Wednesday, August 20, 2008

Rheumatoid arthritis and fasting

Many moons ago (it seems) Bloggeier sent me a pdf of a paper in which a group of researchers made a serious attempt to look at the roll of food allergies in rheumatoid arthritis. They went deeper than simple food challenges, antibody counts and skin prick allergy testing. They looked in to the small intestine, I won't go in to how, and found that people with rheumatoid arthritis have food allergies. Lots of food allergies. Never mind the levels of antibody in the blood, local reaction in the gut picked up far more allergies than it seems fair for anyone to have. Food seems to be important in RA.

I've had this paper lying around for ages but pretty well ignored it due to its vegan/vegetarian stance. I really shouldn't let my biases stop me thinking about interesting stuff. Before I get on to the main jist of this post I'd just like to point out that this group also looked at antibody counts against Proteus mirabilis during their intervention diet and the antibody counts dropped in some subjects. This is important if you have followed Ebringer's work on bacterial mimicry as a trigger for auto immune diseases. There is a protein sequence on the surface of P. mirabilis that is remarkably similar to certain sequences on the HLA molecules associated with RA in humans. The diet changes, used over a year, ONLY helped those people in whom the antibody titre to P. mirabilis dropped. Look at it this way, you could eat a totally allergy free diet, say a cocktail of amino acids and glucose, and P. mirabilis could assemble those amino acids in to an allergenic protein.... Neat hey? RA is associated with antibodies to P. mirabilis and this holds true in various countries around Europe. I'll come back to this later.

Back to the study. They starved their subjects for the first 7 days. As far as I can see they used a water fast. It produced dramatic improvement.

The same group looked at ketosis without calorie deficit and it didn't work, though I don't know what components were used in the less than 40g of carbs per day which were allowed. This may be important, especially if gluten was included in the carbs. In a separate study they looked at various cells in the immune system after a 7 day fast and found that CD4+ lymphocytes, the ones I chatted about here, went sleepeebyes after a fast.

What's happening during a fast? Well, you're not getting any food! So for food allergens it's an absolute, total and complete elimination diet. Then your GUT BACTERIA aren't getting any food either. In fact, your gut bacterial count is likely top drop like a stone when you fast. If you are remotely lucky your P. mirabilis count will also drop and your CD4+ cells might start ignoring both proteus and your HLA DR1 and DR4 molecules.

So fasting is good news. Personally I've only ever played with fasting for 48 hours, in a spirit of companionship with a friend who was fasting for non specific arthritis. We both did 48 hours and, because we were both already in full ketosis, it was easy. That included cooking carbs for my children over that 48 hours. I don't know how easy it would be to extend this to 7 days, and my willpower might be markedly influenced by the size of the RA gorilla sitting on my shoulders. It worked for the non specific arthritis BTW (which has never been worked up and could be rheumatoid).

But no one can fast for ever and expect to stay healthy.

Assuming the improvement occurred, as it really should, anecdote and Kjeldsen-Kragh's work supported, how should you break the fast?

I'd suggest with a single food substance of absolutely no allergenic potential and of no use to P. mirabilis. Beef dripping comes to mind. I discussed long chain fatty acids and starving your gut bacteria in the fiaf posts. The colon, home to P. mirabilis, is anaerobic. Nothing can be done here with a fatty acid. Fatty acids only do oxidation, never fermentation. Aesthetically I guess clarified butter might taste better but watch the casein and lactose. Next would be to add some protein. Not much, say 40 grams as a maximum. You want it all absorbed and none to get through to the colon. Egg yolks first, whole eggs next. If you are still ok you are set up. You can live on eggs and clarified butter. How big is the gorilla?

After that it's a matter of introductions and seeing what happens. In general animal protein won't make it to the colon, cereal protein will always and pulse protein is not worth the risk.

