Monthly Archives: March 2015

Carb Back Loading (CBL) – Weight Loss Magic?

Carb Back Loading – “Weight Loss Magic?”

Reference: Mol Cel Endo, Int Journal of Sports Medicine 2012, How CBL Works

John Kieffer is the training guru who worked out CBL on his own as a means of building strong muscles and losing weight. It appears to be the latest fad, which is not to say that it might actually work!

The question is, “How can I lose weight, and really lose fat, not muscle?” We are becoming aware that our body has a variety of tissues that have different sensitivities to glucose and insulin at different times of day.   In the morning, fat cells and muscle cells are both quite capable of taking up sugar.   If you eat carbs in the morning, you will induce insulin, which has an effect of 8-12 hours and your fat cells get fatter. Hence, the argument is to eat and exercise in a rhythm that matches your natural human physiology.

The method of carb back loading is as follows.   Eat only fat for breakfast, or skip it all together.   Have a light protein, fatty lunch.   Then, do a resistance training workout in the gym for an hour at 4 pm. Get sweaty. THEN, have all the carbs you want!

The physiological argument is as follows. The glucose transporters GLUT4 and GLUT12 are actually hidden inside the cell. They become activated and actually move to the cell surface of muscles with intense exercise. Kieffer claims that once they are activated, energy (glucose specifically) moves into muscle cells but not fat cells. Your muscle cells get bigger and stronger, your fat cells don’t.

His argument is based on several research studies about eating later in the day. In one, 10 women were given standardized calorie meals with either 70% of calories in the morning, or in the evening.   The evening schedule lost more weight from fat.   The problem with the study (though well designed and controlled) was only 10 subjects – with fat content measured by electrical impedance – not DEXA scan. The second study was on 78 police officers who were overweight and on a weight reduction schedule – either eating throughout the day or eating mostly at night.   The night schedule folks lost more weight. That study had tons of problems too. Calorie intake was self reported as proven by a protein intake that was way too low. And the evening group only lost 5 pounds over 6 monhts. That’s not much more.

What’s my read of carb back loading?   It’s interesting physiology, and there likely is some benefit, particularly if you burn 500 calories a day with an intense, one hour work out. But, I believe that’s the benefit of one hour of intense muscle work.

What I do believe is that in the rest of us folks, to lose fat weight, you have to get rid of insulin, and the only way to do that is to cut carbs AND protein.   Yes, protein. Protein is very insulogenic when you get too much of it. In fact, too much protein is just as insulogenic as white bread.   So, to lose weight, you don’t want to eat too much protein, or two many carbs. That leaves fat.   Yes, fat. Delicious, appetite satisfying, satiating fat. And that’s what the Adkins, low carb diet is, a low carb, modest protein, butter, egg and bacon diet.

WWW. What will work for me.   I’m currently making FAT BOMBS. Little snacks of pure fat. Delicious.   Well, some of them are. But I’m now down 20 pounds in three months and I haven’t really been hungry.   My diet is about 70% fat when I track myself on the LoseIt App.   Most days, for me, it’s two jumbo eggs for breakfast and two for lunch. Then a varied, most fatty meat supper. Not very interesting, but only 360 calories by supper time. I walk an average of about two miles a day and eat 70% of my calories at supper. I getting about 1,650 calories a day. That’s something you can do too.  (My abs, well, are not photogenic)

Pop Quiz

  1. CBL or Carb Back Loading is claimed to be the best way to build muscle and lose fat on the market? T or F

That’s his claim

  1. The method is to eat very little carbs in the morning, work out heavily at 4 pm and then eat carbs in the evening.   T or F

In a nutshell

  1. Physiological fact is that exercise induces the activity of glucose transporters in muscle that induce intake of glucose only after intense exercise. T or F

That’s the physiology John Kieffer claims makes his method work.

  1. Some people seem to succeed massively with this method. T or F

Just like every other method out there in media land.

  1. Randomized controlled trials are thin with CBL. T or F

None exist.

