Wednesday, 24 February 2010

Is eating mammlian meat a risky business?

This is an old story, but new to me, now that I started to dig a little deeper. And the story is very simple: humans can't synthesise Neu5Gc, a kind of sialic acid found on a surface of all mammalian cells. Humans don't make Neu5Gc, but they do have Neu5Gc from eating meat from other mammals. Sialic acids do get transported and incorporated into human cells!

As a consequence, Neu5Gc is seen by human immune system as a foreign antigen and response is mounted. This can lead to autoimmune diseases. Whether it does, there is no evidence, but Neu5Gc is being closely looked at now. Another possible implication of presence of Neu5Gc on human cells could be increased risk of infection, e.g. E. coli. This might have contributed to survival advantage in our ancestors who lost the Neu5Gc gene for the human race.

The reason it worries me it that instead of a typical winter cold, this year I have been having a strange kind of infection/inflammation in my chest. CRP is slightly increased, but no symptoms of infection other than occasional mild cough and abundant mucus in the morning. It does not look allergic either.

Also, I remember reading somewhere that higher vitamin D can lead to exaggerated immune response. It is supposed to be anti-inflammatory, but also strengthens immunity, which can be not so good if my immune system is fighting Neu5Gc in my chest.

But the whole Neu5Gc story is not very convincing. Neu5Gc has been found in foetal tissues. If Neu5Gc is present when natural tolerance is being developed, then the antigen should be seen as own, not foreign, regardless of whether if came from dietary meat/milk, or synthesised from scratch. It makes perfect sense though, that antibodies against Neu5Gc can form when children of vegetarian (or nearly vegetarian) mothers start eating meat or drink cow milk. This can be quite common on some ethnic groups. Also, vegetarians who decide to eat meat after many years may have lost natural tolerance and can react to the mammalian meat/milk antigen vigorously. On the other hand, it makes sense to recommend to expectant mothers to eat more red meat, so that more Neu5Gc gets transported to the foetus, thus helping induce natural tolerance.

One might try to use the "leaky gut" argument in addressing the fact that Neu5Gc gets into human cells in the first place, but it appears that pinocytosis is used as transport mechanism. Actually, this is the first example of such transfer of complex compounds from gut to nearly all cells.

LDL cholesterol goes sky high on fatty diet

I am reporting my blood lipids for your perusal:
Total cholesterol = 369 mg/dL
HDL cholesterol = 79 mg/dL
Trojglycerides = 90 mg/dL
LDL cholesterol (direct) = 271 mg/dL
LDL cholesterol (Fried) = 272 mg/dL
LDL cholesterol (Iranian)= 248 mg/dL

I have been on Paleo diet for about three months now, but about a month ago I started to enjoy more animal fat. In addition to chicken skin, fattier cuts of beef (brisket) and even some deer fat collected from stock bones, I gorged on cream and coconuts (whole and oil). And they do have 60% clotted cream in the UK! The LDL results were slightly lower six weeks ago.

Before going Paleo I was vegetarian with low total cholesterol (about 160), high TG (120-150), though not so low HDL (about 50). There are many factors involved, but it is very likely that my LDL went up mostly on extra sat fat.

Is it bad? I don't know. LDL can be dense or fluffy, I did not check Apo(B), but even it is mostly fluffy, I am concerned. I starting to think that diet very rich in saturated fat is not really Paleo, much like dairy, grains and legumes. Some people can indeed thrive on some or all of these foods; others may not, depending on your ancestors, perhaps even the not-so-distant ancestors.

By the way, when I was vegetarian, I had slightly elevated liver enzymes. Only slightly, so I did not bother to check further. Now the enzymes are perfect. This made me wonder if the liver was not getting fatty. Better late than never.

My plan is as follows: even more leafy greens, more EVOO (try making mayonnaise with it!) and avocado, more fish/seafood, more organ meats (ideally bone marrow as well), less fatty meat. (FYI, I have been supplementing 5,000IU vitD3 and fish oil daily for about three months).

