Saturday, 26 February 2011

It's all about ME, baby! (Birth - 1997)

It's all about ME, baby! (1997 - present) is my story after discovering the Atkins Diet. This is my story up to that point. I was born one snowy Winter's day. Mum told me that my cot was placed next to an open window in Central Middlesex Hospital. That explains a lot! Here's mum, me and my sister.

I don't remember much about my early years. As we were relatively poor (dad was a tailor and mum did typing for a solicitor), getting regular French Fancies & Corona lemonade deliveries was considered a status symbol. I ran around in the street with other kids of my age but I was fat. I was also very short for my age (insufficient GH from my pituitary?) and was rubbish at sports in primary school. Here's a photo taken when I was about 9 or 10. I'm the shortest boy in the picture.

Stripy shirts were all the rage, apparently. Even at this tender age, I used to regularly fall asleep after eating a plate of chips (that's fries, to Americans).

In secondary school, sports was dreadful what with having to play cricket using a cricket ball (instead of a tennis ball), contact sports, swimming and showers. Being short, fat & under-developed, I was embarrassed to get undressed in front of my peers, so I developed the art of forging sick notes in my mum's handwriting. I was a very sickly child! ;-D

My forging skills resulted in the total avoidance of swimming (also contact sports, cross-country running etc) and a big improvement in the quality of my handwriting! With tennis, I had to travel to a tennis court by train. I didn't mind doing that, as there were no showers at the tennis courts and I could play the game for a while until I overheated. Secondary school was where I developed a total hatred for almost all sports and when I left, that was the end of exercise as far as I was concerned. When I left secondary school at the age of 18, I was 4 feet 9 inches tall.

At university, I would have a cheese & ham salad baguette washed down with a can of Coke (non-diet in those days) for lunch, followed by a snooze.

At work, I would have a cheese & raw onion roll washed down with a can of Coke for tea-break, followed by a snooze. Here's me at the age of 26. At some point, my pituitary gland "woke up" and secreted GH, as I grew to 6 feet 1 inch tall in my late twenties.

I did manage to get some work done!

When I was dating, I jogged/walked for over 4 miles a day to see my girlfriend. I got slim. After I married, that stopped and as I was a skint Electronic Engineer and Lesley was a skint Cake Decorator, my diet was predominantly cheap carbohydrates, like bread, pasta, potatoes & rice. The result? Lots of snoozes + lots of weight gain. I was a lazy git, apparently.

In 1992, Lesley left to live with her mother. In 1994, I started dating Eileen. At parties, I became (in)famous for falling asleep after eating nibbles made from refined carbohydrates.

Friday, 25 February 2011

"Funny turns": What they aren't and what they might be.

Sometimes, doing a large amount of high-intensity exercise while on a ketogenic diet can result in a "Funny turn", i.e. a weird feeling which may include sweating, dizziness & feeling faint.

The good news is that it's harmless, provided you don't faint, hit your head on something hard/sharp & fatally fracture your skull, or do it regularly. Stop and sit/lie down until the feeling passes. What's happening?

What isn't happening, is a Somogyi rebound. A Somogyi rebound happens when too much insulin is injected and it's bad because it results in rebound hyperglycaemia.

Did you know that there is insulin, insulin and insulin? According to Insulin: Degradation, "It has been estimated that an insulin molecule produced endogenously by the pancreatic beta cells is degraded within approximately one hour after its initial release into circulation (insulin half-life ~ 4–6 minutes)". According to Insulin: As a medication, injected insulin lingers in the blood for hours for fast-acting and days for slow-acting. This makes an overdose of injected insulin dangerous, as it can linger for long enough to cause fatal hypoglycaemia unless medical help is obtained.

What might be happening, is this: On a ketogenic diet, muscle glycogen stores are "trickle-charged" from blood glucose. High-intensity exercise oxidises muscle glycogen at a very rapid rate. See It's all in a day's work (as measured in Joules). Muscles can oxidise carbs at a rate of 4g per minute.

If muscle cells run out of stored glycogen, they become exquisitely sensitive to insulin and glucose importing processes are up-regulated. There is only ~4.5g of glucose in the blood at any given time, topped-up by the liver & kidneys and oxidised by the brain & red blood cells at a rate of less than 4g per hour (if keto-adapted). If muscles suddenly take up glucose at a rate of 4g per minute, blood glucose level can fall rapidly.

As dropping dead due to running for your life on very little or no food is bad, the body has several mechanisms for raising blood glucose.

From Blood Glucose, Insulin & Diabetes, "When BG falls to ~3.3mmol/L, the pituitary gland kicks-in and secretes ACTH (adrenocorticotropic hormone) which stimulates the release of cortisol from the adrenal cortex. Cortisol further stimulates gluconeogenesis in the liver & kidneys. When BG level falls to ~2mmol/L, the pituitary secretes GH (Growth Hormone) which has an anti-insulin effect." Adrenaline secretion increases, as adrenaline shifts fuel utilisation away from carbohydrate and towards fat. A sudden increase in the levels of adrenaline, cortisol & GH in the blood make you sweaty, dizzy & feel faint, so you stop exercising.

If it happens regularly, chronically-elevated adrenaline & cortisol levels result in you "falling apart" after about two years. See Survival of the Smartest (part 2) - Dr Diana Schwarzbein.

How come it's harmless? Glycogen-depleted & exquisitely insulin-sensitive muscles act as a natural blood glucose limiter because they draw in glucose so readily. There's no rebound hyperglycaemia.

This also reduces the "Dawn Phenomenon", another plus point for low-carb diets for people with T1D.

See also Can very-low-carb diets impair your mental faculties.

