Category Archives: Uncategorized

Blood Glucose and Cognitive Decline

Blood Glucose and Cognitive Decline

Reference: Crane, NEJMLancet NeurologyELSA StudyDiabetes Care,

Your HgbA1c is your most important blood test. Get to know it well. It is a simple concept. When blood sugar gets higher, more of it sticks to different proteins. Glucose is a very reactive molecule, ready to stick to anything. You know that from spilling a Coke on your car seat and having sticky goo for weeks thereafter. When you eat 4 scoops of ice cream your blood sugar shoots up for 6-8 hours. In that time it sticks to everything in sight, including your hemoglobin molecules in your red cells. That makes it a nice surrogate marker for glucose also sticking to the proteins in your blood vessels, your kidneys, your brain, your joints and on and on. You can sample your blood and there it is, a nice marker. Now, red cells live about 100 days more or less, so your A1c becomes the average of your glucose over the last 100 days. As fat cells get bigger, they require a higher insulin level to make them react to rising glucose, so A1c becomes a marker of how overweight your body thinks you are. Not your spouse, or your friends, your own internal body signal.

We define adult-onset diabetes as a blood sugar of 126 after an overnight fast. That leads to an A1c of about 6.4. But is that accurate? Is blood sugar healthy at 126? The answer is absolutely not. The Whitehall Study from England shows decreasing cardiac mortality down to a blood sugar of 85 before leveling off. Hmmm. Heart disease is one thing, but which would you rather die from, heart disease or dementia? I’m going for neither. I want old age to just spirit me away.
That’s what this week’s studies relate to. What is the risk of dementia from elevated blood sugar? Turns out, a lot. In fact, much lower than 126 or A1c of 6.4.
Crane’s study in the New England Journal is the hallmark study. The Adult Changes in Thought Study took 2067 elderly adults (average age 76) who yielded 524 folks with dementia. The simplest conclusion of the study was that a blood sugar of 100 compared to 115 raised risk of dementia by 18%. Going the other way, dropping blood glucose from 100 to 95 lowered risk 14%. One could extrapolate and say that dropping from blood glucose of 115 to 95 lowers dementia risk 32%.

There are now more studies following this seminal study that say the same thing. Lancet Neurology confirmed the danger in the ELSA Study.
There are some of us who spike our blood sugars quite high when we sneak that ice cream and that is even riskier. The science of that isn’t completely known but it can be measured with a nifty new test called 1,5-AG ratio that adds a layer of understanding to the risk. This may or may not play out. Something to watch. I want to know mine.
We don’t mean to belabor this point. The message is clear. The size of your fat cells matter. If you are overweight, your blood sugar will likely be higher, and your risk of dementia will be higher. Losing weight and lowering your A1c matters. What’s the target? A1c of 5.5 should be your minimum. 5.1 is perfection.
WWW. What will work for me? Well, with a mother with dementia and a father that had diabetes, my genes are in the crosshairs. I was running an A1c of 5.2 for a couple of years there then suddenly I popped up to 5.9 last year. (Nothing like a wedding in the family to gain a little weight and a broken food to cut the exercise.) I’ve been doing the fast mimicking diet for 5 months now and I’m back down to 5.6. This perfection stuff is a pain in the proverbial…..So, I still have a ways to go. Join me. I’m doing the FMD diet last week of the month. Every month until I’m below 5.5. Each month it gets easier.

Pop Quiz

 

  1. Your A1c reflects what?                                                         Answer: Your average blood glucose over the last 100 days.
  2. How can you lower it?                                                            Answer: Stop eating foods that make it go up like grains and sugar, and lose weight with the Fast Mimicking Diet.
  3. What blood sugar is an A1c of 5.1? (Google Blood Glucose A1c Table)             Answer: 5.1
  4. The current definition of diabetes is based on sound science. T or F               Answer: It was a committee decision that was made 40 years ago. Now way out of date.
  5. What’s the first step most folks need to do to lower their blood sugar?           Answer: Stop drinking it. The calories you drink are the calories your store. Sugared soda is the worst. Orange juice and energy drinks, ditto.

 

What’s the Big Deal with Homocysteine?

What’s the Big Deal about Homocysteine?

