Friday, 23 June 2017

Psoriasis: More than just skin rashes and plaques.

A complication of Psoriasis is Psoriatic arthritis. The picture below shows what can happen to the feet, toes & toenails. Mine are nowhere near that bad.
From https://en.wikipedia.org/wiki/Psoriatic_arthritis

From Signs and symptoms:
"Pain, swelling, or stiffness in one or more joints is commonly present in psoriatic arthritis.[4] Psoriatic arthritis is inflammatory, and affected joints are generally red or warm to the touch.[4] Asymmetrical oligoarthritis, defined as inflammation affecting one to four joints during the first six months of disease, is present in 70% of cases."

This is the form that I have, affecting my left shoulder, right hip & right knee, joints that have been damaged over the years. I recently reduced the pain and inflammation in these joints by doubling my intake of EPA & DHA by eating two cans/day of Tesco Mackerel in spicy sauce, instead of one.

Occasionally (when excessively high temperatures made me feel ill), my hands & feet on the left side of my body would swell, causing "sausage-fingers & sausage-toes". The reason why only the left side of my body was affected is because the heart pumps more to the left than to the right (according to my GP). One solution to this problem is to stop the heart from pumping too much when feeling ill by taking a β1 receptor antagonist (a.k.a. beta blocker) e.g. Atenolol. As this is an off-label use of Atenolol, I ordered them on-line.

I completely suppressed my skin rashes and plaques since 2007, by supplementing with 5,000iu/day of Vitamin D3, ~3g/day of EPA & DHA from Sardines/Mackerel & ~400mg/day of Mg from ~4g/day of Epsom Salts spread out over my waking hours.

However, there's this:-
"Along with the above-noted pain and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion may last for days or weeks without abatement."

I'm lucky in that the exhaustion isn't extreme, but it is significant and it coincides with a high ambient temperature.

Sunday, 4 June 2017

I'm Mackerel-powered, lol!

I was eating one can/day of Tesco Mackerel in Curry, Mexican, Thai Green & Sweet Chilli sauces:-
From https://www.tesco.com/groceries/product/search/default.aspx?searchBox=tesco%20mackerel&icid=tescohp_sws-1_tesco%20mackerel

Mackerel is very high in the long-chain omega 3 polyunsaturates EPA & DHA. It also has a strong flavour, so I get it in strongly-flavoured spicy sauces. It goes nicely with a can of Tesco Everyday Value Sweetcorn 325G

One Sunday night, I got home from the Ploughdium jam and felt hungry, so I had another can of Mackerel bringing the total to two cans that day.

The next day, I was walking to Short & Sweet coffee shop for my brunch, when I noticed that I'd lost something - the pain in my right hip! The second can had raised my intake of Mackerel-sourced omega-3 fats from an average of 3.5g to 7g! Omega-3 fats are anti-inflammatory.

I started eating two cans/day of Mackerel, to maintain the higher intake. Then I noticed my mood gradually rising...and rising...and rising.

I'm now permanently somewhat hyperthymic. See Omega-3 fatty acids and major depression: A primer for the mental health professional.

Friday, 2 June 2017

Why excessively-rapid weight loss is bad, mm-kay?

Nearly 10 years ago, I wrote Everyone is Different. Back then, I warned about excessively-rapid weight loss, as catabolising muscle results in 5.8 times faster weight loss than losing bodyfat alone.

Recently, I was directed towards the following two studies with very similar titles:-
Change in Body Composition during a Weight Loss Trial in Obese Adolescents
&
Changes in Body Composition During Weight Reduction in Obesity: Balance Studies Comparing Effects of Fasting and a Ketogenic Diet

In the first study, the following string of text stood out:- "Although absolute LM increased in boys and decreased in girls.." Boys gained absolute lean mass and girls lost absolute lean mass. Teenage boys have much higher testosterone levels than teenage girls. Ditto for men & women.

In the second study, the full version is behind a pay-wall. There are ways to bypass pay-walls, but they're illegal, so I'm not going to include a link to the full version. I took a couple of screen-shots instead.

Here's Table 2.



Note: The Patient was a 104kg (228.8lb) man.

1. 1000kcal/day mixed diet (60%C, 20%P, 20%F) resulted in a mean daily weight loss of 0.38kg/day (0.836lb/day). Mean potassium balance was positive, so there was some net gain of muscle, even though there was weight loss. Muscle, also glycogen+water gain probably explains the low average weight loss

2. 1000kcal/day ketogenic diet (4%C, 14%P, 82%F ≡ "Nutritional Ketosis") resulted in a mean daily weight loss of 0.82kg/day (1.804lb/day), of which 6.4kg was bodyfat and 0.2kg loss was LBM. Mean potassium balance was negative, so there was some net loss of muscle.

3. 0kcal/day total fast resulted in a mean daily weight loss of 1.28kg/day (2.816lb/day), of which only 3.4kg was bodyfat and 6.2kg was LBM. Mean potassium balance was very negative, so there was large net loss of muscle.

Here's Figure 1.


Can you spot what's going on with the Nutritional Ketosis diet? The 14%P made me suspicious, as it seemed unnecessarily precise. There's a reason for that!

At the end of day 4, weight loss due to glycogen+water depletion is starting to slow down as glycogen becomes exhausted, then it speeds up again because falling blood glucose level (to ~3.3mmol/L) stimulates the pituitary gland to secrete ACTH, which stimulates the adrenal cortex to secrete cortisol, which catabolises muscle into amino acids for the liver & kidneys to use for gluconeogenesis. This speeds up the rate of weight loss for 3 days.

The Energy Balance Equation explains why losing LBM results in 5.8 times faster weight loss.

From Circulating Nutrients in Starvation, here's the Figure.

"Ketone bodies" level rises linearly from near zero to 5mmol/L by day 10 in fasting. It may rise faster on Nutritional Ketosis. As ketone level rises, glucose consumption by the various tissues falls. This is why muscle catabolism stops after 3 days - there's now sufficient dietary protein to supply the amount of glucose needed, by gluconeogenesis.

This is why protein % was set to precisely 14%. If it had been lower, weight loss would have been greater, but muscle loss would have become significant, which would have made Nutritional Ketosis look bad. If it had been higher, weight loss would have been less, which would have made Nutritional Ketosis look bad.

