Public Service Announcement: Calling all Low-carb, Low-fat and Veg*n advocates.

Cont'd from The cause of America's rising obesity rate is irrelevant. The cure for it is what's important.

While you're arguing about which arrangement of deckchairs on deck is best, the ship is sinking.

From https://twitter.com/MaxCRoser/status/936695363167313920

People are getting fatter and sicker in increasing numbers around the world, due to increasing numbers of people over-consuming over-refined, over-marketed & over-moreish Food Products. Getting people to change their diet back to one based on minimally-refined produce would be an improvement.

Why don't you agree to say the same thing, e.g.:-

Base your diet on whole, minimally-refined produce, rather than products. Tweak it to suit.

While you're wasting time shouting each other down, the Food Product Industry is laughing all the way to the bank.

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Dr. John Yudkin's "Diet and coronary thrombosis. Hypothesis and fact", The Lancet, 1957.

Twitter did it again. From http://www.abc.net.au/catalyst/heartofthematter/download/Yudkinssugartheory.pdf

This looks like bad news for the fat-lovers.

There's good correlation between Coronary mortality and total fat intake, for countries 15 to 7. For countries 7 to 1, there's no correlation between Coronary mortality and total fat intake, suggesting that other differences (e.g. quality of health-care, social stress, antioxidant status etc) are significant factors.

This looks like bad news for the meat/fowl/fish/cheese/egg-lovers.

This looks like bad news for the sugar-lovers.

Of course, association ≠ causation.

This looks like bad news for rich people.

In conclusion, total fat intake, animal protein intake, sugar intake & annual income are all associated with increased Coronary mortality, over a certain range of values.

Why do some people have trouble doing things in moderation?

This is related to my previous post.

From http://www.kindredcommunity.com/2013/01/xtreme-eating-awards-2013-extremism-running-amok-at-americas-restaurant-chains/

Some people take low-carbing to an extreme, 'cos if reducing carbohydrate intake has benefits, reducing it to zero must be better. Oy!


We're told that eating 5 portions of fruit and vegetables a day is good for us. One patient who was admitted to St George's with malnutrition, had been eating more than 50 portions of fruit and vegetables a day, 'cos if 5 portions of fruit and vegetables a day is good for us, 50 portions of fruit and vegetables a day must be better. Oy!


People who are taking the anti-clotting medication Warfarin need to maintain an accurate balance between their warfarin dose and their Vitamin K intake to keep their INR between 2 and 3, as warfarin antagonizes vitamin K₁ recycling, depleting active vitamin K₁.
"Between 2003 and 2004, the UK Committee on Safety of Medicines received several reports of increased INR and risk of haemorrhage in people taking warfarin and cranberry juice. Data establishing a causal relationship is still lacking, and a 2006 review found no cases of this interaction reported to the FDA; nevertheless, several authors have recommended that both doctors and patients be made aware of its possibility. The mechanism behind the interaction is still unclear." Here's a clue...

From Possible interaction between warfarin and cranberry juice (emphasis, mine):-
"After a chest infection (treated with cefalexin), a man in his 70s had a poor appetite for two weeks and ate next to nothing, taking only cranberry juice as well as his regular drugs (digoxin, phenytoin, and Warfarin). Six weeks after starting cranberry juice he had been admitted to hospital with an INR (international normalised ratio) > 50. Before, his control of INR had been stable. He died of a gastrointestinal and pericardial haemorrhage. He had not taken any over the counter preparations or herbal medicines, and he had been taking his drugs correctly." Cranberry juice contains no Vitamin K. Oy!

"The Committee on Safety of Medicines has received seven other reports through the yellow card reporting scheme about a possible interaction between warfarin and cranberry juice leading to changes in INR or bleeding. In four cases, the increase in INR or bleeding after patients had drunk cranberry juice was less dramatic. In two cases, INR was generally unstable, and in another case INR decreased. Limited information is available about whether patients complied with their treatment in these cases.

Cranberry juice (Vaccinium macrocarpon) is popular and is also used to prevent cystitis. Interaction with warfarin is biologically plausible, because cranberry juice contains antioxidants, including flavonoids, which are known to inhibit cytochrome P450 enzymes, and warfarin is predominantly metabolised by P450 CYP2C9. The constituents of different brands of cranberry juice may vary, and this might affect their potential for interacting with drugs. Whether the constituents of cranberry juice inhibit CYP2C9 and therefore the metabolism of warfarin or interact in another way needs further investigation. Until then, patients taking warfarin would be prudent to limit their intake of this drink." Oy!

