Wednesday, June 30, 2010

WHS - Benefit of Pastured Dairy

Dairy - complex issue, but pastured is the way to go.

"Pastured Dairy may Prevent Heart Attacks

Not all dairy is created equal. Dairy from grain-fed and pasture-fed cows differs in a number of ways. Pastured dairy contains more fat-soluble nutrients such as vitamin K2, vitamin A, vitamin E, carotenes and omega-3 fatty acids. It also contains more conjugated linoleic acid, a fat-soluble molecule that has been under intense study due to its ability to inhibit obesity and cancer in animals. The findings in human supplementation trials have been mixed, some confirming the animal studies and others not. In feeding experiments in cows, Dr. T. R. Dhiman and colleagues found the following (1):
Cows grazing pasture and receiving no supplemental feed had 500% more conjugated linoleic acid in milk fat than cows fed typical dairy diets.
Fat from ruminants such as cows, sheep and goats is the main source of CLA in the human diet. CLA is fat-soluble. Therefore, skim milk doesn't contain any. It's also present in human body fat in proportion to dietary intake. This can come from dairy or flesh.

In a recent article from the AJCN, Dr. Liesbeth Smit and colleagues examined the level of CLA in the body fat of Costa Rican adults who had suffered a heart attack, and compared it to another group who had not (a case-control study, for the aficionados). People with the highest level of CLA in their body fat were 49% less likely to have had a heart attack, compared to those with the lowest level (2).

Since dairy was the main source of CLA in this population, the association between CLA and heart attack risk is inextricable from the other components in pastured dairy fat. In other words, CLA is simply a marker of pastured dairy fat intake in this population, and the (possible) benefit could just as easily have come from vitamin K2 or something else in the fat.

This study isn't the first one to suggest that pastured dairy fat may be uniquely protective. The Rotterdam and EPIC studies found that a higher vitamin K2 intake is associated with a lower risk of heart attack, cancer and overall mortality (345). In the 1940s, Dr. Weston Price estimated that pastured dairy contains up to 50 times more vitamin K2 than grain-fed dairy. He summarized his findings in the classic book Nutrition and Physical Degeneration. This finding has not been repeated in recent times, but I have a little hunch that may change soon..."

Tuesday, June 29, 2010

Why Doctors Must Know Math

Just for grins, let’s go along with Jane and assume that melanoma is caused by the sun.  If we go to the latest cancer statistics from the American Cancer Society (ACS), we find that 8,700 people died last year from melanoma.  We know that sun exposure and vitamin D (along with maybe the other 5-10 photoproducts we synthesize from sun exposure) help prevent breast, colon and prostate cancer.  If Jane is correct and we avoid the sun, we run less risk of being one of the 8,700 people who perish from melanoma. But what about the other side of the coin?
According to the same ACS statistics, last year 40,230 people died from breast cancer, 32,050 from prostate cancer and 51,370 from colon cancer. So, on the one hand, we have 8,700 people die of a disease that probably isn’t related to sun exposure while on the other we have 123,650 who died from cancers known to be related to lack of sun exposure.  I don’t know about you, but I’ll go with the sun exposure, “disfiguring” superficial skin cancers be damned.
Plus, we didn’t even mention the devastating disease multiple sclerosis, a disease much more common in those with little sun exposure.  There are between 250,000-350,000 new cases of MS diagnosed each year. I’ll be happy to accept the risk of a few minor cancers to significantly reduce my risk of developing MS.
The danger of too much sun is minimal – the danger of too little sun is enormous.  I know which side I come down on.  The health trade offs remind me of a corny joke I heard when I was a kid that made such an impact on me that I’ve remembered it since.  The joke (or parable) was about economic issues, but it applies to sun exposure as well.
Did you hear the one about the guy who took big steps to save his twenty dollar shoes and ripped his 50 dollar pants?
It’s just another way of saying don’t be penny-wise and pound foolish.  In terms of our current discussion, we could say, Don’t be skin-cancer-wise and colon-breast-prostate-foolish.  Which is exactly what the misguided perspective of most dermatologists would have us be.

Monday, June 28, 2010

Wheat - Complex But Not Good

Very interesting from Dr. Davis.Super-carbohydrate

Wheat starches are composed of polymers (repeating chains) of the sugar, glucose. 75% of wheat carbohydrate is the chain of branching glucose units,amylopectin, and 25% is the linear chain of glucose units, amylose.

Both amylopectin and amylose are digested by the salivary and stomach enzyme, amylase, in the human gastrointestinal tract. Amylopectin is more efficiently digested to glucose, while amylose is less efficiently digested, some of it making its way to the colon undigested.

Amylopectin is therefore the “complex carbohydrate” in wheat that is most closely linked to its blood sugar-increasing effect. But not all amylopectin is created equal. The structure of amylopectin varies depending on its source, differing in its branching structure and thereby efficiency of amylase accessibility.

Legumes like kidney beans contain amylopectin C, the least digestible—hence the gas characteristic of beans, since undigested amylopectin fragments make their way to the colon, whereupon colonic bacteria feast on the undigested starches and generate gas, making the sugars unavailable for you to absorb.

Amylopectin B is the form found in bananas and potatoes and, while more digestible than bean amylopectin C, still resists digestion to some degree.

The most digestible is amylopectin A, the form found in wheat. Because it is the most readily digested by amylase, it is the form that most enthusiastically increases blood sugar. This explains why, gram for gram, wheat increases blood sugar to a much greater degree than, say, chickpeas.

The amylopectin A of wheat products, “complex” or no, might be regarded as a super-carbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all other carbohydrate foods.

Sunday, June 27, 2010

"Paradox" - Not

The paradox is why does anyone still think that eating fat makes you either fat or sick when the evidence shows it does not, nor did it ever?  Despite that paradox, the article is a fabulous read.

