"A ship in the harbor is safe, but that's not what ships are for." William Shedd

Saturday, November 21, 2015

Wahls Protocol Trial Results

How did I miss running across this video before now?  In the below video Dr. Terry Wahls gives a presentation to Direct-MS including a brief background on her own personal history with secondary-progressive multiple sclerosis and the diet/exercise methods she developed, and then goes on to report some of the preliminary results of the initial 'Wahls Protocol' clinical trial.  While the video is fairly long, it is well worth your time to watch the entire video, particularly the question and answer session at the end, which is full of great information. 
The PaleoMom has a detailed discussion of the preliminary trial results on her site, and here is a pdf of the full text journal submission to The Journal of Alternative and Complementary Medicine.

Note:  these are not new trial results, the below video is about a year old...

Thursday, October 22, 2015

Non-Celiac Gluten Sensitivity, IBS, Autoimmune Disease

Go here to download a great podcast from Robb Wolf interviewing Dr. Michael Ruscio about non-celiac gluten sensitivity, IBS and autoimmune disease (or go read the transcript). 

Friday, October 9, 2015

Addendum, Addendum

So, a brief addendum to my addendum

I purposely steered clear of insulin in the rundown of hormones related to hunger, as this hobbyhorse has kind of been ridden to death over the years.  However, while searching for the links on my last post I came across a new (to me) blogger, Butter Bob, with some very interesting information about abnormal insulin response.  Bob Briggs has made an incredible journey (he lost 150 pound in a little over a years time) and is sharing some great information.  Here is the post, 'Why Are Fat People Hungry?'.

What particularly caught my attention is about midway down the blog post, in the discussion and graphs of observations by Dr. Joseph Kraft regarding abnormal insulin response.  While most of us are familiar with the idea of chronic elevated insulin, insulin resistance and it's contribution to metabolic syndrome, the graphs of normal vs. elevated insulin response are fascinating.  Dr. Kraft's profiles of abnormal insulin response help us begin to see part of the framework for why some people seem to be more sensitive to carbohydrates in their diet, and find it so difficult to tap into the stored energy in fat cells, leading to 'unusually' elevated hunger between meals.  This may also explain why some people find a low carb/high fat diet to be particularly beneficial.

To quote:  "Two people sit down to eat a meal, one might have a normal insulin response to that meal that will leave them back to normal fasting insulin levels in 3 hours. And they won’t get a very high insulin level even after they eat.  The other one might have higher insulin levels BEFORE they even start eating and after they eat, their insulin numbers might be as high as three times the amount as their normal eating partner and they might not be back at normal fasting levels for 5 hours or more. Some of them, because they remain hungry even after eating because of this high insulin response, will snack, these people will almost never be at normal fasting insulin levels.  One important note, Dr. Kraft tested the low carbohydrate diet and found that it can change these abnormally high insulin patterns to a normal insulin pattern within a years time."

The blog post is actually a transcript of his YouTube video, which I've embedded below.  No doubt I will be referencing his videos/blog posts in the future. . .
Future posts:  I've been working intermittently (heh!) on a post about intermittent fasting (as a weight loss tool and as a tool to reduce inflammation), as well as a post about the role of nutritional ketosis in exercise and how ketosis has worked for me in regards exercise/mountain biking this summer (hint, the post title is "Nutritional Ketosis = Jet Fuel").

Sunday, September 13, 2015

Head, Desk, Addendum - Why do we get hungry?