Thursday, 24 February 2011

Mum's Proposed Ketogenic Diet for Dementia.

The following diet is not intended to induce deep ketosis. It's intended to be a trade-off between ketosis, palatability & simplicity.

Feedback from the nurse on duty:- "Eggs shouldn't be in the "unlimited" list. You're not supposed to eat more than two eggs a week because of the cholesterol". God Bless the NHS! The British Heart Foundation doesn't impose a restriction on egg consumption.

Eggs can be eaten as part of a balanced diet.

Mum's currently eating two eggs a day in her cooked breakfasts.

Effect of dietary egg on human serum cholesterol and triglycerides.

Old people have the lowest mortality when their serum cholesterol is higher than average.

Total cholesterol and risk of mortality in the oldest old.
Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study.
Low total cholesterol and increased risk of dying: are low levels clinical warning signs in the elderly? Results from the Italian Longitudinal Study on Aging.
Higher total serum cholesterol levels are associated with less severe strokes and lower all-cause mortality: ten-year follow-up of ischemic strokes in the Copenhagen Stroke Study.
Serum total cholesterol levels and all-cause mortality in a home-dwelling elderly population: a six-year follow-up.
Lipid-lowering treatment to the end? A review of observational studies and RCTs on cholesterol and mortality in 80+-year olds.

Paul Jaminet has done a series on ketogenic diets.
Ketogenic Diets, I: Ways to Make a Diet Ketogenic
Ketogenic Diets 2: Preventing Muscle and Bone Loss on Ketogenic Diets

Also: See Branched chain amino acids as adjunctive therapy to ketogenic diet in epilepsy: pilot study and hypothesis.

Tuesday, 22 February 2011

Both Sides Now: Medications

People are distrustful of pharmaceutical drugs. Drug Companies = Big Pharma and all that. However, medications have their plus side and their minus side. It all depends.

Some medications give the body something that it needs that it's not sufficiently producing e.g. Insulin (Type 1 diabetes), Adrenaline/Epinephrine (Anaphylactic shock), Corticosteroids (Addison's Disease), Thyroxine (Hypothyroidism), HCG, HGH, trans-dermal Testosterone/Progesterone (Hypopituitarism), Oestrogen (HRT). Bio-identical hormones are fine. Synthetic hormones, not so fine. See The fatal flaw of prescription drugs.

Some medications act as dietary supplements e.g. Adcal-D3 (Calcium & Vitamin D3), Lovaza (EPA & DHA), Effercitrate (Potassium & Citrate). These are also fine.

It's the medications that tweak metabolic pathways that can cause problems.

There are enzyme inhibitors e.g. Statins, Mono-Amine Oxidase Inhibitors (MAOIs), Angiotensin Converting Enzyme Inhibitors (ACEIs) etc. The problem with these is that inhibiting the conversion of "A" into "B" results not only in less "B, C, D etc" but also in more "A". Statins not only reduce serum cholesterol but also reduce the level of Co-enzyme Q 10 and other useful substances. MAOIs (e.g. Moclobemide & St John's Wort) cause high blood pressure if foods & drugs high in amines are consumed. ACEIs (e.g. Ramipril) cause an increase in serum bradykinin which can irritate lungs causing a persistent dry tickly cough. I've had this happen.

There are receptor agonists & receptor antagonists (blockers). Agonists occupy receptors and produce a larger effect than the substance naturally found in the body. Antagonists occupy receptors and produce a smaller effect than the substance naturally found in the body.

Alpha blockers (e.g. Tamsulosin hydrochloride) block alpha adrenoreceptors and are used to treat urinary retention, as they relax smooth muscle in the urethra. Unfortunately, they also cause postural hypotension, as when you stand up, arteries don't contract as much as they should to raise the blood pressure in the brain. I've had this happen. They also reduce iris contraction, leading to being dazzled by oncoming headlights while driving.

Beta blockers (e.g. Atenolol & Propranolol) block beta adrenoreceptors and are used to treat high blood pressure and/or anxiety as they slow down the heart and also block the effects of adrenaline/epinephrine on the brain. Dutch courage in a pill! Unfortunately, the heart is supposed to speed up when you exercise and failure to do so makes exercise very difficult if not impossible. Tolerance can also develop, resulting in zero long-term efficacy. I've had this happen. They also affect other parts of the body.

Angiotensin 2 receptor blockers (e.g. Candesartan Cilexetil) are used to treat high blood pressure as they relax artery walls. These work fine without any obvious side-effects, but there's a study showing a slightly increased (~6%) risk factor for cancer. In some people, Renal Artery Stenosis (narrowing) can occur, but a blood test detects this.

Diuretics (e.g. Bendroflumethiazide) increase urinary output and are used to treat high blood pressure & water retention. Unfortunately, increasing urinary output can cause dehydration & increased thirst, resulting in increased fluid intake i.e. zero net effect. I've had this happen. There are other undesirable side-effects.

Thiazoladinediones (e.g. Rosiglitazone) create new (& empty) fat cells, which allow for the increased disposal of excess serum glucose. Unfortunately, the cells that turn into new fat cells were supposed to have turned into bone cells, so the risk factor for osteoporosis increases.

High-dose Niacin & Fish Oils reduce serum triglycerides by inhibiting the conversion of excess serum glucose into fatty acids (which are esterified into triglycerides). This can increase serum glucose (which is bad).

It's like trying to get a balloon into a box that's too small. You can get most of it in, but another bit bulges out when you try to get the last bit in. Instead of tweaking your metabolism to compensate for your bad diet and/or lifestyle, you should correct your bad diet and/or lifestyle.