In conclusion, don't obsess over scale weight. It's just a rough guide. The irony is that the group of people who can't easily regain lost muscle is the same group of people who often try every fad extreme weight loss diet going - females.

In females, muscle mass is like a bargain at Tesco - When it's gone, it's gone. So please don't do excessively-rapid weight loss diets and/or not eat for more than 48 hours.

There's only one safe rapid fat loss diet and it's The Protein-Sparing Modified Fast (PSMF).

Monday, 10 April 2017

Everyone is different Part 5, Vaccination.

I'm back!


I've seen various arguments from people who are against vaccinations:-

1. Vaccinated people can still catch the diseases for which they've been vaccinated, therefore vaccinations are ineffective.
2. Vaccinations can damage people.
3. Why are un-vaccinated people a threat to vaccinated people? Also, vaccinated people can shed viruses, infecting others.
4. Morbidity & mortality rates fell dramatically before vaccinations were introduced, therefore vaccinations are unnecessary.
5. Vaccines cause Autism.

1. Vaccination can't stop people from being infected by viruses. What it does is give people a much milder form of the disease so that they produce antibodies to the modified virus.

When vaccinated people are infected with full-strength infectious viruses, their bodies have a much faster immune response to them, much reducing the time taken to destroy them, much reducing morbidity & mortality and much reducing the chance of infecting many others with them. See https://en.wikipedia.org/wiki/Vaccination for more detailed information.

2. As everyone is different, some people don't produce any/enough antibodies to the modified virus and have to be re-vaccinated. Most people produce the correct response, which may make them feel mildly unwell. Some people have a bad reaction to the modified virus, which may make them very ill and in very rare cases may damage them. However, if someone is damaged by a modified virus, a full-strength virus would either damage them much more, or kill them. To minimise the risk of harm occurring, the diet should be based on minimally-processed animal & vegetable produce, not over-processed "food" products.

3. They're not. When un-vaccinated people are infected with full-strength infectious viruses, there's a period of time (the incubation period) during which they shed them and infect many other non-vaccinated people (including immunocompromised people who can't be vaccinated) before antibodies are produced and the immune system destroys them. This is why vaccination rates must be high (higher than 95%, say) in order to achieve "herd immunity", to minimise the risk of full-strength infectious viruses from rapidly spreading through dense populations or other populations due to rapid transportation.

Should modified viruses be shed during the incubation period after vaccination, it's not a problem unless they infect immunocompromised people (who would be much more adversely affected, should they be infected by full-strength viruses).

4. Yes, due to improved health care, but there was still higher morbidity & mortality due to catching full-strength viruses back then than there are now from being vaccinated with modified viruses.

5. Association cannot prove causation.
If A is associated with B, the following four scenarios are possible.
1. A caused B.
2. B caused A.
3. A and B were caused by C and/or D and/or E etc etc.
4. It's a Spurious correlation.

Randomised Control Trials (RCTs) can prove/disprove causation, but RCTs on human infants would never be approved by ethics committes. RCTs on rhesus macaques infants done instead. See Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology. Single-dose MMR vaccines haven't contained thimerosal for years, anyway!

See Vaccines and Autism: A Tale of Shifting Hypotheses. If anything....

From http://imageserve.babycenter.com/17/000/382/kkYu7RRkjL9SH22boomXMe3toF1wPiuj_lg.jpg

Disclosure: I have Asperger Syndrome (AS).

If anyone who's not white-listed wants to comment, READ THIS BEFORE COMMENTING.

Thursday, 16 June 2016

The Elephant in the Room.

On Twitter about two weeks ago, Max Roser tweeted the following graphic:
From Health and the Economy in the United States from 1750 to the Present

The plots of low & stable men's BMI's until 1945 made me think.

1. Over-refined sugars & starches entered the US food supply in ~1880. Ref: How the Mid-Victorians Worked, Ate and Died. ∴ Over-refined sugars & starches don't cause obesity.

2. Americans ate more carbohydrate per day from 1909 to 1929 than they do now. Ref: 3rd Fig. from More Thoughts on Macronutrient Trends. ∴ Carbohydrates don't cause obesity.

3. The "low-fat" dietary guidelines were issued in 1980. The two dates at which men's BMI began to increase significantly are 1945 (slow rate of increase) and 1990 (rapid rate of increase). ∴ The 1980 "low-fat" dietary guidelines didn't cause obesity.

So, what happened in the US in 1945 to make men's BMI rise slowly?
After World War 2, the economy was in a slump and something had to be done to get people to consume more, to stimulate economic growth. Corporations changed the way that they marketed to people. Instead of telling people facts about their products, they began to connect with people emotionally. It worked.

Edward Bernays pioneered the psychological tricks used by the Food Product Industry to get people to want things that they didn't need and consume more. For more information about Edward Bernays, watch The Century Of The Self Part 1 of 4 Happiness Machines.

Watch also Unreported World: Obesity in Paradise. At about 7 minutes in, a Samoan explains why they prefer to buy the more expensive imported "crap-in-a-bag/box/bottle" instead of their own inexpensive locally grown produce - they believe that local food is inferior to imported food. I wonder how that belief got into their heads?

See also How Big Business Got Brazil Hooked on Junk Food.

Once a child has adopted poor dietary habits, it's difficult to reverse them. As children are easier to manipulate than adults, there are regulations aimed at restricting marketing to children, regulations which the Food Product Industry finds ways to bypass.
A systematic review of persuasive marketing techniques to promote food to children on television.
Persuasive food marketing to children: use of cartoons and competitions in Australian commercial television advertisements.
Persuasive techniques used in television advertisements to market foods to UK children.
Weekday and weekend food advertising varies on children's television in the USA but persuasive techniques and unhealthy items still dominate.
Influence of food companies' brand mascots and entertainment companies' cartoon media characters on children's diet and health: a systematic review and research needs
Beyond Food Promotion: A Systematic Review on the Influence of the Food Industry on Obesity-Related Dietary Behaviour among Children

Chronic consumption of "crap-in-a-bag/box/bottle" foods high in sugars and fats induces insulin resistance in the hypothalamus resulting in impaired satiety, increased hunger and an increase in food consumption. Ref: The role of fatty acids in insulin resistance.


