Jack LaLanne on Sugarholics

This morning I ran across this little gem of a video.  It is a reminder that dietary wisdom has deep roots, and that what I post here is not new.

As a recovering sugarholic I can testify to the message Mr. LaLanne delivers.  My mother was a sugarholic, as was my father.  Coca Cola, doughnuts, cakes and cookies were regular fare.  Had we taken the advice of Jack LaLanne when he first delivered it there would not be so much obesity and diabetes in my family now.   I am pre-diabetic as a result of a lifetime of poor habits.

To break my dependence on sugar I ate servings of protein, with accompanying fats, with every meal.  When cravings grew strong I snacked on proteins with their fat, along with a little fresh fruit to sweeten.  Although I was unaware of it, I followed Jack's advice.  It worked.

A few weeks ago someone who understood the significance of my fight with sugar and starch awarded me her 6 year Alcoholics Anonymous recovery coin.  Her coin is a touching reminder of how sugar dependent I was only 6 years ago.   I will celebrate my 7th year of freedom from sugar cravings this December. 

Jack's words are as true today as they were when he spoke them.  If you or someone you love is a sugarholic, please watch this short video and share it with others.

Thank you.

Jack Lalanne - Sugarholics-YouTube http://bit.ly/16EmXhv

Is Your Brain Sugar Frosted?

What do sugar cravings, depression, brain fog, poor memory formation, ravenous hunger, over-eating, learning disabilities, daytime sleepiness/fatigue, obesity, Type 2 Diabetes, Altzheimer’s (also known as Type 3 Diabetes) and Non-Alcoholic Fatty Liver Disease share in common?

Diets high in processed sugars and starches.

According to a 2008 US Department of Agriculture report, in 2005 Americans ate on average 150 lbs of sugar every year, with the average American consuming 30 teaspoons of added sugar per day.  The report recommends Americans cut down to an average of 8 teaspoons per day.

Where does all this sugar come from?  Soft drinks are a major source.  For example, just one 12 oz can of Coca Cola shoots about 10 teaspoons of rapidly absorbed sugar into the bloodstream and brain.  Disguised by salt, added sugars are hidden in processed foods.  Read the carbohydrate counts on nutritional panels and you may be surprised at how much sugar processed foods contain.

Another important sugar (glucose) source, one that few people know about, is grain products.  Grains tend to be highly processed, and even unsweetened grains rapidly turn to sugar when digested.  Boxed and cooked cereals, even when unsweetened, represent bowls of sugar to our bodies and brains.  Adding refined sugar compounds these effects.

A significant traditional source of grain in the American diet is bread.  We are told that whole wheat bread is good for health, and USDA dietary guidelines urge us to eat 6 ounces of grain every day (the equivalent of 6 slices of bread), and make half our grains whole grain.  School lunch programs require grain servings with every child’s lunch, scheduled to become whole grain rich by school year 2014-2015  http://bit.ly/ZAd5kI   

But when scientists at University of Guelph tested the theory of “healthy whole wheat bread” the results were surprising http://bit.ly/13MTFIS   Whole wheat bread delivered more sugar to the bloodstream than white bread, and much more than white sourdough bread.  Other sources report two slices of unsweetened whole wheat bread quickly deliver more sugar to the blood stream than white sugar, and many candy bars.

What do high dietary sugar and carbohydrate loads do to the brain?  For one thing they stunt production of brain-derived neurotrophic factor (BDNF).  BDNF is essential to the formation of memories and robust brain function.  Without it we are lost.  Another problem: Glycation.  Sugar makes a great preservative and stiffener.  Fruits with added sugars become fruit leathers.  Sugaring (glycation) makes your arteries stiff, too.  http://bit.ly/13PPCvf Stiff (as opposed to flexible) arteries are fragile and more easily damaged. Artery damage increases the chance of strokes and heart attacks.

