The Monkey Meat and Book Diet: Debunking Associations

The latest issue of The Wilson Quarterly has a the elements of a plan for losing weight: monkey meat and reading. Journalist Scott Wallace, on an assignment with National Geographic, trekked through the Amazon eating "nothing but monkey meat for days on end, losing 30 pounds on the journey."(1)

That's not all--the magazine adds that reading is associated with lower BMI (body mass index). "In particular, readers are less likely to be overweight than TV watchers. Indeed, regular book-reading seems to predict lower BMI about as reliably as regular exercise."(2) (The article cites a forthcoming paper by Fred C. Pampel  in Sociology of Health and Illness.) "Pampel found that education, employment, and other components of socioeconomic status correlate with body mass index (BMI)."

I'm going with reading because it's easier than raising your socioeconomic status. You'll have to source the monkey meat yourself, though. I can't solve all your problems for you.

Of course, I'm kidding. While nearly anyone would lose weight eating a very low carb diet of monkey meat while hiking the Amazon, you need a diet you can live with for the rest of your life. (And just because one person has success with a diet doesn't mean you will. Remember the Twinkie guy and the potato guy?)

As a public policy scholar, Mr. Wallace, who lost 30 pounds, must read a book now and then, yet he had 30 pounds available to lose. Obviously, reading doesn't cause weight loss, it's just associated with normal weight. Association isn't causation. A might cause B, B might cause A, or something else might cause both. What isn't so obvious is associations between diet and weight, exercise and weight, or drugs and health outcomes. It's commonly assumed that "healthy lifestyles" like exercising and eating right cause normal weight and good fitness. But do they? Or are healthier people more likely to exercise, health-minded people more likely to take their pills, and health buffs more likely to follow the latest advice on diet? We're all prone to seeing patterns even where there aren't any--and association is a type of pattern.

In the book Proofiness, Charles Seife writes,

Casuistry--without the extra "u"--is the art of making a misleading argument through seemingly sound principles. Causuistry is a specialized form of casuistry where the fault in the argument comes from implying that there is a causal relationship between two things when in fact there isn't any such linkage.

Causuistry is particularly common in health and nutrition research; you might have even altered your diet because of it.(3)

Seife goes on to debunk the link between Nutrasweet and brain tumors.

Sure, Nutrasweet consumption was going up at the same time brain tumor rates were, but a lot of other things were on the rise too, such as cable TV, Sony Walkmen, Tom Cruise's career.(4)

Comedian Tom Naughton gave a speech called "Science for Smart People"(5) that covered associations. Watch it, and you may never think about health and nutrition news the same way again. (ETA: I referenced the wrong video before.)

1. "Avoiding the Arrow People," The Wilson Quarterly, February 1, 2012.
2. "Paper Treadmills" by Stephen Bates, The Wilson Quarterly, February 1, 2012.
3. Proofiness by Charles Seife, p. 44. Penguin Books, 2010.
4. Ibid, p. 46.
5. "Science for Smart People" by Tom Naughton, 2011.

Vitamin D v. Illness Update

I ran a small, non-randomized, non-clinical, unscientific study where I took a megadose of vitamin D and Mucinex for a persistent sinus infection and counseled my parents to do the same if they were sick. Results:

Me: My sinus infection is long gone. The treatment succeeded where a course of antibiotics failed. The vitamin D toxicity side effects (fatigue, muscle weakness and constipation) are gone as well. (See my posts on SWAMP.)

Mother: She took 50,000 IU for three days when she felt a cold coming on. Then she started taking 7,000 IU per day. She didn't get sick. In addition, her fasting blood sugar, which had been around 140, started dropping. It was 98 this morning. It may not have been because of the vitamin D, but vitamin D reduces inflammation, which is part of metabolic syndrome.

Father: He won't take 50,000 IU of vitamin D at one time. He's taken 10,000 IU per day and Mucinex. He's still sick.

