Archive for the “Good Science” Category

In my previous From The News post, I mentioned that the definition of “high” blood pressure will soon be lowered from 140/90 to 130/80. (The systolic, or top number, is when your heart is contracting. The diastolic, or lower number, is when your heart is between beats.) I also said I believe the redefinition is likely driven by a desire to sell more drugs.

A couple of you commented that the drugs might be necessary. Okay, maybe that’s true for some people. I’ve never had high blood pressure, so I’ve had the luxury of not being personally concerned with the subject. Nonetheless, I thought I’d dig through my database of articles and studies to explain why I’m not convinced that most people diagnosed with “high” blood pressure need drugs.

The best way to treat a health problem is to treat the root cause, not the downstream effect. So what causes high blood pressure? Many of the so-called experts still insist the problem is sodium. (They’re generally the same so-called experts who insist saturated fat causes heart disease.)

Dr. Frank Sucks … er, Sacks – the same researcher who wrote the American Heart Association’s we were right all along about saturated fat! presidential advisory report – has been a long-time champion of low-salt diets. He believes he proved lowering salt will save our hearts with his famous DASH trial. Here’s what his Harvard profile says about it:

These multi-center National Heart Lung and Blood Institute trials found major beneficial additive effects of low salt and a dietary pattern rich in fruits and vegetables on blood pressure.

Actually, that’s not what the DASH trial showed at all. You have to read the study carefully (and I have) to get the true picture, but here’s the brief summary: Sacks put people on either a standard American diet that included plenty of sugar and other junk, or on a low-fat DASH diet that included no sugar and no junk. Then he had them consume versions of those two diets that were high in salt, medium in salt, or very low in salt.

In order to claim he’d proved restricting salt is beneficial, Sucks had to compare the blood-pressure differences between people on the high-salt/junk diet and people on the low-salt/DASH diet. That’s akin to comparing people on a high-salt/high-whiskey diet to people on a low-salt/high-water diet, then declaring that restricting salt prevents liver damage.

Within each diet group – junk food vs. DASH – restricting salt by a whopping 75% only produced a blood-pressure drop of about three points. Whoopee.

Other researchers have found similar results (and unlike Dr. Sucks, reported them honestly). Here are some quotes from a 1998 meta-analysis titled Effects of Sodium Restriction on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterols, and Triglyceride:

In 58 trials of hypertensive persons, the effect of reduced sodium intake on systolic blood pressure was 3.9 mm Hg, and on diastolic blood pressure was 1.9 mm. In 56 trials of normotensive persons, the effect of reduced sodium intake on systolic blood pressure was 1.2 mm Hg.

Once again, restricting sodium produced a teeny drop of a few points.

These results do not support a general recommendation to reduce sodium intake.

Gee, do ya think?

Here are some quotes from a 2008 E Science News article:

Contrary to long-held assumptions, high-salt diets may not increase the risk of death, according to investigators from the Albert Einstein College of Medicine of Yeshiva University.

They reached their conclusion after examining dietary intake among a nationally representative sample of adults in the U.S. The Einstein researchers actually observed a significantly increased risk of death from cardiovascular disease (CVD) associated with lower sodium diets.

“Our findings suggest that for the general adult population, higher sodium is very unlikely to be independently associated with higher risk of death from CVD or all other causes of death,” says Dr. Hillel W. Cohen, lead author of the study and associate professor of epidemiology and population health at Einstein.

And here are some quotes from a Food Navigator article about a Cochrane review of sodium-restriction studies:

The authors, led by Professor Rod Taylor from Peninsula College of Medicine and Dentistry in the UK, found no strong evidence to support the idea that salt reduction reduces cardiovascular disease or all-cause mortality in people with normal or raised blood pressure.

People with normal or raised blood pressure at baseline showed no strong evidence of benefit from salt intake restriction. Salt restriction did, however, increase the risk of death from all causes in those with congestive heart failure, reported the authors.

I found that article amusing because it provided a perfect example of The Anointed in action. The researchers concluded that given the results, we need to conduct more research before governments jump in to set lower targets for salt intake.