Unless you want to stay in frank raging ketosis some carbs are going to be needed. That's a tricky one. Obviously any fiber will feed colonic bacteria. No fiber. Simple sugars with absorption slowed by a high fat meal might do the job. Optimal icecream comes to mind. A peeled potato might do a reasonable job too, as chips if you like.

It feels a bit odd sitting here musing about a disease as nasty as RA when I don't have it. Having read a little about RA, it seems that musing without the disease is infinitely preferable to musing with the disease.

Peter

46 comments:

emil henry said...

Brilliant. Your posts have sparked a certain interest in microbiology for my part. Any textbook recommendations?

What would be the best way to avoid excess glycation? Reduce PUFAs (unstable?) and avoid carbohydrates after high-fat meals? Mix carbohydrates and fat? Just curious.

Cheers,
Emil.

gunther gatherer said...

I second that, Emil.

Reading this blog, as well as various other ones that focus on the actual biochemistry of what our bodies do with and as a result of food, has begun to fascinate me.

Peter, have you some titles for laymen who want to understand biochem from JK and your point of view?

BTW, three kilos from my goal now, and hoping you'll join me at some point in the "fat marathon week" experiment I mentioned in a previous comment.

Thanks,
G

Peter said...

Hi Emil,

There is quite a lot of microbiology in Power Sex and Suicide, a great read by Nick Lane. I've vaguely read assorted pro-microbe texts over the years which detail some of the amazing metabolic tricks bacteria can do but I can't remember any of the titles... The extreme-ophiles are particularly interesting and nowadays I think you could just google or wiki something like bacteria + evolution. There's probably lots out there. Most of the info on H pylori came from pubmed and google

Re glycation, yes avoid sugar and PUFA. There is a bit of a trade off on the omega 3s and they form different signalling molecules to the omega 6s. Obviously we can cope with some glycation.

Peter

Peter said...

Hi Gunther,

Part of the reason I keep the blog is because stuff supportive of JK is spread a bit thin and there's no real text that covers it. For overview I still use an old copy of Mosby's Crash Course in Metabolism and Nutrition. I use the Sarah Benyon copy, 1998 edition. Definitely get it second hand, horribly expensive for what it is, especially as you can wiki "beta oxidation" and get a pretty good overview. Just you have to know what you want to know...

A fat week, hmmm, I can make 3500kcal ok but I'm not sure if 5000kcal is practical. Have to think a bit but I'm willing to try...

Peter

Cardimom said...

Very good post, and what a coincidence, yes? I'm definitely going to give fasting a try again.

Peter, do you have any opinion on legth of fast? You mentioned doing 48 hours with your friend, the study used 7 days, and I had disappointing results with 24 hour, weekly fasts (although I many not have given that enough of a trial).

As a note on food allergies, diet and RA. Now, I haven't experienced much pain relief from a grain free/sugar free diet; BUT, anytime I break from grain free/sugar free, I get CONSIDERABLY worse, as in within a day after a single meal plus dessert. From the available research, I think gluten/grains are a huge player in creating/sustaining an autoimmune response and, in my opinion they should be avoided like the plague by people with any autoimmune disease.

I also think, from experience, simple sugars, particularly refined sugar, is the devil when it comes to inflammation, which is also supported by current research. I have several joints that become visibly more swollen the day after giving in to dessert craving.

Again, excellent post; just the extra motivation I needed to give fasting another try.

Jennifer

Peter said...

Hi Jennifer,

Two days, seven days... Ask your joints! They know best.

Good luck

Peter

Markus said...

have you looked at the role of lectins in leaky gut syndrome.
one plausible hypothesis is that - when lectins (all deadly nightshade plants - potatoes peppers tomatoes (seed juice) grains and legumes etc..) attack the gut mucal lining, whole proteins are allowed across the blood barrier - exciting auto immune response - this has been put forward as a possible cause of MS.

Markus

mtflight said...

Good stuff here. I'll have to look for these books!

