Thursday, February 14, 2008

French paradox in Sweden

This press release came out today, can't see anything on pubmed, but the findings are what you'd expect. Nice, whatever you think of Spurlock (not alot). Quote from Nystrom and his press release:


That signs of liver damage were linked to carbohydrates was another key finding, he said.

"It was not the fat in the hamburgers, it was rather the sugar in the coke," he said.

But the most startling result implies that an intensive fast food diet might have some health benefits too, apparently from fat.

"We found that healthy HDL cholesterol actually increased over the four-week period -- this was very counter-intuitive," said.

HDL, sometimes called "good cholesterol," seems to clean the walls of blood vessels, removing excess "bad cholesterol" that can cause coronary artery disease and transporting it to the liver for processing [in the fairyland of the lipid hypothesis that is, Peter].

Nystrom has yet to publish the cholesterol findings, but said they were consistent with the so-called "French Paradox." For nearly two decades, scientists have wrestled to explain how the French can consume a diet rich in fats -- from abundant butter, cream, cheese and meat -- yet have generally low levels of heart disease and hypertension.


Quick summary of the findings:

Sugar mangles your liver (a ten fold increase is ALT is VERY scary), saturated fat improves your lipids (and lots of other things), there is no French Paradox.

I love the French "Paradox", it makes me think of reality kicking hard at a very heavily barred door.

Peter

40 comments:

  1. The "French paradox" is funny to me too. It's also offensive. French people deliberately pay a great deal of attention to selecting fresh, good quality food, getting good fats, and they are healthier for it. Yet researchers want to pin their better health on some molecule they're consuming by accident, like resveratrol. All because they can't accept the fact that their high-fat diet is healthy in the first place.

    Although I have to say, French people love their white bread and sugar. They're only healthy compared to countries that have worse diets like the US.

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  2. I have had a blog post brewing for a while about the idiocy of the "plant-based diet" people. Of the 1,200 calories in the typical burger, fries, coke meal, only about 250 come from animal products. (I am ignoring the egg yolk in mayonnaise, since there is only one yolk in a whole cup of mayo, which means the amount of animal based products in a tablespoon of may is negligible.)

    The French do love their white bread and sugar - sorta. French breakfasts are terrible, terrible, terrible; it's hard to find anything other than croissants. And when I was there, I was served dessert at every lunch and dinner. On the other hand, we were never served an entire basket of bread - there was one piece of bread or small roll for each person at the table, and that was it. And no one ever served me an entire pound of pasta, either.

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  3. Peter

    The abstract is at

    http://tinyurl.com/2ljbrb


    There is a write up at the NHS choices site with some interesting comments:

    http://tinyurl.com/32d8r6

    Thanks for pointing to this

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  4. by the way the NHS choices site turns this into an anti fat study...."The study does provide a further reason to avoid overeating (especially food high in saturated fat) if one is needed."

    hmmmm

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  5. Yeah breakfast is the worst- the copious amounts of butter are probably the healthiest part. I'm not going to lie though, it's delicious. Baguette with butter and homemade jam, dipped in a bowl of coffee or hot chocolate... it just might be worth shortening my life for every now and then.

    Most French families have all-you-can-eat baguette with meals. Before I knew much about nutrition, when I'd stay with my family over there, I'd get at least 40-50% of my calories from bread. That's in addition to the potatoes that were often served. But I was a big bread eater.

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  6. Hi Peter. Thanks for sharing all of this information. I have been eating "paleo" for a while but, at least in terms of meat, I think the high fat seems more natural. The large amount of dairy I consume seems to go against the general paleo consensus. I discovered your site and quickly read everything I could and made my way to the optimal diet site. Luckily I live in chicago and visited the optimal deli with my wife, thank goodness because she's polish and everything I would not have been able to communicate. Still not sure if the ice cream I bought is optimal. I hope so because it was sooo good. Anyway, thanks for sticking with me, I was able to buy the good dr.'s book at the deli (in english!) and he recommends a potato everyday for the carbs. Now this goes against everything I know. He says it's slow release, I always thought it was quick and therefore really good for cycling, etc. I've been using parsnips just so they don't go bad and then will go to potato but wanted to see what you thought. Also see you use honey in your ice cream. I'll try that!

