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Saturday Morning Obesity and Gut Biome Link Roundup

Spent about 12 hours offline and woke up this morning to about 250 unread emails. Everything from comment notifications, Facebook shares and comments, Tweets, etc.

So, I opened up a new post window and plugged the most interesting stuff I saw as I went through it all.

~ Science Daily: How fiber prevents diabetes, obesity

Scientists have known for the past twenty years that a fiber-rich diet protects the organism against obesity and diabetes but the mechanisms involved have so far eluded them. A French-Swedish team including researchers from CNRS, Inserm and the Université Claude Bernard Lyon 1 (Unité Inserm 855 “Nutrition et Cerveau”) has succeeded in elucidating this mechanism, which involves the intestinal flora and the ability of the intestine to produce glucose between meals. These results, published in the journal Cell on 9 January 2014, also clarify the role of the intestine and its associated microorganisms in maintaining glycaemia. They will give rise to new dietary recommendations to prevent diabetes and obesity.

Most sweet fruit and many vegetables such as salsify, cabbage or beans are rich in so-called fermentable fibers. Such fibers cannot be digested directly by the intestine but are instead fermented by intestinal bacteria into short-chain fatty acids such as propionate and butyrate, which can in fact be assimilated by our bodies. The protective effect of these fibers is well known to researchers: animals fed a fiber-rich diet become less fat and are less likely to develop diabetes than animals fed a fiber-free diet. Nevertheless, the mechanism behind this effect has until now remained a mystery.

The team headed by Gilles Mithieux, CNRS researcher in the “Nutrition et Cerveau” unit (Inserm / Université Claude Bernard Lyon 1), wondered whether this mechanism could be linked to the capacity of the intestine to produce glucose. The intestine is in fact capable of synthesizing this sugar and releasing it into the blood stream between meals and at night. However, glucose has particular properties: it is detected by the nerves in the walls of the portal vein (which collects the blood coming from the intestine), which in turn sends a nerve signal to the brain. In response, the brain triggers a range of protective effects against diabetes and obesity: the sensation of hunger fades, energy expenditure at rest is enhanced and, last but not least, the liver produces less glucose. […]

Apart from this previously unknown mechanism, this work sheds light on the role of the intestinal flora which, by fermenting dietary fiber, provides the intestine with precursors to produce glucose. It also demonstrates the importance of the intestine in the regulation of glucose in the body. Finally, these findings should make it possible to propose nutritional guidelines and to highlight new therapeutic targets for preventing or treating diabetes and obesity.

~ The Times of India: Obese people outnumber the hungry globally

NEW DELHI: There are more overweight or obese people in the developing countries, 904 million adults, than in the developed world, about 557 million. Similarly, more than 30 million overweight children live in the developing world compared to just 10 million in the developed countries. Over one out of every five person in the world is obese.

The number of obese people is close to being double the estimated number of persons going hungry to bed, over 800 million.

~ Hmm, if the obesity epidemic only began in 1979, then perhaps it was the reduction in beef consumption and increase in chicken consumption.

dh findings fig09
(source: USDA)

~ Poly Unsaturated Fat Consumption, 1909-2005

US PUFA consumption 1909 2005
US PUFA consumption 1909 2005 (source: Perfect Health Diet)

~ TED: Sandra Aamodt: Why dieting doesn’t usually work

~ Television set ownership 1975-2009

sets per home
(source: Nielsen)

~ The New York Times: Human Microbiome May Be Seeded Before Birth

We are each home to about 100 trillion bacteria, which we carry with us from birth till death. But when Juliette C. Madan was trained as a neonatologist in the mid-2000s, her teachers told her in no uncertain terms that we only acquire those bacteria after we are born. “It was clear as day, we were told, that fetuses were sterile,” she said.

Dr. Madan is now an assistant professor of pediatrics at the Geisel School of Medicine at Dartmouth, and she’s come to a decidedly different view on the matter. “I think that the tenet that healthy fetuses are sterile is insane,” she said.

Dr. Madan and a number of other researchers are now convinced mothers seed their fetuses with microbes during pregnancy. They argue that this early inoculation may be important to the long-term health of babies. And manipulating these fetal microbes could open up new ways to treat medical conditions ranging from pre-term labor to allergies.

~ LiveScience: Fat or Thin: Gut Bacteria May Play Role

Gut bacteria may be able to “spread” obesity from one organism to another when they are transplanted, at least in mice, a new study suggests.

In the study, mice that had been raised in a sterile environment, so that they lacked gut bacteria, were transplanted with gut bacteria from either a lean person or an obese person. The researchers used gut bacteria from pairs of human twins, one of whom was lean and one who was obese.

Mice that received bacteria from an obese twin gained more weight and fat than those that received bacteria from a lean twin, according to the study published today (Sept. 5) in the journal Science. [5 Ways Gut Bacteria Affect Your Health]

~ The Myth of the Robber Barons with Burt Folsom

I HIGHLY recommend Burt’s book for anyone interested in actual history that doesn’t come from 19th century newspaper editorials and political cartoons: The Myth of the Robber Barons

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More

75 Comments

  1. Jason on January 25, 2014 at 14:17

    Just switched over to cassava starch as I saw that it had similar RS content to PS and I want to test if I have a nightshade intolerance. So far in two 4 TBS doses I noticed no fartage at all like I do with PS. Also, goofing around on Pub med I came across what maybe the highest RS food out there. Mung bean; http://www.ncbi.nlm.nih.gov/pubmed/?term=mung+bean. The beauty is that it gives the same glucose response as raw RS even when cooked. Anyone else experimented with cassava or mung bean noodles?

    • Barbara on January 26, 2014 at 04:25

      The Hubster and I eat mung bean noodles frequently. Took to using them as a way to decrease exposure to wheat products. (Hubster has definite allergic responses to wheat products.) Even boiled for 10 minutes the noodles still retain an al dente type texture. And they are pretty tasty. Also use black bean noodles.

  2. rs711 on January 25, 2014 at 22:39

    The Sandra Aamodt talk on why ‘dieting’ doesn’t work is a great for wasting 12min of your life, whilst also encouraging the circle-jerk of ‘personal responsibility’ and discounting the importance of biology – have your pick,

  3. gabriella kadar on January 26, 2014 at 07:06

    You know you’re in deep when you dream about the pH changes of fecal matter resulting from consumption of raw potato starch………….

  4. Vanner on January 26, 2014 at 08:04

    Because of the colon cancer that runs in my family, I’m liking the potential benefits reported for RS. So I gave it a shot with 2-4 tbsps of Bob’s Redmill Tapioca Starch; because for some reason, I cannot find unmodified potato starch in Canadian stores (we farm potato’s for cryin’ out loud!)

    Since I tend to skip breakfast (I’m not hungry, just black coffee), I’d have a dose of TS before lunch hoping it would help with the after lunch sleepy’s. I don’t know if it’s the empty stomach or the coffee stomach, but the TS gives me a tension headache about 1/2 hr after the dose. So I tried it with dinner — no headache, which is good, didn’t really notice anything else either. I went through this experiment with 3 bags of TS.

    So I decided to try out some RS foods like cold potatos, beans, greenish bananas, even some raw oats a la Selfhacked RS Diet

    Here’s the thing, and I’m pretty sure others would agree, green banana’s taste awfully bitter; beans only taste good if they’re mixed with other foods or sugary sauce; hummus is ok, but again, mixed into a sauce; raw oats were just a colonic mistake; cold potato salad is pretty good….with mayo and eggs. There’s also a good dose of RS in whole grain products, but apparently grains aren’t good for you — I’m not a bread lover anyway.

    Clearly I’m spoiled by my first world existence.

    Hopefully I can figure out how to get more RS in the diet without headaches or bland food. Black bean soup maybe?

    • Danny Grayson on January 26, 2014 at 10:02

      Naw, grains are pretty dope. Don’t fall into the Wheat Belly/Grain Brain hype. Here’s the RS PDF https://freetheanimal.com/wp-content/uploads/2013/08/Resistant-Starch-in-Foods.pdf .
      Don’t know if pinto beans have any, but they taste great. Red lentils apparently have a ton too. You could always blend the green banana or throw something on it (sugar, peanut butter, ____)

    • gabriella kadar on January 26, 2014 at 10:04

      Vanner, I suppose if you have excellent blood glucose regulation then consuming alternative sources of resistant starch isn’t a bad idea. The point of the raw potato starch though is we are comparing the amount consumed by people living in places on this planet where resistant starch is an important part of the diet. The point of this exercise is to increase consumption of resistant starch in a neutral and benign way because the foods we usually consume are not good enough sources. (Unless you want to eat like a goat that is).

      The problem with attempting to ingest sufficient grams of resistant starch through cooked alternatives is the calories and the ease with which cooked starch spikes blood glucose levels.

      It is possible that your headaches are related to sudden low glucose levels in the blood brought on by consuming nothing but resistant starch and coffee.

      I don’t know where you live in this arctic wasteland of ours, but in Toronto it is really easy to find raw potato starch in Korean supermarkets if you can’t find Bob’s Red Mill, which I have to admit is somewhat difficult. There are healthfood stores that carry it and there are those that don’t. There are supermarkets (usually private ones) that carry it as well. Basically any supermarket or store that carries Bob’s Red Mill products will add to their order if you ask them. It’s just good customer service.