My sister was recently heavily afflicted with RA recently. A big heavy gorilla. I told her to stay away from gluten, but I have a feeling that was taken with a grain of salt.

Ended up taking steroids.... a fast would've been great.

mtflight said...

Gunther and Peter,

I vaguely followed the comment dialogue regarding "the fat challenge."

My body fat is in the high teens, and I'd like to get it down to the low teens--what's the challenge? I am a low carb eater, but I eat big. So I'm willing to partake!

Alex

Peter said...

Hi Markus,

There are a few posts under "Gluten". Ebringer has a lot to say about MS and acinetobacter. You can just Pubmed Ebringer. BSE and acinetobacter too! Though he couldn't get that last one published, despite being funded by DEFRA. Politically incorrect.

Alex, Gunther is interested in whether caloric restriction is not needed to maintain target weight, but is needed to get there. Once he's there we were thinking of lots of calories and not too many carbs...

Peter

mtflight said...

Hi Peter,

I concur with that line of thought. In my experience I could eat many surplus calories, and not have any weight gain. As long as the calories are not carbohydrate calories.

In the same way, what was once a "diet" to burn off fat, has settled down to maintenance by itself. Cutting back carbs further affords no weight loss as long as I keep up my surplus calories. Anecdotal if you will, but that's my experience.

gunther gatherer said...

Hi Alex,

The Fat Challenge was a comment I left in Peter's "Food: Optimal Ice Cream" blog entry from a few days ago. Basically, I'm noticing that Peter's maintaining very low weight (from 63 to 65kg) on about 3500kcal a day. I've estimated he eats about 350 grams of fat daily on average. Assuming his ideal weight is 65kg, he's eating more than 100g OVER JK's optimal diet recommendations and still keeping a very low BMI, without any regular exercise and assuming he's not 6 foot 7.

Peter initially got his weight down by reducing carbs on an Atkins plan, going from 67kg to around 60kg. His calories were reduced (around 2000-2500) and he was exercising a lot then. But now he's eating way over that in calories on JK.

My challenge, if you will, is the premise that fat won't make you gain weight, but you do have to reduce calories to get to your initial ideal weight. From there, you go on JK's optimal diet and your weight should stay the same.

Anyway, I'm still trying to get to 65kg, so when I'm there, I'd love to see what happens if you guys would like to try keeping OD levels the same but eating 200 grams more fat. Aw come on, it's just a week...

gunther gatherer said...

PS- I meant Peter was eating over 100g of FAT over JK's optimal diet recommendations. Holding at 63-65kg, he's only religiously limiting protein and carbs, so fat would the thing to test... does it make you gain weight??

treefrog62 said...

Hmm, I am fairly new to reading this blog (finding it very interesting and informative by the way), so I am not sure who/what JK is?
Dr. Eades also claims that once you get to your ideal weight, that eating fat will not cause weight gain. I believe it.

gunther gatherer said...

Hi Treefrog,

JK is Jan Kwasniewski and OD is his Optimal Diet. Peter discusses this regimen in the "what I eat" blog entries.

Can you put up some links to Dr. Eades' comments on not gaining weight with fat alone? I'd be interested in arming myself with this for the Fat Challenge...

ItsTheWooo said...

I am terrified of RA, seriously, I hope to god I never get it.

I'm wondering perhaps the food allergies are an effect, as well as a cause? One immune screwery seems to make another more likely; it's hard to determine causation.
If they get better after fasting, that only may mean that their immune system went to crap after starving (as it tends to do). I would think any ketogenic diet would eliminate almost all allergenic foods (or at least reduce them to infinitesimally small quantities). If they showed no improvements at all on a caloric ketogenic diet, it seems to me that the reason starving worked is because starving is an immune system suppressant (whereas caloric ketosis is not).

Peter said...

ItsTheWoo,

For that paper I only have the abstract, so no idea about grain elimination. But the group are using vegan/vegetarian approach which makes me suspicious.