Monday, 21 February 2011

The usual suspects.

On Facebook, on message boards and in conversation, I often see and hear:-

1. I'm down in the Winter/I keep getting infections/I have allergies/I have aches & pains.

2. I'm up & down a lot.

3. I'm down/I'm anxious/I can't sleep/I get restless legs/cramps/menstrual cramps/muscle spasms/lung spasms/migraines.

4. I've got inflamed or painful joints/skin/guts/lungs/w.h.y.

1. Vitamin D insufficiency/deficiency is widespread by the end of Winter (~90% of people have serum 25(OH)D less than 75nmol/L or 30ng/mL) due to insufficient sun exposure (or sun exposure through glass) during the Summer. A safe & effective dose is 50iu of Vitamin D3 per kg weight per day. See Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients & Vitamin D.

2. Modern diets are lacking in long-chain omega-3 fatty acids (EPA & DHA), as many people don't eat any/enough oily fish. Tinned tuna is not a good source of omega-3 fatty acids. See Omega-3 fatty acids and major depression: A primer for the mental health professional. Women of reproductive age can take flaxseed oil, if they don't like oily fish, or take about ten 1,000mg fish oil capsules each day. Women not of reproductive age & men need to supplement with vegan DHA in addition to flaxseed oil, if they don't like oily fish or fish oil capsules.

3. Diets low in greens are low in magnesium. Excessive stress and/or alcohol consumption increases loss of magnesium in urine. Magnesium deficiency can cause all of the above symptoms. Epsom Salts are a very cheap source of Magnesium. 1 level teaspoonful/day (~4g/day) of Epsom Salts (spread the dose out over 24 hours to prevent it from having a laxative effect by dissolving the crystals in 250ml of warm water, then adding the solution to drinks to spread the 250ml out over 24 hours) provides ~400mg/day of Magnesium. See Magnesium and the Brain: The Original Chill Pill and  Magnesium in Man: Implications for Health and Disease.

4. Vitamin D and omega-3 fatty acids are anti-inflammatory. Inflammation that's worsened by stress and/or anxiety may be alleviated by magnesium.

Difficult-to-treat health problems such as depression are often multifactorial (with physiological AND psychological causes), so it's advisable to try 1. 2. and 3. (with your GP's consent). If you get improvement, you can discontinue supplements one at a time with a washout period of two months for 1. and 2. to see which supplement(s) was/were effective.

Here's a picture to go with the title.

And finally...
I'm so glad that I don't work with David Thorne.

Wednesday, 16 February 2011

A-ha! Another mystery solved.

With a title like that, there can be only one...

If you recall, in Keep 'em tight, I persuaded mum's GP to make recommendations to mum's care home re: Diet & Exercise. If you also recall, in Well, stone the (expletive deleted) crows!, agency carers were unaware of mum's GP's recommendations. Today, I had this for lunch:-

It's the same picture as in a post below, but it looked and tasted so good that I felt the need to post it again. After lunch, I asked the nurse in charge for mum's care plan.

There was no mention of mum's GP's recommendations in the care plan. I am awaiting a phone call from mum's GP tomorrow to find out what the **** is going on.

Update tomorrow.

EDIT: It's now Thursday 17th February. I received the call from mum's GP. He told the nurse who was in charge that day (Tuesday 1st Feb) to get specific information regarding exercise & diet from me. He doesn't know the name of the nurse who was in charge that day. I will be making enquiries. The book will be getting more entries, with fluorescent pink blobs to highlight them.

Some of mum's blood test results have come in. Her B12 is fine. Her calcium is on the high side, so she can stop taking two Adcal-D3 per day (which she hates as they're like chewing on sweetened chalk). Vitamin D result not in, yet. Two Adcal-D3 per day gave her only 800iu/day.

EDIT: It's now Friday 18th February. I saw a different nurse in charge today and asked her what was going on. She showed me mum's care folder and it contained the letter that I had written to mum's GP. On Wednesday, I was shown pages from the care folder but not the letter. A-ha! The nurse asked me to clarify mum's diet, so I got my green, orange & pink marker pens out and wrote a rough guide as to what mum could eat in unlimited amounts, in moderation and in very limited amounts. I photographed the guide and will be producing a tidy version on Word.

A carer said to me today "Whatever you're doing, keep doing it! Yesterday, your mum used her 3 wheeled walker unaided and found her own way to the dining room". Oh, wow!

Just wait until her Vitamin D status is improved. The last time I did that (in 2008), mum's MMSE score shot up from 14/30 to 26/30. Aricept also helped, but it usually gives only a 2 point increase.

Tuesday, 15 February 2011

Is there anybody out there?

'Cos there ain't mushroom in here (ouch!). Cue music video.

I've spotted a variety of fungi growing in my area. Here are some pictures. I think that I know which ones are poisonous, but I'm hoping that someone knowledgable will tell me for certain.

No.1 Found growing on a dead tree stump in my garden. I think non-poisonous.

No.2 Found growing at the base of a live tree in the woods. I think non-poisonous.

No.3 Found growing amongst dead leaves in the woods. I think poisonous.

In other news, mum got a mystery Valentine card on Monday. She managed to get it out of the envelope (despite having a bad tremor) after I got it started for her, and she also managed to read the words on the front of the card and inside. I videoed each event. The book got four green blobs (I use pink & green highlighters to highlight bad & good news) that day!

Sunday, 13 February 2011

Weekend link lurve.

Today, I built a bird table. Ta-da!

