New Directions in Nutrition

It it high time for an update around here. I had been hesitant for a while mostly due to the fact that what I’ve been reading about recently (sexuality) does not seem to fit in thematically with this blog. However, I have recently also changed some of my views on optimal nutrition and am finally implementing some of these changes. Most of my changes in thinking come from my experience with the GAPS diet, the Perfect Health Diet, the Danny Roddy Blog, and 180 Degree Health.

On the Question of Gut Dysbiosis

“Gut dysbiosis” has become a sort of trendy phrase these days and I do not doubt that it is a widespread problem in our society from the lack of fermented foods, overuse of antibiotics, pollution, chemical adulteration of food, and so on and so forth. How is one to deal with it? There are a lot of ideas about this. I basically bought wholesale into the idea that starch is impossible to digest and that simple sugars feed pathogens. This led me to do the GAPS diet which is pretty low in carbohydrate as a therapeutic diet for a while. The problem is that I had already been pretty low carb for a while at that point as my reaction to subjective feelings of gut dysbiosis has always been to go ZC or VLC as a way to starve the bad guys. I realize now that this path was mistaken since probiotics will not grow well without prebiotics and this was shown time and time again by constipation and reduced stool volume. At the time, I also didn’t realize that a VLC diet increases susceptibility to fungal infection in addition to the other problems postulated by the PHD. It is now my conviction that to treat gut dysbiosis it is important to eat a lot of prebiotics and probiotics along with gut healing foods and a low toxin load. This means foods that contain resistant starch or inulin as these seem to be the least problematic sorts of prebiotics and ones that are preferred by good bacteria. Reducing sugars is still important but going low carb can backfire by increasing susceptibility to fungi and also impairing immune function while not providing enough feedstock for probiotic colonies to flourish and do their work. For healing gut dysbiosis, I have thus changed my mind from the GAPS diet to instead a GAPS-style diet plus foods high in resistant starch and inulin including pseudo-grains, white rice, pulses, and starchy tubers. I would also eliminate nuts, seeds, and fruit. Each person will need to test these foods to see if they have reactivity to any of them and eliminate those that produce reactions. In general, however, I have changed the way in which I believe these sorts of problems need to be conceptualized. Instead of starving out the pathogen while also starving yourself of important foods, it’s better to eat enough of every major macro- and micro-nutrient category while simultaneously adding immune system and detoxification support otherwise you risk weakening yourself as you weaken your pathogen which may have more tricks up its sleeve to feed off of you. This does not mean your diet can be a free for all but you must not be totally carbophobic and take the food lists provided by the diet to be gospel. For instance, on the GAPS diet why are lentils and white beans okay but not adzuki beans or mung beans which are both supposed to be very low in toxins and easily digestible.

On Hypothyroidism

It has come to my attention by way of Matt Stone that it seems that part of the efficacy of low carbing is the fact that it pumps up your adrenals for a while and makes you hypothyroid. In the short term, this works out great but it backfires when one does this relentlessly. Low carbing would thus be most effective when combined with carb refeeds every so often to allow the adrenals to rest. Many low carbers have experienced a certain pattern of symptoms that comes after being low carb for a while, this includes oral thrush, dandruff, intolerance to cold, low body temperature, reduced libido, the return of some fat, and so on. I have experienced many of these at this point especially since returning to the GAPS diet for a few weeks thus providing another reason to increase my carbohydrate intake.

On Protein Consumption

By way of Danny Roddy I have become acquainted more and more with the detrimental effects of high tryptophan consumption on the body. These negative effects are largely the result of the increased circulating serotonin that eating a lot of tryptophan can produce. The tryptophan amino acid is, of course, especially rich in muscle meats. In addition, eating too much protein does not seem to be all that beneficial unless you are attempting to build muscle mass. High protein consumption is associated with hypothyroidism, decreased testosterone production, and a shorter lifespan. In addition, restricting protein can produce beneficial results from the autophagy that may be induced. All these considerations make me feel that protein can be anywhere from 5-15% of a diet and should come mainly from variety meats, seafood, gelatin, pulses, and pseudo-grains.