    • Joe on January 26, 2014 at 11:30

      I’m the author of that diet. I find the diet alone provides more RS than necessary from semi green bananas, legumes and cooled starches.

      @vanner
      green bananas taste horrible, semi green bananas are pretty decent. I find even when they are 95% yellow they provide quite a bit of RS.

      @gabriella
      When you consume potato starch you are filling yourself with empty calories. The RDA for potassium is 4600mg. You’d have to eat 12 bananas to get that. I eat about 1600 calories a day and all my food is potassium rich and I still don’t get enough potassium, just because of my low calorie intake. I need to supplement with 1500mg, which I’d rather not because potassium in supplements isn’t the same as the kind found in food. Using nutritionless potato starch, we are losing out on the opportunity to get potassium and other nutrients from food.

      FYI, on my starch based diet my HbA1C and fasting glucose are lower than on a paleo diet. And not only that I had a serious glucose metabolic disorder to begin with. That means if there’s anyone that would do badly on a starch-based diet it would be me. I’ll agree that potatoes do raise insulin levels a bit (even cold potatoes), but they are extremely nutritious. It’s important on a starch based diet though to eat smaller and more frequent meals.

      HbA1C= 5.1 whereas on paleo it was 5.4
      Fasting glucose =85 verses 94
      Fasting insulin is less than 2 in both diets

    • Jason on January 26, 2014 at 11:38

      I too live in Canada (west coast lower mainland) and I can find Bob’s PS easily. Another great source is to find an African Market. The tiny one I found has large bags of potato starch, cassava starch and flour, Plantain flour/fufu, and other flours/starches. They also carry 2 litre jugs of red palm oil for $15 if you like that stuff too. I find many ethnic markets like African, Korean , Caribbean carry unique items like this and usually at great prices too.

    • Kira on January 26, 2014 at 17:47

      Vanner – another Canadian source for potato starch is Bulk Barn. I don’t know how many stores they have outside of Ontario. You can buy it in bulk.

    • dpeck on January 27, 2014 at 12:28

      Vanner, I believe there was a some post in comments made by Tatertot Tim, I wanna say in October, where he used Bob’s Tapioca Starch and measured his blood glucose and it was through the roof after using Tapioca Starch. It’s supposed to have almost as RS as potato starch.

      My memory on this is kinda fuzzy, but I think it’s possible that because Cassava root apparently has a cyanide poisoning risk so they cook it to get rid of that, and I think the cooking process messes up the RS. I’m sure some recombine, but it’s got to be vastly less than potato starch.

      Another recommendation for food would be the plantain chips. Just remember to not ever let them get too hot. If I recall somewhere between 160-170 degrees is the magic number.

    • Vanner on January 27, 2014 at 19:45

      Anyone else get itchy skin experimenting with more RS in the diet? Seems odd.

      I forgot to mention some pros to the cons. The best thing out of all this is a better tolerance for digesting ALL foods — especially starches. It gave me somewhat of an iron gut while running the experiments.

      @Joe
      Thanks for the reply, I really liked that RS article you wrote up; very insightful.

      @Kira
      I did pick some PS up at the bulk barn. It is from a Kosher sources, not sure if this equates to being unmodified or not.

    • gabriella kadar on February 9, 2014 at 09:38

      Don’t know if anyone else addressed your concern about potassium. But it’s the ratio between sodium and potassium that counts. 4600mg potassium requirement reflects an intake of 2400 mg sodium (approximately). Cooked carb foods lend themselves to added salt. Potatoes are a potassium bomb, for sure. Depending on what a person eats and how much salt they add to the food, the ideal potassium intake can fluctuate. All natural foods in their natural state are high in potassium and low in sodium. (I’m sure you can find an exception like unrinsed dulse but I’m not going to nitpick here).

  5. marie on January 26, 2014 at 18:27

    A ‘secret’ my dad’s god-mother once told me : “if you crave a food in nature, eat it immediately, you need it. If you crave a food from the store, go for a swim, swing from a tree branch, play your piano and then see if you still crave it” and she winked. Of course, the unnatural craving passes as you change your mental state. The real one is the body’s call for some nutrient/s.

    Trouble is, if your gut bugs are fubar and you’re on an inflammatory diet of processed food+industrial oil +sugar that pushes you to get a hit of glucose every couple of hours, there is no healthy signaling anymore. I don’t know that ‘mindfulness’ can help in that case. It can be like smoking addiction, “listening to how your body feels” in that case means you go for another cigarette!

    I ‘reset’ out of pure luck years ago by returning to an old fasting tradition coupled to real food, but I had only been off-track for a few years. Hunger became real again and the body’s signals became trustworthy again. I’ve no idea if it would work for the majority who have been off-track for many years.
    I wonder how Sandra Aamodt learned to listen to her hunger again during that year that she mentions it took her. Sounds to me like she had a healthy hunger to begin with.

  6. Stuart on January 26, 2014 at 19:31

    Well I’m from Quebec Canada and ordered BRM PS from iherb as the local health foods stores did not stock it then after I got the PS I see BRM PS at the health foods store and notice that the package now has the french translations so I guess they wanted it to be available without any problems across the country.

    potatoes do contain relatively high amounts of potassium but I only eat smaller ones and eat a lot of vegetables normally. With 2 tbsp PS I can have a bowel movement 3X a day and the long ones can can get above the water line. I have low flush toilets and even before the PS I had to keep the toilet router in the garage in case of blockages! I’m trying for 4tbs again as the tooting was bothersome and might be near my limits.
    Joe I’m about the same as you in caloric consumption but my potassium is within a few hundred mg and sometimes can go higher but is difficult to be consistently above without some potatoes.
    been reading cooling inflammation for a while back and is quite similar ideas without a mention of mega doses of RS
    http://coolinginflammation.blogspot.com/2014/01/gut-flora-risk-and-repair.html

    I’m often at http://www.heartlifetalk.com where many have taken an interest when I passed links to FTA RS series of grounds&gas breaking works!

  7. Harriet on January 27, 2014 at 00:19

    Yesterday I took myself up to 3 tbs of PS and today have so far taken 2 tbs and this afternoon have suffered from really bad adrenaline runs – as though I was under enormous threat though I wasn’t. I still feel as though I’m going to vomit with fear as a result (after 3 hours) with emotional lability. This is NOT normal for me. I am thinking this might relate to blood sugars having to reregulate themselves but does anyone else have any other suggestions?

    • gabkad on January 28, 2014 at 01:16

      It’s hard to keep track of everyone around here, but was it you who just came back from a cruise?

  8. rs711 on January 27, 2014 at 00:32

    A good idea might be to stop for 2-3 days, then reintroduce half a tbsp every 2 days until you can up the dosage into the 3-4 range, comfortably. If you cannot do this without suffering excessive bloating, fartage, adrenal-runs or whatever after a week or 2 – then it might be wise to drop it all together. It really depends on what else is going on with you.

    Keep monitoring yourself with a blood glucose meter and you’d be doing everyone a favor if you reported back.

  9. La Frite on January 27, 2014 at 00:54

    The TED video, which is worth what it’s worth (i.e it is very personal and contextual in the end but aims at touching the viewer), makes me think of some idea of mine:

    who is going on a “diet” usually ? Westerners who feel grossed out by their body image, be it purely mental or supported by real “physical evidence”. I think that the decision to go on a diet for improving the body image to the eyes of the mind is only a surface, a pretext. What I think is beneath is a message from the body (and maybe that includes the bacterial colonies in the gut) that says: stop hurting me / yourself, you are damaging us with your eating habits / sedentarism, etc, please change. The diet will then probably proceed by elimination: It’s not so much what the diet advocates one should eat than what the diet removes from the old and harmful eating habits. The mind will decide: OK, sugar is bad, I will remove it. Wheat makes me fat and inflamed, OK, I will remove it, etc. These eliminations will consequently lead the mind to choose less problematic items to compensate for the caloric deficit to some extent (the diet can still end up hypo-caloric). Then the weight is being lost and therefore the inflammation is reduced. The “body breathes again” and the old habits can take over if the mind is satisfied. This leads to yoyo dieting.

  10. rs711 on January 27, 2014 at 01:00

    @La Frite

    Being purposely hypocaloric for a finite time in order to address a very specific ‘issue’ is one thing – being purposely hypocaloric as part of a long-term approach is by definition unsustainable and MUST be unhealthy (hypo indicating a ‘lack thereof’).

    The talk perpetuates the notion that “it’s all in your head” and that you must exercise “will power” as best you can – total BULLSHIT

    • La Frite on January 27, 2014 at 07:33

      @rs711
      If that’s what the talk is about, then I would agree. But I think it is not exactly about that but instead, she uses the term mindfulness. That is quite different: you can exercise will power with no mindfulness at all. Maintaining a calorie (or let’s say nutrient) deficit in the log run is a bad idea for sure.

      When I hear the word mindfulness, I am more thinking about WHAT and HOW you eat rather than HOW MUCH. The “how much” is secondary to me because I don’t feel the need to overeat or undereat. I eat until satisfied, and usually it does not translate into a mountain of foods or the opposite. But I am mindful of what I eat (i.e food quality, source, etc) as much as possible.

