Sunday, July 28, 2013

Injury-Inspired Makeup Colors

A recent injury left my toe pink and black. I called the color palette "Step into Danger," but Too Faced calls it "Romantic Eye." In fairness, my toe is much brighter.

Really, I slathered on the eye shadow.
Sometimes a mishap shakes us out of a routine and inspires something new. Viva antifragility!

Diabetic Protein Shakes? Rat Chow is Better

Rat chow: that's what Ensure and Enterex Diabetic drinks remind me of. I'm not into protein drinks anymore--haven't been in years--but my parents are elderly and it's hard for them to cook. They're also diabetic, and yet my father's doctor recommended two Ensure drinks per day. That's 80 grams, or 18 teaspoons, of liquid sugar. The main ingredients in Ensure:

Water, Sugar, Corn Maltodextrin, Milk Protein Concentrate, Soy Oil, Soy Protein Isolate, Cocoa Powder (Processed with Alkali), Pea Protein Concentrate, Canola Oil. 

Seriously--the second ingredient is sugar. (Corn maltodextrin in a starchy food additive.) Isn't that a big ol' clue that this isn't suitable for diabetics?

A pharmacist recommended Enterex Diabetic. It has fewer carbs, but 24 grams of liquid carbohydrate is too much at one sitting for many diabetics. The ingredients:

Water, Maltodextrin, Sodium Caseinate, High-Oleic Safflower Oil, Calcium Caseinate, Fiber (Soy Fiber, Gum Arabic, Guar Gum), Canola Oil, Vitamins and Minerals (snipped for brevity)  Natural and Artificial Flavors, Soy Lecithin, Carrageenan, Sucralose, Sodium Hydroxide, Acesulfame Potassium.

Carrageenan (which my mother pronounces "carcinogen") may be a carcinogen; it gave me sinus pain, upset stomach and a migraine headache last year. I ended up in an ambulance. Carrageenan is used to induce inflammation in laboratory animals.

Laboratory rats eat a diet that's better than Ensure or Enterex Diabetic. The list of ingredients in Purina Rat Diet 5012 contains recognizable food. Granted, the rat chow isn't suitable for humans (it contains wheat, soybean oil, and too many grains and carbohydrates), but neither are the protein drinks mentioned, for similar reasons.

What to do for a protein drink? I suggested my eggnog recipe, but Mom doesn't want raw eggs. The protein shake recipes we found online were all full of fruit. Real food, yes, but not suitable for someone with a disease of carbohydrate intolerance. Instead, she's going to try to hot cocoa recipe from 500 Low Carb Recipes by Dana Carpender. Perfect--she's been craving hot cocoa, even though it's summer, and there are only eight grams of net carbs in a cup.

Speaking of chocolate, I'd sooner eat a chocolate bar with good ingredients and limited carbs than a commercial protein drink. Click photo to enlarge.

Alter Eco Dark Blackout (85% cocoa) chocolate bar.

Friday, July 26, 2013

Music Reward

I feel like I've awakened from a dream. The past few days have been spent crowding out pain signals with music, like sending an avalanche down a mountain gulley. I wondered if some people could manage pain with a Wii or a karaoke machine even better than with music alone. But the music came to be a distraction about the time my foot stopped hurting today. I promised some coworkers more work than I could deliver, which I never do, so I'll be back at work tomorrow.

Some studies say that music that you love can make your brain release dopamine. I did feel like something was different, and that I was myself again once I was able to work in silence. Dopamine is a reward neurotransmitter, but I'd had enough music, even though it was rewarding.

My foot, whose problems started this, is doing better, so much so that I was able to run for the bus tonight after a former coworker saw me at the bus stop and we started chatting while my bus drove by. I didn't just trot, I ran. My foot is still healing, though. The color looks like a trendy eye shadow palette in black, rosy red and gray. Call it Step into Danger.

Thursday, July 25, 2013

Anxious? In Pain? Try Music

It's been almost a year since my bike wreck. I'm happy to say that there are no lingering effects from my fractured arm or dental injuries, and in another five months, I'll have replenished my emergency funds.

I'm not quite as pleased to say I'm observing the near-anniversary with a badly stubbed toe. A day and a half ago, I was watering the pots when I tripped over the old, rotted steps I disconnected from the house and stubbed my toe on the brand new steps I built. It still hurts. It hurts more than the fractured arm did. It's almost as bad as turf toe.

It really hurts when I stand. It hurts a lot less when I elevate my foot and rub the bottom of it or elevate it and listen to music. I was at work and in too much pain to go down and get coffee when I put on Alice Cooper and suddenly--no pain. It's just one more reason to love Alice Cooper.

I noticed the same thing back in 2007 when I was infected, recovering from a car wreck and had GI problems. Some researchers at the University of Utah recently studied pain and music(1) and found that certain personality types can mitigate pain with music--anxious people and people who get absorbed in tasks. I don't think I'm anxious, but when I'm busy, people sometimes have to shout at me to get my attention. That's how I feel right now, writing and listening to Nightmare (the Japanese band, not the song): my mind is occupied. I don't feel my foot. An article in Science News says,

Music helps reduce pain by activating sensory pathways that compete with pain pathways, stimulating emotional responses, and engaging cognitive attention. Music, therefore, provided meaningful intellectual and emotional engagement to help reduce pain.(2)

Singing along might really load up the pathways, but I don't think coworkers want to hear me singing "shake it like a bad girl up in Harlem."