The Inuit Paradox
How can people who gorge on fat and rarely see a vegetable be healthier than we are?
by Patricia Gadsby, Photography by Leon Steele
Patricia Cochran, an Inupiat from Northwestern Alaska, is talking about the native foods of her childhood: "We pretty much had a subsistence way of life. Our food supply was right outside our front door. We did our hunting and foraging on the Seward Peninsula and along the Bering Sea.

"Our meat was seal and walrus, marine mammals that live in cold water and have lots of fat. We used seal oil for our cooking and as a dipping sauce for food. We had moose, caribou, and reindeer. We hunted ducks, geese, and little land birds like quail, called ptarmigan. We caught crab and lots of fish-salmon, whitefish, tomcod, pike, and char. Our fish were cooked, dried, smoked, or frozen. We ate frozen raw whitefish, sliced thin. The elders liked stinkfish, fish buried in seal bags or cans in the tundra and left to ferment. And fermented seal flipper, they liked that too."
Cochran's family also received shipments of whale meat from kin living farther north, near Barrow. Beluga was one she liked; raw muktuk, which is whale skin with its underlying blubber, she definitely did not. "To me it has a chew-on-a-tire consistency," she says, "but to many people it's a mainstay." In the short subarctic summers, the family searched for roots and greens and, best of all from a child's point of view, wild blueberries, crowberries, or salmonberries, which her aunts would mix with whipped fat to make a special treat called akutuq-in colloquial English, Eskimo ice cream.
Now Cochran directs the Alaska Native Science Commission, which promotes research on native cultures and the health and environmental issues that affect them. She sits at her keyboard in Anchorage, a bustling city offering fare from Taco Bell to French cuisine. But at home Cochran keeps a freezer filled with fish, seal, walrus, reindeer, and whale meat, sent by her family up north, and she and her husband fish and go berry picking-"sometimes a challenge in Anchorage," she adds, laughing. "I eat fifty-fifty," she explains, half traditional, half regular American.
No one, not even residents of the northernmost villages on Earth, eats an entirely traditional northern diet anymore. Even the groups we came to know as Eskimo-which include the Inupiat and the Yupiks of Alaska, the Canadian Inuit and Inuvialuit, Inuit Greenlanders, and the Siberian Yupiks-have probably seen more changes in their diet in a lifetime than their ancestors did over thousands of years. The closer people live to towns and the more access they have to stores and cash-paying jobs, the more likely they are to have westernized their eating. And with westernization, at least on the North American continent, comes processed foods and cheap carbohydrates-Crisco, Tang, soda, cookies, chips, pizza, fries. "The young and urbanized," says Harriet Kuhnlein, director of the Centre for Indigenous Peoples' Nutrition and Environment at McGill University in Montreal, "are increasingly into fast food." So much so that type 2 diabetes, obesity, and other diseases of Western civilization are becoming causes for concern there too.
Today, when diet books top the best-seller list and nobody seems sure of what to eat to stay healthy, it's surprising to learn how well the Eskimo did on a high-protein, high-fat diet. Shaped by glacial temperatures, stark landscapes, and protracted winters, the traditional Eskimo diet had little in the way of plant food, no agricultural or dairy products, and was unusually low in carbohydrates. Mostly people subsisted on what they hunted and fished. Inland dwellers took advantage of caribou feeding on tundra mosses, lichens, and plants too tough for humans to stomach (though predigested vegetation in the animals' paunches became dinner as well). Coastal people exploited the sea. The main nutritional challenge was avoiding starvation in late winter if primary meat sources became too scarce or lean.
These foods hardly make up the "balanced" diet most of us grew up with, and they look nothing like the mix of grains, fruits, vegetables, meat, eggs, and dairy we're accustomed to seeing in conventional food pyramid diagrams. How could such a diet possibly be adequate? How did people get along on little else but fat and animal protein?
What the diet of the Far North illustrates, says Harold Draper, a biochemist and expert in Eskimo nutrition, is that there are no essential foods-only essential nutrients. And humans can get those nutrients from diverse and eye-opening sources.
One might, for instance, imagine gross vitamin deficiencies arising from a diet with scarcely any fruits and vegetables. What furnishes vitamin A, vital for eyes and bones? We derive much of ours from colorful plant foods, constructing it from pigmented plant precursors called carotenoids (as in carrots). But vitamin A, which is oil soluble, is also plentiful in the oils of cold-water fishes and sea mammals, as well as in the animals' livers, where fat is processed. These dietary staples also provide vitamin D, another oil-soluble vitamin needed for bones. Those of us living in temperate and tropical climates, on the other hand, usually make vitamin D indirectly by exposing skin to strong sun-hardly an option in the Arctic winter-and by consuming fortified cow's milk, to which the indigenous northern groups had little access until recent decades and often don't tolerate all that well.
As for vitamin C, the source in the Eskimo diet was long a mystery. Most animals can synthesize their own vitamin C, or ascorbic acid, in their livers, but humans are among the exceptions, along with other primates and oddballs like guinea pigs and bats. If we don't ingest enough of it, we fall apart from scurvy, a gruesome connective-tissue disease. In the United States today we can get ample supplies from orange juice, citrus fruits, and fresh vegetables. But vitamin C oxidizes with time; getting enough from a ship's provisions was tricky for early 18th- and 19th-century voyagers to the polar regions. Scurvy-joint pain, rotting gums, leaky blood vessels, physical and mental degeneration-plagued European and U.S. expeditions even in the 20th century. However, Arctic peoples living on fresh fish and meat were free of the disease.