So, one man's inadvertent (his doctor should have warned him about eating next to nothing while taking warfarin) dietary extremism resulted in his own death and the restricted intake of cranberry juice for everybody else taking warfarin. Oy. :-(


P.S. It's about time an alternative to warfarin was found. It's difficult to maintain an accurate balance between warfarin dose and Vitamin K intake.

Chow on chow, Parkinson's Law, two ways of doing something, and love.

Another mixed bag of subjects. First, here is Mr Carson C. Chow.

From A Mathematical Challenge to Obesity

According to Mr. Chow, Americans are getting increasingly fat because they're eating increasingly large amounts of "chow", because there's increasingly large amounts of it being produced. That's classic Parkinson's law (consumption expands to absorb the available supply).

According to Armi Legge, over-fat people need to . . . . Eat Less (& Move More).

There are two ways to "Eat Less".

1) Measure everything that goes into your mouth, calculate the calories in it and stick to an average daily calorie limit. Weigh yourself daily and adjust your intake to achieve a certain rate of rolling-averaged weight loss i.e. you consciously create a caloric deficit.

2) Tweak your diet until you find one that you can live with, that results in your belt and/or clothes getting looser i.e. you unconsciously create a caloric deficit. If you can't unconsciously create a caloric deficit, there will have to be some conscious restriction.

1) suits athletes & body-builders, as they are highly-motivated people who have a specific target in mind, whether it be athletic performance or a specific body-fat percentage/muscle mass/appearance.

2) suits the general public, as they aren't generally highly-motivated and won't tolerate hunger pangs.

Unfortunately, "Move More" has to be done consciously. Unconscious "Move More" i.e. Non-Exercise Activity Thermogenesis (NEAT) a.k.a. Spontaneous Physical Activity (SPA) is genetically-determined.

Finally, I read Stretching out. I've been spending too much time on a blog full of fallacies & hate and it's been making me tetchy. I've now disengaged from that blog permanently. Breathe in. Breathe out. That's better!

Continued on Completing the trine: vive la différence!

Diet, Nutrition & Fitness: Whatever the question, the right answer is "It all depends".

The carbohydrate pendulum keeps on swinging! Bloggers keep on fighting!

Carbohydrates are good. No, they're bad. Wait, they're good again. Nope, bad again. Good again. Aargh!

See also http://wholehealthsource.blogspot.co.uk/2012/09/more-thoughts-on-macronutrient-trends.html
 
So, are carbohydrates good or bad? See the title. Gluten? See the title.

As Everyone is Different, whether "X" is good, bad or indifferent all depends on genes (including gender), the expression of those genes, environment (i.e. birth weight, exposure to pollutants in the womb & after birth), general diet (i.e. nutrients, anutrients & anti-nutrients), lifestyle (i.e. sunlight exposure, stress, sleep etc) and type, level & volume of activity.

Rigid diets & taking loadsa supplements to compensate for them.

I do not believe you want to be doing that!

This post was inspired by a recently-published study by Alan Aragon & Brad Schoenfeld, as bodybuilders are a group of people who often eat a rigid diet (some eat skinless chicken breasts, broccoli & brown rice for several meals each day).

See Nutrient timing revisited: is there a post-exercise anabolic window?
"Collectively, these data indicate an increased potential for dietary flexibility while maintaining the pursuit of optimal timing."

This post is also aimed at people who eat severely restricted diets in the (often mistaken) belief that something's making them ill.

People with type 1 diabetes who struggle to keep their blood glucose within reasonable limits (3 to 8mmol/L, or 24 to 144mg/dL) benefit from restricting their intake of high-GL carbohydrates, so this post is not aimed at them. See The problem with Diabetes.

People with type 2 diabetes who severely restrict their intake of carbohydrates must be in caloric deficit, otherwise the physiological insulin resistance caused by high serum NEFAs will mess up just about everything in their body if they are in caloric balance or caloric excess. I've read (so it could be false) that a certain non-skinny blogger who I'm in conflict with (who has type 2 diabetes and who eats a VLC diet) has heart problems and is taking medication(s) for high blood pressure. Hmmm.