No mention of vitamin D levels either, should be checked in AA diseases.

While I have a lot of time for Ebringer and his HLA B27 associated diseases (managed by starch elimination) you have to wonder whether people with this HLA subtype have always been klebsiella intolerant, or if D3 deficiency, omega 6s excess and anything else you can think of might be behind the problem. Unless you are of eskimo descent you probably evolved eating some starches... without ankylosing spondylitis.

Peter

info said...

Hi Peter,
I sense you are not much of a porker: maybe due to higher PUFA?
In the past, pork seems to have been a mainstay of Sardinian and Okinawan fare and it hasn't appeared to effect their longevity.
JK too is not pork averse.
Surely the pig is deserving of a post!
Kind wishes, J

Hermione said...

Hello Peter,

I do have RA. Is this the study you are talking about?
http://ki.se/ki/jsp/polopoly.jsp?d=469&a=52276&l=en&newsdep=469

Norma

The SCD girl said...

I am part of a very (very) small group of individuals treating my RA with dietary changes.

I found out that gluten was no good and neither were grains a couple of years ago. On standard therapy, I didn't get better at all!

After that I started doing more research on the role of gut bacteria, and I realized I had huge imbalances due a total sugar addiction.

Somewhere in that time, my son was diagnosed with autism. Surprise -- he can't handle grains either.

We are both now using the specific carbohydrate diet to treat ourselves. It only allows simple sugar in the form of small quantities of honey. There are no grains, no corn, no potatoes...nothing to feed the gut bugs.

We're both doing a lot better. I guess this diet has been used more widely to treat Crohn's disease/ulcerative colitis/IBS, which I will mention often occurs along with RA.

Thanks for the great read! Susan :)

Bruce K said...

Allergies involve PUFAs. If you are overloaded with PUFAs, you are more sensitive to things. Omega-3 is not the panacea we are led to think. If you look at people eating fish oil, like Sally Fallon and other members of the WAPF, they have liver spots. Those are caused by PUFAs. Ray Peat is probably older than Sally Fallon and he looks 20 years younger since he minimizes all PUFAs. Also recall that age spots (lipofuscin) on your skin imply age spots on your brain. Think it over carefully.

Simple sugars are not to blame IMO. I can eat foods like unheated honey with no reaction. Refined sugars do accelerate lipid peroxidation, WHEN your body is full of PUFAs. If your body wasn't over-loaded with PUFAs, you'd be less reactive. PUFAs spell disaster in a polluted, high-stress world. When you restrict PUFAs, the body makes Mead Acid (20:3 n-9) and that replaces LC-PUFAs. Mead Acid's vastly less inflammatory.

We're told that we need to eat lots of PUFAs, but our bodies can create 20-carbon PUFAs. These are used for eicosanoids, by definition. So, you have to choose whether you want the body run on omega-6 and omega-3, or Mead Acid, which is more stable and less inflammatory. The more you eat PUFAs, the less Mead Acid your body makes. Eating a lot of fish oil can shut down Mead Acid. Any oil that's higher in PUFAs than olive oil will block Mead Acid progressively more. Macadamia oil has 75-85% less PUFAs than olive oil. I prefer its milder taste. Giving up olive oil and nuts is no loss. I would also limit pork and oily fish and poultry.

Hermione said...

The link I posted above is to the recent Swedish study that looked at a vegan diet with and without grains. The diet with grains was more successful, apparently.

Bruce K why avoid pork? I am new to the idea of a hyperlipid diet and am just getting used to the idea that pork is good (JK) and now I read your recommendation to avoid it!

As for PUFAs, if you don't use them as cooking oils and avoid food "products" aren't any naturally occurring PUFAs going to be in manageable proportions.

I find the different approaches even within the hyperlipid fan group totally bewildering.

