499 The Starch Diet [26 Nov 2018]

Years ago I learned that to get a balanced view we need to read widely, especially in the field of natural health. Writers focus on one nutrient or diet and make it sound like the most important or only logical choice. Only by reading many different authors can we begin to see the whole picture. That’s what I have tried to bring to you over the past 10 years writing these articles.

A case in point is Dr. John McDougall’s 2013 book The Starch Solution (read the first chapter here). McDougall advocates a diet rich in starchy foods like grains, legumes, potatoes and sweet potatoes, along with plenty of vegetables and fruit, while eliminating meat, dairy, processed foods and most oils. This is in sharp contrast to the currently popular low-carb high-fat paleo and keto diets.

McDougall observed that when people from other countries with a traditional starch based diet who were trim and healthy moved to the USA and adopted an American diet, they became obese and developed western diseases. The immigrant grandparents remained slim and healthy; their children were overweight and unhealthy; and the grandchildren obese and sick – the opposite of what we would expect. He believed the difference was the increased meat and dairy in their diets.

Over four decades Dr. McDougall developed his diet and helped thousands of patients regain their health. McDougall claims that a diet rich in starch:
• Allowed humans to move beyond the tropics and to develop our large brains;
• fuelled the rise of civilization and fed the Greek and Roman armies;
• Healthy populations around the world get most of their calories from starch;
• will let you lose excess weight almost effortlessly;
• will improve your blood pressure and cholesterol;
• will prevent diabetes, heart disease, and arthritis;
• will make you feel, function, and live better;
• will help save the planet (beef produces 14X more greenhouse gases than potatoes per calorie); and
• will significantly reduce your grocery budget.

I believe that minimally processed starchy foods are part of a healthy diet but I’m not sure I’d take it to the extreme that McDougall does eliminating all animal products. His diet does provide a welcome balance to the high-fat keto diets but I’d like to see some good research supporting his health claims.

Next week – The Last Post. I’m retiring this column after #500.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

488 Exogenous Ketones [10 Sept 2018]

A few weeks ago I wrote about the recent popularity of ketogenic diets [#482 30 July 2018]. These are very low carb diets with either low dietary fat for weight loss or higher dietary fat for other purposes. With both types of ketogenic diets, the main fuel burned for energy is fat – either your own stored fat or fat you eat. The metabolic state of burning fat for fuel is known as ketosis because the fat is first converted to ketones which are then converted to ATP energy in the cells’ mitochondria.

More recent is the promotion of ketone supplements – called exogenous ketones as opposed to endogenous ketones produced within the body. These supplements are purported to have similar benefits to ketogenic diets, but without the dieting. The theory sounds attractive but I’m not buying it. I believe it is the diet, with the reduction of carbs leading to a reduction in blood insulin levels, which provides most of the benefits. The ketones are just a byproduct of the process.

There may however be some benefits from ketone supplements. In a post on the blog The Diabetes Coach, titled “Are Exogenous Ketones Beneficial for Blood Sugar?” Dr Brian Mowll suggests that ketones enhance insulin sensitivity. He cites a small study from Oxford which showed lower glucose spikes with an oral glucose tolerance test for the group who had consumed a ketone drink.

But another ketogenic diet study, with obese diabetics, that Mowll cites as support that ketones increase insulin sensitivity did not include a ketone supplement. There is no evidence that it was the ketones, not the ketogenic diet itself, which provided the benefits.

In any case, if weight loss is the goal, adding extra fat or taking ketone supplements will only reduce the amount of body fat burned. And that, after all, is the whole idea.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