Impressed, the explorer Vilhjalmur Stefansson adopted an Eskimo-style diet for five years during the two Arctic expeditions he led between 1908 and 1918. "The thing to do is to find your antiscorbutics where you are," he wrote. "Pick them up as you go." In 1928, to convince skeptics, he and a young colleague spent a year on an Americanized version of the diet under medical supervision at Bellevue Hospital in New York City. The pair ate steaks, chops, organ meats like brain and liver, poultry, fish, and fat with gusto. "If you have some fresh meat in your diet every day and don't overcook it," Stefansson declared triumphantly, "there will be enough C from that source alone to prevent scurvy."
In fact, all it takes to ward off scurvy is a daily dose of 10 milligrams, says Karen Fediuk, a consulting dietitian and former graduate student of Harriet Kuhnlein's who did her master's thesis on vitamin C. (That's far less than the U.S. recommended daily allowance of 75 to 90 milligrams-75 for women, 90 for men.) Native foods easily supply those 10 milligrams of scurvy prevention, especially when organ meats-preferably raw-are on the menu. For a study published with Kuhnlein in 2002, Fediuk compared the vitamin C content of 100-gram (3.55-ounce) samples of foods eaten by Inuit women living in the Canadian Arctic: Raw caribou liver supplied almost 24 milligrams, seal brain close to 15 milligrams, and raw kelp more than 28 milligrams. Still higher levels were found in whale skin and muktuk.
As you might guess from its antiscorbutic role, vitamin C is crucial for the synthesis of connective tissue, including the matrix of skin. "Wherever collagen's made, you can expect vitamin C," says Kuhnlein. Thick skinned, chewy, and collagen rich, raw muktuk can serve up an impressive 36 milligrams in a 100-gram piece, according to Fediuk's analyses. "Weight for weight, it's as good as orange juice," she says. Traditional Inuit practices like freezing meat and fish and frequently eating them raw, she notes, conserve vitamin C, which is easily cooked off and lost in food processing.
Hunter-gatherer diets like those eaten by these northern groups and other traditional diets based on nomadic herding or subsistence farming are among the older approaches to human eating. Some of these eating plans might seem strange to us-diets centered around milk, meat, and blood among the East African pastoralists, enthusiastic tuber eating by the Quechua living in the High Andes, the staple use of the mongongo nut in the southern African !Kung-but all proved resourceful adaptations to particular eco-niches. No people, though, may have been forced to push the nutritional envelope further than those living at Earth's frozen extremes. The unusual makeup of the far-northern diet led Loren Cordain, a professor of evolutionary nutrition at Colorado State University at Fort Collins, to make an intriguing observation.
Four years ago, Cordain reviewed the macronutrient content (protein, carbohydrates, fat) in the diets of 229 hunter-gatherer groups listed in a series of journal articles collectively known as the Ethnographic Atlas. These are some of the oldest surviving human diets. In general, hunter-gatherers tend to eat more animal protein than we do in our standard Western diet, with its reliance on agriculture and carbohydrates derived from grains and starchy plants. Lowest of all in carbohydrate, and highest in combined fat and protein, are the diets of peoples living in the Far North, where they make up for fewer plant foods with extra fish. What's equally striking, though, says Cordain, is that these meat-and-fish diets also exhibit a natural "protein ceiling." Protein accounts for no more than 35 to 40 percent of their total calories, which suggests to him that's all the protein humans can comfortably handle.
This ceiling, Cordain thinks, could be imposed by the way we process protein for energy. The simplest, fastest way to make energy is to convert carbohydrates into glucose, our body's primary fuel. But if the body is out of carbs, it can burn fat, or if necessary, break down protein. The name given to the convoluted business of making glucose from protein is gluconeogenesis. It takes place in the liver, uses a dizzying slew of enzymes, and creates nitrogen waste that has to be converted into urea and disposed of through the kidneys. On a truly traditional diet, says Draper, recalling his studies in the 1970s, Arctic people had plenty of protein but little carbohydrate, so they often relied on gluconeogenesis. Not only did they have bigger livers to handle the additional work but their urine volumes were also typically larger to get rid of the extra urea. Nonetheless, there appears to be a limit on how much protein the human liver can safely cope with: Too much overwhelms the liver's waste-disposal system, leading to protein poisoning-nausea, diarrhea, wasting, and death.

Whatever the metabolic reason for this syndrome, says John Speth, an archaeologist at the University of Michigan's Museum of Anthropology, plenty of evidence shows that hunters through the ages avoided protein excesses, discarding fat-depleted animals even when food was scarce. Early pioneers and trappers in North America encountered what looks like a similar affliction, sometimes referred to as rabbit starvation because rabbit meat is notoriously lean. Forced to subsist on fat-deficient meat, the men would gorge themselves, yet wither away. Protein can't be the sole source of energy for humans, concludes Cordain. Anyone eating a meaty diet that is low in carbohydrates must have fat as well.

