Thursday, June 28, 2007

Fruit, vegetables and DNA damage

I accidentally deleted this post by some strange miss click of the mouse. I'll re post the bare bones I get the chance. Sorry


Here is the re post

Thursday, June 07, 2007

More from Kitava

Lindeberg and associates (as in the Kitava studies) postulated that elevated uric acid protected the Kitavans from heart disease (it's a good antioxidant). To check this out they compared the blood uric acid levels of these non westernised islanders to a Swedish population. Uric acid levels are basically the same, maybe 10% lower on Kitava. Conclusion:

"The rather similar uric acid levels between Kitava and Sweden imply that uric acid is of minor importance to explain the apparent absence of cardiovascular disease in Kitava"

Lets go back to the low HDL-C and elevated triglycerides levels on Kitava, which also were essentially the same as those in Sweden:

"the relationship between TGs and HDL-C (in Kitava) was similar to that observed in Caucasians"

Yet the conclusion was

"Evaluation of TGs and HDL-C as cardiovascular risk factors must thus be restricted to the study population"

These two papers and statements were written by the same research group. Let's clarify. Essentially uric acid, triglycerides and HLD cholesterol were pretty much the same in Kitava or Sweden. The conclusions from this group are that uric acid is unimportant in keeping the Kitavan's healthy but "bad" lipid levels are important in Sweden yet not in Kitava. Don't forget the levels of uric acid, triglycerides and HDL-C were the same in both populations.

I hadn't read the uric acid paper when I posted on the Kitava study and metabolic syndrome... Nobody will be upset by uric acid bashing. Not so the lipid hypothesis. It just strikes me that researcher's conclusions are determined by their preconceptions

And their future funding.


Heroin and IBS

Kurt Cobain, the late singer/guitarist from Nirvana, had a lot of problems. Both mental and physical. He self medicated with heroin, leading to serious addiction. On an archive BBC interview earlier this year he described the dramatic relief he got from his gut pain by using heroin. He freely admitted that he had multiple other problems leading to his addiction, but the relief from abdominal pain was a significant factor. No one believed him, this was just another junkie excuse. After all, none of the doctors he had consulted for years had an explanation or any therapy for the pain so it was all in his head, wasn't it...

I mention this because I read another account of a person with abdominal pain, this time there was a diagnosis, the label being IBS. This condition varies from modestly inconvenient through to unspeakably painful, with pulsing waves of cramping visceral pain going on for hours. This guy was posting on a discussion board specialising in poppy tea. Poppy tea is a morphine like opioid mixture reported to be more addictive than heroin as judged by withdrawl severity. It is 100% absolutely illegal just about everywhere in the world and DO NOT USE THIS. I only mention it because this poor guy posted to report the dramatic relief he had obtained from his severe IBS by drinking a cup of this poppy tea. The poppy tea board is a very easy going and very supportive place on the net for opioid addicts to hang out, but they all jumped on this guy like a ton of bricks. No one would remotely accept the reality of the relief he had obtained and the universal condemnation was centered around his using IBS as an excuse to consume the opioid tea, rather than coming clean and admitting he was a straightforward addict. I was shocked at the severity of the responses. Kurt Cobain must have gone through the same thing.

Why on earth am I posting all of this?

Well, my disillusionment with the bulk of the medical profession and my journey in to nutrition began with a close friend who was suffering from severe gut problems without a specific label. Over a year or so the problem had been getting progressively worse. On medical advice she had been increasing her fibre intake. Food consisted of whole meal pasta, brown rice, lentils, chickpeas, whole meal bread and vegetables. Some meat and as little fat as possible completed it. During the final consult her doctor suggested increasing the fibre still further, without explaining quite how this might be achieved. My friend mentioned that she had found, quite by accident, that codeine produced dramatic symptomatic relief. After the doctor had been scraped off of the ceiling there followed a lecture on the constipating effects of codeine and the advice to use ibuprofen to control the pain. This was to a patient in whom a duodenal ulcer was high on the list of possibilities. Please don't do this at home either. Even if your doctor tells you to.

At this point I started reading the medical litterature for myself and we had my friend off of omeprazole and pain free within a month. She never went back to the medic, who is probably still recommending fibre and ibuprofen to her IBS patients and steadfastly refusing to think about why they don't get better.

What really struck me with all three stories was the absolute disbelief in all quarters that opioids could produce symptomatic relief in severe IBS. The impression is that people with severe gut problems are considered to use their "functional" problem as an excuse for recreational opioid abuse. Where is the "That's interesting" reaction from doctors? Nowhere.

The cure, by the way, is the elimination of almost all fibre, absolutely all grains and a marked reduction of carbohydrate consumption. She initially ate 20g/d of carbohydrate but currently anything under 70g/d seems fine for maintenance. Some people have to go a little further and eliminate starches and unfermented dairy too, but that wasn't needed in my friend's case. Grain ingestion, especially wheat, causes an immediate flare. No wonder the high fibre diet was a disaster.

So what is the link between IBS, opioids and especially grains?

Our bodies manufacture many short polypeptides for use as neurotransmitters. One specific group of them are the endorphins. These are naturally produced to control many biological processes. Gut motility and the limitation of both physical and emotional pain are two major functions under endorphin control. Morphine-like drugs, including its diacetylated derivative heroin, drop on to endorphin receptors and produce constipation and happiness. Withdrawl does the opposite. Badly.