486 Keeping It Off [27 August 2018]

Most dieters will agree that it’s easier to lose weight than to keep it off. Once we have achieved our goal weight we tend to revert to our old eating habits and the pounds start creeping back on. Remember, weight gain is normal and natural. Here are some strategies for maintaining our desired weight:
• Have a Plan – just like in the weight-losing phase, having a plan directs and motivates us to achieve our new objective.
• Accountability – keep in close contact with your coach through the first year post diet – weekly the first few months, then monthly for the rest of the year. Then check in a few times a year as needed.
• Journaling – several studies show that keeping a food journal increases our rate of successfully keeping the weight off. It increases our awareness of what we are eating; helps identify problem habits, and creates accountability (even if just to our self).
• Exercise daily – with a ketogenic diet, exercise is not necessary for losing fat weight, but it is very important in maintaining our weight. Resistance training exercises (lifting weights) increases muscle mass, further improving our body fat ratio.
• Choose Healthy Foods – strictly limit simple carbs; choose healthy fats; eat sufficient high quality protein (more on this another week)
• Proper Food Combinations – separate carb-rich and fat-rich meals
• Some Quick Tips
o Start the day with a hearty breakfast.
o Don’t shop on an empty stomach.
o Eat mindfully, especially snacking.
o Control food portions; resist second helpings.
o Hot meals are more filling than cold.
o Stay hydrated – drink at least 2 liters of water daily.
o Use alcohol with moderation
o Get enough sleep.
• Reward yourself – each month you meet your maintenance target, treat yourself with something non-fattening like a night out, massage or pedicure.
• Reboot your metabolism for a few weeks every year with the ketogenic diet to return to your desired weight.

Further reading:
"How to keep weight off forever" WebMD
"Ten Habits of People Who Lose Weight and Keep it Off" theconversation.com

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

482 Ketogenic Diets [30 July 2018]

Ketogenic diets (keto for short) have become popular lately for weight loss and other reasons. I have run a weight loss clinic based on a 30 year researched, medically designed, ketogenic protocol for eight years now. While it’s possible to do a ketogenic diet on your own, there are significant challenges to consider.

The objective of the diet is to put your body into a state of ketosis in which fat is burned for energy instead of carbs. This is achieved by keeping total dietary carbs strictly below about 40g per day. Any more than that is just a low carb diet, not a ketogenic diet, and will prevent fat burning while starving your body for calories. See #290 “Low Calorie Balanced Diet” Oct 2014.

Getting adequate protein without the carbs is a challenge. Ideally we need 0.5g of protein for each pound of lean body weight. For me with a healthy weight of 200 lbs my protein intake should be at least 100g.

Another challenge is getting nutrients like vitamins and certain minerals. To remain in ketosis, whole food groups must be eliminated including dairy, fruits, grains and many vegetables. Supplementation of vitamins, calcium, magnesium and potassium is a must. For this reason, a ketogenic diet is not recommended for long term, unless designed for a medical reason such as epilepsy, cancer or Alzheimer’s. For weight loss, stick to it to reach your goal weight, then transition to a healthy maintenance diet.

Other challenges you may face while on a ketogenic diet include: temporary hormone changes affecting menstruation, hair loss, or unwanted hair growth; fatigue from low blood pressure or low blood sugar; headaches from low blood pressure or electrolyte imbalances; and the need to see your doctor to periodically adjust dosage of medications for diabetes, blood pressure, cholesterol, etc.

Our weight loss clinic can help you with all these challenges. It provides a wide variety of low carb, high-quality protein, foods and lists of vegetables to use and avoid. We monitor your weight loss and lean loss weekly to ensure that you are in ketosis and are not burning muscle. And we can guide you through any problems that may arise along the way. There are many benefits to a ketogenic diet besides fat loss, such as normalization of blood sugar, blood pressure, and cholesterol, and reduction in inflammation, as long as it is done correctly and safely.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

460 Risks of Early Weight Gain [26 Feb 2018]

As older adults, few of us weigh what we did as young adults. Gaining weight as we age is normal, at least in this society. But gaining even a moderate amount of weight, like 5 to 20 pounds, will increase our risk of chronic disease and lower our chances of healthy aging.

A large study published in JAMA last July looked at the effect of weight gain from early to middle adulthood on health outcomes in later life. The study used data from the Nurses’ Health Study and the Health Professionals Follow-Up Study to analyze 92,837 women and 25,303 men. The researchers compared the women’s weight at age 18 and the men’s at age 21 with their weight at age 55. They then observed their health outcomes for 15 to 18 years.

As expected, those that had gained the most weight by age 55 were at greatest risk of major chronic diseases. More surprising, perhaps, was that even a small weight gain significantly increased the risks. Women who gained 5 to 20 pounds had a higher risk of diabetes, heart disease, high blood pressure, severe arthritis, gallstones, and certain cancers occurring later in life. Men who gained that amount had a higher risk of diabetes and high blood pressure. The study authors concluded that their data “provide strong evidence that maintaining a healthy weight throughout early and middle adulthood is associated with overall health in those who survive to older ages”.

The other lesson here is that weight gain in early adulthood is significant even if no health problems arise during that time. Weight gain during early to middle adulthood will strongly affect how healthy our later years will be. Maintaining a healthy weight during our younger years will improve the odds for healthy aging. In other words we’re never too young to get back to – and maintain – a healthy weight.