Permanently Limit Carbs

"...Telling a person that they can progressively add more and more dietary carbohydrate means that they don't need to make their peace with not having it. All they need to do is wait a few months..." -The Art and Science of Low Carbohydrate Living

Does the lure of adding back carbs derail people from their diets? I don't have any other explanation for the stampede to safe starches or the drift of the potaleo (potato+paleo) movement. This isn't carb creep, where low-carbers get back on track after some weight gain or other problems, it's keeping watch for excuses to eat carbs.

At this writing, a Google search for the phrase "adding back carbs" yields 16,000 results. The phrase "permanently limit carbs"? This post will make four.

It's time for a different attitude towards high-carb living: it's over. No more pasta, bread, pie, cookies, beer, and so on, ever--unless you're having low-carb versions of those things. (Confession: I'm still trying to kick chocolate. The low-carb brownies are helping.) It sounds harsh, but I've actually found it easier to completely cut out certain foods like wheat than to cut back on them. It's like dealing with a bad relationship: better to stop calling, stop dropping by, stop thinking about it, and just end it and move on. I did the weekly "free day" for years on Body for Life, and cheat day foods ended up creeping into all the other days. Now, with no cheat day, cheating is infrequent. And a cheat day can damage your health. In an interview with Jimmy Moore, Dr. Cate Shanahan answered a question from a caller about having a binge now and then: on an inflammatory food binge, a stroke is possible, and a stroke is permanent. Dr. John Briffa cited a study showing raised triglycerides (which are fueled by carb) are associated with higher risk of stroke and research on carbs, inflammation and stroke. "While a fat indulgence (if there is such a thing) pushes large LDL up," says Dr. William Davis, cardiologist, "the effect is relatively short-lived. Have a carbohydrate indulgence, on the other hand, and small LDL particles persist for up to a week." (Small LDL contributes to atherosclerotic plaque.)

It's also time for a different attitude towards low-carb living: eat a good-enough LC diet. Or as Sean Croxton puts it, don't be weird. I recently read about a woman who, by her own blog account, was neurotic about her eating and ended up going on a sugar bender. She justified it by the fact that--wait for it--her temperature was steadier after her binge. A good-enough diet keeps me from acting like a sailor on shore leave. I get the best groceries I can, but if I feel like eating at McDonald's, I do. If all that's available is canola-soy oil salad dressing, I use it. I also have low-carb ice cream, stevia, Splenda, and diet Dr. Pepper. Not pristine, but they're not major parts of my diet, and for me, they're better than other food I might have if I were too strict or let myself go hungry.

Now that I haven't had a potato or fruit, or bread or pasta, or variety of other starchy, sugary foods in years, I can hardly remember what they taste like. And guess what: I don't crave them anymore--except for the chocolate.

McDonald's v. School Lunches: Which is Healthier?

Proposed elementary school lunch, courtesy of the Healthy, Hunger-Free Kids Act of 2010:


Chef Salad
(1 cup romaine, .5 oz low-fat mozzarella,
1.5 oz grilled chicken) with Whole Wheat
Soft Pretzel (2.5 oz)
Corn, cooked (1/2 cup)
Baby Carrots, raw (1/4 cup)
Banana
Skim Chocolate Milk (8 oz)
Low Fat Ranch Dressing (1.5 oz)
Low Fat Italian Dressing (1.5 oz)

The nutrient composition of this lunch (info from nutritiondata.com):


Carbohydrate: 138g
Fat: 16g
Protein: 37g
Fiber: 10g
Net carbohydrate (ie., digestible): 128g
Calories: 886
CPF composition by calories: approximately 62:17:16

Assumptions: 1 slice commercially prepared whole wheat bread, 1 oz carrots, low fat ranch dressing

Let's look at the nutrient composition of a McDonald's quarter pounder with cheese, small fries and a diet drink or water:
Carbohydrate: 69g
Fat: 37g
Protein: 32 g
Fiber: 6g
Net carbohydrate: 63g
Calories: 740
CPF composition by calories: 37:17:45

To be sure, neither of these meals is health food. Nevertheless, if I had a child, I'd rather he eat the McDonald's meal. Why?