My sister bought this in kit form about a year ago, but couldn't find anyone to assemble it for her. I live about 40 miles away and, having been a bit occupied with mum's illness & (lack of) care, didn't get around to visiting her until today. I also fault-found her Hitachi TV (which uses a cathode ray tube) and inadvertently fixed her digi-box by accidentally rebooting it!

Before I drove there, I noticed that the YouTube videos in my blog weren't playing. I don't know what went wrong, but I've had to change the embed code on all of them from the new "iframe src=" style to the older "embed src=" style and they appear to be working again.

Friday, 11 February 2011

Well, stone the (expletive deleted) crows!

Mum got a letter from the DWP today requesting her new address. I gave it to her to read.

Two fuels for the brain are definitely better than one. When I returned to the home after lunch, I found that an agency carer had given mum chocolate pudding for dessert, as she hadn't been informed about mum's low-carb diet. Mum was semi-conscious. It's now written in the book.

I found Brian/Brianna on my driveway this morning, so I moved him/her to a safer place.

The wet weather is bringing out the amphibians. I nearly trod on a frog during my walk last night. I ran home to get my camera (my phone doesn't have a flash) but when I returned, he/she had hopped it.

Thursday, 10 February 2011

Credit where credit's due.

I've had a busy day today. In the morning I got a man in to fix a broken underground sewer pipe. It was broken when I moved into the house in 1991, but I was quoted £600 to dig up the path and replace the pipe back then. I couldn't afford that, so I rodded the pipe every few years to clear any blockages.

In the spirit of New beginnings, I decided to "get it sorted". So I got a man who knows about these things in. It cost under £100 to do the job, as the whole pipe didn't need to be replaced. That's Karl Gratton, Aldershot, Hants. 07851 894256. Here's an "after" photo after chucking a couple of buckets of water down to clear the cobwebs. I didn't take a "before" photo, but there was a hole in the bottom of the inspection chamber (now cemented) as well as the broken pipe.

After Karl left, I walked to my local Waitrose. By pavement, it's a 20 minute walk, so I took a short-cut through the woods. It was pouring with rain, the path was very muddy and full of puddles. I felt a strange sensation....

My soles had cracked. Oh, wow! What an amazingly heavy bummer!

When I got to Waitrose, I was dismayed to see that they had sold out of Burgen Soya & Linseed bread, as I had a 50p coupon that expired that day. Two assistants (Sally & Barbara) told me that I could get 50p off on a future visit if I showed them the coupon. I bought some nosh as a treat for the soggy walk home. While I was waiting at the checkout, Sally (or maybe Barbara) approached me, holding a loaf of Burgen. Now that's what I call customer service! That's Waitrose, Tresham Crescent, Yateley, Hants, GU46 6FR - 01252 861888.

EDIT: When I'm in Henley, I have lunch at Jay's Kitchen. I phone/text my order in advance and get a freshly-cooked Full English (2 bacon, 2 sausage, 2 egg, baked beans, fried onions, mushrooms & tomatoes) for £3. There's a table & 2 chairs on the pavement. That's Jay's Kitchen, Newtown Rd, Henley-on-Thames, Oxfordshire.

EDIT: Today (16th February), I got this:-

EDIT: Just around the corner, also on Newtown Rd is a car wash done by hand. A basic wash is £6 and a full inside & outside clean is £12. I was given a free bottle of water to drink.

Tuesday, 8 February 2011

Food, glorious food!

This post (inspired by Galina L) will be a trip down food-chain lane, starting at the bottom and working upwards. Humans are at the top (but not always).

1) Bacteria: The Vitamin B12 produced by certain bacteria is the only usable form that vegans will consume, so vegans should either not wash root veggies before cooking, or they should supplement with bacterial-sourced B12.

2) Algae: The EPA & DHA in algae are the only forms that vegans will consume, but beware. EPA has five C=C double-bonds and DHA has six, which makes them very unstable. EPA & DHA that are not inside a plant/animal should be kept cold and away from light.

3) Fungi & Yeasts: I don't have much to say about these other than they are a good source of B Vitamins other than B12. Mushrooms are tasty. Ditto yeast extract (though you either love it or you hate it). Quorn is made from a fungus.

4) Plants: The hotter the climate, the higher the saturated fat content of a fruit/nut/seed. Coconuts have the highest saturated fat content (~91%). The hotter the climate, the lower the pufa content of a fruit/nut/seed. Coconuts have the lowest pufa content (~2%). See the Comparison of dietary fats chart below.

Olives grow in many countries, some hotter than others. The Solesta EVOO that I buy from Aldi has a pufa content of 6.6%. However, some olive oils can have a pufa content as high as 20%.

5) Krill: The EPA & DHA in Krill oil can be consumed as a dietary supplement. The warning that applies to algal EPA & DHA also applies to Krill oil. Krill oil is a good source of Astaxanthin.

6) Fish: Fish that live in warm waters are low in oil (the oil in their livers is rich in Vitamins A & D). Fish that live in cold waters need antifreeze. EPA & DHA have very low freezing points (-54°C & -44°C respectively). The EPA & DHA in Fish oil can be consumed as a dietary supplement. The warning that applies to algal EPA & DHA also applies to Fish oil. See When it comes to fish oil, more is not better. Large fish (e.g. sharks) can eat us.

7) Amphibians: Frog's legs are a delicacy in some countries. What amphibians do you like to eat?

8) Reptiles: Turtle soup, anyone? Large reptiles (e.g. crocodiles) can eat us.

9) Marine mammals: As these are warm-blooded, they have a lower pufa content than fish. However, blubber is cold on the outside, so it's high in EPA & DHA. Large marine mammals (e.g. Killer whales) can eat us.

