Saturday, June 25, 2011

defining a diet and therapies.

Yknow, I need to put the disclaimer up for this post.

I'm not a doctor, I'm not a doctor, I'm not a doctor. This particular post has no goal of advocating a specific diet. This post is intended to explain some issues with alternative diets such as VLC, LC, and PN (Paleo Nutrition) with some references to individual desires to use them as a therapy.


Generally a question will come along such as:

"How will a gluten free diet help my child with ADHD?"

"How will a paleo diet help with my mild Asperger's?"

"What do I do about a specific diet for autism (classical -actual- autism, not Asperger's, nor PDD-NOS, Rett's, nor CDD) ?"

"How about my metabolism, or thyroid conditon?"

The list of questions is endless in minor variations. The primary problem is in defining what, exactly, is meant by the "X diet" - and the search for the all important extensive studies.

I'm going to be blunt. While there are several specific studies of certain aspects of various diets, and research supporting some of the theories, there is not and probably won't be (anytime soon), an extensive, 500 person 3 year study of whatever you think you mean by "X diet."

There *are* enough studies, from the classic WW2 famine study onward, to support various forms of the low carbohydrate, paleolithic foods influenced diet in general.

But what is this diet? What are the relevant factors?


Let's take a basic example, of a person using a paleo diet as a springboard for a gluten-free lifestyle because there's some evidence/suspicion that the gluten is making a condition (suspected celiac, ADHD, minor non specific IBS) worse.

After 3 months, this diet which went so WELL at first, is having issues and behavior or health is going down.

Well, eating local produce, it turns out that this three months has gotten you into the middle of apple season where you live, and your apple intake has quintupled, or septupled. The fructose load has skyrocketed!

Perhaps it's something else, where the carbohydrate level has tripled. Or the lactose or casein levels.

Some of this stuff can even effect your eggs to the point where you end up with different reactions to commercial eggs at different times of year.

And you can't tell why- it could be the vitamin D! NO ONE knows, though there are some theories with merit. No one knows because it's chaotic, and the math for network systems hasn't been applied to all the studies. I'm not sure it can be without much more in depth multivariable studies.


What you can do is look at the basic thrusts and tracks of many of the low carb, autism, and paelo family of diets.

1: No gluten. This gets into- no grains. And thus no grain enzymes, no gluten, no storage molds, no rancidity, no conversions of starches into other sugars (such as happens through cooking or malting)

2: Controlled levels of carbohydrates in a generally raw or unprocessed, balanced, inclusive food. Meaning you get carbohydrates from a carrot, a raspberry, or some other source where the carbohydrate is part of a whole food.

3: low and controlled levels of glucose and fructose. Fructose especially is dangerous as it bypasses some of the control mechanisms in the body that other carbohydrate types like glucose and proteins have to go through. (go to the paNu blog and search fructose, and read what the Doctor has to say)

4: extremely limited or no dairy- losing the lactose and casein that can also cause problems, individually or systemically, with several types of disorder.

5: exercise. at a minimum, some 15 minute sweat inducing power interval type of workout (like 100 kettlebell swings and some situps) that increases the overall metabolic rate.


You need all 5. You can't - just can't- isolate to gluten, or fructose, or bean enzymes, or lactose. The reason is we don't know which specific control items in which combinations are damaging.

It's far better to focus on a broader sense of the map than to narrow to one specific item- replacing gluten with 6 apples a day. replacing all dairy with high processed fakery. (fakery is bad. Fakery is processing, processing is bad. minimize it)


There's nothing unhealthy about leaving the high sugars, grains, beans, and dairy products behind. No one can prove that- if you eat the right foods- axing these will harm you. Every argument relies on "if you don't eat enough plant fiber in salad greens, if you eat too much of X fat, if if if- iuf something, you will be less healthy"

All you have to do- all you have to do- is not "if" yourself.

Saturday, June 11, 2011

that diet report thing.

The paleo blogs blew up this week about the US News report on best diets:

http://health.usnews.com/best-diet/best-overall-diets

As amusing as the user stacking on the "did this work for you" is, I need to write just a little bit more on the topic.