  1. "Individual Differences in the Effects of Music Engagement on Responses to Painful Stimulation" by David H. Bradshaw, Gary W. Donaldson, Robert C. Jacobson, Yoshio Nakamura, and C. Richard Chapman. The Journal of Pain, December 2011, pp 1262-1273.
  2. "Listening to Music Can Be Effective for Reducing Pain in High-Anxiety Persons." Science News January 9, 2012.

Tuesday, July 23, 2013

What to Eat: Going by the Textbook Part II

My last post discussed the book It Starts with Food and the principles it's based on. Going over the post, I realized that the part about hormones raised some questions. How do cells become insulin resistant? How can too much insulin lead to weight gain? Does too much carbohydrate cause leptin resistance?

I'm looking again at the book Endocrinology: Basic and Clinical Principles by Shlomo Melmed and P. Michael Conn from 2005. The book says it isn't clear how insulin resistance develops, but says that it is a "key feature of the prediabetic 'metabolic syndrome' (central obesity, hypertension, insulin resistance, and dyslipidemia)" (page 318). It doesn't say how to reverse it.

The book does say that insulin promotes fat formation and inhibits fat burning:

Insulin promotes lipid synthesis and inhibits lipid degradation. Before insulin became available for treatment of type 1 diabetes, patients with this disease were invariably thin, reflecting the importance of insulin in lipid metabolism....Insulin increases fatty acid synthesis in the liver....Insulin inhibits triglyceride breakdown in adipose tissue...(page 318)
Why would someone have so much insulin in their bloodstream?

The main function of insulin is to lower serum glucose. (page 311)
Where does the glucose come from? The major source for most people is dietary starch and sugar. Reduce the starch and sugar intake, and you'll reduce the need for insulin.

On to leptin. The book's section on leptin begins with an interesting sentence:

Body fat stores remain very constant over time, in spite of large changes in energy intake and energy expenditure. (page 384)

It looks like they don't subscribe to the calorie balance or calories-in-calories-out school of thought of weight control. The authors state that the causes of leptin resistance are unknown, but there are probably several. Since leptin is a fairly recent discovery, I sought a more recent endo book for more information: Manual of Endocrinology and Metabolism, 4th Ed. by Norman Lavin from 2009. It states,

Leptin is a hormone secreted by fat cells and is a major regulator of adiposity....In humans, the level of leptin in the blood correlates strongly with body weight, percentage of body fat, and body mass index. Abdominal fat cells appear to produce more leptin per cell than do fat cells in the thigh. An analysis of 15-year longitudinal data from the New Mexico Process Study found that leptin levels were highly correlated with the development of insulin resistance in older persons....Current data suggest that high leptin levels are at least a marker for insulin resistance and the hyperglycemia of aging and may actually play a role in the pathogenesis of metabolic syndrome. (emphasis in original) (page 696)

In common obesity, a state of leptin resistance develops in which leptin loses its ability to inhibit energy intake and increase energy expenditure. Following weight loss, serum leptin levels fall. (page 20)

Based on these endocrinology books, high blood glucose leads to high insulin levels, which can lead to increased fat storage and decreased fat burning. If this takes the form of a spare tire, those fat cells will release a lot of leptin, which is supposed to regulate appetite, but won't if you're obese and leptin resistant. Since leptin resistance is highly correlated with insulin resistance, you'll not only have a disregulated appetite, but probably, glucose will have a harder time getting into your cells, and your body will have to make more insulin, which can add to the spare tire. The problem isn't just the unattractive spare tire, it's also high blood pressure, dislipidemia, and diabetes (metabolic syndrome).

As good as this information is, it doesn't address the reason my friend (to whom I gave It Starts with Food) got interested in elimination diets in the first place: inflammation. Most foods that are high in sugar or starch (grains, beans, and potatoes) also include lectins, gluten, saponins, or other bits that provoke autoimmune reactions in some people. Those lovely neolithic plant foods are a disaster for some of us in many ways.

What to Eat? Going by the Textbook

"Out with the old spiritual mumbo jumbo, the superstitions, and the backward ways. We're gonna see a brave new world where they run everybody a wire and hook us all up to a grid. Yes, sir, a veritable age of reason." -Ulysses McGill, O Brother, Where Art Thou?

If only. Eighty years after the Tennessee Valley was put on the grid, health gurus recommend mumbo-jumbo like two-thirds of a cup of sugar a day for diabetics,* inflammatory foods like wheat for the inflamed, and a low-fat, high-fiber, grain-based diet that fattens up livestock (in weeks!)** but is supposed to make humans slim and trim. The crazies are running the asylum. Are there any reasonable people in the mainstream?

I recently sent a friend of mine the book It Starts with Food. It discusses the major hormones involved in fat storage, fat burning and inflammation, along with the authors' dietary recommendations based mostly on our paleolithic ancestors' diets and their clinical experience. All their advice sounds right to me, but I know my friend is going to be skeptical about ditching the grains and beans and eating a lot of fat. To that end, following the lead of Dr. Eades, I checked some of the major tenets in the book with endocrinology textbooks available in Google Books. Where I'm writing "check," that means that the fact checked out with an endocrinology textbook.