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  7. Chris, thanks for that NHS choices link.

    I'm trying to keep this polite.

    Looks like the NHS choices people only read the Daily Express and the Sun. I can see no evidence that they read the paper itself!

    Hopefully no one takes any notice of the advice in NHS choices. Unfortunately many people really will base their diet choices on what they read in the Sun.

    Nice to have the full text. Yahoo seem to be a few hours quicker than Pubmed! Probably so is the Sun, but I doubt it worries about accuracy as much.

    Ta

    Peter

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  8. Hi mess talker,

    Dr K does have a few inconsistencies. I feel on the spud front that it is just a bag of glucose, but if we are running with minimal liver/muscle glycogen we can probably just shunt the 30g from a spud in and out of our liver/muscle glycogen stores as needed. No evidence for that, but it doesn't strike me as the same as dropping a potato on to a metabolism already over stuffed with glucose in every available storage space...

    And no fructose in potatoes. I occasionally wonder if that is what makes this Dr K's choice. Genuine Optimal ice cream just uses sucrose, not the glucose honey mixture I like. It uses quite a lot more sucrose than I prefer now my tastebuds are fully LC adapted.

    I envy you the access to the deli. Oh, Newbury has just had a Polish deli open (Polish has become the commonest language after English in Berkshire just recently)!. I saw it a few days ago and never took much notice, the emphasis was on bread in the window. MUST go in and see how much English they speak. Especially re gluten and sausage. Mmmmm, very worth a look.

    Did you get Optimal Nutrition or Homo Optimus? I enjoyed both but Homo Optimus is a very very strange book.

    Enjoy either or both!

    Peter

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  9. Hi chainey,

    I watched Supersize me and enjoyed it, but nothing like as much as the U tube clips you linked to!

    If any one does have an easier way than tags to embed links, I'm listening too. I see chris uses tinyurl. I like the active links from tags. At the moment I just keep a template as a text file on my sidebar.

    Peter

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  10. Hi Peter

    It isn't just NHS choices...

    MedPage today - aimed at doctors - said

    http://tinyurl.com/2xkcbe

    Explain to interested patients that this small study suggested that overdoing it on high-fat foods, even during a short holiday period, for instance, and a failure to exercise can cause liver damage.

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  11. Chris,

    You can even quote this article itself to contradict the headline!!!!

    "Eleven of the 18 volunteers persistently showed ALT above reference limits indicating liver damage (women >19 U/L, men >30 U/L) during the intervention. These increases were linked to weight gain and especially higher sugar and carbohydrate intake, the researchers said."

    There is no conspiracy
    There is no conspiracy
    There is no conspiracy.

    But this is beyond stupidity

    Peter

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  12. Just saw that Dr Biffa has a good post on this too

    http://tinyurl.com/23yug7

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  13. hi, can someone please tell me the exact name of the optimal deli in chicago and where it is located? my sister lives there and i would like to tell her about it and ask her to get me Dr. K's book.

    thank you so much!
    amanda

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  14. Hey team smith. The polish optimal health store in chicago is called Calma Optimal Food and is located at 4208 N Milwaukee rd. Really helps to speak polish but is not necessary. They have Dr.K's book available in enlgish ($20) and their items are marked in english. But the lady helping me didn't understand english at all. Although most items are self serve,if you want some keilbasa or bloodwurst your sister will have to communicate some other way.

    They also deal with a local amish farm and have great deals on eggs, butter, chickens, and rabbits.

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  15. hi mess talker,

    thank you for the address! i am so hoping my sister can get there and it will be interesting to hear what she has to say about the experience. :)

    you mentioned that Dr. K advises a potato a day for carbs and i wanted to comment that i do this fairly regularly. i find that at least in this stage of my life, potatoes are the only way i can eat butter and find it palatable. lol. i can mash up to about 4 tablespoons into one along with other fats like creme fraiche and i feel like the amount of fat helps with the starch/carb effect.

    these days it is almost the only carb i consume except for a few veges like onion, garlic and peppers as condiments to my potato. so i am hoping that's okay!

    maybe if i get Dr. K's book i will understand better what to eat. his website is a little confusing to me.

    amanda

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  16. Who is Dr K? What does the K stand for? Is there a website? Thanks.