  11. Lucy S on January 27, 2014 at 05:59

    Seeing Jason’s post about switching to cassava starch, I realized that it is most likely the PS that has caused my joints to be achy lately. I usually need to limit consumption of nightshade family plants so this amount of PS has really put me over the top, I guess. Not everyone is sensitive to alkaloids.
    http://www.whfoods.com/genpage.php?tname=george&dbid=62

  12. Maria on January 27, 2014 at 09:43

    I just want to start by saying that I love your blog and some of your posts really helped me.
    I don’t have diabetes but I’ve been suffering from hypoglycemia since last year. I even passed out several times with levels like 35 and was unable to eat carbs without crashing to levels like 35, 45 min later. I also did some tests at the hospital (they don’t think reactive hypoglycemia is a real thing and only believe in diagnosis like an insulinoma – doctors here are extremely misformed). However they found out I have nocturnal hypoglycemia in the 40′s during the whole night and that I spend half of my day hypoglycemic.
    I started investigating for myself and I thought I had LADA or something like that but apparently after following the paleo diet my symptoms improved alot. In the first months the hypoglycemia started to happen at the 2h peak instead of the 45min-1h. Now I barely have it (at least during the day – I plan to see what happens at night in my next visit to the hospital – since 40 all night is very dangerous)
    I’ve been checking during the night for a week and surprisingly I didn’t see low numbers, not even close to 40. My glucometer shows numbers around 100 every single night at 2 am. I mean every single night. I started to suspect again this has something to do with diabetes after all but When I wake up around 8.am it’s always 70 or in the very low 70′s. I have to point out this happens wheter I eat LC, VLC or something like Perfect Health Diet. Do you have any idea why I have those kind of numbers now? there seems to be a dysregulation but I don’t think if that’s relevant or not and would like to have your opinion. Also, another question that really confuses me is that I’ve been eating a high protein breakfast with fat and a little bit of carbs for a couple of weeks now (not 50g of protein but fairly high protein for what I was used – usually a couple of eggs and a piece of meat or tuna) and after 1h my blood sugar is usually 110, sometimes goes up to 120. Why does this happen? should I stop eating like this? If you could help me with your opinion I would be very grateful.
    Thank you very much and sorry for my english – I’m from portugal.

    • Richard Nikoley on January 27, 2014 at 11:08

      Maria:

      I’m not doctor but I’d be far happier with BG at 110 or 120 than 40. It’s the LCers who freak out about normal physiological blood glucose.

      Protein is insulinogenic, but it looks to me like your body likes it. Id keep keeping on with good amounts of protein in your meals.

      I’d have never guessed English was your second language. You write better than a lot for whom it’s their first.

  13. Maria on January 27, 2014 at 12:34

    Thank you very much.
    That makes perfect sense, and the fact is that I feel much better on LC (using lots of oconut oil) than eating bread and carbs at every meal.
    I suppose the reading 100 at 2.am every night isn’t concerning, and the fbg of 70 regardless the kind of diet isn’t going to change.
    Also, does everybody eating LC experiences physiological insulin resistance when eating more carbs (like a couple of sweet potatoes)? I’ve read a post by Mark Sisson on that matter that it only happens to those who do VLC or keto… not LC. but from what I test on myself I think that happens to LCarbers as well. I’ve been eating 60g/70g (a piece of fruit included) and when I eat rice or two sweet potatoes my BG goes up to 190. Alternating between low carb and moderate carb on weekends is fine despite the physiological IR?

    Maria

    • Spanish Caravan on January 28, 2014 at 10:39

      Your problem is your perceptionl not BG dysregulation. Your problem is that you think BG readings of 100 at night is a problem. Or that 2h postprandials of 110-120 is a problem. You’ve been brainwashed by the low carbers who use hyperglycemia as the bugaboo to keep low carbers in compliance. These guys make up a blood sugar mafia. The chief mafiosos are the nitwit one-trick ponies like Rosedale who think that once your BG breaches 110, your beta cells burn out and you’re creeping toward diabetes. That in itself is a fantasy and is used to enforce low carb dogmas.

      Your problem is with regard to the 40-50 readings, not the above 110s or 70s. Look, 70 is not hypoglycemic, unelss you have overt symptoms. But most don’t display hypo symptoms at 70. 70 is perfectly normal. 60 is also ok as long as you have no symptoms. 40 is a problem. But it’s scarier than you sound because you caught youself at a moment, probably after a nap or a heavy meal, and is momentary; the blood-brain barrier keeps all the glucose you need from escaping, so the finger prick 40 is not equal to your brain BG at 40. I know some type 1s who sometimes tested their finger BG at 0. Yes 0. They’re still alive because their brains BG reading isn’t 0. The concept is the same as Glucose Deficiency which causes dry eyes, mouth, digestive tract and physiological insulin resistance.

      This isn’t to say 40 isn’t scary but you’re missing the whole point about BG control because you swallowed the whole low-carb dogma of these one-trick ponies hook, line and sinker.

      You have an insulin distribution problem. You may be prediabetic or were before and may have indulted in carby meals that overmobilized your insulin as a dilatory response. There is no way to properly diagnose the etiology of hypoglycemia unless you measure your fasting BG, C-Peptide or insulin. Know those levels and you may get some clue. What on earth makes you think you have LADA? Do you even know what that is?

      Your problem is obesseing over normal BG, having deluded yourself that only a narrow band of BG readings, like 80-90, is acceptable. That is complete, utter rubbish and postprandial readings above 140 are acceptable as long as they’re transitory. Your beta cells regenerate through an interplay of gut microbes and other factors; hyperglycemia is not what irreversibly destroys your beta cells.

    • Tim Malloroy on January 29, 2014 at 04:48

      After I was diagnosed with T2DM, I studied and learned all I could. I found that the research shows excursions of BG above 140 is not normal and that damage to the body when excursions above 140. BG above 140 is not acceptable. BG of up to 140 is normal and anything over is not normal.

      Fasting BG of up to 100 is fairly normal although having it lower than 100 is ideal.

      Jenny Ruhl over at Phlaunt.com has a good right up on normal blood sugar:

      http://www.phlaunt.com/diabetes/16422495.php

      If someone has excursions above 140, they likely have BG control issues and may be on the way to diabetes. However, it could must be doing LC and your body is not fully adapted to fat burning yet. Or it could be your body does not like LC.

      BG readings down to 50 is fine. Anything below 50 dangerous.

      I agree with Richard that you should not buy into the LC dogma about BG levels. I recommend you look over Jenny’s information at the link above.

      When doing LC, your fasting BG can rise and if it stays over 110 long term, there is danger of beta cell burn out. Beta cells can regenerate but that takes a long time and has never been proven in humans yet (no research I can find).

      I view VLC and LC as a therapeutic tool for losing weight and blood sugar control in those that need it (like me). I think most people need 100-125 grams carbs a day and higher as needed by activity for proper BG and weight control. And most of those carbs come from veggies and smart carbs meaning nothing heavily processed.

      Since your BG rises to 190 rice or sweet potatoes, you can drop off the LC for a fews and eat over 100 for a 3 days or more and retry. If it still rises that high when eating rice or sweet potatoes, go get a glucose tolerance test to see how you respond. You may need to limit certain types of carbs to keep your BG from rising too far.

      Doing a carb night (even I do those) can keep fasting BG from rising over 100 and staying there which is dangerous. I found research that shows it can be dangerous. Jenny’s site has more.

      One last thought on BG levels, going to 140 after eating is fine but it should start dropping and end up at fasting levels by 4 hours after eating.

      Alternating between moderate carb and low carb is fine as it has been shown to help with fasting BG and control. Just look at your 45-60 minute level after eating and if it is over 140 consistently, test based on what you eat (in other words eliminate some foods to figure out what food might be doing it). If you have gut biome issues, that could contribute to BG issues also.

    • Spanish Caravan on January 29, 2014 at 21:28

      Tim, Jenny was a pioneer when she came up with that book and set up 2 barriers, 140 after 1h and 12o after 2h as upper bounds of BG control. She has fallen behind considerably in terms of breaking research and is badly in need of catching up. You don’t think I’ve heard of Jenny?

      She knows a lot about BG control and hypoglycemia and appetite control but doesn’t know a lot about insulin sensitivity or steps to improve it. She was eating Bernstein style for a while, gave up, gained weight, developed health problems and then cancer, and is now eating about 70-100 grams of carbs.

      Her claim to fame is that she uncovered research that shows any BG breach above 110 is gonna kill off beta cells. That’s not the case. What the research shows is that beta cells may lose functionality due to prolonged hyperglycemia — the exact level is not clear but it’s probably considerably higher. But there is an interplay of other factors, FFA, gut microbiome, inflammation, etc. Losing one’s beta cell functionality is not caused unilaterally by hyperglycemia, although low-carbers would like that to be the case. Besides, beta cells can regain their functionality. Bernstein even admitted this recently.

      The low carb dogma is built on the ideology that we’re all on the diabetic continuum, that if all live long enough, we’ll all become diabetics. Similar to how GFR falls as people age and ESR rises as people age. That may not be the case, however, with beta cells: we know preciously little about them — the gastric bypass surgery and the newfangled concept of intestinal gluconeogenesis are destroying the basic premise of low carbing for diabetics. BG control has a crucial gut component and hyperglycemia is not the singular destroyer of insulin that we thought it was. There are other factors. In fact, I’ve never seen a single person become insulin sensitive on a VLC diet. Their A1c might improve but almost everyone that’s not insulin dependent can lower their A1c even further by adding 70-120 grams of carbs. You’ll stave off PIR that way but also possibly increase your C-Peptide, if it’s low, indicating depletion of pancreatic beta cells.