But as we know, The Anointed don’t believe they should be bothered with providing evidence before instituting a Grand Plan. So here’s how a spokesperson for a U.K. organization calling itself the Consensus Action on Salt and Health replied to the Cochrane review:

Campaign director Katharine Jenner told FoodNavigator that it is “very disappointing” to see the message from the review indicates that salt reduction may not be beneficial.

“This is a completely inappropriate conclusion, given the strong evidence and the overwhelming public health consensus that salt raises blood pressure which leads to cardiovascular disease,” said Jenner.

Whenever you hear The Anointed insist that by gosh, there’s a consensus and therefore the debate is over, you know they’re peddling junk science they don’t want examined.

Jenner told FoodNavigator that “there is no sense in waiting for further trials before progressing with an international salt reduction programme, which will immediately save many thousands of lives.”

Of course not. Because when The Anointed devise a Grand Plan, it must always be implemented RIGHT NOW or people will die … and it will be your fault for insisting on evidence before proceeding.

Salt restriction is the standard dietary advice, but it doesn’t do much. So after concluding that your low-salt diet just isn’t working for some reason, your doctor will reach for the prescription pad. The drugs do lower blood pressure. But do they save lives?

That’s where it gets a bit murky. In Doctoring Data, Dr. Malcolm Kendrick stated that there’s no convincing clinical evidence that blood-pressure medications reduce mortality for most people with “high” blood pressure.

Here are some quotes from an article on the Whitaker Wellness Institute website:

Another hypertension myth is that it is a silent killer that sets us up for strokes and heart attacks and knocks about five years off life expectancy. Although this is true for patients who have very high blood pressure and/or existing cardiovascular disease, diabetes, or kidney disease, the picture is considerably different for mild hypertension, which is defined under current guidelines as 140-159/90-99.

Scientific data published in top medical journals over the past few years makes it clear that mild hypertension does not confer these risks. For example, reevaluation of data from the renowned Framingham Heart Study shows that deaths related to hypertension barely budge until systolic blood pressure reaches 175 and mortality rates climb significantly only above 185. In other words, malignant hypertension is a killer. Uncomplicated mild hypertension is not.

Sixty percent of hypertensive Americans fall into the mild category. Nevertheless, more than half of them are treated with medications. And that’s the real tragedy.

There is no convincing scientific evidence that treating basically healthy patients with mild hypertension provides any benefits. In a groundbreaking recent study, researchers reviewed all the clinical trials in the medical literature comparing drug treatment of mild hypertension with placebo or no treatment. They found no differences in heart attacks, strokes, and deaths between treated and untreated individuals. But they did find that the drugs caused a lot of misery.

Maybe the drugs provide life-extending benefits for people with very high blood pressure. For people merely in the “high” range of 140 to 159, I’m not convinced. It seems the drugs merely treat a symptom.

As I said earlier, the best option is to treat the root cause. Several studies have hinted at the root cause, or at least one of them. Here are some quotes from a 2010 WebMD article:

A new study shows that a low-carbohydrate diet was equally good as the weight loss drug orlistat (the active ingredient in Alli and Xenical) at helping overweight and obese people lose weight, but people who followed the low-carb diet also experienced a healthy drop in their blood pressure levels.

“I expected the weight loss to be considerable with both therapies but we were surprised to see blood pressure improve so much more with the low-carbohydrate diet than with orlistat,” researcher William S. Yancy, Jr., MD, an associate professor of medicine at Duke University Medical Center, says in a news release. “If people have high blood pressure and a weight problem, a low-carbohydrate diet might be a better option than a weight loss medication.”

In the study, published in the Archives of Internal Medicine, 146 obese or overweight adults were randomly divided into two groups. Many of the participants also had chronic health problems, such as high blood pressure or diabetes.

The first group was advised to follow a low-carbohydrate, ketogenic diet consisting of less than 20 grams of carbohydrates per day, and the second group received the weight loss drug orlistat three times a day, plus counseling in following a low-fat diet (less than 30% of daily calories from fat) at group meetings over 48 weeks.

The results showed weight loss was similar in the two groups. The low-carb diet group lost an average of 9.5% of their body weight and the orlistat group lost an average of 8.5%. Both weight loss methods were also not significantly different at improving cholesterol and glucose levels.

