It's all about ME, baby! (Birth - 1997)

It's all about ME, baby! (1997 - present) is my story after discovering the Atkins Diet. This is my story up to that point. I was born one snowy Winter's day. Mum told me that my cot was placed next to an open window in Central Middlesex Hospital. That explains a lot! Here's mum, me and my sister.


I don't remember much about my early years. As we were relatively poor (dad was a tailor and mum did typing for a solicitor), getting regular French Fancies & Corona lemonade deliveries was considered a status symbol. I ran around in the street with other kids of my age but I was fat. I was also very short for my age (insufficient GH from my pituitary?) and was rubbish at sports in primary school. Here's a photo taken when I was about 9 or 10. I'm the shortest boy in the picture.


Stripy shirts were all the rage, apparently. Even at this tender age, I used to regularly fall asleep after eating a plate of chips.

In secondary school, sports was dreadful what with having to play cricket using a cricket ball (instead of a tennis ball), contact sports, swimming and showers. Being short, fat & under-developed, I was embarrassed to get undressed in front of my peers, so I developed the art of forging sick notes in my mum's handwriting. I was a very sickly child! ;-D

My forging skills resulted in the total avoidance of swimming (also contact sports, cross-country running etc) and a big improvement in the quality of my handwriting! With tennis, I had to travel to a tennis court by train. I didn't mind doing that, as there were no showers at the tennis courts and I could play the game for a while until I overheated. Secondary school was where I developed a total hatred for almost all sports and when I left, that was the end of exercise as far as I was concerned. When I left secondary school at the age of 18, I was 4 feet 9 inches tall.

At university, I would have a cheese & ham salad baguette washed down with a can of Coke (non-diet in those days) for lunch, followed by a snooze.

At work, I would have a cheese & raw onion roll washed down with a can of Coke for tea-break, followed by a snooze. Here's me at the age of 26. At some point, my pituitary gland "woke up" and secreted GH, as I grew to 6 feet 1 inch tall in my late twenties.


I did manage to get some work done!

When I was dating, I jogged/walked for over 4 miles a day to see my girlfriend. I got slim. After I married, that stopped and as I was a skint Electronic Engineer and Lesley was a skint Cake Decorator, my diet was predominantly cheap carbohydrates, like bread, pasta, potatoes & rice. The result? Lots of snoozes + lots of weight gain. I was a lazy git, apparently.

In 1992, Lesley left to live with her mother. In 1994, I started dating Eileen. At parties, I became (in)famous for falling asleep after eating nibbles made from refined carbohydrates.

"Funny turns": What they aren't and what they might be.

Sometimes, doing a large amount of high-intensity exercise while on a ketogenic diet can result in a "Funny turn", i.e. a weird feeling which may include sweating, dizzyness & feeling faint.

The good news is that it's harmless, provided you don't faint, fall and hurt yourself. Stop and sit/lie down until the feeling passes. So, what's happening?

What isn't happening is a Somogyi rebound. A Somogyi rebound only happens when too much insulin is injected and it's bad because it results in hyperglycaemia.


Did you know that there is insulin, insulin and insulin? According to Insulin: Degradation, "It has been estimated that an insulin molecule produced endogenously by the pancreatic beta cells is degraded within approximately one hour after its initial release into circulation (insulin half-life ~ 4–6 minutes)". According to Insulin: As a medication, injected insulin lingers in the blood for hours for fast-acting and days for slow-acting. This makes an overdose of injected insulin dangerous, as it can linger for long enough to cause fatal hypoglycaemia unless medical help is obtained.

What might be happening is this: On a ketogenic diet, muscle glycogen stores are "trickle-charged" using blood glucose. High-intensity exercise burns muscle glycogen at a very rapid rate. See It's all in a day's work (as measured in Joules). Muscles can burn carbs at a rate of 4g a minute.

If muscles run low/out of glycogen, muscle cells become exquisitely sensitive to insulin as glucose importing processes are up-regulated. There is only about 4.5g of glucose in the blood at any given time, topped-up by the liver and burned by the brain & red blood cells at a rate of less than 4g an hour (if keto-adapted). If muscles start to draw in 4g of glucose a minute, blood glucose can vanish very quickly.

As dropping dead due to running for your life on very little or no food is bad, the body has several mechanisms for raising blood glucose very quickly.

From Blood Glucose, Insulin & Diabetes, "When BG falls to about 3.3mmol/L, the pituitary gland kicks-in and secretes ACTH (adrenocorticotropic hormone) which stimulates the release of cortisol from the adrenal cortex. Cortisol further stimulates gluconeogenesis in the liver. When BG level falls to about 2mmol/L, the pituitary secretes GH (Growth Hormone) which has an anti-insulin effect." At a BG level of about 2mmol/L you feel really weird, so you stop exercising.

So why is it harmless? Glycogen-depleted & exquisitely insulin-sensitive muscles act as a natural blood glucose limiter because they draw in glucose so readily. There is no hyperglycaemia.

This also reduces the "Dawn Phenomenon", another plus point for low-carb diets for diabetics.

See also Can very-low-carb diets impair your mental faculties.

Polyphenols, Hormesis and Disease: Part II

In the last post, I explained that the body treats polyphenols as potentially harmful foreign chemicals, or "xenobiotics". How can we reconcile this with the growing evidence that at least a subset of polyphenols have health benefits?

Clues from Ionizing Radiation

One of the more curious things that has been reported in the scientific literature is that although high-dose ionizing radiation (such as X-rays) is clearly harmful, leading to cancer, premature aging and other problems, under some conditions low-dose ionizing radiation can actually decrease cancer risk and increase resistance to other stressors (1, 2, 3, 4, 5). It does so by triggering a protective cellular response, increasing cellular defenses out of proportion to the minor threat posed by the radiation itself. The ability of mild stressors to increase stress resistance is called "hormesis." Exercise is a common example. I've written about this phenomenon in the past (6).