Hermione said...

sorry, my fingers got stuck: the Swedish study found that the vegan diet WITHOUT grains was more successful. This study came out just as I resolved to try low- carb and was reading through to hyperlipid, so it is rather unnerving.

Peter said...

Hi Hermione,

It looks like this study

http://www.ncbi.nlm.nih.gov/pubmed/11600749

which got blogged on under the Gluten and Rheumatoid post some while ago.

As far as I'm concerned the gluten avoidance is what matters, the vegan aspect is a red herring

Peter

PS I don't moderate comments on Hyperlipid unless they are simple advertising (rare). The fact that Bruce posts here dosen't remotely make him (or anyone else) a fan. The fact they are here certainly does not mean I agree with them and anyone is welcome to visit Ray Peat or anyone else's sites if they want infinitely better information than that which they find here. Not for me though, as I'm far to biased and one sided to listen to anyone else! It's true.

Re Pork, I'm currently on beef as it's £0.98/400g. Pork is over £1.60/400g and this makes a differnce to me! UK lard has BHT in it as well as rather a lot of omega 6 PUFA, so dripping (tallow) is my preferred fat (plus butter).

Peter said...

Hi Susan,

Yes, I've read alot about the SCD and I'd agree there is a lot of good practice there. It also reminds me of Caroline Sincaire's IBS/ankylosing spondylitis diet, starch free. These both seem to be pretty effective in a large proportion of people but not all. Fair enough, they're both likely to improve on prednisolone and ibuprofen. I think there are tweaks to both, Sinclaire missed the roll of nightshade lectins and SCD may miss people with salicilate intolerance. But with some tweaking both can be modified to align pretty closely to JK's approach.

I don't think anyone has all the answers, except perhaps Ray Peat and Bruce.

Peter

treefrog62 said...

gunther gatherer,
Here is one of Dr. Eades' posts about not gaining weight in maintenance if carbs are kept low. I also included one paragraph from said post. You might want to check out more from his blog, I've learned a lot there.

And thanks for the JK info, I'll be checking it out.

http://www.proteinpower.com/drmike/uncategorized/low-carb-and-calories-part-2/

As you may recall from the earlier post, a lowered insulin levels opens the door to the fat cells, allowing fat to come out to be burned. If your dietary intake meets all your body’s energy needs, however, your body will simply use these dietary calories and leave the calories in your fat cells alone. And you won’t lose. But lowered insulin levels pretty much prevents fat from going into the fat cells, so even if your caloric intake goes up - as long as your insulin stays low - you won’t store more fat in the fat cells. And your weight will stay the same.

Stan (Heretic) said...

Susan wrote:

It only allows simple sugar in the form of small quantities of honey. There are no grains, no corn, no potatoes...nothing to feed the gut bugs.

This is an interesting comment, also Bruce wrote a similar observation. I once saw a study indicating that honey is a very powerful germicide due to it's bacterial cellullar membrane-busting property, which may be offsetting it's very high sugar contents. Just a thought (I am not advocating to eat a lot of honey, but it just may be the lesser evil).

Regards,
Stan (Heretic)

ieddyi said...

Peter,

I was wondering what areas you have disagreements with Taubes?

THanks

emil henry said...

Peter: Thanks a lot for the reply.

If fats slow down the absorbtion of potatoes/dextrose, wouldn't this reduce glycation?

Gunther: Excellent work on reaching your goals. What other blogs, by the way?

Hermione said...

Thanks Peter I appreciate your reply. Yes I hoped the main point was avoiding the gluten.

I can't follow the science but I trust your analysis and conclustions.

I've noticed on quite a few of your blogs that you refer to the price of meat and like you I enjoy the cheap / fatty cuts. However it seems sense to me to try to get grass fed meat, for the CLA and the quality of the fat, and I would never eat non-organic offal. I think that non-organic, save for lamb / mutton, is more likely to have been fed up with rubbish - certainly soya and cereals though organic food does not guarantee their absence.