But when researchers looked at changes in blood pressure, they found nearly half of those who followed the low-carbohydrate group had their blood pressure medication decreased or discontinued during the study, compared to only 21% of those in the orlistat group.

Plenty of doctors who prescribe low-carb diets have said the same thing: many of their patients end up ditching the blood-pressure medication. In fact, if the patients combine a low-carb diet with the medication, they can actually become dizzy from low blood pressure.

A study published waaaay back in 1985 suggests why a low-carb diet can lower blood pressure:

Both systolic and diastolic blood pressure were found to be significantly related to fasting serum insulin level even when age, weight, and serum glucose level were controlled. The relation between serum insulin and blood pressure was more pronounced in those women with a family history of hypertension. These data indicate that insulin may play a major role in the regulation of blood pressure in obesity and that the previously accepted relation of weight to blood pressure may depend on blood levels of insulin.

So there you go. High blood pressure, like so many other aspects of metabolic syndrome, is apparently driven by chronically high insulin. It’s the high insulin that needs fixing, not the symptoms it produces.

The Whitaker Wellness article provides some practical advice as well:

We would all be better served by shifting the focus to safe, natural, proven therapies that not only lower blood pressure but, unlike antihypertensive drugs, also improve multiple aspects of health.

Regular aerobic and resistance exercise, which reduces systolic blood pressure as effectively as many medications, rejuvenates every system in your body. Losing as little as 10 pounds or 5 percent of your total weight provides significant all-around benefits. Relaxation techniques, meditation, yoga, acupuncture, and neurofeedback reduce stress’s adverse effects on blood pressure, health, and quality of life.

Cutting out high-glycemic sugars and starches lowers blood sugar, lipids, insulin resistance, and other aspects of metabolic syndrome as well as helping to lower blood pressure. Beets, leafy greens, and other nitrate-rich foods boost synthesis of nitric oxide (NO), which dilates and protects the arteries.

Magnesium has powerful effects on blood pressure because it relaxes and reduces pressure on the arteries; that 75-80 percent of Americans fail to get the RDA of magnesium is a likely contributor to our high rates of hypertension. Coenzyme Q10 has positive effects on blood pressure and the entire cardiovascular system.

Cut the refined carbs, eat some leafy greens, get some exercise, and supplement your diet with magnesium and CoQ10. Sounds a lot better than taking medications if you ask me.

Share

Comments 45 Comments »

When I switched to a low-carb diet some years ago, weight loss was only one of the benefits. My arthritis went away, as did restless legs at night, frequent belly aches, psoriasis on the back of my head, and occasional bouts of mild asthma (“mild” because I would wheeze when breathing, but never needed an inhaler).

I also seemed to gain a stronger resistance to colds, flu and sinus infections. When it seems everyone around me at the office is coming down with a nasty cold, I usually don’t have any symptoms at all. Or perhaps I’ll feel tired for a day or two with a bit of a drippy nose, and then it’s over.

One explanation that I read some years ago (sorry, don’t remember where) is that glucose and vitamin C compete for the same cell receptors – and glucose wins. So when blood glucose is elevated, vitamin C doesn’t get into the cells to do its job.

Okay, that makes sense. But I recently read another explanation that also makes sense and is backed up by at least one small but interesting study.

I came across the study while reading an article a reader sent on why the notion that we need five servings of fruits and vegetables per day to be healthy is nonsense. I don’t agree with the conclusion that we only need meat and fish to healthy, by the way. Perhaps that’s true if you’re eating wild-caught fish and caribou who feasted on nutrient-dense wild plants, but unless you live off the land in Alaska, that’s not your meat-and-fish diet. I do agree with the article’s conclusion that the five-per-day rule is arbitrary and encourages some people to consume too much sugar in the form of fruit.

Anyway, the article mentions a study in which researchers measured how efficiently the subjects’ white blood cells were at destroying bacteria and other microorganisms. They measured after fasting (which, interestingly enough, increased the kill-the-bugs efficiency), then measured again at several intervals after having the subjects consume 100 grams of various types of carbohydrates.

