Sleep: Get some rays to help you get some Zs

Sunlight, Vitamin D, Melatonin, Serotonin, Cortisol, Lights out

Treating Diabetic Hyperglycemia With, High Carbohydrate? FAIL!

Giving people who can't metabolize carbs more carbs is not such a fantastic idea.

Alzheimer's: Type 3 Diabetes?

How sugar contributes to diseases of the brain.

Fruitology

Is fruit REALLY all that healthy?

Spouse not paleo?

The trials and tribulations of making a lifestyle change with a loved one who's not quite on board.

12.15.2011

Spouse not paleo? Part 2...

This post was originally written in early December, so forgive the tardy posting.  Life, a newborn baby, and a new educational endeavor has gotten in the way of my blogging...


Since 30 weeks pregnant, my wife, Danielle,  was "all in" on the idea of living a Paleo/Ancestral inspired diet, on the condition that she'd do so after the baby was born.  She's making a concerted effort to not consume grains and seed oils, and drastically reduced her carb consumption, specifically sugar.  I'm so very proud of her!


Some background on my Danielle: she's a self-confessed sugar addict, that has emotional ties to food.  Arguably, Ice Cream and Cake are 2 things she loves more than me.  So the fact that she's cut the sweets down to MAYBE once a week is HUGE and I don't want to downplay that.  I also want to give a heads up that I don't want this entry to come off as scathing towards my wife and family.  But the trials and tribulations of trying to transition them to an Ancestral Diet is proving to be a difficult task.

1st, while she's done a great job in cleaning out the cupboards of junk, and NOT purchasing Paleo no-no's, she still feels sliced bread (yeah, paleo no-no #1) is still a must-buy item.  I've tried educating her on this, and while she understands the reasoning and science behind why bread is bad, she insists that "The boys need bread for sandwiches."  So, still there's this idea that without bread, there's nothing to make the boys for lunch.

Cereal and oatmeal are also still considered "must-buy" grocery items in her mind.  "What will we eat for breakfast?  I can't eat eggs and bacon everyday?!"  I think in this case, it helps not to have an idea that certain foods are "breakfast" foods.  Pork chops, chicken, steak, can all be eaten in the morning.  So can (gasp) vegetables for that matter.  Again, the idea of breakfast specific foods is yet another paradigm to overcome as many, if not most cultures don't parse breakfast foods from dinner foods.  Just today, I saw that she had snuck some toast but neglected to clean up the butter knife.  The evidence was there! 


2nd, as the paleo house guru, one must also be patient with those around.  Encourage but don't judge.  Suggest, but don't require.  Cook as much as you can, as often as you can.  Be the example.  They will thank you for it later. (see the follow up post "Spouse not paleo pt. 3 (soon to come)"


It's real for people who eat ancestrally to shake their heads at every whim or cheat a newbie has.  In my case, I had to remind myself that my wife has had 35 years of programming behind her eating habits!  That's hard to break.  Her nutritional paradigms were deeply engrained, and why not?  She was taught how to eat by her parents, also carb-addicts, and educated by a system of nutrion that covets cutting fat and making carbs the staple of one's diet.  Be patient.

Lastly, we've developed this strange habit of her asking me if certain foods are "Okay."  And when I say something's not allowed on the diet, she'll tend to take it as though it's ME keeping her from eating something she's craving. 

You can't be the "Paleo reference manual" in your household.  It's imperative from a psychological standpoint that those you're trying to sway towards this way of eating do some of the legwork as well.  Educate them on the "whys" and not just the "hows".  Encourage them to read as much material as possible.  Doing this will not only ensure a healthier household, but a happier one as well.  If not, you can create a situation where your family will resent you from taking away their ice cream cakes and bagels.  Compliance to the lifestyle change will more probable if you don't go around being the Primal Food Nazi.  Trust me on this one.  


Some early results:
-My wife has already seen pretty dramatic results as she's lost a good deal of the weight she gained during her pregnancy.  She reports not having bounced back as well (weight-wise) with her first two. 
-My step son Stephen (10) has lost a lot of the visceral fat as his waist circumference has diminished by about 50%!  He's also almost off his ADD med Intuniv having been on the lowest dose possible. (Intuniv is a pretty innocuous non-stimulant med, relative to the other stimulant ADD meds) 
-And finally, my father has been taken off his blood pressure meds (lisinopril and HCTZ) as his BP has not only normalized, but is lower than it's ever been!  He's gone down from as high as 155/111 (that's a critical diastolic) to 100/67.  He's often below 100 systolic!  
More updates to follow....  

12.03.2011

Bone Broth Recipe!


Doing some cooking, made a broth that was delicious!


As you all know Bone Broths are a great way to get many nutrients that aren't found in density in many of modern day foods.  Containing high amounts of magnesium and phosphorus, it's also fantastic in righting the ship if one has gut dysbiosis, intestinal permeability, or one of the many gut-brain connected pathologies.  Bone broths are a staple of the GAPS diet protocol.  Plus, they're freaking delicious.  




Directions:

-About 2 lbs of Beef Bones, chop up celery, sea salt (2 table spoons, or to taste) garlic, onions (if you like).  

-Brown beef bones in oven at 350 until browned.  

-Put bones in in crock pot with chopped up ingredients and fill up with filtered water. 

-Cook on high for 2 hours, then set to low for 12 hours (up to 20 hours)

-Strain out ingredients in to large container and place in fridge overnight.
















-Next day fat should have floated to top making it easy to lift off and discard.  

-Tupperware, or ziplock, freeze what you don't use.  

-Note:  don't over-salt, you can always add sea salt when you use the broth later.

-Enjoy good gut health, and scoff at others that think your strange for drinking broth out of a coffee mug.  

-Continue being awesome.