It’s not always possible to get back to our weight at ages 18 or 21, but any amount of excess weight we lose will benefit. I was 185 pounds at our wedding in 1981 – I’ll never see that again. I just finished losing 30 pounds (with the ketogenic diet we use in our clinic) to get back down to 200. Knowing what I do now, I will make a greater effort to keep it off and maybe lose a bit more.

Sources:
"Associations of Weight Gain from Early to Middle Adulthood with Major Health Outcomes Later in Life", JAMA, July 2017 full article; abstract
Bonnie Liebman, "Why small amounts of weight gain shouldn't go unchecked", Nutrition Action, Feb 19 2018

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

450 PCOS [11 December 2017]

PCOS, Polycystic Ovarian Syndrome, is a common cause of infertility in women. PCOS is a metabolic condition in which there is an excess of estrogen and androgens (male hormones) leading to a variety of symptoms: irregular or absent ovulation, a higher risk of miscarriage, hair loss (male pattern baldness), excess facial hair, acne, fatigue, and mood swings. Conditions frequently associated with PCOS include: insulin resistance, hyperinsulinism, diabetes, weight gain, and hypertension. PCOS is the most common hormone dysfunction of women of reproductive age, affecting an estimated 10% of women.

PCOS is believed to begin with a diet high in simple carbohydrates which leads to insulin resistance and hyperinsulinism. High levels of insulin activate the androgen receptors on the ovaries which causes an increase in male hormones. The male hormones prevent the mature egg follicle from releasing the egg during ovulation, causing infertility. Normally the follicle releases the egg and then attaches as a corpus luteum which triggers production of high amounts of progesterone as a normal part of the ovulatory cycle. When the egg is not released, the follicle attaches to the ovary as a “cyst”, and little if any progesterone is produced. The lack of progesterone leaves estrogen dominant which thickens the uterus and increases the risk of endometrial cancer.

The most important approach to treating PCOS is to deal with the insulin resistance, hyperinsulinism, and excess weight. With high insulin levels, a ketogenic diet is the easiest and safest way to shed the excess fat and eliminate insulin resistance. This should be followed by a healthy diet low in simple carbohydrates, sufficient exercise, stress reduction, and a detox program to support the liver and help it clear the excess hormones. Often this is enough to normalize hormones and restore fertility.

A nutrient that shows promise in treating PCOS is di-chiro-inositol or DCI (trade name ChirositolTM). Studies show that DCI normalizes insulin levels, reducing them when too high but doesn’t take them too low. It also elevates serotonin which reduces sugar cravings. According to the Lorna Vanderhaeghe website (which markets a ChirositolTM product, GlucoSmart), DCI “effectively reduces excess male hormones, reduces weight and appetite, and normalizes ovulation, thereby improving fertility” [www.healthyimmunity.com]. Note a 2011 review in Gynecol. Endrocrinol found the studies to date of insufficient quality for reliable conclusions regarding DCI as a treatment for PCOS.

Sources:
John Lee MD Medical Letter July 1999, quoted in Mercola.com 2 Jan 2008
Wikipedia

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

360 Two Promising Cancer Cures [7 March 2016]

In the last two weeks I outlined the history of cancer theory and the evidence against the Somatic Mutation Theory (SMT). This week I want to share two promising cancer treatments that developed from the Metabolic Theory of Cancer.

According to the metabolic theory, all cancer cells have the same underlying metabolic dysfunction – the cell’s inability to use the oxidative pathway of energy production, forcing it to use fermentation. Treatments based on this theory should be effective on all cancers.

Fermentation is 32 times less efficient than oxidation in energy production so cancer cells require large amounts of glucose. Simply restricting calories was known to shrink tumors (in fact animals studies showed that many chemotherapy drugs reduced tumors only by suppressing appetite!). Expanding on this, Thomas Seyfried developed the Restricted Ketogenic Diet (R-KD) which produces extremely low glucose and very high ketone blood levels. Cancer cells, with their dysfunctional metabolism, are unable to use ketones for fuel and starve while normal cells thrive. R-KD makes cancer cells very vulnerable to other treatments like radiation and chemo while protecting healthy cells from damage, making it an excellent adjunctive therapy. Also the vulnerability of cancer cells make treatments effective at lower doses, reducing the cost and the degree of side effects.

