Showing posts with label Diet. Show all posts
Showing posts with label Diet. Show all posts
Monday, July 21, 2014
Factors out of your control: Why it's time to stop counting calories
For years people relied on the energy balance equation to help themselves lose weight. Since a pound of fat contains 3500 calories, all you need to do to lose a pound of fat is burn 3500 more calories than you eat. Sounds simple enough, the problem is that this isn't how it works. While the calorie surplus or deficit that you create likely has some relationship to how much weight you lose, we don't know how strong that relationship is or how strongly other factors impact this number. In this blog I will go over the primary reasons why this approach should be abandoned.
Monday, May 5, 2014
The 2am low carb wake up call...
As the Paleo diet becomes more popular and people give it a whirl, it's important to understand that many early versions that were low carb presented problems for some people, especially people who were training hard in exercise modalities that primarily use glucose for fuel such as Crossfit. One of the more common experiences under this scenario is waking up between 2am-4am, often times with heavy heart pounding. This phenomenon can be explained and potentially remedied using what we know about blood glucose regulation and what I went over in my last 2 blogs found here and here on allowing the intestine to help the liver with blood glucose regulation.
Now, there is a simple fix, eat more carbohydrates; and you should probably do this over the long term anyway if you are training hard. There is a solution that you can use during short term low-carb dieting to lose weight or if you want to stick to a low carb diet over longer periods. But first, let's take a look at what may be happening to wake you up.
The modern Western diet, being high in carbohydrate and low in fiber, relies heavily upon the liver to regulate blood glucose levels. While it is pretty good at doing it's job, not providing carbohydrates to help it do it's job can make blood glucose regulation difficult. To help your liver keep pace, glucagon and epinepherine levels rise in the blood to communicate to the liver that it needs to release some of the glucose it stores as glycogen, provided it has stored up enough glycogen from the carbohydrates you consume and made enough glycogen from non-carbohydrate sources. But what happens if there is not enough glycogen stored in the liver to keep blood glucose above the critical level?
When you are up and moving around, muscles break down glucose in to lactate that the liver can use to make glucose via a process called the Cori cycle. This likely contributes to blood glucose regulation while you are awake. The interesting thing here is that epinepherine, more commonly known as adrenaline, causes muscle to break down glucose in to lactate and activates the Cori cycle(1). As you may know as well, adrenaline also rapidly increases heart rate and the force of contraction of the heart. Could the 2am low carb wake up call be due to blood glucose levels dipping too low and the adrenals correcting this issue by secreting epinepherine? This could certainly explain why people get woken up and experience a pounding heart. If this is the case, there is a simple correction that should remedy the situation. Remove some of the burden of blood glucose regulation on the liver by allowing the intestine to participate. In other words, increase your fiber intake.
Most Americans get less than 20g of fiber per day and a person who is undertaking a low carbohydrate diet likely gets less if they are avoiding vegetables. Bumping this number up to 60g or more could potentially help a person who wishes to maintain a low carbohydrate diet not have to worry about large drops in blood glucose. Optimally the fiber would come directly from the diet, but you could also take a fiber or resistant starch supplement to get your daily fiber intake up. Many people are taking Bob's Red Mill unmodified potato starch as a supplement to increase fiber intake, just start with a low dose and space out your intake throughout the day to prevent gas. You can work up to 4 tbsp per day which adds approximately 32g of resistant starch/fiber per day.
It may take a while to see significant improvements, especially in people who may not have a large amount of bacteria that ferment fiber/resistant starch in to the short chained fatty acids that help the intestine participate in blood glucose regulation. Be persistent and, most of all, pay attention to what your body is telling you. Gas tends to be a good thing, but if it becomes painful or smells putrid you may have to take it slower.
Now, there is a simple fix, eat more carbohydrates; and you should probably do this over the long term anyway if you are training hard. There is a solution that you can use during short term low-carb dieting to lose weight or if you want to stick to a low carb diet over longer periods. But first, let's take a look at what may be happening to wake you up.
The modern Western diet, being high in carbohydrate and low in fiber, relies heavily upon the liver to regulate blood glucose levels. While it is pretty good at doing it's job, not providing carbohydrates to help it do it's job can make blood glucose regulation difficult. To help your liver keep pace, glucagon and epinepherine levels rise in the blood to communicate to the liver that it needs to release some of the glucose it stores as glycogen, provided it has stored up enough glycogen from the carbohydrates you consume and made enough glycogen from non-carbohydrate sources. But what happens if there is not enough glycogen stored in the liver to keep blood glucose above the critical level?
When you are up and moving around, muscles break down glucose in to lactate that the liver can use to make glucose via a process called the Cori cycle. This likely contributes to blood glucose regulation while you are awake. The interesting thing here is that epinepherine, more commonly known as adrenaline, causes muscle to break down glucose in to lactate and activates the Cori cycle(1). As you may know as well, adrenaline also rapidly increases heart rate and the force of contraction of the heart. Could the 2am low carb wake up call be due to blood glucose levels dipping too low and the adrenals correcting this issue by secreting epinepherine? This could certainly explain why people get woken up and experience a pounding heart. If this is the case, there is a simple correction that should remedy the situation. Remove some of the burden of blood glucose regulation on the liver by allowing the intestine to participate. In other words, increase your fiber intake.
Most Americans get less than 20g of fiber per day and a person who is undertaking a low carbohydrate diet likely gets less if they are avoiding vegetables. Bumping this number up to 60g or more could potentially help a person who wishes to maintain a low carbohydrate diet not have to worry about large drops in blood glucose. Optimally the fiber would come directly from the diet, but you could also take a fiber or resistant starch supplement to get your daily fiber intake up. Many people are taking Bob's Red Mill unmodified potato starch as a supplement to increase fiber intake, just start with a low dose and space out your intake throughout the day to prevent gas. You can work up to 4 tbsp per day which adds approximately 32g of resistant starch/fiber per day.
It may take a while to see significant improvements, especially in people who may not have a large amount of bacteria that ferment fiber/resistant starch in to the short chained fatty acids that help the intestine participate in blood glucose regulation. Be persistent and, most of all, pay attention to what your body is telling you. Gas tends to be a good thing, but if it becomes painful or smells putrid you may have to take it slower.
Monday, April 14, 2014
Olestra may have some clinical value...
I remember eating chips made with Olestra back in college. I remember the warnings of anal leakage, but I also remember thinking that they tasted pretty good. Well, a news study provides evidence that Olestra may help people reduce PCB levels in the blood.
Earlier studies in animals showed that olestra would bind PCBs in the digestive tract, preventing them from being absorbed. Researchers theorized they would see the same effect in humans, and a small trial recently conducted showed that people who ate chips with Olestra saw a reduction in PCBs in the blood(1). PCBs are an environmental toxin associated with cancer, hypertension and diabetes as well as skin conditions.
One of the concerns with Olestra is that it may do the same thing with fat soluble vitamins. The whole anal leakage thing is also still a little concerning, but it will be interesting to see this thing play out. If anything, this does shine a little light on the fact that we are far too lax in letting items enter our food supply. Despite this being a positive finding, we shouldn't be adding things like this to the food supply without researching them well enough to determine exactly what they do.
Earlier studies in animals showed that olestra would bind PCBs in the digestive tract, preventing them from being absorbed. Researchers theorized they would see the same effect in humans, and a small trial recently conducted showed that people who ate chips with Olestra saw a reduction in PCBs in the blood(1). PCBs are an environmental toxin associated with cancer, hypertension and diabetes as well as skin conditions.
One of the concerns with Olestra is that it may do the same thing with fat soluble vitamins. The whole anal leakage thing is also still a little concerning, but it will be interesting to see this thing play out. If anything, this does shine a little light on the fact that we are far too lax in letting items enter our food supply. Despite this being a positive finding, we shouldn't be adding things like this to the food supply without researching them well enough to determine exactly what they do.
Monday, April 7, 2014
Product Review: Veggetti
When I began removing processed food from my diet, I began to realize how much my diet relied on pasta, bread, and cereal. Removing these foods initially was a daunting task, but then I learned about things like lettuce wrapping hamburgers, spaghetti squash, making plantain chips with a mandolin slicer, and turning zucchini in to "pasta" with a julienne slicer. Over the years, my kitchen gadget collection increased from a few knives and a cutting board to about 20 different tools I use on a weekly basis. When a client recommended I give the Veggetti a shot, I thought, "Why not?" I'm glad I did.
Now, I'm not an infomercial guy. I'm typically asleep by the time they come on at night and when I wake up in the morning I like to get work done before making breakfast, so the various tools that find their way in to infomercials rarely come to my attention until they make it to Bed Bath and Beyond. I was training a client one day and she remarked that she missed pasta. I recommended spaghetti squash or julienne slicing a zucchini, and she said she ordered a Veggetti from TV but was waiting for it. After figuring out what the hell a Veggetti was, I went to Bed Bath and Beyond and bought one. I have 3 issues with using a Julienne slicer to make zucchini pasta; it 's time consuming, the seeded center just shreds and your left with a square core of waste, and I often cut my fingers with the slicer when the zucchini gets small. The Veggetti eliminates these issues.
The Veggetti is built fairly well, it's sturdy and can be used to make thin pasta or thick pasta depending on which side you use. The package says you can use it for most types of vegetables, to date I have only used it for zucchini pasta and "spiraly" cut sweet potato strings and it worked well for both. It comes with a cap you can use to hold the veggies, but I had no problem holding the zucchini by the stem and the sweet potato by the tip. I could see someone who's not paying attention cutting a chunk out of their finger if they're in a rush, though. Even if you're not in a rush, this thing works so much faster than a julienne slicer at making zucchini pasta. While there is still a small spirally core that is left over, it resembles a long piece of rotini I just threw it in with the pasta and didn't notice. At $15 before a 20% off coupon, it's well worth the investment. Clean up was easy, the only drawback was that you get extremely long "pasta" so you will need to cut it up a bit if you don't want to slop pasta sauce everywhere.
Now, I'm not an infomercial guy. I'm typically asleep by the time they come on at night and when I wake up in the morning I like to get work done before making breakfast, so the various tools that find their way in to infomercials rarely come to my attention until they make it to Bed Bath and Beyond. I was training a client one day and she remarked that she missed pasta. I recommended spaghetti squash or julienne slicing a zucchini, and she said she ordered a Veggetti from TV but was waiting for it. After figuring out what the hell a Veggetti was, I went to Bed Bath and Beyond and bought one. I have 3 issues with using a Julienne slicer to make zucchini pasta; it 's time consuming, the seeded center just shreds and your left with a square core of waste, and I often cut my fingers with the slicer when the zucchini gets small. The Veggetti eliminates these issues.
The Veggetti is built fairly well, it's sturdy and can be used to make thin pasta or thick pasta depending on which side you use. The package says you can use it for most types of vegetables, to date I have only used it for zucchini pasta and "spiraly" cut sweet potato strings and it worked well for both. It comes with a cap you can use to hold the veggies, but I had no problem holding the zucchini by the stem and the sweet potato by the tip. I could see someone who's not paying attention cutting a chunk out of their finger if they're in a rush, though. Even if you're not in a rush, this thing works so much faster than a julienne slicer at making zucchini pasta. While there is still a small spirally core that is left over, it resembles a long piece of rotini I just threw it in with the pasta and didn't notice. At $15 before a 20% off coupon, it's well worth the investment. Clean up was easy, the only drawback was that you get extremely long "pasta" so you will need to cut it up a bit if you don't want to slop pasta sauce everywhere.
Thursday, April 3, 2014
Logical fallacies aganst a Paleo diet
At this point in time, there is not likely a more controversial diet than the Paleo diet. Advocates tout how much better the vast majority of people who undertake it feel as well as the numerous health improvements, primarily autoimmune diseases that go in to remission, that people see under a Paleo diet. Critics argue that there wasn't a single Paleo diet, per se, and that grains, legumes and dairy have been a major part of a healthy diet for many years. The question then becomes, "So who is right?" Therein lies the problem, the argument between the advocates and critics really isn't about who is right, it's about whether or not the science supports the Paleo diet or not. The problem here, in my opinion, is that those criticizing the diet set the bar at a level that won't likely be met for some time, but that doesn't mean the supporters of Paleo are wrong.
I've been in many discussions with people who basically believe the Paleo diet is poppycock. I've argued with trolls on the internet, I've had physicians tell me it's complete BS, and I've read Paleofantasy in utter surprise that a higher level scientist would make several errors in logic in a published piece. I will spare you the arguments on straw men such as the Paleo diet is low carb or that it's basically a bacon orgy. I will focus on the basic assumption that the Paleo diet views grains, legumes, and dairy as foods that are likely to be problematic for more people than they are healthful.
The first error in logic that comes up in a typical argument is that the onus of proof is on the person making the claim. This is a typical argument from a person who is a contrarian and just likes to argue. If I say I don't believe those 3 groups of food are healthy for people to consume and you say that I'm wrong, it seems to me that both of us has made a claim that needs backing up. At this point, both should provide their reasoning behind their claim, this is how science works.
This isn't typically how it goes, however, and when they ask for evidence they go straight for the gold standard. They say you must provide a randomized controlled clinical trial(RCT) in order for them to take your claim seriously, which is setting the bar higher than they should because, as far as I am aware, there exists no such study that backs up either side of the argument. They then point to a few epidemiological studies or studies comparing whole grain consumption to refined grain consumption to show that grains are perfectly fine to consume. None of them actually show this because epidemiological studies can't show causation and comparing whole grain consumption to refined grain consumption shows nothing about whether grains are a healthy food choice, only that whole grains are better than refined grains.