10.27.2011

Pancake recipe ("Safe starch" version, but not orthodox Paleo)

In our household, we used to enjoy pancakes 2-3 times a week.  But since going paleo, aren't able to partake.  This was very sad, particularly for my wife who thinks my pancakes were the absolute best!  So I set out to make a paleo version of my old recipe.

My style of conventional style pancakes are flat, and not fluffy (just a personal choice).  I cook them in bacon grease which crisps up the edges with a slight crunch similar to Johnny Cakes, and let me tell  you...It's awesome.  So the below recipe is a paleo-ized version of that.  Warning, this is a "Safe-starch" version as we do eat some rice.

Ingredients:
1/4 cup Almond Flour
1/2 cup Rice Flour
3/4 cup of coconut milk
1/2 tsp of salt
2 eggs

Mix together dry ingredients, add eggs and stir in coconut milk.

Add less coconut milk for fluffier pancakes, add less for flat pancakes (which we like).

This is best cooked in bacon grease.  Coconut oil or lard can be substituted.

Cook until the edges crisp.  I use a range, typically cook a ton of bacon, and use the left over grease to cook them.

Unlike most paleo pancakes, the rice flour does a good job binding the ingredients, making a solid cake that you don't necessarily have to handle with kid gloves.

Sorry for the poor lighting in the pics:



Add pastured butter or coconut butter, and a small amount of honey if desired.

ENJOY!

-------------------EDIT-----------------

I thought it might be worth noting from a response I gave on Facebook responding to the issue of using Rice. That thread can be found here.
But here's what I wrote:
PS, the other reason to cook the pancakes in copious amounts of bacon grease and then slather them with butter (aside from adding good saturated fats to your diet) is to lower the GI of the glucose from the rice. And the change in GI is significant!
Two great articles on how fat reduces glycemic load:
Go here: http://perfecthealthdiet.com/?p=4937
and here: http://www.gnolls.org/1029/fat-and-glycemic-index-the-myth-of-complex-carbohydrates/

10.26.2011

Product Review: Ultimate Body Press

Ultimate Press Bar:

Winter is coming, and I'm preparing for the cold weather by acquiring more home gym equipment, so that I can do as many crossfit type exercises at home as possible.  Recently, I was introduced to a site called "Bodyrock.tv" by a friend.  Despite the fact that my friend's motives for sending me there was less fitness related and more "Hey dude, check out this hot chick", the site is actually quite good.



The interval workouts are pretty brutal, totally on par with primal blue print and Crossfit type workouts.  The workouts are well thought out, and...well, the results are undeniable. (just look)  

One of the products I found on the site was the "Ultimate Body Press", which could more accurately be described as a very simple dipping station.  However, due to it's simplicity, the Ultimate Body Press is very versatile and all sorts of really good body weight exercises like reverse push ups, L-stands, leg raises.  Its proximity to the floor makes it real easy to scale the exercises to whatever difficulty you desire.  The best aspect of the UBP is that it's weight and portability makes it easy to move to fit your workout area or setup.  Typically, when using a conventional dipping station, one must tailor a given workout to fit the area around the dip bars.   

The product is very solidly built, and will inspire confidence in it's stability and strength the first time you use it.  The assembly is color coded and simple.  I was off doing my first workout within 20 minutes of receiving the package!

Product shots:



Yes, I workout in my kid's play room.
After having had a chance to use the product for a while, I DEFINITELY recommend purchasing it.  The price tag is reasonable, and always having a dip station in your house is priceless.  As an homage to the site that introduced me to this piece of equipment, I decided to forego my usual Crossfit WoD and try another of the Bodyrock.tv workouts.  It was indeed formidable. 

"Set Fire" Workout:


10.08.2011

Sleep: Get some rays to help you get some Zs. (Sunlight, Vitamin D, Melatonin, Lights Out)


If you're reading this blog, chances are you already know much of this, but I'd like to give some thoughts on the issue of sleep-related neurotransmitters, vitamin D, and their effect on sleep- which in turns affects nutrition, health and function.  The key to all of these elements working to successfully facilitate the process of sleep is "synergy."  Exposure to the stimuli that create such synergy is disrupted by things like culture and technology.

Early man (or "Grok") may have been a cave-dweller, but managed to get plenty of sunlight during waking hours.  Typically, Grok would have woken up with early morning "gentle" sunlight, and gone about his day.  Hunting and gathering food (including scavenging) were activities of focus for most early man (as well as modern hunter-gatherers).  Spending hours under the sun garnered large doses of Vitamin D during Grok's quest for food.

Exercise would be a natural component of such activities, as sprinting would be required to hunt game.  Lifting heavy things would be a component of both hunting and gathering as food items (carcass and plant) would need to be hauled back home for preparation and consumption.  Typically, both hunting and gathering required long hours of walking at a slow pace.

At the end of the day, dusk would induce sleep, and Grok would have only the company of his fellow tribesman and perhaps a (low lumen) fire to compete with the urge to sleep.
This was the algorithm by which humans evolved the biological mechanisms for survival.  Understanding this is helpful in explaining why so many people are sleep-deprived today.

Modern man, on the other hand, is obsessed with avoiding sunlight slathering copious amounts of sunscreen on his skin in an effort to avoid getting skin cancer.  Instead of hunting and gathering, we now spend hours under fluorescents in offices or cubicles staring at computer screens and sitting down without any exercise to speak of.  This is, in the literal sense, the exact opposite environment in which we evolved.


Lights out and morning light
Light sensitive hormones and neurotransmitters like serotonin, melatonin, and dopamine, are secreted relative to the rising and setting of the sun.  It's this morning light that sets our clocks to the circadian cycle.  Here's the catch: humans are now constantly bombarded by artificial light throwing off the timing of sleep rhythms.  If you're reading this blog at night, you too are guilty of subjecting yourself to an artificial light source.  Video screens are responsible for disrupting the sleep of millions of people all across the globe.  Don't subject yourself to this!  Staying up later and waking up sooner is the downfall of many.  Turn off the TV, turn off your computer!  Facebook can wait till tomorrow. (preferably when you're at work and able to do it on your boss's dollar)  I can hear my wife now: "Doctor heal thyself!"