Stefansson had arrived at this conclusion, too, while living among the Copper Eskimo. He recalled how he and his Eskimo companions had become quite ill after weeks of eating "caribou so skinny that there was no appreciable fat behind the eyes or in the marrow." Later he agreed to repeat the miserable experience at Bellevue Hospital, for science's sake, and for a while ate nothing but defatted meat. "The symptoms brought on at Bellevue by an incomplete meat diet [lean without fat] were exactly the same as in the Arctic . . . diarrhea and a feeling of general baffling discomfort," he wrote. He was restored with a fat fix but "had lost considerable weight." For the remainder of his year on meat, Stefansson tucked into his rations of chops and steaks with fat intact. "A normal meat diet is not a high-protein diet," he pronounced. "We were really getting three-quarters of our calories from fat." (Fat is more than twice as calorie dense as protein or carbohydrate, but even so, that's a lot of lard. A typical U.S diet provides about 35 percent of its calories from fat.)
Stefansson dropped 10 pounds on his meat-and-fat regimen and remarked on its "slenderizing" aspect, so perhaps it's no surprise he's been co-opted as a posthumous poster boy for Atkins-type diets. No discussion about diet these days can avoid Atkins. Even some researchers interviewed for this article couldn't resist referring to the Inuit way of eating as the "original Atkins." "Superficially, at a macronutrient level, the two diets certainly look similar," allows Samuel Klein, a nutrition researcher at Washington University in St. Louis, who's attempting to study how Atkins stacks up against conventional weight-loss diets. Like the Inuit diet, Atkins is low in carbohydrates and very high in fat. But numerous researchers, including Klein, point out that there are profound differences between the two diets, beginning with the type of meat and fat eaten.
Fats have been demonized in the United States, says Eric Dewailly, a professor of preventive medicine at Laval University in Quebec. But all fats are not created equal. This lies at the heart of a paradox-the Inuit paradox, if you will. In the Nunavik villages in northern Quebec, adults over 40 get almost half their calories from native foods, says Dewailly, and they don't die of heart attacks at nearly the same rates as other Canadians or Americans. Their cardiac death rate is about half of ours, he says. As someone who looks for links between diet and cardiovascular health, he's intrigued by that reduced risk. Because the traditional Inuit diet is "so restricted," he says, it's easier to study than the famously heart-healthy Mediterranean diet, with its cornucopia of vegetables, fruits, grains, herbs, spices, olive oil, and red wine.
A key difference in the typical Nunavik Inuit's diet is that more than 50 percent of the calories in Inuit native foods come from fats. Much more important, the fats come from wild animals.
Wild-animal fats are different from both farm-animal fats and processed fats, says Dewailly. Farm animals, cooped up and stuffed with agricultural grains (carbohydrates) typically have lots of solid, highly saturated fat. Much of our processed food is also riddled with solid fats, or so-called trans fats, such as the reengineered vegetable oils and shortenings cached in baked goods and snacks. "A lot of the packaged food on supermarket shelves contains them. So do commercial french fries," Dewailly adds.
Trans fats are polyunsaturated vegetable oils tricked up to make them more solid at room temperature. Manufacturers do this by hydrogenating the oils-adding extra hydrogen atoms to their molecular structures-which "twists" their shapes. Dewailly makes twisting sound less like a chemical transformation than a perversion, an act of public-health sabotage: "These man-made fats are dangerous, even worse for the heart than saturated fats." They not only lower high-density lipoprotein cholesterol (HDL, the "good" cholesterol) but they also raise low-density lipoprotein cholesterol (LDL, the "bad" cholesterol) and triglycerides, he says. In the process, trans fats set the stage for heart attacks because they lead to the increase of fatty buildup in artery walls.
Wild animals that range freely and eat what nature intended, says Dewailly, have fat that is far more healthful. Less of their fat is saturated, and more of it is in the monounsaturated form (like olive oil). What's more, cold-water fishes and sea mammals are particularly rich in polyunsaturated fats called n-3 fatty acids or omega-3 fatty acids. These fats appear to benefit the heart and vascular system. But the polyunsaturated fats in most Americans' diets are the omega-6 fatty acids supplied by vegetable oils. By contrast, whale blubber consists of 70 percent monounsaturated fat and close to 30 percent omega-3s, says Dewailly.

Omega-3s evidently help raise HDL cholesterol, lower triglycerides, and are known for anticlotting effects. (Ethnographers have remarked on an Eskimo propensity for nosebleeds.) These fatty acids are believed to protect the heart from life-threatening arrhythmias that can lead to sudden cardiac death. And like a "natural aspirin," adds Dewailly, omega-3 polyunsaturated fats help put a damper on runaway inflammatory processes, which play a part in atherosclerosis, arthritis, diabetes, and other so-called diseases of civilization.

You can be sure, however, that Atkins devotees aren't routinely eating seal and whale blubber. Besides the acquired taste problem, their commerce is extremely restricted in the United States by the Marine Mammal Protection Act, says Bruce Holub, a nutritional biochemist in the department of human biology and nutritional sciences at the University of Guelph in Ontario.
"In heartland America it's probable they're not eating in an Eskimo-like way," says Gary Foster, clinical director of the Weight and Eating Disorders Program at the Pennsylvania School of Medicine. Foster, who describes himself as open-minded about Atkins, says he'd nonetheless worry if people saw the diet as a green light to eat all the butter and bacon-saturated fats-they want. Just before rumors surfaced that Robert Atkins had heart and weight problems when he died, Atkins officials themselves were stressing saturated fat should account for no more than 20 percent of dieters' calories. This seems to be a clear retreat from the diet's original don't-count-the-calories approach to bacon and butter and its happy exhortations to "plow into those prime ribs." Furthermore, 20 percent of calories from saturated fats is double what most nutritionists advise. Before plowing into those prime ribs, readers of a recent edition of the Dr. Atkins' New Diet Revolution are urged to take omega-3 pills to help protect their hearts. "If you watch carefully," says Holub wryly, "you'll see many popular U.S. diets have quietly added omega-3 pills, in the form of fish oil or flaxseed capsules, as supplements."
Needless to say, the subsistence diets of the Far North are not "dieting." Dieting is the price we pay for too little exercise and too much mass-produced food. Northern diets were a way of life in places too cold for agriculture, where food, whether hunted, fished, or foraged, could not be taken for granted. They were about keeping weight on.
This is not to say that people in the Far North were fat: Subsistence living requires exercise-hard physical work. Indeed, among the good reasons for native people to maintain their old way of eating, as far as it's possible today, is that it provides a hedge against obesity, type 2 diabetes, and heart disease. Unfortunately, no place on Earth is immune to the spreading taint of growth and development. The very well-being of the northern food chain is coming under threat from global warming, land development, and industrial pollutants in the marine environment. "I'm a pragmatist," says Cochran, whose organization is involved in pollution monitoring and disseminating food-safety information to native villages. "Global warming we don't have control over. But we can, for example, do cleanups of military sites in Alaska or of communication cables leaching lead into fish-spawning areas. We can help communities make informed food choices. A young woman of childbearing age may choose not to eat certain organ meats that concentrate contaminants. As individuals, we do have options. And eating our salmon and our seal is still a heck of a better option than pulling something processed that's full of additives off a store shelf."
Not often in our industrial society do we hear someone speak so familiarly about "our" food animals. We don't talk of "our pig" and "our beef." We've lost that creature feeling, that sense of kinship with food sources. "You're taught to think in boxes," says Cochran. "In our culture the connectivity between humans, animals, plants, the land they live on, and the air they share is ingrained in us from birth.
"You truthfully can't separate the way we get our food from the way we live," she says. "How we get our food is intrinsic to our culture. It's how we pass on our values and knowledge to the young. When you go out with your aunts and uncles to hunt or to gather, you learn to smell the air, watch the wind, understand the way the ice moves, know the land. You get to know where to pick which plant and what animal to take.
"It's part, too, of your development as a person. You share food with your community. You show respect to your elders by offering them the first catch. You give thanks to the animal that gave up its life for your sustenance. So you get all the physical activity of harvesting your own food, all the social activity of sharing and preparing it, and all the spiritual aspects as well," says Cochran. "You certainly don't get all that, do you, when you buy prepackaged food from a store.
"That's why some of us here in Anchorage are working to protect what's ours, so that others can continue to live back home in the villages," she adds. "Because if we don't take care of our food, it won't be there for us in the future. And if we lose our foods, we lose who we are." The word Inupiat means "the real people." "That's who we are," says Cochran.