This brings up a couple of important points about applying logic. First, just because there is no evidence that something exists doesn't mean it doesn't, especially if it hasn't been studied in depth. At some point I'm sure there was scant evidence that the Earth was round or that bloodletting was a stupid idea, but both ended up being true anyway. There was likely anecdotal evidence for both long before there was an RCT, that's how science works, observation followed by testing. Nevertheless, I'm sure the countless people who died or whose illness was prolonged from bloodletting would have loved to know that there was an argument to be made against it. About 10% of our entire medical system is based on RCTs, the rest is based on anecdotal evidence, epidemiological studies, and other forms of evidence that would not suffice critics of the Paleo diet unless they were using it to argue against the diet, but who have likely benefited from medical care that was based on that inferior data.
Another point about logic is that it should be applied universally. Many critics of Paleo like to point out that just because something wasn't eaten in Paleolithic times doesn't mean that it's bad for you, which is actually true. In the same sense, just because we have been eating something for 10,000 or even 50,000 years and it hasn't killed us before we've reproduced doesn't mean it's good for us, only that it doesn't affect reproduction and therefore won't place selective pressure on our species. This means it won't thin out the herd and force a change in our species, it may simply become a nuisance that people have to deal with as they get older and damage accumulates. Arthritis doesn't kill you, but I imagine anyone who has lived with it for decades would be happy if they didn't have to live the rest of their lives with it.
My final point is about arbitrary points in time. It is not logical to assume that anything that happened prior to the RCT is BS or that anything we are eating now that doesn't cause an immediate cardiac arrest is healthy. There weren't RCTs in ancient Greece when modern humans began to realize that the Earth wasn't flat, but it turned out to be true anyway. Most people aren't interested in finding out exactly what the science says, most are interested in what is most likely the truth and this sometimes requires going outside of what the science specifically says and extrapolating from other areas of science to fill in the holes. In the same way that not all foods that we eat now are healthy, not all new foods are bad just because we didn't eat them at some arbitrary point in time. We are constantly changing and some new foods that weren't available in the Paleolithic such as olive oil and broccoli have turned out to be quite healthy for us.
So why do I follow a Paleo diet? I don't really follow a Paleo diet, I follow a Paleo template. I limit grains, legumes and dairy because I feel there is enough evidence that those foods contain proteins that are not digested well by us that make their way in to our colon and mess with our microbiome. This is likely a dose dependent issue and genetic variability as well as epigenetic factors likely play a role so certain foods may be perfectly fine for some people and not so fine for others. Until there is a way to tell for sure, I will limit those foods, but I still eat them on occasion. You can hedge your bets by eating a diet high in vegetable matter, moderate in meat, and high in fermentable fibers that the healthy bacteria in your gut use to sustain themselves. This should, in theory, also allow you to get away with eating things that are not necessarily healthy for your microbiome as it bolsters the good guys so that the bad guys don't take hold. At least that is what I have come up with based on the evidence, if any new evidence comes to light I will certainly take it in to consideration.
I've been in many discussions with people who basically believe the Paleo diet is poppycock. I've argued with trolls on the internet, I've had physicians tell me it's complete BS, and I've read Paleofantasy in utter surprise that a higher level scientist would make several errors in logic in a published piece. I will spare you the arguments on straw men such as the Paleo diet is low carb or that it's basically a bacon orgy. I will focus on the basic assumption that the Paleo diet views grains, legumes, and dairy as foods that are likely to be problematic for more people than they are healthful.
The first error in logic that comes up in a typical argument is that the onus of proof is on the person making the claim. This is a typical argument from a person who is a contrarian and just likes to argue. If I say I don't believe those 3 groups of food are healthy for people to consume and you say that I'm wrong, it seems to me that both of us has made a claim that needs backing up. At this point, both should provide their reasoning behind their claim, this is how science works.
This isn't typically how it goes, however, and when they ask for evidence they go straight for the gold standard. They say you must provide a randomized controlled clinical trial(RCT) in order for them to take your claim seriously, which is setting the bar higher than they should because, as far as I am aware, there exists no such study that backs up either side of the argument. They then point to a few epidemiological studies or studies comparing whole grain consumption to refined grain consumption to show that grains are perfectly fine to consume. None of them actually show this because epidemiological studies can't show causation and comparing whole grain consumption to refined grain consumption shows nothing about whether grains are a healthy food choice, only that whole grains are better than refined grains.
This brings up a couple of important points about applying logic. First, just because there is no evidence that something exists doesn't mean it doesn't, especially if it hasn't been studied in depth. At some point I'm sure there was scant evidence that the Earth was round or that bloodletting was a stupid idea, but both ended up being true anyway. There was likely anecdotal evidence for both long before there was an RCT, that's how science works, observation followed by testing. Nevertheless, I'm sure the countless people who died or whose illness was prolonged from bloodletting would have loved to know that there was an argument to be made against it. About 10% of our entire medical system is based on RCTs, the rest is based on anecdotal evidence, epidemiological studies, and other forms of evidence that would not suffice critics of the Paleo diet unless they were using it to argue against the diet, but who have likely benefited from medical care that was based on that inferior data.
Another point about logic is that it should be applied universally. Many critics of Paleo like to point out that just because something wasn't eaten in Paleolithic times doesn't mean that it's bad for you, which is actually true. In the same sense, just because we have been eating something for 10,000 or even 50,000 years and it hasn't killed us before we've reproduced doesn't mean it's good for us, only that it doesn't affect reproduction and therefore won't place selective pressure on our species. This means it won't thin out the herd and force a change in our species, it may simply become a nuisance that people have to deal with as they get older and damage accumulates. Arthritis doesn't kill you, but I imagine anyone who has lived with it for decades would be happy if they didn't have to live the rest of their lives with it.
My final point is about arbitrary points in time. It is not logical to assume that anything that happened prior to the RCT is BS or that anything we are eating now that doesn't cause an immediate cardiac arrest is healthy. There weren't RCTs in ancient Greece when modern humans began to realize that the Earth wasn't flat, but it turned out to be true anyway. Most people aren't interested in finding out exactly what the science says, most are interested in what is most likely the truth and this sometimes requires going outside of what the science specifically says and extrapolating from other areas of science to fill in the holes. In the same way that not all foods that we eat now are healthy, not all new foods are bad just because we didn't eat them at some arbitrary point in time. We are constantly changing and some new foods that weren't available in the Paleolithic such as olive oil and broccoli have turned out to be quite healthy for us.
So why do I follow a Paleo diet? I don't really follow a Paleo diet, I follow a Paleo template. I limit grains, legumes and dairy because I feel there is enough evidence that those foods contain proteins that are not digested well by us that make their way in to our colon and mess with our microbiome. This is likely a dose dependent issue and genetic variability as well as epigenetic factors likely play a role so certain foods may be perfectly fine for some people and not so fine for others. Until there is a way to tell for sure, I will limit those foods, but I still eat them on occasion. You can hedge your bets by eating a diet high in vegetable matter, moderate in meat, and high in fermentable fibers that the healthy bacteria in your gut use to sustain themselves. This should, in theory, also allow you to get away with eating things that are not necessarily healthy for your microbiome as it bolsters the good guys so that the bad guys don't take hold. At least that is what I have come up with based on the evidence, if any new evidence comes to light I will certainly take it in to consideration.
Thursday, March 13, 2014
5 important resources for undertaking a Paleo diet
I've helped many people shift from a conventional diet to a Paleo-based diet. More often than not, the information is easy to understand and you can get substantial buy-in by providing a little science, but the problems begin when you get to implementation. In this blog I will go over 5 resources that people should use to help implement a Paleo diet.
1)A thorough plan
Before you take any step, do yourself a favor and get together a solid, detailed plan. If you were going to drive to Florida or plan a vacation anywhere, you wouldn't just wing it because winging it is likely to lead to failure or at least a less than optimal experience. Look at shifting from your standard diet to the Paleo diet as a journey. Where are you going? How are you going to get there? Are there any potential pitfalls along the way? Do I need anything to make this an enjoyable journey? Fortunately, enough people have undertaken this path before you that you likely don't have to pay someone to help you. You can buy a book, or just pop online and read other peoples' experiences. There are a few standard issues that people run in to while implementing a Paleo diet, and most of these issues are due to poor planning. What do you do if you're out eating with friends? What should you have in the house to snack on in case you get hungry? Are there any strategies you can use to reduce the amount of time you spend in the kitchen. Fortunately, these problem have been encountered by other people and can be answered pretty simply if you sit down and develop a detailed plan rather than just say you're going to do a Paleo diet for 30 days and wing it. In my next blog I will discuss how to come up with a detailed plan and provide a sample one I made for a client.2)Nuritiondata.self.com
One of the biggest pitfalls people encounter when "going Paleo" is that they end up neglecting certain nutrients that are contained in a group of foods they may not particularly enjoy. Nutritiondata.self.com is a good way to identify the nutrients you may not be getting and determine which foods you should add in to your diet to get them. Once you sign up, you can enter the foods you eat every day and look at an analysis of which nutrients you are getting and which you may be missing out on with your food choices. From there, you can use the tools section and search for foods high in the nutrients you are deficient in to help make a more healthful diet. I find www.nutritiondata.self.com indispensable when developing a diet for someone and a great value, especially since it's free. It's also a good way to develop a diet for clients while using their existing diet as a template, that way the change is not as severe.3) Good food storage containers
One thing we can never have enough of in my house is food storage containers. Whether we are cutting up vegetables for the next few days, packing lunch, or making extra chili for the following week; we always seem to run out of food storage containers in short order. One of the biggest changes when switching to a Paleo diet is that it is not very convenient from a food prep standpoint. Rather than spend more than an hour every day preparing food, we tend to spend an hour 2 times a week cutting and prepping food and then storing leftovers from each nights dinner in the freezer for the following week so that we are always prepared. A ton of food storage containers in multiple sizes is crucial for cutting back on prep time.4)An activity tracker
Activity trackers are very useful places to store and look at data that may be of interest to you. I've used a Fitbit One on a daily basis for the past 2 years. While I am using it to motivate and compete with my clients, I initially used it to look at how my lifestyle affected my health. I found a few things including coffee and dairy that I eventually removed from my diet since both seemed to be effecting my sleep in a negative way that also caused my morning fasting blood glucose to be a little high. I removed them and saw a fairly substantial improvement after a couple of weeks so I kept them out and make sure not to do other things that may negatively affect my sleep if I do partake in either. Another benefit I find from the Fitbit is that clients who tell me they are doing everything they can to lose weight are often sitting around for hours at a time or only getting 6000 steps per day. If they wonder why the diet isn't working for weight loss and they are getting 6000 steps per day, I can tell them the problem isn't the diet, it's the couch. I go over a bunch of the ways you can use your Fitbit One sleep data in this blog.5)Spices
In terms of nutrient density, nothing beats spices. Ounce for ounce, spices are a far greater source of many essential nutrients than any other foodstuff on the planet. They also contain a ton of phytonutrients that provide many benefits outside of those found in the essential nutrients. For example, turmeric, a spice used frequently in middle eastern cuisine, has a potent anti-inflammatory effect and activates stage 2 cell detoxification. Also, garlic contains a special form of vitamin B-1 called allithiamine that is 50x more bioavailable than the thiamine version of B-1 found in nearly every other food. B-1 is crucial for carbohydrate metabolism, adrenal health, and is a nutrient likely lacking in any Paleo diet that doesn't utilize copious amounts of sesame seeds or tahini. You can check out why B-1 is important and signs you may be deficient here. While fresh spices are best, dried ones should be added to oil first to help release the essential oils. You really can't go wrong with any spices, I like to rotate mine daily so that I get a myriad of benefits that I didn't get when my diet was fairly plain from a spice standpoint. Another added benefit to using spices is that they can be a way to get plant matter in to your diet if you react to FODMAPS because they are consumed in far lower doses than whole plants and vegetables.
Thursday, March 6, 2014
Why your Paleo diet may not be so healthy
I love the logic behind the Paleo diet and the many health problems that people have reversed by undertaking it. People have reversed autoimmune diseases and Type 2 diabetes, lost tons of weight, and drastically improved their overall health in many ways from fatigue and pain relief to just being happier. While there is a lot going for the Paleo diet, I feel many may be making errors in logic when formulating their own personal Paleo diet. In this blog I'll take a look at the primary logical fallacy I see in Paleo world.
So here we have an herbivore who is competing for food against other herbivores in a constantly changing climate that is ultimately responsible for all of the mass extinctions save for the dinosaurs. Being able to eat different foods is not a novelty of an animal living in this world, it's a survival necessity. When competition was tough or the climate changed the foods that were available, having fallback foods that are not typically parts of the native diet can be crucial to survival. While scavenging the remains of dead carcasses may be the first thing that comes to the mind in Paleo world, another one is the consumption of underground storage organisms, also known as roots and tubers.
To get at roots and tubers, you need a couple of traits that these early primates likely didn't have. First, they would have needed the intelligence to be able to identify them as potential food sources, despite the food portion being located underground. Second and more importantly, it would require the use of tools to dig them out. Using a stick to dig a tuber out of the ground was likely one of the first steps in the use of tools, even if it's not it certainly predated the making of hunting tools such as spears, atlatls, and bows. So here we likely have a point in time where a small offshoot of the primates started consuming these fallback foods when the components of their primary diet were not available. However, being fallback foods, they still weren't the bulk of the diet when all food was available.