Reference: Amer Jr Clin NutritionNutrition JournalLIfe Extension,

We’ve known about the risks of homocysteine since the late 60’s when a Harvard researcher by the name of McCulley brought it to the world’s attention with his research. At that time there was a brutal PR war going on about lipids and cholesterol as being the cause of heart disease, which the pharmaceutical industry took up with enthusiasm (because there was so much money to be made). McCulley was essentially booed off the stage with his ideas and homocysteine was swept under the rug, despite continuing research showing that it had an association with headaches, heart attacks, strokes, osteoporosis, macular degeneration, and dementia. Ok, which of those don’t you have? This is the perfect portfolio of what we are getting sick from in this 21st century, and homocysteine is sitting right in the middle of it.
What does homocysteine do? Well, it is really just a shuttle bus moving methyl groups around inside your cell. It backs up when you don’t have enough. That simple. But what do you need methyl groups for? Ah, there’s the rub. (Poor Hamlet, thinking of suicide) Methyl groups are needed to label DNA so that you know which DNA to turn on and off. Having sufficient Methyl-FOLATE, one of the key sources of methyl groups is so powerful that women trying to get pregnant who take METHYL-FOLATE starting one year prior to conception will have as much as a 70% reduction in premature delivery. Wow! Throw in B12 (the other source of methyl groups in nature) with the methyl folate and spina bifida drops 5 fold during pregnancy. I could go for pages describing these effects in the literature, but you get the gist. You need methyl groups to tag and label DNA so that you can turn on the right genes at the right time. Add B6 and methyl glycine (a reservoir chemical to give methyl groups to folate and B12) and you will have pristine, perfect homocysteine levels.
The other thing methyl groups do is to be the first step in making “gunk” water soluble so you can excrete it through your kidneys. Lots of neurotransmitters are “methylated” on their way to excretion, as are all our hormones. Without sufficient methyl groups, we back them up and make more dangerous models.
Where do you get methyl-folate from? The foods are essentially all peas and green vegetables (spinach, asparagus, broccoli), foods we don’t eat anymore. If you eat lots of greens and black-eyed peas (yummy southern soul food cooking) you get lots of good folate.
The real problem is that we don’t measure homocysteine routinely. In fact, many health networks forbid measuring it because it’s not on their list of approved lab tests. Trust me. I know. I’ve gone to battle with one large local health care system only to be told by a nurse reviewer that it doesn’t meet their criteria.
And the irony is that it is ridiculously easy to lower to a normal range. Bredesen in his online training and his book, The End of Alzheimer’s, wants your homocysteine to be 7 or below. You lower it by taking B vitamins.
And that’s what this week’s studies show. B vitamins help slow cognitive decline in aging men. You can correlate that with high homocysteine. The average man in America has a level of 12 but I’ve seen as high as 42 now. For every 1 point above 7, you get a 16% increased risk of Alzheimer’s. Dropping your homocysteine from 12 to 7 halves your risk. Isn’t that just peachy! So simple, so easy, so elegant.
How did we get in this pickle? We evolved eating lots of green leafy vegetables in Africa. We lived to 35. It didn’t harm us then. Bruce Aime’s Triage Theory points out that until a nutrient deficiency makes a biological imperative for evolutionary pressure, it won’t cause trouble. We can skate along the edge of deficiency and not be affected until we fall over that cliff.

WWW.What will work for me. Well, the “cliff” appears to be about age 50 when we seem to get into trouble with sufficient B vitamins. I see very few folks with normal homocysteine. I had a level of 12 when I started and on daily B vitamins, I get down to about 9. I’ve just started with more methyl-folate and I’m waiting to test myself again. I’m bracing for paying the lab fee myself as I know my insurance may not cover it.

Pop Quiz

 

  1. What does homocysteine do?                                        Answer: It’s a passive amino acid shuttle that carries a methyl group off to attach to other chemicals. It’s simply a marker of sufficient methyl groups for everything else downstream.
  2. Soul food is inherently unhealthy? T or F                    Answer: Timeout. Probably the best way to get methyl folate through food. At least if you are eating greens and black-eyed peas.
  3. What should women wishing to become pregnant do in regard to methyl folate?                        Answer: Take it continuously for at least one year prior to pregnancy initiation in order to reduce their risk of premature delivery as much as 70%
  4. Why doesn’t lack of B vitamins hurt us more sooner? Answer: Bruce Ames triage theory explains that it does hurt us if we put on the right glasses to see it’s effect. It takes years of labeling DNA badly for the effect to show
  5. For every point increase in homocysteine over 7, my risk of dementia goes up how much? Answer: 16% You should know your homocysteine. Always.

 

What’s So Dangerous About NightShades?

What’s So Dangerous About NightShades?

Deadly nightshade! Dramatic name and well served. It is a very poisonous plant growing in your backyard (at least in mine in Milwaukee). You should know what the berries look like and rid your yard of them before your pets or children chomp on them. Even Shakespeare was well versed about deadly nightshade, as it made Romeo and Juliet, Act IV, Scene 5. The root and vines are equally poisonous, if not more so. Hence, it shouldn’t be a big surprise if other members of the nightshade family are problematic for humans. Well, they are. If you put potato, tomato or eggplant leaves in your salad, you can then arrange for a timely visit to an ER where you will be treated for all sorts of hallucinations if not more ominous symptoms. No kidding. The alkaloids of nightshades kicked off the field of chemistry and anesthesiology, coming out of the traditional healers otherwise known as witches. That’s why your mother told you never to eat any potato that was green. Don’t eat the shoot either. In fact, cut out the eyes of the potato. Whew, pretty dramatic stuff, this nightshade family!
Is the whole nightshade family so awful? Can we not eat tomatoes, eggplant, potatoes, chilis? Please, please make an exception for chilis.
Is there any credible science about the dangers of nightshades? It’s not just the alkaloids that are problematic. They contain unique lectins that set off the immune system and your response to it. What are lectins? They are the proteins the mimic your own proteins in a fashion to poison you and keep you away from eating plants. All animals have evolved in ecosystems in which they became tolerant to the local lectins and indeed consumed with impunity. Humans evolved in Africa and came out of Africa just 90,000 years ago. The nightshades are all New World plants. We’ve hardly had evolutionary time to adapt to their toxins.