  • Insulin is a hormone that is released to put blood glucose into cells. Check.
  • Consuming carbohydrate raises your blood glucose level. Check.
  • Cells can become insulin resistant, which prevents glucose from entering the cells. Check.
  • Your body then produces extra insulin to force glucose into the cells. Check.
  • Glucagon raises blood sugar levels when they're too low. Check.
  • High insulin levels prevent glucagon from acting. Check. 
  • Leptin is a hormone that signals satiety. Check.
  • Cells can become leptin resistant, preventing satiety signals. Check.
  • Leptin resistance is related to insulin resistance. Check.

In plain English, too much carbohydrate can make you fat and diabetic. It can also distort your appetite and possibly give you hypoglycemia. This isn't opinion, theory, or part of a fad diet, this is straight out of endocrinology textbooks.

Let's look at their paleolithic principles. The authors recommend meat (preferably pasture-raised), vegetables, fruit, animal fat (must be pasture-raised), natural plant fats, and limited nuts. They discourage grains, legumes, sweeteners, seed oils, hydrogenated oils, and dairy except butter. With the exception of butter, this is probably similar to how our ancestors ate for two and a half million years. I base this statement on books written by paleoanthropologists such as Richard Leakey, Alan Walker, Brian Fagan, Peter Ungar, and Loren Cordain. Except for Dr. Cordain, none of these authors promotes any diet that I know of. I've written about evolutionary diets here and here, and the bunkum of the "science" of vegan diets here and here. The short answer is that we've been eating meat as a substantial part of our diet for over two million years. We're pretty sure of this because of the evidence of stone tools, cut marks on animal bones, isotope analysis of our ancestors' bones, and the small gut size of Homo erectus. That our ancestors dispersed and became thin on the ground and rapidly developed big brains point to their being predators, not lotus eaters. I don't think there's any controversy over the notion that grains, dairy and beans are not paleolithic.

Despite this probably being close to our native diet, some of the recommendations are controversial. However, they have to be taken in context. The authors concede that a high-fat diet is inflammatory in the context of a high-carb diet. (I can attest that a high-fat, high-carb meal is hard on my stomach.)  Toxins are stored in animal fat, but pasture-raised animals have far fewer toxins. Some people have problems with low-carb diets, but you have to eat sufficient fat and give yourself time to adapt to the diet. Clogged arteries are full of cholesterol, but your body makes most of your cholesterol. (Check--it's in an endo textbook.) Cutting out dairy means cutting out a calcium source--but some vegetables have calcium and bone health depends on other vitamins and minerals as well as calcium.

I doubt these details are in any endocrinology textbook; however, there have been some clinical studies on paleo and low-carb diets showing favorable results.

As to the efficacy of the diet, the authors rely on their clinical experience with thousands of people. Their diet is very close to what I follow, and my own experience is that I take no medications, have a normal weight, normal lipids, good complexion, no tooth decay, no allergy symptoms, no GI problems, good sleep, and good energy. In the end, you should do what works. As my thermodynamics instructor said, "Concepts are fine, but if you can't get the right answer, you're no use to anyone."

*A person with normal blood glucose has about a teaspoon of glucose in the entire bloodstream.
**The cattle ate a bunch of oatmeal. Sure, it fattened them up, but just think of how they lowered their cholesterol.

Click here for Part II.

Sunday, July 21, 2013

Diabetes Management: Why DIY?

Answer: because probably, nobody else will.

Awhile back, my mother's new primary care doctor saw her for a checkup. According to Mom, the doctor took her blood sugar and wrote "diabetes out of control" on her chart and prescribed Metformin and Lantus (insulin). The doctor didn't look at the blood sugar records Mom brought.

Maybe it's the new medication, maybe because an infection cleared up, or maybe Mom has gotten more insulin sensitive, but she's been getting hypos in the morning. It's dangerous to have blood sugar get too low during the night. The doctor is hard to reach, and who knows how good she is at dosing insulin.

Mom had been fiddling around with her evening insulin dose, but without checking her blood sugar first. So today, after she got her blood sugar up from this morning's level of 55 (70-100 is normal), I suggested she check her blood sugar before taking her evening insulin. When she checked it tonight, it was 70. After doing some reading from Dr. Bernstein's Diabetes Solution, the Wheat Belly blog the Diabetes Update Blog, I said, no insulin, and finish your Quest protein bar. (Most readers know that the liver can make glucose from protein, and does so slowly.) All three sources say that insulin can cause hypos, but Metformin alone doesn't.

I hate to think what might have happened if Mom had taken an insulin shot with her blood sugar already at the bottom of normal. And I hate the fact that the only thing that stood between her and a potential disaster was blogs, a book, and someone with no medical background.

Tuesday, July 16, 2013

How Long does it Take to Heal?

It takes anywhere from seconds to years. It depends on the issue, the person, their diet, and their lifestyle. Lierre Kieth, for instance, felt better the instant she started eating meat again--the tuna was like prana in a can. (Sadly, her back pain from the damage caused by long-term B-12 deficiency will never go away.)

There have been a lot of 30-day challenges out there: 30-day paleo, 30-day Whole 9, even 30-day gluten-free from Dr. Guyanet. (He actually had a terrific blog before he started going on about food reward.) I think these challenges last long enough to get allergens out of your system and let you see if re-exposure bothers you, yet they're short enough to seem manageable. Thirty days is more than long enough to begin clearing up GI problems caused by food. My GERD disappeared within a few days of starting a low-carb diet, and two days on a fat fast cleared up my gastritis.