One of Edward Bernays's psychological tricks is confusing the public by promulgating conflicting information. The Tobacco Industry paid health professionals to advertise cigarettes. On the one hand, you had researchers telling people that smoking was bad for them and on the other hand you had a doctor on TV saying that he preferred to smoke Camel cigarettes. This confused the public and made them mistrust researchers & science. Another dirty trick was setting-up organisations with scientific-sounding names to promulgate conflicting reports which the press published as “science”, saying that “X” was good for you, then some time later “X” was bad for you, then some time later “X” was good for you again and so on. The public mistrusted researchers & science even more.

The recent NOF report from Malhotra et al telling people to eat more fat is conflicting information, resulting in more public confusion and more mistrust of researchers & science.

The Tobacco Industry used Bernays's psychological tricks to encourage women to smoke in public by making smoking a women's rights issue. Cigarettes were marketed to women as "Torches of Freedom". From the 1920's, women became as free as men to greatly increase their risk of getting Emphysema a.k.a. Chronic Obstructive Pulmonary Disease, Lung Cancer & Coronary Heart Disease, while the Tobacco Industry's profits increased.

By wrongly focusing on foods/macronutrients/micronutrients etc, people like Taubes, Teicholz, Malhotra et al are helping the Food Product Industry to continue their manipulation of the masses to over-consume.

So, what happened in the US in 1990 to make men's BMI rise rapidly? As total kcals/day didn't increase significantly (see 1.), something unrelated to food intake happened. See https://twitter.com/KlausKblog/status/867772729264447488  It was the Pharmaceutical Industry. See https://www.statista.com/statistics/184914/prescription-drug-expenditures-in-the-us-since-1960/

Some medications cause weight gain by increasing water retention, and they are heavily prescribed. See https://www.independent.co.uk/life-style/health-and-families/health-news/huge-weight-gains-reported-by-patients-on-prescription-drugs-5333581.html

If only more people knew about The usual suspects.

See also The cause of America's rising obesity rate is irrelevant. The cure for it is what's important.

Sunday, 17 January 2016

Supplement Alert! Carlson Labs Vitamin K2 MK-4 (Menatetrenone).



In 2003, I started supplementing with one a day of Ultra K2 Menatetrenone (MK-4) 15mg (plus 1.5g/day of Ca plus 400mg/day of Mg plus ~1,000iu/day of Vitamin D3) to reverse osteoporosis in my lumbar spine (bone density by DEXA went from -2SD to 0SD) in 3 years. I then used a maintenance dose of 15mg per week (~2,200ug per day). Everything was fine.

At some point, I switched to one a day of Vitacost Ultra Vitamin K with Advanced K2 Complex. Everything was fine.

Around 2012, I switched to one a day of Carlson Labs, Vitamin K2, 5 mg, in order to use-up my remaining iHerb rewards from the use of my discount code NIG935. I'd lost ~$300 of rewards through non-use. Everything was fine - for a while.

In ~2014, my right hip joint, which had previously caused me pain due to iliotibial band impingement on a bony/calcified outgrowth (cured when I began K2 supplementation), began to cause me pain again. As sleeping on my right side worsened the pain, I began to sleep on my left side. My GP felt my right hip joint and declared that there was some "wear & tear" in it and to use topical analgesics. This helped a bit.

In ~2015, my left shoulder joint, which had previously caused me pain due to impingement on a bony/calcified outgrowth (cured when I began K2 supplementation), began to cause me pain again. I assumed that it was "wear & tear", so I put up with it and applied topical analgesics. This helped a bit.

I recently looked-up rotator cuff pain and was perplexed to see that it was usually caused by impingement on a bony/calcified outgrowth. This of course is quite impossible, if taking 5mg/day of K2!

I took a look at the product reviews on iHerb.com, and noticed comments about joint pains from some reviewers, so I ordered a pot of Ultra K2 Menatetrenone (MK-4) 15mg.

Within a week of switching from Carlson Labs to Vitamin Research Products, my joint pains had virtually* all gone.

Therefore, there's something wrong with Carlson Labs, Vitamin K2, 5 mg. DO NOT USE!

*As the rotator cuff is damaged, there will always be some shoulder pain. As a herniated disk in my lumbar spine (before my osteoporosis was reversed) damaged nerves to/from my right leg, I walk lop-sidedly which means that there will always be some hip & knee joint pain.

Friday, 11 December 2015

In starvation or ketosis, protein should have NO EFFECT on blood glucose level, not RAISE it.

From Blood Sugar is Stable:-

In a healthy person, BG (blood glucose) is held at a fairly constant value with slowly-varying glucose inputs (except after high-GL meals, which produce rapidly-varying glucose inputs) by a NFB (negative feed-back) loop. See Blood Glucose, Insulin & Diabetes.

When protein is eaten, this produces a glucagon response from pancreatic alpha cells, which tries to raise blood glucose level by stimulating the liver to convert liver glycogen plus water to glucose. Protein also produces an insulin response from pancreatic beta cells, which tries to lower blood glucose level by a) increasing glucose uptake from the blood and b) inhibiting HPG (hepatic glucose production). The net result is no change in BG level.

In extended fasting or on VLC (very low carbohydrate)/ketogenic diets, there's no liver glycogen left after ~1 day.
The glucagon response has no effect on HGP.

The insulin response still has an effect, until physiological IR* develops.
∴ Blood glucose tries to decrease, but the HPAA keeps it steady by raising cortisol level.

RE How eating sugar & starch can lower your insulin needs: Blood glucose level on a VLC/ketogenic diet can be RAISED, due to the BG NFB HPAA (hypothalamic pituitary adrenal axis) loop not having a precise set point with the cortisol/adrenaline response (hyperglycaemia is not fatal, whereas hypoglycaemia can be fatal, as the brain always needs some glucose to function (~50%E from glucose)).

So, how come people on LCHF (low carbohydrate, high fat) diets can have normal or slightly low BG levels?

