Thursday, May 28, 2015

Health Reporters Easily Punked by Chocolate Study

Did you read about the new study showing chocolate helps you lose weight? I'm sure regular readers here weren't taken in, but you might want to show something to your friends who keep up with health "news." The authors of that study just revealed that it was a hoax to shine a light on the sloppiness of the health media. The study was real and the authors didn't lie about anything but their credentials, they just did a poor experiment, sent out press releases and paid the impressive-sounding journal The International Archives of Medicine 600 euros to publish it.

The study really did show greater weight loss in the chocolate group than the non-chocolate group and the control group, but...

Here’s a dirty little science secret: If you measure a large number of things about a small number of people, you are almost guaranteed to get a “statistically significant” result. Our study included 18 different measurements—weight, cholesterol, sodium, blood protein levels, sleep quality, well-being, etc.—from 15 people. (One subject was dropped.) That study design is a recipe for false positives.... With our 18 measurements, we had a 60% chance of getting some“significant” result with 0.05. (The measurements weren’t independent, so it could be even higher.) The game was stacked in our favor. It’s called p-hacking—fiddling with your experimental design and data to push p values under 0.05—and it’s a big problem. (Emphasis added.)

In other words, the weight loss results could have been luck--for instance, the women might have been on a certain place in their cycles. If the result had been lower blood sugar, some people in the control group might have been getting a cold or under stress--both things raise blood sugar. As for sleep and well-being, a thousand different things are more likely to affect those than a few bites of chocolate.

But the reporters--and even the prestigious sounding International Archives of Medicine, which purports to "rigorously review" articles--asked about none of this. Even a "fact checker" from Shape didn't ask for many details about the study. Quite a bit of nutritional science is like getting a diploma from a mail-order college in the Caribbean: answer a few questions, write a check, and you're official.  Health reporters recycle the articles until junk science becomes conventional wisdom, the same conventional wisdom you'll get from most medical professionals, because that's mostly where they (in general) learn about nutrition.

But...the chocolate is still good for you, isn't it? They selected bitter chocolate because it's a favorite of "whole food fanatics." Never mind that chocolate is highly processed--you can't even make a proper chocolate bar at home--or that the stuff they used (81% is bitter and chalky as aspirin) isn't the milky, sugary junk food the magazines and web sites showed.

For the full story, read this:

Wednesday, May 27, 2015

Apple Cider Vinegar FAIL: FODMAPs & Reflux

On the hypothesis that my mineral deficiencies are caused by low stomach acid, today I tried supplementing with vinegar. This morning, I took a tablespoon of apple cider vinegar with some water at breakfast (a Quest bar and coffee) and at lunch sprinkled some red wine vinegar on my salad. The good: I didn't get hungry between meals--that's unusual for me, especially on such a light breakfast. The bad: I got acid reflux and a lot of burping, which is also unusual for me. Sinus congestion, too. Given my very low-carb breakfast, the only reason I could think of for the reflux was FODMAPs. (Quest bars have prebiotic fiber that gives some people FODMAPs problems, but not me.) Apples are one of the worst things for giving me acid reflux, and apple cider vinegar is apparently high in FODMAPs--fermentable carbohydrates that some people don't digest well. When you don't digest a carbohydrate well, it ferments in your intestines.

Fermentation requires bacteria. But I haven't been giving any care and feeding to my gut bacteria. I've been on a low-carb diet for over five years, don't use resistant starch, don't eat fermented foods except a little homemade coconut yogurt, and I'm in the middle of another round of antibiotics (the second one this year). I've shown the bugs all the charity of Ayn Rand. Yet they've gotten along well enough without any help to give me three hours' acidic misery with nothing but a little vinegar to feed them.

The lack of hunger between meals suggests that I'm digesting my food better, and hopefully, absorbing more minerals. I'm going to try again tomorrow with lime juice or red wine vinegar, which are supposed to be low-FODMAPs.

ETA: From looking at a few scholarly articles (not the alternative health hype that's all over the internet), it's unclear why vinegar is antiglycemic. It may have to do with interference with carbohydrate digestion. 

