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Monday, January 16, 2017

Helping You Eat Healthier

Part 1  –  What is Healthy Eating…

     …and Where Can I Find It?

There are two challenges commonly encountered in nutritional counselling. The first was expected as I first began practicing, and the second was more of a surprise.  The first was explaining what the concepts of healthy eating are and the second is helping people find ways to do it eating away from home.  I was originally trained in the 1970’s when Americans consumed a minority, 25%, of their meals outside of the home.  What has changed is that this figure in now about 50%, or as many meals out as at home.

To help with that we are reviewing restaurants and other sources related to healthy eating and will be posting them in this series as well as on our website.  Our goal is not to favor any particular resources but to expose you to as many healthier ones as we can.  If we have missed any, we would love to hear about them, review them and add them to our list.

But first to explain how we developed our list we must explain a little about our basis of understanding healthy eating.  If one looks at the shift in our food supply that has negatively impacted our health, certain changes stand out as the “large offenders”.  These include:

  • Greatly increased carbohydrate consumption
  • A shift to less healthy dietary carbohydrates and fats
  • A large increase in the omega-6 to omega-3 fatty acid ratio
  • The heavy processing of grains
  • Genetic modification of foods

Greatly increased carbohydrate consumption

The genetic makeup of the majority of western populations favors better metabolic suitability eating a lower carbohydrate diet.  Although we have not changed genetically over the past few million years, the amount of carbohydrate has doubled in our diet.  While this was a gradual shift over most of human existence, it accelerated dramatically over the past 100 years.

The excessive carbohydrate in the diet is now understood to be a primary driver of the obesity and diabetes epidemics.  It is also currently understood that the total fat in the diet is less problematic than is the type of fat which is discussed below.

A shift to less healthy dietary carbohydrates and fats 

Our ancient ancestors derived the carbohydrate energy in their diet primarily from vegetables and healthy nuts/seeds with less from fruits and none from grains or simple sugars.  Grain and simple sugars are now the dominant source of carbohydrate energy in western diets.  Grains have the highest glycemic load which is the stress a food places on our carbohydrate processing enzymes and hormones.  Simple sugars greatly add to this and have been recently declared as a major driver of the obesity epidemic.

The fat in the Paleolithic diet was dominantly monounsaturated and polyunsaturated.  This was the result of higher consumption of nuts/seeds, vegetables and wild grazed animal product such as meat and eggs.  The monounsaturated fats are a known generator of the health benefits of the Mediterranean diet.

The shift to higher amounts of fat from grain fed animal products, and grain and legume oils has shifted this to a higher saturated fat profile.  While some saturated fat in the diet is fine, higher amounts combined with higher carbohydrate intake generates inflammation in the body and is associated with disease risk.  Dale Bredesen, M.D., an Alzheimer’s researcher at UCLA and developer of the MEND treatment program for Alzheimer’s, calls the high carb/high sugar/high saturated fat diet the “Burfooda Triangle” referring to the place where a lot of brains disappear.

The heavy processing of grains

The carbohydrate in grains has a very high glycemic load increasing blood sugar faster and longer than other carbohydrate sources such as vegetables.  This increase in glycemic load is caused by the removal of about 80% of the fiber during refining.  As the refining removes the essential oils which give grain much of its taste, taste is typically added back with sugar further increasing the glycemic load.

The negative effects of grain refining include:

  • Removal of most of the fiber
  • The removal of essential oils and taste
  • The taste issue is compensated typically by added sugar
  • Refining removes between 50-100% of all 23 essential vitamins and minerals

Too much grain is ill-suited to human metabolism and refined grain consumption worsens the problem.

A large increase in the omega-6 to omega-3 fatty acid ratio

Omega-6 and omega-3 fatty acids are used to make pro-inflammatory and anti-inflammatory generators respectively.  The Paleolithic diet was dominant in omega-3 fatty acids as most come from healthy nuts/seeds and vegetable sources.  The fat consumed from animal sources was high in omega-3s as the animals ate mostly green browse such as grass and leaves.  Most animals in the food chain are now fed grain and legumes as it is cheaper and they fatten better and faster.  This has caused the large increase in the percentage of saturated fat in these products but has also shifted the omega fatty acid content from animal product to mostly omega-6. The current western diet has an omega-6:omega-3 ratio of 12:1 which is pro-inflammatory.

Genetic modification of foods

A whole book could be written about the health aspects of GMO foods.  While the concept was developed with good intention, that of helping to feed the starving world, it has largely contributed to over-feeding the developed world.  It has also been a major contributor to the grain dominance and of the shift in fat type and omega-3 fatty acid content in the western diet.

Just to mention some of the recent other major concerns about GMO crops three stand out; food based glyphosate exposure, food induced epigenetic changes and food toxicity.  Glyphosate is the main active ingredient in the common herbicide used on GMO crops.  Soybeans are genetically modified to be tolerant to glyphosate allowing growing fields to be sprayed to remove weeds.  The newest version on GMO corn is also for glyphosate tolerance.

Glyphosate has been shown to injure the human gut lining and is thought to be a contributor to many functional digestive disorders, food sensitivities and perhaps autoimmune disease.  There is also an open question regarding chronic low level exposure and cancer risk.

Food induced epigenetic changes refers to genetic material from the plant changing the pattern of gene activation in the person consuming it.  All humans harbor some genes that when activated may trigger certain diseases.  These genes are, however, protected as our DNA is rolled into balls called histones that don’t allow direct access to each gene inside.  The epigenome consists of areas on these histones that environmental signals can flip allowing access to these genes.

Recently little pieces of genetic material called microRNAs from GMO foods were shown to flip on some of these areas causing ill effects.  Lab rats fed a GMO rice meal tended to develop high LDL or bad cholesterol levels.  A study examining this confirmed that in fact it does by 39% comparing to animals eating a non-GMO grain.  The mechanism was the altering of the gene expression in the animals causing them to reduce the production of LDL receptors in the liver.  These LDL receptors trap LDL circulating through the liver removing it for breakdown.  A piece of genetic material found in the GMO rice called micro RNA 168a changed the animal genetic expression of the LDL receptor.

The herbicide and pesticide contamination comes largely from large commercial crops particularly GMOs as discussed above.

The Solutions

There are solutions to all of the above problems.  Some are behavioral such as deciding to eat dominantly vegetables, fruits and nuts/seeds as carbohydrate rather than dominantly grain.  The US serving ratio of grains to fruits & vegetables is 3:1.  More ideally it should be reversed with 3 times more vegetables & fruits than grains.

This shift also helps two other imbalances, the fat type ratio and the omega-6 to omega-3 ratio.  Vegetable based foods such as avocados, nuts/seeds and olive oil are dominant sources of the more healthy mono-unsaturated fats.  Green plant foods are a source of alpha linolenic acid which the body converts to omega-3 fatty acids.  Grains are rich in linoleic acid which is converted to omega-6 fatty acids.  Animals eating green plants make omega-3s, while those eating grain make omega-6s.  True grass fed beef contains 3-5 times greater omega-3 fatty acids than grain fed beef. We need to be careful what we eat but also what our animal source foods have been eating.