1. Luck. The BG NFB HPAA loop isn't very precise.

2. Excessive intake of Booze. Ethanol inhibits HGP (dunno about RGP (renal glucose production)).

3. Insufficient intake of Protein. This deprives the liver & kidneys of glucogenic amino acids (Alanine & Glutamine are the 2 main ones), forcing BG down and making the HPAA run open-loop and raise cortisol level. There's another source of Alanine & Glutamine available - Lean Body Mass. Uh-oh!


Consuming more protein on extended fasting or a VLC/ketogenic diet can result in higher BG level for three reasons.

1. It allows the HPAA to run closed-loop, as it's supposed to.

2. The lack of a 1st phase insulin response in people with IR/IGT/Met Syn/T2DM* results in a temporary BG level spike with the intake of rapidly-absorbed proteins e.g. whey. There's an unopposed glucagon response, until the 2nd phase insulin response begins.

See http://care.diabetesjournals.org/content/early/2015/11/29/dc15-0750.abstract

*Long-term drastic carbohydrate restriction kills the 1st phase insulin response! See http://carbsanity.blogspot.co.uk/2013/10/insulin-secretion-in-progression-of.html

P.S. This only applies to people who have sufficient liver glycogen, due to them eating some (50 to 100g/day, say) carbohydrate.

3. Hepatic Insulin Resistance results in the insulin response inadequately suppressing Hepatic Glucose Production. As 50g of protein (an 8oz steak, say) yields ~25g of glucose from glucogenic amino acids, there's an increase in the amount of glucose entering circulation, which raises BG level.

See http://bja.oxfordjournals.org/content/85/1/69.long

Friday, 4 December 2015

Low-carbohydrate High-fat diets: Green flags and Red flags.

Fun with flags. But first, a poem!
Atkins Antidote
 

Eating low carbohydrate what threat that poses?
Do my friends think I’m suffering from halitosis?
I’ve got these sticks for measuring ketoacidosis
I’m taking supplements but I don’t know what the dose is

I’m trying hard to keep in a state of ketosis
I’m not sure what the right amount of weight to lose is
I’m sure I’ve put on a pound just through osmosis
Is eating this way risking osteoporosis?

Are my kidneys wrestling with metabolic acidosis?
My store of liver glycogen I don’t know how low is
Who knows what the glycemic load of oats is?
Does anyone know if I can eat samosas?

Ian Turnbull

I do. The answer's "No!" :-D

I've had a humourless #LCHF "JERF" criticise me on Twitter for conflating Ketosis with Ketoacidosis. The eejit either didn't notice that I didn't write the poem, or did notice and was being intellectually dishonest. I suspect the latter. See Everybody knows.........Part 2. I know the difference.
From https://forum.nationstates.net/viewtopic.php?f=23&t=13567&start=8925


The Green flags... 

1. For a person with Insulin Resistance, an ad-libitum low-carb diet results in more weight loss than an ad-libitum high-carb diet.


See How low-carbohydrate diets result in more weight loss than high-carbohydrate diets for people with Insulin Resistance or Type 2 Diabetes , for an explanation.

2. For a person with Type 1 Diabetes Mellitus (T1DM), a lowish-slowish-carb (~150g/day) diet results in minimal disturbances to blood glucose levels and minimal bolus insulin doses.

See Diabetes: which are the safest carbohydrates? , to see which foods should comprise the ~150g/day.

3. For a person with LADA or MODY, see 2.

4. For a person with Type 2 Diabetes Mellitus (T2DM), a LCLF 600kcal/day Protein Sparing Modified Fast can normalise BG in 1 week and reverse T2DM in 8 weeks (provided there are sufficient surviving pancreatic beta-cells). See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/
"After 1 week of restricted energy intake, fasting plasma glucose normalised in the diabetic group (from 9.2 ± 0.4 to 5.9 ± 0.4 mmol/l; p = 0.003)." and
"Maximal insulin response became supranormal at 8 weeks (1.37 ± 0.27 vs controls 1.15 ± 0.18 nmol min−1 m−2)." See also https://www.fend-lectures.org/index.php?menu=view&id=94

After 8 weeks, the diet is changed to one based on whole, minimally-refined animal & vegetable produce.

Compare the above results with the inferior results obtained in A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes, which is 10 weeks of VLCVHF Nutritional Ketosis.


As Insulin Resistance is multi-factorial, ALL of the potential causes need to be addressed. Once this has been done, IR should be reversed, allowing restrictions on dietary carbohydrate intake to be lifted. See also Can supplements & exercise cure Type 2 diabetes?

The Red flags...

The low-carb diet is a temporary patch to ameliorate IR/IGT/Met Syn/T2DM, a bit like replacing a blown fuse by sticking a nail in its place, to allow the house to function while you fix the problem by fitting a new fuse. Although a house functions with a nail instead of a fuse, it's not a good idea to spend the rest of your life without a fuse to protect the house from fire in the event of a short-circuit.

So, why do low-carbers seem to want to spend the rest of their lives using a temporary patch to ameliorate their IR/IGT/Met Syn/T2DM?

Long-term use of very-low-carb, very-high-fat, low protein diets is not recommended.

1. Cortisol & adrenaline levels increase due to insufficient glucose production from dietary protein, resulting in gradually-increasing fasting BG level. See How eating sugar & starch can lower your insulin needs and Survival of the Smartest (part 2) - Dr Diana Schwarzbein.

2. If you do too much high-intensity exercise, you may momentarily black-out, fall and hurt yourself. See "Funny turns": What they aren't and what they might be.

3. Some people seem to gradually go bat-shit crazy. See Can very-low-carb diets impair your mental faculties? Read the comments in https://www.facebook.com/TheFatEmperor/posts/1633434020253792. Do the behaviours of Ivor Cummins & Gearóid Ó Laoi seem normal to you?

4. Insulin Resistance is bad, mmm-kay? See Lifestyle-induced metabolic inflexibility and accelerated ageing syndrome: insulin resistance, friend or foe?

5. Insulin Resistance causes carbohydrate intolerance AND fat intolerance, resulting in high postprandial glucose AND high postprandial TG. See Postprandial lipoprotein clearance in type 2 diabetes: fenofibrate effects.

