Friday, February 5, 2010

Listening To The Experts & Listening To My Body

One of the areas of health that has long been my interest is the concept of metabolism. I can recall a GP telling my Mum, when I was first getting a bit solid around my waist, that I might have a sluggish metabolism, but a thyroid issue was ruled out. So it has always been part of my understanding that my metabolism was the reason behind my weight, and never really blamed over-eating (which I didn't do - I ate the same amount as everyone else) or the foods I ate (which, thanks to Mum, were usually whole foods and sugary treats were very rare). I always understood that it was something else - like a 'fat gene' that I would often hear about.

Throughout my pursuit of information over the last 12+ months, I recognised that I was most probably insulin resistant, caused by my eating. I thought that maybe this was due to my Uni years where I lived on pasta and bread and not much else. But lately a lot of my findings have lead me to wonder whether my high-fruit diet as a child could have played a role in this. I do mean high in fruit - I would eat at least two apples per day, often the gigantic Granny Smith apples, and when in season I would consume nectarines, peaches, and mandarin oranges back-to-back. I adored grapes and would eat them by the bunch (and I loved them, despite the gut pain they ALWAYS triggered!), and we'd always have dried apricots and sultanas on hand to snack on. Fruit juice was part of almost every meal, as soft drink was banned. Not all of these items are comparably high in fructose, but the amount consumed would have potentially nullified the relevance of fructose/glucose ratios. It doesn't really matter where the fructose comes from (except potentially the use of considering fibre in the equation) - once it's in the system, it adds up. Considering that my weight issues have been consistent throughout most of my life, it made sense that, if externally triggered, they must be due to something that had been a normal part of my routine for many more years than my stint at Uni.

There is, of course, a growing understanding of the dangers of fructose, but until recently I did not understand that the problem with fructose might extend beyond the liver damage issue and blood sugar issues, etc. Richard J. Johnson, author of The Sugar Fix, explains it best:

“…we have powerful direct evidence to show that consuming too much fructose-rich sugar and HFCS causes the toxic brew of conditions known as metabolic syndrome. Moreover, this same body of research suggests that starchy foods do not induce metabolic syndrome.”

“It’s worth noting here that the glucose in starchy foods may cause blood glucose levels to rise, which stimulates the pancreas to produce insulin. But this is normal and healthy. Dietary glucose does not cause insulin resistance; fructose does.”

“And so begins a vicious cycle caused by eating high-GI foods, which overstimulate the pancreas. It’s an interesting theory, but it is not well supported by the metabolic facts. Stimulating the pancreas to produce insulin is not the problem. Your body is supposed to produce insulin when blood glucose levels rise, so that’s normal and healthy. It is insulin resistance that is closely linked to metabolic syndrome and weight gain. Glucose does not cause insulin resistance. Fructose does. Glucose does not trick your body into persistent hunger. Fructose does.”

I have also been wondering whether I may be fructose intolerant: yesterday I topped my coconut pancake with a small amount of thawed raspberries, and shortly there after my stomach swelled painfully. Today, I've noticed some intestinal issues as well. These are the same issues I used to find with excessive consumption of grapes, but perhaps I used to bloat a bit after eating all fruit high in fructose but just wasn't paying attention to it. The symptoms and details explained on the What About Fructose? of the Triglycerides-Lowering Diet ring more than a few bells.

One point that has popped up numerous times of late (not necessarily new news, just newly relevant to me) has been that starches are consumed by many peoples who do not seem to have the health issues the Western World experiences. The paradox of Asia's rice-based diet (on average) always seemed unsatisfactorily answered. But lately a variety of voices have explained this in a meaningful way, the thrust of which is that:

Glucose does not cause metabolic syndrome or insulin resistance. If you are not insulin resistant and have a high-functioning metabolism, then consumption of potatoes, corn, and rice should not be harmful as blood glucose levels are unlikely to rise as high as those levels experienced by the insulin resistant.