I think that avoiding nightshade plants can be helpful for RA in some people and I will try it after I've finished the ones I bought recently.

Just now unpasteurised cream is dark yellow and fairly solid; lots of vitamin A and D and CLA. Irrestistable!

Rich said...

True about the resistance of ‘conventional wisdom’ and The Medical Establishment to effects of low carb diets. I have RA, some heart trouble, and am pre-diabetic. My present regime cuts out (= no) gluten, starchy foods, milk products, nightshade vegetables, and sweet stuff of any kind. Weight is down 3 kg, RA improved in 10 days so I can make a fist. Actually, there’s a lot of good things to eat out there.

My study suggests that conditions such as RA and many tumors are potentially caused by many factors. Thus I believe that searches for single causes and magic bullets will be unsuccessful.

Studies may find that a particular treatment is only ~ 20 % effective, and dismiss it from further consideration — WITHOUT RECOGNIZING THAT TREATMENT MIGHT HAVE BEEN 100% EFFECTIVE IN CONTROLLING DISEASE CAUSED BY A PARTICULAR FACTOR. Since one (or one’s doctor) doesn’t know which factors are active, one should attack as many as possible, in hopes of hitting the right one.

All with difficulty in low-carb diet acceptance (self or by others) might find it useful to read:
The Internet Journal of Nutrition and Wellness
ISSN: XXXX-XXXX

Arguments In Favor Of Ketogenic Diets
Joaquín Pérez-Guisado

It is very well-researched and considers negative findings also.

There is also information which suggests that UNHYDROGENATED coconut oild does not deserve the bad rap it has gotten as a saturated fat. It seems t be metabolised much better that C-18, C-20, and C-22 palm oil and animal fats.

Thanks to all for sharing your experiences.

Rich

Peter said...

Hi Rich,

Good to hear you are getting on well and, yes, I think the nightshades are probably a neglected source of lectins.

The main problem I have with considering MCT's as good compared to animal fats is that the evidence base implicating animal fats in any sort of adverse health outcome is very dubious indeed and that what is available comes from people with no understanding of physiological insulin resistance on high fat diets. Linking this latter normal feature of metabolism to the metabolic syndrome is a major error, along with many others!

Peter

Andy said...

I found this study:

http://www.ncbi.nlm.nih.gov/pubmed/10464556

They used high dose vitamin D analogue, alphacalcidiol, along with standard DMARD therapy to treat rheumatoid arthritis. It worked rather effectively. 45% had complete remission and 44% had a satisfactory effect.

Don't know why they used an analogue and not the real thing or whether actual vitamin D has the same effect. One might guess so, cause epidemiology suggests a link between RA and vitamin D deficiency.

Peter said...

Hi Andy,

My guess is that they didn't want to risk hypercalcaemia and could give a big dose of D agonist by using a non calcitropic drug. This is pure pharmacology, like using dexamethasone to mimic cortisol, with all of the fallout that that entails. But interesting never the less. You would need to look 20 years doiwn the road to find out whether the approach yields net benefit. Sounds better than steroids, methotrexate and NSAID though... Personally I'd dump the fibre/starches and see whether I still needed the D3!

Peter

Mary said...
This comment has been removed by the author.
Gardensongs said...

Have questions, hope to encourage your reading/musing on RA. We need help from minds like yours.

Some history:
12/2004 acute anemia - ferritin level 6. IV infusions 3 over 12 months - levels normal, checked yearly.

1/2005 -hypothyroid, dx 2005, probably had 6 years previous. 112 mcg Levothyroxin.

6/2009 - acute de Quervain's tendinitis left wrist, mild in right. PT/acupuncture/massage/chiropractic/splinting - no cortisone - almost pain free now.