6. Dyseverything elseaemia isn't addressed. See Type 2 diabetes: between a rock and a hard place , Type 2 diabetes: your good signalling's gonna go bad and When the only tool in the box is a hammer.

7. Dietary deficiencies may develop. See Rigid diets & taking loadsa supplements to compensate for them.

8. High-fat diets with no energy deficit result in high postprandial TG's. Postprandial lipaemia is atherogenic. See Ultra-high-fat (~80%) diets: The good, the bad and the ugly.

9. Permanently-high NEFAs (a.k.a. FFAs). See  Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, very-low-carbohydrate diet. This raises the RR for Sudden Cardiac Death.

There may be more but I'm knackered, so I'm Publishing!

Saturday, 28 November 2015

Doctor in the House – Watch Diabetes Not Being Reversed Using Low Carb on BBC, While LCHF'ers Freak Out.

This post is about Doctor in the House – Watch Diabetes Reversed Using Low Carb on BBC, While Old-School Dietitians Freak Out.
The YouTube videos may be gone, but the image lives on!
Available to view in the UK on iPlayer 'till 19.12.15 at http://www.bbc.co.uk/iplayer/episode/b06q6y95/doctor-in-the-house-episode-1

In Dr. Eenfeldt's blog post, he makes some schoolboy errors.

1. T2DM (type 2 diabetes mellitus) Reversed with LCHF (low-carb, high-fat) diet. Uh, nope!
a) Sandeep's HbA1c fell from 9.0 to 7.0, which is an improvement but by no means a reversal, as Dr. Chatterjee agrees in https://twitter.com/drchatterjeeuk/status/669875378568171520.
b) Sandeep has T2DM, not T1DM. See When the only tool in the box is a hammer...
Sandeep's BG (blood glucose) went down on LCHF, but what about his dyseverything elseaemia? *sound of crickets chirping*

2. Old-school dietitians freak out. Uh, nope!
In BDA alarmed by controversial and potentially dangerous advice in BBC’s ‘Doctor in the House’, Dr. Duane Mellor sounds pretty cool, calm & collected (though I expect that he sustained injuries from all of the eyeball rolling, as he had to refute for the umpteenth time yet another load of LCHF bullshit).

3. He plays the Shill Gambit card.

Oh, the comments! In typical echo-chamber fashion, LCHF commenters praise Eenfeldt's flawed points. I wonder how long my comment will stay up for?

My comments on the programme (c/p'ed from Facebook):-
"6 minutes in. I think that Priti is deficient in Magnesium (Mg), from her stress levels, anxiety, headaches and difficulty in getting to sleep. Blood tests are useless, as they don't correlate with Mg stores. Need CSF (cerebrospinal fluid) test (lumbar puncture - very painful).

12 minutes in. Priti's blood test results normal. Sandeep has hypovitaminosis D, which is a cause of IR (insulin resistance, it's what caused mine). This important fact is not mentioned. unsure emoticon See http://www.ajcn.org/content/79/5/820.full.pdf

16 minutes in. Talked about sugar in foods & drinks but ignored the large amount of cheese that Sandeep ate earlier. Cheese is *very* energy-dense. Sandeep has been in positive Energy Balance for *way* too long.

24 minutes in. Priti's getting sugar cravings in the morning. Lack of Magnesium also causes IR & poor BG regulation. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549665/

29 minutes in. HIIT (high-intensity interval training) for Sandeep is good for increasing his IS, but little use for reducing his VAT (visceral adipose tissue). You can't out-run your fork.

33 minutes in. Walking for Priti to lose weight? You can't out-walk your fork. If 1,000 steps takes 10 minutes and burns an extra 40kcals, then 10,000 steps takes 100 minutes and burns an extra 400kcals = one chocolate bar.

33:47 minutes in. Sareena has had a full-time job working indoors for the last year. Less sun exposure = falling Vitamin D3 level = deteriorating immune system, deteriorating mood & deteriorating IS. See http://nigeepoo.blogspot.co.uk/2008/12/vitamin-d.html

I don't think that I can watch much more of this programme!"

followed by:-
"In conclusion:-
1. Anyone who suffers from chronic anxiety is probably deficient in Mg.

2. Anyone who lives in the UK (United Kingdom :-D) and has coloured skin and/or works indoors is probably deficient in Vitamin D3.

3. ~85% of people who have T2DM have excessive VAT. Asians who were skinny in early adulthood have limited SAT (sub-cutaneous adipose tissue) hyperplasia, resulting in small skin-folds but large bellies. A LCHF diet is not suitable for over-fat people with T2DM. It should be a LCLF diet i.e. a low-calorie diet, to deplete over-full cells. Calories count.

4. You can't out-walk/run your fork.

5. Dr Chatterjee has a strong bias. This is not a good trait for someone who's supposed to be practising Evidence Based Medicine."

It's interesting that Priti is fatter than Sandeep, yet Priti doesn't have T2DM and Sandeep does. Priti was most likely fatter than Sandeep in their respective childhoods, for whatever reasons. Priti had more SAT hyperplasia than Sandeep, so she has more storage capacity for dietary fat than Sandeep does. Priti can gain more SAT, which protects her from developing T2DM. Sandeep can't, so he gains VAT, which has limited storage capacity and is more metabolically-active than SAT.

See also Adipocyte Hyperplasia - Good or Bad? and A *very* special dual-fuel car analogy for the human body that I just invented.

Saturday, 7 November 2015

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 4.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

"You tend to get what you accept" Tillerman (don't ask). The following music video sums it up.


If you give someone an inch, they'll take a mile. Why do people put up with the following piss-takes?


If you accept crap, you get crap. Therefore, insist on non-crap.

I used to think that I couldn't do certain things, e.g. perform in public, due to extreme shyness.
Now I do things like this...


Almost anything is possible, if you put your mind to it.

FIN.

Friday, 6 November 2015

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.
 
Derren Brown shows how easy it is to manipulate your thoughts, by the use of subliminal images.


I may have mentioned it somewhere on this blog, but everyone is different. The reactions of the kids in the "I ate all your Halloween candy" video in the previous blog post varied from total melt-downs, through feigned deaths, through tears, to "That's all right!". Candy/sweets have different importance to different people and people's suggestibility varies from "Very easy to manipulate" to "Very hard to manipulate".