• There's a boatload of carbohydrate in the school lunch. Much of it is sugar; the soft pretzel will dissolve into glucose (sugar) in short order once it's down the hatch. In one study, "...a concentrated dose of sugar resulted in a dramatic increase in blood levels of adrenaline in children..." and "...nearly all the children complained of feeling weak and shaky." Another study showed pretty much the same thing. The need for carbohydrate in the human diet: none. Carbohydrate also leads to insulin release, which can lead to fat storage. It's probably no coincidence that kids who eat school lunches are more likely to be overweight.
• The grains in the whole wheat bread and pretzel contain nutrient blockers in the form of phytic acid. (In fairness, so does the bun on the burger.) The nutrient blockers glom onto certain minerals and keep them from being absorbed.
• Pretzels are made with high-gluten flour to make them chewy. Even if you aren't celiac, gluten isn't good for your guts.
• There's less fat in the school lunch. Dietary fat is important for satiation and good health.
• There may be more vegetables in the school lunch, but a real chef's salad (romaine lettuce, other greens in season, cucumbers, peppers, carrots, celery, cabbage, and seaweed) is a standard part of dinner at my house.
• With 146 fewer calories, there would be more room my nutritious meals.
• Remember school lunches? I would not ask a child to eat anything I wouldn't eat.

Sources:

"Health: New Data on Sugar and Child Behavior," by Jane E. Brody, New York Times, May 10, 1990.
http://www.nytimes.com/1990/05/10/us/health-new-data-on-sugar-and-child-behavior.html

"Study Sees a Sugar-Adrenaline Link in Children," by Jane E. Brody, New York Times, March 15, 1995.
http://www.nytimes.com/1995/03/15/us/study-sees-a-sugar-adrenaline-link-in-children.html?src=pm

The Thirty-Day Low-Carb Diet Solution by Michael Eades, MD and Mary Dan Eades, MD. 2003.

Fat: It's Not What you Think by Connie Leas. 2008.

"Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines" by Sandro Drago et al, Scandinavian Journal of Gastroenterology, March 2006.

"Children, Parents and Obesity" by Julie Gunlock, National Affairs, Winter 2011.

Vitamin D: Prana in a Pill?

Do people forget what it feels like to be well? I think so. While I was sick with a sinus infection, I remembered running around with my best friend last year, going dancing two or three times a week, and wondered how I ever had the energy to do all that. This morning, I woke up feeling healthy (even though I'm still coughing a little, and still taking Mucinex since I'm really afraid of a relapse). I got up at 6:30 (can't remember the last time I was up that early on a weekend), did some laundry, cleaned out the refrigerator, loaded and unloaded the dishwasher, changed the sheets, took out the trash, bought some groceries and got to work around 10. Concentrating on my work was so much easier than it was when I was sick. (That it was Saturday helped, too.)

I still have some symptoms of vitamin D toxicity. No vomiting, but I've had some momentary but severe acid reflux. I'd forgotten how painful that is. Nevertheless, I'm feeling better than I have in months.

My mother felt a cold coming on yesterday and started taking 50,000 IU of vitamin D per the SWAMP treatment plan. She'd felt listless for quite some time due to an infection, but it's been cleared up for awhile now. When she took a vitamin D test a few months ago, her level was 40--the low end of normal, and below optimal. For reasons I don't understand, her get-up-and-go returned when she took the high dose of vitamin D.

ETA: Dr. Davis noticed octagenarians, like my mother, renewing their energy with vitamin D back in 2007.