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  17. Hey Sue.
    We're referring to Dr. Jan Kwasniewski the founder of the Optimal Diet that I believe Peter has based his hyperlipid approach on. You can find out more at the site: http://homodiet.netfirms.com/index.html

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  18. The other site, which is rather more focused on Dr Kwasniewski's diet, is AHOA.

    There is a mass of information on Stan Popis' homodiet site, much of it is excellent but some ideas go to where I can't convince myself is how the world works. Still mostly excellent and knocks spots off of "NHS choices".

    Peter

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  19. Hi Peter....great blog! I've been able to get up to speed with your nutrition regimen's fundamentals via combing through the archived posts here. There are just a few things I still haven't found.

    First, aside from your "sample day's food intake" post....have you mentioned what your average total caloric intake is? Are you counting calories from fiber in that total or would those be additional (but excluded from consideration)? Have you found that your total daily caloric intake increased, decreased, or remained steady when you switched from high carb to high fat? What about when you switched from Atkins to "even higher fat (80%+)"?

    And finally....would you mind sharing your FitDay profile so that your readers can follow your daily "menu"? No worries if you'd prefer not to....I'm only asking because of how much it would help us better understand how you do things in "real life". :-)


    CHEERS!

    D

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  20. Hi D,

    Total calories usually come in between 2000kcal and 2800kcal, but it's a long time since I put any entries in to Fitday, other than the sample menus and an occasional day's eating when someone has asked this sort of question. I think I used Fitday quite a lot back in 2003-4 when I was starting. Back in those days I think about 3500kcal was the max in a day. I'm basically weight stable except have gone from 64 ish to 65ish Kg in the last 2 weeks as I have been mixing and pouring concrete and have gotten my bike out again. Still 12% bodyfat. For a while in the early days I ate consistent 2000kcal/day and my weight stabilised at 62kg, which I found uncomfortably thin. Also getting over 75% calories from fat is impossible if you limit total calories while eating adequate protein and carbs...

    Nowadays I know that eggs/butter/cream/chocolate through the day keep carbs and protein low. Main meal is where most of the protein comes in. I adjust my cream to give me a stable weight. I do track my weight every few days, occasionally daily, but the bathroom is VERY cold in the morning before the house and baby wake up. Once we're all up I've usually had my first cocoa of the day while feeding Squiggs, so weight becomes a guestimate once the bathroom warms up.

    As a complete aside, since LCing I sleep about a max of 7h/night and wake refreshed at 5-6am! Everyone else sleeps 'til 7am... I may be odd in that.

    Peter

    Oh, forgot re fiber. I just avoid it as much as possible and pretend I never eat it. 5g/day on a good day, 10g/day if I overdose. No need to count calories on this much. Trouble is I like nuts on occasions and even tinned tomatoes have more fiber than I like.

    It took me quite a while to find Fitday and by the time it occurred to me to put in a high carb menu I found I couldn't really remember what I used to eat, but I think the calories were much lower than I'd though. Even enough rice to induce 3 hours anaesthesia doesn't come with may calories. A lot of calories also crept in as biscuits where I worked (we had an ad lib supply and I used to get HUNGRY). I used to weigh probably about 67kg on high carb, with a little paunch but otherwise skinny. Bad combination.

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  21. Hi Peter,
    I think you said you get your daily carbs mainly with some dextrose...is that regular sugar?....and the rest with some tomatoes and onions...that to stay out of ketosis...what do you think about Dr. K suggestion of pottoes with butter for the carbs...I read the book Fiber MEnace and he actually suggests white rice and butter (1:2)...what are your opinions on that.
    Thank you and I am sorry I don't know if dextrose is the same as sugar.

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  22. By the way...for the followers of Dr. K that would like to get his book from the store in Chicago (like I would have liked to)...they don't speak a word of English...so it was imposible to order it on the phone...I am New York City, NY and can't find any of his books.
    I wonder if it is worth ordering them from Poland...Peter is it worth to order them?

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  23. I just found Homo Optimus used at Abebooks.com and ordered it...since I have been always curious to know what is behind this way of eating...thanks Peter for refering us to him and for sharing your experiences with this way of eating.

