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...

 

 

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). 

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").

 

 

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. . .

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

 

 

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!"

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. . .

Dr. Davis Spanks Moises Velasquez-Manoff at the NYT

A quick post to link to Dr. William Davis' (author of Wheat Belly) rebuttal of the New York Times article, 'The Myth of Big, Bad Gluten'. 

 

I think the perfect summation for me comes in from one of the comments on Dr. Davis' post - to paraphrase - "If grains are so great, why do so many people eliminate a litany of health problems when they stop eating grains?" 

And what, exactly is so great about grains in the first place?  There is nothing in grains that you can't get (more of, and in more bioavailable form) from other sources. 

 

Nutrient	Whole grains	Whole milk	Fruit	Vegetables	Seafood	Lean Meats	Nuts and Seeds
Vitamin B-12 (µg)	0.00 [4]	0.58 [5]	0.00 [4]	0.00 [4]	7.42 [7]	0.63 [6]	0.00 [4]
Vitamin B-3 (mg)	1.12 [4]	0.14 [1]	0.89 [3]	2.73 [5]	3.19 [6]	4.73 [7]	0.35 [2]
Phosphorus (mg)	90 [3]	152 [5]	33 [1]	157 [6]	219 [7]	151 [4]	80 [2]
Riboflavin (mg)	0.05 [2]	0.26 [6]	0.09 [3]	0.33 [7]	0.09 [4]	0.14 [5]	0.04 [1]
Thiamine (mg)	0.12 [5]	0.06 [1]	0.11 [3]	0.26 [7]	0.08 [2]	0.18 [6]	0.12 [4]
Folate (µg)	10.3 [4]	8.1 [2]	25.0 [6]	208.3 [7]	10.8 [3]	3.8 [1]	11.0 [5]
Vitamin C (mg)	1.53 [3]	74.2 [5]	221.3 [7]	93.6 [6]	1.9 [4]	0.1 [1]	0.4 [2]
Iron (mg)	0.90 [4]	0.08 [1]	0.69 [2]	2.59 [7]	2.07 [6]	1.10 [5]	0.86 [3]
Vitamin B-6 (mg)	0.09 [3]	0.07 [1]	0.20 [5]	0.42 [7]	0.19 [4]	0.32 [6]	0.08 [2]
Vitamin A (RE)	2 [2]	50 [5]	94 [6]	687 [7]	32 [4]	1 [1]	2 [3]
Magnesium (mg)	32.6 [4]	21.9 [2]	24.6 [3]	54.5 [7]	36.1 [6]	18.0 [1]	35.8 [5]
Calcium (mg)	7.6 [2]	194.3 [7]	43.0 [4]	116.8 [6]	43.1 [5]	6.1 [1]	17.5 [3]
Zinc (mg)	0.67 [4]	0.62 [3]	0.25 [1]	1.04 [5]	7.6 [7]	1.9 [6]	0.6 [2]
Sum rank score	44	44	48	81	65	50	38

 

For the full reference on the above table go to Robb Wolf's 'Paleo vs. Standard American Diet'.



Happy Birthday

 

 

We, therefore, the representatives of the United States of America, in General Congress, assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the name, and by the authority of the good people of these colonies, solemnly publish and declare, that these united colonies are, and of right ought to be free and independent states; that they are absolved from all allegiance to the British Crown, and that all political connection between them and the state of Great Britain, is and ought to be totally dissolved; and that as free and independent states, they have full power to levy war, conclude peace, contract alliances, establish commerce, and to do all other acts and things which independent states may of right do. And for the support of this declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our lives, our fortunes and our sacred honor.  

Portable Pain Relief

Yep, haven't been on the net much lately; this is the time of year where obsession meets desire and . . . I go mountain biking (heh!). 

