonstrating cause and effect. But keep in mind that if A causes B, A and B will be correlated. So if A isn’t correlated with B, A doesn’t cause B. Mente found that a normal sodium intake – the 3400 milligrams the government says is too much – isn’t associated with heart attacks of strokes. But a lower sodium intake is. So naturally, the FDA wants us to cut back. And they’re (ahem) “asking” food companies to volunteer to help.
Back to the Tribune article:
Some companies have worried that though the limits will be voluntary, the FDA is at heart a regulatory agency, and the guidelines are more warning than suggestion.
Gee, do you think?
51 Comments »
It’s been awhile since I’ve done one of these posts, so here some letters from viewers. Actually these are follow-up letters from people who’ve written to me before. Their letters are most of the post, so I’m not going to use quotes. The letters appear in regular text. My comments are in italics.
Down 40 pounds in mere months
Hello, Tom —
I wanted to follow up with you. I originally emailed in February, then again in April. June is here and I am now down 40 pounds! I started out at 245 lbs and I’m at 205. I feel great. My wife has lost about 20 lbs. Again for her to have lost this much weight is truly amazing — she’s never been able to lose it and keep it off because of PCOS and other factors. She’s seeing consistent loss, but in her case the measurements are really amazing. She’s lost 4 inches from her waist and several inches in other areas!
We don’t really count carbs, but generally get anywhere from 25-100 carbs a day. The carbs come from homemade sourdough bread (using natural yeast rather than quick rise stuff — no more than 1 slice a day), berries, and some veggies (above ground varieties). Once a month we might go each a small pizza or something not strict low carb, but for the most part we are avoiding a lot of the processed stuff we used to survive on.
Our typical breakfast is eggs with either bacon, sausage or made into an omelet with veggies. I add 2-3 tablespoons of cream to the eggs and whisk them up in a bowl. I also add 1-2 tablespoons of butter to the pan to help the eggs fry. Lunch is usually a big salad (homemade ranch dressing using ranch dressing mix, full fat greek yogurt and heavy cream) and some type of fatty meat – burger patties, 1/2 of a rib eye, or leftover beef stew (with real bone broth).
Dinner is usually veggies with cheese and/or butter on them and a meat – rib eye, ground beef, bone in skin on fried chicken, etc. For dessert we’ve stuck with berries and cream (thank you for introducing me to that!) and we have 1 piece of dark chocolate with each meal (>75% dark, each piece has 1g sugar). Let me tell ya, starting the day off with a piece of dark chocolate and having no guilt over doing it- – totally awesome.
Doing everything the modern American medical system tells me should make me fat, yet I’ve lost 40 lbs in 6 months and 0 exercise. My wife and I do go on maybe 1-2 walks a week and we’re active around the house, but I dont count that stuff as exercise. I do understand the importance of exercise, especially being behind a computer all day, but not solely for weight loss!
It is amazing to go through this journey. Friends and co-workers have noticed the weight loss and I have shared your movie, facebook groups and website with them, since it all started with Fat Head. Some friends of ours switched to a lower carb lifestyle a few days ago and have already seen results.
A good friend of mine and I were having a discussion and he asked me what I was doing. This guy is a skinny guy who runs 6 miles 2 or 3 times a week and has competed in Tough Mudder several times. He’s recently put on some weight and wanted to know what I was doing. I shared my story and what I’d learned about cholesterol. His cholesterol is at 250 and his doctor wants to put him on statins. I told him to never go to that doctor again and sent him several links, including some videos on YouTube from Fat Head the Movie. I couldn’t believe a doctor actually wanted to put this guy on statins!
Look forward to your book — thanks for everything you do.
Thank you, Matt. I’m looking forward to seeing the book too. Chareva is still drawing some of the characters, and I’m lovin’ what she’s doing with them.
Folks, notice Matt and his wife have kept losing weight, but haven’t been at 20 carbs for months on end. Some days it’s 25, other days they go up to 100. Exactly the point I was making in my previous couple of posts. It’s not necessary to aim for never-ending ketosis to lose weight and become healthy.
A five-year follow up on the whole family
My name is Lorraine and I wrote to you once in September 2011. It has been almost 5 years and I feel obligated to thank you again for the changes you have instilled in my life and also the people I love.
A few months after writing you, I did achieve my goal weight. I have been able to maintain my weight (between 125-130 pounds) effortlessly. Re-reading that post has reminded me of how dire my life was at 25. I was so very depressed and unhealthy, and I’ve nearly forgotten that dark time. I am now 30 years old and things have changed.