To clarify what I mean, I have to go in to the microbiome, teh collection of bacteria located in your GI tract. When a person switches from an entirely plant matter diet to an entirely animal matter diet, as would happen when the dry season or winter comes, the microbiome changes drastically and very quickly(1). As this happens, your microbiome is adapting to the foods that are available and changing what is happening in your body by changing it's inputs, and changing inputs changes outputs What we tend to see in this scenario is a change from mostly carbohydrate/fiber fermenting bacteria to mostly protein/amino acid fermenting bacteria. This change, in theory, will lead to increased intestinal permeability as the butyric acid used to seal up and repair tight junctions between cells in your digestive tract won't be produced as it is a byproduct of bacterial fermentation of fiber in your colon. This, in turn will increase systemic inflammation which sounds like a bad thing, but in the context of low food availability it is actually a beneficial trait.
With increased systemic inflammation, comes insulin resistance. In today's world this is bad because we have unfettered access to all types of foods, but several thousand years ago it probably activated the thrifty genotype that is associated with more efficient fat storage and more energy extraction which is beneficial when food is low. This process is described by Jeff Leach in a blog on his website discussing the effect of a low carb diet on the microbiome and another one where he discusses the Paleo diet and obesity located here. In the grand scheme of things this got us to where we are today, but that doesn't mean that it doesn't contribute to the problems we see in a completely different food environment.
If we flash forward many moons, grains and legumes likely had the same impact on farmers. Here we have an easily storable source of nutrients that can last through even the longest winter, and it just so happens that they have proteins that humans have difficulty breaking down. The result, a steady flow of substrate to bacteria in the colon that ferment amino acids and increase insulin resistance in a time where it is beneficial. Again, beneficial when food is scarce, not so beneficial when food is plentiful.
Start the story from the beginning
When we think of our ancestors, we tend to think of our immediate ones that looked like us, talked like us, and ate diets very similar to ours. The problem with thinking this way is that it starts the narrative halfway through the story. The story doesn't begin with a somewhat modern human with an ape face chasing down game, it begins with a primarily herbivorous primate that was likely incapable of hunting or attaining any meat outside of scavenging dead carcasses. Ok, you got me, it actually begins much further back with a single celled organism, but since their diets didn't consist of food as we look at it today, what they ate doesn't really provide us with concrete evidence as to what we should eat...or does it? More on that later.So here we have an herbivore who is competing for food against other herbivores in a constantly changing climate that is ultimately responsible for all of the mass extinctions save for the dinosaurs. Being able to eat different foods is not a novelty of an animal living in this world, it's a survival necessity. When competition was tough or the climate changed the foods that were available, having fallback foods that are not typically parts of the native diet can be crucial to survival. While scavenging the remains of dead carcasses may be the first thing that comes to the mind in Paleo world, another one is the consumption of underground storage organisms, also known as roots and tubers.
To get at roots and tubers, you need a couple of traits that these early primates likely didn't have. First, they would have needed the intelligence to be able to identify them as potential food sources, despite the food portion being located underground. Second and more importantly, it would require the use of tools to dig them out. Using a stick to dig a tuber out of the ground was likely one of the first steps in the use of tools, even if it's not it certainly predated the making of hunting tools such as spears, atlatls, and bows. So here we likely have a point in time where a small offshoot of the primates started consuming these fallback foods when the components of their primary diet were not available. However, being fallback foods, they still weren't the bulk of the diet when all food was available.
Fallback foods and evolution
Over time our diet likely changed immensely as our ancestors evolved in to something more human-like, but we started as an herbivore and that is likely what our diet should be made mostly out of...plants. When you look at fallback foods, most of them have some sort of importance in to what we evolved in to because those that didn't eat these fallback foods likely evolved in to something else or disappeared altogether. This doesn't mean that a fallback food that helped get us to where we are should become the staple portion of the diet. In fact, if you are arguing for Paleo you really can't do that. Grains and legumes began as a fallback food and were likely necessary to get us where we are now. This doesn't mean that ad libitum grain consumption should be your goal, and in the same way it doesn't mean ad libitum meat or protein consumption should be either.To clarify what I mean, I have to go in to the microbiome, teh collection of bacteria located in your GI tract. When a person switches from an entirely plant matter diet to an entirely animal matter diet, as would happen when the dry season or winter comes, the microbiome changes drastically and very quickly(1). As this happens, your microbiome is adapting to the foods that are available and changing what is happening in your body by changing it's inputs, and changing inputs changes outputs What we tend to see in this scenario is a change from mostly carbohydrate/fiber fermenting bacteria to mostly protein/amino acid fermenting bacteria. This change, in theory, will lead to increased intestinal permeability as the butyric acid used to seal up and repair tight junctions between cells in your digestive tract won't be produced as it is a byproduct of bacterial fermentation of fiber in your colon. This, in turn will increase systemic inflammation which sounds like a bad thing, but in the context of low food availability it is actually a beneficial trait.
With increased systemic inflammation, comes insulin resistance. In today's world this is bad because we have unfettered access to all types of foods, but several thousand years ago it probably activated the thrifty genotype that is associated with more efficient fat storage and more energy extraction which is beneficial when food is low. This process is described by Jeff Leach in a blog on his website discussing the effect of a low carb diet on the microbiome and another one where he discusses the Paleo diet and obesity located here. In the grand scheme of things this got us to where we are today, but that doesn't mean that it doesn't contribute to the problems we see in a completely different food environment.
If we flash forward many moons, grains and legumes likely had the same impact on farmers. Here we have an easily storable source of nutrients that can last through even the longest winter, and it just so happens that they have proteins that humans have difficulty breaking down. The result, a steady flow of substrate to bacteria in the colon that ferment amino acids and increase insulin resistance in a time where it is beneficial. Again, beneficial when food is scarce, not so beneficial when food is plentiful.
Fighting microbes with microbes
Here we have some compelling evidence that a Paleo diet that is 90% meat with a few veggies may not be the best in terms of health. Further support for this notion comes from another blog by Jeff Leach that identifies that it may not be high levels of protein so much as it is low fiber consumption that is the problem with a typical high meat Paleo diet(2). Fermentable fibers, since we can't digest them, provide substrate to the colon that will increase the amount of bacteria that ferment fiber there, This will also crowd out some of the amino acid fermenters, and also creates an acidic environment that amino acid fermenters can't survive in. This is not to say that you cannot eat high levels of protein, only that the smart way to do it is to make sure you are getting enough fiber to support the microbes in your gut. Something I find interesting is that people who undertake ketogenic diets typically don't achieve success unless they limit protein. The assumption is that the excess protein gets converted to glucose in the body, but this doesn't necessarily have to be the only thing at work, your microbes could play a significant role here as well.Would you like some partially digested plant matter with your steak?
I know it sounds like I'm beating the Jeff Leach horse to death, but he is studying the effect of many variables on the microbiome, and since he's hanging around with hunter gatherers, he provides other evidence that the microbiome is critically important and ad libitum meat consumption may not be the best idea. Jeff's experience with a group of Hadza hunters is very eye opening. When these hunter gatherers killed and field dressed an impala, they did something that would make most of us cringe; they tore open the stomach, washed their hands with the partially digested contents, and cut up parts of the raw stomach and ate them(3). While this may seem a little kooky to you and I, maybe they know something that we don't. Maybe there is some undesired consequence to unfettered protein consumption just as there is some undesired consequence to grain and legume consumption. Perhaps "innoculating" themselves with the fiber fermenting bacteria of an herbivore provides some level of protection against large shifts in the microbial composition of the gut. Who knows, but I can't imagine they do this just for the fun of it.Conclusion
Creating a diet based on evolution requires applying the same type of logic throughout the entire story. Grains and legumes as fallback foods were likely beneficial when they were needed, but in a completely different food environment I think there is strong evidence that they are not so good. Of the two, legumes contain fiber as well as hard to digest proteins, so they are likely less problematic than grains. I think it is 100% true that our ancestors ate these foods, just as I am 100% sure that seasonal food availability likely led to times where animal flesh was the primary source of nourishment in the diet. This doesn't mean that it is optimal from a health perspective, only that it was necessary to get us to where we are. Mass consumption of grains and legumes as well as an uber-high protein diet may not be in your best interest if health is your primary concern and you have unlimited availability of fruits and vegetables. This isn't to say that protein isn't necessary, it is. It's merely to point out that eating pounds of bacon, sausage, and steak every day coupled with mass consumption of nut butters and flours likely isn't healthy, especially if fiber in the diet is low. While people like to point out that correlation doesn't equal causation when looking at protein consumption and health, that doesn't mean there is no causation there, simply that we can't imply it from the data. I guess you could just eat the partially digested contents of the cow who made up your hamburger, I'll just hammer some veggies and resistant starch.
Thursday, February 6, 2014
The Human's guide to being Human: Your microbiome
While all biological functions occur through gene/environment interactions, most life on the planet is not possible without some form of assistance from a different form of life. Most plants could not reproduce without pollination by insects and therefore they would not exist today without a little help from their friends. This type of symbiosis is not reserved only for members of the plant kingdom, members of the animal kingdom, including humans, require some assistance too.
I'd like to begin this blog with a couple of questions. What do termites eat? If you're like most people, you know the answer to this question is wood. However, if I were to tell you that termites are incapable of digesting wood, you may become a little confused. The truth is, termites consume wood and as it makes it's way through their digestive tract, microbes found within their digestive tract break down the wood in to something termites can use to perform their every day functions(1). Despite lacking the enzymes capable of breaking down wood in to something that is useful to them, termites are able to consume wood and get something out, but only with the help of bacteria capable of breaking it down first.
For my next question, I'd like to ask you if the diet of Gorillas is high in carbohydrate or high in fat? Gorillas typically consume large amounts of fiber, a carbohydrate, as well as some fruit, also high in carbohydrate. Since gorillas don't eat canola oil and aren't seen tearing apart other animals for food, it seems logical that a gorilla diet is a high carbohydrate diet then, right? Not so fast. Similar to the microbes found in the gut of the termite, microbes in the gut of gorillas break down fiber that they can't digest in to short chained fatty acids that the gorillas can absorb and use for energy. All tolled, including fiber as a carbohydrate, Western Lowland Gorillas consume 84% of their diet in the form of carbohydrate. However, once that is acted upon by the microbes in their gut, almost 60% of what enters their circulation is fat(2). Without microbial fermentation of this non-digestible fiber in their gut, Gorillas would not have access to more than 57% of the calories they consume. In other words, they could not exist without these microbes.
In humans, upwards of 1000 different species of bacteria live in the gut. In addition to the gut, these bacteria can be found anywhere the body is exposed to air including the skin, mouth, eyes, and nose. It may not seem intuitive that the digestive tract is exposed to air, but in actuality the digestive tract is a tube open on both ends, the mouth and anus. In other words, it is not a part of your internal environment, it is actually an interface between the external environment and your internal environment, much like the skin. Bacteria that reside in the gut perform a host of functions including digesting fibers we can't use in to short chained fatty acids that we can, training our immune system, regulating the integrity of the intestinal wall, manufacturing vitamins, and helping transport minerals just to name a few.
The collection of bacteria found within your gut is often referred to as your microbiome. It is estimated that there are 100x more genes in your microbiome than there are genes within your cells. In other words, from a biological function perspective you are more bacteria than human. While all of the above mentioned functions are beneficial to us, the gut is not a sanctuary for good bacteria, bad bacteria can also reside there. Depending on what you eat and the microbes you are exposed to, any number of good or bad bacteria can take up residence in the gut and perform their biological functions.
In the case of good bacteria, there is typically some benefit to the host in them being there. Bad, also called pathogenic, bacteria tend to cause problems by either activating the immune system or secreting toxins directly in to the host. In a way, your gut is like the petri dish mentioned in my last article on how cells work and the bacteria are merely vehicles for the genes that they contain since all biological functions are a product of gene/environment interaction. By filling the petri dish with "food" that benefits a certain type of bacteria, you are effectively altering the genome found within that petri dish, in this instance your gut. In this way, your microbiome is actually a more adaptable part of your total genome. While your coding genes are fixed from birth, and your epigenome can change but over longer periods of time, your microbiome can change relatively quickly based on the type of food that's available. In fact, a recent study showed that switching from a mixed diet to an all meat diet can cause the microbiome to change significantly in as little as 2 days(3). Stress and sleep are also believed to impact the microbiome as would anything that directly affects either one.
Our microbiome is developed relatively early in life and changes as we age. When we are born, we are exposed to the vaginal flora as we exit our mother's birth canal. Those who are born via C-section do not get this exposure because they are removed via an incision in the stomach, which could lead to health issues much later in life. Breast milk is another way we get exposed to beneficial bacteria early in life, so those who are not breast fed are at a further disadvantage in developing a healthy microbiome. As we are able to crawl and interact with our environment as babies and toddlers, we also expose ourselves to more bacteria that will become part of our microbiome.
The hygiene hypothesis postulates that one of the reasons we have seen an increase in allergies and autoimmunity is because our focus on preventing children from ever coming in to contact with microbes from the environment prevents the immune system from developing properly. There is evidence that there is something to the hygiene hypothesis as children raised on farms or with pets are less likely to experience allergies or autoimmunity. Furthermore, the microbiome has been implicated in a range of health problems from autism to depression to obesity so there is the possibility that the microbiome is responsible for multiple areas of development, not just the immune system.
Even once you've entered adulthood, the microbiome will continue to change throughout life. Combined with changes to the epigenome, the microbiome can dramatically change your health. Studies in identical twins show that the same coding genes put through different environments can yield completely different outcomes. There are identical twins where one is obese and one is lean. There are identical twins where one dies of cancer and the other never gets the disease. These changes can only come about through a change in the environment in which the genes are exposed to since the genes are identical. We can adapt to a wide variety of environments, and this flexibility is afforded to us by the epigenome as well as the microbiome.
