Question: How Long Is Breakfast Supposed To Last?

"Sigh... two scrambled eggs, ham, red peppers, lots of spinach, olives and feta cheese for breakfast, yet still starving at 10:00am. How long is breakfast supposed to last in your tummy?"

I received this question from my martial arts training buddy (we tested for black belt the same day) who flatters me by reading my blog - and on occasion sends a scathing comment!  But she also asks great questions like the one above.

The answer is simple – it should last several hours if the breakfast is as high quality (high fat, moderate protein, and only quality carbs) as the one described above.

What’s going wrong for my friend?  She is a self described carb junky.  By eating many carbs all through the day she has presented her body with a problem to solve – rapid disposal of excess blood glucose – which is partially solved by prioritizing the use of sugar as fuel in most every cell in her body.  Following the use it or lose it principle, her body – at the cellular level – has not maintained the capacity to produce high quantities of fat oxidizing enzymes.  If she reduces her sugar intake, her body burns through what she has and then dutifully reports to her – by making her feel hungry – that it is out of fuel.  Yes, even with something like a 2 month supply of fuel stored as fat, she can feel hungry because at the cellular level she’s starved!

How does one interrupt that pattern?  First, you have to get off the high carb train to crazy town, by eating a breakfast like the one she described.  There are much simpler ways to cut back on carbs and start the day with primarily fat and protein, but the breakfast she described is a fine one.

Second, you have to feed your hunger.  When your body tells you it is out of sugar, eat more fat and a little protein.  This does two things – one, you retrain yourself to reach for better foods, and two you don’t put yourself in the untenable position of not eating when hungry.  Fighting hunger is a loser’s game.

Third, drink water and take a short stroll.  Up your intake of electrolytes – your new, non-carb loaded body will shed fluids stored in your body’s cells as a result of chronically high insulin levels.  You may lose as much as five pounds of water weight the first week of carb restriction – and thank goodness for that!  However, as you cells dump excess fluid, the fluid takes electrolytes, and if you don’t replace them you will feel like a person low on electrolytes feels, which is not a desirable outcome. Add salt and potassium to your water and rock on with your life saving low carb ventures.

Fourth – in order to consistently “feed your hunger” you will have to plan ahead and keep high fat/moderate protein foods handy.  Other good picks include almonds, walnuts, macadamia nuts, hard cheeses, bacon, salami, eggs, coconut oil, sunflower seeds, avocadoes and real meat (IOW, leave that low fat chicken/turkey for the low fat fadders). 

In time, usually a week but possibly up to three weeks if you are a hard case, your body learns to run itself on fat, all day long. 

If you want to take your quest for feeling good by running on fat a bit farther, invest in a ketone blood tester and strips.  Once you develop the ability to run on fat and make plenty of ketones, your need to eat sugar to quiet your hunger will vanish.  You’ll find yourself forgetting to eat and feeling your finest.

"Gritty" Topic (Glad Someone Else Is Studying This)

The BLUF:  Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms

Abstract

AIM: To investigate the effect of reducing dietary fiber on patients with idiopathic constipation.

METHODS: Sixty-three cases of idiopathic constipation presenting between May 2008 and May 2010 were enrolled into the study after colonoscopy excluded an organic cause of the constipation. Patients with previous colon surgery or a medical cause of their constipation were excluded. All patients were given an explanation on the role of fiber in the gastrointestinal tract. They were then asked to go on a no fiber diet for 2 wk. Thereafter, they were asked to reduce the amount of dietary fiber intake to a level that they found acceptable. Dietary fiber intake, symptoms of constipation, difficulty in evacuation of stools, anal bleeding, abdominal bloating or abdominal pain were recorded at 1 and 6 mo.