So, arguably, if you can get your metabolism in excellent working order and reverse the damage done by following ways of eating that combine significant amounts of fructose with other damaging behaviours, then eventually starches should not be the enemy (so long as they are not neolithic foods involving damaging factors such as phytic acid). I know that potatoes are out of bounds for me at the moment, since I have no reason to believe that my metabolism is all that great and all evidence points to continued insulin resistance, but it's interesting to think that I may not need to follow a low-carb diet forever. I already know tat the majority of paleo bloggers out there are not even slightly low-carb, and even Richard Nikoley's blog, Free The Animal, details his transition from low-carb to something more moderate, and he has not seemed to experience unpleasant results.

The main reason that I find this interesting (since I am currently happiest when on an all-meat diet) is that a number of nutrition experts have scientific reason to believe that low-carb diets - ketogenic diets in particular - are damaging in the long run. Matt Stone states effusively, in a guest post on The Fat Head Blog, that the ketogenic diet, if followed long-term is 'metabolic suicide'. His own personal experience was that low-carbing worked wonders for him for 3 years, but then his health started to reverse back to his initial state without any real change in his routine. However, the majority of experts attribute this to the process of losing weight itself - that being in caloric deficit for a significant period of time is necessarily going to encourage the body to conserve energy. This aligns with my own understanding, and I haven't seen reason to believe that the metabolism reacts any differently to a lack of dietary sugars vs. a lack of dietary fats/protein other than the insulin response itself in the short-term.

I am understanding more and more that it's not enough to simply trust that what makes you feel best in the short-term is going to work long-term. The obvious points here would be to look at consumption of alcohol, excessive sun-baking (inc. burning), using drugs recreationally, going to loud music gigs, etc etc. The less obvious practices which may well be damaging include my possibly-ruinous consumption of large amounts of fruit throughout most of my young life, and possibly my potential choice of living on an all-meat diet for longer than is my current practice. Perhaps Dr. Atkins had it right when he encouraged his patients to achieve a ketogenic state to accelerate fat-burning, but then to gradually increase the amount of carbs (in the form of vegetables, primarily) in such a way that fat loss didn't stop, but ketosis was no longer the present metabolic state. However, Dr. Kurt Harris suggests:

The paleolithic principle itself argues against LC and VLC being damaging the same way it argues against plants and all carbs as being poison. It just makes no sense, as it implies that humans in any given econiche, even one rich in a huge variety of animal foods, would have been at risk of metabolic damage from being in long term mild ketosis if they were not able to find enough starchy tubers and fruit in season. (We've agreed that grains like white rice are a recent food, I hope).

So, I am currently trying to work with both my body's response to food and the information available to me by the scientific community, and will not be consuming carbs for carbs' sake, but will be aiming to achieve ketosis in order to kick-start fat burning, and then finagle my food consumption to continue fat-burning but perhaps not be in ketosis. Alternate Day Fasting will still be part of the plan, as I want to continue this experiment, but on my feasting days I will be sticking to animal products until I achieve ketosis. Then I may add vegetables back in or take other action to keep clear of ketosis but not block fat burning... I'm not sure if this will actually be possible though, since in the past, whenever I have reincorporated carbs, I have experienced inflammation of various kinds. And as Dr. Harris puts it: Enough nonstarchy greens to choke a gorilla with an otherwise all animal diet will not keep you totally out of ketosis, I guarantee. If it did, I wouldn't want to share your bathroom. In the meantime I will be spending more time swotting up on metabolic functioning so that I can work towards overcoming insulin resistance once and for all!

Let's see how I go!

First, to catch up on the last three days:

Wednesday - Fasting
A fine day for fasting! I have really been enjoying my fasts, even though I miss out on a bit of cooking. I have been a little worried about fasting's effect on my leptin sensitivity though, since on feasting days I seem to be hungrier after eating than before... Re-restricting carbs should help that, I hope. Nuts & cheese tend to pose the most binge danger, so I'll be keeping them out of the house once more.