Some issues can take much longer. Almost a year ago, two of my teeth were knocked out of place in an accident, and they've only recently stopped being sensitive to pressure. This, on a high-nutrient diet of weekly liver and oily fish, red meat, green veg, 10,000 IU of vitamin D3 and 400 micrograms of K2 daily. In other words, a diet high in the nutrients Dr. Weston A. Price found in the traditional diets of people who suffered little or no dental problems. When I had my accident, my dentist warned me that those teeth would be compromised: it would be weeks or years before they'd die and need a root canal. On the standard American diet, that's no doubt the case. On a "heart-healthy," low-fat, low-calorie diet, you might as well start saving up for a root canal. (Fat-soluble vitamins A, and K2, which your teeth need, are best absorbed with, well, fat.) My teeth are still alive and crunching and feel like they've healed.

My left shoulder is another thing that took longer than 30 days to heal. In January 2010, it was so sore I saw my doctor. It was just muscle strain, but I'd suffered with it for years, probably from carrying 20 pounds of photo equipment for three years, then 20 pounds of books for four and a half. It wasn't from lack of exercise (I lifted weights at the time); yet I couldn't carry a purse on that shoulder. Why didn't I see the irony? Around the time I say the doctor, I started a wheat-free diet and soon after, gave my diet a radical carbectomy. Eight months later, my shoulder was well enough for me to ditch the backpack and buy a chic new handbag.

My mother can top this. She started a low-carb diet about the same time I did to control her blood sugar. In spite of this, she had to start taking insulin--a sudden diet switch isn't going to correct the damage from 20 years of out-of-control blood sugar levels. Think fasting blood glucose levels in the 300s. Seventy to 100 is normal, sustained levels above 140 lead to tissue and organ damage. The new diet did bring her blood sugar levels down immediately, and her mood, energy and mental function improved remarkably. This year--three years into a low-carb diet--her kidney function became good enough to go back on metformin, a safe drug that helps control blood sugar, and her fasting blood sugar has gotten so low that she's going to try skipping her evening insulin shot. I read on the Diabetes Update blog that neuropathy can take three years to heal as well. We'll see if this happens for her.

Saturday, July 13, 2013

Corporate Productivity Suggestion: Ditch the Snacks

I'm old enough to remember when the only refreshment at the office was coffee. If you wanted a snack, you had to bring your own or find a vending machine. Yet our brains worked just fine without the constant grazing: we all did our work and only new employees needed frequent reminders of standard operating procedures. Anyone too spacy to remember how to do their job was thought to be a stoner.

Now, cake for every birthday is standard. Some offices have free pop and snacks (read: junk food).

Soda, chips, crackers, and instant oatmeal make for unstable blood sugar in people susceptible to blood sugar swings, and roller coaster blood sugar levels affect mood, thinking and energy for the worse. How often do you see coworkers getting drowsy a few hours after lunch? How often do you hear, "My brain isn't working today"? Snicker-snacking all day long can make for high blood sugar and lethargy in some people--when it's really bad, it's called "carb coma." Think of Thanksgiving afternoon. Thanksgiving is mostly a carbohydrate orgy.

Besides the lost productivity, there's the cost of the snacks. Businesses could give everybody a nice little year-end bonus if they ditched them. There's also the time employees spend walking back and forth to the break room and the time someone has to spend placing the grocery orders, putting them away, and fixing the pop machine when it breaks down.

It's time for the office snicker-snacking to go the way of casual Fridays.

Friday, July 12, 2013

Shedding some Headwinds

Have you seen the list of drugs whose patents are going to expire in 2013 to 2016? It reads like a shopping list of drugs you'll need on a poor diet. Out of the 27 listed, at least 13 are unnecessary (statins), unneeded on a well-planned low-carb diet (acid blockers), treat conditions that might be improved by such a diet (medications for blood pressure, anti-depressants, bipolar disorder, diabetic nerve pain, for instance), or might be improved by removing wheat and other grains (medications for schizophrenia, rheumatoid arthritis, asthma, and osteoporosis).

On the one hand, doctors will feel less encouragement from drug salesmen, seminars and advertisements to prescribe these drugs. Without those headwinds, doctors might be more inclined to suggest diet changes. After all, avoiding grains and eating healthy fats is becoming more mainstream: the book Grain Brain (due out in September) is against wheat, sugar and carbs (presumably too much carb) and is endorsed by several mainstream doctors. Some doctors are giving their patients books such as It Starts with Food and The Primal Blueprint. Wheat Belly was a #1 best seller and a paleo podcast is #2 on the iTunes health chart. When I tell people I avoid carbs and wheat, they don't look at me like I have two heads as they did three years ago. Even my oral surgeon was interested in paleo diets.

On the other hand, managing an illness is a better business model than curing it, as long as it's an illness generally believed to be incurable, like heart disease or diabetes. Patients expect to have a broken arm cured. It will be painful for doctors to realize the treatment they've been giving their patients (like statins) is worse than useless. Some patients will balk at giving up muffins and lattes for more vegetables and a chunk of fatty meat. One therapist in the mental health field told me most of her patients were unwilling to change their diet; that might change if patients keep hearing that diet profoundly affects your mood. A friend of mine, after three years of my nagging her about it, finally tried a wheat-free diet after her doctor suggested it. (It worked.)

Once it becomes common sense to eat real food for your health and to try fixing your problems by tweaking your diet (which I think will happen in my lifetime), a lot of doctors are going to be out of business. (Note to bright young people: don't go into gastroenterology.) The smart ones will precede the wave, get experience using diet to treat patients, and become skilled enough to cure that cases that patients can't Google their way out of.