10) Mammals: As these are warm-blooded, they have a lower pufa content than fish. The pufa content depends a lot on what the mammal eats. Ruminants can eat a wide variety of diets and still maintain a reasonable omega-6:omega-3 ratio in their body-fat. Large mammals (big cats, big dogs and big bears) can eat us.

11) Humans: Many years ago, we ate anything edible that was around, lived outdoors and moved ourselves around using our muscles. We've done well, without modern medicine to save us from infections & injuries (and maybe difficult childbirths).

Nowadays, we eat what's in the shops, live & work indoors and have labour-saving gadgets to do our physical work for us. We're having problems, despite modern medicine.

Monday, 7 February 2011

False dichotomies: Good or Bad?

The false dichotomy a.k.a. false dilemma is an example of black and white thinking i.e. everything is either "good" or "bad" with no shades of grey in-between.

On a popular body-building forum that I post on, I often see posts titled "Is *insert name of food here* good or bad?" I would like to grab the poster by the collar and give him/her a good shake, except that they are almost certainly bigger & stronger than I am and would "Smash me in" (an in-joke on that forum).

I've noticed the same effect elsewhere on the internet where certain things are deemed to be good (e.g. meat from grass-fed animals) or bad (e.g. omega-6 pufas). With man-made trans-fats, there's little doubt. They're bad!

Consider the following curve.

Just about everything food-related follows a J-curve, with amount on the horizontal axis and harm on the vertical axis.

Too little results in starvation/deficiency and too much results in obesity/toxicity. Even dietary carbohydrate can follow a J-curve. See Dangers of Zero-Carb Diets, I: Can There Be a Carbohydrate Deficiency? and Dangers of Zero-Carb Diets, II: Mucus Deficiency and Gastrointestinal Cancers.

The other problem with "good" & "bad" is down to human nature. People think that if "healthy fats" are good, then eating 10 times as much "healthy fats" is better. They also think that if too much sun exposure is bad, then zero sun exposure is better.

Like Goldilocks' porridge, there is a "just right" for everything. See Hormesis.

Sunday, 6 February 2011

Comments Enabled.

Any resemblance to a post by another blogger is completely intentional.

My blog is like Wikipedia. Posts contain hyperlinks, in bold blue text.

I post music videos, as they add variety to what is otherwise a rather dry subject.

I post pictures, as they make my blog stand out.

A blog is not a book. Once a book is published, it becomes outdated as soon as new information appears. A blog is easily edited. Therefore, when I learn something new that makes the information in a blog post outdated, I edit the post to bring the information up-to-date.

I pepper my posts with references, hyperlinked for your convenience. I'm retired, so I have more free time on my hands than someone who is working full-time. However, I don't spend hours typing my posts, as I hate writing. I have other things to do!

I will never write a book. The e-book that I wrote in 2005 was a brain-dump and it's now completely outdated.

I don't mind writing blog posts. I also don't mind spending a little extra time compiling references and creating links. I will stop blogging when I'm either depressed, incapable, dead or have run out of ideas (whichever happens first).

Comments will always be enabled. New commenters will always have their first comment moderated, as retrospective white-listing requires psychic powers! If I think that you can be trusted, I will whitelist you, so your future comments appear immediately.

I will blacklist new commenters for trying to post comments containing:-
Insults, swearing, links to sales pages, long rambles & pointless arguments.

F.A.O. Whitelisted commenters:-
If you break any of the above rules, you will be de-whitelisted until I can trust you again.

I learn a lot from your comments, so keep 'em coming!

Finally, any emails sent to me that contain opinionated and/or poorly-researched rants may be published here (and will get you added to the blocked email senders list). I prefer to keep things public. I didn't expect the Spanish Inquisition!

Saturday, 5 February 2011

It's all in a day's work (as measured in Joules)

Firstly, a relevant video by Flanders and Swann.

The title of this blog post is from the "Physics Man" sketch on The Now Show. Work (also heat) is another word for energy and there are two different units for it.

The calorie (cal) is the amount of energy required to heat 1g of water by 1°C. This is a tiny amount of energy. The dietary Calorie (Cal) = 1,000cal = 1kcal.

The Joule (J) is the SI unit of energy. 1J = 1kg*m^2/s^2.
1Joule/sec = 1Watt (W).

1kcal = 4.186kJ.

At rest, an average human body uses ~1kcal/min = ~4,186J/min = ~69.8J/sec = ~69.8W.

The brain uses ~5g of glucose/hour = 18.75kcal/hour (1g of carb = 3.75kcals, usually rounded-up to 4) = 78487.5J/hour = ~21.8W.

The heart uses ~10W. The liver, kidneys, gut and lungs run continuously so they use energy all of the time.

Skeletal muscle uses a variable amount of energy using a variable proportion of fuels, depending on what you're doing with it. A chap called Steve sent me a spreadsheet of results in 2004 when he underwent a metabolic test on a stationary bike while breathing through a respiratory gas analyser, which calculated kcals oxidised and fuel utilisation by measuring Respiratory Exchange Ratio (RER).