All the carbohydrate loads reduced the ability to destroy microorganisms. And in all cases, it took more than five hours for the blood to regain its normal bug-killing efficiency. But what’s interesting is how much the reduction varied. Here’s how much what the researchers call the phagocytic index (think of it as bug-killing ability) declined for the different types of carbohydrate:

Fructose – 45.1%
Sucrose – 44%
Orange Juice – 42.1%
Glucose – 40.5%
Honey – 39%
Starch – 13.4%

Starch clearly doesn’t reduce bug-killing ability to the same degree as simple carbohydrates. In fact, the researches stated that “Starch ingestion did not have this effect” … but there was an effect, so perhaps they meant that given the small number of subjects, it wasn’t statistically significant.

But wait … isn’t starch just glucose molecules bound together? Why yes, it is. But when you eat whole-food starches, it takes time for your body to break them down. You don’t get the same spike in glucose that you’d get from pure glucose or refined carbohydrates that turn to glucose almost instantly.

Most people also don’t pig out on whole-food starches like they do processed carbohydrates. My (ahem) “healthy” breakfast used to be a cup of Grape Nuts and a glass of orange juice. (The official serving size for Grape Nuts is half a cup. Good luck feeling full on that.) Assuming the orange juice was 6 ounces, that’s just over 100 grams of sugar and processed carbs – in other words, the carb load that would reduce my bug-killing ability by 40% or more, according to the study.

By contrast, a small potato (which I sometimes include as part of my sausage-and-egg breakfast) contains about 25 grams of unprocessed starch. Assuming the relationship between carb load and the phagocytic index is linear, that might reduce my bug-killing ability by 3.35%. Since I believe there are benefits from eating small servings of whole-food starches (feeding the gut bacteria, to name one), I’m fine with that.

When you think about the standard American diet, it’s no wonder people are so susceptible to colds and other infections. If the study is correct, we can pretty much guess what happens when people consume 100 or more grams of simple carbohydrates at, say, 8:00 AM, 1:00 PM, 6:00 PM and again at 10:00 PM for that late-night snack. They’d only be at full bug-killing capacity for five hours out of every 24.

According to the CDC, cold and flu season peaks in the months December through February. I don’t know if the viruses and bacteria are actually more prevalent during those months, or if it simply means more people succumb. Either way, I believe the holidays, with all that sugar and white four being snarfed up in the form of holiday treats, are at least a contributing factor. We lower our immune system’s capacity to fight infections while simultaneously attending gatherings full of people carrying the viruses and bacteria.

I usually cheat on Thanksgiving and enjoy some pumpkin pie, stuffing with the turkey, etc. Not this year. I’ve learned from past experience that if I’ve got any kind of inflammation going, wheat makes it far worse.

I have good days and bad days with the shoulder. On good days, it’s a mild ache. On bad days, it throbs and I reach for the painkiller.  I’ve only had one bad day in the last four, and I’d like to keep it that way.  Stuffing and pumpkin pie aren’t worth the pain, so I’ll skip them. I sure as heck don’t want a cold or flu to add to the discomfort.

Whether you cheat or not, I hope you enjoy your Thanksgiving. And to our non-American readers, I hope you have a good Thursday.

Share

Comments 55 Comments »

Chareva’s parents, Alan and Nancy Smiley, sold their Chicago-area home last month and have moved in with us temporarily, along with her brother and sister-in-law. They’re looking around Franklin now for a new home. For those of you who asked in comments, yes, Alan is the one who built a train line around his property some years ago. That’s one of the things I always liked about the man: his go-go-go, get-things-done drive. That drive is the reason he was able to buy a luxury home in the same neighborhood as mobsters and movie directors at an age when most young husbands are saving for a starter home.

Unfortunately, Alan had a significant stroke in April. As a result, he can no longer move his left arm. He can walk, but has to shuffle along with a cane because he can barely lift his left leg. He’s been plagued by insomnia since the stroke and has occasional hand tremors. The doctors who treated him in Chicago said he might have Parkinson’s.

I’d hate to see this happen to anyone. I especially hate to see it happen to the bundle-of-energy guy who barely left the dance floor at our wedding reception and exhausted several dance partners who were considerably younger.  Some people are happy to retire to an easy chair.  Alan would have preferred to retire to a workshop and a string of projects that require expertise with tools.