  1. It’s reasonable for you to consider this method.

Sure: just fat in the morning, a huge workout and then MODEST calories afterwards, and you will lose weight. Burn 500 calories and you can eat 500 extra, and then still lose weight if you only get to a net of 1500 calories a day.

Eating Salmon Inhibits Prostate Cancer

Eating Salmon Inhibits Prostate Cancer

Reference:   Liu Jr of Pharmacology

Remember hearing about how fish oil CAUSES prostate cancer (SELECT TRIAL)?   Alarmed you a bit, didn’t it? It caused an uproar in my world, with many phone calls and lots of my colleagues being frustrated by the study. It just didn’t make sense! So, a careful look at that study showed lots of design flaws in the association found with much data suggesting a wrong conclusion.

For example, look at the Japanese. They eat a lot of fish and have some of the highest blood levels of omega fats in the world, but have some of the lowest rates of prostate cancer.   If the SELECT trial really was truth, how do you explain that?

In answer to the SELECT trial, researchers at the U. of Washington decided to try and get to the basic science.   What happens to cancer cells when you expose them to known stimulants that get them to grow, with our without DHA and EPA (Fish oil)? And the answer was pretty dramatic, and pretty prompt. If you can understand the jargon of cancer cell receptors, and patiently make your way through the abstract, you pick out words like FFAR (free fatty acid receptors) that are activated by fish oil.

What’s my take on it?   Here is the 90,000 foot interpretation. As a rule, cancer is an inflammatory disease.   Our omega fats come in two families. The omega -3 fats are the precursors to all the anti-inflammatory eicosinoids.   Eicosinoids are the delicate little chemicals that mediate signals between cells in your body and typically last only a few seconds to minutes. There are about 250 of them at last count.   The omega-6 fats are the precursors to inflammation and are the precursor molecules to inflammatory eicosinoids.   In organic chemistry, chemical reactions are pushed harder by frontloading the active ingredients.   The more fish oil you eat, the higher your blood level of omega-3 fats, the more you push anti-inflammatory eicosanoid production. There is now accumulating evidence that the omega fats have opposite effects on cancer cells in general.   The omega-3 family is associated with less cancer, the omega-6 fats with more cancer.   That’s what you expect if cancer is to be caused by inflammation.

And that is what we see in world-wide nutrition epidemiology.   The populations that eat the very most omega fats have some of the lowest rates of cancer in the world.   As populations engage with the world wide economy of industrial farming and mass production of vegetable oils, they get more and more omega-6 fats in their diet, we see more cancer.   Vegetable oils are cheap to grow, taste delicious and heavens knows, we all love fried food. Consumption of vegetable oils has grown exponentially in the last century from almost nothing per capita to very high levels. And vegetable oils are strong sources of omega – 6 fats, thus inflammation, thus cancer.   Added to all this confusion, our leading medical authorities such as the American Heart Association, have it exactly backwards, and still think fats cause high blood cholesterols, not carbs. (They are wrong!) Nina Teicholz in her book, The Big Fat Surprise, got it right as shown on Dr. Mercola’s interview with her. (Opposing opinion expressed by SETH)

WWW.   What will work for me. What’s my bottom line? I take fish oil every day, on the order of 2 grams a day. I think the basic science here gets to the bottom of the controversy, and fits with the population studies we have from around the world.   If you have prostate cancer, I would encourage you to take more fish oil.

Pop Quiz

  1. In the laboratory, fish oil turns off cancer cells growth and reproduction? T or F

True. That’s what this paper says

  1. Fish oil contains high levels of omega three fats? T or F

Also true

  1. Omega-3 fats are the precursors to inflammatory eicosinoids? T or F

False. Pay attention. Omega – 3 fats are precusors to ANTI-inflammatory eicosinoids.

  1. Your body has two main eicosinoids in it, one for inflammation, one for anti-inflammation. T or F

Also false. We have hundreds that work in very complex overlapping, subtle and synergistic ways.