Apparently, modern hunters-gatherers have very low total cholesterol. There is no reason to have high LDL and rationalise.

There is one more reason while I plan on cutting down on meat from mammals: Neu5Gc. I will elaborate in my next post.

Tuesday, 16 February 2010

The key Paleo factor: Food scarcity

Sometimes you just have to create a bit of a virtual reality, a Paleo re-enactment. Even if our food is no longer strictly Paleo, and even if there is no reason we should be very strict about every ingredient (see my post on epigenetic inheritance) food scarcity was more common than food abundance, even in the Neolithic. This might have to be seasonal, to allow for regeneration and repair, but should be considered critical. If CR and longevity is the only goal, food scarcity would be even more important.

When food is everywhere we are tempted and temptation is bad. When we see food and conceptualise eating eat, even if we forgo the opportunity, the brain still registers food, with all biochemical consequences to follow. Just looking at food elicits conditioned responses, which can confuse out metabolism.

But what can we do not to be led into temptation? I think there is a solution: you have to reprogramme you brain, so that is does not perceive most available foods as edible. You simply have to visualise the unhealthfulness of those foods, even possible toxicity, to develop avoidance reaction. Obviously you already have the right reflexes when subjected to the risk of eating a cake or pasta, but some Paleo-like foods are still tempting.

Here are some suggestions to make these associations:
Nut butter from the jar: roasted (AGE compounds - bad), processed fats, possibly in high temperature (possibly trans-fats). Of course you could make your own healthier version, but have no time, don't want to bother, are not that hungry after all. Result: you wait till you have your salad and steak.

Processed meats: nitrates, oxidised cholesterol, contact with plastic packaging; this is clearly not edible food. It surely might be tasty, but it is not food. Making your own would be too much trouble and you go for the leg of lamb instead.

Honey: find an obscure kind of raw honey which you can buy only at a far away farmers market and only twice a year. Any other honey would be just not good enough or contaminated with toxic pesticides. When you buy this honey, eat the while jar to make your head spin, so that you condition yourself to avid for a while. Visualise glycation and its contribution to wrinkles and infertility.

Chocolate: It may be 91% cocoa solids, or even 100% when you mix cocoa liqueur with cocoa butter, but this is not Paleo and should not be in your kitchen in the first place (it is in mine though). If you can't resist, at least don't add Stevia to it; Stevia is a highly processed extract, which will mess with your insulin and digestive juices through conditioned reflexes. Want a treat: eat some raw coconut, if you can find it at home.

Which brings us to another strategy: not to store food. Fresh food is always better, even freezing increases oxidation of fats. Don't cook too much, fried leftovers can be tasty, but are less healthy and should be avoided. Visualise toxicity.

If cheese or cream is your weakness, there is no remedy. If you consider it "approved", then it would be hard to condition your brain to see it as toxic.

After a bit of training you will be able to walk into a supermarket and see no food there. That restaurants do not offer any food you have already discovered a while ago...

Grow, reproduce and lean or meditate and regenerate?

The types of food consumed during the Paleolithic varied with time and geography. In that sense there might have been infinite number of diets and nutrient compositions. But I am starting to conceptualise two distinct dietary modalities: one when food was aplenty, the other during times of food shortage.

It all started when I looked at mTOR signalling, which is nutrient dependent. In a nutshell, more protein (particularly rich in leucin) and carbohydrates, as well as more calories (where abundant fat would also enter the picture), activate mTOR. mTOR is responsible for growth, reproduction and learning. But it is also responsible for increased oxidative stress, ageing and cancer. When mTOR is upregulated, you grow, reproduce, learn, you conquer the world. When mTOR is depressed, you slow down, regenerate, repair your DNA, and prepare for better times.