How important is it for you to be careful about eating them? That’s the rub. Here we enter into the world of functional medicine and away from the world of evidence-based research. We have many, many practitioners who will tell you they have seen amazing things happen when their clients avoid nightshades. Particularly in the field of autoimmune disease, there is lots of anecdotal evidence that the field of nightshade chemistry is one filled with danger. Then why haven’t we seen objective science?
Answer. We haven’t gotten there yet. There are thousands of different lectins and the day has not yet come that modern medicine would endorse research into that field. It’s still too arcane and appears to work only in small subsets of folks. For example, autoimmune diseases. There appears to be some credible evidence from anecdotal reports that anyone with any sort of autoimmune illness should make their best effort to be off nightshades.

We see that same effect with a more prominent lectin source, wheat. By adding 14 plus 14 new chromosomes from two distinct separate grasses to wheat, we tripled the chromosomes and lectins in wheat resulting in many folks being wheat intolerant. Modern medicine looks at the specific immune disease called celiac disease, present in only 1 of 138 people, and dismisses it outright. You don’t have to look far to find someone who feels much better when they avoid wheat.
What’s a conscientious health seeking person to do about nightshades? Oh heck, have a tomato. Enjoy some eggplant. As long as you don’t have any autoimmune disease. But if you come to me with osteoporosis, or arthritis or coronary artery disease…..don’t say you weren’t warned. Those disease get better when you avoid them. And who doesn’t have them?
www.What will work for me. I’m off potatoes, soy and wheat. But I sure like tomatoes, eggplant and chilis. I weed my fence line of deadly nightshade. I don’t think I have any autoimmune illness. Yet. I’m waiting for more research. It’s pretty thin right now. But I’ve been frankly stunned in my functional medicine practice by the people with autoimmune diseases who have gotten better by avoiding them. Some in just a month. I’ve got a few dedicated folks trying out a lectin free diet with severe coronary artery disease. I’m hopeful.

 

Pop Quiz

 

  1. Nightshade plants contain some pretty serious poisons? T or F                  Answer: Even Juliet will tell you yes.
  2. You can safely eat a green potato. T or F                                                         Answer: Please, please, please don’t try.
  3. There is some pretty good proof that lectins are harmful? T or F               Answer: all depends on how you define proof. If you are waiting for a randomized, placebo-controlled trial, you don’t have any proof. If you talk to your neighbor who avoids wheat, just try telling them there is no proof. You will lose a friend and credibility.
  4. Humans are tolerant to what plant-based foods?                                          Answer: Quite a few. Many nuts (not including cashews and peanuts), almost all leafy greens, , olives, avacados……ready Gundry’s book: The Plant Paradox
  5. I free great when I eat a huge green salad with green peppers and tomatoes. Is that so bad? I like the lycopine in the tomatoes for my health.                                         Answer: Come back when you have your first bone density showing osteoporosis. We’ll talk. But until then, I’ll hide behind the concept of conjecture.

 

Leptin Resistance and Inflammation

Leptin Resistance and Inflammation

References: Am Jr Coll CardVitamin HormonesCurr Immunol ReviewCell,

Leptin is the hormone that has several important functions. One is that it is secreted when your fat cells say they are full. It is a feedback loop that tells you that you have had enough to eat, so stop. Fine and dandy. But like everything else in your body, there are layers and layers of delicate complexity far exceeding the first layer of functionality. Another layer is that it essentially mediates the release of fat from fat cells, making it the guardian of your energy stores. When all is well and working properly, your leptin level falls when you don’t have food and your fat cells open up and share their calories. Women have more leptin than men. As a general rule, gaining weight results in a higher leptin level which should result in your feeling full and not eating. Something strange happens, however, when you get inflamed.
The fly in the ointment here is that there is an intersection between metabolism and inflammation. The leptin receptor in your hypothalamus appears to be a critical link. It turns the Proopiomelanocortin system and has you produce melanocortin. MSH. MSH is a potent down-regulator of appetite. With a nice high MSH, you don’t feel like eating. Low MSH, you don’t have a feedback loop. And just what happens with inflammation? Leptin plays a role in that it has a critical effect on innate and adaptive immune response. It promotes the secretion of cytokines like IL-6 and Tumor Necrosis Factor, and there you have it. It sets up the link between metabolism and inflammation. What you see is a dramatic dysregulation of inflammation in folks who become overweight, and thereby establishing the first step in increasing risk for Alzheimer’s, heart disease, cancer, autoimmune disease and just about everything else that ails us. The “Common Soil Hypothesis” is the concept that metabolism and inflammation came from the same source in evolution, way, way back. Here again, we see that nexus and it makes for problems.

What you see happen is as follows. Folks with inflammation, like low-grade mold exposure, have low MSH and high cytokines that damage the leptin receptor in the hypothalamus. Leptin drifts higher in response, trying to bring about control of calorie balance. The person gains weight. Leptin goes higher, but the receptor is damaged and the higher leptin then mediates more inflammation. Around and around you go. If you feel overweight and have chronic pain or chronic fatigue, you likely fit this model. Forget trying to lose weight until you lower your leptin.

How can you lower your leptin most effectively? I suspect the fast mimicking diet will do so, but that is not yet proven. The one good study that shows regeneration of the pancreas beta cell used mice with a genetic defect in their leptin receptor, so they couldn’t be used to proven leptin repair. Right now we can use pioglitizone (ACTOS) which is an old fashioned diabetes drug that has lots of side effects when used for too long, but is dandy at lowering leptin and MMP-9, two mold effects.