An addendum to my previous post, which included my flip comment 'eet moar' if you're 'always hungry'. . .  Yeah, easy for me to say, right?  But we all know it's not always so black and white.  My last post touched on a couple of possible reasons Jeb Bush is 'always hungry' on a paleo diet; namely, those common and lingering entrenched conventional wisdom beliefs that to lose weight, your diet must be low-fat and low-calorie.  Of course, there's more to the story when it comes to why we get hungry. 
Thanks to the way-back machine, here is a post from Mark Sisson digging a little deeper into the idea of 'hunger'.  Hunger isn't simply a matter of  an empty tummy, but is influenced by the body's hormonal and biochemical processes over time, as well as the interplay of environmental and social cues.  I would like to highlight one point.  Quoting from Marks' post, "the overall nutrient-density of our diets appears to impact our experience of hunger. Study subjects who switched to a more nutrient dense diet reported feeling hungry less often, experiencing fewer and milder hunger symptoms and even sensing hunger from different locations in their bodies."  It's important to note that while the food we eat may be replete in calories, it may still be lacking in nutrients.  As Dr. Terry Wahls has noted, many people eating the Standard American Diet are starving themselves at the cellular level, regardless of the number of calories they consume.  This can lead to feelings of hunger, as the body signals that it need more nutrients, even if from a caloric standpoint one is 'over' eating .

For more about the role hormones play in hunger, PaleoMom has an excellent primer.  Whole9 has some additional information about the role of leptin and here is a more in depth exploration of leptin resistance from Dr. Loren Cordain's site.  That (previously) PaleoGuy has a good discussion on ghrelin.  Further zeroing in on the hormonal aspects of hunger, specifically as related to what happens when you have lost weight, a (relatively old)  article in the New England Journal of Medicine looks at the hormonal changes that occur in weight reduced subjects. 
The conventional wisdom weight loss bookend to calorie restriction (eat less) is exercise (move more).  Continuing to use Jeb Bush as an example, several articles mention that Bush swims religiously.  While exercise has many health benefits, it also stimulates the appetite.  An (old) article by Gary Taubes discusses some of the history behind the idea of  exercising for weight loss, and why exercise alone may not contribute to weight loss, but may instead make you more hungry.  From the article - "The feeling of hunger is the brain’s way of trying to satisfy the demands of the body. Just as sweating makes us thirsty, burning off calories makes us hungry."  Here, Dr. Peter Attia talks about how ". . . despite exercising 3-4 hours per day, I had morphed from a lean person into a sort of chubby guy over the preceding several years. . . I exercised more in one day than the average person did in one week. I didn’t eat at McDonalds or Taco Bell. I really cared about my health, but I was overweight. . ."  (Go here for a concise overview of how Dr. Attia lost weight.) 

For me, a deeper understanding of 'hunger' has allowed me to make more informed decisions about what I eat (sometimes 'eet moar' is appropriate, sometimes it's not), when I eat (sometimes going hungry is good, as in intermittent fasting) and how I exercise.  The more you know. . .

Friday, September 11, 2015

From Darkness, A Beacon of Light

"May the lives remembered, the
deeds recognized, and the spirit
reawakened be eternal beacons,
which reaffirm respect for life,
strengthen our resolve to preserve
freedom, and inspire an end to
hatred, ignorance and intolerance."
9/11 Memorial Mission Statement

