Saturday, June 30, 2012

What Cattle Know about Salt

My Uncle Gene on salt in response to his dietician:

Now wait just a minute. I'm a cattle man. I buy undernourished calves at the stock yard and put a big block of salt out for them. For three days, they stand and lick the salt. Cattle know what they need. If the calves need it, so do people.

I don't agree that calves and people need the same nutrients, but he's absolutely right that people need salt, too. If you're starting a low-carb diet, you especially need salt--your body dumps a lot of fluids at the beginning--along with salt and potassium. Nowadays, we "know" too much salt is bad for us. But time was,

Humans did not need to know chemistry to understand the value of salt. Salt deprivation leads to lightheadedness, fatigue, headache, and malaise....Inland hunters followed their prey to salt licks and salt springs. These waters were prized for cooking, and some cultures learned to dry these waters to make dry salt.(1)

For further reading:

http://garytaubes.com/wp-content/uploads/2011/08/science-political-science-of-salt1.pdf
http://www.fathead-movie.com/index.php/2011/08/23/still-another-a-salt-on-science/
http://www.fathead-movie.com/index.php/2011/08/01/another-a-salt-on-science/

Source:
1. The Art and Science of Low Carbohydrate Living by Jeff Volek and Stephen D. Phinney, Beyond Obesity, LLC, 2011. Page 20.

Tuesday, June 26, 2012

Results of my Carrageenan-Free Diet

Certain things should be left in the aquarium.
Readers may recall my ordeal last Saturday with a migraine headache and a trip by ambulance back to my parents' house. Thanks to one of the paramedics jogging my memory, I researched the almond milk I'd started drinking around the time I quit dairy. One of the ingredients was carrageenan, a substance used to induce inflammation, sensitivity to pain and other problems in laboratory animals. Supposedly, the "undegraded" form is safe for human consumption, but undegraded carrageenan has been found to be contaminated with degraded carrageenan, and there are ways that the digestive system could degrade carrageenan itself.

For the past few months, I've felt a little bloated, and was starting to have some mild pain in my lower stomach. I thought it might have been the effects of the antibiotics, oral steroids or decongestant (which gave me an allergic reaction) from back in February. I didn't connect it to the severe headache I had Memorial Day weekend. I've also had occasional sinus pain, which I haven't had since I quit wheat over two years ago. I thought that was from allergies.

Since Sunday morning, I haven't had any almond milk or other products with carrageenan. I've been taking 10,000 IU of vitamin D because of its anti-inflammatory value. Result: no more stomach pain or bloating. My stomach is still a little delicate. There's no more stuffed feeling after meals.

Coincidentally, the Cornucopia Institute came out with a carrageenan-free shopping guide just a few weeks ago. Like reader Suzie_B, biologist Ray Peat of Oregon noticed that carrageenan was listed as an ingredient in cream. He avoids carrageenan as well, since he's had serious allergic symptoms from it. He adds:

Carrageenan enters even the intact, uninflamed gut, and damages both chemical defenses and immunological defenses. When it has produced inflammatory bowel damage, the amount absorbed will be greater, as will the absorption of bacterial endotoxin. Carrageenan and endotoxin synergize in many ways, including their effects on nitric oxide, prostaglandins, toxic free radicals, and the defensive enzyme systems.(1)

Even if you think that food-grade (undegraded) carrageenan is fine and there's no way it could harm you, it may be contaminated with degraded carrageenan. (See table 5 on page 11.) The link is to a paper by JoAnne Tobacman, a physician-scientist who has researched carrageenan for almost 20 years. In a nutshell, ample evidence shows that carrageenan causes or is associated with cancer, inflammation, and ulcerative colitis. (2)

I'm not one to get excited about food additives and I'm not neurotic about eating. But even if you don't have any immediate reaction to carrageenan, it looks like something well worth avoiding.

Sources:

1.  "Food-junk and some mystery ailments: Fatigue, Alzheimer's, Colitis, Immunodeficiency" by Ray Peat, accessed June 26, 2012. http://raypeat.com/articles/nutrition/carrageenan.shtml
2. "Review of Harmful Gastrointestinal Effects of Carrageenan in Animal Experiments by Joanne K. Tobacman," Environmental Health Perspectives, October 2001, p. 983. http://www.cornucopia.org/DrTobacmanComment_toNOSB.pdf


Man Against the Statin Machine

A proposed movie plot: a patient with a serious but treatable medical condition goes to a rehab center, where his condition isn't treated, he's given drugs that make him worse, and so he has to stay and pay for his board. Problem: something similar has already been done, both in the movies and real life.

This was the danger my father was in. Almost a month ago, he had a stroke and went to a rehab center, where he made some progress but stalled. Under Medicare rules, he had to leave or pay full freight for continuing to stay there. The discharge coordinator offered no help to our family. What's worse, the pain in his side was never diagnosed, just treated with a pain patch, and he was given a statin drug without his consent. Statin drugs can cause muscle weakness, fatigue and foggy thinking--some of the reasons my father couldn't go home right away. And according to what I've read, there's no evidence they do any good for people over age 65. Dad is 82. He tried statin drugs before but quit them because they made his arms hurt.

