Wednesday, August 05, 2009

Back on line

BT have finally strung the necessary two tin cans and piece of string to our rental house in Bearsden and we are back on line. A bit of reading to do and then I'll get to a few replies and posts.

Glasgow is excellent. There are really weird things like not having to pay at railway station car parks or for parking anywhere else outside the city centre, a train service to town where you don't look at the time table, just pole up and wait for a train, there are hills pushing in to the suburbs, it's light much longer than down south (until the equinox) but the really strange thing is how polite everyone is. A minor near collision with a supermarket trolley is grounds for profuse apologies on both sides. It's not like the M4 corridor! Just weird. But nice.



Anne Kouwenhoven said...

Welcome back Peter.

I remember many years ago visiting Scotland (I live near Vancouver, Canada) and loving it there.

Question: What do you think of the new study linking cholesterol levels with Alzhiemers & Dementia?


Thanks, anne

Peter said...

Hi Anne,

Yes, we think we're going to like Scotland. Be interesting to see what working here is like but that is some time away yet for me, unless we get stony broke and I have to locum...

The study is observational and generates the rather stupid hypothesis that plasma cholesterol, which essentially never interacts with the CNS cholesterol pool, "causes" AD.

A more sensible hypothesis is that whatever elevates midlife cholesterol levels is a causal agent for AD. I would suggest fructose as number one, all those VLDLs ending up as LDLs. The second is hyperglycaemia, which adds to both the glycation and oxidation of those LDL particles, decreasing uptake and giving a marker for how much sugar and starch a person has conmsumed. The brain uses the Glut3 transporter to control insulin's action for glucose delivery. Too early for people to be looking for insulin resistance in the brain, but it will be there, probably triggered by hyperglycaemia and hyperinsulinaemia.

So, nice study by people in the wrong paradigm, asking the wrong questions.....


mark said...

Hey Peter.

I just got my test results back for lipids. These are after 1 year, 9 months of eating very similar to you, cream butter, fat, minimal carbs from starch and veggies only to add a fat source. No fruit. Some alcohol. Lots of egg yolks.

TC 315
LDL 234
HDL 59
Trig 107

Prior to this, I had been eating a Paleo diet with fruit and a lot of olive oil and no cream. Some alcohol. Not much egg. This is my bloodwork from November 2007:

TC 243
LDL 173
HDL 59
Trig: I didn't write down the number.

Anyways, I'm glad that you're back and I hope Scotland works out well for you. At the least, you will probably avoid any kind of fat tax. :P


lightcan said...

Hi Peter,

I have been looking forward to your posts. Hope you like it in the more 'civilised' Glasgow. I live in Ireland but I was born in Eastern Europe and I find that people here are selfish, materialistic, arrogant and uncivilised (don't care about the mess they make and how it impacts on others or the environment) Unfortunately at home the situation has gotten worse in the last 15 years after the westernisation of the society. It's good to know that there are communities like that similar to, I suspect/guess, the Scandinavians or the Germans.

Regarding the study about Alzheimer's that everybody is curious about and your comments. There might be an association that needs further investigation as you said. But saying that raised cholesterol is caused by fructose and hyperglycemia is a bit confusing to me. Many in the low-carb world say that they have elevated cholesterol since eating low-carb, with low trigs. I have it too. 7.1 TC the last time I checked a year ago. But we don't have hyperglycemia and I do not eat more than a little cup of berries a day and some 30 grams of 85% dark chocolate. Am I supposed to understand that it's a question of residual effect of a bad diet and that continuing the diet of eggs, cream, butter, animal foods, no wheat, potatoes, rice, pasta, etc, my cholesterol will go down?
High cholesterol can be related to hormonal problems too. I read about that on the Life Extension website.
Thanks a lot.

lightcan said...

I started reading on Pubmed about low-carb diets and I found this:
Metabolic effects of low glycaemic index diets. Radulian G, Rusu E, Dragomir A, Posea M. Nutr J. 2009 Jan 29;8:5. I went to the full text and I found this
"Insulin sensitivity may be negatively affected in the long term as low- carbohydrates, high-fat diets favor an increase of plasma circulating free fatty acids [39,40], which under usual dieting conditions is typically associated with many insulin-resistant states in humans [41,42]. Altered fatty acid metabolism contributes to insulin resistance because of alterations in the partitioning of fat between the adipocytes and muscle or liver [15]." It continues, but I didn't want to copy the full paragraph.
Is it correct? I checked the references but it's too complicated for me. When you have time, would you have a look at it? It seems to me that you were once talking about something similar. If you did could you tell me which post it was? Overall, what do you think about the insulin sensitivity issue?