Vegetable and nuts provide greater satiety of the signaling of fullness which helps to reduce the cravings that drive high carbohydrate consumption.  This pattern shifts to less carbohydrate and greater amounts of healthy fats.

As the vast majority of GMO foods and herbicide exposure come from grain and legume crops the above shift helps there as well.  Simply refusing to eat GMO is the best answer.  While we do not have GMO labeling requirements, certified organic products cannot contain GMO products so they are the best assurance of non-GMO.

In the next post I will explain my “filters” to look for to ensure healthy eating.  Once these are understood anyone can evaluate any food source for healthy quality.  Following that we will begin posting the individual reviews to make your task easier.  All of this in the name of healthy eating!

 


Wednesday, January 11, 2017

Detoxification

The Housekeeping That Slows Aging and Fends off Illness

Detoxification is an essential process in maintaining aging resilience and health.  This system works 24/7 cleaning up the “trash” in our system each day.  That includes:

  • Hundreds of breakdown products of our metabolism
  • The residues of the mix of over 80,000 chemicals that we put into our environment including food and water
  • Many dozen hormone residues that can abnormally alter cell function if not eliminated.

That is a lot of work, and the system that does it must function optimally each day.  So here is the problem.  Part 1 of the problem is that our toxic load is higher than ever.  There are 80,000 chemicals approved for use in the U.S. from pesticides to flame retardants, and their residues are found in our food, water, air and even uniformly in human blood and urine samples.

Part 2 of the problem is that the maintenance of this detoxification system to keep it functioning well is at historic low levels.  This system relies heavily on a family of over 1000 enzymes in the liver called cytochromes.  These enzymes are the workers that trap and convert the toxins into excretable forms for elimination.  These cytochromes are highly dependent on our nutrition for recharging.  A broad array of “phytonutrients” which comes predominantly from properly grown fruits and vegetables.

Some of the current problems with “recharging” these cytochromes result from several issues:

  • Commercial growing methods reduce plant phytonutrient content between 60-70%.
  • While vegetables and fruits have been the dominant source of our plant food for about 6 million years, we have shifted to a grain based diet in the last 100 years.  Grain is a poor source of these phytonutrients.

So we have a greater need now than ever before to detoxify combined with weaker detoxification systems. The Standard Process 21-day Purification system is a great way to right this ship a couple of times each year.  The program involves 3 weeks of organic, whole food derived supplements combined with daily nutrient dense smoothies and other phytonutrient loaded foods.  The benefits have been shown to include weight loss, improved skin appearance, energy improvements, better sleep and improvements in blood sugar levels and blood lipids levels.

Join us at 5:30 PM January 18, 2017 to learn about this great program.  Our guest for that program will be Jeannine Ruggieri of Mid-Atlantic Standard Process who will share both her professional and personal experience with the 21-Day Purification Program. Just call the office to reserve your spot!  Guests are welcome.  Call the office at 757-456-5053 and reserve a seat!

 


Tuesday, January 10, 2017

Is It Running Really Rough?

…time for a tune up!

Hesitating when you try to accelerate?

Idling rough?

Won’t start easily in the morning?

The exhaust not looking good?

No, we don’t mean your car, we mean you!  If this was your car, you would have it in the shop to get tuned up.  These are all symptoms of poor detoxification along with weight gain, poor sleep, poor skin quality, blood lipid abnormalities and many others.

These detoxification systems work 24-7 to clear anything we cannot metabolize out of the body.  Metabolized simply means “to burn up as energy or convert to storage fat”.  The human body can only do that with protein, carbohydrate and fat but not with the immense amounts of chemicals and internal breakdown products it must deal with each day.

What else do we deal with:

  • 80,000 environmental chemicals in food, water, air
  • 10,000 chemicals allowed as “food additives”
  • Hundreds of our own hormone residues

So how is that done?

Toxins have always been in the human environment.  However, it was a few hundred from sources such as volcano smoke and heavy metals in some foods sources.  Humans have always had a sophisticated detoxification system to manage these toxins. It begins with a 2-part liver enzyme breakdown process and then help from the kidneys and digestive tract to usher the breakdown products finally out.

This process, however, requires constant “recharging” from dietary nutrients.  It is also a finite system that has a capacity that can be exceeded causing many ill health effects.  This finite capacity and its ability to be overwhelmed is why we hear the little disclaimer at the end of so many drug commercials about “your doctor may want to check your liver enzymes regularly”.  When the amount of drug residue to be detoxified exceeds that capacity, liver cells get injured and leak enzymes.

What’s the problem?

We are at a historic mismatch of a greatly increased toxic load with greatly decreased food content of the phytonutrients that help recharge our detoxification enzymes.  It is the “perfect storm” for toxic related symptoms and illnesses that have been related to toxic overload such as diabetes, autoimmune disease, cancer and several others.

An ongoing study by the CDC of the levels of 32 toxic volatile compounds found in human blood samples found the following in 1990:

  • No subject exhibited none of the 32
  • The average across the large study population was 14
  • Several subjects exhibited all 32
  • Toxic levels were equally found in those from diverse urban/rural, occupational and age groups – none of us are immune!
  • Each subsequent decade has shown persisting and increasing levels

What is the solution?

The best solution is minimizing toxic exposures and eating an organic, high fruit/vegetable, low processed food diet which maximizes the detoxification phytonutrients.  For many this seems to be to a difficult task.  Another option is to do a detoxification program twice each year to regenerate the system for the next several months.  The Standard Process 21-Day Purification program is ideally suited for this option.  The program often leads to encouraging health effects that motivate many to make more lasting changes to their eating.

To help everyone with this process we are hosting an interesting program with Jeannine Ruggieri of Mid-Atlantic Standard Process.  Jeannine will enlighten us about this great program through her own story of how she resolved many of her own health challenges with it.  Please be our guest for this educational program.  Join us at 5:30 PM January 18, 2017 to learn about this great program.  Just call the office at 757-456-5053 to reserve a seat.  Guests are welcome.  Just let us know to save a seat for them also.

 


Wednesday, January 4, 2017

Give us 3 weeks…

…and we will give you a lot more!

Join us January 18, 2017 to learn about the Standard Process 21-Day Purification Program.  This unique 21-day program is designed to purify, nourish, and help maintain a healthy body weight.  Combining a generous menu of whole foods with nutritional supplements, the purification program support the body’s ability to remove naturally occurring toxins and helps patients define a new normal way of life with healthy choices.

The purification program is a great way to jump start a healthier 2017 reaping a broad array of health benefits.  A study of the outcomes of the 21-day program was done at my alma mater, Logan University.  The results were striking given that they occurred in just 3 weeks.

For many the Standard Process 21-Day Purification Program is a quick way to see results and begin a consciousness of healthier lifestyle.  To help you along this path we will have a gift for everyone beginning the purification program in January – A copy of perhaps the best healthy living cookbooks out there.