There's engineering of foods to be as moreish as possible. "The trouble is, they taste too good!" (Crunchy Nut Cornflakes), "Bet you can't eat just one!" (some savoury snack made from refined starch, salt & flavourings) and "Once you pop, you can't stop!" (Pringles). As Harry Hill once said "The problem with heroin is, it's rather moreish!" Although addiction to pure table sugar isn't a thing, addiction to hyperpalatable foods is a thing (which can be reduced by Naltrexone). See Food cravings engineered by industry and Sugar addiction: pushing the drug-sugar analogy to the limit.

Then there's the incessant marketing, including direct adverts, sponsorships, product placements, celebrity endorsements, tie-ins etc. See The Money Spent Selling Sugar to Americans Is Staggering and It’s Not Your Imagination: Celebrities Hawk Pretty Much Only Junk Food.

Then there's the bribery lobbying of government to:-
1. Water-down Dietary Guidelines so that crap-in-a-bag/box/bottle (CIAB) meets them. As people get fatter and sicker, the Guidelines and the government get the blame.
2. Subsidise the ingredients of CIAB so that it's cheaper than produce.

Then there's corruption of science e.g. getting doctors to advertise cigarettes years ago. Organisations with vested interests are created, to promulgate conflicting dietary information. Is it any wonder that the public distrust science and scientists?

Edward Bernays' manipulation techniques have worked exceedingly well. If you're too fat and someone says to you "Nobody made you over-consume that crap", point out the above.

What can you do? You can't sue Food Product manufacturers, as their products don't immediately harm you. See How Ultra-Processed Foods Are Killing Us. Hit them where it hurts i.e. in their bank accounts, by eschewing CIAB and basing your diet on whole, minimally-refined animal and vegetable produce. CIAB should be treat foods, not staple foods.

Finally, here's a nice video on how to form good habits for life.


Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 4.

Thursday, 5 November 2015

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Remember the video "YouTube Challenge - I Told My Kids I Ate All Their Halloween Candy 2015"?


Some of those kids reacted as if their life had just come to an end!

Disclaimer: I don't know anything about psychotherapy, so I don't know how accurate the information is in Hypoglycemia and Neurosis.

Please don't pacify crying babies/toddlers/children with sugary crap.

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

Wednesday, 4 November 2015

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Cont'd from Public Service Announcement: Calling all Low-carb, Low-fat and Veg*n advocates.

I feel a music video coming on! It's Not Safe For Work!


Start of clarification.
I've noticed some confusion over the term "Crap-in-a-bag/box/bottle" (CIAB). My previous post received the following comment, which I'll annotate.
"Is highly processed the problem? Yes.
Tinned tomatoes are processed, what's wrong with including those in your diet. Nothing, other than the fact that they're too salty for me if they're tinned in brine.
What about low sugar baked beans? Nothing, other than the fact that they're too salty for me.
What's wrong with a burger if all it is, is minced beef? Nothing.
Other processed food:
Smoked mackerel Fine.
Frozen peas Fine.
Milled porridge oats Fine.
Parma ham Fine.
Cheese Fine.
Nitrate free bacon Fine.
Prunes Fine.
Almond butter Too calorie-dense & moreish for me.
Filtered milk Fine.
Low sugar jam Fine.
Roasted chestnuts Fine.
Haggis Fine. I think."

CIAB is stuff like French fries/chips, chips/crisps, "fast food", take-aways, pizzas, biscuits/cookies, chocolate, sweets/candy, sugar-sweetened beverages, sugary cereals etc.
End of clarification.

In How to lose weight and get slim by eating "fast food" for 180 days. I showed that it's possible to be healthy on a diet of fast food, if you have a plan and you stick to it. The vast majority of people who eat fast food don't have a plan!

Between the ages of 5 & 8, I spent my 12d/week (that's 5p/week, for those of you who are too young to remember £,s,d.) on sweets. Aniseed balls were 4 for 1d. I also ate French Fancies (small sponge cakes covered in fondant icing) and drank Corona Lemonade (~15% sugar content) at home.

How did I get such a ferocious sweet tooth? Here's the probable answer:- Farley's Rusks.

Look at the health-washing on the Heinz web-site.
"Farley’s Rusks have been loved by mums and babies for generations. Each rusk is lovingly baked using baby grade ingredients."

Let's take a look at the baby grade ingredients:-
"Wheat Flour, Sugar, Palm Oil, Raising Agents (Ammonium Carbonates), Calcium Carbonate, Emulsifier (Monoglycerides), Niacin, Iron, Thiamin, Riboflavin, Vitamin A, Vitamin D."

The first three ingredients are refined starch, refined sugar and refined fat. The refined sugar content is 29% by weight. Perfect food for a baby! The previous sentence may contain traces of sarcasm.

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.

Tuesday, 3 November 2015

Public Service Announcement: Calling all Low-carb, Low-fat and Veg*n advocates.

Cont'd from The cause of America's rising obesity rate is irrelevant. The cure for it is what's important.

While you're rearranging the deckchairs by squabbling over which diet is best...
From http://www.britishtitanicsociety.com/titanic-story-gallery/tragedy/

People are getting fatter and sicker in increasing numbers around the world, due to increasing numbers of people eating a diet based on crap-in-a-bag/box/bottle. Would switching back to a diet based on whole, minimally-processed produce not be an improvement?

So, why don't you all agree to say the same thing, like:-

Base your diet on whole, minimally-processed produce, rather than products. Tweak it to suit.

While you're wasting time shouting each other down, the manufacturers of crap-in-a-bag/box/bottle are laughing all the way to the bank. :-/

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Monday, 2 November 2015

The cause of America's rising obesity rate is irrelevant. The cure for it is what's important.