Nevertheless, Dad rallied himself today, made his bed, packed his bags, and demanded my brother take him home. I discovered the statin drugs while sorting his pills tonight. I don't know whether the doctor at the rehab center deliberately tried to make an invalid out of my father, but my friend Deb Flentje says it happens. (A lot of doctors aren't evil, though, they're just hacks--another reason I didn't go to the emergency room last Saturday night.) 

I'm hopeful that without the statins, my father can make more progress.

The videos below are about statins.






For further reading about statins and cholesterol:
The Great Cholesterol Myth by Dr. Malcom Kendrick.
Numbers Needed to Treat: Statin Drugs
Cardiologist William Davis's articles about statins
Dr. Briffa's articles on statins

Monday, June 25, 2012

Sausage-Induced Headaches: Another Clue Points to Carrageenan

A few years ago when I started a low carb diet and started eating sausage again, I found some sausages gave me a headache, but others didn't. At first, eating them was a crap shoot, but I soon found some I couldn't eat (Applegate Farms Organic & Natural Meats) and some I could (McDonald's Restaurants and Ranch Foods Direct, a local pastured meat company).

Some of Applegate Farms' products contain carrageenan (a highly processed, seaweed-based food additive used to induce pain and inflammation in research animals). McDonald's and Ranch Foods Direct sausage doesn't contain it.

Why put carrageenan in sausage? According to Applegate Farms' website,

Carrageenan, which is derived from red seaweed (Chondrus Crispus), activates extracted protein in the meat to help it bind together when formed. As the meat cooks, the heat forms a gel network, increasing moisture retention and improving the sliceability of the product. Without the addition of carrageenan, there is an increased chance that the protein in the meat "will release water during the cooking cycle, leaving pockets of water between the cooked meat and the casing. Not only is this excess water unappetizing when the product is sliced, but it contributes to microbial growth as well". (Scott Hegenbart, New Product Design, September 1991)
The ironically named book Making Healthy Sausages gives another use for carrageenan: a fat reducer.

In emulsified meat products, such as sausages, pates and meat spreads, pectin enables fat reduction and by adding carrageenan to in edition [sic] to pectin a superior texture may be obtained.
This is a bit off my beat, but as with low-fat diets, politics and money may have played a role in getting this toxin in American foods. Back in 1991:

Handicapped by a foreign bank debt of about $29 billion, the Philippines needs to boost exports to generate more taxable revenue. The country had a trade deficit of $3.9 billion in 1990. In addition, the economy has been wracked by political uncertainty and natural disasters the past two years. Hundreds of thousands of people lost their livelihood when farms, shops, offices and factories were swept away by the eruptions of Mt. Pinatubo. The country's unemployment rate is now about 17%....The U.S. Food and Drug Administration recently ruled that Phillipine carrageenan, a low calorie food additive derived from seaweed, can be sold to processors in the United States. With American demand for low-fat food on the rise, Phillipine companies expect to boost sales of their food additive filler dramatically and bolster the Phillipines' economy.(1)

 The issue is complicated, but the answer is simple: just eat real food.

Source: "Seaweed a Godsend for Filipinos : Trade: The fat substitute carrageenan could be a big boost to the economy. But U.S. producers are trying to derail imports" by George White. Los Angeles Times, September 09, 1991.

 

Carrageenan: A Sickening Thickener. Is it a Migraine Menace?

Let me tell you about my ride in an ambulance last night.

I woke up at six o'clock from a nap with a mild headache. I ate dinner and took my vitamins, along with a couple of extra magnesium pills. Since magnesium helps my TMJ flare-ups, I thought it might help my headache. Then I went to see my mother.

A few hours later, I had a severe headache, sinus pain and nausea. During a brief respite from the pain, I left for home, but less than a mile later, I got out of my car and threw up. A cop, Officer Fisher, pulled up behind me and asked if I was okay. He believed me when he said I hadn't been drinking, but he said I seemed lethargic and he wanted the paramedics to see me. (Later he mentioned that a man he'd recently stopped was having a stroke.)

Thinking I had a migraine headache, the paramedics wanted to take me to the hospital. But since I knew that doctors don't know what causes migraine headaches, and I didn't know what effect their medicine would have on me, I refused care. Besides, I just wanted to sit in a quiet, dark room, and I knew that wouldn't be possible at a hospital. (The risk I took was that I could have been having an aneurysm.) The paramedics took me and my dog to my parents' house and I promised to call 911 if I felt worse. But by around midnight, I felt as if I'd never had a headache. The next morning (today), I did some handyman work at my parents' house and went with a neighbor to jump start my car. (Note to self: check the battery.)