Join us at 5:30 PM January 18, 2017 to learn about this great program.  Our guest for that program will be Jeannine Ruggieri of Mid-Atlantic Standard Process who will share  both her professional and personal experience with the 21-Day Purification Program. Just call the office to reserve your spot!  Guests are welcome.

 


Tuesday, January 3, 2017

The Growing Dark Side of Proton Pump Inhibiting Drugs

There are other options!

The methods used to study and approve drugs often do not have the sensitivity to predict complications that may occur with the longer-term use of many drugs.  These complications will typically not become apparent for a decade or so.  As we get well out past a decade of use with the most common class of drugs to limit stomach acid production, proton pump inhibitors or PPIs, the list of complications continues to grow.

Prior to the last 2 years the established list of adverse events associated with long-term PPI use included:

  • IBS
  • Intestinal clostridia infection
  • Gut yeast infection
  • Pneumonia
  • Neuropathy
  • Magnesium deficiency
  • Osteopenia/osteoporosis

Over the past few years several potentially more serious adverse effects have been seen.   These more recently understood adverse effects are even more alarming given their strong potential impact of quality of life and mortality.  These newer associated effects include:

Stroke  –  Results of a new study were presented at the annual scientific meeting of the American Heart Association.  Higher dose PPI long-term use was associated with a 70% risk of ischemic stroke.  The researchers presenting this study data conclude that “Physicians should encourage more cautious use of PPIs”.  They extended these conclusions to a special concern about PPI use in the United States where several of the PPIs associated with the risk are available without a prescription over-the-counter (OTC).

These complications are thought to be the result of their reduction in nitric oxide synthase levels, an enzyme needed for healthy relaxation of blood vessel walls.  This opens the understanding of another recently associated adverse effect, cardiovascular events such as heart attack.

Cardiovascular events  –  A just published study in the journal Neurogastroenterology and Motility (2016) reviewed all of the data from the previous 17 research trials involving 1750 subjects.  The analysis found that patients using a PPI had a mean increase in cardiovascular events of 70%, strikingly similar to the increase in stroke risk.  Use of one particular PPI was associated with a 217% increased risk which is particularly of concern as it is perhaps the most commonly used OTC drug.  The longest users of any PPI were also at greater risk than the group as a whole with a 133% increased risk.

Chronic kidney disease  –  A study just published in JAMA Internal Medicine collected data from 2 large population studies involving over 250,000 adults looking at PPI use and the risk of chronic kidney disease.  Any use was associated with between 24% and 45% increased risk over the 12-year study period.  Higher use was associated with increased risk of 46% to 76%.

Dementia  –  A new study published in JAMA Neurology looked at the association between PPI use and subsequent dementia risk in a population of over 74,000 older adults.  Those using PPIs had a 44% increased risk of dementia.  Given this huge problem in aging populations the researchers concluded, “The avoidance of PPI medication may prevent the development of dementia.”  Part of the impetus for looking at this association was the observation in other research that the use of these drugs in laboratory animals was found to increase β-amyloid deposits in the brain.  β-amyloid is a toxic protein that is a major contributor to brain cell degeneration in Alzheimer’s and dementia.

The mechanisms by which PPIs increase this risk is not fully understood, but it is thought to be associated with:

  • PPIs are known to lower B12 and other B vitamin absorption.  These vitamins are needed for brain cell normal function.
  • PPIs enter the brain intact and have been shown to alter the function of the enzymes that are involved in β-amyloid production breakdown.

Other solutions

This growing and frightening list of concerns about PPI use should cause a paradigm shift – a new way of looking at the whole problem of dyspepsia or indigestion.  Perhaps the first area to look at is the overuse of these drugs.  Reflux, indigestion and related symptoms are often not coming from over-production of stomach acid.  There are several lines of research supporting this. They include:

  • 40-50% of those taking the drugs do not have good symptom resolution.
  • Studies of prescribing find that 50% of patient’s receiving a PPI do not meet published guidelines for appropriate use.
  • There are several known triggers of reflux symptoms such as food sensitivities which can be resolved by eliminating the problem.
  • Finding a solution should begin with an accurate assessment of the problem.  Most PPIs are prescribed solely on the basis of symptoms.  Even when an endoscopic exam is done and found to be normal, the institution of PPI therapy is then just symptom based.

The Heidelberg GastricpH Test is ideally suited to truly evaluate upper digestive tract acidity.  The test uses a telemetry capsule to transmit pH signals to a receiver which is placed over the stomach. The capsule is swallowed with water, and once it reaches the stomach it sends pH readings to the receiver on the surface of the stomach.  The capsule is tethered to a piece of surgical thread to hold it in the stomach preventing it from quickly passing into the small intestine.  This allows stomach pH readings to be taken repeatedly over the 1-2 hours needed for the test.

A more in-depth description of the test can be found at the link above.  When this test is combined with a thorough history and evaluation, the source of reflux/indigestion can be found and targeted corrective therapy can be used.  The broad use of PPIs as is the norm now will continue to be looked at with greater caution as the research about the long-term effects evolves.  Quick relief today may come at a great cost down the road.

 


Wednesday, December 14, 2016

The Post I Never Wanted to Write…but here I am!

A very controversial paper was published 11 years ago in one of our most prestigious medical journals by a group of prominent epidemiologists.  In this thought provoking paper in the New England Journal of Medicine the authors predicted a decline in life expectancy in the United States in this century.  Their words were disturbing, “…the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly shorter lives than their parents”.

These projections were based on the continuing increase in diseases driven mainly by lifestyle factors such as nutrition and exercise.  The most glaring example is the explosion in type 2 diabetes with the percentage of the population with it doubling about every 15 years.  The part of this iceberg not well seen as it is “below the water line” is prediabetes which now affects 1 in 3 U.S. adults and 15% of adolescents.

So back to the part I never wanted to have to post.  The purpose of that controversial paper was to enlighten us about the dead end that lay at the other end of the route through the maze that society was taking with lifestyle.  The enlightenment was, of course, to push our lifestyle route through this maze in another direction.

Unfortunately, this message got ignored perhaps based on two other misleading messages.  These are that high carb, sugar loaded, chemical laden manufactureddiets that the U.S. consumes couldn’t be that bad and that no matter what we do to ourselves, there are drugs and medical procedures that will serve as the wild card to negate the risk.  We now know the message the prominent epidemiologists gave us 11 years ago was accurate and that these other two competing messages are largely untrue.

The National Center for Health Statistics which tracts statistics on most aspects of our nation’s health revealed some sobering data earlier this month.  For the first time since 1993 during the peak of the AIDs epidemic life expectancy in the U.S.declined.  The current youngest children will have a life expectancy less that of the parents and grandparents.

The primary reasons for the developing decline are the increasing rates of deaths from diseases including:

  • Heart disease
  •  Stroke
  • Diabetes
  • Alzheimer’s disease
  • Kidney disease

These statistics are in spite of ever growing numbers of adults being treated with drugs such as statins which are assumed to be preventing this outcome.  Telling of this disconnect was shown in a study published this year in the Journal of the American Heart Association.  The study looked at the ability of statin treatment to prevent or improve plaque build-up in the carotid artery, a factor that is known to increase the risk of both stroke and heart disease.