Can we reduce leptin with our own lifestyle? Well, quite a lot. If you focus on several key items, you can guide your leptin lower. Keep your daily sleep cycle to a regular pattern. That plays into your POMC system being played every day at the same time. Avoid sugar. Increase fat in your diet. Cut down on your evening meal and increase your daytime eating, making for at least 12 hours of fasting each night. Exercise. Sleep at least 8 hours, starting with at least 3 hours of no food before bed. Consider training yourself to enjoy a cold shower, particularly if you get a nice hot sauna just before. (The Finns had it right.)

WWW.What will work for me. I’m fascinated with leptin and mold illness. I keep seeing women in particular with not only high leptins but super high leptins levels. Just about every one of them has had low MSH levels, meaning some sort of mold or biotoxin exposure. Throw in stress, sugar, lack of exercise, lousy sleep and we make for a perfect storm to elevate leptin, and keep everyone overweight and inflamed.

 

Pop Quiz.

  1. Leptin helps you make MSH which suppresses your appetite. T or F                Answer: Almost right but backward. LACK of leptin results in hight MSH, and then weight loss and lack of appetite.
  2. Inflammation turns on leptin. T or F                                                                      Answer: I’m into backward today. It makes for leptin resistance, which then elevates leptin.
  3. Name a few means by which you can lower your leptin with lifestyle changes. Answer: Regular schedule, exercise, sleep, 12 hours of fasting, weight loss, less sugar….
  4. Leptin allows the release of MSH. What does MSH do?                                     Answer: It’s a potent appetite down-regulator.
  5. The cause of fibromyalgia is likely?                                                                    Answer…….. /biotoxin illness leading to damaged leptin receptors.

 

 

Simple Bicarb May Help Autoimmune Diseases

Simple Bicarb May Help Autoimmune Diseases

References: J. Immunology,

Fascinating! When you drink simple bicarb (Yes, Arm and Hammer cheap stuff) you send several messages in your body we didn’t know about. The first is to make more acid the next time around to help digest the next meal. And the second is for mesothelial cells on the spleen to signal to all the immune cells inside the spleen to chill out. “Don’t make an immune response.”
What are mesothelial cells? They are the lining of your guts, your abdominal cavity. Every organ is lined with them on the outside. We thought they were there primarily so that the organs can slide over each other with no friction. That feature allows you to move without things being caught up inside. But the surface of mesothelial cells have an interesting feature. They have tiny little fingers called microvilli that signal messages internally to the organ beneath about invasion or intrusion. Mount an immune response, or not!

Here is what this study found. Drinking bicarb for a couple of weeks changed the internal splenic macrophages from a population of mostly M1 macrophages (turn on inflammation) to M2 macrophages (Turn off inflammation). Considering that the spleen is the main repository for immune cells waiting for dispatch, that effect is pretty meaningful. What is unique is that the message is transmitted through the wall of the stomach, via these mesothelial cells, into the wall of the spleen via its mesothelial cells with a result of lowered inflammatory response. Macrophages are typically known for gobbling up garbage from old, dead, dysfunctional tissue and they are some of the first to arrive on the scene in inflammation to clean up the “battlefield” of dead and dying tissue. Autoimmune diseases are thought to be a whole scene of dysfunctional, overreactive inflammation and activation of macrophages. Turning them off is a key thing.

It’s not just macrophages but also Treg cells that get altered with bicarb. Treg cells are supposed to be regulators of immune response and help dial it down. This dialing down is helpful at controlling weird autoimmune reactivity too. And this also occurs because of the messages from those mesothelial cells putting out acetylcholine, acting almost like nerve cells even though they are lining cells of organs. Strange cross over reactivity.

Where does alkaline predilection come from? Through most of human history, we were vegans, starting to eat meat just a few million years ago when our brains started getting bigger and needed animal energy to power them. Animal protein has lots of sulfur in it making for a biological ash of acid when all is digested and done. Plant sourced food ends up making alkali with all the magnesium and potassium salts. Most of our biological processes evolved in an alkaline environment. The range and intricacy of our immune function is all founded on an alkaline milieux. Animal food, hence acid, is new. You can measure this in yourself. Eat a diet of pure green vegetables for a week and measure your urinary pH. It will be above 7. Have some cheese and steak and watch your urine pH plummet to 5.5. Every drug store carries pH sticks you can measure on your own.  Ten servings of vegetables is about 1 tsp of bicarb.  Simple

WWW.what will work for me. Considering how much of the Longevity Diet by Longo is based on vegetables, we may find that part of its power comes from shifting the immune response from inflammatory, to anti-inflammatory. Here is a clue that we are probably all better served with more vegetables. Their alkaline salts help you out. So, I ordered doubled vegetables for dinner last night instead of a potato. Then the blooming onion hors d’oeuvres did me in. I’m not sure it really counts as a vegetable.

 

Pop Quiz

  1. Your internal organs are lined by what type of cells?                         Answer: Mesothelial cells
  2. Mesothelial cells are lined by what cellular feature?                          Answer: Tiny fingers called “microvilli”.
  3. This article says these cells do what?                                                    Answer:  The communicate across organs and down regulate inflammatory immune response
  4. What class of diseases is this particularly useful?                               Answer:  Autoimmune in which there appears to be unregulated inflammation.
  5. You can get the same effect of a tsp of bicarb by eating what type of food?                 Answer:  LOTS of vegetables, green in particular.  Roots won’t do it as well, if at all.