All cancer cells produce large amounts of lactic acid in the fermentation process. To get rid of it the cells grow more ports in the cell walls. Young Ko, a researcher at Johns Hopkins, discovered a cancer treatment, 3-bromopyruvate (3BP), that uses these ports to preferentially enter the cancer cells where it inhibits the enzyme hexokinase II and kills the cell. 3BP showed unprecedented success in animal trials, melting tumors while leaving healthy tissue undamaged. In 2009, 3BP restored a 17 year old boy in the Netherlands with advanced liver cancer from the brink of death. Unfortunately disputes over patents and lab space prevented Ko from doing further research for many years, delaying the trials required for drug approval.

Let’s pray these two treatments are approved soon. Imagine cancer treatments where you come out healthier than you started! That’s the way it should be.

Source: Tripping over the Truth: The Metabolic Theory of Cancer by Travis Christofferson, 2014.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

346 Obesity & Cancer [23 Nov 2015]

Obesity is a growing problem worldwide. Recent data show that 69% of US adults are overweight and half of these are obese. Being overweight causes, or is linked to, increases in many different adverse health markers – blood pressure, blood glucose and insulin levels, insulin resistance, dyslipidemia, and inflammation. Obesity increases the risk or worsens the outcomes of several chronic diseases including diabetes, heart disease and cancer.

The impact of obesity on cancer is significant – it has just overtaken smoking as the top preventable cause of cancer death in the US. About 20% of cancer deaths in that country can be attributed to obesity. The ten types of cancers linked to obesity are: esophagus, postmenopausal breast, liver, kidney, gallbladder, pancreas, colon, prostate, ovary and uterus. Obesity not only increases the risk of developing these cancers but also increases the rate of progression, increases the rate of metastasis, lowers the response to treatment, and reduces survival rates.

The relationship between obesity and cancer is complex with many possible causes for the link. Since I last wrote on this topic (#199 January 2013) based on a 2005 article in Cancer Prevention, researchers have learned more about these factors.

High insulin levels promote cancer growth by interacting with tumor cells’ insulin and IGF-1 receptors. Adipocytes near a tumor are more active in obese people, secreting various cancer-promoting hormones and chemical signals called cytokines.

Inflammation is another process that plays a role in the obesity-cancer link. Obesity increases levels of the COX-2 enzyme which promotes production of prostaglandin E2 (PGE2) which increases inflammation (described in my article #85 October 2010). PGE2 is known to promote progression of breast cancer and the conversion of androgens to (cancer-promoting) estrogens.

Animal studies have found that reducing fat weight isn’t as important as reducing the obesity markers associated with higher cancer risks, particularly insulin, cytokines and IGF-1. So while losing excess fat is still a desirable goal, how you lose it may be more important. A ketogenic diet that normalizes insulin levels (which is at the root of most if not all of the other markers) would be ideal.

Source: "Breaking the Obesity-Cancer Link" by S.D. Hursting et al, The Scientist, 2015

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

331 Traumatic Brain Injury [10 Aug 2015]

Brain trauma, including concussions, can lead to long term, often permanent, changes in mental and emotional health. Anything that can help the brain to heal more quickly and completely could significantly improve the outcome. I have previously written about two supplements that aid in brain healing and recently learned of two more.

Omega 3 EFAs, particularly DHA, are essential for brain development and healing. Supplementation with high doses of fish oil is likely responsible for two remarkable recoveries I wrote about in December 2012 [#194]. Several high DHA fish oil supplements are available in Canada.

More recently in February 2015 [#305] I wrote about PQQ, a cellular antioxidant that can increase mitochondrial production. This is very important in protecting brain and nerve tissue from oxidative damage by free radicals following a brain or spinal cord injury. PQQ has recently become available as a supplement in Canada.

Creatine, a popular sports supplement, is also used in the treatment of brain injury. Much of the damage to brain tissue occurs after the trauma due to free radical oxidative damage and lack of oxygen. Creatine supports mitochondrial ATP production, increasing energy available for healing and preventing further damage.

I have just learned about another nutrient that is showing promise for concussion and other brain injuries. Brains normally depend on glucose for energy. Unfortunately glucose metabolism is significantly impaired in the brain following an injury, starving it of energy and slowing the healing process. Ketones are the only known alternative to glucose for brain metabolism. I have previously shown how ketones can cross the blood-brain barrier and provide an alternative energy source for the brains of people suffering from Alzheimer’s and Parkinson’s [#153 February 2012]. Ketones are now proving beneficial following a concussion or more serious brain injuries [alphahealth.ca; Prins, 2008; White & Vankatesh, 2011].