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  24. By the way...when I talk about eating rice with butter is jusy 1/4 cup...30 grs of carb with double the amount in butter in two little batches during the day and then at night the animal protein and egg yolks...I know is not a lot of rice but it would keep the person out of ketosis and the reason not to misx it with protein is to improve digestion.
    I would love to know your thoughts on this...it does keep Dr K proportion of micronutrients...but the reasoning is to improve digestion (more specifically constipation, hemorroids, ibs...etc.)...this Fiber Menace book is written by a forensic nutritionist that deals with digestive problems...the website is fibermenace.com if you are interested in learning more about his point of view. There are some interesting info in the website.

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  25. Hi Misty,

    It's not uncommon for us to add potatoes or a root vegetable to our main meal to keep the carb intake up. The dextrose is pure glucose, as opposed to sucrose which is a joined glucose-fructose molecule. As I get enough fructose in root veggies (excluding potatoes) I just like to keep the other sources low. I doubt I get more than 5 grams of glucose from my cocoa in a day. A number of people have mentioned Fiber Menace and the approach seems very similar to Dr Kwasniewski's. The lectins in rice do not appear to be nearly as problematical as those in wheat/barley/rye and once the rice is polished most have been removed anyway. Rice and potatoes both share the lack of fructose. And pretty well minimal fiber.

    Homo Optimus is the interesting book. Some of the case histories are very interesting. Of the people I have introduced to Optimal Nutrition most have confirmed his statements for whatever problem they had. He is VERY frustrating in that he NEVER references anything. The early sections of the book are the strangest. Philosophy, religion, national effects of nutrition, lots more. The later bits on diseases and nutrition are less controversial. A bit like Weston Price's Nutrition and Physical Degeneration, which becomes a bit eccentric in the later chapters.

    There is a saying in medicine that clinical experience is a poor guide to how effective a treatment is. I'm getting a certain amount of clinical experience with friends trying ON, and this very limited information suggests it does what Dr K says it does. But that's just clinical experience...

    For digestive disorders I would assume Fiber Menace works, certainly ON does. For constipation, it is difficult to make bricks out of butter at body temperature. Making bricks out of straw is easy at any temperature! For ibd/ibs you just stop feeding your gut bacteria. There are many other facets to what happens, but those two keep it very straight forward!

    Enjoy Homo Optimus.

    Peter

    PS I got my ON books by ordering via fax to the Polish web site's office address. Someone there does read English!

    PPS ON does not work for everything! I'll post on my wife's migraines soon.

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  26. Thanks Peter...appreciate all the details.
    Regarding Fiber Menace book, you are right there are a lot of similarities...and I just ordered an used copy of the HO book and should get here at the end of the week...look forward for what seems to be a very interesting reading experience.
    Thank you fro your input regarding the white rice and you are right about the lectins desapiring once is polished...it also has the advantage of being easily digested...and when you add the butter it slows the digestion down ...but one thing that he talks about is how important fat is for the digestive system.
    Anyway, I really enjoy your blog and have learned a lot from you...thanks.
    Hela

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  27. Peter wrote: PPS ON does not work for everything! I'll post on my wife's migraines soon.

    I used to have migraine like headaches every few days in the first year on Optimal diet (8 years ago). I couldn't figure out why but my best guess is improving (and excessive) blood circulation in my head arteries. Aspirin would help. Kwasniewski is mentioning an overactive PS system as the culprit behind migraines. He is probably correct. Note that a high fat diet does stumulate our PS system, sometimes too much, while a high carb low fat diet does the opposite. The headaches have completely disappeared in the second and third year.

    Regards,
    Stan (Heretic)

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  28. I have read Fiber Menace and found it had a few good nuggets of info here and there. BUT, I couldn't swallow it all, at least not without further research.

    FM was extremely repetitive and not very well organized. Early in the book he made several unnecessary, incorrect, and very biased statements about Dr. Atkins (the author clearly had an ax to grind about Atkins yet he seems to agree with Atkins on many points), and he cited unsubstantiated rumor and tabloid sources for his assertions which lessens his credibility, IMO. While I have no problem with the author not liking Dr. Atkins or having a disagreement with the Atkins diet protocol, the personal attacks were completely unnecessary and for the most part, not pertinant to the main premise of the book.