Fast Mimicking Diet #7: Autoimmune Disease

Fast Mimicking Diet #7: Autoimmune Disease

References: Longo in Longevity DietCell RepStem Cell StemCell Reports,

How autoimmune (AI) diseases come about is gradually coming into focus. There is clearly some role to attribute to stimulation of our immune system by foods, lectin foods in particular (of which modern wheat is the champion), lack of sufficient Vitamin D, chemical irritants, leaky membranes in gut and elsewhere and probably some genetic risk factors to boot. Add aging and some 40% of American women have one autoimmune diagnosis, and where you have one, you find more. Longo quotes 9% of the world has one of the major 29 types,but rising at 19% a year.
In autoimmune diseases we find dysregulation of Th1 and Th17 cells, antigen presenting cells and all sorts of other subtle shifts in immune cell populations. And with that, our current intervention based medical system has developed specific strategies to develop methods to inhibit those populations of abnormal cells. These strategies have yielded some impressive gains for MS and RA patients, for which we are grateful.

Is there another way? Well, the Fast Mimicking Diet is catching a lot of folks imagination because it appears to have almost as powerful effect as anything else we have developed to date. Because there are so many AI diseases (130+) it is difficult to find studies using the FMD on any but just a few. Longo found that hisstructured fasting caused a significant dip in circulating white blood cells followed by a burst of new stem cells. In yeast, it can be shown that it’s the down regulation of the PKA glucose sensing system and the TOR protein sensing system. But he admitted they could not have predicted the surge of new hematopoietic stem cells that lead to a normal balance of TH1 and TH17 that he observed.

Longo specifically mentions a study of 20 patients with MS placed on a FMD program. With only twenty subjects, it’s hard to state unequivocal success, but the folks who were in the FMD branch reported feeling better, and in that group there were only 3 relapses in the next 6 months, versus 4 in the control group. Not enough to be statistically significant.

What was remarkable to Longo were the people who wrote to him from around the world who had read his mouse research and enacted their own FMD trials. This isn’t research because there are no controls, but his inbox had many stories of positive results. Larger studies are in progress and starting. His advice: wait, but the diet has been shown to be harmless. (Wink, wink….)

www.What Will Work for me. I’m in. This flood of autoimmune disease I think comes about from the confluence of many factors that are hard to avoid: notably the infiltration of high lectin foods like wheat into every aspect of our diet, the wide spread use of NSAIDS, antibiotics and PPIs making leaky gut, and a sea of chemicals affecting us at every turn. We are all vulnerable to these diseases. Avoiding them is a high priority for me. I’m doing if for my diabetes risk, but this adds to my certainty. If I had MS, I would be all over this. I called as many as remembered in my practice to alert them when I read this. If I neglected anyone, please call!

 

Pop Quiz

  1. Autoimmune diseases have been increasing lately at what rate?                           Answer: 19% a year.
  2. Reasons for autoimmune increase could be?                                                     Answer: lectin containing foods like modern wheat, nightshades, antibiotics, PPIs, NSAIDS, and any given chemical you have stored in your basement to spray on whatever.
  3. Folks with autoimmune diseases have dysfunctional balances of their T cells. T or F     Answer: That’s a simple but accurate answer. (Lots of nuance)
  4. The FMD diet seems to result in a burst of stem cells that are normal. T or F                 Answer: True, though that is so simply stated, most researchers would grind their teeth but the beauty of it is that it is that simple.
  5. The FMD diet is safe to conduct in folks with AI?                                              Answer: As best we know, true, though Longo repeatedly begs you do it under a doctor’s supervision. I’m happy to oblige if you want help.

 

 

 

Eat Spinach, It’s High Fat Food

Eat Spinach, it’s High Fat Food

References: WikipediaBMJHarvard HealthJ Clin GastroScience Based Medicine,

I’ve learned that sugar and white flour is bad for my brain, my weight and just about everything else. Everyone around me is on a Keto Kick trying to lose weight with the Ketogenic diet. And it doesn’t work for me. How can I eat a high fat diet? And what I’m most worried about is my brain. How can I prevent Alzheimer’s?
Well, step one and two of Bredesen’s RECODE program are to eat a low carb high fat diet, and to not eat each night for 12 hours. This is how you teach your brain to run on ketones.

The conundrum comes when I try to eat low carb by having steak, bacon, eggs and cheese. And then my weight doesn’t budge. What gives? Turns out that animal protein and fat are not so good for us. Animal protein turns on the mTOR gene, that makes me age faster. I don’t want to do that. In the last few years, two studies about eating more animal and heart disease have bothered me. A BMJ article from Sweden shows that men who eat animal protein have a 5% increase for heart disease for every 5 gram increase in animal protein. And the Harvard Professional Men’s Study showed that men in the top quartile of meat consumption had 70% more heart disease.

What’s a person to do? Well, eat more vegetables. Guess what happens to vegetables and resistant starches? Where are they digested? Turns out not in your stomach, and not in your small bowel but in your colon by the biome of bacteria in your colon. Resistant starches are carb rich foods prepared in a certain way or eaten before fully ripe. Green bananas, for example are quite resistant and get digested in your colon into short chain fatty acids. Ditto for Peruvian potatoes, cooked and then cooled. The amylose molecule changes its shape with heating, and then again with cooling, making it indigestible in your upper gut which delivers it to your colon, where the bacteria break it down to short chain fatty acids. Propionate and butyrate are amazing super foods. They are the short chain fatty acids that nourish you and your whole body. They are fats. Eating spinach makes for fat. Green beans, ditto. Asparagus, broccoli, cabbage– if it’s above ground, its probably going to go the same route.