Ketones can be produced with a low-carbohydrate ketogenic diet (under medical supervision), administered parentally by IV, or provided through certain ketone-producing foods. Medium chain triglycerides (MCT) found in coconut oil are converted in the liver to ketones. Adding MCT oil, or a special blend designed for the purpose, as soon as possible after an injury will provide needed energy for brain repair, and could reduce long term disabilities.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

327 Leptin Resistance [13 July 2015]

I have previously written several times about the role of insulin and insulin resistance in weight gain but there is another compound involved called leptin.

Leptin, sometimes called the “satiety hormone”, was discovered in 1994. It is secreted by fat cells and tells our brain that we have enough stored energy. It reduces our appetite and promotes the burning of fat for energy. Leptin resistance occurs when this message is blocked, resulting in food cravings, continued fat storage, and eventually obesity. Leptin resistance can also be a factor in female infertility.

Several factors contribute to leptin resistance:
• excess dietary sugar, especially fructose
• high insulin levels
• high triglyceride levels
• inflammation
• MSG (SHN #135)
• lack of sleep
• stress
• low calorie diets that are not ketogenic (your body thinks it’s starving)

So what can we do to reverse leptin resistance?
• greatly reduce simple carbs and processed foods
• eat adequate protein and healthful fats
• avoid between meal snacks to give your liver a rest
• exercise (but don’t overdo cardio)
• get at least 8 hours of restful sleep
• lower insulin levels (e.g. with a ketogenic diet)

Leptin resistance is recognized as a key risk factor for obesity (Zhou & Rui, 2013). Identifying the causes and taking steps to reverse it will make any weight loss program easier to follow and much more effective. The ketogenic diet we use in our Rosetown weight loss clinic doesn’t specifically address leptin resistance but does indirectly deal with the factors causing it, particularly insulin levels, triglycerides, inflammation and dietary sugar.

Sources:
MindBodyGreen post by Barbara Komorek
Wellness Mama post
WebMD article
Dr. Mercola interview with Dr Richard Johnson
Dr. Richard J Johnson book "The Diet Switch"
Y. Zhou and L Rui technical article Front Med 2013 Jun: 7(2) 207-222

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

313 Non-Alcoholic Fatty Liver [6 April 2015]

Fatty liver disease is a common condition in people who regularly consume alcohol. In the last few decades it has also become common in people who drink little or no alcohol; in these people it is called non-alcoholic fatty liver disease (NAFLD). A fatty liver is defined as one with fatty deposits make up 5% or more of the liver.

In North America up to 20% of adults and 10% of children have this condition, but most do not know it. In many people there are no signs or symptoms and it is only discovered by routine liver function tests.

The cause of NAFLD is uncertain, but it is associated with obesity (especially abdominal fat), insulin resistance, Type 2 Diabetes, high cholesterol, high triglycerides and high blood pressure. It is of concern because it can progress to inflammation, liver scarring, and more serious liver disease. Certain medications and high consumption of simple carbs, especially fructose, are linked to NAFLD.

There is no standard medical treatment for NAFLD. Dietary changes, exercise and weight loss are typically recommended. Diet recommendations include: avoidance of alcohol, high-fructose corn syrup, and trans-fats; elimination of all processed foods; and increase in whole foods, fruits, vegetables, whole grains, good fats and proteins. Cruciform vegetables (cabbage family) are especially beneficial for the liver. Some practitioners recommend juicing raw vegetables. There are also many supplements which support liver health:

• N-Acetyl Cysteine – precursor to glutathione
• Alpha-Lipoic Acid – a powerful antioxidant
• Vitamins E and C, certain B vitamins, magnesium
• Turmeric – natural anti-inflammatory
• Herbs like milk thistle, dandelion root, artichoke, garlic
• Coffee drinking in moderation is beneficial for the liver

A protein-sparing ketogenic weight loss program deals with many of the associated conditions – obesity, insulin resistance, diabetes, hypertension, dyslipidemia – so could be one approach to reversing NAFLD.

Sources:
Mayo Clinic
Canadian Liver Foundation
Wikipedia
Dr Mark Hyman

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner. See this article on my website for links to sources and further reading.