People who suffer from gastrointestinal problems after eating gluten-containing foods, or mucus after eating casein-containing foods may have impaired gut integrity. See Gluten - more than just a pain in the guts?

Supplements that I consider of positive value are:-

Fish oils: If the diet is low in oily fish (tinned tuna is not an oily fish), there may be insufficient EPA & DHA (especially in men, children & post-menopausal women). Women of reproductive age can get away with taking flaxseed oil.

Magnesium: If the diet is low in veg/high in dairy, there may be too much Calcium relative to Magnesium.

Vitamin D3: If the lifestyle results in sun-avoidance, insufficiency in Vitamin D is highly likely.

Vitamin K2: If the diet is low in animal fats and/or fermented foods, insufficiency in Vitamin K2 is highly likely.

Supplements that I consider of negative value are:-

Vitamin A: If there's an insufficiency in Vitamin D, supplementing with Vitamin A/β-carotene may exacerbate it. As Vitamin D + Calcium may reduce cancer risk, supplementing with Vitamin A absent Vitamin D3 may increase cancer risk.

Vitamin E: If there's an insufficiency in γ-tocopherol, supplementing with α-tocopherol may exacerbate it. As γ-tocopherol may reduce CHD mortality risk, supplementing with α-tocopherol absent γ-tocopherol may increase CHD mortality risk. Most Vitamin E supplements contain α-tocopherol only. Some Vitamin E supplements contain mixed tocopherols and these are O.K.

Politics, Religion and Diet.

Three subjects that people love to argue about, as they are about beliefs ;-)

Human population vs Year.

 

Politics:

In Palaeolithic times, there weren't many people living on this planet. People hunted and gathered their food, and had relatively non-hierarchical, egalitarian social structures. According to archaeologists, violence in hunter-gatherer societies was ubiquitous. Approximately 25% to 30% of adult male deaths in these societies were due to homicide, compared to an upper estimate of 3% of all deaths in the 20th century. The cause of this is near constant tribal warfare: "From the !Kung in the Kalahari to the Inuit in the Arctic and the aborigines in Australia, two-thirds of modern hunter-gatherers are in a state of almost constant tribal warfare, and nearly 90% go to war at least once a year." However, due to the extremely low population back then, extremely few people were killed in absolute terms. Then, around 10,000 BC, some bright spark/bulb invented agriculture...

Fast-forward a few thousand years to the time of Genghis Khan. He came to power by uniting many of the nomadic tribes of north-east Asia. The Mongol invasions resulted in wholesale massacres of civilian populations. His descendants went on to stretch the Mongol Empire across most of Eurasia by conquering or creating vassal states out of all of modern-day China, Korea, the Caucasus, Central Asian countries, and substantial portions of modern Eastern Europe, Russia and the Middle East. Many of these invasions repeated the earlier large-scale slaughters of local populations. However, due to the low population (around 300 million), few people were killed in absolute terms. Then, around 1,600 AD, some bright spark/bulb invented government...

As mentioned in How did we get to where we are today? Part 2., the invention of liberal government encouraged the exchange of ideas and entrepreneurship. Monarchies taxed people, but their bureaucracies stifled entrepreneurship, so the French and the Chinese invented loads of stuff that never saw the light of day. We Brits got lucky. As a result, the Industrial Revolution created wealth out of dirt, which led to rapid economic growth and rapid population growth. The Green Revolution led to more rapid population growth.

Fast-forward to the 21st Century. Warfare has killed millions of people. Rulers have killed hundreds of millions of people (the vast majority by totalitarian & authoritarian regimes), according to Anarchy Begins at Home: The Blog Series Part 6 – Democide. However, due to the extremely high population, only approximately 5.6% of the total population have been killed by rulers. That's what I call relative peace.

EDIT: I don't want a system where entire populations can be slaughtered by armies led by a charismatic leader. I also don't want a system where the poor & underprivileged are "free" to die in poverty. Some people scrounge off Social Security, but the amount of money scrounged by them pales into insignificance compared to the amount of money scrounged off the rest of us by the wealthiest people on this planet.