Dinner: It was a shockingly hot day, so we picked up a roast chicken after running off to the movies after work to hide in air-conditioned comfort. I served the chicken with a dollop of beetroot dip and a serving of anchovy paste (see my Dips post for recipes) - both were perfect with the juicy chicken!

Thursday - Feasting
I started my day with salmon sashimi (but forgot to photograph it as I was eating it whilst preparing the rest of breakfast) and a couple of coconut pancakes with some cream cheese in lieu of actual cream.

I packed up some leftover chicken for lunch, to help get me through a long night of rehearsals.

I was hungry when I finally made it home, so I whipped up some cheesy sautéed cabbage as an entree to enjoy whilst the lamb chops cooked:

Despite reaching a sufficient amount of consumed calories for the day, I was still hungry, so I made a dessert of coconut pancakes and raspberries. And even after that, with resultant stomach pain from the fruit, I still had the munchies! So I ended up snacking on nuts and a carrot, until finally locking myself away in my bedroom and tried to ignore my hunger pangs. I'm not sure if this reaction was a result of the food I had eaten or the fasting regimen... The crazy weather and extremely busy schedule at work probably didn't help!

Friday - Fasting
Another blissful fast to help alleviate the shame of over-indulgence the previous night! Despite a mad day of full-on classes and uncomfortable weather (kinda humid but cold with misty rain, but still hot inside of buildings thanks to the previous heatwave... Ick!), I didn't find myself heading toward hunger-territory until after lunch, which I washed away with some white tea.

Once home, I whipped up three eggs and a sprinkling of pizza cheese to tide me over until dinner.

And as I type, I'm grilling a couple of blade steaks for the beau & I before we head out to the theatre for the evening. I'd really just like to go to bed, but I'm an MTC subscriber and my dates are secured well ahead of time. Here's hoping it's a good show, else I may finally experience the embarrassment of falling asleep in public!


Sue said...

I'm not to sure about Matt Stone. Richard has a post about Matt making some nasty comments.

Richard had a post also about paleo/low carb working for a good number of years and then some don't feel well. Could be not getting enough iodine:

Jezwyn said...

I'm not really interested in the guy himself - I've read some of his stuff, and most of the time he seems to agree with everything else currently out there that shows the holes in Conventional Wisdom. So I don't really mind how he operates online: if we judge everyone's ideas against personality, no one would read Richard's posts, and Anthony Colpo wouldn't have helped break down the Cholesterol Myth :) Plus, Matt's comment could well have been what he thought was the truth based on Richard's notes about cold extremities and photo quality, but either way, it's not a reason to dismiss his ideas.

I chose to use Matt's recent post as an accessible reference since the other articles that have played a role in the formation of my ideas have been dense and micro-focused, whereas Matt covers almost everything to some depth there. When I get some time I might make a list of further reading at the end of this post.

I know about iodine and I get a decent amount of it, but I'm thinking of experimenting with supplements once I can find a reliable source.

I'm not about to rush out and carb up because a few metabolic experts tout it as a good way to heal the metabolism, but I will be using the primal lifestyle in a targeted way to try and rectify any remaining metabolic issues I have. I do have quite a low body temperature, for one, but then I sometimes feel a real rev of energy after eating, so who knows? Hopefully my research will teach me more about how I can assess the health of my metabolism.

Sandy said...

I've never read any of Dr. Atkins's books, but the more I hear, the more it sounds like he was actually on to something and got dismissed as a "fad" diet and has been reduced to a business. I love the people who go on Atkins, lose weight, then go back to their normal eating habits, gain all the weight back and then some, and then complain that it didn't work. They seem to forget the whole part where you add carbs back in slowly in the form of veggies until you reach your body's desired carb level (at least that's how I understand it). Kind of an important step in maintenance!

I thought I read somewhere that while Asians have been healthy on a rice-diet, as they've become more Westernized, they've started to become as fat and unhealthy as Americans. That their rice-diet is a bad match for their decreasing levels of activity. I'm wondering what your thoughts are there.

Sue said...

Jezwyn, I haven't read that much on Matt Stone's ideas so thought I would point people to that Richard Nikoley post as there may be some good comments.
I look forward to reading more from you.

