Thursday, July 17, 2008

Update

Well, here I am briefly. Things have pretty much ground to a halt on Hyperlipid. What has happened is that my boss has broken his little finger, in to lots of little pieces (pushbiking is pretty dangerous!). The steel pin, support dressing and full time sling don't seem to be doing much good so he's off work for 6 weeks and I've gone from working one day a week to working full time. Then our other primary surgeon is on study leave for his surgery ticket and our full time internal medicine slanted vet is off sick... So this is the first time I've logged on to do anything other than check work emails.

I'm just finishing week four out of six... By the time I get to answer comments people will probably will probably have forgotten they posted them! Still, it pays off a chunk of the mortgage.

So apologies for the lack of activity and replies.

BTW the off sick vet is really interesting. Anaemia to the point of hyperventilation after climbing the stairs and recurrent major infections. Ah, Weight Watchers and wholemeal bread! People love these wacky diets, play at your own risk!

Peter

40 comments:

Bill said...

Hi Peter,
i need to lose weight i weigh 300 lbs at 5 feet 10 inches i wat it to be high in fat 70 or 80% to get my insulin down.I know to much protien turns in to insulin so i want to keep it high fat.I just bought organic cold pressed coconut oil and i love butter and eggs and bacon ant suggestions.

thanks Bill

Kevin said...

Hello Peter,

I read an article in a veterinary periodical that claims vets have a higher suicide rate than MDs or dentists. Your sickly colleague reminded me that stress causes a lot of disease as well as presaging suicide. Probably we vets have better access to euthanasia solution than other medical types. In my state, wyoming, we also have easier access to handguns.

Kevin

Cardimom said...

Ah, just a couple more weeks; the end is in sight. We're all (I assume you too) looking forward to having you back.

Misty said...

Peter,
We all miss you...take as easy as you can....is great that you are able to fill in for your colleague.
Take care,
Hela

Chainey said...

Make hay while the sun shines! I'm in a similar situation (of working irregular hours and having a highly variable income), and I just drop everything else like a hot potato when work comes in.

We'll be here waiting.

Bruce K said...

Bill, you might want to try out the naturally refined coconut oil. It's usually just melted and filtered by fuller's earth or clay. Ray Peat is one of the authorities / proponents of coconut oil and he has seen that unrefined/virgin oils often cause a problem (allergy, hypoglycemia, and intestinal problems). He suggests a coconut oil refined the traditional way by filtration. Spectrum Refined is an acceptable brand in the USA. Otherwise, just look for "76 degree Coconut Oil" as cheap as possible. It should have a clean fresh taste, not a smoky, burnt, or disgusting taste. Here's an article by Ray on coconut oil.

http://raypeat.com/articles/articles/coconut-oil.shtml

Other fats I would suggest are mac nut oil, cocoa butter, ghee, kidney suet, pork leaf fat, etc. They are all very low in PUFAs, whereas most vegetable oils are very high and I would avoid them totally.

http://raypeat.com/articles/articles/fats-degeneration.shtml

Peter said...

Hi Bill,

The approach I use is outlined in some detail here. You may want to back off a little on the amount of fat and remember that JK's ideal weights will be higher than many people want.

Just choose the ratios for weight los, fix yourself up with a Fitday account and you're away.

Peter

Misty said...

Thanks Peter, I just wanted to see your view of it, none-the-less I think you are right about following the OD...hope you are having a restful Sunday.
Hela

Peter said...

Hi Kevin,

Yes, I think I've read the same. Hopefully she'll stop WW soon and get on with regaining the transient weight loss it produces. At least this will get some nutrients on board. Hope so.

Peter

Peter said...

Cardimom, Hela and Chainey,

I've taken some tips from Stephan about ecodriving and use the hour and a half each day in the car as a time to listen to music and chill. The biggest stress is probably on my wife as I'm away just after 7am and often not back until between 8 and 10pm, so she does most of the Squigg work as well as being well in to the third year of her PhD. In her copious spare time she's started writing up her thesis and has begun a novel! That's what comes of being a workaholic and having a supervisor who teaches creative writing on her days off...