Thursday, July 11, 2013

Need a Radiator, or a Distributor Cap, or...Lunch?

Is this a marketing strategy for that underserved low self-esteem market?

At least they're honest.

Wednesday, July 10, 2013

The Fat Fast Is Over

The rioting proteins have been scavenged, the damage feels like it is being repaired, my belly has shrunk back to its normal size, my face is clearing up, and I was down another pound this morning. The ketostick was purple today, showing a "large" amount of ketones.

I am worn out. I feel like I've spent a day or two putting down a riot. I've been staying around 1000 calories per day, but only 80% fat; maybe I'd feel better on 90%, but the situation was urgent and I didn't have time to prepare.

I'm declaring victory and celebrating with a lamb chop, buttered vegetables and lemon ice cream.

Tuesday, July 9, 2013

Gastritis: The Fat Fast is Helping

I've finally found a name for what I have: gastritis. From Wikipedia:

Gastritis is an inflammation of the lining of the stomach, and has many possible causes.[1] The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting and pernicious anemia. Some may have a feeling of fullness or burning in the upper abdomen.[2][3] A gastroscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis.[4] Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. (emphasis added)

Since gastritis can come from injury, burns, severe infections, and autoimmune diseases, it looks like there's something to the idea that systemic inflammation can cause it. I'm glad I'm not bonkers.

Antacids and PPIs (proton pump inhibitors) are the wrong treatments. First, they don't address the real problem: inflammation. Second, PPIs and antacids make your digestion worse--you need stomach acid to digest food. The acid is also a line of defense in your immune system: it kills most bacteria on contact. Third, prolonged antacid use leads to mineral deficiencies and increased risk of bone fractures.(1) Acid rebound makes getting off them a nightmare. I've been through it.(2)

To avoid hot or spicy food depends on the person. Chili peppers actually make my stomach feel better.

The fat fast has also made my stomach feel better. I'm on day 1.5 and the bloating is mostly gone, making my belly flatter. I had a wheat belly without the wheat. The soreness at the top of my stomach is mostly gone. I was down 1.4 pounds this morning, which is fine, but not the reason I'm doing this.

I've found that I need to use a lot of salt on this fast. My blood pressure usually runs at the low end of normal, and low-carb makes you dump salt. (A ketostick showed a moderate ketone level today.) Therefore, all my food has to have salt. Not just a sprinkle, not just a lot, but a glittery crust of salt. Otherwise, I feel light-headed. After meals, I also say to myself what I say to my dog: "Give that food a chance to settle. You might find that you're full." Since fat digests slowly (I'm sure my stomach problems slow it down even more), it takes about 20 minutes after a mini-meal to feel full.

My TMJ pain from walking my dog--the thing I think originally brought this on--is almost completely gone since I haven't been walking Molly and I've been going to yoga. My energy is good--I couldn't go tear it up on the dance floor, but going to work isn't a problem.

  1. "The Dirty Little Secret of Acid Blockers" by Lori Miller. Pain, Pain, Go Away! February 19, 2010.
  2. "On the Rebound and Hating It" by Lori Miller. Pain, Pain, Go Away! February 21, 2010.

Fat Fast is Calming my Stomach

I don't know much about inflammation. What I do know is that immune cells can run amok, mistaking your own tissue for invaders, damaging it and inflaming it. It's also called autoimmune reaction and it can be systemic, throughout your body. And it's miserable.

Food, especially wheat and dairy, is a major cause of inflammation for some people. We focus on carbs around here, but it's funny proteins that cause problems from paranoia to arthritis: gluten, gliadin, whey and casein, for instance. The proteins can also come from your own body: serious injury can cause a release of the DNA from your mitochondria, tiny organelles in your cells, but with their own DNA separate from yours.(1) Interleukin-6 is an inflammatory protein your body makes; homocysteine (another protein) may cause inflammation when there's too much of it.

How do we get these rogue proteins under control? Tess wrote a post on systemic enzymes, calling them THE BEST anti-inflammatory supplement. (Emphasis in original.) I have some enzymes at home, but they're not systemic, and my stomach was so painful and bloated that I didn't want to wait on an order to get here. Besides, I have a hard time swallowing pills, and some enzymes are hell on your tongue. So I'll keep the systemic enzymes in mind as a backup plan and figure out a way to get them down the hatch if I need them.

What else is a good protein slayer? Probably ketones.How to make ketones? Fasting is one way.

In a study of men and women observing Ramadan, a month-long period of intermittent fasting among Muslims, homocysteine, interleukin-6 and especially C-reactive protein (an inflammation marker) decreased compared to a control group.(2) I don't know whether the study measured ketones, but since the subjects fasted for 12 hours at a time, they might have been in ketosis. Ketones, says Dr. Michael Eades, "stimulate the process of chaperone-mediated autophagy (CMA). What is CMA? It is 'a cellular process that allows cells to remove proteins, organelles [like mitochondria -LM], and foreign bodies from the cytosol [the watery interior of the cell] and deliver them to the lysosomes for degradation'."(3)

Some people love intermittent fasting. I HATE it. I ended up going on a binge when I tried it--and I've never been a binge eater. So how to crank up the protein-slaying ketones? The new fat fast,(4) of course. I once joked to a friend who does juice fasts now and then that she ought to do a bacon fast. I had no idea there really was such a thing.