An interesting aspect of the microbiome that bears mentioning is that the appendix may be a reservoir for all of the types of bacteria that make up our microbiome. When an infection of some sort occurs in the digestive tract, the colon pulls water out of circulation which causes diarrhea, a flushing of the digestive tract that removes both good and bacteria. Then, based on the types of foods you eat, you will begin repopulating your colon with bacteria that were hiding in your appendix that make their way out and in to the colon where non-digested food arrives. This is just a hypothesis, but it certainly makes me relieved that I still have my appendix and wasn't one of the people who had appendicitis and convinced it was useless, or more "junk" so to speak.
If we look at the traits of the 3 parts of the genome, we can see that each affects change differently. The microbiome allows you as an individual to adapt to the environment quickly based primarily on the type of food that is available. For example, many of the traits that the microbiome can affect deal with metabolism and the ability to store and use nutrients. Quite a bit of the research I have been looking at recently leads me to believe that the microbiome likely helps us adapt to changes in the seasons in many ways, particularly by altering insulin sensitivity and increasing or decreasing metabolism. It does this as the types of foods available from season to season change, and the types of foods we consume allow the proportions of different strains of bacteria found with in our microbiome to change as we provide a different environment within our inner "petri dish". This is why a diverse array of different bacterial strains within our microbiome is important, it allows us to adapt to a wider variety of environments. Our metabolic flexibility is largely dictated by our microbiome.
The epigenome allows an individual to become better suited to some aspects of the environment that are constant, but is able to change when the environment changes and becomes constant in another way. Coupled with the microbiome, the epigenome likely has huge implications on your health and how you function from day to day as both can make you better at certain things based on how the environment interacts with these aspects of your genome. You are, however, constrained by your coding genes. You are not going to develop the ability to make an enzyme you've never been able to make. Looking back at the termite at the beginning of this blog, if the termite were to somehow lose the microbes within it's microbiome that help it digest wood, it would be curtains for the termite. In this way, the environment that your ancestors evolved in is also pretty important.
If you truly think about it, evolution is happening at all 3 levels of your genome. Your microbiome is evolving based on the food you put in to your body, your cells are evolving as the microbiome changes the inputs to the epigenome which changes the inputs to your cells leading to different outcomes, and the human species as a whole is adapting as these other parts of your genome interact with the coding genes. Furthermore, all 3 aspects of your genome allow you to adapt to the environment that you are in, in either a good way or a bad way. With all of this talk about evolution and adaptation, it seems that a talk about evolution by natural selection is in order for the next blog.
Previous: How your cells work Next: Evolution and adaptation
I'd like to begin this blog with a couple of questions. What do termites eat? If you're like most people, you know the answer to this question is wood. However, if I were to tell you that termites are incapable of digesting wood, you may become a little confused. The truth is, termites consume wood and as it makes it's way through their digestive tract, microbes found within their digestive tract break down the wood in to something termites can use to perform their every day functions(1). Despite lacking the enzymes capable of breaking down wood in to something that is useful to them, termites are able to consume wood and get something out, but only with the help of bacteria capable of breaking it down first.
For my next question, I'd like to ask you if the diet of Gorillas is high in carbohydrate or high in fat? Gorillas typically consume large amounts of fiber, a carbohydrate, as well as some fruit, also high in carbohydrate. Since gorillas don't eat canola oil and aren't seen tearing apart other animals for food, it seems logical that a gorilla diet is a high carbohydrate diet then, right? Not so fast. Similar to the microbes found in the gut of the termite, microbes in the gut of gorillas break down fiber that they can't digest in to short chained fatty acids that the gorillas can absorb and use for energy. All tolled, including fiber as a carbohydrate, Western Lowland Gorillas consume 84% of their diet in the form of carbohydrate. However, once that is acted upon by the microbes in their gut, almost 60% of what enters their circulation is fat(2). Without microbial fermentation of this non-digestible fiber in their gut, Gorillas would not have access to more than 57% of the calories they consume. In other words, they could not exist without these microbes.
In humans, upwards of 1000 different species of bacteria live in the gut. In addition to the gut, these bacteria can be found anywhere the body is exposed to air including the skin, mouth, eyes, and nose. It may not seem intuitive that the digestive tract is exposed to air, but in actuality the digestive tract is a tube open on both ends, the mouth and anus. In other words, it is not a part of your internal environment, it is actually an interface between the external environment and your internal environment, much like the skin. Bacteria that reside in the gut perform a host of functions including digesting fibers we can't use in to short chained fatty acids that we can, training our immune system, regulating the integrity of the intestinal wall, manufacturing vitamins, and helping transport minerals just to name a few.
The collection of bacteria found within your gut is often referred to as your microbiome. It is estimated that there are 100x more genes in your microbiome than there are genes within your cells. In other words, from a biological function perspective you are more bacteria than human. While all of the above mentioned functions are beneficial to us, the gut is not a sanctuary for good bacteria, bad bacteria can also reside there. Depending on what you eat and the microbes you are exposed to, any number of good or bad bacteria can take up residence in the gut and perform their biological functions.
In the case of good bacteria, there is typically some benefit to the host in them being there. Bad, also called pathogenic, bacteria tend to cause problems by either activating the immune system or secreting toxins directly in to the host. In a way, your gut is like the petri dish mentioned in my last article on how cells work and the bacteria are merely vehicles for the genes that they contain since all biological functions are a product of gene/environment interaction. By filling the petri dish with "food" that benefits a certain type of bacteria, you are effectively altering the genome found within that petri dish, in this instance your gut. In this way, your microbiome is actually a more adaptable part of your total genome. While your coding genes are fixed from birth, and your epigenome can change but over longer periods of time, your microbiome can change relatively quickly based on the type of food that's available. In fact, a recent study showed that switching from a mixed diet to an all meat diet can cause the microbiome to change significantly in as little as 2 days(3). Stress and sleep are also believed to impact the microbiome as would anything that directly affects either one.
Our microbiome is developed relatively early in life and changes as we age. When we are born, we are exposed to the vaginal flora as we exit our mother's birth canal. Those who are born via C-section do not get this exposure because they are removed via an incision in the stomach, which could lead to health issues much later in life. Breast milk is another way we get exposed to beneficial bacteria early in life, so those who are not breast fed are at a further disadvantage in developing a healthy microbiome. As we are able to crawl and interact with our environment as babies and toddlers, we also expose ourselves to more bacteria that will become part of our microbiome.
The hygiene hypothesis postulates that one of the reasons we have seen an increase in allergies and autoimmunity is because our focus on preventing children from ever coming in to contact with microbes from the environment prevents the immune system from developing properly. There is evidence that there is something to the hygiene hypothesis as children raised on farms or with pets are less likely to experience allergies or autoimmunity. Furthermore, the microbiome has been implicated in a range of health problems from autism to depression to obesity so there is the possibility that the microbiome is responsible for multiple areas of development, not just the immune system.
Even once you've entered adulthood, the microbiome will continue to change throughout life. Combined with changes to the epigenome, the microbiome can dramatically change your health. Studies in identical twins show that the same coding genes put through different environments can yield completely different outcomes. There are identical twins where one is obese and one is lean. There are identical twins where one dies of cancer and the other never gets the disease. These changes can only come about through a change in the environment in which the genes are exposed to since the genes are identical. We can adapt to a wide variety of environments, and this flexibility is afforded to us by the epigenome as well as the microbiome.
An interesting aspect of the microbiome that bears mentioning is that the appendix may be a reservoir for all of the types of bacteria that make up our microbiome. When an infection of some sort occurs in the digestive tract, the colon pulls water out of circulation which causes diarrhea, a flushing of the digestive tract that removes both good and bacteria. Then, based on the types of foods you eat, you will begin repopulating your colon with bacteria that were hiding in your appendix that make their way out and in to the colon where non-digested food arrives. This is just a hypothesis, but it certainly makes me relieved that I still have my appendix and wasn't one of the people who had appendicitis and convinced it was useless, or more "junk" so to speak.
If we look at the traits of the 3 parts of the genome, we can see that each affects change differently. The microbiome allows you as an individual to adapt to the environment quickly based primarily on the type of food that is available. For example, many of the traits that the microbiome can affect deal with metabolism and the ability to store and use nutrients. Quite a bit of the research I have been looking at recently leads me to believe that the microbiome likely helps us adapt to changes in the seasons in many ways, particularly by altering insulin sensitivity and increasing or decreasing metabolism. It does this as the types of foods available from season to season change, and the types of foods we consume allow the proportions of different strains of bacteria found with in our microbiome to change as we provide a different environment within our inner "petri dish". This is why a diverse array of different bacterial strains within our microbiome is important, it allows us to adapt to a wider variety of environments. Our metabolic flexibility is largely dictated by our microbiome.
The epigenome allows an individual to become better suited to some aspects of the environment that are constant, but is able to change when the environment changes and becomes constant in another way. Coupled with the microbiome, the epigenome likely has huge implications on your health and how you function from day to day as both can make you better at certain things based on how the environment interacts with these aspects of your genome. You are, however, constrained by your coding genes. You are not going to develop the ability to make an enzyme you've never been able to make. Looking back at the termite at the beginning of this blog, if the termite were to somehow lose the microbes within it's microbiome that help it digest wood, it would be curtains for the termite. In this way, the environment that your ancestors evolved in is also pretty important.
If you truly think about it, evolution is happening at all 3 levels of your genome. Your microbiome is evolving based on the food you put in to your body, your cells are evolving as the microbiome changes the inputs to the epigenome which changes the inputs to your cells leading to different outcomes, and the human species as a whole is adapting as these other parts of your genome interact with the coding genes. Furthermore, all 3 aspects of your genome allow you to adapt to the environment that you are in, in either a good way or a bad way. With all of this talk about evolution and adaptation, it seems that a talk about evolution by natural selection is in order for the next blog.
Previous: How your cells work Next: Evolution and adaptation
Thursday, January 9, 2014
Meat-based diet and inflammation? Makes sense from an evolutionary perspective
A new study in the journal Nature set the Paleo blogosphere ablaze last month. This study looked at the effect of diet on changes in gut bacteria and was discussed in my Health Research Recap found here. I went over how I agree that a diet that focuses on meat is likely not the best choice if your goal is to be healthy. In this blog I am going to expand on this topic using the evolutionary template to theorize why this happens.
One of the more interesting aspects of the study in question, found here, is that gut bacteria switched rapidly when going to the extremes of diet. In my opinion, this is a testament to how important a diverse array of bacteria in the gut is to maintaining metabolic flexibility. Humans can thrive on a wide array of diets and the ability of bacteria in the gut to respond to quick changes in the availability of food from the environment is what makes us metabolically flexible. From an evolutionary perspective this makes sense because once our ancestors left Africa, the most likely to survive would have been the ancestors who could adapt to changes in the types of food that were available due to seasonal changes in the climate.
As Summer leads to Fall and Fall leads to Winter, the availability of fruit and other foods that were preferred by our ancestors who remained in Africa would not have been available in more seasonal climates during a time when you couldn't just order takeout. To adapt, they likely needed to consume fallback foods that were available in a wintery climate during that time of year. This would include meats and root vegetables whose availability would change less with the seasons. With this change from a diet high in fruits and vegetables to one with a proportionally smaller amount of these foods and a higher proportion of animal flesh, you are changing the substrate that the bacteria in your gut can ferment from mostly fermentable carbohydrates to amino acids. This, in turn, should change the proportion of bacteria in the gut, favoring the types of gut bacteria that ferment amino acids and scaling back the type that ferment carbohydrates. Could there be some evolutionary benefit for this switch? I think so.
As the diversity of available food reduces during the winter time, there would be a benefit to extracting more energy out of that food. Most people believe that carbohydrates and protein contain the same amount of calories per gram at 4 calories, but this is not true. In a bomb calorimeter, carbohydrates average 4.2 calories of energy per gram while proteins average 5.65 calories per gram. Some of this increased energy content is due to the nitrogen content of protein, which humans don't use for energy. Even if half of the extra energy is from nitrogen, that still leaves an extra 17% more energy in protein per gram than carbohydrates. This is huge when food becomes scarce. One of the first things one notices as they implement a low carbohydrate diet is constipation. Maybe this delay in food transit through the digestive tract allows us to absorb more of that energy or it gives bacteria in the colon more time to ferment amino acids that make it there, providing more energy than we can extract on our own.
On top of the potential for extra extractable energy contained in protein, there is the inflammation associated with the bacteria identified in the study. While our current food environment makes this a bad thing, in the face of food scarcity, this inflammation may be beneficial. Inflammation is associated with insulin resistance and obesity, two conditions associated with the theoretical thrifty genotype that is more likely to experience these conditions. Perhaps the inflammation associated with this change in gut bacteria is expressing these thrifty genes to a greater extent and allowing the host to get by with less food. In other words, the inflammation these types of bacteria create functions as a signaling molecule to the host, letting their body know that it's time to be thrifty and more efficient with cellular energy consumption and storage as the types of available food declines. This inflammation coupled with moderate to high carbohydrate consumption could improve fat stores during the end of fall as the wintery season approaches and begins to take hold.
We can compare this to what we see today in Type 2 diabetes. In Type 2 diabetes, people become insulin resistant which causes their blood glucose to rise. What we see in people with Type 2 diabetes is an eventual spilling of fatty acids in to the blood stream during this process. This is due to the extremely high levels of blood glucose we are able to attain today with the types of foods that are available in addition to the fact that we are able to exceed our ability to store fat. Who knows how this process would play out as it did back when our ancestors were moving out of Africa searching for food and being on the low end of their fat storage capabilities. If it plays out in a similar fashion to the beginning stages of Type 2 diabetes, it is likely that they experienced an enhanced ability to accumulate body fat, a beneficial effect when going in to a season where carbohydrates won't be available. What we are now seeing with Type 2 diabetes could potentially be the consequences of our past environment selecting traits that were advantageous at the time that are now no longer advantageous. A recent study in the journal Nature indicates that this may be so.
