Tuesday, December 16, 2014

The Fruit Of The Progressive Intervention In Diet

For the tl;dr crowd, if you're not familiar with Nina Teicholz's The Big Fat Surprise before,
I just came across this review of her book in "The BMJ (formerly the British Medical Journal)" I thought you'd all find of interest:

"Are some diets “mass murder”?
"From low fat to Atkins and beyond, diets that are based on poor nutrition science are a type of global, uncontrolled experiment that may lead to bad outcomes, concludes Richard Smith"

Note that in the summary they include Atkins in the list of "diets that are based on poor nutrition science", despite the author of the review's conclusion to the contrary.

"By far the best of the books I’ve read to write this article is Nina Teicholz’s The Big Fat Surprise, whose subtitle is “Why butter, meat, and cheese belong in a healthy diet.”3 The title, the subtitle, and the cover of the book are all demeaning, but the forensic demolition of the hypothesis that saturated fat is the cause of cardiovascular disease is impressive. Indeed, the book is deeply disturbing in showing how overenthusiastic scientists, poor science, massive conflicts of interest, and politically driven policy makers can make deeply damaging mistakes. Over 40 years I’ve come to recognise what I might have known from the beginning that science is a human activity with the error, self deception, grandiosity, bias, self interest, cruelty, fraud, and theft that is inherent in all human activities (together with some saintliness), but this book shook me...." 
"Reading these books and consulting some of the original studies has been a sobering experience. The successful attempt to reduce fat in the diet of Americans and others around the world has been a global, uncontrolled experiment, which like all experiments may well have led to bad outcomes. What’s more, it has initiated a further set of uncontrolled global experiments that are continuing. Teicholz has done a remarkable job in analysing how weak science, strong personalities, vested interests, and political expediency have initiated this series of experiments.... It’s surely time for better science and for humility among experts."

Do read the whole thing.  The author is a fairly influential figure in medicine.

Thursday, November 20, 2014

Linoleic Acid, Asthma, and Metabolic Syndrome—a Follow-up.

Wow. Double-whammy:

In this study, to our best knowledge, we report for the first time that 13-S-HODE, a linoleic acid metabolite, causes mitochondrial dysfunction and bronchial epithelial injury. Although much is known about leukotrienes in asthma12, much less attention has been given to other lipid metabolites. We studied 13-S-HODE because of increasing evidence of the role of mitochondrial dysfunction in asthma7, 8, 9 and high concentrations of 13-S-HODE are found in reticulocytes during degeneration of mitochondria of reticulocytes16. On the other hand, mitochondrial dysfunction seems to be crucial in the genesis of epithelial injury and asthma pathogenesis in mice7, 8, 9. Similarly dysfunctional mitochondria have been found in human asthmatic bronchial epithelia30. Transfer of mitochondria from stem cells to alveolar epithelial cells reversed acute lung injury in sepsis, indicating the crucial role that mitochondrial health in lung diseases17. In this context, understanding the effects of 13-S-HODE on airway epithelium is essential because we found its levels to be high in the airway secretions and extracellular fluids. Also it is practically difficult to reduce the levels of 13-S-hydroxyoctadecadienoic acid (13-S-HODE) as there are many sources for its synthesis13, 14, 15.

So metabolite damages your mitochondria, causing asthma.  Among other things, I'd not be surprised.

From 1961:

"The fatty acid composition of erythrocyte and liver mitochondrial lipids was readily and drastically altered by varying the fatty acid content of the diet."

That's in rats, but the same thing has been found in humans, in all the tissues I've read reports about. To quote from the original post: "...the risk for uncontrolled asthma increased with a higher n-6:n-3 PUFA ratio."

So that suggests that a low-omega-6 diet would be useful in inhibiting or preventing asthma.

I'd always assumed it was wheat, as it's been shown to be involved with exercise-induced asthma, along with other varieties of asthma.  Perhaps they work in concert?

Original post.

The "other things" mentioned above are likely the Metabolic Syndrome.  Another paper from the same author:

"Mitochondrial Dysfunction in Metabolic Syndrome and Asthma"

Friday, October 24, 2014

Taking Electrolytes When Running In Death Valley


"I didn’t take any supplemental salt or electrolytes during the run. Further, the foods I consumed were generally low in sodium. None of my teammates took salt or electrolyte supplements.