I'm not prone to migraine headaches. What could have brought this on? The paramedics asked me if I took any drugs, or didn't take any I was supposed to take. No to both. Did I ever have a reaction to fish or peanuts, the foods I ate that night? No. Did I ever have bad headaches? The last one I had was Memorial Day weekend, a Sunday when I had a lot of work to do, but the words on the papers I had to read wouldn't sit still. Hmm.

Last night, I thought I threw up from taking too many magnesium pills. But Memorial Day weekend, I wondered if my headache had something to do with the almond milk I drank. And I had quite a bit of it yesterday, too. But I drink it frequently without getting a headache--so what's going on?

The almond milk I buy contains carrageenan, a thickener made from seaweed. Poking around the web, some people say it gives them migraines (see this). It's also a substance used to induce inflammation in laboratory animals. Carrageenan is so harmful to animals that researchers have issued warnings since 1981 and before:

An increased number of reports have appeared in the literature describing the harmful effects of degraded and undegraded carrageenan supplied to several animal species in their diet or drinking fluid. The harmful effects include foetal toxicity, teratogenicity, birth defects, pulmonary lesions, hepatomegaly, prolonged storage in Kupffer cells, ulcerative disease of the large bowel with hyperplastic, metaplastic, and polypoidal mucosal changes, enhancement of neoplasia by carcinogens, and, more ominously, colorectal carcinoma. Degraded carrageenan as a drug or food additive has been restricted in the United States by the FDA, but undegraded carrageenan is still widely used throughout the world as a food additive. Its harmful effects in animals are almost certainly associated with its degradation during passage through the gastrointestinal tract. There is a need for extreme caution in the use of carrageenan or carrageenan-like products as food additives in our diet, and particularly in slimming recipes.(1)

Researchers have used carrageenan to induce hyperalgesia (increased sensitivity to pain) in laboratory animals to study drugs for migraine headaches (see this, this, this and this).

Carrageenan may also be a carcinogen and may cause intestinal ulcerations and neoplasms:

Although the International Agency for Research on Cancer in 1982 identified sufficient evidence for the carcinogenicity of degraded carrageenan in animals to regard it as posing a carcinogenic risk to humans, carrageenan is still used widely as a thickener, stabilizer, and texturizer in a variety of processed foods prevalent in the Western diet. I reviewed experimental data pertaining to carrageenan's effects with particular attention to the occurrence of ulcerations and neoplasms in association with exposure to carrageenan. In addition, I reviewed from established sources mechanisms for production of degraded carrageenan from undegraded or native carrageenan and data with regard to carrageenan intake. Review of these data demonstrated that exposure to undegraded as well as to degraded carrageenan was associated with the occurrence of intestinal ulcerations and neoplasms.(2)

For a few months now, I've felt like something wasn't quite right: I've been a little bloated, and wondered if something was blocked in my digestive system. I haven't had as much energy as I used to. I don't know for a fact that carrageenan gave me a migraine or it's what's been bothering me. It seems dose-dependent, and maybe added stress (like the mountain of work I had over Memorial Day weekend or my father's recent stroke) triggers some of the effects. But even if carrageenan isn't what made me sick, what I've found out is enough to make me stop eating it.

For further reading: http://blog.healthkismet.com/carrageenan-cancer-health-inflammation

Sources:

1. Cancer Detect Prev. 1981;4(1-4):129-34. Harmful effects of carrageenan fed to animals. Watt J, Marcus R.
2. Environ Health Perspect. 2001 Oct;109(10):983-94. Review of harmful gastrointestinal effects of carrageenan in animal experiments. Tobacman JK.




Saturday, June 23, 2012

A Map through the Medicare Maze

Recently, my father had a stroke. From the hospital, he went to a rehab center and, having made no further progress for some time, has to leave or pay full freight for his continued stay there. He can't go home: he can't take care of himself and my mother can't take care of him (she's in a wheelchair), and they can't afford round-the-clock care. The nursing home staff didn't have any helpful hints.

However, Deb Flentje, whom I buy pasture-raised meat and eggs from, was kind enough to take the time and effort to write out a map through the Medicare maze. Deb used to work in the nursing home field, in a management capacity, as I recall. Here's her description of how Medicare works, and how to choose a nursing home for a loved one.

 *****

 Medicare and What it Covers

First ask for a meeting with the social worker in the hospital. Ask for that person to explain what Part A Medicare and Part B Medicare covers in the nursing facility and assisted living facility and home. Then ask which facilities she recommends for the best rehabilitation. Ask her if those facilities have an Admissions Coordinator that comes to the hospital to evaluate the patients, answer the patient's/family's questions, and will coordinate the transition to the facility. Part A Medicare will cover all costs of his Part A stay. The length of coverage is determined by the initial evaluation done by the nursing facility team and the completion and submission of the MDS form. Your Dad's progress also will determine how many days are covered. Keep close tabs on this, as once he is discharged from Part A, he must be either transferred home, to an assisted living facility or to a private pay bed in the facility. The only expenses covered by Medicare in the nursing facility after coming off of Part A are PT, OT, and Speech therapy treatments, covered under Part B at 80% Medicare and 20% co-insurance, dependent what your plan covers. If he is transferred to assisted living or home, Part A Medicare can cover Home Health services through a Medicare Certified Home Health Agency. Medicare will cover his nursing and therapies at 100% as long as he is making significant progress,  he requires the skills of the nurse and/or the therapist, and he is home bound. This will most likely be short term.