Thanks for your thoughts,

Peter

PS Chainey; why do you keep taking your blog down? It's on my bookmark list alongside Cardimom's

Peter said...

Hela,

Today has been a total family day. Just great. Tidied the garden, fed the ducks on the village pond, been to the park, picnic in Newbury. Squiggs watched a narrowboat come through the lock in central Newbury and was fascinated. Just a good day. Having a brief catch up here while supper cooks... We've grown some tomatillos so it's chicken in green salsa, first of the crop tonight.

Peter

ItsTheWooo said...

kevin - It could also be that individuals who are interested in medicine BUT with mental illnesses may be more inclined toward veterinary school than medical school or dentistry.
For some people, an underlying mental problem may have symptoms like being intolerant of working with humans; if this individual was medically inclined, naturally they would choose to become an animal doc instead of working more closely with people.

I don't mean to imply that vets are antisocial or crazy! I just meant to say that people who have emotional problems may push them toward vet school instead of working with people. I only thought of this because I myself considered working with animals for precisely these reasons, lol.


It's kind of like how mental health workers are notorious for having their own difficulties... a person's profession says a lot about their personality, and being very interested in animals may be a marker for emotional issues that make working with people difficult.


(BTW, in spite of an interest in medicine/health and difficulty with socialization...I finally decided to go to nursing school. Yea, I must have been on crack. If this doesn't work out because of the people thing, my next career might be... vet tech!
I would probably make a better kitty/doggy nurse than a human one. I love animals and find it very easy to deal with them.
I only didn't consider the job because I assumed they must make minimum wage. When I found out vet techs make 20+ per hr I felt like a big idiot for not considering it earlier.

Misty said...

Glad to hear that you had sometime for you and your family...feeding the ducks is so much fun, I lived in Florida right by a lake and used to feed every afternoon lots of ducks(they were there always on time...5:00pm in the summer and 3:00 pm in the winter). Your wife is amazing to be able to do a PhD and take care of Squiggs...being a mother of an 11 month old baby girl, I can testify that is not a trivial job...I can tell you that she must miss your company and help, it is a big help having your husband home.
Anyway, it seems like you were able to recharge energy this weekend.

Chainey said...

ITW: It may be different in other parts of the world, but here in NZ it's exceptionally difficult to become a vet. The places in university are oversubscribed several hundred percent every year so they only take the cream of the students.

Plus, of course, you have to know about the innards of many different critters, not just humans.

Chainey said...

Peter: I fell off the wagon rather badly and decided to "walk the walk" for a while before I talk the talk.

By the way, what do you think of the foodstuff called Creme Fraiche in relation to low-carb eating? I tried some and found it rather palatable.

Nicola said...

Hi Peter,

It is said that we need extra salt to digest cooked meat / protein.
I don't know for shore and when I ask others some believe we need salt but don't know for shore. Those following a raw meat diet claim that salt is not needed.

How do animals on a natural diet of raw meat make hydrochloric acid?

Nicola
Switzerland

Peter said...

Nicola,

I'm not really sure where the question comes from. As I understand it the enzyme carbonic anhydrase splits H2CO3 in parietal cells to give a bicarbonate ion (which ends up in the plasma pool in exchange for a chloride ion) and an H+ ion which is pumped in to the gastric lumen with the Cl- ion. The bicarbonate ion, as NaHCO3, is used to neutralise the HCl in the small intestine giving NaCl. NaCl is easily absorbed from the intestine. I can see no net loss of sodium or chloride here. So is the cooked meat supposed to be doing something to this cycle which raw meat doesn't?

Beyond me.

BTW extracellular fluid is sodium and chloride rich, there is a fair amount in meat, especially if you drink the gravy. Our kidneys have phenomenal powers of sodium retention on a zero added salt diet. Serious sodium disturbance is fatal. I spend half my life pouring salty water of assorted compositions in to the veins of patients in which the control system has gone wrong for various reasons.