Enter the Kitavans. A small island off New Guinea where 80% of folks smoke, but they eat no sugar or western food, and have 70% of their diet from resistant starch and coconut. They are all slender, have no vascular disease or AD. One could properly conclude that their diet is high fat: a combination of coconut and resistant starches from yams and taro.
Hence, a vegetable based diet can be ketogenic. Get it? Eating salads with lots of olive oil, is more fat based than you thought. Do you see the path forward?
www.What will work for me. I went to a Mexican restaurant last night. We had guacamole for hors-d’oerves and I had a shrimp and avacodo/lettuce salad. I felt quite smug navigating a typically high carb, high animal fat environment and escaping feeling good about my meal. This morning, a spinach omelet. I’ve finished 3 cycles of the Fast Mimicking Diet and I’m done another 4 pounds.

 

Pop Quiz

  1. Eating leafy green vegetables turns your fibrous foods into?                      Answer: Fat in so many words, short chain fatty acids
  2. What other foods turn into beneficial fats?                                                     Answer: Resistant starches like cold potatoes and cold rice (emphatically NOT fresh not rice or potatoes), green banana, kasava,
  3. What small group of people smoke like chimneys but have no heart disease and live into their nineties?                                                                                             Answer: The Kitavans
  4. Bredesen calls for a diet composed of?                                                        Answer: Healthy green vegetables, olive oils and very low carbs, low animal fats and low animal protein
  5. What are we trying to teach your brain to do with this strategy?                 Answer: stop running on glucose and learn to use ketones as fuel (small fatty acid molecules) obtained from eating coconut oil, olive oil, and ironically, green vegetables.

 

Fast Mimicking Diet 6: Implications for Coronary Artery Disease

Fast Mimicking Diet 6: Implications for Coronary Artery Disease

References: Whitehall StudyScienceBMJPublic Health NutrAnnals of Int MedBMJ,

Heart attacks are what we die from in America. Fifty percent of us will meet our maker via heart attack, both men and women. It is the penultimate sign of aging, and the last sign for 30% of those who present with sudden death as their first indication of heart disease. We have made huge strides in reducing morbidity and mortality from heart disease in the last 50 years. Longo’s estimate is that we would have roughly 3-4 times the effectiveness on reducing mortality if we focused on enhancing resilience and longevity with the Fast Mimicking genetic program.
Ok, I’m in. Give me the details as they exist now. Let’s start with historical perspective. We know from the Whitehall Study in England that heart disease declines in frequency until your blood glucose is 86. We define diabetes as 124. Hmm. That’s obviously an arbitrary definition made by a committee. The implication is that the lower your glucose is, the less heart disease you will have.

All right. Second concept. The Madison, Wisconsin Rhesus monkey study in which two groups of monkeys were compared with normal diet versus 30% reduction showed that 42% of the normal control diet developed diabetes versus none of the calorie restricted. And cardiovascular disease was reduced 50% in the calorie restricted diet.

What we don’t have is large studies looking specifically at the “Longevity Diet” for coronary artery disease. Instead, we have studies that are close, and probably close enough to be legitimate comparisons. For example, Sofi and Cesari show that adherence to a “Mediterranean Diet” has dramatic reductions in heart disease, Parkinsons, cancer, diabetes. And the closer you adhere to a “Mediterranean Diet” the less heart disease you have. The overlap of “Mediterranean” and Longevity diets is significant. Both are founded on high olive oil, legumes and unrefined cereals, low meat, eggs and cheese, What the Longevity adds is evidence based additions like Time Restricted Feeding with an 11-12 hour feeding window and a 12-13 hour fasting daily, lower animal protein intentionally and lower fruit use.

And the opposite argument is valuable too. If you eat more animal protein and less carbs, as in one arm of the Harvard Professional Health study, you show that mortality doubled from all causes and increased 40% with cardiovascular disease. If low carb but vegetable based, increased CV disease disappeared. Another study from Swedenof 43,396 women showed a 5% increase in cardiovascular disease for each 5 gram increase in protein intake concomitant with a 20 gram decrease of carbs.

Finally, we have Dean Ornish’s and Caldwell Esselstyn’s diets in which folks are kept on extremely low fat, vegan diets. Their patients also showed regression of coronary artery disease. Their limitation is that compliance requires intense discipline, and most folks can’t maintain it.

My conclusion: we have something real here. The challenge is to make it palatable and sustainable. Well, nuts and olive oils are tasty. Fish is pretty good too. Including these fits in the Mediterranean construct, but also matches the behavior of long lived populations like the Okinawans, Greeks of Ikaria, Italians of Calabria, Seventh Day Adventists of California.

WWW.What will work for me. Heart disease is the elephant in the room. It’s what we Americans get. And we get it in proportion to our obesity, and our blood sugar level. I’ve eaten low carb, high protein for two years and ended up with an A1c of 5.9. Low carb is a fine way to lose weight, in the short term. The longer term is now revealed with this new idea: episodic 5 day fasts combined with a low animal protein, high olive oil, high vegetable diet. I’ve switched my breakfast from two eggs to one egg with spinach made in coconut oil.

