Too Fabulous – Just Pour It Out video

  Dad!  Quit sucking back on that soda all day!!

The medical literature starts to shift

Eggs

Eggs (Photo credit: pietroizzo)

That creaking sound you hear is the slow reluctant shifting of the medical literature.

We are starting to see more medical papers and research that reflect the concepts of addressing carb intolerance by reducing carb intake – and thus increasing fat intake.

(1) It is not surprising that this is a well done study – note Jeff Volek as one of the authors:

Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome.

Blesso CN, Andersen CJ, Barona J, Volek JS, Fernandez ML.

Metabolism. 2012 Sep 26. pii: S0026-0495(12)00318-6. doi: 10.1016/j.metabol.2012.08.014.  PMID: 23021013  LINK to abstract

Note that the study participants were not eating low carb – they were having 25-35% of their diet as carbohydrates – which is still a lot less than the carb intake in the “usual” diet.

The study results carry an extra meaning in that this supports the concept that there are many differences in metabolism between people who are eating a carb load that is under or over their personal tolerance limit. Thus, given that carb intolerance is so wide-spread in the general population, any research done on people eating “usual” amounts of carbs cannot be assumed to apply to people eating carb amounts that are within their carb load tolerance. This applies even more so for those eating very low carb or who are adapted to a state of nutritional ketosis.

Thanks for heads-up on this study to a tweet from @CavemanDoctor.

(2) Thankfully, full text is on-line for this extensive review article:

Sugar restriction: the evidence for a drug-free intervention to reduce cardiovascular disease risk.

Thornley S, Tayler R, Sikaris K.

Intern Med J. 2012 Oct;42 Suppl 5:46-58.  PMID: 23035683   LINK to full text

You can click for the PDF version, which is easier to read.

Anaphylaxis to meat – Oh, dear.

English: The tick Amblyomma americanum (Lone S...

English: The tick Amblyomma americanum (Lone Star tick) (Photo credit: Wikipedia)

Have a look at this paper.  It describes in detail a newly recognized medical problem.  The bite of the lone star tick can make a person allergic to all mammalian meat.  The reaction these people display is an anaphylactic reaction, the type of allergy reaction that can be profound and can be deadly.  What can be particularly confusing is that the reaction can be 3-6 hours after eating.  Anaphylactic reactions usually occur very rapidly after exposure to the trigger foods, so the diagnosis can be missed. These reactions tend to develop in severity over time.  A person might have some reaction episodes where the symptoms are partial or mild, and therefore are missed or mis-diagnosed, before later having reaction episodes that are severe and possibly rapidly fatal.

The full text of the paper is posted free online. Go to the abstract and click on PDF.

The authors list the key points as (quote):

1. A newly recognized syndrome of meat-induced delayed anaphylaxis has been identified and may explain some cases that were previously labeled idiopathic.

2 Individuals bitten by lone star ticks may develop IgE antibodies to galactose- α-1,3-galactose (alpha-gal) and later develop a reaction when exposed to alpha-gal present on mammalian meat.

3 Since the reaction typically occurs 3-6 hours after exposure, it usually presents as a patient waking up in the middle of the night, with hives and anaphylaxis, after having ingested meat for dinner.

4. Current guidance is to counsel patients to avoid all mammalian meat (beef, pork, lamb and venison).

Map of the range of the Lone Star Tick (Amblyo...

Map of the range of the Lone Star Tick (Amblyomma americanum). Red indicates where the species is normally found; Blue indicates other locations where the species has been reported. (Photo credit: Wikipedia)

Since this syndrome has only just been recognised, it will be awhile before we know how common it is.  If you suspect you might have had episodes of allergic reaction to meat, stop eating meat until you can discuss this with a doctor. Print out the article and take it with you. If you suspect you might now be in the midst of an allergic reaction to meat, seek urgent medical care now.

Thanks to tweet from @whole9life for heads up on this.

Acellular carbohydrates as a critical concept

English: different sorts of Pasta

English: different sorts of Pasta (Photo credit: Wikipedia)

A missing piece of the puzzle in understanding the health impacts of the carb-containing foods that we eat?

Dr. Ian Spreadbury presents an intriguing and potentially ground-breaking concept in a paper recently published.  The full text of the paper is available free online.

Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity.

Spreadbury I.  Diabetes Metab Syndr Obes. 2012;5:175-89.

PMID:  2282663   Free PMC Article

This is a scholarly and well argued thesis. His key conclusion?

“A dietary pattern with carbohydrates exclusively from cellular low-density sources may remove the root cause of a range of our most prevalent diseases.”