Melatonin Supplementation
Now, I ALWAYS recommend natural sources over supplementation!  I want to make that clear.  But in light of a deficiency, people who are deranged in any neurological or metabolic pathway can benefit from short-term supplementation in order to "right the ship," with the end goal being a tapering off of supplements and reliance on natural food or environmental sources.

Melatonin is a neurotransmitter secreted by the pineal gland during the dark hours of night. This, assuming you have not down-regulated your melatonin receptors, should be enough to cause the feeling of sleepiness.  Melatonin acts in synergy (there's that word again) with decreased sunlight to produce the feeling of sleepiness.  However, all that simply means is that one has a propensity to fall asleep at sundown, but doesn't necessarily imply that sleep at sundown will be a guarantee.  I mention this because often I talk to people that try melatonin for a while, and then report back with how unsuccessful the supplements were in helping them sleep.  Such incidents are not surprising in light of the fact that they work in an office all day, don't get any mid-day sun, and then watch TV and hang out in a well-lit room, with all sorts of stimulants and activities during the late evening.  Think of when the sun goes down.  That's when melatonin would naturally start being secreted.  Turn your lights down or off at that time!

Caution: Melatonin is a hormone, and can be every bit as dangerous as many drugs.  It CAN harm you with over dosing, and over using.  As Mark Sisson says in a post here, he's not a fan of taking melatonin on a regular basis, but is okay with using it to "reset" your diurnal clock when traveling.  My take is that if  you're deranged, you need to reset your clock regardless of whether or not you're traveling, and using the supplement once or twice is not going to get the job done in people with impaired sleep cycles.  Use it for 3-5 days max until you're able to get to sleep and then use it only on an "as needed" basis.  Eventually, you want to get to the point to where you use melatonin supplements VERY rarely. (For example, I've used melatonin once this year)  The worry is that down-regulation of receptor sites or reduced secretion of natural melatonin can occur with over-supplementation, and I concur with that angle.


Vitamin D
Vitamin D is a fat-soluble vitamin that is only produced by the body in the presence of sunlight and UV exposure.  There is some controversy as to the efficacy of vitamin D supplementation, with some claiming that supplements are unsafe.  Also, the efficacy of supplemented vitamin D is relative to the fat composition of the diet, in terms of PUFA ratios (Omega 3s and 6s) as well SFA and MUFA intake. [1]  Frankly, I'm not convinced of the evidence for moderate supplementation being unsafe, but again for peace of mind it would make much more sense to simply get 15-30 minutes of mid-day sun rather than taking a pill.  However, for a large part of the population, mid-day sun exposure is not possible, when either climate is an issue, or they (more commonly) are office dwellers.

Personally, at work I attempt to get out once a day for lunch.  Even with clothes on, it's a better option.  Plus, there's a synergistic psychological response to being out in the sun that, along with vitamin D, helps regulate sleep cycles.  If you choose to supplement (as I do when I can't get out during a shift) then I recommend doing so during the hours of 10am to 3pm to mimic when such exposure to D would typically occur.  15-30 minutes of mid-day sun will garner the average person about 15,000-40,000 IU of naturally produced vitamin D.  However, I'd consume no more than 2,000 IU if supplementing as the typically manufactures use PUFA (often oxidized) as a vehicle for getting the vitamin D in to your bloodstream.

Serotonin
Another neurotransmitter that works synergistically with vitamin D, and UV exposure is serotonin.  You may be familiar with serotonin as a mood hormone.  Selective Serotonin Reuptake Inhibitors (SSRIs) such as Lexapro or Celexa are drugs used to enhance mood, in the clinically depressed.  They seek to inhibit reuptake of serotonin, thus flooding the synapses with the hormone inducing an enhanced mood.  Often people placed on SSRIs are heavy sleepers as a result.

Luckily, there is a natural way to increase serotonin levels and yet again, the sun is the source.  Lower levels of sun exposure are greatly associated with sleep disturbance.  [23]
"The study reports that levels of serotonin in the brains of participants increased in direct relationship to their exposure to sunlight. Catheters placed in the internal jugular veins of participants allowed assessments to be done as these people were exposed to varying degrees of sunlight. The study found that “the rate of production of serotonin by the brain was directly related to the prevailing duration of bright sunlight, and rose rapidly with increased luminosity." [3,4]"

Epinephrine
Of course Grok might have had occasion to stay up late with stimulating activities like having fun, singing, dancing, watching out for predatory animals, intruders, inclement weather, etc.

As some of you may recall from A&P, epinephrine (aka Adrenaline) competes with melatonin receptor sites, reducing the sensation of sleepiness. Workout at 9pm and then try to go to bed at 10pm for an example of this.  I don't care how much melatonin one consumes, if you clean and snatch your max just before hitting the sack, you're doomed to a restless night's sleep at best.

But, more often than modern man, just by virtue of having less epi-stimulating activities, as well as less artificial light, sleep disturbances were most likely rare. (those with such disturbances were probably unfit and selected out.)

The Grok meme can be useful in terms of its simplicity to explain many "whys" but can often point one in the wrong direction as well.

Cortisol 
Speaking of epinephrine, fight or flight is a protective mechanism that humans evolved to cope with survival situations, typically in life or death situations.  In today's day and age, we are faced with many "Stressful" situations which cause the hypothalamus and anterior pituitary gland to secrete cortisol.  Cortisol is also regulated by the sleep cycle in response to light.   "Information about the light-dark cycle is transmitted from the retina to the paired suprachiasmatic nuclei in the hypothalamus."[5]

This is significant because low-level chronic stress (physical or psychological) increases serum levels of cortisol which is typically moderated by rising and falling of the sun.  But if stress is sustained in to the evening and night, cortisol will continue to enter the blood stream, throwing off sleep patterns and reducing REM time. [6]

In the Paleo world, over-training is a common source for chronic cortisol secretion.  To remedy this, ensure 2-3 rest days and avoid chronic cardio.
Avoiding stress, although impossible to eliminate, is key to reducing chronic cortisol syndrome. Play, love, and laugh!  Increase your focus on hobbies, sports, mediation, and hiking.  Mix in a beer (gasp!).  Spend time with your family.  And for the love of Pete, balance your work life with your personal life!  Time is precious, and the pursuit of happiness doesn't always include a larger paycheck or a promotion.