      If you start lowing the low-carb dogma hook, line and sinker, you see everything through the blood sugar lens. That’s why the poor poster above and umpteen low carbers are suffering from imaginary hypoglycemia. It’s called psychosomatic hypoglycemia and is due to the classic low-carb side effect of adrenal and hormone dysregulation that results when you starve your gut microbes: your heart starts racing in the middle of the night, you have anxiety attacks, your hands shake. Of course, low carbers are loath to admit that, so they’ll attribute that to “false hypoglycemia,” a spurious concept if there ever was one. FH when you’ve been low-carbing for 3 years? Like Jen, you have a lot of reading to do. I’m very fond of Jen and her contributions. But her grasp of BG isn’t as solid as you would think and she very strange and ludicrous ideas about saturated fat and carbs: she thinks the combination is lethal.

    • Richard Nikoley on January 29, 2014 at 22:58

      “the gastric bypass surgery and the newfangled concept of intestinal gluconeogenesis are destroying the basic premise of low carbing for diabetics.”

      Yep, my take exactly. Some don’t see it but from what I have seen in the results of RS in BG control, and seen my own and my wife’s and my T2 mom’s get better with gut feeding and more “safe starches,” including legumes, and the that who IGN thing, I knew LC is dead.

      Good riddance. My gloves are off with it. I decided that yesterday.

      It’s as idiotic as low fat, perhaps more so.

    • Tim Malloroy on January 30, 2014 at 06:17

      Hey Spanish Caravan, thanks for the feedback. I agree beta cells can regenerate. However, the research I have read indicates it may (researchers guess from what I could tell) years like nerve regeneration which can take years.

      I also agree with your low carb comments and the reason I mentioned that I see LC and VLC as a tool for weight loss short term and blood sugar control. However I see LC as relative to the situation where 100 g of carbs is low carb for one person and 200 may be for another. I refuse to take medications for T2DM due to the nasty side effects I get and found the RS stuff fascinating since studying gut research.

      My carb intake is around 30-45 grams a day right now not counting potato starch. Once my current n=1 experiment is done I’ll be adding tubers and beans to see how I do. My goal will still be to keep my BG 140 and under most of the time as that seems to be the norm for most people with occassional over 140 spikes. However, personnally, I think diabetics should keep their BG to 140 and below most of the time is good policy until the research bears even more fruit. If beta cell regeneration does take years, then keeping BG down to a moderate level seems to make sense. What do you think of that?

      Now that I see your comments, I just realized Jen’s info is not visible from the top the web site but only search engines.

      Nice to be schooled by someone with more info than I. 🙂

    • Spanish Caravan on February 6, 2014 at 22:24

      Look, I thought I explained the sweet spot for BG control, whether you’re diabetic prediabetic or normal, is about 80-180 grams of net carbs per diem. That’s net carbs (total carbs – fiber – 1/2 of sugar alcohol), not total carbs that some VLCing people are counting. If you wanna count every carb in an avocado, you’re way overestimating it’s glycemic load; it basically behaves like RS glycemic wise. So your 30-45g carbs is more like 20-35g if you eat some fibrous veggies, and you’re probably ketogenic. But that’s a rough guideline and depends on your weight, proteins, and activity level.

      You still don’t seem to understand why staying above ketosis and VLCing will optimize BG control. If you VLC, depending on how low you go, you will experience physiological insulin resistance; it’s a symptom of glucose deficiency, as your brain will pull glucose the same way it pulls from mucous membranes. If your FBG is 100 when you eat 25g carbs, it might be 85 when you eat 120g net carbs and escape the glucose deficient state. Sure you’ll breach 140 but as long as it’s not prolonged and you don’t go over, say 160-180, it’s not an issue, especially if you portion-control. The crux is prolonged hyperglycemia vs. momentary hyperglycemia while insulin responds. So it ends up being a complete wash. Your A1c will in theory be the same, as the peaks and troughs offset while your FBG will be continuously elevated while VLCing.

      You need to portion-control carbs if diabetic; spread them around each meal so you’re not eating more than 35-40g net carbs in one sitting. The same neurotic discipline you brought to VLCing can make you do this. Your mileage can vary depending on insulin sensitivity; if you don’t produce much insulin, it might not work, just like RS doesn’t work for the insulin-depleted. But for the vast majority, whether diabetic or not, you’ll not see your A1c go up when you add carbs judiciously. I’ve seen A1c’s go down significantly.

      If your best A1c is 5.8 with VLC, it’s time to see what 100-150 grams of good quality carbs will do to your BG control. It might go down to 5.3 or 5.0 even. Might A1c has been around 5.0-5.3 since adding 100-150g of safe starch net carbs.

    • Tim Malloroy on February 7, 2014 at 06:04

      So, Spanish Caravan, what authority (i.e. documentation, papers, etc) are you using to make your statements. You see, I am an engineer (attention to detail and all that) and want to see the evidence as I have not found a lot to back up what you state. I am not saying you are wrong — its the “pictures or it didn’t happen” situation. Jenny’s information is not all I have read — and I have read a lot. I can’t find much in support of your position so I’d like to ask respectfully for links or search terms (and where to search).

      On VLC, my fasting BG averages 85-90 and A1C is 5.3 at last check. I did have swings from high 70’s to 103 occasionally but the vast majority are in that middle range. Stating VLC and LC are dead or ketosis is insane is throwing out viable options for some people which is as dogmatic as some of the proponents (although not nearly as bad). I will admit that if I eat between 20-40 grams my fasting BG raises to 100. I have to be very VLC or LC (n=1 though and that might not apply to others).

      I have raised my carb content to 45-60 grams now and added PS which helped stabilize fasting BG quite a lot (which is the reason I cam to Free The Animal). I give many thanks for this information. I agree that eating as many high quality carbs as you can is likely the best option but it comes down to personal preference if VLC/LC works for someone.

      As an aside to Richard, you should have a page of links to research (once your book is out maybe) covering all this and more. It would help tweaks like me that need to read research papers to change their opinion. Commenters can then just point to it.

      BTW, I agree with Paul Jaminet and the perfect health diet for the most part. However, we are very adaptable animals and based on genetics and epigenetics (as well as chronic conditions and gut health) will determine if any of these techniques will work for an individual (n=1).

      Not to be long winded, but I also feel that anyone deciding to do VLC should add pre and probiotics to their regimen for gut health (I did) and eat your dang veggies people.

    • Tim Malloroy on February 8, 2014 at 05:55

      By the way, I want to clarify on the research. I’m looking for research on blood glucose control and not RS. RS research is easy to find but research on safe levels of BG is what I am having problems finding.

    • gabriella kadar on February 8, 2014 at 10:01

      Tim, if you are not overweight, never have been, are in your late 20s or early 30s, in good physical shape, then you are the best example to determine what is normal blood glucose control. You can do your own glucose curves by taking a measured amount of glucose on an empty stomach and watch over the next 5 (yes 5) hours what your body does. (Warning: it’s kind of awful but that’s really the ultimate GTT as opposed to the 3 hour GTT.) Fasting, glucose load, 5 hours… no food. I’ve done this years ago. You’ll find out if you have normal insulin response or insulin resistance or hyperinsulinemia. Glucose curves are findable on google.

  14. Gemma on January 28, 2014 at 09:51

    TEDMED 2013 speaker Larry Smarr: Can you coordinate the dance of your body’s 100 trillion microorganisms?
    http://www.tedmed.com/talks/show?id=18018&ref=about-this-talk

    That would be “our” man 🙂 to try and measure the effects of RS (history of obesity, Crohns etc, stool info geek etc)

    spoke also at TEDyYouth 2012 Sand Diego: http://www.youtube.com/watch?v=Je8YcXQhaT4#t=1085

    more here:
    http://www.theatlantic.com/magazine/archive/2012/07/the-measured-man/309018/?single_page=true

    • edster on March 15, 2014 at 23:45

      Absolutely Gemma! Another of his talks has just been published that goes into more detail than his TEDMED one. This data-driven, scientific approach is exactly what we need, not the typical “carpet bombing” approach of current medicine.
      http://youtu.be/NdkVDKWrmOQ “The Human Microbiome and the Revolution in Digital Health”

  15. rs711 on February 7, 2014 at 04:00

    @Spanish Caravan

    “If you VLC, depending on how low you go, you will experience physiological insulin resistance; it’s a symptom of glucose deficiency, as your brain will pull glucose the same way it pulls from mucous membranes”

    Are you saying that the physiological insulin resistance causes a pathological decrease in BG levels or that there is simply a decrease?

    • Grace/Dr.BG on February 8, 2014 at 15:06

      Richard~ What WONDERFUL RESULTS SO QUICKLY, eh?

      SPANISH CARAVAN~ I want a brain transplant — with yours, please?

      Spencer~
      RS is wonderful but what if your gut is empty of the zoo animals that normally thrive and live there? Our hominid ancestors have introduced at every meal, well water and every hand-to-mouth gesture the ‘bugs from the soil’ until the widespread change in hygeine and antibiotics in the last 50-100 years.