The Case of Resveratrol

Resveratrol is perhaps the most widely known polyphenol, available in supplement stores nationwide. It's seen a lot of hype, being hailed as a "calorie restriction mimetic" and the reason for the "French paradox."* But there is quite a large body of evidence suggesting that resveratrol functions in the same manner as low-dose ionizing radiation and other bioactive polyphenols: by acting as a mild toxin that triggers a hormetic response (7). Just as in the case of radiation, high doses of resveratrol are harmful rather than helpful. This has obvious implications for the supplementation of resveratrol and other polyphenols. A recent review article on polyphenols stated that while dietary polyphenols may be protective, "high-dose fortified foods or dietary supplements are of unproven efficacy and possibly harmful" (8).

The Cellular Response to Oxidants

Although it may not be obvious, radiation and polyphenols activate a cellular response that is similar in many ways. Both activate the transcription factor Nrf2, which activates genes that are involved in detoxification of chemicals and antioxidant defense**(9, 10, 11, 12). This is thought to be due to the fact that polyphenols, just like radiation, may temporarily increase the level of oxidative stress inside cells. Here's a quote from the polyphenol review article quoted above (13):

We have found that [polyphenols] are potentially far more than 'just antioxidants', but that they are probably insignificant players as 'conventional' antioxidants. They appear, under most circumstances, to be just the opposite, i.e. prooxidants, that nevertheless appear to contribute strongly to protection from oxidative stress by inducing cellular endogenous enzymic protective mechanisms. They appear to be able to regulate not only antioxidant gene transcription but also numerous aspects of intracellular signaling cascades involved in the regulation of cell growth, inflammation and many other processes.

It's worth noting that this is essentially the opposite of what you'll hear on the evening news, that polyphenols are direct antioxidants. The scientific cutting edge has largely discarded that hypothesis, but the mainstream has not yet caught on.

Nrf2 is one of the main pathways by which polyphenols increase stress resistance and antioxidant defenses, including the key cellular antioxidant glutathione (14). Nrf2 activity is correlated with longevity across species (15). Inducing Nrf2 activity via polyphenols or by other means substantially reduces the risk of common lifestyle disorders in animal models, including cardiovascular disease, diabetes and cancer (16, 17, 18), although Nrf2 isn't necessarily the only mechanism. The human evidence is broadly consistent with the studies in animals, although not as well developed.

One of the most interesting effects of hormesis is that exposure to one stressor can increase resistance to other stressors. For example, long-term consumption of high-polyphenol chocolate increases sunburn resistance in humans, implying that it induces a hormetic response in skin (19). Polyphenol-rich foods such as green tea reduce sunburn and skin cancer development in animals (20, 21).

Chris Masterjohn first introduced me to Nrf2 and the idea that polyphenols act through hormesis. Chris studies the effects of green tea on health, which seem to be mediated by polyphenols.

A Second Mechanism

There is a place in the body where polyphenols are concentrated enough to be direct antioxidants: in the digestive tract after consuming polyphenol-rich foods. Digestion is a chemically harsh process that readily oxidizes ingested substances such as polyunsaturated fats (22). Oxidized fat is neither healthy when it's formed in the deep fryer, nor when it's formed in the digestive tract (23, 24). Eating polyphenol-rich foods effectively prevents these fats from being oxidized during digestion (25). One consequence of this appears to be better absorption and assimilation of the exceptionally fragile omega-3 polyunsaturated fatty acids (26).

What does it all Mean?

I think that overall, the evidence suggests that polyphenol-rich foods are healthy in moderation, and eating them on a regular basis is generally a good idea. Certain other plant chemicals, such as suforaphane found in cruciferous vegetables, and allicin found in garlic, exhibit similar effects and may also act by hormesis (27). Some of the best-studied polyphenol-rich foods are tea (particularly green tea), blueberries, extra-virgin olive oil, red wine, citrus fruits, hibiscus tea, soy, dark chocolate, coffee, turmeric and other herbs and spices, and a number of traditional medicinal herbs. A good rule of thumb is to "eat the rainbow", choosing foods with a variety of colors.

Supplementing with polyphenols and other plant chemicals in amounts that would not be achievable by eating food is probably not a good idea.


* The "paradox" whereby the French eat a diet rich in saturated fat, yet have a low heart attack risk compared to other affluent Western nations.

** Genes containing an antioxidant response element (ARE) in the promoter region. ARE is also sometimes called the electrophile response element (EpRE).

Mum's Proposed Ketogenic Diet for Dementia.

The following diet is not intended to induce deep ketosis. It's intended to be a trade-off between ketosis, palatability & simplicity.


Feedback from the nurse on duty:- "Eggs shouldn't be in the "unlimited" list. You're not supposed to eat more than two eggs a week because of the cholesterol". God Bless the NHS! The British Heart Foundation doesn't impose a restriction on egg consumption.

Eggs can be eaten as part of a balanced diet.

Mum's currently eating two eggs a day in her cooked breakfasts.

Effect of dietary egg on human serum cholesterol and triglycerides.

Old people have the lowest mortality when their serum cholesterol is higher than average.

Total cholesterol and risk of mortality in the oldest old.
Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study.
Low total cholesterol and increased risk of dying: are low levels clinical warning signs in the elderly? Results from the Italian Longitudinal Study on Aging.
Higher total serum cholesterol levels are associated with less severe strokes and lower all-cause mortality: ten-year follow-up of ischemic strokes in the Copenhagen Stroke Study.
Serum total cholesterol levels and all-cause mortality in a home-dwelling elderly population: a six-year follow-up.
Lipid-lowering treatment to the end? A review of observational studies and RCTs on cholesterol and mortality in 80+-year olds.

Paul Jaminet has done a series on ketogenic diets.
Ketogenic Diets, I: Ways to Make a Diet Ketogenic
Ketogenic Diets 2: Preventing Muscle and Bone Loss on Ketogenic Diets

Also: See Branched chain amino acids as adjunctive therapy to ketogenic diet in epilepsy: pilot study and hypothesis.