 Getting Recommendations for a Nursing Home

Also, talk with your personal physician and your Mom and Dad's physician to see which nursing homes they would recommend. Ask if your Dad's doctor will come to the nursing home to supervise his care there. Most doctors now do not go to nursing homes, with the exception of those who specialize in nursing facility care and that is all they do. You will most likely have to ask the nursing facility for recommendations on which doctors that serve their facility. Ask how many hours per week each physician is in the building. You want a physician that is there and accessible on a consistent basis. Another suggestion is to ask your friends and co-workers if they have any experience with nursing facilities and physicians around Denver. You will begin to hear some facility and physician names that keep coming up. These are the ones to check out personally with a scheduled tour.

 Inspecting the Nursing Home

On the tour, observe the patients and staff. Are the patients happy, content, engaged in life, well positioned in their wheel chairs, clean and neat and dressed appropriately. Are the staff happy, interacting with and concerned with the patients' needs, helpful, courteous, friendly. Is the facility attractive, inviting, clean, and well cared for. Is there an easy means to get outside and sit outside?

Ask to see the dining room and see if it is attractive, inviting, clean, happy, and staffed. See what the menu looks like. Are there choices the patients can make about their meals? Is the food attractive and good tasting. I would ask for a sample. Food is so very important. Are there plenty of staff to help the patients and do you see help given.

Ask to see the therapy room(s). Is it a busy place with lots of patients working with therapists. Do they seem to be working hard and working well with the therapists. Ask them to describe their therapy staff. PT, PT Assistants, OT, OT Assistants, and Speech/Language pathologists. How many of each, How  many hours are they on the premises, how long have they been coming to the facility, who is the leader/manager, are they on staff or coming from a contract therapy company. How many patients are on Part A therapies now? How many are on Part B now? How many are on Hospice? What percentage of patients are discharged home or to Assisted Living?

Ask if the therapy team positions the patients in their beds and wheel chairs using pressure reducing mattresses, seat cushions, and other positioning devices to promote good posture, function and mobility, comfort for the patient, and to prevent pressure ulcer development. Ask them to describe their pressure ulcer prevention protocol and their protocol when a pressure ulcer develops.

Being an Advocate

This is super important to be aware of and to state to the nursing facility staff that you talk with. You must state up front that you are interested in your Dad getting a shot at regaining his independence to return home or to be as independent as he can be in whatever setting is appropriate for him. Unfortunately, there is a movement in health care today for physicians to make assumptions and decisions about a person's  quality of life, potential, worthwhileness that then determine if they "deserve" rehabilitation or should just be put on hospice and have their death brought about  prematurely by not providing things like antibiotics, hospitalizations, therapies, etc. Tell them what your Dad was like before the stroke and that you are expecting him to be given a good chance at rehabilitation to really explore how far he can come back to wholeness and independence. I have literally seen hospice staff trolling around a facility looking for admissions. Hospice should be for true END of life situations where death is eminent.

Wednesday, June 13, 2012

Fibromyalgia Relief Diet: How to DIY

Readers interested in the raw paleo+supplement diet that I've proposed for fibromyalgia might be wondering how to put this into practice. There's a lot to read--you can skip parts if you want to--but the better you understand how this works, and the more lousy conventional wisdom you dispense with, the more likely you are to stick with it and fine-tune it to your needs.

The basic ideas:

Fix any leaks in the gut. A strict paleo diet eliminates foods like grains, potatoes and legumes that can cause this problem, allowing the gut to heal. (UPDATE 6/27/2012: Avoid an additive called carrageenan. It's a neolithic food and an inflammatory.) This may also help with autoimmune diseases.

Stop ingesting antinutrients that interfere with magnesium absorption. Grains and legumes have antinutrients (search for "phytate" at Google Scholar if you're interested). Antacids keep you from absorbing magnesium (and calcium, zinc and iron) and interfere with protein digestion (scroll down for the pictures). The good news here is that this same diet will cure acid reflux--as long as you go easy on the carbohydrates. (I had acid reflux so bad that it gave me an esophageal ulcer. A low-carb diet cured it, and I quit my acid blocking medication for good.) A suggestion: do low carb (roughly 50g of carb per day or less) for a few days before quitting your antacids. If you need an antacid later, drink 1/2 teaspoon of baking soda (sodium bicarbonate) dissolved in a cup of water.