RESULTS: The median age of the patients (16 male, 47 female) was 47 years (range, 20-80 years). At 6 mo, 41 patients remained on a no fiber diet, 16 on a reduced fiber diet, and 6 resumed their high fiber diet for religious or personal reasons. Patients who stopped or reduced dietary fiber had significant improvement in their symptoms while those who continued on a high fiber diet had no change. Of those who stopped fiber completely, the bowel frequency increased from one motion in 3.75 d (± 1.59 d) to one motion in 1.0 d (± 0.0 d) (P 0.001); those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d (± 2.09 d) to one motion per 1.9 d (± 1.21 d) on a reduced fiber diet (P 0.001); those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d (± 1.03 d) before and after consultation. For no fiber, reduced fiber and high fiber groups, respectively, symptoms of bloating were present in 0%, 31.3% and 100% (P 0.001) and straining to pass stools occurred in 0%, 43.8% and 100% (P 0.001).

CONCLUSION: Idiopathic constipation and its associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/

The interesting thing to me is how we came to believe we need fiber at all.  The Inuit do fine with almost zero fiber, and Brit Sailors (as recounted in Taubes' classic "Good Calories Bad Calories") who stayed with the Inuit reported their constipation from shipboard fare went away when they ate with the Inuit.

What seems to drive constipation is gut bacteria - so a simple model that might make sense of folks' observed trend of getting relief from constipation by taking fiber gut bombs (Metamucil, "Shitrucil") is:
1.  First you eat so much neolithic crap that the gut flora and fauna no longer resemble anything a living human prior to 200 years ago; especially by eating sugar and high fiber foods which digest slowly and are still digesting when they reach the colon
2.  Then you drink beverages which are either sugary or contain other non-hydrating elements

Against that back drop, 18 boxes of Colon Blow might indeed be beneficial, but apparently, just eating "high fiber" foods is part of the problem.
PS - click the Colon Blow link if you like classic SNL

Full Fat Dairy Doesn't Make Over Fat Human

The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease.

Kratz M, Baars T, Guyenet S.

Source

Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Mail Stop M4-B402, Seattle, WA, 98109, USA. mkratz@fhcrc.org

Abstract

PURPOSE:

To comprehensively review the data on the relationship between the consumption of dairy fat and high-fat dairy foods, obesity, and cardiometabolic disease.

METHODS:

We have conducted a systematic literature review of observational studies on the relationship between dairy fat and high-fat dairy foods, obesity, and cardiometabolic disease. We have integrated these findings with data from controlled studies showing effects of several minor dairy fatty acids on adiposity and cardiometabolic risk factors, and data on how bovine feeding practices influence the composition of dairy fat.

RESULTS:

In 11 of 16 studies, high-fat dairy intake was inversely associated with measures of adiposity. Studies examining the relationship between high-fat dairy consumption and metabolic health reported either an inverse or no association. Studies investigating the connection between high-fat dairy intake and diabetes or cardiovascular disease incidence were inconsistent. We discuss factors that may have contributed to the variability between studies, including differences in (1) the potential for residual confounding; (2) the types of high-fat dairy foods consumed; and (3) bovine feeding practices (pasture- vs. grain-based) known to influence the composition of dairy fat.

CONCLUSIONS:

The observational evidence does not support the hypothesis that dairy fat or high-fat dairy foods contribute to obesity or cardiometabolic risk, and suggests that high-fat dairy consumption within typical dietary patterns is inversely associated with obesity risk. Although not conclusive, these findings may provide a rationale for future research into the bioactive properties of dairy fat and the impact of bovine feeding practices on the health effects of dairy fat.

http://www.ncbi.nlm.nih.gov/pubmed/22810464

No much to say except this should be no surprise, unless you believe the low fat dogma of the last 30 years.

Head Scratcher

It's a head scratcher that an organization like this - the health newsletter of Harvard - is lazily recommending actions that are ten years out of date.  Even the institution's own scientists have moved past the "lowfat to lower cholesterol" fad and back towards science.

The emailed newsletter starts:
"People can reduce cholesterol levels simply by changing what they eat. For example, if you are a fan of cheeseburgers, eating less meat (and leaner cuts) and more vegetables, fruits, and whole grains can lower your total cholesterol by 25% or more. Cutting back on saturated fat (found in meat and dairy products) and trans fat (partially hydrogenated oils) can reduce cholesterol by 5% to 10%."

They recommend these four things to "lower your cholesterol":
"Stick with unsaturated fats and avoid saturated and trans fats.  
"Get more soluble fiber. 
"Include plant sterols and stanols in your diet."