So here are my recommendations:
1. Get as much mid-day sun as you can without burning yourself. (The time will vary from person to person based of skin pigment and genetics)  If you can't get outside, take a vitamin D supplement.  At work, take your breaks and walk a bit outside.

2.  At sundown, turn all lights out, and minimize your exposure to artificial light sources like TVs or computers.  In your bedroom, eliminate all night lights in your room, even covering up any alarm clock displays.

3.  Avoid caffeine past 4pm.

4.  Eliminate all stimulating activities past sundown, such as dancing,  exercising, walking, etc.

5.  If necessary, take a melatonin supplement about 30 minutes before your desired bedtime.  Do this regularly for a week, and then taper down to using melatonin only when you have trouble going to sleep (i.e. when you're up for over an hour in bed).  Ensure your photo-exposure is minimized, otherwise you render this useless.

6.  Get regular exercise during the day time (office dwellers, walk outdoors on breaks, and use stairs.  If possible use a standing desk).

-----------------
NOTE: citations are linked throughout the article.

10.05.2011

Nutrition tip of the week: Sunlight


Nutrition tip of the week: 

Sunlight a nutrition tip?  Yes!  Try to spend some time in the sun each day.  Instead of overdosing on calcium or taking Vitamin D supplements,  15-30 minutes of midday sun will garner the average person about 15,000-40,000 IU of naturally produced vitamin D!  In addition to calcium absorption, sunlight plays a significant role in regulating circadian sleep patterns.  It increases serotonin levels, thus improving mood.

9.12.2011

Treating Diabetic Hyperglycemia With, High Carbohydrate? FAIL!


I work in a hospital that has a large amount of diabetic patients.  I typically work stoke and ortho, and the pathology of both of those populations tend to be the result of poor lifestyle and nutrition.  Strokes are the result of inflammatory conditions that cause atherosclerosis, clot formation, and resulting ischemic episode.  More often than not, stroke patients have comorbidities associated with diabetes mellitus (DM) and metabolic syndrome (MS), namely obesity, and insulin resistance (IR).  Most of our orthopedic patients are morbidly obese, and require significant orthopedic surgery to replace worn out joints.  Others are amputees who have peripheral vascular disease with necrotic limbs that essentially rot away from poor vasculature.  So, as you can see, I deal with a lot of folks that require nutritional intervention and diabetic pharmacology such as oral anti-diabetic meds like "Metformin" and a slew of long, medium, and short-acting insulins to regulate blood sugar.  Unfortunately, my experience has shown me that conventional nutrition has failed many of these patients in their diabetes management.


The Conversation
Casually, I asked one of the Dieticians why patients are often placed on high carb "Consistent Carbohydrate" diet?  Surely logic would indicate that if a patient has trouble controlling blood sugars, you'd want to attempt to lessen the impact of any subsequent blood sugar spikes with diet.  Wouldn't it make more sense to lower carb intake?  She responded by citing that people "need" a certain amount of carbohydrates.  "It's Nutrition 101," she said.  So  I responded:  Let me get this straight: these IR people (who have down-regulated insulin receptors) and essentially can't metabolize glucose because they don't have enough receptors to use insulin are being given an increased amount of carbs (glucose)?  So, the current methodology is to give them a high (albeit consistent) dose of glucose, and then treat that "expected" sugar spike by exogenous (and alien) insulin doses?  So what we're doing is essentially giving the diabetic patient a toxin (glucose) and then giving the patient an antidote (insulin)?  Something's rotten in Denmark.

So, I very respectfully asked, "Why not just reduce the need for insulin by giving them less carbs?"  I continued, "If a person has IR and thus less insulin receptors, how is increasing insulin going to up-regulate the receptor sites (decreasing IR)?"  She had no response.  She told me she'd look it up and get back to me on that.  She's a pretty astute gal, so I suspect she will get back to me on that.  My take: the nutritional and medical philosophy in the treatment of DM, is akin to purposely clogging up a toilet and using a plunger to force it to flush.  Why not just use less toilet paper?

Upregulation/Downregulation of Insulin Receptor Sites
Up and Down regulation of receptors sites occurs due to 2 sources of stimuli: Glucose and Insulin.  Glucose, in excess, is toxic to cells.  When chemoreceptors sense an increase in glucose they signal the beta cells in the pancreas to secrete insulin in an effort to return blood glucose (BG) levels to homeostasis (80-100 fasting, and ~90-130 one hour after meals).  The process is self-limiting, as receptors are absorbed into the cell (endocytosis) after they bind to insulin.  Glucose through a signaling cascade, is then able to enter the cell through the glucose transporter.  The process can be seen below in figure 1.