After my depression, I started to enjoy all the old things I used to love, like reading, video games, and social events. I also found new hobbies including biking, sprinting, weight training, and hiking. I started living again. I have completed graduate school. I am a physician assistant practicing for almost two years in an emergency department in a busy city hospital. I am also engaged to be married this coming fall. However, this e-mail isn’t really about me. It is more about those around me you have changed after I wrote that e-mail.
My father at the time was over 50 pounds overweight. He was pre-diabetic and had an awful lipid profile. Deep down, I knew he was teetering on the edge of full-blown heart disease. The odds were against him. After my success, he wanted to know what he was doing wrong. He was constantly dieting and failing. I had him watch your documentary. He found you amusing, but he was very doubtful.
He felt hopeless so he gave it a shot. In his 50s, he lost all the weight in only a few months. He began weight training, and as a 59-year-old man continues to weight train 3-4 times a week. He is no longer pre-diabetic and his lipid profile is as his doctor described “that of a 20 year old.” He too has been able to maintain his weight with ease. Because of your documentary, he was able to see the birth of his granddaughter (my niece) and he will be able to see my upcoming wedding. I honestly can say that I don’t know if that would have been possible at the rate he was going.
I met my fiance, a nurse, a little over 2 years ago. He is a type 1 diabetic. He had a hard time controlling his blood sugars so his A1C was never ideal. On his own accord, he started following a low-carb lifestyle. Moving downstate to be closer to me, he found a new endocrinologist. When he told his endocrinologist what he had changed, she gleamed. She and her husband (another doctor) follow a paleo lifestyle. A huge proponent of low-carb lifestyles, she recommends it to everyone, including all her diabetic patients. His A1C is now in an ideal range and his sugars remain controlled throughout the day. He no longer has bad highs, or even worse, bad lows. Also, the amount of insulin he administers daily has dramatically decreased by nearly 25-50%.
My sister was a few pounds overweight when she became pregnant. She was terrified of possibly gaining too much weight during pregnancy as many of her friends have done. She was fearful of conditions like gestational diabetes and preeclampsia. She decided to start following a low-carb lifestyle as well. I gave her recipes, meal plans, and healthy snacking ideas. She was able to maintain a healthy weight throughout her pregnancy and gave birth to a healthy, 7-pound baby girl.
There are others you also helped including my mother, my mother-in-law, many coworkers, many friends, and even my future family. Proponents of the low-carb lifestyle, like you, are a catalyst to creating future healthier generations. Keep up the amazing work.
A million thanks,
A million thanks you to, Lorraine, for letting me know how much you and your loved ones have improved your health. I wish you and your fiance a lovely wedding and a wonderful life together.
24 Comments »
A few random thoughts that occurred to me after my previous post on the “alternative hypothesis”:
1. Too many carbs as an explanation for the rise in obesity and diabetes is still largely correct.
If we were Kitavans and got our carbs from sweet potatoes and other unprocessed foods, maybe the increase in carb intake since the 1970s wouldn’t have been such a problem. But we’re westerners, and a disproportionate share of our carbs come from processed grains. They spike blood sugar (which probably leads to insulin resistance over time) and they provoke inflammation (which probably leads to insulin resistance over time).
In Denise Minger’s book Death by Food Pyramid, she recounts the story of Luise Light, a government scientist who was given the task of writing new nutrition guidelines in the 1970s.
Unlike previous food guides, Light’s version cracked down ruthlessly on empty calories and health-depleting junk food. The new guide’s base was a safari through the produce department – five to nine servings of fresh fruits and vegetables each day. “Protein foods” like meats, eggs, nuts and beans came in at five to seven ounces daily; for dairy, two to three servings were advised.
The guide kept sugar well below 10 percent of total calories and strictly limited refined carbohydrates, with white-flour products like crackers, bagels, and bread rolls shoved into the guide’s no-bueno zone alongside candy and junk food. And the kicker: grains were pruned down to a maximum of two to three servings per day, always in whole form.
The USDA, of course, took her guidelines and mutated them into a pyramid that suggested 6 to 11 servings per day of grains. Light later commented that “no one needs that much bread and cereal in a day unless they are longshoremen or football players” and warned that the six-to-eleven servings of grain per day could spark epidemics of obesity and diabetes.
And so they did. We can blame it on hormonal disruption instead of too much insulin per se, and we can argue about whether or not eating more sweet potatoes and green bananas would have been good or bad. But we were told to eat more breads and cereals, and those foods are a big part of the problem
2. Many of the people currently beating up on Atkins, Taubes, etc., owe them a huge thanks, whether they’ll admit it or not.
Yeah, you can say it’s not all about the carbs. You can say it’s not about the temporary insulin spike after a meal. You can say it’s more about food quality than macronutrients. Heck, I’ll even agree with you. But I suspect if there were no Dr. Atkins and no Good Calories, Bad Calories, a lot of current whole-foodies and paleo types who slam low-carb diets would still be afraid of saturated fats and cholesterol and trying to live on low-fat diets.