  1. Populations with the highest consumption of fish tend to have lower rates of prostate cancer.


  1. Prudent conclusion might be….?

Eat more fish oil. (Or grass raised meat that also is high in omega-3 fats)

The Trouble with Root Canals

The Trouble with Root Canals

Reference: Root Canal Coverup, Meinig

Ever had a toothache and ended up with a root canal?   Did it come back? Were you cured? Do you have a chronic, unexplained condition from which you can’t recover? An autoimmune disease? Are you losing weight, and don’t know why?

Westin Price was just fascinated with this problem. He was a dentist back in the 1920-30s in Cleveland who should be rated as one of America’s genius scientists.   Aside from that interest, he also traveled all over the world, taking pictures of peoples’ teeth and studying their diets, and concluding many of the findings of modern day nutrition 70 years before the rest of us caught up (He discovered Vitamin K2 15 years before the Nobel Prize folks gave it to someone else.). But he also did a huge body of research connecting inflamed, infected teeth with other medical conditions.

Many of his experiments involved removing infected teeth from folks with chronic medical conditions, and then observing their chronic medical condition improve dramatically. He then implanted those teeth into health rabbits and observed them to become ill also, with the equivalent illness the human had. And not just once or twice, but several thousand times. He produced a huge body of research that has laid undiscovered for some 50 years, and is only now being studied and found by credible dentists (Meinig was the president of the American Endodontal Association – and made his living for years doing root canals.)

Here are a few of the pertinent facts he worked with or “proved” that you should know.   Your teeth are not solid. Even the hard dentin is filled with miles of tiny channels that bacteria can hide in. When you have a root canal and have the tooth put back in, it’s still infected. You can’t fix it with antibiotics, as the antibiotics just don’t penetrate into the tooth. You may not be sick, after a root canal, but years later when you have extra stress in your life, like a car accident, a divorce, a death in the family, you are more likely to come down with a chronic disease. Modern dentists will tell you that the tooth is safe, and nothing can get out. It may be that the bacteria can’t get out, but Westin Price did elegant experiments that showed that the toxins get out.   Those toxins play havoc with your immune system, triggering exaggerated responses and thereby starting many other illnesses.

He also had pictures of bacteria in the dentin tubules of infected teeth in his textbook.   Price would take inflamed teeth out of folks, then cut open the dentin, culture the bacteria he found inside, filter the bacteria out but just leave the toxins in the fluid, and inject that fluid into rabbits. He did it over 1,600 times, and always found the same results. The rabbits got sick and died, or developed the same or equivalent illnesses the humans had.

One of the unique findings that I find fascinating is what sugar does to the flow of fluid in dentin. Usually the flow is outward from the inner body of the tooth. With sugar ingestion, your tooth reverses flow and dentin flow goes inward. That allows bacteria to penetrate and take up shop in your teeth. This was not discovered by Price but corroborates his findings and gives a credible explanation for how our modern diet causes so much tooth decay. He did show they then change from oxygen consuming to being able to live without oxygen, and start secreting toxins. And then, with enough of the right stress at the right time, you get sick.

WWW. What will work for me. If you have an unexplained illness, look at your teeth. Do you have gum disease? Are you losing weight and just can’t keep it on? Do you brush AND floss daily?   Are you going crazy with symptoms you can’t figure out?   If you are desperate and are grasping at straws, read this book. It may be a lifeline for you. This knowledge was discovered back in the 20s by one of our genius scientists, and got lost for 70 years. I’m certainly going to floss a lot more. And eat much less sugar.


Pop Quiz

  1. A diet heavy in sugar changes the flow of fluid in your teeth? T or F

True. It reverses it.

  1. If you have cavities, you have bacteria in your dentin (the foundation of your teeth) channels. T or F

True also.