Figure 1.  Insulin glucose cascade [5]

The insulin bathes all receptor sites (also leading to increased down-regulation).  Prolonged or chronic hyperinsulinemia causes the absorption and breakdown of receptor sites in to the cell faster than they can be synthesized.  This is further exacerbated by Tyrosine Kinase (TK) inhibition.  This vicious cycle, accompanied by inflammation, causes IR. [1]

Glucose is either used in cells as energy, or STORED IN FAT (insulin also facilitates the storage of energy as fat).  In addition to energy storage, fat acts as as sort of buffer to keep your blood nutrient and electrolyte levels in homeostasis.  Remember, anything is poisonous in its proper dose whether it's water, oxygen, salt, or sugar.[2]  But in the case of IR patients, the buffer grows at an average of 1.5 lbs. per year. (the statistical weight gain of all Americans on a SAD diet)

Treatment of DM by Conventional Medicine Practitioners
Many people in medical research would tell you that as a diabetic it's best to just avoid sugar/insulin spikes.  Unfortunately, the USDA, ADA, AMA, and AHA have yet to catch up to the scientific literature.  The lipid hypothesis and its subsequent effects on agriculture and pharma have muddied up the ability of the medical establishment to admit flaws in their medical philosophy.  Militant vegans have become powerful lobbyists in perpetuating the current political climate, which continues to subsidize big agribusiness and the entire grain industry.  The paradigm of low fat, high carb, with excess grains is killing the American public, increasing healthcare costs, and bankrupting healthcare.  Want proof of this disconnect?  Let's revisit my RD friend.  She's been schooled in the idea that fat causes heart disease and grains (aka Carbs) should constitute one-half the American diet.


As mentioned before, the current practice of nutritional support for DM patients is to calculate a caloric intake for a person based on BMI and age, and give them what's called a Consistent Carbohydrate Diet (CCHO).  With a CCHO diet, the idea is that blood glucose should reach an expected BG spike, and then doctors manage that level with therapeutic insulin.  But remember: diabetic patients ALREADY have excess insulin in their blood streams!

Despite this, conventional treatment is to push additional supplemental insulin in order to force glucose into the cell in order to normalize BG within the vasculature.   Sure, the carb intake is predictable, but somehow blood sugars rarely are (shocker). Very rarely is a relatively low carb diet considered, and certainly therapeutic ketogenic diets have been limited to research, or the treatment of neurological disease.  It's worth noting that bariatric patients have had success on ketogenic and LC diets, with healthy BMI outcomes and healthier lipid profiles and increased insulin sensitivity.[3]  But again, the conventional thinking of medical practitioners is "management", not "cure."

So, there's a schism and a dichotomy amongst medical professionals.    But make no mistake about it, most of osteopathic medicine is firmly rested on the belief that dietary carbohydrates should be increased beyond what human evolution designed through millions of years natural selection.


[sarcasm] Which clearly has worked SOOOO well for them thus far, considering the fact that rates of cardio vascular disease, diabetes, and obesity, have risen despite a sharp decrease in smoking prevalence and continued dietary recommendations for low fat, high carb diets. [/sarcasm]

--The Japsican

9.01.2011

Nutrition Tip of the Week: Fermented, Probiotic Foods

Nutrition tip of the week: 

Gut health is arguably one of the most important ways to build overall health.  Did you know that MOST of our immune system is located in the gut?  Promote gut health and prevent disease by mixing some fermented foods in to the diet to promote proliferation of good gut flora.  Some examples of HEALTHY fermented probiotic foods:  Yogurt (or yogurt-based drinks), Kefir, Red Wine, Kim Chee, Sauerkraut, Kombucha, pickled meats, and low sugar dark chocolates etc.

8.27.2011

Alzheimer's: Type 3 Diabetes?

Recently, our family has had some experiences with dementia and Alzheimer's as my wife's family recently lost one of their beloved matriarchs.  She was a lively woman, who was outgoing and caring, with a personality that many described as "loving" and "feisty".  But towards the end of her life she had lost the capacity to take care of herself, to communicate, and perform the simplest of activities like eating.   This was a horrible experience for my wife's family as it would be for anyone.  After having been exposed to several accounts of such tragedies, it serves as a reminder of why I want to do what I do.  It strengthens my resolve to rid the world of these terrible and preventable diseases.  NOBODY should have to suffer through an experience like this, and there's no reason anyone should have to.  


As of some recent studies, many experts in health research are leaning towards a new paradygm in Alzheimer's research.  It's the idea that the disease is actually the result of insulin resistance in the brain, hence the new moniker "Type 3 Diabetes", aka "Diabetes of the Brain" [1].  It seems, in the case of Alzheimer's, many folks in conventional medicine have resorted to nutritional therapy.  This is a fantastic example of how powerful the effects of food and nutrition can be in the treatment of some pretty serious and life-threatening diseases.  

So a little elementary physiology and anthropology is in order here to better understand why this works.  We'll keep it simple so a), I don't confuse myself, and b), you don't get too bored.  Using the Grok meme, you have to imagine early man had instances where food wasn't plentiful.  From an evolutionary standpoint, it would make sense that people who's physiology was unfit to cope with such stresses would eventually be selected out.  How did man cope with these thin food times?


As discussed previously, the body was designed to run on a relatively low-carb diet as compared to modern diets.  True there were several examples of hunter-gather diets that were relatively high in carbohydrates such as the Kitavans, however, generally speaking most paleolithic people ate a higher fat, low-to-moderate carb, moderate protein diet.  That macronutrient composition is just how it usually worked out with the types of food available to be gathered or hunted in most climates during that time [2].  


On such a diet, one's body shifts from burning glucose to burning fat as its primary source of fuel, specifically Free Fatty Acids (FFA).  The end product of FFA metabolism are ketone bodies, which end up providing more ATP per molecule, but at the expense of more oxygen.  This means that, while at rest or during mild activity, your body is more efficient when running on ketones as it's primary energy source.  This was base-line for early man [3].  However, due to the high O2 demand, ketones become less efficient in times of extreme physical exertion (ie, crossfit, marathons, MMA, running from predators).  In the event that great physical exertion or stress is necessary, for example "Flight" during a fight or flight moment, epinephrine is released and the body turns to glucose which is supplied by the liver in the form of glycogen.  Large amounts of glucose is then dumped in to the blood stream so that energy is more quickly available for use by the exerting muscles.  While not baseline, such a glucose spike is useful when fending off a lion for example, or hunting a gazelle.  In other words, ketones could be seen as "gasoline", while glucose could be thought of as "nitrous oxide."  