Honestly, how many of you out there were aware of all the bad nutrition “science” before Taubes starting writing about it? I certainly wasn’t. When I worked for a small health magazine in the 1980s, I quoted the USDA and the American Heart Association as reliable sources in my articles – because I assumed they were reliable sources.
3. Mixing it up is probably the way to go.
Based on glowing reviews from readers, I recently read three books by Nassim Nicholas Taleb. Great reads, all three of them. In Antifragile, he makes the point that biological systems are often made stronger by doses of randomness. If you do the same repetitive motion every day, you’ll likely injure yourself. But if you lift weights now and then – a random stressor – you get stronger. Taleb eats meat, but goes vegan for several days now and then. He fasts now and then. I recently heard legendary strength coach Charles Poliquin say (on a Tim Ferriss podcast) that he loves nuts, but he’s careful not to eat the same ones day in and day out. The reason? You can develop an intolerance if you eat the same foods over and over. You need to mix it up.
So I like the approach Rob Faigin suggests in Natural Hormone Enhancement: eat a low-carb/high-fat diet for a few days to promote weight loss, then mix in a day with higher carbs and lower fat. Or maybe a few days now and then.
Tim “Tatertot” Steele wrote an interesting book called The Potato Hack. The “hack” is eating nothing but potatoes for a period of several days. Salt and liquids like vinegar or chicken broth are allowed for flavor, but no fat. Some people have reported losing a pound per day on the diet. I tried it for three days in May and lost … nothing. No change. But the interesting part is that my blood sugar didn’t go through the roof like I feared it might. I usually peaked at around 140 briefly, then dropped well below 100 by an hour after eating. I boiled the potatoes and let them cool in the fridge overnight before reheating them for meals, so perhaps the resistant starch helped keep the glucose level down.
Kudos to Tim, by the way, for not letting his enthusiasm for the potato hack blind him to the danger for diabetics. He tells readers trying the diet for the first time that they absolutely must check their glucose response. He shows what normal responses should look like. He also shows what a diabetic response would look like and says “If your numbers look like this, DON’T DO THIS DIET. You are a diabetic and need to see a doctor.”
Anyway, if you decide to try Faigin’s mix-it-up approach, Steele’s potato-hack meals fit the “higher carb, low-fat day” prescription.
4. Never-ending low-carbing can cause problems for some people, but that doesn’t mean everyone should carb up.
Like I said in my previous post, I would never tell type II diabetics to run out and eat potatoes just because they seem to benefit me. We’re all different. Jimmy Moore interviewed Chris Kresser about diet and thyroid back in 2012, and Kresser made exactly that point. Some people go VLC and they’re fine. They feel great. They don’t develop thyroid issues. But some people do. They stop converting as much T4 (the inactive thyroid hormone) to T3 (the active hormone) and their metabolisms slow down. They’re surprised when Kresser has them eat more carbs and they begin losing weight again.
Too little glucose in the diet can clearly cause problems for some people, but so can too much glucose. In my previous post, I linked to a study demonstrating that going VLC can cause some men to produce less testosterone – not a happy result if you want more muscle and less fat on your body. But I should mention that other studies demonstrate that too much glucose in the system also reduces testosterone.
Here’s the conclusion from one study:
Glucose ingestion induces a significant reduction in total and free T levels in men, which is similar across the spectrum of glucose tolerance.
And from another study:
Oral glucose administration acutely lowers LH and total T concentrations by suppressing pulsatile LH secretion and basal T secretion commensurately.
Too little glucose, your testosterone drops. Too much glucose, your testosterone drops. Paul Jaminet got it right. There’s an ideal range for glucose. For most of us, it’s not zero … but it’s also nothing close to 300 grams per day.
While digging those studies out of my database, I also came across two that demonstrate the importance of the right fats. Here’s the conclusion from this study:
Our results indicate that in men a decrease in dietary fat content and an increase in the degree of unsaturation of fatty acids reduces the serum concentrations of androstenedione, testosterone and free testosterone.
And from this study:
Production rates for T showed a downward trend while on low-fat diet modulation. We conclude that reduction in dietary fat intake (and increase in fiber) results in 12% consistent lowering of circulating androgen levels.
Studies have shown that men today have lower average testosterone levels than men in previous generations. We’ve been jacking up our glucose levels with junk carbs and eating less saturated fat since the 1970s. Could be a coincidence, but I doubt it.
So regardless of whether you stick with VLC or decide to mix it up with higher-carb days, here’s the take-home message for guys: skip the cereals and eat your damned bacon and eggs.
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