Eat a magnesium-rich paleo diet. What is a paleo diet? It's food that our ancestors lived on for millions of years (the Paleolithic Age) before the advent of farming (the Neolithic Age, starting about 10,000 years ago). Think of foods you could get with a spear or your bare hands in the wilderness, and prepare with simple stone tools. Don't think of this nonsense. (Where does Dr. Oz think prehistoric man got pasta makers?) Vegetables, seafood and nuts are the food groups with the highest levels, gram for gram, of magnesium. Like Julianne Taylor, I think lightly cooking the food is fine. The idea is to avoid foods like grains, potatoes and legumes that must be cooked, as well as dairy.

Supplement with magnesium. Dr. Michael Eades, who has treated thousands of patients with a low-carb diet, has some tips on magnesium supplements (what kind and how much), as well as getting started on a low carb diet. I say low carb--unless you are already on a low carb or Zone type of diet, a paleo diet will likely see you reducing the amount of carbohydrate you eat. Since conventional diet advice (low-fat, low-sodium) will make you feel lousy on a low-carb diet, it's important that you read Dr. Eades's blog posts linked to above. If you take blood pressure or diabetes medications, start your low carb (or reduced carb) diet with your doctor's supervision: you'll likely need to reduce or stop your medications. If your doctor gives you a hard time, don't argue. Just ask him or her to monitor you.

Stick with it. It's important to have some support and not to get bored with your new diet. Mark Sisson runs a positive, supportive blog called Mark's Daily Apple; he also wrote The Primal Blueprint and The Primal Blueprint Cookbook. The cookbook isn't strictly paleo, but with a few substitutions (coconut milk for dairy, coconut oil for butter) it's a terrific resource. Julianne's Paleo & Zone Nutrition has some good archives; here's a post on what you can and can't eat on a strict paleo diet. Dr. Seignalet's raw paleo program is here on her blog. Fluent French speakers can order Dr. Seignalet's book or join a site for aficionados of his program. Information junkies should get The Paleo Answer by Dr. Loren Cordain; his blog, published research and other information from his 30 years of research in paleontology are on his site.

What to expect. Here's a case study of a patient of Dr. Robert Hansen, a board certified physician at the Therapeutic Pain Management Clinic in Redding, California. (I don't know how typical this case is.) Dr. Hansen started seeing this patient in early June 2010, and she took a month or so to start strictly adhering to a paleo diet. Results:

A follow-up phone call on November 29, 2010 revealed that she continues on the Paleo Diet and has required no opiate pain medications. This patient had suffered symptoms for over two years, and had a dramatic response to Paleo and exercise. Her irritable bowel syndrome is completely resolved, though she ate beans one day and suffered GI symptoms. As a result she has been strictly Paleo since that time.

Her diffuse joint pain is completely gone, though she does experience muscle pain ranging from 3-5 on a scale from 1-10 on an intermittent basis. The frequency and duration of these painful episodes are markedly diminished compared to their initial presentation. She is sleeping well, and is enjoying a physically active life in marked contrast to the prior two years of symptoms.

Dr. Hansen adds,

My experience with prescribing the Paleo Diet has been that when patients comply they lose weight and feel better. I have had a patient with severe Rheumatoid Arthritis who achieved dramatic improvements within one month of Paleo. He was able to cease using a medication that he had used for 10 years. Previous attempts to stop that medication resulted in a worsening of his Rheumatoid Arthritis pain and joint swelling....My son and I have been following the Paleo Diet for about one year (following a one year trial of a vegan diet). My weight is down 40 pounds from its peak, and my waistline has decreased from 40 to 34. My symptoms of osteoarthritis have improved and my blood pressure is down to the "normal" range. We take omega three supplements (EPA and DHA) and Vitamin D-3. 

Potential Challenges

If you go on a low carb diet (50-100g per day, depending on your size), you'll go through what's called keto-adaptation. That means your body converts from running on sugar to running on fat. Dr. Eades makes an analogy:

When you’ve been on the standard American high-carb diet, you’re loaded with enzymes ready to convert those carbs to energy.  You’ve got some enzymes laying in the weeds waiting to deal with the fat, but mainly dealing with it by storing it, not necessarily burning it.  All the pathways to deal with carbs and their resultant blood glucose are well-oiled and operating smoothly.  Then you start a low-carb diet.  Suddenly, you’ve idled most of the enzyme force you have built to process the carbs in your diet while at the same time you don’t have a ready supply of the enzymes in the quantities needed to deal with your new diet.  It would be like a Ford automobile factory changing in one day into a plant that made iPads.  All the autoworkers would show up and be clueless as how to make an iPad.  It would take a while – not to mention a lot of chaos – to get rid of the autoworkers and replace them with iPad workers.  In a way, that’s kind of what’s happening during the low-carb adaptation period.