      After just one round of miraculous antibiotics, one has wiped out all of these amazing, symbiotic animals in our gut — and they never come back even in 1-2 years with typical urban living that is disconnected from soil contact (gardening, farming, eating minimally washed root vegetables).

      Just got this from Richard: WIRED ATLAS OF THE GUT ECOSYSTEM — devasting graphics of one single round of antibiotics

      Read about the benefit of the probiotics based on ancient soil organisms. I really prefer AOR Probiotic-3. Consider giving that a try first for optimal RESISTANT STARCH results and to fill the ’empty zoo cages’ in your poor poopy gut!
      http://drbganimalpharm.blogspot.jp/2013/11/how-to-cure-sibo-small-intestinal-bowel_16.html

      Grace

    • Spanish Caravan on February 8, 2014 at 12:59

      No rs, what I’m saying is that Physiological Insulin Resistatnce (PIR) results from glucose deficiency the same way mucin deficiency induces dry eyes, nostrils, colon and anemia like symptoms. They’re both ways of preserving glucose for your brain.

      When you VLC, your muscles become insulin resistant to preserve your glucose for the brain. So while your muscles are running on fatty acids, they become insulin resistant. This leaves glucose for your brain but the net result is your BG going up as you’re “physiologically” insulin resistant. There doesn’t really seem to a problem with this state, as there is with mucin deficiency; it’s not known to induce diabetes or make prediabetics diabetic. At least not according to those who advocate VLCing. I have a feeling however, that this is a disease-prone state.

      “The effects of low carbohydrate diets on insulin sensitivity depend on what is used to replace the dietary carbohydrate, and the nature of the subjects studied. Dietary carbohydrates may affect insulin action, at least in part, via alterations in plasma free fatty acids. In normal subjects a high-carbohydrate/low-GI breakfast meal reduced free fatty acids by reducing the undershoot of plasma glucose, whereas low-carbohydrate breakfasts increased postprandial free fatty acids.”

      http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10889799&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

      Why is it disease-prone? Because high serum free fatty acids are implicated in various disease states, especially immune related (and also diabetes in some cases). High serum FFA and very low trigs that we see among those who VLC are associated with nascent autoimmunity, especially rheumatic autoimmunity.

      http://www.ncbi.nlm.nih.gov/pubmed/14600656

      We’re talking about triglycerides as low as 10-20 in some of these guy who are in long-term ketosis; you can only attain those levels in long-term ketosis or in starvation. And starvation is ipso facto ketogenic, a point which most people miss. That’s why the immune related problems that people who undergo starvation apply directly to those who’re in long-term ketosis.

      Why do you think antibody-positive hypothyroidism is rampant in those who VLC? I used to think these people were hypothyroid to begin with but began VLCing to relieve their symptoms. The opposite is happening: healthy people are developing hypothyroidism (either euthyroid or later Hashimoto’s) upon going on ketosis or undertaking autoimmune protocols? Why? That’s because antithyroid antibodies like TG and TPO are markers for abnormal T-lymphocyte function. T-lymphocyte dysfunction, as I’ve mentioned elsewhere, can be induced in long-term VLCing through either thymus atrophy or starvation-like immunodeficiency. There is a correlation of something like 70% between thyroid antibodies and rheumatic autoimmunity; that’s why most people develop RA or other diseases after contracting Hashimoto’s or vice versa.

      Jaminet made a connection between mucin and stomach cancer; he should have made a larger connection between mucin, secretory igA, which is immunoglobulin A found as secretions in tears, saliva, and secretions from the gastrointestinal tract and other epithelium layers. IgA plays an important immune function and could be behind many of the immune problems being encountered by those VLC, along with obviously gut dysbiosis which eviscerates immune-aiding microbes:

      “Secretory IgA (SIgA) serves as the first line of defense in protecting the intestinal epithelium from enteric toxins and pathogenic microorganisms. Through a process known as immune exclusion, SIgA promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking their access to epithelial receptors, entrapping them in mucus, and facilitating their removal by peristaltic and mucociliary activities. In addition, SIgA functions in mucosal immunity and intestinal homeostasis through mechanisms that have only recently been revealed. In just the past several years, SIgA has been identified as having the capacity to directly quench bacterial virulence factors, influence composition of the intestinal microbiota by Fab-dependent and Fab-independent mechanisms, promote retro-transport of antigens across the intestinal epithelium to dendritic cell subsets in gut-associated lymphoid tissue, and, finally, to downregulate proinflammatory responses normally associated with the uptake of highly pathogenic bacteria and potentially allergenic antigens. This review summarizes the intrinsic biological activities now associated with SIgA and their relationships with immunity and intestinal homeostasis.”

      http://www.nature.com/mi/journal/v4/n6/full/mi201141a.html

      We keep triangulating this thing: long-term ketosis and VLCing => glucose deficiency symptoms like dry eyes, constipation, anemia symptoms, PIR + immunodeficient symptoms like unexplained food allergies, allergic rhinitis, sinusitis, respiratory infections, runny nose ==> disease state for T lymphocyte dysfunction and low immunoglobulins ==> pathogenesis of immunodeficiency + autoimmunity ==> then, and this is the reason why it’s hard to connect the dots, years down the road, clinical immunodeficiency and autoimmunity. Some people never get diagnosed because these are crypto disease states that are normally referred to specialists only when symptoms become severe. You’ll never suspect you have selectively immunodeficient; your only symptom might be a mildly runny nose, especially if you supplement with Vit D.

    • Tim Malloroy on February 8, 2014 at 13:47

      Thank you Spanish Caravan! That will give me plenty to read up on and keywords from the research and your post to dig further.

    • Richard Nikoley on February 8, 2014 at 14:23

      Spanish

      Can you expound on that last sentence, because it describes me to a T.

      I’ve pretty much always had a runny nose. Awful seasonal allergies. Paleo helped a lot (I dropped the miracle that was 2 squirts daily of Fonaise in each nostril–literally, awesome drug), but as time went one, just a bit more and a bit more.

      But, I have also always supped D, since 2008 and last I checked was about 80.

      Here’s what’s interesting, nearly a week ago I decided to try the probiotics along with RS. I dose prescript assist, AOR probiotic 3 and primal defense every morning first thing, water only on an empty stomach. 2 hours later, I chase it with PS in water. Then I eat a couple of hours after that.

      Normally I’m a hacking, coughing, gagging, sneezing and nose blowing mess first 30 minutes after I get up. Now, nearly clear as a bell, and I noticed that I haven’t taken a supplemental squirt of Afrin for mild congestion in days.

      What’s up?

    • Spencer on February 8, 2014 at 14:43

      I am experiencing these kinds of symptoms. I am normal on the scale for hypothyroid. I’ve been running tests for the past 6 months, and have come up inconclusive on what is causing a lot these problems. The only real correlation I’ve noted is that I have horrible stool, sort of what you would expect with ibs, and have a lot of allergies to normally benign foods. I haven’t yet had a test for non food allergies. I am also in the process of testing my stool for certain things. But, what I am wondering, is it possible to reverse the damage that has been done?

    • Spanish Caravan on February 8, 2014 at 15:10

      Richard, you could be immune deficient. How long was your VLCing gig? Did this arise with VLCing or was it preexisting? I said 2 years but if you’re vulnerable it could be as short as 3 months. Remember about 20 years ago, when you didn’t have that rhinitis or runny nose. Distinguish that state from when your nose runs when you eat hot, spicy foods. Were you always like that?

      I’d go see an immunologist. What you need are the foolowing:

      – CBCs w/differentials, obviously but all blood tests will carry this.
      – T− and B−Lymphocyte/Nat Killer cell counts: CD19/3/4/8s
      – IgG total and IgG subclasses (1-4)
      – Immunoglobulins A/E/G/M
      – Complements (C2/C3/C4/CH50/C1Q)
      – ANA, for obvious reasons
      – H. pylori, IgG Antibody just in case
      – C1 Function Test (if insurance covers, probably not)

      If you’re classically immunodeficient, i.e., selective immune deficiency, one of your IgGs (IgG Subclass Deficiency) and/or immunoglobulins (Selective Immunoglobulin Deficiency) will be low. If you’re grossly deficient (CVID, etc.), your total IgG will be low along with most of the components.

      You need to be referred if you don’t have symptoms. Most PCPs look for the following symptoms before approving referral:

      – frequent infections, especially recurrent upper respiratory infections, pneumonia, bronchitis, ear infections
      – sinusitis and chronically runny nose,
      – allergic rhinitis: react to allergens such as pollen, dust, animal dander, etc. when encountered by someone with a compromised immune system. Similar to hay fever but usually “sudden onset” while or after VLCing.
      – flu/mono vaccines not working
      – asthma
      – multiple drug allergies; unexplained food allergies
      – frequent skin infections, rashes, psoriasis, eczema, fungal infections, etc.

      Like I said, in may cases, and in the beginning such people are asymptomatic. You’ll never know until the disease progresses to the point where you’re severely immune compromised. IgG Subclass Deficiency could progress to CVID. You might wanna mention to your PCP that you’ve been getting frequent respiratory infections, sudden allergies to airborne particles, foods, and drugs, and that your flu/mono vaccines are not working, and that your runny nose is out of control. Most PCPs are clueless and will not refer, especially in this day and age of HMOs. Heck, you can’t even get WBC differentials these days since they’re crimping on all blood tests.