While non-obese subjects had an average plaque reduction of -4.2% after one year of statin treatment, obese subjects had an average +4.8% increase with the same treatment.

It seems arterial disease is driven by the interaction of several factors not just the levels of LDL cholesterol.  One noticeable associated factor was an inflammatory marker called C-reactive protein (CRP).  Central body fat (belly, waist, hips) generates pronounced inflammation which increases the risk of all 5 diseases mentioned in the list above.  Elevated CRP increased the risk of plaque progression 156% in 1 year.

Before the mind goes to just add an anti-inflammatory drug, a couple of things should be considered.  Their long-term use is associated with substantial increased risk of renal failure which is one of the cited diseases driving the downturn in longevity.  In contrast for every hour of sedentary time replaced by moderate physical activity there is a 24% reduction in the inflammatory marker CRP.

There are many more examples of the inferiority of the treatment of lifestyle driven abnormalities with drugs versus corrective lifestyle.  I talk to several prediabetics each month who are not aware that they have prediabetes in spite of lab studies demonstrating it for a couple of years.  I also talk to diabetics who have been told their blood HA1C levels are good at 7.0% because the medication has lowered it from 9.5%.  The normal range is <5.7% and the increased vascular disease risk at 9.5%, or poorly controlled diabetes, is +130%.  While the risk is lower at an HA1C of 7.0% it is still 40-60% higher than if it was in the normal range.

So why is 6.5%-7.0% which is the upper prediabetic range “good control” with medication? Studies have shown that pushing it lower with that type of treatment will cause episodes of intermittent hypoglycemia and actually increases overall death risk.  The only way to safely improve more in that circumstance is with intense lifestyle management including dietary change, exercise and weight loss.

Another example of how these diseases interrelate was discussed in the scientific section of the European Association for the Study of Diabetes.  Dutch researchers reported their study of brain changes associated both with diabetes and with prediabetes.  The reason for looking at this is that diabetes is a strong risk factor for developing some form of dementia such as Alzheimer’s disease.

Two imaging findings are associated with the brain changes driving dementia in diabetes.  The first is diminished brain volume which represents actual loss of large numbers of neurons or brain cells.  The second is white matter lesions (WMLs) which represent small areas of damage caused by altered blood flow.

Diabetics had 167% greater numbers of WMLs than healthy controls.  Most surprisingly, prediabetics demonstrated considerable increased WMLs with 66% more than age comparable healthy adults.

Brain volume reductions showed similar patterns with diabetics having the greatest but prediabetics having abnormal amounts as well.  The structural brain changes associated with eventual dementia are present in prediabetes but just not as advanced as in diabetes.

So the circumstances at the time I wrote newsletter articles about the New England Journal of Medicine paper 11 years ago have changed.  That alarming projection has become an alarming reality.  What is the same is two-fold.  First is the 11-year old projection should serve as a dramatic wake-up call.  The second is the solution remains the same although more urgent.

In the developing years of 20th century healthcare infectious disease was a major cause of death, and it could be effectively treated with a single drug.  That idea has persisted as the main tenent of health care.  The 21st century finds very different challenges, complex multi-system diseases highly related to several interacting lifestyle errors.  These diseases are not well managed with the one disease/one drug approach we have seemed to carry over.  They are also not ideally managed with the common 6-10 drugs that are trying to get at late effects of chronic lifestyle neglect.  We are working only in the right side of first diagram above.  The solution really lies in working predominantly on the left side of it.

Olshansky et al.  A POTENTIAL DECLINE IN LIFE EXPECTANCY IN THE UNITED STATES IN THE 21ST CENTURY.  New England Journal of Medicine, 2007;352:1138-1144.

Sandfort et al.  OBESITY IS ASSOCIATED WITH PROGRESSION OF ATHEROSCLEROSIS DURING STATIN TREATMENT.  J Amer Heart Assoc, 2016;5:e003621.

Perneger et al.  RISK OF KIDNEY FAILURE ASSOCIATED WITH THE USE OF ACETAMINOPHEN, ASPRIN, AND NONSTERIODAL ANTIINFLAMMATORY DRUGS.  New England Journal of Medicine, 1994;331:1675-1679.

Falconer et al.  SEDENTARY TIME AND MARKERS OF INFLAMMATION IN PEOPLE WITH NEWLY DIAGNOSED TYPE 2 DIABETES.  Nutrition, Metabolism & Cardiovascular Disease, 2014;24:956-962.

Sullivan MG.  BRAIN ATROPHY IS ALREADY EVIDENT IN PATIENTS WITH PREDIABETES.  Clinical Endocrinology News, Sept 14, 2016.

 


Thursday, November 10, 2016

How Hunger Games Bolster Brain Function

 Part 6 of “What Six Months of Soup Can Teach Me”

In many ways this installment of the blog on the benefits of modified intermittent fasting is the most fascinating.  It deals with the idea that the cognitive function of our brains actually improves during the times of sustained caloric reduction.  This interval refers to at least 12 hours where energy or caloric intake is substantially less than immediate needs.  Perhaps the easiest way to get to this state is the modified, intermittent fasting we have been discussing in this blog.

In this modified fasting state, the body shifts to an alternative energy mode of burning stored energy from body fat stores.  To do so it alters a diverse group of hormones and signaling molecules that actually help several of our systems, including the brain, actually function more efficiently.

While this may seem surprising, this trait was essential for man’s survival for most of our existence as we faced a constant challenge to regularly find/catch enough food up until approximately the past 200 years.  We are genetically wired to have heightened function during times of caloric restriction.

The following quote from a Dr. Mark P. Mattson at the Laboratory of Neurosciences, National Institute on Aging in the medical journal, Aging Research Review explains this apparent dilemma:

Because it evolved, in part, for success in seeking and acquiring food, the brain functions best when the individual is hungry and physically active, as typified by the hungry lion stalking and chasing its prey. Indeed, studies of animal models and human subjects demonstrate robust beneficial effects of regular exercise and intermittent energy restriction/fasting on cognitive function and mood, particularly in the contexts of aging and associated neurodegenerative disorders.”

Both animals and humans have required intense mental focus in the fasting state when they were in pursuit of food.  The linking of fasting to better brain function was inherent to survival.

The metabolic changes during the fasting state were thought to impart an advantage to the success of finding subsequent food either through hunting of gathering.  It appears this fasting state increases mental alertness that would be needed pursuing wild game.  This interesting video about Dr. Mattson’s research is about how mice who have an increased genetic pattern towards developing memory impairment and dementia can greatly reduce this tendency with periodic fasting.

When the research is examined on caloric volume/intake the conclusions appear to be that a balance is needed.  There is a wealth of research correlating chronic caloric excess with chronic disease.  Obesity and diabetes, two well established diseases linked to chronic caloric excess are both important risk factors for dementia and Alzheimer’s disease.