While the sports-drink industry markets the importance of electrolytes, Tim Noakes has argued that the body contains enough salt and electrolytes to last for weeks. Further, he points out that in a hot environment, the salt content of sweat and urine drops by 90-plus percent. People see white, crusty sweat on their clothes after running because their bodies are ridding themselves of the excessive salt contained in the typical western diet (Noakes 2012). Ironically, people see the salt crusts and, worrying that they are running low on electrolytes, eat more salt—when they actually may have more than they need.

Talk about putting your money where you mouth is!

If you can run 292 miles through Death Valley without supplementary salt, I think we can put that myth to bed.

Full version (from the link above) here (PDF).

Monday, October 6, 2014

Iatrogenic Ebola?

"iatrogenic /iat·ro·gen·ic/ (i-ă´tro-jen´ik) resulting from the activity of physicians; said of any adverse condition in a patient resulting from treatment by a physician or surgeon."
I was surprised to read this:

"In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?

"In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in west Africa, hospitals unfortunately played this ignominious role in the beginning."

From here, 'In 1976 I discovered Ebola - now I fear an unimaginable tragedy'


Thursday, September 11, 2014

News From The Cereal Industry

"For the last decade, the cereal business has been declining... And the drop-off has accelerated lately, especially among those finicky millennials who tend to graze on healthy options... "...Cereal sales have long been subject to dips brought on by food fads like the Atkins diet or bagel mania. And many cereals are neither gluten-free nor protein-rich, so they fail to resonate with the growing number of consumers who are gluten-intolerant or adherents of the so-called paleo diet.

"...“Additionally, there’s a small but very active and influential group of millennials who are focused on health and don’t like processed food. Guess what, cereal companies? They want to kill you.”"

Hey, it's nothing personal, I'm sure.

"...It also found a way to capitalize on Chex, which had produced consistent sales but little growth since General Mills acquired it in the 1990s. “We had tried everything to move the needle: new advertising, new flavors — and then we marketed it as gluten-free, and it took off,” Mr. Murphy said.

"...MOM, which is owned by the descendants of its founder, John Campbell, also has had success with a relatively new brand, Mom’s Best cereals, “because of an absence of negatives,” Mr. Reppenhagen said. “No hydrogenated oils, no preservatives, no artificial flavors and colors — we even use vegetable dyes in the packaging.”"

Adding protein is also big, apparently. Ick: I wonder what kind of protein they're adding?

Monday, September 8, 2014

Your Sperm Talk To Your Children

"In a recent paper in the Proceedings of the National Academy of Sciences USA, Qing-Yuan Sun of the Chinese Academy of Sciences and colleagues used a drug to make male mice prediabetic. And unexpectedly, their offspring also became prediabetic as adults.

Was this due to the fathers' behavior around their offspring? No—the males were there solely for mating. Instead, becoming prediabetic caused epigenetic silencing of some genes in the pancreas of these males (an organ centrally involved in diabetes). And the same epigenetic changes occurred in their sperm as well, also affecting their offspring's pancreases.

This applies to behavior too, as reported in a recent paper in Nature Neuroscience by Isabelle Mansuy of the University of Zurich and colleagues. Prior work showed that if you stressed young male mice, as adults, they differed from control mice in how readily they explored a new environment and how quickly they gave up trying to cope with a challenging task (findings pertinent to understanding anxiety and depression).

Critically, the offspring of those males showed the same behaviors. Again, Dad wasn't doing any parenting. Instead, the stressful upbringing caused epigenetic changes (due to those micro-RNAs) in sperm. In a tour de force, the authors injected micro-RNAs from sperm of stressed males into fertilized eggs—passing on the behavioral trait. Thus, early life stress changed adult behavior of male mice, who passed it on to their offspring via epigenetic changes in their sperm."

Summing up the prior state of knowledge about sperm and epigenetics, the author states: "Naturally, this is turning out to be wrong."

Naturally. The most remarkable thing about Science, I think, is how it lays bare the arrogance of man.

Weston Price observed, in the 1930s:

"While it has been known that certain injuries were directly related to an inadequate nutrition of the mother during the formative period of the child, my investigations are revealing evidence that the problem goes back still further to defects in the germ plasms as contributed by the two parents. These injuries, therefore, are related directly to the physical condition of one or of both of these individuals prior to the time that conception took place.

"A very important phase of my investigations has been the obtaining of information from these various primitive racial groups indicating that they were conscious that such injuries would occur if the parents were not in excellent physical condition and nourishment.