Our brains were never meant to endure the high sugar loads of the Standard American Diet (SAD).   Excess blood sugar from the sugars and starches in a typical American diet (55-65% carbohydrates) leaves us dull, sleepy and fatigued during the day.  It saps us of the ability to concentrate, and contributes to poor sleep at night. Sugars and starches feed our cravings to eat more sugar and starch.  Over time, sugaring our systems can make the brain less sensitive to insulin, leading to Type 3 Diabetes, also known as Altzheimer’s dementia.  This subtle process spans decades in adults.  Sugar and grains, especially whole grains, rob us of nutrients such as magnesium, which protects the brain and is involved in more than 1000 enzymatic processes in the body.  About 70% of Americans are magnesium deficient.  Constipation, “brain fog”, jaw clenching overnight, headaches (especially migraines and caffeine withdrawal headaches), depression, tremors and muscle cramps are some of the symptoms of magnesium deficiency.  As if this isn’t enough, empty calories from sugars and grains replace the nutrient dense foods we need, leaving us malnourished and sick.

Children are sensitive to high sugar loads.  The child who eats a cereal of refined starches and sugars in the morning is likely to crash at school before lunchtime when his or her blood sugars drop.  Blood sugar drops (hypoglycemia) are common in children and adults on high carbohydrate diets.  These episodes promote attention deficit symptoms, anxiety and irritability.

So it seems we become fat and mentally ill via stealthy foods common to the Standard American Diet.  Hidden sugars in foods we think are good for us are making us sick.  Grains, modern wheat in particular, were never meant to be consumed in great quantities, and certainly not daily, by human beings, or our companion animals.  Just check out the ingredients in foods eaten by obese, sluggish and sick cats and dogs suffering from diabetes, arthritis, dental plaque and gum disease.

Dental plaque, tooth decay, tartar and gum disease are the first signs of a diet gone wrong.  Fermentable carbohydrates, including but not limited to sticky, sugary foods, dried fruits, fruit juices, potato chips, and grain products, contribute to these conditions.  Prevention is key.  A good rule of thumb is: if it decays teeth and causes gum disease, don’t eat it.  If you don’t know which foods to avoid, ask your dentist.

An interesting, albeit sad, video on how diabetes and tooth decay travel together to a population that did not experience them before: http://bit.ly/10W8gFf

Here’s to your health!

Attack of the Killer TMAOs!

Things that make you say, "Hmmm..."

This month the popular press picked up on an April 7, 2013 article published in Nature http://bit.ly/ZTlHhz  Splashed across the internet were titles like "Culprit in Heart Disease Goes Beyond Meat's Fat (New York Times), and "Researchers Find New Pathway Linking Heart Disease to Carnitine" (Forbes--Forbes later recanted with "Is Red Meat a Fish Story? Why You Should Never Believe Health Headlines", but the article was too little, too late  http://bit.ly/ZTk5V9 )

In the Nature study, when fed lean red meat and carnitine, vegans and vegetarians were found to have far less TMAO (trimethylamine-N-oxide) in their blood streams than meat eaters.  The authors note TMAO is thought to contribute to heart disease.   Carnitine was also cast under a shadow of suspicion in their study.

In an interesting twist, ten days after the Nature publication, the Mayo Clinic released a meta-analysis (an evaluation of many studies that address the same issue, in this case carnitine) http://bit.ly/15Mwr9K  that concludes, "Compared with placebo or control, L-carnitine is associated with a 27% reduction in all-cause mortality (mortality=death--AC), a 65% reduction in VAs (deadly heart rhythms--AC), and a 40% reduction in anginal symptoms (heart pain--AC) in patients experiencing an acute myocardial infarction (a heart attack--AC)."   In other words, L-Carnitine looks good for the heart.  Sadly, the Mayo study was overshadowed by the fiery press releases on the Nature study. 

Please let me explain how sad this situation is.

My distinguished colleague, Richard D Feinman PhD (for more information, look him up on Wikipedia :), looked into the Nature authors' reference list for the study and found a curious thing.  Among the references in the Nature article is #33, which contains a table describing the overriding problem with the very paper that listed it.  How the Nature authors overlooked this vital information remains a mystery:

Clicking on the table may enlarge it.

If you look at this table you realize that beef is a mini player in the story of TMA/TMAO (TMA is the molecule from which the liver makes TMAO).  Peas promote over twice as much as beef, and halibut promotes a whopping 100+ times as much TMA/TMAO as beef.













Does red meat kill?  No proof to date, and there is evidence to the contrary. Does TMAO (and/or carnitine) kill, or this just a red herring?

We do not have all the answers.  We never do.  If the Nature article hasn't deterred you, my advice: Ignore the media hype and enjoy your beef guilt-free.  But if you believe in Killer TMAOs, according to the table above you should bid farewell to fish. 