Both Sides Now: Medications

People are distrustful of pharmaceutical drugs. Drug Companies = Big Pharma and all that. However, medications have their plus side and their minus side. It all depends.

Some medications give the body something that it needs that it's not sufficiently producing e.g. Insulin (Type 1 diabetes), Adrenaline/Epinephrine (Anaphylactic shock), Corticosteroids (Addison's Disease), Thyroxine (Hypothyroidism), HCG, HGH, trans-dermal Testosterone/Progesterone (Hypopituitarism), Oestrogen (HRT). Bio-identical hormones are fine. Synthetic hormones, not so fine. See The fatal flaw of prescription drugs.

Some medications act as dietary supplements e.g. Adcal-D3 (Calcium & Vitamin D3), Lovaza (EPA & DHA), Effercitrate (Potassium & Citrate). These are also fine.

It's the medications that tweak metabolic pathways that can cause problems.

There are enzyme inhibitors e.g. Statins, Mono-Amine Oxidase Inhibitors (MAOIs), Angiotensin Converting Enzyme Inhibitors (ACEIs) etc. The problem with these is that inhibiting the conversion of "A" into "B" results not only in less "B, C, D etc" but also in more "A". Statins not only reduce serum cholesterol but also reduce the level of Co-enzyme Q 10 and other useful substances. MAOIs (e.g. Moclobemide & St John's Wort) cause high blood pressure if foods & drugs high in amines are consumed. ACEIs (e.g. Ramipril) cause an increase in serum bradykinin which can irritate lungs causing a persistent dry tickly cough. I've had this happen.

There are receptor agonists & receptor antagonists (blockers). Agonists occupy receptors and produce a larger effect than the substance naturally found in the body. Antagonists occupy receptors and produce a smaller effect than the substance naturally found in the body.

Alpha blockers (e.g. Tamsulosin hydrochloride) block alpha adrenoreceptors and are used to treat urinary retention, as they relax smooth muscle in the urethra. Unfortunately, they also cause postural hypotension, as when you stand up, arteries don't contract as much as they should to raise the blood pressure in the brain. I've had this happen. They also reduce iris contraction, leading to being dazzled by oncoming headlights while driving.

Beta blockers (e.g. Atenolol & Propranolol) block beta adrenoreceptors and are used to treat high blood pressure and/or anxiety as they slow down the heart and also block the effects of adrenaline/epinephrine on the brain. Dutch courage in a pill! Unfortunately, the heart is supposed to speed up when you exercise and failure to do so makes exercise very difficult if not impossible. Tolerance can also develop, resulting in zero long-term efficacy. I've had this happen. They also affect other parts of the body.

Angiotensin 2 receptor blockers (e.g. Candesartan Cilexetil) are used to treat high blood pressure as they relax artery walls. These work fine without any obvious side-effects, but there's a study showing a slightly increased (~6%) risk factor for cancer. In some people, Renal Artery Stenosis (narrowing) can occur, but a blood test detects this.

Diuretics (e.g. Bendroflumethiazide) increase urinary output and are used to treat high blood pressure & water retention. Unfortunately, increasing urinary output can cause dehydration & increased thirst, resulting in increased fluid intake i.e. zero net effect. I've had this happen. There are other undesirable side-effects.

Thiazoladinediones (e.g. Rosiglitazone) create new (& empty) fat cells, which allow for the increased disposal of excess serum glucose. Unfortunately, the cells that turn into new fat cells were supposed to have turned into bone cells, so the risk factor for osteoporosis increases.

High-dose Niacin & Fish Oils reduce serum triglycerides by inhibiting the conversion of excess serum glucose into fatty acids (which are esterified into triglycerides). This can increase serum glucose (which is bad).

It's like trying to get a balloon into a box that's too small. You can get most of it in, but another bit bulges out when you try to get the last bit in. Instead of tweaking your metabolism to compensate for your bad diet and/or lifestyle, you should correct your bad diet and/or lifestyle.

Calories Count. But I Prefer Not To.

A Balanced View On Calories and Weight.

It’s 11:20 AM. Breakfast was only 2 ½ hours ago, yet I’m hungry. So before writing this post, I march myself up to the kitchen and heat up a brioche, a flaky, buttery, mushroom-filled leftover deep in my freezer. There was no label, no caloric info on this bakery item to guide me regarding portion. And I had the whole thing. And it was delicious. My only regret? I didn’t think to photograph it!

I had just read Ashley’s post at Nourishing the Soul entitled The Great Calorie Debate http://bit.ly/egoWZU, including the many reader comments. And struggling to not hoard the space allotted on her comment page, I decided I needed to give this matter my full response.

The comment I did post stated that this, like most subjects, is not such a black and white issue. And if you’ve been reading my blog for a while, you’d know that calorie counting is not my mode of managing weight. Rather than reiterating that viewpoint, I’ll direct you to past posts, focusing on the need for using internal cues, such as hunger and fullness, as distinguished from thoughts (including numbers, shoulds, food rules) and emotional triggers. These also emphasize that weight regulation does come down to calories. But how we regulate them is where some of us may differ.

http://dropitandeat.blogspot.com/2010/06/this-is-my-dog.html

http://dropitandeat.blogspot.com/2011/01/why-carbs-got-bad-rep-and-what-you-can.html

http://dropitandeat.blogspot.com/2010/05/pound-of-feathers-or-pound-of-gold.html

http://dropitandeat.blogspot.com/2010/12/weight-watchers-beware.html

http://dropitandeat.blogspot.com/2010/11/forty-eight-food-filled-hours-and-yes.html

But here’s the other side of the coin, so to speak. No doubt, calorie counting provides a safety net, an insurance of sorts. Trusting a plan’s calorie level can help individuals on both sides of the scale. If you're a restrictive eater, having a reality check about just how much you are falling short calorie-wise, could be quite useful. It might help to understand why you are experiencing unpleasant symptoms, and provide a template to work toward meeting.

One of my favorites for ice cream at a fraction of the
saturated fat and calories compared to premium ice creams!