This corresponds to seasonality with abundance occurring in late summer/early autumn, and lean times in winter/early spring. Probably higher metabolism during the summer would benefit from more sunshine and vitamin D, while dark cave would not be problem in the winter (you would have stored a few-months supply of vitamin D from the summer). Most children would be conceived in late summer, to be born just before the next summer begins. When nutritious food was easy to find your brain was working at high speed, with maximum synaptic plasticity for future survival advantage.

Now we have a choice, but we can't have a cake and eat it too. If you want to grow, reproduce and learn, you go higher protein, more occasional fruit/honey, more calories, more exercise. If you want to survive hoping to extend your life, you go caloric restriction, lower protein, higher fat (during the winter months your own stored fat would have been burnt). The optimal strategy: cycle with the seasons?

Possibly, you can beat the system a little bit towards the end of long winter. When food is scarce and little fat storage remains, one option is to intensify hunting or gathering, meaning: more exercise. This would stimulate mTOR and can possibly sharpen your brains again.

By the way, there can be other important reasons for reproducing during the summer or winter months, one having to do with epigenetic inheritance discussed in my previous post.

All this makes be think again about vegetarians. Those who stick to low starch and mild caloric restriction, being in most cases on a relatively low protein diet, can possibly live longer than the summer season Paleo eaters. Vegetarians would not be optimally fit, might suffer from gluten related conditions, but if they don't gorge on soy, their mTOR would be downregulated. Possible nutrient deficiencies can possibly augment the effect. They could probably do better on a diet based on meat and leafy vegetables with mild caloric restriction, but are still better off than well fed summer hunters. At least in terms of longevity. When it comes to growth and reproduction, vegetarianism is probably the worst option.

Saturday, 13 February 2010

The paleo/primal paradigm can be all wrong

The Paleolithic diet/lifestyle paradigm draws from evolutionary theory. In fact, it is based on the validity of Darwinism. While I am hardly a creationist, I maintain that established truths are not necessarily the only truths, attempting to falsify, rather than confirm, in line with scientific method. The first take on the issue was here, below are some more thoughts.

Switch from vegetarianism to Paleo has done me good and there are other testimonials and blogs. For me there is no way back. But is may be premature to draw generalised conclusions. After all, healthy non-Paleo (and high carb) eaters might have never been considered in the equation as a comparison group. While people with metabolic syndrome or other chronic conditions might indeed benefit tremendously from Paleo-like regimen, it does not follow that all people would. There might indeed be some people who thrive on a modern "balanced" and "healthy" diet, and some might be even doing well on SAD. There is no doubt such people exist, the question is: how many and how they can be identified if prevention is to be considered.

Proponents of the Paleo paradigm base their arguments on two critical propositions:
1. Our Paleolithic ancestors ate the diet and had lifestyles which were optimal for their health.
2. Time from the beginning of agriculture (3-10 thousand years) was not long enough for humans to adapt to the new diet/lifestyle.

The problem with the first proposition is that it does not make clear what is meant by health. What was healthy for reproductive success and contributed to physical and mental prowess (more protein, perhaps seasonal abundance of carbohydrates) might not have been optimal for long term health and longevity, where low protein and, perhaps, caloric restriction could be a better choice.

It is the second proposition, however, which is more problematic. True, if natural selection were the sole factor responsible for inheritance, the time was too short. But what if inheritance is not limited to mutation and recombination of DNA? In "Evolution in Four Dimensions" Eva Jablonka argues that there is more to heredity than DNA and genes. In fact, recent publications on epigenetic inheritance appear to be reviving some of the Lamarckian concepts of evolution. Root Gorelick in his "Neo-Lamarkian medicine" speculates that meiotically-heritable epigenetic signals could be transmitted to future generations. Also Arthur Janov makes very interesting observations on the mental health aspects of epigenetic inheritance. A very insightful review of inheritance of acquired characteristics was published in Nature by Yongsheng Liu. Here is another one.

In essence, if indeed Lamarck was, at least partially, right, then perhaps several generations might be sufficient for a simple adaptation, such as lactose tolerance. But lactose tolerance is still not perfect health, we also need time to create adaptations to handle casein digestion, glycation (from galactose), maybe also insulin response. For all this several centuries could have been enough, let alone 3-10 thousand years.