At 1kcal/min (resting), he oxidised ~95% from fat (~0.11g/min), ~5% from carb (~0.01g/min).
At 2kcal/min (12% max), he oxidised 100% from fat (0.22g/min), 0% from carb (0.00g/min).
At 3kcal/min (18% max), he oxidised 100% from fat (0.33g/min), 0% from carb (0.00g/min).
At 4kcal/min (24% max), he oxidised 99% from fat (0.44g/min), 1% from carb (0.01g/min).
At 5kcal/min (29% max), he oxidised 48% from fat (0.27g/min), 52% from carb (0.69g/min).
At 6kcal/min (35% max), he oxidised 62% from fat (0.41g/min), 38% from carb (0.61g/min).
At 7kcal/min (41% max), he oxidised 58% from fat (0.45g/min), 42% from carb (0.78g/min).
At 8kcal/min (47% max), he oxidised 46% from fat (0.41g/min), 54% from carb (1.15g/min).
At 9kcal/min (53% max), he oxidised 42% from fat (0.53g/min), 58% from carb (1.39g/min).
At 10kcal/min (59% max), he oxidised 44% from fat (0.49g/min), 56% from carb (1.49g/min).
At 11kcal/min (65% max), he oxidised 38% from fat (0.46g/min), 62% from carb (1.82g/min).
At 12kcal/min (71% max), he oxidised 41% from fat (0.55g/min), 59% from carb (1.89g/min).
At 13kcal/min (76% max), he oxidised 37% from fat (0.53g/min), 63% from carb (2.18g/min).
At 14kcal/min (82% max), he oxidised 30% from fat (0.47g/min), 70% from carb (2.61g/min).
At 15kcal/min (88% max), he oxidised 14% from fat (0.23g/min), 86% from carb (3.44g/min).
At 16kcal/min (94% max), he oxidised 0% from fat (0.00g/min), 100% from carb (4.27g/min).
At 17kcal/min (100% max), he oxidised 0% from fat (0.00g/min), 100% from carb (4.53g/min).

There are some interesting points about Steve's data:

1. Over a wide range of exercise intensities, the number of grams of fat Steve oxidised/min was fairly constant.

2. Up to 24% of maximum exercise intensity, Steve derived almost 100% of his energy from the oxidation of fat. Steve was on a LC diet, which shifts fuel usage away from carb and towards fat. This is known as "fat-adaptation".

3. Despite fat-adaptation, above about 45% of maximum exercise intensity, Steve derived more energy from the oxidation of carb than the oxidation of fat.

4. Despite fat-adaptation, above about 80% of maximum exercise intensity, Steve derived almost all of his energy from the oxidation of carb rather than the oxidation of fat.

Note that 17kcals/min = 1186.6W, or 1.19kW! Steve was aerobically fit. A less aerobically fit person derives a higher % of energy from the oxidation of carb than an aerobically fit person. This level of exercise intensity can be maintained for a few seconds only, as carb is oxidised both aerobically and anaerobically, which exhausts PhosphoCreatine stores in muscles and also causes an accumulation of lactate in muscles.

Muscle mass is very metabolically-active compared to fat mass, as one pound of fat mass oxidises only about 2kcal a day. See also Dissecting the Energy Needs of the Body – Research Review

See also It's all in a day's work (as measured in Joules) Part 2.

Here's another Physics Man.

Thursday, 3 February 2011

Move More: Solutions to problems.

Continued from Eat Less, Move More: Solutions to problems.

Firstly, here's "On the rebound" by Floyd Cramer. This was a hit in 1961 and it was recently used in a Sainsbury's "Taste the Difference" advert on TV.

Move More: Problems and their solutions:

1) Exercise makes me eat too much afterwards. Wrap up warm before you go outdoors, as feeling cold stimulates appetite.

2) Exercise is boring. Take a camera with you when you go for a walk. Look around. There's lots of interesting stuff out there that you don't normally notice*. Vary your route so that you see new things each time. Zumba is fun!

3) It's too cold/wet/windy etc. Dress appropriately. Have a small treat when you get back, so that you have something to look forward to.

4) I hate doing "x". Don't do "x", then. Things that I will not do are swimming & team sports (really bad memories from school-days). I also won't do anything faster than a power walk (being 72" tall with 31" legs makes any exercise involving my feet hitting the ground uncomfortable and hard on my joints).

5) I don't have the time. Neither do I. I'm now on-line less than I used to be. I'm sure I'll survive!

*I spotted a large photovoltaic solar panel on the roof of a house the other day. I knocked on the door and asked the occupants about it. Apparently, you get about 1kW from 10 square metres of panel and the Electricity supplier pays you about 43p for every kWh you generate. A 35 square metre system costs about £20,000.

When I realised that I had to get some exercise, it was a blow. Any news that is bad & inevitable takes some getting used to. See Kübler-Ross model. I have now accepted it.

Here's a school photo from when I was about 10.

Can you guess which one's me?

Any more problems & solutions that I haven't thought of?

Wednesday, 2 February 2011

Insulin Resistance: Solutions to problems.

Before I start on what may be the most important thing that I've ever written, here's Don't Stop Movin' by S Club 7. It's a clue to what's coming.

The problem:

Insulin Resistance (IR) is a major problem for a significant percentage of the population in the developed world. If left untreated, it can deteriorate into Type 2 Diabetes (T2D). See Type 2 diabetes in the UK.

IR & T2D can cause:-

High fasting & postprandial serum glucose, which increases the risk factor for Coronary Heart Disease, Retinopathy, Neuropathy & Nephropathy (Kidney failure), amongst other things. 
High fasting & postprandial serum triglycerides, which increases the risk factor for Coronary Heart Disease. See Lifestyle Intervention Leading to Moderate Weight Loss Normalizes Postprandial Triacylglycerolemia Despite Persisting Obesity.
High serum cholesterol, which increases the risk factor for Coronary Heart Disease.
High serum Free Fatty Acids (a.k.a. FFAs a.k.a. NEFAs) from IR fat cells, which increases the risk factor for Sudden cardiac death and also worsens IR in liver & muscle cells. 
High serum uric acid, which increases the risk factor for Gout & Uric acid Kidney stones.
Hypertension, which raises the risk factor for Coronary Heart Disease, Strokes & Kidney failure.
Excessive appetite after eating high-GL carbohydrates, leading to overeating & obesity.
Lethargy/sleepiness after eating almost anything, but especially after eating high-GL carbohydrates, due to postprandial hyperinsulinaemia.