Mineral Deficiencies and Soda Cravings

As readers may know, I have to take mineral supplements. I also crave coffee and soda, which are both acid. Hmmm.

  • Iron is better absorbed with vitamin C (aka ascorbic acid).
  • Calcium is better absorbed with vinegar (acid).
  • Lemon juice (acidic) breaks down meat (which contains minerals). It does it so well you can chemically cook fish in lemon juice to make ceviche.
  • I put vinegar in the dishwasher to dissolve mineral deposits. 
  • Cola is acid (the pH is around 3-4).

Maybe my problem is due to low stomach acid. Years ago, I tried vinegar for GERD without success. Maybe it's time to try it for digestion. Why didn't I think of this before?

Thursday, May 21, 2015

Why Grain-Based Diet Recommendations are Finished

Is that a pork chop? This looks a lot like a low-carb diet.

Bye-bye, Ancel Keys. You were on the cover of Time once, sternly warning readers about cholesterol. Now the agencies you once guided are about to throw you under the bus for three reasons:

  1. Well-done intervention studies have shown the superiority of low-carb diets v. high-carb diets in terms of weight loss and lipids. This is the reason that sounds good. The rest of the story is that the the effects of insulin and carbohydrates on hunger and weight gain have been well-known for a long time--so long that they're described in endocrinology textbooks. Before that, weight gain from starchy diet was described in literature from the nineteenth century.
  2. The well-done intervention studies and the Internet have made it impossible for health "charities" to continue advising high-carb diets for diabetes and weight gain without fear of lawsuits. The Academy of Nutrition and Dietetics did enough applauding of the science and the USDA's positive reaction to it to give themselves carpal tunnel, but really, their lawyers must have told them they needed to swallow their pride, get with the times and cover their asses. Nobody stands up and applauds when they find out they've been horribly wrong.
  3. The USDA as a government agency wouldn't be subject to lawsuits from people who suffered amputation, blindness, neuropathy and kidney failure from following the advice they pushed, just irrelevance and ridicule. But now that Obamacare is in place and young, healthy people haven't exactly rushed to sign up, the costs of amputation, blindness, neuropathy and kidney failure and the medications needed to prevent them for people with the genes for diabetes will be too much to bear. Those who are very sick from diabetes--or IBS, other GI problems, heart disease, autoimmune problems, and other illnesses caused by a diet perfect for fattening livestock--not only need a lot of care, god bless them, but as a group are less able to be productive, or pay taxes, to put a sharp point on it. Pharmaceutical companies might dream of a population on medications from cradle to grave, but there must be people in the federal government up nights wondering how they're going to pay for it.

Now that groups like the AHA and ADA can't promote a grain-based diet and sugar anymore without fear of reprisal, it'll be interesting to see who they whore themselves out to next.

Wednesday, May 20, 2015

Palpitations Gone with Iron

Thanks to my internet friend Larcana, who alerted me to the connection between iron deficiency and palpitations, I doubled down on my iron supplements and, for good measure, washed them down with Emergen-C. It's a cold medicine with a mega-dose of vitamin C, plus B vitamins and minerals. I don't think vitamin C does anything for a cold (a friend bought the stuff and left it at my house the last time she visited), but vitamin C does help iron absorption. After doubling up on iron in the last three days, I feel back to normal. (I'd already been taking quite a bit of magnesium and potassium, so I probably had sufficient levels of those.)

How did I get so low on iron? Maybe it was too many Quest bars instead of red meat when I had odd cravings during my dental infection recently. Maybe because it's too hard to find liver at the grocery store and I haven't eaten much of it lately. Maybe the antibiotics damaged my intestines. And apparently, I'm a heavy bleeder. I just know that it was frightening and unpleasant. Between that and catching a stomach bug yesterday, if I'd felt much worse, I'd have checked myself into the hospital...where they might have put me on a beta blocker instead of tracking down and addressing the cause.