Or like Robin, you might be frustrated that you do everything right—you exercise, choose healthy foods, and only eat half your meals when dining out. Yet your weight has been climbing out of range steadily over the past decades. For you, realizing that the 1 ½ cups of Ben & Jerry’s Chunky Monkey provides more than half the calories you likely need for weight loss, if you are less than 5’7” or less than super active. Sometimes that reality checking is quite valuable.

Last weekend while I was out, I stopped at a restaurant for lunch. Fresh City is a regional place, New England based with the motto: “Bold and original creations you can feel good about…” And I must admit, the food quality and selection was quite good. Yet approaching the counter, glancing up at the menu board I was alarmed. It was my first time being confronted with the calorie value of every menu item.

And I felt very conflicted. I certainly knew I was only going to order foods I enjoy, that much was certain. But how did I feel about the regular wrap being, if I recall correctly,160 calories greater than the low carb wrap option? Or the fact that for those little ones 10 and under, a PB and J contained 777 calories? Unless they are doing early Olympic training, that’s an exorbitant amount for a kid’s lunch, particularly once you add in a beverage to go with!

Well, for the record, I ordered the regular wrap (any surprises there?) and my college age kids couldn’t have chosen the peanut butter and jelly anyway (although the caloric value would’ve been more appropriate for them than the targeted customer)! God knows how large their bread is or how much PB they throw on the sandwich! I could tell you it did make my husband ask about his homemade PB sandwiches (which are a little more than half the calories of those designed for the under 10 crowd.)

So here’s the thing. Most individuals who have not abused their bodies with diets and unhealthy thoughts and rules (yes, that may just leave children and a few select others!) will eat part of the sandwich, regardless of it’s calorie level, and stop when they’ve had enough. And if, perhaps, they ate mindlessly, leading to consuming more than they really needed, then they would feel quite full. 


And so, if they listened to their hunger, they wouldn’t be eating until some time later. Maybe they wouldn’t end up needing a snack later—but maybe they would. The point? Even if you didn’t know how high the calories were, if you just listened to your body, and ate mindfully and trusted, you’d be just fine. (Unless, of course, the what the what the heck effect takes over and your dieter’s thoughts convince you that all is already lost and you may as well keep going.

If you’re going to look at calories, be certain to not set an upper limit. Calorie counting is not a perfect science. For any number of reasons, you may get hungry, even if you ate all the calories you think you're entitled to. Then what?! What’s most important is that you learn to honor your hunger. See http://bit.ly/94Xnm1

It’s 12:55 and I’m not yet ready for lunch. That rich and buttery brioche is still digesting. Lunch just may not happen for awhile. But I think I’ll bring a snack with me when I head out—just in case I get hungry! 
No regrets about the pastry, or about not knowing the calorie content. Sometimes, you just need to trust your body.
BTW, as this is National Eating Disorders Awareness Week, please share this blog with 2-3 friends or family members who might benefit! Thanks!

The usual suspects.

On Facebook, on message boards and face to face, I keep seeing and hearing:-

1) I'm down in the Winter/I keep getting infections/I have allergies/I have aches & pains.

2) I'm up & down a lot.

3) I'm down/anxious/I can't sleep/I get restless legs/cramps/menstrual cramps/muscle spasms/migraines.

4) I've got inflamed or painful joints/skin/guts/lungs/whatever.

5) Ooh! It makes me so mad!

1) Vitamin D insufficiency/deficiency is widespread by the end of Winter (~90% of people have serum 25(OH)D less than 75nmol/L or 30ng/mL) due to insufficient sun exposure during the Summer. A safe & effective dose is 50iu of Vitamin D3/kg body weight/day. See Vitamin D.

2) Modern diets are lacking in long-chain omega-3 fatty acids (EPA & DHA), as many people don't eat any/enough oily fish. Tinned tuna is not an oily fish! See Omega-3 fatty acids and major depression: A primer for the mental health professional. Women of reproductive age can take flaxseed oil, if they can't/won't eat oily fish or take fish oil capsules. Women not of reproductive age & men need to supplement with vegan DHA in addition to flaxseed oil, if they can't/won't eat oily fish or take fish oil capsules.

3) Diets low in greens are low in magnesium. Magnesium deficiency can cause all of the above symptoms. Epsom Salts are a very cheap source of Magnesium. 4g/day of Epsom Salts provides 400mg/day of Magnesium. See Magnesium and the Brain: The Original Chill Pill and Magnesium: Just as important as Calcium.

4) Vitamin D is anti-inflammatory. Fish oil is anti-inflammatory.

5) Vitamin D raises your mood. Fish oil keeps it stable. Magnesium chills you out.


Here's a picture to go with the title.


And finally...
I am so glad that I don't work with David Thorne.

How do you love who you are...

To Liana; if you ever aren't comfortable with yourself, how do you get pass that and just love who you are? - Naama 

Thank you Naama, great question. How do you love who you are...

I will share what works for me,

Break it down to 3 simple things.

One. Realize that the uncomfortableness is there.

Two. Think, here I am, and there is that uncomfortableness.

Three. Speak, aloud anything you want to be. 

These may help:

For step one, you may feel the uncomfortableness is a physical ache or pain. Or you may find the uncomfortableness resides in the head or above the head which may also be in the form of a headache.

For step two, as you think these thoughts you are separating yourself from the uncomfortableness. Now there is you, and now there is that uncomfortableness.

For step three, say aloud whatever you wish you were, or want to feel. It may help to say it after ‘I am ...’ For example I like to say “I am alive, transparent, consistent, and pure energy, and loving.” As you speak these words, your body is familiarizing its self with them. These words create new cells in your body that are made up of a cell memory of ‘alive, transparent, consistent, and pure energy, and loving’. You start to become the way you wish to be on a cellular level. Say it as many times as you like. 

You can do this process as often as you like. You may find one kind of uncomfortableness in the body and get rid of it, and then another is there and then another comes along etc. Remember we have probably picked up a lot of uncomfortableness during our many years as a human. 