  1. These bacteria are the same that are in your mouth at all times, but changed to being able to live without oxygen. T or F

Not fair, that’s in the book and not mentioned in this email

  1. Taking an infected tooth out of a human and culturing the dentin will results in positive bacterial growth, which, when implanted in rabbits, may duplicate the disease the human had. T or F


  1. Everyone with a root canal gets better, what’s the big deal? T or F

Maybe true in the short term, but there appears to be a strong correlation with systemic illness occurring when their immune system isn’t as robust as it is right now: after a big life stressor.

The Glucose Effect of Standing

The Glucose Effect of Standing

Reference: Thorpe Med Sci Sports 2014, Alter, Annals Internal Med 2015Glucose is the problem.   There is pretty clear evidence from the Whitehall study and others that you start making vascular lesions when your blood sugar is more than 86.   That’s a tall order. Most of our doctors tell us our blood sugar is normal when it is under 100, and that all we need to do is exercise more and lose weight if our glucose is under 124.   We aren’t officially “diabetic” until our fasting glucose is over 124, twice.

Then, we find out that 50% of us are going to have Alzheimer’s by the time we get to age 85.   Pleasant thought, isn’t it? That may be all right with you, but seeing the misery my own mother is in, it’s not so good with me. And if my mother is in it, my turn is next. I don’t want to wait for that to happen, I want to do something that makes my risk different.

Well, Alzheimer’s is now being called Type III diabetes. The argument here is that our brains get used to glucose, then gradually resistant to it over time.   Perhaps the key concept here is prolonged exposure to glucose over time.

Well, that raises the question, is there benefit to lowering my glucose?   Considering the demonstrated effectiveness of lower glucose on heart disease, I suspect it’s not unreasonable to posit the same effect for our brains. I make the leap that disordered glucose is damaging, wherever it is and vascular disease just happens to be where it shows up first. But expose the human brain to it for long enough and it will give way too.

So, what is the standing thing all about?   In this study, the researchers took 29 overweight office workers (mean age 49, BMI 29) and put them in a work environment that had them either sitting all day long, or sitting and standing all day, 30 minutes at a time at an electric, height adjusted standing desk.   (Nifty idea!). Guess what happened! Their blood sugar dropped 11 percent.   That’s huge! Just from standing for 30 minutes at a time.

Now, there is increasing research showing that going to a gym for 20 minutes has t’s benefit largely erased by 8 hours of sitting. Dr Alter did a review of all the research out there and shows that prolonged sitting is independently associated with bad health outcomes, regardless of exercise.   Exercise helps over no exercise, but prolonged sitting adds risk back and largely negates the benefit. What should be a louder clarion call is for all of us who get little exercise and have prolonged sitting as part of our jobs.

That leaves the high priest of sitting behavior (The CEO of Apple Computer) saying that prolonged sitting is the new cancer.   And right he is.

WWW. What will work for me.   I’ve got a job that involves prolonged sitting.   All day long, I sit. I get up to greet folks and walk a little bit here and there, but mostly I sit.   I have put my greaseboard up for demonstrations, and used it once or twice. And I’m having a small podium built so that I can put my computer up and stand when I need to.   And as I typed this letter, I realized I was sitting. I’ve typed the last half of it standing.   I’m determined to learn different habits.   Join me.


Pop Quiz

  1. Prolonged sitting each day is independently associated with bad health outcomes. T or F


  1. If I stand half the day, my blood sugar may be as much as 5 % lower. T or F

Nope, 11%.

  1. Modestly high blood sugar with subsequent brain resistance to it may be the ultimate mechanism for Alzheimer’s.

That’s the current thinking.

  1. The majority of Americans sit most of the day.

Yup! That would be me and you, (mostly)

  1. Many of us can make modest adjustments in our workplace that would allow us to stand. T or F

Took me one minute to lift my lap top off the table and stand up. I put a few books underneath it to raise it up for me.