Saturday, June 26, 2010

Vitamin D and Bone Breaks

"This is a bit off topic, but it's such an interesting observation that I'd like to pass it on.
Over the past several years, there have been inevitable bone fractures: People slip on ice, for instance, and fracture a wrist or elbow. Or miss a step and fracture a foot, fall off a ladder and fracture a leg.
People will come to my office and tell me that their orthopedist commented that they healed faster than usual, often faster than anyone else they've seen before. My son was told this after he shattered his hand getting slammed against the boards in hockey; his orthopedist took the screws and cast off much sooner than usual since he judged that healing had occured early. (My son was taking 8000 units vitamin D in gelcap form; I also had him take 20,000 units for several days early after his injury to be absolutely sure he had sufficient levels.)
My suspicion is that people taking vitamin D sufficient to enjoy desirable blood levels (I aim for a 25-hydroxy vitamin D level of 60-70 ng/ml) heal fractures much faster, abbreviating healing time (crudely estimated) by at least 30%.
For any interested orthopedist, it would be an easy clinical study: Enroll people with traumatic fractures, randomize to vitamin D at, say, 10,000 units per day vs. placebo, watch who heals faster gauged by, for instance, x-ray. My prediction: Vitamin D will win hands down with faster healing and perhaps more assured fusion of the fracture site."

Friday, June 25, 2010

Cancer and Sugar, 3 Studies

All three are an interesting read.  Some show a connection to sugar intake and pancreatic cancer, some didn't.    Looks like all three were prospective studies - that is, they prospected through the data from previous studies to test for undiscovered relationships.  This an interesting technique, if not conclusive.  

Diabetes is enough to make me want to stay away from sugar.

Available Carbohydrates, Glycemic Load, and Pancreatic Cancer: Is There a Link?


High-carbohydrate diets have been linked to pancreatic cancer risk in case-control studies, but prospective studies have shown mostly null results. The authors investigated the associations of glycemic load, glycemic index, and carbohydrate intake with pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary intake was assessed by using a self-administered questionnaire. Between 1998 and 2006 (median follow-up = 6.5 years), 266 incident, confirmed pancreatic cancers were identified among 109,175 participants. Hazards ratios and 95% confidence intervals were adjusted for sex, smoking, body mass index, and total energy. Overall, elevated risks for pancreatic cancer were observed in the 90th versus 10th percentile of glycemic load (hazards ratio (HR) = 1.45, 95% confidence interval (CI): 1.05, 2.00), available carbohydrate (HR = 1.47, 95% CI: 1.05, 2.06), and sucrose (HR = 1.37, 95% CI: 0.99, 1.89) intake. The positive association for available carbohydrate intake was observed during the first 4 years of follow-up (HR(<2 years) = 2.60, 95% CI: 1.34, 5.06; HR(2-<4 years) = 1.94, 95% CI: 1.06, 3.55) but not subsequently (HR = 0.86, 95% CI: 0.52, 1.44); the opposite pattern was observed for total fat and saturated fat intake. Rather than being causal, the short-term increase in pancreatic cancer risk associated with high available carbohydrate and low fat intake may be capturing dietary changes associated with subclinical disease.

Glycemic load, glycemic index, and pancreatic cancer risk in the Netherlands Cohort Study1,2

Mirjam M HeinenBas AJ VerhageLH LumeyHenny AM BrantsR Alexandra Goldbohm andPiet A van den Brandt

1 From the Department of Epidemiology, Maastricht University, Maastricht, Netherlands (MMH, BAJV, and PAvdB); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (LHL); and the Department of Food and Chemical Risk Analysis, TNO Quality of Life, Zeist, Netherlands (HAMB and RAG)
Background: Recent studies of pancreatic cancer suggest a role for hyperinsulinemia in carcinogenesis. Because insulin is secreted in response to elevated blood glucose concentrations, dietary factors that increase these concentrations may be important in pancreatic carcinogenesis.
Objective: The objective was to examine prospectively the relation between pancreatic cancer risk and dietary glycemic load (GL), overall glycemic index (GI), and intake of total carbohydrates and mono- and disaccharides.
Design: The Netherlands Cohort Study consisted of 120 852 men and women who completed a baseline questionnaire in 1986. After 13.3 y of follow-up, 408 pancreatic cancer cases were detected, 66% of which were microscopically confirmed. A validated 150-item food-frequency questionnaire, completed at baseline, was used to calculate carbohydrate and mono- and disaccharide intakes and the GL and GI of the diet.
Results: Dietary GL, GI, or intake of carbohydrates and mono- and disaccharides were not associated with pancreatic cancer risk in this cohort. Also, the associations were not modified by sex. Our results did not change after the analysis was restricted to microscopically confirmed pancreatic cancer cases or after individuals who reported a history of diabetes at baseline were excluded from the analyses.