      How I would love to see the igg subclasses, immunoglobulins and ANA status of a Danny Albers, Lucas Talfur, the Eades, and Dave Asprey.

    • gabriella kadar on February 8, 2014 at 15:55

      Spanish, I know someone with CVID. Has to get immunoglobulin shots regularly. Very expensive. She says the specialist told her it’s because she was on too many antibiotics when she was a kid. ?

      Also is mentally ill. Recently had 10 sessions of electroshock. That seems to have, for now, knocked her back from suicidal depression.

    • gabriella kadar on February 8, 2014 at 16:37

      Spanish, then this is the flip side of gut biome issues in regards to vaccines:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987818/

      Again the immune system does not work properly and works better if there are prebiotics.

    • Spanish Caravan on February 8, 2014 at 19:29

      Spencer, you need to see a good immunologist. You’re just not gonna know until your blood results are in. However, the reason why I’m a little suspicious is because these symptoms are not that obvious, unless you’re in a severe state or unless such symptoms were preexisting, i.e., you may have been immune-compromised even before VLCing.

      Just to let you know, chronic diarrhea is also associated IgA deficiency:

      “Various GI diseases also are associated with IgA deficiency. These diseases often cause chronic diarrhea with or without malabsorption. Persistent and recurrent infection with Giardia lamblia, and autoimmune GI diseases (eg, celiac, ulcerative colitis, regional enteritis) must be considered and ruled out in patients with IgA deficiency and GI symptoms. Biopsy specimens may show nodular lymphoid hyperplasia with flattened villi. Conversely, selective IgA deficiency or partial deficiency is present in 2% of celiac disease patients, especially in those patients with other autoimmune diseases.”

      http://emedicine.medscape.com/article/885348-clinical

      Go see an immunologist to get your immunoglobulins, IgG subclasses, and T/B−Lymphocyte/NK cells/CD19/3/4/8s tested (see below). Those tests are crucial. Conventional blood tests will not feature such items. If you have a problem being referred, mention the symptoms below and tell them also that you’ve tested ANA positive but failed to verify what for and that you feel chronic fatigue, joint paints, etc. This may not be ethical. But to get referred these days requires being sick within an inch of your life for diseases without overt symptoms which are nonetheless very serious, which your condition might be.

    • JP on February 8, 2014 at 20:44

      Spanish Caravan, as always, your posts are very interesting and informative. Is supplementing with RS adequate while still running a moderately LC (<50 g NET per day) sufficient to avoid these problems?

      Suspect I have PIR. FBG while VLC was good for a couple of years but has recently moved to around 100 from 80. Have had cold fingers ever since VLC implemented. Most test results and body composition massively improved since VLC. Once a week I cycle in a large carb load (~300 g NET carbs) of rice and/or sweet potatoes after heavy resistance training. As an experiment, I tried a similar amount of parboiled rice that was cooled for 24 hours and lightly stirred fried; it caused lots of bloating.

      Your thoughts? Thanks very much.

    • Spanish Caravan on February 8, 2014 at 21:15

      If you have PIR, I would treat that as a symptom of glucose deficiency. Why would you have PIR? It’s because your brain needs glucose. Same with symptoms like dry eyes and dry colon. If your FBG is in the mid-80s, your brain may not be making your muscles insulin resistant. But does that mean you have enough carbs to stave off autoimmune or immune issues? Not necessarily. You could still have cold fingers and low T3.

      I think you need starchy carbs to some degree to avoid immune problems. The reason is gut dysbiosis could be independent of glucose deficiency; you could still develop it based on a diet that’s above ketosis or VLCing. The other reason is that autoimmunity and immune deficiency are not things you can reverse easily by just adding carbs. Once set in motion, these are more or less permanent states. You can be in a symptom-free state of remission but you probably can’t get rid of latent autoimmune attack that’s happening in the background. So better safe than sorry.

      If you’ve been VLCing for long, check your WBCs, FT3 and triglycerides. Those 3 are the only clues you will have regarding immunity. Supposedly a thymus atrophy (and resultant leptin deficiency) will induce low WBCs. But you can still have immune deficiency when your WBCs are low-normal. Most long-term VCLers have WBCs in the 2-4.5 range; women, much lower. Rarely have I seen such people with WBCs >= 5.5.

    • jason on February 8, 2014 at 21:46

      “Once set in motion, these are more or less permanent states” Not sure if I’m taking this out of context, but you aren’t giving much hope here.

    • JP on February 8, 2014 at 22:24

      SC, thanks for your response. Dry eyes, no. Dry colon, only occasionally.

      WBC was 4.9 most recently (doing the once a week carb load), up from 4.0 the year before (always LC). Trigs were 60 recently and 51 previously. HDLs stay between 80 and 100+. My best LDL-P numbers are when I am strict LC at 1200. Free T3 in the mid 2s. TSH in the mid 2s. I am a mid 50s aged male.

      To be clear, my FBG was mid 80s, but is now around 100. Yikes! No sugar, no grains for the last several years — never, ever. Hence the concern about PIR. I am not quite as lean as a year ago.

    • Spanish Caravan on February 8, 2014 at 22:25

      Jason, if autoimmunity was that easy to reverse, some people would have done that by now.

      We need to try something new. RS and probiotic combos could get us there. Yes, once set in motion, it might not be reversible. The reason is, how are you gonna undo those B/T memory cells that make antibodies and antigens? It’s like being vaccinated against your own tissue. We need nanotechnology to undo the damage. Or, perhaps through RS and probiotics we can impact the suspect gut microbes to do this. But which microbes? And can we isolate them? Or perhaps leptin administration?

      No one knows. So far, we’ve seen that LDN, gluten and dairy free diets, RS and probiotics are palliative. Can they be curative? Especially for autoimmunity that has progressed well-past the symptomatic stage? Possible. That’s why I’m listening to any evidence, any story that might surface regarding this.

    • Spanish Caravan on February 8, 2014 at 22:38

      That sounds more like your beta cells becoming nonfunctional than PIR. Especially if you’re consuming the same amount of carbs as before and your FBG is creeping up. Talk to you endo. He might say all T2 will become insulin dependent, eventually. It’s the insulin resistant to insulin deficient continuum; you’ll kill off beta cells eventually.

      The only way to confirm this is to test your FBG and fasting C-Peptide. If you have a baseline from before, it will tell if the lower C-Peptide is responsible for your higher FBG. It’s possible if you’re consistently in the 100s. The closer your C-Peptide is to 0.5, the harder it is to control BG through diet, even VLCing. If you’re ketogenic and your A1c is > 6.0, you need to be on insulin or insulin mimetics. The answer, I think, might have been moderate carb consumption; I’d think that would have preserved your beta cell functions better than a VLC diet. But we’ll never know.

    • jason on February 8, 2014 at 22:46

      I think you are talking only about PIR right? because: http://www.medicaldaily.com/multiple-sclerosis-diet-doctor-terry-wahls-reverses-ms-diet-alone-249419. Don’t get me wrong, I appreciate your profound knowledge here and I have been on this paleo journey for over 4 years now. Yet I still struggle with weight and hypertension. This recent RS protocol that Richard and Tim started and many others, including me, are embarking on seems so far to be helping. I guess I was just a little taken aback when it seemed you were being a debbie downer to the whole thing. I am probably reading it all wrong though. So, my bad.

    • Spanish Caravan on February 8, 2014 at 22:58

      Jason, that’s not a cure; that’s a palliative relief from autoimmunity through a diet that’s anti-inflammatory. But she’s not cured in the same sense that autoimmune attack has completely ceased. Read her story carefully. She is asymptomatic or has very little symptoms. But MS is still in the background. If we apply that same criteria to other autoimmune diseases, then we can claim that just about everyone who’s on LDN has been cured. That’s not the case. Most people still have detectable antibody levels, even if symptoms are very light or even non-existent. MS is a type of autoimmunity where there are no antibodies. So like AS, you can claim you’re “cured.”

      But you have to be more discerning. It’s like a diabetic claiming he’s cured because he’s achieving normal A1c, say 5.3, because he’s low-carbing. Well, make him take an OGTT and see if he passes. Or, take that diet away from and see if those MS symptoms do not return with a vengeance.

      That’s what’s meant by being “palliative.” Yes, gluten-free and antioxidant-rich diets are palliative; but they’re not curative. When you go through a stressful period, those symptoms will return, no matter how clean your diet is.

    • jason on February 8, 2014 at 23:28

      Thank you, that was a very clarifying response. I appreciate your patience with my asinine comments.

    • rs711 on February 9, 2014 at 02:15

      “starvation is ipso facto ketogenic” —> No. Same was as not eating for 4hrs isn’t intermittent fasting (IF), it’s simply not eating for a while – although both cases are instances where one isn’t ingesting food. So, Ketogenesis is a physiological process or state, that has many similarities to the state of starvation; the operative word being similarities, not identical. Otherwise, why distinguish these states with 2 different terms?

      People who “diet” (regardless of which one) tend to excessively & intentionally, reduce their calories and find it very unnatural to eat until truly satiated. It’s something that has to be learned – 99% of us haven’t grown up in a healthy food environment (& just a healthy environment generally).