 

Thanks to my mom for test driving the Icy Hot Smart Therapy TENS unit.  TENS (Transcutaneous Electrical Nerve Stimulation) machines work by sending stimulating pulses across the surface of the skin and along the nerve strands. These pulses help prevent pain signals from reaching the brain.  They also help stimulate your body to produce higher levels of its own natural painkillers.  The Icy Hot units work pretty well, and certainly DO provide pain relief; portably and reasonably priced.  The batteries need to be replaced fairly often if you use these regularly at all, so you may want to buy some replacement batteries at the get go.  You can find them in most pharmacies and grocery stores.  On the other hand, these units are a bit big for small(er) areas, like the shoulder, which is where I really wanted some relief.  I found this mini on Amazon and have so far been quite pleased.  Of course, there are many, many other TENS unit options out there, with programmable cycles, bigger/better power, and remote controls.  If you are suffering from joint pain/back pain, for whatever reason, these personal TENS units are worth a look. . .

 

 

Things that make you go, hmmmm?

A few million years ago, after my diagnosis with rheumatoid arthritis, and before paleo was even a glimmer in my eye, I briefly supplemented with Knox gelatin.  Gelatin was touted by some as a great supplement for arthritis; as a precursor to cartilage, gelatin could help the body to repair joint damage and also keep damage from occurring in the first place.  It was one of many things I tried, used for a while, and mentally filed away with a reaction of, meh.

 

Years later, as bone broth, with it's healthy dose of gelatin, became touted within the paleosphere, my ears perked up.  I went online and bought some traditional (i.e. slow-simmered), grass-fed beef bone broth and gave it a try.  Soothing and yummy, but expensive - and storing enough to have just a cup a day for a month at a time in my tiny freezer was a pain.  I found myself repeatedly putting off ordering either due to the cost, or because the freezer situation was already at critical mass, so my use of bone broth was intermittent at best.  Maybe I'll eventually get over my fear of leaving a crock-pot simmering with the dogs home alone and regularly make my own bone broth.  But until then. . . with the possible benefits of gelatin for joint health as well as other possible benefits, I thought maybe I should try gelatin again.  I ordered some Great Lakes gelatin (it can be ordered through Amazon); I chose the whole protein gelatin rather than the hydrolyzed gelatin as it 'may' be better for gut health. 

 

And here's were it may get interesting for those in ketosis. 

 

My ketones, as measured by urine test strips, while consistently in the medium and high ranges early on, have been low for a while, sometimes fading away to 'nothing'.  While I'm aware that this was likely just normal sign of keto-adaptation, I still kind of responded with grrrrr every morning when I looked at my test strip.  A few days after I started supplementing with gelatin, my 'peetones' shot up into the medium/high range again and these levels have persisted for almost three weeks - now my response when I look at my test strip in the morning is, hmmm? 

 

The only thing I could find on a quick google search for 'gelatin ketosis' was this thread on reddit (I know, it's reddit, but still).  From the post:

 

"Gelatin which is made up of collagen and proteins from organ/skin/bone of animals contains glycine. Glycine in turn promotes glucagon to be released from the pancreas. Glucagon is the opposite of insulin, it tells fat cells to release fat (dumbed down version)."

 

Again, hmmm?  In the interest of 'science', I received my Great Lakes gelatin and started taking it (approximately one tablespoon per day) the same week as the local trails finally dried out and I was able to start mountain biking again.  Mountain biking, especially with the hilly trails in St. Louis area, can be a pretty high intensity, full body work out.  Obviously, exercise can affect ketosis, but I would expect the affect to wax and wane from day to day, as I'm not able to mountain bike every day.  The past week has essentially been a bust for mountain biking (ok, let's be honest, for exercise, period), and yet my ketones are still in the medium/high range every morning.

 

In any event, an interesting observation I wanted to share. . . I'll update regarding this, and any positive affects on those last stubborn five pounds, in the future. 