NuSi go home. You're drunk!
From http://dietdatabase.com/causes-of-obesity/

On a blog comments section somewhere, a argument discussion took place about what caused America's rising obesity rate. Some people have a hypothesis that there's one main cause. Reductionism of an extremely complex problem down to one main factor is utter stupidity. Here's a rough list, in no particular order:-
Excessive Carbohydrates (Gary Taubes)
Excessive Refined Sugar (John Yudkin. Robert Lustig, Gary Taubes)
Excessive Refined Fructose (Robert Lustig)
Excessive Wheat/Gluten Grains (William Davis)
Excessive Fat (Dean Ornish, Cardwell Esseltyn etc)
Excessive Saturated Fat (Dean Ornish, Cardwell Esseltyn etc)
Excessive Animal Protein (Garth Davis)
Mineral Imbalances (Jane Karlsson, "Duck Dodgers")
The Government (Richard Nikoley)
Dietary Guidelines (Nina Teicholz, Aseem Malhotra et al)
Insufficient protein (Ignatius Brady)

It's not Refined Sugar. Sorry, John Yudkin & Robert Lustig. See below...
Refined Sugar intake (kcal/capita/day) is higher in France than in the USA, but in France there's a lower obesity rate. ∴ Hypothesis disproved*.

*As the Refined Sugar intake data may be unreliable (it's also associational data), the hypothesis is not necessarily disproved. If only there's an interventional study (which proves causation) which results in lower weight on a higher sugar/fructose intake. There is! See The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial. ∴ Hypothesis disproved.

I asked Duck Dodgers what he wanted to happen. He said:-
"My feeling is that if people recognize that enriched foods are the antithesis of whole foods, then the demand for enriched/refined foods may diminish, forcing the industry to change."

I want people to eschew over-refined food products for produce, too. So all of the arguing about what caused America's rising obesity rate was a complete waste of time. This gave me an idea. I decided to run my idea past someone who deals with obese people with T2DM and who just happened to be in the U.K, attending the Health Unplugged Conference, I PM'ed Dr. Jeffrey Gerber on Facebook, inviting him to meet me at Cafe Class in Woking (a location roughly half-way between my home and London).

So this happened...
Ivor Cummins came, too!

Suffice it to say, the afternoon was a blast!

Cont'd on Public Service Announcement: Calling all Low-carb, Low-fat and Veg*n advocates.

Friday, 30 October 2015

A treatment for epilepsy that's as cheap as chips and not a ketogenic diet.

I did some research on PubMed about epilepsy and found something unexpected.
From https://en.wikipedia.org/wiki/Magnesium_sulfate

The art of magnesium transport.
"Patients with hypomagnesemia suffer from a wide range of symptoms including muscle cramps, cardiac arrhythmias and epilepsy."

See also Magnesium: Just as important as Calcium , The usual suspects and Depression: The similarity between magnesium and ketamine.

Failure to communicate: How to fix it.

First, a video. I used this video about two and a half years ago.


We communicate with each other verbally and non-verbally. To maintain a reasonable rate of information flow from talker to listener, non-verbal handshaking from listener to talker is used for flow-control.

Unfortunately, people with an Autism Spectrum Disorder (ASD) like me (I was officially diagnosed as having an ASD, yesterday) can't detect non-verbal handshaking, resulting in failure to communicate. Body-language = Double-Dutch. This is confusing and upsetting for all concerned, because neither the talker nor the listener understand what's going on.

A talker with an ASD thinks "Why won't they listen to me?". "Why are they walking away?", while a listener without an ASD thinks "Why do they keep on talking when I'm giving clear signs that they should stop?".

Like SkyNet, I have become self-aware. Now that I am aware of this problem, I can fix it. Here's the solution. If you're having a conversation with someone, and they don't stop talking when you're giving clear signs that they should stop, do the following:-
From http://365thingsiloveaboutfrance.com/tag/french-hand-gestures/

Oh, look. The French already do it. From the above site:-
"Chut! / Silence!

When you want some one to shut up or fermez-la, you can hold up your index finger in the air (not in front of your lips), and give a severe look to the people disturbing you. French teachers use this gesture frequently."

Please don't give us a severe look. We don't do it on purpose to annoy you. We can't help it. TIA. :-)

Tuesday, 27 October 2015

Both Sides Now: Asperger's.

Continued from Both Sides Now: Nerds!
From http://quotes.lifehack.org/quote/bill-gates/be-nice-to-nerds-chances-are-youll/

A couple of years ago, a psychologist that I was chatting to at a party told me that she thought I had Asperger's. I wasn't upset. I was actually rather relieved, as it explained everything. Since then, several more people, who work for "Disability Challengers", working with children with severe ASDs (Autism Spectrum Disorders) have told me much the same thing.

Here's everything(ish)
A preference for reading science books rather than being with people.
A desire to take things apart and put them back together again (sometimes failing at the latter!) to see how they worked.
Being known as "Professor" at school, as I could chatter away about science facts for hours.
Sucking at forming relationships with women. Logic & emotion mixed like oil & water.
Becoming an Electronic Engineer rather than a Doctor, as it meant working with objects rather than people.
Focussing on a task for hours e.g. Researching, producing new blog posts and updating old ones.
Obsessive behaviour in certain areas.
Loving routine.
Hating change.
Difficulty with communicating facts to people e.g. having a "hectoring" tone.
Offending people without realising it by speaking bluntly or interacting with them in a very logical way, and then failing to recognise their body language shouting "Stop talking!", "Go away!", "Why did you do that?", "I'm offended!" etc at me.

In January 2015, after a series of failed relationship attempts, I asked my GP for a referral to an ASD clinic. After a wait of 10 months, I've got an appointment to see an ASD specialist at the end of this month.

Knowing that I would be seen by a specialist made me more self-aware and I started to push myself into doing things that would normally scare the crap out of me e.g. Approaching a complete stranger in a pub, introducing myself and engaging them in meaningful conversation.

So, I know that there's a monkey on my back and I know what it's getting up to an increasing proportion of the time. Bear with, bear with!

By the way, the computer/smart-phone that you're using to read this post was invented/designed/developed by people like me! Ditto, the Internet.

Sunday, 25 October 2015

Netiquette and obnoxious arseholes.

Hey, look! I baked you a cake!


I live my life on the principle that if I wouldn't like someone doing something to me, I won't do it to them.

If I see a man having a discussion with a woman that I know in the street, I wouldn't barge in and start haranguing the man, because I wouldn't like it if someone did that to me.

So, why is it that on the Net, obnoxious arseholes think it's O.K. to do it? No, it's not! There's something called Netiquette. Observe it.