Conclusions: Overall, our findings do not support the hypothesis that GL, GI, or intake of carbohydrates and mono- and disaccharides are positively associated with pancreatic cancer risk. This is in agreement with previous prospective studies that investigated the relation between GL and GI and pancreatic cancer risk.


Background: Sugar-sweetened carbonated beverages (called soft drinks) and juices, which have a high glycemic load relative to other foods and beverages, have been hypothesized as pancreatic cancer risk factors. However, data thus far are scarce, especially from non-European descent populations. We investigated whether higher consumption of soft drinks and juice increases the risk of pancreatic cancer in Chinese men and women.
Methods: A prospective cohort analysis was done to examine the association between soft drink and juice consumption and the risk of pancreatic cancer in 60,524 participants of the Singapore Chinese Health Study with up to 14 years of follow-up. Information on consumption of soft drinks, juice, and other dietary items, as well as lifestyle and environmental exposures, was collected through in-person interviews at recruitment. Pancreatic cancer cases and deaths were ascertained by record linkage of the cohort database with records of population-based Singapore Cancer Registry and the Singapore Registry of Births and Deaths.
Results: The first 14 years for the cohort resulted in cumulative 648,387 person-years and 140 incident pancreatic cancer cases. Individuals consuming ≥2 soft drinks/wk experienced a statistically significant increased risk of pancreatic cancer (hazard ratio, 1.87; 95% confidence interval, 1.10-3.15) compared with individuals who did not consume soft drinks after adjustment for potential confounders. There was no statistically significant association between juice consumption and risk of pancreatic cancer.
Conclusion: Regular consumption of soft drinks may play an independent role in the development of pancreatic cancer. Cancer Epidemiol Biomarkers Prev; 19(2); 447–55

Thursday, June 24, 2010

Dr. Cordain on Nutrient Density

This is a fascinating link which calculates various vitamin and mineral counts based on the USDA's former dietary recommendations and the paleo diet.  Paleo dominates.  So the good doctor Cordain wants folks to try a diet which is mainly lean meats and vegetables, eating more fruit and veggies and virtually no processed food, grains, legumes or dairy.  It has more nutrient density than the establishment diet.  And the establishment freaks out about his radical diet.  "Go figure."

Wednesday, June 23, 2010

Pollan on Diet

If restated as "eat food, starting with protein and fat and adding some vegetables and fruit", I'd agree w Mr. Pollan 100%.  His other comment - that we spend more time worrying about and trying to understand food than anyone, for no discernible benefit (as a culture), could be attributed to the absolutely miserable science which our government has advocated.  We'd never know how this would have turned out if the Feds had recommended a paleo diet vice a grain diet in the 70s.
As a health writer, I've read hundreds of nutrition studies and countless books on diet and eating. And none of these has contained such useful advice as the cover of Michael Pollan's latest book, "In Defense of Food."
Wrapped around a head of lettuce are seven words that tell you pretty much everything you need to know about healthful eating. "Eat food. Not too much. Mostly plants."

Author Michael Pollan (Alia Malley)This seemingly-simple message is surprisingly complex, because there is food, and then there are what Mr. Pollan describes as "edible food-like substances." Mr. Pollan, who writes for The New York Times Magazine, developed something of a cult following for his best-selling book "The Omnivore's Dilemma," which traced the food chain back to its original source. But while "Omnivore" left many scared to eat, "In Defense of Food" helps the reader bravely navigate the food landscape, explaining what food is, what it isn't and how to tell the difference.
Mr. Pollan agreed to take some time this week to answer a few questions from the Well blog.
In this book, you talk about "nutritionism," the tendency of scientists and nutrition experts to view food as just a sum of its nutrient parts. What's wrong with that thinking?

Two things go wrong with nutritionism. Whatever tentative scientific information is developed, it gets very quickly distorted by the food marketers and manufacturers. They will take partial information about antioxidants, and they are suddenly telling you if you eat almonds you are going to live forever. There is a distortion of what are hypotheses of science. We're guilty of this too. We take sketchy science, and we write headlines.
One of the things that surprised me is how poor the data is that is underlying many of these big dietary trials. If you try to fill out a food frequency questionnaire, you realize very quickly this is not good data. I was as honest as I could be and tried to remember what I'd eaten, and it claimed I was only eating 1,200 calories a day. Clearly, I was forgetting at least 1,000 calories. We know people underreport by about 30 percent. We don't know the first thing about nutrition, which is, "What are people actually eating?" It's hard to build good science on top of that.
Did you expect the phrase, "Eat food. Not too much. Mostly plants." to create such a stir?

I was kind of surprised. After the original article in The Times magazine used those words, I started hearing it then. I realized they had a certain power. That's why I encouraged the publisher to put them on the cover and give it all away there.
But it's not as simple as it sounds, is it?

It's not, because of all these edible food-like substances in the stores that are masquerading as food. It's simple advice as long as you know what food is, but I spend 14 pages trying to define what food is. It's gotten complicated because of food science and the kind of engineering that's gone into processing food.
Speaking of engineering, food from cloned animals appears headed for approval in Europe and the United States. Does cloned food qualify as real food?

I think the bigger concern with cloned animals is not personal health. It's what will it take to keep a herd of genetically identical chickens, horses or pigs alive? Sex and variation is what keeps us from getting wiped out by microbes. If everything is genetically identical, one disease can come along and wipe out the entire group. You will need so many antibiotics and so much sanitation to keep a herd of these creatures going. The bigger concern should be antibiotic resistance.
The nutrition community is fascinated by the French paradox - the fact that the French eat seemingly fattening food but don't get fat. In your book you describe an American paradox. What is it?