3/2010 - dx celiac, gluten free since

5/2010 - "see stars" re-injury left wrist, new PT (taught diagnostics at Duke U), sent to Rheumatologist, MRI showed DeQuervain's and "early degenerative changes at the triscaphe joint & slightly increased signal and probable degenerative changes at the DRUJ"

6/21: RA factor of 61
Anti CCP negative
sed rate by modified westergren 9
C-Reactive protein 0.21
Rheumatologist dx early RA. Prescribed drugs, but will follow me as I search for alternatives.

labs 5/2010:
D, 25 oh total 36 - supplementing 8000

I started a 3.5-day water only fast. Broke the fast when I started getting dizzy.

Broke the fast with bacon and spoonful of honey in tea. Two days of bacon and honey.

Steak today – OK so far.

1. Any general ideas about this whole adventure, what the test results mean or don't, what else I should be doing/not doing.

2. Is the fiber in herbs and spices enough to feed the gut bacteria?

3. Are supplementing with probiotics a good idea? Homemade heavy cream yogurt? (12/2009 my stool analysis for lactobacillus, biufidobacterium and bacillus were all negative and MD encouraged probiotics)

4. any additional tests recommended?

5. If I juice and strain onions, lemons, limes - is the juice then fiber free - to use for a little variety in cooking?

As you said, this gorilla, although just a toddler, has caught my attention. I'm in this for the long haul, and will do whatever I need to do to get myself back to health. Bacon and steak – not a bad life sentence compared to RA…

Thanks so much for all you time, all your wonderful blogs, and if you can add anything to my quest, I'm ever grateful.

Peter said...

Hi Gardensongs,

Sorry to be so slow but I'm just getting my head above water and am having trouble working out to whom I've replied and to whom I haven't!

The basic idea of a fast with LC to break it is exactly how I would go. Most of the green leaf veggies seem to be safe, as do berry type fruits, along with the honey so marked ketosis shouldn't be needed.

I take a lot of Elaine Gottschall's ideas on board (I have a pdf of her allowed and verboten foods, email if you would like a copy) so the home made probiotics are a very reasonable choice. By the time you have some veggies in your diet to keep you out of frank ketosis they will provide enough fibre as far as I can see. You will be up around 10g/d, close to the SAD anyway.

Ultimately your joints will tell you when you have done something food-wise that you shouldn't have. Tracking inflammatory markers is interesting but getting out of bed having slept all night is probably a better marker of progress...

Good luck and again sorry for the delay

Peter

M said...

"I'd suggest with a single food substance of absolutely no allergenic potential and of no use to P. mirabilis. Beef dripping comes to mind. I discussed long chain fatty acids and starving your gut bacteria in the fiaf posts. The colon, home to P. mirabilis, is anaerobic. Nothing can be done here with a fatty acid. Fatty acids only do oxidation, never fermentation."

Wouldn't following a one week diet exclusively with saturated fats like dripping, lard or coconut oil do the trick just as well as starving for a week, then? This would be especially relevant to those who already suffer from eating disorders like anorexia, and can't afford to starve themselves more than they already do.

Peter said...

It would certainly be worth a try, and some eggs would help too.

Peter

M said...

Just a warning to anyone considering going on a 7 day total fast. Reading around on the internet you're told you just feel a little less low on energy, that you feel the need to lie down a bit more often, etc, but that on the whole it's perfectly fine and easily endurable, and even hunger goes away after a while. My experience was by the third day I was sure someone would have to scrape me off the floor and send me to hospital if I continued to do it any longer. I couldn't even lie down in bed, no matter how tired I felt, because any position was painful. I had pain in my joints like I never experienced before, and in places where I never had, and it went on for long after I ended it (just 3 days in). For over a week I couldn't even pick up something off the floor without having to get down on both my knees, it was that painful. I definitely believe in the theory behind fasting, it all makes absolute perfect sense, but there have to be other factors that aren't being taken into consideration, because my experience was that it was just a painful, worthless sacrifice that didn't make me any healthier.

Mary said...