It will take however long it takes you to do the process getting rid of the uncomfortableness. Sometimes minutes, sometimes seconds. The more you do it, the quicker you become at getting rid of uncomfortableness. The more you do it, the more the brain is focused on being whatever it is you say, for me it is being alive, transparent, consistent, and pure energy, and loving :)

Times I do it are anywhere and anytime I feel uncomfortableness. I may be replying to emails, walking down the street, prepping for an audition or phone call, on a plane, at home, browsing the internet, eating food, meeting with people, at the gym, it could literally be anywhere and any place. As soon as the uncomfortableness is there I know I can also get rid of it. 

Write in the comment box below if you would like to share ways how you ‘love who you are’.

 

www.TheEarthDiet.Org

You pusillanimous pipsqueak!

Who said that? To whom? Answer HERE.
We're all insignificant in the scheme of things. Here's another Eric Idle classic.


"And pray that there's intelligent life somewhere up in space, 'cause there's bugger-all down here on Earth." LOL.

Sometimes, I get the feeling that I'm invisible. I write about stuff and a few weeks later, people are arguing about stuff that I've written about. For instance...

What becomes Insulin Resistant first? Liver, Muscle or Fat-mass?
CarbSane says "Where does insulin resistance start? The adipose tissue."
Stephan Guyenet says "I'm not so sure that insulin resistance begins in adipose tissue."

So who's right? They both are. As Lyle McDonald says "It all depends." Referring to Insulin Resistance: Solutions to problems, whatever fills up first becomes IR first. Or have I got it all wrong? Comments, please!

Am I even more insignificant because I have an Engineering Degree but zero qualifications in the field of diet & nutrition? Dr Richard K Bernstein used to be an Engineer. He's done very well as a doctor.

Bearing in mind the title, I'd better put a picture of me below.

I'm NOT a nutritionist, I'm a very naughty boy!

With apologies to Monty Python and Pål Jåbekk, whose recent blog post Kurt Harris, the messiah, the hype and the throwing of scales featured the sketch from Monty Python's Life of Brian (MPLOB) from which I got the title idea. Here's another clip from MPLOB which sums-up me these days...

I'm in an annoyingly (to some people) positive mood at the moment. Anyway, back to the subject.

On Friday 18th February, Jay (of Jay's Kitchen) described me as nutritionist to a customer. I pointed out that I am not, never have been and never will be a nutritionist. I do talk about diet & nutrition rather a lot, though. Sometimes, this can be a total turn-off, so I need to learn to shut my mouth before this happens.

For instance, I was talking to a very overweight & diabetic friend at karaoke on Thursday night after he mentioned that he had had multiple laser treatments for diabetic retinopathy. I pointed out that they can't laser kidneys back together when they fail due to excessively-high blood glucose. He mentioned a pile of daily medications that he had to take.

I mentioned Steve Cooksey and the fact that Steve had gone from fat & diabetic on a pile of daily medications to slim & non-diabetic on zero daily medications, and the fact that I had slimmed down and completely eliminated my glucose intolerance by using Vitamin D3, exercise & a low-carb diet. The 2nd & 3rd items in my list must have gone too far, as he got up to sing and when he finished singing, he sat somewhere else. He hasn't de-friended me on Facebook....yet!

Anyway, here's a link to How It Should Have Ended.

Here's the obligatory picture.


I posted the above picture because a) I used to really enjoy "The Good Life", b) I used to really fancy Felicity Kendall and c) Penelope Keith's character Margo had irony off to a fine art with "Well thank you very much!". Please note:-

In the US, "Thanks a bunch!" means "Thank you very much".
In the UK, "Thanks a bunch!" means what Margo meant.

By the way, I don't do irony. It usually goes right over my head and it doesn't work well in print without smilies. I'm not being ironic with what I just wrote. No, really. I'm not!

Maggie’s 152 lb. Weight Loss—This Time, It’s Not Disordered

Eating Disorder Recovery is More than Achieving a Healthy Weight

At the MFA, Boston, MA

Just this Thursday yet another patient shared her beliefs, her fears about recovery. “If I’m at a normal weight then I won’t need to come in. And everyone will think I’m fine”, she stated. And that was one roadblock to her recovery. Wearing her eating disorder, just like, for a cutter, I suspect, wearing short sleeves, is a way of expressing that there’s a problem. It appears to be a way of passively asking for help, when words fall short. 

Some have been surprised when I described them as still having an eating disorder, complete with thoughts of restriction, denial of hunger, and food and weight preoccupation, in spite of having restored their weight.

A significant drop in weight could be a red flag for an eating disorder, or can be the result of healthy measures, in spite of an eating disorder history. And a normal weight can disguise the pain of your struggling with an eating disorder as well. All of the above apply to Maggie.

You’d think dropping 152 pounds would be a major accomplishment for someone close to 400 pounds. And it is, especially at the age of 67. But the more successful part of this story is the move away from reliance on eating disorder thoughts and behaviors, on both sides of the weight spectrum.

Also at the MFA, Boston

Maggie, at 130 pounds and 5’8” saw herself as a “big fat slob”. A low weight for her height by any medical standards, she was obese by her own. She reports never really feeling good about herself, and by her early 20’s had met criteria for anorexia, plummeting to 117 pounds with restrictive intake and bulimic exercise levels. By that I mean exercising excessively, typically to compensate for eating, in an obsessive way.

Like many I see, a motivation to conceive helped enable her to gain enough for normal menses to resume, and ultimately to carry and deliver a healthy daughter. She managed to maintain a healthy weight, although not a healthy relationship with food and her running shoes. And after some time, triggered by a traumatic event, Maggie’s eating disorder turned to binge eating, with a focus on night eating. (Let me assure you that with support from an eating disorder team, recovery from anorexia does not have to result in binge eating and subsequent obesity! But Maggie had not yet sought help.)