Sunday, August 16, 2015

Head, Meet Desk

Look, there is NO WAY I'm going to touch the third rail and talk politics on my blog, but while checking the newz feed yesterday morning I got zapped anyway.  Did any one else notice while watching 'The Debate' that Jeb Bush was looking a lot more svelte? Yeah, me too.  And I thought nothing of it until I saw a headline indicating that Jeb Bush was cheating on his 'paleo diet' while at the Iowa State Fair -- record scratch -- huh? 
It turns out Bush went 'paleo' in December and has lost around 30 pounds - he had to invest in a new wardrobe (been there - paleo is expensive, from a sartorial standpoint - going from a size 12 to a size 2 it seemed every time I bought a pair of pants I loved, they were too big before I could blink twice).  Scrolling through articles I was pretty excited - hey it's like if Oprah went paleo - way to get the word out Jeb!  And then -- repeat record scratch -- he says he's "always hungry" and the resounding themes from the articles I browsed were a) this diet is bad for him, b) this diet is unsustainable, and c) there's a lot of talk about him 'cheating'.  The record was completely destroyed when I started reading comments from an article in NYT, "Jeb Bush is Definitely, Grumpily Running. . . Away from Calories".
Not surprisingly, I have words to say about this; I'll try to limit myself to a few.
First. While I hate the whole "you're doing it wrong" message, I've got to say, dude, if you're hungry, eat more.  The majority of people entering the paleo diet find it much more satiating than their former diet.  In fact, this is the hammer many critics use to bash the paleo diet; because it is so satiating, people spontaneously reduce calories and THIS why the diet works for weight loss.  To which I say, whatever.  If a diet is so satiating that free range humans on said diet spontaneously control their calories without counting or feeling like they're starving themselves, is this not a win? However, we get some hints as to why Bush may be hungry. 
I saw reports in a couple of articles about a meeting at an IHOP in Colorado Springs where Bush was presented with pancakes, eggs, bacon and hash browns - and he didn't eat a bite.  Apparently he doesn't know that eggs and bacon are the darlings of the paleo crowd.  And this relates back to claim b) this diet isn't sustainable.  I'm sure the eggs weren't free-range, and the bacon didn't come from pastured pork, but at some point the perfect paleo is the enemy of the good paleo.  Better to eat those factory farmed bacon and eggs now than to be starving and eat something even farther afield later.  For a variety of reasons - travel, business meetings, finances, we are often faced with less than perfect food selections.  Occasionally the best choice is to skip a meal, or even two.  But the majority of the time, you can figure out something to eat - it doesn't always have to be the perfect organic, pastured fair tied with a perfect paleo bow.
Another look behind the curtain as to why Bush may be hungry comes from a reference to his 'monotonous go-to lunch, salad with grilled chicken'.  Don't get me wrong, I'm the queen of salads; I love throwing some leaves, vegetables and meat in a bowl - easy peasy - through the weekdays, this is also my go-to lunch (and often, dinner).  But these are HEAVY DUTY salads; I use a large bowl, baby kale and baby lettuces (just say no to iceberg lettuce), a variety of vegetables, avocado, kiwi, strawberries - you get the idea.  Almonds, sesame seeds, sometimes a little gorgonzola cheese, a generous dollop of extra virgin olive oil and a generous portion of protein (not a few strips of desiccated grilled chicken breast).  I have to wonder if Bush is trying to implement a Faileo diet. 
A faileo diet, as it is known in the paleosphere, is the low-fat version of the paleo diet; protein goes a long way, but natural dietary fats are your friend.  After decades of indoctrination in the low-fat mantra, this is a concept many of us had a hard time kicking to the curb.  This MMA fighter, Abe Wagner, tried to implement a faileo diet, and he, umm, failed until he made friends with fat.  To quote "Something that didn’t work for me was trying to stay at a 30/30/40 ratio of macro nutrients. Getting 40% of your calories from carbohydrate is A LOT of broccoli and cauliflower when you are as big as I am and eat as much as I do. I was much more successful once I shifted more to about 65/30/15 and started consuming much more fat.  I know a lot of people try this diet out for weight loss purposes and that’s fine and good, but I eat this way because it makes me feel better. It lets me perform better. I hate that it’s a given in our society that to eat “healthy” your food has to taste bad and that to lose weight, you had to be hungry all the time. I eat nothing but delicious real food, lots of it. . ."
To get back to a) this diet is bad for him, a couple of articles trotted out the tired old 'saturated fat is the devil'.  Look, I thought we had already dealt with that nonsense.  Also go here, here and here.  Putting the dead horse of saturated fat aside, what, exactly, is so alarming about eating whole, minimally processed food?  Jebus wept!
Finally, item c) there's a lot of talk about him 'cheating'.  This goes hand-in-hand with the comments section from the NYT article.  Would someone let me in on why eating fried twinkies at a state fair makes you look like 'one of the people', an 'average joe', if you will?  On the one hand, you have people giving you the side-eye if you don't eat whatever is put in front of you (a couple of articles were happy to point out that the chefs at IHOP got their feeling hurt when Bush didn't eat anything on his plate); on the other hand, you have comments on the NYT article along the lines of, 'I would never vote for Chris Christie because he's too fat' and 'hey, Hillary Clinton is hiding a lot of lbs under those expensive pantsuits'.  And then you have the 'move more, eat less/everything in moderation' crowd (the vast majority of which are male and under 30) saying they would never vote for someone who would eat such an 'extreme' diet (again, I ask, what is  so alarming about eating whole, minimally processed food?).