Americans are a people so obsessed with nutrition yet whose dietary health is so poor. That strikes me as a paradox. We worry more about nutritional health, and we see food in terms of health. Yet we're the world champs in terms of obesity, diabetes, heart disease and the cancers linked to diet. I think it's odd. It suggests that worrying about your dietary health is not necessarily good for your dietary health.
So how should we think about food and health?

I think health should be a byproduct of eating well, for reasons that have nothing to do with health, such as cooking meals, eating together and eating real food. You're going to be healthy, but that's not the goal. The goal should just be eating well for pleasure, for community, and all the other reasons people eat. What I'm trying to do is to bring a man-from-Mars view to the American way of thinking about food. This is so second nature to us - food is either advancing your health or ruining your health. That's a very limited way to think about food, and it's a very limited way to think about health. The health of our bodies is tied to the health of the community and the health of the earth. Health is indivisible. That's my covert message.
A reader commented recently that this sounded like a diet book. Is it?

There is no Michael Pollan diet. It's an algorithm to help you make decisions rather than telling you narrowly: "Eat butter. Don't eat margarine." Although you could probably deduce that from what I'm saying. I don't feel like it's our job to tell people what to eat. I think our job is to help people think about it. I'm trying to take down the cult of expert eating. The danger is that I then offer myself as an expert. I'm trying to channel the wisdom of culture about eating. My idea here is that science so far hasn't figured out nutrition well enough to be the arbiter of our food choices. When science has done that - take the public health campaign around fat, that has been the biggest test case - it didn't work out very well. If science can't guide us yet, who can? The answer is not me. The answer is culture, history and tradition. That's what my rules are all about. The book is trying to show why this nutritionism approach to food doesn't work very well, besides the fact that it ruins our pleasure in eating.
What do you eat?

I eat lots of food. What do you mean?
Does your food ever come out of a package?

Really seldom. If you look in my pantry, you won't find that much processed stuff. Maybe some canned soups and tuna fish. I don't have a lot of low-fat products. I much prefer to eat less of a full-fat product. You wont' find skim milk. We're lucky. I live in Berkeley with a farmers' market four blocks away, and it's open 50 weeks a year. I have the luxury of being able to buy very fresh, good food. I have a weakness for bread. A good white baguette - I have a weakness for that.
After reading your book, I want to plant and grow something. Do you get this a lot?

My first book was about gardening, and I like gardening. It's a really important part of the solution. In so many places, including urban areas, there is a yard, there is a lawn, a little patch of land where you could grow food. My garden is only 10 by 20 feet. It's a postage stamp. I grew so much food there last summer. What food is more local than the food you grow yourself, not to mention the fact that you get all this exercise while you're gardening.
How does one stop eating edible food-like substances and switch to eating real food? Isn't it difficult to change?

We have more choices now than we've ever had. There is organic food at Wal-Mart. The big challenge is that you do have to cook. A lot of us are intimidated by cooking today. We watch cooking shows on TV but we cook very little. We're turning cooking into a spectator sport. This process of outsourcing our food preparation to large corporations, which is what we've been doing the last 50 years, is a big part of our problem. We're seduced by convenience. You're going to have to put a little more time and effort into preparing your food. I'm trying to get across how pleasurable that can be. It needn't be a chore. It can be incredibly rewarding to move food closer to the center of your life.

Tuesday, June 22, 2010

Low Carb Infertility Treatment

Low-carb gynecologist
I've seen a lot of speculation and experiential reporting that infertility is effectively addressed through a Paleo diet, but this is the first report of a clinician using this approach for medical treatment.

How cool would it be to just eat a diet that makes one feel good, sleep well, lose weight, regain health, and have the energy and strength needed to be a good parent - instead of medical treatments - as the path to fertility?

Monday, June 21, 2010

Vitamins Are .... Good for You?

This is the first study I've seen which shows a health benefit from vitamin supplementation.  This is a complex subject, as it seems more and more obvious that many neolithic foods (grains and legumes for example) irritate the gut so much that the gut does not absorb what it should (nutrients), but allows things to enter the blood stream that activate the body's immune response - leading the systemic inflammation and in some cases, the autoimmune disorders.

I like Stephen's summary:

"This result, once again, kills the simplistic notion that body fat is determined exclusively by voluntary food consumption and exercise behaviors (sometimes called the "calories in, calories out" idea, or "gluttony and sloth"). In this case, a multivitamin was able to increase resting energy expenditure and cause fat loss without any voluntary changes in food intake or exercise, suggesting metabolic effects and a possible downward shift of the body fat "setpoint" due to improved nutrient status.
Practical Implications

Does this mean we should all take multivitamins to stay or become thin? No. There is no multivitamin that can match the completeness and balance of a nutrient-dense, whole food, omnivorous diet. Beef liver, leafy greens and sunlight are nature's vitamin pills. Avoiding refined foods instantly doubles the micronutrient content of the typical diet. Properly preparing whole grains by soaking and fermentation is equivalent to taking a multi-mineral along with conventionally prepared grains, as absorption of key minerals is increased by 50-300% (10). Or you can eat root vegetables instead of grains, and enjoy their naturally high mineral availability. Or both."