Vitamin D Gets a Reality Check

Vitamin D Gets a Reality Check

Reference:   Annals of Internal Med 2015, Washington Post

The US Preventative task force is waving a bit of a caution flag out there about Vitamin D. They state that, as best as they can tell, there really isn’t “convincing” evidence that “megadoses” of Vitamin D are helpful.   Certainly, we feel ok about getting extra for bone health.   By extra, the Institute of Medicine, which essentially is the governing body for what is in a vitamin pill or standardized recommendations, has stated that there is little usefulness for more than 800 IU of extra D a day. They also acknowledge that below 20 ng is a problem and should be repaired. But the evidence for more than 4000 IU a day might be skimpy.   More concerning is the worry that high doses might lead to extra kidney stones and calcification in arteries, just what we thought we might be avoiding by taking more.

There is research out there about larger doses that is currently being conducted. We will get those results sometime in 2017 or 18, so, it’s still a ways off. Until then, what to do?

Here are some of my thoughts.   First of all, humans with mid-European skin type III (most Germans, English, French, Poles – who can tan but burn with too much sun) make about 1,000 IU a minute when exposed to mid-day sun in June at age 20. That means we are being advised to have only 36-48 seconds of direct sunlight a day extra. Anything more than that might be dangerous. Hmmm.

I also know that the Journal Science published an article in 2006 that shows that our own natural antibiotic, cathelicidin, is not manufactured until we have a blood level of 32 ng.     It staggers my imagination that we want you to have your own immune system less than that.   In 2008, Smith in the Am J or Clin Nutrition showed that in Antarctica, 2000 IU of Vit D only got your blood level to 29 ng (or 72 nmoles).   In Wisconsin, we know that our D level drops to around 15 ng in winter. In Antarctica, on no D, it drops to 14 ng (34 nmoles) , so being in Wisconsin is just like McMurdo Sound research station. (Disagree?)

My suspicion about the errors in this editorial is somewhere in the middle of all of this recommendation conflict and anxiety.   I do know that there is abundant evidence that Vitamin D administration for decades to infants results in 78% less insulin dependent diabetes 30 years later.   2000 IU to babies!   The Institute of Medicine would fall off their rockers in horror.   But explain to me the epidemic of insulin dependent diabetes we have here in Wisconsin African Americans, whose D is even lower than Caucasians, or the epidemic of Multiple Sclerosis we have in the upper Midwest compared to the South or tropical countries. But that’s just epidemiology and not a clinical trial.

And that’s where I think this sort of recommendation breaks down. You can’t do controlled trials of populations comparing the administration of a drug with no side effects, that last 30 years. Just too expensive. Takes too long. No patience. I am worried about kidney stones.

WWW. What will work for me. I’m anxious about kidney stones. I’ve had 4 clients who have had them. I’ve had them. But so have 8.8% of population. I’m also worried about MS, and tuberculosis, and influenza and cancer. But my judgment is that the fatal flaw is in the effort to apply the pure scientific method. Heaney helps understand that long latency diseases might need another approach. In the meantime, I haven’t seen an epidemic of kidney stones each summer when we get more than 48 seconds of sunshine.   What I would give for just 15 seconds right now.

Bottom line. I want you to have at least 32 ng.   Optimal? Yet to be determined.


Pop Quiz.

  1. Our current recommendations of Vitamin D supplementation involve getting how many seconds of sunshine a day?   A) 12   B) 24   C) 36   D) 72   E) 600

C for most adults, D for over age 71

2.  In Finland, a study of newborns given 2000 IU of D a day for their childhood resulted in how much less insulin dependent diabetes?


3.  The Journal Science showed that your immune system doesn’t kill tuberculosis until your D level is at least   ________?

32 ng

4.  A 20 year old Caucasian with skin type III (Can tan, but also can burn), with 20 minutes of mid day sun on the 20th of June will make how many IU of D a minute?


5.  Long latency diseases like MS and insulin dependent diabetes might be dramatically reduced by sufficient Vitamin D. T or F


6. To prove that D works or doesn’t work, we need a randomized placebo controlled trial that lasts 30 or more years – something that will never happen. T or F

True. It will never happen. We need a different method.

7. We observe epidemics of kidney stones every year after Summerfest when folks get too much fun and too much sun.

You answer that one.