The study looked at people of Latin American descent and identified a gene associated with Type 2 diabetes that is very prevalent in that population(approximately 50%) called SLC16A11. This genetic variant alters fat metabolism and causes an increase in cellular fat levels. People with one copy of this variant are 25% more likely to develop Type 2 diabetes while people with two copies are 50% more likely to develop it when compared to people without this variant. All of this science mumbo jumbo is nice, but the science behind this pales in comparison to where this gene likely came from; Neanderthals.
This is extremely interesting because Neanderthals left Africa much earlier than we did and those that were more adapted to efficiently storing fat were far more likely to be successful in environments where food sources were seasonal. Much of the Neanderthal anatomy was suited to cold weather because they had experienced it for millenia before we made our way out of Africa, it only makes sense that their physiology would be optimized for that environment as well. If this is one of the thrifty genes, perhaps as their diet changed moving in to winter, so did their gut bacteria,. This, in turn, may have increased expression of this gene, as well as others, which would make them more "thrifty" and, thus, better adapted to their environment via improved fat storage.
Another piece of potential "evidence" comes from those undertaking low carbohydrate diets. It is common knowledge that low carbohydrate diets aren't typically effective for fat loss when protein intake is high. The conventional thinking is that this is due to protein causing insulin secretion as well as the ability of certain amino acids to convert to glucose and raise blood glucose levels. However, it is interesting that high protein intake in the face of low fiber intake causes such a dramatic shift in the composition of gut bacteria given that the vast majority of low carbohydrate diets tend to be high in protein and low in fiber(Atkins diet). While a much more gradual shift in the availability of foods is more likely, the ability to adapt quickly would be highly beneficial.
Overall, I think there is a lot of evidence that supports the notion that a diet that is primarily meat, potentially even grass-fed beef, may cause inflammation due to increased protein consumption changing the landscape of the host's gut bacteria. There appears to be a large benefit to the host through this process. You have to be careful with what you can generalize this to, however. I don't believe this indicates that moderate meat consumption is bad, and the ratio of meat to fiber is probably a much bigger determinant of this effect as is the ability of the host to digest protein. Protein consumption, per se, is not the problem. The ability of undigested protein to make it's way to the colon where the types of gut bacteria that can ferment amino acids can act on it is the chief concern. In the absence of high carbohydrate consumption, this inflammation may even be benign.
Preliminary results from the Human Gut Project indicate that people who consume a Paleo diet tend to have higher levels of bacteria that are associated with inflammation, but most of these people have fewer complaints related to inflammatory conditions. I do think this points to a more moderate approach to meat consumption than most people undertaking a Paleo diet implement for the simple fact that most overconsume protein from meat and nuts. However, this doesn't vindicate the consumption of protein from vegetable sources. In fact, given that a lot of these proteins are difficult for humans to digest, especially grains as well as soy and other legumes, they could potentially amplify this effect, especially when fiber intake is low. Since vegans often rely on protein powders rather than whole food sources to fulfill their protein needs, they are essentially consuming high doses of protein that is more likely to become problematic, even at lower total protein intakes Therefore, consuming concentrated sources of harder to digest proteins is not a great idea if you are looking to control inflammation, especially if you are also consuming large amounts of carbohydrates as is typical of the vegan diet.
One of the more interesting aspects of the study in question, found here, is that gut bacteria switched rapidly when going to the extremes of diet. In my opinion, this is a testament to how important a diverse array of bacteria in the gut is to maintaining metabolic flexibility. Humans can thrive on a wide array of diets and the ability of bacteria in the gut to respond to quick changes in the availability of food from the environment is what makes us metabolically flexible. From an evolutionary perspective this makes sense because once our ancestors left Africa, the most likely to survive would have been the ancestors who could adapt to changes in the types of food that were available due to seasonal changes in the climate.
As Summer leads to Fall and Fall leads to Winter, the availability of fruit and other foods that were preferred by our ancestors who remained in Africa would not have been available in more seasonal climates during a time when you couldn't just order takeout. To adapt, they likely needed to consume fallback foods that were available in a wintery climate during that time of year. This would include meats and root vegetables whose availability would change less with the seasons. With this change from a diet high in fruits and vegetables to one with a proportionally smaller amount of these foods and a higher proportion of animal flesh, you are changing the substrate that the bacteria in your gut can ferment from mostly fermentable carbohydrates to amino acids. This, in turn, should change the proportion of bacteria in the gut, favoring the types of gut bacteria that ferment amino acids and scaling back the type that ferment carbohydrates. Could there be some evolutionary benefit for this switch? I think so.
As the diversity of available food reduces during the winter time, there would be a benefit to extracting more energy out of that food. Most people believe that carbohydrates and protein contain the same amount of calories per gram at 4 calories, but this is not true. In a bomb calorimeter, carbohydrates average 4.2 calories of energy per gram while proteins average 5.65 calories per gram. Some of this increased energy content is due to the nitrogen content of protein, which humans don't use for energy. Even if half of the extra energy is from nitrogen, that still leaves an extra 17% more energy in protein per gram than carbohydrates. This is huge when food becomes scarce. One of the first things one notices as they implement a low carbohydrate diet is constipation. Maybe this delay in food transit through the digestive tract allows us to absorb more of that energy or it gives bacteria in the colon more time to ferment amino acids that make it there, providing more energy than we can extract on our own.
On top of the potential for extra extractable energy contained in protein, there is the inflammation associated with the bacteria identified in the study. While our current food environment makes this a bad thing, in the face of food scarcity, this inflammation may be beneficial. Inflammation is associated with insulin resistance and obesity, two conditions associated with the theoretical thrifty genotype that is more likely to experience these conditions. Perhaps the inflammation associated with this change in gut bacteria is expressing these thrifty genes to a greater extent and allowing the host to get by with less food. In other words, the inflammation these types of bacteria create functions as a signaling molecule to the host, letting their body know that it's time to be thrifty and more efficient with cellular energy consumption and storage as the types of available food declines. This inflammation coupled with moderate to high carbohydrate consumption could improve fat stores during the end of fall as the wintery season approaches and begins to take hold.
We can compare this to what we see today in Type 2 diabetes. In Type 2 diabetes, people become insulin resistant which causes their blood glucose to rise. What we see in people with Type 2 diabetes is an eventual spilling of fatty acids in to the blood stream during this process. This is due to the extremely high levels of blood glucose we are able to attain today with the types of foods that are available in addition to the fact that we are able to exceed our ability to store fat. Who knows how this process would play out as it did back when our ancestors were moving out of Africa searching for food and being on the low end of their fat storage capabilities. If it plays out in a similar fashion to the beginning stages of Type 2 diabetes, it is likely that they experienced an enhanced ability to accumulate body fat, a beneficial effect when going in to a season where carbohydrates won't be available. What we are now seeing with Type 2 diabetes could potentially be the consequences of our past environment selecting traits that were advantageous at the time that are now no longer advantageous. A recent study in the journal Nature indicates that this may be so.
The study looked at people of Latin American descent and identified a gene associated with Type 2 diabetes that is very prevalent in that population(approximately 50%) called SLC16A11. This genetic variant alters fat metabolism and causes an increase in cellular fat levels. People with one copy of this variant are 25% more likely to develop Type 2 diabetes while people with two copies are 50% more likely to develop it when compared to people without this variant. All of this science mumbo jumbo is nice, but the science behind this pales in comparison to where this gene likely came from; Neanderthals.
This is extremely interesting because Neanderthals left Africa much earlier than we did and those that were more adapted to efficiently storing fat were far more likely to be successful in environments where food sources were seasonal. Much of the Neanderthal anatomy was suited to cold weather because they had experienced it for millenia before we made our way out of Africa, it only makes sense that their physiology would be optimized for that environment as well. If this is one of the thrifty genes, perhaps as their diet changed moving in to winter, so did their gut bacteria,. This, in turn, may have increased expression of this gene, as well as others, which would make them more "thrifty" and, thus, better adapted to their environment via improved fat storage.
Another piece of potential "evidence" comes from those undertaking low carbohydrate diets. It is common knowledge that low carbohydrate diets aren't typically effective for fat loss when protein intake is high. The conventional thinking is that this is due to protein causing insulin secretion as well as the ability of certain amino acids to convert to glucose and raise blood glucose levels. However, it is interesting that high protein intake in the face of low fiber intake causes such a dramatic shift in the composition of gut bacteria given that the vast majority of low carbohydrate diets tend to be high in protein and low in fiber(Atkins diet). While a much more gradual shift in the availability of foods is more likely, the ability to adapt quickly would be highly beneficial.
Overall, I think there is a lot of evidence that supports the notion that a diet that is primarily meat, potentially even grass-fed beef, may cause inflammation due to increased protein consumption changing the landscape of the host's gut bacteria. There appears to be a large benefit to the host through this process. You have to be careful with what you can generalize this to, however. I don't believe this indicates that moderate meat consumption is bad, and the ratio of meat to fiber is probably a much bigger determinant of this effect as is the ability of the host to digest protein. Protein consumption, per se, is not the problem. The ability of undigested protein to make it's way to the colon where the types of gut bacteria that can ferment amino acids can act on it is the chief concern. In the absence of high carbohydrate consumption, this inflammation may even be benign.
Preliminary results from the Human Gut Project indicate that people who consume a Paleo diet tend to have higher levels of bacteria that are associated with inflammation, but most of these people have fewer complaints related to inflammatory conditions. I do think this points to a more moderate approach to meat consumption than most people undertaking a Paleo diet implement for the simple fact that most overconsume protein from meat and nuts. However, this doesn't vindicate the consumption of protein from vegetable sources. In fact, given that a lot of these proteins are difficult for humans to digest, especially grains as well as soy and other legumes, they could potentially amplify this effect, especially when fiber intake is low. Since vegans often rely on protein powders rather than whole food sources to fulfill their protein needs, they are essentially consuming high doses of protein that is more likely to become problematic, even at lower total protein intakes Therefore, consuming concentrated sources of harder to digest proteins is not a great idea if you are looking to control inflammation, especially if you are also consuming large amounts of carbohydrates as is typical of the vegan diet.
Friday, December 27, 2013
5 tips to help stop GERD
Most people who experience GERD immediately go to the pharmacy and grab an acid reducer to stop the symptoms associated with GERD. In my last blog I went over the reasons why this is a bad idea. In this blog I will give you some tips on how to reduce GERD.
These tips should help you manage the symptoms of GERD. Although they are very helpful, don't expect immediate results overnight. GERD is likely something that takes a while to develop, so it will take a while to correct. Begin implementing these tips and you should be on your way in improving your digestion and correcting GERD.
1)Reduce stress
This may seem like an odd tip, but it's based on hard science. Automatic processes such as digestion, heart rate, blood pressure, and breathing are controlled by the autonomic nervous system(ANS). You have a finite number of resources and your autonomic nervous system helps determine what systems deserve the limited resources you have. When you are stressed, your ANS partitions resources toward your muscles, putting you in fight or flight mode so you can get away from whatever is attacking you or turn it in to food. This directs resources away from your organs of digestion until the stress is resolved. At that time, resources are directed back to the organs of digestion to help your body recover. This process, while useful in times of physiological stress such as coming upon a bear in the woods, can be detrimental when the stress is psychological or ongoing. All stress is handled in the same way by the ANS so all stress will negatively impact digestion unless it is managed properly. One of the best things you can do right before you eat is take in a deep breath and relax.2)Sit down to eat
This goes right along with the reduce stress tip. Too many people eat on the go or while standing up and this can negatively impact digestion for the same reason as above. When you eat, you want to sit down, relax, and take your time. Too many people shove something in to their mouth quickly and jump right out the door. Even if you are getting in to the car and sitting down, you are exposing yourself to stress in the car during your commute, especially if you have to deal with Jersey drivers like I do. Sit down, take your time, and don't jump right up once you've finished eating.3)Chew your food
Digestion begins in the mouth as amylase, the enzyme responsible for digesting carbohydrates, starch to break down starch before it enters the stomach. Focus on putting manageable bites of food in to your mouth and chewing each mouthful 30 times. This will help digestion and make sure food is properly digested so that it doesn't cause bacteria to overgrow from your large intestine in to your small intestine where they can cause problems.4)Eat smaller meals
In general, I prefer people eat 3 meals a day. However, if you are not producing enough digestive enzymes, you may want to focus on 5-6 smaller meals to allow your body to break everything you eat down. The goal is to make sure all of the food that can be digested by you is absorbed before it gets to the end of your digestive tract where the beneficial bacteria in your gut can finish digesting what you can't.5)Use digestive enzymes
As long as you don't have any ulcers, digestive enzymes can be used to help break down your food when you aren't making enough on your own. The added bonus is that as you use these enzymes, you begin making more of your own so you can ween yourself off of them. A project I have been working on leads me to believe that this works by reducing the amount of food available to the bacteria that is making it's way in to the small intestine where it doesn't belong. This bacteria is also negatively influencing your digestive process by altering the digestive tract and once it is starved, you begin producing enzymes on your own. The enzymes you need to take and how much is dependent on what and how much you eat. Betaine HCl w/Pepsin or NOW foods Super Enzymes both seem to work pretty well in capsule form. I more or less agree with this article from SCDLifestyle on how to determine your dosage. However, make sure you get Betaine Hcl WITH Pepsin, not just Betaine Hcl.These tips should help you manage the symptoms of GERD. Although they are very helpful, don't expect immediate results overnight. GERD is likely something that takes a while to develop, so it will take a while to correct. Begin implementing these tips and you should be on your way in improving your digestion and correcting GERD.