I was at work when I had the idea and realized the lunch I brought was too high in carbs and protein. Luckily, I had a jar of coconut butter and had about 1/3 cup of it instead of my lunch. I downloaded the book Fat Fast Cookbook tonight and had the deviled eggs (one serving, or two eggs halves) and some coleslaw. Those were the fattiest eggs I've ever had--full of mayonnaise, bacon and avocado. I thought, this is how food should be--full of fat, not dry. You eat every few hours (which I prefer) and stay around 1000 calories per day. It's a fast, so it's a temporary and not permanent way of eating.

So I've spent half a day on the fat fast. The book doesn't make any claims about inflammation or helping your stomach, but my stomach feels normal. Not hungry or inflamed as it was this morning and has been for awhile, just normal, even after eating a bunch of raw cabbage. Back when I had an acute infection of H. pylori, the bacteria that cause ulcers, I wished I could just stop eating for awhile. I think this fast is as close as you can get to that without starving yourself or taking drugs. You don't have to put much of the food into your sore stomach since fat packs a lot of calories into a little weight. Simply eating causes inflammation.(5) The only bummer about the Fat Fast Cookbook is that so many recipes call for sour cream or cheese, which I love but can't eat--it's those funny proteins. Even though it's after 10pm and I don't feel hungry, eating a regular dinner is a habit and it was a mental adjustment to have just a snack.

I've felt calm but sharp and alert with no headache on roughly 20 grams of carbohydrate since breakfast. So much for needing 130g of carbohydrate a day to run your brain--but regular readers already knew that.

  1. "Deadly Inflammation, but No Sign of Infection" by Lauren Shenkman, Science Now, March 3, 2010.
  2. "Inflammation and Intermittent Fasting" by Dr. Michael Eades. Protein Power blog, August 13, 2007.
  3. "Ketosis Cleans our Cells" by Dr. Michael Eades. Protein Power blog, February 27, 2006.
  4. The Fat Fast Cookbook by Dana Carpender, Amy Dungan and Rebecca Latham. CarbSmart Press, Sparks, Nevada. 2013.
  5.  "Inflammation and Diet" by Dr. Michael Eades. Protein Power blog, July 10, 2007.

Sunday, July 7, 2013

Beyond Food and Fitness: Inflammation

It's a bummer when bad things happen to good dieters: weight gain, acne, need for naps, and indigestion in my case. You can go bananas trying to figure what you ate to make things go wrong.

I recently had all the things I just mentioned, and I know it wasn't diet. The same diet I normally feel good on hasn't changed recently (except for subtracting dairy). The only thing that has been different over the past month is that my TMJ was acting up from my taking my big, strong, sled-dog wannabe for walks every night. I think the continual muscle strain led to systemic inflammation.

Inflammation indicates a mobilization of your immune system; it's a call to arms. Whether the damaged tissue is a result of infection from bacterial invaders, overuse, or physical trauma, the purpose of the inflammation that ensues is to prevent additional damage and repair the damage already done.

But what starts out as a healthy response can have adverse effects if it persists for too long or spreads too far. (1)

Apparently, even a serious, one-time injury can lead to systemic inflammation. Some people get deadly inflammation with no sign of infection. It could be from their bodies releasing a lot of mitochondrial DNA into the bloodstream, and then attacking it.

In a new study, [surgeon Carl] Hauser and colleagues focused on plasma, the colorless fluid in which blood cells are suspended. They took samples of the fluid from 15 seriously injured patients who had just arrived in an urban emergency room. The samples contained a surprising amount of DNA. Specifically, the researchers found 1000 times more mitochondrial DNA—the genetic material belonging to the cell's power plants--than that seen in normal plasma. The data suggest, says Hauser, that when many cells are damaged in an injury, they release a large amount of mitochondrial debris into the blood. "That was the eye-opener for me."
The body responds to this mitochondrial DNA as if it’s a bacterial invader.(2)

Maybe lesser but repetitive injuries bring on lesser systemic inflammation, but enough to cause some problems, including acne, gastroenteritis, and weight gain, which are all associated with systemic inflammation.(3) Yes, I know it sounds nuts. But four years ago, I'd have thought everything on this blog was bonkers.

If this is the case, it's all the more reason why heavy people shouldn't force themselves to exercise. The main reasons are the studies have shown their metabolism actually goes down, and they sustain injuries to their "ankles, knees, hips and low backs."(4) If they injure or strain themselves repeatedly and it causes systemic inflammation, it will make any metabolic syndrome they have worse.

A few days ago, I stopped walking my dog and started taking her on more trips to the dog park where she can run free. I've also gone to weekly yoga classes twice, which has relieved my pain. The acne just showed up; it always takes awhile for the result of bad food or stress to show up on my skin. My middle is a little less squishy and my stomach feels better, but I'm still taking digestive enzymes.

1. It Starts with Food by Dallas and Melissa Hartwig. Victory Belt Publishing, Las Vegas, 2012. Kindle Location 1218.
2. "Deadly Inflammation, but No Sign of Infection" by Lauren Shenkman, Science Now, March 3, 2010.
3. Hartwig, Kindle Location 1343
3. The Art and Science of Low Carbohydrate Living by Jeff Volek and Stephen Phinney. Beyond Obesity, 2012. Kindle Location 242.

Saturday, July 6, 2013

Can an Injury Give You a Stomach Ache?

We know that foods you can't tolerate can cause inflammation in parts of the body outside the GI tract. But can inflammation in other parts of the body cause inflammation in the GI tract? I'm starting to think it's possible.