 

Pop Quiz

 

  1. Increasing animal protein by 5% will increase your risk of heart disease by?             Answer: 5%
  2. Animal protein turns on what “aging” pathway?                                               Answer: The mTOR pathway
  3. At what level of glucose does heart disease no longer occur?                        Answer: 86 (And we define diabetes as 124)
  4. Name key components of the Fast Mimicking Diet.                                        Answer: Daily 12 hour fasting, monthly-quarterly 5 day fasting, low animal protein, high vegetable, low sugar, low refined grains, no trans fat,
  5. The best research studies we have that show the benefit of the Longevity diet looks at what current eating pattern?                                                                                        Answer: The Mediterranean Diet, but we will give you credit for saying Ornish’s or Esselstyn’s too

 

 

Fast Mimicking Diet 4: Reversing Diabetes

Fast Mimicking Diet 4, Reversing Diabetes

References: Whitehall StudyCirculationAgingDiabetes CareCell,

This is a big deal. If you read no email this year but this one, you will be well served. The reversal of diabetes is so important, it is a game changer for all of medicine. Why? Two reasons.

The first is that it is so destructive, effecitively being the cornerstone for all our diseases of modern society. We have defined diabetes by committee and decided that it really wasn’t a disease until you got to a blood level of 124 or so, measured twice, or a Hemoglobin A1c of 6.2 or 6.4 (Remember: the A1c is the percent of hemoglobin molecules with a glucose stuck on them. Red cells live 100 days, about, which makes the A1c a nice surrogate marker for your average glucose over the last 100 days.. But that is looking at a disease you might think about treating. What would happen if you decided to consider what blood sugar results in optimal function? I would refer you to the Whitehall Study from England, It showed that for every point of glucose above 86, you have a 5% increased risk of heart disease. And there is wide acknowledgement now that we need to lower blood sugar, which modern medicine does by treating with drugs. That means an optimal blood sugar should be 86. Bredesen shows abundant evidence that a HgbA1c of 5.5 is what you want if you are anxious about Alzheimer’s.

The second is that everyone has it. There are all sorts of papers saying how many millions of people have it, but that is the DISEASE. If you want optimal function, the picture is much gloomier. The simplest explanation of how your body progresses to diabetes is as follows: your fat cells become insulin resistant in relationship to their size. As you get fatter, your fat cells get bigger. You don’t make ore. And your insulin receptors get further apart, So you become insulin resistant. You raise your insulin to keep that blood sugar in control, which you can only so for so long. After a while, you run out of the ability to keep raising your insulin level. It’s as though you were only given so much insulin in a lifetime. As long as you were only burning a tiny amount a day, you can live a very long time. But it has become pretty apparant that once we get overweight, we are burning up our insulin supply faster than we can maintain for a lifetime of 100 years. And that is what we see today in modern medicine. As we age, being a bit plump gradually turns into our blood sugar slowing rising, and your being put on one pill after another until you get to age 55 or so, and then you flunk out and get put on insulin. Your islets in your pancreas look shaggy with fewer healthier insulin producing cells. And then your kidneys fail and you get on dialysis, and then you flunk and get Alzheimer’s. Till now, the key to reversing diabetes has all been about losing weight, making fat cells smaller and getting the residual ability you have to make insulin in line with your reserve of insulin producing capacity. Imagine having an insulin level of 35 when you weight 190, but a level of 2 when you weight 132. That’s what we see clinically happening.

Here is where the Fast Mimicking Diet (FMD) comes in. What would you think if I told you that the FMD turns on the genes that literally wipe out old, dead, decaying tissue and starts rejuvenation of new insulin producing cells? Yes, produces new insulin cells. We have never seen anything quite like this before. This is like the holy grail of medicine, and it’s right there in front of our faces. The FMD turns on genes that support resiliency, getting rid of old garbage that’s in the way and turning on the growth of new stem cells. This is dieting for your genes sake. And all we are asking of you is 5 days a month until you have got yourself fixed.

WWW.What will work for me. I’ve been getting older and I have a family history of diabetes. To my alarm, this year my A1c ticked up from it’s usual 5.2-5.4. I’ve already done one cycle. I’m starting cycle number two. I just came back from a trip to see old friends I grew up with in India. I’m going to send them copies of Longo’s book. My advice to you is to not trust me, or your own doctor on this topic. Trust your own lab results. Watch your own response. The data is there. This diet will eventually become the “human diet”. We will all be on a variation of it. The good news, if you don’t have any risk factors, is that you only need to do it twice to three times a year, provided you exercise properly.

Pop Quiz

 

  1. Diabetes starts at a Hemoglobin A1c of 6.2. T or F                                         Answer: true, if you call it as the disease and use current medicine’s standards. Optimal is a whole different story. If you have worries about heart disease, Alzheimer’s. autoimmune disease.. or just want to age gracefully into your 90s, you want an optimal A1c: below 5.5
  2. You can lower your A1c by losing weight. How does that work?                    Answer: your fat cells get smaller and the residual insulin you have left become in line with the amount you need to control those fat cells.
  3. If I’m getting a little older and a little heftier, what is happening to my insulin producing cells in the islets in my pancreas?                                                                                 Answer: They are getting fewer and making less insulin.
  4. How many days do I have to do this diet thing?                                                Answer: 5. Four, as best we know, isn’t sufficient.
  5. What is an optimal blood sugar?                                                                         Answer: Your family doctor will tell you under 100 or so but won’t call you diabetic until you are 126, or if they are just checking your urine, you will be normal when you have a sugar below 180 because your kidneys can reabsorb anything below 180. (I kid you not, I talked to a person this week whose doctor was still checking urine for diabetes.)