Alan’s cousin, a neurologist with more than 30 years in the field, offered to drive down from Kentucky last weekend for a visit and a consultation. I was upstairs working on a programming project when Chareva’s mom told me the conversation was turning to nutrition, and Alan thought I might want to listen in. Nutrition? Well, of course I wanted to listen in.

On my way downstairs, I hoped I wasn’t going to hear the standard-issue advice about avoiding fat and eating those hearthealthywholegrains. I promised I’d bite my tongue if need be. After all, Dr. Mike Mayron, the neurologist, made the trip from Kentucky out of the goodness of his heart.

Imagine my relief when Dr. Mayron began by telling Alan that sugars and grains are bad for the brain. We weren’t programmed by evolution to deal with the high levels of glucose those foods produce, he said. We’re programmed to thrive on a diet in which fat is our primary fuel. The best diet to help heal your brain and give it the fuel it needs is a ketogenic diet.

Dr. Mayron explained that he prescribes a ketogenic diet as part of the therapy for a number of brain conditions, then added, “There’s a book I want you to read. I recommend it to all the patients I put on a ketogenic diet, because it was written by a layman and it’s easy to understand. It’s called—“

Holy @#$%, I bet he’s about to say “Keto Clarity.”

“—Keto Clarity, by Jimmy Moore.”

“I’ve got a copy upstairs, Doctor.”

“Oh, good!”

“Actually, Jimmy and I good friends.”

“You’re friends with Jimmy Moore? Seriously?”

“Yeah, in fact he and his wife will be visiting us for Thanksgiving. They were here last Thanksgiving too.”

“Wow. Well, be sure tell him I said thank-you for writing a book that’s helped a lot of people.”

“I will. Actually, hang on, I have a better idea. You can tell him.”

I went and grabbed my iPhone, dialing up Jimmy on FaceTime as I returned to the room. When Jimmy’s face appeared onscreen, I told him I was with a neurologist who wanted to thank him for his work. I handed the phone to Dr. Mayron, and the two of them had a nice chat.

Jimmy then mentioned that he was in Australia to give a speech, and it was 1:00 AM. He should probably try to go back to sleep. Oops. Sorry, Jimmy. It’s a credit to your character that you answered the call cheerfully instead of denigrating my manhood and/or place in the food chain.

After the call with Jimmy, Dr. Mayron continued explaining the many reasons Alan should be on a ketogenic diet, both as a stroke survivor and a type II diabetic. He explained that it normally takes a few weeks to make the adjustment, but there are drink mixes available now that help boost ketones right away. One of them, this one, was originally developed for Navy Seals. Apparently the military figured out Seals have more endurance and focus during long missions if they’re in ketosis.

I was, of course, delighted that Alan was hearing all this from a neurologist. I want him to control his diabetes and be as healthy as he can for as long as he can. After all, he just moved to the same town as the daughter and granddaughters who love him.  We’d all like for him to stick around for awhile.

But I was also delighted to see another example of how more and more doctors are catching on. I didn’t know Dr. Mayron before this weekend. He didn’t know I produced a movie called Fat Head. In fact, as he was assuring Alan that a ketogenic diet doesn’t have to be boring, he said he makes a low-carb pizza crust that taste just like real pizza crust. As he described the ingredients, I asked, “When you found that recipe online, was it by any chance called Fat Head Pizza?”

“As a matter of fact, yes, I’m pretty sure it was.”

“I’m Fat Head.”

I tried not to sound like Michael Keaton saying “I’m Batman.” I also felt obligated to explain that people call it Fat Head Pizza even though all I did was post a recipe my nephew found elsewhere online.

Anyway, my point (and I do have one) is that once again, I saw the Wisdom of Crowds effect at work. I can guarantee you that when Dr. Mayron was in medical school, he wasn’t taught about ketogenic diets as a therapy for brain issues. But thanks to the internet and the astounding ability we all have to acquire and share information, he’s quite familiar with the benefits of a ketogenic diet now. (He lost a lot of weight after going ketogenic himself.) The information gatekeepers don’t control the gates anymore, because the gates are gone. The overlords at the USDA have lost their grip on the conversation about diet and health.