My Blood Work

Edited to correct HDL reference range and add footnotes found in my blood work results - apparently someone was too impatient to get out and mountain bike and forgot to check their work :)

So, in my last post I mentioned the 'helpful' email I received from my insurance company *rolls eyes*; they are so 'helpful' that they are now requiring you to meet their health standards score to save money on your insurance premiums.  You are scored based on your blood pressure, LDL cholesterol, glucose, triglycerides and tobacco use status; if you do not meet a minimum target score, or improve your score next year, your premiums go up.  My indignation over this Big Brother approach and whether it is reasonable, is fodder for another time; I thought some might be interested my blood work as a real life long term paleo/low-carber (sorry, I've only got the last two years on hand). . . 

 

For context - my diet has been 'paleo' for over seven years now, low carb-ish without carb counting; I've entered my diet into FitDay randomly over the years to see where all the values were falling out, but my diet is pretty consistent, so I don't track day-to-day.  Last fall (again, for context after my 2014 blood work) I made some minor changes in my diet to shift into nutritional ketosis, confirmed via urine test strips - or, as I saw in a comment the other day, measuring my peetones - heh!  Slightly less protein and slightly more fats, primarily from avocado, macadamias, coconut oil and butter; no significant changes in my produce consumption, as I was already fairly low-carb. 

 

As for exercise, at the same time that I started a paleo diet, I started weight lifting again.  My experience is that weight lifting is VERY beneficial for my rheumatoid arthritis - likely every bit as crucial as diet; in a future post, I'll discuss more. . .  I started out with pretty low weights, but seven years later, I am lifting literally three times as much weight as I was in the beginning (woot!); lifting sessions are typically 20-30 minutes in duration.  I also started mountain biking again about four years ago.  I ride or lift, on average, four to five days a week.  In the deep winter, when the local trails are trashed due to weather, I mostly lift with an occasional ride here and there when the ground is frozen solid.  In the summer, I mostly ride, with one or two weight lifting sessions a week.    Also, I'd like to note for anyone interested, in shifting my diet toward nutritional ketosis I did not experience any noticeable difference in my exercise performance. 

 

On to the numbers! 

 

Total Cholesterol

2014        2015          Reference Range

186          198            100-199

 

LDL

2014        2015           RR

87            108             0-99

 

VLDL

2014        2015           RR

17            11                5-40

 

HDL

2014       2015            RR

82           79                greater than 59

 

T. Chol./HDL Ratio

2014       2015           RR

2.3          2.5              0.0-4.4
 

Triglycerides

2014        2015         RR

86            54             0-149

 

Glucose

2014        2015         RR

101          103           65-99

 

Hemoglobin A1c

2014        2015         RR

5.4           5.5            4.8-5.6

Footnotes found in my blood work:

**According to ATP-III Guidelines, HDL-C greater than 59 mg/dL is considered a negative risk factor for CHD (coronary heart disease).

**T.Chol./HDL Ratio
    CHD Risk
    1/2 Average Risk    Men-3.4   Women-3.3
          Average Risk    Men-5.0   Women-4.4
    2X Average Risk    Men-9.6   Women-7.1

**Hemoglobin A1c
    Increased risk for diabetes:  5.7 - 6.4

    Diabetes:  greater than 6.4
 

So, I'm thrilled with the lower triglyceride and VLDL numbers.  HDL is still nicely in the very high numbers, keeping my Total Cholesterol/HDL ratio low.  The LDL is outside of the lab reference range, but still below the lower target number of 130 used by the insurance company, so I wasn't penalized for that; it's a shame that they don't include HDL or the Total Cholesterol/HDL ratio in their scoring.  I was penalized for having high blood glucose.  I'm not terribly thrilled with the glucose number, although such numbers are not unusual for those who are very low carb (VLC) and/or in nutritional ketosis.  Peter, Mark and Robb have all blogged about this phenomena. 