Peter

Peter said...

Fair enough Chainey!

Peter

Kevin said...

Chainey said...
ITW: It may be different in other parts of the world, but here in NZ it's exceptionally difficult to become a vet. The places in university are oversubscribed several hundred percent every year so they only take the cream of the students.

While in college we were told the same thing, that there were 10 applicants for every seat in the vet medical school. The fallacy is that every failed medical, dental and chiropractic student also applies to vet medical school as a back-up. The admissions office spent most of their time weeding out dilettantes. One method was giving applicants a tour and showing them students doing rectal exams on cattle. When I was in vet school a tour got to see me cutting a dead calf out of its mother. It had been dead several days and maggots were crawling everywhere...on me, in my hair...

Nicola said...

Hello Peter,

The real human diet is a totally carnivorous one...but when it comes to salt?

http://tinyurl.com/6kouyp

http://tinyurl.com/589yul

Do you believe/know if raw or cooked meat needs extra salt for our body to produce hydrochloric acid and meet all body needs?

Nicola

Peter said...

I would agree that it is possible to be healthy eating a totally carnivorous diet but I personally doubt very much that it has been the pattern for humans world wide.

To reject vegetable food complepetely would be too wasteful of available resources. This seems as contrarian as the vegan approach, except the full vegans do not seem to be healthy long term (not that I know any) unless they supplement, where as full carnivory allows this.

Re salt, digestion cycles salt. Those who suggest cooking increases total body salt requirement need a mechanism. Without that it smells like religion to me. Full carnovores are perfectly well able to extract the 160mmol of salt from extracellular fluid and a few more mmol from intracellular fluid. Zero sodium urine is well within the ability of humans, dogs and cats.

Where is the physiology to base the discussion around?

Peter

marco said...

Hi Peter.

I know I'm probably OT here, but I'd like to ask you a question
with regard to the relationship between cancer and glucose. I've read somewhere glucose has a very similar molecular structure than Vitamin C and this is the reason for many low-carbers to say vitamin C needing is lesser on a LC diet. I'm not trained in molecular biology but could it happen that cancer cells, in their needing for glucose, try to metabolize (BY MISTAKE) Vitamin C molecules, with the consequence of large developement of hydrogen peroxide, TOXIC to them, and maybe less production of glucose via gluconeogenesis? I don't know whether a study combining an EXTREME low-carb diet with large amount of Vitamin C has ever done.
Or maybe they've done a lot of study about cancer and vitamin C, or about cancer and ketogenic diet, but never linking the two things?

Marco

ItsTheWooo said...

I didn't mean to imply that it was in any way easier to become a vet... I meant that people who may have social issues are more likely to want to be a vet than other medically inclined people (and then these individuals may be at a higher risk for suicide because social issues often go together with other emotional problems).

Sort of like how some mental health workers are rumored to be less mentally stable than other health professionals... it doesn't necessarily mean being a mental health worker is more difficult than any other health care job... just that the factor of working with mentally ill people may attract individuals who are a little mentally ill themselves.
Then again, I don't know much about vets, and if what you said was true it does sound like an extraordinarily stressful profession.

JohnN said...

"To reject vegetable food complepetely would be too wasteful of available resources."

Hello Peter,
I'm glad you raised this point. The papers on Fiaf (Fasting induced adipose factor) mention the conversion of starch and fiber to SFA by the gut microbiota.
A few points can be made about this overlooked contribution by the gut flora to overall health:
1. It explains the Kitavan Paradox if there is one.
2. Usable energy (by the host) through the consumption ot starch and fiber may haven been under-estimated without taking into account the positive energy/caloric contribution by the bacteria - our own compost heap. The familiar "a calorie is a calorie" argument and the citing of the laws of thermal dynamics miss this point.
3. One can fuel the body by carb but run it in fat.

Kudos to you for posting on the Fiaf papers. This conclusion from one paper is particularly relevant:

"...these findings support the notion that the gut microbiota can influence both sides of the energy balance equation, and underscore the importance of considering our metabolome in a supraorganismal context."