Remember however, that chronic or prolonged sugar spikes throughout the body are toxic and associated with metabolic derangement.  So, while one would want glucose available in case of an emergency, he'd not want to depend on carbs as his primary source of fuel.  Doing so could lead to chronic conditions, and insulin resistance (as has happened to modern humans).  It's starting to be understood that such insulin resistance is happening in the brain as well.  It occurs when insulin receptor sites are down-regulated (meaning there are less receptors) which retards glucose transport into the cell.  This, coupled with inflammatory processes and resulting oxidative damage are thought to cause the disease.  Enter the Ketogenic Diet.  A ketogenic diet treats both pathways, increasing insulin sensitivity and reducing inflammation in the tissues of the brain.  

Going back to Grok, we'd think of him as a guy who would have occasion to go without food every now and again.  Fasting, unintentionally, was a logical consequence of early man's environment.  They had no Safeways, Starbucks (the horror), KFC, or Costcos in which to gather supplies.  And typically, there was no refrigeration (with the exception of winter) in which to store food for long periods of time.  Man was an opportunistic eater, and even scavenged meat when possible.  He probably ate meat when available via hunting or scavenging and probably ate his fill [4].  But what happened when the hunters returned without meat, or the gathering of edible vegetation returned fruitless?  Protective mechanisms were evolutionarily put in to place to deal with food variations in terms of the types of macronutrients ingested, and the overall calories taken in.  

"The classic ketogenic diet is a high-fat diet developed in the 1920's to mimic the biochemical changes associated with periods of limited food availability." (Kossoff, 2004) [5]

During times of fasting or starvation glucose is in dearth supply, either due to a lack of dietary carbohydrates or a lack of dietary proteins which can be converted to glucose via gluconeogenesis.  In this case the human body is built to operate at low-carb (LC), very low carb (VLC), or even zero carb (ZC) levels.  Your most important organ, the brain, runs on ketone bodies in the absence of glucose, and can do so with efficiency.  In this case, the fuel is typically supplied by fat stores but can be obtained from dietary fat as well.  While your brain still requires a small amount of glucose in order to function, it actually runs more efficiently on a higher ketone to glucose ratio, with research reporting improvement in memory, decision-making, problem-solving, and various other brain-related activities. [8]


Healthy brain (left) vs. Alzheimer's brain (right)

So why the big long explanation about ketones and how the body (and specifically the brain) uses them?  Because high-fat ketogenic diets not only improve brain function in healthy people, but are hugely effective in preventing and treating many neurological diseases, including Alzheimers.  For an explanation of how cholesterol DOESN'T cause Alzheimer's disease, I couldn't even begin to explain it better than Chris Masterjohn.  Go here for his article on why that's not an issue.  

For a while now ketogenic diets have been used to treat a slew of neurological diseases as described in this article here. [7] 


Ketogenic Diet Therapy uses OTHER than epilepsy:
Autism2003
Brain tumors2003
Depression2004
Narcolepsy2004
McArdie's Disease2005
Alzheimer's2005
Traumatic brain injury2005
Parkinson's2005
ALS2006
Migraine2006
Sleep disorders2007
Post hypoxic myoclonus2007
Post anoxic brain injury2008

In summary, diet is a major player in the treatment of many diseases.  It's important not to overlook the dietary component of any disease process, and while conventional medicine is starting to see the value of nutritional therapy in neurological instances, it severely lags behind in that regard concerning many other areas in medicine.  Preventative medicine IS after-all, bad for business.  Just ask your friendly neighborhood pharmaceutical sales rep. 

--The Japsican 



-------------------------------------------------------------------------------------------------------------------------------------------------------------------

[2] Kaplan HS, Hill KR, Lancaster JB, Hurtado AM. A Theory of Human Life History Evolution: Diet, Intelligence, and Longevity. Evolutionary Anthropology 9:156-185, 2000.http://www.unm.edu/~hkaplan/KaplanHillLancasterHurtado_2000_LHEvolution.pdf.


[4] Aiello LC, Wheeler P (1995) "The expensive tissue hypothesis: the brain and the digestive system in human and primate evolution." Current Anthropology, vol. 36, pp. 199-221.

[5] Kossoff EH, "More fat and fewer seizures: dietary therapies for epilepsy."  Lancet Neurol. 2004 Jul;3(7)415-20  http://www.ncbi.nlm.nih.gov/pubmed/15207798

[6] Maciej Gasior, Michael A. Rogawski, Adam L. Hartman.  "Neuroprotective and disease-modifying effects of the ketogenic diet Behav Pharmacol. 2006 September; 17(5-6): 431–439.

[7] Kossof EH, "Ketogenic Diets: Not just for epilepsy any longer" http://www.epilepsy.com/epilepsy/keto_news_aug08
  
[8] Joseph C. LaMannaNicolas SalemMichelle PuchowiczBernadette Erokwu and Smruta Koppaka, et al. "Ketones Suppress Brain Glucose Consumption"  Advances in Experimental Medicine and Biology, 1, Volume 645Oxygen Transport to Tissue XXX, Pages 301-306, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874681/

8.15.2011

Fruitology




So, evidently I'm now taking requests as a friend of mine, Rich, asked me to do a post about fruit and how it affects diet.  I know what many of you are thinking: "Fruit unhealthy?  Crazy talk!  Why would he even question fruit?"  After all, we've all heard the colloquialism: "An apple a day keeps the doctor away."  Fruit being a healthy food has become common speak, or part of the dietary zeitgeist.  But is it?


Since this blog is also about nutrition and health in general, and not solely about paleo or evolutionary health and nutrition, I think that this is a great opportunity to help a friend, and dispel some of the myths about fruit relative to a healthy diet.