"...In the light of these data important new emphasis is placed on the quality of the germ cells of the two parents as well as on the environment provided by the mother. The new evidence indicates that the paternal contribution may be an injured product and that the responsibility for defective germ cells may have to be about equally divided between the father and mother.

"...We are apparently dealing here with a factor which, while it may be related to the germ plasm and to the prenatal growth period, clearly involves other forces than those that are at work in the case of hereditary defectives. Since these changes have to do directly with disturbances in growth of the head, particularly of the face and of the dental arches, we are concerned with such evidence as may be available as to the nature of the forces that readily affect the anatomy of the skull.

"The general architecture of the body is apparently determined primarily by the health of the two germ cells at the time of their union. This architectural design may not be completely fulfilled due to interference with nutritive processes both before and after birth."

Nice to see Price confirmed.

And if there's a way to turn these triggers on, there's a way to turn them off.

In other news:

[Paragraph breaks added for readability.]

"Because germline mutations are the source of all evolutionary adaptations and heritable diseases, characterizing their properties and the rate at which they arise across individuals is of fundamental importance for human genetics.

After decades during which estimates were based on indirect approaches, notably on inferences from evolutionary patterns, it is now feasible to count de novo mutations in transmissions from parents to offspring.

Surprisingly, this direct approach yields a mutation rate that is twofold lower than previous estimates, calling into question our understanding of the chronology of human evolution and raising the possibility that mutation rates have evolved relatively rapidly...."

Surprisingly? Direct measurement is best for a reason, any carpenter can tell you that!

But at any rate, I suspect that the epigenetic effect will prove to be much more important that currently thought, and will explain how a low rate of mutation can produce high rates of change: if you can turn genes on and off in response to the environment, you can adapt without needing to change genes, and in a more predictable fashion.

That trait would be evolutionarily useful...

Wednesday, September 3, 2014

Yes Virginia, The Paleo Diet Was Low-Carb

One of the "diet gurus" I follow and whose work I appreciate (the Prescript-Assist Probiotic was remarkable, thanks!) is Chris Kresser, formerly known as the Healthy Skeptic. I first came across Chris when he interviewed Stephan Guyenet, in Chris's first podcast back in 2010.

Recently, Laura Schoenfeld, who works with Chris as a dietician posted an article titled "Is a Low-Carb Diet Ruining Your Health?" I scanned it, tried to comment, but as commenting on Chris' site no longer seems to work for me, moved along. Then Chris posted a follow-up, "7 Things Everyone Should Know About Low-Carb Diets" because apparently, and not surprisingly, the previous post got a bit of attention.

"Last week, my staff nutritionist Laura Schoenfeld wrote a guest post for my blog called “Is a Low-Carb Diet Ruining Your Health”. Perhaps not surprisingly, it has caused quite a stir."

OK. So I read on, but stopped here:

"#1: Paleo does not equal low-carb, and very low-carb/ketogenic diets are not our “default” nutritional state, as some have claimed."

I'm just going to follow up on this one point. And not get into the rest of his post, or Laura's post. I have issues with both of them, but all those issues stem from this one fundamental misconception. So I'm going to cover just one topic: was the Paleolithic Diet low-carb? I'm not going to cover what people say is a paleolithic diet today, or what modern hunter-gatherers eat (there is one fundamental problem with that, but that's for later), just that one issue, because it's pretty easy to cover.

The Smithsonian Institute recently announced a massive study of Kennewick Man, an anomalous skeleton that appeared to pre-date the Indians and Eskimos who populated the Americas when my European ancestors first arrived. Initially they thought it was a modern skeleton, as it didn't have the physical attributes they associate with Indians, but one item distinguished it:

"The skull, while clearly old, did not look Native American. At first glance, Chatters thought it might belong to an early pioneer or trapper. But the teeth were cavity-free (signaling a diet low in sugar and starch) and worn down to the roots—a combination characteristic of prehistoric teeth.

(My emphasis) Yes, it turns out that being free of cavities is a hallmark of people who ate the paleolithic diet. That's zero cavities, btw, not "not many". I was told when visiting Harvard that the human relics we have from the paleolithic contain "zero" cavities, a statement which I found astounding. (More on that later.)

In fact, whether or not cavities are present (they're known as "caries" to anthropologists) is how one knows what the individual ate.

Take Ötzi, the "iceman", the famed 5,000 year-old mummy found in a glacier in Europe:

"The tooth decay is significant because it shows how starchy foods and the agriculture that created them were a part of Ötzi's regular diet. The team attributes his cavities to eating more breads and cereals."