It is my understanding that this can be 'fixed' by eating a more moderate carbohydrate diet for a short period, which could be a strategy for next year's blood work to ensure I stay within the insurance company's target score and don't end up getting nailed with higher premiums.  I'm well within the overall target score this year, so there's that. . . On the other hand, I would have expected the A1c number to be a bit lower, and the elevated blood glucose still gives me the willies. . . I know Dr. Terry Wahls advocates a ketogenic diet for a variety of reasons - time to reread that section of her book and confirm whether I want to continue with nutritional ketosis or drop back to my 'normal' low-carb paleo diet. 

In any case, Happy Spring all!  The local trails are finally in good shape and although the weather isn't quite so warm as last weekend, the sun is out - I'm off to ride!

Down For the Count

"The formula for weight loss sounds simple: You need to burn more calories than you take in. That usually means moving more and eating less. But does the thought of cutting back on what you eat leave you, well ... hungry?"

 

This is a direct quote from an email I recently received from my insurance company, accompanied by an article explaining that reducing my caloric intake by just a few hundred calories a day will help me lose those unwanted extra pounds.  Oh, really? - well, it depends. . . My insurance company is not the only one bringing up calories in recent months; Mark's Daily Apple had a great post about 7 Common Calorie Myths We Should All Stop Believing and just today, a post on Robb Wolf's site asks, Do Calories Even Matter?  And, for a not so recent post about the almighty calorie, Gary Taubes' post, What would happen if. . . ? Thoughts (and thought experiments) on the calorie issue.

 

Look, it IS true that reducing calories (see the Twinkie Diet),  or tons of exercise, or both (see Biggest Loser) can reduce your 'weight', but what happens when you can't fight your body's need for 'food' any longer, or when you have health conditions that preclude hours of vigorous exercise (or, you know, you work for a living instead of living at the Biggest Loser enclave)?  And what kind of 'weight' are you losing?  Many conventional weight loss plans often reduce muscle mass right along with fat mass - maybe not such a good idea.  And what happens when you go back to eating (and exercising) in the way you always have?  Aaaaand, while dropping some weight may reduce the stress on your arthritic joints, if your focus is exclusively on counting calories, are you getting the nutrition to build healthier joints?

 

People like to measure things - how cold (or hot) is it today?  How many miles to grandma's house?  How much money is in the bank?  How many calories are there in this meal?  But we need some context in what we measure - If it's 35 degrees outside, am I dressed appropriately?  Am I just standing around or am I doing vigorous exercise?  Am I walking to grandma's house?  Or am I driving there?  Flying?  Did I just deposit my paycheck in the bank?  Or did I just pay all my bills?  The same context is important when it comes to calories; it is too simplistic to reduce calories in/calories out  (CICO) to a simple mathematical equation.

 

I recently read a discussion on a cycling forum about weight loss.  It was interesting (and occasionally highly entertaining) to read through the opinions of a diverse group of people whose only common denominator is their obsession with two wheels (and if you think that a group of people whose hobby directly relates to physical activity don't struggle with their weight, think again!).  There were a number of proponents of the conventional calories in/calories out weight loss model (cycle more, eat less!!), and a surprising number (at least to me), that advocated for a 'paleo diet', as well a few people who claimed weight loss success using supplements (or thought some illicit drugs might be in order).  There were a couple of real gems, in my humble opinion; below is one, paraphrased for context. . .

 

"Calories are a unit of energy, just like a joule is. 

 As such calories are not ingested, processed and stored. A vast array of simple and complex compounds are ingested and metabolized and each of these have an associated energy gain which can simplistically be related to the caloric value of the food. It is massively simplistic and in some cases not at all relevant, hence the discussion here and how different foods will aid weight loss better, but it's been taken as a standard because the concept is easy for people to understand and generally is applicable when deciding total amounts of food to eat.

 It seems a nit-picking point, but it isn't. Two foods with the same caloric value can be metabolized in a vastly different way and have a very different impact on the body.