Possible causes (IR is multi-factorial) and solutions:

1. "Bad" genes. My genes aren't particularly good, but it is possible to change the expression of genes. See below.

2. Full cells. A full cell is an IR cell. Consider Liver, Muscle and Fat cells:-

a) Liver cells: Liver cells are a 2-way street. "Stuff" (e.g. FFAs, Glucose & Fructose) goes in and "stuff" (e.g. Ketones & Glucose) comes out. Glucose normally comes out of the liver at a rate of ~5g/hour to fuel the brain, but this can increase a lot under the control of Insulin, Glucagon & Cortisol. If more stuff goes in than comes out, liver glycogen stores fill up and vice-versa. When liver glycogen stores become full, liver cells down-regulate processes that produce liver glycogen e.g. hexokinase & Glu-T2 transporters. Liver cells effectively become IR, to stop more stuff from going in.

However, fructose is transported by Glu-T5 transporters which are insulin-independent & taken up by fructokinase which has a high affinity for fructose, so fructose effectively "barges its way in" to the liver. This is why fructose is a problem for people who have permanently full liver glycogen stores.

The Protein-Sparing Modified Fast (PSMF) depletes liver glycogen and liver & pancreatic fat rapidly. See also Reversing type 2 diabetes, the lecture explaining T2D progression, and how to treat it.

b) Muscle cells: Muscle cells are a 1-way street as far as Glucose is concerned, though Amino Acids can go in & come out. Muscle glycogen cannot be used to produce blood glucose - it can only be used by muscles. When muscle glycogen stores become full, muscle cells down-regulate processes that produce muscle glycogen e.g. hexokinase & Glu-T4 transporters. Muscle cells effectively become IR to stop more stuff from going in.

As per It's all in a day's work (as measured in Joules), muscle cells use mostly fat at rest & lowish-intensity exercise. Glycogen usage increases rapidly as exercise intensity increases. Now do you see the significance of the music video above? Intense exercise (e.g. Running, Sprinting, Resistance training with weights, parts of High-Intensity Interval Training a.k.a. HIIT, parts of Tabata & parts of Zumba) depletes your muscle cells and makes them Insulin Sensitive.

This means that activity is compulsory. See Physiological and health implications of a sedentary lifestyle.

See also Increased Glucose Transport–Phosphorylation and Muscle Glycogen Synthesis after Exercise Training in Insulin-Resistant Subjects
Improvement in Glucose Tolerance After 1 Wk of Exercise in Patients With Mild NIDDM (hat-tip to Go Kaleo) and
Move More: Solutions to problems. Excessive sedentariness was a secondary contributor to my IR.

However, don't overdo it! You may have a funny turn, keel over & hurt yourself. See "Funny turns": What they aren't and what they might be.

c) Fat cells: Fat cells are a 2-way street. Fat cells are a bit like balloons that are full of holes. As stuff (e.g. FFAs & glucose) goes in, the balloon expands to accommodate it. As more stuff goes in and the balloon gets bigger, the internal pressure increases and the holes get bigger, so stuff (e.g. FFAs & glycerol) comes out at a faster rate. At some level of fullness, stuff comes out as fast as it goes in. At that point, fat cells are effectively IR. So, don't overstuff your fat cells by getting too fat. If you are already too fat, medium intensity exercise (e.g. Walking, Power Walking, Jogging, "Aerobics", parts of High-Intensity Interval Training a.k.a. HIIT, parts of Tabata & parts of Zumba) depletes your fat cells and makes them Insulin Sensitive.

Dress appropriately so that you don't feel cold. Feeling cold is what stimulates your appetite, not exercise. See Influence of resistance and aerobic exercise on hunger, circulating levels of acylated ghrelin, and peptide YY in healthy males.

3. Empty (of glycogen) cells.
If carbohydrate intake is too low (say, less than 50g/day), physiological Insulin Resistance develops in order to spare glucose for the brain (as parts of the brain run on glucose only) and red blood cells. This is reversible on increasing carbohydrate intake. People who are on ketogenic diets are advised to increase their carbohydrate intake for a few days prior to taking an Oral Glucose Tolerance Test. See HIGH CARBOHYDRATE DIETS AND INSULIN EFFICIENCY.

4. Deficiency in Vitamin D3.
See Hypovitaminosis D is associated with insulin resistance and ß cell dysfunction.
The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults.
The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.
A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men.
Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals.
Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial.

In January 2003, I had Impaired Glucose Tolerance/Metabolic Syndrome/Prediabetes (fasting serum glucose = 5.8mmol/L & 2 hours post-75g glucose load serum glucose = 8.7mmol/L). A sandwich used to send me to sleep.

By September 2008, I had Normal Glucose Tolerance (fasting serum glucose = 5.0mmol/L & 2 hours post-75g glucose load serum glucose = 3.7mmol/L). I also no longer suffered from carbohydrate-induced comas. I was also about the same weight that I was in 2003, so the improvement wasn't due to weight loss. Hypovitaminosis D was the primary contributor to my IR.

So, either use a UVB sun-lamp as per instructions to receive a sub-erythemal dose (not quite going pink) or get tested by your GP and supplement with Vitamin D3 accordingly. I take 5,000iu of Vitamin D3/day.