      I don’t think “antibody-positive hypothyroidism is rampant in those who VLC” as I haven’t seen data indicating this specifically. Of course VLC doesn’t negate the possibility of an AI disease, far from it. I’m sure there will be cases where it will aggravate it – and cases where it will improve it. I’m trying to figure out the nuances, not make overarching conclusions either way as it will come back to bite me int he *ss.

      You’ve mentioned “T-lymphocyte dysfunction […] can be induced in long-term VLCing through either thymus atrophy or starvation-like immunodeficiency” but have not provided the wealth of evidence that would be reasonably expected to support such a massive claim. Throw me a bone that I can independently chew on and I’ll change my mind – just don’t expect anyone to take your word for it without verifiable data (of some sort).
      I respect Paul Jaminet tons! A connection (aka correlation) is super interesting and made me rethink a lot of my previously held beliefs – I just haven’t seen a causal factor strong enough to make me think “yep, VLCing is inherently unhealthy”.
      Ex: 10 months ago I was living in a dry, dusty apartment and I was VLC with the ‘dryness’ you describe. Paul Jaminet’s writings really hit home with me on the subject of mucin deficiency. When I came back to my hometown in France – not as dry & dusty – with very little else changing, I stopped having those ‘dryness’ issues. That STILL doesn’t he is wrong!

      The section of the nature paper you cite makes a strong case for the importance of SIgA as a “first line of defines in protecting the intestinal epithelium from enteric toxins and pathogenic microorganisms” but I fail to see how this relates DIRECTLY to levels of dietary of carbohydrate(s).

      Btw, I’m not saying carbs may not play a positive role in immunity, far from it. There are loads of established mechanisms. But it’s a whole other story entirely to then make the leap that VLCing is inherently AI disease producing.

      I’ve had allergic asthma, rhinitis and Osgood–Schlatter disease (https://en.wikipedia.org/wiki/Osgood%E2%80%93Schlatter_disease) since a kid and the latter in adolescence. Some things resolved before I changed my diet, some things improved/resolved after my diet. I’m not basing my understanding of nutrition on my n=1, but I’m also not ignoring it. I think you make interesting connections but seem quite invested in the idea that VLCing is inherently bad when there is SO MUCH EVIDENCE to suggest otherwise. The papers you cite (so far) do not address the topic in direct enough ways and the rest of what you say is based on blogosphere anecdotes. Hey, those anecdotes are interesting and useful (that’s why I’m here!) but I don’t changed my mind SOLELY based on that info.
      For example, someone discussed on FTA today gaining weight after trying a RS(potato) regimen, in addition to suffering from hypoglycaemic episodes – I didn’t suddenly tell myself “hey, what Richard is saying is actually all bullshit”. All this told me was that like 99.99% of other things in biology, your mileage will vary.

      Look – I got into this whole nutrition thing because I was absolutely smitten by Gary Taubes “Good Calories, Bad Calories” and I still think its a scientific tour de force. BUT, the more I learn, the more things I can find in his book to disagree with. So, I am in the process of reading through all the Kitavan, Tokelau, Tukisenta and other high-carb populations because these are real results and on the surface, contradict Taubes squarely. Again, science is about resolving conflict, not ignoring it.

    • rs711 on February 9, 2014 at 02:22

      @Spanish Caravan

      Bold, bold 🙂

      Doesn’t this suggest you’re inferring their health state on numbers alone?…and not on how they “look, feel & perform” to quote the great Robb Wolf? Just saying…I get what you mean and there is a lot to say from lab marker, but it’s quite clear that you’re looking to confirm your (apparent) bias towards VLC rather understand the relation between those numbers and health more clearly.

    • JP on February 9, 2014 at 08:18

      SC, thanks for your thoughts. I am consuming more carbs now (for the last year) than before, with the heaviest carb load following hard resistance training. Before that, I was VLC at all times.

      I don’t recall having a C-Peptide test; I have none of the symptoms associated with hypoglycemia. A1c generally runs < 5.0 in the high 4s. RBC levels have always run on the low side for the past couple of decades, even when I was very HC (SAD with lots of wheat products).

      It was easy for me to be ketogenic when I first switched to VLC. It seems much less prevalent now. Perhaps because of a few more carbs. Perhaps because protein intake is a little higher than necessary to be ketogenic. By ketogenic, I am referring to indicators that can be observed without a lab test (e.g., keto sticks, breath odor).

      Thanks again.

    • Justin on February 9, 2014 at 08:36

      Spanish if this advice gets me to a western MD who can actually help me..gonna owe you a big one.

    • Spanish Caravan on February 9, 2014 at 16:31

      JP, your A1c is fine. If you wanna see if there is a confounding factor related to your low RBC, have your endo check fructosamine. But you can check 1h and 2h post prandial and if they’re as usual, you have no issue. You ain’t gonna persuade any PCP or endo that you have a BG issue with a sub 5.0 A1c. Most endos rarely ever see that, especially in diabetics.

      So I don’t know what to make of your rising FBG. It could be late meals or late night snacking and the ensuing “dawn phenomenon,” common in diabetics. But check your prior labs. If you’re seeing an endo, he must have checked your fasting C-Peptide & FBG as a baseline for future checking. Check it next time and see if your insulin secretion is affected by CP being lowered. Interpreting CP and FBG is tricky; your endo wont’ give you the time and you don’t wanna be left to your own devices. Your trigs and WBCs are high for someone who VLC (if you do) and your lipids are stellar, as they normally are when people VLC. But the downside, like I’ve said, is your hormones and immunity: Ft3 is too low, about 25% below the midpoint, which is enough to trigger Raynaud-like symptoms and cold body temperature; you’re in the bottom quartile. You could, like Gabrielle, take Cytomel but I’d exhaust all options with RS if you wanna address those symptoms.

      If you have respiratory infections, conjunctivitis, allergic rhinitis, and sudden onset food allergies, go to an immunologist and ask for those lab items that I wrote up. If you have Raynaud’s and at least one immunodeficient symptom, it’s worthwhile checking to see if all your immunoglobulins and igg classes are within range. But except for FT3, your blood tests couldn’t be better. It’s what we don’t see and what do not get tested, that we’re worried about.

    • JP on February 9, 2014 at 17:34

      Thanks SC! I have a great PCP but no endo as I have never been diabetic or other obvious endo problems. My wife’s endo wants to prescribe a pill for everything. No Cytomel for me! I will get the additional tests next time.

      PCP thinks the lipids, A1C and WBC should/could be better. Wants FBG in the 80s. T3 is clearly a problem. I also need to stay as light as possible for the sports I like.

      The Raynauds is a major inconvenience as I live in and travel to cold areas. I kayak in cold water. No other symptoms or infections, however. Would more iodine help bump the T3?

      100 net carbs is definitely way, way more than I do except on the heavy workout day. I was hoping I could do RS instead.

    • Harriet on February 9, 2014 at 20:02

      I am very much hoping that my autoimmune disease might be able to be turned off again.

      After just over a month (35 days) taking PS – now on 5 tbs a day) my mild ankylosing spondylitis and mild rheumatoid arthritis that had flared up in the first days and then again in week 3 when I upped my PS from 2 tbs to 4 tbs, has now almost settled down to the pre PS level. I was really pleased this morning to have no RA pain in my fingers on waking, though its back now at its usual low level. For most of the day I’m no longer noticing my AS pain and the inflammation is only slight.

      However my immune function is not as good as I would like it. I’ve had my second cold sore on my lip in a fortnight and I’m a bit unwell – not bad, and it doesn’t effect my ability to work, but I know all is not ideal.

      I’m looking to buy the range of probiotics I’ve seen recommended on this site but I hesitate to bring them in to the country when the weather forecast is so hot as they lose some of their efficacy if they have 48 hours in 100 degree F heat whilst awaiting delivery at my end.

    • tatertot on February 9, 2014 at 21:45

      Sounds like you are doing great. Glad to hear it. I think the Prescript Assist probiotics are pretty shelf-stable, you should really get on some good probiotics!

      The website says:
      The probiotic bacteria in Prescript-Assist are unique because each cell is protected by a durable seed-like structure. As a result, they are safeguarded against light, heat and pressure. Routine testing shows that Prescript-Assist retains more than 95 percent of its potency two years after the date of manufacture, even when stored at 98°F. – See more at: http://www.prescript-assist.com/#sthash.MrY0l4D6.dpuf

    • Justin on February 10, 2014 at 06:01

      Spanish –

      Is this immunologist you speak of a real thing or a fictional character?

      I’m going to call you out on this one and find an immunologist or two in the san francisco bay area. I’ll bet you a bag of potato starch that they find my symptoms (similar to what Richard has listed) too minor too treat or even test.

      Spent many years as a kid under the care of allergists/immunologists and never got more than some skin testing and allergy shots.

  16. Ann on February 8, 2014 at 15:56

    A question for Spanish Caravan: Do you think its possible for (long term) Type 1 diabetics to overcome/”cure” their illness by rebuilding the gut (via PS + safe staches + other resistant fibre + probiotics)?