Now when a neurologist wants to educate patients about a good-for-the-brain diet, he recommends a book by a blogger named Jimmy Moore.

And I believe there’s a good chance you’ll hear from Dr. Mayron on a future episode of Jimmy’s podcast show.  Let’s keep that Wisdom of Crowds effect growing.

Share

Comments 67 Comments »

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:

Patient One

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; [5] 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.

Share

Comments 75 Comments »

Someone in comments linked to a study that reminded me of another study that demonstrated why body composition isn’t just about calories. Actually, both studies demonstrated why body composition isn’t just about calories.

First, the study linked in comments, which was reported in Science Daily:

Researchers at McMaster University have uncovered significant new evidence in the quest for the elusive goal of gaining muscle and losing fat, an oft-debated problem for those trying to manage their weight, control their calories and balance their protein consumption.

Scientists have found that it is possible to achieve both, and quickly, but it isn’t easy.

The reader who linked to the study did so because a gym rat once insisted that I had NOT (despite what I might think) lost fat and gained muscle at the same time. I posted about my exchanges with the gym rat more than three years ago. I nicknamed him “Cliffy” because his (ahem) “expert” arguments reminded me of the character from Cheers. In fact, Cliffy and I first had a go-around about why kids get fat, which I recounted in a different post.

Anywhere, here’s part of the post where I recounted Cliffy’s theories about changing body composition:

Cliffy also insisted I did not (contrary to what my mirror and scale were telling me) become both leaner and more muscular after I tightened up my diet and switched to Fred Hahn’s Slow Burn workout method. Cliffy explained that it’s physiologically impossible to gain muscle mass while losing fat mass, and in fact pretty much everyone who loses weight loses some muscle mass. He knew this because some body-building guru he worships said as much.

I tried telling him that I did indeed put on muscle even while losing weight, that my arms and chest and thighs had become noticeably thicker while my waist shrank, but Cliffy explained that I’m an idiot (and a fat, lazy old man) and only thought I’d gained muscle because the weight loss gave me more definition.

So I looked up a clinical study in which women lost body fat while gaining muscle mass and posted the reference. Cliffy read the study and replied that it’s sometimes possible for people who’ve never worked out and are therefore “untrained” to gain muscle while losing weight, but not for anyone who’s been regularly lifting weights – which I had been. When I asked how being “untrained” makes the physiologically impossible become possible, he explained that I’m an idiot (and a fat, lazy old man) and must not have been “trained” even though I’d been lifting weights regularly before switching to Slow Burn.

It is, in fact, possible to lose fat and gain muscle during the same time span, as the study in Science Daily demonstrated:

For the study, 40 young men underwent a month of hard exercise while cutting dietary energy they would normally require by 40 per cent of what they would normally require.

The researchers divided their subjects into two groups. Both groups went on a low calorie diet, one with higher levels of protein than the other. The higher-protein group experienced muscle gains — about 2.5 pounds — despite consuming insufficient energy, while the lower protein group did not add muscle.

Researchers were intrigued because the high-protein group also lost more body fat.

The high-protein group lost 10.5 pounds on average in four weeks, while the lower-protein group only lost eight. The high-protein also gained 2.5 pounds of muscle on average, while the lower-protein group merely maintained their muscle. So the additional fat loss in the high-protein group was more like five pounds.

I’m not suggesting we all run out and undergo the diet-and-exercise regimen these young men did – after all, even one of the researchers described the regimen as “grueling.” But there are a couple of important lessons in there even for those of us who adopt less-than-grueling routines.

One is that lifting weights is a excellent idea if you’re attempting to lose weight. Despite drastically cutting calories and losing weight quickly, both groups at least maintained their muscle mass.

The other lesson is that protein matters. The only difference between the two groups was the proportion of protein in the diet. The high-protein guys put on more muscle and lost more body fat. That’s why, as I explained in a previous post, I choose a high-protein diet over a ketogenic diet. I can’t stay in ketosis unless I restrict my protein to something like 50 grams per day. I believe I’m better off going high-protein.