Head scratcher part 1: There's no evidence - after forty years or more of examination - to show that "lower cholesterol" is a benefit for mortality reduction.  Your government, in its infinite wisdom, spent nearly a billion dollars to prove that its advice to reduce cholesterol and fat intake was in fact good for mortality reduction.  Said government failed to show any such thing.  

Second, eating plant sterols and stanols to lower cholesterol is equivalent scratching your private parts to make the sun come up sooner - I guess is might work, but the evidence is sketchy.  Sure, if you believe the conjecture that cholesterol is a cause of early mortality by causing damage to blood vessels, then it might be considered a common sense thing to use a "natural" plant based "food" to lower cholesterol.  But after forty years, and still no direct evidence that cholesterol manipulation via diet (or statin) is helpful for reduced all cause mortality - REALLY?!  A dearly beloved family member would dutifully down benecol every night on a piece of bread and announce proudly that it was "reducing" her cholesterol - how I managed to keep my pie hole shut about that I'll never know.  The kicker?  For females her age, "low cholesterol" correlates with increased mortality.  
The idea that fiber helps mortality is all the rage, but suffers, like the idea of diet to reduce cholesterol, from a lack of evidence.  Why people remain so in love with the idea is a little confusing when there are so many reasons not to down magnum doses of fiber and so little in the way of evidence that fiber is a big benefit - or any benefit.
The topic of cholesterol and causation of disease is very, very complex.  Seems like folks with "high LDL" (which can mean a lot of cholesterol packaged in LDL particles, or a large number of LDL particles, or some combination of both) have a higher correlation with heart disease; but some folks with "normal" LDL die young (Tim Russert being a prime example, his was reportedly 70, which is "low").  HDL has a correlation with reduced mortality, but efforts to raise HDL do not decrease mortality.  Insurance companies - who have a lot more at stake in your health than do your doctors - bet on your ratio of total cholesterol to LDL cholesterol.  
I read this newsletter to gauge changes in the perception of the common view.  At least this perspective - of doing what is best for you based on changes you can verify for yourself without relying upon "expert opinion" - has become obvious for the old guard.  They advise:
"Find the diet that work for you. When a friend or relative tells you how much his or her cholesterol level dropped after trying a particular diet, you may be tempted to try it yourself. If you do and after a few months you discover that you’re not getting the same benefits, you may need to chalk it up to genetic and physiological differences. There is no one-size-fits-all diet for cholesterol control. You may need to try several approaches to find one that works for you.  Although diet can be a simple and powerful way to improve cholesterol levels, it plays a bigger role for some people than for others. If your doctor suggests a lower-fat, lower-cholesterol diet, and despite your best efforts it isn’t working, you may need a different kind of diet, or medication, or both to bring cholesterol down."
It is curious to consider how this will all play out over time.  I don't see a day when all of the "experts" who have advocated low fat and statins to save the world will just have a conference and announce "what we've been telling you was bogus."  At some point, however, the truth will be too obvious for any rational denial.  The "It's the Sugar, Stupid" paper (from Monday and Wednesday's post) will be another nail in the "low fat for health" coffin, making the causality chain something like:
1. Too much sugar causes metabolic derangement (metabolic syndrome)
2. Unchecked, metabolic syndrome progresses to diabetes (full blown loss of glycemic control), and excess carbohydrate in general exacerbates the issue once one is over the metabolic syndrome threshold
3.  Diabetes predicts about a ten year shorter lifespan, and a much shorter period of active life.
The role of fat and cholesterol in this chain is minimal, and if eating high fat and high cholesterol helps you retain glycemic control and avoid metabolic syndrome, we've been in reverso-world the last 30+ years.