Thursday, November 21, 2013
Anatomy of a great breakfast
People often ask me what I eat for breakfast since I don't eat cereal or bread. For the most part, I stick to a similar breakfast every day as seen below:
This meal consist of 2 sausage links and 2 strips of organic bacon with veggies sauteed in bacon fat and a tsp of Kerrygold butter. The veggies consist of parsnips, carrots, asparagus, russet potatoes, onions and red peppers. I cook this in a cast iron skillet, so the added fat is to make sure it doesn't stick to the pan. Normally I season the veggies with basil, parsley, and garlic but I got a little lazy today. In the mason jar is 1 tbsp of unmodified potato starch mixed in water. So let's break down the benefits of this breakfast.
Prebiotic fiber from vegetables helps cultivate a healthy microbiome by helping to heal the gut and providing food to help healthy bacteria do their job. This is also the reason for the unmodified potato starch. Unmodified potato starch is basically raw potato powder. Unmodified potato starch is considered resistant starch, as long as you don't heat it you can't digest it but the healthy bacteria in your gut ferment it in to short chained fatty acids that heal the gut. I've seen dramatic improvements in my gut health and blood glucose regulation by taking unmodified potato starch every day. I suppose you could just eat raw potatoes if you wanted, I find the potato starch to be a more appealing option.
In addition to the prebiotic fiber, healthy gut bugs like polyphenols, especially quercetin. Polyphenols help give plant based foods their color. To make sure I am getting a wide variety of polyphenols, I eat as many different colors of vegetables and fruit as possible over the course of the day. In this breakfast alone I get red, white, orange, green, and yellow. In addition, I normally have wild blueberries during the week but tend to remove them during the weekend because I drink beer and that has a negative impact on my insulin sensitivity.
This meal consist of 2 sausage links and 2 strips of organic bacon with veggies sauteed in bacon fat and a tsp of Kerrygold butter. The veggies consist of parsnips, carrots, asparagus, russet potatoes, onions and red peppers. I cook this in a cast iron skillet, so the added fat is to make sure it doesn't stick to the pan. Normally I season the veggies with basil, parsley, and garlic but I got a little lazy today. In the mason jar is 1 tbsp of unmodified potato starch mixed in water. So let's break down the benefits of this breakfast.
Building a healthy gut
The first thing to notice is the volume of vegetables compared to meat. Since my diet isn't low carb, I like to eat a large volume of veggies to help support GI health and a healthy community of beneficial bacteria in my gut. Most people take a probiotic to do this, but in my opinion prebiotic fiber from vegetables is a much smarter direction to go. Even if probiotics work, and I do believe they have some benefit, if you don't provide the proper food for the little guys to survive in your gut they won't.Prebiotic fiber from vegetables helps cultivate a healthy microbiome by helping to heal the gut and providing food to help healthy bacteria do their job. This is also the reason for the unmodified potato starch. Unmodified potato starch is basically raw potato powder. Unmodified potato starch is considered resistant starch, as long as you don't heat it you can't digest it but the healthy bacteria in your gut ferment it in to short chained fatty acids that heal the gut. I've seen dramatic improvements in my gut health and blood glucose regulation by taking unmodified potato starch every day. I suppose you could just eat raw potatoes if you wanted, I find the potato starch to be a more appealing option.
In addition to the prebiotic fiber, healthy gut bugs like polyphenols, especially quercetin. Polyphenols help give plant based foods their color. To make sure I am getting a wide variety of polyphenols, I eat as many different colors of vegetables and fruit as possible over the course of the day. In this breakfast alone I get red, white, orange, green, and yellow. In addition, I normally have wild blueberries during the week but tend to remove them during the weekend because I drink beer and that has a negative impact on my insulin sensitivity.
Antioxidant defense
Every 3 days I like to include a vegetable from the cruciferous vegetable family. I chose asparagus this time, but we often rotate brussel sprouts, broccoli, kale, and cauliflower. The reason I like to get cruciferous vegetables in my diet 3 times a week is because they activate the NRF-2 pathway, one of your endogenous sources of antioxidants. Brocoli's anti-cancer benefits are at least partially through NRF-2 pathway activation. Wild blueberries also have the same effect which is why I eat them during the week. I cook my cruciferous vegetables and limit my total weekly consumption to less than 6 servings per week because they can have a goitrogenic effect, they can interfere with thyroid function, when consumed too much. Cooking them lessens this effect, but doesn't remove it entirely. Since their antioxidant benefit lasts 3 days, I don't feel the need to consume them more than every 2-3 days.Allowing a little diversity
Every now and again I will rotate in a different meat or eggs for a while to break the monotony of eating the same thing every day. I also rotate my oils between coconut oil, Kerrygold butter, ghee, and olive oil. In addition, I rotate different vegetables frequently. The other vegetables in the rotation that I haven't mentioned include escarole, sweet potatoes, beets, beet greens, dandelion greens, chard, celery, squash, yellow and green zucchini, green peppers, orange peppers, yellow peppers, and all sorts of different mushrooms. Throughout a week, I like to get at least 20 different vegetables and a few different types of fruit, rotating different vegetables for breakfast helps get me there.Conclusion
I like to set the tone for the day with a good breakfast. The large diversity as well as high volume of vegetables helps keep my gut healthy and keeps me full until lunch, most of the time I could probably even skip lunch without becoming hungry. From a calorie standpoint, this meal provides approximately 500 calories and is my second largest meal behind dinner.
Thursday, October 17, 2013
The walking dead: Is American agricultural policy creating a legion of zombies that will eventually break the bank?
When most people hear the term "the walking dead", it conjures up the image of zombies running amuck in a post-apocalyptic world. Legions of the brain dead undead doing the Frankenstein and looking to devour the brains of any live person within their grasp. However, many of us know a different type of walking dead, one whose transition is far slower. It may begin in their late 40s or early 50s as they lose track of where they put things or misremember things that have happened in their past. Slowly but surely the zombification progresses until they no longer remember friends and family, eventually losing the ability to express themselves, understand a conversation, or even respond to the environment. The walking dead I am referring to are people going through dementia and/or Alzheimer's disease.
While there is an enormous emotional price to having a loved one with dementia or Alzhemier's disease that can't be quantified, there is also an enormous price tag to go along with it. In 2013 alone, the direct costs of Alzheimer's disease in the US was $203 billion and is expected to balloon up to $1.2 trillion per year by 2050(1). Not included in this number is the unpaid care that family give to people with Alzheimer's disease, estimated to be $216 billion in 2012.
Many people associate dementia and Alzheimer's as being a normal part of aging. While it is true that Alzheimer's progresses with age, it is certainly not a normal part of aging. With Alzheimer's comes structural changes within the brain, an accumulation of beta amyloid plaques and tangles in a protein called tau that interfere with normal brain function. While these plaques and tangles tend to accumulate in everyone as they age, they accumulate to a far greater extent and in a consistent pattern in people with Alzheimer's disease. Furthermore, quite a bit of research has recently pointed to dementia and Alzheimer's disease as autoimmune diseases. This is evidenced by high levels of cells of the immune system called immunoglobulins(2) and other immune system proteins(3) in the brains of people with varying degrees of dementia, including Alzheimer's disease.
The brain is meant to be a sanctuary from immune activity. The blood brain barrier prevents large particles such as bacteria and antibodies from entering the brain and causing problems. Within the blood brain barrier are proteins called tight junctions that seal off the area and help regulate what can or cannot enter the brain. These tight junctions are dissolved by a protein called zonulin(4, 5). What makes this interesting is the fact that both the lungs and the gut also contain tight junctions, and zonulin has the same effect on the tight junctions in those tissues as well. Intestinal permeability occurs when the tight junctions between cells of the intestine fail to prevent large particles from entering the blodstream. It is believed that this is due to zonulin dissolving the tight junction. Making this an even more intriguing relationship is that intestinal permeability appears to be a necessary component of many, if not most, autoimmune diseases(6, 7).
A recent study comparing the postmortem brains of people with Alzheimer's disease to healthy controls found the presence of an oral bacteria known to cause periodontal disease in 4 out of the 10 brains of people with Alzheimer's disease and none in the controls(8). Many look at this as evidence of there being a link between periodontal disease and Alzheimer's disease, but if it were a direct link all of the samples of brain tissue from people with Alzheimer's would have it. However, in a person with a properly working blood brain barrier, this bacteria should not have access to the brain. This study supports the notion that a poorly functioning blood brain barrier is a significant causative factor in Alzheimer's disease. Could this be the result of zonulin dissolving the tight junctions? We don't know for sure, but there is ample reason to suggest so.
Many people are aware of gluten. All you have to do is walk in to any grocery store and you get bombarded with gluten free this, or gluten free that. While many people go gluten free, many have no idea what gluten is or why they are going gluten free. One of the few groups who do know what gluten is are people with celiac disease. Celiac disease is an autoimmune disorder that affects the intestinal lining. When someone with celiac disease eats gluten or any other grain containing gliadin, damage occurs to their intestinal tract that causes pain and discomfort as well as malabsorption of nutrients. This can eventually put them in a malnourished state. Part of this response is due to the release of zonulin, which occurs when gliadin interacts with the intestinal wall and causes intestinal permeability..
However, in a study looking at the intestinal tissue of people with celiac disease and people without celiac disease, zonulin appears to be released in both scenarios, albeit for 30 times longer in people with celiac disease(9). It appears that gut bacteria may have a big role in this as people with celiac disease have different gut bacteria than healthy people, and gut bacteria heal the tight junctions when they ferment soluble fiber and resistant starch in to butyric acid. It is important to point out that these tissue samples were removed from people and then treated with zonulin, and were not tested in a living person.
So we have a potential mechanism for Alzheimer's disease where gluten is ingested and interacts with the cells of the intestine causing zonulin release that dissolves the tight junctions there as well as in the blood brain barrier. This allows particles, including inflammatory ones, that shouldn't be in the brain to cross the blood brain barrier and react with structures within the brain. This doesn't necessarily mean that anyone who experiences intestinal permeability will experience Alzheimer's disease, there are far too many factors to take in to consideration. However, I tend to think that people can realize that the blood brain barrier is there for a reason. Compromising the blood brain barrier is a bad idea whether you are genetically prone to Alzheimer's disease or not. One of the problems is you wouldn't know if this was happening or not, there are no pain receptors in the brain so inflammation doesn't typically show up as pain, it shows up slowly as brain dysfunction over time. Furthermore, inflammation compromises the blood brain barrier further.
So what role does American agricultural policy play in this mess? It's very simple. Every year the federal government gives subsidies to "farmers" to grow wheat. I put farmers in quotation marks because most of the people receiving these subsidies are not family farmers, they are large corporations that do farming. The USDA, a lobbying group for these corporate farmers, lobbies the federal government to get these subsidies and then distributes the money to farmers. From 1995-2012, farm subsidies for wheat alone were $35.5 billion(10). This is the reason it's cheaper to buy bread than it is to buy fruits and vegetables. Most people assume it's because bread is cheaper to grow, but this is only the case if you are subsidizing it's production.
This seems innocent enough, the purpose of most lobbying groups is to lobby the federal government for the organizations they represent. However, the USDA has another role. Many of you are familiar with the Food Pyramid/MyPlate which dictates which foods you should be eating regularly. The problem is that it's not written by a bunch of doctors commissioned to make Americans healthy. It's written by the USDA, a trade group that helps determine which foods can be easily produced and which ones are most profitable. There was no grand experiment decades ago to help determine the foods that are fit for human consumption and then translated in to a set of ground rules for healthy human eating. The USDA stated what could be made and that became the contents of the Food Pyramid, which most people assume are a set of healthy eating rules. To make maters worse, physicians and nutritionists in the healthcare industry push these rules as if that is exactly what they are.
The problem doesn't end there. As many of you know, much of the nutritional research to date has shown grains, especially wheat, to be a healthy food option that leads to positive health outcomes. However, this research is tainted because they essentially told everyone that grains are a healthy food choice without having the research to back it up. If you tell a group of people that a certain food product is healthy, which people do you think are going to consume that product? Typically, you are going to get people who are interested in being healthy. This means they are interested in doing other healthy things like exercising, not smoking, getting quality sleep, and a host of other healthy lifestyle choices. This throws off the research because on one side you have people who are doing everything right and on the other side you have people doing everything wrong. If the side doing everything right is told that they should be eating grains and they do, it's not scientifically valid to compare the 2 groups.
As you can see, there is much to be frustrated about with the way we determine which foods people should eat. When you make foods cheap, you make them more appealing to people and increase the likelihood that people will consume them. This drives people to make the wrong choices, especially poor people who are on a limited income. What people don't realize is that these foods really aren't cheap when you factor in the tax dollars needed to subsidize them and the potential health ramifications they can cause before they are adequately tested. Grains, especially wheat, may be costing us money up front in the form of tax dollars as well as on the back end with the emotional and financial costs associated with Alzheimer's disease. Many people will read this statement and say that there is no research that supports this notion. However, just because there is no research directly linking the consumption of grains with Alzheimer's disease doesn't mean it's not true. At one time the "research" pointed to the Earth being flat, that doesn't mean it was flat until the research showed it to be round.
While there is an enormous emotional price to having a loved one with dementia or Alzhemier's disease that can't be quantified, there is also an enormous price tag to go along with it. In 2013 alone, the direct costs of Alzheimer's disease in the US was $203 billion and is expected to balloon up to $1.2 trillion per year by 2050(1). Not included in this number is the unpaid care that family give to people with Alzheimer's disease, estimated to be $216 billion in 2012.