    -Oh and btw as a Type 1 diabetic myself, I, too, went low carb…actually ultra low carb (ulc) last year. During my year long stint ULC’ing my hb1ac rose, the highest was 7.7 if I remember correctly.
    Two months ago, I reintroduced 200-300g carbs daily for a few weeks, and have now settled to around ~120g carbs and at my last checkup (a week ago) my bh1ac fell down to 6.6. Amazing, considering I actually thought it’d be higher.
    I also wanted to mention, since introducing safe carbs + PS; the fungal infection that had made itself known -while ultra low carbing-has disappeared!

    • Spanish Caravan on February 8, 2014 at 18:46

      Ann, I have no idea if we can cure T1 diabetes by rebuilding the gut. I haven’t seen that being done. It might be possible down the road with RS and certain probiotic combinations that neutralize autoimmune attack. But the problem for T1 diabetes is a bit different: most other autoimmune diseases can be put into a state of remission if you take LDN, go gluten/dairy free, supplement w/RS and probiotics. However, even in remission, autoimmune attack continue, i.e., antibodies are still present. It’s just that you’re symptom free or have light symptoms.

      In T1, your beta cells have already been depleted; you need to not only put a stop to autoimmune attack but regenerate those beta cells. I believe they might be able to regain functionality if you have a sufficient number of them and you become insulin sensitive; but in your case, you may not have any beta cells that can become insulin sensitive. I’ve yet to hear anyone taking LDN regaining beta cell functionality when they have T1. I have, however, heard of people being in a state of permanent honeymoon, i.e., defuse taking insulin and live off of beta cells that are remaining indefinitely.

      Having said that, you can’t blame your 7.7 A1c on VLCing. VLCing causes lots of problems but not BG problems that high. Your problem is probably related to the misuse and deployment of insulin. 120g carbs are great and you need to distribute those carbs during the day judiciously. 30 grams per meal, if you can; put the rest to use for snacking. But if your A1c is 6.6, your BG is too high. You need to get that down to at least 5.5 range, ideally between 4.5-5.3. You’ll encounter diabetic complications at 6.6 let alone 7.7. You may need a combination of insulin and/or medications to be in that range.

  17. Jan on February 8, 2014 at 16:04

    @Dr BG I’m wondering if I can take the AOR Probiotic 3 because it has lactose in it. I don’t do well with dairy, except I’m fine with grass fed butter. Do you recommend taking it along with Prescript Assist? I am using your SIBO Steps from AP to get my gut back on track. Feeling much better! Thanks so much for all the info!

    DR BG & SC What are some good carbs/foods to include while healing and rebuilding the gut?

    • BrazilBrad on February 9, 2014 at 06:46

      @SpanishC and Richard, I did a search on Attia’s site trying to find his view on this VLC-thyroid thing. Didn’t find anything but his comment that he will be writing about it in the future. Damn. I really want to know what his take on it is given he’s been keto eating for a long time.

  18. Maria on February 9, 2014 at 05:36

    @SpanishCaravan what’s your take about Coconut oil? And for someone with poor glucose control (severe reactive hypoglycemia due to long term VLC, low fat) and auto immune disease (hashimoto’s) how many carbs should we aim for? I found out I had hashimoto’s when overweight and eating fast food frequently. I did VLC and NO fat for 1 year and that resulted in severe reactive hypoglycemia when I reintroduced carbs (specially gluten). Where should I go from here? How many gms of carbs?

    • Spanish Caravan on February 9, 2014 at 16:15

      If there is one thing VLC doesn’t trigger, it’s severe reactive hypoglycemia. Your BG is normally within a narrow band while VLCing. What’s usually taken as hypoglycemia is actually VLC side effects like heart racing, nervousness, mood swings, insomnia; it’s caused by hormone dysregulation. Unless you confirmed it with a meter, it’s probably not hypoglycemia. Having said that, VLCing is not good for either hormones or your immune health. Assuming you’re not diabetic, I would do at least 100 grams of net carbs per day. More, if you don’t have BG issues.

      If you do for some rare reason are hypoglycemic, you’ll need to distribute those carbs evenly per meal to avoid hypoglycemia, which usually follows a peak. But it probably isn’t: explain how you “did VLC and no fat for 1 year.” See what I mean?

    • JP on February 9, 2014 at 18:02

      Maria, how can you do VLC and “no fat”? The only way I can get adequate calories VLC is with lots of fat. Olive oil, butter, MCT oil, fatty fish and meats. I still eats lots of vegetables, but that’s not sufficient by itself. And why no fat?

    • rs711 on February 10, 2014 at 01:18

      @Maria

      If you were very low on the carbs (~50g/d) and very low on the fat, this means your protein intake would’ve be something ridiculous like over 75%, which is impossible (for humans). This likely means you were NOT on a VLC diet.

      Treating Hashimoto goes wwaaayyy beyond carb counting.

      Try to familiarise yourself with the basics of nutrition —> Robb Wolf, Peter @ Hyperlipid, Chris Kresser, Paul Jaminet, Phinney & Voleck, Stephan Guyenet, Mark Sisson, Stephanie Seneff, Emily Deans, Dr.Briffa & many others…these people agree on much and disagree on loads = this is GOOD.

      Basically = real whole foods, sunlight, adequate sleep & in your case (MAYBE) some meds for your Hashimoto’s. You’d be ahead of 99% of most people if you got those basics down.

      No one will give you the answers, you HAVE to learn from people smarter than you and then make up your own mind. This IS the short-cut.

      Good luck!

  19. maria on February 10, 2014 at 03:49

    @ JP @SpanishCaravan I was probably not VLC now that I think about it. Breakfast was usually cereal with skim milk. lunch and dinner just protein and salad and for snacks I would eat granola bars. (mid morning and afternoon). Sometimes would just eat soup in a meal. I was eating maybe 800 calories a day and low protein. And yes, low fat was probably the main culprit for the reactive hypoglycemia not VLC or LC. @ JP It’s not a matter of why no fat, I was dumb. I did it (3 years ago) because I wanted to lose 15kg quickly and I thought that was the healthy way to do it. Before doing it I was eating candy and chocolate every single day. I live in Portugal and I’m in my 20’s now, every doctor here is afraid of saturated fat. Like it’s going to kill you. The same way they all advice to eat 6 times a day and that was what I was doing for a year. I did in fact lose 15kg in 3 months (coming from the SAD background I can see why) but became severe metabolic dearranged. I weighted 66kg during childhood, had (still have) hashimoto’s and a very bad relationship with food. I was an emotional eater. One day I decided I was going to be skinny and healthy. When I dieted that way my weight dropped to 47 kg. My height is almost 5″7 so I became pretty much anorexic at 17% body fat – hence the amenorrhea and raynaud’s, feeling cold all the time etc. (off topic: I was scouted by some model agents at that time – ironic) When I reintroduced carbs two years ago and I started to eat normal I had severe reactive hypogylycemia 1 hour after eating. I went to several doctors and they all told me to eat carbs every 2h, they say hypoglycemia is not a real thing, doesn’t exist. I even gained weight on purpose just for anyone not to think I was not eating. Anyway I followed their advice because I thought I was going crazy and no one believed what I was saying. I knew it only happened after eating. The outcome of those advices was that I almost died ending up in the ER several times. That’s when I started reading lots and lots of books and paleo blogs and investigating for myself. I travel alot so paleo is thankfully paleo very well known in many other countries. So for me I can say paleo saved my life. I still do experiments on the level of protein and carbs etc but now I know better. My raynaud’s is 70% better. I no longer have hypoglycemia. I regained part of the weight I lost probably because of leptin issues, so I’m learning how to lose weight and maintaining the weight loss without other consequences. And of course I know I can never reverse Hashimoto’s, have it since I was 14, although my thyroid was the only thing that actually improved when I was at a lower body fat. (go figure!). I still need to lose weight for work purposes (and self confidence too not gonna lie) but I know better now. Sometimes doctors aren’t God.

    Sorry for the loooong story. Embarassing.

    • rs711 on February 10, 2014 at 05:23

      @Maria

      The doctors treating you should be embarrassed, not you.

      I hope you don’t feel “responsible” because of the emotional connection you have with food. My healthy relationship with food is not “thanks to willpower” or “merit”…I’m simply lucky biology wise.

      Have you tried a diet full organic of fatty fish & meat, mainly green leafy vegetables, a few nuts, starches & ‘least-engineered-fruit’? And then progressively reintroduce things like whole milk raw dairy (if you like that)?

  20. Joe Blowe on March 9, 2014 at 09:51

    From the NYT Opinion page:

    The Fat Drug
    By Pagan Kennedy
    March 8, 2014

    http://www.nytimes.com/2014/03/09/opinion/sunday/the-fat-drug.html

    If you walk into a farm-supply store today, you’re likely to find a bag of antibiotic powder that claims to boost the growth of poultry and livestock. That’s because decades of agricultural research has shown that antibiotics seem to flip a switch in young animals’ bodies, helping them pack on pounds. Manufacturers brag about the miraculous effects of feeding antibiotics to chicks and nursing calves. Dusty agricultural journals attest to the ways in which the drugs can act like a kind of superfood to produce cheap meat.

    But what if that meat is us? Recently, a group of medical investigators have begun to wonder whether antibiotics might cause the same growth promotion in humans. New evidence shows that America’s obesity epidemic may be connected to our high consumption of these drugs.

    Good story, but just one more smoking gun…

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