Kresser on the Warinner Critique of "Paleo"

An excerpt from this podcast by Chris Kresser, in which Chris responds to this TED talk by Christina Warinner, who thinks she's "debunking" the paleo diet (BTW, most of her criticisms are why I refer to the "Paleolithic Model of Nutrition" vice "eating paleo", which you and I cannot actually do):  

Chris Kresser:  Yeah.  If we were in a room talking about this stuff, I’d probably agree with her more than I would disagree with her, but there are some key points of disagreement, which I hope I made clear.  I also just want to end this by just shifting gears completely and saying that I think we can justify the paleo nutrition approach without even resorting to the evolutionary argument whatsoever, and I’m going to do this in my book.  You can look at paleo nutrition just strictly using modern research, and you can make an argument for it, and people like Mat Lalonde these days are almost exclusively talking about it in these terms to avoid the kind of misunderstanding that can happen that we’ve just been talking about.  But if you think about maximizing nutrient density, so making your diet focus on the most nutrient-dense foods and eating less of the least nutrient-dense foods, what do we see if we do that?  Well, guess what foods are the most nutrient dense, Steve?

Steve Wright:  Uhhhh, wheat.

Chris Kresser:  Haha, either that or beef liver, organ meats.  I’m referring to this in my book.  It’s a peer-reviewed study using a scale of nutrient density that is actually even stacked against animal products because they penalize foods for saturated fat and cholesterol and salt.  But even considering that, even with the deck stacked against them, animal products are still number one on the list.  So organ meats were number one in terms of nutrient density, and then muscle meats and fish and poultry were number two in terms of nutrient density.  The next category is vegetables.  And then after that, you have fruits and nuts, depending on the fruits and nuts switching places.  And then whole legumes are after that, and then whole grains.  And then you have processed, refined grains and sugar at the bottom of the list and seed oils.  So if you evaluate foods just on the basis of nutrient density using modern, clinical, peer-reviewed research, the paleo diet still looks pretty good.

And then the next thing would be minimizing toxins, and using that same argument, we look at foods that have immunogenic or allergenic proteins.  We look at things like phytic acid, which can inhibit mineral absorption.  Phytic acid is in a lot of foods, including good foods like spinach and greens.  In fact, there’s more phytate in spinach and greens than in some grains and legumes, so it’s not that we need to avoid that entirely, but the reason it’s not as much of a problem in greens is that the greens are just so nutrient dense that we’re going to absorb a lot of other nutrients from the greens that aren’t inhibited by phytate.  So it’s not that phytic acid withdraws any nutrients that are already stored in your body.  It just prevents you from absorbing certain nutrients, primarily minerals, in the foods that you eat.

Annual PHA Results

My friend and co-CrossFitter Star, reports:
"Mostly Paleo this past year with some exceptions...
Crossfitting 2x per week for the most part.
Doing HIIT when I'm at a Globo Gym 1x per week."

"Results:
All labs within standards."

"Biggest gain: Blood pressure is 102/70 today...the lowest it has been
in a LONG time!"

"One thing to fix: I'm inside too much...Vitamin D is low.  Woot!  Thanks Coach!"

What a win for you and those you love, Star, congratulations!

It's the Sugar, Folks - NYTimes.com

"Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one."
http://opinionator.blogs.nytimes.com/2013/02/27/its-the-sugar-folks/

Wait - but it's just another epidemiological study, right?  LIke the one AC lambasted on Friday?  Yes, it is, but that does not mean it's wrong!  And, sometimes folks are out to get the one that's paranoid.

This was a unique epidemiological study; not many meet these requirements:

"...and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).  The key point in the article is this: “Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence.” Thus: for every 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent. (The study found no significant difference in results between those countries that rely more heavily on high-fructose corn syrup and those that rely primarily on cane sugar.) This is as good (or bad) as it gets, the closest thing to causation and a smoking gun that we will see. (To prove “scientific” causality you’d have to completely control the diets of thousands of people for decades. It’s as technically impossible as “proving” climate change or football-related head injuries or, for that matter, tobacco-caused cancers.)

"But as Lustig says, “This study is proof enough that sugar is toxic. Now it’s time to do something about it.”  The next steps are obvious, logical, clear and up to the Food and Drug Administration."

While I of course disagree with FURTHER government intervention in health and diet (after all, the government is the reason we all chose sugar over fat the last forty years), I'm a big fan of not overdosing yourself on sugar, as regular readers can attest.  Gary Taubes made this case very strongly and this study is if anything a validation of "Good Calories, Bad Calories".
The path through sugar to diabetes and all of the diseases of the west is well trodden and open to all - take the road less travelled by.