A fat, juicy burger probably would have done me more good--I felt wonderful after having one made of grass-fed angus that I just bought from a ranch in Yuma, near the Nebraska border. I don't know if it makes other people with heart problems feel that good--like they would want to start a religion where the cattle are worshipped, raised with care, and eaten with joy and thanks. But if they're suffering from a lack of iron, any ongoing advice for them to avoid red meat--and the healing it would give them, acknowledged by groups who now recognize that cholesterol and saturated fat were never bad for us--is unforgivable. 

Sunday, May 17, 2015

Dietitians' Recommendations: Progress, but Cognitive Dissonance

The Academy of Nutrition and Dietetics has officially acknowledged well-founded scientific findings(1).  Specifically,

  • Saturated fat is fine.
  • Cholesterol is fine.
  • Red meat has important nutrients, such as protein and iron. They call red meat an "important source of shortfall nutrients, such as iron." They add, "The Academy did not interpret that recommendation as impugning the healthfulness of red meat or its place in recommended meal patterns as a protein..."

Hooray! The fifty pounds of angus beef in my freezer has their blessing! They even called it healthful!

But wait--don't eat too much of it: " meat consumption [at an average of 20 ounces per week] exceeds [our] recommendations for most subgroups and...a greater share of recommended protein consumption should be met by seafood, legumes and nuts."

Let's break this down: red meat is entirely, or almost entirely, fat and protein. If protein is good, and saturated and monounsaturated fat (the two main types of fat in beef, for instance) are good, where's the problem? They don't say, so let's take a look at a few nutrients in some common types of red meat, fish, legumes and nuts.

protein (g)carbs (g)iron (%DV)calories
ground beef, 75% lean, pan fried26015277
pinto beans (cooked)93115162
*per 100-gram serving

The beef, almonds and salmon score well for protein, but pinto beans are over three-quarters carbohydrate, which (except fiber) breaks down into sugar in the body. It's hard to see how such a starchy food that's low in protein (it's only 20% protein) is considered a good protein source. Almonds are three-quarters fat and only 13% protein--hence the high calorie level. Salmon is three-quarters protein and the 75% lean ground beef is 41% protein.

If you replace 200 grams of red meat (7 ounces, or 2 medium-sized burgers) with 100 grams of almonds and 100 grams of pinto beans, you'll get 21 fewer grams of protein, 50 more grams of carbohydrate, and 205 more calories.

Since the Academy mentioned iron as a shortfall nutrient, let's look at iron levels in these foods. Everything except salmon has a good deal of iron in it, but the trouble with nuts and beans is that they contain phytate, which inhibits your absorption of various minerals including iron. In other words, much of that wonderful iron from nuts and beans will go down the toilet undigested. Iron absorption from various beans is around 1% to 2%; same for nuts. If you replace a couple of hamburgers with an equal weight of beans and nuts or even salmon, you'll be reducing significantly reducing your iron intake.

It's time official agencies acknowledged that red meat is healthy. Meantime, it means more burgers for me.

Source: (1) "Academy Comments re: the DGAC Scientific Report,"  Pepin Andrew Tuma, May 8, 2015

Saturday, May 16, 2015

Still Getting Palpitations a Month On

My apparent reaction to epinephrine from a root canal continues. I know the epinephrine is long out of my system, but I'm still having to pop magnesium and potassium pills several times a day. People who dismiss palpitations as a reaction to a very low-carb diet probably haven't been through it.

Peter at Hyperlipid called palpitations from ketogenic diets "interesting." Here's something I think is interesting: the change in my complexion. A few days ago I saw I looked like I was wearing orange makeup, which had matched my skin before. A cosmetologist selected a new shade for me.

L to R: the new foundation and the old. I haven't been this pale since the early 2000s.
I've been taking my iron pills every night (my complexion darkened when I started taking them some years ago). Maybe I'm not absorbing minerals well...

But I'm happy to say my energy levels have been stabilizing--I'm even tired at 10PM, something brand new for me--and I'm having an easy time getting up around 6.