5. Deficiency in Magnesium.
See Magnesium and type 2 diabetes. For the top 999 foods highest in Magnesium per 200kcal serving, see HERE. I've been taking ~4g of Epsom Salts/day (~400mg Mg/day, dissolved in 2 litres of fluids that I drink each day, to avoid laxative effects) since 2003 as it reversed osteoporosis in my lumbar spine.

6. Deficiency in Vitamin K2.
See Vitamin K2 Supplementation Improves Insulin Sensitivity via Osteocalcin Metabolism: A Placebo-Controlled Trial and Vitamin K₂ prevents hyperglycemia and cancellous osteopenia in rats with streptozotocin-induced type 1 diabetes.
Good sources of Vitamin K2 can be found HERE. I was taking 15mg/day of MK-4 since 2003, as it reversed osteoporosis in my lumbar spine. I'm now 15mg of MK-4 three times a week as a maintenance dose.
Note: Warfarin/Coumadin works by depleting Vitamin K, so lots of Vitamin K2 makes Warfarin/Coumadin ineffective.

7. Deficiency in Manganese.
See Manganese supplementation protects against diet-induced diabetes in wild type mice by enhancing insulin secretion. For the top 999 foods highest in Manganese per 100g serving, see HERE.

8. Deficiency in, or excess of Copper w.r.t. Zinc. See Dietary copper supplementation restores β-cell function of Cohen diabetic rats: a link between mitochondrial function and glucose stimulated insulin secretion. For the top 468 foods highest in Copper per 100g serving, see HERE.

9. Deficiency in, or excess of Zinc w.r.t. Copper. See Zinc, pancreatic islet cell function and diabetes: new insights into an old story. For the top 999 foods highest in Zinc per 100g serving, see HERE.

10. Excessive intake of man-made trans-fats.
Base your diet on minimally refined produce rather than over-refined &/or moreish food products.

11. Excessive intake of chemicals.
Don't swallow toothpaste (fluoride) or disclosing tablets (as they may contain iodine). Don't hold till receipts between your lips (may be coated in BPA).

12. More than one of the above. See A tale of the unexpected & an analogy.

Any other ideas?

Finally, the obligatory picture. Hannah Spearritt is rather nice. :-p

I nearly forgot! Today, when I arrived at mum's nursing home, I found her reading a book. She hasn't done that for over a year. She even knew that it was Wednesday. Ketogenic diet for the win. Mum now has a dual-fuel brain. EDIT: Mum passed away in April 2013, so although it's possible to slow the progression of Lewy Body Dementia and reduce the symptoms of it, it wasn't possible to cure it.

Tuesday, 1 February 2011

Keep 'em tight.

Wheel nuts? Nope!
Image from
I'm referring to Tight Junctions. As mentioned at the end of Wheat? Oh, dear! , 10% of people who are healthy enough to donate blood have gut walls permeable enough to let gliadin fragments pass into the blood.

Tight junctions are important, as they keep the contents of the gut inside the gut and out of the blood. If you read Food Combining: What's THAT all about?, you'll see that during digestion, proteins are broken down into individual amino acids & very short peptide chains*. Amino acids & very short peptide chains are small enough to pass through tight junctions. Peptide chains longer than about 3 amino acids are too big to pass through. See also Physiology and Immunology of Digestion.

Carbohydrates are broken down into monosaccharides, which are small enough to pass through. Disaccharides are too large.

Fats are broken down into glycerol and fatty acids. Glycerol is small enough to pass through. Fatty acids and other fatty molecules such as Vitamin D, Co-enzyme Q10, Vitamin K2, curcumin, berberine etc are transported across.

The consequences of having loose junctions are not good. Chains of amino acids that aren't supposed to pass through the gut wall enter the body and produce an antibody response, e.g. Beta-CasoMorphin 7 and/or Gliadorphin 7. That in itself isn't a problem, unless amino acid sequences in the chains match amino acid sequences in certain parts of the body.

Diseases of autoimmune origin such as Coeliac disease (gut), Eczema (skin), Dermatitis herpetiformis (skin), Psoriasis (skin & joints), Sjögren's syndrome (mucous membranes), Cerebellar ataxia (Purkinje cells in the brain), Multiple sclerosis (myelin sheaths of nerves), Type 1 Diabetes (pancreatic beta cells), Rheumatoid arthritis (joints), Asthma (lungs), Lupus erythematosus (various), Autoimmune thyroiditis (thyroid), LADA (pancreatic beta cells) etc are caused by antibody responses inappropriately attacking parts of the body. Autoimmune diseases can also occur after bacterial & viral infections.

The other day, I found Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism.

See also Stronger Intestinal Barrier May Prevent Cancer in the Rest of the Body, New Study Suggests.

So, how do we keep 'em tight? See Vitamin D.
See also Dietary Fat Can Modulate Intestinal Tight Junction Integrity.
See also Shedding Some Light on the Leaky Gut <> Exercise Connection. Plus: 20+ Things You Should or Shouldn't Do to Protect and Restore the Integrity of Your Intestinal Wall.
See also Sulphation and Autism: What are the links? A good source of sulphate is Epsom Salts.

In other news....
I had a phone call from mum's GP this morning. Having read my evidence, he's agreed to test mum's serum B12, 25(OH)D and Calcium and give her supplements accordingly. He's also happy with me giving mum a Ketogenic diet and will also advise the nursing home to exercise mum as often as she is able. Result!

I put four cubes of liver pâté out for Sooty & Sweep (I don't know which one is which as they're identical) and a Magpie swiped two of them. We also have seagulls. I put the other two cubes out of sight in a box.

So far, so good!

P.S. What fuel can be extracted from decomposing seagulls?
Wait for it...
Petrel! (From Petrol Direct, a joke site in case anyone's wondering).