 As for metabolism being a simple concept. Errr... No."

 

To repeat, 'as for metabolism being a simple concept, errr. . . No'.  Below is a 'simple' diagram of metabolism (woe-is-me, I remember memorizing some of these pathways in college).  Please note, the word 'calorie' is not in there. . .

If this diagram seems complicated, think of all the complex structures you body is busily building and rebuilding, over and over and over, ad nauseam.  To quote Taubes, "the mantra that ‘a calorie is a calorie is a calorie' serves only to direct attention away from the meaningful characteristics of the macronutrients in our diets...".  What is the purpose of eating after all?  To keep the number of calories under an arbitrary number based on your size, sex and amount of physical activity, or to provide your body with the nutrients it needs to maintain a fully functioning h. sapiens sapiens?

 

So, what has/is working for me? 

 

A low calorie/high exercise regimen worked to get my weight down to around 115 in my twenties.  Of course, by my thirties I had rheumatoid arthritis, irritable bowel syndrome, cystic acne and my weight had ballooned to about 190, so I guess maybe rice cakes and jogging (and later biking), wasn't entirely. . . optimal.  As the weight piled on, I tried.  I really tried; over the years, more biking, stair-master, aerobics, low-fat, low-cal, vegetarian.  Getting 'the shakes' and brain fog, signs of  blood sugar dysregulation, was an almost daily occurrence.  I'd lose a few pounds, gain back those and five more.  It was maddening, and I felt like such a failure.  Flash forward to the adoption of a paleo/primal diet and intermittent fasting, combined with moderate weight lifting.  Over a period of years, my rheumatoid arthritis and IBS improved and my weight dropped to around 125 (based on the scale at the doctor's office, as I didn't own a scale at this time).  No over night magic, but steady progress.  I didn't count calories.  I didn't count carbs.  I ate nutrient dense meals of meat/fish/fowl and vegetables; no processed food, no grains, no legumes.  Regularly planned 'cheat' meals.  Sometimes my workouts were gung-ho, sometimes they were half-assed.  Nonetheless, I had life changing results.

 

Having achieved these life changing results, I got a bit cocky.  I began mountain biking, stopped using intermittent fasting and became less stringent with my paleo/primal food template . . . and over a period of years, I regained around fifteen pounds (evidence, if I needed it, that up to two hours of vigorous 'cardio' four days a week, plus some weight lifting, won't do a darn thing to keep my weight stable) and I began having more significant trouble with my IBS (I also attribute this to a bout of severe food poisoning and antibiotic treatment).  So, I bought a scale and rededicated myself to quality paleo food and. . . nothing happened; I could NOT make a single pound budge.  Maybe because I'm now in my forties, maybe because my gut flora got all out of whack, maybe because the stars were no longer aligned; I just don't know.  What I DO know is that by switching to a ketogenic paleo template with a daily (most of the time) 16 hour fast (Wahls Paleo Plus ring a bell?), I've gone back down eleven pounds (only four more to get (back) to 125).  Not such a big change really; slightly (very slightly) less protein and slightly more fat (think avocado, macadamias, coconut oil) in my basic no grains, no legumes, no processed food, nutrient dense meat/fish/fowl and vegetables meal plan.  Again, I'm not counting calories, or carbs, or for that matter, grams of fat (although I do confirm ketosis with urine test strips); sometimes my work outs are gung-ho, sometimes they're half-assed, and now that it's winter, I miss more days mountain biking than not. . . the body is a living system, not a static machine and I'm still learning.

A final thoughtful gem from the cycling forum:
 

"You've still missed the point. "Weight loss" is what? The loss of fat? The loss of muscle? Both? Going to the toilet?  Sweating?

Weight gain is what? Adding fat, adding muscle, ingesting food/water?"

It's all about context. . .

 



 In honor of Old Man Winter, and the snow currently falling outside my window, some pictures from the winters I've spent here in Missouri.