    The author is clearly self-taught, which isn't necessarily a bad thing (I don't have scientific or medical credentials either - I'm just married to a scientist :-) ), but the book reads like the ramblings of someone who has spent a lot of time reading a Merck manual or sitting in a medical library, pulling together bits of info that seem to support a theory. If I remember correctly, the author doesn't have any credentials in the medical field; his area is computers or finance or something similarly non-medical. While his medical library research is clearly extensive, I don't recall him having any clinical or laboratory experience to back up his arguments, just his own personal GI issues that he claims to have solved.

    I did find a few ideas in his book that probably have some merit or deserve further investigation, but I would take a lot of his assertions with a grain of salt, or at least look for further corraboration before following some of his advice.

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  29. hi stan and anyone else re. the discussion of headaches: first, what is a "PS" system?

    and secondly, i have in the last couple of weeks begun having minor headaches and twinges all over my head and have been really worried until i read your comments. could this be because of going LC? i have only just started LCing in the last month and i can say that i have never had a headache in my life until now!

    other than the headaches i feel really good. i feel calmer and i am sleeping better.

    is it a bad thing to go too low carb? i find that other than an almost daily potato, i eat very few other carbs. am i doing more harm than good? i guess i feel like i just don't want anything else and i try to just consume a lot more fat.

    thanks for any thoughts!
    amanda

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  30. Hi Stan and Amanda,

    PS is the parasympathetic nervous system. Migraines do appear to be "associated" with over activity in the parasympathetic nervous system and my wife is a classic high baseline PS person with very low heart rate, low BP and tendency to migraines. They certainly have not worsened on LC and there are anecdotes of people stopping migraines with LC eating. Not happened for my wife, though the episodes are easier to stop nowadays if we get in early enough with a "sticking plaster" type treatment.

    Dr Kwasniewski "cheats" on migraines as he has a method of electrotherapy, a system for selectively stimulating activity in the sympathetic or parasympathetic nervous systems, depending on the disease. He uses this to speed up the changes from diet. I have absolutely no information on this, or how it would/might work, so we're stuck with the slow approach through diet. Currently, for my wife, it is over two years of close to ON eating following on from a couple of years of more Atkins style eating. Certainly not a sudden cure. I'll put some more up about our personal experience with migraines soon.

    It is plausible that too low a carb intake could predispose to migraines, a full baked potato can be under 30g of carbs, depends on the size of course!

    Peter

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  31. I've had some headaches too, after never suffering them before. Came on while weight lifting and has been on and off for a few days. I'm almost np carb too. I thought it might be over exertion from lifting. I bet it is low carb. I know adkins warns of headaches for the first few weeks. I thought I could avoid this with fat. When looking at the Inuit they suffered headaches only when they had to eat rabbit and no fats. Bunny malaise. Geuess transition has a process. Although I have to say there's no way I'm going to wait 2-3 years. Months maybe.

    Wesley

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  32. Actually, Peter, potatoes do have a little fructose. Like 0.3g per 100, or 1.5% of the total carbs. I found this out recently. Like you, I also thought they had no fructose.

    http://www.nutritiondata.com/facts-C00001-01c20f4.html
    http://www.nutritiondata.com/facts-C00001-01c20fE.html

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  33. Just a quick comment on headaches. In general the ordinary run of the mill headaches go completely once you get over the transition. My transition was bad as I went cold turkey through caffeine withdrawl from a "full seven mugs a day of Java coffee a day" habit when I started Atkins. This was VERY unpleasant for a week or so. Since then, back in 2003, I've not had a headache at all, and I used to live with them or take paracetamol. When I wasn't taking it for back pain.

    For my wife we are talking migraines. This is a very specific pathology and very, very different from headaches. More on this later.

    Peter

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  34. Just a quick comment on headaches. In general the ordinary run of the mill headaches go completely once you get over the transition. My transition was bad as I went cold turkey through caffeine withdrawl from a "full seven mugs a day of Java coffee" habit when I started Atkins. This was VERY unpleasant for a week or so. Since then, back in 2003, I've not had a headache at all, and I used to live with them or take paracetamol. When I wasn't taking it for back pain.