John

Peter said...

Hi Marco

The similarity between glucose and ascorbate has all sort of ramifications relating to heart disease and cancer, but they seem quite complex. As regards ascorbate for cancer, there seems to be quite good evidence that it is an effective chemotherapeutic agent in vitro at concentrations easily available from intravenous infusion in vivo. Obviously this is relevant to the Pauling Cameron study from the Leven Hospital in Scotland (10g/d IV for 10 days). Looks like free radical generation and apoptosis induction might be the mechanism. Don't have the papers to hand and not sure how well it fits in with ketogenic diets.

Undoubtedly high dose IV ascorbate is chemotherapy, it's not really nutrition. It does seem a great deal safer than a lot of chemotherapies, the question is how effective it is in vivo. Would need a decent trial, unlike the Mayo trial which was supposed to repeat the Leven study but omitted the IV doses of ascorbate. Oops. I don't think you could achieve chemotherapeutic concentrations orally, even with ketogenic hypoglycaemia to help. But really dunno on that one.

PS The Pauling/Cameron paper was only published in Proc Natl Acad Sci USA, Eades has a lot to say about this type of publication (poor peer review).

Peter

Peter said...

Johnn,

I have enormous respect for bacteria, gut and elsewhere. They've been playing evolution for a lot longer than we have, though that may be a wrong way of looking at it... after all we're probably all bacteria/archaebacter derived organisms.

Peter

Bruce K said...

Peter, Michael Eades said in one of his recent posts that you need more salt on a low-carb diet, esp in the beginning phase. I think this might have something to do with the usual advice to drink lots of water. That causes electrolyte imbalances which lead to problems like cramps on low carb diets. Raw meats might prevent this water loss, based on anecdotal reports from people feeding animals raw meat. Avoiding dried foods like cheese might also be a good idea. I have noticed that Jan K. encourages liberal water intake and people who eat his diet say they need to drink more water. There are many reasons, I think, it would be a good idea to avoid drinking water. For starters, most water is deliberately poisoned with fluoride or chlorine bleach. I believe it would be healthier to do anything we can to avoid drinking a water source contaminated with such hazardous chemicals.

JohnN said...

Peter,
No criticism intended on the earlier post. I was just musing about whether human can be part-time ruminant - a vegetarian diet with lower demand on insulin and more suitable for this over-populated Earth.

Peter said...

Johnn,
Yes, this is a niche which has been exploited pretty well by rabbits and guineapigs (who still require coprophagia to fully absorb nutrients) and par excellence by the equidae (who don't). All hind gut fermenters and very successfull, running of volatile fatty acids and using minimal insulin until domesticated. Not sure about the PCRM and their dietary habits. I don't really think real humans could go this route with our canine/feline style gut. If we could, and the Earth then supported 60 billion people, where would we get oil for all those SVUs? There are only so many Iraqs.

Peter

Bruce K said...

"To reject vegetable food completely would be too wasteful of available resources."

I disagree. Growing rabbit food and transporting it by truck is a waste of resources. If you want to grow a few things in your own garden, that might be a good use of resources. I don't know. It seems wasteful to me for stores to sell foods like green vegetables, tomatoes, berries, etc.

Peter said...

I'm thinking evolution-wise. Digging up a sweet potato which has been storing starch for its own use in the future and stealing it's future existence strikes me as a good use of 60 seconds with a grubbing stick. Humans are clever. And remarkably stupid at the same time, eg growing green leaf vegetables nowadays and regarding them as bulk food.

Peter

donny said...

http://jn.nutrition.org/cgi/content/full/127/10/2000

This is a paper that estimates calories from short chain fatty acid synthesis in the colon for the Western Lowland Gorilla. Including fermentation, fat comes in at 60 percent of calories. Carbs at 16 percent. But an almost all greens diet really puts the whole slow-carbs stuff to the test, the carbs are probably absorbed at such a rate that gluconeogenesis is just slightly tamped down.