Other Stuff

A few other things to consider are that fructose and alcohol both appear to be treated similarly in the body and thus produce similar effects when consumed in excess (such as a fatty liver). A few studies, however, appear to show that many of these ill effects of overconsumption can be significantly reduced or eliminated when the consumption is done in the absence of polyunsaturated fats. It thus seems to me that in the hierarchy of evil things that supposedly destroy health, fructose and alcohol may, in fact, both be conditional toxins whose toxic dose depends on PUFA consumption. Reduction of PUFA to minimum levels (while also balancing n-3/n-6 ratio) appears to be the chief thing to do with reduction of fructose and alcohol being secondary. Another interesting thought is about stress. It seems that people who’ve grown on very nutritious foods in a traditional manner can tolerate way more dietary stress without having as many food allergies or problems. I am thus starting to wonder how much optimal adrenal and thyroid function have to do with susceptibility to food intolerances. Recently, I have either become lactose intolerant or only just realized that I am more lactose intolerant than I initially thought. After I finish this phase of carb refeeding, however, I plan to test dairy again to see if my tolerance has improved with improved thyroid and adrenal function but we shall see.

Summary

To summarize some of the conceptual changes:

-I believe a healthy gut depends on prebiotics as much as probitics especially resistant starch and inulin. Low carb programs for treating the gut can impair immunity (especially to fungi) while slowing down growth of probiotic colonies.

-I believe reducing protein (especially tryptophan-rich protein) can be beneficial which means that the optimal protein sources become seafood, variety meats, gelatin, pseudo-grains, and pulses and the optimal protein amount becomes 5-15% of calories.

-I believe a minimum level of carbohydrate must be maintained in all cases. For this minimum I’ll defer to the PHD who puts it at about 20% of calories, however, more may be beneficial depending on your circumstance. I no longer believe fat is a preferred fuel source. Either carbohydrate or fat can be good as long as a few guidelines are observed. Carbohydrate sources are low in toxins, fructose, and insoluble fiber. Fat sources are low in PUFAs. You have an open window of 85%-95% Fat/Carb calories though you will generally do best if you prefer one source and moderate the other one.

-Polyunsaturated fats are the master toxin that can activate fructose or alcohol to produce physiological problems in the body. As such, make sure to balance and minimize PUFAs. I’ll defer to Stephan for this and say that PUFAs should comprise no more than 4% of calories.

Filed under: Bacteria, Diet, Digestion, Fermentation, Health, Macronutrients, Nutrients, VLC

Another Dietary Synthesis

This is just a note of a quick mash up of a few diets for different therapeutic purposes and some common themes I’ve been seeing among them.

First, I would like to say that the reason for this is that basically I find myself wanting to do several therapeutic things at once. For one, I want to improve my digestion and towards this end have looked at the SCD and the GAPS diet. Recently I’ve been diagnosed with a cavity so I am adhering to a tooth remineralization protocol in order to arrest the decay. Both these diets are relatively similar but seem to bias meat, dairy, and fermented vegetables the most thus placing them in the realm of VLC diets if you’re not careful but considering that the digestion protocols require severe restriction of starches, it seems somewhat problematic to get the carbohydrate values up to 20% of calories or so which would be optimal to prevent the problems of zero carb diets.

Here are a few summaries:

The tooth remineralization protocol that is based on Cure Tooth Decay by Ramiel Nagel consists of organ meats especially liver, mollusks, fish/beef broth, raw dairy, and fermented cod liver oil/butter oil as the necessary therapeutic dietary elements. Nuts, grains, seeds are basically out and fruit and honey are limited. Other vegetables are allowed.

The SCD/GAPS diet basically restrict starches severely to predominantly monosaccharides. This means that all fibrous vegetables, some other vegetables, fruit, nuts, seeds, meat, and certain types of dairy are allowed. Because of the possibility of problems between lactose and casein, dairy is introduced slowly over time and fluid milk is never allowed. At best, you can consume ghee, butter, cream, sour cream, kefir, yogurt, clabber, and cheese but no fluid milk. The GAPS diet further emphasizes broths, a probiotic supplement, betaine hcl, and fermented cod liver oil.