Fast forward to the summer of 2002, when at 388 lbs. Maggie presented to see me. Her goal? To lose weight and recover from her many years living with an unhealthy relationship with food. Basically, to learn how to eat and to listen to her body—something she had never really done.

Maggie still comes to see me, every 4-6 weeks. (She has also worked with a therapist, at my recommendation, but they have finished their work together.) Yes, it’s been a very long road, but her progress has been tremendous. It’s quite impressive that she is down 152 lbs. so far. But more impressive, is that it has been years since she has used behaviors to manage her eating and her weight. 

True, there have been slips where I have had to play the “tiger mom” role, insisting that she increase her food intake, when weight loss was getting a bit too rapid. But she heeded my firm warning, and stayed on course. 

And there were certainly frustrations, like when she went to see her primary care physician recently. In reviewing her history, the doctor asked what her weight had been before we began our work together. And when Maggie, somewhat shamefully, admitted it was 388 lbs., the doctor laughed and told her she had to be wrong, dismissing Maggie as exaggerating her weight loss. Could you imagine! This very same visit, the doctor denied her a referral for a therapeutic water program that I requested, to enable her to move more. Because after so many years, no matter how much weight she lost, her knees weren’t going to fix themselves and allow her to start walking. To her credit, the incredible anger and frustration she felt was verbalized, instead of buried with pastries.

Over these years of working together, Maggie has changed the rules. She allows herself to eat later at night—if she’s hungry, and she chooses foods she truly enjoys—but eats them mindfully. Sometimes I find her counting her carbs, but generally only when she’s concerned about her blood sugars, as she was diagnosed with Type 2 Diabetes several years ago.

Perhaps her next challenge will be learning to manage activity—after she has her knees replaced. And for the record, she also followed my most recent advice—she switched to a lovely new doctor, who gladly issued the prescription for the water exercise program!

A-ha! Another mystery solved.

With a title like that, there can be only one...


If you recall, in Keep 'em tight, I persuaded mum's GP to make recommendations to mum's care home re: Diet & Exercise. If you also recall, in Well, stone the (expletive deleted) crows!, agency carers were unaware of mum's GP's recommendations. Today, I had this for lunch:-


It's the same picture as in a post below, but it looked and tasted so good that I felt the need to post it again. After lunch, I asked the nurse in charge for mum's care plan.

There was no mention of mum's GP's recommendations in the care plan. I am awaiting a phone call from mum's GP tomorrow to find out what the **** is going on.

Update tomorrow.

EDIT: It's now Thursday 17th February. I received the call from mum's GP. He told the nurse who was in charge that day (Tuesday 1st Feb) to get specific information regarding exercise & diet from me. He doesn't know the name of the nurse who was in charge that day. I will be making enquiries. The book will be getting more entries, with fluorescent pink blobs to highlight them.

Some of mum's blood test results have come in. Her B12 is fine. Her calcium is on the high side, so she can stop taking two Adcal-D3 per day (which she hates as they're like chewing on sweetened chalk). Vitamin D result not in, yet. Two Adcal-D3 per day gave her only 800iu/day.

EDIT: It's now Friday 18th February. I saw a different nurse in charge today and asked her what was going on. She showed me mum's care folder and it contained the letter that I had written to mum's GP. On Wednesday, I was shown pages from the care folder but not the letter. A-ha! The nurse asked me to clarify mum's diet, so I got my green, orange & pink marker pens out and wrote a rough guide as to what mum could eat in unlimited amounts, in moderation and in very limited amounts. I photographed the guide and will be producing a tidy version on Word.

A carer said to me today "Whatever you're doing, keep doing it! Yesterday, your mum used her 3 wheeled walker unaided and found her own way to the dining room". Oh, wow!

Just wait until her Vitamin D status is improved. The last time I did that (in 2008), mum's MMSE score shot up from 14/30 to 26/30. Aricept also helped, but it usually gives only a 2 point increase.

Is there anybody out there?

'Cos there ain't mushroom in here (ouch!). Cue music video.


I've spotted a variety of fungi growing in my area. Here are some pictures. I think that I know which ones are poisonous, but I'm hoping that someone knowledgable will tell me for certain.

No.1 Found growing on a dead tree stump in my garden. I think non-poisonous.


No.2 Found growing at the base of a live tree in the woods. I think non-poisonous.


No.3 Found growing amongst dead leaves in the woods. I think poisonous.


In other news, mum got a mystery Valentine card on Monday. She managed to get it out of the envelope (despite having a bad tremor) after I got it started for her, and she also managed to read the words on the front of the card and inside. I videoed each event. The book got four green blobs (I use pink & green highlighters to highlight bad & good news) that day!

Where BMI Goes Wrong. Lessons From Cupid.

Yesterday was Valentine’s Day and no, I’m not going to flash more food porn involving chocolates. But with Cupid hovering around lately, I couldn’t help but address the subject of BMI, Body Mass Index.

What if Cupid and his parents showed up in my office concerned about obesity, what would I say? Let’s assume for a moment, from the various images of him these days that his BMI was in fact high. For the record, BMI is simply a calculation of weight divided by height squared, used as a marker for obesity. It is not, as you have been lead to believe, a measure of body fatness, or percent body fat.

If historically, as evidenced by Hallmark’s greeting cards, Cupid has always been husky from his youngest years, here’s what I’d say. Assuming he has paralleled the BMI chart, he is gaining as much annually as any other normal healthy child. It’s just that he started larger, simply genetics, most likely. I would still explore his intake and eating behaviors, recommending modifications to ensure health and prevent disease (just as I would do if an average weight individual presented for, let’s say, food allergies). But if all looked well, I would not create a problem where there was none.

If, however, I discovered he was hoarding the chocolates he planned to deliver, binge eating or emotionally overeating, perhaps because of unrequited love, these patterns would need to be addressed—with me, and with a therapist.

Like chocolates, we come in all shapes and sizes. And if your size, like Cupid’s, has always leaned on the larger end of the spectrum, it is likely that is a healthy, and normal place—for you. If, however, you have never listened to your hunger and fullness, tending to regularly use food for comfort or to manage stress and emotions, there’s room for changing your relationship with food, and as a result, your weight.