 

Religion:

I'm not religious. I have no problem with people believing in God, as long as they have no problem with me not believing in God. A thought experiment that you may find interesting is God's Debris, by Scott Adams.

 

Diet:

Read the rest of my blog, dammit!

In other news...
Mum is now in a coma, but her breathing is regular.

Failure to communicate, civil wars and dim bulbs.

Hat-tip to marie (who's a very bright bulb indeed!) for the following video.


Whaz so civil 'bout war anyway?

The reason why I'm writing this is because there's (un)civil war on the internets between various "camps".

At any given moment:-
There are people who function physically & mentally at their best on VLC/Keto diets.
There are people who function physically & mentally at their best on LC diets.
There are people who function physically & mentally at their best on MC diets.
There are people who function physically & mentally at their best on HC diets.
There are people who function physically & mentally at their best on VHC diets.
As people's circumstances change, they move to a different category.

If you don't understand what I wrote above, you are a dim bulb.
If you think that insults can offend me, you are a dim bulb.
If you think that agreeing 90% with someone makes me an ass/arse-kisser, you are a dim bulb.
If you think that I'll take insults from you without retaliation, you are a dim bulb.
Sadly, due to the Dunning–Kruger effect, dim bulbs are too dim to know that they are dim bulbs!
If you are offended by anything that I wrote above, I don't care.

In other news...
Mum's condition has deteriorated to the point where she is unresponsive and no longer has a swallow reflex. It's just a matter of time before she dies. I've been prepared for this for quite some time.

Musings on the Paleo Diet.

Would you ask the man below for advice on how to give up alcohol?

I recently read Patients less likely to trust and listen to overweight doctors, which mentioned Mark Sisson. Sisson and Robb Wolf are good representatives for the Paleo Diet. Some are bad representatives for the Paleo Diet due to poor physical condition or abrasive personality.

The Paleo Diet gets flak from scientists like Marlene Zuk and Christina Warinner and it was criticised in The Paleo Diet (hat-tip to Melissa McEwen).

The thing is that people don't need to eat a Palaeolithic diet to be 90% free from degenerative diseases. A mere 150 years ago, Mid-Victorian Brits who didn't die in childhood managed to live to a ripe old age, as cheap sugar imports, junk food, labour-saving devices and horseless carriages hadn't yet been invented.

Just Eat Real Food.

Everyone is Different, Part 3.

Cont'd from Everyone is Different, Part 2.

Hat-tip to Bill Lagakos, whose article Missing: 300 kilocalories reminded me of the following graphic from Effects of Dietary Composition During Weight Loss Maintenance: A Controlled Feeding Study.

Lo and behold, even when subjects are bribed to stick to the diets that they are provided with, the effect of eating those diets varies hugely.

So, people like ItsTheWoo and Petro Dobromylskyj (yes, I have to copy and paste the name from his site every freakin' time!) rave about how awful carbs are, while people like Go Kaleo and Matt Stone rave about how awesome carbs are.

Everyone is different for a number of reasons, some of which are unchangeable and some of which are changeable. We can't change our birth weight, what our mums ate when we were in the womb or the chemicals that we were exposed to in the past. We can't change our genes, but we can change the expression of our genes by changing diet, activity and even supplementation. See Influence of Vitamin D Status and Vitamin D₃ Supplementation on Genome Wide Expression of White Blood Cells: A Randomized Double-Blind Clinical Trial.

Continued on Bray et al shows that a calorie *is* a calorie (where weight is concerned)

How the Mid-Victorians Worked, Ate and Died.

Hat-tip to Prof. Tim Noakes, who recently tweeted the above study.

See How the Mid-Victorians Worked, Ate and Died.

"The crude average figures often used to depict the brevity of Victorian lives mislead because they include infant mortality, which was tragically high. If we strip out peri-natal mortality, however, and look at the life expectancy of those who survived the first five years, a very different picture emerges. Victorian contemporary sources reveal that life expectancy for adults in the mid-Victorian period was almost exactly what it is today.
.
.
From 1875 on and especially after 1885, rising imports of cheap food basics were increasingly affecting the food chain at home. Imported North American wheat and new milling techniques reduced the prices of white flour and bread. Tinned meat arrived from the Argentine, Australia and New Zealand, which was cheaper than either home-produced or refrigerated fresh meat also arriving from these sources. Canned fruit and condensed milk became widely available.