Over the first few days to few weeks of low-carb adaptation, your body is laying off the carbohydrate worker enzymes and building new fat worker enzymes.  Once the workforce in your body is changed out, you start functioning properly on your new low-carb, higher-fat diet.  The carbs you used to burn for energy are now replaced to a great extent by ketones (which is why this time is also called the keto-adaptation period) and fat.  Your brain begins to use ketones to replace the glucose it used to use pretty much exclusively, so your thinking clears up.  And the fatigue you used to feel at the start of the diet goes away as ketones and fat (and the army of enzymes required to use them efficiently) take over as the primary sources of energy.  Suddenly you seem to go from not being able to walk out to get the morning paper without puffing and panting to having an abundance of energy.  Because of this low-carb adaptation period, we never, ever counsel our patients to start an exercise program when they start their low-carb diets because a) we know they’ll be too fatigued to do it, and b) we know that in a short time they will start exercising spontaneously to burn off the excess fat on their bodies once the skids are greased, so to speak.

Again, don't do low fat (think low carb, high fat, adequate protein) or low-sodium (your kidneys will be dumping excess fluid) or low-calorie (eat if you're hungry).

I'll be honest: if you're coming off a major sugar habit, like Jimmy Moore describes in The Art and Science of Low-Carb Living, you could be in for a rough few days:

In those first few days, I went through major carbohydrate withdrawal. After all, up to that point I'd had a 16-cans-of-Coke-a-day habit, along with eating whole boxes of Little Debbie snack cakes (among other things). For a while, I felt like I wanted to kill myself--I'm not kidding! The sugar withdrawal was excruciating--perhaps as strong as someone trying to detox from crack cocaine.

Like any detox, the unpleasantness was temporary.

Now that I was consuming a satisfyingly health high-fat, moderate (adequate) protein, low-carb diet, my body seemed to be "at peace" metabolically speaking. I could sense that this was the way of eating my body had been longing for all along, and now it was rewarding me for feeding it properly.

Some people get wheat withdrawal--seriously. Dr. Williams Davis, a practicing cardiologist who prescribes a wheat-free diet for all his patients, writes in Wheat Belly,

Approximately 30 percent of people who remove wheat products abruptly from their diet will experience a withdrawal effect. Unlike opiate or alcohol withdrawal, wheat withdrawal does not result in seizures or hallucinations, blackouts, or other dangerous phenomenon.

The closest parallel to wheat withdrawal is the nicotine withdrawal that results from quitting cigarettes; for some people, the experience is nearly as intense. Like nicotine withdrawal, wheat withdrawal can cause fatigue, mental fogginess, and irritability. It can also be accompanied by dysphoria, a feeling of low mood and sadness. Wheat withdrawal often has the unique effect of diminished capacity to exercise that usually lasts from two to five days. Wheat withdrawal tends to be short-lived; while ex-smokers are usually still climbing the walls after three to four weeks, most ex-wheat eaters feel better after one week....Removing sugar sources forces the body to adapt to mobilizing and burning fatty acids instead of more readily accessed sugars, a process that requires several days to kick in. [Remember keto-adaption? -Ed.]

Yes, these are challenges, but look at it this way: would you give cigarettes to someone in nicotine withdrawal? Or encourage them on their path to better health?

Saturday, June 9, 2012

Developing Resistance to Junk Food

The past few days at the office have seen boxes of pizza, pastries, cupcakes, Chinese food, and wraps for meetings. Temptation? No--except for the wraps made of turkey and spinach, which I ate without the wrapper, of course. This wasn't any great feat of willpower: after over two years of eating little or no wheat, pizza or Chinese, these didn't even look like food to me. The Chinese food was overcooked (broccoli is supposed to be bright green, not dull chartreuse) and the pizza smelled like a wet dog. I think I understand why the French avoid junk food much more than Americans: they just don't like the stuff because they eat real food.

Here's the problem with a frequent cheat day: it keeps your taste for junk food alive. If a friend were trying to quit smoking, would you recommend a weekly smoking day?

Friday, June 8, 2012

Fibromyalgia: A Proposed Diet for Relief

This post is for a friend of mine who is suffering so badly from fibromyalgia that she's unable to work. Comments, suggestions and corrections are welcome. I care more about helping her than being right.

What is fibromyalgia (FM)? Literally, the word means fiber (fibro) and muscle (my) pain (algia). The American Fibromyalgia Syndrome Association lists symptoms that include pain, fatigue, memory and concentration problems, sleep disorders, exercise difficulties, irritable bowel syndrome, chronic headaches and jaw pain. Sufferers have tender points on the neck, back, hips, shoulders, arms and legs. Thyroid disorders are common, but they're not necessarily a cause or effect. Stress and accidents or injuries can set off painful episodes. The vast majority of sufferers are women. Nobody is sure what causes it, but different people suspect nutritional deficiencies, autoimmune disorders or infection. Since it's a syndrome, different things might cause be the cause in different cases.