Many people associate dementia and Alzheimer's as being a normal part of aging. While it is true that Alzheimer's progresses with age, it is certainly not a normal part of aging. With Alzheimer's comes structural changes within the brain, an accumulation of beta amyloid plaques and tangles in a protein called tau that interfere with normal brain function. While these plaques and tangles tend to accumulate in everyone as they age, they accumulate to a far greater extent and in a consistent pattern in people with Alzheimer's disease. Furthermore, quite a bit of research has recently pointed to dementia and Alzheimer's disease as autoimmune diseases. This is evidenced by high levels of cells of the immune system called immunoglobulins(2) and other immune system proteins(3) in the brains of people with varying degrees of dementia, including Alzheimer's disease.
The brain is meant to be a sanctuary from immune activity. The blood brain barrier prevents large particles such as bacteria and antibodies from entering the brain and causing problems. Within the blood brain barrier are proteins called tight junctions that seal off the area and help regulate what can or cannot enter the brain. These tight junctions are dissolved by a protein called zonulin(4, 5). What makes this interesting is the fact that both the lungs and the gut also contain tight junctions, and zonulin has the same effect on the tight junctions in those tissues as well. Intestinal permeability occurs when the tight junctions between cells of the intestine fail to prevent large particles from entering the blodstream. It is believed that this is due to zonulin dissolving the tight junction. Making this an even more intriguing relationship is that intestinal permeability appears to be a necessary component of many, if not most, autoimmune diseases(6, 7).
A recent study comparing the postmortem brains of people with Alzheimer's disease to healthy controls found the presence of an oral bacteria known to cause periodontal disease in 4 out of the 10 brains of people with Alzheimer's disease and none in the controls(8). Many look at this as evidence of there being a link between periodontal disease and Alzheimer's disease, but if it were a direct link all of the samples of brain tissue from people with Alzheimer's would have it. However, in a person with a properly working blood brain barrier, this bacteria should not have access to the brain. This study supports the notion that a poorly functioning blood brain barrier is a significant causative factor in Alzheimer's disease. Could this be the result of zonulin dissolving the tight junctions? We don't know for sure, but there is ample reason to suggest so.
Many people are aware of gluten. All you have to do is walk in to any grocery store and you get bombarded with gluten free this, or gluten free that. While many people go gluten free, many have no idea what gluten is or why they are going gluten free. One of the few groups who do know what gluten is are people with celiac disease. Celiac disease is an autoimmune disorder that affects the intestinal lining. When someone with celiac disease eats gluten or any other grain containing gliadin, damage occurs to their intestinal tract that causes pain and discomfort as well as malabsorption of nutrients. This can eventually put them in a malnourished state. Part of this response is due to the release of zonulin, which occurs when gliadin interacts with the intestinal wall and causes intestinal permeability..
However, in a study looking at the intestinal tissue of people with celiac disease and people without celiac disease, zonulin appears to be released in both scenarios, albeit for 30 times longer in people with celiac disease(9). It appears that gut bacteria may have a big role in this as people with celiac disease have different gut bacteria than healthy people, and gut bacteria heal the tight junctions when they ferment soluble fiber and resistant starch in to butyric acid. It is important to point out that these tissue samples were removed from people and then treated with zonulin, and were not tested in a living person.
So we have a potential mechanism for Alzheimer's disease where gluten is ingested and interacts with the cells of the intestine causing zonulin release that dissolves the tight junctions there as well as in the blood brain barrier. This allows particles, including inflammatory ones, that shouldn't be in the brain to cross the blood brain barrier and react with structures within the brain. This doesn't necessarily mean that anyone who experiences intestinal permeability will experience Alzheimer's disease, there are far too many factors to take in to consideration. However, I tend to think that people can realize that the blood brain barrier is there for a reason. Compromising the blood brain barrier is a bad idea whether you are genetically prone to Alzheimer's disease or not. One of the problems is you wouldn't know if this was happening or not, there are no pain receptors in the brain so inflammation doesn't typically show up as pain, it shows up slowly as brain dysfunction over time. Furthermore, inflammation compromises the blood brain barrier further.
So what role does American agricultural policy play in this mess? It's very simple. Every year the federal government gives subsidies to "farmers" to grow wheat. I put farmers in quotation marks because most of the people receiving these subsidies are not family farmers, they are large corporations that do farming. The USDA, a lobbying group for these corporate farmers, lobbies the federal government to get these subsidies and then distributes the money to farmers. From 1995-2012, farm subsidies for wheat alone were $35.5 billion(10). This is the reason it's cheaper to buy bread than it is to buy fruits and vegetables. Most people assume it's because bread is cheaper to grow, but this is only the case if you are subsidizing it's production.
This seems innocent enough, the purpose of most lobbying groups is to lobby the federal government for the organizations they represent. However, the USDA has another role. Many of you are familiar with the Food Pyramid/MyPlate which dictates which foods you should be eating regularly. The problem is that it's not written by a bunch of doctors commissioned to make Americans healthy. It's written by the USDA, a trade group that helps determine which foods can be easily produced and which ones are most profitable. There was no grand experiment decades ago to help determine the foods that are fit for human consumption and then translated in to a set of ground rules for healthy human eating. The USDA stated what could be made and that became the contents of the Food Pyramid, which most people assume are a set of healthy eating rules. To make maters worse, physicians and nutritionists in the healthcare industry push these rules as if that is exactly what they are.
The problem doesn't end there. As many of you know, much of the nutritional research to date has shown grains, especially wheat, to be a healthy food option that leads to positive health outcomes. However, this research is tainted because they essentially told everyone that grains are a healthy food choice without having the research to back it up. If you tell a group of people that a certain food product is healthy, which people do you think are going to consume that product? Typically, you are going to get people who are interested in being healthy. This means they are interested in doing other healthy things like exercising, not smoking, getting quality sleep, and a host of other healthy lifestyle choices. This throws off the research because on one side you have people who are doing everything right and on the other side you have people doing everything wrong. If the side doing everything right is told that they should be eating grains and they do, it's not scientifically valid to compare the 2 groups.
As you can see, there is much to be frustrated about with the way we determine which foods people should eat. When you make foods cheap, you make them more appealing to people and increase the likelihood that people will consume them. This drives people to make the wrong choices, especially poor people who are on a limited income. What people don't realize is that these foods really aren't cheap when you factor in the tax dollars needed to subsidize them and the potential health ramifications they can cause before they are adequately tested. Grains, especially wheat, may be costing us money up front in the form of tax dollars as well as on the back end with the emotional and financial costs associated with Alzheimer's disease. Many people will read this statement and say that there is no research that supports this notion. However, just because there is no research directly linking the consumption of grains with Alzheimer's disease doesn't mean it's not true. At one time the "research" pointed to the Earth being flat, that doesn't mean it was flat until the research showed it to be round.
Monday, October 14, 2013
Why Paleo? Endurance athlete edition
Call it Paleo, call it Primal, for the most part you see many in either lifestyle poo-pooing endurance activities as unnecessary. Personally, I don't do endurance type activities because I really don't like doing them. Perhaps if I was better suited to doing them I would, but I am not. I also don't recommend clients do them unless they like to do them. More than any other criteria, your physical activity should be something you like to do, that way you do it often. However, I feel the Paleo and Primal crowds aren't using very good logic when they say endurance exercise is unnecessary. Is slamming in to a 300lbs lineman necessary? Is lifting weights at an explosive pace with terrible form necessary? For the most part, any sort of physical activity that doesn't involve you trying to attain food or procreate is unnecessary, so why try to exclude a group just because their mode of exercise isn't your cup of tea? Let's take a look at how the benefits of a Paleo diet translate in to performance benefits for endurance athletes.
Many people are confused with what a Paleo diet is and what it can do for them. Part of this can be blamed on the original message insinuating that if a food wasn't consumed regularly by your ancestors then it wasn't good for you and part of it can be blamed on people currently pushing Paleo that don't really know why it works. Paleo does not mean that any food or environmental factor that has come in the last X number of years is necessarily harmful, there are many examples to the contrary. Olive oil and broccoli are relatively new and are great for health as evidenced by the ample clinical research supporting both.
One of the biggest examples occurred millions of years ago when some of our herbivorous ancestors climbed out of the trees and began scavenging on the DHA rich carcasses left by carnivorous land animals. Organ meats rich in DHA provided a nutrient that is vital for human brain development, and is potentially one of the primary reasons we branched away from other primates and developed a much better brain. If this had never happened, certainly it would be seen as missing out on something that was a complete game changer for life on the planet.
However, on the flip side, many critics also create a logical fallacy. The fallacy on the other side of the fence is that since we have been eating something for the last 30,000 or so years that it is a healthy food. Look at the diseases killing humans today: Diabetes, heart disease, cancer, and Alzheimer's disease to name a few. Few of these diseases affect younger people, they are called chronic diseases of aging because you get them in your 40s, 50s, and beyond. Since these diseases don't typically affect your ability to reproduce and don't kill you before you can reproduce, you can't logically assume they are healthy unless your goal in life is to live to the age of 30, have 3 kids, and then die.
So then why should you be eating a Paleo diet? Let's take a look at the primary reasons, the proteins in grains, legumes, and dairy. The proteins in grains(1), legumes and dairy are immunogenic, meaning they elicit an immune response. In a healthy person without celiac disease this doesn't mean they are necessarily toxic. Look at hay fever. Pollen isn't toxic, it just elicits an immune response that gives you itchy eyes, causes you to sneeze and cough, and gives a headache. Does that mean not being able to see or constantly sneezing is something you want to do all day long? It would certainly affect your performance. Ironically, seasonal allergies as well as most other autoimmune diseases are linked to intestinal permeability(2) and many resolve on a Paleo diet.
However, therein lies the problem with the immune response to the proteins in grains, legumes, and dairy; the symptoms can range from headaches to gastrointestinal flares to metabolic dysfunction and can affect any system in the body. In fact, a lot of people have no idea they have this response until they completely remove them from the diet for a couple of months because their body has become adapted to the constant firing of the immune system and the low grade inflammation accompanying it. However, there are quantifiable things going on in your body that you may not be aware of.
When these proteins interact with the intestinal wall, they can cause intestinal permeability. Intestinal permeability is a fancy way of saying that your gut is leaking it's contents in to your bloodstream. By releasing a protein called zonulin, proteins found in grains, legumes, and dairy(Especially gluten) may dissolve the tight junctions between the cells that separate the contents of your digestive tract from your blood. This process is well known in people with celiac disease, but studies on intestinal tissue taken from healthy people indicates that it may happen in everyone who consumes gluten, it just takes longer to repair in people with celiac disease(3). In addition, zonulin is known to regulate the tight junctions in the lungs(4, ) and blood brain barrier(5). Since zonulin from the gut enters the circulation, this means it is free to interact with the tight junctions in these areas, potentially compromising brain and lung function by increasing their permeability to toxins.
This can lead to some pretty serious performance consequences. Obviously poor brain or lung function will have a big impact on performance in endurance sports. An increase in airway infections will also negatively impact training. However, one of the bigger impacts has to do with glucose utilization and insulin sensitivity.
Lipopolysaccharide(LPS) is a component of the cell membranes of bacteria found in your gut. When it enters your bloodstream, your body sense it is under attack. As a result, your immune system fires off and produces inflammation that signals your muscle and fat tissue to become insulin resistant. This spares glucose for the immune system to fight off the attacker, which isn't even really there. In addition, your immune system signals your liver to start dumping glucose in to the blood to help provide more glucose to the immune system. This is one of the reasons fasting blood glucose is high in diabetics, even if they haven't been eating carbohydrates.
Now think about that from an endurance performance perspective. You train hard which empties out your glycogen stores and burns some fat, but when you recover and eat some carbohydrate from grains you fire off the immune system. This causes your immune system to consume some of the carbohydrate you take in to fight off the infection caused by what you are eating. In addition, your muscles and fat tissue become insulin resistant so they aren't getting the energy they need to get ready for your next training session until the immune system clears the mess you created with what you chose to eat. Maybe performance isn't affected immediately because you consume so many carbohydrates, but over time you are causing progressively more damage to your digestive tract and metabolism by consuming more grains. Couple that with the fact that you are training hard which will compromise your immune system further. Also, if your liver is constantly called upon to pump glucose in to your bloodstream, cortisol may increase due to gluconeogenesis. I think all of these issues warrant some attention from the endurance sport crowd given how hard they train and how many events they participate in annually.
Before I go, let me preface what I say with a caveat. We are all different, each and every one of us. Some of us may be able to eat dairy, some may not. Some of us may be able to eat a lot of grains, some of us a few, some of us none at all. Unless there has been a 2-3 month period in your life where you've completely abstained from grains, legumes, and dairy you have no idea whether or not they are affecting your health and/or performance. That's why you should just give it a try, replace grains with dextrose, potatoes, or other tubers. If you or anyone in your family has Type 2 diabetes, heart disease, get frequent respiratory infections, or experience any form of autoimmunity I would strongly suggest you look in to the Paleo diet, not only from a performance perspective but also for general health as these conditions are associated with intestinal permeability.
Many people are confused with what a Paleo diet is and what it can do for them. Part of this can be blamed on the original message insinuating that if a food wasn't consumed regularly by your ancestors then it wasn't good for you and part of it can be blamed on people currently pushing Paleo that don't really know why it works. Paleo does not mean that any food or environmental factor that has come in the last X number of years is necessarily harmful, there are many examples to the contrary. Olive oil and broccoli are relatively new and are great for health as evidenced by the ample clinical research supporting both.