Jezwyn said...

Absolutely Sandy, although I'm talking about the inverse of returning to old eating ways - sticking to the Induction (ketogenic) phase for too long. I do know of people who climbed the carb ladder again as directed and gained weight, so then stepped back down to keep the weight off, and that worked for them - but for how long? Has it damaged their metabolic rate? I'm keen to find out, although my free time is limited so it'll be in fits and starts.

From what I've seen, Asians subsisting on a tradition rice-based diet still have very good health markers, but those in the bigger cities who have the mixed SAD full of industrial oils etc are the ones whose health has understandably declined. Of course, if portions are larger than their lifestyle activity level needs, then that's not going to work well either, unless their bodies fight for homeostasis...

Sue, that's why I worry about posts that are an emotional response to a personal attack - the attacked and their friends tend to bundle the attackers ideas in with the insult in their wish to retaliate. I read through the comments on that post, and that's exactly what happened. I'm glad Dr. Eades stepped in to point that out, too (which I read after responding to you). It's sad when debate is obscured by argument - it seems like few of Richard's commenters took heed of his note describing the fact that Matt & he agree on most aspects of health.

Katelyn said...

Eating an all meat diet can be perfectly healhy. I am now almost 11 months Zero Carb and have never LOOKED and FELT better. Many tribal groups were in lifetime ketosis for the low carb of their diets. I eat beef, eggs and herbs (via tea) and believe I'm hitting all of my nutritional bases. I also use magnesium (for sleeping well), vitamin D and potassium. I do intense weightlifting and a small amount of cardio, and regularly hike and do snow-shoeing.

zero carb

Jezwyn said...

The point is, Katelyn, that thanks to evolution, some individuals physiology now may not thrive on a ZC diet.

Just because it works for you (and I reckon it works for me too), doesn't mean it woks for everyone. I've seen a lot of nutrition experts point that out to you all over the web, including Dr. Eades just recently...

The other issue I'm interested is the long-term damage argument - 11 months may not be long enough to truly know how your body is responding to a lifestyle choice. Your age may have a lot to do with this.

And the other issue that I'm noticing is that for all the low-carb traditional diets out there, even those primarily carnivorous, included large amounts of organ meat. You've probably seen Mark Sisson's recent post regarding the importance of consuming organs on ZC in order to receive adequate nutrition. I haven't looked into the science of it all, but from a purely anthropological perspective, organ consumption seems to ring true and necessary. So again, since muscle meat ZC requires you to supplement in order to receive adequate nutrition, who knows what effect long-term non-food supplementation will have?

My point is, those of us outside the field of science & nutrition are dependent on the information provided by those inside that circle, and even the insiders can't agree on what is true or false. So we pick the gurus who seem to preach the lifestyle we're trying and feel best following in the present, but what happens to us if something starts going wrong? We need to be willing to listen to everybody - not just those who agree with what our bodies tell us today.

Anonymous said...

Dr. Eades addressed the issue of rising obesity in China, and apparently the Chinese are eating more wheat and less rice:

Another China study

Midgy said...

Hi, I am new to your blog and loving your recipes! I came across this one where you mentioned being uncomfortable after having some raspberries with your coconut pancakes. Some people (like Suzanne Somers) believe you shouldn't mix fat with fruit because it will cause intestinal discomfort, so I thought maybe this is your problem - the mixing of fat and fruit and not necessarily the low amount of sugar in raspberries. She recommends eating fruit on an empty stomach.

Jezwyn said...

Hi Midgy, thanks for reading!

I don't believe in the fruit/fat interpretation - no one would put fruit in their pemmican if that were true! And I always used to eat fruit alone - I'm more likely to feel the sting from the more-sour fruits (especially grapes and raspberries) if there's nothing else in my belly. I know that, for me, too much fruit (which might not be much at all) can give me tummy aches and diarrhea. Fact of life, and maybe suggests fructose intolerance. At any rate, I don't eat fruit much!