Endorphins are produced by ourselves. Exorphins are similar peptides produced from our diet. Partially digested gluten from wheat is a major source. Eating a high gluten diet produces lots of exorphins. Constipation, often after an initial spasm reaction, is the result, just as it is from heroin. And pain too, because although exorphins do reach the brain, they never get there in the quantity needed to produce pain relief or happiness. In fact depression is common in IBS patients, but then chronic severe pain coupled with totally wrong advice tends to lead to depression!

When an IBS patient eventually has a bowel movement there is an immediate removal of the exorphins in contact with the gut wall. Acute opioid withdrawl produces diarrhoea. Remember the opening scenes of Trainspotting, with the methadone suppository and the worst public lavatory in Scotland?

So IBS is a functional problem of constipation with gut spasm alternating with diarrhoea. Eating grains is the commonest trigger. Wholegrains are the worst! Try telling that to your doctor.

BTW there are also exorphins in casein, haemoglobin and spinach but these do not seem to be as indestructible as the gluten derived peptides, although casmorphins do come a close second for many people.

Grains and heroin have a lot in common. Avoid both!


Tuesday, June 05, 2007

Living on the isolated island of Kitava

On the island of Kitava there are coconuts, sweet potatoes, yams, a few other starches and fish to eat. This leads to an interesting diet. The estimated percentages of energy from protein, fat and carbohydrates are 10%, 21% and 69% in Kitava. Most of the fat is saturated. Three quarters of the population smoke.

Obviously high carb eating should mean catastrophic blood lipids. You would expect low HDL cholesterol and high triglycerides. And this is exactly what you find. HDL-C down at 1.1mmol/l (some as low as 0.5mmol/l) and triglycerides up at 1.7mmol/l (some up at 3.0mmol/l). Not a good ratio. They smoke too. Must be a hotbed of cardiovascular disease. Especially as some of the total cholesterol readings were up around the (gasp) 7.0mmol/l mark. Pravastatin in the local well water is the obvious answer.

Except they have no heart disease. On a diet of 70% carbohydrate. Life expectancy, ignoring neonatal mortality which appears to be high, is around seventy years. That's without any medical facilities. How do they do it?

BTW there were two amusing comments in the discussion of this paper. The best was:

"Evaluation of TGs and HDL-C as cardiovascular risk factors must thus be restricted to the study population"

I'll rephrase that. In Sweden "bad" lipds (and smoking!) are BAD. Not so in Kitava, here "bad" lipids are not bad. They're a product of diet composition. As there is no heart disease they must be good!

So what's happening? Do horrible triglycerides block to your arteries like hot beef fat blocks a cold sewer in Sweden, but then by magic they become non sticky in Kitava? Go figure. Hint, maybe it's not the lipids that trigger the blocked arteries.

Second comment was

"our findings lend no support to the concept that a very high intake of carbohydrates (>60% of energy) increases the risk of cardiovascular disease"

ie living on low fat doughnuts is safe for everyone. Everyone. No suggestion that you have to live in Kitava for this to be the case. So if you eat a junk diet in Sweden and get Kitava lipids in Sweden plus smoke Kitava cigarettes, will you be OK? Somehow I doubt it!

So why are the Kitavans free of heart disease?

Their average fasting glucose is 3.7mmol/l and their fasting insulin 4.0 microU/ml. They do not have any features of metabolic syndrome! Except the lipids of course. Despite eating appalling quantities of carbohydrate. If we define metabolic syndrome as carbohydrate intolerance how do the Kitavans manage this?

I think that this goes back to the main limit on population growth, which is food. Daniel Quinn is the best source of information on this subject. As the Kitavans live with minimal Western food it seems they must be living within the food production capacity of their island. The basic principle is that populations grow to the limit set by their food supply. On Kitava you cannot make babies out of thin air. No extra yams means no extra people. The fluctuations in food and population must mean there are fluctuations in hunger and plenty, but if populations really do expand to the limits of food supply, the island location must ultimately apply calorie restriction. On average.

Ad lib food on a global basis has resulted in a population explosion. On an individual basis it results in a waistline explosion. As carbohydrate is cheap, addictive and hunger generating it is what usually fuels the metabolic syndrome, hence "bad" lipids are associated with metabolic syndrome as carbohydrates are the usual tool of excess calorie intake.

Calorie restriction, intermittent fasting and once daily eating all limit the development of insulin resistance and hyperglycaemia, pretty well independent of macro nutrient ratio. On Kitava there must be accidental calorie restriction as the population is in equilibrium with with a fixed food supply, hence no metabolic syndrome. Despite the "bad" lipids, which merely reflect the composition of their restricted diet.

Can we all do the same? Probably yes, but having read about life on the calorie restricted optimal nutrition (CRON) diet this is definitely not for me. Licking the plate clean because the sauce is delicious is one thing. Doing it because you are starving is quite another! No, there does appear to be a better way.

Eating a ketogenic diet appears to mimic calorie restriction. Ketosis limits appetite so allows modest calorie restriction without any hunger. Forget any drug which may be developed to mimic eating a high fat diet. Better pile on the lard, dump the "healthy" carbohydrate and generate a few ketone bodies. Enough to keep your energy intake reasonable without that desperate dreaming of food which is reputed to go with CRON.

Or you can starve on a balanced diet.