The second study (the one the first study reminded me of) was one I first read about in the excellent book The poor, misunderstood calorie by Dr. Bill Lagakos.

Dr. Lagakos recounted a study in which adults who were deficient in growth hormone were divided into a treatment group and a control group. The treatment group was given growth hormone. There was no other intervention for either group.

After three-and-a-half years, body weight hadn’t changed significantly in either group. But the people treated with growth hormone gained 12 pounds of muscle and lost 12 pounds of fat on average. That’s a lot of additional muscle.  If you don’t believe me, go buy 12 pounds of lean beef and stare at it for a moment.

So once again, we see that it’s possible to gain muscle while losing fat – this time because of a change in hormones. As Dr. Lagakos wrote:

They gained muscle and lost fat without a change in energy balance … this demonstrates that a particular hormonal milieu, in this case elevated growth hormone, is capable of regulating fat mass independent of energy balance.

That’s why it isn’t just about calories. Hormones tell your body what to do with those calories.

Every time you eat, you trigger the release of hormones. What you eat determines which hormones are released. Anyone who believes 500 calories of bread and 500 calories of beef produce the same hormonal response is simply ignorant.

You can probably guess which 500 calories I’d choose. And that’s why, despite what Cliffy insisted, I lost weight while putting on muscle.

Share

Comments 77 Comments »

A dietary shift is definitely happening. Here’s how I know that for sure:

The big-money bankers are on board.

In case you didn’t see it in the comments section of my most recent post, Credit Suisse just published an 84-page report titled Fat: The New Health Paradigm. I skimmed it and was impressed, but my initial response was why is a bank publishing this?

The answer (echoed by a handful of readers) is that Credit Suisse is an investment bank, and their reports are intended to inform investors of economic trends. If there’s a big movement among consumers to embrace natural fats and cut back on grains and vegetable oils, that will of course have an economic impact. Probably not a good time to invest in General Mills.

Two of the bullet points from the document’s summary section make that clear:

  • What is the outlook? Globally, we expect fat to grow from the current 26% of calorie intake to 31% by 2030, with saturated fat growing the fastest and going from 9.4% of total energy intake to 13%. This implies that fat consump¬tion per capita will grow 1.3% a year over the next fifteen years versus a rate of 0.9% over the last fifty years. We expect saturated fat to grow at 2% a year versus a historical rate of 0.6% a year; monounsaturated at 1.3% a year versus 1.0%; polyunsaturated omega-6 to decline 0.2% a year versus a 1.3% past growth rate and polyunsaturated omega-3 to grow at 0.7% a year versus 1.6% a year over the last 50 years.
  • Among foods, the main winners are likely to be eggs, milk and dairy products (cheese, yogurt and butter) and nuts with annual rates of growth around 2.5-4%. The losers are likely to be wheat and maize and to a lesser extent solvent-extracted vegetable oils. Meat consumption per capita should grow at 1.4% a year and fish at 1.6% supported by a fast expanding aquacul¬ture industry.

But there’s waaaaay more to the report than predictions of what consumers will be buying or not buying in the near future. There are explanations of the various types of fats, a history of fat in the human diet, and a history of the anti-fat hysteria that took hold in the 1960s and became official policy in the 1980s. There’s a lovely, concise section that looks at the evidence (more like lack of evidence) that fat causes heart disease and obesity. There’s a similar section on the health effects of red meat. And of course, there are sections on the recent shift in consumer attitudes about fat.

I’m still reading the thing (since I have a full-time job and all that), but here’s a sample of other bullet points from the opening summary:

  • Triangulating several topics such as anthropology, breast feeding, evolution of primates, height trends in the human population, or energy needs of our various vital organs, we have concluded that natural fat consumption is lower than “ideal” and if anything could increase safely well beyond current levels.
  • The 1960s brought a major change in the perception of fat in the world and particularly in the U.S., where saturated fat was blamed for being the main cause behind an epidemic of heart attacks. We will see that it was not saturated fat that caused the epidemic as its consumption declined between 1930 and 1960. Smoking and alcohol were far more likely factors behind the heart attack epidemic.
  • Saturated fat has not been a driver of obesity: fat does not make you fat. At current levels of consumption the most likely culprit behind growing obesity level of the world population is carbohydrates. A second potential factor is solvent-extracted vegetable oils (canola, corn oil, soybean oil, sunflower oil, cottonseed oil). Globally consumption per capita of these oils increased by 214% between 1961 and 2011 and 169% in the U.S. Increased calories intake—if we use the U.S. as an example—played a role, but please note that carbohydrates and vegetable oils accounted for over 90% of the increase in calorie intake in this period.
  • A proper review of the so called “fat paradoxes” (France, Israel and Japan) suggests that saturated fats are actually healthy and omega-6 fats, at current levels of consumption in the developed world, are not necessarily so.
  • Doctors and patients’ focus on “bad” and “good” cholesterol is superficial at best and most likely misleading. The most mentioned factors that doctors use to assess the risk of CVDs—total blood cholesterol (TC) and LDL cholesterol (the “bad” cholesterol)—are poor indicators of CVD risk. In women in particular, TC has zero predictive value if we look at all causes of death. Low blood cholesterol in men could be as bad as very high cholesterol. The best indicators are the size of LDL particles (pattern A or B) and the ratio of TG (triglycerides) to HDL (the “good” cholesterol). A VAP test to check your pattern A/B costs less than $100 in the U.S., yet few know of its existence.
  • Based on medical and our own research we can conclude that the intake of saturated fat (butter, palm and coconut oil and lard) poses no risk to our health and particularly to the heart. In the words of probably the most important epidemiological study published on the subject by Siri-Tarino et al: “There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.” Saturated fat is actually a healthy source of energy and it has a positive effect on the pat¬tern A/B.
  • The main factor behind a high level of saturated fats in our blood is actually carbohydrates, not the amount of saturated fat we eat.

Wow. Great stuff … from a bank.

In case you had any doubts that most doctors don’t keep up with the latest diet and health research, the report includes this finding:

We conducted two proprietary surveys of doctors, nutritionist and consumers to understand better their perception of the issues we mentioned previously. All three groups showed superficial knowledge on the potential benefits or risks of increased fat consumption. Their views are influenced significantly more by public health bodies or by WHO and AHA rather than by medical research. Even on the “easy” topic of cholesterol, 40% of nutritionists and 70% of the general practitioners we surveyed still believe that eating cholesterol-rich foods is bad for your heart.

Go figure. The nutritionists are more likely than doctors to know that cholesterol has been found not guilty of causing heart disease.

In term of macronutrients, 45% of the doctors surveyed said that their perception of protein has improved, versus only 5% saying it has worsened; 29% of the doctors said that their perception of fat has improved versus only 7% saying it has worsened; and 15% only said that their perception of carbohydrates has improved versus 26% saying it has worsened.

Answering what makes you fat if eaten in large quantities, the doctors correctly pointed to sugar and carbohydrates (32% and 26%); fat and saturated fats are not as bad (23% and 16%) and protein collected only 2% of the responses.

However, the doctors believed that the best diet for weight loss is a low calorie one (65%), followed by low carbohydrate (36%) and low fat (7%). Among nutritionists, 42% prefer the low carbohydrate diet, against 30% for the general practice group.

Let’s focus on the positive. Yes, nearly two-thirds of doctors surveyed believe low-calorie diets are best for weight loss, but only 7% recommended a low-fat diet, versus 36% who recommended a low-carb diet. I’d wager a large sum that 15 or 20 years ago, more doctors would have been recommending a low-fat diet than a low-carb diet. It’s progress. And I was pleasantly surprised to see that 42% of the nutritionists recommend a low-carb diet.

I plan to read the entire report when I can. If anything jumps out at me as particularly interesting, I’ll post about it.

In the meantime, I see this report as another sign that the arterycloggingsaturatedfat! paradigm is dying out. The American Heart Association doesn’t want it to happen, The Guy From CSPI doesn’t want it to happen, the USDA Dietary Guidelines Committee doesn’t want it to happen, and countless makers of low-fat and low-cholesterol food-like products don’t want it to happen. But it’s happening.

And you can take that to the bank.

Share

Comments 74 Comments »