Maybe as an adult your BMI is out of range, placing you in the “obese” category. That puts you in good company, with top paid professional athletes such as Vince Wilfork and Charles Barkley. BMI is hardly the best way to gauge your size, or your risk of disease. Many with high BMI’s are quite healthy and fit, often at the top of their game. BMI may be high simply from a high muscle mass. Remember, body mass index does not distinguish where that mass comes from—muscle or fat (or bone, for that matter).

Years ago a woman who did body building recreationally came in for assistance with weight loss. It was winter, and quite frankly, visually I could never have guessed what her risk was. By the charts, she was obese, with a high weight for her height. But when I assessed her eating, I could only conclude that she wasn’t eating enough, regardless of her weight concerns. Weeks later, following a half marathon, she reported that she was hospitalized with internal bleeding. Apparently, her percent body fat was so low that there was damage to her internal organs, resulting in the bleed. Yes, body fat does have a function, and cushioning our internal organs is just one example.

But if your weight has been climbing out of a healthy range, and you have not dramatically increased your muscle mass, it may be time to take a closer look—at your activity as well as your food intake and eating behaviors.

And we should be most focused on an individual’s pattern, as opposed to their absolute weight or BMI. I had a teen patient not long ago who presented at the 50^th percentile BMI for age. Great, no? His doctor thought so, and was quite pleased with his healthy place on the chart. But a look at his BMI chart revealed that he had plummeted in a very short period, from a high BMI to “normal”. Unfortunately, this drop resulted from anything but normal thoughts and behaviors around food, but rather the consequence of a full-blown anorexia. And reinforcing how “healthy” his recent BMI was only added flames to the fire.

As for the adult Cupid, waist circumference, or waist to hip ratio, would likely tell me more, suggestive of abdominal fat, and associated with chronic diseases including Type 2 diabetes. A waist circumference above 35 inches (women) and 40 inches (men) it is considered a predictor of increased risk. The waist-to-hip ratio—literally, your waist measurement divided by your widest hip measurement—is also a good predictor of risk. 1.0 or above is greater risk, and desirable is 0.8 for women, 0.9 for men. See http://www.cdc.gov/healthyweight/assessing/index.html

But perhaps the best measure to use would be percent body fat (most accurately determined by underwater weighing, but indirectly measured with calipers or more high tech devices).

And yet I rarely recommend it. Why? Because we really don’t need another measure, another number to fixate on. If your weight is climbing out of range, you’ll know it. Take a look at your eating patterns, and activity. Focus on eating mindfully and separating physical hunger from all the other reasons you eat. Reread some past posts on this blog for more guidance!

And if your weight is above a “desirable” BMI, but has been stable for years, and you have normal blood pressure, cholesterol and blood sugar, let it go. As long as you can comfortably engage in activity to keep you strong and fit for years to come.

Gluten-Free Chocolate Muffins Recipe

Sexy delicious gluten-free vegan chocolate muffins.

Today's post is short and sweet and all about muffins. Not just any old muffins, either. Gluten-free chocolate muffins. Because as any gluten-free goddess knows, chocolate makes breakfast better.

Gluten-free chocolate muffins for breakfast or tea time.

GFG Chocolate Muffins Recipe

I happen to love the taste of quinoa flour. It complements chocolate perfectly. But if you're not a fan of quinoa flour's taste, substitute your own higher protein flour. Buckwheat, almond, or brown rice flour should work.

Preheat the oven to 375ºF. Line a twelve muffin tin with paper liners.

Ingredients:

1/2 cup organic quinoa flour

1 cup sorghum flour

1/4 cup GF millet flour

1/4 cup potato starch (not potato flour)

1/2 cup unsweetened cocoa powder

1 1/2 teaspoons baking powder

1/2 teaspoon baking soda

1/2 teaspoon fine sea salt

1 teaspoon xanthan gum

1/2 teaspoon nutmeg

1 cup organic light brown sugar

1/4 cup light olive oil

3/4 cup to 1 cup rice milk- start with less

1 tablespoon Ener-G Foods Egg Replacer whisked with 1/4 cup warm water till frothy*

1/4 teaspoon lemon juice or light tasting rice vinegar

Instructions:

Whisk the dry ingredients in a bowl. Add the wet ingredients. Mix until the batter is smooth- it will be slightly sticky. If it climbs the beaters use a figure eight motion to control the batter better.

If the batter is too thick, add in a little rice milk at a time until it becomes smooth- like a thick version of cake batter.

Stir in:

1/2 cup chopped pecans or walnuts (omit for nut-free)

Heaping 1/2 cup of vegan chocolate chips

Spoon the batter into twelve lined muffin cups. Swirl and smooth the tops with a wet finger if you need to. Top each muffin with a pecan, chopped walnuts, or a couple of chocolate chips, as you prefer.

Bake in the center of a hot oven until domed and firm, but springy. About 17-20 minutes. Remove the baked muffins from the pan as soon as possible and cool on a wire rack (this keeps the bottoms from steaming).

Fabulous, fabulous, fabulous warm from the oven, when the chocolate chips are melty. When cooled, I recommend wrapping each muffin in foil and freezing in a freezer bag for optimum freshness. Thaw to room temperature.

Cook time: 20 min

Yield: One dozen muffins

*Or use two large free-range organic eggs and omit the vinegar.

Recipe Source: glutenfreegoddess.blogspot.com

All images & content are copyright protected, all rights reserved. Please do not use our images or content without prior permission. Thank you. 

Weekend link lurve.

Today, I built a bird table. Ta-da!


My sister bought this in kit form about a year ago, but couldn't find anyone to assemble it for her. I live about 40 miles away and, having been a bit occupied with mum's illness & (lack of) care, didn't get around to visiting her until today. I also fault-found her Hitachi TV (which uses a cathode ray tube) and inadvertently fixed her digi-box by accidentally rebooting it!