As for my dinner plate, surf and turf are still on the menu.

Stone Age Body, Space Age Diet: Nutrition, Metabolism and Mental Health

I presented Psychiatric Grand Rounds this week, Stone Age Body, Space Age Diet: Nutrition, Metabolism and Mental Health.  If you missed it and wish to see the lecture on line, you will find it here:  http://bit.ly/MybyHr   or at the OHSU Video Player: http://bit.ly/YeHgf2  Key papers and slides can be found on March 6, 2012 here:  http://bit.ly/Y5tsUQ

Psychiatric Grand Rounds, Oregon Health and Sciences University

Psychiatric Grand Rounds http://bit.ly/yEtoPM

On Tuesday March 6, 2012 from noon to 1 PM I will present Stone Age Body, Space Age Diet: Nutrition, Metabolism and Mental Health at Psychiatric Grand Rounds, Oregon Health and Sciences University in Portland Oregon.  This lecture is open to the public.  If you plan to attend, please know that parking on "Pill Hill" (OHSU) is a challenge.  Arrive early and obtain a parking pass from the information booth/center on the hill.

I look forward to seeing you there!

My posts regarding statins at Forbes

• How Rare Are Statin-Related Memory Issues? Very, according to Forbes. http://onforb.es/wuhqQd

  
  

  In this article the argument is made that memory loss is a rare event, based on the JUPITER study.  Comments under this article speculate that now that the suggestion statins cause memory problems is in the press, statin patients will claim they have memory problems, where previously there were none.

  
  

  I'm not convinced that memory problems are rare.   Statin patients have long complained of memory loss, not only in my office, but on line.  At the heart of the issue is how physicians get their information regarding the risks and benefits of drugs, and how valid that information is.  I posted the following comments under the Forbes article:

  
  

  Me:

  
  
  

  If you don’t ask the question you won’t find the answer. As a psychiatrist I ask the question. You can see for yourself. Go to www.askapatient.com and type in the first three letters of any statin to read what patients report. Reports that precede this one are not influenced by the latest news. Lipid soluble statins that cross the blood brain barrier are most suspect. By the way, statins inhibit HMG-CoA reductase, an enzyme in the pathway that makes cholesterol, CoQ10 and dolichol. The brain uses HMG-CoA reductase to produce cholesterol on site. The blood brain barrier and the brain’s requirement for cholesterol are reasons the brain retains it’s own HMG-CoA reductase rather than harvesting cholesterol from the blood. Cholesterol is involved in signaling and brain structure. I think we are seeing the tip of the iceberg here.
• Matthew Herper, Forbes Staff:

  But what if you get the same answers if you give a placebo? In Jupiter, about one-sixth of people reported myalgia, whether they were getting Crestor or placebo.

  Me:

  Sadly, when you look at these trials you must ask who is behind them. AstraZeneca, marketer of Crestor (rosuvastatin), was behind JUPITER. Michel de Lorgeril, MD, of Joseph Fourier University and the National Center of Scientific Research in Grenoble, France, and co-authors re-evaluated the data and found wide discrepancies. So, how solid is that data? Will we ever know? A bigger news story that did not make front page news (although the press reported it here and there) is tactics used by pharmaceutical companies to make research studies an arm of marketing. Richard Horton, editor of the Lancet, gives testimony to Parliament as to tactics employed:

  http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhealth/42/4121604.htm

   The beginning of the JUPITER trial pre-dates Dr. Horton’s testimony. There is a Statins Effect Survey going on now, by University of California San Diego. It will be interesting to see what the researchers learn. What we need is independently funded studies, sans pharmaceutical company influence, but money is at issue. Advertisements should be eliminated from medical journals to help prevent publication bias, but money is an obstacle here as well. While the US government has made attempts to make research more transparent, basically whoever pays determines what we get.
  
  

  
  

  If you wonder whether a statin is right for you, I suggest you start your research with www.thennt.com:

  
  

  Satins for heart disease prevention, without prior heart disease:

  http://www.thennt.com/statins-for-heart-disease-prevention-without-prior-heart-disease/

  
  

  Statins for heart disease prevention, with prior heart disease:

  http://www.thennt.com/statins-for-heart-disease-prevention-with-known-heart-disease/

  
  

  There is much more to this issue, which I plan to share on a later post.