It's been frustrating, though, trying to look up reasons for these strange reactions and finding little on low-carb sites but weight loss, weight loss, weight loss. People complaining they don't feel good are shouted down as heretics.

Monday, May 11, 2015

I'm Low Carb but Can't Fast; Need Supplements

Here are two annoying myths about low-carb diets: everybody on a LC diet can fast, and nobody will need supplements. I've been low-carb for over five years, and fairly strict: slip-ups give me acid reflux within a few days. But I can't fast and I still need supplements.

I don't mind needing three real meals a day plus snacks or taking vitamins. What's annoying is people not believing me when I say I need to do this.

"But, are you sure?" they ask. "Are you really low-carb? Did you just start? Is it just cravings? Have you stopped eating grains?" I'm sure I'm hypoglycemic: I had most of the symptoms most of my life and the blood glucose meter confirmed my falling blood sugar when I tried to fast. I quit eating wheat five years ago. I know cravings from hunger and don't have a history of binge eating. A medical test confirmed that I had iron deficiency anemia; if I don't take iron pills, I get so weak I can barely prise myself out of a chair. Without my other vitamin and mineral pills, I get constipated and I have heart palpitations, trouble swallowing, and acne. Wounds take weeks or months or longer to heal. (Lest anyone associate my diet with these problems, I had all of them before I started low-carb, and my nosebleeds from septoplasty finally healed eleven years after the surgery some months after I started a low-carb diet plus supplements.)

Dr. Atkins, who treated thousands of patients, recommended that his patients eat three solid meals a day (unless they weren't hungry for them) and take supplements. He said hypoglycemia was common. This brings me to another annoyance: business lunches. Where I work, there's usually nothing at a business lunch I can eat. "Oh," someone says, "can you eat salad?" Yes, I can eat salad. But with no protein and little fat, combined with an hour and a half at a noisy restaurant where I can't make out any conversation because everyone is talking at once, I'll be all out of nice by 2 PM. Ross Perot used to have business meetings where everybody stood. Not only should everybody stand, they should all eat stinky fish during the meeting. Everyone will be feel a little happier from the omega 3s, and yet be back to work in a few minutes.

"But," you say, "some people are allergic to fish." Are they sure? Do they just dislike it? Are they craving something else? Have they had an allergy test? Oh, OK. Those people can eat raw kale instead.

Food for $29 a Week? Yes, if you're Doing Low-Carb and Shopping the Sales

With some help from my frugal Internet friend Galina, I've figured out how to live within a $29-per-week grocery budget, which is what some people get as part of SNAP:

 caloriesprice$/100 calories
12 eggs            852  $    3.00  $             0.35
2 chickens, whole         4,280  $    8.40  $             0.20
head romaine lettuce            106  $    0.99  $             0.93
pound butter         3,240  $    5.00  $             0.15
head cabbage            218  $    1.62  $             0.74
avocado            227  $    0.88  $             0.39
can salmon            536  $    2.48  $             0.46
3 pounds pork         4,272  $    4.50  $             0.11
salad dressing         2,176  $    1.49  $             0.07
        15,907  $  28.36  $             0.18
Calories per day         2,272    

 I've seen butter for $5 a pound, whole chickens for $2 a pound, eggs for $3 or less a dozen and Galina tells me she sees pork on sale sometimes for $1.50 a pound. The rest of the prices come from store flyers and my latest shopping trip. Calories are from and the web site of Double Q Salmon.

Some people complain that low-carb is an "expensive diet." But look at the price per hundred calories--18 cents! There's plenty of satiating fat and protein and other nutrients.

Is this perfect food? No--there's seed oil in the dressing and a lot of omega-6 fats in the pork. But it's food without the antinutrients of grains and beans and the fattening, blood-sugar spiking, tooth-decaying effects of those foods.

Saturday, May 9, 2015

Nutritious Food on $29 a Week? Probably not Possible

Here's what $33.58 will buy--that's pretty close to the $29 a week challenge some people have taken lately in sympathy with people on the SNAP program. (The maximum amount you can get on SNAP is $194 per month according to the USDA, which comes out to $44.77 per week.)