A few commenters on the NYT article intelligently pointed out that discussions about diet and nutrition opens the door to discussions about FDA policies and the current use of agra subsidies, so yay on that front.  And while there were certainly many comments on the NYT article stating that a candidate's weight/dietary choices were irrelevant, and the only thing that really matters are their policies, I was shocked at the number of comments that equated weight and diet with presidential qualifications.  As someone who was a size 2 in my twenties, a size 12 in my thirties, and is currently a size 2 again, I can assure you that my IQ and problem solving abilities are not dependent on my pant size.  Heh, who in their right mind would want to be a politician?

Some day, in the near future, a troop of chipmunks is going to march out of the forest and say "Look, we're taking over. We may have brains the size of walnuts, but even we can do better than this!"

Friday, August 14, 2015

Don't Shoot the Dog

A conversation at work this week about dog 'training' got the mental juices flowing - what is the most effective way to break bad habits?  Or better yet create good habits from bad? 

I have a coworker who has good dogs, but the dogs have a few issues that are essentially bad habits.  There is the old (I mean really old) idea of negative reinforcement - punitive response every time the unwanted behavior is presented - also known as yanking on the leash and yelling 'No' after the dog has already done the unwanted behavior.  And there is the more current idea of behavior shaping and positive reinforcement.  Both get results, but obviously one is considerably less stressful for all involved.
Our canine friends aren't the only ones that develop bad habits, nor are they the only ones that can benefit from more positive methods of changing behavior patterns.  Think how much more pleasant the work environment would be if people were motivated to perform well at their jobs, as opposed to being threatened with punitive measures if they don't perform well.  Imagine how much more successful we would all be if, instead of trying to shame ourselves out of a bad habit, we could feel positive about modifying it into a good habit.  Do you really think elite athletes correct their bad habits by having a coach wave their arms around and scream at them to just 'stop doing it that way'?  Of course not; they use behavior modification to improve their pedal stroke, or racket swing, or back flip.
One of the pioneers in regards to behavior shaping/modification is Karen Pryor.  In her book "Don't Shoot the Dog!" (sadly, not available for e-readers, print copy only) she describes "the  underlying principles of behavioral training and through  numerous fascinating examples reveals how this art  can be applied to virtually any common situation.  And best of all, she tells how to do it without  yelling, threats, force, punishment, guilt trips--or  shooting the dog. 8 methods for putting an end to  all kinds of undesirable behavior. The 10 laws of  "shaping" behavior--for results without strain  or pain. . ."  Believe me, the information is not just valuable for 'training' dogs - over the years I've wished this book was required reading for anyone in a managerial position. 
As always, Mark Sisson has something to say about How to Break Bad Habits, as well as How to Develop Good Habits.  And the current issue of Paleo Magazine has an article about '5 Steps to Create a New Habit'.  The common theme is to have a strategy; if you really want to break a bad habit, or develop a good habit (or turn a bad habit into a good habit), a little planning is needed, followed by consistently following the plan.
A final note, because I just can't help myself, about dog training.  Sending your dog off to be trained by a 'professional' is akin to hiring a personal trainer to go to the gym and do the workouts for you; if you think you need help, find someone that will work one-on-one with you and your dog together.   And for the love of doG, find someone that is using the current standards of POSITIVE REINFORCEMENT.   Forget all that tired old crap about dominance and submission and blah, blah, blah.  Being the pack 'alpha' is about leadership - think about the people in your life that you consider good leaders - what characteristics make them a good leader in your eyes?  Good leadership isn't about throwing your weight around and shouting "It's my way or the highway!"  One of the best books I've ever read about the human/dog relationship, and what it really means to be leader of the pack, is Bones Would Rain from the Sky  by Suzanne Clothier.
Of course, 'No' is still a useful tool when you're out hiking and your dog is standing over a reeking squirrel carcass getting ready to have a good roll. . .