This would fit the observations that different people have different level of tolerance to agricultural diets. In one of my previous posts, I argued that this might have to do with geographic origin of our ancestors. But if epigenetic inheritance were to be responsible for our adaptation to agricultural diet(s), then even few generations can make a difference. If so, then not only geography should play a role, but also the details of out forefathers' menus in the past centuries. We can only infer that indirectly. Were they peasants, artisans, knights, noblemen? Were they rich or poor? After all, it might be the case that they ate hardly any carbohydrates until the 20th century and even then not on a regular basis.

But it gets more complicated than that. Even if environmental signals can indeed translate into inheritance bypassing natural selection (something Darwin believed to be the domain of the future of evolutionary theory) then there are two possibilities:
1. The environmental (dietary) impact is nocuous and induces permanent pathological change, which becomes inherited.
2. The environmental (dietary) impact is challenging and induces adaptation. This can be achieved by activation or amplification of genes (e.g. responsible for free radical scavenging in response to oxidative stress from intensive exercise), which can then be passes by epigenetically. This adaptive response is sometimes described as hormesis, and it applies to low level exposure to normally very harmful factors, such as ionising radiation.

If the impact of agricultural diet was not overwhelmingly harmful (after Darwinian selection took care of the infertile high-carbohydrate early farmers' children), but could be considered a low level stressor instead, then hormesis and epigenetic inheritance could be responsible for adaptation. This might have been the case with knights and nobles, who hunted and/or had more meat on their tables. This could have also applies to fishermen or the poor who nevertheless had ample access to cheap herring. Now, metabolism of peasants who had to subsist on gruel, bread and later potatoes, may have been devastated by excess carbohydrates. Metabolic defects (such as hyperinsulinemia) might have been perpetuated in offspring. But then again some of them managed to poach some small game, gather snails, eggs, and supplemented with plenty of green leafy vegetables to keep metabolism in balance, which would in effect simulate hormesis.

Indeed, if one's ancestors were predominantly grain eaters or vegetarians and their metabolism adjusted with no clinical manifestations, then it is possible than going Paleo with large amounts of meat constitute a new environmental stress! Small amounts of meat would lead to hormesis, but large amount would be overwhelming leading to cancer and early death.

Now, how to we fit Pottenger's cats into the picture?

Saturday, 6 February 2010

Lose weight and make money the Paleo way

This guy is a genius, I mean Winton Rossiter, a financial analyst who is in business to pay people in the UK to lose weight:

The scheme actually started a while ago as a pilot and now is to be extended:

As a financial analyst he must have done his Crystal Ball modelling and might be getting the money both from the patients and the NHS (taxpayers). The patients stand to get rewards for achieving target weight loss, but they have to invest their own cash. The balance at the end of the year can actually be positive for the patient, but only is the target is reached. Now, this is being done with the NHS, so the official nutritional guidelines have to be observed. They most likely don't monitor what people are actually eating, but they do send information packs with recommendations. Weight Wins (or rather Accelerated Concepts Ltd) knows that high carbs are not going to be successful in most people, so they will be quids in.

So what? The good news is that if you can, you may want to try to take advantage of the scheme and lose weight the sustainable Paleo way. You will have to invest a bit, but if you are considerably overweight, you can earn several hundred. Of course, you would also earn better health and save the NHS money in the future!

It appears that this has been already done in America. I wonder what kinds of diets were used and how successful it was short and long term.

Friday, 5 February 2010

Onychophagia, ADHD, restless leg syndrome and diet?