One of the biggest examples occurred millions of years ago when some of our herbivorous ancestors climbed out of the trees and began scavenging on the DHA rich carcasses left by carnivorous land animals. Organ meats rich in DHA provided a nutrient that is vital for human brain development, and is potentially one of the primary reasons we branched away from other primates and developed a much better brain. If this had never happened, certainly it would be seen as missing out on something that was a complete game changer for life on the planet.
However, on the flip side, many critics also create a logical fallacy. The fallacy on the other side of the fence is that since we have been eating something for the last 30,000 or so years that it is a healthy food. Look at the diseases killing humans today: Diabetes, heart disease, cancer, and Alzheimer's disease to name a few. Few of these diseases affect younger people, they are called chronic diseases of aging because you get them in your 40s, 50s, and beyond. Since these diseases don't typically affect your ability to reproduce and don't kill you before you can reproduce, you can't logically assume they are healthy unless your goal in life is to live to the age of 30, have 3 kids, and then die.
So then why should you be eating a Paleo diet? Let's take a look at the primary reasons, the proteins in grains, legumes, and dairy. The proteins in grains(1), legumes and dairy are immunogenic, meaning they elicit an immune response. In a healthy person without celiac disease this doesn't mean they are necessarily toxic. Look at hay fever. Pollen isn't toxic, it just elicits an immune response that gives you itchy eyes, causes you to sneeze and cough, and gives a headache. Does that mean not being able to see or constantly sneezing is something you want to do all day long? It would certainly affect your performance. Ironically, seasonal allergies as well as most other autoimmune diseases are linked to intestinal permeability(2) and many resolve on a Paleo diet.
However, therein lies the problem with the immune response to the proteins in grains, legumes, and dairy; the symptoms can range from headaches to gastrointestinal flares to metabolic dysfunction and can affect any system in the body. In fact, a lot of people have no idea they have this response until they completely remove them from the diet for a couple of months because their body has become adapted to the constant firing of the immune system and the low grade inflammation accompanying it. However, there are quantifiable things going on in your body that you may not be aware of.
When these proteins interact with the intestinal wall, they can cause intestinal permeability. Intestinal permeability is a fancy way of saying that your gut is leaking it's contents in to your bloodstream. By releasing a protein called zonulin, proteins found in grains, legumes, and dairy(Especially gluten) may dissolve the tight junctions between the cells that separate the contents of your digestive tract from your blood. This process is well known in people with celiac disease, but studies on intestinal tissue taken from healthy people indicates that it may happen in everyone who consumes gluten, it just takes longer to repair in people with celiac disease(3). In addition, zonulin is known to regulate the tight junctions in the lungs(4, ) and blood brain barrier(5). Since zonulin from the gut enters the circulation, this means it is free to interact with the tight junctions in these areas, potentially compromising brain and lung function by increasing their permeability to toxins.
This can lead to some pretty serious performance consequences. Obviously poor brain or lung function will have a big impact on performance in endurance sports. An increase in airway infections will also negatively impact training. However, one of the bigger impacts has to do with glucose utilization and insulin sensitivity.
Lipopolysaccharide(LPS) is a component of the cell membranes of bacteria found in your gut. When it enters your bloodstream, your body sense it is under attack. As a result, your immune system fires off and produces inflammation that signals your muscle and fat tissue to become insulin resistant. This spares glucose for the immune system to fight off the attacker, which isn't even really there. In addition, your immune system signals your liver to start dumping glucose in to the blood to help provide more glucose to the immune system. This is one of the reasons fasting blood glucose is high in diabetics, even if they haven't been eating carbohydrates.
Now think about that from an endurance performance perspective. You train hard which empties out your glycogen stores and burns some fat, but when you recover and eat some carbohydrate from grains you fire off the immune system. This causes your immune system to consume some of the carbohydrate you take in to fight off the infection caused by what you are eating. In addition, your muscles and fat tissue become insulin resistant so they aren't getting the energy they need to get ready for your next training session until the immune system clears the mess you created with what you chose to eat. Maybe performance isn't affected immediately because you consume so many carbohydrates, but over time you are causing progressively more damage to your digestive tract and metabolism by consuming more grains. Couple that with the fact that you are training hard which will compromise your immune system further. Also, if your liver is constantly called upon to pump glucose in to your bloodstream, cortisol may increase due to gluconeogenesis. I think all of these issues warrant some attention from the endurance sport crowd given how hard they train and how many events they participate in annually.
Before I go, let me preface what I say with a caveat. We are all different, each and every one of us. Some of us may be able to eat dairy, some may not. Some of us may be able to eat a lot of grains, some of us a few, some of us none at all. Unless there has been a 2-3 month period in your life where you've completely abstained from grains, legumes, and dairy you have no idea whether or not they are affecting your health and/or performance. That's why you should just give it a try, replace grains with dextrose, potatoes, or other tubers. If you or anyone in your family has Type 2 diabetes, heart disease, get frequent respiratory infections, or experience any form of autoimmunity I would strongly suggest you look in to the Paleo diet, not only from a performance perspective but also for general health as these conditions are associated with intestinal permeability.
Thursday, October 10, 2013
Why Paleo? The primary reason I avoid grains and legumes.
I was recently having a discussion with a few people on the reasons I eat a Paleo diet. Like most discussions on religion and politics, it quickly degraded in to more of a name calling contest. Rather than get involved in any of that, I simply provided my case and let it be. However, I realized there's probably quite a few people who don't know why they are eating Paleo or why it may be a healthier way of eating. In this blog we will go over why much of the data you read on nutrition is probably wrong, why there is a lack of evidence for Paleo, and the primary reason grains and legumes are probably not wise nutritional choices if health is your goal.
Many people point to the data that shows grains and legumes to be healthy food options. The problem is this data doesn't show what they propose that it does. Most of this data is epidemiological data. The researchers provide food questionnaires that people fill out and the researchers compare this data to predetermined health outcomes. There are many problems with this type of data. The primary reason it is faulty is that the researchers are not controlling extraneous variables. For example, if you tell a population that whole grains are healthy, people who are interested in health will gravitate towards eating whole grains. People who are interested in health also tend to exercise, limit alcohol consumption, don't smoke, and keep a pretty regular sleep schedule. As such, these people will skew the results toward better health outcomes, not necessarily because whole grains are healthy, but because these people lead otherwise healthy lives. Because of this, epidemiological can show that there is a relationship between two variables, it cannot say the direction of the relationship. In other words, it could be that people who eat whole grains are healthy, but it could also be that people who are healthy eat whole grains. This means that this type of data is good for establishing relationships that can be further studied in a controlled clinical trial, not to say whether something is healthy to consume or not.
The other studies typically cited to show that grains or legumes are healthy foods don't have a proper control group. When you are trying to determine whether something is beneficial or not, you would want to compare a diet that is otherwise identical between two groups with the exception that one group contains that food and the other doesn't. Obviously this is very difficult to do, few people want to be locked in a metabolic ward and have their food weighed and prepared for them for long periods of time. In addition, you would have to do these studies over very long periods of time which is probably not something you're going to see happen. This is why most of the data is epidemiological. Of the few studies we have, none compare eating whole grains to eating no grains, they compare eating whole grains to refined grains. If a study shows a difference between the two, and most do, it doesn't necessarily mean that the one that is better is a healthy food. If you ran a study and compared heroin to crack and heroine was better than crack, that wouldn't make crack a healthy option, only healthier than crack.
This presents a problem. At the end of the day, research is unlikely to give us solid answers as to what is healthy. So if the studies don't appear to be of any help, how do you make a decision? When studies are of no help you want to look at mechanism. Mechanism refers to a specific way that something could lead to beneficial or bad health outcomes. The criteria I use is whether a food provides a wide range of essential nutrients, contains some nutrient that is hard to get from other foods, or contains some nonessential nutrient that provides a health benefit. When you look at grains and legumes, none of these apply. For a more thorough explanation of why watch this.
Now, is there something in grains or legumes that should give you reservations in consuming them? Many things have been brought up that really didn't pan out in the research such as phytic acid and lectins. However, there is one potential issue that has been supported by the research that should give you concern with consuming grains or legumes. Grains and legumes contain hard to digest storage proteins called prolamins. Humans do not produce enough of the enzymes used to digest these proteins so they pretty much go through the intestinal tract untouched. Gluten is probably the best known prolamin, is contained in wheat, and causes major problems in people with celiac disease. This may not seem like an issue, but these prolamins have other insidious properties. All of the prolamins in grains, particularly the gliadin in gluten, are immunogenic. In fact, gluten will elicit an immune response, and it will do this in all people whether they have celiac disease or not(1). This doesn't mean they are necessarily toxic, but firing off the immune system without reason shouldn't be one of your primary nutritional goals if health is your goal. The prolamins in legumes haven't been specifically studied, but given that their structure is basically the same as the prolamins in grains, I see no reason to test the waters.
If grains and legumes provided something you couldn't get elsewhere, were loaded with nutrients that are hard to get, or possessed some phytonutrient that is of benefit I would say go ahead and eat them. But their lack of nutrient density coupled with their immunogenic properties give me good reason to not recommend people consume them on a regular basis, and certainly not as a staple in their diet. Will you die if you eat a sandwich? Nope. Are you ever going to find a solid clinical study showing them to be unhealthy over the long term? Probably not. Just ask yourself, would you submit yourself to stay in a metabolic ward away from your family for 6-9 months while you eat a strict diet of measured food that may or may not contain legumes or grains. Do you think researchers are going to find 100 people to do so and who would fund that study? If the day ever comes that we see that study and the data supports grain and legume consumption I'll be all in. Until that day, I am going to go with my N=1 study that shows I am missing nothing from passing on those foods and potentially improving my health by avoiding them. I certainly feel better, have more energy, and get sick far less often.
Many people point to the data that shows grains and legumes to be healthy food options. The problem is this data doesn't show what they propose that it does. Most of this data is epidemiological data. The researchers provide food questionnaires that people fill out and the researchers compare this data to predetermined health outcomes. There are many problems with this type of data. The primary reason it is faulty is that the researchers are not controlling extraneous variables. For example, if you tell a population that whole grains are healthy, people who are interested in health will gravitate towards eating whole grains. People who are interested in health also tend to exercise, limit alcohol consumption, don't smoke, and keep a pretty regular sleep schedule. As such, these people will skew the results toward better health outcomes, not necessarily because whole grains are healthy, but because these people lead otherwise healthy lives. Because of this, epidemiological can show that there is a relationship between two variables, it cannot say the direction of the relationship. In other words, it could be that people who eat whole grains are healthy, but it could also be that people who are healthy eat whole grains. This means that this type of data is good for establishing relationships that can be further studied in a controlled clinical trial, not to say whether something is healthy to consume or not.
The other studies typically cited to show that grains or legumes are healthy foods don't have a proper control group. When you are trying to determine whether something is beneficial or not, you would want to compare a diet that is otherwise identical between two groups with the exception that one group contains that food and the other doesn't. Obviously this is very difficult to do, few people want to be locked in a metabolic ward and have their food weighed and prepared for them for long periods of time. In addition, you would have to do these studies over very long periods of time which is probably not something you're going to see happen. This is why most of the data is epidemiological. Of the few studies we have, none compare eating whole grains to eating no grains, they compare eating whole grains to refined grains. If a study shows a difference between the two, and most do, it doesn't necessarily mean that the one that is better is a healthy food. If you ran a study and compared heroin to crack and heroine was better than crack, that wouldn't make crack a healthy option, only healthier than crack.
This presents a problem. At the end of the day, research is unlikely to give us solid answers as to what is healthy. So if the studies don't appear to be of any help, how do you make a decision? When studies are of no help you want to look at mechanism. Mechanism refers to a specific way that something could lead to beneficial or bad health outcomes. The criteria I use is whether a food provides a wide range of essential nutrients, contains some nutrient that is hard to get from other foods, or contains some nonessential nutrient that provides a health benefit. When you look at grains and legumes, none of these apply. For a more thorough explanation of why watch this.
Now, is there something in grains or legumes that should give you reservations in consuming them? Many things have been brought up that really didn't pan out in the research such as phytic acid and lectins. However, there is one potential issue that has been supported by the research that should give you concern with consuming grains or legumes. Grains and legumes contain hard to digest storage proteins called prolamins. Humans do not produce enough of the enzymes used to digest these proteins so they pretty much go through the intestinal tract untouched. Gluten is probably the best known prolamin, is contained in wheat, and causes major problems in people with celiac disease. This may not seem like an issue, but these prolamins have other insidious properties. All of the prolamins in grains, particularly the gliadin in gluten, are immunogenic. In fact, gluten will elicit an immune response, and it will do this in all people whether they have celiac disease or not(1). This doesn't mean they are necessarily toxic, but firing off the immune system without reason shouldn't be one of your primary nutritional goals if health is your goal. The prolamins in legumes haven't been specifically studied, but given that their structure is basically the same as the prolamins in grains, I see no reason to test the waters.
If grains and legumes provided something you couldn't get elsewhere, were loaded with nutrients that are hard to get, or possessed some phytonutrient that is of benefit I would say go ahead and eat them. But their lack of nutrient density coupled with their immunogenic properties give me good reason to not recommend people consume them on a regular basis, and certainly not as a staple in their diet. Will you die if you eat a sandwich? Nope. Are you ever going to find a solid clinical study showing them to be unhealthy over the long term? Probably not. Just ask yourself, would you submit yourself to stay in a metabolic ward away from your family for 6-9 months while you eat a strict diet of measured food that may or may not contain legumes or grains. Do you think researchers are going to find 100 people to do so and who would fund that study? If the day ever comes that we see that study and the data supports grain and legume consumption I'll be all in. Until that day, I am going to go with my N=1 study that shows I am missing nothing from passing on those foods and potentially improving my health by avoiding them. I certainly feel better, have more energy, and get sick far less often.
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