Dr. Mattson summarized this best in his Aging Research Review paper:

“In addition to disengaging beneficial adaptive responses in the brain, sedentary overindulgent lifestyles promote obesity, diabetes and cardiovascular disease, all of which may increase the risk of cognitive impairment and Alzheimer’sdisease.”

In contrast, there is a growing body of research finding that regular, intermittent negative energy balance or caloric deficit increases brain functioning and cognition.  Prominent brain researchers are now advocating intermittent fasting as an important therapy for cognitive decline.

The moral of this relationship between periodic fasting and better cognitive functioning is not that it is needed now to pursue food successfully.  Spending an afternoon observing the legions regularly gorging in fast food establishments would testify to that point.  For most of us we need only to think about the sleepy, foggy brain status after some feasting event such as a thanksgiving meal where we over-indulged.

The current value of periodic fasting is not survival by better food obtainment but rather better brain functioning by its ability to “re-set” metabolic functioning that is so critical for optimal brain health and function.  While ongoing caloric restriction can effectively improve a wide array of chronic health challenges including brain health and cognitive functioning, few will adopt that long-term behavior.  The intermittent modified fasting as described in this series results in much the same long-term benefit but in a much more lifestyle friendly manner for most.

 


Thursday, October 13, 2016

Modified Intermittent Fasting and Powerful Antioxidant Effects

Part 5 of “What Six Months of Soup Can Teach Me”

I had a couple of weeks off from posting updates here related to conference travel.  As it is hard to impossible to do the 2 days a week of the program during travel, add to that a hurricane power outage and that became a couple of weeks off.  First, that’s OK.  A short interruption around life’s requirements won’t undo the benefits.  It will, however, if “life’s requirements” become a frequent norm rather than the exception.

The another observation over that time has been that some of the goals of the modified fasting program have become incorporated into my eating the other days.  These include less grains and lower carbohydrate consumption.  What the modified fasting helped my brain appreciate is that the benefits are many, and the “hardships” of doing so really aren’t hardships or difficult.  This is kind of like all of the worry about jumping into cold water that proves not to be that cold after all once we get in.

To summarize up to this point, modified intermittent fasting consists of only consuming a low carbohydrate, “paleo like” soup two non-consecutive days each week.  The first serving is eaten within 30 minutes of getting up.  The second is eaten 12 hours later. This would create a low energy meal at say 6 AM followed by 12 hours of fasting, a second low energy meal at 6 PM followed by another 12-hour fast until the next morning.  Normal eating occurs on the other 5 days.

The fasting intervals move us from the fed mode where we build fat to the fasting mode where we burn fat for energy.  The important changes, however, are that in this fasting mode, blood sugar, insulin, inflammatory signaling and blood lipid profiles all occur.  With time these factors permanently shift from the disease causing pattern to a disease improving/preventing pattern.

We left off in the 4th post talking about the metabolic effects of this 2 day each week program, and they are many including changes that lower the risk of diabetes, heart disease and about all of the other common chronic metabolic related diseases that are all too prevalent.  While it may be easier to see how eating a very small amount of carbohydrate 2 days per week would help improve blood sugar levels as well as blood lipids such as cholesterol and triglycerides, it may be a little harder to understand how it may help the risk of many cancers and of degenerative brain diseases such as dementia and Alzheimer’s Disease.

Many of the positive effects of modified fasting do relate to spending time with lower energy intake, particularly of carbohydrates.  This moves us from the metabolic pattern of converting excess carbs/sugars to fat which is the American dietary induced norm and to one where we begin to covert stored fat back into energy.  Another very important one is that it upregulates our production of internal antioxidants which has broad benefit to reducing the risks of many types of disease.

We humans produce potentially harmful molecules called free radicals.  These are molecules that are generated by metabolism and can damage our own tissue if they are left active too long.


They are notable in that they are missing one electron in the outer portion.

Electrons have to be paired in even numbers to be stable.  The molecule in the left side of the diagram has 6 electrons in the outer ring.  Notice that each one has a paired electron opposite it.  The free radical on the left is simply one that has lost one electron and is unstable.  This loss could have been triggered by normal metabolism which makes a few mistakes or some stress exposure such as radiation or toxins.

The problem with a free radical is that it will aggressively seek to steal an electron form a molecule close to it to become stable.  Two locations that this may occur with important consequences are stealing a molecule from our cell DNA or from the cell membrane.  That area of the DNA is then damaged or mutated and often becomes a potent disease generator from heart disease to cancer.

The cell membrane is how the cell protects its inner components such as the DNA and also how the cell communicates with the environment outside the cell.  If the membrane becomes damaged, its communication is impaired.  For example, if insulin is trying to tell cells to take in glucose that may be impaired.  This process is termed “insulin resistance”, and it is an important early step in the development of diabetes.

As we would expect there is a potent system to neutralize free radicals, the antioxidant system.  Antioxidants can donate an electron to a free radical making it neutral and preventing it from damaging cell components to find this electron.

While dietary antioxidants help to neutralize the free radicals that we generate continually, they are often sporadically supplied and are inadequate at fully neutralizing the average daily production of free radicals.  The majority of antioxidants are plant based in fruits and some vegetables that were sporadically available only during certain seasons.

So how did humans survive for 5-6 million years with erratic availability of food based antioxidants?  We have another internal system of antioxidant enzymes.  The dominant members of this family include glutathione (GSH), super oxide dismutase (SOD), and catalase (CT).  These enzymes account for about 80% of the total antioxidant capacity on the body on any given day.

On days where we have good food based antioxidant exposure we are at 100% antioxidant capacity.  If the dietary component is weak, we still have 80% of our total capacity.  This is why the majority of large longitudinal studies have failed to find strong links between dietary antioxidant supplements and strong disease preventative effect.  In contrast, studies that have looked at our internal levels of antioxidant enzymes and disease find that there is a strong correlation with protective effect.

This understanding brings up the important question, what increases our internal antioxidant enzyme production?  The first clues came from studies on ongoing caloric restriction.  Ongoing reductions of caloric intake of 40-50% have been associated with extensions of healthy lifespan (disease free) of about 20%.  The next step was to explore how sustained caloric restriction does that.  A major factor was that it causes a marked increase in the production of these protective antioxidant enzymes.

That’s where the difficulty came in.  Few adults will adhere to this daily dietary pattern from mid-life on.  This modified intermittent dietary pattern demonstrated many of the other benefits of caloric restriction including lowering blood glucose, insulin and improving blood lipid patterns.  Given this similar pattern of improvements to daily caloric restriction, the impact was then examined on antioxidant enzyme production.  Sure enough it also causes increases in these important disease preventing enzymes.  As modified intermittent fasting is much easier for most to follow compared to ongoing, heavy caloric restriction, it is a viable alternative to reap these benefits.

This relationship between modified intermittent fasting and improvement in internal antioxidant enzyme levels opens up understandings of how this pattern of dietary behavior may produce benefits such as cancer protection and anti-aging benefits rather than just fat loss.