This morning, I was walking my dog when the cause of my recent TMJ problems and headaches struck me: it was from walking my dog. Molly's so strong that she pulled my mother around in a wheelchair when Mom was in rehab a few years ago. I've tried to get her to walk without pulling, to no avail. When she pulls, I have to pull back and it makes me tense my neck and jaw. Molly has her own treadmill, which I bought when I had this problem before, and henceforth she'll just have to stay on it if she wants to walk.

Molly on her treadmill, not the Iditarod. She could have been a contender.
What does this have to do with stomach aches? Lately, my stomach has hurt and nothing seems to digest well. I haven't tried any new foods lately; in fact, I got rid of instant coffee, sweet potatoes and dairy within the past few months and felt better for it. Normally my stomach feels fine, but it wasn't always so.

Back in 2006, I was in a car wreck and sustained a sprained neck and back; a few months later, I developed TMJ pain that was so bad I couldn't sleep. At the time, I was on a high-carb diet (~180g per day) and eating wheat and dairy. After the accident, I needed 20 pills a day. I needed a chiropractor, splint therapy for my TMJ, and pills for acid reflux. Around that time, I was diagnosed with an acute infection of H. pylori; I was making only two antibodies instead of the usual three. I went on medication for acid reflux for the next three years. I was so cranky at work that my boss had a word with me about it. I had a pile of work and a helper with the IQ of a doorknob. I think my system got overwhelmed with inflammation from the carbs, food intolerances, injuries and stress. It was about that time that my diet and exercise program quit working for me and I started gaining weight. However, there were a lot of things going on at the same time, and I was around the age when people start gaining weight, so it's hard to say whether inflammation caused my stomach problems or vice versa. Probably, it was a perfect storm for declining health.

However, my stomach was fine last year in the months after my bike wreck, when I fractured my arm and broke a tooth from my chin hitting the sidewalk. In fact, I shoveled it in with no gastric distress and my TMJ acted up only after oral surgery. Without a doubt, better diet (low-carb and free of the worst irritants) helped, but I've been on pretty much the same diet with my problems of late.

One difference, I think, is chronic and systemic inflammation vs. acute inflammation. After my bike wreck, I bled for a day and my arm swelled, I had some pain (not a lot) over the next month or so, but I was healing and wasn't being re-injured, unlike the continual muscle strain I've had from walking my dog. I was on a low-carb, high-fat, wheat-free diet. I don't think I had chronic, systemic inflammation.

Swelling from a recent injury is acute inflammation. But overtraining or continually eating something you can't tolerate leads to chronic, systemic inflammation. As Mark Sisson puts it,

...what’s the deal with inflammation being linked with all those chronic illnesses – like obesity, heart disease, and depression? How does something normal and helpful go haywire and become implicated in some of the most crushing, tragic diseases of our time?
When inflammation becomes chronic and systemic, when it ceases to be an acute response, when it becomes a constant low-level feature of your physiology that’s always on and always engaged, the big problems arise. The inflammatory response is supposed to be short and to the point. I mean, just look at its responsiveness. Go twist an ankle (don’t, not really) and watch how fast it swells up and gets warm to the touch. It isn’t meant to be on all the time.
And because a big part of inflammation is breaking the tissue down, targeting damaged tissue and invading pathogens, before building it back up, the inflammatory response has the potential to damage the body. That’s why it’s normally a tightly regulated system, because we don’t want it getting out of hand and targeting healthy tissue. But if it’s on all the time, regulation becomes a lot harder.(1)

Can system inflammation cause stomach distress? Phinney & Volek mention the possible effect of free radicals on the GI tract from overtraining:

[Reactive oxygen species or ROS] (aka oxygen free radicals) are highly reactive molecules produced by mitochondria that damage tissue proteins and membrane polyunsaturated fats....ROS are tightly linked to inflammation and aging...we have preliminary evidence that prolonged intense training (even in highly trained athletes) can overwhelm system anti-oxidant defenses and degrade membrane essential fatty acid content. This in turn could explain both impaired immune function and loss of gastro-intestinal integrity commonly observed after prolonged exercise.(2)

This article(3) suggests that repeated, but not acute, stress aggravates inflammation.

Today, after not letting Molly drag me along on the walk, and taking some DGL pills for my stomach, my stomach, neck and jaw feel better. Dark chocolate also settles my stomach.

1. "What is Inflammation?" by Mark Sisson. January 5, 2012.
2. The Art and Science of Low-Carbohydrate Performance by Jeff Volek and Stephen Phinney. 2012, Beyond Obesity. Page 44. 3. "Repeated, but not acute, stress suppresses inflammatory plasma extravasation." PNAS 1999 96 (25) 14629-14634; doi:10.1073/pnas.96.25.14629

Thursday, July 4, 2013

Bored with Steak and Salad?

How about almond-crusted liver and gathered greens & veg with refreshing paleo ranch dressing.

Home-grown lettuce (along with a little from the farmer's market), nasturtium, lamb's quarters and borage flowers along with cucumber and bell peppers make for an interesting salad.

To make the liver, have a beaten egg and some almond meal ready. (I take a handful of almonds and put them in the food processor with the S blade for a few minutes.) Cut the film off the liver and cut the liver into pieces about 1.5" square. Roll the pieces in the egg, then in the almond meal and fry in lard over medium heat.