Let's start with the question: Is fruit healthy?   The answer to that it depends on the fruit, and the person eating it.  Fruits can be wonderfully nutritious as far as plant foods are concerned, but as you'll see not all fruit is created equal.  For example, berries tend to be the most antioxidant rich of fruits, and these include but are not limited to: Blueberries, black berries, raspberries, acai, elderberries and cranberries.  Apples, strawberries, peaches and plums have respectable amounts of antioxidants as well. (1)


Some fruits are best avoided or eaten in moderation and should be treated as more of a desert due to their high fructose content and high glycemic index.  For example, one banana has the same amount of sugar as a Hershey bar.  One serving of grapes (151g) has more sugar than 12 Pixy Stix straws, or a Kit Kat. (2, 3)  Think of high sugar fruit as having a cookie or a cupcake every once in a while.  Poor choices from a sugar/GI/carb perspective include bananas, apples, dates, grapes, mangoes, pineapple, and persimmon. (4)
(Lay off those persimmons Rich)


An explanation of why sugar/fructose can play a problematic role, watch this: http://www.youtube.com/watch?v=dBnniua6-oM




Your body doesn't discern the difference between sugars whether from an orange, an apple, a watermelon, a bon bon, or a kit kat.  They all affect insulin spikes, hunger, fat storage and insulin resistance the same.  But for some reason there's this idea that  fruit has some inherent "good" version of fructose/sugar and fruit reverence amongst some vegans and vegetarians can reach almost cult-like proportions if talking with the right fool.  Personally, I don't suffer fools very well.


So, what happened?  How could such a staple of our ancestral diet have gone so awry as to become bad for us?  Well, in a very similar way to how we screwed up much of the food we consume, we've altered fruit since the Neolithic advent of agriculture.

How you ask?



First, just by gathering fruit, humans (and all animals for that matter) typically select the largest, most colorful, and most palatable versions of said fruit.  Apples for example, have gotten much larger and sweeter over time.  Examples of this process are found throughout the world with all edible vegetation such as Corn, Rice, Oranges, Tomatoes, etc.  Corn, for example, started off as a kind of grass (Teosinte) and through generations of selection, became maize, or what we call "corn". (5)  Most fruit, as shown in the archaeological record, were much more fibrous, and as such, self-limiting in it's density to sugar ratio.


Secondly, agriculture, especially modern agri-business have increased this selection process by production volume in their never-ending quest for yield and profit.  He who has the largest and sweetest sugar-filled apples garners the most money.


Lastly, big agribusiness tampers with the DNA of many fruits to make them resistant to certain toxic pesticides, and to develop sweeter strains.

So is fruit always unhealthy?  No.  For those without any metabolic derangement such as obesity, diabetes, or thyroid disregulation, fruit can be fine.  But again, treat it as a treat.  If your trying to lose weight, I'd consume fruit in moderation, and keep my overall carb intake to around 100 grams.  For maintenance, I'd keep my carb intake to around 150-250g, without a steep performance bias. 



If someone was an endurance athlete or an athlete with a performance bias, I'd up the carbs to a level that facilitates performance without eliciting fat storage.  That's something that you're going to have to determine with some n=1 experimentation.  But based on your activity level, it could be anywhere from 200-400g.  Everyone's different in that regard.  


If someone were an obese or sedentary person for example, a lower carb approach might be more appropriate, and I'd avoid ingesting too much fruit in an effort to reduce carb intake so that we can get that person to a leaner, more fat-burning (burning fat preferentially as ketones) vs. carb-burning machine.


As you can see, the amount of fruit that's "Okay" is largely dependent on the patient.  If one is eating a nutrient-dense diet, most likely he's already eating plenty of meat and fat which are incredibly satiating, and uninclined to take in too many carbs anyway.  Once one's reached a good level of metabolic homeostasis and/or leaned out, adding more fruit to the diet might be appropriate (or perhaps some low GI tubers).  But, as I've said over and over again, it's better to get most of your carbs from vegetables if possible, as they are equal or greater in nutrient density, antioxidants, as fruits with less insulinogenic effects.


And Rich, to answer your question:  I'd not indulge in eating 2 lbs of grapes in one sitting or an entire watermelon very often, but as long as you keep such binges acute and rare, rather than chronic and often, you're probably gonna be okay. (if not ab-less.)

8.11.2011

Nutrition tip of the week


Here was a recent "Nutrition Tip of the Week" post that I typically make on FB.  Below it is the conversation that ensued:

Nutrition tip of the week: Cut down on your intake of seed oils like canola, corn, vegetable, soy, etc. Research has shown for a while now that it's polyunsaturated fats (and not saturated) that are unstable, oxidizing in the blood stream causing inflammation. It's the inflammation (and not the cholesterol) that cause heart disease (and stroke).
August 11 at 8:19am · Privacy: ·  · 

    • Nick Tiesi I would hope that you are not including olive oil in that. Because "research" has shown that the Mediterranean diet, which is high in olive oil, helps prevent heart disease and stroke
      August 11 at 10:02am · 

    • Ian Dominguez Yes I purposely didn't include it, but with a HUGE caveat. Yes it's true Olive Oil can be healthy, but do you know WHY? The info on that isn't often elucidated to people very well, and people just regurgitate how healthy olive oil is to other people, without having a real grasp on it. Olive oil is indeed healthy, but only in it's raw form and NOT as a cooking oil. Under temperature, it oxidizes and then (although less so) has the same inflammatory properties as other seed oils. If you're consuming PRE-oxidized PUFAs, it's particularly bad for you.
      August 11 at 10:10am · 

    • Ian Dominguez Also, the process by which the oil is extracted from the olive seed (wrap your head around how unnatural that is) uses heat, pressure, detergents and chemicals (highly processed) in an effort to squeeze out the oil. In this process, oxidation occurs, and the antioxidant polyphenols are washed away (The natural preservatives in the oil). This causes further rancidity and oxidation. Generally speaking, the lower quality manufacturers are more processed (to lower costs and raise profit). So, in those cases you've got bad, rancid (oxidized) olive oil already on the shelf. And even the "good" olive oils go bad relatively quickly. So you have to use it in a couple of months or less. To do the research to determine which oils are high quality or not must be done by looking at the italian source for quality as the US has poor regulation on quality. Because of all this, I recommend to just avoid it, or use it in moderation.
      August 11 at 10:25am · 