One of the most fascinating beneficial effects of modified intermittent fasting and disease prevention/modification is its ability to improve brain function.  Given the emerging epidemic of degenerative brain diseases such as dementia and Alzheimer’s Disease, the implications are immense.  We will discuss this area in the next post.

 


Thursday, September 8, 2016

How to Tell If Diet Mismatches Genetic Determined Metabolic Ability

Part 4 of “What Six Months of Soup Can Teach Me”

A few practical tips on doing this modified fasting diet are in order.  Timing this around what is going on in life can be helpful.  It gets harder during stressful times.  This made me appreciate how “stress eating” is a problem in the first place.  In contrast, this gets easier during times of high constructive activity.  It seems if we are meaningfully engaged, we don’t get as preoccupied with eating.  The moral is that controlling stress and being busy with meaningful activity is a poorly appreciated part of good dietary behavior.

On to the issues of what is happening with our eating behavior and why a modified fasting diet can be so helpful.  The real issue with the current Western diet for the majority of the U.S. population is that its composition places maximum stress on the portion of our metabolic machinery that is least adept at handling it.  Maximum stress on a weak area typically will cause failure, which in this case, is chronic metabolic disease.

That weak area is the broad group of enzymes used to manage a main end product of carbohydrate digestion – sugars.  There are many dozens of different enzymes involved in the process of trying to convert sugars into energy.  As we previously discussed, when the amounts of sugars exceed the need at the moment, it goes to the liver to be converted to the fat, triglyceride.  The triglycerides are then circulated destined for fat storage in the central (abdomen) portion of the body.  If carbohydrate/sugar intake chronically exceeds the need of the moment, triglyceride is increasingly produced and fat stores increase.

One of the primary features of the Paleo period genetic pattern is multiple SNPs of the genes involved in processing sugars to energy.  The 75-80% of westerners who have this pattern just cannot manage high amounts of carbohydrate/sugar under normal circumstances.

A great question to answer might be how much carbohydrate/sugar does one consume?

The chart shows estimates of both the amount of energy or calories from carbohydrate as well as the factors regarding its quality.  The more refined the carbohydrate, the faster the sugars become available generating more metabolic stress.  Added refined sugars require no digestion before absorption so all of their energy is immediately available whether it is needed at that instant or not.

By all measures the amount of carbohydrate in the western diet has increased from 200-600%, yet the genetic ability to manage it has literally not changed.  The second and equally troublesome factor is the “glycemic load” of the western diet.  Glycemic load is a combination of how much and how fast a given carbohydrate will raise blood sugar.  Not all carbs are created equal.  Simple sugars and grains have a disproportionately high glycemic load compared to fruits and vegetables.  Simply put, they generate far more stress per gram on metabolism than other carb sources.

A great analogy might be a worker who can process 50 files very accurately in a 40-hour work week.  If you want to make this good worker make a lot of mistakes you can do it one or both of two ways. Have them try to process 200 files in the same week (increased amount of carbohydrate), or have them try to process the same 50 files but only working 2 hours a day for the 5 days (high glycemic load).  The western diet is like having that worker try to do both!

So how do we tell if we are in metabolic stress trying to manage carbohydrates?  The first sign is white adipose tissue or belly fat which is stored triglyceride.

Typically, when triglyceride production stays high, more will be produced in the liver than can be quickly transferred to belly fat causing blood triglyceride levels to rise.  As fat stores become high, belly fat begins to produce inflammation which begins to injure insulin receptors which are needed to signal cells to take in and use blood sugar.  This fuels the whole triglyceride production cycle even further.

Additionally, when liver triglyceride production is high,  the production of HDL or “good cholesterol” drops and the production of a very small cholesterol molecule, VLDL, increases.  These VLDL particles are particularly worrisome as they become very small dense LDL which is the most dangerous regarding vascular disease risk.

The last step in this metabolic dysfunction cascade is that the insulin resistance so impairs the ability of cells to take in sugars to burn or convert to triglyceride that blood sugar rises.  At the first sign of this the diagnosis of “pre-diabetes” is made, and as it progresses it is eventually called diabetes.  Pre-diabetes is like calling the first trimester of pregnancy “pre-pregnancy”.  I think it should more appropriately be called simply early diabetes.

That was a lot so I’ll summarize.  The common order of problems showing up suggesting metabolic distress in handling carbohydrates is:

1)    Belly fat – excess triglyceride

2)    Increasing blood triglyceride – >125 mild concern, >150 real concern

3)    Decreased HDL – < 40-50.  A triglyceride/HDL >3 is a real concern

4)    VLDL cholesterol >30

5)    Increased small LDL particles – requires specialized testing called an NMR profile

6)    Increased blood sugar

The small LDL particle size needs a little explanation.  We generally make two sizes of LDL or “bad cholesterol”.  The size of the particles determines their ability to cause vascular disease with small, dense particles being more dangerous than large, fluffy ones.  We all make some of each but in varying ratios.  Genetics influence this ratio some, but diet also highly affects it.

The diagram shows 2 persons (“S” and “L”) with an identical LDL cholesterol value of 130 mg/dL.  This is the total weight of LDL in a fixed volume of blood. The small, dense particles are called apo B and the large, fluffy ones are apo A.

While person “S” and person “L” have the same total weight of LDL, person “S” on the left side has many more small particles and therefore greater risk.

Some persons with “normal” LDL cholesterol levels develop vascular disease while others with relatively high LDL cholesterol never will.  The particle size and number variable is thought to be an important determinant of this contradictory risk.

The point of all of this is that before blood sugar inches up into abnormal range, the body has been firing warning shots across the bow for many years with the above changes in body and blood profile.  Diabetes is a late effect of chronic metabolic chaos.

A minority in western populations can tolerate a greater percentage of carbohydrate and a somewhat higher glycemic load.  This is like the uncle someone has who smoked a pack of cigarettes and drank a quart of whiskey each day living to be relatively healthy until killed in a skydiving accident on his 90th birthday.  We all assume we are “that guy”, but they are very rare.  Most of us will need to give careful attention to matching our diet chemistry to our true metabolic ability.  Not doing so has led to the epidemic of metabolic disease which we are trying to beat down with drugs.  The food got us there, and it is the foundation for an effective solution.

So I continue with the modified, intermittent fasting to help reset my metabolism.  Starting with a normal body fat I still lost 7 lbs the first 2 weeks and 1 inch off my waist.  If you take the list of the problems that show up early indicating some metabolic stress, the modified, intermittent fasting does a “system restore” on it all.  The first indicator that that is happening is pulling triglycerides out of belly fat to burn for energy.  I choose not to curse my genetics but rather cheer the knowledge of a solution.

 


Thursday, August 25, 2016

What Six Months of Soup Can Teach Me

Part 3 – How Genetics and Lifestyle Interact, Good or Bad

The big question for all of us to address is how much of our health and disease outcomes will be determined by genetics and how much will be determined by lifestyle, particularly diet.  If you accept that genetics is largely responsible, you will be absolved of most responsibility for the outcome.  Your only hope is medical breakthroughs if you drew poor genetic cards.