There is some risk that his research and theories will be used falsely as an argument in favor of foods that are simply low in carbohydrate density.  In fact, his focus is on both the density of carbs in foods AND on whether the carbs (starch and sugar) are present within cells.

He also does not propose that simply switching from a long-term intake of high-carbohydrate-density acellular foods will instantly fix the problems that have been set in motion – such as impacts on the gut microbe population (the microbiome), inflammation and leptin resistance – nor simply erase the downstream outcomes such as obesity and diabetes.  He does propose that such a dietary change might bring great benefits and that over time the body would likely slowly at least partially recover.  He calls for research into these questions.

My attention was first brought to this paper by Dr. Jay Wortman on his blog, and it has received other attention.

It is likely to become much more widely known now that Dr. Andrew Weil has commented on it HERE and HERE. (Note: Weil’s previously broken link they now have fixed)

I don’t agree fully with Dr. Weil’s comments.  For example, his statement

 “If Spreadbury is right, the obesity solution is straightforward.”

is just so wrong I don’t know where to start.

I love this at the bottom of Dr. Spreadbury’s paper

“This work was not supported by funding.”.

Of course, there are other aspects of carbohydrate intake that still need to be taken into consideration – especially the impact of per-meal carb total intake (not solely the form of the carbs) on blood glucose control in diabetes – where there is a combined impact from carb food form and total.

Sugar Damage and Related Research

For anyone interested in looking “behind the scenes” at the research that goes into development of medical knowledge, this is a link to what I have been doing this morning. (Note: it is not obvious, but there are 4 pages, you click at the top right.)

http://www.ncbi.nlm.nih.gov/sites/myncbi/collections/public/18SLu9dl8FbUgixFr7tzWyi/

I have spent the past couple of hours looking at research related to damage from high blood sugars and from molecules that have been damaged by sugar (glycation). Some of these molecules are called AGEs, which is Advanced Glycation End Products. In the body, these attach to receptors, which are thus called RAGEs, or Receptors for Advanced Glycation End Products. It gets confusing as AGEs aren’t the only damaging molecules from high blood sugars. On top of that, it is now known that RAGEs react to many other molecules that occur within the body, not just those related to sugar damage.

AGEs are produced in your body and they are also present in foods. The AGEs present in foods (bacon is, sadly, the source of the greatest amount of AGEs in the typical North American diet) have been shown in research to have damaging effects.

This list of published papers is in no way an attempt to be complete, just some interesting ones I have set aside in a list, published in the past few months, to pursue in more depth later. To be more complete, I would do other searches on PubMed  using related search terms or following the work of specific researchers. For example, the older citations on the list are because I followed backwards Dr. Ceriello’s work, for example:

Vascul Pharmacol. 2012 May 16. [Epub ahead of print]

The emerging challenge in diabetes: The “metabolic memory”

Ceriello A.

Abstract

Large randomized studies have established that early intensive glycemic control reduces the risk of diabetic complications, both micro and macrovascular. However, epidemiological and prospective data support a long-term influence of early metabolic control on clinical outcomes. This phenomenon has recently been defined as “metabolic memory.” Potential mechanisms for propagating this “memory” may be the production of reactive species unrelated to the presence of hyperglycemia, depending on the previous production of AGEs which can maintain RAGE over-expression, on the level of glycation of mitochondrial proteins and on the amount of mtDNA produced, all conditions able to induce an altered gene expression which may be persistent even when glycemia is normalized. Clinically, the emergence of this “metabolic memory” suggests the need for a very early aggressive treatment aiming to “normalize” the metabolic control and the addition of agents which reduce cellular reactive species and glycation in addition to normalizing glucose levels in diabetic patients in order to minimize long-term diabetic complications.

Copyright © 2012. Published by Elsevier Inc.  PMID:22609133

I generally will look at a thousand or so of these “abstracts” of published papers in a typical week, on many different health-related topics, but mostly regarding diet and nutrition.

The place to go online for information about AGEs is to the website The AGE-less Way, where you can learn about this subject and the very important work of Dr. Jaime Uribarri MD and Dr. Helen Vlassara MD.  There is much useful info on their site and they also have a book out, The AGE-less Way, available in print and on Kindle.  Dr. Uribarri was interviewed by Jimmy Moore in January 2012. http://www.thelivinlowcarbshow.com/shownotes/5670/532-dr-jaime-uribarri-warns-of-disease-making-advanced-glycation-end-products-ages/

Short Link for this post http://wp.me/p2jTRh-7F