@M

I, too, had severe rheumatoid arthritis. I could only sleep 1-1/2 hours before waking up with severe pain everywhere.

As RA drugs have sometimes lethal side effects, I refused all treatment and instead researched online what foods cause flareups in others, experimented on myself and adjusted my diet accordingly. Miraculously, after three years I had myself in complete remission. My diet was primarily low carb except for buckwheat my only "grain".

After three years of remission, I went completely low carb which meant eliminating buckwheat and starchy vegetables and had problems with constipation so I contacted someone I knew was battling diabetes. Offhand, he added that I might find science bloggers interesting. That led me to the "Cooling Inflammation" blog by Art Ayers, PhD. He has a MUCH easier method of achieving the same results as I did without weakening my immune system by eliminating foods that cause flareups forever.

All inflammation is essentially caused by missing gut flora (bacteria) usually caused by the use of antibiotics. A strong immune system requires a diverse diet because some gut flora evolved to be dependent on other flora already being present before it can establish itself in your intestines. This sounds daunting, but it's actually easy to accomplish by eating a diverse diet (especially strong plants that are resistant to disease and insects - like herbs, weeds/foraging, wild berries in moderation) and continuing to try the foods that cause flareups until you've reached tolerance (a few weeks at most). Dr. Ayers advocates gardening and eating vegetables merely rinsed off (partly "dirty") for the good bacteria they provide while being careful not to pick up parasites. He also advocates pets and children and friends in good health who will also pass good bacteria to you.

He also has good suggestions about how to manage pain with mentholated ointments like Vicks vaporub while you "cure" yourself through diet.

If it all sounds bizarre, I can assure it works. I've been free of RA for almost 5 years now. Good luck to you!

Peter said...

A throw away comment:

Eat germs. My own choices are definitely yoghurt and soil bacteria. The soil bacteria seem especially beneficial and I know of other people who have had success with diversifying their gut microbiota. I'm still no plant lover but bugs are a different matter.

Beats a colonic microbiota transplant.

Peter

M said...

Thank you very much, Mary and Peter. :) I'm very lucky with my RA. I do get pain in my back at night and a little bit of stiffness on my right toe that quickly goes away, nothing like it used to be when it hurt to walk, so the low-carb diet seems to be working. But of course, any advise on improvements that I can make is very much appreciated.

Peter, I read in one of your comments that you've been supplement-free for quite some time, so I'm assuming you get your soil bacteria from your home-grown vegetables? For those of us who don't have a back yard where they can grow their own stuff, I imagine it would be a good idea to take pro/pre-biotics in pill form? I'm just not sure what type of probiotics I should be asking for at the pharmacy. I absolutely love making my own yogurts but, just like Itsthewoo, I find they cause me to eat compulsively and gain weight, so I don't use them anymore.

Peter said...

I now have a couple of mature Lime trees, an Oak and a Sycamore in my garden. I dig up some earth from the bare ground under the canopy, shake it up with some water, let it settle out and drink the supernatant. I agree it sounds weird but the cult of bacteriophobia and cleanliness probably has a great deal to answer for. We get out microbiota from our mother's perineum (and rectum, if you've been there you'll know what happens, this "accident" is no accident at all...), her skin and from soil at weaning. Hazel sticks EVERYTHING in her mouth. I try to avoid clearly toxic leaves... Before we had a garden I'd go out to a patch of ancient woodland (Norfolk and Suffolk have quite a few of these) for my climax woodland bugs. Yeah gods, I get stranger with each passing year! But where else should we get our gut microbiota from? Preferable to the cot in an ICU unit, grateful though I would be for one of those if a child of ours ever needed it!

Peter

Mary said...

anthrax?

Peter said...

Salmonella, campylobacter, yersinia, pseudomonas, acinetobacter, klebsiella. They are all pretty well ubiquitous. Good old legionella is quite widespread outside of air con coolers too.

Peter