Yes, Man and Bali. I'm looking at you! When someone is commenting from the safety of their computer keyboards (or Smartphone touch-screens), they can turn into obnoxious arseholes. In real life, they might get a punch in the chops, which they'd richly deserve.

Addendum: On a Facebook status, far far away, the following conversation occurred (the beginning has been redacted):-

Me: I've liked some of their comments, too. That's why it's odd that they're playing up now. They seem to be "White knighting" Jane.

Kade: And now the plot thickens. You see, this might be something entirely different.

As an amused onlooker with no real interest in this drama, or the anonymous actors, I'll offer two educated explanations.

1. As you've already touched on, this might be a simple case of plain 'White Knighting', which isn't all that uncommon on the internet. Case closed.

2. If one were to really consider where the various moving parts of these dietary arguments -- and their actors -- find their home ground, Jane would actually be someone who'd get considerable sympathy from the plant-based or plant-centred crowd. Her general theories and ideas espouse a very low animal product intake paired with a puritanical focus on non-refined plant foods. Considering this avenue, one could see where this is going and why those individuals would like my comments and support her regularly. It's one of those areas where they find considerable overlaps of agreement.

Too bad they didn't realise that even *you* share in those overlaps and that much of your exchange with Jane is actually harmless and over a truly minor disagreement. Unfortunately, the relative anonymity of the internet not only makes individuals rambunctious, but also extremely presumptive of things they cannot gauge, such as tone and intent behind comments. This might prompt certain hot shots into White Knighting for someone in a friendly disagreement, which they can't decipher as being friendly, *because* that someone also happens to relatively champion their outlook in a highly volatile environment where even mild disagreements are far too often perceived as polarising.

Me: I couldn't have put it better myself!

Would it be a good idea to put what you just wrote in an addendum at the end of my blog post?

Kade: Up to you, Nige. Go for it if it is any good to the point you're making. ; )


As a result of the above conversation, I've changed my mind about Man & Bali. They're not obnoxious arseholes.

Further addendum: We seem to getting on O.K. now!

Cooperation is so much better than endless squabbling.

Saturday, 24 October 2015

Science and zealots: How to detect bad science and how to detect zealots.

Last night, I got banned from Zoë Harcombe's blog. More on that later. Meanwhile, this...
From http://capisho.blogspot.co.uk/2013/07/science-vs-faith.html

I re-read It's all about ME, baby! (1997 - present) and there's something important missing.

In 2005, I discovered Lyle McDonald. Before this happened, I had the following beliefs:-
1. If something works for me, it must work for everyone else.
2. If someone with qualifications states a fact, it must be true.
3. If someone without qualifications states a fact, it must be false.
4. If a study confirms my beliefs, it must be true.
5. If a study contradicts my beliefs, it must be false.

Sound familiar?
1. is a "Hasty generalisation" fallacy.
2. is an "Appeal to authority" fallacy.
3. is an "Ad hominem" fallacy.
4. & 5. are "Cherry-picking" fallacies.

Suffice it to say, Lyle bitch-slapped the fallacies out of me. Thank you so much! Read Lyle's site, if you want to learn.

How can studies conflict with each other so much?


Having read a number of conflicting studies, here are some of the tricks that bad studies use:-

1. Fudge the methodology:-
a) In a meta-study (a study of studies), to make something that's bad (e.g. some types of saturated fats/fatty acids) look harmless or to make something that's good (e.g. Vitamin D) look useless, fudge the inclusion criteria so that only studies using low intakes or a narrow range of intakes are used, so that the RRs are either close to 1 or have 95% CI values above & below 1. In addition, include studies that show both positive and negative results (due to them looking at different types of saturated fats/fatty acids, say), so that the overall result is null. See Siri-Tarino et al, Forests & Trees and "Eureka!" moments.

b) In a meta-study, set the Δintake to values that are much smaller than a typical portion. See Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose–response meta-analysis of prospective cohort studies.

c) In a study, use a different type of the thing being studied (but bury this fact somewhere obscure so it's missed) to get the opposite result. e.g. To make "carbs" look bad, use a test "carb" that comprises 50% simple carbs (fructose) and 50% complex carbs (maltodextrin), thus guaranteeing a bad outcome (high % small LDL particles). See https://www.ncbi.nlm.nih.gov/pubmed/?term=Krauss%20RM[Author]%20AND%20Dreon%20DM[Author]%20AND%20(hasabstract[text]%20AND%20%22humans%22[MeSH%20Terms])

2. Fudge the statistics:- e.g. Regression toward the mean. I'm not a stats nerd, but there are many ways to lie with statistics.

3. Make the abstract have a different conclusion from the full study (which you hide behind a pay-wall), by excluding the methodology & results.


Back to Zoë Harcombe: I left some comments on Jennifer Elliott vs Dietitians Association of Australia.

My M.O. for detecting zealots is by using a slowly, slowly, catchee monkey approach. I left a comment supportive of low-carb diets, because:-

For people with Insulin Resistance, low-carb diets DO ameliorate obesity, postprandial sleepiness and postprandial hyperglycaemia.

Was that loud enough?

I added that I thought the first priority should be to tackle the causes of the Insulin Resistance, because permanently reversing a condition is better than merely ameliorating it.

My comments were helpful, with links to blog posts showing the above and how to reverse T2DM in 8 weeks.

I then "went in for the kill" and strongly criticised Jennifer Elliot's article, as it contained cherry-picked references. I included three more links to my blog as supportive evidence. This resulted in the removal of all but one of my comments (and the comment that remained had the link removed) and the addition of the following comment:-

"Zoë Harcombe says:
Nigel – too many comments purely trying to get traffic to your site – link above removed; other comments spammed. You’re now spammed.
Best wishes – Zoe"

The correct word is "banned", Zoë! Spammers try to sell something. My information is free.
Low-carb zealot successfully detected.

It's not a problem if a lay person becomes a low-carb zealot, but it is a problem if a Doctor/Health Professional/Fitness Trainer becomes one. Cognitive bias and a refusal to accept contradictory evidence are not healthy traits for someone who's supposed to be practising evidence-based medicine/health/fitness.