What's helped? Dr. Michael Holick writes in The Vitamin D Solution,

The "fibromyalgia epidemic" that some doctors refer to may actually be a massive increase in vitamin D deficiency-related osteomalacia...I've estimated that 40 to 60 percent of patients who have been diagnosed with fibromyalgia or chronic fatigue syndrome have a vitamin D deficiency and suffer from osteomalacia.(1)

While fibromyalgia is associated vitamin D deficiency, it seems unlikely that's the cause of the illness. According to the Vitamin D Council's website, "There is no evidence that risk or symptoms of fibromyalgia are related to sunlight exposure."(2) Doing a search on Google Scholar, I couldn't find any link between fibromyalgia and latitude, as there is with certain other illnesses. However, if an infection is involved, vitamin D might help because of its antiviral and antibacterial properties. D is also an anti-inflammatory, but Dr. Seignalet says that there is no muscle inflammation in FM.(3)

I did find a few studies showing raw or mostly raw vegan diets alleviated FM symptoms. (4),(5). The Hallelujah Diet is explained here; it allows a small amount of grains.

Dr. Jean Seignalet, a French physician, reported a 97% success rate with a raw paleo diet. (6) What's going on?

The first thing I thought of when I saw the list of FM symptoms was magnesium deficiency. From The MedlinePlus Medical Encyclopediaa lack of magnesium can cause confusion, fatigue, insomnia, muscle twitching, poor memory, reduced ability to learn, continued muscle contraction, delirium, numbness and tingling, among other problems. Stress can crank up adrenaline, which burns through magnesium, says Dr. Carolyn Dean in The Magnesium Miracle (7). Dr. Dean says, "[I]n my experience, a person with fibromyalgia can diminish her or her symptoms by 50 percent by taking the right amount of magnesium. In order to get sufficient magnesium into the tissues of the body that may mean taking IV magnesium, or more conveniently, applying magnesium oil or gel on the body."(8)

What does magnesium have to do with raw vegan diets, vitamin D and raw paleo diets? Severe magnesium deficiency badly impairs vitamin D's ability to work. (9). But raw vegan and raw paleo diets should be high-magnesium diets. Dr. Loren Cordain calculated the nutritional values of certain food groups and ranked them in his book The Paleo Answer. Magnesium is most plentiful in nuts, seafood and leafy green vegetables. (10) (It's also in coffee and chocolate.) Thiamine (vitamin B1) and calcium (in the right proportion to magnesium) are important cofactors of magnesium(11) and vegetables rank #1 on Dr. Cordain's list for vitamin B1 and #2 for calcium.  Raw vegetables are staples of a raw vegan diet and Dr. Seignalet's raw paleo program (12).

But if "up to 80 percent of the U.S. population is suffering from a magnesium deficiency," as it states at nutritionalmagnesium.org, is magnesium deficiency really the cause of FM, or just a symptom? And if the root of FM is magnesium deficiency, why does the raw paleo program work so much better than supplementing? The raw paleo and vegan programs include cofactors of magnesium and mostly or entirely eliminate grains and beans--two foods that can cause leaky gut and, without special preparation, bind to magnesium (and other minerals) keep you from absorbing them. "Increasingly," says Dr. Cordain, "scientific evidence shows that [eliminating gluten] may work for many...autoimmune diseases." (13) He lists several other leaky gut triggers, most of which can't be eaten raw (the major exceptions are tomatoes and peppers). Dr. Seignalet believed that FM was an autoimmune disease that started in the gut and ended up "fouling" muscle cells, if I'm reading the Google translation of his book correctly. I don't have enough of a biology background to know how plausible this is, but it seems to me that nutrients aren't getting to the cells.

How could you make the raw paleo program even better? Nutritionist and RN Julianne Taylor doesn't think the program has to be raw.(14) If you are taking antacids, get off them: they impair absorption of magnesium and many other nutrients. Likewise, low stomach acid might be a problem: nutrients don't necessarily dissolve in weak stomach acid. Look into HCl pills if that might be the case. Avoid alcohol and stress as much as possible--they're magnesium burners. And take the magnesium supplements and a multivitamin: if you have a leaky gut, it's going to take awhile to heal and absorb nutrients. UPDATE 6/27/2012: Avoid an additive called carrageenan. It's used to create inflammation in laboratory animals, and it can damage the gut--exactly the thing this diet seeks to avoid.