One thing I observed when going Paleo was that I completely lost the desire to bite my fingernails. Now I can confess, I have had this disgusting habit since my teenage years. No more temptation and even revulsion on the thought of it! What happened? Medical science is limited: no publications with onychophagia AND diet in Pubmed. The one study that is found only addresses the speed of growth of fingernails and toenails (puzzling, nowadays nails are growing much faster than decades ago! Is it IGF-1 and/or insulin?). Google search has not been very useful either: biting fingernails has to do wih nerves, which actually might be the case, whether associated with some micronutrient deficiency or not.

I actually suspected micronutrients since the white spots (leuconychia) also stopped appearing on my fingernals; in my vegetarian days I used to have them a few times a year.

But other symptoms also improved: no restless leg syndrome. It was not severe and actually I did not self-diagnose it until a few years ago, but it was something beyond my control and I like to be in control. Which I am now, at least when it comes to restelss leg. So it had to do with nerves, after all.

Probably the biggest improvement after I changed to Paleo involved what I had also self-diagnosed as adult ADHD. It was a very mild case and would have gone unnoticed, but my wife, who is a psychologist, was working with a patient who matched my profile quite well. I did some reading on adult ADHD and: Bingo! Then I had to learn to live with it. Until I gave up gluten, that is. Now everything is in focus, much better organised (except this blog), probably a bit less manic. And no fingernail biting! Gluten has been linked to ADHD in children and gluten-free diet can do wonders, but many adults never realise they might have symptoms of ADHD as well and that for them the Paleo could be the answer.

And the wight has been staying solid rock constant, though perhaps another half an inch of abdominal fat is gone (now probably only half an inch is left). This means more fat in the diet. I am experimenting with coconuts and also with cocoa butter. In a couple of weeks I will have my blood tests done and will report extensively.

In defence of pharmaceutical industry

I have no time to follow the new on a regular basis, but I always have the time to check the best Paleo-related blogs. Methuselah has made me aware of a recent BBC File on 4 broadcast on pharma industry:

It is good that such things get the attention of the media, all for the public good. But you have to see it in perspective.

Pharma industry is probably the most regulated of all. The number of hurdles in developing a new drug is beyond belief. There is scrutiny at every step. Of course, things happen sometimes because of negligence, sometimes because of greed. But the industry is there to make money.

Now consider the public health experts on a mission to make us live healthier lives on a low fat, high carb diet. What is the level of evidence in official recommendations? Where is the scrutiny? Hundreds, maybe thousands of people gained weight on Seroquel, millions are getting fat and diabetic on the official healthy diet.

A book "The Big Fat Lies" has just come out written by a British lawyer Hannah Sutter. It accuses the Food Standards Agency and its experts with conflicts of interest of making people fat, which essentially translates into more disease and more death.

Did BBC comment on this book, or at least on the evidence it contains? Each day many new people are getting diabetic and die, yet according to Google News, only Daily Mail covered the story, which can actually turn some people off reading the book.

All in all, I think that pharma industry is probably the most ethical off them all, if you consider food, transport (safety, pollution, cosmic radiation on flights), telecom (radiation), cosmetics (unfounded claims, safety, cost), clothing and shoes (chemicals, effect on posture), plastics (leaching), paints, agriculture (hormone disrupting pesticides), etc.

Also, the common conspiracy argument that Big Pharma dwells on the disease and is even interested in more people getting more and more diseased simply does not hold. With less obesity, diabetes, cancer, hypertension and arthritis the companies would simply be developing more lifestyle drugs, perhaps more gene therapies, perhaps more effort would go into longevity research (e.g. how to counter cross-linking Maillard chemicals), sports physiology research. There would always be room for improvement and profit.

Now, eat me alive :)

By the way, the Sutter book is excellent when you realise that it has been written from a lawyer's point of view. It is also an easily read summary of current low carb thinking. The author is not, however, an expert in nutrition and is not aware of nuances, such as oxidation of cholesterol and fats, omega-6 (recommenting nuts as super food) or intermittent fasting (recommending NOT to skip breakfasts). But this book is a gem and I hope things will change quite soon, i.e. in 20-30 years. For Big Pharma now is the time to start thinking strategically about the change in demand which is inevitable.