If you accept that lifestyle is primarily determinant, it puts the control of your health fate squarely on you.  To my thinking, this is the best case scenario.  What science has shown us since the completion of the analysis of the entire human genome in 2000, the reality is that our health fate is a mixture of both genetics and lifestyle.

There are approximately 23,000 genes in each of us that our responsible for the design of the proteins, enzymes and other things that form are makeup and function.  Each gene can have many little variations called single nucleotide polymorphisms, or SNPs, with “many” being defined as 40-60.  Some 3.5 million SNPs have been identified in the human genome so we all have thousands of them.

A SNP is a variation of just one nucleotide in a long genetic chain of code.  This is shown here in two variations where “G” or “T” are substituted for the more ideal “A”.

If a polymorphism of a gene that makes an important enzyme in carbohydrate and sugar management exists, the resulting enzyme will function more weakly than normal rendering that person less carbohydrate and sugar tolerant.  Another way of saying that is that they will get in metabolic trouble more quickly eating a higher carb/sugar diet.

The reason I choose this example is that this pattern seems to exist in about 75-80% of the U.S. population including me.  My dominant genetic pattern comes from my mother’s side of the family, Irish transplants from the earlier 1900’s.  Diabetes and heart disease were the norm in the preceding two generations I knew.  A favorite uncle died of a second heart attack before the age of 40.

So what difference would this Irish/Western European genetic background have to do with carbohydrate tolerance?  It seems when our ancestors left Africa way back, they came to a fork in the road.  They must have listened to one of my favorite philosophers, Yogi Berra who was quoted saying, “if you come to a fork in the road, take it!”  My group turned left up into Europe, while others went to the middle east and beyond.

The theory goes that in Europe there were more animals which led to hunter- gathering type survival.  For those who took the right fork to the middle east, animals were more scarce so they ate more what they could gather which was more dominantly carbohydrate.  Once they figured out how to domesticate grain in Turkey in 9000 B.C., modern plant agriculture was born further increasing the percentage of dietary carbohydrate for those folks.

Two dominant gene patterns naturally occurred in these populations with implications about carbohydrate tolerance.  Those in the middle eastern group who genetically were favored to handle larger amounts of carbohydrate tended to be much healthier, while those who had the less able carbohydrate genetic pattern struggled.  One of the early victims of metabolic stress is fertility so each population became fairly uniform in genetic pattern suited to the food supply of the area.

My tribe was Paleo-type diet suited.  Migrate us again to the U.S and put our genetic pattern into a 55% carbohydrate, refined sugar and high grain dietary environment and metabolic chaos has ensued.

Fortunately, those who have genetic mediated difficulty in managing carbs/sugars problems can largely be prevented with parts of two different strategies.  The first is keep yourself in a dietary environment that does not stress your metabolic weaknesses.  This is the lower carbohydrate (<40% of energy), very low sugar eating pattern.  Carbs should also come only from whole, complex carbohydrates and are dominantly from vegetables rather than grains.  Grains have a glycemic load (they raise blood sugar and sugar management stress) 8-10 times higher than the same grams of carbs from vegetables.

The second part to managing genetic weaknesses is a targeted nutrient program.

The diagram shows an important enzyme reaction in converting a breakdown product of sugar, pyruvate, to acetyl CoA which becomes energy.

The conversion of pyruvate to energy is begun by the enzyme, pyruvate dehydrogenase, When the gene responsible makes a copy of the enzyme, it is inactive.  It is activated by “cofactor” which in this case is vitamin B1 or thiamine.  Those with a gene pattern that causes them to make a weak version of the enzyme can increase its activity by adding higher amounts of co-factor or vitamin B1.

The best approach to our genetic weaknesses is to consume a diet that is compatible with our strengths and places little stress on the weaknesses as well as supplementing extra nutrients known to increase weak enzyme activities.

But how can one tell what their pattern is?  There are a few ways.  First is family history, although that is not foolproof.  A lot of processed carbohydrate products didn’t exist when grandma was a kid, sugar wasn’t added to everything, nor was processed grain a staple as it is now.  She could have had a subtler carbohydrate intolerance that her diet didn’t not exploit, but ours will.

The second is “wait and see” which many are doing.  If we end up at 55 years old with diabetes and 2 or 3 other related diseases, it tells us more about our intolerances. I don’t think this “wish I had known sooner” approach is the right way to go for me.

The third approach is that different tests such as blood chemistry profiles show the stress of an imbalance between genetic mediated metabolic ability and our diet.  This allows the pre-empting of the potential bad outcome before it has done the damage.  I will talk about how to do that in the next post.

So what does all of this have to do with modified fasting and the chicken soup?  Everything!  If the body is saying we have a metabolic mismatch between fuel and the ability to manage it, modified fasting periodically helps perform a “system restore”.  I do it every so often to keep my computer healthy, why not for my health?


Thursday, August 18, 2016

What Six Months of Soup Can Teach Me

Part 2 – The Fed Versus Fasting State

A word of caution is needed here.  There are some health problems that may be helped by this intermittent modified fasting dietary pattern but it should only be done with the agreement of your doctor and with some professional monitoring during the process.  More severe diabetes controlled with medication is an example.  Reducing medication levels under supervision may be needed.  While this is an objective of the dietary pattern it must be done carefully with supervision.  Kidney disease may be another precaution.  So any doubt, coordinate any large dietary change with your treating physician.

So, how am I doing at this?  I am a couple of days into the 5:2 dietary pattern and no body parts have fallen off yet.  I didn’t expect any to but thought I should reassure everyone about that.

This dietary plan uses a modified fasting pattern of 2 days per week to “reboot” a more normalized metabolic pattern.  On the two days of the modified fasting, 1-1.5 cups of soup is consumed twice at 12-hour intervals.  Tea or black coffee can be consumed as well as water.  The idea is to switch our metabolism from the fed state to one of fasting.  But just “what does that do?” seems to be the question.

As I have a higher genetic risk pattern (I will explain that in a later post), and I tend to do things “the best they can be done”, I am actually doing the 3:4 version which is 4 days of modified fasting and 3 normal dietary days.  Dr. Mosley’s 5:2 version works, but I am doing it a little more aggressively – an affliction I have!

In the fed state dietary energy (calories) is used to provide immediate energy to cells.  All excess is then sent to the liver for conversion to a storage fat, triglyceride.  If fed state occupies too much of our day, we are in a fat production and storage mode increasing all of the diseases that are associated with it.  Carbohydrates especially accelerate the production of triglycerides, thus the high protein/low carb content or Paleo-esque nature of the soup.  The increase in carbohydrate in the western diet over the past 200-300 years from 30% to about 55% of energy has been particularly contributory to the overweight and obesity epidemic as well as its associated chronic disease epidemic.