 

Fast Mimicking Diet 2: The Human Method Simplified

Fast Mimicking Diet 2 The Human Method

References: Longo: The Longevity Diet, ScienceGut,

Last week we heard about yeast being used to explore what genes are needed to make the right environment for longevity. Valter Longo’s hypotheses was that those same genes exist in mammals, humans included. If he could make the same changes in longevity by diet and its effect on genes in mice that he made in yeast, he would have a huge scientific win. He started looking at mice and their genetic code. Mice live about two years and start getting cancer around a year and a half. That makes a useful model.
What did he find? The exact same thing. Two key ideas. Extra sugar activate the PKA gene. That causes trouble. Mice with lower PKA activity, live longer. That simple. And extra protein activates the growth hormone receptor and TOR-6SK and increases the level of insulin and insulin like growth factor. Certain amino acids appear to be more potent at activating the TOR-6SK complex, like leucine. which then accelerates aging. That’s it. The foundation of aging down to two simple key processes. Too much sugar, and too much protein. That duo is the foundation of what Longo called his “basic juvenology research”, one of his Five Pillars of Proof.
The story is all about the nuance of glucose and protein.

Our body runs on glucose. It is our preferred food for our brain, if present. The story is all about how it is delivered and what happens to our bodies if we get too much, too fast. When you get low glycemic carbs from vegetables, your blood sugar rises very slowly and you hardly get an insulin response. (For example, it takes 19 cups of asparagus to make 50 grams of glucose). If you have a diet of broccoli, spinach and green beans, you hardly get any insulin spike at all. A substantial portion of those vegetables make it to your colon where the biome in your colon changes those coarse fiber rich foods to short chain fatty acids, just like in gorillas (See this column from 2 weeks ago). Just like with gorillas, a high fiber diet actually results in substantial increase in fatty acids, or fat. Adhering to a Mediterranean Diet appears to make this possible, all due to the activity of the biome in your gut.
A high protein diet changes your gut biome and increases many markers of cardiovascular disease,TMAO (trimethylamine oxide). So we have seen these changes from other lines of research as well.

We are even beginning to understand the incredible complexity of our gut biome. Our colon is there to take high fiber foods and digest them for us, releasing short chain fatty acids, turning low glycemic vegetables into short chain fatty acids. Bacteroidetes are more abundant in the stool samples of those eating a mostly plant based diet, while Firmicutes were more abundant in those who eat a more animal products diet. From those major families, the specific bacteria Prevotella and Lachnospira were more common in vegetarians and vegans while Streptococcus is more common among the omnivores with higher meat intake.

Can we take this to humans with specific guidelines? Well yes. This is what Longo has come up with. Protein should be about 0.31-0.36 grams per pound per day, of which about 40 grams for women weighing 130 and 60 grams for men weighing 200. Once you hit age 65, you likely need a little more protein, but not that much. Just a little.

Your diet should be rich in healthy fats like olive oil, fish and coconut oil, walnuts and almonds. These fats essentially do the same process of helping you get more calories from fat, like the gorilla. Trans fats and saturated fats are to be avoided. And there should be plenty of Healthy Carbs – the type that make it to your colon and turn into fat. They generally have a glycemic index under 20, or 45 max which would include beans (if you aren’t lectin sensitive). The carbs that get digested in your small bowel and make sugar spikes look like ground flours of any kind, sugar in particular, high fructose corn syrup in double particular, fruit juices or too much modern fruit (modern apples are nowhere near the original Himalayan apple – ditto for pears, bananas, on and on that we have altered in the last 100 years to be much richer in sugar). Most grains are just too rich in carbs to be too good for you, unless you have changed them to be resistant, usually by cooking and then cooling. Same with potatoes. The original potato from Peru was a fine food with a GI of 40. Now it’s a glycemic index of 80-95, unless you boil it and cool it making it resistant. (Is this enough to confuse you a little?)
Finally, cut your meals down to 2 and a snack. Try to fit all your food into 11-12 hours of eating and not for 3 hours before bedtime. Breakfast is NOT the meal to skip as there is plenty of evidence that that habit correlates with many illnesses.

Ok? Next week, we will discuss how to FAST and do it right so that you kick start your genes into being supercharged. It’s cool, and it works.
WWW. What will work for me. This is evidence based and I get it. I’m so fascinated that I drew my own lab tests and started doing it full bore, as much as can be done living in a modern 8-5 work world. It’s the fasting part that has my attention. I’ve completed my first 5 day session and intend to do it again. It wasn’t so hard. More next week.

Pop Quiz

 

  1. Animal protein appears to shorten longevity? T or F                           Answer: True
  2. We need animal protein to support our healthy brain? T or F          Answer: Again true. Conundrum? Yup. We get B12 only from animal sources. But nature doesn’t care much about you once you have made your babies and passed on your genes.
  3. A high carb diet is bad for you. T or F                                                    Answer: All in the details. High in low glycemic green vegetables, it’s very good for you and is actually a high fat diet.
  4. The über enemy of nutrition is?                                                           Answer: Sugar, fructose in particular when it gets above the 6% found in fruit.
  5. How much protein can I have a day?                                                   Answer: 0.31-0.16 grams per pound when under 65 A little more after. But not much.