The grass-fed angus was inexpensive ($3.90 per pound) because I buy it in bulk--and it's an odd cut (cheek meat).

There are a lot more calories here than in the rice, beans, tortillas and vegetation others have bought on the challenge. Nevertheless, what you see here amounts to only 5,397 calories, or 771 calories a day.

caloriesprice$/100 calorie
12 eggs852$3.00$0.35
4.75# beef3,629$18.53$0.51
2 cans sardines400$6.98$1.75
head cabbage218$1.62$0.74
red bell pepper37$0.88$2.38
English cucumber34$1.69$4.97

To eat such a diet for a week on 1,500 calories per day would cost $65.

You might get more calories for less money on potatoes, rice and beans, but many people on such a high-carb diet will spend a lot of time hungry and tired because it will give them roller-coaster blood sugars. Diabetics will need more medication. People with bad teeth may see them get worse. As for nutrition, grains and beans have nutrient blockers that interfere with mineral absorption. 

But note that the first letter of SNAP stands for Supplemental. It's not meant to be a person's entire food budget. What to do? Here's one idea. 

Get a job.

ETA: If you're willing to eat non-pastured meat and eggs and shop the sales, a $29-a-week low-carb diet can be done. See this.

Monday, May 4, 2015

This Just In: Yogurt Doesn't Improve Health

A recent study from Spain finds

"In comparison with people that did not eat yogurt, those who ate this dairy product regularly did not display any significant improvement in their score on the physical component of quality of life, and although there was a slight improvement mentally, this was not statistically significant," states López-García.

Most yogurt is pretty much pudding with a little bacteria. Pudding is a sugar bomb. Hard to believe the stuff doesn't improve health outcomes, isn't it?

But as usual, researchers are calling for...more research.

"For future research more specific instruments must be used which may increase the probability of finding a potential benefit of this food."

Sunday, May 3, 2015

Adventures in Adrenaline

Jim said he didn't want no more damned adventures. -The Adventures of Huckleberry Finn by Mark Twain

Getting a shot of epinephrine once again made me feel tired and gave me palpitations. At least this time I knew to pop magnesium pills (good ones ending in -ate) like candy. I now carry three magnesium pills with me in case of emergency--they don't have any at hospitals.

The second part of my root canal was Wednesday. Thursday was a major deadline at work, and when a code enforcement officer called me about some overgrown weeds in my front yard, I was all out of nice. Between the mostly cold weather, a dental infection and shots of the dreaded epinephrine, I hadn't felt up to anything but going to work and being bothered by a bureaucrat over some weeds was too much.

But by Saturday, I felt well enough to weed the front yard, prune the tree there and clean the house. Today (Sunday), I found I felt better if I moved around--I spaded up part of the back yard to plant more grass, since part of the lawn died last year when I was helping take care of my parents. I weeded the back yard, fertilized the roses, ironed my clothes and went to a meetup. I also walked around the neighborhood taking photos of yards that really do look bad in case I hear from Code Enforcement again.

Part of my reaction to epinephrine might have been from a low-carb diet. Ten years ago, Michael Eades quoted a 1992 paper from the American Journal of Physiology regarding both fasting and a low-carb diet:

Plasma insulin, a potent inhibitor of lipolysis, declines; plasma epinephrine, a potent lipolytic agent, increases. In addition, adipose tissue sensitivity to insulin is decreased, whereas sensitivity of epinephrine is enhanced...

Peter over at Hyperlipid has also mentioned people getting palpitations on very low carb diets from their own adrenaline.

The first paper which had me thinking was this one.  
"Both the pre-and post-exercise levels of adrenaline, noradrenaline, and cortisol were enhanced." 
This is the sort of thing I file as interesting. That is, until the anecdotes trickle in about people who have gone to extreme ketogenic diets and have developed abnormal cardiac rhythms.

Anyway. It's Sunday night, and I'm off to tear up the dance floor.