David Jenkins was involved with that study. He did another study where he tried to feed people an all vegetable and fruit diet, but he had to add about a cup of nuts to keep them from losing weight. They spent a solid eight hours a day just eating. The amount of food was ridiculous, I think it was over ten pounds. By the time you take a lot of this stuff (I mean the Dean Ornish Eat more weigh less stuff) to the extremes necessary to achieve desireable therapeutic results, the diet just isn't practical. They test at the extremes, then they advise more moderate approaches that don't actually do anything.

JohnN said...

Peter:
With 60B folks fattening on grain, alternative energy research had better get started on plan to recycle oil through liposuction. I'm pretty sure surgery can be employed to stretch the length of the colon to enhance its fermenting efficiency.
There's this growing horde of plant-eaters goaded by this catchy mantra with Haiku-like simplicity: "Eat food, not too much, mostly plant." The middle part of which seems difficult to implement without help if you're constantly in a graze mode.

Peter said...

Johnn,

Don't forget to harvest the methane produced too, with the price of gas in the UK we could do with more high fiber humans contributing to the national gas supply. Practicalities again impinge, but perhaps a flatulence storage organ could be implanted and vegans could then off load twice a day at specialised gas collection points... Dunno as I like the image much!

Peter

Peter said...

Hi Donny,

Was he involved in the Paignton Zoo entertainment-pseudoscience documentary? If I had a little more time I'd have blogged on it ages ago. Another "gathering was good for a week" diet!

"honey, hazelnuts and fresh fruits and vegetables like watercress, broccoli, carrots, cabbage, tomatoes, radishes, strawberries, melons, mangoes, apricots, bananas, plums, figs and Satsuma mandarins"

I'd love to see many HGs eating this way!

Peter

Peter said...

This "study"?

Sven said...

"...other great apes are very effective hindgut fermentors (Milton and Demment 1988, Van Soest 1994). The sacculated colon of humans led Elliot and Barclay-Smith (1904) to conclude that the colonic structure of humans is closer to that of a herbivore than to an omnivore."

Is that true? Is the digestive tract of apes similar to humans´?

donny said...

Nope, not that study. Very similar protocol and results, though. I always have trouble digging the study up because searches generally result in the zoo study you posted. I'll find it later and post it.

JohnN said...

For Chainey:
The French must be in a creative mood in naming fermented cream "fresh cream" - the English translation for creme fraiche. You can easily make it at home just like making yogurt by substituting heavy cream for milk.
Slowing down the fermentation by chilling the cream (overnight) half-way through yields more delicate flavor. Top that on berries with a few drops of balsamic vinegar and maple syrup is my favorite dessert.
I recall Peter commented previously to the effect that fermented cream can undo the damage of Pasteurization. Perhaps, by straightening out the damaged protein with their own HSP, or digesting and then reconstituting it? I'd like to think the bacteria makes the milk alive again with the new enzymes.

Bruce K said...

"I'm thinking evolution-wise. Digging up a sweet potato which has been storing starch for its own use in the future and stealing it's future existence strikes me as a good use of 60 seconds with a grubbing stick."

True, but how many grow potatoes in their back yards? Most are shipped. We need to change our whole concept of nutrition to rely on dense foods rather than high-fiber rabbit food.

"Humans are clever. And remarkably stupid at the same time, eg growing green leaf vegetables nowadays and regarding them as bulk food."

Vegans use lots of stupid arguments like saying it takes so many pounds of grain to make one pound of meat, but who can eat 20 pounds of grain, or whatever it would be? We evolved to eat a low-fiber diet, IMO. A lot of tribes ate no-fiber diets. Using land to grow rabbit food is a worse waste of resources than feeding the cows grain, IMO.

Here's another example. It would be much smarter to import coconut oil than to import bananas, if you look at the cost-per-calorie side of the equation. Michael Pollan's axiom to "eat food, not too much, and mostly plants" is 2/3rds right.