    • Jamesha Sandoval Chavez Wow Ian. Thank u for your health blog/tips! Been using cinnamon. Lol!
      August 11 at 10:44am · 

    • Jamesha Sandoval Chavez What about coconut oil? I've been hearing alot on this lately.
      August 11 at 10:45am · 

    • Nick Tiesi you should do the cinnamon challenge!
      August 11 at 10:56am · 

    • Ian Dominguez Jamesha! Thanks for the kind words! Coconut oil is awesome for you, and I will give you a long-winded reason when I get back. LOL.
      August 11 at 11:01am · 

    • Kimberly Williams Shelby IAN!!! You rock buddy! I am taking ALL your health information in as I go through my transformation. Keep the info flowing...THANKYOU!
      August 11 at 11:35am · 

    • Ian Dominguez Kimberly, can you enlighten us in what you're doing?! I love it when people get healthy!
      August 11 at 11:43am · 

    • Ian Dominguez Nick, hell no! That's nuts! Never even heard of the cinnamon challenge. Haha
      August 11 at 11:46am · 

    • Kimberly Williams Shelby I am working with Beachbody and their workouts and educating on good carbs vs bad carbs. I am 38 :) and do not expect to be like I was when I was 21 however, weight is not your friend and there is a healthy way to loose weight and a not so healthy way. And unfortunately, many of us have very bad information! I started a fews back and I 've lost 7lbs :)
      August 11 at 11:47am · 

    • Jamesha Sandoval Chavez R u doing crossfit? Thinking about enrolling my freshman son in it after football season.
      August 11 at 12:03pm · 

    • Kimberly Williams Shelby ‎@Nick I have heard that cinnamon is good for those with diabities, it helps control or lower your sugar. Is that what you are referring to?
      August 11 at 12:10pm · 

    • Kimberly Williams Shelby No, I have Slim in 6, Hip Hop Abs, 10min workouts, and shakeology dvd's. But anything that keeps you moving regularly is good.
      August 11 at 12:11pm · 

    • Jamesha Sandoval Chavez Awesome Kim! I just started up again after trying to heal from a car accident injury. Ugh. One day at a time! :) Go team health!
      August 11 at 1:12pm · 

    • Ian Dominguez Jamesha Chavez, as you probably know, LDLs are lipoproteins that carry cholesterol to the cells throughout the body as needed. (we die without cholesterol) The cholesterol molecule itself isn't water-soluble, and thus needs a protein carrier to distribute it where needed. What happens to lipids like those found on a PUFA-rich LDL, is that the PUFAs oxidize creating smaller, denser LDLs. That oxidation causes the inflammatory, plaque-building cascade. The reason coconut oil is a great and healthy option is that there is much less oxidation, and thus less damage and subsequent inflammation. The LDLs stay large and buoyant, and are able to distribute the lipids where needed taking shelter in a cell before they go bad.
      Saturated fat, like those found in coconut oil, especially those accompanied by rich amounts of antioxidants, don't oxidize in the bloodstream as quickly as their polyunsaturated counterparts (see above post about olive oil). In contrast, the seed oils (PUFAs) tend to not get to their intended destination, oxidizing, creating inflammation throughout the vasculature.

      This article on pubmed talks about how "Virgin" coconut oil is superior to regular old coconut oil, in it's heart healthy effects. I will say though that both VCO and CO are superior to any and all seed oils.
      http://www.ncbi.nlm.nih.go​v/pubmed/15329324


      www.ncbi.nlm.nih.gov
      PubMed is a service of the U.S. National Library of Medicine that includes over ...See More

      August 11 at 3:05pm ·  · 

    • Ian Dominguez Here's another explaining the oxidative process with PUFAs: http://www.cholesterol-and​-health.com/Does-Cholester​ol-Cause-Heart-Disease-Myt​h.html#oxinjury

      www.cholesterol-and-health.com
      The cholesterol-fed rabbit produced atherosclerosis but the response-to-injury r...See More

      August 11 at 3:07pm ·  · 

    • Ian Dominguez Kimberly Williams Shelby, that's awesome! Best of luck to you! Give us some updates as you reach your goals!!! Funny thing, today I went in for a check up at the doctor, and I found out that I'm 22 lbs lighter than my last visit in Feb, and my Body Fat percentage was 11%. I haven't been that low since HS.
      August 11 at 3:15pm ·  ·  1 person

    • Roberta Griego olive oil, avocado oil and coconut oil are better. ;)
      August 11 at 4:11pm · 

    • Ian Dominguez Avocado oil is great as well, but again, similarly to Olive Oil, don't cook with it, as it oxidizes easily under heat. Drizzle it over salads, (along with olive) and it's very healthy. OR pour it over already cooked foods. I cook primarily with animal fats, ghee, butter, or coconut oil, as they are the most stable under heat.
      August 11 at 9:15pm · 

    • Jamesha Sandoval Chavez Oooo very interesting about the oils Ian! I just bought some virgin coconut oil. It smells yum. Ian r u doing crossfit?
      August 11 at 9:49pm · 

    • Ian Dominguez yep, on my own. I had to put my membership on hold until my shoulder is back up and running. (Rotator cuff injury)
      August 11 at 9:52pm · 

    • Nick Tiesi this is the cinnamon challengehttp://www.youtube.com/wat​ch?v=mNQEcTGkAgM

      www.youtube.com
      The BEST Cinnamon Challenge Video Featured Main Page on Ebaumsworld.com

      August 11 at 10:38pm ·  · 

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