The PHD diet attempts to reduce the complications of zero carb diets such as kidney stones and scurvy by ensuring that carbohydrate intake is 20% of calories mostly coming from safe starches like white rice and starchy tubers.

A few problems present themselves in that the remineralization protocol restricts the honey and fruit that the SCD/GAPS allow while the SCD/GAPS restrict many of the starches the PHD and remineralization protocol allow as well as the dairy component. I am attempting to come up with a reasonable synthesis and it seems that it would be the common elements between the SCD/GAPS and the remineralization protocol plus the restriction of fruit and honey and the restriction of fluid milk which is to be compensated by increased consumption of yogurt, kefir, or cheese and a mandatory consumption of squash, radish, rutabaga, celeriac, and (maybe) turnips. Between the allowed tubers and the dairy, I would hope the carbohydrate requirements could be met and between the lactose restriction, the digestion needs can be met while not shirking the needs of the teeth.

So here is my new dietary synthesis:

Protein and fat should come from seafood and red meat especially organ meats and mollusks. Mollusks and liver should be consumed every week as should fish and bone broths.

Carbohydrate should come from fibrous vegetables, fermented vegetables, dairy, and especially squash, radish, rutabagas, celeriac, and turnips.

Fruit should be restricted except for fatty fruit (olive, coconut, avocado)

Dairy should be restricted to raw fermented dairy such as raw yogurt, kefir, or cheese. Cream may also work since it is mostly fat but avoid fluid milk.

Take fermented cod liver oil/butter oil, a probiotic, and betaine hcl if necessary daily. You may also want to take some of the PHD recommendations especially selenium.

This is the next dietary iteration that I will attempt to implement. By the way, this is not meant as an ideal diet but a relatively safe and clean diet that may be helpful therapeutically. If you have none of these issues then you can probably go ahead with any tuber you like, white rice, some beans, pseudo-grains, fruit, honey, nuts, and raw fluid milk.

Filed under: Diet, Digestion, Fermentation, Hcl, Macronutrients, Nutrients, Raw milk, Supplements, Teeth, VLC

Some Thoughts on the Pathogenesis of Diabetes

Let me preface this by saying that I am not a scientist at all. I was trained in semiotics and film/video production.

One of the things that I’ve been wondering about ever since I started looking at CarbSane‘s blog is where elevated non-esterified fatty acids (NEFAs) fit in in the grand scheme of things. Let me elaborate a little first so that this makes sense. The theory of fattening and insulin resistance that is usually given goes something like this: carbohydrates are the most insulinogenic macronutrient and the SAD (Standard American Diet) is a high carb diet and over time this leads to chronically elevated insulin levels, especially if you are snacking all the time which you are more likely to do on the SAD since you’re running on glucose (instead of fat) which your body has limited storage for. Additionally, insulin is the master hormone for fattening and if it’s always high then you are always accumulating fat rather than burning it. Of course, this has some truth to it but the picture is a bit more complicated than this and I’ve been looking for a way to reconcile this with some more nuanced descriptions of how fattening actually works.

Insulin is not the only hormone implicated in this process. There are, at the very least, two others: leptin and ASP. But anyway, that isn’t exactly my point. CarbSane mentions often how the one thing that bothers her the most about low carb is that it is necessarily a high fat diet and that elevated NEFAs in the blood appear connected to sudden cardiac death (SCD) as well as diabetes (that is, elevated NEFAs are supposed to happen before the elevated blood sugar happens). But looking more at her posts, it seems that the likely mechanism of fattening and eventually diabetes works something like this:

-One goes into caloric surplus in some way (for now, it is my belief that nutrient poor foods like most grain carbs combined with liquid calories and food toxins like fructose or those found in grain carbs induce hyperphagia over time either as a function of form (such as the difficulty of the body recognizing liquid calories) or damage to the leptin receptor (the possibility of wheat lectin binding leptin has been hypothesized by Stephan)).