Further Recommended Reading:
Fibromyalgia Relief Diet: How to DIY
The Role of Magnesium in Fibromyalgia: An investigatory paper by Mark London
The Truths and Myths of the use of Guaifenesin for Fibromyalgia or Guaifenesin:  One Medicine, Several Effects by Mark London
Magnesium Deficiency and Fibromyalgia by Emily Deans

Sources:
1. The Vitamin D Solution by Dr. Michael Holick, Kindle location 424. Penguin Group, New York. 2010
2. http://www.vitamindcouncil.org/health-conditions/musculoskeletal/fibromyalgia/.
3. L'ALIMENTATION ou la Troisième Médecine by Dr. Jean Seignalet. 2004. Google translation of the fibromyalgia section here.
4. "Vegan diet alleviates fibromyalgia symptoms," Scandinavian Journal of Rheumatology 2000, Vol. 29, No. 5, Pages 308-313.
5. "Fibromyalgia syndrome improved using a mostly raw vegetarian diet: An observational study," BMC Complementary and Alternative Medicine 2001, 1:7 doi:10.1186/1472-6882-1-7
6. Seignalet.
7. The Magnesium Miracle by Dr. Carolyn Dean, Random House, New York. 2007, p. 47-49
8. Ibid p. 179.
9. http://www.vitamindcouncil.org/news-archive/2009/magnesium-and-vitamin-ds-co-factors
10. The Paleo Answer by Dr. Loren Cordain, Kindle location 2409, John Wiley & Sons, 2012
11. Dean, p. 37-38.
12. http://seignaletdiet.wordpress.com/diet-basis/ 
13. Cordain, location 3565.
14. Dr. Jean Seignalet, ancestral diet and auto-immune disease trials by Julianne Taylor. April 1, 2011.







Sunday, June 3, 2012

Unlimited Nuts => Weight Gain for Me

Regular readers may know that I have dessert for breakfast (and sometimes dip for dinner). But the past few weeks saw me working long hours at ramming speed. Something had to give: it was my almond meal chocolate cookies and Dr. William Davis's low-carb brownies, both made with nut flour.

This had a happy result (besides the good paychecks): the five pounds I put on a few months ago when I discovered these is leaving my midriff. It isn't the lack of sweetness at breakfast, since I've been having low carb, dairy-free chocolate custard for breakfast instead--two big pieces of it, along with coffee with coconut oil. I haven't completely given up nuts, I just don't have them every day, and when I do, I eat a handful of pistachios.

With all due respect to Dr. Davis, I can't eat unlimited nuts and keep a flat belly. Dr. Richard Bernstein is on to nuts raising blood sugar,(1) and therefore, for some of us, causing weight gain:

Nuts

Although all nuts contain carbohydrate (as well as protein and fat), they usually raise blood sugar slowly and can in small amounts be worked into meal plans. As with most other foods, you will want to look up your favorite nuts in one of the books listed in Chapter 3 in order to obtain their carbohydrate content. By way of example, 10 pistachio nuts (small, not jumbo) contain only 1 gram carbohydrate, while 10 cashew nuts contain 5 grams of carbohydrate. Although a few nuts may contain little carbohydrate, the catch is in the word “few.” Very few of us can eat only a few nuts. In fact, I don’t have a single patient who can count out a preplanned number of nuts, eat them, and then stop. So unless you have unusual will power, beware. Just avoid them altogether. Also beware of peanut butter, another deceptive addiction. One tablespoon of natural, unsweetened peanut butter contains 3 grams of carbohydrate, and will raise my blood sugar 15 mg/dl. Imagine, however, the effect on blood sugar of downing 10 tablespoons.

I don't think I have a big appetite, but it's too easy for me to eat half a can of cashews at one sitting. Or a few celery stalks with almond butter. (And yes, I realize I'm very fortunate that this is my most pressing health issue.)

With dairy gone, wheat gone, and excessive nuts gone, my hunt for interesting low-carb food continues.

1. Dr. Bernstein's Diabetes Solution by Dr. Richard Bernstein, Chapter 10: Diet Guidelines Essential to the Treatment of All Diabetics. Accessed June 3, 2012.

Saturday, June 2, 2012

Fibromyalgia Help: Quick & Dirty Version

I've been researching fibromyalgia for the past few weeks and have come to a couple of conclusions. I'll give my reasoning and cite clinical research in a future post.

Step 1. Go on a strict paleo diet (no grains, no dairy, no legumes, no soy, no artificial sweeteners, no seed oils, period). Eat plenty of non-starchy veg, as long as it doesn't interfere with any thyroid or digestive problems. What is a paleo diet? See this. What's left to eat? See this.
Step 2. Avoid large doses of calcium supplements--they interfere with magnesium absorption.
Step 3. If you're on acid blockers, get off of them. They interfere with magnesium absorption, they can lead to other health problems, and they were never meant to be taken indefinitely. See this post to learn how I cured my GERD. Basically, I went on a low carb diet and it cleared up within a few days.
Step 4. Take magnesium supplements. A supplement ending in -ate will be better absorbed than Mg oxide. How much magnesium? If you get diarrhea, you're taking too much.

If you have any health problems, especially thyroid or kidney issues, see your endocrinologist before starting supplements. However, I'm not aware of any reason that a paleo diet would be harmful to anyone, and getting off acid blockers can only help you--if you don't overindulge in carbohydrates.