USnews states: "Experts took issue with the Paleo diet on every measure. Regardless of what a dieter's goal is—weight loss, heart health, or finding a diet that's easy to follow—most experts concluded he or she is better off looking elsewhere."

Well, let's take a quick look. A fair amount of analysis has been done on the methodology and suspected .... industry bias... of this report. So I'm just going
to hit a few high points:

http://health.usnews.com/best-diet/paleo-diet


How's the paleo diet for your heart?

USnews: "While some studies have linked Paleo diets with reducing blood pressure, bad “LDL” cholesterol, and triglycerides (a fatty substance that can raise heart disease risk), they have been few, small, and short. And all that fat would worry most experts."

Okay. Let's parse this. The studies there ARE show the paleo diet can be linked to lowering blood pressure, ldl cholesterol, and triglycerides.

So the experts worry that it's unsafe because it's got too much fat.


Logic?


USnews on health risks:

"By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients. Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems."

Which nutrients exactly? If you look into the vegan diet (same review) and poke around a bit, you find piles and piles of sources for replacements or improvements on every nutrient class. Leaving out the beans, soymilk, and tofu that form the basis of the vegan Way, we have complete animal sources of protein, vitamin D, and other nutrients.

Lean meat choices? See the first point. "all that fat" has been proven in the existing studies to NOT be a problem.



In the section "analyzing" how well the Paleo diet conforms to accepted guidelines, note the first thing is the fat:

"Fat. At about 39 percent of daily calories from fat, a sample Paleo menu exceeds the government’s 35 percent cap by a bit."

All this scare about fat, over 4%? 4%!?!?.


Okay, note that the report couldn't find a way to come down on salt. Paleo wins on balancing the sodium intake.

Fiber- well, veggies. fiber. Got it.

The potassium intake on the paleo diet is high enough to actually be used as a reason for the paleo diet to work. Not the only reason, but it's tops on many nutrients like potassium without supplements.

USnews on Vitamin B12:

"Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. You’ll have no trouble meeting the recommendation—fish and meat are B-12 powerhouses."

USnews on Vitamin D:

"Vitamin D. You’ll get very little or none, so you’ll either have to supplement (the non-caveman way) or just make sure you spend enough time in the sun to get the 15 micrograms recommended. Some experts suggest five to 30 minutes of sun between 10 a.m. and 3 p.m., twice a week and without sunscreen, to meet the recommendation, according to the National Institutes of Health."

Supplementing vitamin D the caveman way is pretty easy. Lard. The non hydrogenated, natural kind. (from pigs that see sunlight.) We're talking tablespoons per week here- the ONLY thing that beats it in vitamin D is cod liver oil.

Though, for a paleo man or woman, a couple hours of sunlight a week isn't at all difficult. Because paleo is more than a diet and involves getting outside and moving mass in space (exercise)

And last, on the nutrient list- calcium

USnews:

"Calcium. It’s essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 to 1,300 mg. Because you’re not allowed dairy or fortified cereals, you’ll likely only get about 700 mg. from a Paleo menu."


Balls. That's it, just balls.

First, the 1300mg is based on the lower bioavailability of calcium from milk sources. You get something like one and a half to double the amount of bioavailable calcium from non dairy sources. Which means 700mg might not be low, even if it's true.

It's not.

Calcium is available in a wide range of natural sources, once you exclude dairy and those ever-so-healthy "fortified" cereal chem lab experiments. Sardines, salmon, trout- not exotic fish, but inexpensive sources. Kale, spinach, collards- essentially every dark green leafy vegetable will have some significant calcium source.

Not. A. Problem.


Diabetes is often a big issue with dieters these days. I'll leave it to you- look at one of the top rated diets- DASH, and read (carefully) the diabetes section (read more link int he page).

Then read the paleo section.

While the facts are nearly identical, the wording, tone, and phrasing are rather heavily slanted.


For a final comment, I'd like to point out the USnews sees a major issue with the paleo diet in that it requires you to shop in the produce section, and at the meat counter.


you know, where the food is....fresh?