    For my wife we are talking migraines. This is a very specific pathology and very, very different from headaches. More on this later.

    Peter

    Bruce, I see the fructose comment. Interesting. Evolution mixes stuff.

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  35. thanks peter,
    I've started to add potato to the diet and feel better. I have switched to tea instead of my daily espressos and have given up alcohol for lent. There seems to be a few options for what could be causing my headaches which are dull and annoying and not harsh like migraines can be. I was just intrigued by the PS comments. I've learned a lot from your blog and could learn a lot more if I had the patience and the brain power to decipher some of the medical jargon. Good thoughts for your wife with her migraines.

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  36. Hi Wesley,

    Hee he, the techspeak is quite hard to avoid!!! I think I do this at work, then just pull myself up and drop back in to English.

    Actually, if I remember OK from the time of Atkins induction diet, he does warn of headaches.... So long since I've been there. Thanks for your thoughts for my wife's migraines, we've got a pretty good patch which we apply when they happen. Need to sort the post. Her whole family gets them...

    Peter

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  37. Hey Peter,

    I talk to a lot of migraineurs. Migraines suck... Do triptans help? Have you considered getting your wife's estrogen levels checked? stabilizing with E2 patch/oral contraceptives often help (by preventing the drastic drop that happens monthly). Some relief with Magnesium 500mg 1-2 tabs daily and riboflavin B2 400-500mg daily has been shown to help compared with placebo. I know you're on fish oil, but fish oil has benefit for migraines as well (stabilizes electric conductivity both in brain and the heart; high dose 3000mg/d divided EPA+DHA or even more). Vit D (60 ng/ml 25(OH)D) and TSH 0.2-2.0 (whatever the American units are) is crucial as well. Hope that helps! g

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  38. Hi g,

    Thanks for the input. I've been trying to put a coherent framework around migraines and am certainly missing parts of the puzzle. There are certainly dietary triggers in many people but we eat such a restricted diet in terms of junk food that it would have to be an amine (variable content in meat depending on age) or a salycilate/glutamate source that was intermittent and there is no obvious pattern. The oestogen link is interesting in view of the papers you sent off blog about AF. Not only is she her mother's daughter in terms of migraines but she will also have patches of AF if she ever sugar binges (did this seriously once in the early days and it was bad for several hours). There has to be a common link there. We tried magnesium and it didn't seem to be very effective. If you're on a high carb low Mg diet I think it might help. The roll of Mg and the roll of ketone bodies (Dr McCleary) suggest that at the cellular level it might be an energy failure problem, which LC sorts out for some people. One of our problems is that she only has a few a year. One of her sisters triggers with citric acid and has improved dramatically (was having many each week) on a change in the brands of soft drinks she consumes in normal teenager amounts). I've heard commercial citric acid is often glutamate contaminated, just hearsay. We're in the process of supplementing D3 and she's on low dose fish oils, high doses she bruises too easily.

    With a multiple month gap you have to wait a long while on a sustained elimination diet/supplement regimen to find out if you have sorted it! There has never been a meal we can point to and say "Ah ha!".

    The current "patch" we use is 5HPT at 50mg combined with niacin 50mg based on this paper. I don't do the D3 load as it is small compared to our normal daily dose and the Mg/Ca aspects don't seem necessary (multiple interventions again too).

    We don't want to go down the drug route as Squiggs is still feeding from his mum, so even the antihistamine in the discussion paper is out.

    The 5HTP/B3 combo aborts them in about 2-3 hours as opposed to 2-3 days and is good enough that she rarely ever misses work.

    Thanks again, and to all who've commented on migraines.

    Peter

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  39. I just tried to look up that NHS Chocies site, purely for laughs you understand.

    The comments appear to have been vapourised.

    I find this on a lot of "official" medical sites, either comments never get posted or they are soon removed if they are too sensible.

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  40. Hi Peter, the AHOA link unfortunately didn't work. I bought Dr Kwasniewski's books thru the Polish publishers site. They will send to Europe/US.

    Thanks for the great blog!

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