An additional problem from the constant fed state that upregulates triglyceride production is that some persons have difficulty transporting all of the triglyceride out of the liver to fat storage.  This causes these fats to build up in the liver itself creating non-alcoholic fatty liver disease (NAFLD).  A recent study reported that the number of male teens with NAFLD doubled over the past several decades with 1 in 10 affected by the disease and 1 of every 2 obese teens affected.

In contrast when we are in the fasted state, triglyceride is pulled out of fat storage and burned for energy directly as triglyceride and as ketones which are made in the liver from triglyceride.  The reason the liver turns some of the triglyceride into ketones is that the brain can only burn glucose and ketones but not fat.  We can exploit that in some individuals with cognitive decline or mild dementia using a modified fasting to improve brain function, but more about that in another post.

There are many other positive benefits to spending some time in the fasting state.  It lowers blood sugar and insulin levels which lowers diabetes risk and the risks of many other associated diseases such as arterial disease (heart, stroke, etc), dementia/Alzhiemer’s disease, kidney disease, neuropathy and others.

The metabolic changes during the fasting state were thought to impart an advantage to the success of finding subsequent food either through hunting of gathering.  It appears this fasting state increases mental alertness that would be needed pursuing wild game.  This interesting video is about how mice who have an increased genetic pattern towards developing memory impairment and dementia can greatly reduce this tendency with periodic fasting.

One of the other convincing pieces of evidence for periodic fasting comes from studies about the effect of caloric restriction on healthy longevity.  It seems restricting overall energy consumption in mammals results in important increases in healthy longevity.  This is defined as not simply living longer but being free of chronic disease for a greater portion of this longevity as well, which I think is an objective of almost all of us.

The picture shows the measured effects of caloric restriction in laboratory animals.  The RER is resting energy reserves or stored fat, while WAT is white adipose tissue, the belly fat most associated with disease risk.  Notice the survival age with caloric restriction increases about 15-20% over the ad libitum, or free eating group.

The difficulty with caloric restriction is that it requires constant reductions in caloric intake of 60% for several decades, an ongoing lifestyle few would undertake.  Intermittent fasting, however, can induce a disproportionate amount of the benefit of ongoing caloric restriction but in a much more tolerated way for most persons.

I guess the other alternative is to live in the wilderness and only eat what you catch or find as did our ancient ancestors who were the origins of our genetic machinery.  This is a trait I learned from parenting.  If they don’t like option “A”, make it look better by giving them a less appealing option “B”!

Not everyone has the same urgency for avoiding the constant fed state and not everyone requires such strict adherence to the Paleo dietary pattern of only 35% of energy from carbohydrate, very low grain, no added sugars.  We are not all genetically wired the same.  There appears to be 2 dominant genetic patterns that most humans have which govern the urgency/intensity of dietary behavior.  I will discuss these 2 patterns in the next post, how they appeared to have originated and how to tell which you may have.  In the meantime, I continue to explore what six months of soup can teach me.  The first few days have been easier than I expected.


Thursday, August 11, 2016

What Six Months of Soup Can Teach Me

Part 1 – What is This Journey About and Why Do It?

Welcome to this blog series on the beginning of my adventure with several days each week of semi-fasting.  This journey begins after an encounter with a patient who I suggested make this specific lifestyle change.  The same question that I have answered many times  – “Do you do this?” – was their immediate response.  In the past I have always answered that I largely follow what I am asking them to do in my own ongoing lifestyle.  That response has been honest but left me feeling as if it were an evasive one.

I am not sure what struck me to respond differently this time, but here I am beginning the same journey that I suggested to my patient would be the ideal one for them to resolve several health issues.  I had suggested that this patient begin a 5:2 dietary pattern, a modified Paleo pattern that is perhaps more palatable and yet effective in the right circumstances.

The 5:2 dietary pattern was developed by Dr. Michael Mosley, although the credit for the scientific basis really should go back to our Paleolithic period ancestors.  Of course their contribution came out of survival rather than scientific curiosity concerning health issues.  These distant relatives survived by basically eating what they could find or catch only when they could find or catch it.  This led to a diet with the following characteristics:

  • ·         Animal based protein and fat
  • ·         Plants that grew naturally without agriculture
  • ·         No grain or dairy
  • ·         Periods of eating interspersed with long periods without eating
  • ·         Fairly intense physical activity in pursuit of food

In an interesting video about this eating pattern.

Dr. Mosley explains some of the rationale from the scientific perspective as well as his personal perspective.  I disagree with him somewhat on the exercise portion and will discuss this later in this series.

Currently it is estimated that 80% of all chronic health problems are the long-term effects of lifestyle related factors with diet and exercise being foremost.  Back to the Paleo diet characteristics; it seems that the long periods where humans were without food (fasting) but pursuing food required a specific genetically determined metabolic efficiency that helped the body function optimally.  These periods of shifted metabolism actually help the body over the long-term and not just during fasting.  If we fast some, we appear to benefit all of the time.

As fertility is one of the first victims of a mismatch between metabolism (one’s chemical functioning) and diet (the fuel provided), the early population became fairly uniform in genetically determined metabolism as the dietary pattern was fixed and uniform.  We are thought to be over 99% genetically identical to these distant relatives who thrived in this dietary environment.

The reality is that we are wired to thrive in the above lifestyle pattern and, unfortunately destined to be ill in the environment of constant availability of high amounts of refined grain, added simple sugars, higher amounts of carbohydrates and no energy expenditure to obtain food.

So this is the background with which I approach this six months of soup.  I am committed for the rest of the year which is actually 5, months but that title has no rhythm so we will use “6”.  The 5:2 dietary pattern suggests only a cup of soup (grain-less) twice a day at 12-hour intervals.  The soup meets the above food criteria and provides enough energy to function yet induces the positive benefits at 12 hour intervals of fasting. (refer to the cup of soup recipe at the bottom of the post)

The idea is that it is a simple plan that closely mimics the Paleo metabolic state.  This is done on two non-consecutive days with 5 days of one’s typical eating pattern.  Complete overhaul of lifestyle 7-days each week is difficult for most leading to long-term failure, but most can comply with a couple of days each week.  This begins to induce positive metabolic changes; and between the results and progressive reality that good lifestyle is not that difficult, progressive improvements to the daily diet become doable.

Plain tea or coffee is allowed as is water.  Exercise and activity is also needed.  The whole goal is to exploit the beneficial effects of a dietary pattern that maximizes the positive aspects of our genetically determined metabolism and minimizes the negative side.

The real essence of this lifestyle pattern is that it is supported by broad scientific research suggesting that it can prevent or help lower metabolic disease risks such as the current diabetes epidemic, improve and maintain cognitive function, reduce the epidemic of affect disorders (anxiety, depression) as well as other benefits.  In this series I will share the ups and downs, ins and outs and lessons of this journey.  I will also share the extensive science behind all of this and how it applies to my life.

More about what happens is “fasting” mode in the next report and, of course, how I am doing with all of that.  Soup for breakfast at 5 AM and a little coffee and water today until soup between 5 and 6 PM tonight. So far so good!