Friday, June 18, 2010

Thought Experiment

TE for today is, "what muscle are you working when you deadlift?"
Those of you who understand the CrossFit idea will immediately think, "Look, we don't care about working this muscle or that muscle, we want increased work capacity."
That said, and trick questions aside, most of us are hamstring deficient, core strength deficient, and glute activation deficient. DLs are a great way to address those deficiencies - 'holistically.'
Most of us will be limited by mobility or weakness in the back initially. As we dead lift, we gain some of both strength and mobility, and perhaps hamstring strength becomes the limiter. Perhaps the back gets stronger and upper torso muscles become the limiter (unable to resist spinal deflection under load). At some point, we may get stronger but find we are not aware enough of our body position when under high loads. In any event, to have the capacity to safely lift objects from the ground - whether that be a barbell, a pot or an injured buddy - we must be stronger in all the relevant muscles AND have the capacity to use them skillfully to execute the lift.
IOW - you want adaptations in your bones (more stress to the bones means they add more density/strength), your muscles, and in the nervous system that dictates how these structures interact.
This is exactly why machines have failed to produce performance improvements. They can give an improvement in contractile potential, some bone density, but almost all the nervous system adaptations to machine based training are not helpful to performance. Machines are better than nothing, and offer the benefit that any fool can use them and most won't get hurt.  But an athlete can do much better.
Dead lift early and often!

Deer Jerky - It's What's For Breakfast

This was a beautiful animal, the meat well processed, and the cuts are just beautiful as they go onto the dehydrator.  I wish I could eat meat of this quality every day.  I have a tag for this year's mule deer season in Utah, wish me luck.

Thursday, June 17, 2010

Sun and D, Still More

"A couple of weeks ago, I was reading The Vitamin D Solution on a plane, and the guy sitting across the aisle from me was reading Predictably Irrational, which I had read and enjoyed a while back.  I kept looking to see where he was in his book, and he kept glancing at mine.  After we had landed and were taxiing in, he asked me if I had ever known anyone who had responded medically to vitamin D.  He then told me that he had been experiencing severe, debilitating pains in the bones in his chest, back and legs.  He went to his doctor, who checked his vitamin D levels, found them way low, and started my new friend on a course of vitamin D supplements, which, in due course, had gotten rid of his problem.  He was a pretty tan guy, so I asked him about his sun exposure and wondered why he would be vitamin D deficient.  He then told me he was a kidney transplant patient, which explained everything.  As you will learn when you read Dr. Holick’s book, the kidney converts the inactive form of vitamin D circulating in the blood to the active form.  This gentleman’s transplanted kidney obviously wasn’t doing it for him.  Vitamin D supplements did the trick, however, and his pains had vanished.
The subject matter I’ve covered in this post barely scratches the surface of what’s there in Dr. Holick’s new book.  I heartily recommend it to all."

Wednesday, June 16, 2010

Sun and D, Still More

"Many people labor away in offices for 50 weeks of the year then escape for a couple of weeks of fun in the sun.  Since they have limited time, they don’t want to spend it with graduated sun exposure while they develop a tan.  They pile on the sunscreen in copious amounts, hit the beach and stay out all day, stopping only long enough to put on more sunscreen.  During this process, they accumulate the effects of huge exposure to UVA and often pay the price years later by developing melanoma.  Those hardy folk who work outdoors all year long and have constant sun exposure almost never develop melanoma.  Why?  Because they develop a tan that blocks the UVA.  Plus, thanks to their constant sun exposure, they receive the benefit of plenty of vitamin D synthesis, which has been shown to be protective against melanoma.  The poor schmucks on vacation who broil in the sun while basting themselves with sunscreen get way too much UVA and don’t get any vitamin D because sunscreen blocks virtually all of the vitamin D synthesizing rays.  They are the victims of a true double whammy.
And that is what I suspect is driving the increase in melanoma in teens today: their poor misguided parents attempting to do the right thing.  Very sad, indeed.
Along with the increase in melanoma, the huge epidemic of fibromyalgia we are seeing today is in great measure a consequence of vitamin D deficiency.  Without enough vitamin D, bone doesn’t harden as it should.  It grows, but is softer and mushier and less supportive than it should be.  The body continues to make more bone to try to remedy the problem and the bones actually enlarge.  This enlargement presses against the periosteum, the fibrous sheath that surrounds the bone and through which the nerves run.  As the pulpy bony growth presses against the periosteum, it stimulates the nerves in the periosteum and causes the deep bone pain common to sufferers of fibromyalgia.  Doctors who are up to date on their vitamin D knowledge will press the breastbone to try to elicit pain.  And if they do, their patient is probably suffering from a vitamin D deficiency.  If that’s what the blood test shows, then the fibromyalgia can be treated with a course of sunshine and/or vitamin D supplementation."

Tuesday, June 15, 2010

Sun and D, Still More

"Here’s what happened.
When I was a kid, I played outside all the time.  So did all my friends.  We were outside, especially during the summer, from the time we got up until it was dark.  Since we played outside most all the time, as summer approached and the suns rays became more direct, we had already developed the base of tan from being outside all during the spring when it was difficult to get sunburned.  Our tans protected us from the effects of the sun, blocking both UVA and UVB light.
UVB rays are those that burn the skin and the ones that drive the synthesis of vitamin D.  UVA rays are those that mobilize the melanin (the pigment in the skin) and bring it to the surface.  When enough melanin comes to the surface, our skin gets darker, i.e., we develop a tan.  The tan then protects us from the harmful effects of the sun, allowing us to stay out all day without getting a sunburn and without getting too much UVA, which is important since excess UVA exposure is thought to be the cause of melanoma.
Although many sunscreens available today claim to block both UVB and UVA, when today’s teens were young children, virtually all of the sunscreens on the market then blocked UVB only.  Which is probably the root cause of the increase in melanoma in adolescents today.  Here’s what happens.
People who don’t use sunscreens and who have good sense get out of the sun when they begin to burn.  Avoiding the sun limits the exposure to both UVB, the burning rays, and UVA, the melanoma-stimulating rays.  When people slather on sunscreen that blocks UVB only, they can then stay out in the sun for a long time without burning.  The price they pay for this is that they end up with an extremely large dose of UVA, which doesn’t cause pain but sows the seeds for later melanoma development, a fate that has in the past befallen many a vacationer to the sunny areas of the world."