  
  

  
  

  
  

How Can People Who Gorge on Fat and Rarely See a Vegetable Be Healthier Than We Are?

http://discovermagazine.com/2004/oct/inuit-paradox

The Inuit Paradox

by Patricia Gadsby

This article presents a conundrum for many of us.

The Inuit demonstrate that humans can survive in good health, without diabetes, heart disease, tooth decay or constipation, on a 70% (saturated) fat carnivorous diet.  Without oranges, where do they get vitamin C? Without grains, where do they get vitamin E? Without fiber how can they stay "regular"?  How do they maintain their probiotics? Eating so much saturated fat, why didn’t traditional Inuit endure chronic illnesses Americans believe come from consuming saturated fats?  

While Atkins was mostly correct in his assertion that the human body can maintain normal weight and reasonable health on a very low carbohydrate, carnivorous diet, the Inuit show that he left out a few details.  He relied on muscle meat rather than organ meats, overlooked probiotics, did not include bone broth or bone-based foods for minerals and other invaluable elements, and more.  This could explain why dietary supplements are required for an Atkins diet, and may also explain why some people do not do well on this diet.  In his defense, however, for cultural reasons Americans are unlikely to embrace an Inuit-style diet.

To live successfully on a carnivorous diet we must eat the organs (liver, e.g.--most of us don't eat liver anymore—offal is a source of vitamins and minerals, including B vitamins, and vitamin C), eat raw meat (a source of Vitamin C) and fat, make use of the bones and skin ("snout to tail" dining) and promote fermentation (rotted "stink fish", one Inuit source of probiotics).  This is what the Inuit did.  Since most of us eat an omnivorous diet sans organ meats (a.k.a. offal, considered "awful" by most Americans) but full of muscle meats, American omnivores are best served by eating nutrient-dense vegetables along with animal foods (meats, fish, eggs, poultry, our ancient B12 source).  A clean source of raw animal foods would help us optimize our health.  We need properly prepared bone broth (soup stock) to prevent mineral deficiencies, replenish and repair bones and joints, promote regularity and restful sleep, keep skin youthful, etc. (watch any film from the 1940s and notice the popularity of traditional home-made bone-based soups that take a day or two to properly prepare).  We need natural fats for energy and organ support.  Sadly, and to our peril, most American omnivores no longer value these dietary ways but depend on supplements and government regulated food fortification to make up for what we lack. 

One might argue that the traditional Inuit were short lived as a reason not to look in their dietary direction.  But most Inuit groups had a significant number of elderly individuals, sometimes living to 80 years and beyond. By and large mortality came from accidents, violent conflicts (human and animal), and infectious disease rather than chronic disease.  The introduction of disease by the Russians is cited as one factor in Inuit mortality, much as war and European diseases such as syphilis, small pox, measles and influenza decimated Native American populations.  To say these people were short lived due to diet is unsubstantiated.  Theirs are the diets that carried humans to modern times and modern longevity, with our ambulances, surgeries, heart stents and bypasses, injectable insulin, chemotherapy, antibiotics, and dentistry.

On the subject of dentistry, in addition to contributing to tooth decay it turns out that the fermentable carbohydrates (sugars and starches) the Inuit lacked stress our insulin producing cells, promote obesity, strokes, heart disease and diabetes, and feed cancers.  An abscessed tooth is a potentially deadly five-alarm fire you cannot ignore.  Without modern dentistry, fearing the dreaded abscess you and I might be smarter about what we eat, and if so, you might not bother to read this article.  Traditional native populations were acutely aware that obeying Mother Nature is the key to health.  Wild animals obey her laws and have excellent teeth and overall health under normal conditions.  Mother Nature's dietary law states that no matter what diet you embrace, if it rots your teeth don't eat it, 'just one more reason to be selective about your carbohydrate intake. 

So, to those of us who insist humans require grains, fiber, fruits and vegetables, yogurt, and cannot be carnivores in good health, the Inuit demonstrate how early Native Americans survived their winters, how early humans survived the Ice Ages, and the complete nutrition available to us in wild fish and game. And, although we will not embrace their diet verbatim anytime soon, we can learn a lot from the traditional Inuit.