Wednesday, July 3, 2013

Achy? Neurotic? Etc.? When Wheat-Free Isn't Enough

Everyone loves a good mystery, but in real life, we all love a good solution even more. The book Why Isn't my Brain Working? by Datis Kharrazian is the latter. Even if your brain is working (and I think mine works pretty well), it's worth reading for the insights into the gut-brain connection, cross-reactivity of foods, and what you can do if you get glutened.

In my younger days, I read self-help books and went to counseling to be happier. It didn't help much--all they talked about was attitude. Relying on attitude to solve a biological problem is like trying to smile your way out of an infection of H. pylori. I guess I was lucky that I didn't go in for drugs and didn't think doctors could help me. Good thing. I now know my problem was largely hypoglycemia.

The management of [certain patients with poor blood sugar control] is so fundamentally basic and easy....[Yet] It is not uncommon for [them] to be put on psychotropic drugs, sleep medications, or labeled as having bipolar disorder. (Kindle location 1356)

Dr. Kharrazian gave the patient in question a diet and herbs to stabilize her blood sugar. Indeed, a low-carb, wheat-free diet blew away all the mental techniques for me. He hammers home the importance of eating a low-carb diet.

Another mystery the book solved: why, years ago, a test for H. pylori showed I was making only two antibodies instead of the usual three. My doctor, in his fifties, I think, said he'd never seen such a result. Speaking of tests for antibodies related to foods, the author says,

When all the results are below the reference range it can mean your immune system is suppressed and not able to produce enough antibodies for a positive test result...[One] cause is the person's immune system is simply fatigued and under functioning. (Kindle location 3060)

At the time, I was eating a lot of wheat and dairy, a lot of carbohydrate, and working out hard six days a week. Later on, my doctor also diagnosed iron deficiency anemia, which he suspected from my pallid complexion.

Why bring up dairy? A few months ago, I decided to give it up totally (except for a bit of butter) because it gave me acne. Lately, the niggling pain in my right knee is gone, I almost never have a nosebleed, and my anxiety around others is gone. I also gave up instant coffee a few months ago, since it also gave me acne and tore up my stomach. Dr. Kharrazian says that dairy proteins and some brands of instant coffee are cross-reactive with gluten, meaning "the immune system mistakes one protein for another." (Most of the other cross-reactive foods are things that paleo people and low-carbers don't eat except as a cheat. Potatoes are one.) If you're sensitive to gluten, you may be sensitive to dairy also.

The immune system can also mistake protein structures in the nervous system for gluten.

Second, many people with gluten sensitivity have silent celiac disease, meaning their symptoms are not intestinal. Instead, they experience reactions to gluten in the brain, thyroid, joints, skin, or other tissues...Finally, the most common area of non-intestinal manifestation of gluten sensitivity is the brain and nervous system. (Kindle location 2572)

Gluten sensitivity has been shown to be a significant trigger in psychiatric disorders, movement disorders, sensory ganglionapathy, ataxia, general neurological impairment, neuromyelitis, multiple sclerosis, neuropathy, myoclonus, apraxia, myopathy, neuromuscular disease, multiple systems atrophy, cerebellar disease, migraines, hearing loss, cognitive impairment, dementia, restless leg syndrome, and disorders in virtually almost every part of the nervous system evaluated. (Kindle location 2641)

If you've had a negative test for celiac, wheat might still be bad news for you. A traditional celiac test is limited to one or two parts of the gluten protein; there are at least ten different things in wheat you can be sensitive to. (Kindle location 2882)

The book has several recommendations for supplements and diet to help heal a variety of problems generally chalked up to age or laziness or craziness.

Why Isn't My Brain Working has other chapters on inflammation, stress, circulation, hormones, autoimmunity, and therapies. (Dr. Kharrazian also wrote a book called Why Do I Still Have Thyroid Symptoms?)

I'm not planning to change my diet or routine--but this book would have been a godsend to me long ago.

Tuesday, July 2, 2013

Updates: Mom, TMJ, Anxiety and Dairy

My mom is back to normal, able to walk a little with a walker and doing a little cooking. Perhaps because her recent infection is gone and she isn't eating any more hospital food, her blood sugars have gotten low enough that she's decided to reduce her insulin dose.

My TMJ pain has been acting up. But last weekend, a friend invited me to her restorative yoga class, and the next day, for the first time in weeks, I didn't need any aspirin. I'm planning to take her class on a regular basis.

I had some anxiety that's now gone. I've always been good on the phone, and good on the Internet, but tended to get kind of freaky in person. I was the weird girl in The Breakfast Club. The anxiety defied all reason and most experience. And yet it just evaporated over the past couple weeks. Why? I quit all dairy except butter around two months ago and I'm finally finished healing from my bike wreck. Those are the only things I can think of that happened recently. There's some evidence that people with autism improve on wheat-free, dairy-free diets. I'm not autistic, but there may be a mechanism between dairy and brain function.

To that end, I'm reading Why Isn't my Brain Working? by Datis Kharrazian. (Imagine giving this book to someone or being seen reading it.) I found it while seeking answers to my dairy question, but--sit down for this--a low or limited carb diet is good for the brain. The same diet that's good for your teeth, weight, lipids, and GI tract, a diet similar to what we evolved on, is good for your brain, too. I'm getting the sense that the entire human body is adapted to our native diet.

EDITED TO ADD: The niggling pain in my right knee is gone, too, and I've had almost no nosebleeds. It suggests that something about dairy was bothering me.