This expansion in the range of foods was advertised by most contemporaries, and by subsequent historians, as representing a significant ‘improvement’ in the working class diet. The reality was very different. These changes undoubtedly increased the variety and quantity of the working class diet, but its quality deteriorated markedly. The imported canned meats were fatty and usually ‘corned’ or salted. Cheaper sugar promoted a huge increase in sugar consumption in confectionery, now mass-produced for the first time, and in the new processed foods such as sugar-laden condensed milk, and canned fruits bathed in heavy syrup. The increased sugar consumption caused such damage to the nation’s teeth that by 1900 it was commonly noted that people could no longer chew tough foods and were unable to eat many vegetables, fruits and nuts [26]. For all these reasons the late-Victorian diet actually damaged the health of the nation, and the health of the working classes in particular.

The decline was astonishingly rapid..."

See also Who Lives Longest? (h/t to Melissa McEwen)

Oh no, not again!

Today's title is a quote from Douglas Adams' "The Hitchhiker's Guide to the Galaxy".



There seems to be a lot of hysteria & worry around the Internet.

Oh, noes! They took away her lunch-box (they didn't)! Her lunch-box! That's crap!

Oh, noes! They made her eat chicken nuggets (they didn't)! Chicken nuggets! That's crap!

Oh, noes! They made her eat a portion of grain! A portion of grain! That's crap!

Oh, noes! They wanted to give her a carton of skimmed milk! Skimmed milk! That's crap!

Oh, noes! They wanted to give her a carton of chocolate milk! Chocolate milk! That's crap!

Is there too much fat in this Guacamole?

Is there too much omega-6 in this pork?

Is there too much BPA in this bottled water?

And so on...

Firstly, chicken nuggets, grains, skimmed milk and chocolate milk are not crap. They're not perfect, but they're far better than chocolate/candy bars and fizzy drinks.

Schools act in loco parentis, so they are not going to feed the children crap. USDA guidelines are nowhere near perfect, but children who aren't humongously fat are metabolically-flexible. Therefore, whether they eat carbohydrates or fats, their bodies will burn them. If a child has been diagnosed with Coeliac disease, they won't be given gluten grains (unless the school wants to get sued).

Eat some carbs, dammit. See Why I Ditched Low Carb.

To quote from The Hitchhiker's Guide to the Galaxy again, DON'T PANIC! The dose makes the poison. Dietary fructose is used by the liver to make blood glucose to run red blood cells & the brain. A non-keto-adapted brain uses ~140g/day of glucose. Therefore, in the absence of any other dietary carbohydrates, a child could eat 100g/day of fructose, or 200g/day of sucrose without harm. Obviously, other carbohydrates are being eaten, so the amount of fructose that can be eaten without harm is probably ~50g/day, or ~100g/day of sucrose, or ~90g/day of HFCS55.

Warning, irony alert. So, light up a large spliff and chill a bit! Here's a song to help.



EDIT: Worrying about "X" may be worse for you than "X" itself, due to the adverse effect of chronically-elevated cortisol.

Does it really matter?

I mean, does it really matter exactly how & why low-carb diets work? My thoughts...



There's a lot of in-fighting on the internet about low-carb & paleo diets etc. Which is "best", exactly how they work and so on. I don't believe that there is a best diet. Everyone is different (in genetics, environment, activity etc). To boil it down to the basics:-

1) Eat real food that hasn't been buggered-about with too much. Grains that have had the outer husk removed (e.g. white rice) are O.K. Grains that have been rolled flat or inflated to a large size by heating to >100°C are O.K. Grains that have been ground into dust are not O.K.

2) If eating "X" causes you problems, stop eating "X". If certain proteins cause you problems, you either have a genetic condition (e.g. coeliac disease) or excessive gut permeability. The first isn't fixable but the second may be. If certain carbohydrates cause you problems, you either have a genetic problem or insulin resistance. The first isn't fixable but the second may be.

The real enemy here is the food manufacturers. They don't want people to stop eating their highly-profitable Crap-in-a-Bag/Box/Bottle (CIAB), as it's bad for business. They also influence Governments. So let's stop fighting amongst ourselves and attack the real enemy any way that we can. Lead by example.

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.