-Now that you are in caloric surplus, you begin to store more and more fat. You begin to have chronically high levels of insulin to inhibit lipolysis of all that fat which is necessary to avoid elevated NEFAs and lipotoxicity in the body.

-Eventually, however, fat cells become insulin resistant and this leads to elevated NEFAs which continues to exasperate production of insulin in the body. Over time, the rest of you becomes insulin resistant and now you are diabetic.

-To summarize, it appears the problem is pathological overeating caused by some damage to leptin which eventually leads to fattening and chronically elevated insulin through insulin’s attempt to inhibit the lipolysis of all that fat tissue and this eventually leads to insulin resistance in fat cells, elevated NEFAs and, eventually, elevated blood sugar and diabetes.

The reason Paleo diets work, I believe, is because calorie intake is spontaneously reduced through the consumption of nutrient dense foods. This caloric deficit combined with the removal of the bulk of food toxins and the change from glucose to fat as the main fuel source makes it so that now those fats can actually be burned and used for energy and the hormonal system has a chance to heal. Hence, no macronutrient in particular is the culprit but food toxins and low-grade macronutrients (which are usually grain carbs) that lead to the initial caloric excess that changes the body’s fat setpoint. This is why this sort of thing doesn’t happen to the Kitavans. For someone who is metabolically healthy, it would seem that as long as the foods you eat are whole foods, macronutrient ratios don’t really matter that much.

In relation to NEFAs there is another issue of interest. CarbSane is worried about the elevated NEFAs that seem to be produced in those on very low carb (VLC) diets, however, I believe this worry may be misplaced. The reason I believe it may be misplaced is because the phenomena of elevated NEFAs seems to be caused by very different things in diabetes than in a VLC diet and I do not believe elevated NEFAs are sufficient to produce diabetes in an individual outside of the context of elevated NEFAs in the pathogenesis of diabetes described above. On a VLC diet, insulin is being minimized and so lipolysis is encouraged and since virtually no carbs are being eaten this makes sense as lipids are the main fuel source. A normal person on the SAD would have a lower level of NEFAs but they are also running on a combination of lipids and glucose so this makes sense. On a VLC diet, the elevated NEFAs are also not occurring in defiance of insulin but because the diet is designed to produce little insulin in the body. Hormones are thus not being disturbed in the same way. Also, I wonder how rigorously “elevated” is being applied which is to say that if people on a VLC diet have elevated NEFAs relative to those on the SAD, I’m not sure if that really means anything. In the pathogenesis of diabetes it does since a diabetic on the SAD versus a “normal” person on the SAD can be compared to one another to see what difference the pathological state is having on that person. VLC is designed to elevate NEFAs so unless your body is trying to kill you, I find it hard to believe that elevated NEFAs in the context of normal functioning are a problem or that we would be designed in such a way that would put our lives in mortal danger if we were forced to survive on a VLC diet. Once again, I must say that I believe that any macronutrient ratio is perfectly fine so long as food toxins are not consumed and whole foods are consumed.

Looking through some posts at hyperlipid (this one in particular) it would seem that VLC produces a temporary physiological insulin resistance since the body is getting adapted to low carb intake but that this is not pathological and if one were to change to high carb the next day, the body would adapt to it and become insulin sensitive within a week. Thus, the carb loading that low carbers due before blood sugar tests are done because those tests are attempting to measure how insulin sensitive your tissues are in the context of a moderate to high carb diet. The low carbers thus make their diets temporarily moderate to high carb in order to get an accurate reading of insulin sensitivity.

In summary, I am coming to believe that this physiological insulin resistance and elevated NEFAs are nothing to worry about so long as they are not in a context that suggests that they are markers of a pathological state which I believe they are not in the context of a VLC diet. Now, I do not advocate a VLC diet for other reasons and if you do believe these things are to be worried about, the solution is simple. Instead of a very low carb, high fat diet eat a low to moderate carb, high fat diet and there you have it.

Filed under: ASP, Diabetes, Diet, Hormones, Insulin, Macronutrients, NEFAs, Obesity, Pathogenesis, VLC