Unlike Kennewick man, Ötzi's soft tissue was preserved, so they were able to do a DNA analysis on the contents of his gut, and, sure enough:

"According to the DNA reconstruction, the man's last meal was composed of red deer (Cervus elaphus) meat, and, possibly, cereals; this meal had been preceded by another one based on ibex (Capra ibex), different species of dicots, and cereals."

That, in a nutshell, is the difference between a paleolithic diet and a neolithic diet: cavities, and starchy foods. Starchy foods are tough to track through the archeological records, but happily for us, cavities are easy to track.

Now it turns out that there was was one paleolithic group that ate a non-low-carb diet. I suspect these people had run out of anything better to eat, because they were subsisting on snails and acorns.

"When hunter-gatherers started adding grains and starches to their diet, it brought about the "age of cavities." At least that's what a lot of people thought. But it turns out that even before agriculture, what hunter-gatherers ate could rot their teeth.

"The evidence comes from a cave in Morocco — the Cave of the Pigeons, it's called — where ancient people lived and died between 12,000 and 15,000 years ago. These were hunters and gatherers; they didn't grow stuff. And what was astonishing to scientists who've studied the cave people was the condition of their teeth.

""Basically, nearly everybody in the population had caries," or tooth decay, says Louise Humphrey, a paleo-anthropologist with the Natural History Museum in London.

"Humphrey says 94 percent of the more than 50 people from the cave she studied had serious tooth decay. "I was quite surprised by that," says Humphrey. "I haven't seen that extent of caries in other ancient populations.""

That's unique, in other words. So what did they eat?

"But apparently, these ancient people had a thing for acorns.

""Acorns," says Humphrey, "are high in carbohydrates. They also have quite a sticky texture. So they would have adhered easily to the teeth."

"Yes, these people did eat meat. And snails, apparently, whose shells littered the cave. But they also ate a lot acorns, judging by the debris they left behind.

"Without toothbrushes ... without dental floss ... that diet rotted their teeth."

So these are your teeth on a non-low-carb Paleo diet. (See picture above) Not a pretty sight.

One other researcher has the following insight on what caries prevalence tells us about ancient diet:

"...it is supposed that H. erectus, a hunter-gatherer, obtained approximately 50% of its calories from carbohydrates (Wrangham, 2009) and under the hypothesis of cooking (that obviously included meat and vegetables), caries should have been present much earlier in the fossil record. However, caries appears clearly much later. So, the data on oral does not support the idea of a cariogenic diet based on cooked [tuberous] vegetables from the earliest periods. Maybe, in the beginning, fire was employed only for cooking meat."

Most likely, of course, it's because they weren't eating much in the way of carbohydrates:

"Caselitz (1998) analyzed the historical evolution of caries in 518 human populations of Europe, Asia and America in a wide timeline from the Paleolithic to the present, confirming that during Paleolithic and Mesolithic periods, the hunter-gatherers had less caries and lesions progressed more slowly. Caries indices have increased gradually from Neolithic times, until they reach the high rates observed at the present.... This phenomenon, observed in North Africa, Near East, China and Europe has been attributed to the drastic change in the diet that means the introduction and spread of cereals in the entire antique world..."

("Caries Through Time: An Anthropological Overview")

Alright, but all this is some random blogger putting together a bunch of posts and drawing a conclusion that reinforces his prejudices. What good is that?

(I'll put my biases on display: I had massive cavities when I was a kid, I don't know how many. I had eight teeth pulled, including my wisdom teeth; what got me interested in the Paleo diet was when the afore-mentioned Stephan Guyenet convinced me that my tooth issues were soley the result of diet. I'd already gone largely sugar-free and had been cavity-free for about 20 years. So I was receptive to the idea that my tooth issues were the result of diet, and not genetics.)

So let's go to the expert. Dr. Daniel Lieberman is the Chairman of the Department of Human Evolutionary Biology at Harvard. He's one of the foremost anthropologists on the planet, and he recently completed his magnum opus, The Evolution of the Human Head. More to the point here, he released a newer book, The Story of the Human Body: Evolution, Health, and Disease.

In this book, he discusses a number of mismatch diseases; which are caused by a discrepancy between our environment and the environment we evolved to live in. One of the first mismatch diseases he discusses is cavities.