Before I drove there, I noticed that the YouTube videos in my blog weren't playing. I don't know what went wrong, but I've had to change the embed code on all of them from the new "iframe src=" style to the older "embed src=" style and they appear to be working again.

Polyphenols, Hormesis and Disease: Part I

What are Polyphenols?
Polyphenols are a diverse class of molecules containing multiple phenol rings. They are synthesized in large amounts by plants, certain fungi and a few animals, and serve many purposes, including defense against predators/infections, defense against sunlight damage and chemical oxidation, and coloration. The color of many fruits and vegetables, such as blueberries, eggplants, red potatoes and apples comes from polyphenols. Some familiar classes of polyphenols in the diet-health literature are flavonoids, isoflavonoids, anthocyanidins, and lignins.

The Case Against Polyphenols

Many diet-health authorities seem pretty well convinced that dietary polyphenols are an important part of good health, due to their supposed antioxidant properties. In the past, I've been critical of the hypothesis. There are several reasons for it:

1. Polyphenols are often, but not always, defensive compounds that interfere with digestive processes, which is why they often taste bitter and/or astringent. Plant-eating animals including humans have evolved defensive strategies against polyphenol-rich foods, such as polyphenol-binding proteins in saliva (1).
2. Ingested polyphenols are poorly absorbed (2). The concentration in blood is low, and the concentration inside cells is probably considerably lower*. In contrast, essential antioxidant nutrients such as vitamins E and C are efficiently absorbed and retained rather than excluded from the circulation.
3. Polyphenols that manage to cross the gut barrier are rapidly degraded by the liver, just like a variety of other foreign molecules, again suggesting that the body doesn't want them hanging around (2).
4. The most visible hypothesis of how polyphenols influence health is the idea that they are antioxidants, protecting against the ravages of reactive oxygen species. While many polyphenols are effective antioxidants at high concentrations in a test tube, I don't find it very plausible that the low and transient blood concentration of polyphenols achieved by eating polyphenol-rich foods makes a meaningful contribution to that person's overall antioxidant status, when compared to the relatively high concentrations of other antioxidants in blood* (uric acid; vitamins C, E; ubiquinone) and particularly inside cells (SOD1/2, catalase, glutathione reductase, thioredoxin reductase, paraoxonase 1, etc.).
5. There are a number of studies showing that the antioxidant capacity of the blood increases after eating polyphenol-rich foods. These are often confounded by the fact that fructose (in fruit and some vegetables) and caffeine (in tea and coffee) can increase the blood level of uric acid, the blood's main water-soluble antioxidant. Drinking sugar water has the same effect (2).
6. Rodent studies showing that polyphenols improve health typically use massive doses that exceed what a person could consume eating food, and do not account for the possibility that the rodents may have been calorie restricted because their food tastes awful.

The main point is that the body does not seem to "want" polyphenols in the circulation at any appreciable level, and therefore it gets rid of them pronto. Why? I think it's because the diversity and chemical structure of polyphenols makes them potentially bioactive-- they have a high probability of altering signaling pathways and enzyme activity, in the same manner as pharmaceutical drugs. It would not be a very smart evolutionary strategy to let plants (that often don't want you eating them) take the reins on your biochemistry. Also, at high enough concentrations polyphenols can be pro-oxidants, promoting excess production of free radicals, although the biological relevance of that may be questionable due to the concentrations required.

A Reappraisal

After reading more about polyphenols, and coming to understand that the prevailing hypothesis of why they work makes no sense, I decided that the whole thing is probably bunk: at best, specific polyphenols are protective in rodents at unnaturally high doses due to some drug-like effect. But-- I kept my finger on the pulse of the field just in case, and I began to notice that more sophisticated studies were emerging almost weekly that seemed to confirm that realistic amounts of certain polyphenol-rich foods (not just massive quantities of polyphenol extract) have protective effects against a variety of health problems. There are many such studies, and I won't attempt to review them comprehensively, but here are a few I've come across:

• Dr. David Grassi and colleagues showed that polyphenol-rich chocolate lowers blood pressure, improves insulin sensitivity and lowers LDL cholesterol in hypertensive and insulin resistant volunteers when compared with white chocolate (3). Although dark chocolate is also probably richer in magnesium, copper and other nutrients than white chocolate, the study is still intriguing.
• Dr. Christine Morand and colleagues showed that drinking orange juice every day lowers blood pressure and increases vascular reactivity in overweight volunteers, an effect that they were able to specifically attribute to the polyphenol hesperidin (4).
• Dr. F. Natella and colleagues showed that red wine prevents the increase in oxidized blood lipids (fats) that occurs after consuming a meal high in oxidized and potentially oxidizable fats (5).
• Several studies have shown that hibiscus tea lowers blood pressure in people with hypertension when consumed regularly (6, 7, 8). It also happens to be delicious.
• Dr. Arpita Basu and colleagues showed that blueberries lower blood pressure and oxidized LDL in men and women with metabolic syndrome (9).
• Animal studies have generally shown similar results. Dr. Xianli Wu and colleagues showed that whole blueberries potently inhibit atherosclerosis (hardening and thickening of the arteries that can lead to a heart attack) in a susceptible strain of mice (10). This effect was associated with a higher expression level of antioxidant enzymes in the vessel walls and other tissues.

Wait a minute... let's rewind. Eating blueberries causes mice to increase the expression level of their own antioxidant enzymes?? Why would that happen if blueberry polyphenols were protecting against oxidative stress? One would expect the opposite reaction if they were. What's going on here?

In the face of this accumulating evidence, I've had to reconsider my position on polyphenols. In the process, and through conversations with knowledgeable researchers in the polyphenol field, I encountered a different hypothesis that puts the puzzle pieces together nicely.  I'll discuss that in the next post.


* Serum levels of polyphenols briefly enter the mid nM to low uM range, depending on the food (2). Compare that with the main serum antioxidants: ~200 uM for uric acid, ~100 uM for vitamin C, ~30 uM for vitamin E.