I May Have Vitamin D Toxicity, But I Feel Better

Having taken megadoses of vitamin D for the past few weeks (think 10,000 to 50,000 IU per day), I now have some symptoms of vitamin D toxicity: muscle weakness, a little fatigue, and constipation. (I wondered last night why I found it so difficult to shovel a few inches of wet snow.) Overall, I feel pretty good, certainly better than when I was sick with a sinus infection and way better than when I was suffering from side effects and an allergic reaction to Benzonatate. A few people have remarked that I sound better and the pink is back in my cheeks. Without a test, it's not possible to know for certain that these symptoms are caused by too much vitamin D, but I'm going to stop taking it for now. The vitamin is stored in the fat, so it's going to be in my system for awhile, fighting any microbes left in my sinuses. Researcher Michael Holick says in The Vitamin D Solution,

Most humans obtain from sun exposure their vitamin D requirements between the hours of 10:00 A.M. and 3:00 P.M. and mainly in the late spring, summer, and early fall. Because vitamin D is fat soluble, it's stored in body fat and released throughout the winter months, allowing you to be vitamin D sufficient throughout the year.

So it looks like I'm set for vitamin D for awhile.

(Why was a taking so much vitamin D? It's my SWAMP treatment for a sinus infection. See this, this and this.)

Sinus Infections: The Swamp Hypothesis

Imagine that your sinuses are a stream. When all is well, the water (or mucus) flows along. There are some bugs here and there, but not too many.

If the stream becomes blocked, the water backs up, sits still, and the bugs multiply. The stream becomes a swamp. Current thinking is to annihilate the bugs with antibiotics. My idea is to drain the swamp and activate some natural predators.

As I understand it, inflammation causes your sinuses to become blocked. The mucus builds up, making a habitat for bacteria overgrowth. Thus infected, white blood cells enter the mucus, making it thick and less able to be moved along.

A substance that's both an anti-inflammatory and immune cell activator is vitamin D. My thinking is that it should enable the body's immune cells to kill most of the bugs and un-inflame the sinus passages to allow mucus to flow. There's clinical and observational evidence that vitamin D is helpful in preventing and fighting respiratory infections. I've been taking 20,000 to 50,000 units per day for the past few days. I've also been taking Mucinex DM (guaifinesesin + a cough suppressant) as a mucus thinner. My father came down with a cold last week, and has been taking around 10,000 IU of vitamin D along with Mucinex DM.

Results: My father normally takes Mucinex DM with a cold; he believes the addition of vitamin D has helped. He's brutally honest about this sort of thing--if he didn't think it did any good, he'd have said so. He felt mostly better (but not completely well) within a few days.

As for me, I've been ill with a cold and/or sinus infection for over a month. I've had a course of antibiotics, which helped but didn't cure me. This morning, I woke up feeling better than I have since January. The pain in my wisdom tooth is mostly gone. I don't feel any sinus pressure, didn't need any aspirin today, and took only one Mucinex (I'd been taking three per day). My taste is less delicate: last week, I didn't want to cook, so I ate lunch at McDonald's (bunless burger and side salad) or elsewhere. Lately, I've gone back to liver and sardines, among my other usual fare. I'm coughing less. However, the swamp draining has created a river of post-nasal drip down my throat, making it hurt. Two teaspoons of black elderberry syrup made it feel better.

Downsides: too much vitamin D can be toxic. The doses mentioned here are medicinal, and not what I take when I'm well. However, antibiotics, steroids and cough suppressants can have their own side effects--I recently spent a miserable day suffering the side effects and an allergic reaction to Benzonatate.

Sources:
Correspondence John F. Aloia and Melissa Li-Ng, Epidemiology and Infection, October 2007.
Vitamin D and Influenza by Michael Eades MD., Protein Power Blog, May 16, 2009.
Healing Your Sinuses by Ralph B. Metson MD with Steven Mardon. McGraw-Hill, 2005.
"Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey," Archives of Internal Medicine, February 23, 2009, Adit A. Ginde, MD, MPH; Jonathan M. Mansbach, MD; Carlos A. Camargo Jr, MD, DrPH.
The Vitamin D Solution by Michael F. Holick, PhD, MD. Penguin Group, 2010.