(Full disclosure: While Dr. Lieberman does not share all my opinions on the Paleo Diet, I need to note the following, from the Acknowledgements in that book: "Special thanks go to David Pilbeam, Carole Hooven, Alan Garber, and Tucker Goodrich , who read multiple chapters." I'm biased toward this book.)

I mentioned above a visit to Harvard. My friend John Durant had a similar visit, here's his account:

"“Notice anything?” Dr. Lieberman asked. “Look at the teeth. They’re straight. And no cavities. His wisdom teeth came in just fine. Humans, like all animals, have evolved teeth that are well suited to their natural diet. An infected tooth can easily kill you, and there were no dentists in the Paleolithic.”

"Nearly one hundred thousand years before dentists and orthodontists, this hunter-gatherer had a strong, straight set of chompers. Skhul V challenged much of what I’d been taught about the history of human health.

"“Now, look,” Dr. Lieberman continued, “hunter-gatherers didn’t have perfect teeth. This guy has well-worn teeth, and he’s actually missing one due to an abscess. So don’t stop going to the dentist. But wait until I show you the skulls of early farmers—a lot of them would need to get fitted for dentures.”

"“So what’s the secret? Eat less sugar?” I asked.

"“Well, yes, but healthy teeth depend on a variety of factors,” Dr. Lieberman explained. “First, yes, it matters what you eat. Amylase in your saliva breaks down carbohydrate into sugar in your mouth. Bacteria feed on the sugar and produce acid that wears away the enamel on teeth, giving you cavities. We’ll see what happened to the early farmers who started eating a starchier diet.”

"To figure out what humans used to eat, teeth are a good place to start. Not only do teeth fossilize well, but they’re the first point of contact between the food we eat and our body, the first part of our internal digestive tract. And if our teeth aren’t well adapted to a particular food, it’s unlikely the rest of our digestive tract is. But whatever Skhul V was eating, his teeth seemed to be up to the challenge."

Professor Lieberman in his book is pretty succinct in his coverage of the topic of cavities:

"Unfortunately, humans have little natural defense against cavity-causing microbes other than saliva, presumably because we did not evolve to eat copious quantities of starchy, sugary foods. Cavities occur at low frequencies in apes, they are rare among hunter-gatherers, they started to become rampant following the origin of agriculture, and they spiked in the nineteenth and twentieth centuries. Today cavities afflict nearly 2.5 billion people worldwide."

"...if we really wanted to prevent them, we would have to reduce our consumption of sugar and starch drastically. However, ever since farming, most of the world’s population has been dependent on cereals and grains for most of their calories, making a truly cavity-preventing diet impossible for all but a few. In effect, cavities are the price we pay for cheap calories. Like most parents, I let my daughter eat cavity-causing foods, encouraged her to brush her teeth, and sent her to the dentist, knowing full well that she’d probably get a few cavities. I hope she forgives me."

To me, this seems to be a pretty clear indication that the Paleolithic diet as actually eaten in the Paleolithic period did not include a large amount of carbohydrates; or, if it did, they were eaten infrequently enough so that the population of bacteria required to rot your teeth did not have the opportunity to arise in your mouth.

Keep in mind, other than the acorn-eaters, the Paleolithic cavity count was around zero.

I'd be very interested to hear another explanation for this particular phenomena, but for me, it's pretty cut-and-dried. Our Paleolithic ancestors ate fewer carbohydrates than any other group currently existing, or there was some other unknown phenomena that protected their teeth.

So what's the right amount of carbohydrates to eat on a Paleo diet? The amount that means you won't need to brush your teeth, ever. If you don't get any cavities, then you're eating the right amount. If you're getting cavities, you're eating too much. Based on the evidence above, I'm going to guess that's a low number. So why not err on the safe side, as there's no good evidence not to?

We got by for quite a long time on that diet, and became human while eating it.

"On the other hand, there are some foods that inhibit the formation of caries. Diets rich in meat lead to low caries frequencies due to the fatty acids’ antibacterial power and their capacity to reduce the adherence of plaque on dental surfaces. The intake of dairy products and fish (foods rich in calcium and casein that can increase urea concentration) modifies pH values and the quantity of salivary production, inhibiting the formation of dental plaque. Finally, a food rich in polyphenols (such as cacao, coffee and tea) inhibits the bacterial metabolism and stimulates the salivary secretion representing, thus, another mechanism of caries prevention (Bowen, 1994; Touger-Decker & Loveren, 2003).
(From the Caries Overview.)