ItsTheWooo said...

Hi Peter, so glad to see you back online. It must be so invigorating to be located in a slower paced beautiful country like Scotland - I would love to settle somewhere like that (ugh, remind myself of new joisey and I might as well die). I've been listening to "big country" more or less on repeat the past two days so I've been thinking of Scotland myself.

Regarding Alzheimers... I tend to think it's brain starvation, secondary to energy deprivation from brain insulin resistance. This is why insulin has been shown to improve alzheimers, and so does a ketogenic diet. It is essentially diabetes of the brain and improves with similar treatments focused on improving cellular energy utilization of glucose (or alternately ketones).

As a nurse in a LTC I've noticed anecdotal relationship between diabetes and dementias - not just vascular dementia (which is obvious - syndrome x / hypertensives get that) but also alzheimers type. No, not every diabetic has these problems but a lot do. The mental status of elderly diabetics is usually quite poor.

I also agree with the more modern thinking that the amyloid and tau plaques are symptomatic as well as causative. When insulin is not being utilized correctly amyloidosis occurs.

It's really amazing how stupid the hypotheses these people generate can be. A hobby is researching leptin particularly as related to energy deprived/weight reduced states... I came across an abstract which detailed an observation between elevated leptin and "unexplained infertility". The researchers hypothesized that elevated leptin plays a role in unexplained infertility.

After I face-palmed, I asked myself how it is possible these researchers didn't seem to consider hyperinsulinemia will always cause hyperleptinemia... and it is well known hyperinsulinemia causes PCOS-like fertility disorders in women?
Leptin is also an inflammatory hormone and tends to be elevated in chronic illness in general. But, 9 times out of 10 (made up statistic lulz) if a woman presents with hyperleptinemia (even if non-obese) and unexplained infertility, you probably should measure insulin level and glucose tolerance too.
And you damn well know they didn't even consider that... because, everyone knows only fat women with excess hair growth ("PCOS") have infertility related to high insulin, right? It's clearly the fatness that's the problem, and these women weren't fat.

It's kind of annoying being smarter than people payed to be smarter than me.

Peter said...

Hi Its,

It's nice to be back,

Lightcan, I'll get a proper reply out soon but even without the building work of any other work things are still a bit hectic and your comment needs a little paper finding.

Hi Mark,

Your blood numbers look similar to mine... Be interesting for myself to get a second EBCT scan...


lightcan said...

Oh, Peter, thank you for responding. I'm used to being ignored and trying to find a reason for it. (I didn't structure/phrase my question properly, it's not relevant or interesting, I showed how ignorant I really am, I was too negative, etc.)
I'll have my blood test results in two weeks or so, then I'll see the effects of a year of low-carb high-fat diet on my high cholesterol.
Thank you.

Peter said...

Hi Lightcan,

Insulin resistance is quite normal and utterly essential under conditions of starvation or carbohydrate "deficiency" . If you have no access to glucose but kept your metabolism running on glucose, it would be all gone in a day and you would die. Running on fats, as you do in starvation or LC eating, REQUIRES that you do not use glucose and leave it for your brain. Again, this is utterly normal. The pathology begins when there are large amounts of free fatty acids available AND glucose. Next few posts will be along these lines but you might want to have a read at this post and any beginning with "Physiological Insulin Resistance" in the index.

The text you cite might have been copy pasted from Dr Raz's paper discussed in the linked post. Limited understanding coupled with a carbohydrate based agenda and no evidence base. Listen the phrasing "Insulin sensitivity may be negatively affected in the long term". The word MAY means that they think it's bad but have no evidence. It's not. This is received wisdom and is better filed under religion!

BTW my TC is well over 300mg/dl and LDL by calculation around 250mg/dl. Shrug.


I've got several more posts on Alzheimers coming but energy starvation does seem to be core to the problem. I'd always been a bit puzzled by CNS insulin resistance as I didn't realise the brain cells used insulin to control glucose uptake, then I tripped over the GLUT3 transporter and suddenly there is a route for CNS insulin resistance and a roll for ketones to bypass it. How it works is a puzzle as brains don't do fatty acids so.... But well worth thinking about. Maybe something to do with leptin?????????


trinkwasser said...

Welcome to civilisation! There's not much of that Sahf Of The Rivvah.

Your enforced absence has at least given me the chance to catch up on your excellent blog, end to end, although I still have over 30 downloaded papers to plough through.